With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at Mayo Clinic initiated a COT program in September of 2017, during the<br/>use of Cerner Electronic Health Record (EHR) system. Study metrics included provider<br/>satisfaction and perceptions regarding opioid prescription. Mayo Clinic transitioned its EHR<br/>system from Cerner to Epic in October 2018. This study aims to understand if provider perceptions<br/>about COT changed after the EHR transition and the reasons underlying those perceptions.

This thesis project will discuss how the three macronutrients, protein, carbohydrate and fat, benefit the body and what happens when the body is lacking in any of them. It also delves into micronutrients and supplements and how those can aid in the recovery process following an injury. Inflammation and sleep as well as mood disturbances are also explained. Meal options are available in the second half of this paper displaying pictures of nutritional meals along with their ingredients, instructions and calories. This project displays how a lack of protein can decrease muscle protein synthesis, how carbohydrate deficiency can lead to fatigue and more injury and how Omega-3 fatty acids are more beneficial than Omega-6 fatty acids. In addition, the paper discusses how vitamins, such as vitamin D and C, are important in providing bone strength and preventing excess inflammation. Supplements are reported to be beneficial, however, a disadvantage of consuming nutrients from a synthetic source can rob the athlete of a healthy mixture of nutrients and minerals. Overall, consumption of proper nutrients can aid in the recovery process following an injury and sleep is an important factor that should also be considered while the body heals.

The United States healthcare system does not perform as well as other countries including Germany and England, despite spending the most money on healthcare. It is well-established that there have been attempts at reform in the U.S. healthcare system multiple times in the past. This research paper describes the health care systems in the U.S., Germany, and England to analyze the strengths to create practical healthcare reform ideas for the U.S. This was done by describing each of the country's health care systems in detail, including the history of each country's health care system, the quality of care, the access to care, and the funding of the health care system. Based on this analysis of these health care systems, recommendations for health care reform are provided for the U.S. with revisions to the Affordable Care Act.

This review of research aimed to explore and understand the benefits of transferable life skills learned through playing sports. Life skills are internal assets, characteristics, and skills that are developed from certain experiences and are beneficial if not necessary to complete daily tasks. Life skills can further be broken down into emotional, cognitive, and social subcategories. During this review of research, it was found that participation in sports programs may enhance the acquisition or improvement of these personal assets due to the development of physical, emotional, psychological, and social aspects, which can be transferred to different areas of life, such as work, school, and family. This leads us to hypothesize that participation in sports can be beneficial when it comes to developing life skills that are used in all aspects of life. The current body of literature suggests that Youth sports should be encouraged from a young age for the obvious physical benefits and behind-the-scenes psychological benefits.

Background: Creation and reuse of reliable clinical code sets could accelerate the use of EHR data for research. To support that vision, there is an imperative need for methodologically. driven, transparent and automatic approaches to create error-free clinical code sets. Objectives: Propose and evaluate an automatic, generalizable, and knowledge-based approach that uses as starting point a correct and complete knowledge base of ingredients (e.g., the US Drug Enforcement Administration Controlled Substance repository list includes fentanyl as an opioid) to create medication code sets (e.g., Abstral is an opioid medication with fentanyl as ingredient). Methods: Algorithms were written to convert lists of ingredients into medication code sets, where all the medications are codified in the RxNorm terminology, are active medications and have at least one ingredient from the ingredient list. Generalizability and accuracy of the methods was demonstrated by applying them to the discovery of opioid and anti-depressant medications. Results: Errors (39 (1.73%) and 13 (6.28%)), obsolete drugs (172 (7.61%) and 0 (0%)) and missing medications (1,587 (41.26%) and 1,456 (87.55%)) were found in publicly available opioid and antidepressant medication code sets, respectively. Conclusion: The proposed knowledge-based algorithms to discover correct, complete, and up to date ingredient-based medication code sets proved to be accurate and reusable. The resulting algorithms and code sets have been made publicly available for others to use.

This research paper examines the impact of journaling on anxiety and team cohesion on a women’s beach volleyball team (n=12). Each athlete was given a 30-Day Reset Journal to complete and asked to complete a mid and end of program survey assessing their anxiety and team cohesion levels. The team head coach (n=1) was asked to have weekly discussions with the team about the journal and respond to a mid and end of program survey assessing if they perceived their team was benefiting from the journal. Athlete anxiety results were broken into four categories: Total Anxiety (p value: 0.40), Worry Score (p value: 0.41), Concentration Disruption Score (p value: 0.82), and Somatic Trait Score (p value: 0.20). Team cohesion results were displayed in five categories: Total Team Cohesion (p value: 0.46), Purpose and Goals (p value: 0.17), Team Relationships (p value: 0.26), Problem Solving (p value: 0.85), and Skills and Learning (p value: 0.47). Although anxiety scores did overall decrease, the data reflected no significant difference between the middle and end surveys. Team cohesion results also displayed decreases with no significant difference between the two surveys. Throughout the study, only four statements within the survey displayed significant change between mid and end program surveys (three anxiety and one team cohesion). Though results were not found to be significant, this study provides some insight into the potential benefits journaling can offer athletes in lowering their anxiety and how placing an emphasis on team discussion with a focus on goal development and shared purpose can increase team cohesion.