Public Health Commons^™

Decreasing Inappropriate Usage Of The Emergency Department (Creating Alliances To Deliver Population Health To Seasonal Workforce), Olivia Foster, Lynley Steele-Miller

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No abstract provided.

A Rare Case Of Leprosy In West Florida, Adrian Lugo, Taylor Studsrud, Nemer Dabage, James Demaio

West Florida Division GME Research Day 2020

• Leprosy is caused by acid-fast bacilli of the M. leprae complex, which includes M. leprae and M. lepromatosis.
• Transmission in the U.S. is rare, but has been documented in hunters who handle wild ninebanded armadillo.
• The origins of M. leprae infection among armadillos, the geographic range of the infected animals, and the potential risks infected armadillos present to people have been topics of concern.
• The infection originated amongst armadillos decades before they were ever used in leprosy research, and numerous surveys have confirmed that armadillos in the southern United States are a large natural reservoir for M. leprae; its prevalence …

End The Glow!, Roli Kushwaha, Anthony Furiato, Justin Mcnamee

West Florida Division GME Research Day 2020

Aortic dissection (AD) is part of a group of acute aortic syndromes consisting of intramural aortic hematoma, penetrating aortic ulcer, and aortic rupture. On its own, the incidence is ~3 to 8 cases per 100,000 per year, and up to 25% of cases are missed. The in-hospital mortality when treated is 27%, and with a 2% increase in mortality/hour. Imaging modalities like CT angiography, TEE, and MRA have made improved diagnosis of the disease, but are costly, potentially harmful, time consuming, and require patient stability when in use (1). The key question we have as emergency department providers is if …

Impact Of Order Set Use On Stroke Care, Bilal Nadeem, Edward Waseleski, Meryem Maras-Casey, Sabih Alam, Adnan Faruqui, Michael Gutierrez, Maruthsakhi Molugu, Christina Oricompil, Ashar Mahmood, Katherine Torralba, Fatima Agha, Nour Tlimat, Olu Oyesanmi, Salman Muddassir, Nikolay Mitzov

West Florida Division GME Research Day 2020

A case control study of 118 patients from Oak Hill Hospital between the months of August 2019 and January 2020 was recently completed for a hospital research quality improvement study. The objective was to determine if the use of either Hemorrhagic or Ischemic Stroke Order Set had an effect on the length of stay (LOS) or adherence to current stroke guideline recommendations when compared to its disuse. Results indicate use of either the Hemorrhagic or Ischemic Stroke Order Set led to a decreased length of stay and an increased adherence to current stroke guideline recommendations. Limitations of the study included …

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Michael King, Heather Schramm

West Florida Division GME Research Day 2020

No abstract provided.

Covid-19 Newsletter (Vol. 2), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Epilepsy Risk Among Survivors Of Intensive Care Unit Hospitalization For Sepsis, Tresah C. Antaya, Britney N. Allen, Lucie Richard, Salimah Z. Shariff, Gustavo Saposnik, Jorge Burneo

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• 407 (0.28%) patients developed epilepsy within 2 years of their ICU discharge, 103 (25.3%) of whom were exposed to sepsis.
• Sepsis survivors were significantly more likely to develop epilepsy, relative to non-septic ICU survivors.
• Among sepsis survivors, epilepsy risk increased with age and was higher among those with chronic kidney disease.

Be A Hero Too, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Harm Reduction In The Emergency Department, Alexa J. Golden

Family Medicine Clerkship Student Projects

The number of overdose deaths in Vermont has been trending up over the past several years. A majority of these fatalities involved synthetic opioid fentanyl. The Emergency Department (ED) at Central Vermont Medical Center delivers medication assisted treatment (MAT) through the Rapid Access to MAT (RAM) program. This program has connected many people in the region to treatment for opiate use disorder. However it was identified that we lacked connection to harm reduction services for those not interested in MAT. Harm reduction education was provided for recovery coaches and ED nursing staff. Harm reduction kits containing life-saving supplies such as …

Easily Digestible: Addressing Food Literacy With Short Educational Videos, Kalle J. Fjeld

Family Medicine Clerkship Student Projects

Food literacy is the knowledge and skills needed to select and prepare food as well as determine food intake. These skills are necessary for a healthy diet, which is a major contributing factor to chronic disease prevention and management. People with diseases such as diabetes and cardiovascular disease can have great benefit from improving diet quality through increasing at-home food preparation and consumption of fruits and vegetables. In partnership with a Food Farmacy pilot program at Hudson Headwaters Health Network in Glens Falls, NY this project sought to use web-based food literacy education for a population of 40 patients with …

Raising Awareness About The Vermont Donor Milk Center, Rosie Friedman, Emi Eakin

Family Medicine Clerkship Student Projects

The Vermont Donor Milk Center (VDMC) is an emerging community resource that provides donated, pasteurized breast milk to new parents for their infants. Upon questioning, we identified that many providers did not know about the VDMC or how to prescribe milk. In addition, VDMC expressed that they have not been able to complete the community outreach they had initially hoped for. We chose to dedicate our project to disseminating information about VDMC to perinatal care providers in Vermont.

A Motivational Interviewing Approach Toward Mask Wearing In Franklin County, Vermont, Ashleigh N. Peterson

Family Medicine Clerkship Student Projects

COVID-19 has caused significant morbidity and mortality in Vermont and worldwide since the start of the pandemic. Wearing cloth face masks has been proven to limit viral spread, but few studies have quantified how many people are wearing masks or what their reasons are for doing so. This study aimed to assess and encourage mask use in Franklin County, Vermont by piloting an in-office motivational interviewing intervention at a primary care office.

Improving Hpv Vaccination Rates, Emily Eichner

Family Medicine Clerkship Student Projects

HPV is a very common infection and can cause multiple types of cancers. The HPV vaccination is effective at preventing these infections and subsequent cancers. The HPV vaccine is most effective when given to adolescents; however, the vaccination rates for girls and especially boys remain low. Many reasons exist for parent's choice not to have their kids' vaccinated against HPV. Identifying and addressing these barriers through educational materials for parents will hopefully help improve HPV vaccination rates and reduce rates of these preventable cancers.

Addressing Barriers To Physical Activity In Vermont's Geriatric Population, Stephanie Udawatta

Family Medicine Clerkship Student Projects

A wide array of barriers exist which prevent many geriatric patients from engaging in regular physical activity. This project addresses the barriers unique to Vermont's population of geriatric patients and explores potential solutions.

Addressing Adolescent And Young Adult Mental Health During The Covid-19 Pandemic, Megan Boyer

Family Medicine Clerkship Student Projects

This quality improvement project at South Burlington Family Medicine aimed to investigate the mental health of individuals ages 13-25 in our practice during the COVID-19 pandemic. Eligible patients received a PHQ-9 questionnaire with two additional questions related to COVID-19. Recommendations for future interventions to serve this population were made based on these preliminary findings, with the goal of doing a full PDSA cycle in the near future.

Promoting Physical Activity In School-Aged Children During The Covid-19 Pandemic, Abigail H. Belser

Family Medicine Clerkship Student Projects

Due to the COVID-19 pandemic, children and adolescents are engaging in less physical activity and are increasing their sedentary behavior. These changes can lead to long-lasting negative lifestyle behaviors, which increases risk of health complications.

To ensure safety during the pandemic, guidelines have created restrictions on physical education and sports, which are both primary physical activity outlets for children and adolescents. Children and adolescents have to find alternate ways and resources to meet the recommended 60 minutes of physical activity daily.

An informational pamphlet was created to educate parents and children of current physical activity recommendations, with resources and ideas …

Telemedicine Quality Improvement, Isidora R. Beach

Family Medicine Clerkship Student Projects

Telemedicine use has increased dramatically since the advent of the COVID-19 pandemic in the spring of 2020. However, not all patients and physicians were prepared for this rapid change, and little evaluation of these new mechanisms for delivery of healthcare has occurred thus far. This community project explores patient and physician perspectives on the use of telemedicine in place of in-person visits and makes recommendations for future improvements. Ultimately, telemedicine use will not likely diminish any time soon, making it increasingly important to triage patient visits to determine which would lend themselves well to the telemedicine format. As this project …

Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell

Family Medicine Clerkship Student Projects

The expansion of telehealth with COVID-19 and recent recommendations to use at-home blood pressure monitoring to diagnose and monitor hypertension have increased the need for materials and education for clinicians and patients. A pilot project in Primary Care Internal Medicine UVM in Essex, VT, produced an electronic medical record dot phrase and compiled educational materials to initiate nurse visits for at-home BP measurements. Materials and experience with this pilot was researched for initiation of a similar program at UVM Family Medicine Hinesburg.

Conversations About Safe Firearm Storage With Patients: Why And How, Rose Martin

Family Medicine Clerkship Student Projects

This project outlines the need for firearm safe storage counseling in the medical encounter and provides some evidence-based suggestions regarding how to approach conversations about safe firearm storage with patients.

The Use Of Mindful Breathing As Part Of The Healthcare Intake Process, Deena Chanowitz, Lauren Struck

Family Medicine Clerkship Student Projects

Most Americans visit the doctor’s office for an acute or chronic condition or for preventative care. No matter what the reason, a visit to the doctor’s office can be stressful for a patient. Our study was designed to determine whether a patient’s experience of the visit can be improved using a mindful breathing exercise. We developed a system for teaching a two minute breathing exercise, with a brief questionnaire to evaluate how the patient feels before and after the intervention. We presented our study design to practitioners in primary care offices in VT and CT who were receptive to the …

Onecare Vermont Aco Quality Metric Evaluation, Alexander Braun

Family Medicine Clerkship Student Projects

This project explores OneCare Vermont ACO quality metrics and how they can be used to improve patient care and reimbursement in a Vermont family medicine practice. Perspectives of physicians within the practice and others familiar with OneCare Vermont operations are shared. Several metrics were identified as areas for improvement within the practice by comparing ACO metrics with patient data.