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Expanding Awareness of TBI Resources in the North Country
Nicholas W. Krant
Disability, emotional dysregulation and financial stress are only some of the issues that many patients who suffer TBI encounter. While resources are available to alleviate some of these burdens on patients who suffer TBI in New York's North Country, patients often struggle to find these resources. This project endeavors to create a resource for patients, family members and practitioners to find available resources.
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Patient Pamphlet for Basic Lab Values
Robert A. Adamian
As a result of lab results being immediately available to patients online, many patients experience unnecessary anxiety when viewing their results before speaking with their physician. Misleading lab values and increased patient concerns lead to more time spent by physicians answering messages on EPIC, which adds to the burden of public health costs. To combat this, a double-sided pamphlet was made with quick high yield facts about lab data that patients can use for information in the time between seeing their results and communicating with their doctor.
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Current Landscape of Screening for Abdominal Aortic Aneurysms in Females
Maxwell T. Tulimieri and John G. King
There is some controversy over if females are under-screened for abdominal aortic aneurysms (AAAs). The USPSTF 2019 AAA screening guidelines give an I recommendation for females 65-75 who smoke, yet the Society for Vascular Surgery (SVS) highly recommends with strong evidence a 1-time screening ultrasound for men or women age 65-75 with a tobacco history. This project entails a 10-minute recorded PowerPoint educational session for Milton Family Practice providers on the current landscape of AAA screening in females including differing practice guidelines and their histories, cause of said discrepancies, associated cost and insurance coverage, and suggested creative solutions to billing difficulties as well as provider response and feedback.
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Preventive Medicine Screening Measures
Isaac Adams
In order to make progress towards long-term health on a community level, it is imperative to address health needs on a population basis and using a preventive strategy to prevent the development of more serious illness. With this in mind, this project aimed to create a poster providing easy to understand information to patients with regard to health screenings. Specifically, it addressed screenings for diabetes and pre diabetes, colon cancer, lung cancer, and breast cancer.
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Improving Identification of Dermatological Conditions in Skin of Color
Sam Afshari B.S. and Simran Kalsi M.S.
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.
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The Diabetes Template
Samuel J. Aldous
This presentation describes the construction of a diabetes follow up note template. This template was designed to streamline these visits for practitioners to provide a comprehensive amount of data collection with maximum efficiency. This should allow for more time for practitioners to spend talking to patients and managing their care rather than collecting details from different sections of the patient's chart.
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Improving Home Medication Literacy and Communication
Jeremy Altman
As pharmaceutical companies continue to promote drugs through advertisements on various media, there is a need for physicians to help patients conduct safe and responsible medical research at home. Additionally, polypharmacy leads to potential confusion and medication errors made at home. A list of answers from Frequently Asked Questions has been curated to be added to an "After Visit Summary" to help patients navigate their research on medication from home while they wait to discuss with their physician.
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Improving Dental Health Screening in the Primary Care Setting
Kali Amoah
Oral health is an important part of systemic health that is often overlooked by patients due to various barriers to dental care. Dental caries is a public health crisis and one of the most common chronic diseases globally. Poor oral health and the resulting inflammation caused by oral bacteria is associated with cardiovascular disease, pregnancy complications, poor glycemic control in diabetes mellitus, and many more conditions. The goal of this project is to increase dental health screening in the primary care setting and to provide a list of affordable dental clinics in Vermont that take Medicaid/ Medicare and offer sliding scale payment options. With increased dental health screening in primary care offices, the hope is to detect dental pathology earlier on in the disease course and connect patients with dental clinics that provide affordable dental care.
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The Benefits of Outdoor Recreation and Selected Resources Around Hinesburg VT
Micaila Baroffio
Spending time outside has historically been associated with improved mental and physical health outcomes. However, research has shown that nature-based recreation has been decreasing in recent years. Healthcare providers hold a unique position in the ability to encourage patients to seek improvement in their health. Therefore, this research focused creating a pamphlet to improve awareness of the benefits of outdoor recreation and provide selected resources around Hinesburg VT.
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Tickborne Disease Prevention and Education
Clara Berard
Over the last decade, the incidence of tickborne disease has been increasing in Vermont and across the United States. Many people have questions and concerns about tickborne diseases that their healthcare providers don't have the time or knowledge to answer. By designing a way to efficiently distribute educational materials on tickborne diseases to patients, their questions and concerns can be more easily addressed.
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Improving Lyme Disease Literacy
Eliot Binkerd-Dale
Lyme disease and Tick-borne illnesses are a relevant and growing concern throughout New York State. There is considerable confusion surrounding the diagnosis and treatment of Lyme disease among the general public. This project aims to improve Lyme disease literacy among patients of a Family Medicine practice through after-visit education.
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Implementation LGBTQ+ Health Education Through Case-Based Learning
Bradley A. Blansky
Primary care graduate medical education programs often do not provide adequate training regarding the healthcare needs of the LGBTQ+ population. The purpose of this community project was to develop a case-based teaching session to help provide family medicine residents a basic understanding of LGBTQ+ healthcare. This didactic session was found to be an engaging and effective method of teaching physicians about LGBTQ+ health. Additional work is needed to further train physicians and other healthcare professionals about the challenges faced by marginalized populations in our healthcare system.
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Culturally Sensitive Carbohydrate Sources for Nepalese with Diabetes or Prediabetes
Rachel Bombardier
Over 8,000 refugees have started new lives in Vermont since 1980. Many of these people utilize the Community Health Centers of Burlington, for some this may be their first time navigating America's healthcare system. This is a daunting task due to a multitude of barriers, including missing cultural competencies in various aspects of their care. This project focuses on dietary recommendations for Nepalese patients with prediabetes and type 2 diabetes, specifically carbohydrate sources based on fiber content. Type 2 diabetes is a very prevalent chronic disease that costs Vermont $520 million each year. Understanding healthy food options in a culturally sensitive approach, will allow better care and recommendations for the Nepalese. A Nepalese-focused handout on carbohydrate sources was generated based on local Asian markets that they frequent.
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HIV Pre-Exposure Prophylaxis (PrEP): Increasing Awareness in Primary Care
Carl W. Brasch
Primary care is a setting that has great potential for screening and reducing the rate of HIV transmission.
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Healthy Affordable Food in Milton, VT
Nicholas D. Brunette
Access to healthy affordable food is a common issue in nationally and in Vermont. This project aims to provide resources for patients and families at Milton Family Practice who need access to healthy food options.
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Healthy Affordable Food in Milton, VT
Nicholas D. Brunette
Food insecurity disproportionately affects those of lower socioeconomic status and ultimately leads to poorer health and excess healthcare expenditures. Providing local and online resources for healthy affordable eating to patients of Milton Family Practice may help address some of these concerns.
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Implementation of an Ultrasound Screening Program in a Rural Family Medicine Practice for Abdominal Aortic Aneurysms
Rachel Carpenter
The American Academy of Family Physicians (AAFP) supports the USPSTF recommendation of a one-time screening assessment of all men aged 65 to 75 years old who have ever smoked for an abdominal aortic aneurysm (AAA) via ultrasonography – grade B recommendation. Despite this, few eligible patients are referred specifically for screening and many patients that are screened only have it performed as an incidental finding of other indications for imaging. AAA screening, when done, has demonstrated up to a 40% reduction in AAA specific deaths and a 3% reduction in all cause mortality after 13 years follow up. The initiation of ultrasound use in a primary care clinic has the potential to not only increase AAA screening but also lead to more widespread use of this imaging modality on a comprehensive level.
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Barriers to Head and Neck Cancer Treatment in Rural Populations
Amy K. Chang
Head and Neck cancer (HNC) patients have unique outcomes and resource needs. They often experience debilitating speech, nutrition, respiratory, and psychological problems, requiring a multidisciplinary team. Additionally, they also require more support in terms of alcohol and tobacco support, whether that be an addiction medicine specialist or a support group. The coordination of these specialists is difficult in a rural setting with limited resources. Furthermore, HNC is more prevalent in developing countries and rural populations due to use of known etiological factors like tobacco and alcohol. The combination of high prevalence and low resources in rural populations may lead to suboptimal treatment and worst outcomes.
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Community Services for Patient Referral Document
Jett Choquette
Patients have a need for referral to a variety of services that directly relate to their health and wellbeing that are not generally included in the traditional referral system of healthcare networks. These services include (but are not limited to) social work support, pandemic support, elderly services, LQBTQ+ services, intimate partner violence services, functional medicine, and substance use disorder and mental health support and treatment. Because these services are not part of the traditional healthcare referral system, healthcare providers may not have an up-to-date list of organizations and programs in the community that could provide these needed services. This is especially important in the current era when there has been increased turnover of healthcare workers at all levels leading to low institutional/community knowledge. To address this need, a community service patient referral document was developed after interviewing healthcare workers in the community and reviewing patient needs throughout the family medicine clerkship to inform resource selection.
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Trust Your Gut: Promoting gut health through updated nutrition education
Christina Cobb
Physician time and nutrition education are limited, yet lifestyle changes, including healthy eating, are often the primary intervention for both preventing & managing chronic conditions, such as cardiovascular disease, hypertension, and type 2 diabetes. There is growing evidence of the importance of gut health & the microbiome’s link to several aspects of health, including the immune system, mental health, and metabolic syndrome. Through collaboration with two dietitians, a "promoting gut health" patient handout was created and existing nutrition handouts were updated to reflect current dietary recommendations.
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Primary Care Management of Alcohol Withdrawal
Julie Connor
Alcohol use disorder (AUD) is prevalent yet undertreated in rural Vermont. Approximately half of those with AUD who stop drinking experience alcohol withdrawal. Alcohol withdrawal can range from uncomfortable to life threatening symptoms. Untreated alcohol withdrawal can also lead to recurrence of alcohol use. The mainstay for management of alcohol withdrawal has been inpatient or intensive outpatient programs. However, there are barriers to accessing these programs including availability of beds, patient reluctance, lack of transportation, not knowing about these programs, and cost. Primary care management of alcohol withdrawal is safe, accessible and has the potential to reduce symptoms of alcohol withdrawal, improve engagement with treatment for alcohol use disorder, and reduce alcohol related health complications. In this project, a patient instruction sheet and self-assessment of withdrawal symptoms to be used as part of a protocol for primary care management of alcohol withdrawal.
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