The USF arm of the NIH trials will be performed at Genesis, Tampa General Hospial and USF clinics.

Tampa, FL (Oct. 26, 2009) -- The University of South Florida is participating in two federal studies to see whether the H1N1 vaccine can safely elicit a protective immune response in pregnant women, as well as in children and young adults, all of whom are HIV-infected.

USF will be one of 35 sites and eight sub-sites in the United States and Puerto Rico participating in the two studies, which are sponsored and funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both part of the National Institutes of Health. Investigators plan to vaccinate about 130 HIV-infected women and 140 HIV-infected children and young adults around the country.

USF is participating in both studies as part of its role as a site of the International Maternal-Pediatric-Adolescent AIDS Clinical Trials Group (IMPAACT) network, a project of NIAID and NICHD that develops and implements multi-center HIV treatment and prevention research trials.

In the first study, on HIV-infected pregnant women, about 10 women are expected to be enrolled in the Tampa Bay area, said Dr. Karen L. Bruder, USF assistant professor of obstetrics and gynecology and the principal investigator for USF’s study site. Dr. Bruder also is medical director of the Genesis at HealthPark clinic of Tampa General Hospital.

The study is particularly important for this group of women because pregnant women already are at greater risk of suffering serious complications from the H1N1 virus, largely because their immune systems do not function at their normal levels. If a pregnant woman also is infected with HIV, her immune system is further compromised.

“She is already immuno-suppressed,” Dr. Bruder said.

Dr. Karen Bruder leads the USF study site testing whether the H1N1 vaccine protects HIV-infected pregnant women.

The study will look at how the vaccine affects the woman and her infant -- for instance, how many antibodies to the H1N1 influenza virus does the woman develop in response to the vaccine? Are those antibodies transferred to the fetus? After the baby is born, does it still have antibodies to the virus?

The study will also evaluate whether the vaccine affects the woman’s HIV viral load or the cells in the immune system that are often affected by HIV.

Women in the study will receive two doses of vaccine. The women’s response to the vaccine will be evaluated during pregnancy, at delivery, and at 3 and 6 months after delivery. The babies will be evaluated when they are 3 and 6 months old.

USF’s work in the study will be performed at Genesis, Tampa General and at USF clinics.
In the second study, at least four HIV-infected children or young adults will receive the H1N1 vaccine at the USF clinics, said Dr. Jorge Lujan-Zilbermann, associate professor of pediatrics and principal investigator for the USF site of the study.

This study will divide subjects into three age groups: ages 4 to 9, 10 to 17, and 18 to 24. As in the first study, the children and young adults will receive vaccine in two doses three weeks apart. Study subjects will be followed for seven months.

The study will examine how safe the vaccine is, how effectively it stimulates the immune system to make antibodies to the H1N1 influenza virus, and how long children and young adults maintain these antibodies in their blood after being vaccinated. The study will also look at other immune responses.

The vaccine all study subjects will receive contains inactivated virus, so it will not be possible for them to contract H1N1 influenza from the vaccine. Because of the increased vulnerability of HIV-infected pregnant women, children and youth, the trials will test whether doses of the licensed 2009 H1N1 influenza vaccine that are higher than doses being tested in other groups can safely elicit protective immune responses in these populations.

The IMPAACT sites participating in these studies will receive vaccine from Novartis Vaccines and Diagnostics of Cambridge, Mass, through the Office of the Assistant Secretary for Preparedness and Response for the U.S. Department of Health and Human Services.

For more information about NIH-sponsored clinical trials of H1N1 influenza vaccine in HIV-infected pregnant women, children and youth, see http://www3.niaid.nih.gov/news/newsreleases/2009/H1N1HIVTrials.htm and http://www3.niaid.nih.gov/news/QA/H1N1VacHIVChildYouthPregWomenqa.htm

- USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $380.4 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

- Story by Lisa Greene, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

The $117-million award will go to the data coordinating center at USF and 19 consortia

The National Institutes of Health recently announced a second phase of its Rare Disease Clinical Research Network (RDCRN), which includes a Data Management Coordinating Center led by the University of South Florida’s Jeffrey Krischer, PhD. The USF center and 19 new and returning consortia will be awarded $117 million over the next five years. The research conducted with this second round of funding will explore the natural history, epidemiology, diagnosis and treatment of more than 95 rare diseases.

Dr. Krischer, professor and chief of epidemiology and biostatistics for the USF Department of Pediatrics, has been principal investigator for the RDCRN’s data coordinating center from its start. Under his leadership, USF has become the hub for epidemiological research in both rare diseases and juvenile diabetes and garnered world-wide attention as a model for large-scale clinical research. The consortia within the RDCRN funnel their data to USF for collection, storage, management and analysis.

USF has received nearly $15.3 million for the NIH’s rare diseases research initiative over the last five years. With this second phase of funding, Dr. Krischer expects to receive another $15 million over the next five years as data from the new studies come in.

"The great success of the first five years meant we coordinated 10 networks of studies. We'll now nearly double this to 19 networks,” Dr. Krischer said. “We built a foundation that we're now expanding to many more diseases, many more countries, and designing studies that will help many more patients. It’s a testimony to the methods we’ve developed at USF that we can now expand into new areas of study.”

“We built our strength in autoimmune disorders,” Dr. Krischer added. “This new funding will expand our scope to primary immune disorders and immune-mediated disorders, as well as many others that we don’t understand well. Some are genetic and some simply have unknown causes. By looking at these rare diseases, we can look at the different facets of the immune system and the role it plays in health.”

"The progress made by researchers through the network is important and impressive," said NIH Director Francis S. Collins, MD, PhD. "We have shown that this approach can be a catalyst for progress in meeting the challenge of rare diseases, and we are eager to launch this next phase of the program."

Since its creation in 2003, the RDCRN has enrolled more than 5,000 patients in 33 clinical studies of various rare diseases, ranging from ataxias and primary immune deficiency disorders to inherited neuropathies and mitochondrial diseases. A rare disease is defined as a disease or condition affecting fewer than 200,000 persons in the United States. Approximately 6,500 such disorders have been identified, affecting an estimated 25 million Americans.

The RDCRN is unique in its approach to addressing rare diseases as a group. Previously, the NIH's institutes and centers funded research on individual rare diseases in their respective disease-type or organ domains. The RDCRN is the first program that aims to create a specialized infrastructure to support rare diseases research.

Patient recruitment for clinical studies is a fundamental challenge in rare diseases research because typically so few patients are affected in any one area. The RDCRN was designed to address this problem by fostering collaboration among scientists and shared access to geographically distributed research resources. Network consortia have also established training programs for clinical investigators who are interested in rare diseases research.

"Collaboration is a critical element of rare diseases research and the partnerships represented in this program have tremendous potential to make great strides in understanding these diseases," said Stephen C. Groft, PharmD, director of NIH's Office of Rare Diseases Research (ORDR). "The network emphasizes collaboration not just among investigators from multiple research sites but between investigators and patient advocates as well."

The direct involvement of patient advocacy groups in network operations, activities, and strategy is a major feature of the RDCRN. Each consortium in the network includes relevant patient advocacy groups in the consortium membership and activities. These patient advocacy group representatives serve as research partners within their own consortia.

Funds and scientific oversight for the RDCRN will be provided by ORDR and seven NIH Institutes, which will also contribute considerable administrative support to the network: the National Institute of Neurological Disorders and Stroke (NINDS), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the National Heart, Lung and Blood Institute (NHLBI). Several consortia will also receive financial support from their associated patient advocacy groups.

In the RDCRN's first phase, the network's Data and Technology Coordinating Center (DTCC) led by Dr. Krischer developed a management system for the collection, storage, and analysis of RDCRC data, and additional systems to address needs of individual studies, such as a laboratory data collection system, a specimen tracking system, and a pharmacy management system (to support blinded distribution of study agents and placebos).

The DTCC also created RDCRN's central public Web site, developed as a portal for the rare diseases community, including patients and their families and health care professionals, to provide information on rare disease research, consortium activities, RDCRN-approved protocols, disease information, and practice guidelines. Located at http://rarediseasesnetwork.epi.usf.edu/, the Web site had over 3.4 million visits in 2008. The RDCRN DTCC also developed a unique voluntary patient registry that provides ongoing contact with approximately 5,000 individuals from over 60 countries representing 42 diseases, alerting them when new studies are opened in the network or when ongoing studies expand to new sites.

In this second phase of the RDCRN, USF will continue these data management efforts, under a new name and with a slightly different charge, as the Data Management Coordinating Center (DMCC). The DMCC will develop uniform investigative clinical research protocols for data collection in collaboration with the RDCRN Steering Committee, monitor protocol adherence, data collection and data submission, and work with the each consortium's Data and Safety Monitoring Boards to establish protocols for adverse events notification and reporting.

The Department of Pediatrics new simulation center emphasizes multidisciplinary team training for routine and crisis medical scenarios

Dr. John Curran works with a team of residents and neontal nurse to stabilize a "newborn" during a recent emergency simulation exercise at the TEAMS Center.

It was a delivery room complication. The full-term newborn had inhaled meconium, its own feces, on its way out the birth canal and was having trouble breathing.

In a nearby room, USF Health Associate Vice President Dr. John Curran, a veteran pediatrician and neonatologist, was touring the Department of Pediatrics new Team Education and Multidisciplinary Simulation (TEAMS) Center with guest and colleague Dr. David Tayloe, president of the American Academy of Pediatrics. The 2,300-square-foot facility houses more than $250,000 worth of high-fidelity patient simulators – adults, a child and newborns – each with a computer-driven age-appropriate physiology that can mimic routine and crisis medical scenarios. The life-like mannequins can convulse, turn blue around the mouth, reproduce breathing sounds, recreate variations in blood pressure and heart rate, even secrete blood and other imitation bodily fluids.

With Dr. Tayloe at his side, Dr. Curran was unexpectedly whisked away to the simulation center’s labor and delivery room, where a team of USF neonatologists and an NICU nurse were already working on the tiny patient in distress – a newborn mannequin hooked up to a beeping monitor. In a nearby bed, the mother, an adult-size mannequin, shouts out: “What’s going on with my baby? Is he alright? Why won’t anyone tell me anything?”

Dr. Curran suctions and opens the airway.

Dr. Curran begins ventilation as USF neonatology fellow Dr. Cathy Kotto-Kome performs chest compressions. Assisting at left is neontalogy fellow Yahdira Rodriguez-Prado.

Dr. Latha Kumaraswamy, a neonatology fellow, loads a syringe with epinephrine.

As the senior physician, Dr. Curran steps in to open the newborn’s airway by inserting a breathing tube. When the newborn’s heart rate continues to fall after the tube is inserted, ventilation and CPR compressions are begun. A succession of rapid-fire questions and commands cuts through the tension. Dr. Curran: “Where’s the oxygen?…Give me a good-size tube; you have all kinds of smaller ones.” Nurse: “Have we confirmed placement of the tube?” Neonatology fellow: “It’s good!” Dr. Curran: “Let’s get an umbilical cord line in.” Nurse: “Can we get a dose of epinephrine?” Neonatology fellow: “Epi in.” Nurse: “Heart rate coming up… Let’s call NICU and tell them we’re bringing a baby over and have a ventilator ready!”

Outside the room, TEAMS Center Director Laura Haubner, MD, and coordinator Jason Fields, punch up different angles of the scene on a computer monitor for better views of the team at work and control the infant’s vital signs as the drill unfolds. Once Dr. Haubner is satisfied with the team’s response, she brings up the baby’s heart rate with a few clicks of the computer mouse.

Above: USF pediatrician Dr. Laura Haubner, director of the TEAMS Center, and Jason Fields, center coordinator, monitor the team's responses from a control station outside the L&D room. Below: They punch up different views on a computer screen as the emergency scenario unfolds and record for evaluation after the simulation exercise.

Following the emergency scenario, Dr. Haubner ushers the team and residents who observed the simulation into the center’s conference room, where she facilitates a debriefing. The health professionals watch a replay of their performance on a giant screen, critique their strengths and weaknesses, and discuss what they’ve learned. Dr. Haubner prods with questions: “When the heart rate dropped to 35, what were you thinking?... Were the chest compressions and ventilation well coordinated?... Do you feel you called for help readily enough?”

The debriefings are often an “eye-opening” experience for physicians and nurses, said Dr. Haubner, an assistant professor of pediatrics. “The teaching points elicited by the videotape can be very powerful. They get a sense of how important it is to set roles for each team member in advance and clearly designate a team leader.”

Dr. Haubner leads the team in a post-simulation debriefing, where members can critique their performance replayed on a giant screen.

Seated next to Dr. Terri Ashmeade (left), USF assistant professor of pediatrics and TGH NICU medical director, and Jason Fields (right), TEAMS coordinator, Dr. Curran poses a question to the group based on a rare, real-life delivery complication he experienced.

The center is intended to do more than allow physicians, nurses and medical students to practice, hone or retool their clinical skills in an environment without risk to real patients. “We strategically teach them how to deal with conflict and emotional distractions in both routine and crisis situations,” Dr. Haubner said.

The simulation team training focuses on multidisciplinary group dynamics, leadership, interpersonal communications skills and decision making under pressure, and emphasizes using all available information, equipment and people to achieve safe and efficient outcomes. “This crew resources management approach has traditionally been used by high stakes industries like aviation and nuclear power for simulation training, but it’s slowly being adapted by medicine, Dr. Haubner said. “We’re pretty high stakes too.”

The potential benefit for patient safety and improved outcomes is huge, she said. “According to the Institute of Medicine, most medical errors are based on lack of teamwork and miscommunication, not caused by inadequate medical knowledge.”

Dr. Curran with Dr. Paul Tayloe, president of the American Academy of Pediatrics, who observed the emergency L&D simulation during his visit to the TEAMS Center July 23. Dr. Tayloe earlier that morning had delivered the annual John S. Curran Lectureship, speaking to USF pediatrics faculty and residents about health reform.

Dr. Tayloe, who observed the emergency scenario and debriefing, was impressed by what he saw. “This is great. I can see how this type of simulation training would help take a lot of the anxiety out of having to walk into a real-life emergency and respond effectively as part of a team,” he said. “But keep in mind, if you find yourself practicing in a rural area, usually you are the team and must be able to save a baby’s life on your own. I still advise residents to take plenty of call in the delivery room!”

Housed on the first floor of the 17 Davis Building, the TEAMS Center formally opened July 1 and is operated by the Department of Pediatrics with support from the Office of Graduate Medical Education. It has been used by more than 130 USF faculty, residents and fellows -- primarily from Pediatrics, Internal Medicine and Emergency Medicine -- as well advanced registered nurse practitioners and respiratory therapists from Tampa General Hospital. The center expects to expand its simulation training to more health professionals and disciplines in the coming months, Dr. Haubner said.

Using one of the center's task-trainer simulators, third-year pediatrics resident Dr. Karolina Dembinski practices placing an umbilical catheter, used to deliver medications and fluids to critically ill infants, as neonatology fellow Luis Munoz observes.

In addition to Dr. Haubner and Jason Fields, TEAMS Center faculty include Brad Peckler, MD, from Emergency Medicine (Team Health), and Erika Abel, MD, USF assistant professor and program director of Med-Peds. For more information, please contact Dr. Haubner at lhaubner@health.usf.edu, or Jason Fields at jfields@health.usf.edu.

- Story by Anne DeLotto Baier, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

Construction begins on state-of-the-art neonatal nursery

Pam Muma swings a hammer at the NICU wall-breaking ceremony.

The dream of building a world-class neonatal unit for Tampa Bay’s tiniest babies is well on its way to reality.

Donning hardhats and safety glasses, Pam and Les Muma swung their sledgehammers with gusto, creating two big holes in a wall to signal the beginning of construction on the Jennifer Leigh Muma Neonatal Intensive Care Unit at Tampa General Hospital. The $35-million project – a tangible sign of the partnership between USF Health and TGH to transform research and care for newborns – will completely redesign and expand Tampa General’s existing neonatal nursery. Construction is expected to be complete in early 2011.

Physicians, nurses and other clinicians, hospital and university officials, and construction team members gathered March 31 on the fourth floor of Tampa General’s West Pavilion for the construction kick-off. They nibbled cookies with pink and blue icing in the shape of baby booties and sipped on non-alcoholic champagne. They reviewed the tabletop model of the 53,000 square-foot unit, which will increase the current NICU from 52 beds grouped in open areas to 82 beds in private rooms and a 12-bed transitional nursery.

The new NICU is being funded in part by the Mumas’ generous $6 million gift to USF Health – a donation in memory of their daughter Jennifer Leigh Muma, who died in a neonatal nursery. Their gift, one of the largest in Florida to support research and care for newborns, has a total impact of $14 million after eligible state and internal USF matches. It supports a USF-TGH initiative to build research and medical teams, laboratories at USF Health and an expanded NICU to advance the care and well-being of premature babies.

In addition, the TGH Foundation capital campaign, “Tiny babies. Big Priority,” has raised more $7.6 million towards the NICU renovation. That includes more than $170,000 brought in by a physician campaign led by Robert Nelson, MD, chair of USF Pediatrics; David Keefe, MD, chair of USF Obstetrics and Gynecology; and Thomas Bernasek, MD, vice chair of the TGH Medical Staff.

Dr. Lewis Rubin, who holds the Pamela S. and Leslie M. Muma Endowed Chair in Neonatology at USF, says the redesigned NICU will be family-centered while employing the latest technology.

“Everyone here today is part of the team that will make this dream happen,” Pam Muma said. “We want to help any family who experiences a situation similar to ours and do all we can to make sure these smallest, sickest children go home healthy.”

“This day is special and there is also an emotional aspect,” Les Muma said. “We wanted our daughter’s name to live on, and she will live on through this.”

Lewis Rubin, MD, who joined USF to fill the Pamela S. and Leslie M. Muma Endowed Chair in Neonatology, said the new NICU has been planned with the latest research on NICU design and environment in mind. Input was solicited from physicians, nurses, respiratory therapists, housekeeping staff, traffic engineers, interior designers and focus groups were held with the parents of premature babies to create a place that will be welcoming for families and maximize the comfort and well-being of fragile infants in need of critical care.

“Of the three neonatal intensive care units I’ve helped plan, this one by far has been the best at involving in its design all the people who will be using the space,” said Dr. Rubin, medical director of TGH’s NICU. “The Jennifer Leigh Muma Neonatal Intensive Care Unit will absolutely be a world-class newborn center. It will be baby and family friendly, while taking advantage of the latest technology in telecommunications and bioinformatics.”

Jim Warren, Chairman of the Board of the Florida Health Sciences Center, thanked attendees for the work they do everyday "to take care of this very vulnerable patient population."

The redesigned NICU will join a growing trend in the care of premature babies – private rooms that strive to replicate the relatively quiet, nurturing environment of the mother’s womb and emphasize family-centered care whenever medically possible. Traditionally, NICUs have been modeled around life-saving equipment with isolettes in one big room leaving little privacy for parent-infant bonding or confidential medical discussions.

Evidence is mounting to suggest that premature babies thrive better in private rooms than in group areas with harsher lights, louder noises, more traffic and other excessive stimuli, Dr. Rubin said. The private rooms in the redesigned NICU will include a place for parents to sleep, ambient lighting, and noise kept low enough for babies to recognize parents’ voices. Windows will allow nurses to see into the rooms, and hand-held PDAs will let them monitor infants and communicate with other team members from anywhere in the NICU. At the same time, the unit will incorporate common areas where parents can gather to socialize and support one another, and siblings can play.

L to R: USF Pediatrics Chair Dr. Robert Nelson, Dr. Lewis Rubin, TGH NICU nurse manager Pam Sanders, Dr. Laura Haubner and Dr. Terri Ashmeade look over the construction model.

Since the Mumas’ gift was announced two and a half years ago, USF Health has opened the Lisa Muma Weitz Advanced Microscopy and Cell Imaging Core, a state-of-the-art laboratory with applications for basic and translational research in neonatology, pediatrics and perinatology. USF has also recruited key members of the research and medical team, including Dr. Rubin and recently Michael Fant, MD, PhD, professor of pediatrics with research expertise in fetal growth and placental development.

Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, said the Mumas’ vision and leadership will create a brighter future for premature babies receiving care in the Tampa Bay area. Their gift will help translate research into the best evidence-based treatment for newborns, he said.

"It shows that when a university and a hospital are committed to excellence in education, research and clinical care, they can achieve so much more together than either could do alone,” Dr. Klasko said. “This kind of partnership is what makes communities great.”

Pam and Les Muma's generous gift in memory of their daughter has been a catalyst in the USF-TGH partnership to transform newborn research and care.

- Story by Anne DeLotto Baierr, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

Stuart M. Kilpinen, Aetna Network Vice President; William S. Wood, MD, MBA, Medical Director, Aetna-Southeast Region with USF Health Pediatrics' Lynn Ringenberg, MD, Medical Director, USF Pediatric Mobile Health Program/Ronald McDonald Care Mobile.

Aetna Foundation Awards USF Health Pediatrics in Effort to Help Battle Childhood Obesity

On July 31, the Aetna Foundation and USF experts in pediatrics took an important step in strengthening community efforts against childhood obesity. The Aetna Foundation presented a $25,000 donation to the USF Pediatric Mobile Health Program/Ronald McDonald Care Mobile. The funding will benefit the Obesity Action Screening Intervention Support Program (OASIS), which was developed by specialists in the mobile health team and the USF Healthy Weight Clinic. OASIS provides needed health care access, treatment and follow-up care to children and teens who are medically overweight. Program results show that children, teens and families fully engaged in OASIS see marked improvements in their weight and are more likely to have lasting, positive lifestyle changes that contribute to better health.

“Children make up 33% of the current population, but they’re 100% of the future, so it’s everyone’s job to keep them healthy!” says Lynn Ringenberg, MD, Medical Director, USF Health Pediatric Mobile Health Program/Ronald McDonald Care Mobile, "...Making Life Better through access to care, health education and compassion.”

July 31, 2008. Leaders with the Aetna Foundation tour USF Health Pediatrics' Ronald McDonald Care Mobile.

More on the USF Pediatric Mobile Health Program...
The USF Pediatric Mobile Health Program provides health care and education to students in fifty-nine Title I schools in Hillsborough and Pasco counties. These are schools where the majority of its students receive free or reduced lunches. Hilllsborough County is the 8th largest school district in the United States. The target audience for the USF Pediatric Mobile Health program is uninsured, undocumented or underinsured, primarily minority, children and teens with limited access to health care.

The prevalence of overweight and obese children and adolescents in the United States has increased dramatically over the past few decades. In 2003-2004, 33.6% of the children between the ages of 2 and 19 years had Body Mass Indexes (BMIs) greater than 85% (at risk for overweight/overweight) and 17.1% had BMIs greater than 95% (overweight/obese). Over the past three decades, obesity rates have doubled in children aged 2-5 years and adolescents aged 12-19 years and more than tripled in children aged 6-11 years.

The team of experts in the mobile health program, in collaboration with the USF Healthy Weight Clinic, has developed the Obesity Action Screening Intervention Support (OASIS) Program, which targets underserved and marginalized "overweight/at risk" children or teens whose BMI is greater than 85%. These children/teens are the most difficult to manage and the most "at risk" to develop serious problems such as type 2 diabetes, hypertension, obstructive sleep apnea, behavioral disorders, poor school performance and non-alcoholic fatty liver disease. As advocates for children's health issues, we believe that active medical intervention is the key ingredient missing in many of the local obesity education initiatives.

Through this generous $25,000 donation from the Aetna Foundation, the USF Pediatric Mobile Health Program/Ronald McDonald Care Mobile will provide needed health care access, treatment and follow-up care to children and teens with elevated weight/BMI.

A “green” home built by Siebel Falls Homes with proceeds to Ronald McDonald House Charities and Mercy Ships. From L to Right: Dr. Lynn Ringenberg, Dept. of Pediatrics, Ronald McDonald Care Mobile Medical Director; "Ronald McDonald"; Lee Bonta, USF Health Development; Jeannette Fleischer, ARNP, Care Mobile Program Director; and Alison Barrick, Ronald McDonald House Charities of Tampa Bay.

On June 19, 2008, the team in the USF Department of Pediatrics received a donation of $7,000 for its Ronald McDonald Care Mobile Program. The donation was made by Mr. Larry Falls of Siebel Falls Homes. Below - a behind the scenes look at how the idea for the donation came about.

In 2007, Larry Falls of Siebel Falls Homes was approached by the Pasco Building Association (PBA) to build their 2007 Showcase Home. Shortly after, he contacted Ronald McDonald House Charities of Tampa Bay to determine which program they should choose to receive a portion of the proceeds from the sale of the home. Once he heard about the Ronald McDonald Care Mobile program, he instantly made the decision – the Care Mobile seemed a perfect fit. His company also chose Mercy Ships and the Pasco Building Association to receive donations.

Next came the task of building a luxurious home that relied mainly on monetary, material and labor donations from the homebuilder and contributing subcontractors. They also intended to build Florida's first truly "green" luxury community. On June 19, Siebel Falls Homes unveiled the Showcase Home in their Alsace community located in Land O'Lakes, Florida. Many of the product and service donors were on hand to view the finished product and take part in an appreciation ceremony. Also on hand was the Care Mobile and its core team including Dr. Lynn Ringenberg,the Care Mobile's Medical Director; Jeanette Fleischer,ARNP, the Care Mobile's Program Director; Tammy Holland; driver Eileen Acevado; Ronald McDonald, RMHC PR & Development Coordinator Alison Barrick and Lee Bonta, USF Health Development. Although the home has not yet sold, the Department of Pediatrics, USF College of Medicine, which operates the care mobile program, were presented with a check for $7,000. The amount represents a portion of the profit expected from the eventual sale of the home. "These funds will be put to good use," says Dr. Ringenberg, "This will buy a lot of diesel for the Care Mobile. We are very grateful to Siebel Falls Homes for their generous donation." Ringenberg is also the Division Chief of General Academic Pediatrics and the Co-Director Med-Peds Training Program at the USF College of Medicine.

Newbrief by USF Pediatrics.

OTHER LINKS:
Hillsborough County Public Schools Awards USF Pediatrics for Ronald McDonald Care Mobile Program

Background: USF Pediatrics' Care Mobile Program

L to R: Lee Bonta, USF Health Office of Development & Alumni Affairs, Dr. Lynne Ringenberg, Medical Director of USF College of Medicine, Pediatrics Dept. Ronald McDonald Care Mobile Program, and Jeannette Fleischer, ARNP, Program Director.

On May 20, 2008 officials from the Hillsborough County School Board awarded the team in USF Health Pediatrics for its efforts with the Ronald McDonald Care Mobile. The care mobile bearing the name of the internationally recognized clown “Ronald McDonald” is used by pediatric faculty, medical students, pediatric residents, nurse practitioner students and nursing students to visit approximately 60 schools in Hillsborough and one in Pasco County. The care mobile also visits a domestic shelter and a homeless shelter on a weekly basis. The mobile health program recently marked a milestone, providing free care to over 3-thousand children and adolescents in the past 24 months. Visits by the care mobile and USF Health crew are done in Title 1 schools which are primarily located in underserved communities where a majority of the students qualify for free and reduced lunch.

The 40 foot medical and dental clinic-on-wheels has a home at USF Health Pediatrics thanks to a collaborative relationship with Ronald McDonald House Charities of Tampa Bay. This is one of only 29 care mobiles in operation worldwide. Inspired by the number of children served, the care mobile team is out in the schools five days a week providing health care to many, including some Saturday visits for various community events, like sports and back to school physicals and health fairs.

With award in hand, USF Health's Karen Van Cleaf, RN Nurse Manager of Pediatrics, celebrates with Veronica Gonner, (at right) ARNP, Vice President for Women & Children Services.

The May 20 recognition for USF Health Pediatrics was part of a school board meeting that also recognized the community efforts of Tampa General Hospital and 8 other local organizations.

“I think that we are extremely fortunate to have a mobile clinic like this in order to help innumerable families and their children,” says Jeannette Fleisher, ARNP, Ronald McDonald Care Mobile Program Director. “We’ve been able to detect many undiagnosed diseases and address untreated medical conditions during our visits with families. These are health problems that keep the children from either attending school or from fulfilling their academic potential because they can’t do well in class if they aren’t feeling well. We’re very fortunate to be able to help. We wish we were able to go to more schools.”

Background on the care mobile…
Since January 2006, the Department of Pediatrics in the University of South Florida’s College of Medicine has been home to the care mobile. Jeannette Fleischer, ARNP, is the Program Director. Dr. Lynn Ringenberg is the Medical Director. Last Summer, the team worked with the S.M.A.R.T. Institute at USF Health. By combining their medical expertise, the care mobile team provided pre-participation physical exams required for school athletic teams.

During this June 23,2007 school visit, for example, the USF Health team included experts in pediatrics and sports medicine. In all, they saw approximately 85 children in just four hours.

“The program strives to identify, treat and refer children with chronic or untreated health conditions, improve health outcomes, provide continuity of care, educated children and families, and screen and enroll eligible families in federal Medicaid or state insurance programs”, explains Dr. Ringenberg. The USF Health pediatrician estimates that more than 50 per cent of the kids they see in the Ronald McDonald 'van' are un-insured – making their visits critical for families whose only alternative to seeing a doctor may be going to a hospital emergency room.

For more information on upcoming visits by the care mobile or information on how to contribute to this program, click here
or contact (813) 259-8754.

Story by Lissette Campos

University of South Florida, College of Medicine, Tampa Bay. The Department of Pediatrics is led by Dr. Robert M. Nelson, Jr. His team sees patients in various locations across the Tampa Bay area, including Hillsborough and Pinellas Counties. As part of this ongoing series, USF Health in Español, below is a listing of pediatricians who are also available for patient-doctor visits in Spanish.

USF Health en Español...
El Departamento de Pediatria en la Universidad del Sur de la Florida esta dirigido por el Dr. Robert Nelson. El equipo de especialistas atiende a pacientes en varios sitios medicos a traves del area de Tampa Bay, incluyendo los condados de Hillsborough y Pinellas. Como parte de nuestra serie especial, USF Health en Español , les brindamos esta lista de pediatras disponibles a pacientes que quieran consultas medicas en Español.

- Dr. Carmen Alfaro, Pediatria General
- Dr. Al Campos, Especialista en Pediatria Renal
- Dr. Frank Diamond, Especialista en Endocrinologia & Diabetes Juvenil
- Dr. Francisco Flores, Especialista en Pediatria Renal
- Dr. Jorge Lujan, Especialista en Enfermedades Infecciosas
- Dr. Luis Maldonado, Pediatria General
- Dr. Chuck Paidas, Cirugano en Pediatria
- Dr. Ever Rivera, Pediatria General
- Dr. Carina Rodriguez, Especialista en Enfermedades Infecciosas
- Dr. Lisa Rodriguez, Pediatria General

25 de abril del 2007, Tampa, FL. El Dr. Robert Nelson, al centro, rodeado por miembros de USF Health Pediatrics. El grupo, incluyendo pediatras y empleados administrativos, participaron en un evento especial en vispera de la apertura del nuevo centro medico USF Health South Tampa Center situado al lado del hospital Tampa General.

Para mas informacion sobre el Departamento de Pediatria, llamar al (813) 259-8700 o visitar la pagina web de USF Health Pediatrics.

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