The Shifting Role and Expectations of Physical Therapy in the Pediatric Cystic Fibrosis Clinic During a Global Pandemic
Ana Cairns, Colby Wyatt, C Chaloner, J Takatsuki-Jordan, and A Williams
In January 2020, a CFF supported quality improvement study to optimize physical therapy (PT) services in our pediatric CF clinic was underway. •An initial survey had been completed in 2019 to assess family satisfaction with the current provision of PT services. •In March 2020 the COVID-19 pandemic caused a major shift in clinical care in the midst of our project. •Care was changed to telehealth and “hybrid” clinic visits, thereby altering the context of our study, necessitating a change in the focus.
Cross-sectional Survey regarding Marijuana Use in Pregnancy
Kathleen S. Carlson
Introduction • There is a paucity of data regarding extent and patterns of marijuana use in pregnancy. • Nausea, sleep problems, anxiety are commonly reported reasons for use (Kaarid, 2021) • Marijuana use in pregnancy is associated with increased risk for neonates of preterm delivery, NICU admission, small for gestational age, and lower 1min APGAR scores (Marchand, 2022) • Knowledge of reasons and patterns of marijuana use is important to properly counsel patients, identify patients at risk for use during pregnancy and to offer alternative therapies that are safer during pregnancy.
Center for Applied Science and Technology
Robert Carlson, Scot Remick, Lindsey Gower, Sue LaPierre, Anne Breggia, and Bob Carlson
The journey from basic research to its application in clinical medicine is long and often fragmented. MaineHealth, as the largest healthcare system in Maine, is uniquely situated to create synergies between research and clinical medicine. The new MMCRI Center for Applied Science and Technology is a collaborative effort between the MMC Research Institute (MMCRI) and NorDx, the MaineHealth Diagnostic Laboratory, that provides the infrastructure needed for coordinated integration of MMCRI research core facility instrumentation and data resources with NorDx clinical instrumentation, data resources and support services. The new infrastructure provided by the Center will facilitate and broaden participation in the vital research needed to develop new diagnostic tools and therapies that will ultimately improve the health of Maine people.
Exploring Provider Attitudes toward Falls Prevention in the Inpatient Setting
Emily Carter MD, Sarah Hallen, Gavin Welch, Nikki Gordon, and Mark Parker
The rate of falls and falls with injury within Maine Medical Center are rising. •MMC’s InterprofessionalFalls Committee performed a root cause analysis to identify the factors driving this change. •This analysis highlighted the role that nursing and PT/OT’s have on fall prevention and it uncovered the lack of engagement amongst physicians and APPs. •We performed a literature review and found that there were no references identifying specific barriers to inpatient provider engagement; however, in other clinical settings such as the ED and assisted living, barriers to provider falls assessment have been identified. •We utilized the theoretical domains framework (TDF) to identify the barriers to behavior change (i.e. lack of engagement).
Behavioral Support Checklist Making MMC More Autism Friendly
Rachel Coffey and Sarah Reynolds
Introduction • Patients with Autism Spectrum Disorder and their families report suboptimal medical experiences. • Boston Medical Center championed the “Autism Friendlieness Initiative” through ● Autism Support Checklist ● Provider Training ● Visit Preparation ● Sensory Accommodations
Demographic Factors Contributing to NAS Treatment
Meg Curran and Emma Freeman
Infants that were formula fed, had unpartnered parents, birthing parents who used illicit substances, and multiple medication exposures were more likely to be treated for NAS
Pediatric Dermatology eConsult Program with Dermoscopy: Sub Analysis of Infantile Hemangiomas
Peggy R. Cyr, Madeline Prentiss, Laura Houk, and Elizabeth Seiverling
There are no pediatric dermatologists in Maine. Greater distance from a dermatologist is associated with delays in care and nonadherence to treatment. Timely care is especially crucial for patients with infantile hemangiomas (IH) due to a narrow “window of opportunity” for optimal treatment. A store and forward electronic consultation eConsult ) platform was implemented within our electronic medical record (Epic) to triage referrals from primary care providers ( PCPs). Here we present an analysis of the program outcomes in respect to pediatric eConsults with emphasis on treatment for IH.
Implementing Trauma-Informed Developmental Care in NICU/CCN: Findings from a Pre-Intervention Care Team Survey
Priorities Identified by Care Team in NICU/CCN Provide Path to Improving Patient Care
Early Warning: Exploring Risk Factors for Hospital Acquired Pressure Injuries Using the Electronic Medical Record
Tricia Foley and Nicole M T Radmore
Introduction -Severe Hospital Acquired Pressure Injuries (HAPIs) are, by law, reported to the State of Maine and present a financial burden, as Medicare will not cover costs for these injuries.
Cytokine CXCL2 concentration in the cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage is associated with patient-reported headache pain
Elizabeth Glisic, Joanne T. deKay, Patricia Lerwick, David J. Gagnon, Richard Riker, and Sergey Ryzhov
Subarachnoid hemorrhage (SAH) is a severe type of stroke categorized by a sharp, sudden, and persistent headache. The mechanism of headache after SAH is currently poorly understood but the neuro-inflammatory response has been identified as a target in understanding the causes of headache after SAH. A better understanding of this mechanism may lead to identification of molecular targets for therapeutic reduction of headache pain and improving outcomes after SAH. In this study, we collected cerebrospinal fluid (CSF) from patients hospitalized with SAH and conducted a cytokine array to screen for soluble factors involved in SAH-associated headache Introduction
Adolescent and Young Adult (AYA) Cancer Survivorship Survey
Amy Haskins, Christina Holt, Lauren Boehm, and Ashley Speckhart
Introduction •AYA cancer survivors face unique healthcare challenges following curative therapy •High loss to follow up rate despite importance of survivorship care
Assessment of Obstetric Outcomes Graphs and Figures for New Mainers
Amy Haskins, Brendan Prast, and Tina Holt
• 4% of Maine’s population in 2018 was recent immigrants
• Maine Medical Center provides obstetrical care for more newly arrived, non- English speaking patients
• Increased risk for health disparities due to: language barriers, low socioeconomic status and stressors from a history of trauma.
Pre-operative anxiety related to major urogynecologicsurgery
Nadi Nina Kaonga, Mary C Brandes, and Caroline Foust-Wright
Introduction •Higher levels of pre-operative anxiety are associated with adverse outcomes1-3(e.g., delayed recovery, higher post-op pain levels) •Most evidence arose from cardiothoracic and orthopedic literature (on emergent surgeries) and there is opportunity to further understand perioperative anxiety and elective/quality of life surgeries [within gynecology]4
A Multicenter Pilot Study to Evaluate the Effect of EVOO on Lipid Parameters
Caroline Knight, Ralph Hamill, Katherine Brady, and Stacia Kozidis
The purpose of this multi-center, double-blinded pilot study was to determine if EVOO has a positive effect on HDL cholesterol levels and anti-inflammatory markers for subjects diagnosed with CVD and to determine if the polyphenol concentration is proportional to those effects. Subjects completed consecutive 28-day periods (with a 14- day washout between) in which they will either consume the low polyphenol EVOO daily or the high polyphenol EVOO. In a double-blinded manner, each subject was his or her own control with a 14-day washout between study periods. HDL levels and other parameters were be measured after each period of the protocol. We anticipated HDL levels will improve with both olive oils. We expect the high polyphenol concentration EVOO would show a greater effect than the EVOO with a low polyphenol concentration.
A Period Seroprevalence(SARS-CoV-2) Survey in MHCCN Cancer Healthcare Workers (HCWs) Providing Patient Care during the Height of the Outbreak: A Registry Study (Second Year Progress)
Caroline Knight, Jill Prescott, Jill Hobart, Jamie Saunders, Kimberly Caron, Sandra Neptune, Patty Brown, Kyla Sturtevant, Sean Eller, Lisa Lemire, Anne Breggia, Susan L. Guerin-Staples, Lee Lucas, Paul Han, Rachit Kumar, Johnson Liu, Robert Carlson, and Scot Remick
In December 2019, emergence of a new coronavirus in Wuhan, China heralded the onset of a global pandemic (aka Covid-19) that is well into its third year. At the outset, the initial first wave of the alpha variant in 2020 had less impact on our state and HCWs. In December 2020, Covid-19 vaccinations became available. By fall and winter 2021-2022, the delta and subsequent omicron variants nearly overwhelmed Maine healthcare systems and work force. In June 2020, we embarked on a period seroprevalencestudy in the MaineHealthCancer Network (MHCCN) to document Covid-19 exposure in our rural cancer care workforce. Enrollment continues over two discrete periods during our study, essentially pre-and post-vaccination and with two discrete SARS-CoV-2 antibody-testing platforms as the pandemic evolved. This ongoing study provides additional insight into viral antibody (Ab) response across the settings of potential occupational exposure, rapid community spread, and vaccination.
Applying the ‘problem and solution trees’ participatory method to design a public health program on COVID 19 testing for underserved populations
Mike Kohut, Elizabeth A Jacobs, Kathleen M Fairfield, G D. Sclar, and K Hudak
Here we present a case study example of how we applied qualitative research and ‘problem and solution ’trees’( to identity barriers to testing for people who are unhoused
Comparing Orthopedic Randomized Control Trials Published in High-Impact Medical and Orthopedic Journals
Andrew Lachance and Emily Dissler
PURPOSE To compare study characteristics, methodologic quality and outcome direction among operative randomized orthopedic trials published in high-impact medical and orthopedic journals and to identify study attributes associated with greater exposure and impact
Prostate cancer screening behaviors among U.S. immigrants: a cross-sectional analysis using the NHIS database
Joshua Linscott, Mathew Hayn, Jesse Sammon, and Stephen Ryan
Background • The health of immigrants is affected by barriers that challenge all underserved groups, but immigrant-specific factors such as language proficiency and access to physician services are unique and modifiable obstacles that can impede access to quality healthcare. • Immigrants are less likely than the U.S.-born populations to receive screening for breast, cervical, and colorectal cancers. • Patients with limited English proficiency (LEP) are more likely to be diagnosed with advanced stage cancer. • LEP patients with male genitourinary (GU) cancers are 2.58x more likely to be diagnosed at an advanced stage. • Research suggests physicians often do not discuss PSA testing with patients when a language barrier is present.
Implementing Uniform Curriculum to Increase Efficiency and Access to Simulation
Christine Mallar, Bethany Rocheleau, Shelly Chipman, Mike Shepherd, and Erin Siebers
• Using Standardized Patients (SPs) is effective in improving communication skills.
• Conducting SP training can be cost prohibitive in terms of time and labor.
• Demands of current curriculum created a need for an innovative and more efficient approach to meet new CLER requirement.
Implementation of a Readiness Model for Kidney Transplant Patients
Shelby McDonnell, John Vella, and Ardyce Peters
Increasing Access to Kidney Transplantation: How Decreasing Time in Transplant Evaluation Led to More Timely Eligibility for Organ Offers
Bilateral Total Hip Arthroplasty: Outcomes of Staged vs. Simultaneous THA Performed Using the Anterior Based Muscle Sparing Approach
Brian J. McGrory, George Babikian, and Adam Rana
•Total Hip Arthroplasty (THA) procedures are becoming increasingly common globally. •There is current debate surrounding the efficacy of simultaneous versus staged bilateral total hip arthroplasty, mainly with regards to patient outcomes and complications. •This study examines the perioperative and postoperative outcomes of simultaneous and staged bilateral THA procedures using the Anterior Based Muscle Sparing (ABMS) approach, also known as the ABLE Advanced Anterior Approach.
Perioperative and Postoperative Outcomes of Morbidly Obese Patients Undergoing Primary Elective Total Hip Arthroplasty with a Muscle Sparing Approach
Brian J. McGrory, George Babikian, and Adam Rana
Obesity is associated with an increased risk of complications after total hip arthroplasty (THA), including infection and dislocation. •Due to the higher risk of osteoarthritis in obese individuals, understanding factors that can reduce the risk of complications is important. •This study examined the outcomes of morbidly obese (BMI ≥ 40) compared to healthy weight patients(BMI between 18.5-24.9 kg/m2)who underwent a THA with the ABLEapproach. •The ABLE approach: •This approach uses the interval between the anterior aspect of the gluteus mediusand the posterior aspect of the tensor fascia lata. •ABLE is minimally invasive, muscle sparing, and is associated with less painful postoperative results and quicker recovery. •Research on postoperative and perioperative outcomes of THA in morbidly obese patients using the ABLE approach has not previously been studied.
Development of a Codebook for A Prospective Mixed Methods Study Focusing on Experiences of Mindfulness Intervention in Patients Undergoing Colorectal Surgery
Laura Nicolais, Rebecca Brown, Julie Fitzgibbons, and Rachel Farrington
Mindfulness is a state of being present with one's thoughts without judgment • Relaxation is a technique to help achieve a state of rest (i.e., physical relaxation) and inner calm (i.e., mental relaxation). • Prior research has shown the many benefits of mindfulness and relaxation practice including improved psychological well-being, stress relief, reduced pain perception, improved sleep, relief of headaches, vomiting; all of which could prove beneficial in the postoperative phase.1 • Measuring the mental and emotional response to a mindfulness intervention in a quantitative manner can be challenging and therefore, a qualitative approach is justified.
Takotsubo’sCardiomyopathy: Clinical Characteristics and Outcomes in the Rural State of Maine
Laura Onderko, Bhavini Prajapati, Wendy Craig, and Roisin Morgan
Pre-existing psychiatric diagnosis linked to developing Takotsubo’sCardiomyopathy. Patients from rural areas less likely to be on psychiatric medications and had higher Takotsubo’srecurrence rate.
Maine Medical Center Experience with Left Ventricular Device Explantation
Laura Onderko, Lauren Vickerson, and Andrew Schwartzman
Introduction •Left ventricular assist device (LVAD) is an implantable heart pump that helps support the heart in patients with end stage heart failure with reduced ejection fraction •LVAD therapy is now approved for use as a bridge to transplantation (BTT) and as a destination therapy (DT) in patients who are not candidates for heart transplantation. •The existing literature suggests that close to 10% of patients implanted with LVAD could be explanted for recovery, but the actual rate of explant is significantly lower •Need to examine the clinical course of explanted patients to provide better guidance for the decision to explant •Purpose of this study was to describe the characteristics and outcomes of patients who underwent LVAD explantationat Maine Medical Center
Printing is not supported at the primary Gallery Thumbnail page. Please first navigate to a specific Image before printing.