2020 Dental Alumna of the Year passionate about dentistry, community

Published on Thursday, February 13, 2020

By: Kate Royals, [email protected]

Dr. Barbara Mauldin, a 1984 graduate of the School of Dentistry at the University of Mississippi Medical Center and the 2020 Dental Alumna of the Year, almost didn’t become a dentist.

This is despite the fact she began her career as a dental hygienist and that her father was a dentist in her hometown of Vicksburg.

But after her husband completed graduate school while she was working, she approached him about going back to school herself. She told him she wanted to go to medical school.

He agreed, but asked why she would want to leave dentistry.

She considered her husband’s point.

“I had never given a thought to being a lady dentist because there weren’t any, to my knowledge, back in that time period,” Mauldin remembered. “I had never (considered) being the dentist and not just an auxiliary in the office.”

Woman and man hug.
Mauldin shares a hug with Dr. Kevin Holman, Dental Alumni Board president and a 1990 School of Dentistry alumnus.

That conversation would shape the rest of her life.

After returning to the University of Southern Mississippi to complete her degree and prerequisite courses, she applied and interviewed for a spot in the dental school along with her older brother.

She began dental school at 24 years old as one of five women in a class of 50.

“I’ve always felt as if I’ve been blessed by God with giving me the idea of pursuing dentistry,” she said.

She said times were different then, but the education she received was superior.

“I remember being at one of the clinics with one of these graduates (a resident from another school), and he was asking me, as a junior, how to do certain procedures. He didn’t know what I already knew and I’d only had two years to his four,” she remembered. “I thought at that moment, ‘I’m in a very, very good school.’”

Her education has served her well, she said. She has run her own practice in Petal since 1984 while remaining involved in her community, raising four children of her own and a foster son and taking on leadership roles in organized dentistry.

She is currently the president of the Mississippi Dental Association, where she was the first female dentist to become Speaker of the House in 2007. 

Dr. Butch Gilbert, professor emeritus in the School of Dentistry, was one of Mauldin’s teachers during dental school.

Portrait of Dr. Butch Gilbert
Gilbert

“Barbara came to the dental school as a dental student with high academic abilities, leadership skills and commitment to service. That has translated into what she has accomplished in her practice and community through the years,” said Gilbert. “Her integrity, compassion for others and leadership abilities make her a wonderful role model for dental students and young dentists. As to her accomplishments and values, she is what the Alumnus of the Year award represents.”

As Gilbert and those who know Mauldin will say, community and service are important to her, values for which she credits her parents.

“One of the things I learned from my parents is communities don’t just happen,” she said, explaining how she watched her father in his dentistry practice in Vicksburg.

As soon as she opened her own practice, she joined the Petal Chamber of Commerce. When Rotary Club began accepting women, she joined her local chapter and became president in 1999. She is now involved with the organization at the district level, which spans southeast Mississippi and southeast Louisiana, including New Orleans. 

She has been on mission trips to Nicaragua, Honduras, Peru and Nepal. She was involved in the creation of the Fellowship Health Clinic in Hattiesburg. The clinic provides medical, dental and pharmaceutical care to uninsured and underinsured people in Forrest and Lamar counties, and Mauldin performs free tooth extractions for patients who are referred to her from the clinic. 

Portrait of Dr. Barbara Mauldin and Dr. Charles Harrell.

Mauldin poses with her friend and colleague, Dr. Charles Harrell, a 1990 School of Dentistry graduate and a fellow dentist in Petal.

Her dedication to service is what prompts Dr. Charles Harrell, a fellow dentist in Petal, to describe her as “very kindhearted and passionate about what she does.”

Harrell, a 1990 graduate of the School of Dentistry, remembers how Mauldin took him under her wings when he first started his practice just down the street from her practice.

“She’s done a lot for the dental profession and works to provide better patient care,” said Harrell, referring to her longtime involvement with the Mississippi Dental Association.

Mauldin was honored during the annual Dental Alumni and Friends dinner on Friday.

“It really does mean a lot to me,” said Mauldin. “I’ve had a lot of accolades over the years, but to be recognized by my peers is something that stands out to me.”

Original Article

Source

ER Goddess: Physicians Must Demand Accountability from EMRs

Wolters Kluwer Health

JavaScript Error
JavaScript has been disabled on your browser. You must enable it to continue. Here’s how to enable JavaScript in the following browsers:

Internet Explorer

  1. From the Tools menu, select Options
  2. Click the Content tab
  3. Select Enable JavaScript

Firefox

  1. From the Tools menu, choose Internet Options
  2. Click the Security tab
  3. Click Custom Level
  4. Set Active Scripting to Enable

Safari

  1. From the Edit menu, choose Preferences
  2. Click the Security tab
  3. Select Enable JavaScript

Original Article

Source

Chronic Disease Decision Making and “What Matters Most”

The increasing use of the question, “What matters most to you?” is a welcome development in the effort to provide patient‐centered care. However, it is difficult for clinicians to translate answers to this question into treatment plans for chronic conditions, including recognizing when to consider options other than clinical practice guideline (CPG)–directed therapy. Goal elicitation is most helpful when a patient has different treatment options with clearly identifiable trade‐offs. In the face of trade‐offs, goal elicitation helps patients to prioritize among potentially competing outcomes. While decision aids (DAs) focus on trade‐offs by delineating options and outcomes, the robust outcome data necessary to create DAs for older patients with multimorbidity are often lacking and even mild cognitive impairment makes the use of DAs difficult. The challenges for providing chronic disease care to older patients who are at risk for adverse events from CPG‐directed therapy because of multimorbidity and/or frailty are to organize the complexity of individual combinations of diseases, conditions, and syndromes into common sets of trade‐offs and to identify those goals or priorities that will directly inform a plan of care.

Source

Photos: 340 JPS students receive free dental care during Give Kids a Smile

Published on Monday, February 10, 2020

School of Dentistry students and faculty welcomed and treated nearly 400 elementary school students from the Jackson Public School District last Friday during the 14th annual Give Kids a Smile event.

The children received free dental treatment in the form of cleanings, fluoride treatments and sealants, and dental students, in return, got needed experience and a chance to give back to their community. Plus, they had fun: many School of Dentistry students dressed up as tooth fairies and wore colorful costumes to amuse the sometimes nervous child.

The American Dental Association began the Give Kids a Smile program in 2003 as a way for dentists to join with the community to provide dental services to underserved children. In 2017, the School of Dentistry incorporated Give Kids a Smile into a new, weeklong effort providing care to underserved and uninsured adults and veterans from across the state called Dental Mission Week.

Girl in yellow dental glasses looks at her teeth in mirror.

Ivori Williams inspects her newly cleaned teeth.

Dental student brushes girls teeth.
Ali Bounds, a fourth-year dental student, brushes Tamyra Austin’s teeth.
Close up of dental student working with patient in foreground.

Justin Starnes, a second-year dental student, finishes a cleaning.

Dental student looks on as her professor checks out a pediatric patient.

Lakymberya Buckner, a third-year dental hygiene student, watches Dr. Bill Boteler, an assistant professor of dentistry, prepare to check Williams’ teeth.

Two dental hygiene students lean out of interior office window.

Emily Revette, left, and Ashtin Hunter, fourth-year dental hygiene students, await the arrival of more JPS students.

Close of up patient with dental tools in mouth.

Cortez McGee receives a fluoride treatment.

Man in blue scrubs, center, looks at child and dental student in foreground.

State Sen. Hillman Frazier, a regular attendee and supporter of Dental Mission Week, observes a child being treated during the Give Kids a Smile event.

A patient, center, looks up at Dr. Woodward as she chats before two dental students on the left and right begin work.
Dr. LouAnn Woodward, standing center, UMMC vice chancellor for health affairs, gives a few words of encouragement to Ja’Niya Flemmons before getting the JPS student gets her teeth cleaned by Lien Huynh, left, a fourth-year dental hygiene student, and Ashlynne Baney, a third-year dental hygiene student.
Student in a gold hat laughs.

Louis Montgomery III, a fourth-year dental hygiene student, shares a laugh with his fellow students.

Two dental students lean over a pediatric patient while working.

Brandon Bouldin gets a cleaning with the help of Montana Mills, left, a fourth-year dental hygiene student, and Alexis Hollingsworth, a third-year dental hygiene student.

Girl in gold cape.

Jackie McGrath, a first-year dental student, entertained and played with JPS students in the dental clinic’s waiting room.

Dental hygiene student with pediatric patient.

Rebecca Jenkins, a fourth-year dental hygiene student, finishes McGee’s cleaning.

Two dental students work on pediatric patient between them.
Brooke Barnes, a dental assisting technology student at Hinds Community College, and Trent Johnson, a third-year dental student at UMMC, work on Christopher Bouldin’s teeth.
Dental students high five elementary students.
First-year dental students, from left, Will Allen, Julianna Woodward, Kaeton Long and Codi Ballard give high-fives to Johnson Elementary School students.
Two women pose for portrait in front of dental clinic doors.

Jessica Edwards, left, community relations liasion for Garner Dental Group, and Shirley Hamm, marketing director for Garner Dental Group, show up in support of Give Kids a Smile. Garner Dental Group donated $20,000 to GKAS this year.

Original Article

Source

Second Opinion: It’s Probably Nothing

Wolters Kluwer Health

JavaScript Error
JavaScript has been disabled on your browser. You must enable it to continue. Here’s how to enable JavaScript in the following browsers:

Internet Explorer

  1. From the Tools menu, select Options
  2. Click the Content tab
  3. Select Enable JavaScript

Firefox

  1. From the Tools menu, choose Internet Options
  2. Click the Security tab
  3. Click Custom Level
  4. Set Active Scripting to Enable

Safari

  1. From the Edit menu, choose Preferences
  2. Click the Security tab
  3. Select Enable JavaScript

Original Article

Source

The Prevention of Cardiovascular Disease in Older Adults

Cardiovascular disease (CVD) is common in older adults. CVD is a significant cause of both death and disability in old age. Though the prevention and treatment of CVD have been extensively studied, historically older adults and especially those older than 75 years have been underrepresented in clinical investigations designed to determine the best way to prevent or treat CVD. As a result, geriatrics clinicians frequently need to decide which interventions to recommend for their patients by extrapolation from existing data, which may or may not be applicable to the patients they are caring for. This narrative review summarizes existing data regarding the prevention of three common CVDs in older adults: stroke, coronary artery disease, and peripheral artery disease. Special emphasis is given to the prevention of CVD in those aged 75 years or older.

Source

Eye care providers can often spot the unexpected during routine exams

Published on Thursday, February 6, 2020

By: Ruth Cummins, [email protected]

When a third-grader has trouble seeing the board at school, a routine visit to the eye doctor likely will end with a new pair of glasses.

For Ridgeland resident Grace Thaggard, however, the appointment revealed something much more life-changing. Dr. Kimberly Crowder, now chair of the Department of Ophthalmology at the University of Mississippi Medical Center, saw significant inflammation that immediately concerned her.

“Dr. Crowder pulled my mom aside and said, ‘I see something, and it’s worth checking out,’” said Thaggard, now a 21-year-old chemistry major at the University of Alabama-Birmingham

Portrait of Grace Thaggard
Grace Thaggard of Ridgeland is a junior at the University of Alabama-Birmingham.

Crowder referred Grace to pediatric ophthalmologist Dr. Nils Mungan, a professor in the Department of Ophthalmology. The diagnosis: Grace was positive for HLA-B27, a protein on the surface of white blood cells that places you at a higher than average risk for autoimmune diseases such as inflammation of the bones of the spine and arthritis.

Grace also was diagnosed with bilateral iritis, a swelling and inflammation in the colored ring around the pupil of the eye. That condition is often found in people who develop certain autoimmune diseases that have a possible genetic association.

A blood test pinpointed Grace’s HLA-B27, which can be genetically passed down. “I wondered if it had come from me,” said Grace’s mom, Carol Thaggard. “I knew I had something rheumatological.”

Grace’s father and Carol Thaggard’s husband, Dr. Anson Thaggard, is an associate professor in UMMC’s Department of Radiology.

Carol Thaggard was being treated by Dr. Vikas Majithia, UMMC division chief of rheumatology, for the autoimmune disorder mixed connective tissue disease. “He tested me, and I had HLA-B27,” she said. Years later, Crowder diagnosed her with iritis.

Other than the inflammation that she never felt, Grace had no symptoms when Crowder first examined her. HLA-B27 is just one example of conditions that an ophthalmologist or optometrist can detect or suspect from a routine eye exam, Crowder said.

“I don’t think that I will ever stop being amazed that I find the unexpected on eye exams,” Crowder said.

Patients can learn for the first time they have one of an array of conditions or diseases – diabetes being a frequent one – thanks to an eye exam. High blood pressure, autoimmune diseases, sexually transmitted diseases and some cancers are among conditions that can come to light during an exam, in addition to warning signs that a patient may be at high risk for stroke.

The eye is the only place in the body where a doctor has an unobstructed view of blood vessels, nerves and connecting tissue without performing surgery. They use special instruments and powerful lenses to examine the front and the back of the eye, looking carefully for conditions that can affect each of those areas.

It’s why the American Academy of Ophthalmology on its website calls an eye exam “a window to our soul and body’s overall health.”

Portrait of Roya Attar
Attar

Dr. Roya Attar, an optometrist and assistant professor of ophthalmology, remembers examining a healthy patient who was experiencing vision changes. As Attar peered into the woman’s fundus, or the back part of the eye, “I noted that she had a unique bleeding pattern in her eye,” Attar said. Retinal hemorrhages with a white center, known as Roth spots, are relatively rare.

Concerned, Attar referred her patient to UMMC retinal specialist Dr. Brian Tieu, assistant professor of ophthalmology. Following that retinal consult and a medical workup, the patient was diagnosed with multiple myeloma, a serious blood cancer. Because the eye exam resulted in the cancer being discovered early, Attar said, “her survival rate improved dramatically.”

In many cases, patients don’t seek out an eye professional unless they’ve noticed a change in their vision or have significant eye irritation or pain, Attar and Crowder say. “And unfortunately, the majority of patients don’t have regular annual eye exams, despite the universal sentiment that sight is our most treasured sense,” Attar said.

Patients also may not realize that blurred vision, eye irritation and redness can’t always be remedied by glasses or over-the-counter eye drops, Attar said. They can be clues that a patient has a far more serious eye or other health condition, such as diabetes, one of the most common causes of blindness worldwide. Diabetic retinopathy, a complication of diabetes, is the top retinal vascular disease.

Signs a patient could have diabetes include sudden shifts in a patient’s eyeglasses prescription or sudden blurred distance vision. Attar advises such patients to see their primary care physician for an evaluation of their blood sugar and other diabetic markers before their eye care provider prescribes glasses.

In Grace Thaggard’s case, the partnership between Department of Ophthalmology providers and those in other Medical Center specialties was critical to her treatment, which continues today. Grace also saw Majithia, who placed her on medications to control the autoimmune issues associated with HLA-B27.

Make no mistake: An eye exam should never replace the need for patients to regularly see their primary care provider, Crowder said. “I am not a primary care doctor, and I will never have that knowledge and expertise without going back to repeat residency training,” she said.

If Mississippi is going to make an impact on chronic diseases like obesity and diabetes that place the state “in the top 10 on all the wrong lists,” Crowder said, primary and population health programs must vastly improve.

“If I’m diagnosing diabetes in an adult, then the system is very broken, because once I see diabetes in the eyes, the patient has had the disease undiagnosed for quite some time,” she said. “The focus has to be shifted to prevention. I agree with appropriate referrals to eye doctors for many disease processes, but it upsets me to see the current system is failing our population.

“The answer is not, and never will be, ‘Get more eye exams.’”

Her parents’ diligence in ensuring she get good eye care, however, made all the difference for Grace.

Being diagnosed in elementary school “was a lot,” she said. “Your main fear as a third-grader is going blind. It was overwhelming at first, but I knew that if it had been untreated, you could have degenerative effects.”

She managed her condition with steroid drops until they eventually caused problems with the pressure in her eyes. On her current medications from Majithia, “I haven’t had a flare-up in three years, and I haven’t had to use the drops.”

A UAB junior, Grace is studying German and forensic science in addition to chemistry, with plans to pursue her doctorate in inorganic or environmental chemistry.

“The good news is it doesn’t hurt,” she said of her condition. “The bad news is that my body isn’t going to give me warning that something is wrong. That’s why I go to the eye doctor every six months and have bloodwork.

“But had I not had problems seeing the board as a third-grader, I don’t know when we would have figured this out. The main problem had nothing to do with my eyes.”

Original Article

Source

Myths in Emergency Medicine: Still Prescribing Oseltamivir?

Wolters Kluwer Health

JavaScript Error
JavaScript has been disabled on your browser. You must enable it to continue. Here’s how to enable JavaScript in the following browsers:

Internet Explorer

  1. From the Tools menu, select Options
  2. Click the Content tab
  3. Select Enable JavaScript

Firefox

  1. From the Tools menu, choose Internet Options
  2. Click the Security tab
  3. Click Custom Level
  4. Set Active Scripting to Enable

Safari

  1. From the Edit menu, choose Preferences
  2. Click the Security tab
  3. Select Enable JavaScript

Original Article

Source

Sex Differences in Dementia Primary Care Performance and Health Service Use: A Population‐Based Study


OBJECTIVES

Growing evidence points to underlying sex differences in the risk factors and clinical presentation of dementia. It is unclear, however, whether sex differences also exist in the management and healthcare utilization of persons with dementia. We compared primary care performance and health service use indicators for newly identified men and women with dementia in Ontario, Canada, over a 12‐year period.

DESIGN

Population‐based, repeated cohort study between 2002 and 2014.

SETTING

Ontario, Canada.

PARTICIPANTS

A total of 318 350 community‐dwelling adults, aged 65 years and older, newly identified with dementia, followed for up to 1 year.

MEASUREMENTS

Eighteen indicators of primary care performance and health service use were assessed.

RESULTS

Approximately 60% of the study population were women. Few differences in the indicators were observed between sexes, although men had fewer diagnoses first recorded by the family physician, more visits to noncognition specialists, less use of home care, more hospitalizations and readmissions, and longer discharge delays. Most indicators remained relatively stable over time for both men (median relative change = 13.7%; interquartile range [IQR] = 4.5%‐29.7%) and women (median relative change = 15.7%; IQR = 5.9%‐31.5%). Notable improvements over time for both sexes included access to an interprofessional primary care team, use of home care, and decreased use of long‐term care. Areas of worsening included a higher occurrence of emergency department visits, lower continuity of care, and longer discharge delays.

CONCLUSION

These findings raise awareness on the similarities and differences in management and health system use for men and women newly diagnosed with dementia, particularly the imbalance in hospital and home care use. As health systems continue to adapt to meet the needs of the growing dementia population, policy makers and clinicians should be mindful to develop care plans and interventions that consider the influence of sex on the need for services.

Source

Nursing alum receives national award for diabetic peds work

Published on Monday, February 3, 2020

By: Kate Royals, [email protected]

Dr. Katelyn Armstrong has a particular passion for the patients she works with as a nurse practitioner at the University of Mississippi Medical Center – because she’s been in their shoes.

When the UMMC Center for Telehealth approached Armstrong and her colleagues in the pediatric endocrinology clinic, she saw an opportunity. Armstrong, who has been working with diabetic patients in the clinic since 2014, translated the partnership into her project while in school for her Doctor of Nursing Practice degree.

That project, “The Impact of Remote Patient Monitoring on Pediatric Patients with Diabetes,” made her the only D.N.P. student in the nation to receive the American Association of Colleges of Nursing’s Excellence in Advancing Nursing Practice Award this year.

Armstrong has plenty of personal experience with diabetes. At 16, she was diagnosed with type 1 diabetes. As a child, she watched her father cope with the disease. 

The firsthand knowledge makes her an exceptional, and unique, provider, and is the reason she enrolled at the University of Mississippi School of Nursing for her Bachelor of Science in Nursing when she was 20 years old. Over the next 11 years she continued her education while working and received all three of her degrees from UMMC.

“I just felt like having been there, I could help other people … I think especially for a younger patient, coming from someone who’s been through what you’re going through (is different) than someone just saying  ‘You should do this, you should do that,’” she said. “I try to level with them.”

From left to right, AACN Board Chair Ann Cary, Katelyn Armstrong and AACN President and CEO Deborah Trautman share a smile as Armstrong displays her award.
Ann Cary, left, AACN board chair, and Deborah Trautman, right, AACN president and CEO, share a smile with Armstrong after presenting her with the award.

But Armstrong is also aware that working with her patients is about more than just making sure they know what to do.

“With diabetes, you have to have a passion for it … it’s easy to just say, ‘if you don’t do these things then too bad, I can’t help you,’” she explained. “But it’s a lot more than the patient knowing what to do. It’s figuring out what the barriers are in their life.”

For example, a teenager who may not want his friends to know he has the disease.

Or a young child whose family struggles to afford healthy foods.

“There are lots of different things you have to consider when you’re managing diabetes – and you’re working with the whole family unit,” Armstrong said.

In her project, Armstrong looked at two years’ worth of data from the partnership with her clinic and the Center for Telehealth in which 89 diabetic patients received a glucose monitor that connects to an iPad. The iPad communicates blood sugar readings to the Center for Telehealth and also contains educational modules for patients. 

The results showed the tool worked.

Overall, there was a decrease in hospital and emergency room visits and a decrease in patients’ hemoglobin A1C levels, which measures a person’s average level of blood sugar over the past two to three months.

While patients were using the iPads for remote-patient monitoring and sending in their information, nurses and staff at the Center for Telehealth had a protocol for when to call Armstrong and other providers and when to recommend an emergency room visit or to call 911.

The system also allowed Armstrong and her team to intervene in a preventative way.

“Even if we just noticed a trend in (a patient’s) blood sugar being higher or lower, we could look at it and make insulin adjustments in between visits” every three months, she said.

Portrait of Michelle Palokas
Palokas

Dr. Michelle Palokas, assistant professor and director of the DNP program, is one of the faculty members who nominated Armstrong.

“She improved care for the diabetic patients she sees in clinic,” said Palokas.

And although the project is complete and she graduated with her doctorate, Palokas doesn’t expect Armstrong to ever quit trying to improve how she cares for patients.

“I think she’s going to be very influential and always look for things that need to be changed or improved – and she will lead those changes. I really believe that,” Palokas said.

Armstrong said she is indebted to the School of Nursing for the education it offered her.

“I feel like I kind of grew up here,” Armstrong, who received her bachelor’s, master’s and doctoral degrees at the School of Nursing, said. “The faculty at the SON is so wonderful. That’s so important when you’re in school, to have people who support, guide and help you.”

Armstrong received the award at the AACN’s Doctoral Education Conference on Friday in Naples, Fla.

Dr. Ann Cary, chair of AACN’s Board of Directors, called Armstrong’s work “groundbreaking” and “innovative.”

“AACN is pleased to recognize Dr. Katelyn Armstrong from the University of Mississippi with the 2019 Outstanding DNP Project Award for her groundbreaking work in the area of remote monitoring of pediatric patients with diabetes,” said Cary.  “Her innovative work serves as a model for other DNP students who are working to translate the latest scientific evidence related to safe patient care into contemporary nursing practice.”
Original Article

Source