November 2018 Accolades

Dr. Gregg Bell, assistant professor in the College’s Department of Community Medicine and Population Health and Institute for Rural Health Research, provided a poster presentation about his research on National Data Centers at the American Public Health Association Annual Meeting and Expo in San Diego, California, November 10-14.

Research on long-acting, reversible contraception conducted by CCHS faculty and residents was accepted for presentation at the Society of Teachers in Family Medicine’s 52nd Annual Spring Conference in Toronto April 27-May 1, 2019. Those involved in the research are Drs. Louanne Friend, Kristine Graettinger, Kathryn Kouchi, Cheree Melton, Catherine Skinner, Amy Wambolt and Ashley Wambolt. The title of the presentation is A Retrospective Chart Review: Long Acting Reversible Contraception at University Medical Center.

Online exhibition examines smoking in the military

The latest online exhibition of The University of Alabama Center for the Study of Tobacco and Society examines smoking in the military and was released in November to coincide with the 100th anniversary of the end of World War I.

Dr. Alan Blum, the College’s Gerald Leon Wallace, MD, Endowed Chair in Family Medicine, also directs the center and was instrumental in the creation of the exhibition, “The Makin’s of a Nation: Tobacco & World War I,” along with Kevin Bailey, the center’s digital archivist.

The exhibition includes more than 30 original cigarette advertisements and other items and images of tobacco on the front lines of the First World War, which are part of the center’s collection, as well as collections of the Library of Congress, the National Archives and the New York Public Library. One advertisement refers to cigarettes as “Munitions of Peace.”

Smoking’s close association with the US Military started in World War I, when tobacco companies began to target military personnel through the distribution of cigarettes to servicemen and the eventual inclusion of cigarettes into rations.

Graettinger speaks at Chamber event

Dr. Kristine Graettinger, associate professor and chair of the College’s Department of Obstetrics and Gynecology, provided the December presentation for the Women’s Leadership Alliance Lunch & Learn.

The Women’s Leadership Alliance is part of the Chamber of Commerce of West Alabama.

“One of my favorite things about obstetrics and gynecology is guiding women through important transitions – adolescence, pregnancy and menopause,” Graettinger said.

Graettinger, who also practices at University Medical Center, which is operated by the College, focused much of her presentation on the topics of perimenopause and menopause.

Perimenopause typically begins several years before menopause and is the time when ovaries gradually begin to make less estrogen. Perimenopause lasts until menopause, the point where ovaries stop releasing eggs.

The average age for women to experience menopause, defined as 12 months with no menstruation, is 51. The most common indicators of menopause are less predictable menstrual cycles and hot flashes.

Graettinger said hot flashes are a normal response to decreased estrogen in the body. She said keeping cool by dressing in layers that can be removed and using relaxation techniques can help. “And maintaining a healthy lifestyle. Exercise, don’t smoke, and I can’t emphasize enough the importance of good nutrition. Lots of fruits and vegetables, good fats, fiber, iron, calcium and plenty of water.”

Graettinger said while menopause is a normal transition and can be managed without medication, there are times when hot flashes become disruptive to daily life. She said there are medications that can help, as well as hormone replacement.

She said menopause is often associated with forgetfulness, irritability, mood changes, depression and anxiety, “but these aren’t clearly linked to menopause.” She said women going through menopause are often juggling busy families, careers and caring for others. “They are wearing many hats. That fogginess and irritability can be related to life stressors and sleep disruption because of hot flashes.”

Graettinger encouraged audience members to spend time caring for themselves. “Menopause is a normal transition and it can be managed. Keep a healthy lifestyle, and regular annual checkups. Know your body. Care for yourself like you do your loved ones.”

Genes can provide information about drug addiction, treatment

Understanding the genes that play a role in addiction could help predict who becomes addicted and how people might respond to treatment, said Dr. Jeremy Day, assistant professor of Neurobiology at the University of Alabama at Birmingham.

Day provided the College’s Alice Mclean Stewart Endowed Lecture for Addiction Education on November 30. His talk was titled “Control-Alter-Delete: Gene Regulatory Mechanisms in Drug Abuse and Addiction.”

“If there’s a mutation in the dopamine receptor, for example, it could make an individual vulnerable to addiction,” Day said. “The challenge is understanding what genes are important in addiction.”

The National Institute on Drug Abuse reports there were 72,000 drug overdose deaths last year, exceeding the number of deaths from car accidents. In 2016, half of all high school seniors nationwide reported using illicit drugs, according to the NIDA.

Day characterized drug addiction as a chronic, relapsing disorder. But, he said, not everyone who uses drugs becomes addicted – only about 20 percent do.

Most illicit drugs work by elevating dopamine levels, an important chemical messenger in the brain involved with reward, motivation, memory, attention and even regulating body movements. When released in large amounts, dopamine creates feelings of pleasure, as well as motivation to repeat a specific behavior, even if harmful.

Risk factors for drug addiction include: psychiatric illnesses, drug availability, socio-economic status, childhood abuse, age at first exposure – and genetics, Day said. He said a number of addiction studies involving twins have been conducted and show that there is a heritability factor: 54 percent for heroin and opiates, up to 79 percent for marijuana, up to 81 percent for cocaine and 79 percent for hallucinogens.

“Genetics contributes to addiction but having a gene variance doesn’t mean you’ll become addicted,” Day said, adding that gene variations reside in the brain’s regulatory areas. He said the waves of addiction include drug delivery, which can result in a change in gene expression, “and then these genes can turn on other receptors.”

The Alice McLean Stewart Endowed Fund for Addiction Education was established in 1994 by Alice McLean Stewart to develop and understanding and spread knowledge of alcoholism and other chemical abuse elements through this lecture series.

Medical student at CCHS awarded scholarship to study abroad

David Osula, a University of Alabama School of Medicine student completing his clinical education at the College, was awarded a study abroad scholarship to complete a clinical elective in Peru.

Earlier this year, School of Medicine students had the opportunity to submit proposals to UAB International Medical Education for study trips to underserved communities. Eight students, including Osula, received scholarships.

Osula is a fourth-year medical student at the College, which also functions as the School of Medicine’s Tuscaloosa Regional Campus.

UAB International Medical Education’s mission is to advance education for medical students through global service learning. It serves that purpose by developing, coordinating and financially supporting educational clinical programs for medical students who wish to participate in clinical electives.

Osula will soon embark on a four-week experience at Hospital de Alta Complejidad in Trujillo, Peru. He will work closely with an infectious disease physician – participating in rounds, treatments and examinations. Osula will also participate in Community Health Campaigns, which are weekly health fairs that give patients the opportunity to receive medical exams and treatment on a free, first-come first-served basis.

“I’m excited that I’ll get both inpatient and primary care medical experience while being immersed in the Spanish language and culture,” he said. “I’ll have the opportunity to work with underserved populations, get excellent clinical exposure, improve my Spanish language proficiency and engage in a completely new health care system and culture.”

New CCHS Faculty

Dr. Joy Bradley joined the College as an assistant professor in the Department of Community Medicine and Population Health. She will also work with the College’s Institute for Rural Health Research. Bradley originally joined the College as a post-doctoral fellow in 2017. She received a PhD in Health Promotion and Behavior from the University of Georgia. She received her master’s degree in Marriage and Family Therapy/Counseling from the University of Louisiana at Monroe, and her bachelor’s degree in Psychology from Albany State University in Albany, Georgia.

Dr. Randi Henderson-Mitchell joined the College as an assistant professor in the Department of Community Medicine and Population Health. She will also work with the College’s Institute for Rural Health Research. Henderson-Mitchell previously served as a research data analyst for the Institute, and before that was a graduate research assistant with the Institute. She received her PhD and an MBA from The University of Alabama. She earned a master’s degree in Health Education from Baylor University in Waco, Texas, and completed her undergraduate degree at Texas Tech University in Lubbock.

Dr. Robert Osburne joined the College as an adjunct clinical faculty member in the Department of Family, Internal, and Rural Medicine. He cares for patients at University Medical Center, which is operated by the College, and his clinical practice focus areas are diabetes and thyroid diseases. Osburne is a board-certified endocrinologist with 35 years of clinical endocrinology practice experience. He practiced previously at Simon Williamson Clinic in Birmingham, Alabama, until his retirement in 2017. He has been associated with community hospital internal medicine residency training programs for 30 years, including at Baptist Medical Center Princeton in Birmingham and Atlanta Medical Center.

Dr. Salah Uddin joined the College as a neurology hospitalist. Uddin will care for University Medical Center patients at DCH Regional Medical Center in Tuscaloosa and will be part of the teaching team that works with the College’s residents and medical student. The College operates UMC. Uddin graduated from the University of Dhaka Medical College in Bangladesh. He completed a neurology residency at John F. Kennedy Medical Center in Edison, New Jersey, and a post-doctoral fellowship at Strong Memorial Hospital at the University of Rochester in New York. Prior to joining the College, Uddin was director of Neurology and Stroke at Shelby Baptist Hospital in Alabaster, Alabama.

UA recognizes CCHS researchers

College faculty and staff were among those recently recognized by The University of Alabama for receiving their first externally funded research awards during the past academic year.

Those recognized were: Dr. Nathan Culmer, director of Academic Technologies and Faculty Development; Glenn Davis, NRP, director of the EMS Division; Dr. Louanne Friend, assistant professor in the Department of Community Medicine and Population Health; Travis Parker, NRP, EMS Division program specialist; and Dr. Raheem Paxton, associate professor in the Department of Community Medicine and Population Health.

They were among a total of 80 faculty and staff recognized during the Celebrate Research First Awardee Luncheon last month at the Hotel Capstone on the UA campus. The event was initiated to promote, enhance and generate excitement for research activities and opportunities on campus.

“Through their efforts to secure support for their research and scholarly activity, these researchers are helping the University stay on the forefront of innovation,” said Dr. John C. Higginbotham, UA’s interim vice president for research and the College’s associate dean for Research.

Mission Moment: Event highlights College’s research and scholarly activity

Research and scholarly efforts of CCHS faculty, staff, residents, medical students and graduate students were highlighted during the College’s 10th Annual Research and Scholarly Activity Day.

Twenty-seven poster presentations were displayed at the Nov. 8 event, held at CCHS. Judges were: Dr. Abbey Gregg, assistant professor in the College’s Department of Community Medicine and Population Health; Dr. Pamela Foster, professor in the College’s Department of Community Medicine and Population Health; Dr. Louanne Friend, assistant professor in the College’s Department of Community Medicine and Population Health; and Dr. Michele Montgomery, assistant dean and associate professor in UA’s Capstone College of Nursing.

 


Winners were named in two categories:

Medical Student and Resident Division

First Place:  Dr. Richard Giovane, Dr. Louanne Friend, Mathew Leatherwood, Hui Wang, for Predicting the Need to Order Blood Cultures Using Neuroshell©: A Retrospective Chart Review.

Second Place:  Dr. Russ Guin, Dr. Louanne Friend, Suzanne Henson, RD, for Hiding in Plain Sight: An Innovative Hypertension Identification and Treatment.

Third Place:  Dr. Cory Luckie, Dr. Jared Ellis, Dr. Cecil Robinson, for Interprofessional ACLS Simulation Retraining to Promote Resident Confidence.


Faculty Division

First Place:  Dr. Caroline Boxmeyer, Andrea Hayes, Steven Simmons, for Sustained use of Power PATH, an Aligned Parent and Child Social Emotional Learning Program at Pickens County Early Learning Center.

Second Place:  Dr. Qinglin Hu, Hui Wang, Dr. Gregg Bell, for The Socio-Economic Context of Opioid Abuse in Alabama: A County-Level Analysis.

Third Place:  Dr. Randi-Henderson-Mitchell, Dr. John C. Higginbotham, Dr. Lea Yerby, Dr. Jason Parton, Dr. Daniel Avery, Dr. Marilyn Whitman, Dr. Shawn Mitchell, for The Rotavirus Vaccine Series Completion and Health Care Utilization in a Medicaid Population.

Third Place:  Dr. Lea Yerby, Dr. Joy Bradley, for How Communities Change Us: Professional Identity Formation Analysis Utilizing Reflections from a Third-Year Rural and Community Medicine Rotation.

 

Of the posters, 14 were presented in the Medical Student and Resident Division, and 13 in the Faculty Division.

Hiding in Plain Sight: Hypertension

A study by three College researchers that focuses on better identifying pre-hypertensive patients was presented during a poster session at the 10th Annual Ochsner Evidence Based Nursing Conference in New Orleans in October.

The study, Hiding in Plain Sight (HIPS): An Innovative Hypertension Identification and Treatment Program, is designed to identify patients with elevated blood pressure who might not yet be diagnosed with hypertension.

The study involved embedding a template into University Medical Center’s electronic medical record that gives physicians and other health-care providers a flag to patients who might be undiagnosed with hypertension. UMC is operated by the College.

A lifestyle curriculum for patients was developed as part of the study, and this information is now being transferred into an app to provide improved access for UMC patients. In addition, the embedded template provides physicians access to a decision-making tree for referral to lifestyle education and pharmacotherapy.

The study was piloted at UMC’s Northport location and could soon be expanded to UMC in Tuscaloosa. Funding for the study was awarded by the Alabama Department of Public Health.

Dr. Louanne Friend, assistant professor in the College’s Department of Community Medicine and Population Health, is the principle investigator of the study. Co-principle investigators are: Suzanne Henson, RD, assistant professor in the Department of Family, Internal, and Rural Medicine and practicing dietitian at UMC; and Amy Sherwood, director of Health Information Technology for the College.

The conference was hosted by the Center for Evidence Based Practicing and Nursing Research, which is part of Ochsner Health System.

Students learn about interprofessional practice and social determinants of health

Knowledge of how to practice with different health care providers is essential for future practitioners, but so, too, is an understanding of the impact social factors can have on health.

For that reason, a co-enrolled course for University of Alabama medical and nursing students, Introduction to Interprofessional Health Care Teams and Critical Care Procedures, now incorporates information about social determinants of health.

The course was created by Dr. Louanne Friend, assistant professor in the College’s Department of Community Medicine and Population Health, and Dr. Richard Friend, professor of family medicine and interim dean of CCHS, and a family medicine physician.

The course, an elective that began in spring semester 2015, introduces students to interprofessional practice – when practitioners from different health professions collaboratively learn about, from and with each other to improve patients’ health outcomes. The course focuses on roles and responsibilities, communication, teamwork, and values and ethics for interprofessional practice.

To date, 59 medical and 108 nursing students have completed the course, and outcomes have shown increased student camaraderie, confidence to practice collaboratively and knowledge of healthy work environments.

Louanne Friend said while faculty are excited about the number of students taking and completing the course and the positive feedback, they agreed that a key component to health outcomes – prevention and primary care – was needed within the course content.

To introduce students to the impact that social factors, such as poverty, lack of access to health care and inadequate education, can have on health, Dr. Allyson Gold, a professor at the UA School of Law, recently delivered a guest lecture titled “Rx for Justice: Using the Medical-Legal Partnership to Improve Patient Health Outcomes.”

Gold identified the relationship between legal issues and negative health outcomes, and how the Medical Legal Partnership Model of Health can improve patient health. Under this model, lawyers are integrated into health-care settings to assist patients with unmet social needs, including lack of health insurance, public benefits, housing and utilities and income support.

Future plans for the course including opening the class to students from Social Work and Clinical Psychology and creating opportunities for students to participate in clinic and inpatient services.

Friend said the ultimate goal is to train students from different disciplines to collaborate to address health disparities among low-income populations.