CCHS to host two physicians as part of UA’s Cuba Week

The University of Alabama’s Cuba Center will host its 2016 Cuba Week Monday, Oct. 24, through Friday, Oct. 28, and Cuban guests have been invited to visit UA and present with faculty from across campus throughout the week.

The College of Community Health Sciences is participating in the week by hosting two physicians—Dr. José de Jesús Portilla García and Dr. Nancy de la C. Milián Melero.

The CCHS presentations as part of UA Cuba Week will be held on Wednesday, Oct. 26, at the Bryant-Jordan Performing Arts Center on the UA campus. Portilla will present “Achievements of the Cuban National Healthcare System: The 1950s to the Present,” and Milián will present “Training Doctors  for Cuba and the World.” Together, they will present “The Mother and Child Care Program in Cuba.”

Some CCHS faculty, including Dr. Richard Streiffer, dean of the College, have spent time in Cuba learning about its healthcare system and approach to medical education. Streiffer says there is much the US can learn from Cuban medicine.

“Politics aside, most agree that in the 50 years since the Cuban Revolution, Cubans have systematically built a rational, if not relatively resource frugal healthcare system,” Streiffer says. “It is grounded in holistic primary care with a family doctor and nurse-run consultorios (clinics) located in every neighborhood across the country. Every physician becomes a family doctor first; some then go on to specialize.”

Portilla and Milian will also meet with CCHS faculty, medical students and residents to discuss their country’s approach to health care and medical education. Some of the topics of conversation and discussion will include maternity care, geriatric care and what it is like to be a patient in Cuba.

The College will also facilitate a trip to a rural community so that Cubans can understand some of the issues facing the state, such as a shortage of health care resources and primary care physicians.

For more information about UA’s Cuba Week, visit cuba.ua.edu.

Parkinsonism, ADHD in Grandchildren and Geriatric Depression topics in fall semester of Mini Med School

Mini Medical School is back in session this fall semester. The University of Alabama College of Community Health Sciences kicked off its second semester of the lecture series for UA’s OLLI program that has been put on by faculty and resident physicians at CCHS.

Mini Medical School lets adults and community  learners explore trends in medicine and health, and the lectures by CCHS faculty and residents provide information about issues and advances in medicine and research. OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers education courses as well as field trips, socials, special events and travel.

Parkinsonism — Dr. Catherine Ikard

Many people think of Parkinson’s disease as a single disorder, but it is actually more complicated than that, said Dr. Catherine Ikard, a neurologist at University Medical Center and assistant professor of Internal Medicine and Psychiatry and Behavioral Health for the College.

Parkinsonism is a syndrome characterized by decreased movement and is associated with tremors and a loss of balance, Ikard said at her lecture, titled “Parkinsonism and Parkinson’s Disease,” which she presented as part of the Mini Medical School series on Sept. 15.

Parkinsonism can appear in an array of disorders, some even as a result of repeated head trauma or medication, but the most common one—the one most people refer to when they think of Parkinson’s Disease—is Idiopathic Parkinson’s Disease.

Idiopathic Parkinson’s Disease is the progressive loss of dopamine-producing cells in the brain. The disease is slow and degenerative. “We don’t know why this happens,” Ikard said.

There are motor symptoms, which include shaking, smaller and slower movements, becoming stiff and losing balance more easily. Motor symptoms usually start on one side of the body. Tremors can worsen when the patient is at rest, and they are suppressible by concentration.

Non-motor symptoms include affective disorders, such as depression, orthostatic hypotension (when blood pressure falls significantly when standing up too quickly), memory impairment, fatigue, constipation and sleep disturbances.

There is no test for Idiopathic Parkinson’s Disease, Ikard said. The diagnosis is clinical. “We often have to watch a tremor over time—months, sometimes years,” Ikard said.

Medication and therapy can help treat symptoms, Ikard said. The most common medication is Levodopa, and physical and speech therapy can help improve lifestyle. “I cannot emphasize enough how important therapy is for patients with Parkinsonism,” said Ikard. Exercise improves symptoms, too, she said.

There are clues that the disorder might not be traditional Idiopathic Parkinson’s Disease, Ikard said.

Some of these include: rapid progression of the disease, absence of tremors, frequent falls early in the disease, abnormal eye movement and poor response to Levodopa. If that is the case, the Parkinsonism could be tied to another disorder.

Grandchildren and ADHD — Dr. Brian Gannon

Children are very active from the ages of 2 to 5, but that busyness should decrease over time, said Dr. Brian Gannon, a pediatrician at University Medical Center and an assistant professor of Pediatrics for the College.

But as children get older and if they are easily distracted, can’t stick with a task for a reasonable amount of time and their activity level is not appropriate for their age, they could suffer from ADHD, or attention deficit hyperactivity disorder.

“ADHD is defined as an activity level that is inappropriate for age, that interferes with school work, that causes trouble in dealing with adults,” Gannon said during a lecture on Sept. 22, titled “Grandparents and ADHD.”

Gannon said about 5 percent of the general population in the US qualifies for an ADHD diagnosis. He said sometimes the markers of what appears to be ADHD are actually caused by other medical issues. He said hearing, vision and speech problems can cause some of the same symptoms of ADHD, as can developmental delays, autism and sensory processing disorder.

“We want to look at medical issues because they may cause similar issues to ADHD,” Gannon said.

A child’s living situation – unstable home environment, varying and inconsistent rules and food insecurity – is also a factor. “My job as a physician is to advocate for the child and help parents problem solve. We don’t want to just throw medicine at a child.”

Gannon said medication can help and should be part of efforts to manage ADHD, but is only part of the answer. “Children still need to follow the rules, and do their work. With medication, they can do it without your help.”

Geriatric Depression — Dr. John Burkhardt

Older adults are at risk for depression. One reason: The more medical burdens one has, the higher the risk of depression, said Dr. John Burkhardt, a clinical psychologist with University Medical Center-Northport.

“Chronic pain conditions can be managed, but you never get a break from them. Heart problems can precipitate depressive episodes, and then you have to eat differently, go to physical therapy and deal with a chronic condition. What does that do to your mood?” said Burkhardt, also an assistant professor of Psychiatry and Behavioral medicine for UA’s College of Community Health Sciences, which operates UMC-Northport.

His remarks came in a lecture titled “Geriatric Depression” that he provided on Sept. 29 as part of the Mini Medical School lecture series.

Burkhardt said changes in previous functioning, pain and sleep disruption, significant weight gain or loss, a loss of interest in activities, a sad and depressed mood, a feeling of being a burden – and if those conditions and feelings go on for two weeks or more – could signal possible depression. “A lot of people go through sad times. But when it starts to impact your functioning, that could be depression.”

With older couples, depression can also be “contagious,” Burkhardt said. “If one spouse is depressed, the other spouse is at an increased risk of depression.”

Late-life depression, which happens after the age of 60, can carry added risk because it can transition to dementia, Burkhardt said.

He stressed that depression needs to be treated, particularly in the elderly, who might not seek care because of an associated perceived stigma. He noted that suicide is the 17th leading cause of death in those aged 65 and older.

“When you’re depressed, you’re not good at coping with your physical conditions. Depression impacts the person who is experiencing it, and their families. Who wants to visit people when they aren’t happy? Then they’re alone.”

Burkhardt recommended that people watch for changes in behavior, thoughts, appetite, sleep and whether they lose interest in activities once important to them. “See a provider if you suspect depression. Don’t let stigma keep you from getting help. Don’t isolate yourself. Be social, stay active and have a daily structure.”

 

Payne-Foster receives research award for cultural competency training program

Dr. Pamela Payne-Foster recently received the University of Alabama School of Medicine Dean’s Research Award for the “Development of a Culturally Competent Training Program for Medical Students and Residents at the Tuscaloosa Regional Campus.”

Payne-Foster, associate professor of Community and Rural Medicine and deputy director of the Institute for Rural Health Research at the College of Community Health Sciences, won the award for developing a half-day training session for The University of Alabama’s Rural Health Conference, which will be held on March 30 and 31, 2017. The topic for the 18th annual conference, hosted by the College and the Institute, is women’s health.

The training session will be for resident physicians, medical students and faculty at the College on the topic of cultural competency.

“I know that is an important skill that students need in the future, and it is not offered much in their curriculum,” Payne-Foster says. “It also builds on some foundational work that the College has been doing for several years.

Payne-Foster learned of the award in August and received $1,000 of funding.

A planning committee comprised primarily of medical students and residents has started to develop the training session with pre- and post-evaluations that will be held in conjunction with the Rural Health Conference.

Learn more about the annual conference at rhc.ua.edu.

Four medical students selected to Alpha Omega Alpha Honor Society

Four medical students at the UA College of Community Health Sciences were selected to the Alpha Omega Alpha Honor Medical Society.

The students, all in their fourth year of medical school, are Reaves Crabtree, Maria Gulas, Julia (Massey) Steigler and Chelsea Turgeon. 

Alpha Omega Alpha is a professional medical organization that recognizes excellence in scholarship as well as an outstanding commitment and dedication to caring for others. The top 25 percent of a medical school class is eligible for nomination to the honor society, and up to 16 percent may be selected.

About 3,000 students, alumni and faculty are elected to Alpha Omega Alpha each year. The society has 120 chapters in medical schools throughout the United States and has elected more than 150,000 members since its founding in 1902.

In its role as a regional campus of the University of Alabama School of Medicine, the College provides clinical education to a subset of third- and fourth-year medical students. The students complete the first two years of basic science courses at the School of Medicine’s main campus in Birmingham, and then complete clinical rotations on the Tuscaloosa Regional Campus in the departments of Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology, Neurology, Psychiatry and Surgery.

“Congratulations Reaves, Maria, Julia and Chelsea on your accomplishments and for this recognition,” says Brook Hubner, director of Medical Student Affairs at the College.

Flu Shot Campaign Begins

The annual University of Alabama flu shot campaign, an effort by the University to protect students, faculty and staff from the flu, kicked off Sept. 7. Flu shots will be provided during the months of September, October and November at locations across campus, including the Quad, University buildings and student residence halls. The shots are free and no insurance is required. The goal of the flu shot campaign, which is led by UA’s College of Community Health Sciences, is to make getting a flu shot as easy and convenient as possible. Last year, more than 8,000 vaccinations were given.

Kamal awarded second Sara Crews Finley, M.D. Endowed Leadership Scholarship

Salmaan Zaki Kamal, a medical student at the College of Community Health Sciences, has been selected as the 2016 recipient of the Sara Crews Finley, M.D., Endowed Leadership Scholarship. The University of Alabama School of Medicine scholarship, which supports students who demonstrate exceptional academic and leadership abilities, includes full tuition for the third year of medical school and is renewable for the fourth year.

U.S. News: 10 Gross Things You Should Stop Doing in College

Take a look at this U.S. News slideshow with several quotes from Dr. Thomas Weida, Associate Dean of Clinical Affairs at CCHS.

Right at Home

A CCHS nurse practitioner is providing care by going directly to her patients who need her most.

The Willard Report

The report gave rise to the specialty of family practice (now family medicine), and highlighted the need for physicians to understand the impact communities have on health and the importance of providing care in communities.

Health Coach

Program helps University Medical Center patients achieve their goals and control their diseases.