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Physical Therapy Management Of Gross Function Loss Following Gunshot Wound To Left Hand: A Case Report
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Background and Purpose: Nonfatal gunshot emergencies occur regularly within the United States but do not often lead to patients entering outpatient physical therapy clinics for rehabilitation. The complex musculoskeletal injuries which result from gunshot wounds may require prolonged rehabilitative care to best achieve functional outcomes, but clinicians may find a gap in the current literature for guidance. The purpose of this case study is to describe the outpatient rehabilitation treatment interventions for a gunshot wound to the hand, including manual therapy, therapeutic exercise, therapeutic activity, and neuromuscular reeducation.Case Description: The patient was a 34-year-old, left hand dominant, white male who presented to physical therapy after accidentally discharging his handgun on the ventral side of his left hand. During initial examination, the patient presented with gross dysfunction of the musculoskeletal, neuromuscular and integumentary systems which limited his ability to use his left hand while performing activities of daily living (ADLs) and work tasks.Outcomes: The patient improved towards all set goals including strength, pain rating, and range of motion (ROM). AROM wrist flexion improved from 20 degrees to 70 degrees, PROM forearm supination improved from -45 degrees to 64 degrees and average PROM metacarpophalangeal flexion improved from 29 degrees to 75.8 degrees. Wrist extension remained highly restricted, limiting the patient’s ability to fully return to ADLs, IADLs, and all necessary job functions.Discussion: The patient displayed improvements in ROM as demonstrated by handheld goniometry values, strength as demonstrated by MMT grades and dynamometry, and progressed exceptionally well towards all chosen goals. These outcomes suggest that a comprehensive approach to the PT rehabilitation of a gunshot wound to the hand appears to be successful in promoting functional patient gains.https://dune.une.edu/pt_studcrpres/1002/thumbnail.jp
Proprioceptive Neuromuscular Facilitation And Overground Gait Training For A Patient Following A Left Central Medullary Stroke: A Case Report
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Background and Purpose: Central medullary stroke is a rare type of stroke that is characterized by contralateral hemiplegia sparing the face, contralateral loss of deep sensation, and ipsilateral hypoglossal paralysis. It makes up a small percentage of the types of strokes that affect nearly 795,000 Americans every year. While there has been extensive research on rehabilitation principles for the general treatment of stroke, there has been little research on rehabilitation for patients following a central medullary stroke. The purpose of this case report was to describe a multifaceted intervention program with the emphasis on proprioceptive neuromuscular facilitation (PNF) and overground gait training (OGT) for a patient following a left central medullary stroke. Case Description: The patient was a 71-year-old female who received daily physical therapy (PT) for six weeks at an inpatient rehabilitation facility. The interventions included coordination, balance, gait, and functional mobility, with focus on PNF and OGT. Her progress was tracked using the Function in Sitting Test (FIST), Barthel Index (BI), and the Encompass Health Rehabilitation Functional Skills Assessment (EHRFSA). Outcomes: The patient experienced significant improvement in all three outcome measures. Her score for the FIST improved from 29/56 to 56/56, while her score on the BI improved from 45/100 to 70/100. On her initial examination the patient was dependent for all aspects of mobility, but at discharge required only minimum/no assistance. Discussion: Interventions such as PNF, OGT, and functional mobility exercises may have been beneficial for this patient in regard to the improvement in gait and decreased need for assistance. More research on PNF and OGT, along with other beneficial interventions for patients with central medullary stroke is warranted.https://dune.une.edu/pt_studcrpres/1013/thumbnail.jp
The Student Placement Decision-Making Process: A Study Of Administrator Considerations
Get PDFA myriad of factors are considered in the out-of-district placement process of special needs students, but there is not a standardized process for weighing these. Little is known about how Maine School Administrators weigh each factor to determine the appropriate placement. This interpretive phenomenological study examined the question: What is the hierarchy of priority of the factors used to determine out-of-district placements by Maine special education administrators?
Six special education administrators representing different geographic areas of the state of Maine were interviewed individually. The researcher utilized a purposive sampling method to recruit from within the targeted population those who have experience with the phenomenon of out-of-district placements. This qualitative phenomenological study identified trends and correlations based on transcript analysis of these six interviews. Data collected included information about length in position, demographics of district, number of out-of-district placements, experiences with the placement process, and an analysis of each director’s priorities during the decision-making process.
Thematic findings included factors such as: safety, progress, medical needs, disability category, and finances. Safety was the primary or most important factor identified in the process hierarchy. The notion that students are making progress in their individual program was also a primary consideration. Complex medical needs were also a factor for most district leaders when placing students out-of-district. Administrators did not report finances as a factor in this process, but all identified availability (both openings and potential fit) as a factor.
Safety was the resounding issue leading to out-of-district placements. This finding suggests that, if educators can better identify how to provide programs that ensure safety for students, more students could remain in-district. Understanding what these out-of-district placements provide that might be replicated in a public-school setting or public day program might help increase internal capacities of a district. District leaders should look at programs within their regions and find ways to share programs and resources to program for students in the least restrictive environment. In some cases, bringing in external training and expertise to build sustainable long-term programs would be in the interests of both students, staff, and communities
Statin Treatment In Specific Patient Groups: Role For Improved Cardiovascular Risk Markers
Get PDFAmple evidence supports the use of statin therapy for secondary prevention in patients with a history of atherosclerotic cardiovascular disease (ASCVD), but evidence is wanting in the case of primary prevention, low-risk individuals, and elderly adults 65+. Statins are effective in lowering low-density lipoprotein (LDL), which has long been a target for treatment decisions. We discuss the weakening dependence between cholesterol levels and mortality as a function of age and highlight recent findings on lipoprotein subfractions and other superior markers of ASCVD risk. The efficacy of statins is compared for distinct subsets of patients based on age, diabetes, ASCVD, and coronary artery calcium (CAC) status. Most cardiovascular risk calculators heavily weight age and overestimate one’s absolute risk of ASCVD, particularly in very old adults. Improvements in risk assessment enable the identification of specific patient populations that benefit most from statin treatment. Derisking is particularly important for adults over 75, in whom treatment benefits are reduced and adverse musculoskeletal effects are amplified. The CAC score stratifies the benefit effect size obtainable with statins, and forms of coenzyme Q are discussed for improving patient outcomes. Robust risk estimator tools and personalized, evidence-based approaches are needed to optimally reduce cardiovascular events and mortality rates through administration of cholesterol-lowering medications
A Study in Arches, The Gym and the Maples; Westbrook Junior College, 1940s
No full textFrom a 1940s Admissions photograph folder of campus views, this sepia toned print of the front steps and entrance to McArthur Gymnasium is shot from the Green through an arch of maple trees. The print is labeled on the front, lower left corner, with A Study in Arches, The Gym and the Maples. On the lower right corner is the label: Westbrook Junior College, Portland, Maine.https://dune.une.edu/wchc_photos_mcarthur/1002/thumbnail.jp
Intuitive Eating
Get PDFThis pamphlet contains information on what intuitive eating is, how to become an intuitive eater, and some tips for how to become more of an intuitive eater at home. There is also the recommendation that the audience follows the USDA MyPlate at mealtimes to help supplement in healthy dietary habits with eating intuitively.https://dune.une.edu/an_studedres/1187/thumbnail.jp
Food and Culture of Ethiopia
Get PDFAn educational fact sheet highlighting the food and culture in Ethiopia. The fact sheet will be used as a resource for my peers in the field of nutrition and to educate them about the traditional ethnic cuisine of Ethiopia and how it relates to nutrition.https://dune.une.edu/an_studedres/1172/thumbnail.jp
Saint Francis College Library (photo #2)
No full textStudents in Saint Francis College library. Currently Ketchum Library at the University of New England.https://dune.une.edu/sfchc_photos/1034/thumbnail.jp
Saint Francis Buildings (photo #2)
No full textStella Maris Boarding School now part of the University of New England.https://dune.une.edu/sfchc_photos/1004/thumbnail.jp
UNE UFA AAC Library Subcommittee Resource Highlight: September 2020
Get PDFSeptember 2020 library resources highlight compiled for the University Faculty Assembly Academic Affairs Committee\u27s Library Sub-committee at the University of New England. Focus on: McGraw Hill Case Files health podcasts, ILL Coordinator retirement, and Library Instruction delivery modes