College of Health and Pharmacy

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A SURVEY STUDY EXPLORING THRUST JOINT MANIPULATION CURRICULUMS WITHIN ENTRY-LEVEL DOCTOR OF PHYSICAL THERAPY PROGRAMS
(2024-04-18) Howland, Chad
Background and Purpose: The Commission of Accreditation in Physical Therapy Education (CAPTE) requires entry-level Doctor of Physical Therapy (DPT) programs to produce students competent in delivering physical therapy interventions, which include thrust joint manipulation (TJM). However, no mandate exists concerning TJM curricular design or what constitutes entry-level competency. This study sought to explore the current state of TJM education and provide an update on curriculum characteristics and standards. Methods and Results: An online-based survey was distributed to accredited entry-level DPT programs between September 2022 to August 2023. Eligible respondents were physical therapist educators serving as the primary instructor in musculoskeletal coursework for the spine or pelvis. The survey collected data on program demographics, instructor demographics, TJM curriculum design, and perceived competency of students specific to TJM of the spine or pelvis. Survey respondents’ data was analyzed using descriptive statistics (n = 78). Survey results showed the highest percentage (78.%) of respondents were board-certified orthopedic specialists (OCS), with less than one-half reporting advanced certifications in spinal manipulative therapy (47.4%). Nearly all respondents (94.8%) viewed TJM as an entry-level skill and considered their students satisfactory or above satisfactory by graduation. Most respondents view TJM of the upper cervical spine as a post entry-level skill (Figure). A disparity between spinal regions taught in TJM curricula was observed, with lumbar TJM representing the highest percentage of responses (98.7%). Conclusion: Compared to a decade ago, a higher percentage of physical therapist educators teaching TJM reported advanced certifications in orthopedics or manual therapy. However, both program and TJM curriculum characteristics appear comparable to previous reports. The results from this study may not be generalizable to all entry-level DPT programs given the low response rate.
ARE YOU TIRED? AN INTERVENTION FOR CENTRALIZED FATIGUE BASED ON PAIN SCIENCE – A PILOT STUDY
(2025-04-17) Burgio, Chiara; Davis, Michaela; Grinnell, Emily; Perez, Leonardo; Robichaud, Grace; Steinbarger, Kimberly
Introduction: Fatigue is a debilitating condition affecting up to 80% of individuals with inflammatory rheumatic diseases, with severe fatigue impacting up to 42% of this population. Despite its prevalence and significance, fatigue remains under-addressed in clinical practice, especially in patients with centralized fatigue, a condition where sensory input is amplified across multiple systems. Recent evidence suggests that centralized fatigue, like centralized pain, may benefit from interventions grounded in pain science principles. This proposed study aims to evaluate the feasibility of a Pain Neuroscience Education (PNE)-based intervention in managing fatigue. Methods: Five adults were recruited for this pilot study. Adults aged 18 and older, both healthy and those with chronic diseases, were recruited from the local area. Exclusion criteria included children and individuals with sensory deficits in the hands. Participants received baseline assessments using the Chalder Fatigue Scale, Central Sensitization Inventory, and Wind-up Ratio (WUR), a test for centralized sensitivity. They then participated in an educational session focused on understanding fatigue and central sensitization, delivered by investigators blinded to their survey results. Following the session, participants were contacted at 4 weeks for follow-up, and reassessed at 8 weeks using the same measures. Discussion/Conclusion: The proposed study has good feasibility with a few modifications. It was difficult to recruit participants in person and coordinate the three touchpoints on a consistent timeline, therefore the measurement data is incomplete. The authors recommendation is to drop the only in person, non-survey measure, the wind up ratio. Without this measure, the entire study can be completed online, which will make recruitment and scheduling easier. This intervention holds potential for improving non-pharmacological treatment options for fatigue, particularly in individuals with chronic inflammatory conditions, where fatigue often limits daily functioning. The eventual results may offer a novel approach to managing fatigue through education based on pain science principles.
ASSESSING METACOGNITIVE AWARENESS INVENTORY (MAI) IMPROVEMENT IN THE FIRST PROFESSIONAL SEMESTER OF PHARMACY
(2025-04-17) Ouellette, Abigail; Vigue, Elizabeth; Frail, Thomas; McLean, Peter
Background: Increased metacognitive awareness is linked to success in doctoral level programs. Some doctoral programs in medicine and pharmacy have researched specific metacognitive awareness activities. However, none have evaluated metacognitive awareness, as a whole, in pharmacy students. Recognizing the struggle transitioning from undergraduate coursework to professional Doctor of Pharmacy coursework, we aimed to understand metacognitive awareness changes for pharmacy students during the first professional semester. Method: First professional year pharmacy students were given a National Institute of Health approved 52-question Metacognitive Awareness Inventory (MAI) survey during orientation week at Husson University School of Pharmacy. In the MAI survey, one point is given for answering “yes” to each question. Students repeated the survey during the final week of their first semester in the Doctor of Pharmacy program. Results: Twenty students completed both the pre- and post-semester surveys. Overall, mean MAI scores increased by 5 points (38 to 43). The following domains saw increases in score over the study period: Declarative Knowledge (+0.3; 6 to 6.3), Procedural Knowledge (+0.3; 3.2 to 3.5), Conditional Knowledge (+0.7; 3.9 to 4.6), Information Management (+0.8; 7.1 to 7.9), Comprehension Monitoring (+0.6; 5 to 5.6), and Evaluation (+0.5; 3 to 3.5). Planning (-0.35; 4.95 to 4.6) and Debugging Strategies (-0.18; 4.58 to 4.4) were the only domains that saw a decrease in score over the study period. Conclusion: MAI scores changed as a whole and within each domain. Data collected from this study can be used to inform future metacognitive research for pharmacy students entering the doctoral phase of their programs.
ASSESSING THE COMMUNITY MOBILITY NEEDS OF ELDERLY INDIVIDUALS IN RURAL AND URBAN MAINE
(2025-04-17) Baron, Gabrielle; Bicknell, Isabelle; Girsa, Maisey; Kelly, Cavenaugh
This mixed methods survey examines community mobility patterns and barriers of community-dwelling elderly individuals in Maine. Community mobility includes driving, walking, biking, wheelchair use, and accessing public or private transportation (Justiss, 2013). Limited community mobility factors like inadequate transportation and socioeconomic challenges significantly impact health outcomes (Syed, S.T, et al., 2013). Transportation barriers lead to missed or rescheduled medical appointments, delayed care, and lapses in medication adherence, which can worsen chronic illnesses and result in poorer health outcomes (Syed, S.T, et al., 2013). Urban areas have dense populations, developed infrastructure, and nearby grocery stores, healthcare, and transit. High density and limited infrastructure hinder those with mobility or cognitive impairments. Uneven sidewalks, crowding, traffic, and scarce accessible parking are common issues (Pendleton & Schultz-Krohn, 2018). The CDC (2019) also notes navigating urban grocery stores and public transit overwhelms individuals with disabilities, leading to decreased participation in activities. Transportation barriers in rural Maine healthcare access cause missed appointments and worsening health disparities (Maine Center for Disease Control and Prevention, 2025). Residents of rural communities in Maine have unique socioeconomic and age-related vulnerabilities that impact access to health services. Maine is the oldest and most rural state in the country (Gale et al., 2017). A literature search on EBSCO, PubMed, and Google Scholar using terms such as community mobility," "Maine," "older adults," "survey," and "public transportation," yielded no relevant studies, highlighting the need for research in this area. Our research question is: How does community mobility impact the quality of life for a sample of the elderly population in rural and urban areas of Maine? Survey criteria of a sample population of rural adults in Maine: those over the age of 60 who use mobility aids, require assistance for basic activities, or have fallen over three times in the past six months.
BLOOD FLOW RESTRICTION TRAINING FOR PERSISTENT KNEE EXTENSOR WEAKNESS
(2023-04-20) Scott, Wayne; Michaud-Gardner, Alyssa; Sylvia, Jack; Topiwala, Dave
This case study presents the effects of 8 weeks of blood flow restriction training (BFRT) for persistent knee extensor weakness following a long standing repaired ACL injury. A 20 year old female with no history of knee injury prior to the initial ACL tear in 2020 received a patellar bone graft 6 months later. The patient received traditional physical therapy for 6 weeks, which was inconsistent due to COVID-19 interruptions. The participant presented with an antalgic gait and difficulty performing stairs as a result of persistent knee extensor muscle weakness. The participant's knee extensor strength was tested using a Biodex force dynamometer. Initial testing demonstrated that the involved side knee extensors could only produce 68.7% of the muscle torque of the uninvolved side knee extensors. The participant underwent BFRT at a frequency of 2 sessions per week for a total of 8 weeks. The participant performed unilateral knee extensions, step ups, and leg presses for sets of 30, 15, 15 and 15 reps. Blood flow was restricted with a tourniquet inflated to 80% of the pressure which caused full arterial blood flow occlusion for the duration of each exercise with 2 minutes of cuff deflation between exercises. Following 8 weeks of training, the participant’s knee extensors on the involved side were able to produce 82.9% of the muscle torque of the uninvolved side knee extensors. In this case, BFRT demonstrated the ability to improve persistent knee extensor weakness following ACL repair. This improvement in strength was maintained at 3 and 6 month follow up testing. Significantly, the patient’s antalgic gait and difficulty performing stairs resolved during the 8 weeks of training.
BLOOD FLOW RESTRICTION TRAINING: A CASE STUDY
(2025-04-17) Artkop, Kyle; Goodwin, Payton; Palmer, Emelia; Villanova, Brianna; Scott, Wayne
The following study was conducted to determine the efficacy of blood flow restriction training (BFRT) in improving residual quadriceps weakness as an alternative therapeutic intervention for increasing knee strength and stability. The participant demonstrated persistent quadriceps weakness despite previous physical therapy interventions for a MCL and medial meniscus tear of the knee. Two sessions per week for eight weeks of BFRT were performed on the involved quadriceps, utilizing a tourniquet at 80% occlusion pressure. The participant performed the following unilateral exercises: seated knee extensions, step-downs, and leg presses. The participant completed sets of 30, 15, 15, and 15 repetitions, or went to failure. Thirty-second rest breaks were provided between sets during each exercise with the occlusion maintained. At the completion of each exercise, the pressure was released, and a 2-minute non-occluded rest break was taken. Occlusion was restored for the next exercise. At the end of the 8-week training period, the participant's knee extensor strength was retested with a maximal voluntary contraction (MVC). The findings indicated a 5.6 Nm increase in the MVC of the involved quadriceps, demonstrating an improvement in strength. In addition the participant reported there was decreased joint pain, as well as improved knee stability during activities of daily living. These findings warrant further research into the efficacy of BFRT as an alternative treatment method for patients with persistent quadriceps weakness.
CAN BLOOD FLOW RESTRICTION TRAINING REVERSE LONG-STANDING QUADRICEPS WEAKNESS?
(2024-04-18) Gregoire, Jacob; Hammill, Elizabeth; Lemay, Amber; Olsen, Madison; Sargent, Hannah; Scott, Wayne
Background: Blood Flow Restriction Training (BFRT) involves the application of a tourniquet device during resistance exercises, offering a method for muscle strengthening with low-load training, which reduces stress on joints and tissues. BFRT is commonly employed in rehabilitating injuries of the knee including ligament injuries and damage to the menisci. Previous studies suggest that BFRT induces hypertrophy through a combined response to metabolic stress and mechanical tension. Purpose: This study investigated if BFRT could address long-standing quadriceps weakness following ACL, medial meniscus and MCL injury, commonly referred to as the "unhappy triad." Study Design: A case study was conducted on a 24-year-old female soccer player, five years postoperative ACL and meniscus repair, who reported knee pain, weakness, and instability during functional activities and sports. Methods: The participant underwent BFRT sessions twice a week for eight weeks. Exercises were performed with 80% blood flow restriction on the affected limb, interrupting arterial blood flow during 3 exercises with a 2-minute rest break in between exercises during which the cuff was deflated. Exercises included unilateral knee extensions, step-ups, and leg presses, comprising four sets of each exercise with repetitions of 30, 15, 15, and 15, with 30 seconds of rest in between each set. Results: Our study revealed improvements in maximal volitional isometric contraction (MVIC) torque, burst torque, self-reported confidence, and thigh symmetry. MVIC torque of the affected limb increased by 8.5% and burst torque increased by 23% indicating enhanced strength. Conclusion: The case study highlights promising outcomes of BFRT in improving strength in the knee extensor muscles of persons with chronic weakness. Future research should explore qualitative assessments and BMI, skinfold measurements, and functional evaluations to provide a comprehensive understanding of BFRT's efficacy.
CAN WALKING THE PLANK IMPROVE GAIT?
(2024-04-18) Andrews, Evan; Driscoll, Alyssa; Matte, Kayla; Newcomb, Ryley; Payeur, Mikaylah; Scott, Danielle; Wheelock, Ryan; Sidaway, Ben
Purpose: This study examined the effect of balance practice on narrow planks on the fall risk, balance confidence and gait characteristics of older adults. Participants and methods: The Dynamic Gait Index (DGI), the Activities-specific Balance Confidence (ABC) scale and fear of falling were recorded in 10 older adults (73-91 years). The participants then walked over a 6 m long computerized gait mat at normal and quick walking speeds enabling various gait parameters to be recorded. Following these pretests participants practiced walking along planks that decreased in width with practice. Participants practiced for 30 minutes twice a week for 4 weeks. A post-test was conducted at the end of practice and a retention test was administered a week following practice. Data were analyzed using t-tests and analyses of variance (ANOVA). Results: Practice walking on planks significantly improved DGI and ABC scores. The DGI mean improved from “fall risk” to “no risk” and from “moderate physical functioning” to “high physical functioning.” Analysis of gait parameters revealed significant increases in gait velocity at both speeds along with an increase in stride length. The increase in stride length was accompanied by a significant decrease in stride length variability and stance percentage. Conclusion: Quantitative gait markers of fall risk in older adults showed significant improvement following the plank training. The balance training improved dynamic postural control enabling participants to reduce stance time and thus take longer strides consequently increasing gait speed. The improvement in DGI and ABC scores demonstrate clinically meaningful impacts in both gait performance and self-reported balance confidence.
CHARACTERIZATION AND ANALYSIS OF BIOACTIVES IN BLUEBERRY-DERIVED EXOSOMES: NEW INSIGHTS INTO A POTENTIAL ANTIOXIDATION NANOMEDICINE
(2023-04-20) Dunham, Kaitlyn; Canham, Spencer; Palmer, Emilie; Bai, Shuhua; Yang, Tianzhi
Blueberries provide evident benefits of reducing oxidative stress and inflammation, improving cognitive function, and protecting against neurodegenerative diseases as a “super” fruit. However, high levels of bioactive molecules in blueberries, such as anthocyanin, have poor stability and absorption, leading to low bioavailability in the brain. Exosomes attract strong interest as an important vehicle of intercellular communication and as a delivery carrier of bioactive molecules. Herein, the study focuses on characterizing blueberry-derived exosomal nano-vesicles that contain bioactive molecules, and determining if they have better stability and are more readily taken up by cells. Blueberry juice was directly extracted with an electric blender and passed through filter papers. The collected juice was sequentially centrifuged at 1,000 × g for 10 min, 3,000 × g for 20 min, and 10,000 × g for 40 min at 4 °C to remove large particles and debris. The final supernatant was centrifuged at 100,000 × g for 30 min to obtain exosomes. The exosome morphology was observed with scanning electron microscopy (SEM) and the particle size was determined with a Nano Sizing Analyzer. The exosomes had a size of 82.7±6.4 nm and appeared as individually sphere-shaped morphology as shown in SEM images. Exosomes were analyzed and quantified for total proteins and RNAs. Well-known exosome-unique markers, including Cis-Golgi matrix protein GM130, adaptor protein and sort cargo ALIX, tumor susceptibility gene TSG10, intercellular adhesion molecule 1 (ICAM-1), apoptosis ANXA5, integral membrane protein FLOT, epithelial cell adhesion molecule (EpCam), and transmembrane tetraspanin family CD63 and CD81, were detected by an Exo-Check array. MicroRNA sequencing analysis revealed that the intersection between differentially expressed genes and miRNAs contained in exosomes could unveil a set of candidate target genes. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) study demonstrated that the exosomes showed cytotoxicity in neural cancerous cells. The characterized exosomes with biomolecules may deliver therapeutic molecules in the brain and target neural cells, leading to improved efficacy in the treatment of neurodegenerative diseases.
COMPENSATION FOR BOARD OF PHARMACY MEMBERS IN THE UNITED STATES
(2023-04-20) Pham, Hannah; Ifeji, Chidubem; White, Cassandra
Background: No published data exists regarding compensation and demographic differences between the memberships of the 50 United States (U.S.) Boards of Pharmacy. Objectives: The purpose of this study was to quantify and compare the per diem pay rate for U.S. Board of Pharmacy members. Board member demographics and compensation for mileage and meals were also evaluated. Methods: In June 2022, each state Board of Pharmacy was contacted to gather data including per diem pay, mileage and meal compensation, number of meetings per year, number and gender of Board members, length of appointment, and regulatory statutes. Results: The average per diem pay for Board members was $75.86 (median = $50.00, range = $0.00 to $250.00, n = 48 states). Most states report paying Board members for mileage (95.1%, n = 39 out of 41) and meals (80.0%, n = 28 out of 35). On average, Boards are composed of 8.3 members (median = 7.5, range = 5-17, n = 50), meet 8.3 times annually (median = 8, range 3-16, n = 47), and have a 4.5 year length of appointment (median = 4, range = 3-6, n = 47). Males represented 61.2% of occupied Board positions and pharmacists accounted for 74.1% of all positions. The average year for pharmacy statute update was 2002. Conclusion: Compensation for U.S. Board of Pharmacy members varies greatly, from unpaid (n = 8 states) to a high of $250.00 per diem. Only 38.8% of occupied Board positions are held by women and pharmacy technicians represent just 3.6% of all positions. Fair compensation, increased female and pharmacy technician representation, and more timely pharmacy statute updates are necessary in order to achieve inclusion, diversity, and equity between state Boards of Pharmacy.
CURRENT PRACTICE OF SCREENING FOR DEPRESSION IN INDIVIDUALS WITH POST-STROKE APHASIA
(2024-04-18) Bucklin, Calista; LeBoeuf, Clarence; Drakopoulos, Anthony; Davis, Kimberly
This study aims to identify current practices regarding mental health assessment protocols and tools utilized among practicing occupational therapists (OT) and occupational therapist assistants (OTA) currently working with clients who have experienced post-stroke aphasia. This was done by creating a survey that gathered information surrounding participants' current knowledge of depression among aphasic patients, what the current practice is at their place of work around screening for depression in patients with Aphasia, and whether or not they think a protocol would be beneficial for this population. The Husson IRB approved this study as a qualitative study with a descriptive design and non-probability sampling. An invitation to participate was sent through two American Occupational Therapy Association (AOTA) CommunOT listservs. In addition, the invitation was sent to all members of the Maine and New Hampshire Occupational Therapy Associations. Data was collected anonymously using Google Forms. The survey was open and available between March 12 and April 5, 2024. Preliminary data identifies the majority of practitioners working with clients with post-stroke aphasia are occupational therapists with between 2 and 24 years of experience and a median of 10 years. Approximately 18% of respondents are not aware of the prevalence of individuals who experience post-stroke aphasia and nearly 46% state that they are not aware that these individuals are seven times more likely to have symptoms of depression. While all respondents indicated that screening for depression would be beneficial, only nine percent reported that they did assess and none used a standardized method. Based on this data, there appears to be a knowledge gap in care and treatment for clients who experience post-stroke aphasia and symptoms of depression. Standardized assessment tools and protocol development, in addition to specific training, are needed to help ensure quality holistic care of people who have post-stroke aphasia.
DELETION OF DIVALENT METAL TRANSPORTER HOMOLOGS IN Caenorhabditis elegans PREVENTS LANTHANUM- AND YTTERBIUM-INDUCED OXIDATIVE INJURY
(2025-04-17) Rusiecki, Aaron; Letourneau, Lindsay; Quinlan, Alaina; Smith, Erin; Vose, Paige; Caito, Samuel
Lanthanide series elements are transition metals that are used in a variety of electronics, including superconductors, electronic polishers, hybrid car components, and rechargeable batteries, as well as in fertilizers, antimicrobials, contrast agents for medical imaging and diesel fuel additives. Levels of lanthanides have risen significantly in both industrial areas and environmentally. While we are starting to recognize health effects of lanthanide exposure, it is currently unknown how lanthanide metals enter cells. If we are to understand their toxicokinetics in the human body, it is imperative to determine mechanisms by which lanthanides are distributed. We hypothesized that endogenous divalent metal transporters (DMTs) are responsible for lanthanide entry into cells, and that genetic ablation of DMT transporters in Caenorhabditis elegans would protect the worms from lanthanide-induced toxicity. In this study, we treated wild type N2 or transgenic worms that lacked DMT homologs smf-1, smf-2, or smf-3, with increasing concentrations of La or ytterbium (Yb). Knock out of either of the smf genes shifted the dose-response curve for La or Yb to the right of the N2 dose-response curve, signifying protection from the mutations. We have previously observed that La and Yb cause increased body burden of oxidative stress in worms. Treatment of the smf mutant worms with La or Yb caused significantly less reactive oxygen species (ROS) generated in the worm as compared to N2 worms. Glutathione levels have been shown to decrease in N2 worms following La or Yb treatment, however GSH levels were rescued by deletion of the smf genes. Furthermore, smf mutants showed less mitochondrial damage and had increased levels of ATP as compared to N2. These results suggest that DMTs are important mediators for lanthanide series elements to enter eukaryotic cells.
DIFFERENTIAL LPS BINDING TO DIABETIC AND CONTROL HUMAN FIBROBASTS SUGGESTS MECHANISM FOR HIGH LEVELS OF INTERLEUKIN-8 EXPRESSION
(2025-04-17) Harriman, Katelyn; Lindblad, William
It is known that wound healing in the diabetic person is impaired and is characterized by excessive inflammation. However, the underlying mechanism(s) contributing to this heightened inflammatory response remain largely unknown. Previous studies from this laboratory, and others, have shown that fibroblasts can secrete pro-inflammatory mediators in response to exposure to lipopolysaccharide (LPS), a known inducer of inflammation. Further, fibroblasts obtained from type I diabetic individuals (GM01842) show significantly enhanced secretion of pro-inflammatory mediators compared to non-diabetic control cells (GM23973). This study had two primary aims, namely to investigate whether this increased secretion is due to elevated expression of CD14/TLR4 receptors, and whether LPS binding correlates with the expression of pro-inflammatory interleukin-8 (IL-8) versus extracellular matrix protein type I collagen (COL1A1). Non-transformed human dermal fibroblasts from the Coriell Cell Repository were maintained under standard culture conditions. Cell binding conditions were optimized (temperature, time, and ligand concentration) for binding Alexa488-labelled LPS, and flow cytometry was used to quantify LPS binding. mRNA levels for COL1A1 and IL-8 were determined by RT-PCR using Bio-Rad SYP qPCR kits. Binding of LPS to GM01872 was shown to be dose dependent with 500 ng providing a significant increase in cell fluorescence. Of note, exposure of GM23973 cells to this LPS content suppressed fluorescence suggesting that the environment of the CD14 receptor may be altered. Given prior results and from the current study, IL-8 expression in GM01872 cells was significantly higher than GM23973 and whereas expression of COL1A1 was at non-treated levels. These findings provide additional insights into the dysregulated inflammation observed in diabetic wound healing. CD14/TLR4 binding environments may be altered to facilitate higher levels of pro-inflammatory gene expression by cells that have experienced the hyperglycemic state of diabetes. These data offer new targets for therapeutic intervention.
DISCIPLINARY OUTCOMES FOR MAINE BOARD OF PHARMACY COMPLAINTS IN 2022
(2024-04-18) White, Cassandra; Dumont, Erica; Mroz, Katherine
The purpose of the licensing system regulated by the Maine Board of Pharmacy (MeBOP) is to protect the public against 1. dishonest or unethical licensees, and 2. licensees who have fallen below minimum standards of competence in the practice of pharmacy. Violators are subject to disciplinary action that can range from a formal warning to license revocation, with or without civil penalties. The purpose of this study was to quantify and compare complaints submitted to the MeBOP for the 2022 calendar year. The majority of complaints in 2022 were against pharmacists (57.9%, n = 66 of 114 complaints), consistent with disciplinary records for all United States (U.S) Boards of Pharmacy (BOP)1. 78.8% were licensed as a pharmacist-in-charge (PIC). The MeBOP had far less complaints against pharmacy technicians (1.8%, n = 2 of 114) compared to U.S. BOPs (25.2%, n = 1,309 of 5,196)1. There was a high number of dismissed complaints (53.5%), while 14% resulted in a letter of guidance and 32.5% were offered consent agreements. 21.9% of complaints were against licensees with prior discipline. The average civil penalty (n = 34 of 114) was $12,000 (median = $1,625, range = $250 - $175,000). Investigation into complaint data for U.S. BOPs is necessary in order to establish best practices for the management of complaints, complaint outcomes, and the impact of complaints on licensees. The MeBOP and other U.S. BOPs can collect and use complaint data to contemplate ways to promote a more just culture. Future studies are needed to evaluate the number of complaints each U.S. BOP receives, PIC designation and license status, types of violations (e.g. prescription misfill, drug diversion), ways to promote the reduction of recidivism, as well as the civil penalties and how these compare across states. 1. NABP Clearinghouse Update - 2022. Innovations. March 2023;52(3):7.
Domestic Violence and Children’s Mental Health
(2023-05) Thompson, Zainab
Exposure to domestic violence is a significant predictor of children’s mental health problems. Children exposed to domestic violence will likely develop internalizing and externalizing disorders, substance abuse disorders, poor school outcomes, and a lack of prosocial behaviors (Colizzi et al., 2020). Exposure to family violence contributes to adverse childhood experiences (ACEs), which are linked to causing trauma and long-term psychological distress (Lloyd, 2018). Most mental health problems begin during the teenage years when children encounter ACEs and continue to adversely affect them in adulthood (Colizzi et al.). Children's mental health problems become a burden to the guardians, community, and society and are associated with increased healthcare costs (Orr et al., 2020). Therefore, preventing mental disorders development and reinforcing resilience in violence-exposed children is thus relevant to evade these negative consequences. The project aimed to identify the effects of family or domestic violence exposure on children, the protective and risk factors that influence the effects of violence exposure, and the intervention applicable to prevent violence-exposure effects for children aged below thirteen years. The project’s recommended intervention is a public health preventive approach at the primary, secondary, and tertiary levels to prevent violence-exposed children from developing mental health problems and disorders. Specifically, the intervention will include mindfulness training, cognitive behavior therapy, psychosocial fulfillment, and learning to regulate social and emotional responses to challenges faced, which will help prevent the development of mental health problems in children and teenagers. The reviewed literature suggests that the intervention should be evidence-based, and population-based, incorporate risk assessments and promotion of protective factors, integrate multisector and multilevel collaboration, and be operationalized within a socio-ecological framework (Carlson et al., 2019; Colizzi et al. ; Eriksson et al., 2022; Fong et al., 2019). Eventually, the intervention will reinforce resilience and positively 3 influence the mental health of at-risk and violence-exposed children to offer a better quality of life. Catering for children facing developmental adversity is essential to prevent negative consequences later in life. Future research should focus on how to best implement this intervention that specifically targets violence-exposed children and their mental health.
EFFECTS OF BISPHOSPHONATE TREATMENT OF POST-MENOPAUSAL WOMEN ON BONE QUALITY PARAMETERS OF NEWLY FORMED BONE DETERMINED BY RAMAN SPECTROSCOPY. A COMPARISON VS HEALTHY PREMENOPAUSAL WOMEN
(2023-04-20) Phipps, Roger J.; Gamsjaeger, Sonja; Shane, Elizabeth; Cohen, Adi; Dempster, David W.; Eriksen, Erik F.; Paschalis, Eleftherios P.
In the treatment of postmenopausal osteoporosis (PMO), the potent bisphosphonates (BPs) alendronate (ALN; Fosamax), risedronate (RIS; Actonel) and zoledronate (ZOL; Reclast) are first line therapy. They produce similar decreases in fracture risk despite different levels of suppression of bone resorption and bone turnover (ALN>ZOL>RIS). To determine if differences in effects on bone quality may play a role in this apparent discrepancy, this study assessed the effects of these BPs on bone quality indices of newly formed trabecular bone. Methods: Iliac crest bone biopsies from PMO patients treated with ALN (for 3 years and ≥ 5 years), RIS (for 3 years and ≥ 5 years), and ZOL (for 6 months, 2 years, ZOL2 and 3 years, ZOL3) were analyzed by Raman microspectroscopy. Bone quality indices mineral to matrix ratio (MM), mineral crystallite maturity/crystallinity (MMC), and glycosaminoglycan (GAG), and pyridinoline (Pyd) content were determined. Biopsies from placebo treated PMO women (PMO-PLC) were also analyzed. Data were compared with those in healthy adult premenopausal women (HC) by ANCOVA followed by post-hoc testing (significance p<0.05). Results: Both RIS groups had MM, MMC and Pyd values similar to HC. ZOL3 had MM and Pyd similar to HC and ZOL2 had MMC similar to HC. Both ALN groups had only MM similar to HC. None of the BP-treated groups had similar GAG to HC. The PLC group had MM similar to HC but was significantly different for MMC, GAG and Pyd. Conclusion: in this analysis PMO patients treated with RIS (Actonel) formed bone with quality closest to that in HC. Those treated with ALN (Fosamax) formed bone with quality least similar to HC. These differences in effects on bone quality may in part explain how these BPs achieve similar antifracture efficacy in treatment of PMO despite differences in bone turnover suppression.
Effects of Distraction Techniques During Immunizations
(2023-05) Walker, April M.
Routine vaccine injections are some of the most common painful procedures during childhood especially when they are administered without adopting any pain management practice. According to the Center for Disease Control and Prevention (2022), an experience of pain is a biological component that makes some people react very strongly to the idea of procedures involving a needle. Pain from a needle is usually not severe but the brain still focuses on it. Therefore, managing the pain can reduce fear and avoidance of medical care during childhood related experiences of painful procedures such as immunizations. The purpose of this project is to determine if the use of distraction techniques vs. no distraction techniques during immunizations decrease pain levels. An Evidence Based Practice (EBP) conceptual framework will be used to provide evidence that distraction techniques during childhood immunizations decrease pain levels. The expected outcome of this project is to increase awareness of the use of distraction techniques vs. no distraction techniques while administering immunizations to children. The hope is that this study will prove effective for implementing distraction techniques for children receiving immunizations and provide education for healthcare facilities, healthcare providers, and parents to implement appropriate pain and distress management strategies during future vaccinations (Ouach et al., 2019).
ENHANCING CANCER SURVIVORSHIP EDUCATION: A COLLABORATIVE WORKSHOP APPROACH TO ONCOLOGY REHABILITATION
(2025-04-17) Alley, Mikaela; Boy, Virginia; Cailler, Taylor; Giles, Ben; Marter, Marissa; McCannell, Jessica; Strickler, Julia; Bochynski, Jennifer; Slike, Michelle
Purpose: As the number of individuals diagnosed with cancer continues to rise, the need for physical therapy intervention to support physical and mental well-being is becoming increasingly important. Seven doctor of physical therapy students and two physical therapy educators created two educational sessions on oncology topics for the community in Bangor, ME. Goals were to improve student knowledge in oncology topics and provide education to the community regarding the benefits of oncology rehabilitation to improve quality of life. Description: Students developed learning objectives and presentations utilizing learning theories, including: connectivism, constructivism, and andragogy to design two workshops. These workshops included presentations with an incorporation of active learning activities. Topics were determined based on community needs and included: an introduction to oncology rehabilitation, cancer related fatigue, exercise, cancer related pain, lymphedema, chemotherapy-induced peripheral neuropathy, and mental health. These evidence-based workshops were available in-person and remotely via Zoom. Assessment of the learning experience included a participant pretest and post-test and a satisfaction survey. Outcomes: 16 participants attended with two participants attending both presentations. 87% of the participants improved their score from pretest to post-test. The remaining 13% had the same score. Overall, participants felt each workshop was highly organized and reported satisfaction with the material and its relevance to their everyday lives. Participants were also satisfied with the hands-on learning activities. Importance and Future Considerations: Participation in these workshops brought awareness to cancer survivors and caregivers on the benefits of PT rehabilitation. DPT students benefited from this project by growing their knowledge of oncology rehabilitation and their ability to provide patient education. Based on the research outcomes, cancer survivors may benefit from additional education regarding their condition management. Through hands-on workshops, cancer survivors may be more satisfied and prepared to manage their conditions.
ERROR ESTIMATION AND KNOWLEDGE OF RESULTS IN LEARNING A NOVEL MOTOR TASK
(2023-04-20) Duffy, Hannah; Lees, Jennifer; Shamaly, Shannon; Sidaway, Ben
When learning a new motor skill, feedback on the errors in performance, or knowledge of results, is important in order to make adjustments to the future response attempts. However, previous studies have shown that when high frequencies of feedback are provided to a learner such feedback can suppress intrinsic error detection and corrections processes resulting in poorer performance when that feedback is no longer available. Other studies have shown that requiring error estimation during practice prior to feedback being provided enhances learning of the skill. Such research though has not investigated the role of different frequencies of error estimation on learning nor has the combined effect of requiring error estimation while providing different frequencies of knowledge of results been investigated. It remains unknown whether there is an optimal frequency of error estimation for motor learning or whether error estimation may interact with the frequency of feedback. The present study included 6 randomly assigned intervention groups of young adults (18-35 years) that were differentiated on the basis of knowledge results (0%, 33%, or 100%) and error estimation (0%, 33%, or 100%) frequency. Each group was taught a shuffle-board like skill aiming at a target that was hidden from view. Each group performed a series of ten blocks of 12 practice trials followed by three retention tests (5 min, 1 day, 1 week), and a transfer test. Response error (absolute, constant, and variable) was calculated for each phase of the experiment along with the accuracy of error estimation. Preliminary results show that requiring overt error estimation of learners ameliorates the negative impact of high frequencies of knowledge of results feedback on skill learning. Discussion focuses on the potential interaction of error estimation and feedback for motor learning in clinical practice.
EVIDENCE-BASED PRACTICE IN SCHOOL-BASED OCCUPATIONAL THERAPY-GUIDELINES FOR PRACTICE.
(2025-04-17) Bylund, Naomi; Gerritsen, Amy; Lee, Hannah; Warren, Hannah; Howland, Katey
This project was created in response to the Maine Department of Education’s request for an exploration of the literature surrounding evidence-based practices in school-based occupational therapy. A review of the literature is the first step in developing guidelines for occupational therapists in Maine. As education models evolve, there is a growing need for structured, evidence-informed approaches to service delivery. The authors analyzed the literature using a level of evidence framework in order to provide a comprehensive overview of best practices. Levels of evidence are assigned to studies based on the research design, quality of the study, and applicability for clinical practice (Hissong et.al, 2015). To conduct the examination of literature, the authors (with the guidance of stakeholders) identified and categorized five key components in school-based practice; Response to Intervention (RTI), Universal Design for Learning (UDL), workload versus caseload models, push-in/pull-out service delivery, and interprofessional collaboration. Studies in each area were examined, rated, and a summary provided. In addition, the authors created a literature table with embedded resources offering practitioners in the state of Maine an easy to read guide to understand the evidence surrounding each component of service delivery. The findings emphasize an importance for integrating occupational therapy interventions within general education to enhance accessibility and effectiveness. In collaboration with the Maine Department of Education, this project aims to provide valuable resources and guidelines to assist in promoting evidence-based models of occupational therapy service delivery in schools. The authors of this project will be presenting their findings and project to the Maine Department of Education and occupational therapy practitioners in the state of Maine. Hissong, A., Lape, J., Bailey, D. (2015) Bailey’s Research for the Health Professional (3rd ed). F.A Davis Company

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