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1. Two Case Reports in Pregnant Patients with Plasminogen Activator Inhibitor-1 (PAI- 1) Deficiency, Haihong (Henry) Mao, MD, MS, Resident – Fort Wayne ($200) 2. SMA Syndrome as a Cause of Recurrent Nausea and Vomiting in an Anorexic Patient, Toyosi Morgan, MBBS, MPH, MBA – IU ($150) 3. Biliary Atresia – An Atypical Case Presentation, Ryan Deweese, MD – St. Vincent ($100) 4. Toxic Epidermal Necrolysis (TENS): A Case of a Lethal Skin Condition Masquerading as a Common Ailment, Phumeza Msikinya, MD – IU ($50)1. Incidence of Hyponatremia in Mini- Marathon Participants, Chris LaFollette, MD – St. Francis ($300) 2. Weight Gain Ratios in Gestational Diabetes: A Case Control Study, Jennifer Schamerloh, MD – St. Francis ($200)Honorable Mention Colorectal Cancer Screening – Performance Improvement, Kwanza Devlin, MD – St. Joseph ($50)Are We Asking the Right Questions in the Existing Review of Systems – AWARE ROS (Pilot Study), Eric Weaver, MD – St. Joseph ($50) Poster Presentations1. Optimal Dosing of Candida Antigen for Treatment of the Common Wart, Sara Bruns, DO – St. Francis ($100) Co-Authors: Michelle McCarthy, MD; Carrie Anderson, MD2. The Impact of the Primary Care Workforce Distribution on Health Outcomes, Azita Chehresa, MD, PhD – IU ($50) Co-Authors: C.M. Muegge, MS, MPH; N. Countryman, MD; K. Kochhar, MBBS; J.J. Brokaw, PhD; P. Nalin, MD; A.M. Holloway, MHA; T.W. Zollinger, DrPH On March 6, 2008, almost 150 residents and staff members from Indiana’s family medicine residency programs packed into the ballroom at the Marriott North in Indianapolis for the annual IAFP Residents’ Day/Research Forum. This event gives family medicine residents from around the state the chance to present their original research, case presentations or poster presentations to their peers and teachers. Our sincere thanks go out to Larry Allen, MD , ofSyracuse, Indiana, who was our moderator for the day, and who joined Debbie Allen, MD , and Ray Nicholson, MD , on the panel of judges that awarded the following prizes at the end of the day.Residents’ Day/Research Forum Grows More Popular Each Year# Page 232008 IAFP Faculty Development Day The 2008 IAFP Faculty Development Day was held at the Marriott North in Indianapolis on March 5. This year’s theme was “Molding Our Future: Innovations in Family Medicine Residency Education.” With the recent change in the program requirements for family medicine residency education and the P4 Project’s emphasis on innovations that facilitate the key goals of the Future of Family Medicine initiative, residency programs are the incubators for change that will lead our specialty forward in the coming decades. Residency programs will also be instrumental in helping to provoke much- needed changes in the health care delivery system in the United States and will no doubt develop models of practice that will be adopted by their graduates. This was the rationale for the program, planned by Christopher Doehring, MD , program chair, and featuring keynote speaker Dr. John Saultz , chairman, OHSU Department of Family Medicine, who presented “Transforming Family Medicine: Taking a Leap of Faith.” The remainder of the program was split into two sections: Innovations in Curricula and Innovations in Evaluation. In the former section, attendees heard presentations on Cultural awareness programs, international medicine rotations/track and family medicine-based fellowships. In the latter, presentations were heard on the Collaborative OSCE Program, the Learner’s Portfolio/Journal and incorporating the competencies into rotation goals and objectives/evaluations. The IAFP would like to thank Dr. Doehring for his work in planning the program and serving as our moderator for the day and all of the faculty members and speakers without whose contributions the Faculty Development Day would not be possible. Our speakers included: Laurie Pylitt, MHPE, PA-C, IU/Methodist – Indianapolis Bill Rozycki, PhD, IU/Methodist – Indianapolis Kevin Ericson, MD, St. Joseph’s – South Bend Curt Ward, MD, St. Vincent’s – Indianapolis Javier Sevilla, MD, IU/Methodist – Indianapolis Kevin Gebke, MD, IU/Methodist, Geriatrics Anne Knox, MD, St. Vincent’s Current Fellow David Harsha, MD, Program Director, St. Vincent’s FMRP Diana Burtea, MD, and Kathy Zoppi, PhD, Community Hospital John Saultz, MD – OHSU Kathy Zoppi, PhD, MPH, Community Hospitals – Indianapolis Carrie Anderson, MD, and Richard Feldman, MD, St. Francis – Indianapolis Dale Patterson, MD – Memorial South Bend# Page 24Update to Treatment of Tobacco Dependence Fits with Patient-Centered Medical Home More than 55 organizations have reviewed and endorsed the Guideline Update, including the AAFP. It delivered a clear message to the nation’s health care professionals: there has never been a better time for their patients to quit smoking. “The 2008 update provides an excellent summary of evidence that has been accumulating about effective tobacco dependence treatment,” says family physician Carlos Jaén, MD, PhD, vice chair of the guideline update panel. Jaén is chair of the department of family and community medicine at the University of Texas Health Science Center in San Antonio. He’s also a member of the AAFP Tobacco Cessation Advisory Committee. The management concepts set forth in the guideline update stand to benefit family physicians and their patients in particular, Jaén says. “At no other time in history have we had such a large number of effective treatments and interventions that can be delivered in the context of the family medicine office.” The update makes it clear that tobacco dependence is a chronic disease that often requires repeated interventions and multiple attempts to quit, Jaén says. “We wouldn’t think of counseling a diabetic patient for diet and exercise once and then be done with it. The same applies to tobacco dependence.” It shouldn’t be just the doctor who intervenes, Jaén adds. “The people who work in our family medicine offices are very motivated to help patients. This guideline update provides tools to help all of us help our patients. It should be a team effort — which fits into the concept of the patient-centered medical home. “The new guideline also provides a ‘blueprint’ for clinicians and health care systems, describing how smokers can access effective treatments, how clinicians can provide such treatments quickly and effectively and how health care systems can support both smokers and clinicians in smoking cessation efforts,” Jaén continues. In response to the Guideline, Indiana is taking action. In June, Dr. Judy Monroe, Indiana state health commissioner and family physician, will convene a group of health care provider organizations to discuss the new guideline and develop recommended strategies Indiana should employ. This will be incorporated into the 2015 Indiana Tobacco Control Strategic Plan. Individual, group and telephone counseling are all effective, according to the update, and their effectiveness increases with treatment intensity. “I was pleasantly surprised by the strength of evidence for counseling provided by telephone quitlines,” Jaén says. “It’s a powerful way to augment anything we do in the office.” The number of Hoosiers seeking assistance to quit smoking has ramped up in the past year. In April, 1,358 Hoosiers contacted the free Indiana Tobacco Quitline (800.QUIT.NOW) for assistance from trained quit coaches. The Indiana Quitline is available and free to any adult Hoosier who is ready to quit. On Wednesday, May 7, the U.S. Public Health Service released the 2008 Clinical Practice Guideline Update: Treating Tobacco Use and Dependence. It represents nearly two years of work by a 24-member panel and has been informed by the input and review of many tobacco treatment researchers and clinicians. The Guideline Update is designed to provide an evidence-based blueprint for clinicians and health systems to assist patients who smoke to successfully quit tobacco use.# Page 25ITPC’s network of locally affiliated coalitions also have cessation resources available that reach all of the Indiana’s counties to provide help to smokers who are ready to quit. Log on to www.itpc.in.gov to get a full listing of those local resources. Guidelines Provide Further Direction for Quitting The PHS guidelines included 10 key recommendations: •Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence. •It is essential that clinicians and health care delivery systems consistently identify and document tobacco use status and treat every tobacco user seen in a health care setting. •Tobacco dependence treatment is effective across a broad range of populations. Clinicians should encourage every patient willing to make a quit attempt to use the counseling treatments and medications recommended in the Guideline. •Clinicians should offer every patient who uses tobacco at least the brief treatments shown to be effective in the new Guideline. •Individual, group and telephone counseling are effective, and their effectiveness increases with treatment intensity. Two components of counseling are especially effective, and clinicians should use these when counseling patients making a quit attempt: 1) practical counseling (problem- solving/skills training) and 2) social support delivered as part of the treatment. •Numerous effective medications are available for tobacco dependence and clinicians should encourage their use by all patients attempting to quit smoking except when medically contraindicated or with specific populations in which there is insufficient evidence of effectiveness. There are seven first- line medications available that reliably increase long-term smoking abstinence rates.•Counseling and medication are effective when used by themselves for treating tobacco dependence. The combination of counseling and medication, however, is more effective than either alone. Thus, clinicians should encourage all individuals making a quit attempt to use both counseling and medication. •Telephone quitting counseling (800.QUIT.NOW) is effective with diverse populations and has broad reach. Therefore, both clinicians and health care delivery systems should ensure patient access to quitlines and promote quitline use. •If a tobacco user currently is unwilling to make a quit attempt, clinicians should use the motivations treatments in the Guideline to be effective in increasing future quit attempts. •Tobacco dependence treatments are both clinically effective and highly cost-effective relative to interventions for other clinical disorders. Providing coverage for these treatments increases quit rates. Insurers and purchasers should ensure that all insurance plans including the counseling andmedication identified as effective as covered benefits. Copies of the Guideline and its companion materials are available at http://www.surgeongeneral.gov/tobacco. For more information regarding the free Indiana Tobacco Quitline, call toll-free 800.QUIT.NOW (784.8669). The service is free to anyone 18 years and older and an Indiana resident.