photo booth

CCHS Employees Honored for Years of Service

Twenty-six CCHS employees were recognized for their years of service to The University of Alabama.

UA’s Service Recognition Program recognizes staff employees achieving continuous service milestones of 5, 10, 15, 20, 25, 30, 35 and 40 years of service. Staff being recognized are invited to an annual reception and receive a commemorative key ring.

 

5 years:
Hollie Camatti – Business Office
Ashley Justice Galbraith – Internal Medicine
Emily Parker – Lab and X-ray
Kathy Pritchett – Business Office
Jennifer Simmons – Lab and X-ray
Allyson Welch – Business Office

10 years:
Allison Arendale – Dean’s Office
Latrice Bradley – Pediatrics
Jane Caraway – Internal Medicine
Nikki Clayton – Psychiatry and Behavioral Medicine
Jennifer Croft – Family Medicine
Angela Hammond – Faculty/Staff Clinic
Paulette Roberts – Medical Records
Judy Whitehead – OB/GYN
Christine Zoebelein – Medical Records

15 years:
Loretta Bryant – Medical Records
Jan Chaisson – Medical Records
Cynia Duggins – Business Office
Ann King – Health IT
Erica Rice – Business Office
Melissa Scruggs – Pediatrics
Lori Upton – Family Medicine
Rhonda Waldrop – Lab and X-ray
Sylvia Winston – Business Office

25 years:
Judy Dunn – Social Work
Linda Jackson – Rural Programs

31 years:
Cynthia Moore – Rural Programs

College merges departments to create Department of Family, Internal and Rural Medicine

The College of Community Health Sciences’ departments of Family Medicine and Internal Medicine have joined, and along with the College’s Rural Health Leaders Pipeline programs, now form the Department of Family, Internal, and Rural Medicine, or FIRM. The University of Alabama Board of Trustees approved the merger at its June 2016 meeting.

Dr. Richard Streiffer, dean of the College, said the departments of Family Medicine and Internal Medicine were already collaborating in many ways, including a joint inpatient teaching service created in 2015 and through the College’s geriatrics program. Rather than continuing as two separate departments, consolidation will benefit patients, medical students and residents, says Streiffer.

“Medical practice and training are becoming much more interdisciplinary, interprofessional and collaborative than ever before,” Streiffer says. “Our structure dates back to the origins of the College, for the most part, and has perpetuated ‘silos’ that no longer make sense.”

Plus, the primary aim of the Rural Health Leaders Pipeline is to prepare students from rural areas of Alabama to provide health care in rural areas—particularly as family medicine physicians.

“Hence, the creation of FIRM into a single administrative unit gives us the unique opportunity to realign these key programs and disciplines, resources and strategies to be more collaborative and, ultimately, more effective,” Streiffer says.

Dr. Richard Friend, director of the College’s Family Medicine Residency and chair of FIRM, says the merger will also allow the College to reexamine its use of clinical space in University Medical Center for efficiency.

Being part of a single unit, FIRM will be able to more easily implement clinical guidelines and processes as part of the College’s ongoing effort to become certified as a Patient-Centered Medical Home, as well as continue to increase collaboration in research and education.

Dr. Scott Arnold will serve as vice chair of FIRM and division director for internal medicine. Dr. Catherine Scarbrough, associate residency director, will provide oversight of curricular aspects of residency and fellowship education within the department. Dr. Jane Weida, associate residency director, will serve as director of all FIRM clinics. Dr. John Wheat continues as director of the Rural Health Leaders Pipeline.

Gates Phillips

New Family Medicine, Pediatrics Faculty Join College

Dr. Katie Gates has joined the College of Community Health Sciences as assistant professor of Family, Internal, and Rural Medicine. Gates is a graduate of The University of Alabama Family Medicine Residency, operated by the College, where she served as chief resident.

Originally from Oxford, Alabama, Gates earned her bachelor’s degree from The University of Alabama. As a Rural Medical Scholar, she earned her master’s at UA in human and environmental sciences and her medical degree from the University of Alabama School of Medicine, receiving her third and fourth years of clinical education at the College, which also operates as the School of Medicine’s Tuscaloosa Regional Campus. The Rural Medical Scholars Program is for rural Alabama students who want to become physicians and practice in rural communities.

Gates graduated from the College’s Family Medicine Residency in 2016.

 

Dr. Sara Phillips has joined the College as assistant professor of Pediatrics.

Phillips is originally from Boaz, Alabama, and received her bachelor’s degree in biology from The University of Alabama. As a Rural Medical Scholar, she earned her master’s at UA in human and environmental sciences and her medical degree from the University of Alabama School of Medicine, receiving her third and fourth years of clinical education at the College, which also operates as the School of Medicine’s Tuscaloosa Regional Campus.

Phillips completed her residency in pediatrics at the Arkansas Children’s Hospital at the University of Arkansas for Medical Sciences

 

Partnership joins UA and Pickens County in improving rural community’s health and educating students

 

The University of Alabama has teamed up with Pickens County to provide learning opportunities for students while improving the health and wellbeing of the rural county of nearly 20,000.

The University of Alabama-Pickens County Partnership seeks to provide sustainable health care for the county and “real world” training for UA students in medicine, nursing, social work, psychology, health education and other disciplines. Students will gain practice from internships and other learning opportunities, while Pickens County will gain additional and needed health resources.

When it was feared that Pickens County Medical Center, a 56-bed hospital that has provided inpatient, outpatient and emergency care for the rural county since it opened in 1979, would close, members of the community took action.

They met with UA leaders, including Dr. Richard Streiffer, dean of the UA College of Community Health Sciences, and former president Dr. Judy Bonner, and what began as a discussion about how to keep the medical center open evolved into a conversation about sustaining health care in the county.

CCHS hosted a meeting in December 2014 that included Pickens County leaders and citizens and UA vice presidents and deans. The conversation centered on envisioning a new model of health care for the county via an academic-community partnership. The idea was coined a Health Care Teaching County.

“A health care teaching county is novel in that in that it provides help for a community and learning opportunities and experiences for students,” says Streiffer. “It will train future physicians and other health care providers where most will practice, and sustain health care in communities that most need it.”

In 2015, $600,000 was obtained from the Alabama Legislature to initiate the Partnership, and with CCHS as the coordinator, the funds will be used to support the Partnership in the following ways:

1. A Partnership Coordinator was hired. Wilamena Hopkins joined the Partnership in May 2016 as coordinator. Originally from rural Archer, Florida, Hopkins, studied health care management at UA and has worked as an event and training coordinator for Maude Whatley Health Services in Tuscaloosa.

“My role is to make sure the community is aware of the Partnership and understands the Partnership, and I’ll be making sure that we are headed in the right direction and that at the end of this year, funding will continue,” Hopkins says. “I will be making sure that we are introducing innovative ideas into the community and providing needed resources.”

2. A portion of funding obtained will support eight projects that address Pickens County health issues. Each project includes a UA faculty, UA student and a Pickens County community organization or similar entity.

Disseminating the Power PATH mental health preventive intervention to Pickens County Community Action Head Start Program
Principal Investigator: Dr. Caroline Boxmeyer, associate professor of Psychiatry and Behavioral Medicine at CCHS
Co PIs: Dr. Ansley Gilpin, assistant professor of psychology at UA, and Dr. Jason DeCaro, associate professor of anthropology
Collaboration: Pickens County Community Action Head Start Program

TelePlay: Connecting physicians, families and autism professionals to increase early autism identification in Pickens County
PI: Lea Yerby, assistant professor of Community and Rural Medicine at CCHS
Co PIs: Dr. Angela Barber, assistant professor of Communicative Disorders and the clinical research director of Autism Spectrum Disorders Clinic at UA
Collaboration: Dr. Julia Boothe, family medicine physician in Pickens County

Improving Pickens County Residents’ Knowledge of Risk Factors for Cardiovascular Disease and Type 2 Diabetes
PI: Dr. Michele Montgomery, assistant professor at the Capstone College of Nursing
Co PI:  Dr. Paige Johnson, assistant professor at the Capstone College of Nursing
Collaboration: Pickens County Community Action Committee & CDC, Inc., Pickens County Board of Education, Pickens County Head Start, and the Diabetes Coalition

Development of a Rural Family Medicine Residency in Pickens County
PI: Dr. Richard Friend, director of the College’s Family Medicine Residency
Collaboration: Jim Marshall, CEO of Pickens County Medical Center; Deborah Tucker, CEO of Whatley Health Services

Pickens County Medical-Legal Partnership for the Elderly
PI: Gaines B. Brake, staff attorney with the Elder Law Clinic at The University of Alabama School of Law
Collaboration: Jim Marshall, CEO of Pickens County Medical Center

Improving Access to Cardiac Rehabilitation Services in Pickens County
PI: Dr. Avani Shah, assistant professor of Social Work at UA
Co PI: Dr. Jonathan Wingo, associate professor of Kinesiology at UA
Collaboration: Sharon Crawford Wester, RRT, Cardiopulmonary Rehab Pickens County Medical Center

Alabama Literacy Project
PI: Carol A. Donovan, professor of special education and multiple abilities at UA
Collaboration: Jamie Chapman, Superintendent of Pickens County Schools

Bringing Healthy Food options and ease of preparation home to our senior adults
PI: Jennifer Anderson, director of Osher Lifelong Learning Institute at UA
Co PI: Suzanne Henson, dietitian and assistant professor in Family Medicine at CCHS
Collaboration: Anne Jones, Pickens County Family Center and Mayor Joe Lancaster, City of Carrollton, Alabama

 

3. The Partnership also sought recent UA graduates for one-year paid fellowships that provide opportunities to serve in health-related capacities in Pickens County. Four fellows joined the Partnership: August Anderson, Laura Beth Hurst, Courtney Rentas and Judson Russell.

They will spend time in Pickens County in community engagement and leadership development activities, which include seminars on health and public policy as well as social determinants of health. They will also work on projects throughout the year.

 

Across the country, rural hospitals struggle to survive. Since 2011, Alabama rural hospitals have closed in Florala, Elba, Clanton, Hartselle, Thomasville and Roanoke. Others cut services, notably obstetrical care.

Pickens County Medical Center, which is county-owned and located in Carrollton, Alabama, had seen layoffs and furloughs and had cut programs and reduced services over the years.

What makes this worse is that rural areas are in more need of health care, as their citizens are typically older, sicker and poorer.

In Pickens County, 27 percent of the population lives below the poverty line and health outcome rankings show that the county is 41st among the state’s 67 counties.

Learn more about the Partnership at cchs.ua.edu/pickenscounty.

20160616_111127

Faculty present at annual meeting of family physicians

Faculty at the College of Community Health Sciences presented about dementia, obesity in the media, pediatric limp and other topics at the annual meeting of the Alabama Academy of Family Physicians, which was held June 15-19 in Sandestin, Florida.

The meeting allows family medicine physicians throughout the state to connect, earn continuing medical education and learn more about representing family medicine in the legislative, regulatory and public arenas.

Pediatric Limp

Your child can’t sleep because his or her legs ache, something parents call growing pains. Doctors refer to this as non-specific limb pains of childhood and estimate that 20 percent of children aged 2 to 12 report mild to severe pain in their legs at night. There are no symptoms in the morning.

“The leg pain must be bilateral and it only occurs at night. The cause is unknown and there is no pain, limp or symptoms during the day,” said Dr. Richard Friend, an associate professor of family medicine for the College and director of its Family Medicine Residency. “We think it’s related to increased activity – moving around a lot during the day, and increased sports.”

Growing pains are often described as an ache or throb in the legs, often in the front of the thighs, the calves or behind the knee. Studies indicate the pains could be a sign of overused muscles.

In addition to growing pains, Friend also touched on other walking-related pain children might face in his presentation, “Pediatric Limp.” Juvenile rheumatoid arthritis can onset between the ages of 4 and 10, he said, and leg pain in children ages 11 to 16 often is a result of overuse.

Friend said when physicians exam children with leg pain, they need to take a good health history of the patient and perform a physical exam. “Observe the patient crawling and walking. Get the child or caretaker to localize the pain. Is it morning or evening pain, or all-day pain? This is important because arthritic pain is a morning pain while leukemia is mostly a night pain.”

When performing a physical evaluation, Friend said “listen to the sound of the feet hitting the floor. Have them stand on their toes and heels and hop on one foot.”

If needed, take x-rays of the area in question, from the hips to the feet, he said, adding that ultrasounds and bone scans can also be useful.

 

Dementia: Differentiating the Types

Physical and mental activity are among the best ways to treat or slow dementia, which affects 25 million people in the developed world and is the sixth leading cause of death, said Dr. Tom Weida, a professor of family medicine for the College and associate dean for Clinical Affairs.

Alzheimer’s dementia is the most common form of dementia and is a clinical loss of memory. “It’s the inability to lay down new memory, and it can lead to paranoia, delusions and an inability to swallow,” Wedia said in his presentation, “Dementia: Differentiating the Types.” He said the clinical presentation of Alzheimer’s dementia is a loss of: memory, executive function, visual-spatial orientation and social graces.

While age is the most common risk factor for dementia, family history, head trauma, depression and obesity also contribute to the risk. Weida said a strong screening tool is a verbal fluency test that requires patients to name as many animals as they can in 60 seconds. If patients name fewer than 15 animals, “it is suggestive of dementia. This is a highly specific and highly sensitive test.”

There are medications that can be prescribed for dementia, but they have side effects and there is limited evidence that they are effective, although they might slow dementia a bit, Weida said. He said non-medication treatments like physical activity and cognitive activity “seem to work the best. Brain stimulation seems to quell dementia states – art, music, reading, crossword puzzles and number puzzles.”

Good health is also important, Weida said, particularly a diet low in saturated fat, and high in fruits, vegetables and folic acid.

 

Interviewing for Residency

The College’s Family Medicine Residency, a three-year program that provides specialty training for physicians, accepts 16 new residents each year but annually receives approximately 2,000 applications. Of those, 150 applicants are interviewed.

“You are competing against a lot of people,” residency Director Dr. Richard Friend told an audience of more than 50 medical students ready to enter residencies.

Across Alabama, family medicine residencies accept only 55 medical school graduates per year. There are just 470 family medicine residencies in the United States. Funding for residency training slots is provided by Medicare, the US health program for the elderly. “There won’t be any new slots any time soon,” Friend said, which makes residency interviews vitally important.

When medical school graduates apply for residency positions, they use the Electronic Residency Application System, or ERAS, which is a system that collects common information from all graduates. “Interviews provide what can’t be seen in ERAS,” Friend said. “Applicants can explain their strengths and weaknesses … and showcase themselves.”

He said the interview process starts when the application is submitted to ERAS. “Don’t do your application the night before. Work hard on it and don’t take it lightly. Proofread it and make sure it’s complete. Spend time on your personal statement. Remember, you’re competing against a lot of people.

Friend said the College’s program, The University of Alabama Family Medicine Residency, ranks the applicants it brings in prior to their interviews. “Some candidates have moved up in rank after the interview,” he said.

Other advice? “Have a professional email address and voice mail message. And find out how you appear online. Social media is a good resource for us,” Friend said.

 

Updates in Adult Primary Care

Dr. Scott Arnold, chair of Internal Medicine for the College, provided a review in literature of the previous year in primary care and shared his recommended changes in practice.

One study he shared looked at the relationship between the use of lipid-lowering statins and a heightened risk for diabetes. More than 3,000 non-diabetic statin users and more than 3,000 non-diabetic statin non-users were studied retroactively, and diabetes developed in 31 percent of the statin users versus 19.4 percent of the statin non-users.

This is consistent with other prior studies, Arnold said.

“This appears to be a real entity,” he said. “It should give us pause only with those with primary prevention patients with borderline benefits. When do the benefits outweigh the risks?”

Another study he shared looked at identifying the community acquired pneumonia (CAP) pathogen and whether or not antibiotics should be used to treat this pathogen.

The study examined 2,200 adults in five hospitals in Chicago and Nashville who demonstrated CAP. Only 38 percent of the cases had an identifiable pathogen, and of those, 23 percent were viruses, 11 percent bacterium, 3 percent were both and 1 percent fungus or mycobacterium.

“We are overusing antibiotics for CAP,” he said. “We need to figure out in the future who needs antibiotics and who doesn’t.”

 

Obesity in the Media

When doctors have conversations with their patients about weight loss, realistic goals must be set, said Dr. Alan Blum, the Gerald Leon Wallace Endowed Chair of Family Medicine for the College.

One-third of the United States is obese and Alabama has led the nation in obesity trends, Blum said in his presentation. But with the media littered with advertisements for sugary drinks and supersized fast food portions, coupled with magazines and TV advertising touting extreme weight loss goals, like losing 30 pounds in 30 days, reality gets skewed, he said.

As a result, many patients arrive into the exam room with unrealistic expectations.

“Many people might suggest that a pound a week is normal weight loss,” Blum said. “But we’re really not ever giving good advice if we’re going to suggest that to our patients. I ask instead, ‘What would you like to weigh?’ People usually have a number. Then I ask, ‘When was the last time you weighed that much?’”

The reality test, he said, is when he asks the patient how long they think it will take to lose the weight.

“If it took 10 years to get there, why would they think it should take three months to get it off?” he says.

Blum thinks more action must be taken to prevent obesity in the first place. He says physicians should make the following suggestions to patients:  support breastfeeding, limit sugary beverages, encourage family meals with less fast foods and more fruits and vegetables, get exercise and spend two hours a day or less on a phone or at a TV.

AAFP-student-officers-web

Medical students elected as student officers for Alabama Academy of Family Physicians

Two medical students at the College of Community Health Sciences were elected to yearlong student leadership positions with the Alabama Academy of Family Physicians.

The University of Alabama School of Medicine students, who are receiving their third and fourth years of clinical education at the College, were named to the positions after an election that took place at the Academy’s annual meeting, which was held June 16-19 in Sandestin, Florida.

D. Paul Strickland, a third-year medical student and a Rural Medical Scholar, was elected the communications chair for the student leaders.

Jessica Powell, a fourth-year medical student and also a Rural Medical Scholar, was elected as the communications liaison to Tuscaloosa.

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 medical students. All students receive their first two years of medical education at the School of Medicine’s main campus in Birmingham.

Four additional medical students from other School of Medicine campuses were also elected to positions.

More than 900 family physicians and more than 430 students and family medicine residents across the state make up the Alabama Academy of Family Physicians. The annual meeting allows members to connect, earn continuing medical education and learn more about representing family medicine in the legislative, regulatory and public arenas.

The 41st Annual Graduation Ceremony honoring the 2016 graduates of The University of Alabama Family Medicine Residency and Fellowships

Residents, fellows honored at graduation

Twenty-one physicians were honored at the 41st annual graduation ceremony of The University of Alabama Family Medicine Residency and Fellowships.

The 14 resident physicians and seven fellows who were honored at the ceremony, held Saturday, June 25, at the Zone-South at Bryant Denny Stadium on the UA campus, will soon begin their own practices in Alabama and other states. Some resident physicians will go on to complete fellowship programs.

The UA College of Community Health Sciences provides graduate medical education through both the three-year Family Medicine Residency and year-long fellowships for family medicine physicians seeking additional training in behavioral health, hospitalist medicine, obstetrics, rural public psychiatry, sports medicine or geriatric medicine.

“We’re very proud of the work this group has done in continuing the mission of the College,” said Dr. Richard Streiffer, dean of CCHS, as he welcomed graduates and attendees.

Dr. A Robert Sheppard, associate professor of Internal Medicine and the director of the College’s Hospitalist Fellowship, was the guest speaker of the ceremony.

He shared with the graduates that he grew up poor on a farm in south Alabama, and that he initially struggled when he came to UA as a pre-med student. His academic advisers discouraged him from pursuing medicine because of his low grades, he said, and he had trouble with reading comprehension and vocabulary.

But he worked diligently, improved and was eventually accepted to the University of Alabama School of Medicine.

“Don’t ever give up,” he said to the graduates. “And don’t ever let someone tell you that you can’t do something.”

Awards were given to many of the graduating residents, including the inaugural William W. Winternitz Award in Geriatrics, which was given to Dr. Michael Gabriel in recognition of his interest in geriatrics and exceptional care of the geriatric population.

Dr. Anne Halli-Tierney, a geriatrician and assistant professor in Family Medicine at the College, presented the award, which is named in honor of Dr. William W. Winternitz, a founding faculty member of the College who passed away in October 2015.

“[Dr. Winternitz] had a passion for the field of medicine and especially for academic medicine and the betterment of medical students and residents.” Halli-Tierney said.

Winternitz joined the College in 1977, serving as professor and chair of Internal Medicine and Director of Medical Student Affairs. He remained active at the College after his retirement.

He and his wife, Madeleine Hill, established the William W. Winternitz Geriatric Gift Fund to support the College’s Geriatric Initiative to provide enhanced educational opportunities for medical students and residents, new service-based learning opportunities and increased patient interaction.

“This award is supported by and named for a man truly dedicated to teaching both patients and medical learners,” said Halli-Tierney. “And it is given to the resident who has shown a solid interest in geriatric medicine and has provided exceptional, compassionate care of the geriatric population during his time at CCHS.”

 

2016 Graduating Fellows:

Dr. Nicole Denise Arthur, Obstetrics Fellow
Dr. Alexis Tanishia Mason, Behavioral Health Fellow
Dr. Byron Oswaldo Mata Gonzalez, Hospitalist Fellow
Dr. Bogdan Strambu, Hospitalist Fellow
Dr. Antoanela Zaharia, Hospitalist Fellow
Dr. Matthew David Andres, Sports Medicine Fellow
Dr. Carl Hunter Russell, Sports Medicine Fellow

 

2016 Graduating Residents:

Dr. Chandra Rekha Americhetty
Dr. Sirisha Chada
Dr. Mary Margaret Clapp
Dr. Jason Lee Clemons
Dr. Eric James Curley
Dr. Timothy Scott Eckford (chief resident)
Dr. Michael Daniel Gabriel
Dr. Katie Marie Gates (chief resident)
Dr. Maysoon Hamed
Dr. Ambreen Mardhani
Dr. Bhavika Rajanikant Patel (chief resident)
Dr. Jerry Yue Shen
Dr. Ross Alexander Summerford

 

Residency Award Winners

William R. Willard Award – Dr. Jacquelynn Luker (first-year resident)
Internal Medicine-Intern Award – Dr. Jacquelynn Luker
Internal Medicine-Best Resident – Dr. Katie Gates and Dr. Ross Summerford
Pediatrics Award – Dr. Eric Curley
Psychiatry Award – Dr. Bhavika Patel
Psychiatry/R3 Award – Dr. Jason Clemons
Obstetrics and Gynecology Award – Dr. Michael Gabriel
Research/Scholarship Award – Dr. Mary Margaret Clapp, Dr. Katie Gates, and Dr. Ambreen Mardhani
William W. Winternitz Award in Geriatrics – Dr. Michael Gabriel
Society of Teachers in Family Medicine Teaching Award – Dr. Jason Clemons
Clinical Competency Committee Awards –  Dr. Jason Clemons (third year), Dr. Keri Merschman (second year), Dr. Cheree Melton (first year), and Dr. Ashley Wambolt (first year)
William F. deShazo III Award – Dr. Ross Summerford
360 Award – Dr. Katie Gates

 

Rural Medical Scholar Graduates Recognized
Dr. Jason Clemons
Dr. Katie Gates
Dr. Ross Summerford
The College’s Rural Medical Scholars Program is designed to recruit students from rural Alabama who want to become physicians and practice in rural communities in the state.

For more coverage of the event, including photo galleries, click here.

Mini Med School series with OLLI continues

There are times patients might ask their doctors for medications and tests that might not be necessary and that could cause harm, according to Dr. Ray Brignac, a family medicine physician who practices at University Medical Center-Northport, which is operated by the College.

During a lecture that was part of the College’s Mini Medical School program with The University of Alabama’s OLLI program, Brignac said doctors and patients need to talk and to use evidence-based recommendations to make the best care decisions possible.

“You need to put as much research into your medical decisions as you do buying a car or a washing machine,” he said. “There’s a lot of information out there. Try to go where the evidence is.”

A national campaign called Choosing Wisely advocates just that. The campaign encourages doctors and patients to have conversations informed by evidence-based recommendations that facilitate good decisions about appropriate care based on a patient’s individual situation, and to avoid unnecessary medical tests, treatments and procedures.

“The Choosing Wisely campaign gives us good tools to be better informed and wiser,” said Brignac, who titled his lecture “Choosing Wisely in Geriatrics.”

OLLI, short for Osher Lifelong Learning Institute, is a member-led program educational program catering to those aged 50 years and older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for OLLI members and community learners to explore trends in medicine and health and to receive important information about issues and advances in medicine and research.

Brignac presented on May 3, and Dr. Catherine Ikard, a physician at University Medical Center and UMC-Northport, presented on May 10.


Choosing Wisely in Geriatrics
Brignac said older people often have more medical conditions and, as a result, take more medications than younger people. While medications have benefits, they also carry risks. “Is it always wrong to take medications? No. But you need to exercise caution,” he said.

He noted that sleeping pills help with insomnia, which affects many people over the age of 60, but studies show increased falls by those taking sleeping pills. Antibiotics do not cure colds and have risks, including diarrhea and damage to nerves and tendons. Nutritional supplements have the potential to react with other medications. Narcotics are not always the best way to treat chronic pain and non-drug interventions like exercise and physical therapy are sometimes more  effective. Non-steroidal anti-inflammatory medications like Aleve and Ibuprofen are safe but can sometimes cause gastrointestinal bleeding and increased risk of heart attack or stroke, and while acetaminophen, found in Tylenol, is a good medication, if taken in excess can damage the liver. Medications for heartburn and acid reflux can carry higher risk of osteoporosis, but sometimes avoiding certain foods and sleeping with the head of the bed raised can help.

“It’s not that you shouldn’t ever take these drugs, but you need to be aware of the risks,” Brignac said. “It’s always good to questions medications – are there alternatives, lower doses?”

Many older patients have low back pain and often ask for X-rays or MRIs, Brignac said. He recommends patients wait a month before tests because most back pain clears up in that time. “If you jump right into testing, you can create needless anxiety, or you might wind up under the surgeon’s knife unnecessarily.”

Brignac joined University Medical Center-Northport last year after a 34-year practice at Selma Medical Associates in Selma, Ala. In addition to family medicine, Brignac also has an interest in geriatrics and nursing home patients and is working to build a “hands-on” nursing home practice in Northport and Tuscaloosa.

Recognizing, Treating and Preventing Strokes
If you suspect someone you know is having a stroke, the most important information that can be relayed to the EMT or physician treating that person is the last known well time, said Dr. Catherine Ikard.  This will determine the course of treatment.

Ikard, assistant professor in Psychiatry and Behavioral Medicine and Internal Medicine, spoke about the causes, symptoms and treatments of strokes at a lecture she presented as part of the College’s Mini Medical School with The University of Alabama’s OLLI program.

OLLI, short for Osher Lifelong Learning Institute, is a member-led educational program catering to those aged 50 years or older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for adults and community learners to explore trends in medicine and health, and the lectures by CCHS faculty offer important information about issues and advances in medicine and research.

One of the best ways to identify if someone might be having a stroke is to ask the person to smile. If the smile is lopsided or there is drooping, the person might be having a stroke, Ikard said.

If a stroke is caused by a blood clot, a medication called a tissue plasminogen activator, or tPA, may be given within four and a half hours of the last-known well time, said Ikard.

After four and a half hours, or if the patient cannot receive a tPA for medical reasons, endovascular therapy can be used, which involves the use of a stent retriever that a doctor routes through a catheter to the blocked artery and removes the clot, Ikard said.

“If you suspect a stroke, call 911,” Ikard said. “If it is a stroke, every 30 minute delay could lead to a 10 percent relative reduction in recovery.”

Wilamena_Hopkins

Coordinator of UA-Pickens County Partnership joins College

Wilamena Hopkins has joined the College of Community Health Sciences as the project coordinator for the UA-Pickens County Partnership, an effort that seeks to provide sustainable health care for the rural county and “real world” training for UA students.

The partnership of UA and Pickens County and its medical center will allow students in medicine, nursing, social work, psychology, health education and other UA disciplines to gain practice from internships and other learning opportunities in Pickens County, and the rural county will gain additional health resources.

Hopkins will be located primarily in Pickens County at its medical center and will direct and facilitate overall development, oversight implementation and administration for the project and serve as a liaison into the community and promote the partnership and its projects to the people of Pickens County and the UA community.

Approximately $600,000 was obtained from the Alabama Legislature in 2015 for the project, and the funds will be used for projects that address health needs in Pickens County, for fellows to serve in health-related capacities in Pickens County and for the project coordinator.

Four recent UA graduates have been selected for a one-year fellowship that will provide opportunities to serve in health-related capacities in Pickens County.

The projects that address an identifiable health issue or priority within the Pickens County community must involve UA faculty, students and a Pickens County community organization or similar entity.

The grant projects include:

1. Disseminating the Power PATH mental health preventive intervention to Pickens County Community Action Head Start Program
Principal Investigator: Dr. Caroline Boxmeyer, associate professor of Psychiatry and Behavioral Medicine at CCHS
Co PIs: Dr. Ansley Gilpin, assistant professor of psychology at UA, and Dr. Jason DeCaro, associate professor of anthropology
Collaboration: Pickens County Community Action Head Start Program

2. TelePlay: Connecting physicians, families and autism professionals to increase early autism identification in Pickens County
PI: Dr. Lea Yerby, assistant professor of Community and Rural Medicine at CCHS
Co PIs: Dr. Angela Barber, assistant professor of Communicative Disorders and the clinical research director of Autism Spectrum Disorders Clinic at UA
Collaboration: Dr. Julia Boothe, family medicine physician in Pickens County

3. Improving Pickens County Residents’ Knowledge of Risk Factors for Cardiovascular Disease and Type 2 Diabetes
PI: Dr. Michele Montgomery, assistant professor at the Capstone College of Nursing
Co PI:  Dr. Paige Johnson, assistant professor at the Capstone College of Nursing
Collaboration: Pickens County Community Action Committee & CDC, Inc., Pickens County Board of Education, Pickens County Head Start, and the Diabetes Coalition

4. Development of a Rural Family Medicine Residency in Pickens County
PI: Dr. Richard Friend, director of the College’s Family Medicine Residency
Collaboration: Jim Marshall, CEO of Pickens County Medical Center; Deborah Tucker, CEO of Whatley Health Services

5. Pickens County Medical-Legal Partnership for the Elderly
PI: Gaines B. Brake, staff attorney with the Elder Law Clinic at The University of Alabama School of Law
Collaboration: Jim Marshall, CEO of Pickens County Medical Center

6. Improving Access to Cardiac Rehabilitation Services in Pickens County
PI: Dr. Avani Shah, assistant professor of Social Work at UA
Co PI: Dr. Jonathan Wingo, associate professor of Kinesiology at UA
Collaboration: Sharon Crawford Wester, RRT, Cardiopulmonary Rehab Pickens County Medical Center

7. Alabama Literacy Project
PI: Carol A. Donovan, professor of special education and multiple abilities at UA
Collaboration: Jamie Chapman, Superintendent of Pickens County Schools

8. Bringing Healthy Food options and ease of preparation home to our senior adults
PI: Jennifer Anderson, director of Osher Lifelong Learning Institute at UA
Co PI: Suzanne Henson, dietitian and assistant professor in Family Medicine at CCHS
Collaboration: Anne Jones, Pickens County Family Center and Mayor Joe Lancaster, City of Carrollton, Alabama

 

Morales-Aleman_Headshot

Faculty joins Institute for Rural Health Research, Community and Rural Medicine

Dr. Mercedes Morales-Alemán has joined the College of Community Health Sciences as an assistant professor in the Department of Community and Rural Medicine and the Institute for Rural Health Research.

Morales-Alemán researches health disparities and health promotion among Latino populations in the southeastern United States through a community-based participatory lens.

She received her bachelor’s degree from the University of Puerto Rico, and her master’s and doctoral degrees in ecological-community psychology from Michigan State University.

Morales-Alemán was a research fellow for the Centers for Disease Control and Prevention in the Division of HIV/AIDS Prevention. At the CDC, she studied the multi-level predictors of intimate partner violence and access to HIV services in ethnic minority communities at risk for or living with HIV and AIDS.

She recently completed a training fellowship in Preventive Medicine at the University of Alabama at Birmingham, where she studied the social determinants of sexual health and health care access among adolescent Latinas in the South.

“I look forward to contributing to the University’s mission of excellence in research, teaching and service and to the Institute’s mission of bringing the highest attainable standard of health to rural citizens,” she says.