Defining the Domain of Geriatric Medicine in an Urban Public Health System Affiliated with an Academic Medical Center

The American Geriatrics Society has recommended a reexamination of the roles and deployment of providers with expertise in geriatric medicine. Healthcare systems use a variety of strategies to maximize their geriatric expertise. In general, these health systems tend to focus geriatric medicine resources on a group of older adults that are locally defined as the most in need. This article describes a model of care within an academic urban public health system and describes how local characteristics interact to define the domain of geriatric medicine. This domain is defined using 4 years of data from an electronic medical record combined with data collected from clinical trials. From January 2002 to December 2005, 31,443 adults aged 65 and older were seen at any clinical site within this healthcare system. The mean age was 75 (range 65–105); 61% were women; 35% African American, and 2% Hispanic. The payer mix was 80% Medicare and 17% Medicaid. The local geriatric medicine program includes sites of care in inpatient, ambulatory, nursing home, and home-based settings. By design, this geriatric medicine clinical practice complements the care provided to older adults by the primary care practice. Primary care physicians tend to cede care to geriatric medicine for older adults with advanced disability or geriatric syndromes. This is most apparent for older adults in nursing facilities or those requiring home-based care. There is a dynamic interplay between design features, reputation, and capacity that modulates volume, location, and type of patients seen by geriatrics

An Exploratory study of compliance with dietary recommendations among college students majoring in health-related disciplines: application of the transtheoretical model

Compliance with food group and nutrient recommendations, and self-efficacy, stage of change, perceived barriers and benefits for healthy eating were assessed among a convenience sample of college students majoring in health-related disciplines. Dietary and psychosocial data were collected using three-day food records and scales, respectively. Means (SD), frequencies, and percents were calculated on all data, and logistic regressions were used to determine whether any of the psychosocial correlates predicted the stage of change for healthy eating. Noncompliance with food group recommendations ranged from 53% for the meat/meat alternates group to 93% for the vegetables/juice group, whereas noncompliance with nutrient recommendations ranged from 26% for cholesterol to 99% for potassium. A majority of students (57%) self-classified in the preaction and 40% in the action stages of change for eating healthy. The students' self-efficacy to eat healthy was highest in positive/social situations and lowest when experiencing emotional upset. The most important perceived barrier to healthy eating was that friends/roommates do not like to eat healthy foods, and the most important perceived benefit was that eating healthy foods provides the body with adequate nutrients. The difficult/inconvenient self-efficacy subscale predicted the stage of change for healthy eating. These students would benefit from interactive learning opportunities that teach how to purchase and prepare more whole grain foods, fruits, and vegetables, enhance their self-efficacy for making healthy food choices when experiencing negative emotions, and overcome perceived barriers to healthy eating

Debunking myths of protocol registration

Developing and registering protocols may seem like an added burden to systematic review investigators. This paper discusses benefits of protocol registration and debunks common misperceptions on the barriers of protocol registration. Protocol registration is easy to do, reduces duplication of effort and benefits the review team by preventing later confusion

COVID-19_Covid Vaccine Education Webinar

Video of Vaccine Education Webinar a collaboration between the UMaine Institute of Medicine, Innovative Media Research and Commercialization Center, and Northern Light Health. The webinar was moderated by Kelley Strout, PhD, Director of the UMaine School of Nursing and included the following panelists: Jim Jarvis, MD, Northern Light Health Lisa Letourneau, MD, MPH, Department of Health and Human Services Laura Blaisdell, MD, MPH, Maine Health Included as supplemental content is a screenshot of a webpage with details regarding the webinar

UMaine Institute of Medicine Lecture Series, Spring 2024

The Spring 2024 Lecture Series hosted by the University of Maine Institute of Medicine. Aging Well in the Pine Tree State: Lessons Learned from the Research, Lenard Kaye, Ph.D., Center on Aging Panic: The Untold Truths: Kelly R. Klein, MD, MPH, FACEP, Northern Light Eastern Maine Medical Center Cultural Competence in Nursing: Colleen Marzilli, Ph.D., DNP, MBA, APRN, FNP-BC, University of Maine School of Nursing Thrive and Flourish: A Holistic Approach to Nurturing Wellness and Resilience in Nursing Students through an Immersive Bridge Week Experience: Kelley Strout, Ph.D., RN, Director, University of Maine School of Nursing Precision Microbiome for Health: Jack A. Gilbert, Ph.D. The Human Microbiome and Cancer Risk: Opportunities for Prospective Studies: Emily Vogtmann, Ph.D., National Cancer Institute Antimicrobial chemicals, antimicrobial resistance, and the indoor microbiome: Erica Hartmann, Ph.D., Northwestern University PATHOME Study / One Health: Kelley Baker, Ph.D. University of Iow

UMaine Institute of Medicine Seminar Series

Promotional flyer for the University of Maine spring 2021 seminar series. The seminar series is for students, faculty, staff, healthcare providers and other members of the public interested in learning about research in medicine. Each presentation will be followed by Q&A opportunities. Moderator: David Harder, Ph.D., University Research Professor of Medicine, Director UMaine Institute of Medicine

New UMaine program addresses opioid epidemic challenges

Addressing the opioid epidemic in the United States requires expanding access to treatment and work to prevent the more than 130 deaths each day from opioid-related drug overdoses nationwide. Maine\u27s rate of fatal overdoses due to opioids - the class of drugs that include heroin and morphine as well as fentanyl, oxycodone, and hydrocodone - has increased significantly in t he last decade; with serious consequences for individuals, families, and communities

Maternal Blood Pressure in Relation to Prenatal Lipid-Based Nutrient Supplementation and Adverse Birth Outcomes in a Ghanaian Cohort: A Randomized Controlled Trial and Cohort Analysis

Background It is unknown whether prenatal lipid-based nutrient supplements (LNSs) affect blood pressure (BP). Associations between hypertension and birth outcomes using recently updated BP cutoffs are undetermined. Objectives We aimed to assess the impact of LNSs on maternal hypertension and associations between hypertension and birth outcomes. Methods Pregnant Ghanaian women at ≤20 weeks of gestation (n = 1320) were randomly assigned to receive daily 1) iron and folic acid (IFA), 2) multiple micronutrients (MMN), or 3) LNSs until delivery. BP was measured at enrollment and 36 weeks of gestation. We analyzed the effect of LNSs on BP using ANOVA and associations between hypertension [systolic BP (SBP) ≥130 mm Hg or diastolic BP (DBP) ≥80 mm Hg] and birth outcomes by linear and logistic regressions. Results Mean ± SD SBP and DBP were 110 ± 11 and 63 ± 8 mm Hg at 36 weeks of gestation and did not differ by supplementation group (SBP, P \u3e 0.05; DBP, P \u3e 0.05). At enrollment, higher DBP was associated with lower birth weight and shorter gestation; women with high DBP had greater risk of low birth weight (LBW) [risk ratio (RR): 2.58; 95% CI: 1.09, 6.08] and preterm birth (PTB) (RR: 3.30; 95% CI: 1.47, 7.40). At 36 weeks of gestation, higher SBP was associated with lower birth weight, length, and head circumference and shorter gestation; higher DBP was associated with lower birth weight and length; and women with high DBP had greater risk of LBW (RR: 3.39; 95% CI: 1.32, 8.69). Neither high SBP nor hypertension were associated with birth outcomes at either time point. Conclusions Daily provision of LNSs does not affect maternal hypertension, compared with IFA and MMN. Higher SBP and DBP are associated with a shorter gestation and smaller birth size; however, only high DBP is associated with LBW and PTB. The new BP cutoffs may help identify pregnancies at risk of adverse birth outcomes. This trial was registered at clinicaltrials.gov as NCT00970866