Longtime College supporter honored for contributions to community

Madeleine Hill, a longtime supporter of the College of Community Health Sciences and an alumna of UA’s School of Social Work, was honored at the 2017 Central Alabama Women of Distinction Awards Luncheon earlier this month.

Hill received the Karen LaMaoreaux Bryan Lifetime Achievement Award during the luncheon, held at the Harbert Center in Birmingham. The Women of Distinction Awards are presented to honor women who have made special contributions to their communities through civic, academic or professional efforts and who are exemplary role models for girls and young women.

Hill and her husband, Dr. William Winternitz, an internist and longtime CCHS faculty member, provided a significant gift to the College for a Geriatrics initiative that provided the initiative for establishing a Geriatric Fellowship at CCHS.

“There is an acute need for any viable medical school to address the surge in (the aging) population that we are experiencing,” Hill said at the time. She and her husband said they hoped their contribution would help the College create awareness about the need for the study of Geriatrics to deal with the distinct issues of older adults, and to promote care of their health. They also expressed hope that their efforts would help the College, which also functions as a regional campus of the University of Alabama School of Medicine, attract future medical students and resident physicians interested in practicing Geriatrics.

Hill has a degree from Huntingdon College and a Master’s in Policy and Planning from The University of Alabama School of Social Work. She has served as a consultant to United Way of West Alabama and Tuscaloosa City Schools.

She helped establish Hospice of West Alabama, one of the first hospices in the state. She also served as the executive director of West Alabama AIDS outreach.

Hill was the founding president of the board of directors for Habitat for Humanity and was a founding member of Tuscaloosa’s One Place board of directors. She was named a Pillar of West Alabama by the Community Foundation of West Alabama, and she received the Howard Gundy Award for Exceptional Service to the School of Social Work by The University of Alabama.

WVUA: CCHS to hold Brussel Sprout Challenge

Dr. Richard Streiffer, Dean at the College of Community Health Sciences discusses the history of the Brussel Sprout Challenge.

WVUA Report: Dealing with Allergy Season

Segment on 2017 allergy season with commentary from Dr. Richard Streiffer, Dean at the College of Community Health Sciences.

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.

UA News: UA’s CCHS Hosts Brussels Sprout Challenge at Heart Walk

The University of Alabama’s College of Community Health Sciences will once again be hosting the Brussels Sprout Challenge during the American Heart Association West Alabama Heart Walk on Saturday, March 25.

The College is partnering with Manna Grocery and Deli to roast and serve Brussels sprouts at the walk, which will start at 8 a.m. March 25 at the Tuscaloosa Amphitheater. Last year, more than 900 Brussels sprouts were distributed at the challenge.

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.

CCHS hosts two Cuban physicians, discusses health care topics as part of UA Cuba Week

October Mini Med School Topics: Women’s Health, Injury Prevention and Telemedicine

Breast cancer is the second leading cause of death among women, so prevention and screening are important, not only for breast cancer but also for other gynecologic cancers, according to Dr. Kristie Graettinger, associate professor and chair of the College’s Department of Obstetrics and Gynecology.

Graettinger provided a presentation, “Women’s Health Update: Cancer Prevention,” at the Oct. 20 Mini Medical School program conducted in collaboration with UA’s OLLI program.

In addition to her presentation, three other faculty members presented during the month of October. Dr. Ray Stewart, assistant professor of Sports Medicine, talked about “Preventing Injury” on Oct. 6, and Dr. Karen Burgess, chair of Pediatrics, gave a presentation on “Telemedicine” on Oct. 13.

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 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.

In her presentation, Graettinger said to think of cancer prevention as three tiers: “prevention, screening and treatment.” Prevention is interventions to reduce the risk of cancer, including maintaining a healthy weight, being physically active, having a diet high in fruits, vegetables and whole grains and low in processed foods and red meats, and receiving vaccinations that can protect against cancer, such as the HPV vaccine for cervical cancer. Examples of screening include mammograms for breast cancer and pap smears for cervical cancer.

“The goal is first to try and prevent cancer, and also to identify people at risk for the disease,” Graettinger said.

Breast cancer is the second leading cause of death among women, right behind lung cancer, and will affect 1 in 8 women in their lifetimes. Approximately 250,000 cases of breast cancer are diagnosed every year.

Having a first-degree relative, such as a mother or sister, with breast cancer doubles the risk, but that amounts to only 15 percent of women diagnosed. Breast cancer screening includes mammograms, clinical exams performed by a physician or health professional, breast self-exams and genetic testing.

A mammogram is an x-ray of the breast. Currently there is not a consensus among organizations about the age a woman without a family history of breast cancer should be – ranging from 40 to 50 – to begin receiving annual mammograms.

There is recent evidence that clinical breast exams might not be helpful for women without symptoms of breast cancer, “but have that discussion with your doctor,” Graettinger said. She added that the concept of breast self-exams has shifted to “being aware of your breasts.”

For women with the inherited BRCA gene mutation, “this is serious business and increases the risk of breast cancer from 1 in 8 to 1 in 2, or by 50 percent, and the risk of ovarian cancer is 10 times greater,” Graettinger said. Having the BRCA gene is “not extremely common, but it’s not rare,” she said, adding that women with a personal history of breast cancer should consult with their physicians about this genetic testing.

Other gynecologic cancers include cervical, ovarian and uterine cancer. Of those, only cervical cancer has a screening test – pap smears, which detect precancerous changes on the cervix. Pap smears are now recommended every three years for women ages 21 to 65.

Ovarian and uterine cancers are detected by signs and symptoms, “which is scary because sometimes these are found in the later stages,” Graettinger said. Symptoms of ovarian cancer are vague and include pelvic and abdominal pain and pressure, bloating and feeling full quickly, and irregular bleeding. Approximately 20,000 cases of ovarian cancer are diagnosed annually. Pressure, pain and bleeding after menopause are common symptoms of uterine cancer, which primarily strikes women over the age of 50.
In Stewart’s presentation, he said that “sprains and strains are where the vast majority of injuries are occurring.” The most common sports injury is an ankle sprain, followed by a groin sprain and a hamstring sprain.

Stewart said the goal is to introduce preventive measures to avoid the injury. A warm up is a good way to do that. A warm up should get the body moving, introduce a light sweat and “literally warm up the muscles,” he said.

Stretching is a good way to prevent injuries, too. There is dynamic stretching, which are bouncing, jerking movements, static stretching, which are slow, deliberate movements that are held for about 20 seconds, and then proprioceptive neuromuscular facilitation, or PNF stretching, which combines static stretching with isometric movements to increase flexibility.

To prevent an ankle sprain, Stewart suggested wearing an ankle support to reduce the risk and to conduct balance training: stand on one leg in order to train muscles to support the ankle.

To prevent a hamstring sprain, Nordic hamstring exercises are best, Stewart said.

There is a higher injury rate of the ACL in women, and prevention requires regular exercises. Plyometrics, known as “jump training” help may reduce an ACL injury, but must be performed throughout the athlete’s season. After the participant stops performing the training exercises, he or she becomes at risk for injury again.
Burgess introduced many of participants in the Mini Medical School series to the concept of telemedicine for the first time.

Telemedicine is any medical information exchanged from one site to another through the use of technology. It could be a phone or computer.

“We use it to improve access to care,” said Burgess.

Many parts of Alabama are rural and are underserved in primary care and specialty care providers. Unfortunately, many of the underserved areas in Alabama are also areas with limited connectivity, which makes it difficult to access telemedicine, Burgess said.

Burgess spoke about CCHS Telemedicine and Telehealth efforts, including the asthma education program that she and Beth Smith, a nurse practitioner in pediatrics at University Medical Center, have led. Students at Greensboro Elementary School in Hale County and their parents are taught through telemedicine about asthma symptoms, medication and treatment. The program teaches  students how to use a spacer with their asthma inhaler for more effective usage of their medicine.

The program so far has revealed that students and parents are learning more about asthma and how to treat it.

One participant said: “Until today I had no idea what telemedicine was. Thank you for coming here and telling us about that today.”

 

Parkinsonism, ADHD in Grandchildren and Geriatric Depression topics in fall semester of Mini Med School

Mini Medical School is back in session this fall semester. The University of Alabama College of Community Health Sciences kicked off its second semester of the lecture series for UA’s OLLI program that has been put on by faculty and resident physicians at CCHS.

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 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.

Parkinsonism — Dr. Catherine Ikard

Many people think of Parkinson’s disease as a single disorder, but it is actually more complicated than that, said Dr. Catherine Ikard, a neurologist at University Medical Center and assistant professor of Internal Medicine and Psychiatry and Behavioral Health for the College.

Parkinsonism is a syndrome characterized by decreased movement and is associated with tremors and a loss of balance, Ikard said at her lecture, titled “Parkinsonism and Parkinson’s Disease,” which she presented as part of the Mini Medical School series on Sept. 15.

Parkinsonism can appear in an array of disorders, some even as a result of repeated head trauma or medication, but the most common one—the one most people refer to when they think of Parkinson’s Disease—is Idiopathic Parkinson’s Disease.

Idiopathic Parkinson’s Disease is the progressive loss of dopamine-producing cells in the brain. The disease is slow and degenerative. “We don’t know why this happens,” Ikard said.

There are motor symptoms, which include shaking, smaller and slower movements, becoming stiff and losing balance more easily. Motor symptoms usually start on one side of the body. Tremors can worsen when the patient is at rest, and they are suppressible by concentration.

Non-motor symptoms include affective disorders, such as depression, orthostatic hypotension (when blood pressure falls significantly when standing up too quickly), memory impairment, fatigue, constipation and sleep disturbances.

There is no test for Idiopathic Parkinson’s Disease, Ikard said. The diagnosis is clinical. “We often have to watch a tremor over time—months, sometimes years,” Ikard said.

Medication and therapy can help treat symptoms, Ikard said. The most common medication is Levodopa, and physical and speech therapy can help improve lifestyle. “I cannot emphasize enough how important therapy is for patients with Parkinsonism,” said Ikard. Exercise improves symptoms, too, she said.

There are clues that the disorder might not be traditional Idiopathic Parkinson’s Disease, Ikard said.

Some of these include: rapid progression of the disease, absence of tremors, frequent falls early in the disease, abnormal eye movement and poor response to Levodopa. If that is the case, the Parkinsonism could be tied to another disorder.

Grandchildren and ADHD — Dr. Brian Gannon

Children are very active from the ages of 2 to 5, but that busyness should decrease over time, said Dr. Brian Gannon, a pediatrician at University Medical Center and an assistant professor of Pediatrics for the College.

But as children get older and if they are easily distracted, can’t stick with a task for a reasonable amount of time and their activity level is not appropriate for their age, they could suffer from ADHD, or attention deficit hyperactivity disorder.

“ADHD is defined as an activity level that is inappropriate for age, that interferes with school work, that causes trouble in dealing with adults,” Gannon said during a lecture on Sept. 22, titled “Grandparents and ADHD.”

Gannon said about 5 percent of the general population in the US qualifies for an ADHD diagnosis. He said sometimes the markers of what appears to be ADHD are actually caused by other medical issues. He said hearing, vision and speech problems can cause some of the same symptoms of ADHD, as can developmental delays, autism and sensory processing disorder.

“We want to look at medical issues because they may cause similar issues to ADHD,” Gannon said.

A child’s living situation – unstable home environment, varying and inconsistent rules and food insecurity – is also a factor. “My job as a physician is to advocate for the child and help parents problem solve. We don’t want to just throw medicine at a child.”

Gannon said medication can help and should be part of efforts to manage ADHD, but is only part of the answer. “Children still need to follow the rules, and do their work. With medication, they can do it without your help.”

Geriatric Depression — Dr. John Burkhardt

Older adults are at risk for depression. One reason: The more medical burdens one has, the higher the risk of depression, said Dr. John Burkhardt, a clinical psychologist with University Medical Center-Northport.

“Chronic pain conditions can be managed, but you never get a break from them. Heart problems can precipitate depressive episodes, and then you have to eat differently, go to physical therapy and deal with a chronic condition. What does that do to your mood?” said Burkhardt, also an assistant professor of Psychiatry and Behavioral medicine for UA’s College of Community Health Sciences, which operates UMC-Northport.

His remarks came in a lecture titled “Geriatric Depression” that he provided on Sept. 29 as part of the Mini Medical School lecture series.

Burkhardt said changes in previous functioning, pain and sleep disruption, significant weight gain or loss, a loss of interest in activities, a sad and depressed mood, a feeling of being a burden – and if those conditions and feelings go on for two weeks or more – could signal possible depression. “A lot of people go through sad times. But when it starts to impact your functioning, that could be depression.”

With older couples, depression can also be “contagious,” Burkhardt said. “If one spouse is depressed, the other spouse is at an increased risk of depression.”

Late-life depression, which happens after the age of 60, can carry added risk because it can transition to dementia, Burkhardt said.

He stressed that depression needs to be treated, particularly in the elderly, who might not seek care because of an associated perceived stigma. He noted that suicide is the 17th leading cause of death in those aged 65 and older.

“When you’re depressed, you’re not good at coping with your physical conditions. Depression impacts the person who is experiencing it, and their families. Who wants to visit people when they aren’t happy? Then they’re alone.”

Burkhardt recommended that people watch for changes in behavior, thoughts, appetite, sleep and whether they lose interest in activities once important to them. “See a provider if you suspect depression. Don’t let stigma keep you from getting help. Don’t isolate yourself. Be social, stay active and have a daily structure.”

 

Flu Shot Campaign Begins

The annual University of Alabama flu shot campaign, an effort by the University to protect students, faculty and staff from the flu, kicked off Sept. 7. Flu shots will be provided during the months of September, October and November at locations across campus, including the Quad, University buildings and student residence halls. The shots are free and no insurance is required. The goal of the flu shot campaign, which is led by UA’s College of Community Health Sciences, is to make getting a flu shot as easy and convenient as possible. Last year, more than 8,000 vaccinations were given.