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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.
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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.
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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.
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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.
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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.
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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.
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Contraception Education in Brookfield, CT
Kiyon Naser-Tavakolian
I decided to educate the population on contraceptives because Danbury, CT is a heavily populated area with a low socioeconomic status and from 2002-2014 Connecticut as a whole has had 46-52% of all pregnancies considered unplanned or unintended compared to the 51% nationally. Patient knowledge regarding contraceptives is not at the level one would expect. Targeting contraceptive education is an effective primary prevention strategy for unplanned or unintended pregnancies.
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Screening for Developmental Delays in Brandon VT
Flang Nguyen
Brandon Medical Center (BMC) currently uses the developmental milestones screening tool built into their electronic medical record to look for developmental delays. Usage of the tool has been awkward, inconvenient, and unmanageable in the office setting. BMC, being the main health care provider for newborns, infants, and toddlers of Brandon, VT, is looking to improve their screening systems for developmental delays during well-child visits
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HPV Vaccination in Vermont Males - Evaluation and Guidelines for Improvement
Carl A. Nunziato
Despite approval from the FDA for use in males to prevent genital warts and oropharyngeal and anal carcinomas, HPV Vaccination in young males lags behind immunization rates for females. In order to improve vaccination rates at Stowe Family practice several "best practices" for improving HPV vaccination rates were researched and combined with a patient handout and flyer.
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Alcohol Use Among Middle School Children in Vermont
Sargis Ohanyan
Alcohol and drug education classes have reduced alcohol use in Vermont middle schools to approximately 20%, however currently no screening or intervention programs are available for the aforementioned 20%. Experts agree that early alcohol use significantly increases the risk of myriad psychosocial problems later in life, therefore early screening and intervention is paramount. The focus of this project is to raise awareness for the need of early screening/intervention regarding alcohol use in Vermont middle schools.
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Pediatric Lipid Screening Guidelines: Information for Patients and Families
Erin R. Pichiotino, MPH
Universal Pediatric Lipid Screening Guidelines are currently based on expert opinion only. Bright Futures/American Academy of Pediatrics currently recommends screening all patients ages 9-11 and again at ages 17-21. The US Preventive Services Task Force (USPSTF), however, concludes the evidence is insufficient to recommend for or against routine screening. This discordance leaves ambiguity for implementation in Family Medicine practices in Vermont. A survey of providers at Milton Family Practice showed that only 14% of providers at Milton Family Practice regularly perform lipid screening on their pediatric patients.
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Preventing Lyme Disease in Windsor County, VT
J P
Lyme disease is a bacterial infection caused by Borrelia burgdorferi and is transmitted primarily by deer ticks (Ixodes scapularis). A deer tick must be attached for at least 36 hours for transmission to occur. It can be prevented by preventing tick bites, removing ticks early, and providing post-bite prophylaxis when appropriate. Lyme disease has been on the rise in Vermont since 2005. The Vermont Department of Health (VDH) has launched its “Be Tick Smart” Lyme disease prevention campaign, promoting tick-bite reduction through its slogan, “Repel, Inspect, Remove.” This project extended the campaign to school children in Windsor County, Vermont.
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Online Summer Activity Tracker for Teens
Jamie E. Richter
To address teenage obesity by encouraging physical activity and making teens aware of time spent in passive activities. Teens will be able to log onto an interactive web site to track their physical activity and earn raffle entries for reaching fitness goals. Teens will also be asked to track their computer and TV time to make them more aware of how much time they spend in these passive activities.
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Increasing the Recognition of Generalized Anxiety Disorder in Primary Care
Sarah Rosner
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.
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Assessing barriers to meeting weight gain goals in obese pregnant women
Margo Seybolt
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.
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Increasing the use of dementia screening in the primary care setting
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
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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.
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Opioid Abuse Treatment in Pregnancy
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.
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Car Seat Safety in Children Ages 4 and Above
Sasha Taylor
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.
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Educating the Colchester Community About Measles and its Prevention
Phildrich Teh
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.
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Increasing Naloxone Availability
Brian Till
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.
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Drug Treatment Court: The Power of Understanding Addiction
Asaad Traina
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.
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Increasing Patient Knowledge of Obstructive Sleep Apnea and Sleep Studies
Billy Tran
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
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