Medicine and Health Sciences Commons^™

Impacts Of Community-Based Natural Resource Management On Wealth, Food Security And Child Health In Tanzania, Sharon Pailler, Robin Naidoo, Neil D. Burgess, Olivia E. Freeman, Brendan Fisher

Rubenstein School of Environment and Natural Resources Faculty Publications

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-indifferences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than …

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 …

Induced Lactation, Katherine M. Evans

Family Medicine Scholarly Works

Induced lactation refers to the production of breast milk in a woman who has never been pregnant. While induced lactation has been practiced developing nations for centuries, it has only recently been introduced to the United States. Induced lactation allows a woman to provide both nutrition and nurture an emotional bond with an infant in cases of adoption, surrogacy, same-sex couples, maternal-infant separation, and emergencies/natural disasters. Many protocols for inducing lactation have been described, though all vary widely in methodology and effectiveness. The current review summarizes the physiology of human lactation, psychosocial factors involved with inducing lactation, non-pharmacologic and pharmacologic …

The Skinny On Pediatric Obesity, Kim Hageman Md, Rob Luebbers Md

Family Medicine Scholarly Works

Pediatric obesity prevalence in the U.S. has been on the rise for the past few decades. Providers of pediatric patients need to be able to properly define pediatric weight concerns (overweight and obesity) in order to accurately diagnose and therefore help manage the problem. There are a number of contributing factors, which also need to be understood in order to help families manage pediatric weight concerns. Current guidelines to help define and manage pediatric weight concerns are discussed in this lecture.

Robustness Of Spatial Micronetworks, Thomas C. Mcandrew, Christopher M. Danforth, James P. Bagrow

College of Engineering and Mathematical Sciences Faculty Publications

Power lines, roadways, pipelines, and other physical infrastructure are critical to modern society. These structures may be viewed as spatial networks where geographic distances play a role in the functionality and construction cost of links. Traditionally, studies of network robustness have primarily considered the connectedness of large, random networks. Yet for spatial infrastructure, physical distances must also play a role in network robustness. Understanding the robustness of small spatial networks is particularly important with the increasing interest in microgrids, i.e., small-area distributed power grids that are well suited to using renewable energy resources. We study the random failures of links …

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 …

Mainstreaming Early Warning Systems In Development And Planning Processes: Multilevel Implementation Of Sendai Framework In Indus And Sahel, Asim Zia, Courtney Hammond Wagner

College of Agriculture and Life Sciences Faculty Publications

The third UN World Congress on Disaster Risk Reduction, held in Sendai, Japan in March 2015, agreed on a new framework to guide disaster risk reduction policy and practice for the next 15 years. The Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR) leaves important implementation issues unspecified and potentially creates both problems and opportunities for complex, multilevel governance systems in coping with hazards and disastrous events. Early warning systems (EWS), if built into the mainstream of planning for development and disaster relief and recovery, could present a significant opportunity to realize many SFDRR goals. We explore the complexities of …

Are Conservation Organizations Configured For Effective Adaptation To Global Change?, Paul R. Armsworth, Eric R. Larson, Stephen T. Jackson, Dov F. Sax, Paul Simonin, Bernd Blossey, Nancy Green, Mary L. Klein, Liza Lester, Taylor H. Ricketts, Michael C. Runge, M. Rebecca Shaw

Rubenstein School of Environment and Natural Resources Faculty Publications

© The Ecological Society of America. Conservation organizations must adapt to respond to the ecological impacts of global change. Numerous changes to conservation actions (eg facilitated ecological transitions, managed relocations, or increased corridor development) have been recommended, but some institutional restructuring within organizations may also be needed. Here we discuss the capacity of conservation organizations to adapt to changing environmental conditions, focusing primarily on public agencies and nonprofits active in land protection and management in the US. After first reviewing how these organizations anticipate and detect impacts affecting target species and ecosystems, we then discuss whether they are sufficiently flexible …

Social Entrepreneurship And Social Business: Retrospective And Prospective Research, Edgard Barki, Graziella Comini, Ann Cunliffe, Stuart Hart, Sudhanshu Rai

Grossman School of Business Faculty Publications

Social Entrepreneurship and Social Business (SE/SB), inclusive business, businesses with social impact and a higher purpose are becoming increasingly important both in academia and the business world (Sassmannshausen & Volkmann, 2013). Since the influential article by Dees (1998), many different perspectives about social entrepreneurship and social business have been discussed in academia. On the management side, these types of businesses have also proliferated in the last decades. Yunus with his work leading Grameen Bank has inspired many other entrepreneurs and organizations to create a new kind of business more embedded with a social purpose. The main purpose of the Social …

Towards A Structural Understanding Of Spore Germination In Clostridium Difficile, Chloe M. Adams

Graduate College Dissertations and Theses

Clostridium difficile is a Gram-positive bacterium that causes a toxin-mediated disease, typically in individuals whose normal intestinal flora has been compromised by antibiotic therapy. C. difficile is naturally resistant to many antibiotics and produces spores that can withstand harsh environmental conditions and many disinfectants, making the infection difficult to clear and easy to spread. The infection begins when spores from the environment are ingested and germinate upon exposure to taurocholate and glycine in the digestive tract. This germination process is required to initiate infection and thus represents a good target for the development of novel therapeutics. Although spore germination is …

Promoting Time In Nature For Children: Investigating The Role Of Provider Nature Relatedness, Lindsey Gauderer

Graduate College Dissertations and Theses

Research has shown that time spent in and exposure to natural environments has numerous benefits for children, both physical and mental. At the same time, children face many barriers to obtaining time in the outdoors and today's youth spend less time outside than previous generations. Initiatives such as health care provider prescriptions for outdoor activity aim to encourage exposure to nature as a health intervention for children. In order to enhance the potential for success of programs such as these, factors influencing their implementation need to be assessed. This study aims to explore the impact that provider connectedness to nature, …

Glycogen Synthase Kinase-3Β: An Investigation Of The Novel Serine 389 Phosphorylation Site, Brendan Deegan Hare

Graduate College Dissertations and Theses

Stress associated psychiatric disorders such as depression, anxiety, and post-traumatic stress disorder affect a large proportion of the population. Reductions in the complexity of neuronal morphology and reduced neurogenesis are commonly observed outcomes following stress exposure in rodent models and may represent a mechanism for the reduced brain volume in stress sensitive regions such as the hippocampus observed in individuals diagnosed with stress associated disorders. Multiple lines of evidence suggest that glycogen synthase kinase (GSK)-B may play a role in the neurodegenerative phenotype observed following stress exposure. GSK3B is atypical in that it is inhibited by phosphorylation. This inhibitory phosphorylation …

Multi-Sensory Stimulation Environments For Use With Dementia Patients: Staff Perspectives On Reduction Of Agitation And Negative Behaviors, Megan Houston

Graduate College Dissertations and Theses

Background: Dementia is a degenerative neurological disorder that afflicts a growing proportion of the global population. Complementary alternative medicine (CAM) modalities are under investigation for their therapeutic value in the management of dementia.

Purpose: Nursing care of dementia sufferers can include managing agitation and negative behaviors; this study investigates staff appraisal of the Multi-Sensory Stimulation Environment (MSSE) as an intervention for these nursing challenges.

Methods: A purposive sample of nursing staff employed in residential care for dementia patients were recruited 10 weeks after the initiation of an open-access MSSE at the facility to complete a confidential self-administered questionnaire.

Results: 79% …

A Prelimary Study Of Differences Between Voluntary And Involuntary Retirement From Driving: Quality Of Life And Depression In A Rural Population, Elizabeth Ann Pruitt Saxton

Graduate College Dissertations and Theses

Research has revealed a variety of negative health consequences for older adults who stop driving, and with the "graying of America," this will be a frequently encountered issue for healthcare providers. The purpose of this study was to determine if there are differences in quality of life and depressive symptoms between former drivers who made the decision to stop driving voluntarily and former drivers who made the decision involuntarily (either in a resistant or in a reluctant manner). In this cross-sectional cohort comparison study, community dwelling older adults were asked to complete questionnaires of depression (using the Geriatric Depression Scale), …

Reverse Engineering The Human Brain: An Evolutionary Computation Approach To The Analysis Of Fmri, Nicholas Allgaier

Graduate College Dissertations and Theses

The field of neuroimaging has truly become data rich, and as such, novel analytical methods capable of gleaning meaningful information from large stores of imaging data are in high demand. Those methods that might also be applicable on the level of individual subjects, and thus potentially useful clinically, are of special interest. In this dissertation we introduce just such a method, called nonlinear functional mapping (NFM), and demonstrate its application in the analysis of resting state fMRI (functional Magnetic Resonance Imaging) from a 242-subject subset of the IMAGEN project, a European study of risk-taking behavior in adolescents that includes longitudinal …

The Health Care Provider's Experience With Fathers Of Overweight And Obese Children, Eliza Weston Anti

Graduate College Dissertations and Theses

The purpose of this study was to uncover the experience of health care providers (HCPs) as they work with fathers of children who are overweight and obese in the outpatient setting. Interpretative phenomenological analysis was used for data collection and analysis in this study. Seven HCPs were interviewed about their experiences. Two major themes emerged from the experiences of these HCPs: "dad in the backseat," and "paternal resistance." The theme of "dad in the backseat" captured to the HCPs' perception of parental roles and related stereotypes with respect to fathers' lack of presence in the health-care setting, family roles that …

Interprofessional Care Of Elders: Utilizing The Virtual Learning Environment, Mary Val Palumbo, Jennie De Gagne

College of Nursing and Health Sciences Faculty Publications

Background: Video conferencing and a virtual environment was used for teaching interprofessional practice (IPP) when caring for the elderly with students from eight healthcare professions. Is this pedagogy perceived as effective by the students in Interprofessional Competency Domains¹?

Methods: Twenty interprofessional conferences (90 minutes in length) were conducted. Students from nursing, physical therapy, speech and language therapy, social work, nutrition, medicine, exercise science, and pharmacy collaboratively developed a plan of care for a frail elder.

Using the Interprofessional Competency Domains¹, an evaluation survey was developed which included 14 Likert-scaled, five open-ended, and demographic questions. Quantitative data …