Medicine and Health Sciences Commons^™

More Than A Meal : A Resource For Communities Striving For Food Sovereignty Through The Charitable Food System, Kaitlin J. Robertson

Food Systems Master's Project Reports

The 2020 pandemic and economic crisis showcased the fragility of the American food system. In the months of quarantine and lockdowns, a growing number of Americans searched for ways to feed themselves and their families. Community-based and volunteer-supported feeding programs worked to bridge the divide between the hungry and their next meal. In many cases, these programs rely on an unpaid workforce and donations – of time, food, and facilities. With limited resources, volunteer-led programs often lack centralized training options; this guidebook seeks to fill that void. This project is a streamlined, introductory-level guide for volunteers and community members working …

Emulating Agricultural Disease Management: Comparing Risk Preferences Between Industry Professionals And Online Participants Using Experimental Gaming Simulations And Paired Lottery Choice Surveys, Eric M. Clark, Scott C. Merrill, Luke Trinity, Gabriela Bucini, Nicholas Cheney, Ollin Langle-Chimal, Trisha Shrum, Christopher Koliba, Asim Zia, Julia M. Smith

College of Agriculture and Life Sciences Faculty Publications

Mitigating the spread of disease is crucial for the well-being of agricultural production systems. Implementing biosecurity disease prevention measures can be expensive, so producers must balance the costs of biosecurity investments with the expected benefits of reducing the risk of infections. To investigate the risk associated with this decision making process, we developed an online experimental game that simulates biosecurity investment allocation of a pork production facility during an outbreak. Participants are presented with several scenarios that vary the visibility of the disease status and biosecurity protection implemented at neighboring facilities. Certain rounds allowed participants to spend resources to reduce …

Quantifying Language Changes Surrounding Mental Health On Twitter, Anne Marie Stupinski

Graduate College Dissertations and Theses

Mental health challenges are thought to afflict around 10% of the global population each year, with many going untreated due to stigma and limited access to services. Here, we explore trends in words and phrases related to mental health through a collection of 1- , 2-, and 3-grams parsed from a data stream of roughly 10% of all English tweets since 2012. We examine temporal dynamics of mental health language, finding that the popularity of the phrase ‘mental health’ increased by nearly two orders of magnitude between 2012 and 2018. We observe that mentions of ‘mental health’ spike annually and …

Health Screening For Individuals Diagnosed With Mental Illness Within A Housing-First Organization, Jennifer J. Chamberlin

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

Background: Individuals with serious mental illness are a high-risk population that need improved access to physical health care. Many have negative experiences with the healthcare system and need support in accessing it. A housing-first organization in Vermont offers wrap-around services to these individuals but does not have a standardized way to assess for client healthcare needs or to communicate with primary care provider offices.

Purpose: The project aimed to: 1. Identify the current processes used to assess client health needs; 2. Change organizational workflow to include comprehensive and standardized health protocols. 3. Instruct staff to increase knowledge to identify and …

Preliminary Analysis Of Vermont's Ems Naloxone Leave-Behind Program, Samantha J. Bissonette

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

Background: Naloxone is well known to effectively reverse the effects of unintentional opiate overdose and reduce mortality from opiate overdose (12, 18). Despite activation of emergency medical services (EMS) after an overdose, many patients choose against transport to a hospital for further treatment and initiation of support services. These patients were previously left on scene without any additional support or services, despite encountering emergency medical personnel. To supplement the state's naloxone distribution efforts, Vermont initiated an EMS protocol allowing all levels of providers to provide naloxone leave-behind kits to patients and/or their family or friends when a patient is identified …

Climate Impacts Associated With Reduced Diet Diversity In Children Across Nineteen Countries, Meredith T. Niles, Benjamin F. Emery, Serge Wiltshire, Molly E. Brown, Brendan Fisher, Taylor H. Ricketts

College of Agriculture and Life Sciences Faculty Publications

It is widely anticipated that climate change will negatively affect both food security and diet diversity. Diet diversity is especially critical for children as it correlates with macro and micronutrient intake important for child development. Despite these anticipated links, little empirical evidence has demonstrated a relationship between diet diversity and climate change, especially across large datasets spanning multiple global regions and with more recent climate data. Here we use survey data from 19 countries and more than 107 000 children, coupled with 30 years of precipitation and temperature data, to explore the relationship of climate to child diet diversity while …

Improving The Therapeutic Environment In The Crisis Stabilization Unit At Glens Falls Hospital, Emma Hall

Family Medicine Clerkship Student Projects

The Crisis Stabilization Unit (CSU) at Glens Falls Hospital provides a separate, safe space within the Emergency Department for adults and children struggling with mental health crises to stabilize before discharge or admission to an inpatient psychiatric unit. An increase in mental health crises over the past 10+ years plus a shortage of nearby inpatient beds, especially for adolescents and children, has led to longer stays in the CSU. Longer stays in a place not built for therapeutic intervention but rather for crisis stabilization may lead to increased agitation, prolonged stays or prolonged time to stabilize a patient, and potentially …

Opportunities For Patient Self-Reflection During Acute Phase Of Depression Treatment, Millen Abselab

Family Medicine Clerkship Student Projects

This project for UVMMC Family Medicine at Hinesburg investigates the acute phase of depression treatment for adult patients and introduces opportunities for patient empowerment during this 4-to-6-week window through de-identified automated text surveys for self-reflection about treatment and pattern tracking contributory to mood. Sample text survey built on Beck Depression Inventory (BDI-II) and deployment of text surveys is based on Mosio. Future interventions can utilize mobile phone apps based on patient response to surveys.

Medication-Assisted Withdrawal And Alcohol Use Disorder Treatment In The Ambulatory Setting, Jacob Okie Weiss, Javad Mashkuri Md, Marissa Patrick Aprn

Family Medicine Clerkship Student Projects

Alcohol use disorder (AUD) represents a significant burden of disease in central Vermont, but receives little attention and resources compared to other drivers of morbidity and mortality. As part of a community health improvement project, primary care providers in central Vermont were surveyed regarding current practices and perceived barriers related to the effective treatment of AUD. 69% of respondents reported treating alcohol withdrawal syndrome (AWS) and 83% reported treating AUD. Respondents indicated concern about the safety and efficacy of the medications they currently prescribe and expressed interest in learning about other evidence-based treatments for AWS and AUD. The most frequently …

Understanding The Profiles Of Adolescents Engaged In Intentional Self-Poisoning With Suicidal Intent And The Role Of Primary Care In Early Intervention In Vermont, Rachael Comeau

Graduate College Dissertations and Theses

Suicide prevention is a top public health priority in Vermont. It is a complex issue, requiring a multi-faceted response from many different public and private stakeholders. Because intentional self-poisoning with suicidal intent is rarely lethal, it presents a particularly good opportunity for secondary interventions in the primary care setting. Extensive research has been done on intentional self-poisoning with suicidal intent and its relationship to subsequent risk of death by suicide, but gaps exist in research utilizing poison center data in the primary care setting. This dissertation employs an explanatory sequential mixed method research design to (a) develop a profile of …

Updating Evidence-Based Patient Education Resources For Sleep: Sleep Hygiene And Benzodiazepine Discontinuation, Carolyn Geraci, Madeline Fritz

Family Medicine Clerkship Student Projects

There is a major need for patient education around the topics of sleep hygiene and benzodiazepine sleep aid discontinuation in the family medicine clinic setting. Current patient-focused educational materials need updating and are not comprehensive enough. We therefore created new handouts and smartphrases which integrate into the electronic medical record system with the goal of educating patients on these topics.

Increasing Patient Access To Lgbtq+ Healthcare Through Expanding The Vermont Diversity Health Project, Rachel Harrison

Family Medicine Clerkship Student Projects

Numerous studies have documented various disparities in health outcomes and barriers to healthcare access for LGBTQ+ individuals. One major way to combat this is to increase access to healthcare for LGBTQ+ patients and increase provider knowledge of how to best care for them. Through expanding the Vermont Diversity Health Project database of providers and having providers participate in LGBTQ+ Best Practices trainings (both hosted by Pride Center of Vermont), we may reduce LGBTQ+ health disparities in our local community.

Evaluating Patient And Provider Knowledge Of Safe Pharmaceutical Disposal Procedures In Vermont Through A Public Health And Environmental Lens, Emily R. Straley

Family Medicine Clerkship Student Projects

Patient and provider knowledge of safe pharmaceutical disposal procedures is crucial from both a public health and environmental standpoint. Unfortunately, studies have shown that Vermont residents are largely unaware of safe drug disposal programs in their communities. This project evaluated patient knowledge of drug disposal practices and awareness of safe pharmaceutical disposal procedures at Hinesburg Family Medicine. A short phrase was created to better disseminate information about safe drug disposal in Hinesburg, which can be added to a patient’s after visit summary. Many patients report never discussing medication disposal with their physician. Therefore, increased provider communication regarding leftover and unused …

Improving Access To Meditation And Mindfulness For The Management Of Anxiety, Stress, And Other Chronic Diseases, Alex Cohen, Jesse Naumann

Family Medicine Clerkship Student Projects

Chronic diseases can have an enormous burden on not only an individual’s quality of life, but their economic output as well. The challenge is that many patients with a chronic disease are not fully treated despite many different medications and doctor’s appointments. Mindfulness is an extremely beneficial tool that can be used as an adjunctive treatment for different chronic health diseases including anxiety, depression, insomnia, chronic pain, and many others. An enormous barrier is that many patients are unsure about what mindfulness truly is, and where one can go about accessing mindfulness resources. Our goal was to create a quick …

Combating Seasonal Affective Disorder In Vermont, Prasanna Kumar

Family Medicine Clerkship Student Projects

Seasonal Affective Disorder (SAD) is a cyclical pattern of depression-like symptoms that occur during the winter months. In Vermont, SAD is estimated to affect up to 10% of individuals. An informational flyer was developed that explained the symptoms of SAD, what the treatment options are, and then linked individuals with local resources for wellness activities in Chittenden County using QR codes in order to prevent SAD. The flyer was distributed at the Community Health Care Centers of Burlington South End office. The flyer was met with enthusiasm and will be given out to patients at the end of this season …

Assessment And Awareness Of Mental Health Conditions Among Refugees In Vermont, Sandi Caus

Family Medicine Clerkship Student Projects

Refugees experience profound hardship in their home-country, displaced country and throughout the period of re-settlement. Experiences like direct or indirect exposure to traumatic events, torture, sexual abuse and stigmatized refugee identity post-resttlement are major risk factors for the development of mental health coniditions inlcuding PTSD, depression and psychosis. Despite major risk factors for the development of mental health conditions, culturally-specific mental health stigma persists as a major barrier to addressing mental health among refugees. This project emphasizes techniques and self-education that can be utilized to improve mentah health screening and identification among refugee patients in Vermont.

Development And Validation Of The Smoker Self-Stigma Questionnaire (Sssq), Thomas Geist

Graduate College Dissertations and Theses

Though rates of smoking have declined for decades, the tobacco epidemic persists. During this time, denormalization of smoking and the tobacco industry emerged as viable strategies to decrease smoking rates. However, researchers have become increasingly concerned with denormalization strategies’ impact on the stigmatization of smokers, and have questioned their ethics and continued utility. Unfortunately, current research lacks a theoretically and psychometrically sound measure to represent smokers’ experience of stigma and help explore these issues. This study sought to develop and validate such a measure, the Smoker Self-Stigma Questionnaire (SSSQ). Initial items for the SSSQ were developed to cover three domains …