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The File of Life: A Lifeline for First Responders in Fairfield County, CT
Brittany Gilmore
During a medical emergency, it can be difficult for first responders to obtain crucial medical information about their patients for a variety of reasons. The patient may be unconscious, have an altered mental status, or simply not know their medical history. This project aimed to increase awareness of the File of Life program, which many local Fire and EMS departments are implementing to improve their ability to deliver life-saving care.
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Tackling Access to a Healthier Life
Edom Alemayehu Girma
Obesity is a known risk factor for complications during childhood and later in adult life. While numerous factors play a role in the prevalence of obesity, this project focused on better intervention for obesity management in the family medicine clinic located in Plattsburgh, NY. Interviews and literature searches were conducted to determine possible strategies to better assist patients in attaining their sustainable weight loss goals and an overall healthier lifestyle.
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Long Phone Wait Times at Newtown Primary Care
Krystal Gopaul
Getting an appointment with a PCP has historically always been challenging but at Newtown Primary Care long wait times on the phone when booking an appointment is also frequently cited as a local challenge. This project explores phone wait times as well as patient, staff and provider perspectives on challenges accessing primary care appointments at Newtown Primary Care.
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Improving Mental Health Access in a Rural Setting via Telehealth
Timothy W. Greenfield
There are several barriers patients face when accessing mental healthcare in rural areas including: lack of internet, lack of resources, and stigma.
Local options are limited, and patients face barriers such as access to transportation.
These factors position telehealth as a unique, tangible solution for patients in the community.
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Improving Access to Medication Assisted Treatment for Opioid Use Disorder in a Rural Emergency Department
Warren Grunvald
Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.
Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department
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Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department
Warren Grunvald
Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.
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Anticipatory Guidance on Breastfeeding Support in Vermont
Ian Guertin
Breastfeeding is an optimal source of nutrition for babies and has health benefits. Vermont strives to support families in meeting their breastfeeding goals. This project developed anticipatory guidance that can be given to prenatal patients about breastfeeding support resources in Vermont.
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Addressing Diabetes Education in Chittenden County
Varun Gupta
The percent of adults in Chittenden County with diabetes who have received diabetes education was short of national goals. To gather more information about the problem, a NP and 2 diabetic patients were interviewed. A educational handout was created to address some of the concerns brought up that reflect some of the unmet educational needs.
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Polypharmacy And Fall Risk Education In Elderly Adults
Mohamad K. Hamze
The primary care office is often the setting for medication management and risk-reduction and PCPs frequently reconcile and manage the prescriptions of numerous specialists who see a patient separately. For patients >65, one must consider the necessity of prescribed medications that may contribute to increased fall risk in this age group. Patients themselves may be uncertain of the types of medications they may be taking that potentially put them at increased risk for falls or adverse outcomes of falls. Thus, they may benefit from easily accessible educational materials on commonly-prescribed medications in these categories so that they may work with their physician to make informed decisions on their medication regimens.
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Addressing Maladaptive Coping Mechanisms in Response to External Stressors and Negative Affective States in Primary Care Settings
Matthew C. Hanna
Individuals respond to negative affective states, including depression and bipolar disorder, and external stressful events with a wide variety of adaptive and maladaptive coping mechanisms or a mixture of both. Maladaptive coping mechanisms include substance use and binge eating, as well as avoidance or withdrawal behaviors. Understanding how patients respond to external stressors and adapt to negative affective states, including depression and hypomania, via questionnaires seeking to elucidate coping mechanisms is of utmost importance to recognize patients at risk of substance use, binge-eating, and other maladaptive behaviors. Only through explicit identification of these mechanisms can providers work with patients to take steps to mitigate negative health effects of maladaptive coping behaviors via targeted patient education and formation of collaborative partnerships with patients.
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Keep an Eye On Your Ocular Health: The Importance of Routine Eye Exams
Kiana Heredia
When it comes to scheduling preventive health screening exams, eye exams are often overlooked. Individuals may not understand the importance of their ocular health, and many assume a basic vision screening is comprehensive. However, that is not the case and eye diseases are common and can go undetected for a long period of time before symptoms appear. Seeing a licensed optometrist or ophthalmologist for comprehensive eye exams is important for detecting eye disease in the early stages when treatment is available to prevent vision loss is most effective.
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Overcoming Barriers to Care in the Treatment of Opioid Use Disorder
Max C. HoddWells
There are many barriers to care when it comes to the treatment of opioid use disorder (OUD), and patients often require significant resources to achieve success. Patients requiring treatment for OUD at Central Maine Medical Center in Lewiston, Maine are often enrolled in an intensive outpatient clinic (IOP), which requires access to certain technology, transportation to appointments, and time-intensive counseling, among other things. The demands of IOP are important for successful and holistic treatment, but it presents unique challenges to socioeconomically disadvantaged patients who have limited resources.
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Anxiety Screening in Pediatric Populations
Shubhankar Joshi
This project is aimed to elucidate guidelines for addressing newly changed recommendations for pediatric anxiety. Similar to the depression screening PHQ2, we hope to establish/develop a similar questionnaire that would serve as a quick screening tool and then further steps for treatment and recommendations on anxiety diagnosis.
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Resources for LGBTQ+ Patients
Elie Kaadi
Many LGBTQ+ patients face issues when seeking care from their primary care providers as well as specialists. This could be due to lack of information that is taught during medical education as well as lack of information that is available to the public.
This project aims to provide helpful information for both physicians and patients that is relevant for the care of LGBTQ+ patients.
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Perceptions of Teleophthalmology
Kisha Kalra
One of the greatest burdens facing patients with eye-related pathologies is access to ophthalmologists in the area. Teleophthalmology is a way for eye examinations to be conducted in the easily-accessible primary care setting, with images sent to ophthalmologists for interpretation. This project addresses the perceptions of this model amongst patients and primary care physicians.
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Benign vs. Malignant: Improving Prevention and Detection of Cancerous vs. Non-Cancerous Skin Lesions Through Inclusive Patient Education
Simran Kalsi and Sam Afshari
Vermont consistently has one of the highest annual rates of melanoma in the United States. This is likely due to a range of factors including population demographics (predominantly white, aging population), active outdoor lifestyles, intense seasonal bursts of sun exposure, and inadequate Winter sun protection. The COVID-19 pandemic and its associated shutdowns have caused significant delays in healthcare delivery, further exacerbating the incidence and severity of melanoma. Primary care providers are therefore an increasingly essential first line of defense in detecting suspicious skin lesions and expediting treatment of skin cancer, but patients should be aware of when to seek evaluation. I developed a patient-centered educational bookmark (adapted from the American Academy of Dermatology) to improve public knowledge about when a skin lesion is likely to be malignant vs. benign. The bookmark was distributed to Thomas Chittenden Health Center in Williston, VT and the University of Vermont Medical Center Family Medicine clinic in Hinesburg, VT. Qualitative feedback was collected and categorized according to major themes including appearance, utility, and relevance to Vermonters. Future directions for this project include further distribution at local libraries, book fairs, and schools as well as quantitative evaluation of its efficacy as an intervention through population surveys.
I worked in collaboration with Sam Afshari for the distribution of this intervention across clinics and for collection of feedback. I distributed and collected feedback for Sam's presentation "Improving Identification of Dermatologic Conditions in Skin of Color" (see Slide 7 for details).
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An Assessment of Skills Before Pills, A Series Promoting Lifestyle Medicine
Kyle J. Kellett
Lifestyle medicine seeks to treat the root cause of chronic medical conditions through lifestyle medications, including diet and exercise habits, tobacco and alcohol use, and mental health. Skills Before Pills is a novel, multidisciplinary, 8-week group appointment series aimed at promoting lifestyle change to address chronic medical conditions developed by the physicians at South Burlington Family Medicine. The aim of this project was to construct a quality improvement survey to collect patient feedback on the series with the goal of continually improving the course to promote long-term, positive, change in behavior.
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Peri-Operative Optimization: Social Determinants of Health
Adam F. Kohutnicki
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 address those SDOH. The clinicians identified specific SDOH of primary concern that they believe should be addressed in the pre-operative visit: family dynamics, financial considerations, and transportation. The proposed intervention includes a "dot-phrase" that can be utilized by clinicians during these encounters to specifically address these SDOH and coordinate additional interventions to address areas of need. Further investigation into the specific costs and savings of such an intervention, additional SDOH to be included in such interventions, and additional collateral information from surgical perspectives is warranted.
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Outpatient pamphlet intervention providing Evidence-Based Stretches and Exercises for Non-specific Back Pain
Jason Lach
A pamphlet was created using stretches and exercises similar to those supported in a randomized control trial (Kim 2020) for treatment and prevention of non-specific lower back pain. The pamphlet with written instructions, pictures and links to instructional videos was created to provide an informational resource patients could use to relieve back pain at home and to promote core strengthening exercises to prevent further back injury injury. The pamphlet was available for two weeks and provided to a family medicine physician at Newtown primary care and a patient with non-specific back pain for feedback.
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Return to Play Following Covid-19
Tyler Landman
Covid-19 infections among adolescents have led to significant decreases in physical activity and fitness. Many adolescents have been subject to return to play clearance before being able to get back to their sport. Protocols are not only a moving target but are also different from school to school, and county to county. Many patients are not involved in the decision making process of when they get to play again, and furthermore end up being out of sport longer than they need to due to the ordering of unnecessary tests, and long wait times for them. The aim of this study was to provide triage nurses and clinical site supervisor the most up to date and easy to use return to play protocol; to prevent unnecessary doctor’s visits and allow patients to be more engaged in the return to play decision making process.
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Dietary Effects of Vitamin K on INRs
Michael A. Lawson
INR monitoring can be difficult for patients. Vitamin K plays a major role in the regulation of INR control and warfarin efficacy. Fluctuations in daily vitamin K intake can alter INR values, leading to coagulopathic adverse events. Consistent daily vitamin K intake may help patients improve INR control.
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Transgender Care within Family Medicine: Focusing on Feminizing Hormone Therapy
Stellar Levy
Transgender populations experience health disparities and barriers related to gender identity or expression. Many people who identify as transgender avoid or delay care because of perceived or real transphobia and discrimination by health care providers and institutions. Providers may benefit from easy access to information about people who identify as transgender and their health needs.
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When Patients Re-engage
Timothy L. Long
Patients can often feel overwhelmed or intimidated by a trip to the doctor's office. But when a patient has not seen a doctor in several years, those feelings can contribute to avoidance of the healthcare system in general. This project seeks to help assuage concerns and empower patients during their first visit back to a primary care physician.
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A Mobile App To Improve Patient Education In The Management of Chronic LBP
Cole Lutz
The purpose of this project is to educate patients about the treatment of CLBP through an interactive mobile app, with the goal of improving transparency regarding the risks and benefits of various interventions. Most patients with CLBP lack the time and knowledge to perform a thorough literature review to determine the rates of efficacy and complications associated with their treatment. A mobile app that summarizes this data and translates it in a way that patients can understand would facilitate clearer communication and expectations between patients and providers. With improved patient education, patients would presumably be more likely to participate in informed shared decision making with their provider regarding their car. Additionally, patients would be more likely to collaborate with their providers to select the least invasive treatments appropriate for their condition that are associated with the highest rates of efficacy and patient satisfaction. Ideally, this approach would result in improved patient outcomes and a greater proportion of patients being satisfied with their treatment.
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