Family Nurse Practitioner Joins Gifford Health Center at Berlin

Jeff Lourie

Jeff Lourie

Family nurse practitioner Jeff Lourie has brought his passion for primary care to the Gifford Health Center at Berlin.

A Cape Elizabeth, Maine, native, Lourie attended The Evergreen State College in Olympia, Wash., earning his bachelor’s degree in organic chemistry. He went on to work in a research lab studying organic chemical synthesis before discovering that what he really wanted to do was help people – hands on.

He became a certified nursing assistant in his native Maine, and then went on to pursue his family nurse practitioner degree at the University of Southern Maine in Portland.

From there he was certain of his career path: rural, primary care.

“It’s where you can really make a difference,” he says of primary care, noting that difference comes in the bonds formed with whole families. “When you see two, three, four generations of families, you really get to understand why things happen.”

Lourie worked for three years at a rural family practice in Wilton, Maine, before moving with his wife, Emily, to her native Vermont in 2013. The couple moved to Barre and Lourie went to work at Berlin Family Practice as a practitioner for Fletcher Allen Health Care.

This month he joined the Gifford Health Center at Berlin, part of Gifford Health Care in Randolph.

In Berlin, Lourie works with family nurse practitioner Tara Meyer in providing primary care at the multi-specialty health center located just off Airport Road.

Board certified by the American Academy of Nurse Practitioners, Lourie is a member of the American Nurses Association, the American Association of Nurse Practitioners, and is on the board of The Vermont Nurse Practitioners Association.

He brings clinical interests in diabetes management, weight loss, preventative care, and pediatrics to the health center. He is also a certified medical examiner for those seeking a commercial driver’s license.

As a primary care provider, Lourie sees his role in part as a motivator and in part as an advocate for patient goals.

“My goal is to partner with patients,” he says. “I want to work on the issues that they want to work on.”

Lourie is seeing new patients of all ages. Call him at the Gifford Health Center at Berlin at (802) 229-2325.

Family Nurse Practitioner with Doctorate Degree Joins Gifford

Christina Harlow

Christina Harlow

A nurse practitioner with advanced degrees and diverse experience has joined Gifford Health Care’s family practice in Randolph.

Family nurse practitioner Christina Harlow holds a bachelor’s degree in nursing from Colorado Mesa University, a master’s degree in nursing from the University of Arizona College of Nursing in Tucson and a doctor of nursing practice degree from the same institution.

She is board certified by the American Nurses Credentialing Center, a member of the American Nurses Association, and has experience in emergency medicine, psychiatrics and more.

A native of Wisconsin, Harlow’s first career was as a mountain bike guide and a river guide in Utah and West Virginia. During that time, however, Harlow lost a brother to mental illness. Looking to her future, she knew she needed a more stable career. The loss of her brother struck an interest in better understanding depression and anxiety.

She went to nursing school and worked internationally as a volunteer in Honduras and Northern India and in the United States as a psychiatric registered nurse, then in specialty and inpatient care and finally in an emergency room. “I wanted to be more well-rounded, because psych is everywhere,” she says of her diverse experience.

She went on to nurse practitioner school and then took the extra step to earn her doctorate in the field.

She worked as an emergency department nurse practitioner in Colorado and as an adjunct professor at Adam’s State University, before deciding to move to Vermont with her family.

Her husband, Dr. Nathaniel Harlow, grew up in Vermont and wanted to be closer to family here.

The couple both joined Gifford – him as a sports medicine provider at the Sharon Health Center and her as a family medicine nurse practitioner in Randolph, where she is looking forward to getting to know her patients and providing well-rounded care.

“I wanted more than just a passing relationship with my patients,” she notes of her emergency department work. “I am really interested in continuity of care.”

In Harlow, patients will find a highly-educated, compassionate caregiver and open communicator.

“Being a nurse first, I have open communication with my patients. I nurse to my patients,” she says. “I like to focus on health. Your health is your wealth.”

“I also really embrace a holistic perspective,” she says, noting she considers a patient’s emotional and spiritual well-being in addition to more common inquiries about diet and exercise.

Harlow’s specific clinical interests include preventative care, women’s health, holistic care and mental illness. As a family nurse practitioner, she treats all ages as well as both men and women.

In her free time, Harlow – a competitive mountain biker, road cyclist, adventure racer, distance runner and climber – enjoys travel and the outdoors. She and her husband are currently living in Brookfield with their young daughter, Juliana, 1.

Harlow is seeing new patients. Call Gifford’s central scheduling line at 728-2777 to make an appointment with Harlow.

Fellowship-trained Sports Medicine Doctor Joins Sharon Health Center

Dr. Nathaniel HarlowDr. Nathaniel “Nat” Harlow grew up in Vermont, in Underhill, so when it came time to put his newly earned sports medicine fellowship to work, he looked to the Green Mountains of his childhood.

Dr. Harlow has joined Gifford Medical Center’s renowned sports medicine practice in Sharon.

A graduate of Brown University in Providence, R.I., he went on to medical school at the University of New England College of Osteopathic Medicine in Biddeford, Maine.

Interested in rural medicine, he completed a family medicine residency at St. Mary’s Family Medicine Residency in Grand Junction, Colo., and went on to work at a Critical Access Hospital in Del Norte, Colo., as an emergency department physician and director of emergency medicine for three years.

An avid climber, skier and mountain biker, Dr. Harlow had considered a sports medicine fellowship out of residency, but the program wasn’t yet developed.

Through his emergency physician role and through work with ski area clinics, he saw many skiing traumas and acute orthopedic injuries. The interest was sparked once more, and by now the fellowship program was developed.

He completed a primary care sports medicine fellowship at Rocky Mountain Orthopedics through St. Mary’s Family Medicine Residency in Grand Junction, Colo.

Already board certified by the American Board of Family Medicine, he went on to earn an additional Certificate of Added Qualification in sports medicine from the same board.

“I believe strongly in providing health care in rural, underserved areas,” says Dr. Harlow, and “I really wanted to come back to Vermont.”

He found just what he was looking for – rural medicine with a sports medicine focus at the Sharon Health Center.

“I’m very excited to be part of the practice. It’s such a strong team environment. It’s a unique practice setting for sports medicine,” he says.

In Sharon, Dr. Harlow is working alongside podiatrists, chiropractors, another sports medicine doctor, an athletic trainer and physical therapists.

Dr. Harlow practices full-spectrum primary care sports medicine including non-operative orthopedics care, as well as the medical aspects of sports medicine, such as care of concussions, sports pre-screenings for heart health, people with asthma and diabetics. He has strong interests in combining sports and wilderness medicine to care for the mountain athlete, using exercise as medicine for non-athletes to help treat and prevent chronic conditions, and osteopathic manipulation.

Friendly and approachable, Dr. Harlow listens to his patients and works with athletes and non-athletes alike to help them reach or return to fitness goals.

Dr. Harlow is a member of the American Medical Society for Sports Medicine, American Academy of Family Physicians and the Wilderness Medical Society.

Now living in Brookfield with his wife and fellow Gifford health care provider, family nurse practitioner Christina Harlow, and their 1-year-old daughter, Juliana, Dr. Harlow enjoys fly fishing and playing guitar in addition to mountain sports. He is also an avid volunteer, both at home and internationally. In fact, he hopes to reach out to area high schools and colleges to provide expertise in concussion management, for example.

To schedule an appointment or learn more, call him at the Sharon Health Center at 763-8000.

Ob/Gyn Dr. Melissa Scalera Joins Gifford Team

Dr. Melissa Scalera

Dr. Melissa Scalera

On her road to becoming an ob/gyn, Dr. Melissa Scalera flirted with Vermont. First there was her undergraduate studies at Williams College just three miles south of the Vermont border in Massachusetts. She crossed the border for Chinese food, antiques, and skiing. Later her residency was at Albany Medical Center in nearby New York.

Now she and her ski enthusiast family are thrilled to be calling Vermont home.

Dr. Scalera has joined Gifford Ob/Gyn & Midwifery in Randolph.

Originally from New Jersey, Dr. Scalera was the first person in her immediate family to attend college.

Her mother made a list of “academically acceptable” schools, starting with Harvard, that her daughter would be “allowed” to attend, Dr. Scalera recalls. Williams was on it. Scalera loved the school and everything about learning. Initially she thought that she’d major in Spanish literature or art history. “Choose something else” was her dad’s reply.

She graduated with a degree in psychology in the middle of a recession and applied for any and every job she could find. She took a position with a direct marketing company that made and sold leather bound books.

Hunched over a budget report one night at 10 p.m. at that long-ago job, she had an epiphany.

Unhappy stuck in a cubical all day, she wanted to be more active, look at fewer spreadsheets, see the sun, and talk to people.

About the same time, she had seen an ob/gyn for a routine exam and blood work. The exam went well, but the follow-up appointment to go over the results of the blood work with a different doctor was less than stellar. He was cranky, didn’t listen, and she left thinking “I can do better than that.”

Twenty-one and full of confidence, she called her mom and said, “I want to be a doctor.” She quit her job, moved in with her parents, and did two years of post-baccalaureate studies in the pre-medical curriculum at nearby Seton Hall University in South Orange, N.J.

She went on to the New Jersey School of Medicine at the University of Medicine and Dentistry of New Jersey in Newark, earning her doctor of medicine degree in 1997. A four-year ob/gyn residency followed at Albany Medical Center in New York.

She spent the next 14 years working as an ob/gyn physician in the United States, in Washington, Texas, Oregon, Pennsylvania, and North Carolina, and in New Zealand.

Her work in New Zealand was meant to be a six-month adventure. She liked it so much she stayed seven years. Her role in New Zealand was that of a specialist. Midwives in New Zealand provide complete obstetric care for low-risk births. General practitioners’ offices provide Pap smears and routine gynecologic care. Dr. Scalera consequently handled high-risk maternity cases, colposcopy or abnormal Pap smears, and gynecologic surgeries.

“I basically backed up every mid-wife in town.”

“I think Gifford and Vermont are the closest to New Zealand that I’m going to get and still be in the continental U.S.,” says Dr. Scalera, who returned to the States to be near family but looked north for snow.

Dr. Scalera and her family, including her husband of 20 years, Bob Pressey, son Michael, 11, and daughter Catherine, 5, are living in Randolph, where they are loving the community and the school system. They hope to find an older home to buy within walking distance of Gifford.

“I think people are really, really nice, and already kids are coming over to ask if my son would like to come out and play,” says Dr. Scalera, remembering her own childhood of neighborhood children at play and wanting that for her family.

Dr. Scalera is board certified by the American Board of Obstetrics and Gynecology and The Royal Australian and New Zealand College of Obstetricians and Gynecologists.

She describes her bedside manner as “friendly.” “I like people and I love to talk,” she says. Her clinical interests include general obstetrics and gynecology.

“Gifford,” she says, is “a really fantastic match for me.”

Dr. Scalera is accepting new patients. Call her at Gifford Ob/Gyn & Midwifery at (802) 728-2401.

Randolph Artist Erica Sears Brings Unique Talent to Hometown Hospital

Randolph artist Erica Sears

“Untitled in Blues” is among Randolph artist Erica Sears’ works now in the Gifford gallery.

Three panels stretch from floor to ceiling. A painted image of a woman on sandstone is just inches tall.

Renowned local artist Erica Sears’ works are in the Gifford Gallery in a month-long show that does not disappoint.

Sears is a Randolph native who graduated from Randolph Union High School in 1985. She went on to receive her bachelor’s degree in fine arts from Otis Art Institute of Parsons School of Design in Los Angeles, where she lived for 15 years before returning to Randolph in 2000.

She has previously shown her work in Los Angeles and throughout this region at Chandler, First Light Studios, Gifford years ago, in Bethel and currently at the White River Craft Center. Three panels also hang in the upper Ester Mesh Gallery at Chandler as part of its permanent collection.

Sears, who has had a varied career, including making, selling and teaching art for 25 years, has a studio in her home and works full-time at Gifford in the Food and Nutrition Services Department.

“My art is how I express, celebrate, explain or push through what happens in my life. Many different things inspire me, influence me, call to me. Each piece is a visual page in my journal. Each idea that needs to be expressed has its own medium that tells the story. Some in paint, some in clay, cloth, pastel, ink, metal or rock. “

Her Gifford show includes 10 pieces, including “garlic moon,” which is made of garlic skins, coated in gloss and set upon a painted block of wood. The three long panels took about two years to create. Wax, birch bark, oil pastel, pencil, ink and charcoal make up other works. “Untitled in Blues” and “Untitled in Reds” – acrylics on canvas – are more recent works.

“I am a very tactile artist,” Sears notes. “I love color and texture. I love all mediums. I love watching how the images take shape. I love watching people interact with the pieces. The conversations that happen between the viewer and the piece are amazing.”

Interact with Sears’ work at Gifford now through Sept. 24. The gallery is located just inside the main entrance of the South Main Street medical center.

Ob/gyn Dr. Sean Tubens Joins Gifford in Randolph

Dr. Sean Tubens

Dr. Sean Tubens

Dr. Sean Tubens’ path to becoming an ob/gyn physician was anything but direct.

The Baltimore native joined the U.S. Marines out of high school and spent four years as an aviation electrician working on F18s and serving during Operation Desert Storm.

He returned home to Baltimore unsure what he would do next. The idea of becoming a lawyer or psychologist appealed to him but the years of school seemed daunting. His father was a hairdresser and although his first instinct was “no way,” he took up his father’s trade.

“It ended up being a lot of fun, and I was actually really good at it,” he recalls, noting he worked as a hair stylist for 12 years and even owned his own salon.

And then the unthinkable happened. His parents died. Both of them.

His mother was diagnosed with cancer on Dec. 1, 1996. She died that same month on Dec. 31. His father had a lung transplant that same year. He had pulmonary fibrosis. Despite the transplant, he died on Aug. 31, 1997 – exactly eight months after his spouse.

An only child, Dr. Tubens found himself at a crossroads and asking the question “Am I happy with the direction of my life?”

“I just didn’t feel I was making a contribution to other people in a way I was capable of,” he said.

After years of avoiding school, “I decided maybe I wanted to be a surgeon.”

At age 31, he hired a tutor to get through his college entrance exams. “I had no college experience whatsoever.”

He attended Towson University in his native Baltimore, graduating magna cum laude in just three years while still working full-time at his salon. He was accepted to and attended Ross University School of Medicine in Dominica in the West Indies and New Jersey.

Obstetrics and gynecology wasn’t his first choice when it came to medicine – until he assisted with a birth from beginning to end. “It was from that moment that I realized what an honor and a privilege it is to be involved in this process, and that that was what I wanted to do.”

Dr. Tubens went on to complete his obstetrics and gynecology residency at Bayfront Medical Center in St. Petersburg, Fla., working exclusively on high risk pregnancies and performing gynecologic surgeries. “I love gynecologic surgery, specifically laparoscopic procedures,” he says.

His work at Bayfront earned him recognitions for excellence in laparoscopic surgery, excellence in reproductive endocrinology and as outstanding resident teacher of the year.

When it came time to look for a job, Dr. Tubens looked for a warm and friendly community where he and his wife could settle with their two huskies.

He has found that in Vermont and at Gifford.

“People are so welcoming. They smile. That’s very attractive,” said Dr. Tubens. “We hope we can spend the rest of our lives here.”

He and his wife, physician assistant Susan Post-Tubens, have bought a home in Bethel.

They have three grown children and in their free-time enjoy golf, skiing, snowboarding, hiking, travel and reading.

For the region, Dr. Tubens, a physician with a calming demeanor who collaborates with patients to improve quality of life, is a new resource for more complicated pregnancies and surgery. His clinical interests include high-risk pregnancies, office gynecologic procedures as well as gynecologic surgery, especially laparoscopic surgery.

His greatest priority is patient safety and care, notes the physician who is a member of both the American College of Physicians and the American College of Obstetrics and Gynecologists. “The most important thing is the patient. That is the number one priority.”

Dr. Tubens is working full-time at Gifford Ob/Gyn & Midwifery in Randolph. Call him at (802) 728-2401.

Orthopedist Dr. Kenyatta Norman Makes Gifford Position Permanent

Dr. Kenyatta Norman

Dr. Kenyatta Norman

Skilled surgeon to stay on in Randolph

When orthopedic surgeon Dr. Kenyatta Norman first came to Gifford Medical Center in January it was meant to be temporary. She was what the industry calls a locum tenens physician. In simple terms, a locum tenens doctor fills in when a hospital has an opening, hasn’t filled it but doesn’t want patients to have to go without care.

Dr. Norman has spent her career working across the country as a locum. That is, until now.

In Gifford and the region, Dr. Norman has found a place where she wants to continue to work and a community where she wants to live and raise a family.

“I am excited to be here. The people are so warm, friendly and nice. That was part of the reason I decided to stay. This area seems perfect as I will be able to be involved with my future children and continue to give excellent care to my patients,” said Dr. Norman.

A native of Indiana, Dr. Norman pursued medicine in part because someone told her she couldn’t.

“I think somebody told me I couldn’t be a doctor (an older gentleman), and I thought ‘Really? Wow.’ I think that cemented it there,” she said, demonstrating the competitive spirit required to become a great surgeon.

She was a child at the time but becoming a physician became her goal.

She earned her bachelor’s degree in biology from Indiana University in Bloomington with a minor in sociology. She went on to medical school at Indiana University School of Medicine.

“I was initially interested in primary care, but after a rotation in general surgery I realized I liked the OR and working with my hands,” she recalled.

And then she did a rotation in orthopedics. “I was enamored after my first orthopedic surgery as a medical student.”

Dr. Norman went on to an orthopedic residency was at Howard University School of Medicine in Washington, D.C., and then continued onto an orthopedic oncology fellowship at Mount Clemens Medical Regional Center in Michigan.

Since, she has worked at Veterans Affairs Medical Centers in Hampton, Va., and Martinsburg, W. Va., and at hospitals and health centers in Kentucky, New Mexico, Illinois and Virginia. The New Mexico post was at Indian Health Services.

“I have worked in many different settings,” Dr. Norman said of her career, “and Gifford is definitely at the top!”

At Gifford, Dr. Norman provides general orthopedics care, help for fractures, arthroscopic surgery and more. Her subspecialty is orthopedic oncology.

A good-natured caregiver who is quick to laugh, Dr. Norman says, “I try to make everyone feel at home and I try to make sure everyone understands his or her health problem, and I really try to treat every patient like a member of my family.”

Dr. Norman is a member of the American Academy of Orthopaedic Surgeons.

She is practicing full-time at Gifford in Randolph with physician assistant Brad Salzmann. Previously from St. Louis, she and her husband have made the community their home.

“I am ready to be part of the Gifford team and become a Vermonter. I may even learn to snowboard,” Dr. Norman said.

Call her at Gifford at (802) 728-2455. Appointments can be made by calling central scheduled at (802) 728-2777.

A Bowl Full of Teamwork: Message from the Medical Staff President

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Ellamarie Russo-DeMara, DO

Ellamarie Russo-DeMara, DO

As health care providers, doctors, nurse practitioners, and physician assistants are often who patients think of and look to when they need care.

In medicine, we’ve long known, however, that it is not an individual providing your care, but a team. From those working hard to keep our facilities clean and well-maintained, to those ordering the supplies needed for an office procedure or surgery, to those scheduling your appointments and answering your calls, it takes everyone doing their job well to ensure that you get the care you expect.

At Gifford, we are fortunate to have an outstanding team that takes its role of providing your care one step further. Here, we’re not just caring for your illness, but for you as a person. As someone who is privileged enough to work at Gifford, I am afforded opportunities to see this special brand of care first-hand. And yet, it often goes unrecognized because it happens so quietly, so seamlessly and with so little fanfare

In this year’s Annual Report, you get a special glimpse at just a bit of what quietly makes Gifford so special. It’s countless acts of kindness by selfless individuals all committed to you. Separately, these efforts are remarkable. Together, they tell a story – a story of a medical center and medical team that takes caring far outside of the exam room to the community, home, and family.

~ Ellamarie Russo-DeMara, DO, Medical Staff President and Gynecologist

_______________________

“Gifford is in the final phase of the Sharon Health Center addition. Sharon has become renowned throughout Vermont and beyond for excellence in sports medicine. This addition is driven by patient demand for care as more and more athletes and weekend warriors seek help from our outstanding team of podiatrists, chiropractors and sports medicine providers.”

~ Dr. Ovleto Ciccarelli, Surgery Division Medical Director

___________________

2013 MEDICAL EXECUTIVE COMMITTEE

President - Ellamarie Russo-DeMara, DO
Vice President - Joseph Pelletier, MD
Secretary - Nicolas Benoit, DPM
Past President - Marcus Coxon, MD
Surgical Division Medical Director - Ovleto Ciccarelli, MD
Hospital Division Medical Director - Martin Johns, MD
Medicine Division Medical Director, Peer Review Committee Chair - Joshua Plavin, MD, MPH
Credentials Committee Chair - Mark Seymour, DO
Administrator - Joseph Woodin

Podiatrist Dr. Samantha Harris Joins Berlin Practice

Gifford podiatrist Samantha Harris

Dr. Samantha Harris

Drawn to the region because of the maple industry, podiatrist Dr. Samantha Harris has joined Gifford Medical Center, specifically the Gifford Health Center at Berlin.

A native of Nashville, Tenn., Dr. Harris started her medical career as a physical therapist, attending Tennessee State University in Nashville and working for seven years in the field before deciding to advance her career. “I wanted to be able to do more for patients and looked into medical school,” she said.

She considered a career in orthopedics but after two podiatric surgeries of her own – one on each foot a year apart – her eyes were opened to the field of foot and ankle surgery.

She attended the Ohio College of Podiatric Medicine in Independence, Ohio, and then completed her residency in podiatric medicine and surgery at Mercy St. Vincent Medical Center in Toledo.

She returned to Tennessee to work in private practice before love and maple syrup had her looking to Vermont.

Dr. Harris’ significant other, Devin Randall, lives in Upstate New York and has a passion for maple production and farming. For the couple, that meant casting their eyes to Vermont. For Dr. Harris, Gifford, which is home to bustling podiatry practices, was the perfect fit.

“I felt like I had known everyone for years on the interview. It was like, ‘Wow, this place is perfect for me,’” says the personable caregiver. “I loved it.”

Gifford has multiple podiatrists, Dr. Rob Rinaldi, Dr. Nick Benoit and Dr. Paul Smith, practicing in Randolph, Sharon and Berlin. Dr. Harris joins the Berlin practice.

Podiatrists diagnose and treat disorders of the foot and ankle, from ingrown toenails and diabetic foot care to reconstructive surgery. Dr. Harris provides all types of podiatry care. Her physical therapy experience also brings extensive knowledge of the body and she is known for spending time with patients, listening and partnering with patients in their recovery.

“I understand the patient point of view as well as the physician point of view,” she says, recalling her own podiatric surgery experiences. “I can look from the inside out.”

Dr. Harris is accepting new patients. Call her at the Gifford Health Center at Berlin at (802) 229-2325 or schedule an appointment with any member of the podiatry team by calling Gifford’s central scheduling line at (802) 728-2777.

Employee Anniversaries

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

employee awards banquetAt this year’s annual Employee Awards Banquet, the following employees were honored for their years of dedication and service to Gifford and its patients.

(Employees are honored on their 5-, 10-, 15-, etc., year anniversaries.)

5 years
Jenell Archer
Angela Bailey
Christie Blodgett
Elizabeth Britch
Sheri Brown
Kristine Day
Peggy Eaccarino
Kate Fellows
Angela Fletcher
Ginny Giles
Jan Giles
Cindy Gurdak
Vera Jones
Brittany Kelton
Sarah Larmie
Laura Larrabee
Peter Loescher
Heidi McClellan
Melinda Mercier
Jamie Miller
Kim Nelson
Shane Parks
Kathleen Riley
Fern Rogers
Brian Sargent
Megan Sault
Joel Schumacher
Jackie Sprague
Melissa Thayer
Scott Warren
Lisa Woods

10 years
Julie Arms
Gail Bourassa
Patrice Conard
Cindy Duval
James Kirkpatrick
Judy Libby
Terry MacDougal
Joe Pelletier
Dan Pritchard
Rob Rinaldi
Sandi Standish

15 years
Kim Connolly
Donna Ferris
Tara Fitzpatrick
Ronda Flaherty
Tina Grant
Beryl McPhetres
Michele Packard
Kim Summers

20 years
Tom Carter
Darlene Doyle
Marc Fournier
Rosalie Knowles
Kevin McNamara
Deanna Mitchell
Sue Molinario
Melanie Munyon
Bonnie Pettit
Karen Sargent
Starr Strong

25 years
Bonnie Hervieux-Woodbury
Kathy MacAskill
Pam Overstrom
Gail Proctor
Laudell Slack

35 years
Marcia Eaton
Karen Lagro

40 years
Maureen Heyder