Medicine and Health Sciences Commons^™

Osa Stop-Bang Screening Tool, Seth E. Wolf

Family Medicine Clerkship Student Projects

No abstract provided.

Increasing Advance Directive Utilization In Hardwick, Vt, Maeve Lauren Donnelly

Family Medicine Clerkship Student Projects

This project was created to increase advance directive use at the Hardwick Area Health Center in Hardwick, VT. The project was aimed at creating awareness of the lack of advance directive use both to the providers and patients, so persuasive educational flyers were made to hang around the office. This project helped increase the attitude and awareness of the importance of advance directive planning.

Substance Use Disorder Treatment Decision Aid For Adults In Chittenden County Vermont, Elizabeth V. Mcleod

Family Medicine Clerkship Student Projects

Substance Abuse Disorders (SUDs) are a prevalent public health concern in both the national and local arena resulting in millions of dollars in pubic health costs and loss of life. Navigating the treatment options available in Chittenden County can be time consuming, difficult, and delay treatment. In order to help guide adult patients and their families in Chittenden County along their journey towards recovery from SUDs, a treatment decision aid was developed for choosing the right level of care.

Improving Patient Knowledge Of Antimicrobial Resistance And Appropriate Antibiotic Use In A Rutland County Acute Care Center, Stephen D. Daniels

Family Medicine Clerkship Student Projects

Antimicrobial resistant infections are one of the most prevalent global health concerns of our time. It is paramount that action be taken to do all we can to reduce the burden that these “superbug” infections bring in the form of both serious illness and financial strain on healthcare systems. As healthcare professionals, the onus falls on us to educate the public on basic knowledge regarding bacterial/viral illness, as well as proper antibiotic utilization, so that we can all work in coercion with one another to combat this global health concern. The here-in project describes an educational piece with this goal …

Educating Patients On Screening Guidelines And Expectations For Well-Woman Examinations, Cyrus Maxim Jalai

Family Medicine Clerkship Student Projects

Female patients seeing primary care in rural settings often do not seek out specialized care from a practicing OB/GYN, favoring instead to utilize their family practitioner to respond to their complaints. As such, it would be effective to work to educate these patients at their well-women examinations on routine screenings, immunizations, and health maintenance methods they should expect based on their presenting age. A handout simplifying and synthesizing the main screening and general health guidelines for annual well-women examinations may be helpful for female patients using primary care practitioners as their source for obstetric and gynecologic care.

Barriers To Smoking Cessation In Patients Enrolled In Suboxone Treatment Programs, Thomas L. Arnell

Family Medicine Clerkship Student Projects

Cigarette smoking is the leading cause of preventable death and disease in the United States, accounting for more than 480,000 deaths every year. The prevalence of tobacco use among substance abuse treatment program enrollees is substantially higher than that of the general population, with recent estimates ranging between 75-97%. The aim of this project was to identify specific barriers to smoking cessation in patients enrolled in suboxone treatment programs in Franklin County, VT. The most commonly cited barriers among survey responders were related to fear of the effects of tobacco withdrawl, while the most important barrier was related to fear …

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.

Art Interventions For Seniors In New Milford, Ct, Lauren Gaffaney

Family Medicine Clerkship Student Projects

There is a growing body of evidence that art therapy for seniors has been shown to improve sociability and mood, reduce the risk of dementia, decrease agitation, depression, isolation, and improve the overall quality of life. Recent research conducted in Burlington with the UVM LCOM Public Health Program suggested that art appreciation and history sessions can have similarly beneficial effects while requiring less volunteer/caregiver time, equipment, and with a lower cost. I surveyed the art interventions available in New Milford, CT and found there were limited active art classes available and no art appreciation sessions. I presented an art appreciation …

A Provider's Guide To Medical Cannabis: Thc And Cbd. Putting The Evidence To Work For Improved Patient Care, Danielle Smith

Family Medicine Clerkship Student Projects

Please use abstract uploaded with previous powerpoint

Conjunctivitis: Patient Information, Nicole Jedrzynski

Family Medicine Clerkship Student Projects

Conjunctivitis or “pink eye” is a common affliction encountered frequently in family medicine. Most cases are viral and do not require antibiotics, and more accurate information for patients and their caregivers is needed to minimize unnecessary visits to urgent care and the emergency room. This will facilitate better patient care and fewer healthcare costs.

Eat, Sleep, Console For Neonatal Abstinence Syndrome Babies, Kathryn Patton

Family Medicine Clerkship Student Projects

Neonatal Abstinence Syndrome (NAS) is a complex disorder that manifests with neurologic, gastrointestinal, and musculoskeletal disturbances and is most often associated with opioid withdrawal. In the US, 6 out of 1,000 babies are born to mothers who used opioids during their pregnancy. These babies go on to develop NAS. Androscoggin County, where Central Maine Medical Center is located, has an even higher rate of babies with NAS: 100 out of 1,000. Most institutions use the Finnegan Neonatal Abstinence Scoring System (FNASS) to guide pharmacologic treatment. This system assigns a score based on 21 clinical signs of withdrawal with a score …

Transportation As A Barrier To Healthcare, Melissa Romero

Family Medicine Clerkship Student Projects

Lack of transportation is large barrier to medical care, particularly in rural areas. Many patients decline medical appointments because they do not have access to a personal vehicle or other transportation resources. Consequences include missed appointments and higher healthcare costs for patients and providers in the future. Solutions will involve educating patients on resources available to them, simplifying access to current programs, introduction of new programs, and the collaboration of public and private entities to provide new services.

Sleeping Mindfully, Jinal Gandhi

Family Medicine Clerkship Student Projects

Insomnia is a disorder of hyperarousal that affects up to 30% of adults. Insomnia is based on cognitive dysfunction that causes us to worry and neuroendocrine factors that upregulate our autonomic nervous system. Studies have shown that just 10 minutes of daily mindfulness practice can improve sleep. Mindfulness is able to work at the root of both causes of insomnia. It improves our ability to relax through increasing attentional factors that impart control over stress hormones and helps reduce ruminative thoughts.

Domestic Violence (Dv) Screening, Wilson Huang

Family Medicine Clerkship Student Projects

Domestic Violence (DV) is an understated yet significant source of morbidity and mortality for victims. Healthcare providers have a unique opportunity and responsibility to identify patients who may be victims of DV. A formal screening method for DV should be developed and routinely employed in local practices to address this issue.

A Quick Guide To Eating Healthy With Type Ii Diabetes, Caleb Lee Watkins

Family Medicine Clerkship Student Projects

Diabetes is becoming increasingly more prevalent in the U.S. and in the state of Vermont. With an increased prevalence of diabetes and a worsening obesity crisis, the total cost of diabetes management is increasing as well. The population around Bellows Falls, VT has not been spared from this epidemic. Many patients in this region have struggled to make and maintain lifestyle changes, particularly surrounding diet and exercise. Therefore, a one-page, double-sided handout was created to provide easily digestible information to patients about managing their diabetes through proper nutrition.

Community-Based Exercise Education During Colder Months, Cole S. Shapiro

Family Medicine Clerkship Student Projects

Approximately 50% of US adults and 75% of US high school students don't meet recommended weekly physical activity guidelines, and physical activity declines further during colder seasons. Resources describing local suggestions for physical activity should be made broadly available to community members, such as at their primary health care office.

How To Improve A Medication-Assisted Treatment Program For Opioid Use Disorder: First, Look At The Evidence, Collin York

Family Medicine Clerkship Student Projects

The prevalence of Opioid Use Disorder (OUD) in the United States has been described as an epidemic, and rural areas have been affected in particular. A treatment paradigm called Medication-Assisted Treatment (MAT) has been demonstrated to be effective at treating OUD, and more and more rural, primary care clinics are establishing MAT programs. One such clinic is Hudson Headwaters Health Network, a FQHC in Upstate New York. I wrote a literature review and distributed it to staff involved in MAT program design, and I also wrote a practical evidence guide for MAT providers. Providers completed a survey assessing the evidence …

Melanoma Surveillance, Samuel Logan

Family Medicine Clerkship Student Projects

According to the CDC, in 2015 the rate of melanoma of the skin was 22.1 per 100 thousand people, the sixth most common cancer. In Vermont this rate was 35.8 per 100 thousand, higher than the national average. In Berlin, VT, it was noted that patients often are concerned about their nevi, but often do not know when it is appropriate to bring them to their physician's attention. A pamphlet was developed to assist physicians in educating patients on the characteristics of melanocytic nevi and encourage patients to speak to their physician when they find moles which meet these characteristics.

Interventions For Fall Prevention In Community-Dwelling Older Persons, Gregory S. Roy

Family Medicine Clerkship Student Projects

Falls in individuals over the age of 65 is a pervasive problem resulting in significant health and economic burden in our country. Thus, effective fall prevention strategies are an important public health measure, especially in an age group that is growing rapidly. Research has shown a multifactorial approach to fall prevention addressing environmental hazards, strength and balance, medications, and medical comorbidities to be most effective. Despite there being strong evidence to support this, many individuals are unaware of the factors that put them at risk and ways to mitigate them. An educational pamphlet containing evidence-based strategies to reduce fall risk …

A Better Night’S Sleep: Improving Sleep Without Medication Through Behavioral Modification, Kyle Remy

Family Medicine Clerkship Student Projects

Approximately 40 million Americans experience insomnia each year, defined by the American Academy of Sleep Medicine as unsatisfactory sleep that impacts daytime functioning. Sleep quality and duration affect daily functioning, quality of life, and overall health. Poor sleep quality/duration, increasing usage of technology before bedtime, and a growing reliance on medications for sleep have contributed to a nationally-recognized public health issue; The American Academy of Sleep Medicine has estimated annual costs of insomnia to be around $63.2 billion in worker productivity. Sleep hygiene is recommend by the American Academy of Family Physicians as a first-line approach to improving sleep. Patient …

Family Medicine Resident Education On Perioperative Management Of Patients On Anticoagulation, Hanna Mathers

Family Medicine Clerkship Student Projects

Family Medicine residents at CMMC in Lewiston, Maine manage patients in an outpatient clinic as well as on an inpatient family medicine teaching service. Many patients in the community are anticoagulated for native valve atrial fibrillation and undergo surgical procedures both in the inpatient and outpatient setting. Residents are often asked on to determine the necessity and timing of anticoagulation discontinuation for patients that they see. With patients on newer oral anticoagulants and various degrees of risk, it can be a challenge to make an informed choice. Residents have found that they would feel more confident in perioperative management of …

The Truth About Vaccines, Ramin Badiyan

Family Medicine Clerkship Student Projects

Shedding light on childhood vaccinations

Osteoporosis: What To Be Aware Of As A Patient, Jonathan H. Borden

Family Medicine Clerkship Student Projects

The prevalence of Osteoporosis is increasing with the growing elderly population in our nation. Studies show that the incorporation of osteoporosis risk screening into primary care intake protocols significantly decreases the rate of osteoporotic fractures in patients. This project aimed to increase osteoporotic screening within a primary care office in St. Albans VT via the development and distribution of an “Osteoporosis: What to be aware of as a patient” brochure to patients that met the criteria for being at risk of being osteoporotic (women ages 65+, women who are post-menopausal but younger than 65, men ages 70+).

X-Ray Referrals For Uncomplicated Fractures, Gregory P. Johnston

Family Medicine Clerkship Student Projects

Emergency departments (EDs) in the United States are frequently overutilized for patients in need of an X-ray imaging despite outpatient clinics, ski hills, and express care facilities having the capacity to perform X-Rays and have them read and interpreted by local Radiologists. ED visits are associated with significantly increased wait times and auxiliary costs compared to express care and outpatient facilities. Particularly within the State of Vermont, ski hills provide a reliable population of injured patients with uncomplicated fractures in need of an X-ray examination. Here, we assess potential causes and explanations for ED overuse and lack of express care …

An Exploration Of The Benefits And Challenges Associated With Introducing Point-Of-Care Ultrasound To A Rural Primary Care Setting, Daniel Bak

Family Medicine Clerkship Student Projects

Castleton Family Health Center serves the western portion of Rutland County, which is designated as both rural and medically underserved. The regional Community Health Needs Assessment set goals to increase primary care visits, decrease inappropriate utilization of the emergency department, and work towards seamless care transitions without loss of information or gaps in care. Additionally, the Vermont Department of Health (Rutland region) identified both transportation limitations and a shortage of medical specialists as significant barriers to accessing care in the region. Point-of-care ultrasound may serve to address these community needs by improving the quality and continuity of care provided by …

Barriers To Implementation Of Point-Of-Care Ultrasound In Primary Care, Jack Dubuque

Family Medicine Clerkship Student Projects

Point-of-care ultrasound (POCUS) is a safe and rapidly evolving diagnostic tool that has changed the practice of many hospital based specialties and has been introduced into Family Medicine residencies over the last few years.

While the UVMMC Family Medicine residency has introduced POCUS into the curriculum, many practicing physicians have limited knowledge about the technology. This study aims to document the views and concerns of primary care providers about use and implementation of POCUS.

Let's Put The Kibosh On Cardiovascular Disease, David Viscido

Family Medicine Clerkship Student Projects

Heart disease is the #1 cause of death in the US. Coronary heart disease (CHD) is the most common form of heart disease. The age-adjusted rate of death due to heart disease is no longer on the decline, and Vermont is not meeting its statewide goals for reducing the death rate due to CHD. The purpose of this project was to reinforce decades-long efforts to educate Vermonters on the modifiable risk factors of heart disease. The hope is to remind people that, though heart disease isn't going away any time soon, we can each make healthy lifestyle changes to reduce …

Education And Expectations For Patients With Viral Upper Respiratory Infections, Kathryn Thomas

Family Medicine Clerkship Student Projects

Non influenza viral upper respiratory illnesses are responsible for a significant percentage of sick visits to primary care physicians. Patients who expect antibiotics are more likely to be given them, and this contributes to growing antibiotic resistance. Setting appropriate expectations for the course of a typical upper respiratory infection can reduce repeat visits, and reduce the number of antibiotic prescriptions. Additionally, many over the counter cold and flu remedies do not have a significant impact on cold duration or symptoms. The flyer produced in the course of this project details the average time course for an upper respiratory infection, instructs …

When To Bring Your Child To The Emergency Room: A Pamphlet For Parents, Trina Thornburgh

Family Medicine Clerkship Student Projects

For decades, emergency departments (EDs) have struggled with overuse. Children who receive their primary care at a community health clinic or who are Medicaid-insured are twice as likely as private practice patients to seek care in the ED. Additionally, many New American families do not have a comprehensive understanding of the US healthcare system. A pamphlet was created as a health literacy intervention for parents to better understand when to call 911, visit the ED, or go to a primary care provider. The pamphlet is being translated into 8 languages commonly spoken by New American families in Chittenden County, VT.

Low Back Pain In Family Practice, Marc R. Kostrubiak

Family Medicine Clerkship Student Projects

Low Back Pain (LBP) is the worlds leading cause of disability and the second most common reason for visiting a physician in the US. LBP is the second only to heart disease in healthcare costs. In most cases a definitive cause is never found, however most cases are also self-limited. Patient education in this area is currently insufficient and many people expect to receive advanced imaging and treatments. Most of the time these are not indicated and may be harmful to patients. To address the gap in patient knowledge and improve health literacy a patient focused educational trifold pamphlet was …