Contact Sports and Concussions: A Real Threat to Student Athletes

May 30, 2011 by · 1 Comment 

 

Coach checks player for concussion symptoms.

Athens, GA––For many athletes, summer means grueling pre-season training sessions in the sweltering heat. As such, legions of Georgia parents will enroll their children in football camps, hoping that one day their boy will become the next Matt Ryan or Aaron Murray. Unfortunately, there could be a steep price attached to seeing their child shine in peewee football.

Each year, school-related contact sports cause about four million concussions. Kids playing football, soccer, and ice hockey are the most likely to end up in the ER as a result of such brain injuries said Dr.Margot Putukian, the director of athletic medicine at Princeton University.

Children aged 11 to14 are the most susceptible to head injuries, on and off the field, because they are most likely to take ill-considered risks, Putukian said. Problems intensify for kids who play contact sports, which increase the chance of re-injury after a first concussion, and introduce more dangerous repercussions.

The more times a child’s brain is injured, the more likely he or she is to lose cognitive function, become depressed, or even die as a result, said Dr. Jack Jallo, a professor of neurosurgery at the Thomas Jefferson University Medical College in Philadelphia.  Student athletes may be unable to pay attention in school, earn lower grades, or no longer be competitive for the college scholarships they desperately want.

In impoverished neighborhoods where athletic accomplishment is the only possible route to college, studies show far more concussions each year than in affluent areas.

“Kids are willing to take significant risks so that they can continue to play,” Jallo said.  “And for a lot of these inner city kids I see, they don’t have another future planned. Sports are it.

Many believe that costly helmets fully protect from brain injuries. In reality, they only provide a false sense of security, said Dr. Matt Grady, who specializes in pediatric sports medicine at the Children’s Hospital of Philadelphia. Helmets may lessen impact, turning a potentially severe brain injury into a more moderate one, but they won’t keep the brain safe, he said. Jallo agrees. “ Just because you’re wearing a helmet doesn’t mean you’re immune to head injuries,” he said. “You can’t just have a helmet on and then use your head an a weapon against opposing team players.”

The best protectors against concussions, Putukian said, are the coaches and athletic trainers on the sidelines. Rapid detection of concussions is crucial for the health of young athletes. Unfortunately, many concussions go undetected at the middle and high school level.

This is partly due to the high costs of hiring qualified athletic trainers said Michael Ferrara, the director of athletic training at the University of Georgia.  Athens-Clarke and Oconee County student athletes are fortunate because their school budgets are still paying for athletic trainers, although some work only part-time. Athens-Clarke County schools receive help from athletic trainers only a few times a week or on game days.

This puts assessment of possible brain injury in the hands of coaches during routine practices. And these coaches may be relying on criteria that aren’t completely up-to-date. The old rule was that a player had to lose consciousness, at least for a few seconds, in order to truly have a concussion, Putukian said.  Doctors now realize that only 10 percent of concussions involve being “knocked out,” and often a child may act normal only to develop symptoms later. That’s why, she said, it’s vital that coaches know how to screen for symptoms.

The best sideline test for concussions is a toolkit such as the one available online from the Centers for Disease Control and Prevention, Grady said. The toolkit provides guidelines for testing kids, as well as a list of key symptoms including loss of balance, nausea or vomiting.

Jallo urges coaches to test for a concussion at intervals because a kid who seems fine right after the big hit may worsen over the next hour or so. One of the best ways is simply to ask the youngster questions about where they are or what they were doing during the hours before the injury.

Still the best solution for concussions and other brain injuries is not to have one, Jallo said, but he realizes that these are impossible to eliminate from sports. “ I doubt knowing the risk for a concussion is going to stop parents from putting their kids in the game,” he said. “But the important thing is that if we are going to put our children in these sports and condone them, we should be able to protect them as well.”

Sustainable farmers have feet in dirt, eyes on future

May 11, 2011 by · Leave a Comment 

From the road, Wakefield Farm’s pastures look  like most lining Highway 172 to Hartwell: brilliant green fields, studded with stands of trees  and dotted with cows. But in fact this 1500-acre cattle farm bears scant resemblance to most cattle operations in Georgia. Wakefield’s owner and manager want to raise and sell top-quality beef, but they also strive to protect the land and water where their cattle breed, graze and grow to market weight.

Organic, locally-grown foods are available nearly everywhere these days. Farmer’s markets park trucks and pitch tents on small town squares, and in the hustle and bustle of cities.

But agriculture isn’t just about vegetables, it’s also about the poultry, beef, pork and dairy products shoppers buy in grocery stores, whether it’s a Whole Foods or, now that the country’s largest retailer has jumped on the healthy eating bandwagon, a Walmart.

And Georgia plays a major role in stocking those coolers.

Poultry and livestock farming is big business in Georgia, which holds the top spot for broiler production in the US and brings about  1 million cows and calves to market annually.

Hart County – Wakefield’s home – is a small land area but a major force in animal production. The county generates the second largest income in the state for livestock, poultry and their products, and nationwide ranks 126 out of 3,079 counties in the entire country.

Although livestock is economically essential for Hart County and for Georgia’s economy, this type of farming can take a major toll on land scarred by the region’s history.

Much of Georgia’s best topsoil now lies on the bottom of streams, loosened and depleted by years of cotton farming.

“Now you just scuff your toe on the ground and you’re hitting red clay,” said Robert Tate, who works with students in UGA’s organic certificate program.

Georgia farmers now grow a more diverse array of crops than they once did and many former cotton fields are now pastures. While this helps soil quality rebound, herds of  thousand-pound, hoofed animals can still have a rough impact on land and water.

Sustainable farming practices, aimed at protecting soil, water and the whole ecology of the farm, are a way to give back to the land that feeds him, says Wakefield manager Scott Fleming. “If this is my livelihood, what I depend on to eat, to put money in my pocket,” he said, “wouldn’t you think I’m going to try my best to protect that?”

Fleming and Asa Phillips, Jr., who owns Wakefield, are determined to keep the farm’s land intact and healthy for future generations.

On a traditional livestock farm, cows may wade into streams to drink and cool off, eroding banks and fouling water. At Wakefield, fencing and knee-high grass act as buffers for nutrient runoff and keep the cattle’s contact with water at a minimum.

Instead, massive concrete tanks with underground piping have been installed throughout the pastures to provide accessible, clean water for the cows. And since cattle have a habit of trashing their most frequently visited spots, specially made fabrics – called geotextiles – are placed under gravel in heavy use areas to prevent erosion and mud from piling up.

To give the ground time to recuperate, cows are rotated from pasture to pasture and act as natural lawnmowers. Fields of long grass lining paddocks are planted without tilling the soil and will later be harvested to make hay. To support the local economy, Wakefield uses poultry litter from nearby chicken houses when possible.

While Wakefield is taking strides to remain in the forefront of sustainable livestock farming, it is not an organic farm. They occasionally use synthetic fertilizers and pesticides, and they sometimes supplement their mostly grass-fed cattle with grain.

Although organic production is defined and standardized by the government, sustainable agriculture doesn’t fit into such a cookie-cutter mold.

Sustainability isn’t just about avoiding pesticides and hormones. It’s an umbrella term, and organic is just a piece of the pie, says Gary Hawkins, a pollution prevention specialist at UGA.

Instead, sustainability is about systems and studying the specific situation of each farm, says Julia Gaskin, the sustainable agriculture coordinator at UGA. It isn’t as easy as slapping a “sustainable” label on a farm or product.

What sustainable does mean, she says, is balancing profitability, environmentally conscious behavior and quality of life across generations.

The prospect of earning slow returns on major investments explains why more farmers don’t adopt sustainable practices.

Many farmers can’t justify the higher up-front costs of switching to alternative practices, which can require more time, manpower and management than conventional agriculture. “Management-wise, conventional agriculture is simpler,” said Tate, from the UGA organic program.

“It’s not necessarily a quick turnaround,” said UGA’s Hawkins. “But that high initial input for some practices should provide long-term benefits down the road.”

Modest financial incentives are available to farmers through government agencies like the USDA to conserve water, soil and other natural resources. Through the Conservation Reserve Program with the Natural Resources Conservation Service (NRCS), farmers can get assistance to implement resource-saving practices.

Wakefield takes advantage of such cost-share programs, but Fleming says that many farmers don’t see the point. Why would you spend money on water tanks when there’s a creek running through the pasture?

Commitment to the future, a love of farming, and financial resources are needed to think beyond the immediate cash-flow model. “It takes a real degree of personal responsibility,” said Gaskin. “We need to think about it terms of our own personal choices and our lives.”

Public support is also crucial: local extension agencies provide information and tools for farmers who want to shift to sustainability. Wakefield turns to UGA for help with soil testing, pest management and other issues that pop up.

“We have a real good relationship with them [UGA] and it’s a real benefit to us,” said Fleming, the farm manager.

Even small steps make a difference. “You need to get people on the path and keep them moving that way.” said Gaskin.

Hart County farmers are taking steps to become leaders in sustainable practices. In 2007, 164 of the county’s 657 farms reported using conservation methods, the second highest number in the state behind neighboring Franklin County.

For farmers like Fleming, implementing sustainable practices just makes sense. “To me, it’s a no-brainer,” he said. “We’ve got to take care of this [land] if we expect it to take care of us.”

Using Mobile Apps for Health Could Result in Risks

May 6, 2011 by · Leave a Comment 

Sole reliance on smart phone technology could result in risks.

Text messaging, email, digital photography, GPS, web surfing… and health.

When smart phones or tablets are used to make personal health decisions, manage medical care or transmit health information, they become part of a rapidly expanding field know as mHealth.

Doctors, patients, healthcare administrators and even students in UGA’s New Media Institute are  paying attention and getting involved with wireless innovations related to health. If you operate on Gizmodo time, then mHealth is not a new concept. Experts have been excited about  its benefits – and concerned about pitfalls — for years.

Dr. Joseph Kim is one of them.

Originally trained as  a physician, he has founded three websites focused on medicine and technology and become an mHealth pundit who speaks often to professional groups. Last month he cautioned an audience of journalists that the world of health-related mobile apps is a wild frontier where anything can happen.

Anyone with the technical know-how can develop an mHealth app, they aren’t regulated by any government agency or medical association, erroneous information may be built into them and an app might violate individual privacy, Kim told the Association of Health Care Journalists.

No special credentials are needed to develop an app and classify it as “health” or “medical,” said Kim, and distribution through  iTunes and similar services for other platforms is near universal.

At the University of Georgia’s New Media Institute (NMI), students who develop health-related apps for smart phones are not required to have any training in health or medicine.

“We think it [the cell phone] is a really potentially useful tool for communicating important personal information about health to people,” said Dr. Scott Shamp, director of the institute.

The NMI has been operating in the mHealth space since 2004, when students spent one day producing mobile PSA’s encouraging individuals to be checked for HIV status.Now, students devote entire semesters to develop “promo”-types – designed to show the range of technical possibilities – of applications showing how technology could be used to advance personal health, said Shamp.

Although student projects at the NMI are never intended for distribution to the public, the fact that students can make them indicates how simple it is for a tech-savvy group to produce these apps. Students earn a  New Media Certificate by successfully completing four courses, including the one where they have the opportunity to design health apps.

“Our focus is on idea generation,” said Shamp, whose students build apps that encourage people to exercise more, or eat less, but do not venture into wireless manipulation of diagnosis, disease management, or medical treatment.

Like Kim, Shamp knows this is no place for amateurs.

“You get into a whole lot more dangerous realm when you start talking about collecting healthcare information,” Shamp said, “that’s one thing that people consider to be very private.” People see health information as highly personal, because lives can be upended by  stigma and discrimination related to health status.

That said, phones are also highly personal “When was the last time you let someone see your phone?” Shamp asked.

Since people are less likely to share their cell phone with others, they may assume that the information uploaded into mHealth apps is secure as well. But, we are quickly finding out about the grave potential of privacy breaches from cell phone makers and service providers: consider the recent tracking revelation with Apple.

Because there are no  regulations or legal protections associated with mHealth apps, naïve patients  may  place their own health, or health information, at risk by using them, said Kim.

Felicia Harris is a graduate student at the University of Georgia. With a concentration in Mass Media, she is interested in the media’s effects on people’s well-being and livelihood.

 

Walking Fast May Mean Longer Life for Elderly

May 6, 2011 by · Leave a Comment 

MONROE, Ga. – A recent study suggests that doctors can learn a great deal simply by timing how long it takes an older person to walk a set distance at a normal pace. In fact, they can gain some idea of how long that person will live.

Researchers who analyzed walking speed and survival for nearly 35,000 seniors concluded that gait speed could become a new “vital sign” that can be used to predict how long people will live.

“Walking is the result of proper functioning of a complex network of organs, systems and apparati,” said Dr. Matteo Cesari, a geriatric specialist in Rome whose editorial accompanied the study in the January 5th issue of the Journal of the American Medical Association.

“We do not know whether a person walks fast because he or she is healthy, or vice versa,” said Cesari, “this is not trivial because in medicine you need to treat the cause to have a significant effect, not the consequence.”

These observations ring true for Vicki Gasaway, who sees the correlation between walking pace and health in her clients at the Walton County Senior Citizen’s Council, Inc.

You notice people moving a little slower and those are the people who start participating less and eventually die, said Gasaway, who has worked with elderly people for 10 years and is executive director of the Center.

Researchers analyzed information about gait speed from nine large studies collected between 1986 and 2001. Although methods varied slightly from study to study, all timed walking speed over a measured distance.

This is a quick, easy and inexpensive assessment for caregivers or health providers to perform and monitor over time: all it takes is a four-meter walkway and a stopwatch.

Energy, movement control, and multiple organ systems are all involved in walking, which is why slower walking may be a warning signal in older patients – especially those who say they are doing fine.

Aging and diseases are primary contributors to a slowing gait speed, said Cesari. A decreasing gait speed could provide a warning sign for caregivers, pointing to underlying health conditions before they become clinically evident.

The assessment for gait speed aids physicians in determining a patient’s biological age, in other words, moving away from birth dates to determining how old their body is.

At Walton County Senior Citizen’s Council, birth age takes a back seat to biological age for citizens who exercise weekly, do chair exercises with a nutritionist, and even line dance.

“We have a few 90-something year olds who are still very active,” said Gasaway, “they have some health issues but they keep coming and their mobility is quite good.”

The team of researchers found that remaining years of life for each sex and age increased as walking speed increased, with gait speeds of one meter per second or higher consistently signifying survival that was longer than expected by sex and age alone.

Still, Cesari stresses the importance of gait speed as only a complementary guideline to improve routine clinical assessments.

“You should not consider gait speed as a condition to treat, but only as a marker of wellbeing,” said Cesari.

Felicia Harris is a graduate student at the University of Georgia. With a concentration in Mass Media, she is interested in the media’s effects on people’s well-being and livelihood.

Children Put on “Backburner” When It comes to Emergency Planning

April 29, 2011 by · Leave a Comment 

March marks the start of tornado season.

March marks the start of tornado season, and Hall County is infamous for twisters. Hall County ranks fourth in the nation for deadliest tornadoes, and Gainesville appears twice on the list of 25 deadliest ever, according to the NOAA’s Storm Prediction Center.

If and when a tornado strikes local communities, emergency care for adults in the Gainesville-Hall County area should be adequate. For children, on the other hand, the Northeast Georgia Medical Center may not have sufficient resources.

Most hospital emergency rooms in the United States aren’t equipped to treat large numbers of kids at once, said Kathryn Koelemay, a medical epidemiologist who serves on the pediatric triage task force for King County, Oregon. Koelemay, who spoke at the 2011 Public Health Preparedness Summit on February 23 at the Atlanta Marriott Marquis, said a recent California study shows that only about 6 percent of all hospitals nationwide have enough equipment and supplies for children.

“Hospitals normally plan for vulnerable populations that frequent the ER like the homeless or the elderly,” Koelemay said. “Kids are usually put on the backburner when it comes to emergency planning.”

This rings true for Kevin Matson, manager of environmental safety and regional disaster planning for the Northeast Georgia Health System. Like most U.S. hospitals, Northeast Georgia Medical Center purchases emergency supplies with federal funds administered through the state’s preparedness and response agency. This program emphasizes care for adults and requires hospitals to store what they’re most likely to need during a disaster.  The fact is that adults outnumber children in Hall County and specialized equipment for children is expensive, Matson said. Pediatric ventilators cost anywhere from $20,000 to $40,000, Matson said, and hospitals can’t afford to stockpile more of these items.

But the hospital can afford to amass intravenous fluids, medications, gowns and IV tubes designed for children, he said, and NGMC has plenty of these on hand.

NGMC is the main hospital for 13 counties and it “has more than enough resources, specialized tools and on staff physicians” to treat an average load of pediatric patients, Matson said.

However, if for example, a tornado hit a nearby school caused a surge of pediatric patients at NGMC, Matson said the hospital would have to transfer young patients and activate emergency agreements with other hospitals and community pediatricians.

For general hospitals, the issue is not a shortage of emergency medicine specialists but a shortage of certified pediatricians, Koelemay told the preparedness conference in Atlanta.  “Treating a child requires a different skill set and lots of practice,” she said. “They have different vitals, require different dosages and sometimes different medicines altogether.” Physicians who aren’t used to treating kids can be overwhelmed during a disaster.

To address this, Koelemay and her Oregon colleagues created a pediatric toolkit for emergency use by hospital physicians who don’t ordinarily care for children.

The toolkit includes information about pediatric treatments, dosages and procedures, as well as a list of basic supplies that all hospitals should have in case of emergency. It also comes with a color-coded, easy-to-use tape measurement system that helps doctors use a child’s height to determine correct treatment protocols in emergencies.

Matson said that a color-coded measuring system is available to NGMC doctors, though he admitted it is probably not used nearly enough when it comes to treating children.

Like Koelemay, Matson would like to see more emphasis on emergency preparedness for children. “Our pediatric emergency supplies are limited based the state and federal grant limitations,” he said. “We could certainly improve by having a pediatric toolkit, as would other practices in this country.”

Ear Infection Before Two Needs Immediate Treatment

April 29, 2011 by · Leave a Comment 

Gainesville, GA—Few creatures are as miserable as a small child with a raging ear infection. Emily Bailey of Flowery Branch, has witnessed this five times since Bridget, her three-year-old daughter, was born. “A sick child is not a happy child,” Bailey said. “They are clingy and require lots more attention to comfort them through the sick times. I think it is sometimes harder on parents to see their little ones sick than it is for them to suffer through it.”

Bailey takes her daughter to the pediatrician as soon as symptoms strike, which is usually after what she calls  “a persistent cold that doesn’t budge for at least a week.” Kathy Morse, a nurse practitioner at Pediatric Associates in Braselton, Ga., says Bailey is doing the right thing.

Parents should consult a doctor right away if a child aged two or younger has a high fever, pulls at their ears and cries when sucking or sleeping – classic signs of acute otitis media.

Because severe, untreated ear infections can permanently damage hearing, Morse prescribes antibiotics to children with lingering ear infections. And she is quick to prescribe antibiotics for infants under two because they usually don’t heal as well on their own.

A new study highlights the wisdom of this approach. Researchers from the University of Pittsburgh School of Medicine divided 291 children, all under age two and suffering acute otitis media, into two groups. One group was immediately given Augmentin (a common antibacterial drug), and the other received an inactive pill. After 7 days, researchers found that about three quarters of infants in both groups had improved— they were no longer crying or pulling on their ears. This signaled that in the short run, antibiotic treatment didn’t make much difference.

The real benefits of antibiotic treatment showed up after 12 days when doctors checked the kids’ ears for evidence that the infection was still there even though symptoms had lessened. Of the 144 infants given Augmentin, only 23 still had signs of acute otitis media; of the147 left untreated, infection persisted in 75.

Bailey says she usually sees a noticeable improvement in her daughter’s symptoms after the third day of antibiotic treatment. She said that only one occasion the infection did not clear after the first round of antibiotics so her doctor had to prescribe a stronger dosage.

Although these results favor immediate treatment, they are unlikely to be the last word in an ongoing debate about whether ”watchful waiting” or immediate antibiotic therapy is a better approach to treat common childhood ear infections. Some say that the rush to prescribe antibiotics for every ear infection yields drug resistance. But Dr. Jack Paradise, co-author of the University of Pittsburgh study, believes the argument for immediate treatment of infants under two is persuasive.

“In a very young child, the condition causes immense pain, and even if symptoms go away on their own, there still may be a lingering infection that can cause permanent hearing damage,” Paradise said. He added, “It is not the responsibility of the child to eliminate unnecessary anti-microbial treatment, it is the doctor’s.”

The real culprit in development of antibiotic resistance is not treatment of a single childhood ailment, but instead “antibiotics apparent in everyday life, from agriculture, cattle, chickens, and prescriptions for other respiratory problems.”

Gainesville pediatrician Eugene Cindea agrees with Paradise’s recommendations for treating ear infections in very young children, but gives more credence to the idea that using antibiotics in this way may contribute to drug resistance.

“Development of antibiotic resistance in children is certainly related to antimicrobial over-exposure,” said Cindea, who practices at the Longstreet Clinic in Gainesville. “Doctors must be careful and judicious in the prescription of antibiotics for ear infections. A physician should never treat a patient over the phone or prescribe medicine on the basis of symptoms before thorough examination.”

When a child has a mild ear infection or is older than two, Cindea waits and watches to see if the problem spontaneously heals.

In fact, “85 percent of infections in children over 2 years old clear up on their own,” Morse said. For older children, she usually prescribes eardrops for pain and suggests acetaminophen or ibuprofen.

Waiting for an ear infection to clear on its own can be agonizing for parents of a slow-healing child. “For us, watching and waiting has failed more times than it has succeeded,” Bailey said. “When we take the waiting path, it’s usually a long road to recovery that takes twice as long than with antibiotic treatment.”

What parents really want to know, of course, is whether ear infections can be prevented. “I usually tell adults to marry someone with good genetics,” said Cindea. “Outside of good genes and taking their children out of daycare, there isn’t much they can do. Ear infections aren’t preventable.”

Proposed Title X Cuts Could Be “Tragic” for Women, Health Department, Taxpayers

April 29, 2011 by · Leave a Comment 

Gainesville, GA — The recent battle over federal funding for Planned Parenthood is still echoing here.

The attempt by congressional Republicans to stop all $327 million of federal Title X money — while targeting Planned Parenthood as an abortion provider — endangered funding for women’s health services at clinics in Hall County, public health workers say. Those clinics are partly funded by Title X money.

Signed by President Richard Nixon in 1970, Title X was established to provide free reproductive health care, including birth control, to women living at or below the poverty level. Although it has never underwritten abortion, some conservatives want to end Title X as a way of cutting federal funds to agencies involved in abortion.

Referring to Planned Parenthood, U.S. Rep. Mike Pence (R-Ind.) recently said, “The largest abortion provider in America should not also be the largest recipient of federal funding under Title X.” He sponsored a bill to end federal funding to the organization.

While the GOP efforts against Title X failed this year, the brouhaha about cutting the money is far from over.

If Title X is abolished, there could be “tragic” consequences for low-income women and for the health care system in Hall County, said Jennifer Parker, the women’s health coordinator for the county. Women with no other resources rely on Title X for overall physical exams as well as screenings for breast cancer and cervical cancer, preventive immunizations, and screenings for sexually transmitted infections, she said.

“We are the only health providers some women see,’’ Parker said. “If we cut Title X, repercussions would be critical for these women.”

Title X cutbacks would affect the wave of new Health Department clients who have flocked there since the economic downturn left them without jobs and health insurance. Every day, more women in this predicament call the Health Department, Parker said.

Some of these women may have early, treatable cancers. “If a woman comes to the Health Department because she can’t afford birth control, she’s probably not getting Pap smears or mammograms on a regular basis from a private-practice gynecologist,” said Melba Kida, a nurse practitioner at Hall County’s Health Department. “It makes sense that the majority of low-income women depend on the Health Department for cancer screenings.”

Although local health departments aren’t equipped to treat cancer, they can refer patients to physicians participating in the Health Access Initiative, a Hall County program that provides inexpensive care to uninsured adults. The Health Department staff also helps women apply for Medicaid if needed.

“We rely very heavily on Title X to keep our program and the department alive,” said Kida. “Even if a woman cannot afford to pay, the Health Department is still mandated to provide services. If we continue to see many people that are unable to pay for care, and if we don’t have federal funding, we may have no other choice but to close our doors.”

The state’s Public Health District 2, which includes Hall and 12 other counties, received more than $500,000 in federal funding for fiscal year 2011 to cover staff salaries, supplies and equipment to run reproductive health care programs.  All federal money is funneled through the state, and since the recent economic downturn, Parker said the state has diverted $93,141 from family planning clinics to other programs. Normally, she said, all Title X funds would be depleted by the end of the fiscal year, June 30.

If all federal funds stopped, that would drive more patients to the Good News Clinics, which is Hall County’s only privately run, nonprofit clinic and a major source of free care in the area.

Good News receives no Title X money, but staff member Jean Peeples predicts that its patient load will increase if services are cut at the Health Department. The clinic, which has two volunteer gynecologists who see patients once a week, already handles about 800 monthly visits from uninsured women. Waiting times will increase if cutbacks occur at the county Health Department, Peeples said.

Good News screens for cervical and breast cancer but does not provide birth control.

Kida disagrees with the conservative rationale for cuts in funding. “Title X doesn’t pay for abortions and never has. It stands to reason that when you have more people pregnant who didn’t want to be, your rates of abortion may very well go up. Do they think that just because there is no family planning, people are going to stop having sex? To me, that just seems shortsighted.”

Small clinics like Good News obviously can’t shoulder the whole burden of family planning, and any decrease in federal support will have to be made up elsewhere — most likely in state taxes, defenders of Title X say. “I think that taking away money from our clinics is just going to result in an even larger burden on our taxpayers,” Parker said.

There is evidence that Title X saves health care dollars in the long run because it provides so many preventive services, including breast exams, Pap smears and screenings for sexually transmitted diseases. The Guttmacher Institute, a research and advocacy group on sexual and reproductive health, estimates the program saves U.S. taxpayers at least $3.4 billion each year.

U.S. Rep. Tom Graves, a Republican whose district includes Hall County, supported the Pence-sponsored bill. A Graves spokesman said the congressman sought “to protect millions of pro-life taxpayers from subsidizing Planned Parenthood, the largest abortion provider in America.”

“This bill is not about health services; it’s about protecting innocent, unborn life,’’ said spokesman John Donnelly.

Meanwhile, on general Title X funding, Parker said it all comes down to the welfare of children born into low-income families.

“Our mission [at the Health Department] is to help families plan for children they can provide and care for, so that when they grow up, they’ll be good citizens of Georgia,” Parker said. And with or without Title X, Parker said, the department “will do everything in [its] power to support that effort.”

Elbert County Officials Prepared for Emergency, Residents Not

April 28, 2011 by · Leave a Comment 

By Chelsea Toledo

Train Tracks running through Elberton, GA. Photo by Chelsea Toledo


Most people know to seek high ground during a flood, or to take shelter in the basement during a tornado. But would you know what to do if a train jumped the tracks and leaked dangerous chemicals?

Chuck Almond knows.

As Elbert County’s Emergency Services Director, Chuck Almond is an expert on foresight. When most people are preparing for swimsuit weather, Almond is getting bids from tree removal services whose crews would re-open vital roads in the wake of a tornado.

Severe weather is a major topic in Elbert County’s emergency operations plan, which focuses not on earthquakes and tsunamis, but on for disasters that a rural Georgia town is likely to face.

This is the type of forethought that the Centers for Disease Control and Prevention (CDC) encourages all communities to exercise.

“We have a railway that comes right through the middle of town, so one of our biggest concerns is train derailment,” said Almond.

This scenario is particularly threatening, as freight trains running through Elberton can carry hazardous chemicals such as ANFO, an explosive compound used in granite mining.

If this happened, alarms would go out to Elberton residents.

“We use TV, radio, and we have warning sirens,” says Almond.

“We also use social networking sites such as Facebook, and we’re pushing now to implement a texting system,” he said.

Disaster specialists from law enforcement, emergency services, public health, and other Georgia agencies have input into emergency plans tailored to each county. Primary responsibility for disaster planning, however, rests with local officials.

Elbert County has a detailed emergency plan that fulfills most guidelines set out by the CDC.

The plan falls short, however, when it comes to community awareness of the plan and involvement in its execution.

The best plans, according to CDC, are developed by people who would be affected by community crisis. If this happens, people will feel it is their plan and they will pay attention to it.

Christina Singleton, the Associate Director of Science for the CDC, advocated the necessity of community involvement at a recent summit for Public Health Emergency Preparedness.

“We need to nudge those stakeholders to the table that are reflective of the community,” said Singleton.

But not all Elbert County citizens are on board with the county’s plans, or even aware of them. Tiffany Rucker and Susan Dunn, employees of Mr. Haircut in Athens and longtime Elberton residents, both feel unprepared to face disaster.

“I don’t think anybody in Elberton would know what to do,” said Rucker.

“We’re prepared at a level zero,” added Dunn.

There’s nothing wrong with sirens or Facebook alerts, but residents
would be better able to protect themselves and their families if they understood which organizations are responsible for emergency response.

Local health departments are on the front lines of any emergency that affects public health, for example, but most people don’t know that, according to Mary Champion, Elbert County’s head nurse.

“The community is not really aware of a lot of what public health does…It’s not just shots and birth control. We’re here to promote and prevent,” said Champion.

The role of health departments’ personnel and other first responders is spelled out in the local disaster plan, but the plan itself isn’t easy for interested residents to fine.

According to Almond, a copy of the plan is at the public library. On a recent visit, library staff could not locate the plan, nor were they aware of the document’s existence.

Like many other community guidelines, the strength of emergency response plans is derived from the careful planning of professionals such as Chuck Almond, but their effectiveness is greatly limited by public awareness and the willingness of the community to participate in planning and spreading such information.

FEMA administrator Rich Serino addressed that issue at the Public Health Preparedness Summit.

“We’re all in this together, no matter how you look at it. I know it sounds simplistic, but it’s true,” he said.

Depression Often Overlooked

April 27, 2011 by · Leave a Comment 

Winder Adult Day Health Center

WINDER, Ga.-

Approximately 38 million Americans are now over 65, and their numbers increase with every Boomer birthday. Georgia has more than its share, ranking 9th in the nation for people over the age 65: one in 10 state residents falling in this category.

While the soaring need for healthcare in general has been in the headlines since the first Boomers turned 60, less attention is paid to the fact that many older folks are depressed. And their depression may well be ignored or mistaken for signs of dementia.

Because Alzheimer’s disease and other forms of dementia are so frightening to aging people, they worry constantly about this. In fact, depression is the most common mood disorder in older adults. The last chapters of life are filled with potential triggers for depression: the death of a spouse, loneliness, decreased mobility, financial challenges, chronic pain or frustration related to memory loss.

Winder gerontologist, Rasha Samara, says that she has seen patients with depression, lose motivation, abandon their interests, and stop being active.

“They may not only neglect their own interests but their own well being too. They will come into the office and may not have bathed for a couple of days or cut their fingernails in months.” said Dr. Samara.

In her office, she uses two different tests to try and identify what is going with a patient: the mini-mental status exam (MMSE) and the geriatric depression scale.

The MMSE tests cognitive function and screens for cognitive loss. The depression scale involves asking patients how they feel about their quality of life, whether life seems worthless to them, and whether they still take pleasure in favorite activities or pastimes?

Because dementia and depression can have some of the same initial symptoms Dr. Samara believes it’s important to use the two tests together.

Depending on whether the patient is depressed or showing signs of dementia she may prescribe medication as needed. But she also encourages people to act on their own behalf.

“I tell my patients to do whatever mental exercises they enjoy, whether it is crosswords puzzles, reading the newspaper every day, word searches, or chess,” said Dr. Samara.

Dr. Kerstin Gerst, Associate Professor of Gerontology at the University of Georgia, also recommends that people get out and socialize in addition to engaging in intellectually challenging activities. Social interactions require listening, processing information, and formulating and expressing ideas. All are key activities for the brain.

“It’s important to create new neurons by learning something new whether it’s trying a new language or playing a musical instrument,” Dr. Gerst said.

Mental illness not only influences an individual’s psychological state but also may undermine their overall physical health.

“It’s a much worse outcome if someone has a combination of medical and mental conditions such as diabetes and depression,” Dr. Gerst said.

Dr. Samara says emotional problems may affect physical health in several ways.

Inability to understand and address one’s medical condition, follow doctors’ directions, take the correct amount of medicine, or eat a healthy diet, can lead to or worsen hypertension, diabetes or other conditions. Physical and mental health are closely related.

Unfortunately, depression is not like physical ailments in which a person develops symptoms, takes notice, and reports the problem to a health provider. Mental health issues are also easily mistaken for signs of physical illness, by provider and patient, which allows the real problem to go untreated.

“Mental health problems are mostly first reported from family, friends, or caretakers because they recognize a person’s behavior changing,” said Dr. Samara.

Many mood and cognitive problems are treatable but not curable.

“It’s important to distinguish between treatable and curable, especially for families and friends who think dad is going to be cured of Alzheimer’s,” said Dr. Samara.

It may not be possible to truly cure depression or other mood disorders, either, but individuals and families can take steps to improve the situation.

Getting a depressed older person out of the house and into a social situation is one of these, and adult day programs help fill this need.

Two facilities in Barrow County that provide services for seniors are the Winder Adult Day Health Center and The Barrow County Senior Center. An adult day health center is facility that provides a planned program of activities daily to promote individual’s well being through social and health services. A senior center is a place in a community where seniors can gather for support, socialization, fitness, and other activities provided for older people.

The Winder Adult Day Health Center serves 30 adults whose mental and physical functions have been diminished by Alzheimer’s disease or other forms of dementia, stroke, depression or other emotional conditions, or developmental disabilities.  The center offers a therapeutic activity program, nutritious meals, medical monitoring and physical and occupational therapy.

The center tries to provide activities that are educational and mentally stimulating for patients. They have brain-centered activities in the morning and physically active games in the afternoon.

In addition to helping keep clients active mentally and physically, the center’s programs also encourage social interactions among people.

About once a week Keith Adams, program coordinator at Winder Adult Day Center, comes up with a short questionnaire called, “get to know your neighbor”.

“I ask simple questions like, what do you like to do better, ride on a train or fly on a plane? It gets people to think about other things like their fears or past stories, that lead to discussion,” said Mr. Adams.

The Barrow County Senior Center is a multipurpose center that offers meals, some health-related services, and activities. On weekdays, 25 -to 30 people participate in senior center activities.

“Basically it is for their mental health, with all the activities we provide including puzzles, exercise, cards, computer games, and outside outings,” said Karen Townley, director of Barrow Senior Center.

Since they see the same people daily, the staff are alert to changes of mood in regular clients.

“We are here for them, sometimes they just want to talk, and of course if it’s something more we refer them to outside sources,” Ms. Townley said.

Experts agree that older adults who socialize, and who limber up with their brains with regular activity, will be better off in terms of mental and physical health.

Local food activist beats cancer odds

April 12, 2011 by · Leave a Comment 


Click on the image to view Soundslides Presentation.

by Chelsea Toledo

Midge Leventry answers the door with a blank look and a book in her hand. She has forgotten about her appointment.

“If you want to write about me, you might as well know the whole thing,” she says, propping up her bare feet.

“The whole thing” is a story Leventry’s spacious West Athens home can barely contain.

Leventry is president of Inca Organics, importing fair trade quinoa from Ecuador. In Athens, she is actively involved with the Slow Food movement, promoting “good, clean, fair food.” In 2008, Leventy planted a vegetable garden for the Athens Area Homeless Shelter.

She has also beaten harsh health odds, having bounced back from stage-3 ovarian cancer.

Born in1940 and wowed by post-war convenience foods, Marjorie Ellen Laurig Leventry wanted a career developing recipes for major food companies. She earned a bachelor’s degree in dietetics from Cornell University in 1962, and looking back she is glad that her dreams did not come true.

“I would have been working with Jell-O and Miracle Whip and all those awful things they put out,” she said.

Instead, she married Bob Leventry shortly after graduation and they eventually settled in Peoria, IL. Leventry worked as a registered dietician and taught nutrition at Illinois Central College. Her husband was an executive with US Steel, RLI Insurance and Rupperman Marketing.

When the couple encountered difficulty with conception, they adopted two children. Their son Rick is now 41 and works as pharmaceutical district manager in Birmingham, AL. Ellen, 37, is a fourth-generation graduate of Cornell, where she is the communications director for the College of Agriculture.

In 1993, the children had grown out of their childhood home in Peoria, and the Leventrys had outgrown their jobs. In their early fifties, they joined the Peace Corps and were stationed near Quito, Ecuador, where Midge was expected to use her nutrition expertise to improve the diets of indigenous people.

“As it turned out,” she said, “they were eating better than we were, and they were wondering why we were there.”

The mainstay of the traditional Equadorian diet is quinoa, a gluten-free complete protein grown in Ecuador, Peru, and Bolivia. Leventry could see that people who still ate this way were healthy and well nourished.

In a misguided effort to modernize, “Ecuador was told that it was a dirty, indigenous food and that they should give it to the pigs,” said Leventry. Ecuadorians who had switched to a Western diet were more likely to be malnourished than traditionalists.

The Leventrys returned to the U.S. in 1996 and started their own company, initially importing Ecuadorian artisan goods. In 1998, they began importing quinoa using the Inca Organics label. Whole Foods is now among their distributors.

The couple returns one third of the quinoa to the farmers who grew it, encouraging them to sell it or eat it themselves.

“We wanted to work with the indigenous,” said Leventry, “We did not want to work with the hacienda owners who were already wealthy.”

Leventry also maintained her own health regimen. Once a smoker, she gave that up for running when she was 39 and has run four marathons.

“Ever since I’d been running, I never had to take an aspirin or anything,” said Leventry, “I don’t get sick.”

In the summer of 2008, however, she did get sick. While vacationing at her summer home in Elk Lake, MI, she experienced unusual, rapid weight gain.

“Unlike men, women are very in tune to their bodies,” explains Leventry’s surgeon, Dr. Benedict Benigno, “and if they say there’s something not right, as protean as that is, they should never ignore it.”

After having an MRI, Leventry was diagnosed with stage-3 ovarian cancer.

“I immediately thought I was going to die,” said Leventry.

“I started thinking about where Bob would find a new wife. We have a neighbor next door who’s a widow…” she laughed.

Dr. Benigno performed an experimental procedure called heated intraperitoneal chemoperfusion (HIPEC) on Leventry.

This means infusing a heated chemotherapy solution into the peritoneal cavity, at the time of surgery to remove an abdominal tumor, to eradicate remaining cancer cells. A nurse massages the patient’s abdomen for 90 minutes, distributing the solution, which is then drained.

Leventry underwent six traditional chemotherapy treatments following the procedure “just for maintenance.” After treating Leventry for an intestinal blockage in July 2009, Benigno confirmed that she was cancer-free.

“I’m alive, and I feel like I’m alive. I’m not concerned. I’m not scared,” said Leventry, “It certainly makes you a lot more humble. I thought I was invincible before.”

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