Block Clerkship Projects

Follow

• 

  Over the Counter Medication Education Approach

  Gurpinder Gill and Ian Crane

  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.

• 

  Determining Barriers to Oral Health Care in Bennington County

  Taylor Goller MS-3

  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.

• 

  Osteoporosis: Prevention, Screening, and Treatment in the Primary Care Setting

  Jeanne T. Gosselin

  Osteoporosis, with its related fragility fractures, is largely a preventable disorder, not an inevitable part of aging. Through effective education, screening, and treatement in the primary care setting, it may be possible to curb the impending rise of osteoporosis and costly fractures as the population ages. A time-conserving patient education pamphlet on osteoporosis was developed for a family medicine practice in central Vermont. The educational intervention is sensitive to the time constraints of a busy practice and may provide a much needed foundation for osteoporosis education in the primary care setting.

• 

  Added Sugars: Educating the Public on New Guidelines

  Michael A. Grant

  Added sugars are a non-nutritional source of calories found in many food products where people do not expect to find them. There is ongoing discussion of the healthy amount of added sugars to consume as well as new guidelines and labeling efforts. This project reviews the epidemiology of a small town in VT and considers ways to improve the awareness of added sugars and how to reduce the amount consumed by its residents.

• 

  Pediatric Tooth Care and Fluoride Exposure in Maine

  Lucas Grover

  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.

• 

  Implementing Developmental Screening per AAP Guidelines

  Douglas Handley

  "Fewer than half of the nation's pediatricians conduct systematic surveillance of young children's development… time and cost are among the barriers." Missing developmental delay leads to further attenuation of the problem and can lead to additional developmental problems. Developmental delay can often be corrected or treated to reduce the impact it has on the child. The AAP suggests "developmental surveillance" at every well child visit and standardized "developmental screening" at WCC 9 months, 18 months, and 24 or 30 month.

• 

  Development and Implementation of a Suboxone Therapy Group

  David Hermel

  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.

• 

  Increasing Awareness of the HPV Vaccine

  Jonathan M. Hernandez

  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.

• 

  Improving Vaccination Rates at UVMMC Family Medicine, Berlin

  Emily G. Jones

  Practitioners don't know current vaccination rates for their practice. Some current reported rates look incorrect, according to the Medical Director. Other reports show areas for improvement. One problem is that patients no longer in the practice remain in the system and decrease rates; another problem is that paper records were loaded manually by persons without medical training when the electronic medical record.

• 

  Substance Abuse Amongst High School and College Students

  Herman Kalsi

  Substance abuse among young adults is hardly a new trend. About 50% of full-time college students binge drink or abuse prescription drugs, 25% of which meet the definition of having substance abuse or a dependence. That is three times the rate of the general population. Estimated overall total cost of substance abuse in US is $600 billion annually. Ease of access is a main contributor to drug abuse amongst college students.

• 

  Implications of Long-term Proton Pump Inhibitor Use: Promoting Step-Down Therapy for Management of Gastro-esophageal Reflux Disease in the Outpatient Setting

  Sonam Kapadia

  Per the International Montreal Consensus, gastro-esophageal reflux disease (GERD) is defined as a "condition which develops when the reflux of stomach contents causes troublesome symptoms or complications". GERD is the most common disease of the gastrointestinal tract with an estimated prevalence affecting 20% of the Western population. According to the National Ambulatory Medical Care Survey, 38.53 million annual outpatient visits are related to GERD. The ABIM Foundation's "Choosing Wisely" initiative in collaboration with the American Gastroenterological Association draws attention to the evidence based recommendation: "For pharmacological treatment of patients with gastro-esophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals."

• 

  Barriers to recovery for Buprenorphine Patients in Bangor, Maine

  Erin L. Keller and John McLaren

  Opiate addiction is a major public health problem in Maine. Addiction is a chronic disease with high relapse rates. A better understanding of the demographics and barriers to recovery in opiate addicted populations can help to improve the success of buprenorphine treatment programs.

• 

  Polypharmacy Management in a Rural Family Medicine Practice: View from Multiple Perspectives

  Sarah Anne Kelso

  Polypharmacy is a growing problem in the United States. The elderly population is expanding, and the use of specialists to manage their healthcare is increasing. This project looks at the role of the primary care physician at a rural Family Medicine practice in reducing the risks of polypharmacy. The perspectives of patients and the local pharmacist were used to create an education tool about polypharmacy management within this community. Increased awareness of this issue and how it applies to patients within the practice were the results of this intervention.

• 

  Promoting Awareness of Hepatitis C in Burlington, Vermont’s Homeless Population

  Catherine M. LaPenta

  Chronic Hepatitis C infection is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Most Hep C + patients are unaware that they are infected. Chronic HCV infection represents a huge public health and financial burden. While about 1% of the general U.S. population is HCV+, the prevalence is as high as 41.7% in some homeless populations in the U.S. Awareness of Hep C is low and Vermont’s homeless patients who are HCV+ are likely severely underdiagnosed and undertreated.

• 

  Better Teeth, Better Health: Identifying Challenges with Dental Care in Lewiston, ME

  Mary B. Ledoux

  My project aimed to elucidate barriers to dental health care in the Lewiston-Auburn community. Obstacles highlighted included cost of care, lack of education and guidance in preventative oral health, and paucity of resources available to aid patients in identifying affordable programs. The data generated can be used in the future to better direct oral health interventions at CMMC Family Practice Clinic. Additionally, the survey responses were used to assemble educational material to distribute to patients.

• 

  An Introduction to Alcohol Use Disorder and Motivational Interviewing at Henry Abbott Technical High School in Danbury, CT

  Laura D. Leonard and Dylan C. Hershkowitz

  We presented to high school students interested in careers in health about alcohol use and motivational interviewing. We demonstrated effective motivational interviewing skills including asking open ended questions, using non-judgmental language and eliciting change talk from patients. Finally we facilitated breakout sessions which allowed students to practice identifying at risk behaviors and to practice motivational interviewing.

• 

  Implementing a mentorship group to encourage long-term treatment of opioid addiction

  Shannon Li

  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.

• 

  Screening, Brief Intervention and Referral to Treatment for Substance Abuse in Waitsfield, VT

  Chi An Liu

  Substance abuse is an issue in Waitsfield, VT and currently there is no formal program or intervention at Mad River Family Practice to help patients overcome their addictions. Screening, brief intervention and referral to treatment (SBIRT) is a program to identify at risk patients, raise awareness of their abuse, and help them find support and treatment they need.

• 

  Raising Healthy Vermonters: Preventing Childhood Obesity by Establishing Healthy Habits

  Melanie Ma

  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 stay active.

• 

  Preventing and Recognizing Anorexia Athletics - For Coaches and Athletes

  William Manning

  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 can use to develop basic recognition and early intervention skills.

• 

  Diagnosis and Treatment of PTSD and other service-related conditions in the Veteran Patient Population

  Christopher Mayhew

  There are approximately 48,602 veterans living in the state of Vermont with roughly 20% residing in Chittenden County. According to national VA statistics, only 40% of the veteran population receives some health care from the VA. Currently UVM providers receive no formal training in delivering care to veterans and there are no military history templates or PTSD screening tools in PRISM. Giving community providers access to basic VA tools, information and resources will help improve the quality of care they offer to their veteran patients.

• 

  Increasing Awareness of Community Resources and Support for Individuals with Depression

  Erin McElroy

  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.

• 

  Barriers To Recovery For Bangor's Buprenorphine Patients

  John R. McLaren and Erin Keller

  There are several buprenorphine providers at EMMc's Center for Family Medicine serving the greater Bangor, ME region - an area of substantial opiate use. Among the patient population of outpatient buprenorphine users, both locally and nationally, there are high rates of relapse (~32%). In order to decrease relapse rates, it's first imperative to conduct a baseline review of the current buprenorphine population to identify specific types of patients who are at higher risk of relapse. By understanding the barriers to recovery, the office hopes to apply an intervention to the current program, targeting this local demographic more effectively.

• 

  Managing Medications: Promoting Awareness of the Importance of Accurate Medication Lists

  Christopher Meserve

  Extensive medication lists are a problem everywhere throughout the United States. As a rural state that has a rapidly aging population, these lists will continue to grow and the added aspect of lack of access to services (whether via the internet or transportation) makes managing these medication lists harder for Maine’s population. The perspectives of patients at the CMMC Family Medicine Clinic were obtained through an anonymous survey, and two interviews with community members were conducted to identify specific issues. The feedback and responses from both of these methods were incorporated into an informational pamphlet that was distributed within the clinic to promote knowledge and awareness. Increased knowledge and awareness of available services and personal practices that can improve medication management were the results of this project.

• 

  Mental Health Awareness Among High School and College Students: Barriers to Knowledge, Accessibility, and Utilization of Resources

  Imelda Muller

  In 75% of individuals with mental health illness, age of onset is prior to 24. High School and College Students often face unique life stressors that increase their vulnerability to mental health challenges, including anxiety, depression, and suicide. Students facing mental health issues in Danbury often do not receive adequate support. This is partially attributable to lack of knowledge about mental health, stigma, and lack of available mental health resources specific for this age group. Students who do not receive these supports during times of vulnerability perform more poorly in school, have lower rates of completing high school and college, and more difficulty finding jobs than their peers. This may contribute to an overall higher cost burden on society and the health care system, as well as increase their risk of debilitating illness and suicide. Educational intervention and resiliency training at a young age may be instrumental in minimizing or preventing detrimental effects of poorly supported mental illness.