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.

Increasing Advanced Directive Utilization In Primary Care, Alejandro Castro

Family Medicine Clerkship Student Projects

Advance directives are a vital tool ensuring patient’s wishes regarding end-of-life care are met. End-of-life discussions with physicians are associated with fewer aggressive interventions and greater quality of life metrics. Increased utilization of advance directives by Vermonters could ensure the wishes of patients are met.

Healthier Living: Diabetes Management, Brandon Childs

Family Medicine Clerkship Student Projects

More than 55,000 Vermonters suffer from diabetes, which is the 6th leading cause of death in the state. There are currently 705 patients in South Burlington Family Practice with a diagnosis of diabetes. More than 100 of them are living with uncontrolled diabetes (elevated HbA1c > 8%) and have not yet obtained the necessary education to manage their chronic disease. Physicians must manage all patients diabetes goals and expectations in 15-30 minute appointments alone, but may refer patients to the Community Health Team for further diabetes education.

Strides For Change: Incentivizing Hispanic Youth To Promote Exercise, Fitness And Wellbeing, Priyanka Chilakamarri

Family Medicine Clerkship Student Projects

The United Way of Western Connecticut's 2014 annual report on Danbury's Young Children found that Danbury's children are facing many physical fitness challenges compared to the state of CT. A study looking at 4th graders in a physical fitness test finds that Danbury students consistently have a harder time passing the fitness test. Of the population studied, 42.5% were ethnically Hispanic.

Increasing Awareness Of Community Resources And Support For Individuals With Depression, Erin Mcelroy

Family Medicine Clerkship Student Projects

Depression is a common mental disorder characterized by loss of interest or pleasure, feelings of guilt or low-self worth, disturbed sleep or appetite, low energy, poor concentration, insomnia or hypersomnia, and occasionally suicidal thoughts. These problems can lead to substantial impairments in an individual's daily functioning. At its worst, depression can lead to suicide. In Vermont, suicide consistently ranks as one of the top 10 leading causes of death.

Radon: The New Carbon Monoxide, Katherine M. Evans

Family Medicine Clerkship Student Projects

Radon is derived from breakdown of uranium naturally found in the environment all across the globe. Some geographic locations have higher levels of radon than others. Like carbon monoxide, radon is colorless and odorless. It is the second leading cause of lung cancer in the United States. Human exposure happens primarily via buildings: 1 in 8 Vermont homes exceed the recommended level. In Brattleboro, 1 in 5 homes exceed the recommended level, but between January 1993 and January 2014, the Vermont Department of Health received only 329 home testing kits from Brattleboro.

Development And Implementation Of A Suboxone Therapy Group, David Hermel

Family Medicine Clerkship Student Projects

Implementing effective opiate detoxification is critical to the health and well-being of the Lewiston-Auburn area, which has the highest rate of admissions for substance abuse (especially non-heroin opiates) and mental health conditions in Maine. The number of Maine residents seeking treatment for prescription drug abuse topped the nation at 368 admissions per 100,000 residents in 2008.

Over The Counter Medication Education Approach, Gurpinder Gill, Ian Crane

Family Medicine Clerkship Student Projects

OTC meds are essential because they give the patient the ability to avoid an unnecessary visit to the doctor's office. They also allow the health care provider to better focus on those with more serious illnesses, and some patients do not have appropriate health care access and rely solely on non-prescription meds. However, patients who use OTC meds do have a tendency to underestimate the serious risks of these meds such as potential for abuse, toxicity, adverse effects, drug interactions, and the delay in seeking a physician's advice.

Preventing Lyme Disease In Windsor County, Vt, J P

Family Medicine Clerkship Student Projects

Lyme disease is a bacterial infection caused by Borrelia burgdorferi and is transmitted primarily by deer ticks (Ixodes scapularis). A deer tick must be attached for at least 36 hours for transmission to occur. It can be prevented by preventing tick bites, removing ticks early, and providing post-bite prophylaxis when appropriate. Lyme disease has been on the rise in Vermont since 2005. The Vermont Department of Health (VDH) has launched its “Be Tick Smart” Lyme disease prevention campaign, promoting tick-bite reduction through its slogan, “Repel, Inspect, Remove.” This project extended the campaign to school children in Windsor County, Vermont.

Preventing And Recognizing Anorexia Athletics - For Coaches And Athletes, William Manning

Family Medicine Clerkship Student Projects

High school athletes are uniquely vulnerable to developing disordered eating. Athletes in general have a higher incidence of eating disorders than does the general population and over 90% of new eating disorders are diagnosed in individuals under 25 years of age. Even in sub-clinical eating disorders, the long-term health consequences can be dire. High school coaches and athletes are aware of eating disorders as a concept but do not regularly receive education of anorexia athletica, its signs and symptoms, and how to intervene in suspected cases. This project created a 10 min YouTube video that high school coaches and athletes …

Clearing The Air: What You Need To Know About Tobacco, Brenton Nash

Family Medicine Clerkship Student Projects

No abstract provided.

Implementing A Mentorship Group To Encourage Long-Term Treatment Of Opioid Addiction, Shannon Li

Family Medicine Clerkship Student Projects

In 2012, Maine topped the nation’s list for prescription opioid abuse. For every 100 residents in the state, 22 prescriptions for opioid pain relievers were prescribed by the healthcare providers. There’s approximately 3,876 primary treatment admissions for prescription opioid abuse between 2009-2013. Since 2010, the number of people seeking treatment has increased 15%, but in order for patients to benefit the most from the suboxone/methadone treatment, it's imperative to provide them with the social support they need, so they could stay in the treatment program long enough to have a significant health benefit.

Pediatric Tooth Care And Fluoride Exposure In Maine, Lucas Grover

Family Medicine Clerkship Student Projects

Maine is a large and rural state with limited access to fluoridated drinking water and consistent health and dental care. There is little information and guidance for parents regarding the importance of home pediatric dental care, early dentist visits, and home testing for fluoridated drinking water. Parents and primary care providers must engage in a dialog regarding proper tooth care to identify child specific risk factors that can lead to childhood caries and chronic tooth decay if not addressed early and aggressively.

The Hidden In Plain Sight Program — A Novel And Interactive Approach To Substance Abuse Prevention And Education, Murtaza I. Bharmal

Family Medicine Clerkship Student Projects

Introduction. Despite stabilizing trends in alcohol, tobacco, marijuana, prescription medication, and illicit drug use reported by the National Institute of Drug Abuse, there is clear evidence that substance abuse is pervasive throughout Aroostook county as well as the state of Maine. Further research shows that parents often overlook everyday items that may indicate that an adolescent is engaging in some form of risky behavior. More so, parents are often apprehensive about talking to their children about risky behaviors and do not know how to appropriately manage these issues or where to seek help. Although there are many resources for substance …

Alcohol Use Among Middle School Children In Vermont, Sargis Ohanyan

Family Medicine Clerkship Student Projects

Alcohol and drug education classes have reduced alcohol use in Vermont middle schools to approximately 20%, however currently no screening or intervention programs are available for the aforementioned 20%. Experts agree that early alcohol use significantly increases the risk of myriad psychosocial problems later in life, therefore early screening and intervention is paramount. The focus of this project is to raise awareness for the need of early screening/intervention regarding alcohol use in Vermont middle schools.