National Comorbidity Survey has shown that anxiety disorders are the most frequent disorders in the population, with a lifetime prevalence of 28.8%, and a 5.7% lifetime prevalence of Generalized Anxiety Disorder (GAD) specifically. The presence of anxiety disorders contribute in an additive fashion to poor function, reduced quality of life, and more sick days from work. Despite being as common and impairing as depressive disorders, anxiety disorders have received much less attention in terms of the media, research, and public health efforts, and are often undetected and undertreated. Only a minority of patients with anxiety, 15-36%, are recognized in primary care. Without proper diagnosis, there can’t be sufficient treatment.
Obesity is a known risk factor for complications during pregnancy and birth, as well as worse outcomes. This study looked at the health risks and outcomes of pregnancy in obese women (BMI>35) at the family medicine clinic in Bangor, ME as well as what interventions are being done know to encourage women to meet their weight gain goals. Interviews and literature searches were conducted to determine possible strategies to better get obese pregnant women to meet their weight gain goals.
Syed S. Shehab
More than 5 million people have Alzheimer’s disease today and 450,000 people in the US die of Alzheimer’s every year. By 2050 the number of people living with Alzheimer’s could triple. 40% of patients living with Alzheimer's disease are undiagnosed. Early detection promotes better dementia care, lowers costs of care, and increases quality of life
Slow Foods for Health Increasing Knowledge of Glycemic Index in Adolescents for Healthier Food Choices
Meredith Kayleigh Sooy
Obesity has reached epidemic proportions through the United States affect all age groups, genders, and races. This is especially troubling in the pediatric population where 12.5 million children were found to be overweight in 2010. Many adolescents have inadequate knowledge of nutrition basics to make healthy choices. Based on interviews within the community of Colchester, VT a need for information about the glycemic index was seen. A handout geared towards adolescents was created with information about the glycemic index and using this information to make healthy food choices. This handout was made available to all providers of Colchester Family Practice for use with their adolescent patients.
Catherine A. Suppan
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.
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 for their old children. This project set out to create an informational resource about car seat safety in children ages 4 and above and distribute it to applicable families in Hinesburg family practice.
Measles is a highly contagious disease with potential complications ranging from diarrhea, pneumonia, otits media, uveitis, and encephalitis. Since the introduction of the measles vaccine in 1967, incidence of measles in the United States has drastically decreased: by 1985, number of cases had fallen by 99%, by 2000, measles was declared to be eliminated from the US. Over the last decade, measles cases per year has been limited to a median of 70. In recent years however, the U.S. has seen an alarming rate of measles cases. The increasing number of measles cases per year in the U.S. highlights the need for more public awareness of the efficacy and safety of the MMR vaccine.
Administration of naloxone is credited with the reversal of at least 10,000 opioid overdoses in the United States between 1996-2010 alone.[i] Moreover, intranasal naloxone has proven an equally effective route of drug administration when compared to IV dosing in emergent prehospital settings[ii], and retrospective studies have shown no significant difference in efficacy between doses delivered by healthcare professionals and non-healthcare professionals.[iii] Despite these facts, and broad protections provided to physicians prescribing naloxone and citizens administering naloxone outlined in Vermont Act 75, few if any Vermont physicians have incorporated prescribing naloxone into their practice. This project intended to find the barriers to prescribing and begin prophylactic distribution of naloxone to Stowe Family Practice patients.
[i] Centers for Disease Control and Prevention (CDC).Community-based opioid overdose prevention programs providing naloxone - United States, 2010. MMWR Morb Mortal Wkly Rep. 2012 Feb 17;61(6):101-5.
[ii] Barton ED, Colwell CB, et al. Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting. J Emerg Med. 2005 Oct;29(3):265-71.
[iii] Doe-Simkins M, Quinn E, et al. Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: a retrospective cohort study. BMC Public Health. 2014 Apr 1;14:297. doi: 10.1186/1471-2458-14-297.
The Drug Treatment Court in Burlington is one of about 3000 drug treatment courts nationwide. They were developed as an “alternate sentencing court”, a method of restorative justice that would allow people who had multiple criminal charges related to substance abuse to overcome their addiction, have their criminal charges dismissed, and pursue a fuller life. As part of this program, many participants attend an Intensive Outpatient Program (IOP). As a third year medical student, I lead an educational session with the aim of helping participants understand the neurophysiology behind their addiction.
Sleep Apnea is a common and shockingly under-diagnosed disorder. OSA has various health consequences, including increased risk of cardiovascular disease and stroke. Many patients don't ask about OSA due to lack of awareness and an intimidation about the process of care for OSA. This project helps to increasing understanding of the sleep study and make OSA a more approachable disorder
Amy I. Triano
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 brochure with healthy living tips was made available to patients and providers in exam rooms. A presentation was given to providers in the office with details about the website as well as about community programs that they could refer people to and their contacts in the community. The response from providers and office staff was positive. It is still too early to tell whether or not the implementation of the website will encourage and improve healthy living in Berlin, VT.
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.
The incidence of Lyme disease has been increasing since it was first discovered in 1975 in Lyme, CT. If Lyme disease is left untreated, an early localized infection (represented by a single EM) can disseminate to other parts of the body. Spirochetes disseminate through the blood and cause multiple EM rashes and other sequelae. This project aimed to educate high school students about tick-borne illnesses and what they can do to protect themselves.
Kai Ping Wang
Today, Tobacco is still the #1 leading cause of preventable death in the United States. Use of tobacco products leads to chronic illnesses such as asthma, heart disease, cancer, lung disease, and stroke. According to the latest data in 2013 from the Behavioral Risk Factor Surveillance System, 16.6% of adults in Vermont are current smokers compared to 19% of adults nationwide. This projects seeks to provide easier access to the available resources in the local Milton, VT community for smoking cessation.
Katherine Y. Wang
About one half of pregnancies in the United States are unintended (mistimed or unwanted). Only 54% of pregnancies in Vermont are planned and only 29% of women in Vermont have talked to a health care worker about healthy pregnancies prior to conception. Physicians are equipped to provide the necessary information to women about preconception care and contraception, but do not regularly have these conversations with the majority of their patients. One Key Question is an initiative developed by the Oregon Foundation for Reproductive Health that allows providers to screen women patients for their pregnancy intention in the next year and appropriately respond with preconception or contraceptive counseling.
Allergic rhinitis affects up to 30% of the population yet there is evidence that it is under treated and misdiagnosed. Allergy symptoms closely mimic other common illnesses and most medication used to treat seasonal allergies is now available over the counter. This shift in therapy means that patients are now self-medicating with little knowledge of what they are actually treating. Therefore this project aims to clear common misconceptions that prevail in the general population of Vermont as well as provide some guidance on the types of medications used to treat seasonal allergies.
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.
Amy Wei-Hsin Yu
Many elders must choose between paying bills, buying medication or buying food. Some elders are unaware that they qualify for food assistance, or would feel stigmatized using it. Only 1 in 3 eligible seniors (60+) participate in 3SquaresVT (SNAP), a federal nutrition program of the USDA administered by the Vermont Department for Children and Families. Over 14,000 (11%) of Vermont seniors face the threat of hunger and almost 7,000 (5%) are at-risk for hunger (food-insecure). Food insecurity can be screened for by using Hunger Free Vermont’s Two Question Screen.
Mindfulness can be defined as open-hearted, non-judgmental, present moment awareness.
Evidence-based Benefits include
- Blood pressure
- Anxiety, stress, & depression
- Chronic pain
- Medical care visits (inpatient and outpatient)
- Immune function
- Ability to act effectively under stress
- Quality of life
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
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.
Awareness and Prevention of Heroin Use in Springfield VT and a Drug Recovery Resource Map of Southern VT
Yun-Yun Kathy Chen
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.
Cyberbullying has become a growing public health concern with the rising interest and use of social media applications. This occurs mostly in the adolescent population but can continue through to college and adulthood.
Some important differences between cyberbullying and traditional bullying include:
- Students experiences cyberbullying can also be cyberbullies themselves
- Girls are more likely to be involved with cyberbullying.
- Cyberbullying doesn’t just reach students at school but at home as well.
- Students experiencing cyberbullying are 2x more likely to develop depression and anxiety disorders than those experiencing traditional bullying.
- 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 cancers.
- Overweight and obese teens have fewer friends than their normal weight peers. They also suffer from higher rates of depression and suicide if they are being teased by about their weight.
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