E-Newsletter

July-August 2009

Chapter News

• MAAP Nominated for the Outstanding Chapter Award!
  In early 2009, the Chapter was nominated with several other Chapters for the Outstanding Chapter Award. While the Chapter did not receive the award this year, we are honored to have been selected by the District Vice Chairs of the AAP for our outstanding work as a Chapter in 2008.

• Pediatric Job Board Coming Soon!
  The Chapter is in the process of creating a Pediatric Job Board on our website where you can post your resume for free or employers may post a job listing for a small fee. The job board will provide members with access to national pediatric health care job opportunities as well as those posted from Maine.

• Interested in Being a Preceptor for Medical Students?
  The Chapter has received a grant to connect medical students at UNE with practicing pediatricians for 1/2 day career shadowing opportunities. There are also opportunities to host a medical student during their 4-week rural rotations. If you are interested in participating in either of these, contact Aubrie at 782-0856 or agridleyentwood@aap.net.

• MAAP Welcomes First Intern, Brittany Roy
  This summer the Chapter is getting help from a summer intern. Brittany just finished her sophomore year at Stonehill College in Easton Mass. She is a neuroscience major and is interested in possibly becoming a pediatric nurse practitioner.

Breastfeeding and Obesity Prevention

A Press Release from the US Breastfeeding Committee

HELPING AMERICANS ACHIEVE PUBLIC HEALTH GOALS:
Breastfeeding and Obesity Prevention

Washington, DC--As the country celebrates National Public Health Week, there is much discussion of how the United States is falling behind in many important health measures, despite the fact that we spend more on health care than any other nation. Yet amid the talk about life expectancy, infant mortality, and health disparities among minority populations, the very earliest act of disease prevention--breastfeeding--is often overlooked. Click here for full article.

Breastfeeding and Oral Health

A Press Release from the US Breastfeeding Committee

THE FACTS ABOUT BREASTFEEDING AND ORAL HEALTH

Washington, DC--As the country celebrates National Children's Dental Health Month, many health care professionals, teachers, and parents are promoting the benefits of good oral health to children. Although it is easy to find accurate information about the proper way to brush and floss, parents often receive conflicting information about breastfeeding and oral health. This has presented a barrier to continued breastfeeding beyond six months of age, when an infant typically begins to develop normal oral flora (bacteria) with the eruption of primary teeth. Click here for full article.

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Transition Resource Highlight: The Service Tapestry

The Service Tapestry is an online transition resources database. It is user-friendly and contains resources for youth, family members, educators and service providers to locate supports and services within their area.

Click here to search the Service Tapestry.

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Advances in the Identification and Treatment of Childhood Behavioral Disorders: July 13-14, Waterville

Best practices and current concepts in the field of developmental and behavioral pediatrics: a two-day program for professionals working with children and teens with behavioral problems and their families.

Intended Audience: primary care physicians, nurse practitioners, physician assistants, psychologists, social workers, teachers and counselors.

Topics: Strategies that work in the home, school and community to help children and families experience their world as a better place will be provided. The program features interactive sessions, case studies, didactic and small group presentations. Topics include Anxiety Disorders which affects about 10-15% of children, OCD which affects 2-5%, Autism which occurs in 1 out of 150 children, Bipolar Disorder, environmental toxins and their effects on children, the use of SSRI's during pregnancy, the effects of maternal depression on children and families, and the use of hypnosis in a primary care physician's office.

Click here for more information.
Click here for a PDF of the brochure.

Maine Universal Screening Pilot for Autism and Developmental Delays

Dear Medical Professional:

I am writing to request your participation in a field trial to integrate an enhanced universal screening process for autism and developmental delays into medical offices when young children are seen. The field trials will be approximately six months in duration. Assessment tools will be provided at no cost.

The Legislature and the Department of Health and Human Services have determined that universal screening for autism and other developmental disabilities needs to be implemented. The goal is to determine how the State can support medical professionals integrating universal screening into their practices. These trials will provide information about how to best implement universal screening statewide.
A diverse team of medical professionals, including pediatricians, developmental specialists, general practitioners, nurse practitioners, psychologists, and professionals in the fields of social work and speech pathology met to address protocols for universal screening. The workgroup evaluated screening tools for ease of administration and cost. They made the following recommendations:

· Screen all children using the Parents Evaluation Developmental Status (PEDS) screening tool at their 9- and 18-month well-child visits.
· Screen all children using the Modified Checklist for Autism in Toddlers (M-CHAT) screening tool at their 18- and 24-month well-child visits.

According to the American Academy of Pediatrics, each of the screening tools is completed by a parent. It takes only five minutes for the parents to complete each tool and about two minutes for a medical assistant to score the assessment. The PEDS screening tool is $33.00 per pad of fifty, but as previously mentioned, they will be provided to trial participants at no charge. The M-CHAT screening tool is available at no cost.

As part of the trial, resource information will also be provided to facilitate timely referral for evaluation and services.

We hope that you will be interested in taking part in this field trial. To volunteer or request additional information contact Nancy Cronin 1-800-244-3990. Thank you for your time and consideration.

Sincerely,
Nancy Cronin
PDD Systems Change Coordinator
Nancy.e.cronin@maine.gov

M-Chat Data Entry Forms Available for EMRs!

Dr. John Vogt has developed M-Chat data-entry forms for the Electronic Medical Records system Centricity. In addition to the data-entry forms, he has created a method to print out the M-Chat forms, and many other assessments, with the patient’s name bar coded. Once the parent fills out the M-Chat – staff simply scans in the assessment and the machine attaches the assessment to the patient’s record and automatically scores it. He is also in the process of creating the forms for the ASQ-SE.

Dr. Vogt is offering this technology for free! He said that the entry forms can be quickly uploaded onto Centricity at no cost. The scanning capability requires purchasing software and a scanner (a cost of about $2,000). The data-entry forms can easily be used with, or without, the scanning capability.

If you are interested in the program or wondering if other EMRs work with the program, contact Nancy Cronin at nancy.e.cronin@maine.gov or 287-4214.

Could Medications be a Cause of the Autism "Epidemic"?

An article in the Autism Society of Maine Newsletter by Dr. Peter Bridgman suggests that medication use in pregnancy may be a cause of autism.

"Recent data analysis has shown that among antiseizure medications, Valproic Acid (Depakote, Depakene) has the highest potential to harm the developing baby.  This medication is used to control seizures, and also is effective for migraine headaches and bipolar depression. Neurologists and psychiatrists have become heavy prescribers of this drug.  A recent study in Britain showed a higher incidence of autism in children born to mothers who had taken Valproate while pregnant.  (1.)  Just this April, the New England Journal of Medicine published an article summarizing a 5 year prospective study looking at the cognitive development of babies born to mothers who had taken a single antiseizure medication while pregnant.  The outcome was substantially worse with Valproate compared to the other medications (Lamictal, Dilantin, or Tegretol).  When tested at 3 years of age, the babies born to moms who had been on Valproate had IQ scores 9 points lower than the others. (2.)" Click here for full article.

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12 Points about Lyme Disease from Dr. Bea Szantyr

1. Lyme disease is a potentially preventable bacterial infection which, in late stages, can be devastating.

 2. Lyme disease is caused by the bacteria Borrelia burgdorferi ( bor ee’ lee uh burg door’ fur eye) and is spread by the bite of an infected tick.

 3. The number of cases reported in Maine has been increasing annually and doubled between 2001 and 2002, reaching more than 200 cases per year, and again in 2007 to reach more than 500 cases per year. In 2008 there were 878 confirmed cases reported. We know that this may underestimate the true number of cases of Lyme disease by a factor of 10.

Click here for full article.

Fact Sheet on BPA and Infant Formula

To: Pediatric Health Care Providers
From: Dora Anne, Mills, MD, MPH, Director, Maine Center for Disease Control and Prevention
Date: March 1, 2009
Re: Questions and Answers about BPA and formula

In response to a number of questions on BPA (Bisphenol-A), especially from local WIC agencies and clients, the Maine CDC has developed a fact sheet on this subject that we hope will help provide some guidance for parents of young children. The Maine CDC is not promoting either the liquid concentrate or powder formula (we formerly preferentially promoted the liquid concentrate) provided by WIC. We are asking that clients make the choice of the feeding method that is best for them using this additional information and talking with their baby’s doctor if questions remain.

The fact sheet was developed primarily by staff in the Toxicology Program, WIC Program and Family Health Division at Maine CDC. If you have further questions on this subject, the fact sheet has several websites listed that may be useful. If you have questions regarding WIC policies please contact the WIC Program at 207-287-3991 or 1-800-437-9300. If you have questions regarding toxicology please contact the Environmental and Occupational Health Program at 207-287-6455 or 1-866-292-3474.

These BPA fact sheets can be obtained on our website at:
http://www.maine.gov/dhhs/wic/bpa_faq.html.

Manufacturers Consider Scare Tactics to Combat BPA Bans

Thank you to our friends at Physicians for Social Responsibility, Maine Chapter for alerting us to a recent Washington Post Article based on internal notes of a private beverage and can industry meeting held at the end of May.

" . . . frustrated industry executives huddled for hours Thursday trying to figure out how to tamp down public concerns over the chemical bisphenol A, or BPA. The notes said the executives are particularly concerned about the views of young mothers, who often make purchasing decisions for households and who are most likely to be focused on health concerns," wrote Post reporter Lyndsey Layton.

Participants at the meeting discussed a range of strategies, including scaring consumers into believing that BPA bans would result in reduced access to baby food.

Read the Washington Post story online here.

BPA, a synthetic hormone that mimics estrogen, is used to line food and beverage cans and to make hard polycarbonate plastic. Studies conducted on laboratory animals and cell cultures link BPA to breast cancer, prostate cancer, obesity, diabetes, and other illnesses, even at low doses.

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Chapter to Hold Immunization Congress: September 29, Hallowell

In parternship with the Maine Medical Association and the Maine Immunization Coalition, the Chapter will be holding an Immunization Congress on September 29th at Maple Hill Farm in Hallowell. The entire day will be devoted to immunizations but will take place in two parts. The morning will be a CME-program on responding to parents' concerns with immunizations and the afternoon will be a working session focused on financing issues. Space is limited and the afternoon session will be made up of a diverse group of people involved with immunization financing including physicians, insurors, parents, industry, legislators, state government and more. Watch for a Save the Date coming soon!

Maine CDC Seeks Info on Pediatricians' Expected Use of Influenza Vaccine

A Message from Dr. Steve Meister:

Maine AAP members,

I wanted to ask the members of the Maine Chapter to give feedback on the amount of influenza vaccine the State will to need protect children this year.

H1N1 continues to show up around New England and even here in Maine and if the CDC begins to tout the importance of protection against the flu, we could have a much larger than usual demand for seasonal influenza vaccine this fall.

Maine CDC has already ordered 140,000 doses of Thimerasol free vaccine, and we have about 280,000 kids age 6 months to 18 years eligible to get the flu shot. Last year, the VFC program distributed 80,000 doses of pediatric vaccine to community providers, so we have already ramped up the order. This may be adequate, but we would like to make certain that every parent who wants their child vaccinated will have access to a vaccine.

It's very tough to predict how much vaccine we'll need, we can guess (based on our past and the experience of other states) that about 40% of the children will get a vaccine, and a percentage of the children under 9 will require 2 doses. That puts us right around 140,000 doses. If there is an alert sent out on radio and television, we could see an increase in demand to over 50% (this has happened in other states, in
past years). We may be able to order an additional 30,000 doses of Thimerasol free vaccine. Whatever we don't use could be used by the adult population, especially the population of pregnant women. Please, let me know what you think and I'll bring your opinions to Dr. Dora Mills.

Thanks
Steve

Stephen Meister MD, MHSA, FAAP
Stephen.Meister@maine.gov
Medical Director
Family Health Division
Maine CDC
207-287-5345

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Chapter Seeks Members' Interst in Pediatric Topics for Legislative Testimony

Is there a specific pediatric topic that you are an expert on or have a passion for? If so, we want to know! The Chapter will be updating its key contacts listing and would like you to be on it. Also, if you are willing to provide legislative testimony on a specific topic we would like to know. Please contact Aubrie at agridleyentwood@aap.net if you want to be on our internal key contacts listing.

Insurance Coverage for Medically Necessary Infant Formula Now Required

On January 1, 2009 Public Law 595 went into effect requiring all individual health insurance policies, contracts and certificates to provide coverage for amino acid-based elemental infant formula for children 2 years of age and under. For more information, visit www.bbphi.com.

Chapter Successful in Helping to Eliminate Smoking in State Parks

At the Fall 2008 Membership Meeting, Chapter Member, Dr. Rosalinda Maraya suggested the Chapter make it a legislative priority to eliminate smoking on beaches and the membership in attendance agreed. Through the work of the Maine Medical Association, the Chapter advocated on behalf of "An Act to Protect Maine's State Parks and State Historic Sites". The act was passed by the legislature and signed into law by Governor Baldacci on May 1, 2009 and took effect immediately. The law states that "A person may not smoke tobacco or any other substance in, on or within 20 feet of a beach, playground, snack bar, group picnic shelter, business facility, enclosed area, public place or restroom in a state park or state historic site."

Chapter Successful in Establishing Workplace Breast Pumping Law

"An Act To Facilitate Lactation at the Workplace by New Mothers" was signed into law on May 6, 2009. The law provides that an employer shall provide "adequate unpaid break time or permit an employee to use paid break time or meal time each day to express breast milk for her nursing child for up to 3 years following childbirth. The employer shall make reasonable efforts to provide a clean room or other location, other than a bathroom, where an employee may express breast milk in privacy. An employer may not discriminate in any way against an employee who chooses to express breast milk in the workplace." Dr. Michele Ghim represented the Chapter and testified on behalf of the law. To read her testimony, click here. The law goes into effect on September 13, 2009.

Dr. Daniel Summers Represents Chapter at Marriage Equality Bill Hearings

On March 26th child advocates gathered at the Augusta Civic Center to speak on behalf of children and support the Marriage Equality Bill. Dr. Daniel Summers represented the Chapter; click here to read his testimony. Dr. Summers was quoted in a March 27, 2009 article in the Bangor Daily News "Child advocates speak in favor of gay marriage".

Federal Health Care Reform Update...How YOU Can Help!

The Time is Now! With health care reform in full swing now is the time to act on behalf of our nation’s children. Congress will be in recess until July 7.  The recess provides you with an opportunity to speak with your members of Congress while they are home in your state and urge them to provide children with the services they need and deserve in any health reform proposal.

Please contact your representatives’ offices as soon as possible to schedule a local meeting with your member or their staff. Additionally, we encourage your chapter members to participate in local town hall meetings and rallies that your representative or senator is attending. As you know, many members of Congress will hold events to hear from their constituents. With health care a reform a priority for President Obama and Congress, many of the events could include presentations and/or Q&A sessions on health care reform. Click here for entire Update.

Health Care Reform Talking Points
Health Care Reform Background

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MAAP Offers FREE Oral Health Resources for Your Practice!

The Chapter now has available two resources for your practice to assist you in fighting off early childhood caries in your patients. The Steps to Healthy Teeth brochure is a great resource for your waiting room or to give out at WCCs. The Oral Health Flip Chart is a sturdy clinical tool for use in your exam rooms during WCCs and feature pictures of caries and healthy teeth, fluoride information, risk assessment, anticipatory guidance, and more! Contact Aubrie at 782-0856 or agridleyentwood@aap.net to order.

"The ECC Epidemic"

An article in Contemporary Pediatrics by Ray Wagner, MD, and Rama Oskouian, DMD, MPH asks "Are you missing the diganosis of the most common chronic disease of childhood?"

Several years ago, I had one of those pediatric wake-up calls that scared me. I was attending to the care of a 2 1/2-year-old child with Beckwith-Wiedemann syndrome. He lived in a low income family, and temporarily had fallen through the health insurance safety net. For some reason, his Medicaid insurance had lapsed, and here he was in my office appearing very ill with a temperature of 40° C (104° F). His left maxillary area was quite swollen and dusky red. I looked in his mouth, and not surprisingly, found an
infected first left upper molar surrounded by a very erythematous gingiva. His teeth were riddled with cavities. Fortunately, I was able to urgently admit him to the...
Click here for entire article.

Free In-Office Trainings on Oral Health offered to Pediatric Practices

Early Childhood Caries (ECC) is the most common chronic childhood disease in America- five times more common than asthma!

The Kids Oral Health Partnership can provide free training to pediatric practices on:
· Oral screening and risk assessment
· Caregiver guidance, and brochures
· Fluoride varnish application – MaineCare now pays for medical providers to apply fluoride varnish.
· Effective referrals to the dental office.

Click here for a brochure with details on the trainings or contact Bonnie Vaughan at bvaughan@mcd.org .

The KOHP web site, has lots of resources on oral health for infants and young children, including a list of “Oral Health Care Services for Children in Maine” (a listing of pediatric dentists and oral health clinics, as well as the MaineCare member number for finding out who is accepting MaineCare). The list is updated frequently.

Improving Oral Health Access Through Innovation Programs: September 11, Portsmouth NH

4th Annual Rural Oral Health Conference.
Keynotes to include:

• Dr. Edwin Smith, the dentist featured on a recent ABC 20/20 special "A Hidden America: Children of the Mountains"
  
  
• Ms. Tricia Brooks, senior fellow at the Center of Children and Families (CCF) and an assistant research professor at the Georgetown University Health Policy Institute

Click here for more information.

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 H1N1 and Pregnant Women HAN Altert

On June 24, 2009 Maine CDC issued the advisory intended to provide guidance for the diagnosis and management of pregnant women with influenza like illness (ILI) during the current outbreak of novel influenza A H1N1 in Maine. Click here for entire Advisory.

All Maine CDC Health Advisories can be found at their webpage where you can also sign up for an RSS Feed for HAN Advisories.

 Maine CDC's Preliminary Summer Plans to Address H1N1

On June 1, 2009 Maine CDC issued plans for addressing H1N1 Flu this summer. Maine CDC expects to update the plans based on the course of the flu and continues in close contact with U.S. CDC, including daily conference calls and emails, and this contact is also expected to inform and revise our summer work. Click here for details of the plan.

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  MAAP Selected to Participate in the AAP Chapter Quality Network Asthma Pilot Project

The Chapter is proud to announce that we are one of four chapters chosen to participate in the AAP Chapter Quality Network Asthma Pilot Project. Despite advances in the medical treatment of asthma over the last 20 years, asthma still remains a significant health issue for children in the state of Maine. Over 28,000 children in Maine are currently affected by asthma which is the highest rate in New England (10.7% currently).

From April 2009 to November 2010, the goal of the AAP is to lead a quality improvement collaborative and achieve measurable improvements in asthma outcomes with 10 to 15 participating practices in each state by implementing the NHLBI/NAEPP guidelines. The Maine AAP will partner with existing health systems, the Maine Asthma Council (CDC), and the AH! Asthma Health Program to work on this project.

Amy Belisle, MD, Pediatric Hospitalist at CMMC is the Physician Project Lead; Barbara Chilmoncyzk, MD, Chief of Pediatric Allergy and Immunology at MMC and the Director of the AH! Program, is the Local Asthma Expert; and Aubrie Entwood, Executive Director of the Maine AAP, is the Chapter Project Manager.

Please look for upcoming information about the project as we begin to recruit practices this summer. Our first gathering of participating practices in Maine with the Quality Improvement team from the National AAP will be Friday, September 25th, and Saturday, September 26th, at Central Maine Medical Center in Lewiston.

  AAP's Quality Improvement Innovation Network (QuIIN) Opportunities

National Performance Measures: Care for Children with Otitis Media Effusion Project
The AAP Quality Improvement Innovation Network (QuIIN) is recruiting pediatric practices for a study testing the feasibility and reliability of performance measures assessing the care of children with otitis media with effusion (OME). These measures were developed by the American Medical Association-convened Physician Consortium for Performance Improvement (AMA-PCPI) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO/HNS). The measures have been selected by the Ambulatory Care Quality Alliance (AQA) for use by insurers and health plans, but have not been evaluated in practice.

The application due date has been extended until we reach our goal of 20 practices. For more information, click here or contact Keri Thiessen, MEd, Senior Health Policy Analyst, QuIIN, at kthiessen@aap.org


Practicing Safety: A Child Abuse and Neglect Prevention Project
The AAP Quality Improvement Innovation Network (QuIIN) is recruiting pediatric practices for an upcoming improvement project that will test tools and resources necessary to identify children at risk for child abuse and neglect. Practicing Safety: A Child Abuse and Neglect Prevention Projectwill involve clinical teams using a systematic approach to the prevention of child abuse and neglect, through the use of improvement science methods, including measurement.

Teams will use a toolkit, consisting of 3 bundles (parent, infant, toddler) that focus on maternal depression screening, coping with crying, toilet training, and effective discipline to assist them helping parents who are in need.

If you are interested in participating, and would like more information or an application, please click here or contact Jill Healy, MS, Project Manager, QuIIN at jhealy@aap.org.

EQIPP Data Collection Tool: Immunization Course
The AAP Quality Improvement Innovation Network (QuIIN) is recruiting the primary care practice physician to test the feasibility of the data collection tool that has been developed for the upcoming Education in Quality Improvement for Pediatric Practice (EQIPP) Immunizations course. Participating physicians will be asked to complete the data collection tool on 5 charts of children ages 19-23 months and 5 charts of adolescent patients ages 13-18 years. Participants will be asked to complete an on-line survey to help the EQIPP planning group make any final adjustments to the data collection tool before it is programmed in the course. The physicians' time is expected to be limited on this project as only one round of testing the EQIPP Immunizations Data Collection Tool is required. Participants will be given 2 weeks to collect data and provide feedback. We are looking for no more than 10 volunteers.

If interested, contact Lori Morawski, Manager, Quality Improvement Programs,(lmorawski@aap.org) to receive additional information, the data collection tool, and the link to the online survey.


Test for Respiratory and Asthma Control in Kids (TRACK)
The AAP Quality Improvement Innovation Network (QuIIN) is assisting in site recruitment for a study to obtain cross-validation of Test for Respiratory and Asthma Control in Kids (TRACK). The TRACK tool was developed by AstraZeneca, with the assistance of QualityMetric - a data collection and analysis firm, as a response to a consensus that a standardized questionnaire completed by parents or caregivers could be useful in assessing and monitoring respiratory control problems in preschool-aged children. If you are interested in participating and would like to receive more information along with the application packet, contact Melissa A. Singleton, MEd., Project Consultant, QuIIN, at QuIIN@aap.org, or 815-861-4498.

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Maine Welcomes First Pediatric Rheumatologist!

Rheumatology Associates in Portland is pleased to announce that Edward Fels, M.D. will be joining the practice on September 1, 2009. Dr. Fels received his M.D. from State University of New York at Brooklyn College of Medicine, completed his residency at Maine Medical Center, and his Fellowship at Duke University Medical Center. He is Board certified in Pediatrics and Internal Medicine and Board eligible in Pediatric and Adult Rheumatology.

Appointments for pediatric and adult patients can be made by contacting Rheumatology Associates at (207) 774-5761.

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Save the Date! Maine AAP Fall Conference--Update in Pediatric Surgery: November 7, Lewiston

Co-Sponsored by CMMC, St. Mary's, and MMC

Topics to include:
* Lump in the Groin: what is it? what to do? when?
*Stabilization and Transport of the Critically Ill child with Surgical Problems--trauma, volvulus, congenital anomaly
*Remote Diagnosis and Management of Common Surgical Conditions: Appendicitis, Intususception, Pyloric Stenosis
*Bariatric Surgery in childhood
*Comanagement of Surgical Patients by community Pediatricians and General Surgeons
*Long term managment of pediatric GI conditions
*E Burn Management: what can you do yourself, what should you transfer: locally/to Portland/to Shriners Boston
*Routine Office Procedures: removal of sutures/drains, glue, burn dressings, abscess I+D, wound surveillance, skin bx, etc.

And MUCH MUCH MORE!!!

Check the Chapter's Website soon for more information!

Problems in Pediatrics: July 6-10, Waterville

A balanced update on a wide range of current, clinically relevant topics for the practicing pediatrician. The course features 45-minute lectures followed by 15-minute discussions. The faculty initiates the topics and facilitates the following discussions in a relaxed forum, which encourages the mutual exchange of views and data and allows ample time for participant-faculty interaction.

Intended Audience: Practicing pediatricians, family physicians, pediatric nurses, nurse practitioners, physician assistants, and other health care professionals.

Click here for more information.

Advances in the Identification and Treatment of Childhood Behavioral Disorders: July 13-14, Waterville

Best practices and current concepts in the field of developmental and behavioral pediatrics: a two-day program for professionals working with children and teens with behavioral problems and their families.

Intended Audience: primary care physicians, nurse practitioners, physician assistants, psychologists, social workers, teachers and counselors.

Topics: Strategies that work in the home, school and community to help children and families experience their world as a better place will be provided. The program features interactive sessions, case studies, didactic and small group presentations. Topics include Anxiety Disorders which affects about 10-15% of children, OCD which affects 2-5%, Autism which occurs in 1 out of 150 children, Bipolar Disorder, environmental toxins and their effects on children, the use of SSRI's during pregnancy, the effects of maternal depression on children and families, and the use of hypnosis in a primary care physician's office.

Click here for more information.
Click here for a PDF of the brochure.n visit the Family Planning Association of Maine's Website.

Improving Oral Health Access Through Innovation Programs: September 11, Portsmouth NH

4th Annual Rural Oral Health Conference.
Keynotes to include:

• Dr. Edwin Smith, the dentist featured on a recent ABC 20/20 special "A Hidden America: Children of the Mountains"
  
  
• Ms. Tricia Brooks, senior fellow at the Center of Children and Families (CCF) and an assistant research professor at the Georgetown University Health Policy Institute

Click here for more information.

  Post-Pediatric Psychiatry Portal Now Available at MMC!

Maine Medical Center’s residency programs in Child & Adolescent Psychiatry (CAP) and General Psychiatry are pleased to announce the recently created Post Pediatric Psychiatry Portal (approved by the ACGME in April, 2009) and are currently recruiting for July, 2009.

The PPPP program at Maine Medical Center will be an intensive, integrated program over 3 years. The first year will incorporate salient features of a PGY-2 year general psychiatry training year including inpatient general adult psychiatry, addictions psychiatry, inpatient adolescent psychiatry, and a home-based treatment team for children and adolescents. Year two of training will blend outpatient general psychiatry and child and adolescent psychiatry for long-term therapy cases and psychopharmacology. The final year of training will continue with longitudinal treatment of adults and outpatient CAP, but will include consultation/liaison at Barbara Bush Childrens’ Hospital, developmental disabilities inpatient work, early childhood issues, and acute CAP. Training in Portland Maine offers a wealth of clinical opportunities including Maine Medical Center (tertiary care for Northern New England), Spring Harbor Hospital, the Collaborative School in New Gloucester, and Long Creek Youth Development Center.

The interested applicant must have completed a residency in pediatrics and be enthusiastic about beginning a novel training program. If interested, please contact either Mary Liberty, residency coordinator, at 207 662 2733, or Sandra Fritsch, M.D., program director at 207 662 4377, or fritss@mmc.org.

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This is a bi-monthly posting of relevant pediatric news and events, including CMEs.  If you have news or events you would like added to the September-October E-Newsletter, please email Aubrie at agridleyentwood@aap.net by August 1st.