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Full-Text Articles in Medicine and Health Sciences
Community Resilience In Vermont After The 2023 Flooding Event, Alex Poniz
Community Resilience In Vermont After The 2023 Flooding Event, Alex Poniz
Family Medicine Clerkship Student Projects
Between July 10th-11th 2023 Vermont experienced catastrophic flooding after receiving prolonged heavy rainfall of up to 9” over 48 hrs. Damage from the 2023 event rivals the historic destruction of Hurricane Irene in 2011 and is exceeded only by the Great Vermont Flood of 1927, an event predating modern flood controls. We collected oral histories from Vermonters to better understand their lived experience of the flood and its impacts, and identifed common themes related to community and individual resilience.
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
PTSD is a prevalent mental health disorder that is especially prominent in the veteran population. Often veterans go without diagnosis and subsequently without treatment due to lack of awareness, screening, and a stigma they will loose benefits from the VA. This project aimed to identify the number of veterans with PTSD and provide alternative treatment methods for symptom management.
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 …
Peri-Operative Optimization: Social Determinants Of Health, Adam F. Kohutnicki
Peri-Operative Optimization: Social Determinants Of Health, Adam F. Kohutnicki
Family Medicine Clerkship Student Projects
This project investigated how clinicians at a rural Vermont family medicine practice observed various social determinants of health (SDOH) of their patient population affected patients' preparedness for surgery. Two clinicians involved in the community, a practicing family medicine physician and a practicing social worker, were interviewed to collect qualitative data on how various SDOH they have observed through their clinical practice have influenced patients' preparedness for surgery. This information was then utilized to create a "dot-phrase" that clinicians can use as part of a patient's pre-operative visit in the outpatient setting to assess SDOH and plan subsequent targeted interventions to …
Improving Identification Of Dermatological Conditions In Skin Of Color, Sam Afshari B.S., Simran Kalsi M.S.
Improving Identification Of Dermatological Conditions In Skin Of Color, Sam Afshari B.S., Simran Kalsi M.S.
Family Medicine Clerkship Student Projects
Vermont primary care practitioners are less likely to have experience diagnosing dark skin tones given that the state population is 94.2% white. Only 4.5% of images in general medicine textbooks and 4-19% of images in dermatology textbooks depicted darker skin. Black patients are significantly less likely to see a dermatologist, which highlights the importance of diagnosis at the primary care office.
Approach To Providing Culturally Sensitive Gynecologic And Obstetric Care For Somali Women, Izabella Ostrowski
Approach To Providing Culturally Sensitive Gynecologic And Obstetric Care For Somali Women, Izabella Ostrowski
Family Medicine Clerkship Student Projects
Many refugees have fled Somalia over the past 30 years due to political instability and civil war. Since 1980, over 8,000 refugees have settled in Vermont, with about 9% of refugees being from Somalia. Community Health Centers of Burlington (CHCB) provides prenatal and primary care to many Somali women in the community. There are known gynecologic and obstetric health disparities for Somali women, such as significantly lower completion rates of mammography and pap smears than non-Somali patients. Research has shown that an understanding of cultural health beliefs and values are crucial for creating tailored prevention programs for refugee women. This …
The State Of Sleep: What Keeps Vermont Up At Night?, Magalie Carey
The State Of Sleep: What Keeps Vermont Up At Night?, Magalie Carey
Family Medicine Clerkship Student Projects
No abstract provided.
Medication-Assisted Withdrawal And Alcohol Use Disorder Treatment In The Ambulatory Setting, Jacob Okie Weiss, Javad Mashkuri Md, Marissa Patrick Aprn
Medication-Assisted Withdrawal And Alcohol Use Disorder Treatment In The Ambulatory Setting, Jacob Okie Weiss, Javad Mashkuri Md, Marissa Patrick Aprn
Family Medicine Clerkship Student Projects
Alcohol use disorder (AUD) represents a significant burden of disease in central Vermont, but receives little attention and resources compared to other drivers of morbidity and mortality. As part of a community health improvement project, primary care providers in central Vermont were surveyed regarding current practices and perceived barriers related to the effective treatment of AUD. 69% of respondents reported treating alcohol withdrawal syndrome (AWS) and 83% reported treating AUD. Respondents indicated concern about the safety and efficacy of the medications they currently prescribe and expressed interest in learning about other evidence-based treatments for AWS and AUD. The most frequently …
Increasing Patient Access To Lgbtq+ Healthcare Through Expanding The Vermont Diversity Health Project, Rachel Harrison
Increasing Patient Access To Lgbtq+ Healthcare Through Expanding The Vermont Diversity Health Project, Rachel Harrison
Family Medicine Clerkship Student Projects
Numerous studies have documented various disparities in health outcomes and barriers to healthcare access for LGBTQ+ individuals. One major way to combat this is to increase access to healthcare for LGBTQ+ patients and increase provider knowledge of how to best care for them. Through expanding the Vermont Diversity Health Project database of providers and having providers participate in LGBTQ+ Best Practices trainings (both hosted by Pride Center of Vermont), we may reduce LGBTQ+ health disparities in our local community.
Evaluating Patient And Provider Knowledge Of Safe Pharmaceutical Disposal Procedures In Vermont Through A Public Health And Environmental Lens, Emily R. Straley
Evaluating Patient And Provider Knowledge Of Safe Pharmaceutical Disposal Procedures In Vermont Through A Public Health And Environmental Lens, Emily R. Straley
Family Medicine Clerkship Student Projects
Patient and provider knowledge of safe pharmaceutical disposal procedures is crucial from both a public health and environmental standpoint. Unfortunately, studies have shown that Vermont residents are largely unaware of safe drug disposal programs in their communities. This project evaluated patient knowledge of drug disposal practices and awareness of safe pharmaceutical disposal procedures at Hinesburg Family Medicine. A short phrase was created to better disseminate information about safe drug disposal in Hinesburg, which can be added to a patient’s after visit summary. Many patients report never discussing medication disposal with their physician. Therefore, increased provider communication regarding leftover and unused …
Evaluation Of Growth In Clinical Genetics Competency Among Pcps Participating In The Uvmhn Genomic Dna Testing Program, Christina Hansen
Evaluation Of Growth In Clinical Genetics Competency Among Pcps Participating In The Uvmhn Genomic Dna Testing Program, Christina Hansen
Family Medicine Clerkship Student Projects
Recently UVM Health Network Family Medicine practices have implemented “The Genomic DNA Test” pilot program to begin a concerted effort toward offering genetically informed primary care to all patients. The program aims to increase the number of participating primary care providers stepwise over time. However, some providers may find integration of genomic testing and discussion of clinical genetics issues with patients to be challenging given the relatively recent change toward emphasis on these topics in medical training curricula. The aim of this project was to develop a pilot survey to gather information from current participating providers about how participation in …
Supporting Patient Education On Bladder Cancer And Risk Factors Specific To Vermont, Evan Gaston
Supporting Patient Education On Bladder Cancer And Risk Factors Specific To Vermont, Evan Gaston
Family Medicine Clerkship Student Projects
Physician and patient education materials regarding the incidence of bladder cancer in Vermont, the absence of recommended screening, and discussion of risks of bladder cancer with emphasis on private well water testing through the Vermont Department of Health.
Harm Reduction In The Emergency Department, Alexa J. Golden
Harm Reduction In The Emergency Department, Alexa J. Golden
Family Medicine Clerkship Student Projects
The number of overdose deaths in Vermont has been trending up over the past several years. A majority of these fatalities involved synthetic opioid fentanyl. The Emergency Department (ED) at Central Vermont Medical Center delivers medication assisted treatment (MAT) through the Rapid Access to MAT (RAM) program. This program has connected many people in the region to treatment for opiate use disorder. However it was identified that we lacked connection to harm reduction services for those not interested in MAT. Harm reduction education was provided for recovery coaches and ED nursing staff. Harm reduction kits containing life-saving supplies such as …
Raising Awareness About The Vermont Donor Milk Center, Rosie Friedman, Emi Eakin
Raising Awareness About The Vermont Donor Milk Center, Rosie Friedman, Emi Eakin
Family Medicine Clerkship Student Projects
The Vermont Donor Milk Center (VDMC) is an emerging community resource that provides donated, pasteurized breast milk to new parents for their infants. Upon questioning, we identified that many providers did not know about the VDMC or how to prescribe milk. In addition, VDMC expressed that they have not been able to complete the community outreach they had initially hoped for. We chose to dedicate our project to disseminating information about VDMC to perinatal care providers in Vermont.
A Motivational Interviewing Approach Toward Mask Wearing In Franklin County, Vermont, Ashleigh N. Peterson
A Motivational Interviewing Approach Toward Mask Wearing In Franklin County, Vermont, Ashleigh N. Peterson
Family Medicine Clerkship Student Projects
COVID-19 has caused significant morbidity and mortality in Vermont and worldwide since the start of the pandemic. Wearing cloth face masks has been proven to limit viral spread, but few studies have quantified how many people are wearing masks or what their reasons are for doing so. This study aimed to assess and encourage mask use in Franklin County, Vermont by piloting an in-office motivational interviewing intervention at a primary care office.
Improving Hpv Vaccination Rates, Emily Eichner
Improving Hpv Vaccination Rates, Emily Eichner
Family Medicine Clerkship Student Projects
HPV is a very common infection and can cause multiple types of cancers. The HPV vaccination is effective at preventing these infections and subsequent cancers. The HPV vaccine is most effective when given to adolescents; however, the vaccination rates for girls and especially boys remain low. Many reasons exist for parent's choice not to have their kids' vaccinated against HPV. Identifying and addressing these barriers through educational materials for parents will hopefully help improve HPV vaccination rates and reduce rates of these preventable cancers.
Addressing Barriers To Physical Activity In Vermont's Geriatric Population, Stephanie Udawatta
Addressing Barriers To Physical Activity In Vermont's Geriatric Population, Stephanie Udawatta
Family Medicine Clerkship Student Projects
A wide array of barriers exist which prevent many geriatric patients from engaging in regular physical activity. This project addresses the barriers unique to Vermont's population of geriatric patients and explores potential solutions.
Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell
Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell
Family Medicine Clerkship Student Projects
The expansion of telehealth with COVID-19 and recent recommendations to use at-home blood pressure monitoring to diagnose and monitor hypertension have increased the need for materials and education for clinicians and patients. A pilot project in Primary Care Internal Medicine UVM in Essex, VT, produced an electronic medical record dot phrase and compiled educational materials to initiate nurse visits for at-home BP measurements. Materials and experience with this pilot was researched for initiation of a similar program at UVM Family Medicine Hinesburg.
Onecare Vermont Aco Quality Metric Evaluation, Alexander Braun
Onecare Vermont Aco Quality Metric Evaluation, Alexander Braun
Family Medicine Clerkship Student Projects
This project explores OneCare Vermont ACO quality metrics and how they can be used to improve patient care and reimbursement in a Vermont family medicine practice. Perspectives of physicians within the practice and others familiar with OneCare Vermont operations are shared. Several metrics were identified as areas for improvement within the practice by comparing ACO metrics with patient data.
Improving Cardiac Arrest Outcomes With Hands-Only Cpr, Ethan Witt
Improving Cardiac Arrest Outcomes With Hands-Only Cpr, Ethan Witt
Family Medicine Clerkship Student Projects
Bystander CPR is one of the most effective and necessary components of cardiac arrest management, increasing survival rates by two to three times. However, rates of bystander CPR are inadequately low. Hands-only CPR has been found to be an effective intervention in the management of cardiac arrest and addresses many of the barriers to bystander CPR.
An Educational Module For Adolescents On Cannabis Following Its Legalization, Anna Lidofsky
An Educational Module For Adolescents On Cannabis Following Its Legalization, Anna Lidofsky
Family Medicine Clerkship Student Projects
Recreational use of cannabis has been recently legalized in Vermont. One year prior to its legalization, 42% of high school students in Washington County reported at least one-time use of cannabis. An educational module for adolescents was developed to address the increasing potency of cannabis and health risks associated with its use.
Patient Education On Sweetened Beverages: An Interactive And Module-Based Approach, Matt Tsai
Patient Education On Sweetened Beverages: An Interactive And Module-Based Approach, Matt Tsai
Family Medicine Clerkship Student Projects
As sugary beverages continue to contribute to negative health outcomes, there remains a need for efficient, effective patient education in this area. A custom, interactive and reflective web-based module on sugary beverages for adult participants (n=42) was introduced at a rural Vermont outpatient clinic. Built-in quizzes evaluated learning through a pre and post-intervention design. On average, participants improved significantly from a pre-module mean score of 3.00 to a post-module score of 4.33 (p<0.0001). Additionally, participants' average rating of the module's effectiveness was 8.3 out of 10. A module-based approach may be one efficacious solution to improve patient education on sugary beverage consumption.
Emergency Medical Services In Hinesburg, Vt, William Tyler Prince
Emergency Medical Services In Hinesburg, Vt, William Tyler Prince
Family Medicine Clerkship Student Projects
Ambulance transport in Hinesburg, VT is currently provided by a service over 20 minutes away and will cease in June 2020. Town officials are currently trying to decide whether to expand local first response to include ambulance transport or to contract with Richmond Rescue, which is a well-established 911 transport service in a nearby town. Through literature/budget reviews and interviews with involved community members, it is apparent that although an independent Hinesburg EMS may have shorter response times, its volunteer corps is insufficient to sustain a transport service. Richmond Rescue can provide a higher level of medical care at a …
Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal
Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal
Family Medicine Clerkship Student Projects
Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.
Provider Opinion: Should We Screen And Counsel Parents Of Teen Drivers Regarding Texting/Distracted Driving?, Daniel Lambert
Provider Opinion: Should We Screen And Counsel Parents Of Teen Drivers Regarding Texting/Distracted Driving?, Daniel Lambert
Family Medicine Clerkship Student Projects
Adolescent texting and driving has been directly responsible for the deaths of 11 teenagers every day. 33% of teenagers in Vermont admit to texting and driving making it one of the most prevalent risky behaviors in their age group. Currently there is no routine screening recommendation for parents with adolescent drivers addressing texting and driving. Mobile application information can improve parental monitoring and prevent texting and driving habits from forming in adolescents.
Smoking Prevention Program For Adolescents: A Hands-On Approach, Sean Closs
Smoking Prevention Program For Adolescents: A Hands-On Approach, Sean Closs
Family Medicine Clerkship Student Projects
This project is an initial pilot idea for hands-on experiences to reinforce smoking prevention in adolescents. The proposed idea is to have students specifically those identified 'at-risk', being given opportunities to interact with pathology specimens on-site at the hospital, introduce spirometry, and real-world panel discussions. The resources of the hospital provide a unique opportunity for promotion of this public health goal.
Intimate Partner Violence In Immigrant/Refugee Populations, Lisa H. Wang
Intimate Partner Violence In Immigrant/Refugee Populations, Lisa H. Wang
Family Medicine Clerkship Student Projects
Intimate partner violence (IPV) is the most common type of violence affecting women. Globally, Central Africa and South Asia have some of the highest rates of IPV. In Vermont, the majority of refugees are from these regions. Individual, interpersonal, and especially cultural values play critical roles in the definition/appraisal and decision to seek help in these women. This study examines ways to mitigate challenges that healthcare professionals have in identifying women who need help and barriers preventing these women from seeking help.
Immunization Safety: Addressing Parental Safety Concerns, Andrew Gallagher
Immunization Safety: Addressing Parental Safety Concerns, Andrew Gallagher
Family Medicine Clerkship Student Projects
Since 1998, when a fraudulent research paper alleged a connection between the MMR vaccine and autism, increasing numbers of parents are refusing routine childhood vaccinations. Recent research has shown parents’ top vaccine-related concerns included the number of vaccines during the first 2 years of life, administration of too many vaccines in a single doctor visit, and a possible link between vaccines and autism. More than 10% of parents of young children refuse or delay vaccinations, with most believing that delaying vaccine doses is safer than providing them in accordance with the Centers for Disease Control and Prevention’s recommended vaccination.
Identification Of Barriers To Organ Donation: A Primary Care Interventional Approach, Brittany L. Rocque Msc
Identification Of Barriers To Organ Donation: A Primary Care Interventional Approach, Brittany L. Rocque Msc
Family Medicine Clerkship Student Projects
Organ transplantation provides a potentially life saving intervention for patient with end-organ failure as well as substantial cost-benefit with relation to Medicare expenditure. Despite the advantages of transplantation, deceased organ donors are in short supply and many patients die or lose quality years while awaiting transplantation. Registered organ donor rates are relatively low in our opt-in system being 52% nationwide and only 44% in Vermont, which is below the >50% per state goal. Non-organ donor patients were given and informational brochure and surveyed regarding their attitudes and beliefs toward organ donation.
Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly
Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly
Family Medicine Clerkship Student Projects
Advance Directives (ADs) have been shown to be associated with increased patient satisfaction with end-of-life care, decreased in-hospital deaths, and decreased end-of-life costs in high-cost regions. Nationally, prevalence of ADs has increased over the last 20 years, but the majority of patients still have not completed an AD. A significant obstacle to completion is lack of awareness. A presentation to increase knowledge regarding ADs among primary care staff was created to address this.