UA News: Presentation Seeks to Raise Awareness About Mental Health Crisis in Jails

The University of Alabama’s Dr. Marisa Giggie hopes to bring attention to the mental health crisis in jails and prisons during a presentation and panel discussion. The session is titled, “Mental Health in Correctional Settings in Tuscaloosa” and will begin at 12:15 p.m. Tuesday, April 25, in Willard Auditorium at DCH Regional Medical Center in Tuscaloosa.

WVUA: Health Matters – Adult Immunizations (April 12, 2017)

Immunizations are often considered something just for children before they head to day care or school for the first time, but immunizations are important for adults, too.

Dr. Jane Weida at University Medical Center in Tuscaloosa says skipping your shots can result in some nasty consequences.

Adults should be getting a tetanus and diphtheria shot every 10 years, Weida says, and it’s a good idea to get a whooping cough booster, too.

WVUA: Health Matters – Sinusitus (April 5, 2017)

Most people develop some sinus issue or other at least once in their life.

When it strikes, it’s tempting to ask your doctor for some antibiotics, but that’s not always the correct course of action.

Dr. Ricky Friend with the University of Alabama’s College of Community Health Sciences says even the worst sinus infections are rarely bacterial, and even those association with fever, facial pain or thick green drainage usually don’t require antibiotics.

Health Notes – The confusing world of over-the-counter medications

To help people become savvy consumers in drug stores and pharmacies and wiser users of over-the-counter medications, Dr. Richard Streiffer, dean of UA’s College of Community Health Sciences and a family medicine physician, went shopping.

He recounted his shopping experience and provided helpful information in a presentation March 9 that was part of the Mini Medical School lecture series hosted by the College in collaboration with UA’s OLLI program. His presentation was titled “Over-the-counter drugs: A prescription for confusion.”

Streiffer said Americans make a lot of trips to the drug store for over-the-counter medications, about 3 billion trips annually, and there are approximately 300,000 over-the-counter medications on the market. “I want to help you be a little smarter as a consumer,” he told the audience.

He said people spend a lot of money on over-the-counter medications they might not need or that might not be effective. In addition, some of the medications can cause adverse health effects, particularly if people are taking multiple medications or have chronic health conditions, he said.

Streiffer offered strategies people can use to better gauge cost and effectiveness. His top tips: buy generic brands and read labels.

“There’s a fear of generics, but it’s really just a labeling and marketing difference,” he said. “For the most part, find the brand name and look next to it for the generic.”

He noted that a quick read of the labels on Excedrin and Excedrin Migraine showed that both contain the exact same ingredients; they are just marketed – and priced – differently.

Streiffer showed examples of men’s and women’s multi-vitamins and the only ingredient differences between the two were that the men’s blend had cayenne pepper and the women’s had dried cranberry. He added that affluent people with good diets don’t really need multi-vitamins, which can cost $25 or more per month.

Streiffer said it’s often difficult to discern differences between supplements and medications. “Talk about overwhelming, and supplements aren’t regulated,” he said.

Supplements are classified as food, so they are not regulated by the US Food and Drug Administration. They are marketed as supporters, not relievers, and might include information on labels such as “in support of sleep.”

“There is usually little scientific evidence to prove the effectiveness of supplements, and they can cause side effects,” Streiffer said. For example, ginseng has been touted for improving energy, depression and nausea, and cranberry for improving urinary track health.

“There’s no evidence for this. When something sounds too good to be true, it probably is. As a society, we are too quick to grab a pill,” Streiffer said.


College hosts third annual Brussels Sprout Challenge at Heart Walk

For the third straight year, UA’s College of Community Health Sciences hosted the Brussels Sprout Challenge during the American Heart Association West Alabama Heart Walk on March 25.

The College and its University Medical Center partnered with Manna Grocery and Deli in Tuscaloosa to roast and serve Brussels sprouts at the walk, which began at the Tuscaloosa Amphitheater and continued along the downtown river walk. More than 900 Brussels sprouts were distributed at the challenge.

To complete the Brussels Sprout Challenge, participants had to eat one roasted Brussels sprout at each mile marker of the 3.1 mile walk. Those who completed the challenge by eating all three Brussels sprouts were awarded a T-shirt at the end of the walk.

The College also provided handouts about the health benefits of Brussels sprouts, which include heart health and cancer protection, as well as Brussels sprout recipes.

The goal of the Brussels Sprout Challenge is to offer a challenge that promotes healthy lifestyle choices – a healthy diet and exercise – while complementing the American Heart Association’s mission to build healthier lives free of heart disease and stroke.

The mission of the College is to improve and promote the health of individuals and communities in Alabama and the region.

Women’s health focus of Rural Health Conference

Women’s health is the focus 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.

“Empowering Women in Health: Bridging the Gap between Clinical and Community,” will be held March 30-31, from 8 am to 4 pm each day, at the Bryant Conference Center on the UA campus.

Keynote speakers include: Dr. Jeanne Marrazzo, professor of Medicine and director of the Division of Infectious Diseases at the University of Alabama at Birmingham; and Dr. Marji Gold, a faculty member in the Department of Family and Social Medicine at Albert Einstein College of Medicine in New York City.

Marrazzo is internationally recognized for her research and education efforts in the field of sexually transmitted infections, especially as they affect women’s health. Her conference presentation is titled “Optimizing Infectious Disease Care for Women in Rural Settings: Current Challenges and Opportunities.”

Marrazzo conducts research on the human microbiome, specifically as it relates to female reproductive tract infections and hormonal contraception. Her other research interests include prevention of HIV infection using biomedical interventions, including microbicides. She recently led the VOICE Study, a National Institutes of Health-funded study that evaluated HIV pre-exposure prophylaxis to women at high risk for HIV infection in sub-Saharan Africa.

She obtained her medical degree from Jefferson Medical College in Philadelphia and completed a residency in Internal Medicine at Yale-New Haven Hospital in Connecticut. She earned a master’s degree in Public Health with a concentration in Epidemiology at the University of Washington in Seattle, where she also completed a fellowship in Infectious Disease.

Gold was instrumental in integrating a women’s health curriculum into the family medicine residency at Albert Einstein College of Medicine, and has focused on woman-centered language as an integral component of woman-centered care. Her conference presentation is titled “Reproductive Equality.”

Gold works with medical students, residents and fellows at Albert Einstein College of Medicine, and also maintains a primary care practice at a community health center in the Bronx where she supervises medical students and residents. Gold received her medical degree from New York University College of Medicine and completed a Family Medicine residency at Albert Einstein College of Medicine.

Breakout sessions on issues related to the conference topic will also be offered. Sessions include: Lactation Support and Resources; Long-acting Reversible Contraceptives; Understanding the Link between Food Insecurity and Obesity among African-American Women; Sexual Health among Latinas in Alabama; and Domestic Violence and Sexual Assault on Women.

The annual Rural Health Conference is attended by health-care providers, researchers, community leaders, government officials and policymakers who hear from prominent speakers in the field and share information and knowledge about rural health issues.

The registration fee for the conference is $150 per person and $35 for students and includes breakfast and lunch on both days. Continuing education will be provided for some health care professionals.

For more information and to register online, visit the conference website or call (205) 348-9640.

The Institute for Rural Health Research was established in 2001 and conducts research to improve health in rural Alabama. The goal is to produce research that is useful to communities, health care providers and policymakers as they work to improve the availability, accessibility and quality of health care in rural areas. The Institute also serves as a resource for community organizations, researchers and individuals working to improve the health of communities in Alabama.

Crimson White: UA professor lectures on key issues with over-the-counter drugs

To help society become smarter consumers in pharmacies, Dean and professor of Family Medicine in College of Community Health Sciences Dr. Rick Streiffer presented a lecture entitled, “Over-the-Counter Drugs: A Prescription for Confusion” on Thursday.

Streiffer initially spoke about how common the confusion in buying over-the-counter drugs is for most ages, and how people in the United States make trips to drug store regularly for various concerns, spending a lot of money on items they do not need. According to him, many products can cause adverse effects for people as well.

College receives grant to provide colonoscopy training to faculty and residents

By Kimberly Florence

The College of Community Health Sciences wants to increase the number of colonoscopy procedures performed by family medicine physicians in underserved communities of rural Alabama, and it plans to accomplish this goal through a grant from the American Cancer Society.

Dr. Richard Friend, director of the College’s Family Medicine Residency, applied for the grant in early 2016. In June 2016, the College received an endowment of $70,000 that matched an additional $70,000 from CCHS.

The money will be used to fund colonoscopy training for the Family Medicine faculty and residents, said Friend.

“The purpose of this grant is to train more providers to do colonoscopies throughout the state,” he said. “The way we are approaching that is by training more faculty who will in turn train more residents.”

The grant will fund the purchase of a high-fidelity simulator that faculty and residents will use to learn. The simulator uses computerized manikins to guide providers through performing the procedure and records proficiency. Once providers have met certain requirements, they can to move on to assisted cases in surgery with live patients. Friend says the simulator will be purchased in about a month.

Residents will begin their training under the direction of Friend. Dr. Drake Lavender, associate professor of Family Medicine.

Two faculty members will also receive training: Dr. Jared Ellis, associate director of the Residency, and Dr. Ed Geno, associate professor of Family Medicine. Once they complete their training, they will join Friend and Lavender in training residents.

The majority of residencies across the country do not provide colonoscopy training and family medicine physicians perform only 8 percent of colonoscopies in the state, said Friend. By training more family physicians to perform the procedure, the College hopes to provide greater access to patients in rural areas who may not be able to get to an urban setting where the majority of colonoscopies are performed, said Friend.

“There are people in our region who can’t get to the larger metropolitan areas like Tuscaloosa and Birmingham,” Friend said. “We hope to provide these services in smaller rural medical centers where they’re needed the most.”

The College’s mission is to improve and promote the health of individuals and communities in Alabama and the region through the provision of high quality, accessible healthcare, and one of the ways it does that is by sending its trained physicians into Alabama’s rural and underserved communities.

Immunizations in older adults, addiction and teens, schizophrenia and cholesterol topics in weekly Mini Med School lecture series

About one-third of people will get shingles in their lifetime, and while the shingles vaccine is only about 50 percent effective, it is still worth it to avoid getting the virus, said Dr. Jane Weida, director of clinical affairs for the College of Community Health Sciences’ Department of Family, Internal, and Rural Medicine.

Weida gave her talk, “Immunizations for Older People — Staying Sharp on Shots,” on Feb. 9 as part of the Mini Medical School lecture series put on by CCHS in collaboration with UA’s OLLI program.

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. The lecture series is open to OLLI participants and to the public.

Shingles is caused by the same virus that causes chickenpox. A painful rash develops, usually on a single area on one side of the body, that can be very painful, said Weida, who is also an associate director of The University Family Medicine Residency, operated by CCHS, and an associate professor of Family Medicine.

View Fox 6’s report on Weida’s talk:

Someone who has had chickenpox can get shingles.

“When you’re little you get chickenpox and then the virus stays in the nerves along the back and neck,” said Weida. “Sometimes, we don’t know how, it reactivates.”

Being older, having poor immune function and having had chickenpox before 18 months of age increases the risk of shingles.

“If you never have had the chickenpox, you can’t get shingles first,” she said. “If you’ve never been immunized for chickenpox or shingles, you should get immunized for both. You can catch chickenpox from someone with shingles, but not shingles.”

Insurance will cover the shingles vaccine after age 60, though it can be given starting at age 50.

Older people need immunizations to boost immunity to diseases, even those to which they have already been immunized, such as tetanus, diphtheria and whooping cough, and to protect against diseases that affect older adults preferentially, including shingles and pneumonia, said Weida.

Weida also encouraged attendees to get their flu shot each year, as 3 million to 5 million people are infected by influenza each year, and 250,000 to 500,000 die each year from the flu. The best time to get your flu shot is about mid-October to November, said Weida.

The flu shot’s effectiveness can fade, Weida said, so it is important not to get it  too early, especially for those older than 65.

The flu is spread through coughing or sneezing and by touching surfaces with the virus. However, soap and water deactivates the virus, Weida said.

On Feb. 2, Dr. Thaddeus Ulzen, associate dean of Academic Affairs and chair of Psychiatry and Behavioral Medicine, gave his talk on schizophrenia, which is a chronic and severe mental disorder that affects 1 percent of people worldwide.

Symptoms typically present between late adolescence and early adulthood. Ulzen said that symptoms may be subtle, but those around the person may notice that “something is just not quite right, or the person is not his or herself.”

Symptoms include hallucinations, delusions, thought disorders and movement disorders. Reduced emotions and feelings of pleasure and reduced speaking may also be symptoms.

“I describe it as a disruption of what I call ‘security of thought’—that your thoughts belong to you,” said Ulzen. “The feeling is that someone is intruding on your thoughts.”

Medication can be used to treat schizophrenia, but other aspects must be introduced into the treatment, said Ulzen, including psychosocial interventions and cognitive behavioral therapy. Community treatment, which includes family education and support, is also important.

Schizophrenia cannot be cured, and those affected with the disorder have it for life.

“As a child psychiatrist, I always say that we are in preventive psychiatry. Most disorders we see, including schizophrenia, start quite young.”

Ulzen said he works with general physicians to help them identify the signs of schizophrenia and other psychiatric disorders.

“My job is to help physicians understand that this is the beginning of the big tsunami about to come and never to say ‘It’s just a phase.’ If the patient is concerned enough to walk into the room, they know something is wrong.”


Addiction and Teens
In a 2015 study, one out of 17 high school seniors were daily smokers of tobacco, said Dr. Sara Phillips, assistant professor of Pediatrics at CCHS, during her talk “Addiction and Teens” on Feb. 16.

According to the CDC, cigarette smoking causes about one of every five deaths in the US each year and life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90 percent, said Phillips.

“I think if we target young people and try to get them to quit early on, it could be like they never smoked.”

Most teens want to quit, she said, and nicotine replacement and cognitive behavioral intervention can be helpful forms of treatment.

While there are other dangerous drugs that teenagers use, smoking causes annually more deaths than overdoses have in 15 years, said Phillips.

More money is spent on tobacco advertising than any other drug, though there are regulations.

Advertising for alcohol is not regulated, and people aged 12 to 20 years drink 11 percent of all alcohol consumed in the US. More than 100,000 deaths can be attributed to excess alcohol consumption, including the deaths of 5,000 people younger than 21 years, said Phillips.

Younger drinkers are more likely to develop alcohol dependence or abuse later in life, and they are at higher risk of suicide and death from alcohol poisoning. This is for a couple of reasons, said Phillips.

“One, their brains are not fully developed, and two, they’re novices to drinking. They don’t know their limits,” she said.

Of illegal drugs, marijuana is the most commonly used and adolescents can become addicted, despite popular belief, said Phillips.

One study showed an average loss of eight IQ points with heavy marijuana use as a teen and continued use as an adult. It can also lead to memory problems, breathing issues and hallucinations and paranoia.

Genetics can play a role in addiction in teens. Children whose parents are alcohol-dependent are four to six times more likely to develop alcohol dependence compared to others with no family history. Teens with mental health issues are also more at risk to use or abuse substances, Phillips said.

Treating cholesterol isn’t about treating a number—it’s about treating the risk factors and the disease process, said Dr. Ed Geno, assistant professor of Family Medicine in the College’s Department of Family, Internal, and Rural Medicine.

Cholesterol is essential in the human body, said Geno. Two types of cholesterol levels are checked: LDL and HDL. The two have different clinical implications:

LDL carries cholesterol from the liver to the tissues and deposits it. Geno called this “lousy cholesterol,” which is how he helps patients remember it is not good for that number to be too high.

“Happy cholesterol” is how Geno helps patients remember HDL, which carries cholesterol from the tissues back to the liver.

High levels of the LDL cholesterol can lead to plaque buildup in arteries and lead to cardiovascular disease (CVD).

Statins may be used to prevent CVD in adults.

“We are trying to use primary prevention in treating cholesterol,” Geno said. “That means we are trying to keep someone from ever having a heart attack. Secondary prevention would be keeping a heart attack from happening again.”

When treating a person’s cholesterol, risk factors and the disease process is taken into account—not just the patient’s cholesterol numbers.

Adults without a history of CVD may be prescribed a statin for the prevention of a CVD event and mortality  depending on if: 1) the adult is between age 40 and 75; 2) the adult has one or more CVD risk factors, which include dyslipidemia, diabetes, hypertension or smoking; and 3) the there is a calculated risk by the physician of a cardiovascular event within 10 years.

Dean talks to Alabama Public Radio about potential impact of Affordable Care Act repeal

The Affordable Care Act is seen as one of the defining pieces of President Obama’s legacy – and the new Republican majority has targeted it for repeal. Leading lawmakers in both houses of Congress have begun work dismantling Obamacare – despite not having any plan in place for a replacement, and despite polling that suggests an overwhelming majority of Americans oppose its repeal without a replacement ready.