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Historic Preservation Program Newsletter, Historic Preservation Program Newsletter

Historic Preservation Program Newsletter

2017.

UNIVERSITY OF VERMONT HISTORIC PRESERVATION PROGRAM HISTORY DEPARTMENT - WHEELER HOUSE - BURLINGTON, VERMONT

Asthma In Vermont Dairy Farmers, Wyll T. Everett, Victoria Lauren Close, Rebecca Merriam-Stelfox, Sravana Paladugu, Jacob B. Reibel, Ruby L. Russell, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction. Although 5.4% of the Vermont population participates in agriculture as an occupation, little data exists on the prevalence of asthma in Vermont dairy farmers, due to inadequate sample sizes. Previous studies have shown dairy farmers are at risk of respiratory illness due to unique exposures intrinsic to their occupation. We conducted a study to assess the prevalence of asthma in dairy farmers in Vermont, to understand rates among this population and potential occupational risks.

Methods. We distributed a paper survey modeled after previously-validated surveys, such as the BRFSS, to farmers at Vermont Farmer Bureau meetings, farmers markets, …

Willingness To Donate Blood During The Summer, Christopher Bernard, Taylor Brown, Ramya Ghantasala, Obhijit Hazarika, Nicole Leonard, Cori Polonski, Zachary Wunrow, Michelle Heleba, Jan Carney, Mark K. Fung

Public Health Projects, 2008-present

Introduction. Each year donation rates fall in the summer months straining blood banks’ capacities to meet local demands. In hopes of identifying factors to increase summer donations, our study investigated donor reported barriers which influence summer donations habits.

Methods. An anonymous 16 question survey investigating various donation factors was administered across multiple American Red Cross (ARC) donation centers in Vermont. Questions addressed donor demographics, frequency of blood donation, preference in appointment making modalities including smartphone app use, summer travel habits, willingness to donate during vacation, and factors that deter donors from donating on vacation.

Results. A total …

Vermont Healthy Kids' Meals: Parents' Perspectives, Ashley C. Hodges, Geordie C. Lonza, Lindsay S. Howe, Omkar Betageri, Ryan Erik Landvater, Sean Closs, Tina Zuk, Paula Tracy

Public Health Projects, 2008-present

Introduction. Childhood obesity has increased for decades. Options on kids’ menus in restaurants typically involve unhealthy choices such as fries, chicken fingers, and grilled cheese, with soda as the drink. When healthy options are the default choice, children are more likely to eat them. Though initially skeptical of modifications, restaurants will enact changes to maintain customer satisfaction and profits, and there is no significant difference in price of healthier kids’ meals.

Methods. 187 paper and electronic surveys were administered throughout Vermont to explore attitudes towards availability, cost, and importance of healthy kids’ meals, as well as income, education, and children …

Effects Of Art From The Heart On Nurse Satisfaction And Patient Well-Being, Kassandra J. Gibbs, Eric C. King, Nicholas S. Loschiavo, Unchan Pyon, Jasmine Y. Robinson, Luke Soelch, Brianna F. Waller, Rebecca Schwarz, Buffy F. Dekmar, Sarah Mccarthy

Public Health Projects, 2008-present

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient "About Me" pages to patients, families and employees at University of Vermont Medical Center (UVMMC).

Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.

Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short …

Gaps In Adolescent Tobacco Prevention And Counseling In Vermont, Dexter C. Allen, Morgan Hadley, Margaret Klepack, Amber J. Meservey, Lynn Sipsey, Greg Whitcher, Mushtaba Yuridullah, Jill Sudhoff-Guerin, Jill Jemison, Jan Carney

Public Health Projects, 2008-present

Introduction. Tobacco use remains the leading cause of preventable death in Vermont. While the Vermont Blueprint for Health includes compensation for adult tobacco counseling, it includes no specific mention of pediatric populations. Research questions: To what extent are tobacco assessment and cessation efforts occurring in the primary care setting with pediatric patients? What factors influence their practices?

Methods. A 12-question electronic survey, modeled on an American Academy of Pediatrics survey, was distributed to primary care providers throughout Vermont; through the UVM departments of pediatrics, family medicine, the Vermont Medical Society and the Vermont Area Health Education Center. We …

Assessing The Awareness Of Lead Hazards In The Greater Burlington Area, Tessa R. Barclay, Laura Taylor Director, Steven Everse, Bailey Fay, Aaron M. Gelinne, Eliot S. Jia, Julia Mcginty, Sunit K. Misra, Lauren Pyatt

Public Health Projects, 2008-present

Introduction. Lead is a heavy metal found in and around homes built before 1978, comprising more than 80% of the housing stock in Chittenden County, Vermont. Lead exposure during infancy and childhood can have deleterious effects on development. Our study assessed baseline community understanding of potential household lead hazards in Chittenden County, Vermont.

Methods.. 123 paper, 10-question surveys were randomly administered to Chittenden County, VT residents to assess recognition of lead toxicology symptoms and awareness of lead safety programs. Scores were treated as continuous variables, demographically grouped, and analyzed using non-parametric statistical analysis (Mann-Whitney & Kruskal-Wallis). Individual questions …

Stress Identification And Management In Cots Family Shelter Residents, Kristen J. Bartlett, James Duguay, Sebastian A. Franco, Marie Kenney, Callie Linehan, Alexander W. Marchese, Rebecca Robbins, Brian J. Rosen, Rebecca Mills, Anne Brena, Jan Carney

Public Health Projects, 2008-present

Introduction. Previous studies have demonstrated that the homeless population experience higher stress levels than the general population. The goal of our study was to identify potential sources of stress for families staying with COTS, the largest service provider for the homeless and those at risk of becoming homeless in Vermont, and also to gauge potential interest in evidence-based stress-reduction strategies.

Methods. Interviews were conducted with seven adult representatives of seven different families (of fourteen eligible) currently residing at the family shelters managed by COTS, in fall 2016. Questions included a mix of short answer items and open ended …

Nutrition Education In Vermont Public Schools, Garyn Worrall, Allison Greene, Suven Cooper, Francis G. Gause Iv, Patrick Saunders, Daniel Lambert, Rebekah Misir, Alison Howe, Katy Davis

Public Health Projects, 2008-present

Introduction. Despite positive changes, childhood obesity and food insecurity remain prevalent across the country. Vermont is not immune to these issues. We set out to: research the level of nutrition education Vermont elementary schools provide their students, understand teacher perceptions of these programs, and recommend ways to fill identified gaps.

Methods. Our study is a cross-sectional survey of Vermont educators around nutrition education. The survey consisted of 17 questions, used LimeSurvey, and included demographic and nutrition education questions. The survey was distributed statewide through newsletters and list-servers.

Results. 64 responses met inclusion criteria. Vermont elementary school (K-6) …

The Effects Of Poetry In Elderly Populations With Memory Impairment, Michael Burton, Katherine Clifford, John P. Corbett, Midori Eckenstein, Jenna Conway Jorgensen, Stephanie S. Kulaga, Hyunsoo Joshua No, Nathaniel White, Judith Christensen

Public Health Projects, 2008-present

Introduction. A small body of research on therapeutic use of poetry in individuals with memory impairment demonstrates benefits similar to that of more widely studied music interventions. This project aims to assess the effects of participation in a poetry group on the residents of a memory care floor within the Converse Home, an assisted living facility in Burlington, Vermont.

Methods.. We evaluated the effects of twelve group poetry sessions on residents' well-being in several domains. Each session included a reading and writing portion, which were evaluated separately to assess differences in measures of communication, interest, and enjoyment. These …

Patient Perspectives On Medication Assisted Therapy In Vermont, Ashley D. Adkins, Holly Bachilas, Florence Dibiase, Michael J. Marallo, John Paul Nsubuga, Lloyd Patashnick, Curran Uppaluri, Elizabeth Cote, Charles Maclean

Public Health Projects, 2008-present

Introduction. Medication-Assisted Therapy (MAT) for opioid addiction has dramatically increased in Vermont, supported by a novel statewide system that integrates specialty treatment centers ("Hubs") with primary care office-based opioid therapy ("Spokes"). In 2010, Vermont had the highest per capita buprenorphine use in the US. Previous studies of patient perspectives of MAT have identified social barriers, rigid program rules, and concerns about withdrawal and relapse as common causes of treatment failure. Our goal was to elicit patient perspectives on barriers and enablers of successful MAT to further inform system refinement.

Methods. An interview guide was developed based on previous …

Diagnostic Medical Errors: Patient's Perspectives On A Pervasive Problem, Cody J. Couperus, Sree Sahithi Kolli, Sergio Andres Munoz, Quinn Self, Russell R. Reeves, Erica Worswick, Sterling A. York, Allen B. Repp

Public Health Projects, 2008-present

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient's health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition.

Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies.

Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative …

Public Health Outcomes As A Measure Of Efficacy Of Syringe Exchange Programs, Andrew Corse, Katelyn Donaldson, Andrew Gallagher, Anita Li, Morgan R. Pratt, Benjamin F. Smith, Amelia V. Tajik, Peter Jacobsen, T. Vezina, Jerry Larrabee

Public Health Projects, 2008-present

Introduction. A syringe exchange is a public health intervention that offers nonjudgmental services to intravenous drug users (IVDU), providing clean syringes in exchange for used syringes. While prior studies demonstrated that syringe exchanges can reduce transmission of HIV, hepatitis C, and other blood-borne pathogens, other measures of health improvements have been less studied.

Methods. 91 members of Vermont CARES syringe exchange program were surveyed on their healthcare practices. New members were defined asprogram.

Results. Long-term members tended to have a primary care provider (PCP). Lack of insurance and fear of judgment were commonly cited reasons for not …

Prenatal Lead Exposure Risk Assessment By Vermont Maternity Care Providers, Amy M. Berkman, Brendon Kinsley, Margaret S. Johnston, Rose Kristine Leu, Niketu P. Patel, Maia Sakradse, George Zhang, Wendy Davis, Matthew Bradstreet

Public Health Projects, 2008-present

Introduction. One percent of women of childbearing age in the U.S. have blood lead levels ≥ 5 ug/dL, which are associated with maternal hypertension during pregnancy, neural tube and cardiac defects in infants, low birth weight, prematurity, and spontaneous abortion. It is unknown whether obstetrics providers in Vermont are screening their pregnant patients for lead levels and educating them on lead exposure risks.

Objective. To gain an understanding of current lead screening practices in Vermont and issue recommendations for disseminating lead screening information.

Methods. We developed and e-mailed a survey to practicing OB/GYN physicians, maternity care focused …

Public Awareness Of Medical Imaging As A Source Of Ionizing Radiation Exposure, Tim Fields, Michael J. Hall, Arjun Janardhan, Lawrence J. Leung, Samantha Magier, Allison B. Robbins, Katie C. Warther, Razelle Hoffman-Contois, William Irwin, Jan Carney

Public Health Projects, 2008-present

Background. Biological effects of exposure to ionizing radiation (IR) are well known. Literature suggests most patients and physicians lack proficient understanding of risks associated with ionizing radiation. Our study goals were to: assess the extent to which productive, informed conversations regarding ionizing radiation are occurring between patients and providers; characterize public awareness of medical imaging procedures as sources of IR exposure; and investigate best practices in patientprovider communications.

Methods. We developed and administered a 17-question survey to 303 adults at five locations across Chittenden County, Vermont, over a 6-week period in fall 2016. Descriptive and statistical analyses were …

Understanding Refugees' Perspectives On Health Care, Khaled H. Al Tawil, Nathan L. Centybear, Julia Lane Cowenhoven, Emily Kinn, Joseph J. Lahey, Jayne Manigrasso, Chantal Mendes, Martha Friedman, Shaden Eldakar-Hein

Public Health Projects, 2008-present

Introduction. Burlington, Vermont accepts refugees from around the world. These individuals face unique barriers to accessing healthcare due to language, culture and finances. Research suggests that cultural beliefs about healthcare can affect ability or willingness to seek medical care. Gaining a better understanding of refugee perspectives of the healthcare system may offer insight into how to rectify this issue.

Objectives. The goal of this study was to learn about refugee perspectives of the healthcare system and assess their use of services.

Methods. We surveyed a convenience sample of 24 refugees to learn more about thoughts and practices surrounding …

Analysis Of Care Coordination For Children With Special Health Care Needs: A Parent's Perspective, Kristen M. Dalton, Desiree N. Dibella, Alan Lee, Althea L. Morrison, Adam Michael Schlauch, Marc J. Vecchio, Paige M. Wood, Lisa Maynes, Heather Link

Public Health Projects, 2008-present

Introduction. Care coordination involves organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve improved outcomes, a recent national focus. Compared to the national average, a higher percentage of Vermont children are cared for in an office that meets medical home criteria. However, there is limited research on medical home and care coordination for children with special health care needs (CSHCN) in the state of Vermont.

Objectives. The goal of this study was to assess family perceptions, knowledge, and attitudes about how well care coordination is working for Vermont …

Headphones And Adolescents: Hearing Loss Prevention, Taylor Sommer

Family Medicine Clerkship Student Projects

Headphone use of adolescents is on the rise due to increased availability of personal listening devices. Hearing loss has also increased in adolescents. This project aims at preventing noise-induced hearing loss by educating adolescents on proper use of headphones.

E-Cigarette Prevention Among Vermont Youth, Tyler W. Wark

Family Medicine Clerkship Student Projects

E-cigarettes are increasingly used by U.S. adolescents, a trend that is particularly troublesome from a public health perspective because they have been linked to conventional tobacco smoking. In Vermont, recent data from 2015 reports that 30% of high school students ever used electronic vapor products. At present the scientific, regulatory, and lay communities all have a dearth of quality information regarding e-cigarettes and their potential adverse health effects. This school-based intervention aims to promote awareness and educate at-risk youth in the Milton School District about e-cigarettes through an educational fact sheet and health blog post.

Sad Management In Lewiston, Me, Ashley L. Deeb

Family Medicine Clerkship Student Projects

Seasonal affective disorder may be a significant issue in Lewiston, ME due to it's latitude. In addition, lack of transportation and poverty are also issues in this community. This project attempts to address treatment and increase awareness of SAD in Lewiston.

Counseling Pregnant Women On Marijuana Use, Theresa B. Flanagan

Family Medicine Clerkship Student Projects

Marijuana is the most commonly used illicit substance for pregnant women nationwide, with rates of use trending upward. Marijuana use in Penobscot County is elevated well above the national average, and is likely to continue to rise with the legalization of recreational marijuana in the state of Maine. Though the American Congress of Obstetricians and Gynecologists (ACOG) discourages marijuana use during pregnancy and breastfeeding, studies have shown that providers do not emphasize counseling pregnant patients on marijuana use. This project looked at provider practices and perceptions regarding marijuana use during pregnancy at the Center for Family Medicine at Eastern Maine …

Promotion Of Skin Protection In Children In Waterbury, Vt, Kelsey M. Sullivan

Family Medicine Clerkship Student Projects

Background: Vermont has among the highest rates of skin cancer in the nation. Between 2001 and 2005, Vermont had the highest incidence of melanoma of any state, 63% higher than the national average. It is also estimated that if children under 18 regularly used sunscreen of at least SPF 15, the incidence of squamous and basal cell carcinomas would decrease by 78%. Modeling by the EPA and CDC suggests that recommended sun protection measures could prevent 11,000 cases of skin cancer, 50 deaths, and $30 million in cancer treatment costs nationwide. Intervention: To create an information sheet on skin protection …

Promoting Antibiotic Stewardship, Saurabh Patel

Family Medicine Clerkship Student Projects

Antibiotics are not always prescribed optimally in the outpatient setting for common respiratory illnesses. Providers also spend time reiterating the same facts to patients about antibiotics and why their use is not warranted for their common cold symptoms. By providing a visual aid that can capture the attention of patients and present concise, easy to retain facts, we may lessen the amount of time providers spend counseling. At the same time, we are able to get patients to contribute to the fight against antibiotic overuse, antimicrobial resistance, and healthcare associated infections.

Concussion, Kasra Sarabakhsh

Family Medicine Clerkship Student Projects

Concussions are very common, especially among young athletes and students. Most patients are encouraged to rest and avoid activities that are physically and cognitively demanding. However, there is not much education regarding alcohol use after a concussion and its detrimental effects on brain recovery.

Connecting Seniors In Franklin County Vermont To Community Resources, Autumn Reilly

Family Medicine Clerkship Student Projects

Vermont currently has the second oldest population in the country and the elderly population is continuing to increase. Senior citizens define aging successfully as having good health, strong friendships, and being able to participate in activities. In order to meet the needs of seniors it is important to find ways to better connect them with available community resources. The aim of this project was to create a pamphlet of community resources available to seniors in Franklin County, Vermont to aid in connecting them to community involvement and support.

Assessing Patient Perspective Of Current Suboxone Treatment, Midori Eckenstein

Family Medicine Clerkship Student Projects

The number of people seeking treatment for opioid abuse and heroin use. While this number is increasing the number of heroin fatalities is also on the rise. Methadone clinics are reporting better retention rates than suboxone treatment. This project explores the patient perspectives of suboxone therapy and what can be improved to help establish better practices.

Educating Patients About Behavioral Interventions And Exercises For Musculoskeletal Lower Back Pain, Alex Jacobson

Family Medicine Clerkship Student Projects

Low back pain (LBP) is a common problem which affects all genders and most ages. It results in considerable direct and indirect costs, and these costs are financial, workforce and social. The majority of lower back pain occurs due to a musculoskeletal etiology and often presents to the primary care physician. We worked with local physicians, chiropractors, physical therapists, and athletic trainers to develop exercises and behavioral modifications that patients can do to improve lower back pain symptoms.

Expanding Access To Dental Care For Patients On Suboxone, Nathan E. White

Family Medicine Clerkship Student Projects

Those using Suboxone® for medication-assisted treatment for opioid dependence are at increased risk for poor oral health for a variety of reasons including lifestyle factors, effects of opioids and the direct impact of Suboxone® on the oral environment. Medication assisted addiction treatment programs do not regularly address these concerns. This project aims to educate patients about the importance of oral health, remind providers to screen for dental issues and make referrals for dental care and to promote oral health as an important aspect of well being in this vulnerable population

Opioid Prescribing: New Vermont Regulations For Providers, Lloyd Patashnick

Family Medicine Clerkship Student Projects

Opioid abuse is serious problem in Vermont with an estimated yearly health cost of $38 million. In 2015, 28% of Windham county residents were prescribed opioids. In order to combat the ongoing crisis of opioid prescription abuse, the State of Vermont will implement new prescribing regulations which will take effect in July, 2017. To ensure compliance with these new regulations, health care providers need to be educated to allow for a seamless transition in patient care.

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.