Medicine and Health Sciences Commons^™

Behavioral Intervention Education For Pediatric Functional Constipation: A Feasibility Project, Meredith Brady, Jean Pelski Ph.D., Aprn, Nnp-Bc

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

Background: Functional constipation (FC) is a common condition frequently seen in pediatric primary care, with an estimated median prevalence of 16% among pediatric patients (Mugie et al., 2011). Standard care for this condition is typically limited to laxative therapy, however evidence supports improved outcomes for patients who also receive behavioral intervention education. Purpose: The purpose of this quality improvement study was to assess the feasibility of implementing a standardized intervention strategy in a primary care setting for pediatric patients with FC to inform a future pilot study. Methods and interventions: This feasibility study was completed in three steps. 1) A …

Plasma-Based Assays Distinguish Hyperfibrinolysis And Shutdown Subgroups In Trauma-Induced Coagulopathy, Michael A. Lawson, Lori A. Holle, Nathan E. Dow, Grant Hennig, Bas De Laat, Hunter B. Moore, Ernest E. Moore, Mitchell J. Cohen, Beth A. Bouchard, Kalev Freeman, Alisa S. Wolberg

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

BACKGROUND

Trauma patients with abnormal fibrinolysis have increased morbidity and mortality. Knowledge of mechanisms differentiating fibrinolytic phenotypes is important to optimize treatment. We hypothesized that subjects with abnormal fibrinolysis identified by whole blood viscoelastometry can also be distinguished by plasma thrombin generation, clot structure, fibrin formation, and plasmin generation measurements.

METHODS

Platelet-poor plasma (PPP) from an observational cross-sectional trauma cohort with fibrinolysis shutdown (% lysis at 30 minutes [LY30] < 0.9, n = 11) or hyperfibrinolysis (LY30 > 3%, n = 9) defined by whole blood thromboelastography were studied. Noninjured control subjects provided comparative samples. Thrombin generation, fibrin structure and formation, and plasmin generation were measured by fluorescence, confocal …

Benign Vs. Malignant: Improving Prevention And Detection Of Cancerous Vs. Non-Cancerous Skin Lesions Through Inclusive Patient Education, Simran Kalsi, Sam Afshari

Family Medicine Clerkship Student Projects

Vermont consistently has one of the highest annual rates of melanoma in the United States. This is likely due to a range of factors including population demographics (predominantly white, aging population), active outdoor lifestyles, intense seasonal bursts of sun exposure, and inadequate Winter sun protection. The COVID-19 pandemic and its associated shutdowns have caused significant delays in healthcare delivery, further exacerbating the incidence and severity of melanoma. Primary care providers are therefore an increasingly essential first line of defense in detecting suspicious skin lesions and expediting treatment of skin cancer, but patients should be aware of when to seek evaluation. …

Improving Identification Of Dermatological Conditions In Skin Of Color, Sam Afshari B.S., Simran Kalsi M.S.

Family Medicine Clerkship Student Projects

Vermont primary care practitioners are less likely to have experience diagnosing dark skin tones given that the state population is 94.2% white. Only 4.5% of images in general medicine textbooks and 4-19% of images in dermatology textbooks depicted darker skin. Black patients are significantly less likely to see a dermatologist, which highlights the importance of diagnosis at the primary care office.