Medicine and Health Sciences Commons^™

Increasing Advanced Directive Utilization In Primary Care, Alejandro Castro

Family Medicine Clerkship Student Projects

Advance directives are a vital tool ensuring patient’s wishes regarding end-of-life care are met. End-of-life discussions with physicians are associated with fewer aggressive interventions and greater quality of life metrics. Increased utilization of advance directives by Vermonters could ensure the wishes of patients are met.

Healthier Living: Diabetes Management, Brandon Childs

Family Medicine Clerkship Student Projects

More than 55,000 Vermonters suffer from diabetes, which is the 6th leading cause of death in the state. There are currently 705 patients in South Burlington Family Practice with a diagnosis of diabetes. More than 100 of them are living with uncontrolled diabetes (elevated HbA1c > 8%) and have not yet obtained the necessary education to manage their chronic disease. Physicians must manage all patients diabetes goals and expectations in 15-30 minute appointments alone, but may refer patients to the Community Health Team for further diabetes education.

Strides For Change: Incentivizing Hispanic Youth To Promote Exercise, Fitness And Wellbeing, Priyanka Chilakamarri

Family Medicine Clerkship Student Projects

The United Way of Western Connecticut's 2014 annual report on Danbury's Young Children found that Danbury's children are facing many physical fitness challenges compared to the state of CT. A study looking at 4th graders in a physical fitness test finds that Danbury students consistently have a harder time passing the fitness test. Of the population studied, 42.5% were ethnically Hispanic.

Increasing Awareness Of Community Resources And Support For Individuals With Depression, Erin Mcelroy

Family Medicine Clerkship Student Projects

Depression is a common mental disorder characterized by loss of interest or pleasure, feelings of guilt or low-self worth, disturbed sleep or appetite, low energy, poor concentration, insomnia or hypersomnia, and occasionally suicidal thoughts. These problems can lead to substantial impairments in an individual's daily functioning. At its worst, depression can lead to suicide. In Vermont, suicide consistently ranks as one of the top 10 leading causes of death.

Decreasing The Smoking Rate At Emmc Family Medicinecenter And Residency In Bangor, Me, Alex Coffman

Family Medicine Clerkship Student Projects

Maine's rate of adult current smoking is 20%, which is significantly higher than all other New England states (Connecticut 16%, New Hampshire 17%, Massachusetts 16%, Vermont 17%, and Rhode Island 17%). The national adult smoking rate in the US is 17.8%. An estimated 2,200 Maine adults die each year from their own smoking.

Radon: The New Carbon Monoxide, Katherine M. Evans

Family Medicine Clerkship Student Projects

Radon is derived from breakdown of uranium naturally found in the environment all across the globe. Some geographic locations have higher levels of radon than others. Like carbon monoxide, radon is colorless and odorless. It is the second leading cause of lung cancer in the United States. Human exposure happens primarily via buildings: 1 in 8 Vermont homes exceed the recommended level. In Brattleboro, 1 in 5 homes exceed the recommended level, but between January 1993 and January 2014, the Vermont Department of Health received only 329 home testing kits from Brattleboro.

Development And Implementation Of A Suboxone Therapy Group, David Hermel

Family Medicine Clerkship Student Projects

Implementing effective opiate detoxification is critical to the health and well-being of the Lewiston-Auburn area, which has the highest rate of admissions for substance abuse (especially non-heroin opiates) and mental health conditions in Maine. The number of Maine residents seeking treatment for prescription drug abuse topped the nation at 368 admissions per 100,000 residents in 2008.

Over The Counter Medication Education Approach, Gurpinder Gill, Ian Crane

Family Medicine Clerkship Student Projects

OTC meds are essential because they give the patient the ability to avoid an unnecessary visit to the doctor's office. They also allow the health care provider to better focus on those with more serious illnesses, and some patients do not have appropriate health care access and rely solely on non-prescription meds. However, patients who use OTC meds do have a tendency to underestimate the serious risks of these meds such as potential for abuse, toxicity, adverse effects, drug interactions, and the delay in seeking a physician's advice.

Preventing Lyme Disease In Windsor County, Vt, J P

Family Medicine Clerkship Student Projects

Lyme disease is a bacterial infection caused by Borrelia burgdorferi and is transmitted primarily by deer ticks (Ixodes scapularis). A deer tick must be attached for at least 36 hours for transmission to occur. It can be prevented by preventing tick bites, removing ticks early, and providing post-bite prophylaxis when appropriate. Lyme disease has been on the rise in Vermont since 2005. The Vermont Department of Health (VDH) has launched its “Be Tick Smart” Lyme disease prevention campaign, promoting tick-bite reduction through its slogan, “Repel, Inspect, Remove.” This project extended the campaign to school children in Windsor County, Vermont.

Preventing And Recognizing Anorexia Athletics - For Coaches And Athletes, William Manning

Family Medicine Clerkship Student Projects

High school athletes are uniquely vulnerable to developing disordered eating. Athletes in general have a higher incidence of eating disorders than does the general population and over 90% of new eating disorders are diagnosed in individuals under 25 years of age. Even in sub-clinical eating disorders, the long-term health consequences can be dire. High school coaches and athletes are aware of eating disorders as a concept but do not regularly receive education of anorexia athletica, its signs and symptoms, and how to intervene in suspected cases. This project created a 10 min YouTube video that high school coaches and athletes …

Clearing The Air: What You Need To Know About Tobacco, Brenton Nash

Family Medicine Clerkship Student Projects

No abstract provided.

Implementing A Mentorship Group To Encourage Long-Term Treatment Of Opioid Addiction, Shannon Li

Family Medicine Clerkship Student Projects

In 2012, Maine topped the nation’s list for prescription opioid abuse. For every 100 residents in the state, 22 prescriptions for opioid pain relievers were prescribed by the healthcare providers. There’s approximately 3,876 primary treatment admissions for prescription opioid abuse between 2009-2013. Since 2010, the number of people seeking treatment has increased 15%, but in order for patients to benefit the most from the suboxone/methadone treatment, it's imperative to provide them with the social support they need, so they could stay in the treatment program long enough to have a significant health benefit.

Pediatric Tooth Care And Fluoride Exposure In Maine, Lucas Grover

Family Medicine Clerkship Student Projects

Maine is a large and rural state with limited access to fluoridated drinking water and consistent health and dental care. There is little information and guidance for parents regarding the importance of home pediatric dental care, early dentist visits, and home testing for fluoridated drinking water. Parents and primary care providers must engage in a dialog regarding proper tooth care to identify child specific risk factors that can lead to childhood caries and chronic tooth decay if not addressed early and aggressively.

The Hidden In Plain Sight Program — A Novel And Interactive Approach To Substance Abuse Prevention And Education, Murtaza I. Bharmal

Family Medicine Clerkship Student Projects

Introduction. Despite stabilizing trends in alcohol, tobacco, marijuana, prescription medication, and illicit drug use reported by the National Institute of Drug Abuse, there is clear evidence that substance abuse is pervasive throughout Aroostook county as well as the state of Maine. Further research shows that parents often overlook everyday items that may indicate that an adolescent is engaging in some form of risky behavior. More so, parents are often apprehensive about talking to their children about risky behaviors and do not know how to appropriately manage these issues or where to seek help. Although there are many resources for substance …

Alcohol Use Among Middle School Children In Vermont, Sargis Ohanyan

Family Medicine Clerkship Student Projects

Alcohol and drug education classes have reduced alcohol use in Vermont middle schools to approximately 20%, however currently no screening or intervention programs are available for the aforementioned 20%. Experts agree that early alcohol use significantly increases the risk of myriad psychosocial problems later in life, therefore early screening and intervention is paramount. The focus of this project is to raise awareness for the need of early screening/intervention regarding alcohol use in Vermont middle schools.

Obesity Intervention And Prevention, Bridget Ann Colgan

Family Medicine Clerkship Student Projects

Obesity is a prevalent health concern at Berlin Family Practice, with 41% of the patients seen in the past two years with a BMI greater than or equal to 30, many suffering from comorbid diseases of hypertension, diabetes, high cholesterol, and stroke. In an effort to assist patients in making lifestyle changes to improve nutrition, activity level, and weight loss, this project aims to incorporate the Vermont Department of Health's Weight and Health Profile into patient visits. Feedback from both practitioners and patients on how to improve and update this tool will be provided to Vermont Department of Health Physical …

Hpv Vaccination In Vermont Males - Evaluation And Guidelines For Improvement, Carl A. Nunziato

Family Medicine Clerkship Student Projects

Despite approval from the FDA for use in males to prevent genital warts and oropharyngeal and anal carcinomas, HPV Vaccination in young males lags behind immunization rates for females. In order to improve vaccination rates at Stowe Family practice several "best practices" for improving HPV vaccination rates were researched and combined with a patient handout and flyer.

Burnout Prevention In Primary Care Providers, Dylan M. Devlin

Family Medicine Clerkship Student Projects

Burnout is a pervasive problem in primary healthcare. Mindfulness training has been shown in decrease symptoms associated with burnout and improve overall patient care. This project attempts to evaluate the rates of both burnout and mindfulness in healthcare workers within Rutland County, Vermont. A survey was distributed to both administrative and primary healthcare workers within the Community Health Centers of the Rutland Region system to determine if employees suffer from symptoms of burnout as well as their willingness to participate in mindfulness training.

Creating An Effective Education Pamphlet On Sun Protection And Skin Cancer Prevention, Alexandra E. Brown

Family Medicine Clerkship Student Projects

Melanoma and other skin cancers are increasing in incidence in the United States. In Connecticut, the melanoma rate is higher than the national average. The public health cost of skin cancer treatment ranges from $2-$8 billion annually. The costs to the individual are also high and the diagnosis of an advanced stage cancer is always emotionally challenging for a patient and his/her family. Efforts should be aimed at primary and secondary prevention of skin cancer, and patient education is an important element of this goal. The creation and use of patient education pamphlets can help to increase patient awareness of …

Improving Healthy Habits In Berlin, Vt, Amy I. Triano

Family Medicine Clerkship Student Projects

A significant percentage of patient’s at Berlin Family Practice have diagnoses of Type II Diabetes, hypertension, high cholesterol, and/or obesity. Essential to treatment and management of these conditions are a healthy diet and exercise. There are many local and national resources available but no single place where patient’s can find links to national as well as local resources in the Central Vermont community. There is also insufficient time for physicians or nurses to counsel patients on relevant resources. This project involved creation of a website with community and national resources for healthy living that providers could refer patients to. A …

Contraception Education In Brookfield, Ct, Kiyon Naser-Tavakolian

Family Medicine Clerkship Student Projects

I decided to educate the population on contraceptives because Danbury, CT is a heavily populated area with a low socioeconomic status and from 2002-2014 Connecticut as a whole has had 46-52% of all pregnancies considered unplanned or unintended compared to the 51% nationally. Patient knowledge regarding contraceptives is not at the level one would expect. Targeting contraceptive education is an effective primary prevention strategy for unplanned or unintended pregnancies.

Determining Barriers To Oral Health Care In Bennington County, Taylor Goller Ms-3

Family Medicine Clerkship Student Projects

Bennington County has some of the worst oral health outcomes in the state of Vermont. A survey was designed to assess current oral health problems, maintenance habits, and barriers to oral health services access. Results are preliminary.

Car Seat Safety In Children Ages 4 And Above, Sasha Taylor

Family Medicine Clerkship Student Projects

Motor vehicle injuries are one of the leading causes of preventable deaths in children in the United States. The increased use of safety seats, booster seats, and seat belts have been extremely efficacious in reducing morbidity and mortality in this population. However, there is evidence suggesting that children ages 4 and older are less likely to be adequately secured in a car than younger children, and subsequently have worse outcomes in motor vehicle accidents. While there is copious information on car seat safety in infants and toddlers, parents often find themselves confused about the appropriate type of car safety mechanism …

Self-Reflection Book In K-3rd Grade After School Program, Rebekah Wieland

Family Medicine Clerkship Student Projects

Anxiety (3%) and Depression (4%) are the third and fourth most prevalent parent reported mental health diagnosis among children 3-17 years old according to the 2007 National Survey of Children’s Health Study. Both depression and anxiety are increasing in prevalence over time in the United States. Dr. Melanie Lawrence of Newbury Health Clinic reports that a lot of her practice involves anxiety and depression management, especially in young children. The creation of a self-reflection book completed and kept by young children would be a good introduction to talking about stressors and coping strategies.

Community Perception Of Electronic Cigarettes And Their Role As Smoking Cessation Aids, Alejandro Velez

Family Medicine Clerkship Student Projects

The popularity of electronic cigarettes is increasing, yet the research is lagging behind. In an effort to better understand, and therefore better advice our patients, a small number of current daily cigarette smokers were surveyed on their understanding of electronic cigarettes and their usage. Two smoking cessation counselors were also interviewed to better contextualize the role of electronic cigarettes as possible smoking cessation aids. Finally, a review of the available research was done to produce a poster, and possibly a handout, in hopes to educate all patients (regardless of their current smoking habits) regarding electronic cigarettes.

Getting Real About Food: "Fed Up" & Nutrition Education, Hillary Anderson

Family Medicine Clerkship Student Projects

Getting Real About Food: “Fed Up” & Nutrition Education is a summary presentation designed to help facilitate discussion about the U.S. food industry and its impact on the American diet. The Grace Cottage Community Health team identified the 2014 documentary “Fed Up” as a critical learning tool to enhancing their community education programs for patients, providers, and staff members; this project focuses on summarizing key points and statistics as well as highlighting opportunities for pilot-testing and implementation across different community venues.

Opioid Abuse Treatment In Pregnancy, Catherine A. Suppan

Family Medicine Clerkship Student Projects

Opioid abuse remains an enormous issue in the state of Vermont, including among women who are pregnant. Several regional groups exist to help, support and educate women who are newly pregnant and interested in addressing their drug addiction. Knowledge of these programs, however, remains minimal. My project aimed to address the lack awareness of one of these programs in the Rutland region, BAMBI.

Increasing Awareness Of The Hpv Vaccine, Jonathan M. Hernandez

Family Medicine Clerkship Student Projects

Increasing the public awareness and knowledge of HPV complications and prevention through vaccination is an effective intervention to increase vaccination rates and reduce overall public health cost and burden.

Raising Healthy Vermonters: Preventing Childhood Obesity By Establishing Healthy Habits, Melanie Ma

Family Medicine Clerkship Student Projects

The State of Vermont has one of the lowest rates of childhood obesity in the country. While this statistic is encouraging, it does not make our communities immune. Many Vermonters struggle with obesity and its related illnesses, especially in rural, low-income areas of the state where the ability to afford fresh produce can be challenging.

To keep the rate of childhood obesity low in Vermont, children should be encouraged to establish healthy habits as early as possible. The goal of this project is to provide parents with effective and feasible ways to help their children develop healthy eating habits and …

Chronic Pain Management With High Dose Opioid Medication, Joshua Cohen

Family Medicine Clerkship Student Projects

Chronic pain management with non-abuse deterrent high dose opioids is a necessary but dangerous practice. This project addressed physician opinions about this sensitive issue and audited patient records to assess documentation compliance with VT rules. The goal is to standardize communication and documentation in order to improve safety for patients, physicians, and the community at large.