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Articles 1 - 30 of 42
Full-Text Articles in Primary Care
Concussion Management In Primary Care, James Levins
Concussion Management In Primary Care, James Levins
Family Medicine Clerkship Student Projects
Concussion awareness is a hot topic in youth sports, resulting in increased health care visits. There has been much change in concussion management over the past decade. VT passed a law (Act 68) implementing a concussion management program in schools. Not all primary care physicians are aware of how this law may affect their practice, nor are they all aware of some of the recent changes in concussion management. Improper concussion management can lead to prolonged symptoms, recurrent injuries and long-term sequelae.
Improving Vascular Health Of Patients With Diabetes Mellitus, Pishoy Haroun
Improving Vascular Health Of Patients With Diabetes Mellitus, Pishoy Haroun
Family Medicine Clerkship Student Projects
Some diabetic patients are reluctant to take the extra step in their long-term health care, which is particularly problematic as it relates to cardiovascular disease. In addition to difficulty controlling blood glucose levels, patients struggle maintaining an appropriate blood pressure. This is often due to a reluctance to maintain a proper diet, exercise regularly, and take certain medications. Studies have shown that compliance with exercise regimens falls from 80% at 6 weeks to 20% at one year. Many patients are reluctant to start on a statin, and some physicians are even hesitant to adhere to the new recommendations proposed by …
Influenza: Protect Yourself And Others, Sarah Fieber
Influenza: Protect Yourself And Others, Sarah Fieber
Family Medicine Clerkship Student Projects
In clinic, I would recommend to each patient that he or she should consider having a flu shot as flu season is quickly approaching. I heard a plethora of reasons for not being vaccinated, and few of these reasons were fact based. Teenagers are inconsistent about flu vaccination, and I thought if I could present an argument in favor of flu vaccinations, this could make a difference for the coming generations.
Awareness And Prevention Of Heroin Use In Springfield Vt And A Drug Recovery Resource Map Of Southern Vt, Yun-Yun Kathy Chen
Awareness And Prevention Of Heroin Use In Springfield Vt And A Drug Recovery Resource Map Of Southern Vt, Yun-Yun Kathy Chen
Family Medicine Clerkship Student Projects
Since 2000, more than 770% increase in treatment of opiate addiction according to Governor Shumlin’s Vermont annual address. On July 11, 2014, there was a shooting incident in Springfield, Vt., that injured a convicted drug dealer and wounded two other people was triggered by a dispute over heroin. This project aimed to create an educational and interactive pamphlet that can be used in the Family Practice office at Springfield Health Center and beyond in order to encourage dialogue and de-stigmatize heroin use recovery.
Providers’ Views On Transition Of Healthcare For Youth With Developmental Disabilities, Cordelia Y. Ross
Providers’ Views On Transition Of Healthcare For Youth With Developmental Disabilities, Cordelia Y. Ross
Family Medicine Clerkship Student Projects
Problem: Youth with DD have conditions that may limit their ability to function, with resulting social, emotional, or behavioral sequelae, and experience difficulty transitioning from child to adult health care. Also, adult providers may lack training and comfort level in working with patients with DD. For example, youth with ASD need an adult provider who understands autism but doesn’t see every health or behavior problem as a result of autism.
National Need: 1 in 6 children in the U.S. has a DD. Each year, almost half a million of these children transition into adulthood. As for ASD, 1 in 68 …
Improving Vaccination Rates In Bangor, Me, Noah Quinlan, Whitney Thomas
Improving Vaccination Rates In Bangor, Me, Noah Quinlan, Whitney Thomas
Family Medicine Clerkship Student Projects
Providers believe vaccination rates at EMMC Center for Family Medicine can be higher. A resurgence in some preventable diseases is likely due to decreased immunization rates. While other preventable diseases have not seen a resurgence, the potential for outbreak exists if immunization rates remain low. Factors contributing to low immunization rates are misinformation, lack of awareness, cost, inconvenience, and infrequent office visits by adolescents.
Mindfulness Resources In Lewiston, Me, Sabrina Bedell
Mindfulness Resources In Lewiston, Me, Sabrina Bedell
Family Medicine Clerkship Student Projects
Mindfulness can be defined as open-hearted, non-judgmental, present moment awareness.
Evidence-based Benefits include
Decreased:
- Blood pressure
- Anxiety, stress, & depression
- Chronic pain
- Medical care visits (inpatient and outpatient)
Increased:
- Immune function
- Ability to act effectively under stress
- Self-esteem
- Quality of life
Fluoride Supplementation: Recommendations In The Primary Care Office, Dwight Parker
Fluoride Supplementation: Recommendations In The Primary Care Office, Dwight Parker
Family Medicine Clerkship Student Projects
Physicians in a Vermont family practice setting tend not to be very familiar with CDC/AAP/AAD recommendations regarding fluoride, especially when it came to rural areas in Vermont not on town or public water. Questions include: What are the pros and cons of fluoride supplementation? What are the indications for supplementation? How does one go about testing their well water? Which towns have fluoridated water, and what are their levels? What doses are recommended, and what options are there for treatment?
Hpv Vaccination In Vermont: Identifying Educational Resources For Adolescents, Shane Greene
Hpv Vaccination In Vermont: Identifying Educational Resources For Adolescents, Shane Greene
Family Medicine Clerkship Student Projects
HPV vaccine is unique in that (1) it's not a required vaccine to enter school and (2) it's given at an age where patients have more agency over their medical care, so an adolescent who doesn't want to get the shot is often able to avoid it. In Vermont, there's a lack of educational material aimed at young adults about the benefits of the HPV vaccine.
Identifying And Treating Food Insecurity, Nicholas Field
Identifying And Treating Food Insecurity, Nicholas Field
Family Medicine Clerkship Student Projects
13% of Vermont households are food insecure, an increase of 45% since 2000. 25,400 children and 7,800 seniors in Vermont live with food insecurity. Based on metrics including poor health, hospitalizations, and lower educational productivity, food insecurity cost the State of Vermont $340,000,000 in 2010 alone.
Managing And Treating Allergic Rhinitis In The Primary Care Setting, Leah Novinger
Managing And Treating Allergic Rhinitis In The Primary Care Setting, Leah Novinger
Family Medicine Clerkship Student Projects
Screening and appropriate treatment of allergic rhinitis in the primary care setting is a challenge for providers due to time constraints. Providers in the practice desired more information about where in the community to refer patients with persistent allergic rhinitis and what information or test results they should send those specialists.
Creating Patient Instructions For Community Health Resources, Kevin Saiki
Creating Patient Instructions For Community Health Resources, Kevin Saiki
Family Medicine Clerkship Student Projects
In the US, more than a third of adults are obese as well as 17% of children. A recent report estimates the annual cost of obesity in Maine amounts to approximately 452 million dollars. Additional reports estimate the cost of obesity to the entire country lies somewhere between 10-30 billion annually.
Encouraging patients to have healthy diet rich with whole grains, fruits, and vegetables, and to maintain regular exercise (150 minutes a week) are effective ways to combat higher BMIs and to stave off associated hypertension, coronary artery disease, type II diabetes, and dyslipidemia.
Marijuana Use Among Pregnant Women In Buprenorphine Treatment For Opioid Dependence, Tara Higgins
Marijuana Use Among Pregnant Women In Buprenorphine Treatment For Opioid Dependence, Tara Higgins
Family Medicine Clerkship Student Projects
New program, "Closer to Home," will allow pregnant women in buprenorphine treatment for opioid dependence to get treatment closer to home and deliver at Copley Hospital instead of being required to go to Burlington. This requires local physicians to prescribe buprenorphine to pregnant women. In creating the program, prescribing physicians have to decide policies around non-opioid substance use.
Increasing Awareness Of Adverse Childhood Experience (Ace) And The Benefits Of Inquiring About Ace, Maya Son
Increasing Awareness Of Adverse Childhood Experience (Ace) And The Benefits Of Inquiring About Ace, Maya Son
Family Medicine Clerkship Student Projects
Adverse Childhood Experiences (ACE), including childhood abuse/neglect, household dysfunction, and exposure to other traumatic stressors, have a large impact on health costs as well as social services, education, juvenile justice. Impact of ACE crosses socioeconomic boundaries. In 2011, the Vermont Department of Health reported that 58% of VT adults had experienced at least 1 ACE, and 17% of VT women had four or more ACEs.
Alternative Medicine Resources For Primary Care Physicians, Laura Lazzarini, Angelina Palombo
Alternative Medicine Resources For Primary Care Physicians, Laura Lazzarini, Angelina Palombo
Family Medicine Clerkship Student Projects
Despite the prevalence of patients that would benefit from Complimentary and Alternative Medicine (CAM) at EMMC Center for Family Medicine (CFM), practicing physicians lack sufficient education on CAM and knowledge of community resources to refer their patients to.
Hpv Infection Prevention In Males By Gardasil Vaccination, Russell Landry
Hpv Infection Prevention In Males By Gardasil Vaccination, Russell Landry
Family Medicine Clerkship Student Projects
About 1% of sexually active males in the U.S. have genital warts. Each year 400 males get HPV related cancer of the penis, and 1,500 get HPV related cancer of the anus. 2-3 cases of Genital warts have been reported at Harwood High School (Moretown and Waitsfield), where the school nurse reports 1-3 males students each year seeking information about STIs (including HPV).
Dietary Supplement Education In A Primary Care Setting, Suleiman Ismael, Mikaela Rodriguez
Dietary Supplement Education In A Primary Care Setting, Suleiman Ismael, Mikaela Rodriguez
Family Medicine Clerkship Student Projects
More than 50% of American adults use at least one dietary supplement. Despite their popularity, patients and physicians are often unaware of the limited regulation of these products as well as their potential risks and benefits. During our rotation at the Center for Family Medicine in Bangor, Maine, we observed several patients asking about the efficacy and safety of various supplements. Also, many patients wanted to avoid taking pharmacological drugs and inquired about any "natural" treatments to their illnesses. The residents we worked with expressed a lack of confidence in their ability to discuss dietary supplements with their patients. In …
Addiction Burden And Resources For Patients In Connecticut, Jacob Reynolds
Addiction Burden And Resources For Patients In Connecticut, Jacob Reynolds
Family Medicine Clerkship Student Projects
Nationally, the US has 60 million smokers, 14 million dependent on alcohol, and 14 million illicit drug users. One quarter of Americans over 15 have physiologic dependence on at least one addictive substance. A quarter of all deaths in the US are caused by addictive substances: alcohol, tobacco, drugs. There are an additional 40 million injuries and illnesses per year. Locally, one Connecticut therapist reports sending 30 of her patients under age 22 to in-patient treatment for opiate abuse.
Vermont Radon Exposure, Gary Gilmond
Vermont Radon Exposure, Gary Gilmond
Family Medicine Clerkship Student Projects
Radon is a natural, odorless and tasteless radioactive gas that is found in soil, rocks and water all over the US including Vermont. Long-term radon exposure is linked to over 21,000 lung cancer deaths a year in the US, second only to tobacco. Roughly 1 in 8 homes in Vermont are believed to have high radon levels. Vermont law does not require a radon test as part of a real estate transaction. Thus despite the danger of Radon exposure, the issue remains unrecognized by many Vermonters. Since 2000 only 15,488 state radon test kits have been ordered in Vermont.
Summer Physical Activity Log And Reward System For Children In Colchester, Vermont, Bryce Edwards
Summer Physical Activity Log And Reward System For Children In Colchester, Vermont, Bryce Edwards
Family Medicine Clerkship Student Projects
- Childhood obesity has doubled in children and quadrupled in adolescents in the past 30 years.
- As of 2012, over 1/3 of children and adolescents in the United States are overweight or obese.
- A study from the CDC estimates that 1 in 3 children born In the year 2000 will develop diabetes in their lifetime.
- Obese children are at an increased risk for developing cardiovascular disease, diabetes and pre-diabetes, joint problems, sleep apnea, as well as social and psychological problems stemming from stigmatization and poor self-esteem. Overweight and obesity are also risk factors for multiple types of …
Opiate Abuse In Brandon, Vt: Empowering Support Systems, Raj Thakrar
Opiate Abuse In Brandon, Vt: Empowering Support Systems, Raj Thakrar
Family Medicine Clerkship Student Projects
Primary care physicians and emergency physicians have reported a surge in opiate abuse within the state of Vermont. It is being labeled as a public health epidemic and crisis, with a 2013 mortality rate of almost double what it was in 2012. There are several factors that play a role in why Vermont has seen such a growth in opiate abuse, from easy access to opiate dealers in major urban cities such as New York, Boston, and Philadelphia to a decrease in law enforcement coverage in rural areas of the state. One major element, and the focus of this project, …
Common Naturopathic Therapies For Chronic Conditions, Jordan E. Perlman
Common Naturopathic Therapies For Chronic Conditions, Jordan E. Perlman
Family Medicine Clerkship Student Projects
Complementary and Alternative Medicine has started to achieve greater public prominence – many patients report satisfaction and believe these therapies are cost effective. Allopathic physicians are largely unfamiliar with the supplements prescribed by naturopathic doctors, and have trouble integrating these therapies into traditional treatment plans. Patients are not trained to evaluate the safety or efficacy of their medication regimens, and rely on their primary care physicians to provide that service -– even if the majority of their "medications" are supplements recommended by an "alternative" provider.
Non-Pharmacologic Treatment For Infants With Neonatal Abstinence Syndrome (Nas), Michael Capata
Non-Pharmacologic Treatment For Infants With Neonatal Abstinence Syndrome (Nas), Michael Capata
Family Medicine Clerkship Student Projects
50-70% of babies born to mothers on Subutex and methadone during pregnancy show signs of withdrawing from these medications. This is known as Neonatal Abstinence Syndrome (NAS). In order to reduce the chance these children will need to be put on medication, it is important for them to be placed in a non-stimulating environment for the first five days of their life. Often, the mothers and families of these children are not aware of, or do not practice, non-pharmacological methods to reduce the amount of stimulation their children are exposed to.
Health And Community Resources For Older Adults In Chittenden County, Vermont, Matthew Jordan
Health And Community Resources For Older Adults In Chittenden County, Vermont, Matthew Jordan
Family Medicine Clerkship Student Projects
The vast number of resources available to older adults are widely unknown to both health care providers and the older adult population itself.
Using Local Resources To Build Strong, Healthy Families, Cornelia Willis
Using Local Resources To Build Strong, Healthy Families, Cornelia Willis
Family Medicine Clerkship Student Projects
Although obesity rates across all demographics continue to climb annually, when separated into income levels, the prevalence of obesity in poor adults and children are rising at a greater rate than middle class individuals. A recent publication by the Food Research and Action Center (FRAC) compiled a list of data points that indicated that, while the trend is gradually slowing, rates of severe obesity are about 1.7 times greater in children coming from families whose incomes fell below the poverty line than equal counterparts in the middle class income bracket. High fat, high carb foods are often the staple of …
Caregiver Burden: Finding Resources, Offering Support, Sarah Johnson
Caregiver Burden: Finding Resources, Offering Support, Sarah Johnson
Family Medicine Clerkship Student Projects
- Definition: Informal caregivers are unpaid individuals (often a spouse, partner, family member, friend or neighbor) involved in supporting others in activities of daily living.
- Caregiver burden is an emerging public health issue largely attributed to longer life expectancy that not only increases the number of elderly individuals, but also the level of dependency in these individuals.
- Despite many formal support services, informal support continues to be the primary source of care for the elderly, dependent and disabled.
- Unpaid family caregivers will likely continue to be the primary source of long-term care in the United States as …
Community Resources For Elevated Bmi In Downeast, Me, Nicolas Monte
Community Resources For Elevated Bmi In Downeast, Me, Nicolas Monte
Family Medicine Clerkship Student Projects
The US is currently mired in a decades-long battle against an epidemic of obesity. According to the CDC 69.2% of the US population over the age of 20 is either overweight or obese. As primary care clinics move towards becoming “Patient-Centered Medical Homes” the need exists to provide adequate and specific educational materials.While a great wealth of educational resources exist to inform patients about the nature and pathogenesis of individual diseases, access to specific local treatment tools is lacking. Although nearly all clinicians screen patients for elevated BMI and provide general information about general healthy habits, this is often the …
Creating A Guide For Patient Self-Management Of Weight Loss (For Management Of Diabetes), Kelsey Preston
Creating A Guide For Patient Self-Management Of Weight Loss (For Management Of Diabetes), Kelsey Preston
Family Medicine Clerkship Student Projects
In my first week working with Dr. Flynn, I saw more patients coming in with a diagnosis of diabetes than those without; this is likely untrue, but it certainly felt like that. I realized how big of an issue diabetes really is, and hoped to work on a project targeted towards diabetes. While I noticed medical and medicinal management of patients with diabetes was adequate, there was a large gap in patient self-management of their diabetes – they followed their prescriptions, but did not seem to have changed other aspects of their lives, most importantly, their diets.
Food For Thought: Nutrition Education And Nutrient Delivery At Two Local Elementary Schools, Jenna Bodmer
Food For Thought: Nutrition Education And Nutrient Delivery At Two Local Elementary Schools, Jenna Bodmer
Family Medicine Clerkship Student Projects
I designed a 20 minute powerpoint presentation and delivered it to healthcare providers in the area.
- Discussed the growing problem of obesity, and new federal regulations designed to curb it - Summarized data gathered in interviews at both schools
- Compared schools to each other
- Suggested changes that each school could make in the future
- Offered suggestions for changes in office practices and office collaboration with schools, for PCP's in the area
Medicare Part D: Avoiding The “Donut Hole” And Cost-Related Medication Nonadherence, Daryl Selen
Medicare Part D: Avoiding The “Donut Hole” And Cost-Related Medication Nonadherence, Daryl Selen
Family Medicine Clerkship Student Projects
Problem: Studies have shown that only ~50% of patients with chronic conditions take their medications as prescribed. Patient nonadherence can be due to forgetfulness, desire to avoid adverse side effects, and high costs of medications, particularly in patients with low incomes, multiple chronic health problems, and no prescription coverage. Attempting to reduce medication costs by taking less than prescribed dose does not allow for full therapeutic benefits, and may put patients at increased risk for declining health. Consequences of cost-related nonadherence (CRN) and underuse: increased ED visits, psychiatric admissions, nursing home admissions, and decreased health status. In patients with asthma, …