McKinney Selected for Fellowship

Robert McKinney, assistant professor of social work in the department of Psychiatry and Behavioral Medicine at The University of Alabama’s College of Community Health Sciences, was among 16 faculty nationwide chosen for the 2018 class of the Society of Teachers in Family Medicine’s Behavioral Science/Family Systems Educator Fellowship.

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.

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.”

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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.

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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.

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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.

Judson Russell, a fellow with The University of Alabama-Pickens County Partnership, conducts a health screening on a student at Reform Elementary School. (Photo by Andrea Mabry)

Projects underway in UA-Pickens County Partnership

In Pickens County, elementary school students in Gordo are learning how to garden and how to prepare healthy foods. Meanwhile, Head Start teachers in Carrollton are being trained to identify and prevent mental health issues. Both of these are part of ongoing projects with The University of Alabama-Pickens County Partnership.

Coordinated by the UA College of Community Health Sciences, the partnership seeks to provide sustainable health care for the rural county and real world training for UA students in medicine, nursing, social work, psychology, health education and other disciplines.

Pickens County is a medically underserved area and a primary care, mental health and dental health professional shortage area. The county ranks 41st in in the state in health outcomes.

Four recent UA graduates who are completing year-long fellowships with the partnership and are working on collective and individual projects.

The fellows, August Anderson, Laura Beth Brown, Courtney Rentas and Judson Russell, are conducting health screenings at schools across Pickens County, including Pickens Academy, Aliceville Elementary, Gordo High School and Reform Elementary School.

“While the health screenings have been a top priority for the fellows for the past couple of weeks, they have remained actively involved in their community projects,” says Wilamena Dailey, coordinator for the Partnership.

Anderson’s individual project is providing health education in Pickens County Schools. Brown is focusing on senior centers and providing the elderly with care, activities and resources. Rentas and Russell are focused on activities at the 4H House in Gordo. Rentas is educating students about nutrition through hands-on cooking demonstrations, and Russell teaches them about growing healthy foods through a teaching garden.

Eight projects that address health issues in Pickens County are also part of the partnership. Each includes UA faculty, UA students and a Pickens County community organization.

An update on some of the projects underway:

Disseminating the Power PATH Mental Health Preventive Intervention to Pickens County Community Action Head Start Program:
Dr. Caroline Boxmeyer, associate professor of Psychiatry and Behavioral Medicine at CCHS and the principal investigator of the project, has implemented the first portion of the Power PATH Program, equipping Pickens County Head Start teachers  with training and resources to use in the future to identify and help prevent mental illness. The second part of the program—a training program for parents—is underway.

Boxmeyer is working alongside Dr. Ansley Gilpin, assistant professor of psychology at UA, and Dr. Jason DeCaro, associate professor of anthropology at UA. They are collaborating with the Pickens County Community Action Head Start Program.

Improving Pickens County Residents’ Knowledge of Risk Factors for Cardiovascular Disease and Type 2 Diabetes:

Health screenings have been conducted at the Pickens County Head Start Pre-K Program and at the Board of Education as part of the project. Led by Dr. Michele Montgomery and Dr. Paige Johnson, both assistant professors at the UA Capstone College of Nursing, the project is in collaboration with the Pickens County Community Action Committee and CDC, Inc., the Pickens County Board of Education, Pickens County Head Start and the Diabetes Coalition.

Pickens County Medical-Legal Partnership for the Elderly
Gaines Brake, staff attorney with the Elder Law Clinic at UA’s School of Law, is seeing clients at Pickens County Medical Center and throughout the community to increase awareness about the Medical-Legal Partnership. The Elder Law Clinic also hosts hours at Pickens County Medical Center, where it provides free legal advice and representation to individuals aged 60 and over. Gaines is working with Jim Marshall, CEO of Pickens County Medical Center.

Improving Access to Cardiac Rehabilitation Services in Pickens County
An expansion of the Cardiac Rehabilitation Center at Pickens County Medical Center is completed. Dr. Avani Shah, assistant professor of social work at UA, and Dr. Jonathan Wingo, associate professor of kinesiology at UA, have collaborated with Sharon Crawford Webster, RRT, of the Cardiopulmonary Rehab at Pickens County Medical Center on the project.

The College’s mission is to improve and promote the health of individuals and communities in Alabama and the region, and one of the ways it seeks to do that is by engaging communities as partners, particularly in rural and underserved areas.

In Pickens County, there are nine primary care physicians per 10,000 residents, and one-third of the population lives below the poverty line. The county ranked 45th of Alabama’s 67 counties in social and economic factors that contribute to health. Thirty-six percent of adults are considered obese.

Click here to view all the planned projects for the partnership, and to learn more about Pickens County.

Dr. John Sullivan, an alumnus of The University of Alabama Family Medicine Residency, gave a lecture on snake venom poisoning on Nov. 11 at the College.

Alumnus, antivenin developer speaks to med students about snakebites

Resident speaks about hypertension at Mini Medical School

One in three adults in America has hypertension, according to the US Centers for Disease Control and Prevention. However, hypertension can be treated with lifestyle modifications and medications, said Dr. Brittney Anderson, a third-year resident physician at The University of Alabama Family Medicine Residency.

Dr. Brittney Anderson, third-year resident at The University of Alabama Family Medicine Residency

Dr. Brittney Anderson, third-year resident at The University of Alabama Family Medicine Residency

Anderson provided a presentation on hypertension on Nov. 3 as part of the Mini Medical School program conducted by the UA College of Community Health Sciences 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 residents 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.

Anderson started her presentation by illustrating hypertension, or high blood pressure.

“Think of it the way you would think of pressure from a water hose. What would alter that pressure? The size of the hose, and what the fluid in the hose is having to overcome,” she said.

Cholesterol buildup, for instance, can inhibit blood from moving at a normal pressure through blood vessels, she said.

Diagnosing hypertension starts with an accurate blood pressure reading, which can sometimes be challenging due to faulty or inaccurate measuring cuffs or other factors with the patient and environment, Anderson said.

She offered tips for an accurate blood pressure reading. First, be at your calmest—don’t worry about engaging in conversation. Second, support your back and feet, and keep your legs uncrossed. Third, empty your bladder so that it doesn’t affect your body’s stress level. And fourth, keep your arm supported at your heart level and make sure the cuff is over your bare arm (and not your clothes).

If patients are using an automated cuff for measuring blood pressure at home, the physician may ask that it be brought in for the exam to compare, Anderson said.

Normal blood pressure less than 120 mm Hg systolic and less than 80 mm Hg diastolic. Prehypertension is between 120-139 mm Hg systolic and 80-89 mm Hg diastolic. When the systolic reads 140-159 mm Hg, and diastolic reads 90-99 mm Hg, the patient may be diagnosed as Hypertension Stage 1. Hypertension Stage 2 is when the systolic is 160 mm Hg or higher, and the diastolic reading is 100 mm Hg or higher. A Hypertensive Crisis, which requires emergency intervention, is when the systolic is read at higher than 180 mm Hg and higher than 110 mm Hg diastolic.

If a patient has an elevated blood pressure reading of greater than or equal to 180/110 mm Hg, then the diagnosis is clearly hypertension, Anderson says.

“But if not, then we have to do some more digging,” she said. It could be that the patient suffers from “white coat hypertension,” which means the patient is nervous simply from being in the doctor’s office. Patients in that case would be asked to wear an ambulatory blood pressure cuff 24 hours a day for a few days for an accurate measurement.

Or, if a patient is diabetic, it causes damage to blood vessels. That means that if a reading is greater than 130/80 mm Hg and the patient is diabetic, then it is a diagnosis of hypertension.

There are risk factors that lead to hypertension, Anderson said. Primary risk factors include age, obesity, family history, race, diet and exercise and alcohol use. Secondary risk factors include medicines (like decongestants, birth control and steroids), illicit drugs, sleep apnea and renal disease.

Hypertension can be treated through lifestyle modifications, like weight loss, adopting an eating plan, adding physical activity and reducing alcohol and sodium intake, Anderson said. There are many medications, too. Thiazides, ACE inhibitors and calcium channel blockers are some of the most common.

In Remembrance: Dr. Ernest Cole Brock, Jr.

Dr. Ernest Cole Brock, Jr., a longtime physician for the Alabama Crimson Tide and the creator of a sports medicine lecture series for the College of Community Health Sciences, passed away on Nov. 5 at his home in Tuscaloosa. He was 91.

Dr. Ernest Cole Brock, Jr., with his wife, Hannah Brock

Dr. Ernest Cole Brock, Jr., with his wife, Hannah Brock

Brock was an orthopedic surgeon who practiced in Tuscaloosa for many years, in addition to serving as a physician for the Alabama football team.

He and his wife, Hannah Brock, created The Ernest Cole Brock III Endowment for Continuing Medical Education at the College to support a lecture series on treating concussions and other athletic injuries. They created the fund to honor the memory of their son Ernest Cole Brock III who died in 1999 at the age of 36. The inaugural lecture was held in January 2013.

Brock grew up in Fairfield, Alabama. In 1943, at age 18, he entered the United States Air Force and fought as a gunner in 32 combat missions in Guam and Japan. After he returned to the US, he accepted a scholarship to play football at Wake Forest University in North Carolina.

Brock had plans to be a football coach and a science teacher, but after he suffered a career-ending leg injury during his second year of college, he decided to pursue medical school. He received his medical degree from Wake Forest University and then completed his residency in orthopedic surgery at University Hospital in Birmingham (now UAB Hospital).

After residency, he joined the hospital’s staff and served as the physician for high school football players at Legion Field.

“[Orthopedic surgery] is a good field to be in,” Brock said to the College in a 2014 interview. “Most of the patients are young and can heal.”

Brock later formed an orthopedic surgery and sports medicine practice in Tuscaloosa and began traveling as a surgeon with the Crimson Tide and head coach Paul “Bear” Bryant.

“I enjoyed working for the team, and Coach Bryant was nice to work for,” Brock said.

For 25 years, Brock was the team orthopedist for Alabama. He also served as an orthopedic preceptor for the College, training residents and medical students on the diagnosis and treatment of musculoskeletal conditions. He practiced in Tuscaloosa until he retired in 1992.

Dr. James Robinson, chair of Sports Medicine, team physician for Alabama and an alumnus of the College’s Residency, said Brock was a mentor to him when he was training.

“Dr. Brock’s legacy to CCHS will be maintained by the annual lecture series that bears his name and by the continuation of the physician care of the athletic department through the deShazo Sports Medicine Clinic,” he said.

Brock’s funeral was held Nov. 9 at Calvary Baptist Church in Tuscaloosa.

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Scholarships awarded to medical students, Rural Medical Scholars

Scholarships were recently awarded to four medical students receiving their clinical education at The University of Alabama College of Community Health Sciences. Rural Medical Scholars also received awards.