ScholarWorks @ UVM

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  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, and William Pendlebury

  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.

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  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, and Katelyn Shea

  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.

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  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, and Cate Nicholas

  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.

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  Barriers to Identifying Trafficked Youth in the Vermont Healthcare Setting

  Benjamin Earle, Sarah Johnson, Nishan Bingham, Sarah Rosner, Maya Son, Edith Klimoski, Courtney Schaad, and Andrea Green

  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.

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  Congestive Heart Failure Patient Education Intervention to Address 30 Day CHF Readmission

  Jeanne Gosselin, Jennifer Hanson, Sonam Kapadia, Matthew Lin, Brenton Nash, Luke Neill, and Christine Tran

  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.

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  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, and Jerry Larrabee

  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.

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  The Sara Holbrook Community Center: A Needs Assessment

  Elizabeth Abernathey, Meredith Bryden, Kristin Carr, W. Christian Crannell, Colin King, Andrew Nobe, Michelle VanHorne, Stephen Contompasis, and Jenny Kounta

  Introduction. The Sara Holbrook Community Center (SHCC) offers an after school program for 36 elementary students from the diverse North End neighborhood of Burlington. In recent years, disrespectful behavior and bullying have become a growing problem in the program. Through administering a needs assessment to the staff at Sara Holbrook, we examined the strengths and challenges facing the program and devised potential recommendations to address staff-identified issues.

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  What Are the Barriers and Motivators to Exercise in 50-65 Year-Old Adults?

  Raymond A. Addante, Patrick M. Benson, Liqun Chen, Jenna Ford, Jessica Louie, Kenneth S. Mensch, Dijana Poljak, Kathryn Schlosser, Pam Farnham, and Alexandra Jasinowski

  Introduction. The benefit of exercise in adults has been well established. Research has demonstrated improved cardiovascular health, decreased bone fractures, and increased mental capacity. While the benefits of exercise has clearly been demonstrated, personal barriers to exercise are yet to be fully elucidated. Thus, in collaboration with the YMCA, this study aimed to clarify barriers to exercise in 50-65 year-old adults.

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  Addressing Health Needs of Burlington Probation and Parole Clients

  Zoe F. Agoos, Alison W. Frizell, David Y. Harari, Michael Ma, Jigar M. Patel, Jordan E. Perlman, Michael Ursiny, Herb Sinkinson, and Jill K. Jemison

  Introduction. Higher rates of recidivism have been observed in offenders with specific health risks. Criminal justice literature identifies probation/parole as an ideal time to im-plement health interventions to reduce recidivism, but significant barriers exist

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  Screening for Food Insecurity in Primary Care

  Jenna Arruda, Logan Bartram, Bruno Cardoso, Andrew Jones, Amanda Peel, Darlene Peterson, Justin Van Backer, Sarah Weisman, and Marianne Burke

  Introduction. Hunger Free VT (HFVT) is a non-profit organization whose mission is to end the injustice of hunger and malnutrition for all Vermonters. HFVT developed an internet-based Continuing Medical Education (CME) course in order to bring awareness to the issue of food insecurity and enhance medical provider training. The CME course entitled Childhood Hunger in Vermont: The Hidden Impacts on Health, Development, and Wellbeing was started by 59 health care providers in VT but only completed by 4.

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  Assessing Attitudes Towards Tobacco Advertising in Winooski, VT

  Kristopher Azevedo, Benjamin Brown, Eric Chang, Jessie Evangelista, Ian McDaniels, Olga Kusina, Anisha Patel, Kate Nugent, Burton Wilcke, and Jan Carney

  Introduction. Smoking rates are 15% in Vermont and higher in low-income populations. Winooski, Vermont is vulnerable to high tobacco use rates given that 23.6% of Winooski residents live below the poverty line. Tobacco advertising, which has been shown to have a direct, dose-dependent association with youth tobacco use, is highly prevalent in stores in Winooski.

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  Analysis of Learning Outcomes in LGBTQ+ Medical School Curriculum

  S. Blaney, S. Gardner, J. Garuz, J. Hobson, J. Kelada, H. Munroe, J. Pan, J. Taylor, C. Nicholas, and M. Murray

  Introduction. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are at increased risk for negative health outcomes and experience increased barriers to health care.

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  Establishing A Continuum of Care to Improve Follow-Up Rates for Survivors of Sexual Assault

  M. Bole, J. Ellis, W. Hine, J. Larson, D. Nettlow, J. Price, K. Root, K. Vastine, and J. Gallant

  Introduction. In 2011 there were over 1000 reported sexual assaults in Vermont. Current recommendations suggest that survivors of sexual assault (survivors) receive follow- up care within two weeks after an initial Sexual Assault Nurse Examiner (SANE) exam, but fewer than 15% receive documented follow-up. A published report has demonstrated increased follow-up to over 80% when appointments are scheduled prior to discharge from the emergency department (ED).

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  Promoting Screening of Cognitive Impairment and Dementia in Vermont: A proposal for ongoing continuing medical education (CME)

  Bryan Brown, Jessica Faraci, Shrey Kanjiya, Elizabeth Landell, Marisa Liu, Emily Rosen, Eli Schned, William Pendlebury, Jeanne Hutchins, and Martha Richardson

  In 2010, 11,382 Vermonters were diagnosed with dementia, many of whom had Alzheimer’s disease (AD). In 2025, an estimated 1 in 8 Vermonters aged 65 or older will have some form of dementia. Reported rates of overlooked dementia are between 35% and 90% or greater. Clinical presentations of dementia are often insidious and attributed to aging, making an accurate diagnosis difficult. Because of the challenges of dementia screening and diagnosis, primary care physicians (PCPs) are often unwilling to diagnose, discuss, and treat dementia due to AD.3 Although physicians are reluctant to screen for dementia, research in Vermont (VT) has shown a clear preference by patients and their families for earlier diagnosis. A timely diagnosis allows the patient and their family to plan for the future and start treatment earlier. Our research demonstrated PCPs may be misinformed about the usefulness and implications of dementia screening and diagnosis. In an effort to further educate physicians, we propose instituting a mandatory continuing medical education (CME) hour focused on screening for dementia. Our project surveyed 72 physicians to determine their attitudes towards screening, the assessment tools they use, and their attitudes towards a required CME hour.

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  Evaluating Barriers to Health in Homebound Individuals

  B. Clements, T. Goldberg, D. Gorlen, E. Goveia, K. Hughes, D. Mealiea, N. Meredyth, R. Meehan, A. Anton, and J. Carney

  Introduction. Homebound individuals in Vermont often have multiple comorbidities and can face significant food insecurity. In response to this problem, the Chittenden County Emergency Food Shelf (CEFS) Homebound Delivery Program (HDP) delivers one week of food per month to 130 individuals in Chittenden County, Vermont.

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  Money Follows the Person: Transitioning Nursing Home Residents into the Community

  Whitney Creed, Ryan Hendrix, Matthew MacKinnon, Marissa Mendez, Nancy Tran, Shane Verhoef, Hope Yu, Linda Martinez, Rio Demers, Jeanne Hutchins, and William Pendlebury

  Introduction. Research has shown that admission to nursing homes (NH) is associated with decline in several measures of well-being; transitioning out of a NH into the community is a positive predictor for quality of life. Currently, the State of Vermont offers several housing options for Medicaid eligible NH residents; however, there are very few opportunities to fully integrate into the community

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  Heat vs. Health: Wood Smoke in Vermont

  Michael Cunningham, Avanti Golikeri, Ethan Leveillee, Jennifer Makrides, Hank Ng, Janet Trang, Mark Wilkinson, Heidi Hales, Razelle Hoffman - Contois, and Jan Carney

  Introduction. Given rising energy prices in recent years, wood burning stoves offer an attractive and affordable means of home heating. Unfortunately, wood smoke emissions have been linked to respiratory and cardiovascular disease and, in some cases, premature death. Recent studies have also discovered known carcinogens in wood smoke emissions.

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  Pilot Study of the Effects of Tai Chi on Elderly Fall Risks

  A. Dauten, K. Klingman, K. Min, E. Schloff, V. Shah, C. Sheahan, S. Vossoughi, P. Trabulsy, K. Hall, and D. DeLuca

  Introduction. Falls in the elderly are a significant public health concern. Tai Chi has been shown to reduce falls in this population and increase muscle strength, balance, mood, confidence and sleep.

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  Smoke-Free Policy in Vermont Public Housing Authorities

  C. Hackett, J. Hood, J. Lane, E. Laryea - Walker, T. Lemay, A. Paine, M. Squiers, R. Ryan, and D. Kaminsky

  Introduction. Millions of adults and children living in public housing face exposure to second hand smoke from adjacent apartments. These tenants are less able to escape smoke exposure by moving, and Housing Authorities are beginning to implement smoke-free policies. We assessed the status of smoke-free policy in Vermont public housing, and explored the experience of tenants and managers in Burlington who recently implemented such a policy.

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  Is Blood Donation an Opportunity for Hypertension Awareness?

  J. Hao, C. Kerrigan, L. Kreiger, J. McAvoy, C. Sikavi, D. Swift, L. Wickberg, C. Dembeck, C. Frenette, J. Carney, and M. Fung

  Blood centers serve as a cornerstone of public health by providing potentially lifesaving blood products. Interactions with millions of potential donors provides these centers with a unique means of health education and screening opportunities.

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  Opiate Prescription Practices and VPMS Use: Impacts of the Vermont Prescription Monitoring System

  J. Kilcj, N. Mulheron, K. Pelletier, A. Roberts, J. Simon, C. Wilson, A. Rubin, and M. Sanderson

  Introduction. Our project assessed prescriber use of the Vermont Prescription Monitoring System (VPMS) and collected suggestions for its improvement, and for reducing opiate diversion.

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  A Community Model to Improve Physical Activity in Children

  Hany Abdallah, Laura Caldwell, Conor Carpenter, Katherine Scovner, Timothy Snow, Karan Verma, Janice Gallant, and Sarah Adams-Kollitz

  Introdction: • The prevalence of overweight / obese children aged 2-5 in the United States is 21.2%. The National Center of Health Statistics estimates a 30% increase in the prevalence of obesity between 2001 and 2004. • The Vermont Department of Health estimates that about 30% of low income children between 2 and 5 years of age are overweight or at risk of becoming overweight. • Physical activity programming at child care centers is the most important predictor of physical activity in preschool-aged children, more important than the child’s socioeconomic and demographic characteristics. • Although the National Association for Sports and Physical Education offers some guidelines, there are no clear recommendations for physical activity in childcare settings in Vermont and nationwide.

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  The Effects of Game Based Nutrition Intervention on 5th Graders School Lunch Choices

  Adam Ackerman, Karina Eastman, Albert Emery, Paige Georgiadis, Camilo Martinez, David Reisman, Maramawit Wubeshet, Sarah Heusner, Caroline Homan, and Robert Luby

  Introduction: Evidence shows that consumption of fruits and vegetables has health benefits, yet children across the country consume less than levels recommended by the USDA. Breifel et. al. showed that children aged 5-18 consume up to half of their daily nourishment in the school setting. The National School Lunch Program (NSLP) aims to ensure access to nutritious food for school aged children. The Burlington School Food Project aims to provide nutritious and appealing meals to all students which meet the NSLP guidelines. Observations demonstrate that although the food is available children do not always take advantage of the healthy options provided. Studies have shown that where food is eaten as well as how food is marketed impacts the choices children make on what they consume.[iv],[v] A recent study showed that intervention coupled with food-based education was successful in improving eating habits. Our goal was to improve the food choices made by 5th graders eating lunch at school through a game-based intervention. We hypothesized that by presenting fruits and vegetable in a fun and dynamic manner, in conjunction with education and role-modeling, we could increase the amount and variety of fruits and vegetables consumed by students at lunch.

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  Assessing Wellness Needs of Breast Cancer Survivors in Vermont

  Alison Alpert, Wai Lun Au, David Larsen, Jenna Pariseau, Vanessa Patten, Elizabeth Robison, George Vana, Linda Dyer, and Jan Carney

  Background: • In Vermont, 500 breast cancer diagnoses are made annually. • As of 2005, epidemiological data suggest that as many as 7,000 breast cancer survivors were living in VT. • Dragonheart Vermont’s “Survivorship NOW”4 initiative aims to bridge the gap between treatment and recovery. • A literature review, including the Taking Charge program and a survivor needs assessment done by Dr. Geller, supported conducting a needs assessment in three areas: exercise, nutrition, and emotional support. • UVM COM paired with Dragonheart Vermont’s “Survivorship NOW” initiative to determine how to best address these needs.

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  3 Squares VT Food Assistance Usage by Patrons at the Chittenden Emergency Food Shelf

  Ashley Atiyeh, Elizabeth Blasberg, Katelyn Cushanick, Daniel Edberg, Mairin Jerome, Patrick Ng, Rob Meehan, and Jan Carney

  • The federally funded 3SquaresVT program (formerly Food Stamps) increases access to healthy food and helps to stimulate local economies. • 10.9% of Vermont households are food insecure and 15.8% of children live in food insecure households. • Many families are eligible for 3SquaresVT but choose not to enroll, hurting Vermont’s economy and stressing charitable organizations like the Chittenden Emergency Food Shelf (CEFS).