Medicine and Health Sciences Commons^™

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Carolyn A. Curtis, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Prostate Cancer: Screening, Current Guidelines And Patient Education, Timothy F. Flanagan

Family Medicine Clerkship Student Projects

Recent changes in prostate cancer screening guidelines may create an opportunity for patient education. By creating a succinct hand-out on prostate cancer screening, providers enable their patients to understand screening, and provide sites with opportunities for further learning.

Vitamin D Screening And Supplementation, Christina Cahill

Family Medicine Clerkship Student Projects

Vitamin D helps protect against osteoporosis (by promoting calcium absorption), moderates cell growth, aids in neuromuscular and immune function and reduces inflammation. However, there is insufficient data to access the benefits and harms for screening for Vitamin D deficiency. This study looks at current recommendations for Vitamin D screening and aims to provide information to providers and patients about Vitamin D.

Integrating Care: The Primary Care Provider’S Role In Age-Related Macular Degeneration In Eastern Maine, Homer Chiang, Steven Coffin

Family Medicine Clerkship Student Projects

Objectives: To assess general patient knowledge of age-related macular degeneration (AMD), including risk factors, early signs, treatment options, and low-vision resources. We also aimed to assess primary care provider practice patterns including early detection, timely referral to ophthalmology, and management after diagnosis of AMD.

Methods: A 20-point patient questionnaire was distributed to all adult patients at check-in by front office staff at the Center for Family Medicine office in Bangor, ME. Additionally, a looping waiting room slideshow and informational exam room flyer were created for patient education. A 10-point online questionnaire was distributed to residents and faculty at the Center …

Evaluating Patient Literacy To Improve Health Outcomes In Milton, Vt, Lindsay R. Miller

Family Medicine Clerkship Student Projects

Health literacy is one aspect of overall literacy that has an enormous impact on patient health outcomes, including knowledge of disease, health markers, general health status, and number of hospitalizations, among others. More than 1/3 of the US population has basic or below basic health literacy status. In Chittenden County, diabetes and heart disease deaths are higher than the state average; these diseases require complex personal care and management. Health care providers working at Milton Family Practice in Milton, VT, often noted that patients were often unwilling to disclose literacy issues and there were often problems communicating instructions to patients …

Linking Food Insecure Patients With Community Supported Agriculture (Csa), Daniel Orlins Trigg

Family Medicine Clerkship Student Projects

Food insecurity screening is needed to link food insecure patients to interventions that will help improve their nutrition and overall health such as annual community supported agriculture (CSA) shares. In Vermont, food insecurity is widespread, as 76% of Vermonters experience some level of food insecurity. This has serious health consequences. Food insecure patients are more likely to suffer from hypertension and diabetes than non-food insecure patients. Clinicians need to screen for and detect food insecurity. Several methods are available, yet clinician awareness varies. Providers can rely upon predictive metrics that utilize patient characteristics or simple question-based screening tools. This study …

Screening For Domestic Violence Against Women: A Public Health Crisis In Maine, Clare Park

Family Medicine Clerkship Student Projects

The role of healthcare providers in stopping domestic violence against women, a public health crisis, through promoting a culture of universal screening and community education.

Development Of Guidelines For Refugee Screening At Cmmc Family Medicine Residency, Lewiston, Maine, Catherine Hayes

Family Medicine Clerkship Student Projects

Lewiston Maine has the second highest number of refugees in the state of Maine, with 191 total intakes in 2015. Refugee populations face unique health concerns, and providing care for refugees requires education and development of a specialized skill set. This project provided a reference for clinic providers to assist with medical intake screening visits for refugees.