Patient Care

National Media Spotlight on UConn’s Migrant Farm Worker Clinics

Univision producer Emilce Elgarresta and Dr. Bruce Gould, founder of the migrant farm worker clinics, during the video shoot at Thrall's Tobacco Farm in Windsor.
Univision producer Emilce Elgarresta and Dr. Bruce Gould, founder of the migrant farm worker clinics, during the video shoot at Thrall’s Tobacco Farm in Windsor.

The UConn Migrant Farm Worker Clinics received national media exposure this week after being featured on the Spanish language Univision Network (watch video). The segment was part of a series of reports that aired during Univision’s special Health Week campaign June 6-13.

The migrant farm worker clinics are organized and run by health profession students involved with the Connecticut Area Health Education Centers (CT AHEC) Program at UConn Health. The students, along with physician advisors and volunteer interpreters, help provide medical and dental screenings for the hundreds of migrant workers who come to Connecticut each growing season.

The lifesaving care they provide caught the attention of Univision producer Emilce Elgarresta. She contacted Dr. Bruce Gould, UConn Health’s associate dean of primary care who started the mobile health clinics in 1997. Elgarresta said she wanted to do a story about the clinics because she was very impressed and moved with Dr. Gould’s commitment to help the farm workers.

“Migrant farm workers are among the most economically disadvantaged and most medically vulnerable groups in the United States having little, if any, access to health care or medication,” says Gould. “The clinics are a way to provide them much needed medical care while teaching students that caring for the poor and vulnerable is part of the gift of being a health care provider.”

Filming
Univision video shoot during a UConn Migrant Farm Worker Clinic at Thrall Tobacco Farm in Windsor.

A few weeks later, Elgarresta flew to Connecticut from Miami and she and her crew spent two days in Connecticut taping the story. The segment highlighted the clinic held recently at the Thrall Tobacco Farm in Windsor where workers from Puerto Rico and Mexico took advantage of the free health exams.

Hannah Kotler, a second-year medical student and one of last year’s clinic coordinators, and Dr. Kenia Mansilla, a family medicine physician in Hartford and a longtime clinic volunteer, were interviewed in Spanish for the segment.

The story is part of a yearly campaign by Univision, the fifth largest television network in the U.S., to provide their audience with information about timely health care topics and disease prevention. The stories are aired across the network’s news and entertainment shows, as well as their radio networks, webcasts and town hall broadcasts.

The UConn Migrant Farm Worker Clinics operate annually from June to October and provide services to more than 400 migrant farm workers at nine farms and greenhouses throughout the state. The clinic engages pre-health professions students including high school and college students, as well as health professions trainees and residents.

The Connecticut Area Health Education Center Network (CT AHEC) is a federal and state funded program supporting primary care workforce development.  CT AHEC is located within the University of Connecticut’s Center for Public Health and Health Policy at UConn Health in Farmington, Conn.

 

Patient Safety and Quality Improvement Symposium

Third-year medical students who won first place for "Instituting low dose CT screening for qualified individuals at the Brownstone APC clinic." From left, Corey Dwyer, Melissa Argraves, Monica Townsend, Ethan Talbot, Adarsha Selvachandran, Patrick Field, Charles Ma, and Christopher Hammel.
Third-year medical students who won first place for “Instituting low dose CT screening for qualified individuals at the Brownstone APC clinic.” From left, Corey Dwyer, Melissa Argraves, Monica Townsend, Ethan Talbot, Adarsha Selvachandran, Patrick Field, Charles Ma, and Christopher Hammel.

The 11th Annual Symposium for Patient Safety and Quality Improvement (CQI) was held June 8 and attended by approximately 100 medical students, residents, faculty and UConn Health community members.

Sponsored by the Connecticut Area Health Education Center Program (CT AHEC) and the UConn School of Medicine, the CQI Symposium is the culmination of the quality improvement curriculum for the third-year medical students. During their internal medicine ambulatory experience, all students participate in designing, implementing and evaluating a quality improvement intervention targeting an opportunity for improvement identified at their site.

A total of 15 student and resident posters were featured.  Judges for the CQI projects included representatives from John Dempsey’s Center for Bronchiectasis Care, epidemiology and infection control, quality program departments,  Internal Medicine Residency Program, Center for Public Health and Health Policy/Correctional Managed Health Care, as well as the Department of Family Medicine.

Dr. Richard Zavoski
Dr. Richard Zavoski

The keynote speaker for the symposium was Dr. Robert Zavoski, a pediatrician and the medical director of medicaid programs for the Connecticut Department of Social Services. Zavoski utilized humor and practical examples to discuss the important role of quality improvement in practice, health policy and public health. Zavoski applauded all student and resident participants at the Symposium for their commitment to excellence and quality improvement.

First place award for resident poster:
Reducing Readmissions in Patients with LACE Score ≥ 10 : Comparing Different Strategies “ (St. Francis/UConn Health); Bhavtosh Dedania, Arushi Khurana, Gurukripa Kowlgi, Nikhil Kapila, Victoria Forbes, Ausia Iqbal, Shaina Lynch, Khushboo Sheth, Joseph Fusco, Donna Pepito, Kaitlyn Guardino, Karen Zanoria, Anthony Yoder, Henry Igid, Amanda Kost, Kelly Mazurek, Dipen Khanapara, Amrita Panwala, Mamta Shah, Edgar Naut.

First place award for medical student poster:
“Instituting low dose CT screening for qualified individuals at the Brownstone APC clinic”  (Hartford Hospital); Adarsha Selvachandran, Monica Townsend, Melissa Argraves, Christopher Hammel, Charles Ma, Ethan Talbot, Patrick Field, Corey Dwyer.

Robison Named GSA Fellow

Julie Robison
Julie Robison

The Gerontological Society of America (GSA) has awarded Fellow status to Julie Robison, Ph.D., associate professor in the UConn Center on Aging. The GSA is the world’s oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging.

The GSA fellowship is an acknowledgment of Robison’s outstanding and continuing work in the field of gerontology. She will be honored during the Society’s 68th Annual Scientific Meeting this November in Orlando, Fla.

Cancer Survivors Day 2015

Former head coach for men’s basketball Donald (Dee) Rowe was the featured speaker at the 18th annual UConn Health Cancer Survivors Day held at Farmington Gardens on May 2.  More than 170 attendees listened as Rowe described his inspiring cancer journey at UConn Health.

Nancy Baccaro, APRN and coordinator for the Survivorship Program, hosted the event which included a brunch for the survivors, their caregivers and families. Participants enjoyed outdoor games such as bocce, volleyball, and croquet. Indoor activities included yoga, chair massages, creating healing stones, and taking photo booth pictures.

As in years past, many departments throughout UConn Health donated gift baskets for the survivors.

Survivors Day is celebrated in hundreds of communities throughout the U.S. and Canada. According to the National Cancer Institute, there are 13.7 million cancer survivors in the U.S. today.

Goal: 80% Screened for Colorectal Cancer by 2018

Signing the 80% by 2018 pledge from left, Daniel Rosenberg, Dr. Thomas Devers, Anne Diamond, Dr. Pramod Srivastava, and Dr. Joel Levine.
Signing the 80% by 2018 pledge from left, Daniel Rosenberg, Dr. Thomas Devers, Anne Diamond, Dr. Pramod Srivastava, and Dr. Joel Levine.

Colorectal cancer is a major public health problem. It is the second leading cause of cancer death, and a cause of considerable suffering among more than 140,000 adults diagnosed with colorectal cancer each year. However, colorectal cancer can be detected early at a curable stage, and it can be prevented through the detection and removal of precancerous polyps.

UConn Health stands united in the belief that we can eliminate colorectal cancer as a major public health problem. We have screening technologies that work, the national capacity to apply these technologies, and effective local models for delivering the continuum of care in a more organized fashion. Equal access to care is everyone’s responsibility. We share a commitment to eliminating disparities in access to care. As such, UConn Health will work to empower communities, patients, providers, community health centers and health systems to embrace these models and develop the partnerships needed to deliver coordinated, quality colorectal cancer screening and follow up care that engages the patient and empowers them to complete needed care from screening through treatment and long-term follow-up.

UConn Health is embracing the shared goal of reaching 80% screened for colorectal cancer by 2018.

Genice Nelson Honored for Impact in Sickle Cell Disease Community

Genice Nelson
Genice Nelson

In conjunction with FENDI, and in recognition of Women’s History Month, the Sickle Cell Disease Association of America, Inc. (SCDAA) has honored UConn Health’s Genice Nelson, APRN, as one of several women nationally who have made a significant impact in the Sickle Cell Disease community. Genice and the other women have gone above and beyond the call of duty in hopes of making a difference in the sickle cell patient community, and their efforts have not gone unnoticed. To show their appreciation, SCDAA has named the honorees the 2015 Iconic Women. The women will each receive a commemorative award from the SCDAA, as well as national recognition throughout the month of March.

Please visit SCDAA’s official Iconic Women website and make a contribution to SCDAA in honor of Genice’s work in Sickle Cell Disease by clicking on “Connecticut” and following the link by her picture. Be sure to include Genice’s name in the message box on the donation page so our local Connecticut SCDAA chapter can receive a portion of the donation.

Coll Elected to American Geriatrics Society Board

Congratulations to Dr. Patrick Coll, professor in the UConn Center on Aging and Department of Family Medicine, who has just been elected as a member of the Board of Directors of the American Geriatrics Society (AGS).

Dr. Patrick Coll
Dr. Patrick Coll

The AGS is a not-for-profit organization of over 6,000 health professionals devoted to improving the health, independence and quality of life of all older people. The Society provides leadership to health care professionals, policy makers and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy.

“This is a great honor for Dr. Coll. Being a member of the Board of Directors is a highly competitive position with important leadership responsibilities,” says Dr. George Kuchel, director of the UConn Center on Aging. “Those responsibilities increasingly involve an ongoing dialogue with Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, and the National Institute on Aging, and other federal agencies involved in funding clinical, educational, and research efforts addressing the needs of our aging society.”

 

The Cuff That Could Arrest the Aging Process

Dr. Rene Cuadra, a resident who assists in the INFINITY trial, shows study participant Gerald Kehoe how to use a 24-hour blood pressure monitor. (Chris DeFrancesco/UConn Health Photo)
Dr. Rene Cuadra, a resident who assists in the INFINITY trial, shows study participant Gerald Kehoe how to use a 24-hour blood pressure monitor. (Chris DeFrancesco/UConn Health Photo)
Learn more or join the study:
1-860-679-2705

Could the aging process be slowed – or even stopped – by aggressively managing an older person’s hypertension, or high blood pressure?
Researchers at UConn Health are finding blood pressure to be a reliable predictor of the progression of what’s known as “white matter disease,” or small-vessel disease of the brain, which impacts the decline in cognitive function, mobility, and balance associated with aging.

But it goes beyond putting on a blood pressure cuff during the occasional visit to the doctor’s office.

“We’ve learned from prior research that there is an important relationship between out-of-office blood pressure – but not doctor’s office pressure – and the progression of blood vessel disease of the brain and its associated decline in function,” says Dr. William B. White, professor of medicine and chief of the Calhoun Cardiology Center Division of Hypertension and Clinical Pharmacology. “The program we’re doing now is actually evaluating interventions using 24-hour monitoring to guide the therapy that we hope will prevent the functional loss.”

Dr. William White is running a clinical trial studying the connection between blood pressure management and aging.
Dr. William White is running a clinical trial studying the connection between blood pressure management and aging.

Along the way, White, the immediate past president of the American Society of Hypertension, has made some incidental observations.

“We’ve found in a number of cases that the hypertensive patients joining this study were actually overmedicated,” White says. “We were able to bring their blood pressure under control by reducing their medications. The around-the-clock blood pressure monitoring provides us the crucial data that enables us to this. More isn’t always better.”

Such was the case for Gerald Kehoe, who joined the study two and a half years ago. He recalls he was having great difficulty controlling his hypertension.

“I came here because of Dr. White’s reputation, and I believed he could stabilize my blood pressure,” Kehoe says. “This allows me to take my blood pressure over 24 hours and give Dr. White an idea of how my blood pressure changes during different times and events. That’s the way we learned how erratic our blood pressure is. Without that I don’t think they could regulate it fully.”

Kehoe says White reduced his medications and was able to stabilize his blood pressure.

Kehoe also got his wife to join the study. Fran Kehoe’s improvement was less drastic than her husband’s – she had less room for improvement.
“The people here are really nice, and I joke with them, ‘Oh, you like him better,’” Fran Kehoe says. “But you’re doing this for other people who are coming along later. If they can find out what caused the problem, they can save somebody else.”

Radio Health Minute
Listen to Dr. White explain the goals of the INFINITY Trial

Fran Kehoe says she’s living proof of the difference clinical trials can make, noting that she, as a cancer survivor, is the beneficiary of someone’s past participation.

INFINITY Trial participant Fran Kehoe is timed and observed walking up and down stairs. (Chris DeFrancesco/UConn Health Photo)
INFINITY Trial participant Fran Kehoe is timed and observed walking up and down stairs. (Chris DeFrancesco/UConn Health Photo)

Gerald Kehoe says the study also has short-term benefits for the participants.

“I feel wonderful,” he says. “I really appreciate what the study has done for me, and I hope it will do the same for other people.”
Study participants receive blood pressure care and treatment, including medications, over a three-year period, during which they undergo a series of tests to measure mobility, cognitive function, and white matter hyperintensities, the signs of small vessel brain damage. Participants periodically wear an ambulatory blood pressure monitor for 24-hour duration.

The researchers, led by White and Dr. Leslie Wolfson, professor of neurology, are in the home stretch of recruiting study participants for what’s known as “The INFINITY Trial,” a multi-year, $3.4 million study funded by the National Institute on Aging, a division of the National Institutes of Health.

Those interested in joining or learning more about INFINITY, which stands for “Intensive Versus Standard Ambulatory Blood Pressure Levels to Prevent Functional Decline in the Elderly,” should call 860-679-2705. Study participants must be at least 75 years old, have a history of hypertension, and cannot have a history of clinical stroke or major neurologic disability. The doctors and project man
agers can determine potential eligibility with a simple phone interview.

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UConn Health Awarded Advanced Certification for Primary Stroke Centers

UConn Health has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check markPrimary Stroke Center Certifcation for Advanced Certification for Primary Stroke Centers. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations.

UConn Health underwent a rigorous onsite review in December. The Joint Commission experts evaluated compliance with stroke-related standards and requirements, including program management, delivery of clinical care, and performance improvement.

“UConn Health has thoroughly demonstrated the greatest level of commitment to the care of stroke patients through its Advanced Certification for Primary Stroke Centers,” said Michele Sacco, interim executive director, Certification Programs. “We commend UConn Health for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in its community.”

“We congratulate UConn Health for achieving this designation,” said Nancy Brown, chief executive officer, the American Heart Association/American Stroke Association. “By adhering to this very specific set of treatment guidelines, UConn has clearly made it a priority to deliver high quality care to all patients affected by stroke.”

Dr. Sanjay Mittal
Dr. Sanjay Mittal

“We’re pleased to receive advanced certification from The Joint Commission and the American Heart Association/American Stroke Association,” said Dr. Sanjay Mittal, director of the Stroke Program at UConn Health. “The certification provides us with the opportunity to highlight the exceptional stroke care we provide as well as to continually strive to advance our care even further.”

Established in 2003, Advanced Certification for Primary Stroke Centers is awarded for a two-year period to Joint Commission-accredited acute care hospitals. The certification was derived from the Brain Attack Coalition’s “Recommendations for the Establishment of Primary Stroke Centers” (JAMA, 2000) and the “Revised and Updated Recommendations for the Establishment of Primary Stroke Centers” (Stroke, 2011).

Stroke is the number four cause of death and a leading cause of adult disability in the United States, according to the American Heart Association/American Stroke Association. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year.

 

Trestman Named Interim Director of CPHHP

Dr. Robert Trestman
Dr. Robert Trestman

Robert Trestman, M.D., Ph.D., executive director of Correctional Managed Health Care, has agreed to also serve as interim director of the cross-campus Center for Public Health and Health Policy (CPHHP). He succeeds Ann Ferris, Ph.D. R.D., who is retiring after 37 years of service to the University of Connecticut but continuing part-time to lead her research team.

CPHHP, now in its tenth year, coordinates public health-related activities within the University. CPHHP is a leader in health policy analysis and research, population health management and evaluation, and has developed and deployed tools to integrate and analyze large public health data sets.

Dr. Trestman’s diverse background in medicine and administration are an excellent fit for the CPHHP. He received his Ph.D. in Psychology and M.D. from the University of Tennessee, and trained in psychiatry and neurobiology at the Mount Sinai School of Medicine in New York City. Dr. Trestman has served as clinical vice-chair of psychiatry at the Mount Sinai Medical Center and at the UConn Health Center, studied the neurobiology and treatment of people with severe mood and personality disorders, and conducts translational research on correctional health.

He has published over 140 articles and book chapters and is the senior editor of the forthcoming Oxford Textbook of Correctional Psychiatry in which he contributed eight of 72 chapters. Dr. Trestman has also been newly appointed to the editorial board of the Journal of the American Academy of Psychiatry and the Law.

Recently, he was named chair of the Board of Directors of the Children’s Fund of Connecticut, a collaboration of UConn Health, Connecticut Children’s Medical Center, and Yale. Dr. Trestman is also chair of the American Psychiatric Association Work Group on Persons with Mental Illness in the Criminal Justice System, consults to the National Institute of Mental Health, the Substance Abuse and Mental Health Services Agency, the U.S. Department of Justice, and the Vera Institute of Justice.