Medicine and Health Sciences Commons^™

Ensuring Access To Dental Care For Pregnant Women In Vermont, Katia Chavez, Heather Gardiner, Shane Greene, Nicolas Monte, Dwight Parker, Shravan Rao, Reiko Sakai, Kristin Fontaine, Wendy Davis

Public Health Projects, 2008-present

Introduction. In Vermont, $2.7 million is spent annually caring for children ages 0-5 with early childhood caries (ECC) who require hospitalization for treatment. Nationwide, obstetricians are often not familiar with published prenatal oral health guidelines. It is unclear how providers in Vermont address prenatal oral health. Recently, the $495 Medicaid cap on reimbursement for perinatal dental care was lifted and now extends coverage 60 days after delivery, making the prenatal period an ideal time to intervene.

Congestive Heart Failure Patient Education Intervention To Address 30 Day Chf Readmission, Jeanne Gosselin, Jennifer Hanson, Sonam Kapadia, Matthew Lin, Brenton Nash, Luke Neill, Christine Tran, Ted James, William Hopkins, Lori Notowitz

Public Health Projects, 2008-present

Introduction. The ACA Hospital Readmissions Reduction Program recently cut reimbursement for 30 day readmissions. Risk-adjusted congestive heart failure (CHF) 30-day readmission rate at Fletcher Allen Health Care (FAHC) in 2012 approached 22.2% among Medicare patients.

Public Awareness And Perception Of Ionizing Radiation, Jenna Bateman, Bryce Edwards, Katherine Evans, James Levins, Amanda O’Meara, Merima Ruhotina, Richard Smith, Razelle Hoffman-Contois, Heidi Hales, Linda Boccuzzo, Jan Carney

Public Health Projects, 2008-present

Introduction. Exposure to ionizing radiation has potential for acute and chronic health effects. Within the general public, there is discrepancy between perceived and actual health risks. It is vital to assess existing knowledge and perceptions about ionizing radiation among Vermonters.

Barriers To And Resources For Asthma Management In Vermont Elementary Schools, Samantha Boyd, Benjamin Farahnik, Anja Jokela, Emily Keller, Russell Landry, Mikaela Lee, Alice Stoddart, Christopher Ting, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction. Asthma is a chronic obstructive lung disease that causes wheezing, coughing, and shortness of breath, and is a cause of school absenteeism. School nurses play an integral role in asthma care for elementary-aged children.

Barriers To Identifying Trafficked Youth In The Vermont Healthcare Setting, Benjamin Earle, Sarah Johnson, Nishan Bingham, Sarah Rosner, Maya Son, Edith Klimoski, Courtney Schaad, Andrea Green

Public Health Projects, 2008-present

Introduction. Human trafficking affects victims’ physical and psychological health. This study aimed to identify the barriers to access, disclosure, and identification in a healthcare setting for potential trafficked youth in Vermont.

The Effectiveness Of Health Care Coordinators Within A Novel Home Care Model For Elders, Betsy Davis, Jan Carney, Sean Bullis, Sarah Fieber, Chang-Wei Huang, Elizabeth May, Caitlin Mcfarland, Jacob Reynolds, Katelyn Shea

Public Health Projects, 2008-present

Introduction. Our project studied the effectiveness of health care coordinators in a program known as Support and Services at Home (SASH). SASH has been designed to fill the needs of independent, home-bound elders who still need regular access to healthcare.

Creating An Online Cme Module: Early Detection And Diagnosis Of Dementia And Alzheimer’S Disease, Alex Coffman, Grant Goodrich, Matthew Jordan, Erica Marden, Xiaofan Pan, Cornelia Willis, Emily Xue, Martha Richardson, William Pendlebury

Public Health Projects, 2008-present

Introduction. The number of individuals living with dementia and Alzheimer’s disease (AD) in the United States is growing annually; only 40% are properly diagnosed. Primary care providers should identify individuals with cognitive impairment and provide options for care; early diagnosis of dementia and AD helps patients and families plan for the future, increases quality of life, and allows for treatment options.

Competition As A Potential Motivator For Blood Donation, Brandon Childs, Gary Gilmond, Hannah Lowe, Benjamin Jorgensen, Angelina Palombo, Chris Frenette, Mark Fung

Public Health Projects, 2008-present

Introduction. Investigating motivational factors for blood donation is invaluable to understanding how to increase blood availability. Our study evaluates the perceived effect of competition as an intrinsic motivator for blood donation.

Happy Feet: Podiatric Needs Of The Burlington Homeless Population, Priyanka Chilakamarri, Gurpinder Gill, Karl Kristiansen, Benjamin Rayikanti, Michael Sun, Whitney Thomas, Mark Pasanen, Julia Paradiso, Aurora Lenz-Watson

Public Health Projects, 2008-present

Introduction. Many homeless individuals spend a large portion of their days standing or walking, placing particular importance on lower extremity health in this population. However, few studies have been performed to investigate the podiatric needs of this group.

Circle Time Health Curriculum Designed For Pre-Schoolers, Angela Doswell, Laura Griesinger, David Hermel, Bharath Krishnamurthy, Josephine Stout, Daniel Stratz, Phildrich Teh, Elizabeth Valitchka, Jennifer Fink, Cate Nicholas

Public Health Projects, 2008-present

Introduction. Over 20% of low-income, Head Start eligible children are not up to date on regular healthcare exams. While many barriers exist in ensuring universal access and compliance with standard healthcare visits for young children, we sought to educate children about physician’s practices in order to engage and integrate their involvement and understanding of their well-being.

Assessing The Feasibility Of A Mobile Hiv Screening Unit In Vermont: A Community Survey, Kelsey Preston, Daniel Haddad, William Thompson, Sarah Ebert, Kevin Saiki, Leslie Wenning, Stephen Balise, Janel Martir, Peter Jacobsen, Jerry Larrabee

Public Health Projects, 2008-present

Introduction. Estimates show that 20% of HIV-positive individuals are unaware of their serostatus, in part due to limited access to testing services. Challenges of HIV testing within communities may be overcome by providing non-traditional avenues for testing and counseling, such as mobile HIV testing units. Such services have demonstrated success in increasing awareness of personal HIV status, and facilitating diagnosis and treatment.

Nutrition As The Foundation For Good Health: Evaluating The Impact Of Food Programs On Health, Adam Burgess, Nicholas Field, Douglas Handley, Laura Lazzarini, Dilasha Mahat, Daryl Selen, Raj Thakrar, Sarah Adams-Kollitz, Janice Gallant

Public Health Projects, 2008-present

Introduction. Previous studies have demonstrated a link between food insecurity and childhood behavioral problems, particularly internal problems such as anxiety and depression. Burlington Children’s Space (BCS), a local preschool and daycare in Burlington, VT, has created a healthy and nutritious meal program for their children, many of whom cannot afford enough to eat well at home.

Factors Leading To Adolescent Drug Abuse In Winooski, Yun-Yun Kathy Chen, Gia Fraher, Megan Wetzel, Ilsley Colton, Herman Kalsi, Weiss Surkhabi, Flang Nguyen, Kate Nugent, Burton Wilcke

Public Health Projects, 2008-present

Introduction. This study collaborated with the Winooski Coalition for a Safe and Peaceful Community (WCSPC) in order to identify underlying risk factors for initiating drug use in adolescents, ages 13-18 in Winooski, Vermont by implementing focus groups with community stakeholders and agencies.

An Evaluation Of Food Insecurity & Health Behavior Among Rural Community Supported Agriculture (Csa) Participants, Michael Capata, Ian Crane, Taylor Goller, Angie Li, Erin Mcelroy, Noah Quinlan, Deborah Shamsian, Thomas Delaney, Jill Jemison, Paul Feenan, Breck Knauft

Public Health Projects, 2008-present

Introduction. Access to healthy foods is a major barrier for individuals achieving a healthy diet. The literature reveals several investigations into causes of food insecurity, but few focus on Community Supported Agriculture (CSA) programs that attempt to address food insecurity and related health behaviors of participants.

Access To Transportation For Chittenden County Senior Citizens, Alejandro Castro, Leah Fox, Emily Hadley Strout, Pishoy Haroun, Blake Leavitt, Cordelia Ross, Mutlay Sayan, Alyson Platzer, Jeanne Hutchins

Public Health Projects, 2008-present

Introduction. Elderly age often means a progressive loss of independence and mobility. Research has shown that this lack of mobility has a detrimental effect on health and well-being. It is estimated that 25% of Vermonters will be ?65 years by 2030. Thus, the rapid rise in the elderly population will translate into a greater need for reliable transportation. We sought to explore if and how lack of transportation compromised areas of seniors’ daily lives.

Family, Social, And Sexual Health Education In Elementary Aged Children, Sabrina Bedell, Madeline Eells, Tara Higgins, Suleiman Ismael, John Nesbitt, Colette Oesterle, Nicholas Sinclair, Liz Shayne, Eileen Cichoskikelly

Public Health Projects, 2008-present

Introduction. Multiple public health agencies stress the importance of school health education, including family, social and sexual health. The Schoolhouse Learning Center, a private elementary school with grades K-5, wishes to implement a social health curriculum guided by the Sexuality Information and Education Council of the United States (SIECUS).

Concussion Management In Primary Care, James Levins

Family Medicine Clerkship Student Projects

Concussion awareness is a hot topic in youth sports, resulting in increased health care visits. There has been much change in concussion management over the past decade. VT passed a law (Act 68) implementing a concussion management program in schools. Not all primary care physicians are aware of how this law may affect their practice, nor are they all aware of some of the recent changes in concussion management. Improper concussion management can lead to prolonged symptoms, recurrent injuries and long-term sequelae.

Improving Vascular Health Of Patients With Diabetes Mellitus, Pishoy Haroun

Family Medicine Clerkship Student Projects

Some diabetic patients are reluctant to take the extra step in their long-term health care, which is particularly problematic as it relates to cardiovascular disease. In addition to difficulty controlling blood glucose levels, patients struggle maintaining an appropriate blood pressure. This is often due to a reluctance to maintain a proper diet, exercise regularly, and take certain medications. Studies have shown that compliance with exercise regimens falls from 80% at 6 weeks to 20% at one year. Many patients are reluctant to start on a statin, and some physicians are even hesitant to adhere to the new recommendations proposed by …

Influenza: Protect Yourself And Others, Sarah Fieber

Family Medicine Clerkship Student Projects

In clinic, I would recommend to each patient that he or she should consider having a flu shot as flu season is quickly approaching. I heard a plethora of reasons for not being vaccinated, and few of these reasons were fact based. Teenagers are inconsistent about flu vaccination, and I thought if I could present an argument in favor of flu vaccinations, this could make a difference for the coming generations.

Awareness And Prevention Of Heroin Use In Springfield Vt And A Drug Recovery Resource Map Of Southern Vt, Yun-Yun Kathy Chen

Family Medicine Clerkship Student Projects

Since 2000, more than 770% increase in treatment of opiate addiction according to Governor Shumlin’s Vermont annual address. On July 11, 2014, there was a shooting incident in Springfield, Vt., that injured a convicted drug dealer and wounded two other people was triggered by a dispute over heroin. This project aimed to create an educational and interactive pamphlet that can be used in the Family Practice office at Springfield Health Center and beyond in order to encourage dialogue and de-stigmatize heroin use recovery.

Providers’ Views On Transition Of Healthcare For Youth With Developmental Disabilities, Cordelia Y. Ross

Family Medicine Clerkship Student Projects

Problem: Youth with DD have conditions that may limit their ability to function, with resulting social, emotional, or behavioral sequelae, and experience difficulty transitioning from child to adult health care. Also, adult providers may lack training and comfort level in working with patients with DD. For example, youth with ASD need an adult provider who understands autism but doesn’t see every health or behavior problem as a result of autism.

National Need: 1 in 6 children in the U.S. has a DD. Each year, almost half a million of these children transition into adulthood. As for ASD, 1 in 68 …

Improving Vaccination Rates In Bangor, Me, Noah Quinlan, Whitney Thomas

Family Medicine Clerkship Student Projects

Providers believe vaccination rates at EMMC Center for Family Medicine can be higher. A resurgence in some preventable diseases is likely due to decreased immunization rates. While other preventable diseases have not seen a resurgence, the potential for outbreak exists if immunization rates remain low. Factors contributing to low immunization rates are misinformation, lack of awareness, cost, inconvenience, and infrequent office visits by adolescents.

Mindfulness Resources In Lewiston, Me, Sabrina Bedell

Family Medicine Clerkship Student Projects

Mindfulness can be defined as open-hearted, non-judgmental, present moment awareness.
Evidence-based Benefits include
Decreased:
- Blood pressure
- Anxiety, stress, & depression
- Chronic pain
- Medical care visits (inpatient and outpatient)
Increased:
- Immune function
- Ability to act effectively under stress
- Self-esteem
- Quality of life

Fluoride Supplementation: Recommendations In The Primary Care Office, Dwight Parker

Family Medicine Clerkship Student Projects

Physicians in a Vermont family practice setting tend not to be very familiar with CDC/AAP/AAD recommendations regarding fluoride, especially when it came to rural areas in Vermont not on town or public water. Questions include: What are the pros and cons of fluoride supplementation? What are the indications for supplementation? How does one go about testing their well water? Which towns have fluoridated water, and what are their levels? What doses are recommended, and what options are there for treatment?

Hpv Vaccination In Vermont: Identifying Educational Resources For Adolescents, Shane Greene

Family Medicine Clerkship Student Projects

HPV vaccine is unique in that (1) it's not a required vaccine to enter school and (2) it's given at an age where patients have more agency over their medical care, so an adolescent who doesn't want to get the shot is often able to avoid it. In Vermont, there's a lack of educational material aimed at young adults about the benefits of the HPV vaccine.

Identifying And Treating Food Insecurity, Nicholas Field

Family Medicine Clerkship Student Projects

13% of Vermont households are food insecure, an increase of 45% since 2000. 25,400 children and 7,800 seniors in Vermont live with food insecurity. Based on metrics including poor health, hospitalizations, and lower educational productivity, food insecurity cost the State of Vermont $340,000,000 in 2010 alone.

Managing And Treating Allergic Rhinitis In The Primary Care Setting, Leah Novinger

Family Medicine Clerkship Student Projects

Screening and appropriate treatment of allergic rhinitis in the primary care setting is a challenge for providers due to time constraints. Providers in the practice desired more information about where in the community to refer patients with persistent allergic rhinitis and what information or test results they should send those specialists.

Creating Patient Instructions For Community Health Resources, Kevin Saiki

Family Medicine Clerkship Student Projects

In the US, more than a third of adults are obese as well as 17% of children. A recent report estimates the annual cost of obesity in Maine amounts to approximately 452 million dollars. Additional reports estimate the cost of obesity to the entire country lies somewhere between 10-30 billion annually.

Encouraging patients to have healthy diet rich with whole grains, fruits, and vegetables, and to maintain regular exercise (150 minutes a week) are effective ways to combat higher BMIs and to stave off associated hypertension, coronary artery disease, type II diabetes, and dyslipidemia.

Marijuana Use Among Pregnant Women In Buprenorphine Treatment For Opioid Dependence, Tara Higgins

Family Medicine Clerkship Student Projects

New program, "Closer to Home," will allow pregnant women in buprenorphine treatment for opioid dependence to get treatment closer to home and deliver at Copley Hospital instead of being required to go to Burlington. This requires local physicians to prescribe buprenorphine to pregnant women. In creating the program, prescribing physicians have to decide policies around non-opioid substance use.

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.