Addressing the Needs of Sara Holbrook Community Center Caregivers

Previous research: parental stress can negatively impact behavioral and cognitive development of children. Each year, over 4,000 people use SHCC resources: preschool, after school care, teen programs, food shelf, ESL services, etc. SHCC supports families at the center itself, but many families still experience difficulties at home that contribute to caregiver stress. The purpose of this study: understand the needs of the caregivers of students who attend SHCC and propose actionable solutions to address the top identified needs.https://scholarworks.uvm.edu/comphp_gallery/1315/thumbnail.jp

Associations Between Daily Wellness Behaviors and Outcomes among Medical Students

Objective: Explore which wellness behaviors have the greatest impact on wellbeing outcomes in medical students. Methods: A total of 213 medical students were enrolled in this study between June and September 2021. Participants completed a battery of online surveys, including demographic information, and 60-second nightly surveys on the WE-MD smartphone app, which assessed wellness-related indicators (exercise duration, sleep quality, nutrition quality, etc.) and wellbeing outcomes (mood, focus, stress, etc.). Results: 116 participants completed \u3e50% of nightly surveys between September 2021 and November 2021 and were included in the analysis. All wellness indicators were significantly associated with at least one wellness outcome. Quality of social interactions had the greatest relative positive association with wellbeing. Any amount of exercise, including 1-30 minutes, was significantly associated with improved wellbeing outcomes compared to no exercise. A lagged analysis separating indicators and outcomes by one day found wellbeing was only associated with limited sleep (\u3c 6 hours) and higher nutritional quality the day prior. Conclusion: This study provides substantial information on daily wellness behaviors and their relative impact on medical student wellbeing. Social interaction and exercise of any duration may be more important to wellbeing than previously recognized. Infrequently studied behaviors, including kindness, nutrition, and screen time, were also found to have significant associations with wellbeing. The numerous significant associations between behaviors and outcomes suggest a cumulative effect and point to the multifactorial nature of medical student wellbeing. This study may aid medical schools in developing high-impact initiatives and curricular changes that promote wellbeing for their students

Creating a screening tool to prevent intimate partner violence (IPV)

https://scholarworks.uvm.edu/fmclerk/2044/thumbnail.jp

A Comparative Analysis of Health-Related Quality of Life 1 Year Following Myomectomy or Uterine Artery Embolization: Findings from the COMPARE-UF Registry.

Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31-45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p < 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p < 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL. Clinicaltrials.Gov Identifier: NCT02260752

A Comparative Analysis of Health-Related Quality of Life 1 Year Following Myomectomy or Uterine Artery Embolization: Findings from the COMPARE-UF Registry

Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31-45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p \u3c 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p \u3c 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL. Clinicaltrials.Gov Identifier: NCT02260752

A Comparative Analysis of Health-Related Quality of Life 1 Year Following Myomectomy or Uterine Artery Embolization:Findings from the COMPARE-UF Registry

Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31-45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p < 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p < 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL. Clinicaltrials.Gov Identifier: NCT02260752

Long Term Health-Related Quality of Life and Symptom Severity Following Hysterectomy, Myomectomy, or Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids

BACKGROUND: Few studies have directly compared different surgical procedures for uterine fibroids with respect to long-term health-related quality of life outcomes and symptom improvement. OBJECTIVE: We examined differences in change from baseline to 1, 2 or 3-year follow-up in health-related quality of life and symptom severity among patients who underwent abdominal myomectomy, laparoscopic or robotic myomectomy, abdominal hysterectomy, laparoscopic or robotic hysterectomy, or uterine artery embolization. STUDY DESIGN: The COMPARE-UF Registry is a multi-institutional prospective observational cohort study of women undergoing treatment for uterine fibroids. A subset of 1,384 women ages 31-45 years who underwent either abdominal myomectomy (n=237), laparoscopic myomectomy (n=272), abdominal hysterectomy (n=177), laparoscopic hysterectomy(n=522), or uterine artery embolization (n=176) were included in this analysis. We obtained demographics, fibroid history, and symptoms by questionnaires at enrollment and at 1-, 2-, and 3-years post-treatment. We used the Uterine Fibroids Symptom and Quality of Life (UFS-QoL) questionnaire to ascertain symptom severity and health-related quality of life scores among participants To account for potential baseline differences across treatment groups, a propensity score model was used to derive overlap weights and compare total HR-QoL and symptom severity (SS) scores post-enrollment with a repeated measures model. For this HRQOL tool, a specific minimal clinically important difference (MCID) has not been determined, but based on previous research, a difference of 10 points was considered a reasonable estimate of MCID. Use of this difference was agreed upon by the Steering Committee at the time the analysis was planned. RESULTS: At baseline, women undergoing hysterectomy and uterine artery embolization reported the lowest health-related quality of life scores and highest symptom severity scores compared to those undergoing abdominal myomectomy or laparoscopic myomectomy (p\u3c0.001). Those undergoing hysterectomy and uterine artery embolization reported the longest duration of fibroid symptoms with a mean of 6.3 years (SD: 6.7, p\u3c0.001). The most common fibroid symptoms were menorrhagia (75.3%), bulk symptoms (74.2%), and bloating (73.2%). More than half (54.9%) of participants reported anemia, and 9.4% women reported a history of blood transfusion. Across all modalities, total health-related quality of life and symptom severity score markedly improved from baseline to 1-year with the largest improvement in the laparoscopic hysterectomy group (UFS-QoL: delta= (+) 49.2; symptom severity: delta= (-)51.3). Those undergoing abdominal myomectomy, laparoscopic myomectomy, and uterine artery embolization also demonstrated significant improvement in health-related quality of life ( delta= (+)43.9, (+)32.9, (+)40.7, respectively) and symptom severity (delta= (-)41.4, (-) 31.5, (-) 38.5, respectively) at 1 year, and the improvement persisted from baseline for uterine sparing procedures during 2(nd) (UFS-QOL: delta= (+)40.7, (+)37.4, (+)39.3 SS: delta= (-) 38.5, (-) 32.0, (-) 37.7 and 3(rd) year (UFS-QOL: delta= (+) 40.9, (+)39.9, (+)41.1and SS: delta= (-) 33.9 , (-)36.5, (-) 33.0, respectively), post-treatment intervals, however with a trend towards decline in degree of improvement from years 1 and 2. Differences from baseline were greatest for hysterectomy; however, this may reflect the relative importance of bleeding in the UFS-QoL, rather than clinically meaningful symptom recurrence among women undergoing uterus-sparing treatments. CONCLUSION: All treatment modalities were associated with significant improvement in health-related quality of life and symptom severity reduction 1-year post-treatment. However, abdominal myomectomy, laparoscopic myomectomy and uterine artery embolization indicated an a gradual decline in symptom improvement and health-related quality of life by 3(rd) year post-procedure