Digital Commons Network^™

Culturally Competent Resources Focused On Wellbeing & Mental Health In Vermont's Immigrant Communities, Meron Yishak

Family Medicine Clerkship Student Projects

Recognizing the unique stressors and barriers immigrants often face, this list compiles a range of culturally-sensitive online & in-person resources here in Vermont. It includes community organizations, hotlines, online platforms, and services working to address the diverse needs of immigrant populations. By empowering immigrants with knowledge of available resources, this guide strives to promote well-being within immigrant communities.

Prescription Stimulants: Preventing Misuse Among Adults With Adhd, Sadie M. Casale

Family Medicine Clerkship Student Projects

Stimulant drugs are a cornerstone in the treatment of Attention Deficit and Hyperactivity Disorder (ADHD) and are being prescribed at increasing rates. The safe prescription and use of these drugs by providers and patients alike is critically important to appropriately treating ADHD and preventing misuse. This presentation discusses how patients can be educated on the uses of stimulants and provides information on what to do in case of overdose. Additionally, resources for providers are provided to continue improving awareness of at-risk patients and community resources available to them.

Safer Prescription Opioid Use In The Greater Danbury Area, Ying K. Loo

Family Medicine Clerkship Student Projects

Opioid use disorder continues to be a major public health concern worldwide, with over 16 million people affected, and is associated with increased health care costs, reduced quality of life, lost productivity, and loss of life due to opioid overdose deaths. The neurobiology and susceptibility for opioid dependence and addiction is not well-understood by patients, and the lack of understanding of the safe use of prescription opioid regarding its intended effect of pain-relief versus other potential side effects and withdrawal symptoms may lead to misuse. This community health improvement project aims to empower patients and their family members to better …

Consent Education For Adolescents, Paige T. Song

Family Medicine Clerkship Student Projects

In primary care practices, prevention and early intervention is key. Educating adolescent patients about consent and reinforcing the topic early on may help to decrease the downstream prevalence of sexual violence.

Assisting Rural Mat Patients Through Peer Social Support, Anthony Plochocki

Family Medicine Clerkship Student Projects

Throughout the COVID19 Pandemic, there has been a spike in opioid relapse and opioid overdose related death. This problem, though multifactorial, can be attributed to lack of social outlets for MAT patients. Now that different social support groups are reopening, there is a greater emphasis placed on groups for patients suffering with alcoholism rather than those suffering from opioid addiction. This project hopes to plant the seeds for group therapy for MAT patients, giving them a social outlet with the hopeful outcome assisting patients with forming non-user networks.

A Comparison Of Maternal Oxycodone And Buprenorphine Use On Prenatal Development In Mice, Utilizing A New Volitional Drug Administration Apparatus, Nellie Anne Stidham

Graduate College Dissertations and Theses

Opioid Use Disorder is a growing problem in the United States. During the 2000s, approximately 75% of opioid use disorders were initiated through the misuse of prescription opioids, particularly among women. With a rise in opioid use disorder and overdoses across the nation, there has also been a dramatic rise in neonatal withdrawal syndrome (NOWS). Prenatal opioid exposure is known to have long term effects on children’s development, including effects on learning, social behavior, and deteriorating school performance. The majority of prenatal opioid exposure rodent models utilize injection for delivery of opioids to mothers during pregnancy. These studies trade translatability …

Creating A Screening Tool To Prevent Intimate Partner Violence (Ipv), Ankrish B. Milne

Family Medicine Clerkship Student Projects

No abstract provided.

Primary Care Management Of Alcohol Withdrawal, Julie Connor

Family Medicine Clerkship Student Projects

Alcohol use disorder (AUD) is prevalent yet undertreated in rural Vermont. Approximately half of those with AUD who stop drinking experience alcohol withdrawal. Alcohol withdrawal can range from uncomfortable to life threatening symptoms. Untreated alcohol withdrawal can also lead to recurrence of alcohol use. The mainstay for management of alcohol withdrawal has been inpatient or intensive outpatient programs. However, there are barriers to accessing these programs including availability of beds, patient reluctance, lack of transportation, not knowing about these programs, and cost. Primary care management of alcohol withdrawal is safe, accessible and has the potential to reduce symptoms of alcohol …

Improving Ipv Screening & Access To Resources For Patients In Primary Care, Daniel J. Fried

Family Medicine Clerkship Student Projects

Primary care providers can improve their screening protocols for intimate partner violence (IPV) and how they connect resources to their patients.

Assessing Prescriber And Staff Readiness For Change And Evaluation Of Chronic Pain Management, Collin J. Anderson

Family Medicine Clerkship Student Projects

Survey-based study of opioid prescribers and staff members at a community health center. Designed to assess current opioid prescribing practices, management of chronic pain patients, and readiness for future change.

Vermont Legislators' Opinions Regarding The Opioid Epidemic, Liam Du Preez, Emily Eichner, Jonathan Gau, Ryan Harned, Matthew Lebow, Bridget Moore, Casandra Nowicki, Elizabeth Cote, Charles Maclean, Jan Carney

Public Health Projects, 2008-present

Introduction

• The VT General Assembly includes 180 legislators: 150 representatives and 30 senators

• State legislators have substantial power to create opioid-related policies

• During the 2017-18 VT legislative session 22 opioid related bills were introduced and 9 were passed

• No data currently exist on how VT legislators gather information and formulate public health decisions regarding opioid policies

Purpose

• Examine VT legislators’ understanding of the opioid epidemic

• Identify what drives legislators to draft legislation, including beliefs, priorities, and voting decisions

• Inform health and human services professionals to best respond to legislators’ knowledge gaps and continuing …

An Educational Module For Adolescents On Cannabis Following Its Legalization, Anna Lidofsky

Family Medicine Clerkship Student Projects

Recreational use of cannabis has been recently legalized in Vermont. One year prior to its legalization, 42% of high school students in Washington County reported at least one-time use of cannabis. An educational module for adolescents was developed to address the increasing potency of cannabis and health risks associated with its use.

Social Support Groups Focused On Substance Abuse And Addiction Available To Patients In Franklin County, Vermont, Michael Nilo

Family Medicine Clerkship Student Projects

Substance abuse/addiction, especially of opioids, is a major problem in Franklin County, where resources are not easily accessible to patients struggling/in recovery. Educating patients about the availability of peer support groups/recovery centers and clinics in the community may provide an attractive resource for patients who need additional help.

Referral Patterns And Service Provision In Child Protective Services: Child, Caregiver, And Case Predictors, Hannah Mead Holbrook

Graduate College Dissertations and Theses

Child maltreatment, and recurrent maltreatment in particular, occurs at an alarmingly high rate. Frequency of reports to Child Protective Services (CPS) is associated with negative psychological outcomes, and children whose reports are unsubstantiated experience similar risk of behavioral, emotional, and substance use disorders as those whose reports are substantiated. Prior research has demonstrated that children with no CPS reports and children with one CPS report showed no significant differences in rates of maltreatment perpetration or substance use in adulthood, suggesting that prevention efforts after one report may have strong merit in reducing negative outcomes in adulthood. However, patterns and risk …

An Evidence-Based Non-Opiate Withdrawal Treatment Protocol For Vermont Correctional Facilities, Kate J. Shaper

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: The purpose of this project was to implement an improved standard of care for patients in acute opiate withdrawal in 6 correctional facilities using available evidence-based practice.

Methods: A comprehensive literature review of non-opiate interventions for acute opiate withdrawal (AOW) confirmed that clonidine effectively treats the objective symptoms, with lower risk for abuse and diversion. Additional supportive measures for AOW included hydroxyzine (Vistaril/Atarax), acetaminophen, and loperamide. Using these findings, a new medication protocol was formulated in partnership with the state medical director, the Department of Corrections, and the state director of nursing. An educational presentation regarding implementation and safety …

A Physician's Guide To Motivational Interviewing, Anthony J. Gallegos

Family Medicine Clerkship Student Projects

Recommending lifestyle changes to patients is a crucial part of a primary care physician's role. Guiding patients to make behavioral change is a challenge physicians must face on a daily basis, and based on current literature, it can be delivered more effectively in the form of motivational interviewing as opposed to traditional advice-giving. This project aims to provide physician's with a quick reference guide to Motivational Interviewing to display at their desk, as well as a template to be filled out with the patient detailing their plans for change. Together, these tools can improve the delivery of advice, and strengthen …

Use Of Opioids For Pain Management: Educating Patients And Providers On Upcoming Changes To Vermont State Law, Ashley C. Hodges

Family Medicine Clerkship Student Projects

Vermont is suffering from an opioid epidemic. With 112 opioid-related deaths in 2016, nearly every community has been touched by this crisis. In an attempt to combat this problem, new legislation (effective July 1, 2017) will change how opioids are prescribed for both acute and chronic pain management in Vermont. Changes include dose limitations for acute pain, stricter monitoring requirements, and mandated prescribing of naloxone (an overdose reversal agent) for patients on high doses of opioids or on both opioids and benzodiazepines. This project aims to educate patients about upcoming changes.

Provider Education & Requirements For Opioid Prescriptions, Lawrence J. Leung

Family Medicine Clerkship Student Projects

Nationally, there has been a surge in the opioid prescription crisis with associated overdose deaths. Vermont is no exception, with increasing opioid overdose related deaths within the last 10 years. A sample (n=111) of opioid addiction patients at the Community Health Centers of Burlington (CHCB) have demonstrated that 25% have their initial use due to provider prescription. New Vermont regulations to decrease opioid prescriptions are inefficient. The goal of this project is to implement a streamlined intervention to improve provider education and comfort regarding new Vermont state opioid prescribing regulations.

The Sbirt Method For Alcohol Misuse Screening And Treatment, Blake Coulter Mcknight

College of Nursing and Health Sciences Nursing Master Project Publications

Heavy episodic drinking, or “binge drinking”, is a significant behavioral health problem on American college campuses. It is associated with numerous physical, social, and legal consequences in this population, including but not limited to intoxicated driving, physical and sexual assault, accidents, alcohol poisoning, compromised academic performance, criminal justice system involvement, exclusion from athletic competition, and expulsion from student housing. The Screening, Brief Intervention, and Referral to Treatment method, or “SBIRT”, has gained increasing recognition in recent years as an effective, validated tool for screening for and intervening in behavioral health problems generally and problematic alcohol use in particular. The purpose …

Broadening Perspectives On The Management Of Chronic Pain, Daniel Ianno

Family Medicine Clerkship Student Projects

Complementary and alternative treatments are often overlooked when managing patients with chronic pain. Given the prevalent problem of prescription opioid abuse, narcotics should be avoided in the treatment of chronic pain if possible. When appropriate, practitioners should ensure patients have explored a wide variety of pain relief therapies prior to initiation of narcotics for the treatment of chronic pain. Increasing awareness and understanding of complementary and alternative therapies among practitioners and patients will hopefully help to mitigate the perceived need for narcotics in the treatment of chronic pain.

Introducing Opiate Addicts To The Hub And Spoke Treatment System In Vermont, Richard T. Carrick

Family Medicine Clerkship Student Projects

Opiate abuse and addiction is an epidemic in the state of Vermont. Brandon Medical Center has recently become involved in Vermont's "Hub and Spoke" system of medically assisted opiate addiction treatment. This project involved the development of a pamphlet for safe, low-threshold transmission of information regarding opiate addiction and entrance into this system for patient's who may be suffering from this disease.

Intimate Partner Violence: Providing Resources To Patients And Facilitating Understanding, Andrew R. Sheridan

Family Medicine Clerkship Student Projects

Intimate Partner Violence is defined as physical violence, emotional violence, sexual violence, psychological aggression and stalking against a current or former partner. High volume primary care offices like UVMHN Berlin Family Medicine address primarily medical concerns of patients. While this includes mental health, IPV is infrequently a part of doctor-patient interactions. This project assesses available data on IPV nationally and in Vermont. It aims to understand how IPV is currently addressed, recommendations regarding addressing it and provides resources to patients.

Increasing Naloxone Distribution In Vt Emergency Departments, Olivia M. Harris

Family Medicine Clerkship Student Projects

Fatalities caused by overdose from opioids are increasing in Vermont. Evidence shows that Naloxone safely and effectively reverses the effects of opioids in overdose. This project aims to determine why physicians in VT Emergency Departments are not consistently distributing Naloxone to all patients with an overdose, and to increase awareness and implementation of this practice.

Drug Treatment Court: The Power Of Understanding Addiction, Asaad Traina

Family Medicine Clerkship Student Projects

The Drug Treatment Court in Burlington is one of about 3000 drug treatment courts nationwide. They were developed as an “alternate sentencing court”, a method of restorative justice that would allow people who had multiple criminal charges related to substance abuse to overcome their addiction, have their criminal charges dismissed, and pursue a fuller life. As part of this program, many participants attend an Intensive Outpatient Program (IOP). As a third year medical student, I lead an educational session with the aim of helping participants understand the neurophysiology behind their addiction.

Alcohol Use Among Middle School Children In Vermont, Sargis Ohanyan

Family Medicine Clerkship Student Projects

Alcohol and drug education classes have reduced alcohol use in Vermont middle schools to approximately 20%, however currently no screening or intervention programs are available for the aforementioned 20%. Experts agree that early alcohol use significantly increases the risk of myriad psychosocial problems later in life, therefore early screening and intervention is paramount. The focus of this project is to raise awareness for the need of early screening/intervention regarding alcohol use in Vermont middle schools.

Screening, Brief Intervention And Referral To Treatment For Substance Abuse In Waitsfield, Vt, Chi An Liu

Family Medicine Clerkship Student Projects

Substance abuse is an issue in Waitsfield, VT and currently there is no formal program or intervention at Mad River Family Practice to help patients overcome their addictions. Screening, brief intervention and referral to treatment (SBIRT) is a program to identify at risk patients, raise awareness of their abuse, and help them find support and treatment they need.

Screaming Behind A Door: The Experiences Of Individuals Incarcerated Without Opioid Maintenance Treatment, Shoshana Aronowitz

Graduate College Dissertations and Theses

Background & Purpose: Opioid maintenance therapy (OMT) is an effective method of treating opioid addiction. Of incarcerated individuals in the U.S., 50-85% have a history of substance abuse, and >80% of inmates with opioid addiction history do not receive treatment. The purpose of this study was to explore individuals' experiences after being tapered from OMT upon incarceration. Methods: Interpretative phenomenological analysis (IPA) was employed using in-depth interviewing of 10 participants. Results: Analysis identified six themes that captured the essence of the participants' experiences. Implications & Conclusion: Losing OMT upon incarceration was described as an extremely stressful experience for many individuals, …

Increasing Awareness Of Adverse Childhood Experience (Ace) And The Benefits Of Inquiring About Ace, Maya Son

Family Medicine Clerkship Student Projects

Adverse Childhood Experiences (ACE), including childhood abuse/neglect, household dysfunction, and exposure to other traumatic stressors, have a large impact on health costs as well as social services, education, juvenile justice. Impact of ACE crosses socioeconomic boundaries. In 2011, the Vermont Department of Health reported that 58% of VT adults had experienced at least 1 ACE, and 17% of VT women had four or more ACEs.

Addressing Health Needs Of Burlington Probation And Parole Clients, Zoe F. Agoos, Alison W. Frizell, David Y. Harari, Michael Ma, Jigar M. Patel, Jordan E. Perlman, Michael Ursiny, Herb Sinkinson, Jill K. Jemison

Public Health Projects, 2008-present

Introduction. Higher rates of recidivism have been observed in offenders with specific health risks. Criminal justice literature identifies probation/parole as an ideal time to im-plement health interventions to reduce recidivism, but significant barriers exist