Med students practice tai chi, learn health benefits

Medical students learned about the health benefits of tai chi along with a few basic movements on Jan. 13 at Dean’s Hour at The University of Alabama College of Community Health Sciences.

Madeleine Hill, a longtime friend of the College and a member of its Board of Visitors, spoke about the benefits of tai chi, and introduced students to a few basic movements of sun, one of the five basic styles of the Chinese martial art.

The Dean’s Hour Lecture Series is a monthly forum for medical students created by the College to raise students’ awareness of community health issues.

Hill has taught tai chi for more than 10 years. Her late husband, Dr. William Winternitz, was a faculty member at CCHS for many years, and they both have supported the College’s Geriatrics Initiative.

Tai chi helps to reduce stress, promote relaxation and enhance peace of mind, Hill said. She has seen first hand through her teaching of tai chi how it has helped to reduce pain for some of her students. It also improves concentration and memory.

Another benefit of tai chi is that it helps to improve balance. According to the CDC, older Americans experienced 29 million falls in 2014, causing 7 million injuries and costing about $31 billion in annual Medicare costs. More than 27,000 older adults died from a fall in 2014.

“There’s a good reason to improve our balance,” Hill said.

One of the College’s functions is to serve as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, providing clinical education for a cohort of third- and fourth-year students.

“How could this come into play in your own practices?” Hill asked students. “It starts with you. You’re the best example to your patients of how you maintain your own lives and take care of yourselves.”

Rural Health Conference to focus on empowering women in health care

Empowering women in health care is the topic of the 18th Annual Rural Health Conference hosted by The University of Alabama College of Community Health Sciences and its Institute for Rural Health Research.

The conference, titled “Empowering Women in Health: Bridging the Gap Between Clinical and Community,” will be held March 30-31 at the Bryant Conference Center on the UA campus.

The conference will feature keynote speaker Jeanne Marrazzo, professor of medicine and director of the Division of Infectious Diseases at the University of Alabama at Birmingham. Her talk is titled, “Optimizing Infectious Disease Care for Women in Rural Settings: Current Challenges and Opportunities.”

Poster and oral presentations may be submitted to the conference, and the deadline has been extended to Feb. 10. Encouraged submission topics include health disparities, sexual/reproductive health, intimate partner violence/social justice, cancer care and research, cardiovascular disease in women, and autoimmune diseases.

Click here to learn more about submitting presentations. For more information about the conference, click here.

UMC clinic helps children and families navigate foster care

By Amelia Neumeister

As a foster parent, Dr. Brian Gannon knows that children and families in foster care can face challenges navigating medical care, paperwork, state agencies, schools and other aspects of case management. He has eight children—six of which were adopted. And four of those adoptions were through foster placements.

Physicians can legally request information on foster children, says Gannon, an assistant professor of Pediatrics at the College of Community Health Sciences and a pediatrician at University Medical Center, which the College operates. So he wanted to streamline the flow of information, help to gather all of a foster child’s relevant information in one place and provide them access to health care and resources. To do that, he started the FRESH Start Clinic at UMC.

FRESH stands for Fostering Resilience through Education, Support and Healthy choices. Since opening its doors in July 2016 at UMC, the FRESH Start Clinic provides care for children in foster care and for families and professionals who support them. The clinic is held on Thursday afternoons.

The goal of the clinic is to advocate for the specialized needs of children in foster care and to change the way children in foster care are obtaining medical care, says Gannon.

He and his team of nurses, a receptionist and social work students wanted to create a clinic for foster children based off the Patient-Centered Medical Home, a model of health care that is patient-centered, accessible, continuous, comprehensive and coordinated, and that focuses on quality and safety.

The clinic works in partnership with the Tuscaloosa County Department of Human Resources, and includes all members of the foster child’s team in health care decisions as appropriate, including the foster parents, birth parents, DHR caseworkers and investigators, noncustodial family members, residential home staff and mental health providers.

“There are different [foster care clinic] models across the country,” says Gannon. “A lot of the larger cities will have foster care clinics that are much more involved than what we are starting right now. We’d like to work into that. The goal would be to have mental health, development and social work all on-site as part of the process, because these kids are known to have more needs than your average pediatric population.”

Gannon had the idea for the FRESH Start Clinic after studying similar clinics in urban areas where foster care is more commonly found, he says. By partnering with UMC, he hopes the clinic can serve as a state-wide model and can bring access to rural areas where foster homes are less common.

Gannon says he drew from his experiences as a both a doctor and a foster parent to help plan the clinic.

“There are so many little things that make it difficult as a foster parent to get the care   that the child needs,” he says. “So, my goal was to make all that easier.”

Foster parents can call to set up an appointment in the clinic as soon as the child is placed in their care, Gannon says. They can be seen within a week. At the first visit, the child’s medical, social and psychiatric history will be collected and requests will be submitted for any  additional records needed. Gathering this information helps to streamlines the process of medical care for children in the foster system, Gannon says.

Once additional records are obtained, another visit will be scheduled. The clinic will assess the child’s adjustment to his or her foster placement and will look into any behavioral concerns a foster parent might have. A trauma assessment will also be performed to help families address needs of children who have suffered from abuse or neglect.

From there, the FRESH Start Clinic can provide primary care for children in state custody or can serve as a consultant to their chosen doctor. The clinic also stays in touch with DHR and is notified of any changes in the child’s placement or goals.

The FRESH Start Clinic knows how to gather background information and navigate paperwork that many foster parents simply don’t have time for, Gannon says. If the parents are not dealing with paperwork, they will have less difficulty making appointments, he says.

“I’ve gotten a lot of positive feedback from the foster parents that I’ve worked with as well as the caseworkers, because the DHR caseworkers will have dozens of children on their caseload,” Gannon says. “Often they’ve had more negative experiences than foster parents have as far as interacting with doctors’ offices and things being challenging and not running smoothly, and they’ve been very pleased with the efficiency that we’ve been able to provide to them.”

The long-term goal for the clinic is to create an infrastructure to bring the clinic to a wider audience.

“I would love for this to be a model for the state and have interested doctors all over the state who have extra training and special interests,” he says. “And we could have case managers that make sure all these children get what they need. I think over time that would be a really good goal. But we are starting small—starting with one county.”

Sleep problems, adapted athletics topics at Mini Med School

More than 50 percent of adults in the US experience intermittent sleep disturbances, and only 30 percent of adults report regularly getting enough sleep.

Chronically tired individuals face increased risk of illnesses and an overall lower quality of life, says Dr. Katie Gates, assistant professor of Family Medicine at The University of Alabama College of Community Health Sciences.

Gates gave her talk, “Sleep Problems,” on Jan. 26 as part of the Mini Medical School lecture series put on by CCHS in collaboration with UA’s OLLI program. On Jan. 19, Dr. Jimmy Robinson, endowed chair of Sports Medicine at CCHS, gave his talk, “Adapted Athletics.”

Mini Medical School lets adults and community learners explore trends in medicine and health, and the lectures by CCHS faculty and resident physicians provide information about issues and advances in medicine and research. OLLI, short for the 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.

Gates broke down sleep disorders into four categories: Those who can’t sleep includes sufferers of insomnia and restless leg syndrome. Those who won’t sleep likely have delayed sleep phase syndrome. Those with excessive daytime sleepiness may suffer from narcolepsy or obstructive sleep apnea. And those with increased movements during sleep include REM sleep behavior disorder sufferers, or those with periodic limb movement.

Three criteria must be met for a diagnosis of insomnia: First, the patient must complain of difficulty sleeping, difficulty staying asleep or waking up too early. Second, the sleep difficulty must occur despite adequate opportunity and circumstances to sleep. And third, the lack of sleep must negatively affect daytime function.

“Insomnia is a very common complaint, and it does increase with age, unfortunately,” Gates said. Women report insomnia 50 percent more often than men. It can be treated with cognitive behavior therapy or with medications.

Delayed sleep phase is a circadian rhythm disorder, meaning “the brain has gotten off its track,” said Gates. It’s characterized by the person going to bed very late and waking up late.

“This can be genetic or socially reinforced,” she said.

Obstructive sleep apnea is the most common sleep breathing disorder, and it affects 20 to 30 percent of males and 10 to 15 percent of females.

“With my patient population, it seems higher than this,” Gates said.

Risk factors for sleep apnea include age, obesity, craniofacial abnormalities and smoking. Continuous positive airway pressure, or a CPAP machine, is recommended treatment.

In some instances of diagnosing a sleep disorder, a physician may order a polysomnography, or a sleep study.

Cognitive behavioral therapy can be a treatment for some sleep disorders, said Gates, and a therapist may focus on changing false beliefs and attitudes about sleep. One of these might be that everyone needs at least eight hours of sleep, she said.

Music therapy can be another way to treat a lack of sleep.

“Choose music you are familiar with,” Gates said.

She said the music should have a slow and stable rhythm with low-frequency tones and relaxing melodies.

“Try out different genres, like classical or acoustic, to find what works for you.”

View a WVUA report on Gates’ lecture here:

Robinson, in his talk about adapted athletics, said the number of adapted athletes is rising. In the 1960 Summer Paralympic Games in Rome, 400 athletes came from 23 countries. In 2016, 4,316 athletes came to Rio from 159 countries.

The International Paralympic Committee assigns points to athletes based on their impairments. The classification systems differ by sport and are developed to govern the sport. Players are allocated points based on an evaluation by the International Paralympic Committee.

A lower score indicates a more severe activity limitation than a higher score. A team is not allowed to have more than a certain maximum sum of points on the field of play at the same time in order to ensure equal competition with the opposing team.

As time progresses, a disability may get worse, so a player can be reviewed again.

“Disabilities are evolving,” said Robinson. “It’s important to have this avenue to challenge their disability, especially if it’s progressive.”

Robinson, also spoke about the Alabama Adapted Athletics Program, which was started in 2003 by husband and wife Brent Hardin and Margaret Stran. Though the program received an initial funding of only $5,000 from the Christopher Reeve Foundation, it now operates off an annual budget of $450,000, offers six full scholarships and supports five sports: women’s and men’s basketball, tennis, rowing and golf.

In Remembrance: Dr. Charles LeMaistre

Dr. Charles LeMaistre, an alumnus of The University of Alabama College of Community Health Sciences who played a key role in getting health warnings on cigarettes and who served as president of MD Anderson Center for nearly two decades, passed away Jan. 28. He was 92 years old.

LeMaistre, a native of Lockhart, Alabama, received his undergraduate degree from UA and completed his first two years of medical education at CCHS, which also serves a regional campus of the University of Alabama School of Medicine. He graduated from Cornell University Medical College in 1947.

He completed a residency and research fellowship in infectious diseases at New York Hospital and Cornell University, where he became a professor and conducted research on germ warfare defense as a member of the US Public Health Service Epidemic Intelligence Service. He began teaching at Emory University School of Medicine in Atlanta in 1954 and later became chair of its Department of Preventive Medicine and Community Health.

LeMaistre moved to teach at the University of Texas Southwestern Medical School in Houston and served as medical director of Woodlawn Hospital’s Chest Division. During this time, he was named to the US Surgeon General’s Advisory Committee on Smoking and Health, which produced the landmark 1964 report that first linked smoking to cancer and other health problems and led to warning labels on cigarette packages.

LeMaistre was named associate dean for Health Affairs at The University of Texas in Austin in 1965 and was soon promoted to vice chancellor and then chancellor. In 1978, he began his 18-year legacy as president of the MD Anderson Center in Houston, and during his tenure the center became one of the top outpatient cancer centers in the world.

“He was recognized as an outstanding physician, a gifted educator, a committed leader, a champion for cancer prevention and an all-around extraordinary human being,” says Dr. Ronald DePinho, current president of the MD Anderson Center. “His confidence and charisma helped build MD Anderson into the world’s most impactful cancer center.”

In addition to his research on cancer and the harmful effects of smoking, LeMaistre led the National Conference on Smoking OR Health in 1981, the International Summit on Smoking Control Leaders in 1985 and served as president of the American Cancer Society in 1987. The following year, the American Cancer Society presented LeMaistre with the organization’s highest honor, the American Cancer Society Medal of Honor.

Repealing without replacing Affordable Care Act will hurt rural hospitals, dean says in news report

As the Senate takes steps to fast track getting rid of the Affordable Care Act, Dr. Richard Streiffer, dean of The Univeristy of Alabama College of Community Health Sciences, says repealing the ACA without replacing it will hurt many rural hospitals struggling to stay open, according to a Fox 6 WBRC report.

Even a small change in coverage could even force some of these rural hospitals to close, Streiffer said in the report.

“I don’t believe that anyone, Republican or Democrat, is opposed to trying to improve it, but the rhetoric of ‘let’s get rid of it’ without knowing where we’re going to go and how we’re going to improve it is concerning,” Streiffer said in the report.

Streiffer says the United States should learn from the rest of the world and focus on regular check-ups and the prevention of illnesses in a WVUA report.

Streiffer says that when people have a primary care physician that they see yearly, chronic illnesses are less expensive to control and potential illnesses are caught and dealt with early, which means patients stay healthier, according to WVUA.

View both reports here:

Dean speaks to WVUA, CBS 42 on spike in flu cases

Alabama has seen a spike in the number of flu cases reported, and Dr. Richard Streiffer, dean of The University of Alabama College of Community Health Sciences, says it isn’t too late to get a flu shot, according to reports from CBS 42 WIAT and WVUA.

Alabama joins Arizona and Georgia as the three states in the U.S. with the highest number of flu cases, according to WVUA.

Streiffer encourages anyone who hasn’t had a flu shot to go get one, according to CBS 42.

“Most insurances will pay for it, but if you don’t have insurance … whatever it costs is a pretty good investment as opposed to the risk of an expensive complication and hospitalization and loss of time from work,” Streiffer said to CBS 42.

Streiffer told WVUA that he is unsure why there is an increase in flu cases in Alabama.

“But it doesn’t appear that the flu that is in the community is anymore severe this year than in prior years,” Streiffer said in the report. “The flu vaccine should be protective to the majority of the population.”

Streiffer says it is not too late to get a flu shot, according to the report.

View both reports: