Funny story today. The weather today was beautiful. The clouds finally cleared up and the sky was a clear blue all day. The temperature was also perfect, right around 70 degrees all day long. And no, the funny story is not that I actually had a chance to see the sun in the middle of July. I was on the bus ride home and the bus passed by the bank where an electronic clock flashed the time and the temperature. When the temperature flashed it read, "96 degrees". The women next to me shouted, "96? Man, I knew it was hot today!" Only in Juneau, AK could a 70 degree day suddenly turn into a 96 degree day.
I worked very hard today to finish my telephone survey report. I am very proud of my efforts and excited to share my findings at the staff meeting on Tuesday. After I present to the staff, I will post my report on the blog so that everyone can get an idea of what kinds of issues I have been dealing with. It was fun to see my work culminate in a meaningful report that will serve this organization well into the future. Essentially, I am combining the voices of 100+ patients into one giant statement that will give dentists at staff at SEARHC a unique look into the mindset of their patient base.
At one point today Dr. Hort looked over and saw how hard I was working to make sure that no patient voice went unheard and that no suggestion or recommendation went unexplained. She reminded me that I wasn't getting a grade on the project and that it did not have to be perfect. Apparently, she has never seen me critique myself. Even without the motivation of a grade, I want to give my best effort and give back to the dentists and staff who have given so much to me over the past two months. I also spent a lot of time continuing to compile information for my patient education material. Tomorrow I will be outlining the patient education material and creating a rough layout of everything to present to Dr. Bornstein on Monday.
Because of the poor weather, I have been a bit lazy the last few weeks so it was nice to wear shorts and go running again today. I'm going to enjoy running in the 70 degree weather for the next week and a half because I will soon be confined to a treadmill by the heat and humidity in St. Louis.
Tomorrow I am also taking the morning off to go dog sledding. Unlike my failed expedition in Skagway, the weather is supposed to be nice so I should definitely get off the ground on onto the glacier. Check back for what I'm sure will be some pretty cool pictures.
Thursday, July 8, 2010
Wednesday, July 7, 2010
Day 52 - Sustainability
My main focus today was on sustainability. I am really proud of the work I have done over the past eight weeks, so I want to ensure that all of my efforts continue even as I head back to school and the SEARHC staff goes back to their day-to-day routine. It is easy for a project to gain momentum when an unpaid, hard-working (sometimes) intern is dedicating nearly forty hours per week to a specific task, but it becomes a completely different dynamic when I pass off my project to somebody who may have other job responsibilities.
For this reason, I spent today focusing on how to make sure my project is sustainable. One of the main ways that I am going to do this is to develop a strong foundation of researched materials to leave in a database before I leave. I have focused on four main research topics: nutrition, vertical transmission, newborn child's dental timeline, and the correlation between a mother's oral health and her child's oral health. This material should get the SEARHC staff through the first few months after I leave as they adjust to finding the correct staff members to be in charge of the patient education material, how they will fit these new responsibilities into their schedule, and how efficiently and effectively the distribution of patient education material goes.
Also, today brought some excitement as the Xyltiol products for the vending machine finally arrived. Almost seven weeks ago I spent an entire afternoon finding gums and mints with a high concentration of Xyltiol and making sure that we had products that fit in the large slots and products that fit in the small slots in the vending machine. If you are at work or school tomorrow and stop by the vending machine at lunch, know that a lot more thought goes into the placement of the Reese's Cups than you would have ever imagined! Tomorrow we are going to the bank to pick up quarters, dimes, and nickels so that we can stock the machine the appropriate amount of change. Dr. Hort and I are also going to start pricing the items and loading them into the vending machine. The vending machine will be fully functional by the time that I leave, which is another exciting accomplishment.
For dinner tonight I went over to Dr. Nascimento's with Dr. Dee, the Wilkinsons, and Dr. Marcotte. Dr. Nascimento is one of those people that excels at everything she does. Over the past few months I have seen her teach herself to sew, paint, carve, and crochet without so much as batting an eyelid. Tonight, she cooked dinner without the aid of a recipe book and the food was so good we had to cut our card game short because we were all too stuffed full and tired. As we sat and ate I started to get a little sentimental knowing that I will be leaving this group soon. The project has not only exceeded my expectations through my community service, but socially as well. I never could have imagined that I would meet so many people who would make my summer in Alaska so enjoyable.
Another full day tomorrow. Time is winding down...
For this reason, I spent today focusing on how to make sure my project is sustainable. One of the main ways that I am going to do this is to develop a strong foundation of researched materials to leave in a database before I leave. I have focused on four main research topics: nutrition, vertical transmission, newborn child's dental timeline, and the correlation between a mother's oral health and her child's oral health. This material should get the SEARHC staff through the first few months after I leave as they adjust to finding the correct staff members to be in charge of the patient education material, how they will fit these new responsibilities into their schedule, and how efficiently and effectively the distribution of patient education material goes.
Also, today brought some excitement as the Xyltiol products for the vending machine finally arrived. Almost seven weeks ago I spent an entire afternoon finding gums and mints with a high concentration of Xyltiol and making sure that we had products that fit in the large slots and products that fit in the small slots in the vending machine. If you are at work or school tomorrow and stop by the vending machine at lunch, know that a lot more thought goes into the placement of the Reese's Cups than you would have ever imagined! Tomorrow we are going to the bank to pick up quarters, dimes, and nickels so that we can stock the machine the appropriate amount of change. Dr. Hort and I are also going to start pricing the items and loading them into the vending machine. The vending machine will be fully functional by the time that I leave, which is another exciting accomplishment.
For dinner tonight I went over to Dr. Nascimento's with Dr. Dee, the Wilkinsons, and Dr. Marcotte. Dr. Nascimento is one of those people that excels at everything she does. Over the past few months I have seen her teach herself to sew, paint, carve, and crochet without so much as batting an eyelid. Tonight, she cooked dinner without the aid of a recipe book and the food was so good we had to cut our card game short because we were all too stuffed full and tired. As we sat and ate I started to get a little sentimental knowing that I will be leaving this group soon. The project has not only exceeded my expectations through my community service, but socially as well. I never could have imagined that I would meet so many people who would make my summer in Alaska so enjoyable.
Another full day tomorrow. Time is winding down...
Tuesday, July 6, 2010
Day 51 - Patient education material
Today, for the first time, the finality of what these last two weeks will bring began to sink in. I realized that I can't put off research for another day, or decide to go hiking instead of making a few extra phone calls - it's time to bear down and finish what I have started. While this may take a bit of the "fun" aspect out of my summer project, I have also started to realize how much I have taken on and how happy I will be with my finished product. And, like most, I do better when the end is in sight and the pressure of meeting a deadline grows stronger and stronger.
I began to outline the six month cycle for my patient education material today. Once I compiled all of the research data I began to summarize and recount all that had gone into compiling the data, why I felt it was important, etc. This report will eventually go to Dr. Bornstein for approval (hopefully by Wednesday afternoon) and editing to make sure the things we want to do will not be considered too radical or unacceptable by SEARHC standards.
On Sunday night at the Hort's somebody mused that Alaska had not been hit too hard by the economic recession and that the housing market had actually thrived in the past few years. I joked that the reason Alaska had remained unscathed is because everything in this state is 10 years behind the continental United States. So at some point in 2020 we will all be thriving again while Alaska will be hit with this sudden economic downturn...
On a serious note, a lot of what SEARHC has given to their patients in the past is very old fashioned and uniformed. A tri-fold brochure, an 8" x 10" poster - things that do not take into account the ever growing influence technology has on our society. My proposal contains a lot of technological integration - recognizing that the patient base is constantly connected on their cell phones or their computers. I'm hoping that our ideas will be accepted as the evolution of patient education and not as a knock against the conservative Tlingit culture.
After lunch, I spent the afternoon continuing to make my patient phone calls. I can continue the telephone survey through the end of the week and compile that data over the weekend. As I look back at where I started 7 weeks ago it is hard to believe that I have dialed over 300 numbers in the past few weeks.
I have definitely had better nights than I had tonight. Between the Cardinals 9th inning implosion (and the stampede of nasty text messages from my friends that quickly followed) and my mysterious Alaskan rash, I am just about ready for bed. The rash is nothing too serious. I spoke with Dr. Bornstein and he said the only rash I would have gotten from Alaska is if I was running through the brush without a shirt on and happened to stumble upon some nettles. Since I tip toe through the brush, fully-clothed because of my fear of bears that could not be the cause of the rash. I took some Benedryl and am hoping a good night of sleep will do the trick.
Off to bed and ready for a busy day tomorrow...
I began to outline the six month cycle for my patient education material today. Once I compiled all of the research data I began to summarize and recount all that had gone into compiling the data, why I felt it was important, etc. This report will eventually go to Dr. Bornstein for approval (hopefully by Wednesday afternoon) and editing to make sure the things we want to do will not be considered too radical or unacceptable by SEARHC standards.
On Sunday night at the Hort's somebody mused that Alaska had not been hit too hard by the economic recession and that the housing market had actually thrived in the past few years. I joked that the reason Alaska had remained unscathed is because everything in this state is 10 years behind the continental United States. So at some point in 2020 we will all be thriving again while Alaska will be hit with this sudden economic downturn...
On a serious note, a lot of what SEARHC has given to their patients in the past is very old fashioned and uniformed. A tri-fold brochure, an 8" x 10" poster - things that do not take into account the ever growing influence technology has on our society. My proposal contains a lot of technological integration - recognizing that the patient base is constantly connected on their cell phones or their computers. I'm hoping that our ideas will be accepted as the evolution of patient education and not as a knock against the conservative Tlingit culture.
After lunch, I spent the afternoon continuing to make my patient phone calls. I can continue the telephone survey through the end of the week and compile that data over the weekend. As I look back at where I started 7 weeks ago it is hard to believe that I have dialed over 300 numbers in the past few weeks.
I have definitely had better nights than I had tonight. Between the Cardinals 9th inning implosion (and the stampede of nasty text messages from my friends that quickly followed) and my mysterious Alaskan rash, I am just about ready for bed. The rash is nothing too serious. I spoke with Dr. Bornstein and he said the only rash I would have gotten from Alaska is if I was running through the brush without a shirt on and happened to stumble upon some nettles. Since I tip toe through the brush, fully-clothed because of my fear of bears that could not be the cause of the rash. I took some Benedryl and am hoping a good night of sleep will do the trick.
Off to bed and ready for a busy day tomorrow...
Monday, July 5, 2010
Day 50 - **New pictures**
Not a whole lot going on today - the clinic was closed so I had the day off. Spent the day relaxing and doing a whole lot of nothing. Tomorrow I start developing the patient education material and putting a final product together.
I am definitely entering the backstretch and can see the finish in sight.
I am definitely entering the backstretch and can see the finish in sight.
Day 49 - 4th of July
Today was a fun day, but definitely not the 4th of July I have become accustomed too. I woke up early and drove downtown with some people from the SEARHC office to get a good spot for the Juneau parade. The weather was awful - 40 degrees, freezing cold rain, and a strong wind - but we all stood huddled together as the parade started.
The parade was pretty cool. It was a collection of flat bed trucks decorated by local politicians and organizations. Every float throws candy to the kids lining the parade route, and kids collect this candy in large pillowcases. It is like Halloween in July. It was interesting to see the mix of Tlingit culture and American culture during the parade. The parade then continued over to Douglas Island and ended at Sandy Beach where there was lots of food and fair type activities. We drove over to Sandy Beach and ate hot dogs (trying to make it seem like the 4th of July even though the weather was better suited for Thanksgiving) before eventually succumbing to the numbing rain.
I never pictured myself huddled under a blanket in my bed, drinking hot tea on the 4th of July. I think I can say with absolute certainty that I will be spending every future 4th in a location with a minimum temperature of 80 degrees.
After warming up and getting some rest, the group went out to dinner at a restaurant called The Hanger. It's right on the harbor and one side of the restaurant is a giant window where you can look out over Douglas Island and see the cruise ships passing by. After dinner, we all congregated at Dr. Hort's house to wait for the midnight fireworks show. We were all skeptical that the city was going to shoot off the fireworks since the weather did not appear to be any nicer than it was yesterday when everything was canceled.
However, come 12:01 AM on July 5th, we finally got our 4th of July fireworks show. Because Juneau is surrounded by mountains on all sides the "boom" from the fireworks echoed for minutes at a time, trapped in between the mountains. That's about it for the 4th. I have tomorrow off so I'll have to find a way to keep myself busy before going back to work on Tuesday.
The parade was pretty cool. It was a collection of flat bed trucks decorated by local politicians and organizations. Every float throws candy to the kids lining the parade route, and kids collect this candy in large pillowcases. It is like Halloween in July. It was interesting to see the mix of Tlingit culture and American culture during the parade. The parade then continued over to Douglas Island and ended at Sandy Beach where there was lots of food and fair type activities. We drove over to Sandy Beach and ate hot dogs (trying to make it seem like the 4th of July even though the weather was better suited for Thanksgiving) before eventually succumbing to the numbing rain.
I never pictured myself huddled under a blanket in my bed, drinking hot tea on the 4th of July. I think I can say with absolute certainty that I will be spending every future 4th in a location with a minimum temperature of 80 degrees.
After warming up and getting some rest, the group went out to dinner at a restaurant called The Hanger. It's right on the harbor and one side of the restaurant is a giant window where you can look out over Douglas Island and see the cruise ships passing by. After dinner, we all congregated at Dr. Hort's house to wait for the midnight fireworks show. We were all skeptical that the city was going to shoot off the fireworks since the weather did not appear to be any nicer than it was yesterday when everything was canceled.
However, come 12:01 AM on July 5th, we finally got our 4th of July fireworks show. Because Juneau is surrounded by mountains on all sides the "boom" from the fireworks echoed for minutes at a time, trapped in between the mountains. That's about it for the 4th. I have tomorrow off so I'll have to find a way to keep myself busy before going back to work on Tuesday.
Sunday, July 4, 2010
Day 48 - 24 hours worth of rain
When I woke up today it was raining, and as I prepare to go to bed it is still raining outside. To top it off, at no time in between was it ever not raining. Welcome to Southeast Alaska! Dr. Dee is out of town this weekend, but he left me the key to his apartment so I could go over there and do laundry. He also has a TV, a nice leather couch, and wireless internet so I decided to spend the day there. Between all of the traveling and my busy schedule I have not gotten a chance to do laundry many times - there are some articles of clothing that have been in the bottom of my laundry basket so long I forgot I brought them to Alaska with me.
In the afternoon I met up with the Wilkinson's and went to the movies. We saw two movies - Toy Story 3 and Grown Ups. It was a good way to spend a rainy Saturday afternoon. We all had dinner at The Valley Restaurant and then headed back home.
Usually, Juneau has a fireworks show at midnight on July 3rd since it is too bright until about 11 on the 4th. However, due to the poor weather, the fireworks were delayed until tomorrow (the 4th) at midnight. So I went from potentially being one of the first people to celebrate the 4th of July with fireworks to probably being the last. Tomorrow there is a big parade and carnival downtown so I hope that the weather clears up. I have gotten used to the rain, but I hope it warms up a bit to make it feel a bit more like the 4th of July I am used to.
In the afternoon I met up with the Wilkinson's and went to the movies. We saw two movies - Toy Story 3 and Grown Ups. It was a good way to spend a rainy Saturday afternoon. We all had dinner at The Valley Restaurant and then headed back home.
Usually, Juneau has a fireworks show at midnight on July 3rd since it is too bright until about 11 on the 4th. However, due to the poor weather, the fireworks were delayed until tomorrow (the 4th) at midnight. So I went from potentially being one of the first people to celebrate the 4th of July with fireworks to probably being the last. Tomorrow there is a big parade and carnival downtown so I hope that the weather clears up. I have gotten used to the rain, but I hope it warms up a bit to make it feel a bit more like the 4th of July I am used to.
Friday, July 2, 2010
Day 47 - Another week down
Things are still going very well 7 weeks into my summer project. I just wrapped up my surveying and interviewing yesterday. The month of June was very exciting as I got to travel all throughout Southeast Alaska. I got interesting perspective from tiny villages such as Hoonah and from large, regional hospitals like in Sitka. In between, I managed to visit SEARHC's only clinic that serves non natives (Haines), and took a day trip to Skagway right on the U.S./Canada border. It's been a whirlwind month, but it's been a month that has shown me lots of different perspectives, mindsets, and beliefs. My project would not have had the same meaning had I not been able to travel (by land, boat, and air!), so I am thankful to SEARHC for giving me that opportunity and an unbelievable amount of freedom. Just last night I compiled all of the data and met with Dr. Hort to discuss where to go from here. We have come up with a pretty unique plan - one that should ensure that the work I have done here will carry on long after I am gone.
Since we decided to focus on the OB subgroup, our education material will focus on oral health related to the pregnancy cycle. One of the main things that we found out in our interviewing was that patients really only are interested in receiving education material at appointments, basically they only want to learn if they are not being inconvenienced. This is perfect when dealing with OB patients because they are frequently visiting the OBGYN and coming in and out of the medical comlpex on SEARHC's campus. The dental clinic has a presence in the medical complex so there is an easy connection between two. We will now work to design a monthly program that will give these pregnant women access to prenatal oral health information in a variety of ways. The program will be structured so that women are receiving something monthly, culminating in a dental gift basket following the birth of their child. The education material will be part of a six month cycle, starting in the third month of pregnancy. Women will receive something new from the dental clinic each month in a different manner.
We think this will be an effective way of distributing patient education material for multiple reasons. First, surveying allowed us to conclude that there is not one clear cut method in which people prefer to receive educational materials. Some love the concept of utilizing technologies such as email and text message, whereas other are completely satisfied receiving brochures or pamphlets. By setting up a monthly program that can correlate to a woman's pregnancy schedule, we can utilize many different methods of distribution. Possibly a brochure at month three, a conversation with a dental team member at month five, an informational video at month seven, and a gift at month nine. This is just an example, but the concept of diversifying the way in which we are reaching out to patients should ensure that people will find at least one effective piece of information as they go through the process.
Also, we found that there are three or four main pieces of information that these women are interested in learning about. So by creating a system in which they are receiving something new each month we are ensuring that everyone has an opportunity to learn many different things. This goes hand-in-hand with the concept of offering a variety of ways to distribute the education materials. Again, we think this will prove to be effective because it will ensure that people won't be bored by information fed to them over and over, time and time again. The patients will have access to lots of different information so they can always be on the lookout for something new.
I am really looking forward to working hard over the next two weeks to make this goal a reality. In addition to the patient education material, I will be submitting a report to Dr. Bornstein and Dr. Sohonage (the two directors of the dental clinic) detailing the results of my telephone survey on why people are continually missing their appointments. This data should prove useful in creating a more peaceful union between the dental staff and the administrative staff in the clinics. By interviwing so many patients in so many diverse locations I have really had an opportunity to gain a perspective that most in the SEARHC organization have not. I have, in a sense, started to think like a SEARHC patient and will give them a voice in my report and education materials that they wouldn't have otherwise had the opportunity to express or receive.
Besides the excitement of finally compiling data and finishing up a few telephone surveys, I had an opportunity to go hiking with Dr. Bornstein and Sam after work today. Among the cooler things about living in Alaska is that there is an endless amount of time to each day. Even if you work until 5 or 6 you still have a good 5 hours of daylight to go out hiking or exploring. This can also turn into a bit of curse because sometimes you are laying in bed at 10 PM and see it's still bright outside and kick yourself for not taking advantage of the extra hours of light. Today, Dr. Bornstein, Sam, and I went off to the East Glacier Trail. I have hiked this trail before, but not like I hiked it today. We veered off of the main path onto a small auxiliary path towards some old mining camps. Juneau has a storied history of mining, and many of the trails still have remains of old mining equipment. We hiked on old pipelines and sat and rested in camps filled with rusted stoves, pots, and pans. We even got to hike in a small cave that lead to the generator that powered a lot of the mining equipment. And, to top it off, it did not rain today!
After the hike, I went over to the Bornstein residence for dinner. We had fresh halibut caught from Fred Meyer Superstore. We concluded the night with an intense game of Bananagrams before I came back to the dorm. Today was an exciting day and a great kickoff to the final two week push of my project. Looking forward to an exciting 4th of July weekend...
Since we decided to focus on the OB subgroup, our education material will focus on oral health related to the pregnancy cycle. One of the main things that we found out in our interviewing was that patients really only are interested in receiving education material at appointments, basically they only want to learn if they are not being inconvenienced. This is perfect when dealing with OB patients because they are frequently visiting the OBGYN and coming in and out of the medical comlpex on SEARHC's campus. The dental clinic has a presence in the medical complex so there is an easy connection between two. We will now work to design a monthly program that will give these pregnant women access to prenatal oral health information in a variety of ways. The program will be structured so that women are receiving something monthly, culminating in a dental gift basket following the birth of their child. The education material will be part of a six month cycle, starting in the third month of pregnancy. Women will receive something new from the dental clinic each month in a different manner.
We think this will be an effective way of distributing patient education material for multiple reasons. First, surveying allowed us to conclude that there is not one clear cut method in which people prefer to receive educational materials. Some love the concept of utilizing technologies such as email and text message, whereas other are completely satisfied receiving brochures or pamphlets. By setting up a monthly program that can correlate to a woman's pregnancy schedule, we can utilize many different methods of distribution. Possibly a brochure at month three, a conversation with a dental team member at month five, an informational video at month seven, and a gift at month nine. This is just an example, but the concept of diversifying the way in which we are reaching out to patients should ensure that people will find at least one effective piece of information as they go through the process.
Also, we found that there are three or four main pieces of information that these women are interested in learning about. So by creating a system in which they are receiving something new each month we are ensuring that everyone has an opportunity to learn many different things. This goes hand-in-hand with the concept of offering a variety of ways to distribute the education materials. Again, we think this will prove to be effective because it will ensure that people won't be bored by information fed to them over and over, time and time again. The patients will have access to lots of different information so they can always be on the lookout for something new.
I am really looking forward to working hard over the next two weeks to make this goal a reality. In addition to the patient education material, I will be submitting a report to Dr. Bornstein and Dr. Sohonage (the two directors of the dental clinic) detailing the results of my telephone survey on why people are continually missing their appointments. This data should prove useful in creating a more peaceful union between the dental staff and the administrative staff in the clinics. By interviwing so many patients in so many diverse locations I have really had an opportunity to gain a perspective that most in the SEARHC organization have not. I have, in a sense, started to think like a SEARHC patient and will give them a voice in my report and education materials that they wouldn't have otherwise had the opportunity to express or receive.
Besides the excitement of finally compiling data and finishing up a few telephone surveys, I had an opportunity to go hiking with Dr. Bornstein and Sam after work today. Among the cooler things about living in Alaska is that there is an endless amount of time to each day. Even if you work until 5 or 6 you still have a good 5 hours of daylight to go out hiking or exploring. This can also turn into a bit of curse because sometimes you are laying in bed at 10 PM and see it's still bright outside and kick yourself for not taking advantage of the extra hours of light. Today, Dr. Bornstein, Sam, and I went off to the East Glacier Trail. I have hiked this trail before, but not like I hiked it today. We veered off of the main path onto a small auxiliary path towards some old mining camps. Juneau has a storied history of mining, and many of the trails still have remains of old mining equipment. We hiked on old pipelines and sat and rested in camps filled with rusted stoves, pots, and pans. We even got to hike in a small cave that lead to the generator that powered a lot of the mining equipment. And, to top it off, it did not rain today!
After the hike, I went over to the Bornstein residence for dinner. We had fresh halibut caught from Fred Meyer Superstore. We concluded the night with an intense game of Bananagrams before I came back to the dorm. Today was an exciting day and a great kickoff to the final two week push of my project. Looking forward to an exciting 4th of July weekend...
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