Medicine and Health Sciences Commons^™

An Assessment Of The Needs Of Maine Primary Care Providers Relating To Tobacco Prevention, Assessment, And Treatment Of Lgbtqia+ Youth And Young Adults, Logan Gerchman, Sarah M. Gabrielson, Toni Eimicke, Brandy Brown

Costas T. Lambrew Research Retreat 2024

Most primary care providers in Maine ask youth about tobacco use but don’t adjust strategies for LGBTQIA+ youth.

Most want LGBTQIA+ specific resources for smoking prevention and cessation.

Understanding Inpatient Diagnostic Imaging Use In Children’S Hospitals To Prioritize Stewardship Efforts, Megan Collins, Matt Hall, John R. Stephens, Jessica Markham

Posters

Background: Healthcare waste, including overuse of treatments or testing such as unnecessary diagnostic imaging, has estimated annual costs of over $760 billion in the United States. The most prevalent and costly imaging studies among hospitalized children are not known. Objective: To describe diagnostic imaging studies among hospitalized children with the highest prevalence, cost, rates of repetition, and hospital variation to help inform de-implementation efforts. Design/Methods: We performed a retrospective cohort study of children <18 years of age hospitalized from 1/1/2021 to 12/31/2022 across 45 hospitals in the Pediatric Health Information System. We identified all radiologic imaging for inpatient and observation encounters using billing codes. We grouped images by modality and body location, and excluded images classified as other/unspecified body location. The intraclass correlation coefficient was used to measure variation across hospitals in imaging use after adjusting for age and severity. Higher numbers indicate a higher degree of variation. Results: We identified 1,523,343 encounters; 59.1% had diagnostic imaging (Table 1). The most prevalent diagnostic imaging studies were chest x-ray (XR), abdominal XR, and echocardiogram. The images most frequently repeated were chest XR, echocardiogram, and abdominal XR. The costliest individual diagnostic imaging studies were echocardiogram, chest XR, and head/brain MRI (Table 2). Although chest XR was among the least expensive imaging modalities per unit cost, given the high prevalence of use and repeat use it was one of the costliest tests overall. Head US, interventional XR, and abdominal US had the highest variability of use between hospitals (Table 2, Figure). Conclusion(s): Chest XR and echocardiograms were among the most prevalent, costly, and frequently repeated imaging studies. Abdominal XR, abdominal ultrasound, bone/joint XR, head/brain CT, and head/brain MRI were high in both prevalence and cost among hospitalized children. Five of the 10 most commonly used imaging techniques and four of the 10 most commonly repeated imaging techniques expose children to ionizing radiation. These results could help identify areas that should be targeted to reduce radiation exposure, improve care, and decrease costs for hospitalized children.

The Association Of Season Of Surgery And Patient Reported Outcomes Following Total Hip Arthroplasty, Catherine M. Call, Andrew Lachance, Zachary Radford, Henry Stoddard, Callahan Sturgeon, George Babikian, Adam Rana, Brian J. Mcgrory

Costas T. Lambrew Research Retreat 2024

Introduction

• Understanding the impact of situational variables on surgical recovery can improve outcomes in total hip arthroplasty (THA).

• Literature examining hospital outcomes by season remains inconclusive, with limited focus on patient experience.

• The aim of this study was to investigate if there were differences in hospital and patient-reported outcomes measures (PROMS) after THA depending on the season in an area with 4 distinct seasons.

Machine Learning Approaches For Neurological Risk Stratification Within 6 Hours Of Cardiac Arrest, Richard R. Riker, Qingchu Jin, Hunter Williams, Teresa May, David Seder, Raimond L. Winslow

Costas T. Lambrew Research Retreat 2024

Background:

• Prognostication of neurological outcome should be delayed at least 72 hours after cardiac arrest. Early stratification of risk severity provides important information enabling improved medical decision making, research enrollment, and precision medicine approaches.

• We propose that electroencephalography (EEG)-derived indices are valid biomarkers of severity of neurological injury very early after cardiac arrest.

• This study was designed to assess the relative impact of early clinical data and processed EEG indices in the first 6 hours after recovery of spontaneous circulation (ROSC) after cardiac arrest.

The Impact Of Birth Volume On Neonatal Resuscitation Practices In Neonates Treated With Therapeutic Hypothermia, Allison Zanno, Matthew Ryzewski, Leah M. Seften, Anya K. Cutler, Whittney Barkhuff, Deirdre O Reilly, Jay Kerecman, Alexa Craig, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Background

• Neonatal resuscitation is a high acuity, low-occurrence (HALO) event

• Clinicians in hospitals with low birth volumes lack regular opportunities to maintain Neonatal Resuscitation Program (NRP®) skills due to low birth volumes

• Data used for this analysis was provided through the Northeast Regional Hypothermia Consortium of neonates who received therapeutic hypothermia at four northern New England tertiary care centers

• We investigated differences in resuscitative practices in hospitals with varied birth volumes.

A Retrospective Review Of Cosmetic Surgery Medical Tourism Complications During Covid-19 Pandemic, Rachel Blaisdell, Claire Mcnary, Catherine Barkach, Emanuela Peshel, Elizabeth Boudiab, Lauren Oliver, Samuel Mucci

Posters

• Cosmetic surgery medical tourism refers to traveling outside one’s geographic region for the purpose of a cosmetic procedure
• Benefits include reduced cost, shorter wait times, and newer “trendy” procedures
• Potential problems include a lack of continuity of care for patients, travel after surgery, and exposure to foreign pathogens

Heart Rate Metrics In Surgical Residents Performing An Educational Task Under Stress, Harkirat Jawanda, Kathryn K. Howard, Rose E. Callahan

Posters

Although a moderate amount of stress can be beneficial for performance, excess stress can lead to a decrease in fine motor skills, focus, decision-making skills, and communication.1-3.

• These effects can be especially detrimental in the operating room, where a stress-induced lapse in performance can lead to catastrophic outcomes for patients.
• One unique stressor experienced by surgical residents is observation by an attending surgeon during procedures, which has been shown to lead to an increase in stress related behaviors.4
• Mimicking the stress of the operating room in simulation environments presents the opportunity for residents to improve their ability to recognize and …

Comparing Plastic Surgeon Operative Time For Deep Inferior Epigastric Perforator (Diep) Flap Breast Reconstruction, Christopher J. Issa, Elizabeth M. Boudiab, Jeffrey Desano, Neil S. Sachanandani, Jeremy Powers, Kongkrit Chaiyasate

Posters

The deep inferior epigastric perforator (DIEP) flap has remained the gold standard for perforator flap reconstruction due to its consistent anatomy and low morbidity. Despite higher longterm patient satisfaction in autologous breast reconstruction compared to breast implants,1–3 implant-based reconstruction remains more common due to shorter operative time.

Several studies have examined the issue of optimizing efficiency of autologous breast reconstruction but were typically performed in the context of immediate reconstruction. In our institution and others, however, two-stage delayed reconstruction is the norm — a tissue expander is placed at the first stage for preservation of the skin envelope; after expansion …

Perioperative Antibiotic Use In Neonatal General Surgery: A Survey Of Apsa Membership, Samuel K. Osei, Ashley Williams, Diane Studzinski, Patrick Karabon, Begum Akay, Pavan Brahmamdam

Posters

• Guidelines for antibiotic prophylaxis for surgical site infection (SSI) are widely used for adult patients.
• There is limited data on prophylaxis in pediatrics, and there are no standardized guidelines for neonates.
• Perioperative antibiotic use in neonates based on the surgeon’s preference.

Emergency Department Treatment Of Elevated Blood Pressure In The Headache Patient, Lauren Eberhardt, Michelle Jankowski, Brett Todd

Posters

• Headache is an extremely common emergency department (ED) chief complaint, accounting for 1-3% of emergency department (ED) visits per year globally.
• Headache is often associated with elevated blood pressure and the most frequent clinical manifestation of hypertensive urgency, occurring in 35.9% of patients.5
• First line treatments used for acute headache management in the ED include intravenous fluid (IVF), anti-dopaminergic agents, aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), and ketorolac.6
• Rescue analgesia is needed for pain management in 16% to 18.1% of patients.8,9.
• Rescue analgesia includes: additional doses of first line analgesia or initiation of a second line medication1,6,10,11 such as magnesium sulfate, …

Characterizing The Effectiveness Of Prehospital Pediatric Pain Management In Children With Long Bone Fractures, Revelle Gappy, Ashima Goyal, John Frawley, Sariely Sandoval, Nai-Wei Chen, Remle Crowe, Robert Swor

Posters

Prehospital pediatric pain management has been poorly understood and sub-optimally treated.1-3 Pain scales for children differ from adult pain scales and it is unclear if pain assessments are well documented, particularly in infants and toddlers.4-6 Surveys of emergency medical services (EMS) personnel identify barriers to pain management including discomfort with emergency care of injured children, concern for allergic reactions, additional pain from intravenous catheter insertion, parental influence, as well as lack of knowledge and experience secondary to the relatively infrequent treatment of acutely injured children.7-9

The effectiveness of prehospital pain medication administration for children is unknown, as is the efficacy …

Vesicant Infusates Are Not Associated With Ultrasound-Guided Peripheral Intravenous Catheter Failure: A Secondary Analysis Of Existing Data, Mahmoud Hijazi, Amit Bahl, Nai-Wei Chen

Posters

With over 300 million used annually in the United States, peripheral intravenous catheters (PIVC) are the most commonly used invasive device in the acute care setting1,2. Unfortunately, PIVCs have high failure rates with up to 63% failing prematurely3,4.

Certain intravenous medications categorized as vesicants and irritants are known to cause vein and local tissue injury. The Infusion Nursing Society (INS) created this list based on infusate osmolarity thresholds that increase the likelihood of these complications5.

It is perceived the impact of these medications on larger proximal veins with higher flow rates and improved hemodilution diminishes the likelihood of these complications. …

Quantifying The Importance Of Orthopaedic Surgeon Attributes By The Public, Rasheed Abdullah, James E. Feng, Phillip Vartanyan, Hassan Alosh, Drew Moore, Leonardo M. Cavinatto, Betina Hinckel

Posters

Evaluate what surgeon attributes are currently important to our patients, and what modalities may be most effective in finding orthopaedic surgeons, using online crowdsourcing.

Operative Versus Non-Operative Treatment Of Z-Type Clavicle Shaft Fracture In Adolescents: A Retrospective Study, Sami Azeroual, Colin Van Wagoner, Jeffrey Leider, Ehab Saleh

Posters

• The clavicle is one of the most fractured bones in the human body.
• Traditional treatment involves conservative management with a sling or immobilization but recently the effectiveness of the approach has been questioned.
• Studies done on the adult population have found higher rates of mal or non-union than previously noted, especially in those with displaced or comminuted fractures.
• The noted malunion or non-union was noted to have effects on shoulder mechanics, pain with overhead activity, and loss of strength and endurance.
• Due to differences in physiology the findings in the adult studies do not necessarily translate to the pediatric population. …

The Power Of Empowerment: What Happens When We Include Patients In Nutritional Decision-Making, Katarina Konstantino Bsn, Julia Vaughan Bsn, Jennifer Hillyard Bsn

Nurse Residency

In hospitalized patients, how do personalized meal selections impact patient satisfaction and overall quality of life during hospital stays?

Call Me Telephone Triage Skills For Pediatricians Across Multiple Settings, Cody Clary, Jonathan Ermer, Rebecca Callahan, Kayla Heller, Luke Stephens, Margaret Kirkpatrick, Nehal Parikh, Cody Tigges, Madhuradhar Chegondi

Presentations

Come explore current evidence surrounding telephone triage skills across a variety of settings and learn ways to teach these valuable skills while promoting best practices. Outpatient pediatricians, hospitalists, ICU physicians and ED providers all have telephone calls incorporated into their work. Often physicians are operating with very little training in this area, and methodology about teaching these skills to pediatric trainees is limited. We will highlight educational innovations at a variety of programs designed to improve resident and fellow education, sharing our results and providing opportunities for others to design their own content relevant to their own practice. Participants will …

Variation In Systemic Corticosteroid Prescribing During Asthma-Related Hospitalizations Across Children's Hospitals, Sian Best, Matt Hall, Jessica L. Bettenhausen, Shelby Chesbro, Nicholas Clark, Megan Collins, Adrienne G. Deporre, Jonathan Ermer, Bridgette Jones, Leah Jones, Jessica Markham, Elisha Mccoy, Maria Newmaster, Laura Plencner, Henry T. Puls, Smit Shah, Kathryn Kyler

Presentations

Asthma exacerbations are a leading cause of pediatric hospitalizations, and systemic corticosteroids remain a key component of inpatient treatment. Emergency department-focused studies have shown dexamethasone to be equivalent to prednisone/prednisolone in terms of outcomes such as readmission rates, but less is known about the trends in dexamethasone use versus other systemic corticosteroids, and associated outcomes in the inpatient setting. Objective (216) To describe variability and trends in inpatient systemic corticosteroid prescribing practices for acute asthma exacerbations, and to determine associations between the prescribed steroid and hospitalization outcomes. Design/Methods (949) This retrospective cross-sectional study utilized the PHIS database to examine patients …

Nurturing Respectful Maternity Care In Rural Kenya: Assessing The Impact Of Educational Interventions On Local Healthcare Workers, Jessie Chen, Jassmine Duong, Urangoo Matthews, Avery Rocha

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Improving Knowledge Of Diabetes Self-Management In High Hba1c Diabetic Adults In Stockton, California, Alexis M. Maciel, Preet K. Grewal, Malina M. Carrillo, Jasmir A. Shergill

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Say Yes To Oral Care! A Quantitative Report On Oral Health And Education In The Unhoused Population, Kiana Correa, Sharon Lew, Brianna Satram, Ashika Singh

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Education And Bingo Exercise: Pressure Injury Reduction In An Assisted Living Facility, Emmalee Holmes, Ashley Jaynes, Annah Khan, Caitlin Thornton, Brooke Waller

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Healthy Heart And Soul: A Qualitative Report On How Faith-Based Programs Can Provide Effective Education On Cardiovascular Health, Damaris Carlson, Haley Grieger, Claire Madrona, Ingrid Scott

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Nutrition Education For Older Adults, Dan Le, Eddie Hoang, Hillary Tran, Hemza Salem, Carlos Amaya

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

Breathe Easy Project: A Quality Improvement Project On Management Of Asthma At Hoover Elementary School, Alex Butts, Jessica Leung, Jaynah Palma

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

No abstract provided.

The Impact Of Health-Related Social Needs On Health Outcomes Among Youth Presenting To A Midwest Pediatric Diabetes Clinic Network, Jasmine Roghair, Emily Dewit, Katelyn Evans, Mitchell Barnes, Heather Feingold, Samantha Jacob, Courtney M. Winterer, Jeffrey D. Colvin, Mark A. Clements, Shilpi Relan, Kelsee Halpin

Posters

Objective: Screening for health-related social needs (HRSNs) is recommended as part of routine diabetes care given the strong impact of social factors on health outcomes. Our objective was to compare diabetes-related health outcomes among youth presenting to a tertiary diabetes center based on whether they screened positive or negative for HRSNs at a routine clinic visit. Methods: Baseline data were collected from patients whose parent/guardian completed a HRSN screen as part of their child’s diabetes clinic intake from 9/1/21 to 8/30/22. The screen is a 6-item questionnaire adapted from the Accountable Health Communities HRSNs Screening Tool. Longitudinal data were analyzed …

Dental Manifestations Of A 4-Year Old Male Patient With Congenital Vitamin D Rickets: Review Of The Literature And Report Of A Case, Richard Nguyen, Robin Onikul, Brenda S. Bohaty, Neena Patel, Jenna Sparks, Amy Burleson

Posters

Patients that present with Vitamin D-resistant rickets may have abnormal tooth morphology, such as enlarged pulp horns that may extend into the dentino-enamel junction. As a result of this communication, there may be an increased chance of pulpal infection, resulting in spontaneous dental abscesses occurring without evident caries or history of trauma. The purpose of this poster is to report the case of a four-year-old patient who presented to Children’s Mercy Kansas City Dental clinic with chief concern for swelling of the face with unknown causes. The patient’s medical history was significant for congenital Vitamin D-resistant rickets. The poster presents …

February In Santiago Atitlan, Guatemala, Grace Milburn

Posters

Describes her experience working in Santiago Atitlan, Guatemala.

May 2024, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

May is Mental Health Awareness Month

• 1 in 5 U.S. adults experience a mental health condition each year.
• You are not alone on your mental health journey.
• Mental illness affects more than 50 million people in the U.S.

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Student Research Posters

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …