Medicine and Health Sciences Commons^™

Improving Pubmed For The Novice At The Expense Of The Expert: Surveying Librarians 3 Years Post-New Pubmed, Tim Kenny Mls, Heather Kemp Mlis

Maine Medical Center

Background: In 2019 PubMed, the publically accessible search interface for the MEDLINE database underwent a user interface update and overhaul. MEDLINE is the primary component of PubMed, a literature database developed and maintained by the NLM National Center for Biotechnology Information (NCBI)” (National Library of Medicine, 2022).

Methods: Using a brief web-based survey, comprised of both closed-ended and open-ended questions, health science library professionals provided feedback on the new PubMed.

How Help Provided The Pathway To Become Age-Friendly, Chesley Ferris, Anna Pleet, Emily Carter

Maine Medical Center

In assessing how the 4Ms framework applies to the Hospital Elder Life Program, we were able to target specific ways to deliver more Age-Friendly care to those enrolled in the program.

Equipping Health Professions Educators To Better Address Medical Misinformation, Brian G. Southwell, Andrea Anderson, Anne Berry, Kamilah Weems, Lisa Howley, Cristina Pelin, Maya Vasser, Michael Cassara, Marie C. Petrizzo, Samara Ginzburg, Renee Mcleod-Sordjan, Joseph Weiner, Lexie Morales, Mark Saunders, Emiri Uchiyama, Laura Fothergill, Deborah Sherman, Rebecca L. Toonkel, Alison M. Vargovich, Nicholas M. Fusco, Kelly Foltz-Ramos, Jessica Kruger, William Prescott Jr, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik, Leah Mallory, Aashna Sunderrajan, Sara Serritella, Nicole L. Pierce, Olabisi Falana, Eve Bloomgarden, Shika Jain, Lisa Mordell, Vineet Arora

Maine Medical Center

As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings …

The Rapid Increase Of Digital Resources And Research Used At The Maine Medical Center Library And The Nation: Since The Beginning Of The Covid 19 Pandemic, Maegan L. Halica

Maine Medical Center

Health science resources have increasingly become accessible to researchers, health care professionals, and health scientists. With the current technology available in the healthcare settings affiliated with all MaineHealth, authors of various publications can share their knowledge with others across the globe. The COVID 19 pandemic created a situation that not only increased the need for technological communication and accessibility at a rapid pace, but the situation also created an alternative outlet for those in a medical library to utilize needed information pertaining to their position through the crisis of the pandemic.

Finding The Right Scope: Dermoscopy For Primary Care, Peggy Cyr, Elizabeth Seiverling

Maine Medical Center

Background

• Primary care physicians (PCPs) frequently address skin concerns and perform clinical skin examinations1

• For PCPs, the use of dermoscopy has been shown to increase the sensitivity for skin cancer diagnosis compared to unassisted examinations2,3

• Prior to this study, no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy

Objectives

• To develop an expert opinion consensus statement on 2 proficiency standards for PCPs using dermoscopy

Impact Of Dermoscopy Training For Pcps On Nnb To Detect Melanoma, Madeline Prentiss, Kathryn Stevens, Henry Stoddard, Peggy Cyr, Laura Houk, Hadjh Ahrns, Elizabeth Seiverling

Maine Medical Center

The goal of this project was to analyze the impact of dermoscopy training on the number of melanocytic nevi needed to biopsy (NNB) to detect a melanoma in the primary care setting .

Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Hadjh Ahrns, Abby Markham, Elizabeth V Seiverling

Maine Medical Center

Here we present an analysis of pediatric dermatology eConsults with emphasis on dermoscopy utilization and the impact on eConsult on infantile hemangiomas (IH) management.

The Dangers Of Aces, Olivia Carey, Thea Forrest, Adna Abdi

Maine Medical Center

ACEs stands for Adverse Childhood Experiences, included (but not limited to) physical, emotional, and sexual abuse, substance abuse, neglect, dysfunctional families, and mental illness'. ACEs impacts childhood development and increases chances of future health implications.

Mapping Melanoma Risk And Locating High-Need Regions For Dermoscopy And Skin Biopsy Training, Calla Hladky, Madeline Prentiss, Henry Stoddard, Kathryn Stevens, Elizabeth Seiverling, Peg Cyr

Maine Medical Center

Background- Dermoscopy and skin biopsy trainings have been shown to help improve PCPs’ knowledge of and confidence in detecting skin cancer. The goal of this project was to determine where to focus training efforts in order to maximize our impact and reach regions that face the highest burden of melanoma in the state.

Supporting An Advanced Practice Provider (App) Residency Program, Dina Mckelvy

Maine Medical Center

No abstract provided.

Resilience Of Regional Hospital Nursing Staff Working During The Covid-19 Pandemic Measured By The Connor-Davidson Resilience Scale., Jill Petzel

Maine Medical Center

As the COVID-19 pandemic stretches on, the importance of resilience is increasing as it protects against PTSD while aiding an individual in selecting healthy coping strategies. In a study of 657 healthcare workers in New York City in April 2020, more than half of healthcare workers screened positive for acute stress (PTSD symptoms), almost half screened positive for depression, and one third screened positive for anxiety; many also reported symptoms of insomnia (Schecter et al., 2020).

Resilience is important in nursing because it ensures a viable, healthy workforce for the future. Resilience has been described as the ability to ‘bounce …

Preventing Falls-Interventions In Geriatric Psychiatry Patients: An Overview Of Current Literature, Samantha Beckwith

Maine Medical Center

PREVENTING FALLS-INTERVENTIONS IN GERIATRIC PSYCHIATRY PATIENTS: AN OVERVIEW OF CURRENT LITERATURE

Samantha Beckwith, BSN, RN, PMH-BC, P6

Background: The Inpatient Psychiatry unit at Maine Medical Center (P6) is a 21-bed unit specializing in geriatric and medical psychiatry. The majority of patients have a primary diagnosis of Dementia with Behavioral Disturbance. The unit features 12 double occupancy rooms and one single occupancy room, as well as a large activity room. Patients participate in a therapeutic milieu in which they are encouraged to interact with other patients in common areas and ambulate around the unit. The average number of patients is 19.6 …

Joint Annual Wellness Visit Scheduling, Rob Chamberlin, Jennifer Bliss, Andrea Lai, Paula Dougherty, Deb Swett, Logan Merrithew, Pam Stevens, Scott Williams

Maine Medical Center

Problem/Impact Statement: The pharmacists in Scarborough & Westbrook Primary Care conduct Medicare Annual Wellness Visits (AWVs) with a physician. The pharmacist and physician see the patient individually. The practices achieved and sustained FY18 Joint AWV volume goals through a new process to reschedule physician-only AWVs to Joints AWVs with a pharmacist. This leads to reschedule rework and reduced time practice staff have for patient care.

Enhancing Interprofessional Collaboration And Communication With Art, Amy Moore, Dina Mckelvy

Maine Medical Center

An overview of the Art & Medicine, an interprofessional program piloted by Maine Medical Center Library and Knowledge Services in the fall of 2018.The poster details learning objectives, themes and activities offered during this four session, evening event.

Northern New England Palliative Care Teleconsult Research Laboratory, Ava Daruvala, Rebecca N. Hutchinson, Eric Anderson, Paul Han

Maine Medical Center

Introduction:

• Palliative care (PC) is an approach that improves the quality of life of patients and their families.

• Delivery of PC via telehealth technology (tele-PC) has been proposed as a solution to increase access to PC in rural areas. • The feasibility, acceptability, and effectiveness of applying telehealth technology to PC remains unknown.

• The overarching purpose of the proposed study is to 1) evaluate the feasibility and acceptability of a tele-PC intervention for seriously ill patients, and 2) generate pilot data to better understand provider-patient communication during tele-PC consultations

Social Influence And Moment-To-Moment Changes In Young Adults’ Mood And Psychotic Symptoms, K Powers, K A. Johnson, M Graham, A Cloutier, K Stewart, S Lynch, D Robbins, R Mesholm-Gately, K A. Woodberry

Maine Medical Center

Background:

• Social situations can have a significant impact on young people’s mood and mental experiences.

• More specifically, we want to know how someone’s perceived social influence in social situations relates to their mood and psychotic symptoms.

• Past studies have found connections between lower perceived social status (rank, comparison, and related concepts) and psychotic symptoms anxiety, depression, and other mood related psychopathology.

• We use experience sampling methods to capture moment-to-moment changes in mood and psychotic symptoms in a variety of social settings.

Predictors For Discharge After Robotic Hysterectomy – A Retrospective Analysis, Heidi Fox, Kristiina Hyrkas

Maine Medical Center

Introduction:

Hysterectomy is one of the most common surgeries performed in the United States with more than 600,000 procedures annually . It has been estimated that in 2011, there were more than 64,000 surgeries performed in an outpatient setting. The highest rate of 0.46% (464/100,000 adult women) has been reported in Maine. The average length of stay was 0.65 days for laparoscopic and 0.79 days for vaginal hysterectomies [1]. Traditionally, hysterectomies have been performed as an inpatient procedure to manage postoperative pain and monitor complications such as bleeding, anemia and return of bowel function. Development of minimally invasive surgery techniques …

Community Oncology Clinicians’ Knowledge, Beliefs, And Attitudes Regarding Genomic Tumor Testing, Eric Anderson, Alexandra Hinton, Kimberly Murray, Hayley Mandeville, Caitlin Gutheil, Leo Waterston, Lee Lucas, Christine Duarte, Christian Thomas, Susan Miesfeldt, Petra Helbig, Andrey Antov, Jens Rueter, Paul Han

Maine Medical Center

Introduction: Genomic tumor testing (GTT) is a new technology that promises to make cancer treatment more precise. However, little is known about clinicians’ knowledge, beliefs, and attitudes regarding GTT, particularly in community oncology settings.

Per- And Polyfluoroalkyl Substances And Bone Mineral Density In Mid-Childhood, Shravanthi M. Seshasayee, Rachel Cluett, Lisa B. Rokoff, Sheryl L. Rifas-Shiman, Diane R. Gold, Brent Coull, Catherine M. Gordon, Clifford J. Rosen, Emily Oken, Sharon K. Sagiv, Abby F. Fleisch

Maine Medical Center

Background:

• Identifying factors that impair bone accrual during childhood is a critical step toward osteoporosis prevention.

• One potential risk factor not well characterized in childhood is the role of chemicals in the environment.

• Perfluoroalkyl substances (PFASs) are synthetic additives used to make clothing, furniture, and cookware stain repellant and are detectable in almost all US adults.

• PFASs act as PPAR-γ agonists,2 androgen receptor antagonists, and directly intercalate into bone, raising the possibility that they may lead to low bone accrual.

• While two population-based studies in adults have shown associations between PFASs and low areal bone …

Effect Of A Robust Electronic Medical Record Order Set On Hepatitis C Screening Rate At A Community Hospital, Hannah Olsen, Caroline Knight, Harold Van Lonkhuyzen

Maine Medical Center

Background:

Hepatitis C Virus (HCV) infection is a liver infection that typically begins as an acute infection and if left untreated, can become a chronic infection. One-time HCV testing is recommended by the CDC and United States Preventive Services Task Force (USPSTF) for asymptomatic individuals based on evaluated exposure or other circumstances that increase HCV exposure (HCV Guidance, 2018); (CDC, 2012). Patients with severe mental disorders, such as schizophrenia and bipolar disorders are particularly at risk for HCV infection with past studies finding approximately 6.2 - 29.8% of patients with severe mental disorders having comorbid HCV (Ayano et al., 2018) …

Characteristics Of Inpatients With Opioid Use Disorder Seen By “Imat” Consult Service From 7/2016 - 6/2017, Katherine Nenninger, Jenny Carwile, Jonathan Fellers, Kinna Thakarar

Maine Medical Center

Introduction:

• For people with opioid use disorder (OUD), admission to the hospital can provide an opportunity to initiate substance use disorder (SUD) treatment and preventive care

• In 2016, a multidisciplinary “IMAT” (integrated medication for addiction treatment) inpatient team was established to help treat patients with SUD

Neurocardiac Risk Stratification 6 Hours After Resuscitation From Cardiac Arrest, A Bilkanovic, Z Haxhija, L Lucas, J Dziodzio, R R. Riker, T May, H Friberg, D B. Seder

Maine Medical Center

Introduction:

• An increasing number of patients are resuscitated from out-ofhospital cardiac arrest. Triage to optimal treatment pathways could improve and increase the efficacy of post-resuscition care.

• Despite great variability in etiology, duration, and patterns of injury from cardiac arrest, post-resuscitation treatment guidelines emphasize standard treatments. We hypothesize that by categorizing competing risks very early after resuscitation, it may be possible to improve the efficacy and efficiency of care.

• When measured very early after resuscitation, suppression ratio (SR, the percentage of suppressed EEG), correlates with severity of brain injury and the likelihood of poor neurological outcome.

• The …

Analysis Of Anti-Diabetic Exosomes Secreted From Beige Adipocytes, Rachelle Mendola, Chad Doucette, Daniel Nguyen, Su Su, Aaron Brown

Maine Medical Center

Accumulation of excess fat in white adipose tissue is associated with an increase in risk for type 2 diabetes. Within white fat tissue resides a population of “beige” adipocytes that are activated by cold exposure and expend energy contained in fats, which is released as heat. Increasing energy expenditure through beige adipocyte activation has been shown to reduce diabetic symptoms in rodent models of obesity. However, activation of beige adipocytes through exposure of humans to cold temperatures is uncomfortable and likely not a realistic strategy to control body weight. In addition to its fat burning potential, secreted factors derived from …

Potential Of Vascular Endothelial Growth Factor As A Biomarker Of Coronary Artery Disease In Subjects Undergoing Cabg Surgery, Teaka Jackson, Sarah Peterson, Amanda Favreau-Lessard, Joanne Burgess, Susan Bosworth-Farrell, Robert S. Kramer, Douglas B. Sawyer, Sergey Ryzhov, Michael P. Robich

Maine Medical Center

Introduction:

• Coronary artery disease (CAD) causes local hypoxia due to reduced blood flow

• Hypoxic conditions are known to induce vascular endothelial growth factor (VEGF) production, a key contributor to angiogenesis

• The purpose of this study was to determine the potential of VEGF as a marker of myocardial stress in subjects with CAD undergoing coronary artery bypass grafting (CABG) surgery

The Relationship Between Uncertainty Tolerance And Oncologists’ Perceptions Of Large-Panel Genomic Tumor Testing, Eric Anderson, Alexandra Hinton, Christine Lary, Kimberly Murray, Leo Waterson, Paul Han, Maine Cancer Genomics Initiative

Maine Medical Center

Introduction:

Large-panel genomic tumor testing (GTT) is a new technology that promises to make cancer treatment more precise, but that currently poses many uncertainties regarding its clinical value and appropriate use. Uncertainty Tolerance (UT), a psychological construct that describes trait-level differences in individuals’ responses to uncertainty, may influence oncologists’ perceptions and attitudes regarding GTT.

What’S Happening To Our Patients In Their Final Year Of Life?, Teresa Letellier, Amy Haskins, Christina Holt

Maine Medical Center

We want to “die well” which includes:

• Effective symptom management

• Receiving care consistent with wishes Who achieves this, and how?

• Primary care physicians (PCPs) – Insufficient time and training

• Palliative care physicians – Better quality care and decreased health care cost in last years of life

• “Surprise Question” – “Would you be surprised if this patient dies in the next year?”

• To recognize our sickest patients and discuss goals of care and consult palliative care, if appropriate • “Advance care planning tab” – To record code status, advance directive, POLST forms, medical power of …

Identifying Youth At Clinical High Risk: What’S The Emotional Impact?, K A. Woodberry, K S. Powers, C Bryant, D Downing, M Verdi, L Kennedy, D I. Shapiro, R Girgis, G Brucato, D Huang, F M. Crump, C M. Corcoran, L I. Seidman, B Link, W R. Mcfarlane, L Yang

Maine Medical Center

Background:

Early intervention in major mental illness promises to improve the lives of those identified.

• But could identifying youth as at clinical high risk (CHR) for psychosis also do harm given that the majority never develop a psychotic disorder?

• Could telling someone they are at risk for psychosis activate internalized stigma that has been associated with increased emotional distress, social withdrawal, non-engagement in treatment, and suicide risk in CHR youth?

• Within the context of a larger study of stigma in CHR, we compared emotional responses to the CHR concept assessed before and after clinical feedback by study …

Getting Personal With Dementia: Physician Assistant Student Virtual Reality Immersion, Diane Visich, Dana Vilmore, Elizabeth Dyer

Maine Medical Center

Introduction:

Approximately 5.7 million people in the United States are living with dementia, with numbers expected to rise to 13.8 million by 2050 As prevalence grows, it is crucial to train future providers to meet the complex and diverse needs of patients and caregivers. Virtual reality (VR) is a growing tool in medical education, but few studies explore this tool for dementia education. One study found VR had a positive impact on medical and pharmacy students’ knowledge and attitudes toward people with dementia.Another study found VR increased the understanding and empathy in medical and physician assistant (PA) students for adults …

Prions To Pathways: Safeguarding Against Creutzfeldt-Jakob Disease In The Operating Room, Jessica Mary Adams Atkinson, Sonja Carol Orff

Maine Medical Center

Introduction:

As defined by the Center for Disease Control (CDC, 2018), Creutzfeldt-Jakob Disease (CJD) is a rapidly progressive, rare, transmissible, and fatal illness. Miscoiling of healthy proteins caused by an abnormal isoform of cellular glycoprotein resulting in protein folding has been found to be the molecular mechanism during the pathological process of this malady (Figure 1), (Castle, Gill, 2017). The current problem is that few recommendations are available for organizations to consider how to manage potential CJD patient cases, and institutions are left to compile and develop their own guidelines and/or protocols for clinical practice. The standards of care for …

Reducing Catheter Associated Urinary Tract Infections (Cauti) By Decreasing Use Of Indwelling Catheters, Joanne Chapman, Brenda Clark, Brian Jumper, Carrie Strick

Maine Medical Center

Background:

Catheter Associated Urinary Tract Infections (CAUTI) are considered a preventable hospital-acquired infection [2]. Centers for Medicaid and Medicare no longer reimburse hospitals for preventable CAUTIs [2]. A concerted effort to decrease our indwelling urinary catheter (IUC) rate has led to a decrease in the number of infections related to these catheters at Maine Medical Center (MMC) in Portland, Maine. Starting in 2012 as a result of The Joint Commission National Patient Safety Goal, the inter-professional CAUTI committee focus has been on decreasing utilization of IUC[1]. After an initial large decrease in utilization, the rates have flattened. The effort over …