Block Clerkship Projects

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Bridging the Gap

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 Resources in Lewiston, ME

Sabrina Bedell

Mindfulness can be defined as open-hearted, non-judgmental, present moment awareness.
Evidence-based Benefits include
Decreased:
- Blood pressure
- Anxiety, stress, & depression
- Chronic pain
- Medical care visits (inpatient and outpatient)
Increased:
- Immune function
- Ability to act effectively under stress
- Self-esteem
- Quality of life
Food For Thought: Nutrition Education and Nutrient Delivery at Two Local Elementary Schools

Jenna Bodmer

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
Non-Pharmacologic Treatment for Infants with Neonatal Abstinence Syndrome (NAS)

Michael Capata

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 and Internet Safety, Waterbury CT

Gia Colman

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.
Summer Physical Activity Log and Reward System for Children in Colchester, Vermont

Bryce Edwards

- 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.
Hand-washing in the FM Outpatient Setting

Madeline Eells

The threat of healthcare-associated infections (HCAIs) is universal, affecting every healthcare facility and system around the world. The diagnosis of HCAI is complex and relies on diverse diagnostic criteria and methods. Although there are many routes of transmission of HCAI, one of the most easily preventable vectors is bacteria carried on healthcare workers hands.
Influenza: Protect Yourself and Others

Sarah Fieber

In clinic, I would recommend to each patient that he or she should consider having a flu shot as flu season is quickly approaching. I heard a plethora of reasons for not being vaccinated, and few of these reasons were fact based. Teenagers are inconsistent about flu vaccination, and I thought if I could present an argument in favor of flu vaccinations, this could make a difference for the coming generations.
Identifying and Treating Food Insecurity

Nicholas Field

13% of Vermont households are food insecure, an increase of 45% since 2000. 25,400 children and 7,800 seniors in Vermont live with food insecurity. Based on metrics including poor health, hospitalizations, and lower educational productivity, food insecurity cost the State of Vermont $340,000,000 in 2010 alone.
Promoting Public Water Fluoridation in Bennington VT

Leah Fox

The Centers for Disease Control and Prevention has recognized community water fluoridation as one of the ten greatest public health achievements of the 20th century. It reduces tooth decay over a person's lifetime by 25%. Over the past 40 years, there have been 6 failed attempts to fluoridate the drinking water in the town of Bennington. There is an overabundance of tooth decay affecting citizens of Bennington. The need for dental care in Bennington far outweighs the resources available.
Improving Patient Education and Access to Anxiety Treatment

Heather Gardiner

According to the World Health Organization, in developed countries, mental health accounts for more disability than any other group of illnesses. About 25% of adults in the United States are reported to have a mental illness. Anxiety disorders are the most prevalent class of mental disorders faced by individuals in the United States. Although anxiety disorders are treatable, only 34% of people diagnosed receive treatment.
Vermont Radon Exposure

Gary Gilmond

Radon is a natural, odorless and tasteless radioactive gas that is found in soil, rocks and water all over the US including Vermont. Long-term radon exposure is linked to over 21,000 lung cancer deaths a year in the US, second only to tobacco. Roughly 1 in 8 homes in Vermont are believed to have high radon levels. Vermont law does not require a radon test as part of a real estate transaction. Thus despite the danger of Radon exposure, the issue remains unrecognized by many Vermonters. Since 2000 only 15,488 state radon test kits have been ordered in Vermont.
HPV Vaccination in Vermont: Identifying Educational Resources for Adolescents

Shane Greene

HPV vaccine is unique in that (1) it's not a required vaccine to enter school and (2) it's given at an age where patients have more agency over their medical care, so an adolescent who doesn't want to get the shot is often able to avoid it. In Vermont, there's a lack of educational material aimed at young adults about the benefits of the HPV vaccine.
Increasing Access to Community Support Groups for Patients with Mental Health Needs: A Guide for Primary Care Physicians

Daniel Haddad

A large percentage of patients seen by primary care physicians suffer from mental health afflictions that are requiring increasingly more time and resources to treat. There is a lack of mental health providers to meet the needs of the community which result in 3-6 month waiting periods for patients to get an appointment with mental health providers. More mental health resources are needed to help family practitioners address this problem.
Improving Vascular Health of Patients with Diabetes Mellitus

Pishoy Haroun

Some diabetic patients are reluctant to take the extra step in their long-term health care, which is particularly problematic as it relates to cardiovascular disease. In addition to difficulty controlling blood glucose levels, patients struggle maintaining an appropriate blood pressure. This is often due to a reluctance to maintain a proper diet, exercise regularly, and take certain medications. Studies have shown that compliance with exercise regimens falls from 80% at 6 weeks to 20% at one year. Many patients are reluctant to start on a statin, and some physicians are even hesitant to adhere to the new recommendations proposed by the AHA.
Marijuana Use Among Pregnant Women in Buprenorphine Treatment for Opioid Dependence

Tara Higgins

New program, "Closer to Home," will allow pregnant women in buprenorphine treatment for opioid dependence to get treatment closer to home and deliver at Copley Hospital instead of being required to go to Burlington. This requires local physicians to prescribe buprenorphine to pregnant women. In creating the program, prescribing physicians have to decide policies around non-opioid substance use.
Low T? Late Onset Hypogonadism

Cheng-Wei Huang

Recently, there has been an increase in commercials and ads by pharmaceuticals pushing for testosterone supplementation by capitalizing on the sensitive subject of "low T" or decreased manhood and vague non-specific symptoms of low T. The idea that testosterone is something that occurs within our natural body and that we are only supplementing what’s originally there can be misleading. Many may interpret this as there is no harm but good, but the latest studies have shown otherwise. It is clear that there is a lack of proper understanding regarding testosterone treatment in the public, from when treatment would be suitable to what the risks and benefits are.
Dietary Supplement Education in a Primary Care Setting

Suleiman Ismael and Mikaela Rodriguez

More than 50% of American adults use at least one dietary supplement. Despite their popularity, patients and physicians are often unaware of the limited regulation of these products as well as their potential risks and benefits. During our rotation at the Center for Family Medicine in Bangor, Maine, we observed several patients asking about the efficacy and safety of various supplements. Also, many patients wanted to avoid taking pharmacological drugs and inquired about any "natural" treatments to their illnesses. The residents we worked with expressed a lack of confidence in their ability to discuss dietary supplements with their patients. In the overwhelming majority of cases, if a patient did not bring up supplement use on their own, the providers never inquired about it.
Caregiver Burden: Finding Resources, Offering Support

Sarah Johnson

- Definition: Informal caregivers are unpaid individuals (often a spouse, partner, family member, friend or neighbor) involved in supporting others in activities of daily living.
- Caregiver burden is an emerging public health issue largely attributed to longer life expectancy that not only increases the number of elderly individuals, but also the level of dependency in these individuals.
- Despite many formal support services, informal support continues to be the primary source of care for the elderly, dependent and disabled.
- Unpaid family caregivers will likely continue to be the primary source of long-term care in the United States as the aging population will more than double between the years 2000 and 2030 from 35.1 million to 71.5 million.
- In 2009, three in ten U.S. households reported at least one person providing unpaid care as a family caregiver.
- Caregivers report performing housekeeping and personal tasks, running errands, managing medical needs and more.
- Caregivers spend on average 20.4 hours per week providing care. Those who live with their care recipient spend 39.3 hours per week caring for that person.
Health and Community Resources For Older Adults in Chittenden County, Vermont

Matthew Jordan

The vast number of resources available to older adults are widely unknown to both health care providers and the older adult population itself.
HPV Infection Prevention in Males by Gardasil Vaccination

Russell Landry

About 1% of sexually active males in the U.S. have genital warts. Each year 400 males get HPV related cancer of the penis, and 1,500 get HPV related cancer of the anus. 2-3 cases of Genital warts have been reported at Harwood High School (Moretown and Waitsfield), where the school nurse reports 1-3 males students each year seeking information about STIs (including HPV).
Alternative Medicine Resources for Primary Care Physicians

Laura Lazzarini and Angelina Palombo

Despite the prevalence of patients that would benefit from Complimentary and Alternative Medicine (CAM) at EMMC Center for Family Medicine (CFM), practicing physicians lack sufficient education on CAM and knowledge of community resources to refer their patients to.
Concussion Management in Primary Care

James Levins

Concussion awareness is a hot topic in youth sports, resulting in increased health care visits. There has been much change in concussion management over the past decade. VT passed a law (Act 68) implementing a concussion management program in schools. Not all primary care physicians are aware of how this law may affect their practice, nor are they all aware of some of the recent changes in concussion management. Improper concussion management can lead to prolonged symptoms, recurrent injuries and long-term sequelae.
School Based Yoga Intervention for Childhood Stress Management

Erica Marden

Childhood stress can have immediate and long-term negative impacts on physical health, mental health, school performance, self-esteem, and relationships. For children in rural communities there are fewer resources available as recreational and therapeutic outlets for healthy stress reduction. Extracurricular activity involvement also puts significant financial and time burdens on families. There is a particular need to provide children in rural areas with tools to manage stress that can be incorporated into the school day and require few resources. Yoga is an excellent school-based activity that has proven benefits on physical and emotional health for both students and teachers. It has been shown to be effective at improving children's sense of wellbeing and reducing self-perceived levels of stress, and can practiced individually at home without requiring any special equipment.