University of Vermont Community Tobacco Use and Attitudes Survey

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.https://scholarworks.uvm.edu/comphp_gallery/1216/thumbnail.jp

UVM Tobacco Use and Attitudes After Implementation of a Tobacco-Free Policy

Introduction: Widespread public health initiatives have led to falling smoking rates. Currently, 1,620 U.S. colleges have adopted smoke-free policies. In August 2015, the University of Vermont (UVM) adopted a tobacco-free policy that bans all forms of tobacco use on university property. The purpose of this study was to compare tobacco use and attitudes before and after policy implementation.https://scholarworks.uvm.edu/comphp_gallery/1230/thumbnail.jp

Barriers to Complete Adult Vaccinations in Vermont

Introduction/Background: • Child immunization is nearly universally accepted as an effective preventative measure against infectious diseases, yet adult immunization rates continue to lag behind recommended levels. • Epidemiological trends suggest a correlation between vaccine administration and decreased rates of significant morbidity and mortality, hospitalization and emergency department visits, work absenteeism, and illness associated expenses. • As of 2010, Vermont is failing to meet its adult immunization goals by 13-43%. • This study aims to understand and identify specific barriers to adult immunization in Vermont.https://scholarworks.uvm.edu/comphp_gallery/1076/thumbnail.jp

The Impact of Paid Sick Days on Public Health in an Elementary School Population

Background: The societal impact of Paid Sick Days (PSDs) has not been fully addressed in Vermont. Evidence suggests that PSDs benefit the well being of the employee in addition to saving expenses for the employer and the state. PSDs prevent the spread of diseases such as influenza and allow the ailing individual to receive proper medical attention. Inadequate PSDs not only affect the individual who needs time away from work due to illness, but extend to their entire family. Studies have documented the adverse effects from lack of PSDs on the ability for parents to care for their child. The following facts are known: • 7 states require private sector employees to provide “flexible” PSDs for family members (Vermont does not). • 66% of employers in Vermont do not provide PSDs for their employees. • Parents with PSDs or vacation are 5.2 times more likely to take time off from work to care for their sick child. We hypothesize that elementary aged children of working parents, who have an insufficient amount of PSDs, are more likely to attend school with an acute illness and are more likely to receive inadequate health care (i.e., miss well child check ups).https://scholarworks.uvm.edu/comphp_gallery/1015/thumbnail.jp

Factors Leading to Adolescent Drug Abuse in Winooski

Introduction. This study collaborated with the Winooski Coalition for a Safe and Peaceful Community (WCSPC) in order to identify underlying risk factors for initiating drug use in adolescents, ages 13-18 in Winooski, Vermont by implementing focus groups with community stakeholders and agencies.https://scholarworks.uvm.edu/comphp_gallery/1198/thumbnail.jp

Access to Health Care Through Catamount Health; Do Providers Know Enough to Refer?

Background: On November 1, 2007, Vermont launched ‘Catamount Health,’ a state-sponsored private insurance plan. The goal: to close the gap between privately insured and Medicaid insured Vermonters. Previous programs such as Dr. Dynasaur and VHAP were already in place to care for children and low-income residents respectively. Now, under the umbrella title of “Green Mountain Care,” Catamount Health joins them. Catamount Health offers private coverage through either Blue Cross/Blue Shield of VT or MVP Health Care, the cost of which is offset by the state according to income level and household size. To qualify for Catamount, an individual must have an income of at least $1,277 (lower incomes qualify for VHAP), and meet a number of criteria: • Vermont residents 18 years or older • Not currently eligible for other state-sponsored health insurance programs • Have been living without health insurance for 12 months or more unless insurance was lost due to: - Loss of employment - Divorce from or death of a spouse/partner - Dis-enrollment from college or your parent’s plan - No longer eligible for Medicaid or VHAP - No longer have COBRA coverage • Do not have access to insurance through employer The estimate of uninsured Vermonters is 65,000, or 10$1.6 million dollars to fund a large-scale advertising campaign on television, radio, newspaper, and on foot. Following this campaign, there is a high likelihood that Vermonters will bring questions and concerns about Catamount to their physician offices and community leaders, emphasizing the importance of a well-educated provider.https://scholarworks.uvm.edu/comphp_gallery/1021/thumbnail.jp

Brain changes associated with cognitive and emotional factors in chronic pain : a systematic review

An emerging technique in chronic pain research is MRI, which has led to the understanding that chronic pain patients display brain structure and function alterations. Many of these altered brain regions and networks are not just involved in pain processing, but also in other sensory and particularly cognitive tasks. Therefore, the next step is to investigate the relation between brain alterations and pain related cognitive and emotional factors. This review aims at providing an overview of the existing literature on this subject. Pubmed, Web of Science and Embase were searched for original research reports. Twenty eight eligible papers were included, with information on the association of brain alterations with pain catastrophizing, fear-avoidance, anxiety and depressive symptoms. Methodological quality of eligible papers was checked by two independent researchers. Evidence on the direction of these associations is inconclusive. Pain catastrophizing is related to brain areas involved in pain processing, attention to pain, emotion and motor activity, and to reduced top-down pain inhibition. In contrast to pain catastrophizing, evidence on anxiety and depressive symptoms shows no clear association with brain characteristics. However, all included cognitive or emotional factors showed significant associations with resting state fMRI data, providing that even at rest the brain reserves a certain activity for these pain-related factors. Brain changes associated with illness perceptions, pain attention, attitudes and beliefs seem to receive less attention in literature. Significance: This review shows that maladaptive cognitive and emotional factors are associated with several brain regions involved in chronic pain. Targeting these factors in these patients might normalize specific brain alterations

A review of diagnostic and functional imaging in headache

The neuroimaging of headache patients has revolutionised our understanding of the pathophysiology of primary headaches and provided unique insights into these syndromes. Modern imaging studies point, together with the clinical picture, towards a central triggering cause. The early functional imaging work using positron emission tomography shed light on the genesis of some syndromes, and has recently been refined, implying that the observed activation in migraine (brainstem) and in several trigeminal-autonomic headaches (hypothalamic grey) is involved in the pain process in either a permissive or triggering manner rather than simply as a response to first-division nociception per se. Using the advanced method of voxel-based morphometry, it has been suggested that there is a correlation between the brain area activated specifically in acute cluster headache — the posterior hypothalamic grey matter — and an increase in grey matter in the same region. No structural changes have been found for migraine and medication overuse headache, whereas patients with chronic tension-type headache demonstrated a significant grey matter decrease in regions known to be involved in pain processing. Modern neuroimaging thus clearly suggests that most primary headache syndromes are predominantly driven from the brain, activating the trigeminovascular reflex and needing therapeutics that act on both sides: centrally and peripherally