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Full-Text Articles in Medicine and Health Sciences
Movement Matters: Encouraging Activity In Preventive Medicine, Stefanie Geiger Kelsey
Movement Matters: Encouraging Activity In Preventive Medicine, Stefanie Geiger Kelsey
Family Medicine Clerkship Student Projects
No abstract provided.
Bridging Language Barriers In Clinical Screening: Leveraging Large Language Models (Llms) To Generate Bilingual Screening Surveys For Patients With Limited English Proficiency (Plep), Tyler Vandyk
Family Medicine Clerkship Student Projects
This study addresses the critical need for accessible clinical screening in communities with a high incidence of Patients with Limited English Proficiency (PLEP). Recognizing the limitations of existing interpreter services and the scarcity of validated translations for standard clinical surveys like PHQ-9 and GAD-7, we developed a novel approach leveraging Large Language Models (LLMs). Our method utilizes GPT-4 to create bilingual versions of these surveys, which are then formatted into printable PDFs via a Python script and LuaLaTeX compiler. The resulting surveys, validated for translation accuracy and cultural competency, are made accessible through a Google repository. Preliminary results demonstrate that …
Promoting Spine Health For Adolescent Athletes, Taylor R. Walker
Promoting Spine Health For Adolescent Athletes, Taylor R. Walker
Family Medicine Clerkship Student Projects
Based on interviews with local stakeholders in public health and literature review, developed an informational brochure for high school athletes containing prevention and management strategies and resources for low back pain. The aim of this project is to help young athletes stay healthy and live well as they age by promoting spine health.
Extended Release Buprenorphine (Sublocade) Prescribing In Primary Care, Heather Kettlewell
Extended Release Buprenorphine (Sublocade) Prescribing In Primary Care, Heather Kettlewell
Family Medicine Clerkship Student Projects
There are many barriers to accessing opioid use disorder (OUD) treatment, especially for rural communities that may be far away from healthcare providers. There is a need for interventions to increase accessibility of OUD treatment. Extended release injectable buprenorphine (Sublocade) provides an option for patients to receive treatment via once a month injections. This could make OUD treatment more accessible to rural and socioeconomically disadvantaged patients by reducing the number of times they would need to travel to the clinic. Our intervention is to create a protocol for prescribing extended release buprenorphine at Family Medicine Hinesburg.
Increasing Equitable Cardiovascular Disease Screening And Prevention For Women Of Low Socioeconomic Status: You First, Isabel N. Martinez Daniel
Increasing Equitable Cardiovascular Disease Screening And Prevention For Women Of Low Socioeconomic Status: You First, Isabel N. Martinez Daniel
Family Medicine Clerkship Student Projects
Cardiovascular disease (CVD) continues to be the leading cause of death in females of all ages and races. Given the potential reduction in risk of coronary events with modifiable behaviors, primary care physicians are in a unique position to be able to use shared decision making and patient education to help dramatically reduce the potential burden of cardiovascular disease. Consideration for social determinants of health, such SES, should not be forgotten when aiming to provide adequate and accessible healthcare. Furthermore, the incorporation of unique programs, such as You First, into primary care offices can increase equitable care for patients and …
Community Health Interventions To Reduce The Impact Of Private Drinking Water Contaminants, Ian Minearo
Community Health Interventions To Reduce The Impact Of Private Drinking Water Contaminants, Ian Minearo
Family Medicine Clerkship Student Projects
Contaminants, such as arsenic, E. Coli, and gross alpha, is found in soil, bedrock, and water and can seep into private wells and water sources. In addition, copper and lead in older homes can leech into the water in homes over time to due corrosion. In Vermont, 40% of households drink water from a private well while 40% of private drinking water systems tested for contaminants exceeded the drinking water limits. Public water is managed by the towns and state, but private water is the responsibility of the homeowner who may not know if and when they should test their …
Patient Satisfaction And Staff Protection, Cole T. Zweber
Patient Satisfaction And Staff Protection, Cole T. Zweber
Family Medicine Clerkship Student Projects
Front desk, reception, and rooming staff at Middlebury Family Health have experienced an increased degree of patient agitation and frustration since 2020 and the COVID pandemic (this trend of increased violence in healthcare settings is seen nationally as well). This is a source of physical and emotional strain on staff and can contribute to decreased quality of care for all patients. Former projects have addressed the need for increased training and support for staff facing these tense interactions. This project aims to describe the underlying factors and sources of patient agitation, namely access to care for urgent issues, in order …
Patient Guide To Starting A Glp-1 Agonist, Jenna G. Eaton
Patient Guide To Starting A Glp-1 Agonist, Jenna G. Eaton
Family Medicine Clerkship Student Projects
With the increasing prevalence of diabetes and obesity in Vermont, GLP-1 agonists are being prescribed more and more to help treat these conditions. Providers at Milton Family Medicine relayed that they have been prescribing them more as well over the recent years and have seen significant benefit for their patients. With increased use of these medications, patients continue to have many questions around how GLP-1 agonists work, their side effects, and how to pay for these expensive medications. There is a need to have education materials available at the office to answer these questions for our patients.
Preconception Care Quick Facts, Aathmika Krishnan
Preconception Care Quick Facts, Aathmika Krishnan
Family Medicine Clerkship Student Projects
The number of unintended pregnancies in the United States is about 50%. In 2020 the US had a maternal mortality rate greater than three times the rate of other high-income countries. Given these trends, preconception care should be an integral part of primary care for people of reproductive age to allow for frequent monitoring and follow-up. An informational pamphlet about preconception care was developed and made available to community members considering pregnancy soon.
Quality Improvement Of X-Ray Imaging For Unspecified Chronic Knee Pain And Suspected Knee Osteoarthritis In The Primary Care Setting, Ty E. Bever
Family Medicine Clerkship Student Projects
Although a comprehensive history and physical exam are the mainstays of initial evaluation, plain X-rays are clinically indicated for chronic knee pain of greater than 6 weeks duration and acute traumatic pain in patients who meet specific evidence-based criteria, according to the American Academy of Family Physicians (AAFP). However, there remains significant variation in what radiographic protocols are used in clinical practice, specifically in terms of what radiographic views are ordered and whether the imaging is performed with the patient weight-bearing (WB) or non-weight-bearing (NWB). In fact, several studies have shown that non-weight-bearing knee radiographs are frequently ordered by general …
Nutritional Support For Oncology Patients: Role For The Pcp, Annabelle S. Feist
Nutritional Support For Oncology Patients: Role For The Pcp, Annabelle S. Feist
Family Medicine Clerkship Student Projects
Adequate nutrition is a key prognostic factor in the treatment outcomes of patients with cancer diagnoses. Despite the increased morbidity and mortality of malnutrition, the importance of nutrition for oncology patients is often not well communicated and not well understood by patients. Part of this issue stems from the limited information most patient can absorb at any given doctors appointment, especially regarding their cancer. Primary care providers hold a unique position to fill this gap and have the information be heard and retained given their usual role in addressing overall health. This project compiles resources in an easily accessible and …
Improving Care For Lgbtq+ Patients, Justin Henningsen
Improving Care For Lgbtq+ Patients, Justin Henningsen
Family Medicine Clerkship Student Projects
LGBTQ+ patients are at higher risks for many health conditions. Providers and staff are not always comfortable supporting conversations about gender and sexuality. In this project, I provided training to staff members of Hardwick Area Health Center on risks and best practices.
Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve
Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve
Family Medicine Clerkship Student Projects
Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.
Planetary Health: Helping Providers And Patients Prepare For Climate Change, Chellam Nayar
Planetary Health: Helping Providers And Patients Prepare For Climate Change, Chellam Nayar
Family Medicine Clerkship Student Projects
Climate change has been called the greatest global health threat of the 21st century. The effects of changing temperatures and increasing pollution have been shown to increase the incidence and mortality of cardiovascular diseases, affect respiratory health, increase the risk of new infectious disease outbreaks, affect mental health, and exacerbate inequities between those with means and those without. In Vermont, climate change is leading to an increase in average temperatures, more extreme heat events, shorter winters, more storms, poor air quality due to wildfire smoke, an increase in cyanobacteria blooms, and a longer tick season, among others. This project will …
De-Escalation Training For Office Staff, Robin Tucker Angier
De-Escalation Training For Office Staff, Robin Tucker Angier
Family Medicine Clerkship Student Projects
Office staff at Middlebury Family Health have experienced an increase in patient agitation, aggression, and verbal abuse since the start of the COVID pandemic. This project was aimed at providing the staff with de-escalation education to better serve themselves and their patients, as well as to decrease overall burnout and decreased quality of mental health.
Cigarette Smoking Cessation Tool, Pavan K. Anant
Cigarette Smoking Cessation Tool, Pavan K. Anant
Family Medicine Clerkship Student Projects
In Vermont, tobacco use disorder is a pervasive problem that closely rivals national averages. The Cigarette Smoking Cessation Tool seeks to identify patients with significant motivation to quit smoking cigarettes' and aims to connect them with appropriate local resources and clinic advocates.
Patient Pamphlet For Basic Lab Values, Robert A. Adamian
Patient Pamphlet For Basic Lab Values, Robert A. Adamian
Family Medicine Clerkship Student Projects
As a result of lab results being immediately available to patients online, many patients experience unnecessary anxiety when viewing their results before speaking with their physician. Misleading lab values and increased patient concerns lead to more time spent by physicians answering messages on EPIC, which adds to the burden of public health costs. To combat this, a double-sided pamphlet was made with quick high yield facts about lab data that patients can use for information in the time between seeing their results and communicating with their doctor.
Adolescent Substance Use: Standardizing Screening Methods In Clinical Practice, Bryan D. Shin
Adolescent Substance Use: Standardizing Screening Methods In Clinical Practice, Bryan D. Shin
Family Medicine Clerkship Student Projects
Adolescent substance use is a highly pervasive issue that strongly correlates with increasing depression and anxiety rates. Standardized screening tools for substance use, such as the CRAFFT or the Screening to Brief Intervention Tool, are freely available but not widely utilized for every patient encounter in clinical practice. This project aimed to improve standardization of substance use screening at a primary care clinic located in Castleton, Vermont through implementation of the CRAFFT tool as an automatically-loaded form in each adolescent encounter note. The goal was to improve substance use detection rates by facilitating efficient incorporation of standardized screening into the …
Improving Identification Of Peripheral Arterial Disease In The Outpatient Setting, William Robinson
Improving Identification Of Peripheral Arterial Disease In The Outpatient Setting, William Robinson
Family Medicine Clerkship Student Projects
Over 7 million Americans are known to have peripheral arterial disease (PAD). However, it is well established that many more live with the disease and are simply undiagnosed, often due to variations in presentation. Presence of PAD is associated with significant morbidity and mortality, but when caught in its early stages, progression can be slowed with simple conservative measures. Therefore, a more targeted screening program with in-office ankle-brachial index capability (sensitivity and specificity >90% for diagnosing PAD) could identify a debilitating disease much earlier in its course regardless of symptom presentation, and create an opportunity to significantly improve preventative health …
Patient Rights To Prescription Glasses, Louis Briones
Patient Rights To Prescription Glasses, Louis Briones
Family Medicine Clerkship Student Projects
Uncorrected Refractive Error (URE) accounts for vision loss in millions of Americans. Eyeglasses are the simplest and safest way to correct refractive errors. Prescription eyewear coverage is not universally covered across most health insurance policies. This project details Medicare and Vermont Medicaid coverage for Prescription Glasses. Also included is information outlining where to buy affordable frames and organizations in Vermont that can help acquire prescriptions not covered by insurance.
Screening For Ptsd In Veterans And Expanding Awareness Of Ptsd Resources, Audree S. Baroni, Bradford Clark
Screening For Ptsd In Veterans And Expanding Awareness Of Ptsd Resources, Audree S. Baroni, Bradford Clark
Family Medicine Clerkship Student Projects
Veterans are at an increased risk for PTSD however widespread screening is currently not being done, so disease is going unrecognized and untreated. There are many reasons for this, including stigmatization within the military, access to care, and unknown resources. We looked at PTSD screening within the veteran population in Berlin, VT and provided resources to local providers.
Increasing Access Of Outpatient Therapeutic Services For Adolescents With Persistent Symptoms After Sport-Related Traumatic Brain Injury, Natalie J. Bales
Increasing Access Of Outpatient Therapeutic Services For Adolescents With Persistent Symptoms After Sport-Related Traumatic Brain Injury, Natalie J. Bales
Family Medicine Clerkship Student Projects
Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and …
Using Narrative Medicine To Address Healthcare Stigma In Washington County, Vermont, Finlay Pilcher
Using Narrative Medicine To Address Healthcare Stigma In Washington County, Vermont, Finlay Pilcher
Family Medicine Clerkship Student Projects
Stigma is a barrier to good health for people with certain medical conditions and non-medical circumstances. The purpose of this project is to use stories from members of the Washington County Community to advocate for the use of narrative medicine to mitigate healthcare stigma. A 10-minute recording was shared of an interview with someone with opioid use disorder during the presentation. Afterwards, healthcare professionals were asked whether the presentation, including the recording, impacted their percetion of narrative medicine and its clinical utility.
Obtaining A Gender-Affirming Sexual History With Gender Nonconforming And Transgender Patients, Gabriela Bosmenier Cruz
Obtaining A Gender-Affirming Sexual History With Gender Nonconforming And Transgender Patients, Gabriela Bosmenier Cruz
Family Medicine Clerkship Student Projects
This project introduces a methodology to change how providers ask the 5 P's of a sexual history using gender-affirming language. Obtaining a gender-affirming sexual history will improve sexual health care, especially with gender nonconforming and transgender patients. Taking time to discuss sexual health and function can lead to prompt identification of sexual problems, risk-taking behaviors, and infection prevention. Using appropriate language to communicate with all patients can lead to better doctor-patient relationship.
Colorectal Cancer Screening In The Primary Care Setting: Community Outreach To Improve Screening Rates, Liberty J. Dupuis
Colorectal Cancer Screening In The Primary Care Setting: Community Outreach To Improve Screening Rates, Liberty J. Dupuis
Family Medicine Clerkship Student Projects
Colorectal cancer remains a leading cause of death from cancer in men and women in the U.S. and worldwide. Screening for colorectal cancer beginning at age 45 offers the opportunity for early intervention and decisive treatment for precancerous colon polyps as well as the early identification of cancer. This project aims to assess preferences around recommendations for colorectal cancer screening tests amongst a group of primary care providers as well as barriers that are commonly cited to those providers by patients who do not undergo or complete screening. The results of the provider survey were used to make recommendations for …
Over-The-Counter Approval Of Progestin-Only Pills, Hannah Grace Donovan
Over-The-Counter Approval Of Progestin-Only Pills, Hannah Grace Donovan
Family Medicine Clerkship Student Projects
Most women in the United States use contraception at some point in their life. While there are many types of short- and long-acting reversible birth control options available via prescription, the oral contraceptive pill (OCP) remains the most used reversible contraceptive agent. The proportion of those using an OCP is inversely proportional with age; more specifically, people who can get pregnant between the ages of 15 and 29 use OCPs most frequently. However, people in this age range may face increased barriers to obtaining contraception, such as cost, insurance, social and familial factors, policy, transportation, and access to healthcare. In …
Expanding Awareness Of Air Quality And Health Impacts In The Clinical Setting, Caitlin Early
Expanding Awareness Of Air Quality And Health Impacts In The Clinical Setting, Caitlin Early
Family Medicine Clerkship Student Projects
Smoke from Canadian wildfires has greatly impacted the air quality in Vermont this year, 2023. Poor air quality can lead to an increase in inflammatory reactions in the body, for example increasing asthma and COPD exacerbations and causing symptoms in those with cardiovascular disease. This project aimed to improve awareness of the negative health impacts of poor air quality, particularly for those patients with existing lung and heart disease, those of older age, and children. This intervention sparked conversation between patients and providers to discuss symptoms, medication refills, and recommendations for poor air quality days. With lines of communication open …
Transportation To Little Rivers Health Clinic In Wells River, Vermont, Anupama Balasubramanian
Transportation To Little Rivers Health Clinic In Wells River, Vermont, Anupama Balasubramanian
Family Medicine Clerkship Student Projects
Transportation to healthcare appointments is one of the biggest challenges that rural patients face. Currently, there are no resources available to patients at Little Rivers Health Care that can help them with transportation-related knowledge. This project aims to create a guide that improves patients' understanding of the options they have available in getting to their appointments.
Contraceptive Education And Resource Provision In Male-Dominated Rural Family Medicine Clinic, Christine E. Horn
Contraceptive Education And Resource Provision In Male-Dominated Rural Family Medicine Clinic, Christine E. Horn
Family Medicine Clerkship Student Projects
Many women, particularly adolescent women, are uncomfortable discussing sexual health and contraception options with male providers and prefer to see female providers; however, in rural areas, there are barriers to seeing female providers including low physician density, long travel distances to clinics, and long waitlists. The project's primary goal was to bridge the knowledge gap surrounding contraception among adolescents in a rural area of Vermont, the Mad River Valley, while ensuring that healthcare providers at the local male-dominated family medicine office, CVMC Mad River, are equipped with up-to-date information regarding contraception prescribing recommendations. The project entailed 1) creation of a …
Naloxone Community Engagement Project, Olivia E. Domingue
Naloxone Community Engagement Project, Olivia E. Domingue
Family Medicine Clerkship Student Projects
This abstract focuses on the distribution of naloxone from Milton Family Medicine, a family medicine practice in rural Vermont. By interviewing representatives involved in the distribution of naloxone throughout the state, I pinpointed ways to best advertise naloxone to the patient community in Milton, provide information around harm reduction practices and naloxone administration and simultaneously dispel stigma regarding overdose prevention.