Medicine and Health Sciences Commons^™

The Vermont Youth Conservation Corps Health Care Share: An Immunization For The Future, Paul Feenan

Food Systems Summit 2015

In 2012, The Farm at VYCC partnered with Central Vermont Medical Center (CVMC) to pilot the Health Care Share (HCS), a food security initiative that provides farm fresh produce and poultry to families in need. In 2013, the University of Vermont Medical Center (then Fletcher Allen Health Care), joined the program. Medical providers identify patient and employee families who are unable to afford or access fresh, nutritious food. Families enrolled in the HCS receive a weekly allotment of fresh produce, information on food storage and preparation, and increased access to nutritional counseling.

The HCS relies on a constellation of local …

Vermonters’ Opinions On Low-Dose Ct Lung Cancer Screening, Benjamin Albertson, Eric Bennett, Homer Chiang, Erin Keller, Katherine Lantz, Melanie Ma, Sharon Mallory, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction: Lung cancer is the number one cause of cancer death among men and women in Vermont and the United States. Smoking increases the risk of lung cancer—nearly 90% of lung cancer is due to smoking. Frequently, lung cancers do not present clinically until they are advanced stage and therefore prognosis is poor. However, if detected early lung cancers are more operable and patients have better outcomes. In December 2013 the US Preventive Services Task Force released new guidelines for lung cancer screening among current and former smokers ages 55 to 80. It is recommended that current and former (within …

The Role Of Art In The Patient Experience: An Evaluation Of Art From The Heart At Uvm Medical Center, Doug Chieffe, Steven Coffin, Sarah King, Syed Shehab, Catherine Suppan, Gwen Warren, Rebecca Wieland, Rebecca Schwarz, Mark Pasanen

Public Health Projects, 2008-present

Introduction: The World Health Organization defines health as a state of total physical, mental and social well-being, not just the absence of disease or fragility. Making art in medical settings reduces pain, tiredness, emotional distress and other feelings that negatively affect well-being, while enhancing positive emotions and communication. According to the 2009 “State of the Field Report” by the Society for the Arts in Healthcare, 43-45% of healthcare institutions reported having some form of an art program. Art from the Heart (AFTH) is a program of Burlington City Arts in collaboration with the University of Vermont Medical Center. With the …

Healthcare Barriers Of Residents At A Subsidized Housing Community, Curtis T. Adams, Amy M. Hopkins, Daniel J. Ianno, H. Omer Ikizler, Kristi Kilpatrick, Jani M. Kim, Sargis Ohanyan, Sarah K. Russell, Virginia Hood

Public Health Projects, 2008-present

Introduction: Despite expanded healthcare programs, the low income and elderly lack coverage of vision, hearing, and dental services. Community services are often asked to fill these gaps. To evaluate the situation in Burlington, VT, we surveyed staff and residents in Burlington Housing Authority (BHA) subsidized housing to (1) identify gaps in healthcare coverage and (2) assess barriers to accessing those services in this population.

Who's Accessing Emergency Food Services?, Jia Xin Huang, Michael Hudson, Johanna A. Kelley, Billy Kien, Christopher R. Mayhew, Kiyon Naser-Tavakolian, Jamie Elyse Richter, Alexander W. Thomas, Kelly Mclemore, Judith Christensen

Public Health Projects, 2008-present

Introduction:

Last year, Chittenden Emergency Food Shelf provided 1,260,517 pounds of food to over 11,000 people each month via groceries, hot meals and home delivery, supplying an average of almost 40% of food for families.

CEFS seeks to improve their services and offerings by better understanding the demographics, food preference, and needs of the clients they serve.

Our goal was to collect demographic and utilization data to identify areas where CEFS could enhance services and improve client access to healthful food.

The Charitable Habits Of Blood Donors, Kathryn Colelli, Alyssa Correll, Shannon Li, Jameson Loyal, Ryan Sofka, Jordan Taylor, Andrew Tranmer, Chris Frenette, Mark Fung

Public Health Projects, 2008-present

Introduction: There is a need for a constant supply of blood and blood products (e.g. plasma and platelets) in the American health care system. Common recipients of blood include: patients at risk for major hemorrhage, patients with sickle cell anemia, patients undergoing surgery, and thrombocytopenia in neonatal patients. This demand is met through nationwide blood banks, such as the American Red Cross, and their blood donation programs. The American Red Cross relies solely on volunteer donors; thus, one of the most pressing issues facing this institution is getting donors in the door. Through our survey questions we hope to uncover …

Evaluating Services For Bhutanese Elders At The Champlain Senior Center, Elizabeth Cochrane, Nazey Gulec, Dylan Hershkowitz, Mary Ledoux, Dale Lee, Mohammad Mertaban, Carl Nunziato, Elena Siani, Bonnie Campono, Jeanne Hutchins

Public Health Projects, 2008-present

Introduction:

•Bhutanese refugees have been living in Vermont since 2008. They constitute a vulnerable population due to lack of language skills, increased health care requirements and lack of access to transportation.

The Champlain Senior Center (CSC) provides services and a community space for Bhutanese refugee elders (older than 55 years).

We aimed to determine the necessity for the CSC in the elders’ wellbeing and to demonstrate that services are crucial to ensure this New American elderly population’s needs are being met.

A Life Skills Toolkit: Curriculum Development For Sustainable Public Health Community Engagement, Muhrtaza Bharmal, Bryce Bludevich, Tracey Dafonte, Jonathan Hernandez, Jill Jemison, Sarah Kelso, Tristan Mcknight, Ryan Nichols, Christopher Williams, Margaret Schwalbaum, Luke Zitterkopf

Public Health Projects, 2008-present

Introduction: Committee On Temporary Shelter (COTS) is a community organization that provides gateway housing opportunities to fourteen previously homeless veterans through its Canal Street program in Winooski, VT. Many of the residents struggle with physical fitness, poor nutrition, and mental illness, including PTSD. Research has shown that there is an increasing prevalence of overweight or obese veterans returning from service, and these individuals present a particular challenge to primary care physicians as their mental health issues are closely related to their level of fitness. It has been demonstrated that veterans often suffer from ingrained food insecurity, which negatively influences post-service …

Evaluating Communication Tools And Increasing Fruit And Vegetable Consumption In Vermont Head Start Classrooms, Meghan Breen, Leah Cipri, Troy Larson, Laura Leonard, Andy Liu, Will Manning, Kai Ping Wang, Isobel Santos, Jennifer Fink, Missy Kuncz, Andrea Green

Public Health Projects, 2008-present

Introduction:

We designed a program for four Head Start classrooms that aimed to: 1) Provide classrooms a tool that would facilitate communication with families about nutrition, 2) Educate families about the MyMeal tool, and 3) Increase fruit and vegetable consumption by providing families with fresh fruits and vegetables Fruit and vegetables are important components of a healthy diet, and sufficient consumption helps reduce the risk of developing cardiovascular disease, cancer, diabetes and obesity. Eating behaviors during childhood are highly parentally influenced and function as the foundation for future eating patterns. Studies have shown that the extent to which fruits and …

Improving Wic Retention In Vermont: Beneficiary Attitudes Toward Co-Location In Medical Homes, Lillian Chang, Eunice Fu, Erin Pichiotino, Sasha Taylor, Brian Till, Amy Triano, John Whittier, Donna Bister, Jenna Whitson, Allison K. Howe

Public Health Projects, 2008-present

Introduction:

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a national program aimed at improving the nutrition and health of pregnant women and children.

Those eligible for Vermont WIC include anyone pregnant or with children under 5 that has an income below 185% of federal poverty level or is enrolled in Vermont Medicaid.

WIC has been shown to improve birth outcomes1, breast feeding rates2, infant growth and development, and consumption of important nutrients.

Those enrolled in WIC report high levels of satisfaction

Despite the benefits of WIC, retention rates of eligible families remain low.

Studies have …

Role Of Physicians In Addressing Food Insecurity In Vermont Seniors, Joshua Cohen, Reid Feller, Olivia Harris, Lohrasb Sayadi, Margaret Seybolt, Alejandro Velez, Amy Yu, Daty Davis, Naomi Fukagawa, Jane Kolodinsky

Public Health Projects, 2008-present

Introduction:

This study investigated Vermont physicians’ awareness of - and engagement in – addressing food insecurity experienced by their elderly patients. This information is needed to better understand the role physicians play in solving this problem and to know how education and access to services could ensure that the needs of elders are met in a culturally sensitive manner.

Many elders must choose between paying bills, buying medication or buying food. Some elders are unaware that they qualify for food assistance, or would feel stigmatized using it.

Nationally, 56% of physicians reported that they were not knowledgeable about food insecurity. …

University Of Vermont Community Tobacco Use And Attitudes Survey, Hillary Anderson, Kyle Concannon, Catherine Lapenta, Robin Leopold, Christina Litsakos, Imelda Muller, Asaad Traina, Tom Delaney, Burton Wilcke, Jan K. Carney

Public Health Projects, 2008-present

Introduction: Smoking remains an important public health issue in U.S. Colleges. 17.3% of U.S. smokers are 18-24 years old. 28% of U.S. college students began smoking at age 19 or older. Currently 1,104 U.S. Colleges have adopted Tobacco-Free policies.

Barriers To Exercise And Nutrition For Special Olympics Athletes, Alyssa Kwok, Danielle Leahy, John Mclaren, Christopher Meserve, Joseph Miller, Sierra Trejos, Jacqueline Wade, Mike Frisbie, Chris Langevin, Stephen Contompasis

Public Health Projects, 2008-present

Problem

People with intellectual disability (ID) have higher rates of obesity.

Special Olympics Vermont (SOVT) athletes compete in sports events throughout the year.

Athletes may lose fitness between seasons.

Their nutrition habits remain unknown. •Barriers to exercise and nutrition remain unknown.

Goal

We were tasked with designing a successful exercise and nutrition program for SOVT athletes.

Attitudes Towards Vaccination Among Medical Students: A Two-Site Study, Dylan Devlin, Michael Grant, Trishul Kapoor, Marie Lemay, Sarah Manning, Meredith Sooy, Chris Finley, Jan Carney

Public Health Projects, 2008-present

Introduction:

Mandatory immunization for school age children in the 20th Century led to a substantial decline in infectious disease.

All US states allow medical exemptions from immunizations with 49 permitting additional religious exemptions and 19 permitting additional philosophical exemptions.

Vaccine exemptions have lead to an increase in the incidence of disease outbreaks.

Healthcare providers play a critical role in educating parents about the benefits and risks of immunizations.

This project compares student attitudes and knowledge regarding vaccination at medical schools in two distinct states: one with no additional exemptions (West Virginia) and one with both additional exemptions (Vermont).

Living With Hepatitis C: A Vermont Needs Assessment, Alexandra Brown, Justin Genziano, Julia Powers, Samy Ramadan, Amy Schumer, Matthew Shear, Katherine Wang, Peter Jacobsen, Jerry Larrabee

Public Health Projects, 2008-present

Background:

Hepatitis C (HCV)

Viral infection of the liver spread primarily via blood-to-blood contact (e.g., intravenous drug use (IVDU))

United States: 3.2 million chronic HCV infections (2010)

Vermont: 1.63 cases per 1000 people (2012-2013)

Barriers to Care

Exclusion of current IV drug users from HCV treatment programs despite their high rates of infection

Lack of support, causing decreased treatment adherence

Poor access to treatment: cost, transportation, competing priorities of housing, addiction management, and food

HIV and HCV

Research has shown that the multidisciplinary and integrated HIV model is appropriate for HCV

Vermont CARES

Non-profit organization that provides comprehensive services to …

Public Perception Of Pesticide Exposure In Vermont, Nicholas Bonenfant, Ayse Celebioglu, Bridget Colgan, Pierre Galea, Lucas Grover, Joshua Weaver, Tom Delaney, Razelle Hoffman-Contoi, Linda Boccuzzo, Heidi Hales, Jan Carney, Razelle Hoffman-Contois

Public Health Projects, 2008-present

Introduction: A pesticide is any substance intended for preventing, destroying, repelling, or mitigating any pest.1 The public generally believes that insects, diseases, and other pests need to be controlled but is also becoming concerned about the impact of pesticides on their health and the local ecosystem. Pesticide exposure occurs with public and private use. Studies indicate consumers have diverse levels of awareness, knowledge, and attitudes regarding pesticide use and health risks.2 The goal of this project is to identify levels of awareness, knowledge, and attitudes toward pesticide usage in Vermont to help State agencies focus public awareness and education.

Improving Healthy Habits In Berlin, Vt, Amy I. Triano

Family Medicine Clerkship Student Projects

A significant percentage of patient’s at Berlin Family Practice have diagnoses of Type II Diabetes, hypertension, high cholesterol, and/or obesity. Essential to treatment and management of these conditions are a healthy diet and exercise. There are many local and national resources available but no single place where patient’s can find links to national as well as local resources in the Central Vermont community. There is also insufficient time for physicians or nurses to counsel patients on relevant resources. This project involved creation of a website with community and national resources for healthy living that providers could refer patients to. A …

Determining Barriers To Oral Health Care In Bennington County, Taylor Goller Ms-3

Family Medicine Clerkship Student Projects

Bennington County has some of the worst oral health outcomes in the state of Vermont. A survey was designed to assess current oral health problems, maintenance habits, and barriers to oral health services access. Results are preliminary.

Community Perception Of Electronic Cigarettes And Their Role As Smoking Cessation Aids, Alejandro Velez

Family Medicine Clerkship Student Projects

The popularity of electronic cigarettes is increasing, yet the research is lagging behind. In an effort to better understand, and therefore better advice our patients, a small number of current daily cigarette smokers were surveyed on their understanding of electronic cigarettes and their usage. Two smoking cessation counselors were also interviewed to better contextualize the role of electronic cigarettes as possible smoking cessation aids. Finally, a review of the available research was done to produce a poster, and possibly a handout, in hopes to educate all patients (regardless of their current smoking habits) regarding electronic cigarettes.

Provider Resources For Smoking Cessation Counselling, Pierre Galea

Family Medicine Clerkship Student Projects

Tobacco is still the leading cause of preventable death. The Vermont Department of Health has instituted smoking-related goals for "Healthy Vermonters 2020." One resource that is useful for providers who counsel patients to quit smoking is 802quits. Strategic utilization of this resource and implementation within the healthcare center, is invaluable for providers, and is an effective tool to reach patients and support them throughout their journey.

Slow Foods For Health Increasing Knowledge Of Glycemic Index In Adolescents For Healthier Food Choices, Meredith Kayleigh Sooy

Family Medicine Clerkship Student Projects

Obesity has reached epidemic proportions through the United States affect all age groups, genders, and races. This is especially troubling in the pediatric population where 12.5 million children were found to be overweight in 2010. Many adolescents have inadequate knowledge of nutrition basics to make healthy choices. Based on interviews within the community of Colchester, VT a need for information about the glycemic index was seen. A handout geared towards adolescents was created with information about the glycemic index and using this information to make healthy food choices. This handout was made available to all providers of Colchester Family Practice …

Defining Food Agency: An Ethnographic Exploration Of Home And Student Cooks In The Northeast, Maria Carabello

Graduate College Dissertations and Theses

According to popular and academic sources, home cooking is in decline. Nutrition and public health scholars concern that a loss of cooking abilities may diminish individuals' control over their food choices, thus contributing to poor health outcomes. Yet, there are still many unanswered questions. What skills, strategies, and knowledge sets are required to cook a meal on any given occasion? What capacity separates those who cook with ease from those who struggle to incorporate cooking into their daily routines? I propose that this difference is determined by an individual's capacity to employ a range of cognitive and technical skills related …

A Comparative Examination Of The Safety Programs At Ucla, Umn, And Uvm In Response To Recent Chemistry Laboratory Incidents, Victoria Carhart

Graduate College Dissertations and Theses

Laboratory safety has recently become more of an imperative in research laboratories than it has ever been in the past. Recent accidents at several universities have escalated the awareness of safety concerns in laboratory workspaces among the general public and created a greater need for a stronger culture of safety in chemistry research overall. Historically, results and publications have been the top priority of most researchers, not laboratory safety.

This thesis discusses a number of laboratory accidents. The first happened in December of 2008 at the University of California, Los Angeles (UCLA) and resulted in the death of a graduate …

From Dar Es Salaam To Dartmouth: A Case Study Of The Experiences Of Fogarty Aids International Training And Research Program Fellows At Dartmouth College, Lisa Anne Purvis

Graduate College Dissertations and Theses

From Dar es Salaam to Dartmouth: A Case Study of the Experiences of Fogarty AIDS International Training and Research Program Fellows at Dartmouth

Lisa Purvis, EdD Candidate, MPH, MBA

Background

The United States (US) is a major host nation to international college students and scholars who study a variety of disciplines (Farrugia & Bhandari, 2014). Beginning in the last decade, the demand for global health training has risen (Kanter, 2008; Kerry, Ndung'u, Walensky, Lees, Kayanjas, & Bangsberg, 2011).

Since 2000, Geisel School of Medicine at Dartmouth has been one of 26 US universities participating in a global health training program, …

Lyme Disease Awareness In Downeast Maine, Justin L. Genziano

Family Medicine Clerkship Student Projects

Lyme disease is caused by the bacteria Borrelia burgdorferi and is transmitted by the deer tick (Ixodes scapularis). Lyme disease is endemic in the state of Maine with 1,399 probable and confirmed cases reported in 2014. The rate in coastal Hancock County has doubled since 2012, and has the third highest rate of infection in the state.

Medical providers in Hancock County have observed an increase in anxiety and concern about Lyme disease in the community, and have found that much of this is driven by hearsay or unreliable information from the internet. The goal of this project …

Barriers To Recovery For Bangor's Buprenorphine Patients, John R. Mclaren, Erin Keller

Family Medicine Clerkship Student Projects

There are several buprenorphine providers at EMMc's Center for Family Medicine serving the greater Bangor, ME region - an area of substantial opiate use. Among the patient population of outpatient buprenorphine users, both locally and nationally, there are high rates of relapse (~32%). In order to decrease relapse rates, it's first imperative to conduct a baseline review of the current buprenorphine population to identify specific types of patients who are at higher risk of relapse. By understanding the barriers to recovery, the office hopes to apply an intervention to the current program, targeting this local demographic more effectively.

Pediatric Lipid Screening Guidelines: Information For Patients And Families, Erin R. Pichiotino, Mph

Family Medicine Clerkship Student Projects

Universal Pediatric Lipid Screening Guidelines are currently based on expert opinion only. Bright Futures/American Academy of Pediatrics currently recommends screening all patients ages 9-11 and again at ages 17-21. The US Preventive Services Task Force (USPSTF), however, concludes the evidence is insufficient to recommend for or against routine screening. This discordance leaves ambiguity for implementation in Family Medicine practices in Vermont. A survey of providers at Milton Family Practice showed that only 14% of providers at Milton Family Practice regularly perform lipid screening on their pediatric patients.