That was 20 years ago, but now Bell wonders if those injuries could have had long-term effects.

     That question brought him to the USF Health Byrd Alzheimer’s Institute Tuesday for the institute’s annual Memory Screening Day. About 100 people came to get free screening, a process that can show whether they should receive further testing for cognitive problems.

     Bell was among them. He sat down with Dr. Amanda Smith, medical director of the Byrd Institute, who asked him a series of questions.

     What’s the date? What city are we in? What county? What building are you in? What floor of the building are we on?

Former Tampa Bay Buccaneers tight end Jerry Bell answers questions on a memory screening quiz given by Dr. Amanda Smith, medical director of the USF Health Byrd Alzheimer's Institute.

     Bell, 50, answered the questions with ease. But he plans to return each year, to make sure his cognitive abilities show no signs of decline. Bell knows early diagnosis can slow progress of Alzheimer’s symptoms.

     “There’s no cure – but I might get to see my grandkids for five years more,” he said.

     Bell is thinking far ahead. His two children are in college, and he has no grandchildren yet.

     But his presence at Tuesday’s event had a larger purpose as well. Bell wants to bring more attention to the increased risk of Alzheimer’s for former NFL players. The potential long-term damage of head injuries to football players has been the subject of national debate recently, with a Congressional hearing held to discuss the risks and whether players are adequately safeguarded and treated.

     “The thing is, let’s find out what the risk is,” Bell said. “Nobody’s saying, ‘Stop playing football,’ because the guys won’t do it. But put some things in place to make it safer.”

     Working to design better helmets, strictly enforcing game rules to help avoid head injuries and treating head injuries with vigilance are among the steps that football coaches and physicians need to take, Bell said.
Both times Bell was concussed, nobody worried much, he said.

     “I played the rest of the game,” he said. “That’s how it was done.”

     Still, he figures he was lucky.  Now a senior account manager for a company that sells computer equipment, Bell played tight end. His linebacker teammates got hit harder and more often.

     “I had about half the amount of contact that some people did,” he said.

     On Tuesday, he fielded Dr. Smith’s questions correctly as they became more complex.

     I’m going to say three words: apple, book, cat. How do you spell “world” backwards? Please count backwards from 100, by 7s. How many words can you say that start with the letter “f?” What were the three words I said earlier?

     The range of questions is meant to test different aspects of how the brain works, Dr. Smith told Bell.

     “People tend to think of Alzheimer’s as just memory and forgetting,” she said. “But some people show up first with language problems. They can’t find words for things. They hold up a pen and call it ‘that thing you write with.’ “

Former NFL players Jerry Bell, left, and E.G. Green, right, stand outside the USF Health Byrd Alzheimer's Institute with Dr. Amanda Smith.

Getting that early screening will become even more important as medications now in development make it easier to prevent the symptoms of Alzheimer’s, said Dave Morgan, PhD, chief scientific officer of the Byrd Institute.

     “The analogy that I like is that it’s better to take your statins before you have a heart attack, rather than after,” he said.

    Bell wasn’t the only NFL player answering such questions at the Byrd Institute Tuesday. Former Colts player E.G. Green, 34, got a screening test as well. Green may seem young to take such a test, but he said it’s important to show that it’s okay for football players to take steps to protect their health.

    “We grew up in a culture where you try to mask all injuries,” he said. “You have to be able to make it. You have to ‘tough it out.’ Once the game is over, it’s hard to think you’re not Superman anymore.”

      Players, their families and their doctors and coaches need to be aware of that mindset, he said, so that former players get appropriate care.

     “You transform from a gladiator to a citizen,” he said. “You need to be able to take care of yourself after football.”

     - Story by Lisa Greene, USF Health Communications; photos by Eric Younghans, USF Health Communications

L to R: Dr. William Dalton, Dr. Richard Roetzheim, Maria Pinzon, Dr. Leslene Gordon, Dr. B. Lee Green and Dr. Ralph Wilcox.

The USF-Moffitt Center of Excellence for Cancer Health Disparities was formally introduced to the community Nov. 12 at a reception attended by community leaders, elected officials and university and Moffitt Cancer Center faculty and staff.

The center’s new name -- Center for Equal Health: Community Partnerships in Research, Education and Training – was unveiled for the audience by community directors Leslene Gordon, PhD, of the Hillsborough County Health Department and Maria Pinzon of the Hispanic Services Council.

The center will focus on reducing cancer-related disparities among Florida’s minority and underserved populations. Researchers will address such questions as why African-American men are much more likely to develop and die from prostate cancer than white men. This summer, USF and Moffitt were awarded a highly competitive $6-million, five-year program grant from the National Center on Minority Health and Health Disparities, National Institutes of Health, to establish the center --- one of three in Florida.

Desiree Rivers, PhD, center director, was emcee for the reception.

“I’ve spent my entire career documenting the toll of health disparities, so it’s very exciting that we have the chance to do something to develop effective solutions,” said Center Co-Director Richard Roetzheim, MD, MPH, professor and director of research for the USF Department of Family Medicine. “It will be challenging, but we’ve assembled a tremendous team of talented people from USF, Moffitt and the community.”

“The community must be a vital and active participant in our Center,” said Center Co-Director B. Lee Green, PhD, professor and vice president of Moffitt Diversity. “The Center is not intended to be about statistics, but about addressing the needs of real people – some of whom unfortunately suffer disproportionately from serious diseases and disabilities.”

USF Provost Ralph Wilcox, PhD, said the legal, socioeconomic, structural and other barriers that lead to inequities in care and poorer health outcomes for minority and disadvantaged populations are daunting, but not insurmountable.

“The Center is exactly the type of partnership model that allows Moffitt and USF to unleash their complementary strengths,” Wilcox said. “I remain hopeful that this collaboration will help us better understand the scope and root causes of disparities and, most importantly, generate solutions to close the gaps of these disparities.”

Florida ranks second in the United States in the number of deaths from cancer, said Moffitt CEO William Dalton, PhD, MD. He noted that USF and Moffitt had a one in 10 chance of securing the highly competitive NCMHD Center of Excellence award. “Competing with the best and brightest in the nation to win this grant speaks volumes about this community and the partnership between USF and Moffitt,” he said.

USF Provost Ralph Wilcox, PhD, with the College of Public Health's Deanna Wathington, MPH, co-leader for the center's Community Engagement Core.

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

RELATED STORY:
USF-Moffitt Center of Excellence Targets disparities in cancer care and outcomes

     She had five kilometers to run and she wasn’t sure she could do it.

     Once, it would have been easy.

     Schofield could always count on her body to perform. She grew up in Lakeland playing soccer. She could run fast, kick strong.

     Her athletic ability won her a scholarship and made her a soccer star at Florida State University. It helped her set college scoring records that remain unbroken. It guided her decision to move to Tampa to coach soccer for Tampa Preparatory School and competitive youth soccer teams.

     But all that was before.

     Now, 28-year-old Schofield was scared.

                                                                     ***

          It began on a Sunday afternoon in January 2008. Schofield had been at the soccer fields all weekend, coaching and leading personal training sessions. She started to feel dizzy and confused. 

     “My head was out to here,” she said. “I felt like I had been hit by a bus.”

     She called her mom in Lakeland, who told her she would drive over and take her to a doctor.

     But Schofield decided the pain was too bad. Her head felt like it was going to explode. She drove herself to a walk-in clinic, went in, waited, saw the doctor.

Cindy Schofield didn't know whether she would ever walk again after a sudden illness nearly killed her.

     Her mom met her in the parking lot and asked her what the doctor had said.

     “I don’t remember,” Schofield told her.

     Her mom drove her to a local hospital. Her father and her brother soon joined her. Doctors took her to get an MRI. Later, she wouldn’t remember any of that, either.

     Nor would she remember the MRI results. A doctor came out and delivered the news to her parents.

     “She has a cancerous brain tumor,” he told them. “She’ll be dead in two years.”

                                                                 ***

     Her parents, devastated, began making phone calls. They were determined to get their daughter the best treatment possible. They took her to H. Lee Moffitt Cancer Center & Research Institute.

     There, Schofield underwent surgery. Doctors were prepared to do a biopsy and to remove whatever part of the tumor they could.

     They didn’t find what they expected.

     This part, Schofield does remember: she was with her father when his cell phone rang with the biopsy results.

     He started to cry. It wasn’t cancer.

     Amidst his tears of relief, her father didn’t realize it was something just as deadly.

                                                           ***

     Schofield kept getting worse. Her vision kept blurring. The pain in her head was horrible. She could no longer move the left side of her body. She couldn’t even walk.

     Moffitt doctors believed her problem was related to multiple sclerosis. They suggested that Schofield see Dr. Stanley Krolczyk, USF assistant professor of neurology and director of the USF Multiple Sclerosis Center. Schofield was impressed when he came in to see her on his day off.

     But Dr. Krolczyk wasn’t happy with what he saw. On a disability scale of 1 to 10, Schofield scored an 8.5 – and 10 was dead.

     “She was going downhill very rapidly,” he said. “There was active inflammation in her whole brain, white blood cells attacking the brain, denuding the neurons of myelin and destroying the brain tissue.”

     Myelin is the protective sheath that covers nerve fibers, like insulation around a wire. When the body’s immune system attacks myelin, it can strip nerves bare, creating scar tissue and leaving neurons unable to communicate.

     Schofield had been attacked by an extremely rare form of multiple sclerosis, called tumefactive MS. While the severity and course of MS is different for every patient, most of them become more disabled gradually, sometimes following a pattern of remission and relapse. In contrast, tumefactive MS can hit somebody like a thunderbolt out of a blue sky.

     “There’s no way to predict which individuals develop this,” Dr. Krolczyk said. “It looks like an aggressive brain tumor on an MRI.”

     Nor is the prognosis any better. Most patients die within a few months.

Dr. Stanley Krolczyk, USF assistant professor of neurology and director of the USF Multiple Sclerosis Center, said the inflammation in Schofield's brain was so bad it could be mistaken on an MRI for a brain tumor.

      Schofield’s situation seemed bleak. About 460,000 people in the U.S. now have MS. But Dr. Krolczyk has found only a few dozen published cases that seem as severe as hers.

     With such a rare condition, there were no guidelines – no protocol to guide Dr. Krolczyk on the best way to save Schofield. He had to design his own treatment.

     Schofield’s best chance, Dr. Krolczyk decided, was aggressive action to try to reduce the swelling and inflammation in her brain before it created any more damage. He decided on a combination of three drugs to attack the inflammation in every way possible.

     Schofield received steroids to reduce the inflammation in her brain. Plasma exchange to remove antibodies and inflammatory mediators from her blood. And a special chemotherapy drug to suppress the T-cells that could attack her brain again.

     Schofield was hospitalized for weeks, but she would remember little of her time there. Only one decision stayed with her: sometime in her hospital bed, unable to walk, she vowed this would not be her future.

Schofield wound up in the hospital, unable to move the left side of her body.

      She would recover, she promised herself. She would walk again. And then she would run. Still in the hospital, she decided she would run a 5K.

                                                                  ***

     It was that vow to herself that Schofield thought of as she approached the starting line of her 5K – the Susan G. Komen Race for the Cure, held in St. Petersburg in October.

     She was still scared. Her balance wasn’t good. What if she stumbled? A stubbed toe might send her sprawling.

     But she stepped over the starting line and began to run.

                                                                 ***

     When she left the hospital, Schofield came home to a different world. Her parents left Lakeland and moved in with her. They rented a hospital bed for the living room. The once strong athlete was in a wheelchair. Not only could she not walk, she couldn’t even lift her left arm.

     Her life seemed to have turned into a shuttle between doctor’s visits and physical therapy sessions. At first, there were days when Schofield didn’t even want to get out of bed.

     And then she would tell herself: No. She was not going back to the hospital. She forced herself to do more.

     Her parents and Dr. Krolczyk encouraged her as well. He and Lise Casady, a USF nurse practitioner who works with Dr. Krolczyk, were in constant contact.

     “They pushed me when I needed to be pushed,” Schofield said.

     She set small goals. She had to work just to gain enough hand strength to squish a stress ball. To be able to lift her arm long enough to put her hair in a ponytail.

Schofield was determined to run again.

     She still felt mentally fuzzy as well. She had to work to remember daily routines, dates and even the trauma that had struck her life. She joked about the movie “50 First Dates,” in which Drew Barrymore suffers a brain injury and can’t remember anything for longer than a day. She tried to write things down to help her memory.

     Schofield had been through hard times before. In her sophomore year of college, her fiancé was killed in a skydiving accident. Shattered, Schofield nearly left FSU. It was her close ties to the members of her soccer team that pulled her through.

     “That was my family,” she said. “I don’t know what I would have done without them.”

     Now, she was relying on athletics to help her again.

                                                                ***

     As she ran, her mind began to slip backwards. Everything started to replay through her mind. Her brush with death, her fall into disability, and all she had been through just trying to walk.

     She struggled not to cry. She didn’t even think about the ground that she was covering, or the speed she was traveling. She just relived the struggle, stride after stride.

                                                               ***

      Schofield moved from a wheelchair to a walker, then to a heavy cane. Next to a lighter one.

      She gradually began reclaiming her life. She returned to her passion, coaching soccer, limping along the sidelines with her cane.

      One tournament weekend, she got tired of the cane. It was in the way. She decided on the spot that she could balance without it. So she put it down.

      The next day, she walked into her physical therapist’s office on her own.

      “I told her I graduated,” Schofield laughed.

      Still, Schofield wasn’t sure she could balance well enough to run. In the spring, she began to run on a treadmill – slowly, about 4.5 mph – so that she could hold on to the arm rails.

     Gradually she increased her speed and distance. Dr. Krolczyk was impressed with her determination.

     “She’s a very hard worker,” he said. “It’s great to have patients like that.”

     Schofield was learning as well about taking care of herself, being careful not to get overheated and giving herself more time to rest after exercise or long spells of coaching in the Florida heat. She also remained on a medicine to modify her immune system.

     Although MS patients are known for going through periods of relapse, Schofield and Dr. Krolczyk are cautiously optimistic.

     “So far she only appears to get better,” Dr. Krolczyk said. “We hope this was one unbelieveably bad case that will not recur.”

     Despite her progress, Schofield was still scared to run outside. Her balance remained a little shaky; she couldn’t balance while standing only on her left foot. She was still afraid of falling.

     Four days before the race, she went to the Upper Tampa Bay Trail with something to prove. She turned right, where the trees shade the path and the trail runs true north, and began to run.

                                                                     ***

      Step by step, the distance fell away. Thirty-two minutes after she began to run, Cindy Schofield, a woman left battered by multiple sclerosis, crossed the finish line.

Schofield runs along a sunny section of the Upper Tampa Bay Trail.

     Her mother cheered as she saw her daughter cross the line and then she began to spread the news. She got out the cell phone, calling everyone: Cindy did it. She finished. She really did it.

      But Schofield saw the clock coming over the finish line.

     “That’s it?” she asked herself.

     She had been so scared. She hadn’t run for speed – just to finish. Now, she thought, she could have run faster if she had pushed harder.

     She felt a rush of her old competitive spirit. In November, she decided, she would do another 5K. Then a half-marathon, maybe in the spring. And this time, she’d run faster.

     Then she knew.

     She was back.

Runner 3443, Cindy Schofield

                                                                ***

-- Story by Lisa Greene, USF Health Communications; Trail photos by Eric Younghans, USF Health Communications; Other photos courtesy of Cindy Schofield

Read St. Petersburg Times story...

Tampa, FL (Nov. 12, 2009) -- A multidisciplinary team of USF Health and Tampa General Hospital physicians recently performed the first Ex Utero Intrapartum Treatment (EXIT) at TGH -- successfully securing an airway for a baby girl with a large benign tumor wrapped around her neck before fully delivering the 7 pound, 11 ounce infant by Cesarean section.

EXIT is an innovative procedure developed to deliver infants with severe congenital abnormalities that may make breathing after delivery difficult or impossible. During EXIT, the newborn is partially delivered in a manner similar to a C-section, but the umbilical cord supplying oxygen from mother to baby is not immediately cut. Instead, the baby is intubated -- a breathing tube is inserted through the mouth or nose into the windpipe – and delivery of the infant is completed and cord cut only after a clear airway has been established.

“The biggest challenge in this type of procedure is establishing an airway for the fetus while maintaining a steady supply of oxygen so that no neurological damage occurs,” said Valerie Whiteman, MD, lead USF obstetrician for the EXIT delivery on Oct. 1. “If you can’t successfully intubate on the first attempt, surgical intervention is required and that potentially increases the risk for both the fetus and mother.”

Dr. Valerie Whiteman, interim director of Maternal-Fetal Medicine at USF Health, led the EXIT delivery.

This challenging, uncommon procedure (only about 100 cases have been documented in the United States) required extensive, seamless coordination by the USF-TGH team of 20-plus physicians, nurses and other health professionals assembled inside and just outside the operating room.

The following were the key physicians on the EXIT delivery team:

• Maternal-Fetal Medicine -- Dr. Valerie Whiteman, USF assistant professor of obstetrics and gynecology and interim director of Maternal-Fetal Medicine, assisted by Dr. Aaron Deutsch, senior maternal fetal medicine fellow

• Anesthesia – Dr. Devanand Mangar, anesthesiologist with Gulf-to-Bay Anesthesiology and chief of staff at Tampa General Hospital, and Dr. Amrat Anand, Gulf-to-Bay anesthesiologist

• Neonatalogy - Dr. Terri Ashmeade and Dr. Laura Haubner, both USF assistant professors of pediatrics, and Dr. Lewis Rubin, professor and chief of neonatology at USF

• Pediatric Surgery - Dr. Charles Paidas, director of USF Division of Pediatric Surgery

Patty Bornick, RN, MSN, perinatal navigator for the USF Health Fetal Care Center of Tampa Bay, coordinated care for the high-risk obstetric patient, a 31-year-old woman who lives in Tampa with her husband and two other children.

Anesthesiologists delivered anesthesia to the mother and a medication to prevent contractions during intubation. Obstetricians performed the high-risk surgical delivery using a special autosuturing device to minimize maternal bleeding. Neonatologists intubated once the infant’s head and shoulders were delivered and assessed the baby after birth. The pediatric surgeon was on standby in case intubation proved difficult, so that some of the tumor could be cut away or a hole could be made in the windpipe. The infant’s heart rate was continually monitored by ultrasound for any signs of oxygen loss.

The USF-TGH team established protocols and contingency plans for the surgery and practiced with two dry runs in the operating room in August and September. During the actual EXIT procedure, intubation was successful on the first attempt.

“We were all familiar with our roles, our equipment and what steps needed to be taken when. We prepared for the best and worst case scenarios. It took teamwork, teamwork and more teamwork,” Dr. Whiteman said. “This EXIT procedure required tremendous collaboration, and the successful outcome speaks well of the partnership between TGH and USF and our extensive resources.”

“Preparing for the procedure with Dr. Laura Haubner, director of the Department of Pediatrics Center for Team Education and Multidisciplinary Simulation was vital,” said Dr. Ashmeade, the neonatologist who placed the breathing tube. “She is an expert in critical resource management and patient safety. I knew that she was aware of the entire situation in the operating room, which allowed me to concentrate solely on securing the baby’s airway.”

USF pediatric surgeon Dr. Charles Paidas has already performed one surgery to begin removing the benign tumor wrapped around the baby's neck.

The baby was discharged home from Tampa General’s neonatal intensive care unit on Oct. 12. The benign tumor, a cystic hygroma, will be resected in two stages because it is attached from the base of her skull to her tongue, and surrounds her heart, windpipe and great vessels. She underwent a first operation Oct. 30 to remove the neck portion of the hygroma. In two to three months, a second operation will remove the remainder of the tumor in her right chest.

“This was not simply a team, but a team that practiced all aspects of the planned procedure and practice makes perfect,” Dr. Paidas said.

- 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 $380.3 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

- Tampa General Hospital -
Tampa General is a 988-bed acute care hospital on the west coast of Florida that serves as the region’s only center for level I trauma care, comprehensive burn care and adult solid organ transplants. It is the primary teaching hospital for the University of South Florida College of Medicine. TGH is also one of only 16 comprehensive stroke centers in Florida and is a state-certified spinal cord and head injury rehabilitation center.

- News release by Anne DeLotto Baier, USF Health Communications

Dr. Alexander Rosemurgy was recognized for his dedication to pancreatic cancer research and patient advocacy.

USF -TGH surgeon Alexander Rosemurgy, MD, was recently honored for his leading expertise and research contributions in the field of pancreatic cancer by the patient-based advocacy organization Pancreatic Cancer Action Network of Tampa Bay.

Dr. Rosemurgy was recognized for his years of dedication to helping patients and families understand and fight the devastating disease Nov. 5 at the local PCAN’s 3rd Annual Auction for Action at the Columbia Restaurant in Ybor City.

Dr. Rosemurgy, professor of surgery and medicine and surgical director of the Digestive Disorders Center at Tampa General Hospital, holds the Vivian Clark Reeves/Joy McCann Culverhouse Endowed Chair for Digestive Diseases and Pancreatic Cancer at USF.

He is world renowned for his expertise in resecting pancreatic cancers and has extended the lives of many patients through surgery. Dr. Rosemurgy and colleagues at USF-TGH continue to conduct innovative research in the field of pancreatic research and have published numerous high-impact papers about how to best operate on patients with pancreatic cancer.

Pancreatic cancer is among the top four cancer killers in the United States. Most of the more than 30,000 Americans diagnosed with pancreatic cancer die of it because the symptoms are often so subtle that the disease is far advanced before it is diagnosed.

The Pancreatic Cancer Action Network is a nationwide network of people dedicated to working together to advance research, support patients and create hope for those affected by pancreatic cancer. The organization raises money for direct private funding of research -- and advocates for more aggressive federal research funding of medical breakthroughs in prevention, diagnosis and treatment of pancreatic cancer.

- Photo by Ellen Fiss, Tampa General Hospital

Dr. Fenske helped secure the seed money from the American Academy of Dermatology for the fundraising effort to build the school’s Proud Panther Pavilion, which provides students and staff with year-round shade protection and reduced sun exposure while participating in activities on the school’s existing outdoor courts.

Dr. Neil Fenske stands under the Proud Panther Pavilion with Jamie Dietrich, parent of an Essrig Elementary student.

A ribbon-cutting ceremony officially opening the pavilion was held Oct. 30 at Essrig Elementary to thank all of the supporters and donors who made the pavilion possible. Dr. Fenske presented information to the students about the importance of sun protection and acknowledged the AAD grant award and the school’s efforts to protect the students.

In addition to the AAD grant, provided in June 2008 and called the 2008 Shade Structure Program Grant, funding for the pavilion came from events and activities supported by the school, the students and their families, the PTA, and the School Advisory Council. Additional grants and donations came from St. Lucy’s Vision, SAMS Club Giving Program, Dr. Nalin Patel, and Library Interior Signage. The Hillsborough County Public School System provided matching funds, as well.

Story by Sarah A. Worth, USF Health Communications

The move was deliberate – a way for the military C-17 to evade ground fire as it landed in Bagram, Afghanistan.

It was just one more sign of the dangers that soldiers face every day – signs that USF's Nicole Johnson saw firsthand a few weeks ago, as she went to visit the troops with a group of five other former Miss Americas.

"It changed my life," said Johnson, Miss America 1999 and director of education, communication, and outreach for the USF Diabetes Center. "You see their struggle and what they're giving up. They're 20 years old, and they're dying for us."

USF's Nicole Johnson, Miss America 1999, surrounded by soldiers in Afghanistan with a banner of well-wished from USF Health faculty, staff and students.

The group made the trip to boost morale among the soldiers and thank them for the work they do. Unlike traditional USO shows, the Miss Americas didn't perform for crowds. Instead, their work was more personal. They listened to soldiers' stories of home and families far away. They joked about the irony of beauty queens in flak jackets. And they cried with soldiers as they talked of comrades who had died.

"We'd just hug them, and say, 'We love you, and we are here because we want you to know that,' " Johnson said. "It became that intense and emotional."

The group spent the most time with soldiers who had been under heavy fire, often witnessing the deaths of their battle buddies. With little prompting, soldiers would pour out stories of loss and talk to the women about trying to cope with grief while standing guard in a lonely land.

"We would get back on the helicopters every night, and we'd just cry for about 30 minutes," Johnson said. "It just still hurts, thinking about it – a kid that's 20 or 21, they don't deserve to have their lives cut short. And I don't know how they deal with all the psychological turmoil."

Nicole Johnson, front left, and five other Miss Americas visit with soldiers in Afghanistan.

The trip was physically demanding as well. In an effort to reach as many soldiers as possible, the women were up at 3 a.m. each day, often not returning to their temporary home – a wooden hut – until at least 10 pm. Reminders of danger were constant. They wore helmets and flak jackets, and a bomb shelter loomed just a few dozen feet from the hut. One helicopter crashed the day after Johnson rode in it. A village was bombed the day after the women visited.

But there were lighter moments too.

"I think we shocked the soldiers," Johnson laughed.

Soldiers' jaws would drop as they saw a platoon of beauty queens hit the ground and begin competing against each other to see who could do the most push-ups. The women invented a comic "Miss America formation," starting by standing at attention and segueing into a series of hokey model poses.

The oldest in the group, Miss America 1948, Bebe Shopp, 80, told all the soldiers the same thing:

"You may not know my name – but your grandfathers did."

The group flew first into Ali Al Salem Air Base in Kuwait, and spent nearly two days there. While the soldiers there are physically safer at that base, known as "The Rock," than those on the front lines, Johnson said, it's still difficult.

"It's very safe, but desolate," she said. "It was dirt, dust and more dirt. It was very depressing. There was nothing there to do."

Visitors usually arrive there on their way to Iraq or Afghanistan, so soldiers based in Kuwait rarely interact with them. When Johnson and her companions did, they saw a universal response when they were introduced.

"It was a lot of joy," she said. "Their faces would light up, and then their eyes would get big."

Then she laughed.

"The sobering fact was, I was easily older, at 35, than almost everybody there."

Ericka Dunlap, Miss America 2004, and USF's Nicole Johnson, Miss America 1999, as their Blackhawk helicopter takes off.

As a public health doctoral student, Johnson was pleased to see health messages about hand-washing, flu prevention and dehydration everywhere she went. Soldiers couldn't enter the cafeteria without washing their hands first.

"They really do so much better than we do at motivating people to practice good health and providing access to the right tools," she said.

There were scarier signs too: one warned to be on the lookout for cobras.

In the midst of the bomb shelters and the unfamiliar terrain, reminders of home stood out. There was a Subway and a Pizza Hut. Soldiers had painted concrete construction barriers in bright colors to honor other military units and to memorialize Sept. 11.

When the women visited Bagram Hospital, where Johnson saw a boy injured by a bomb and scrubbed in to witness a surgery to help an Afghan man wounded by insurgents, Johnson took photos of the hospital beds. Each one was ready to receive injured soldiers, covered with a quilt sewn by American hands and marked by at least one letter written by anonymous American well-wishers.

Making the journey wasn't an easy decision for Johnson. It meant a long separation from her 3-year-old daughter, Ava, and, since Johnson has type 1 diabetes, the possibility of health complications in a place with limited care.

Johnson was able to use Skype a few times during the trip to contact her family, but she wound up in a base hospital on the last night of her stay when her insulin pump backed up, sending her blood sugar level to a dangerous high. Because soldiers diagnosed with diabetes usually leave the Army, the base hospital did not have any insulin. Johnson had brought her own store of insulin, and was able to use the hospital's syringes for an injection.

Still, even Johnson's diabetes provided opportunities. She posed for a photo with one soldier holding her insulin pump high in the air. The soldier wanted to show his wife, who has diabetes, that even Miss America uses an insulin pump. Johnson also brought two banners from USF Health, signed by USF faculty, staff and students with messages of support for the soldiers. One banner is now displayed in Bagram Hospital; the other is in the terminal at Bargram Air Field.

Nicole Johnson also brought this USF Health banner to Afghanistan.

Johnson also brought five banners signed by children at her daughter's school. They are now displayed at the various Afghanistan bases the women visited, including some in base churches.

Despite the hardships of the trip, Johnson has already volunteered to return.

"War doesn't seem real to us here. I'm thankful to understand a little more about that reality," she said. "We get so wrapped up our world and our lives, and we're all spoiled. We all owe it to do more for the people who are sacrificing their lives – to do more to support them."

-- Story by Lisa Greene, USF Health Communications; Photos by Nicole Johnson, USF Diabetes Center

Dr. Stephen Klasko, CEO for USF Health and dean of the College of Medicine, makes a point while speaking with Jessy Divo de Romero, President (Rectora) of the University of Carabobo, and USF President Judy Genshaft.

The University’s global health initiative got a boost last month when USF President Judy Genshaft met with representatives from three Latin American universities -- the University of Carabobo in Venezuela, the University of Panama College of Medicine, and the Universidad Latina College of Health Sciences -- to sign agreements for collaboration.

During their two-day visit here, Sept. 21-22, top officials of the University of Panama and Universidad Latina also held extensive discussions with USF Health leadership on ways the College of Medicine can partner with their medical schools on education and research.
The guests met with Hispanic medical students and faculty. They toured the Morsani and South Tampa Centers for Advanced Healthcare, several USF Health-directed programs at Tampa General Hospital, USF Health’s new da Vinci Center for Computer Assisted Surgery, the Shimberg Health Sciences Library and the Center for Human Morpho-Informatics.

Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, presented some recent achievements of USF Health and its medical college, including PaperFree Tampa Bay, simulation training, iTunes Health and others.

Leaders of USF Health and the Panama schools discussed institutional and regional needs in medical sciences. John Sinnott, MD, vice dean of International Affairs and director of Infectious Diseases, and Lynette Menezes, PhD, director of International Affairs for the College of Medicine, have facilitated faculty and student exchanges and capacity building to enhance HIV clinical research and infectious diseases education in Panama.

Discussions with Deborah Sutherland, PhD, USF Health associate vice-president for Continuing Professional Development, focused on ways to advance continuing medical education, technological training and leadership. With the support of IT technology, the discussions are continuing long distance to develop Memoranda of Understanding for approval.

“With these efforts the USF College of Medicine and USF Health are moving forward to achieve the global mission of USF,” said Carlos Callegari, MD, PhD, professor of public health and pediatrics and senior advisor for the Ibero-Americas Programs at USF Health, “We’re incorporating our distinguished friends from Panama and Venezuela into a long-lasting partnership committed to improving world health.”

After hours of hard work, the Latin American visitors joined their USF colleagues and members of the Hillsborough County Medical Association for a night of music and medicine at the Dean’s Lecture Series. They were entertained at the Tampa Bay Performing Arts Center by psychiatrist-pianist Dr. Richard Kogan, who played pieces by composer George Gershwin and spoke about the power of music to heal.

L to R: Dr. Stephen Klasko, CEO for USF Health and dean of the College of Medicine; Dr. Ann DeBaldo, associate vice president, International Programs, USF Health; Jessy Divo de Romero, President (Rectora) of the University of Carabobo; USF President Judy Genshaft; Veronica Arce, secretary of Board of Directors, University of Latina; Dr. John Sinnott, director of Infectious Disease and International Medicine at USF; Dr. Julio Rodriguez, dean of the University of Panama College of Medicine; Dr. John Curran, USF Health associate vice president for academic and faculty affairs; and Maria Crummett, dean of International Affairs at USF.

Jessy Divo de Romero, President of the University of Carabobo, Venezuela, and USF President Judy Genshaft sign the collaborative agreement.

Top officials from medical schools at the University of Panama College of Medicine and the Universidad Latina College of Health Sciences met with USF Health leadership to discuss opportunities for educational and research collaboation.

Dr. Donald Hilbelink, director of the Center for Human Morpho-Informatics, which combines the resources of medical and engineering faculty, shows the visitors a 3-D computer reconstruction of human anatomy.

Dr. Carlos Callegari (right), senior advisor for Ibero-Americas Programs at USF Health, shows one of the guests the same reconstructed human anatomy on a personal hand-held device.

Dr. Julio Rodriguez, dean of the University of Panama College of Medicine, tries out the high-fidelity endovascular simulator at the USF Health Simulation Center at Tampa General Hospital.

Veronica Arce, secretary of the Board of Directors of Universidad Latina, checks out a device held by Dr. Lennox Hoyte, medical director of the USF Health daVinci Center for Computer Assisted Surgery.

L to R: Jessy Divo de Romero, President of the University of Carabobo; Dr. John Curran, associate vp for USF Health academic and faculty affairs; and Veronica Arce, secretary of Board of Directors, Universidad Latina.

- Photos by Eric Younghans, USF Health Communications, and Dr. Carlos Callegari, Ibero-Americas Programs at USF Health

Listen to psychiatrist-musician Dr. Richard Kogan play Gershwin

Faculty, staff and students nearly filled the USF Health Auditorium Sept. 22 to hear award-winning concert pianist Richard Kogan, MD, play for the Department of Psychiatry Grand Rounds. As a psychiatrist and a musician, Dr. Kogan provided key insights into how vital music is to medicine.

“Music is a highly underutilized modality,” Dr. Kogan said. “When science documents exactly what music does for healing, there will be an explosion in its use for treating people.”

From left, Dr. Lois Nixon, Dr. Francisco Fernandez, Dr. Richard Kogan, and first-year medical student Trey Penton.

In the Grand Rounds, Dr. Kogan focused on George Gershwin, noting that the world-renowned composer’s story is probably the most profound example of the healing power of music. Dr. Kogan said the young Gershwin would probably be diagnosed today with Attention Deficit Hyperactive Disorder (ADHD) and that his lack of focus and bad behavior as a child came to an abrupt halt when he first heard a violinist at a school assembly.

“Gershwin was transfixed by the music,” Dr. Kogan said, adding that Gershwin had come from a poor home and that hearing the violinist was probably his first real exposure to music. After that moment, Gershwin’s bad behavior stopped and he pored over learning music, even dropping out of school at the age of 15 to devote himself to it. Gershwin noted himself that “studying piano turned a bad boy into a good boy.”

Dr. Kogan displayed his own musical talent by playing Gershwin’s Rhapsody in Blue (which Gershwin wrote in three weeks) and then Summertime (from the score Gershwin wrote for the play Porgy and Bess).

Although Gershwin’s ADHD may have been eased after finding music, Dr. Kogan said that Gershwin continued with mental illness, entering a boastful period in his 20’s that might have been signs of narcissism, and then serious depression at age 35, with sleeping troubles and crying spells. Interestingly, Dr. Kogan said, it was during these down times that Gershwin wrote mostly peppy love songs, and that writing the bluesy, melancholy tone for Porgy and Bess may have helped him deal with some of his depression.

Signs of the brain tumor that eventually killed Gershwin came next, with dizzy spells, pounding headaches, and the sense that he smelled burning garbage or rubber before blacking out. George Gershwin died July 9, 1937, following surgery trying to remove the tumor.

Dr. Kogan studied piano at the Juilliard School and medicine at Harvard Medical School. He is known for his lecture/recitals that explore music’s role in healing and the influence mental illness has had on the creative output of classical composers. The evening following USF’s Grand Rounds, Dr. Kogan performed for the Second Annual Hillsborough County Medical Association/USF Health Dean’s Lecture, an annual collaborative lecture also supported by Tampa General Hospital.

Story by Sarah A. Worth, USF Health Communications
Photos by Eric Younghans, USF Health Communications

The trip was part of the travel award the USF/Tampa General Hospital Comprehensive Epilepsy Program earned last year from the International League Against Epilepsy (ILAE) to partner with and develop comprehensive epilepsy programs in Latin American.  The USF/TGH program was one of four centers selected nationally for the ILAE award.

Drs. Fernando Vale and Selim Benbadis (center) with a DR health team.

Dr. Benbadis, professor of neurology, directs the USF/TGH program and Dr. Vale, associate professor of neurosurgery, is the surgical director for the program.

While in the Dominican Republic, the two USF physicians visited Hospital Padre Billini, the Hospital Robert Reid Cabral for Children, and the General Hospital Plaza de la Salud, and met with administrators to plan future collaboration opportunities. Drs. Benbadis and Vale also gave medical lectures to hospital physicians, residents and students at the Hospital Padre Billini and attended the annual meeting of the Sociedad Dominicana de Neurologia y Neurocirugia (SDNN). Both lectured at the SDNN meeting, with Dr. Benbadis presenting “What Every Neurologist Should Know About Epilepsy” and Dr. Vale presenting “Temporal Lobe Surgery.”

Drs. Benbadis (center) and Vale (right) presented medical lectures while in DR.

“We met many neurologists, child neurologists, and neurosurgeons who were very enthusiastic about our mission to help develop epilepsy centers in their country,” Dr. Benbadis said.

“We believe we have formed new relationships and solidified existing ones, and we have no doubts that our collaboration will flourish and develop. From Dr. Vale’s and my point of view, we feel that this endeavor adds a new challenge and a new dimension to our successful epilepsy program. We believe that our Dominican colleagues truly have the capability and motivation to successfully develop centers. This could be a bridge to, and a model for, other Latin American countries.”

The ILAE is a worldwide association of physicians and health professionals dedicated to improving the lives of people with epilepsy through education, research and improved access to treatments.  The USF/TGH Epilepsy Program meets and exceeds the guidelines for a fourth (highest) level medical and surgical epilepsy center, based on guidelines established by the National Association of Epilepsy Centers. It is one of only four centers in Florida, and the only one in West Central Florida, with this level of expertise.

Story by Sarah A. Worth, USF Health Communications.

Athletes know this. So do healthcare providers. But your immune system and emotions may be working against you. Any inflammation, whether part of an allergy, an infection, or associated with injury can derail your mood, your reaction time and your motivation to push on.

The USF College of Nursing will host “Frontiers in Psychoneuroimmunology: Emotions, the Immune System and Performance,” the second annual national conference for the Center for Psychoneuroimmunology, September 17-20, 2009 at Saddlebrook Resort in Tampa, Florida. This symposium will bring together some of the nation’s leading experts to discuss the influence emotions and the immune system have upon performance — whether it’s in a sports arena, hospital, or war zone.

PNI is a scientific field dealing with the relationships among the mind (psyche), the brain (neuro) and the immune system (immunology) and what all that has to do with your health and susceptibility to disease.

“In the early days when the term ‘psychoneuroimmunology’ was coined, the bias was that the brain controls everything – that information flows in the direction of gravity, from the nervous system down to the rest of the body,” said Nick Hall, PhD, Professor and Director of the Center for Psychoneuroimmunology at the USF College of Nursing. “For more than 25 years researchers in the field of PNI have been accumulating evidence showing that what you think and feel may alter your immune system – that there are things you can do to help achieve optimal health. Now, we know the reverse is true. Your mood and level of motivation can be profoundly affected by your immune system.”

Stressful memories of traumatic events, shift-work and crossing time zones can affect the immune system and performance. Self-destructive emotions can be triggered by injury and the immune system. To gain a better understanding of the factors leading to suboptimal performance, as well as potential solutions, the “Frontiers in Psychoneuroimmunology: Emotions, the Immune System and Performance” program incorporates both theory and practical exercises. This will include experiencing the premier Saddlebrook Executive Challenge course used to train elite athletes and corporations to better cope with change and adversity. Upon completion of the conference, participants will gain a better understanding of the causes of sub-optimal performance, as well as learn practical solutions.

“More than anything else, Psychoneuroimmunology is about preventing illness and optimizing performance,” said Dr. Hall.

The conference’s keynote speakers are some of the nation’s leading PNI experts and include
Charles Figley, PhD, Professor and Distinguished Chair in Disaster Mental Health at Tulane University; Keith Kelley, PhD, Professor of Immunophysiology at the University of Illinois; and Teodor Postolache, MD, Director of the Mood and Anxiety Program at the University of Maryland School of Medicine. Dr. Figley will present, “Stress Injury and Performance: Lessons from the Battlefield’, Dr. Kelley will discuss inflammation, mental fatigue and motivation and Dr. Postolache will discuss the impact shift work and crossing time zones has upon health and performance. 

Other top scholars include USF College of Nursing’s Maureen Groer, RN, PhD, FAAN, Director of the Center for Women’s Health Research; Theresa Beckie, PhD, FAHA, Professor; and Nick Hall, PhD, Professor and Director of the Center for Psychoneuroimmunology. Dr. Groer will discuss performance of police officers in stressful virtual reality scenarios, Dr. Beckie will present information regarding the ability of exercise to reduce inflammatory biomarkers in women with coronary disease and Dr. Hall will present the interrelationships between emotions and performance. Dr. Hall’s research on emotions and health has been featured on “Nova” and the Emmy-Award winning television series “Healing and the Mind” produced by Bill Moyers for PBS. 

“Everyone can learn how to take a more active role in preventing illness, improving quality of life and take advantage of therapies that may allow traditional medical treatments to work better,” Dr. Hall said. “There are scientifically based things you can do, such as mindfulness meditation, stress management or reframing exercises, that can make a significant difference in promoting your overall health – in ways you may have never imagined.”

For more information visit: www.health.usf.edu/nocms/nursing/pni or https://www.cme.hsc.usf.edu/pni/.

-- Story by Ashlea Hudak, College of Nursing Communications

Two USF surgeons traveled to Medellin, Colombia, last week to remove a brain tumor.

Dr. Harry van Loveren, professor and chairman of the Department of Neurological Surgery, and Dr. K. Paul Boyev, associate professor and director of the Division of Otology/Neurotology, made the trip.

The patient, a 54-year old woman, had been suffering from headaches for many years and suddenly developed numbness on the left side of her face. MRI studies revealed she had a meningioma tumor in the petro-clival region, which is at the base of the skull between and below the level of the eyes. Removing such tumors can be quite difficult, and may result in blindness, deafness, dizziness, or in paralysis of eye movements, the face, or of the entire side of the body.

Dr. Sergio Angel of the Clinica Medellin travelled to Tampa and spent a month with the neurological surgery department at USF, where he watched Drs. Van Loveren and Boyev remove several of these tumors. He thereafter invited them to remove the tumor he had diagnosed in his patient.

The operation went very well, and the patient was up and walking on the second post-operative day and experienced no complications.

      Kaitlin Spears, a 9-year-old Pinellas County resident, doesn't let her insulin pump stop her from coloring on the floor during a USF focus group at the Children With Diabetes conference.

      If you imagined the perfect place for children with diabetes, what would it have?

      For families of these children, the list is long and varied: Health professionals who really understand diabetes. Less time waiting to be seen. Someone available to answer questions at all hours of the day, who can tell parents what to do when their child's blood sugar is too high at midnight.

      A medical center that has healthy extras: a gym, a kitchen, and a children's play area.

     More places to learn about diabetes and more people to teach it.

     And, maybe most of all, each other.

     "To meet other people" with diabetes, said Clearwater parent Scott Roan. "To learn from others."

     Those were among the items on the wish list at an unusual focus group meeting hosted by USF Health Wednesday in Orlando at "Friends for Life," an international conference sponsored by Children With Diabetes, Inc. USF invited families there to brainstorm. The university is planning a new center for people with diabetes and wanted to hear from families about their needs.

     The focus group, led by Nicole Johnson, Miss America 1999 and director of communications and education for the USF Diabetes Center, became a standing-room only crowd. It included parents and children with diabetes, as well as doctors and other health care providers.

     Two other USF Health staffers - Michael Hoad, vice president of communications, and Jay Wolfson, assistant vice president for health law, policy and safety - prepared to help Johnson lead the focus group by getting some first-hand experience. Johnson made both men spend 24 hours wearing an insulin pump. Johnson has Type 1 diabetes herself, so the ones they wore were just like hers: hot pink.

The hot pink triplets: Jay Wolfson, Nicole Johnson and Michael Hoad (L to R) show off their matching insulin pumps.   

     Parents told the USF trio that finding out your child has diabetes is an overwhelming, often isolating experience. With that moment of diagnosis, their lives changed forever - yet they often felt lost. They had been thrown into deep water with little knowledge and fewer resources.

     "You're sent home and supposed to be Dr. Mom," said Tampa parent Alysia Ekizian. "It would be great if there were someone you could get 24 hours. We, as parents, need constant coaching."

      Parents often feel that they don't have anywhere to turn for that kind of help. What's more, outside of their children's endocrinologists, sometimes even the medical professionals seem to know little about their problems. Roan once brought his daughter to the emergency room because she was suffering from ketosis, a condition that occurs when chemical ketones start building up in the body because insulin is too low and the body starts breaking down fat for energy. Because insulin levels are low, blood sugar levels also rise.

     "They come back and say, ‘Did you know, her sugar is high?' " Roan told the group with exasperation.

     Another parent said one doctor told him it was the first time he had ever seen an insulin pump.
Such stories are one reason USF Health wants to develop a center that specializes in care for diabetes, Wolfson said. Studies have shown that when diabetes patients need other medical care, whether it's for having knee surgery or giving birth, caring for their diabetes often gets lost in the shuffle.

     "Things break down a lot," Wolfson said. "They don't seem to be able to coordinate with your diabetes."

     Health care providers aren't the only ones with that problem, said Holly Plotts, a Pennsylvania mom whose teen-age daughter has diabetes. Parents sometimes find that schools are reluctant to let children check their sugar or carry snacks, and may not know that federal law requires them to accommodate diabetes.

     Pennsylvania cardiologist Bob Bulgarelli told the group that he envisions a diabetes center where patients don't feel like they're visiting an uncomfortable doctor's office. No exam rooms with paper on the tables, he said. Lamps and cozy furniture. A gym and a kitchen, so people can practice the healthy eating and exercise habits that are so important to diabetes.

     Cardiologist Bob Bulgarelli talks about what diabetes patients need.

     "It needs to be more than your standard terrible box office," Dr. Bulgarelli said. "It can be a place they can spend the day."

     Again and again, parents returned to the importance of having children be able to meet other children with diabetes . They want their kids to play with other kids who wear insulin pumps. Kids who don't think it's weird to check your blood sugar. Kids who understand how you feel when your blood sugar gets low.

     The best part of the Orlando conference, parents said, was to watch their children doing exactly that. Imagine a center where parents could do that in their own hometown, said Adina Singer, of Quebec. She envisioned a place that would provide health care, yet also be something of a hub for the diabetes community. It could host support groups, social events, even the occasional party.

     "You want to recruit families. You want families to join you and stay with you for years and years," Singer said. "You want to create something that's more inviting... A place where people are going to want to come."

      -- Story and photos by Lisa Greene, USF Health Communications

L to R: Florida Attorney General Bill McCollum and Gov. Charlie Crist present the COPH 25th Anniversary resolution to USF President Judy Genshaft and USF Health CEO Dr. Stephen Klasko.

The outstanding contributions and dedication of the USF College of Public Health in addressing the complex health challenges of a diverse and growing state were recognized by Florida Gov. Charlie Crist on June 9 in Tallahassee.

The 25th Anniversary of the College of Public Health was recognized with a formal resolution offered by Florida Attorney General Bill McCollum and unanimously passed by the Florida Cabinet.

Crist presented the resolution to USF President Judy Genshaft and Stephen Klasko, MD, MBA, CEO for USF Health.

They were joined by a USF contingent comprised of Sam Bell, chair of the USF COPH Advisory Board and a former Florida legislator instrumental in founding the College; Paul Burress, a COPH alumnus living in Tallahassee; Cindy Burress, a master’s student in COPH; Betty Castor, director of USF’s Patel Center; Doug Kerr, director of USF Health Development; Charles Mahan, MD; dean emeritus of COPH; John Phelps, member of the COPH Advisory Board and former clerk of the Florida House of Representatives; and Deanna Wathington, MD, MPH, COPH interim associate dean of academic affairs.

L to R: USF President Judy Genshaft, COPH founder Sam Bell (holding signed resolution), USF Health CEO Dr. Stephen Klasko, COPH Interim Associate Dean Dr. Deanna Wathington; Betty Castor of USF Patel Center, and USF Health Development Director Doug Kerr.

The USF College of Public Health was created by the Florida legislature in 1984 to provide leadership for the Florida public health system through the development of academic programs and by serving as a resource for the state’s public health officials.

Since then, the College has graduated more than 3,000 public health professionals with master’s and doctoral degrees and graduate certificates, and nearly 300 undergraduates have completed a new public health minor. Faculty have generated more than $275 million in external research funding, and the College’s endowment has topped $13 million.

“Today, we are recognized leaders in distance learning, social marketing, maternal and child health, and global infectious diseases research,” said Donna Petersen, ScD, dean of the College of Public Health. “For 25 years, public health has been our passion and our promise.”

Florida Gov. Charlie Crist welcomes USF Health's Dr. Stephen Klasko to Tallahassee.

Dr. Klasko, with the USF contingent, addresses Gov. Crist and his Cabinet.

Dr. Wathington, center, with COPH alum Paul Burress and COPH master's student Cindy Burress

Betty Castor snaps a photo of President Genshaft, Sam Bell and Dr. Klasko with the state resolution recognizing COPH's 25th anniversary

USF President Judy Genshaft leads a toast to Sam Bell for his vision and leadership in helping establish the College of Public Health.

- Photos by Colin Hackley

Robbie Miles, certified Tai Chi instructor, leads the North Tampa class offered by the USF Parkinson's Disease and Movement Disorders Center.

An ancient Chinese exercise is being put to new therapeutic use by the USF Health Parkinson’s Disease and Movement Disorders Center.

The Center in partnership with the National Parkinson’s Foundation (NPF) offers free Tai Chi classes across the greater Tampa Bay area especially designed for patients with Parkinson’s and their caregivers. The gentle movements and controlled breathing of Tai Chi are performed in a slow, relaxed manner intended to create a sense of relaxation, improve balance and posture, and boost the flow of energy (or chi) in the body.

The first class started in a gymnasium in New Port Richey with 20 participants in 2005. Now more than 200 patients and caregivers are taking Tai chi weekly at seven sites, said Eden Feldman, MSW, a social worker and outreach coordinator for the Movement Disorders Center.

Eden Feldman, MSW, outreach coordinator for the USF PD and Movement Disorders Center, coordinates the free weekly Tai Chi classes for patients with PD and their caregivers across the greater Tampa Bay area.

Because it is practiced slowly, Tai Chi doesn’t tax patients as much as some other exercises that rely on strength, force, speed or even holding one posture for an extended time, Feldman said. “It helps with slowness, stiffness, tremor and balance problems – symptoms that are all components of Parkinson’s disease…. And we figured our male patients would rather do Tai Chi than yoga, since Tai chi is a martial art as well as an exercise.”

Tai Chi for Parkinson’s is increasingly recommended by support groups and mentioned as a complementary therapy on the Mayo and Cleveland Clinics websites. While some smaller studies suggests that Tai Chi improves mobility and balance for those with Parkinson’s, more rigorous randomized trials are need to validate the specific benefits of Tai Chi for this patient population.

"An emerging body of scientific evidence indicates that exercise, including Tai Chi, not only improves symptoms and helps keep patients functioning at their best, but may also be useful in slowing disease progression,” said Robert Hauser, MD, director of the USF Parkinson’s Disease and Movement Disorders Center. “This is an exciting possibility that is now a major research focus.”

Above: Miles, says she has seen improvements in students' posture and balance after even a few Tai Chi sessions. Below: Arms floating upward, caregiver Mary Olson practices a basic movement.

Robbie Miles, a certified personal trainer also certified in Tai Chi instruction, has taught the class out of the North Tampa Gold’s Gym since November. Miles, 54, learned Tai Chi to help her cope with the draining effects of another chronic disease, ulcerative colitis, which she has lived with for 20 years.

“Some days I felt 70 years old, other days 90, so I can relate to how my students with Parkinson’s sometimes feel,” Miles said. “I got into Tai Chi to help heal my body and it has helped greatly with pain control and increasing my energy level.”

At a recent Monday afternoon class, as the Miles warms up the group with some flexes as they sit in chairs, and follows with meditative deep breathing combined with simple hand movements. After a brief break, the class transitions into the Tai Chi movements requiring shifting of body weight and coordination of upper and lower body -- exercises that can challenge concentration and balance.

While the exercise regimen is to tailored to particpants’ limitations, Miles challenges them to stretch themselves.

“I will modify the routine, and break things into smaller steps, if it gets too difficult for anyone to keep up,” said Miles, who encourages her students with humor and gentle prodding. “I want to make sure they’re getting all the benefits of the exercise with minimal risk.”

Miles has seen improvements in many participants, even after a few sessions. “People come into class with much better posture, walking straighter. They move more easily and have better body awareness,” she said. “And the balance training is really helpful … I even had one patent say ‘I can stand on one foot and put on my underwear, and I couldn’t do that a year ago!’”

Harold Stein, a regular at the weekly classes, says Tai Chi is an ideal exercise for everyone.

Harold Stein, 78, who practiced judo before moving from Michigan to Florida five years ago, is an enthusiastic regular at the weekly Tai Chi classes. He was diagnosed with Parkinson’s about a year ago after a fall resulting in a shoulder injury. A neurologist noticed a slight tremor in his hand.

“The main thing is you have to keep moving; if not, the stiffness sets in. If I practice this religiously, it may help decrease the dosage of medication needed,” said Stein, who takes Sinemet, a first-line medication that replaces dopamine, the brain chemical depleted in Parkinson’s disease. “Tai Chi is ideal exercise therapy for anyone, really, because you don’t need equipment, certain clothes or a special room.”

Maria Swanson, 59, diagnosed with early-onset Parkinson’s at age 45, admits it’s sometimes hard to get to class, but she’s always glad when she makes the effort. “The breathing aspect of the Tai Chi movements really helps me to calm down, and I sleep better at night,” she said.

Maria Swason, who has lived with Parkinson's more than 14 years, says the deep breathing and relaxation of Tai Chi have helped her.

It’s not only Parkinson’s patients who report benefit from the Tai Chi classes. Nearly 40 percent of those attending are caregivers. Sometimes they come with the patients; other times on their own.

“I always leave Tai Chi feeling better. It’s such a great stress reliever,” said Mary Olson, who has cared for a husband with Parkinson’s disease for the last 26 years and finds social support sharing experiences with other caregivers in the class.

While many Parkinson’s patients tend to shy away from group classes, Feldman said, they feel more comfortable in a class where the person next to them either has Parkinson’s or understands the symptoms because their spouse or family member lives with the progressive neurological disease. Most patients have mild to moderate Parkinson’s, but some come to class with walkers and wheelchairs, joining in the deep breathing exercises and upper body movements.

The Tai Chi classes are part of the comprehensive package of education and support services for patients and caregivers offered by the USF Health Parkinson’s Disease and Movement Disorders Center, designated as one of only 29 NPF Centers of Excellence worldwide. Other services include lectures about treatments, disease management, diet and exercise, and a mentor program that matches newly diagnosed patients with those who have had Parkinson’s several years.

The USF Center is also one of the country’s leading sites for testing new medications to combat movement disorders, and is working on new surgeries and innovative cell-based therapies that may offer hope to patients who no longer benefit from drug therapy.

For more information about the Tai Chi classes and other outreach services, contact Feldman at efeldman@health.usf.edu or (813) 844-4547.

Feldman and Miles with the North Tampa Tai Chi class

- Story by Anne DeLotto Baier, USF Health Communications
- Photos by Eric Younghans, USF Health Communications
- Video by Eric Younghans and Klaus Herdocia, USF Health Communications

At a community health fair for farm workers and their families in Ruskin, Sara Thomas, a student in the USF master's of medical sciences program, fits a child's bicycle helmet.

For hundreds of USF Health students, giving back is one of the many benefits of community health outreach. Training with their colleagues in medicine, nursing, public health and physical therapy is another.

Now in its sixth year, the USF Health Service Corps gives students plenty of opportunities to work side-by-side while reaching out to communities in need. The corps is sponsored by the USF Area Health Education Center (AHEC), a program covering a nine-county area on Florida’s west central coast that seeks to improve the supply, distribution, diversity and quality of the health care workforce, ultimately increasing access to health care in medically underserved areas.

Throughout the year, USF Health students in the corps enthusiastically volunteer at health fairs in rural and inner city areas; socialize with cancer patients and their families; organize collection drives for food, clothing, toys and backto-school supplies; teach school children about public health and safety issues; donate blood; participate in fundraising events; and serve as camp counselors for children with special health needs.

While nearly half of the nation’s medical schools boast strong community health outreach programs, the emphasis on interdisciplinary student interaction makes the USF Health Service Corps stand out, according to Steven Specter, associate dean for Student Affairs at the USF College of Medicine.

“The uniqueness is that you have students of various professional disciplines working collaboratively to deliver services to the community,” Specter says. “The program provides much-needed services and a great opportunity for students to learn the humanistic responsibility of giving back.”

USF medical students conduct blood sugar screenings.

The culture of caring created when students contribute to the health of the community is something the university leadership views as crucial to developing well-rounded professionals. Reaching deep into the heart of diverse, medically underserved populations, the USF Health Service Corps consistently receives high marks for providing hands-on experience to students and exposing them to some of the social, cultural and economic barriers to health. These invaluable experiences can make indelible impressions on students, cultivating cultural awareness and empathy and potentially impacting the way they relate with patients throughout their careers. Volunteering with peers in other disciplines also gives students a chance to share and ultimately appreciate different perspectives when tackling health service projects.

“Although students in the health professions have not traditionally trained together, they are expected to know how to work together,” says Cindy Selleck, director of the USF AHEC program. USF Health faculty volunteers provide guidance, mentoring and experience, and help to make professional interaction a fundamentally ingrained skill by the time students graduate.

Whether they are conducting faculty-supervised blood pressure and blood sugar screenings for migrant farm workers or teaching middle school students the importance of hand washing in preventing infections, USF Health Service Corps volunteers create meaningful links between the community and the university.

“Without the USF Health Service Corps, Mobile Medical would be much less effective in our efforts to serve the community,” says Sister Sara Proctor, program coordinator for Catholic Charities Mobile Medical Services, which serves farm workers and other low-income residents of East and South Hillsborough County.

Ultimately, the desired outcome of the program is prevention and increased access to health care, which mirrors nationwide goals. Matching student skills, interests and schedules with community agency requests, Ellen Kent, faculty coordinator for the USF Health Service Corps, taps into a wealth of dedicated faculty, students and community health care advocates to fuel the program. While there’s no shortage of enthusiasm, the recent economic downturn has created gnawing concern about continued state funding for AHEC, making community donations essential to the program’s longevity.

“We provide students with meaningful and fun opportunitiesto serve the community,” Kent says. “It’s really about creating a culture of caring for students and healthier populations.”

– Story by Judy Silverstein Gray
- Photos by Eric Younghans, USF Health Communications

By The Numbers*

7,577 Annual USF Health student volunteer service hours1,284 Student hours dedicated to health fairs, screenings, health education, fitness/safety activities1,250 Middle school/high school students impacted by educational programs

$11,245 Funds raised for nonprofit health organizations

Read more about USF’s Health Service Corps at http://health.usf.edu/ahec/servicecorps.htm

*2007-2008 USF Health Service Corps Facts

This article appeared in the Spring-Summer 2009 issue of USF Magazine.

Healthy Start mother Selena Scott went to Capitol Hill recently to advocate for the USF COPH administered program, which aims to lower infant mortality rates in Central Florida.

Some might see Selena Scott as an unemployed single mother living in one of Tampa’s poorest neighborhoods.

But she is more than that.

Scott, 35, is determined to be the best mother to her son, 8-month-old Jayden, that she can be.

And so she is transforming herself into a community activist with the help of a program that assists mothers and babies: the Central Hillsborough Healthy Start Project. Administered by USF, the federally funded program aims to lower infant mortality rates in Central Tampa.

Scott stood in front of a group of other Healthy Start mothers on a recent morning and told them about her work advocating for Healthy Start – on Capitol Hill.

“It was a great visit,” she told the group. “They know it’s a wonderful program that helps moms and babies.”

She finished by urging any mothers who get the chance to speak out as well, and won a round of applause for her speech.

It’s that kind of grassroots leadership that Estrellita “Lo” Berry, project director, sees as a vital part of making Healthy Start successful.

“Not everybody gets it,” Berry says. “If you’re genuine about working with folks to make lifelong health changes, you’ve got to include them in the creation and delivery of services.”

Central Hillsborough Healthy Start, a project of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies and USF’s College of Public Health, invites women to form “community councils” to help each other. Berry has brought community residents into focus groups to talk about how the program can do more. She has hired area residents onto her staff.

“You build capacity by educating and hiring from the community you serve,” she says. “They’re going to be passionate. They’re going to be invested.”

Scott’s investment stems from gratitude. Healthy Start nurses began helping her before Jayden was born. She developed gestational diabetes while she was pregnant, and Jayden arrived nearly three weeks early. They gave her advice on everything from putting Jayden to sleep on his back to help with breastfeeding.

Monthly support group meetings offer moms advice on medicine, child raising and more.

Scott now goes to support group meetings with other moms, relies on Healthy Start for advice about medicines and child-raising tips, and hopes to return to school to become a licensed child-care worker.

“You have a support network,” says Scott, sitting in her living room, shaking a rattle at Jayden. He laughs and grabs for it and grins. The room has been overtaken by Jayden’s toys. Winnie the Pooh sprawls on the coffee table and Jayden’s walker holds the place of honor.

Meanwhile, Berry hopes that the support network is helping to change some of the grim facts about babies in Central Tampa. Babies here are more than twice as likely to die during their first year of life than the average American baby. Healthy Start is attacking that rate with a variety of programs: home visits and support groups, Healthy Start Coalition activities, special projects targeting African-American babies, and a program for fathers.

Research shows the program is helping change some of the grim facts about babies in Central Tampa.

The project seems to be helping. USF researchers recently published an article in Maternal and Child Health Journal, showing that in the Central Tampa area, Healthy Start moms had a 30 percent lower rate of preterm births than mothers who didn’t receive services. The finding is important because reducing preterm births could also reduce infant mortality.

But for Berry, that’s not enough. Healthy Start’s $1.5 million budget serves 500 mothers annually, but 5,000 babies are born each year in their service area.

“We’re only seeing a drop in the bucket,” she says of Healthy Start’s work.

And so moms like Scott will keep working. Since Scott first got help from Healthy Start, she’s helped organize spaghetti dinners, clothing donations and other projects. If she sees a pregnant woman, she makes sure she knows about Healthy Start. She’s a believer.

“They have that personal relationship with you,” Scott says. “It’s not just about numbers and the caseloads. They’re part of my family now.”

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

This article appeared in the Spring/Summer 2009 issue of USF Magazine.

Dr. Anne Curtis, USF cardiology chief, was a member of the Heart Rhythm Society task force calling for stricter oversight of lead wires.

Millions of patients have benefitted from the lifesaving technology of pacemakers and implantable cardioverter defibrillators (ICDs). However, significant performance expectations placed on these devices and the lead wires within them, present surveillance and monitoring challenges. To ensure physicians and patients have timely, accurate and understandable information when lead malfunctions occur, the Heart Rhythm Society (HRS), a group of physicians who treat cardiac arrhythmias, earlier this month (May 13) released the first comprehensive guidelines on lead performance.

“The guidelines are meant to standardize the evaluation of new pacing and defibrillator leads as well as the follow-up and reporting of lead problems. They recommend more rigorous post-market surveillance of leads and more strongly encourage physicians to report problems,” said Anne Curtis, M.D, professor and chief of Cardiology at USF Health. Dr. Curtis, a past president of HRS, was a member of the HRS Task Force on Lead Performance Policies and Guidelines, which included physicians from Johns Hopkins, Stanford, Yale, Beth Deaconess Medical Center, Minneapolis Heart Institute, the Cleveland Clinic and the Mayo Clinic.

Pacemakers are used to treat irregular heart rhythms, called arrhythmias, and can alleviate some symptoms such as fatigue, shortness of breath and fainting. ICDs, defibrillators for short, deliver a shock to the heart to prevent death from sudden cardiac arrest. The flexible wire that connects the pacemaker or ICD to the heart muscle is known as a lead. A lead may experience more than 500 million repetitive cardiac cycles during its lifetime, and although substantial scientific and engineering advances have improved their performance, occasionally leads malfunction.

The recommendations for stricter oversight of lead wires are intended to improve patient safety, Dr. Curtis said.

“Early identification of lead problems will lead to earlier action to protect patients,” she said, “whether that means increased monitoring of patients who have leads with potential problems, removal of the lead from the market, or removal of the lead from patients in select circumstances.”

The task force provided a wide range of recommendations on issues including communication of lead performance, pre-market evaluation of leads, post-market monitoring of lead performance, threshold for action and communication after abnormal lead performance is identified and clinical recommendations for physicians. Emerging modalities for lead surveillance including remote monitoring and the use of the NCDR ICD Registry™ as a post-market surveillance tool were also addressed. In addition, the task force encouraged the FDA to provide guidance that explains when and how manufacturers can legally use terms other than “recall” in their product advisory notifications.

“One important note is that it is frequently riskier to remove a lead that had been recalled than to leave it in place and follow it closely,” Dr. Curtis said. “For this reason, lead problems should lead to a frank discussion between physician and patient about the facts of the lead recall and recommendations for management.”

The comprehensive guidelines were developed by HRS in collaboration with the American Academy of Cardiology and the American Heart Association. They will be published in the June 2009 issue of HeartRhythm, the official journal of the Heart Rhythm Society.

RELATED STORY:
U.S. registry sheds light on risk from ICD, pacemaker replacement

Still, the change was slight. It hadn't changed colors. It was just a little bigger.

She thought about getting it checked, but she didn't want to pay for a doctor's visit. She'd wait for a skin screening, she thought. She showed it to some of her family members, but nobody seemed worried.

Time went on, and Goldberger put off getting it checked. Finally, more than six months after she had noticed the change, she went to a community forum, the Focus on Females Women's Healthcare Symposium. Among the speakers: Dr. Mary Lien, assistant professor of dermatology at USF College of Medicine.

Dr. Lien's word burned into Goldberger's mind.

"She kept saying it over and over again," Goldberger said. "The cost of an unnecessary biopsy is dollars. But the cost of missing a necessary biopsy could be your life."

Finally concerned, Goldberger called USF Health and asked for the first available dermatology appointment.  She went to see Dr. Phillip Shenefelt, a USF associate professor of dermatology, and got the mole biopsied.

USF dermatologist Dr. Phillip Shenefelt with patient Norma Goldberger.

Then a USF resident called Goldberger with the results: she needed surgery. The next day.

The mole that Goldberger had delayed getting checked turned out to be melanoma, the deadliest kind of skin cancer. Fortunately for her, it was still at stage 1, the earliest and most easily treated stage. Goldberger had that mole, and two others close to it, removed the next day.

"Really, I owe Dr. Lien's presentation to motivating me, to not waiting around anymore," Goldberger said.

Dr. Lien said she tries to walk the line between scaring people and motivating them.

"I don't like to be the voice of doom," she said. "But there's a problem with skin cancer. It doesn't hurt."

That makes it easy to put off getting suspicious moles checked, she said.

Goldberger's decision to finally get her mole checked may have saved her life, Dr. Shenefelt said.

"The deeper it goes, the higher the risk of metastasis," or spreading to other areas, he said. "That can be very serious, and sometimes fatal."

Dr. Neil Fenske, professor and chairman of the dermatology department, said he hopes Goldberger's experience will inspire others to act.

"I am so glad Mrs. Goldberger got her unusual mole checked in time to have her melanoma successfully treated," he said.  "I hope her story will remind people just how important it is to get regular skin cancer screenings."

Goldberger, 63, feels fortunate. She and her husband, Stephen, celebrate their 41^st wedding anniversary this month. After raising three children, owning a business and then editing a magazine together, they have retired and divide their time between Ohio and Apollo Beach.

Still, the experience has changed Goldberger's behavior.

"I'm using sunscreen religiously now," she said. "I always wear a hat. I bought an Australian top that looks dreadful over a bathing suit, but it's an SPF fabric."

L to R: Dr. Shenefelt, Dr. Mary Lien and Goldberger

Goldberger also has returned to USF practitioners since to have other moles checked.

"I don't feel a private office physician is as up on the latest research as a teaching hospital," she said. "I feel the quality of medical care in a teaching hospital is higher."

But when she returned to see Dr. Shenefelt after a biopsy this month, she got good news. This time, the biopsy results were normal.

FREE SKIN CANCER SCREENING

It's almost time for Melanoma Monday, a national event to raise awareness about skin cancer. At USF Health, hundreds of patients get free skin cancer screenings each year from the university's dermatologists and medical residents. This year's Melanoma Monday will be: May 4 from 5 p.m. to 8 p.m. at the USF Health Medical Clinic, 12901 Bruce B. Downs Blvd.

DANGER SIGNS ON THE SKIN

Dermatologists have an "ABCDE" list of when you should get a mole or pigmented spot checked. The symptoms are:

Asymmetry - one half unlike the other half

Border - Irregular, scalloped or poorly defined border

Color - Varied from one area to another; shades of tan, brown, black, or sometimes white, red or blue

Diameter - Melanomas are usually bigger than 6 mm (the size of a pencil eraser), although they can be smaller

Evolving - A mole or spot that looks different from the rest or is changing in size, color or shape.

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

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USF medical students teach tanning dangers

Last fall, fourth-year medical student Salma Pothiawala helped start a local chapter of Check Your Skin, a national organization dedicated to raising awareness of skin cancer and the importance of sun protection. The USF chapter is under the guidance of Dr. Mary Lien, associate professor in the USF Department of Dermatology and Cutaneous Surgery. Through community outreach programs and teach-ins, USF medical students increase skin cancer awareness and educate teens on how to correctly perform self skin exams.

Fourth-year medical student Salma Pothiawala (left) and second-year medical student Mark Halsey share skin cancer information with a student at a recent health fair at Brooks-DeBartolo Collegiate High School.

“The students have been very interactive and interested in what we have to say and I hope we are making a positive impact on their lives,” Pothiawala said. “We hope to become much more active in the community in the future. It is essential to reach out to individuals in the community regarding the necessity for sun protection, especially in a state like Florida, where people are involved in so many outdoor activities. We must stop the development of skin cancers before they start by educating this young population. Melanoma is the most common cancer in females between the ages of 25 and 29.”

In addition to Pothiawala, USF medical students also involved in the Check Your Skin chapter are Mark Halsey and Katherine Madden.

“All of us medical students who have become involved in Check Your Skin are passionate about dermatology and preventative medicine,” Pothiawala said.

One of their most recent educational efforts was at a health fair at Brooks-DeBartolo Collegiate High in late April, during which they had a booth about skin cancer-related issues and shared skin cancer information with students.

- Story by Sarah Worth

Dr. Robert Hauser, recipient of a Michael J. Fox Foundation for Parkinson's Research grant, with actor and activist Michael J. Fox

LUTZ -- Actor and activist Michael J. Fox said Friday he's an incurable optimist.

Want proof? "I took up golf in my 40s, with Parkinson's disease,'' Fox said at a press conference in Tampa Bay, where he came to participate in the Outback Steakhouse Pro-Am tournament.

"Make no mistake, I'm a horrible golfer," Fox joked.

 Just before teeing off Friday, Fox held a press conference with professional golfer Tim Simpson and Dr. Robert A. Hauser, director of the USF Parkinson's Disease and Movement Disorders Center of Excellence.

Dr.  Hauser, a 2007 recipient of a Michael J. Fox Foundation grant, told the group there are reasons to hope in the fight against Parkinson's, which affects about one million Americans.

"Although Parkinson's disease is a progressive neurologic disorder, there have been really great advances over the past decade," Dr. Hauser said.

Hauser spoke about some of his own research looking for ways to diagnose Parkinson's earlier, before people begin to suffer problems with tremors, rigidity, and slowness of movement. Earlier diagnosis and treatment could help slow the progression of the disease, he said. He also pointed to the potential for genetic and stem cell research in understanding and treating the disease.

"Ultimately, though we really want a cure," Dr. Hauser said. "The future looks very, very bright, but smart investigators can't do it by themselves. Funding is just so critical to research."

Dr. Hauser thanked Fox and his foundation for its work funding Parkinson's research, and thanked Fox and Simpson for being "such an inspiration" to other patients.

L to R:

Fox made worldwide news when he announced in 1998 that he had been diagnosed with early-onset Parkinson's in 1991. Since then, Fox has continued acting, but also has become an outspoken advocate for Parkinson's awareness and research.

At the press conference Friday, Fox praised Simpson, who has struggled with essential tremor, a neurological condition related to Parkinson's. Simpson was able to return to professional golf after he had brain surgery four years ago to calm the involuntary movements. In 2006, he was named "Comeback Player of the Year" on the Champions Tour.

"It's not for the faint of heart," Fox said of deep brain stimulation, the procedure that Simpson underwent.

Simpson showed off the small bulge  in his chest - "my deck of cards" - he called it, where the electronic device is implanted. An internal wire goes from that device into his brain, sending out signals that stop the tremors.

" I feel very blessed, Simpson said. "I feel I've been given a second chance through DBS surgery."

Fox said his disease goes up and down, and he never knows whether he'll have a good day or a bad day. But, he said, he's learned to accept that. He's grateful to be in a position to show people that it's possible to have Parkinson's and have a full, active life.

L to R: Dr. Hauser, professional golfer Tim Simpson and Fox

"One thing you don't have a choice about right now - and we're working on it - is that you have Parkinson's," Fox said. "You don't have a choice about that. But around that non-choice, there are thousands of other choices that you still have. You're still intact. You're not ‘You minus that.' You're not defined by that. So that means you can go out and be a bad golfer if you want. It's okay to be shaky. You can be shaky and still be steady."

Related Story:
USF physicians lead in Parkinson's disease treatment and research

-- Story by Lisa Greene, USF Health Communications

-- Photos by Eric Younghans, USF Health Communications

Miss America 2008 Kirsten Haglund, left, spoke to the clients at USF Hope House.

For one young woman, the trigger was an alcoholic father.

For another, it was gymnastics.

For Miss America, it was ballet.

The women gathered Thursday at USF Hope House for Eating Disorders to share stories and get a dose of inspiration from Kirsten Haglund, who became Miss America 2008 after overcoming an eating disorder she suffered as a young teen-ager.

Haglund developed anorexia around age 12 after she went to a summer ballet camp and became more intensely involved in dance. All the best dancers seemed thinner than she was. Alone and insecure about her talent, Haglund started to diet.

“When I started to cut back, it felt very good, very powerful,” she said. But as her problem deepened, dieting became a downward spiral. The more weight she lost, the more unhappy with her body she became. She felt weak and unhappy. Ultimately, starving hurt her dance ability.

“I couldn’t get through a ballet class because I had no energy,” she said.

Haglund began to overcome her illness after her mother intervened, taking her “screaming and crying” to a doctor. It took a treatment team and more than a year for her to return to a healthy weight. She’s worked hard since then to keep a healthy attitude towards food and to understand that she feels better and happier when she eats. She’s learned to find fulfillment through faith, rather than through starving herself. She no longer takes ballet.

“It’s a problem, it’s an illness,” Haglund told the group. “It’s not your fault.”

But it is an onogoing fight.

“I’m just worried that I’m never going to get out of it,” Tampa student Karla Olsen, 21, told Haglund. “Like I’m never going to be fully recovered.”

Olsen said it’s helped her, as she works on that recovery, to be able to turn to Hope House as a resource. The house provides free outreach and support groups for people struggling with eating disorders and their families.

Haglund and the others talked about using food as a way to cope with problems, and how doing so can be as addictive as a drug.

One 15-year-old girl was struck by the contradiction: How did you handle anorexia while you were competing to be Miss America? Didn’t that make it more about your body?

“It wasn’t a trigger for me,” Haglund said. Although she could see how it might be for some young women, she entered the pageant almost on a whim, seeking to win scholarship money. She was active in musical theater and comfortable on stage, so she thought of the pageant more as a performance event, rather than a contest to find the perfect body image.

For the evening gown segment in Haglund’s first pageant, she wore her prom dress. She chose eating disorders awareness because it was something she knew about. But she figured she would talk about other girls’ struggles. She didn’t really think about talking about her own.

“Then I won,” Haglund laughed. “I put myself in a situation where I had to be accountable. I couldn’t slip back.”

But Haglund found the travels and stress of her year of serving as Miss America to be liberating rather than tense. She spent a year on the road traveling, never knowing what she might be asked to do, where she would end up, or who she might be. It showed her she could handle not being in control of her surroundings.

“I had to deal with it and life didn’t fall apart,” she said.

22-year-old Jennifer Goetz came to hear Haglund Thursday and was inspired.

“She’s extremely down to earth,” Goetz said. “She lays it on the line, that she’s not perfect and doesn’t live up to that image…she lets people understand that she goes through the same pressures that we do, and people with eating disorders come in all shapes and sizes.”

Haglund competed with scores of other women to become Miss America. She wore a crown and criss-crossed the country speaking her mind. But in a small room at Hope House Thursday, she was just one more member of a sorority bonded in a struggle against the same illness.

“You’re someone like us,” Olsen told her. “So you understand.”

More than 12 million people in the United States struggle with eating disorders. At some point during their lives, an estimated 180,000 people in Hillsborough and Pinellas Counties will suffer from an eating disorder. USF Hope House for Eating Disorders, directed by Pauline Powers, MD, professor of psychiatry at USF Health, is the only organization of its kind in Florida that provides free outreach and supportive intervention for individuals and families struggling with an eating disorder.

- Story by Lisa Greene, USF Health Communications

- Photos by Eric Younghans, USF Health Communications

Sandra Magyar, right, accepts her award from Donna Petersen, ScD, dean of the College of Public Health.

Tampa, FL (April 2, 2009) — Sandra Magyar, executive director of the Florida Public Health Association (FPHA), has been named the Florida Outstanding Woman in Public Health for 2009 by the University of South Florida College of Public Health.

The College bestows the award each year to a woman whose career accomplishments and leadership have contributed significantly to the field of public health in Florida. Magyar was honored at an awards ceremony April 1 at the USF College of Public Health Auditorium in Tampa.

Under Magyar’s leadership, the FPHA has nearly doubled its membership to one of the largest of any state American Public Health Association (APHA) affiliate. Many other organizations in Florida and nationwide have sought to use the model Magyar developed for the FPHA in advancing public health advocacy, education and networking.

Magyar started her career as a health educator at the Duval County Public Health Unit in 1973, rising to the position of Operations and Management Consultant Manager. She became executive director of FPHA in 2002, after serving in a variety of volunteer positions for the organization including annual education conference chair, executive board member, and president. She was instrumental in creating the Florida Public Health Foundation, which was subsequently funded by the Florida Legislature to serve the state’s public health interests.

Magyar has been executive director of the American Association of Public Health Physicians and of the Florida Association of County Health Officers, the state group of county health department executives. She currently chairs the Board of Directors for the State Employees Credit Union. She helped forge a connection between the USF College of Public Health’s Public Health Leadership Institute and FPHA, raising awareness among members interested in career development or pursuing graduate studies in public health.

Magyar has been recognized for her work and scope of leadership with prestigious awards from the FPHA, the Southern Public Health Association and the APHA. She holds a master’s of education degree in health education with an emphasis in administration from the University of North Florida in Jacksonville.

The Florida Outstanding Woman in Public Health Award was initiated by USF in 1988, and nominations are solicited from public health practitioners across the state.

- 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 $360 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.

- Photo by Eric Younghans, USF Health Communications

But talk to any of them about their PWH work and you’re more likely to hear about the impact their visits have on those communities and how their time there gives local residents the basic patient care, health education and preventative medicine they might not otherwise receive.

“These communities are in dire need of healthcare,” said Sara Saporta, a second-year USF medical student and co-president of PWH. “We provide some of the basic resources that we take for granted here in the states. The enthusiasm these people have about receiving even the most basic of things, like toothbrushes, toothpaste and soap, is not just astounding, it’s illuminating.”

Project World Health Board
Back row: Sara Saporta (Co-President), Ty Jeske (Co-President), Jael Rodriguez (Fundraising), Patrick Carroll (Treasurer), Matt DiVeronica (Pharmacy Co-Chair)
Front row: Irene Hotalen (Fundraising Chair), Meghan NeSmith (Pharmacy Co-Chair)

Each year, USF students travel to the Jarabacoa region of the Dominican Republic. Returning the same region each year helps both the students and the communities since the established ties provide continuity of care for the patients and a sense of follow up for the students.

“Although the week is full of long, exhausting days of nonstop patient encounters, we gain skills that we bring back with us to school, to the clinics, to our future patients, and to these same people when we return the next year.”

The trips are only possible because of generous donations made by supporters and business partners, Saporta said. Last year’s effort meant more than $200,000 that allowed 50 individuals to travel to Jarabacoa, including attending physicians, residents, nurses, a dental hygienist and first- through fourth-year medical students. The team provided care to more than 2,500 residents. This year’s trip is set for April and fundraising is kicking into full gear, Saporta said.

New this year is business partnership with the Red Elephant Restaurant here in Tampa. On Feb. 23, the restaurant will donate 20 percent of the bill of anyone eating lunch or dinner there who mentions USF’s Project World Health.

In addition, the medical students host an annual fundraiser called the E-Ball, at which proceeds from live and silent auctions go to PWH. Although this event is typically for fellow medical students and faculty, donations to be auctioned off are always welcome, Saporta said.

Artist and third-year medical student Navid Eghbalieh donated his painting "Esperanza" to be auctioned at the PWH E-Ball, with proceeds going directly to PWH. The scene of this child in the Dominican Republic was taken by photographer Jennifer Browning and inspired Eghbalieh to put oil to canvas.

“Last year, some of the most successful items auctioned off were those of personal time and services, like a faculty member who sails offering an outing on his sailboat, or another faculty member who is a pilot offering a plane ride to Key West in his single-engine plane. The students also quickly bid on dinners with residents, since we love the extra time with physicians to learn more about the field of medicine.”

The group also accepts direct donations, which can best be made online and allows the donation to be deposited directly into the PWH account.

For more information about Project World Health, visit their web site or email Sara Saporta at ssaport1@health.usf.edu, Co-chair Ty Jeske at tjeske@health.usf.edu, or Fundraising Chair Irene Hotalen at ihotalen@health.usf.edu.

Story by Sarah Worth, USF Health Communications

Dr. Bryan Bognar talks with medical students about his interest in public health.

Dr. Bryan Bognar has been a key member of USF’s faculty since 1992, taking on jobs ranging from helping revamp the medical school curriculum to developing a national smoking cessation program.

But last fall Dr. Bognar played a new role: USF student.

Ten years after he started, Dr. Bognar received a master’s degree in public health.

“I promised my family I was going to finish my MPH,” joked Dr. Bognar, an associate professor of internal medicine. “My wife rolled her eyes and said, ‘Sure you are.’ ”

Not only did Dr. Bognar finish, but he could have been a case study for his own thesis. Dr. Bognar looked at the value that a public health perspective brings to medicine. He studied how national medical school accreditation standards allow incorporating public health education in a medical curriculum. His conclusion: the standards allow public health education in the door, but they could be more explicit to encourage more interaction.

“I don’t think we do a good enough job helping the students see the big picture, and what role they are playing in the health system,” he said.

Dr. Bognar thinks U.S. medical students could benefit from learning more about everything from social marketing to population health and patient safety. He first became drawn to public health when, as an internist, he became interested in evidence-based medicine.

“I became intrigued with the population-based perspective and the translation of population studies to the care of individual patients,” said Dr. Bognar, 45.

That interest has only deepened over the years. In addition to seeing patients, Dr. Bognar worked in the dean’s office for several years, serving as associate dean for undergraduate medical education and the interim vice dean for educational affairs.

In Dr. Bognar’s experience, his move has been unusual. He knows many public health students who have gone on to medical school, but rarely has he seen the reverse. Yet Dr. Bognar thinks he values public health even more now than when he started. It’s a perspective that’s well-suited to USF Health, where medicine and public health are under the same umbrella.

Donna Petersen, ScD, dean of the College of Public Health, hopes that Bognar will be among the first in a wave of doctors and medical students turning to public health.

“That’s the ultimate example of what we’re about,” she said. “The integration of science and the [] clinical professions into public health.”

While Dr. Petersen thinks educators have “improved dramatically” in introducing medical schools to public health, she agrees with Dr. Bognar’s take on medical school standards. She pointed to a report by the Institutes of Medicine, which called for increased public health training for medical students and said more doctors need MPH degrees.

At USF, students can pursue a combined MD/PhD program. Two years ago, USF also began offering a concentration in public health for MD students, a program that already has attracted more than two dozen students.

Meanwhile, to finish his degree, Dr. Bognar also completed two other tasks during the fall semester: his last class, on Human Error and Patient Safety, and a field experience project. Dr. Bognar set up a plan to help medical students who run the Bridge Healthcare Clinic, a student-led program for uninsured patients. Dr. Bognar’s work there involved designing a system so that women who needed follow-up care after a screening mammogram could receive it.

- Story by Lisa Greene, USF Health Communications
- Photo by Eric Younghans, USF Health Communications/Media Center

Dr. Francisco Fernandez, chair of Psychiatry at USF Health, chats with a visitor before her memory screening.

The Alzheimer's Care Center at USF welcomed more than 200 community visitors Nov. 18 for its inaugural event: National Memory Screening Day.

It's the first time that the free memory disorder screenings were supported by the Center’s powerful consortium of three clinical entities: the Johnnie B. Byrd, Sr. Alzheimer's Center, the Eric Pfeiffer Suncoast Alzheimer's Center and the USF Memory Disorders Clinic.

“One purpose, one place, one team. USF Health is delighted to welcome this new consortium at the forefront of Alzheimer's research and care to the community," said Stephen Klasko, MD, MBA, CEO for USF Health and the Byrd Institute and dean of the College of Medicine.

Clinicians and practitioners from across USF Health and main campus worked together to provide the confidential memory screenings, hearing and safe-driving screenings, blood pressure checks, and "brain aerobics” to visitors who traveled to USF from as far away as Brooksville and Sun City. Services were offered in both English and Spanish.

According to USF Health experts, memory screening is important to identify people who are at risk for Alzheimer's disease or dementia. Early diagnosis makes the medications available sooner, which can be important in slowing the rate of cognitive decline and helping reduce the burden caused by this disease.

“A multi-disciplinary approach is also critical,” said Dr. Terry Chisolm, who was supervising six doctoral students from the USF Communications Disorders Program. “Hearing and balance are huge issues in elderly people. Whatever else is going on with a patient, the risk of falls is high and costly. Working together with psychology, geriatric medicine, pharmacy, psychiatry, social work, and nursing, we see the ‘whole’ patient.”

Barbara Eller has her hearing tested by students from the USF Department of Communication Sciences and Disorders.

Among the visitors was 82-year-old Barbara Eller of Tampa. The former educator taught children for more than 40 years, but this time, she's the one learning about how to keep her memory in check. Her daughter, Amy Scherzer, persuaded Eller to attend.

“I don't remember names, and that's very annoying," said Eller. "I have to think about the words to finish a sentence sometimes. I'm mostly annoyed by it, because I think I'm a very intelligent person."

Eller worked her way through the battery of tests, which included a confidential memory screening, hearing and safe driving screenings and gait and balance tests. She scored a perfect 30 out of 30 on her memory test, where she had to repeat words, identify common months, dates and seasons, and draw objects presented to her by her screener.

As she moved from room to room in the Byrd Institute facility, meeting different members of the Alzheimer's clinical care team, Eller felt more confident with her results. “It's very impressive that you offer this service,” she said. “It's reassuring to me to be here.”

Alzheimer's affects 10 percent of people age 65 and older and the Alzheimer's Association estimates that 5.2 million Americans currently live with the disease.

Above: Dr. Amanda Smith, interim director of the Eric Pfeiffer Suncoast Alzheimer's Center, is interviewed by WUSF-FM about National Memory Screening Day. Below: Dr. Kristin Fargher, assistant director of the Suncoast Alzheimer's Center, conducts a memory screening.

- Story by Susanna Martinez Tarokh and Melanie Meyer, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

Dr. John Curran with Tampa Bay Rays fans Justin Richards, left, and Sean Newkirk, right, patients at the USF Health Cystic Fibrosis Clinic.

The Tampa Bay Rays lost the opening game of the World Series Wednesday night, but Justin Richards was still thrilled to be in the audience of cowbell-clanging fans.

“Justin was so excited – he loved being there. He didn’t get to bed until 2 in the morning, but he still got up Thursday and went to school!” said his mother Alice Richards.

Justin, 12, and Sean Newkirk, 18 – both patients at the USF Health Cystic Fibrosis Clinic -- managed to score free tickets to the big game with the help of John Curran, MD, professor of pediatrics and associate vice president for Faculty and Academic Affairs at USF Health. The young Rays fans are both patients of Bruce Schnapf of the USF Department of Pediatrics.

Dr. Curran, a board member of the American Academy of Pediatrics, was approached by the Academy to identify two children with specific chronic illnesses from the Children’s Medical Services program at USF Health to receive the free tickets. The tickets were donated by Matt Bubala, host of the nationally syndicated Good Parenting radio show. Based in Chicago, Bubala had purchased a block of World Series tickets in advance with the hope that his beloved Chicago Cubs team might make it to the series. He wanted to do something good with the leftover tickets to benefit children, so he contacted the Academy’s public relations staff and they contacted Dr. Curran.

Justin was accompanied to the game by his father, and Sean went with his aunt. They sat in the same right field section as Bubala at Tropicana Field. As an unexpected bonus, Justin managed to snag a baseball from one of the Philadelphia Phillies players at batting practice before the game.

“We were very appreciative for the tickets as the children are from families with very real financial constraints and would not otherwise have had the opportunity to attend the game,” Dr. Curran said.

Dr. Curran supervises Florida’s Tampa Bay region of CMS, a Title V program for children with special health care needs. CMS partners with USF Health to provide care across the region, which encompasses Hillsborough, Pinellas, Pasco, Polk, Highlands and Hardee Counties.

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

Amanda Smith, MD, (far right) interim director of the Eric Pfeiffer Suncoast Alzheimer's Center, welcomes Byrd Institute board members who toured the center, which relocated to the facility Oct. 8.

The Johnnie B. Byrd Sr. Alzheimer’s Center and Research Institute will strategically invest in its science and clinical operations; aggressively pursue National Institutes of Health research grants, state funding and private donations; and seek academic entrepreneurial alliances with companies developing new therapies for Alzheimer’s, said Stephen Klasko, MD, MBA, the center’s chief executive officer who also serves as CEO for USF Health and dean of the College of Medicine.

The Blueprint for Strategic Action intended to guide the Byrd Institute over the next five years was presented by Dr. Klasko at the Oct. 20 meeting of the Joint Affiliation Board and the Institute’s Board of Directors.

The Blueprint, which was endorsed by board members, outlines major goals and benchmarks for success as the Institute advances its vision of becoming a world-class Alzheimer’s research, education and clinical care center.

“Alzheimer’s disease is a horrible scourge and we need do whatever we can to make it go away.” Dr. Klasko said. “We want to be a global powerhouse for everything Alzheimer’s. We want to be a national model of excellence for state, university and private sector collaboration. We want to be a magnet for Alzheimer’s fundraising and attract entrepreneurs looking to invest in Alzheimer’s research.”

Dr. Klasko reiterated that the top priority will be to increase sustainable revenue so that the Institute can stay steadfastly focused on it statewide research mission of developing treatments to cure and prevent Alzheimer’s disease.

The five planks of the Byrd Institute/USF Blueprint for Strategic Action are:

• State-of-the-Art Basic & Translational Research
• Integrated Clinical Research & Clinical Care
• Meet Statewide Citizen Awareness, Education & Outreach
• Integration: “Synergy Works!”
• Creative Capitalization & Financial Model

Chad Dickey, PhD, (left) assistant professor of Molecular Medicine, chats with postdoctoral student Umesh Jinwal (right). Dr. Dickey and Ed Weeber, PhD, moved their teams to the Byrd Institute last month.

Expense reductions have included some necessary personnel reductions, primarily temporary personnel and administrative support positions, Dr. Klasko said. Most of the Institute’s scientists and clinicians were retained as USF employees. Dr. Klasko and the USF/Byrd Transition Team continue to work on leveraging the talent and resources of both institutions. In keeping with this synergistic approach, the Blueprint for Strategic Action complements the university’s broad neuroscience agenda recently outlined by USF President Judy Genshaft.

Among the early accomplishments has been the integration of clinical research and care. Three practices caring for a total of 200 to 300 patients a month -- the Eric Pfeiffer Suncoast Alzheimer’s and Gerontology Center at USF, the Byrd Clinic, and the USF Department of Psychiatry’s Memory Disorders Center -- are now all under the umbrella of a common administrative core. This newly established Alzheimer’s Disease Comprehensive Clinical Center operates out of the Byrd Institute’s state-of-the-art facility. A chief clinical officer is being recruited for the center.

“Everyone really came together to make this happen,” said Cliff Gooch, MD, chair of neurology at USF, who heads the clinical transition. “There has been a remarkable spirit of cooperation by faculty and staff because of their tremendous commitment to finding treatments and cures for Alzheimer’s.”

USF and the Byrd Institute are preparing to submit a competitive application for renewal of the Alzheimer’s Disease Research Center directed by Huntington Potter, PhD. Dr. Potter is working with newly appointed ADRC administrator Jessica Banko.

Dr. Klasko emphasized that Byrd Institute board members will be invaluable in helping raise community awareness about the Institute and advocating the tremendous need for Alzheimer’s research.

“There may be some bumps along the way, but we will get there,” Sherrill Tomasino, chair of the Joint Affiliation Board, said of the partnership between the Byrd Alzheimer’s Institute and USF. “I really do feel encouraged that we’re doing the right thing.”

USF Health and the Byrd Institute engaged Maverick Healthcare Consulting (www.MavHC.com) to assist in the development of the Blueprint for Strategic Action. These same consultants assisted the USF Health College of Medicine with a Blueprint for Strategic Action several years ago.

Dr. Klasko leads the way as board members tour the Byrd Institute's state-of-the-art vivarium.

Huntington Potter, PhD, (right) director of the Alzheimer's Disease Research Center, with Thomas Conklin, a member of the Byrd Alzheimer's Institute Board of Directors.

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

Click here for Photo Gallery.

L to R: USF President Judy Genshaft, Carol and Frank Morsani, USF Board of Trustees Chair Rhea Law, and USF Health CEO Dr. Stephen Klasko.

More than 300 of USF Health’s friends and long-term supporters gathered the evening of Friday, Oct. 10, to celebrate the opening of the Carol and Frank Morsani Center for Advanced Healthcare.

The ribbon-cutting gala honored Carol and Frank Morsani, whose vision and generosity made the center a reality. They were lauded for their commitment to the Tampa community and in making a difference in education, research, athletics and health care at USF. The evening also included a tribute to Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, for his leadership in transforming healthcare in Tampa and beyond.

“For nearly 40 years, USF Health’s extraordinary team of scientists, clinicians and students have stood on the cutting edge of the search for better methods of preventing, diagnosing, educating and treating human disease,” said Pam Muma, the gala’s chair who hosted the event along with USF President Judy Genshaft. “Your endorsement of their work inspires us all to accomplish more.”

In his remarks introducing the Morsanis, Dr. Klasko said the vision for USF Health encompasses new ways of thinking about health that includes combining the best in medicine, nursing, public health, physical therapy and pharmacy to make life better. It taps into new ways of delivering quality and safety based on the latest technology.

“This building models our response to the challenge of the future of health care,” said Dr. Klasko, who thanked the Morsanis for their leadership and vision. “We believe our colleges can transform how we understand the full spectrum of health. We believe our education will transform how our students change the world. And we believe that transformational research will drive how we do everything.”

The event was held on the fifth floor of the Morsani Center, which will be built out in the future. The draped walls were bathed in soft green and gold lighting and guests dined at tables decorated with festive flowers and candles. The momentous evening, which culminated with a ribbon cutting, raised more than $150,000 to benefit the programs and research activities of USF Health.

Click below for time lapse of Morsani Center construction:

Related Links:
- About the Carol & Frank Morsani Center for Advanced Healthcare
- About Carol and Frank Morsani
- About Dr. Stephen Klasko
- Sponsors
- Photo Gallery

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

The event – sponsored this year by Aetna and MAG Mutual – finds and awards individuals and organizations in the community who have a major impact on the quality of health provided to area residents. The winners were announced and recognized Oct. 2 at a dinner in Tampa.

Dr. Sleasman, who holds the Robert A. Good Chair in Immunology and is the division director for immunology at the USF Health Department of Pediatrics, works out of the USF Children’s Research Institute at All Children’s Hospital in St. Petersburg. He studies immune disorders in children and adolescents.

Dr. Sleasman was cited for advances he and others have made on perinatal transmission of the HIV virus between mother and child, which have contributed to an all-time low in these infections in the United States. Supported by National Institutes of Health funding, his team is also focusing on advancing a B-cell approach to HIV vaccines.

Six faculty members from USF Health (including Dr. Sleasman) were among 33 people across the Tampa Bay area named by an independent panel of judges as finalists for the 2008 Tampa Bay Business Journal Health Care Hero Awards. Other faculty and their respective catgories were:

COMMUNITY OUTREACH:
Lynn Ringenberg, MD, chief of the General Pediatrics Division and medical director of the Ronald MacDonald Care Mobile

HEALTH CARE EDUCATOR:
Eduardo Gonzalez, MD, associate professor in the Department of Family Medicine; and Jeff Konin, PhD, ATC, PT, associate professor in the Department of Orthopaedics and Sports Medicine, and executive director of the Sport Medicine and Athletic Related Trauma Institute at USF Health.

PHYSICIAN:
Robert Hauser, MD, professor of Neurology and director of the Parkinson's Disease and Movement Disorders Center at USF-Tampa General Hospital; and Richard Karl, MD, professor of surgery and former chair of the Department of Surgery.

The 2008 Health Care Heroes “stand out as shining examples of what gives Tampa Bay increasingly rich health care assets,” Tampa Bay Business Journal Editor Alexis Muellner wrote in his preface to the paper’s special section introducing the winners and finalists. “Each is a vortex of their own, doing meaningful work that forces change for people and their health, and their quality of life.”

Newsbrief by Anne DeLotto Baier, USF Health Communications

88 years young, Shirley Marie Turner has her eye on the future and making a difference in nursing. After more than three decades of retirement she and her daughter Janis Boyd have found a way to make that happen. At the USF College of Nursing, Janis is creating a scholarship fund in her mother’s name.

“I just love nursing,” says Shirley, now a retired nurse in Delray Beach. “…love it because you’re helping people. I know sometimes it can be difficult. It was difficult for me when I was young to be able to afford nursing school, so I can understand those young people who want to go and don’t have the finances to. Thank goodness my father was able to get funding for me to go.”

Janis, a USF graduate, Class of ‘73, says it’s the kind of legacy that certainly “fits” her mom, a petite 4’5” woman with a Herculean passion for nursing and kids. “My late husband Jack and I have been involved with USF scholarships for years. I thought it would be good to create a nursing scholarship in mom’s name. At first she said ‘I’m so not worthy!’” laughs Janis. “I said ‘Mom, you raised three teenaged daughters at one time! I think that counts for something!’ After it sunk in, mom thought it was really cool.”

Cool indeed.

“I think what the USF College of Nursing is doing is so great, so I went for it,” says Shirley. “It’s always a great thing when you’re able to give back,” says Janis.

Looking back, it’s clear that nursing allowed this family to have the best of both worlds. For the kids, it was quality time with mom at home. For Shirley, it was a rewarding career.

William Robert Turner and Shirley Marie Foreman were married on April 25, 1941.

A 1942 graduate of the Springfield City Hospital Nursing School in Ohio, then Shirley Marie Foreman, began her nursing career ‘working the floor’ of Springfield City Hospital. Two years later and married, Shirley faced the question new moms have struggled with for generations – whether or not to become a stay at home mom. She made the choice to put her nursing career on hold until her girls, Lois, Janis and Sara were in high school and college. “It was very fulfilling to be able to do that,” says Shirley of her return after years of child rearing. “At the same time, Florida was having nursing shortages, and I wanted to help.”

Speaking from her home in Homosassa, daughter Janis is quick to point out that Shirley was as devoted to her colleagues as she was to her patients. “Mom often worked weekends and holidays to give nurses who were still raising kids time to spend with their families,” says Janis beaming with pride. “Helping people has always been mom’s first priority.”

“I just did what the Lord wanted me to do. I felt a calling and followed my heart,” says Shirley. “I’d work my own weekends and then help other nurses if they wanted a day off for a special reason. We were a team.”

Daughter Sara, who lives in Palm Coast, Florida, notes that her mother first felt a calling for nursing since childhood. “Mom knew she wanted to be a nurse when she was just 10 or 11 years old. We always felt that mom had a gift. When ever one of us was sick, one of the first things mom did was to touch us. She could tell, just by touching us, what was going on,” says Sara, who also attended USF. “We could NEVER fake being sick because mom could tell right away!” adds Janis. “We never got to stay home faking we were sick. Believe me, we tried!”

As one might expect, Shirley’s nursing memories are many and varied – stretching from Ohio to Florida. “Too many to remember in great detail,” she says with a laugh. Her daughter’s personal favorite is one from Ohio. “In the early days, they had large hospital rooms with 4 to 6 patients to a room. Mom was taking care of a group of men one day when one of them told her he needed something, but he was having a hard time telling her what that was. He was an older man, shy and in a roomful of other men. Maybe he wasn’t comfortable telling my mom, a tiny, pretty 22 year-old, what he needed,” says Janis with a chuckle. “Finally he said to her ‘I need…you know…one of those vases.’ And my mom said ‘Oh, okay. How big is your bouquet?’ Well, as it turned out, what he wanted was a urinal.”

True story.

“Oh my, yes!” says Shirley, almost blushing.

Focusing on today, Shirley marvels at the increased choices nursing students have. “Back in 1942, you hit the books and from then on it was ‘learn and do’” says Shirley. “And back then, you were either an operating room nurse, an emergency room nurse, or a floor nurse…and even those were limited,” she recalls. “Now? My goodness, it’s wide open! Unbelievable!” Re-energized by the opportunity to give back to the profession she loves, Shirley’s golden years of retirement are filled with a renewed sense of optimism and hope.

“There just never seems to be enough qualified nurses around and this is our way of doing our part to help,” says Janis.

“The College of Nursing is honored to have a scholarship memorializing Shirley Turner,” says Patricia Burns, PhD, RN, Dean of nursing and Senior Associate Vice President, USF Health. “She is truly a role model for the nursing profession and her passion for nursing is infectious.”

Shirley has this advice for nursing students of today. “Number one, you really have to love it. You have to know in your heart that you want to do this. It may be tough sometimes, as any job would be, but if you really want to do it, hang in there! It will work out.”

Shirley Turner is living proof of that.

Story by Lissette Campos, USF Health Communications

Other Links:

PHOTO GALLERY

Nursing Life Magazine Spring 2008 Edition

USF College of Nursing

The Tampa Bay Convention Center was alive with thousands of women who came for a day of inspirational keynote speakers, breakout lectures, health screenings and beauty consultations. The exhibit hall was full of sponsorship booths offering everything from makeup consultations to an "oxygen bar". USF Health was represented with a booth alongside the college of medicine's main teaching hospital, Tampa General Hospital.

The USF Department of Dermatology & Cutaneous Surgery featured its Cosmetic & Laser Center in the exhibit hall. Physician Assistant Anthony Yarand and esthetician Mary Smith enjoyed the day talking with women about the services offered at our Davis Island location.

Dr. Fenske lectured to hundreds of women during the morning sessions on Discover the "Super Powers" of Smart Skincare. Meanwhile in another part of the convention center the residents and staff lead by Drs. Basil Cherpelis and Mary Lien offered free skin cancer screening to over 200 women throughout the day.

The Department of Dermatology & Cutaneous Surgery has participated with Speaking of Women's Health since 2006.

Other links:

USF Dermatology & Cutaneous Surgery
Speaking of Women's Health

Photo Gallery:

The Hillsborough County Board of County Commissioners recognized the value to the community of the BRIDGE Healthcare Clinic with a resolution at the board's Sept. 4 publicly-televised meeting. The BRIDGE, which stands for Building Relationships and Initiatives Dedicated to Gaining Equality, is the University’s student-run clinic offering free primary care, social services and physical therapy to uninsured adults living in the university area. The faculty-supervised clinic is based at the University Area Community Center.

The meeting was attended by several medical, physical therapy and social work students who volunteer at the BRIDGE Clinic as well as Alicia Monroe, MD, vice dean for Educational Affairs at the USF College of Medicine; William S. Quillen, PT, PhD, professor and director
of the School of Physical Therapy & Rehabilitation Sciences; and Dr. Laurie Woodard, associate professor of family medicine and a faculty mentor at the clinic.

Commissioner Kevin White presented Dr. Monroe with a plaque containing the following resolution:

HILLSBOROUGH BOARD OF COUNTY COMMISSIONERS RESOLUTION - Sept. 4, 2008

Whereas the University of South Florida, classified by the internationally recognized Carnegie Foundation as one of America’s top research institutions, has also earned Carnegie recognition for “Community Engagement”, the only university in Florida to do so; and

Dr. Alicia Monroe, vice dean for Educational Affairs at the USF College of Medicine, receives the resolution from Commissioner Kevin White.

Dr. Monroe (above) and Aaron Jaworek (below), a senior USF medical student and one of the BRIDGE Clinic's co-directors, addressed the Hillsborough County Commission.

Newsbrief by Anne DeLotto Baier, USF Health Communications

Tampa, FL (Aug. 22, 2008) -- The Johnnie B. Byrd Alzheimer's Center & Research Institute’s Board of Directors today unanimously approved a new CEO -- Stephen K. Klasko, MD, MBA, dean of the University of South Florida College of Medicine and senior vice president for USF Health.

Dr. Klasko’s was named CEO immediately following the Board’s approval of the affiliation agreement intended to help the Byrd Alzheimer’s Institute and USF move together in advancing Alzheimer’s research and treatment. The day before, Aug. 21, the same affiliation agreement was signed by USF President Judy Genshaft and affirmed by the USF Board of Trustees executive committee.

“Collaboration has been the key for the Byrd Institute and we will continue to move forward under that model. Synergy is a remarkable force, and I am eager for us to accelerate that process,” Dr. Klasko said.

Huntington Potter, PhD, the center’s first CEO, has signed an offer from USF to remain as a senior scientist at the Byrd Alzheimer’s Institute and tenured professor in the USF Department of Molecular Medicine. Dr. Potter is also the Pfeiffer Endowed Chair in Alzheimer’s Disease Research at USF and principal investigator for the prestigious Alzheimer’s Disease Research Center (ADRC) grant obtained from the National Institute on Aging. “Dr. Potter is definitely very important to continuing the great work begun by the Byrd Institute,” Dr. Klasko said.

Dr. Stephen Klasko

Dr. Klasko will meet with all Byrd Institute staff on Aug. 25 and introduce the team that will provide transition support for the Institute. At a combined meeting of the Byrd Alzheimer’s Institute Board of Directors and its Joint Affiliation Board in October, Dr. Klasko will present a blueprint for strategic action intended to consolidate resources and services and leverage the talent of both institutions.

“We will look at every opportunity to generate revenue by attracting more NIH research support and tapping into entrepreneurial funding,” Dr. Klakso said. “At the same time, we’ll work to reduce administrative expenses, because every expense takes dollars way from what we can spend on Alzheimer’s research, patient care and education.”

“My role as CEO is to assess our joint potential, address the realities and lead so we can achieve our goals,” Dr. Klasko said. “I am truly committed to helping the Byrd Alzheimer’s Institute become one of the best in the world for outstanding research with the goal of discovering a cure for Alzheimer’s disease. I believe we can successfully do that together.”

- About the Byrd Alzheimer’s Institute -

The mission of the Johnnie B. Byrd, Sr. Byrd Alzheimer's Center & Research Institute is to collaborate with researchers throughout the State of Florida and the wider global research community to develop treatments to cure and prevent Alzheimer's disease. The Institute provides a physical location—the world's largest freestanding research center dedicated to Alzheimer's research—that conducts state-of-the-art research, in addition to serving as the site for coordinating and facilitating Florida's various efforts to diagnose, treat and prevent the disease.

- About 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 $308 million in research funding last year, USF is one of the nation’s top 63 public research universities and one of Florida’s top three research universities.

Melissa Matson, USF Doctor of Physical Therapy student.

This summer Melissa Matson, a member of the USF School of Physical Therapy & Rehabilitation Sciences DPT 2010 class, had a valuable opportunity to share the rewarding aspects of becoming a physical therapist. High school students from around the country gathered for a 10-day conference to learn about careers in the medical and healthcare fields. Matson had the privilege of being on staff for the conferences organized by LeadAmerica and held at DePaul University in Chicago and San Francisco State University. Many students arrived at the conference convinced that they were destined to be anesthesiologists or pediatric neurosurgeons, however, others expressed a desire to investigate the entire healthcare spectrum. After several of the “future physicians” discovered the extensive educational commitment for their career choice, they began exploring other options as well.

Throughout each of the conferences, Matson had a group of 18-20 students that she was responsible to lead and mentor in small group discussions and prepare the students for a history-taking opportunity with standardized patients. While other small group leaders were pursuing professions such as nursing, psychology, and pharmacy, Matson's group has the opportunity to get an inside perspective on what it is like to be a physical therapy student. They learned about the high demand for physical therapists, the benefits of a shorter educational commitment than an MD, and the wide scope of practice available to a physical therapist.

"It was an honor to be the sole representative of the physical therapy profession," said Matson. " I was thoroughly excited about recruiting future physical therapists, and I am thankful for the USF School of Physical Therapy for preparing me for this opportunity."

She also had the opportunity to give a hands-on lecture to more than 240 students on how to conduct the basic head-to-toe physical assessment. The 1st year classes she took with her fellow MD students at the USF College of Medicine gave her the knowledge and confidence to conduct this with ease.

"Melissa's involvement with Lead America reflects the type of young professional leaders we hope to educate here in the School of Physical Therapy & Rehabilitation sciences, COM and USF Health," said William S. Quillen, PT, PhD, Associate Dean, College of Medicine and Director, USF School of Physical Therapy & Rehabilitation Sciences.

The USF student also represented physical therapy in a panel discussion. Fielding questions, she and fellow panelists were able to open the eyes of the students to careers they had not previously considered.

Throughout the week following the panel discussion, Matson was encouraged by the number of students who pursued her with additional questions regarding physical therapy. Many were excited about PT as a career option. Several participants expressed a desire to remain in contact with this USF physical therapy student in the future as they are in the process of making their college and career plans. It has been an intense, yet very rewarding summer for Matson. Hopefully, we will now have a few more up and coming additions to the physical therapy profession.

"I answered questions from enthusiastic students wondering how they could work with athletes through physical therapy. It was a joy to share my passion with students eager to listen," said this proud USF Doctor of Physical therapy student, Class of 2010. Go Bulls!!

Other links:

LeadAmerica Medicine & Healthcare program

USF School of Physical Therapy & Rehabilitation Sciences

In keeping with USF Health’s core values to improve life by looking at the full spectrum of health, the USF Wellness initiative is being launched for its employees.

Over the course of the next year, employees from the Colleges of Public Health, Nursing and Medicine, as well as the USF Physicians Group, will be presented with opportunities to participate in a variety of health-focused programs, courses and pilot projects.

The overall goal of these activities is broad in scope, but singular in focus: to improve the health and well being of USF employees, said Robert Pedowitz, MD, chair of the USF Department of Orthopaedics and Sports Medicine and co-chair of the USF Wellness Executive Council.

“The aim is to take a proactive approach to prevention, starting with our own valued assets, our employees,” Dr. Pedowitz said. “Such a project is a natural extension of the USF Health vision: improving the health of our own USF Health community.”

The fully integrated effort – planned by representatives from all three USF Health colleges for employees throughout USF Health – has been in the making for several years. Sharing the wellness charge with Dr. Pedowitz is Donna Petersen, ScD, dean of the College of Public Health and also co-chair of the USF Wellness Executive Council.

Starting at home...
“If we want to truly realize our vision of a healthier community enjoying a better quality of life, we have to start at home,” Dr. Petersen said. “We have to make ourselves healthier, we have to invest in our collective well being, and we have to demonstrate that it makes a difference before we can bring the greater community along to this way of thinking.”

The real push for a wellness program came in the past six months following a USF Health Leadership Institute real-life case project that looked at the current wellness initiatives taking place at USF. What the project team found, Dr. Pedowitz said, was that there are several existing smaller programs scattered around USF Health and even overlapping in some areas, but no coordinated effort to bring a unified program together for everyone.

The USF Wellness Executive Council (listed below) took the Leadership Institute findings as a guide for developing, implementing and evaluating a full-encompassing wellness effort for employees.

Workplace wellness programs have long been associated with healthier employees, which translate into better productivity for employers. The USF Wellness Program is aiming for that outcome, as well, but is also taking a more philosophical look at the project.

“So much of what we do is a ‘reactive’ approach to health care: someone has a broken bone, we fix it,” Dr. Pedowitz said. “Well, now we’re pushing USF Health to take a more ‘proactive’ role, using a more preventive and healthier approach that could help employees avoid healthcare costs in the first place.”

Just to give a hint, Dr. Petersen said that this soon-to-be-launched wellness initiative is starting with a focus on physical activity but it won't end there.

“We will be asking our colleagues to share with us what would help them make a difference in their ‘health lives,” Dr. Petersen said.

“Is it nutrition counseling and cooking classes? Is it stress management or stress reduction? Is it smoking cessation or addiction counseling? Or is it creating a work environment that encourages healthier habits? When it comes to improving our health, we are interested in any and all ideas to help us do that,” said Dr. Petersen.

USF Wellness to reach Tampa Bay community ...
Although initially designed to focus internally on USF Health employees, Dr. Pedowitz said that future goals for the initiative is to go beyond USF Health by “reaching across campus and out into the community, and becoming a national model for taking a proactive role in healthcare.”

Coming Soon...
The USF Wellness Program will feature a variety of health-focused activities, including options that are interactive, team-based and independent.

Some activities make use of the USF Health grounds, with sign-up tables for kickoffs, and others tap into the internet, with web-based options for employees to track their progress as they work toward their goals. One program even features a chance to earn cash rewards for making a goal.

Although several ideas are in the works, employees are encouraged to submit their ideas for healthy options. For more information or ideas for this program, please contact Dee Jeffers, Wellness Program Director at djeffers@health.usf.edu.

The first in the series is set to start in September. Be on the lookout for a USF Health Wellness resources web page for updates, options and opportunities for making YOUR life better.

Meet the team...

USF Wellness Executive Council

Robert Pedowitz, co-chair
Donna Petersen, co-chair
Julie Baldwin, COPH
Denise Edwards, COM
Kevin Kip, CON
Deanna Wathington, COPH, COM
Micki Cuppett, COM
Michael Hoad, USF, USF Health

Wellness Operations Staff

Dee Jeffers, program director
Christina Bernadotte, research support specialist

Story by Sarah Worth, USF Health Communications
Photo gallery by Eric Younghans, USF Health Media Center

Dr. Kathleen Armstrong, Director, USF Health Pediatric Psychology Program

Publication date: August 1, 2008
Article entitled: "The Girl in the Window"
Publication: St. Petersburg Times

Times' reporter Lane DeGregory’s, “The Girl in the Window,” has kicked off an international wave of concern. The story, published in the St. Petersburg Times on August 1, tells the story of Dani, a girl who grew to the age of six with such deprivation that she was essentially a feral child.

In the article, DeGregory quotes a USF Health pediatric psychologist, the first to evaluate Dani, and the first to grasp what years of deprivation had done to her.

“My hope is that this raises people’s awareness of the needs of children to social and emotional attachments, and to early experiences,” said Kathleen Armstrong, PhD, the director of USF Health’s pediatric psychology program.

In the article, Dr. Armstrong talks about the development of the brain in the first five years, and the permanent loss that can occur then. “This was an extreme case, but it shows how much a child can be hurt.”

“I’m getting calls from around the world, but I want to note that in this case, it took a lot of people in our pediatrics department to help" said Armstrong. “It took a team effort to find this child the help and support she deserves – and that every child deserves. Even now the outcome remains guarded.”

For full story of Danielle, now 9 and adopted by a new family, click here: St. Petersburg Times Article.

The University of South Florida Area Health Education Center took its opportunity to shine recently when the program hosted a visit by Elizabeth Duke, PhD, administrator for the federal Health Resources and Services Administration. HRSA oversees the nation’s AHEC programs, including the one at USF and four other medical schools across Florida.

Dr. Duke was in Tampa to present the keynote address at the National Health Service Corps Scholars Conference. She and her senior advisor Steve Smith spent the morning of Aug. 1 with USF AHEC Program Director Cynthia S. Selleck, DSN, ARNP; Gulfcoast North AHEC Executive Director Jody Lazzara, LMHC; and Gulfcoast South AHEC Chief Executive Officer Edna Apostol, MPH. "It was an honor for us to have Dr. Duke visit our program," Dr. Selleck said.

AHEC works closely with NHSC to encourage, train, recruit and retain a diverse and broad range of health professionals to practice in communities where the need is greatest, primarily in medically underserved inner-city and rural areas experiencing servere healthcare workforce shortages. Dr. Selleck is an NHSC Ambassador and also serves as the current president of the National AHEC Organization. Dr. Duke's visit was the opportunity to showcase for the HRSA guests two of AHEC's "pipeline” programs that target promising underrepresented and disadvantaged youth interested in pursuing careers in health. Students partcipating in Interdisciplinary Community Health Scholars (ICHS) and Pre-Medical Student Enrichment Program (PSEP) shared with Dr. Duke the impact of their AHEC experiencs.

Public health students Renee Clark, left, and LaShanta Rice, were part of an ICHS team that develped an educational toolkit for a Sarasota initiative helping women to have substance free pregnancies.

ICHS brings teams of students from various health professions together for the summer to help tackle real-life public health issues. Public health graduate students and ICHS participants Renee Clarke and LaShanta Rice showed Dr. Duke an educational toolkit their team created for Clean Start, a Healthy Start Coalition of Sarasota County initiative to help women have substance abuse-free pregnancies. “Within the team setting, we were exposed to social workers, nurses, physicians and saw how everyone has an important piece of trying to solve a particular problem,” said team member Alyssa Brown, a second-year medical student. “We learned all the steps that need to be taken to get a community program off the ground.”

PSEP participants Harold Paul, a USF senior, and Daniel Quinones, a USF junior, shared their experiences as part of this intensive six-week summer program for highly motivated underrepresented minority and disadvantaged students preparing for medical or physical therapy school. Participants shadow community physicians, review for the MCAT (medical college entrance examination), work with patient simulators and standardized patients in the Center for Advanced Clinical Learning, and attend clinical seminars on such topics as health disparities, obesity, diabetes and heart disease. Mr. Quinones shadowed the chief of orthopedic surgery at St. Joseph’s Hospital and observed several surgeries as well as physician interactions with patients. “I would say about 80 percent of his patients spoke only Spanish,” said Quinones, who hopes to one day be an orthopedic surgeon or neurosurgeon. “I learned a lot about the cultural aspects of medicine and barriers to care. It makes me want to be a better doctor…. Even if I become a specialist, I’d want to give back to the community.”

USF undergraduate students Harold Paul, left, and Daniel Quinones shared the insights they gained participating in this summer's Pre-medical Student Enrichment Program.

AHEC introduces PSEP and ICHS students to community partners such as Premier Community Healthcare Group, a federally qualified health center that cares for medically underserved and uninsured patients in East Pasco County. Dr. Marlene Hart, medical director of Premier, along with Tampa Community Health Center CEO Charlie Bottoms and Suncoast Community Health Center CEO Brantz Roszel, also attended the meeting with Dr. Duke . The three FQHC executives spoke highly of their regard for AHEC. "It seems as if the best of the best come to us through you," Mr. Roszel told Dr. Selleck. "I'm glad we could add some insights into how important you are."

Dr. Duke commended the students on their interest in AHEC and was particularly impressed with the FQHC collaboration. “We desperately need diverse health professionals who understand patients who speak different languages and come from different cultural backgrounds,” she said. “I hope to meet you in the near future in your new roles.”

Story by Anne DeLotto Baier, USF Health Communications, and Anne Maynard, AHEC

HRSA Administrator Elizabeth Duke, PhD, center, with her senior advisor Steve Smith and USF AHEC Program Director Cynthia Selleck, DSN, ARNP.

Dr. Elizabeth Duke, center, with the USF students who shared their AHEC experiences during her visit. From left to right: Daniel Quinones, Harold Paul, Alyssa Brown, LaShanta Rice, and Renee Clarke.

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.

Dr. Jose Montero, associate professor in the Division of Infectious Disease, and Dr. Marela Velez, a division fellow, are two of 14 USF infectious disease physicians who treat patients at the Hillsborough County Health Department's Specialty Care Center.

It was a gray morning when officials from the Duval County Health Department recently arrived for a day at the Hillsborough County Health Department. Inside the building, the atmosphere was bright and full of energy as representatives of the two health departments began discussing innovative ideas. Sharing knowledge about designing and refining programs, infrastructure, technology, and research in order to create the most effective public health care for Florida’s residents was the call of the day.

As a peer county, with similar demographics to Hillsborough, Duval County will strive to make improvements based on what has worked in Tampa Bay. One program that has worked exceptionally well is the HIV Clinical Research Unit, a long-term partnership between the USF Division of Infectious Disease and International Medicine and the HCHD. The unit operates in conjunction with the county’s Specialty Care Center and conducts clinical research relevant to the HIV community it serves.

“We realize that Hillsborough’s Disease Control Program is recognized as one of the best in the state. We are here to obtain information about the clinics: HIV, STD, TB, as well as the Immunization program so that we can model our programs after their programs,” said Aaron Hilliard, PhD, assistant director of Environmental Health and Disease Control for the Duval County Health Department. “We see there has been an increase in quality and efficiencies here. We can go back to Duval and make it happen.”

L to R: Mike Kilcomons, RN, BSN, MPH, Public Health Officer, HCHD; Fayshonda Cooks, RN, BSN, CAPPM, Disease Control Program Administrator, Duval County Health Department; Aaron Hilliard, PhD, Assistant Director, Environmental Health and Disease Control, Duval County Health Department; and Mike Wagner, Health Center Administrator, HCHD

Advances in HIV Research

The USF HIV Clinical Research Unit operates out of the HCHD in downtown Tampa. This unit has been designed to facilitate access to innovative experimental therapies before they are widely available to the greatest number of patients. The physicians, supplied by the USF Division of Infectious Diseases, and care providers have been contributors to evidence-based medicine for over 13 years. Their efforts have been instrumental in bringing more than 20 HIV medications to market. The research team has conducted more than 110 HIV research studies, including Phase I-IV pharmaceutical studies, investigational device and testing evaluations, epidemiologic, health services, and outcomes research. Four to eight studies are ongoing at any time, with approximately 50 patients participating in studies each year.

“The HIV Clinical Research Unit serves as an exceptional study and trial environment with a highly qualified staff and an excellent performance record,” said Charurut Somboonwit, MD, assistant professor of medicine in the USF Division of Infectious Disease and director of communicable diseases for HCHD.

This unique partnership with USF benefits HCHD and the community by offsetting approximately $300,000 a year for care and medications that would otherwise be billed to the Hillsborough County Health Plan, Medicaid, Medicare, and other indigent funds. Enhancing their professional growth, Health Department professionals gain experience with new agents and laboratory tests before their general availability. This experience facilitates HCHD’s leading role as a community education resource. Additionally, the research unit works to improve the public image and the prestige of public sector healthcare through its association with a facility that offers state-of-the-art diagnosis and management.

Providing Specialized, Comprehensive Care

A reported 8,732 people live with HIV/AIDS in Pinellas and Hillsborough counties, according to the HCHD’s Epidemiology and Public Health Surveillance Department. The Specialty Care Center at HCHD provides the comprehensive primary healthcare services to HIV/AIDS patients and operates a STD clinic for the county. Through Ryan White CARE Act funding, the Center provides comprehensive HIV care to any HIV-infected patient desiring services, regardless of ability to pay. It is not the clinic’s accessibility, however, that attracts patients from all over Florida. It is the superior quality of care. In addition to providing excellent care from HIV-trained disease clinicians, the center addresses the myriad of social issues of HIV care. Social workers and on-site ADAP representatives assist patients in obtaining health care coverage, medications, and links to other community resources. The center also provides dental care, an often neglected, but integral part of comprehensive HIV/AIDS care.

“We call it a center, not a clinic, because the patient is at the center of our care. We give them whatever they need, when they need it,” said Debbie Morgan, a dental professional at the Specialty Care Center. Morgan provides dental care to HIV-positive patients, and is passionate about her contribution. The dental services are extensive: “We do everything from fillings to extractions; probably the only level of dentistry that we do not do is cosmetic.”

She explains: “The mouth is the closest portal to the heart for infection. We try to keep patients with compromised immune systems from any type of infection that may get into the lymph system or the circulatory system and filter into the heart causing other cardiac problems. We are really promoting wellness. When the mouth looks healthy, generally we know the person is eating correctly and being compliant with their medication.”

Touch-screen customer service satisfaction surveys are available at kiosks throughout the HCHD.

Continuous Quality Improvements

As patients leave the HCHD they are asked to complete an anonymous electronic customer service survey available at computer kiosks throughout the facility. The survey helps the clinic continuously improve the quality of care provided.
“The only constant is that everything is always changing and being improved upon at the Hillsborough County Health Department,” said Mike Kilcommons, RN, BSN, MPH, public health officer.

- Story by Kaeley Hamilton, Julian Corvin, Dr. Jennifer Logan/Division of Infectious Disease & International Medicine

- Photos by Kaeley Hamilton

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=562 http://hscweb3.hsc.usf.edu/health/now/?p=537 http://hscweb3.hsc.usf.edu/health/now/?p=537#comments Wed, 16 Jul 2008 16:06:40 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=537

Tampa, FL (July 18, 2008) -- The University of South Florida and Johnnie B. Byrd Sr. Alzheimer’s Center & Research Institute today approved an affiliation agreement intended to help them move together in advancing Alzheimer’s research and treatment. The agreement, unanimously approved July 18 at the first meeting of the seven-member Joint Affiliation Board, must still be voted on by the full boards of both institutitons.

The agreement will be considered at the next regularly scheduled meetings of the USF Board of Trustees on Aug. 21, and of the Byrd Alzheimer's Institute Board of Directors on Aug. 22.

In other action:

- Sherrill Tomasino was elected chair of the Joint Affiliation Board. Tomasino is a member of both the USF Board of Trustees and the Byrd Alzheimer's Institute Board of Directors.

- Members approved a motion to add a member of the Florida Board of Governors to the Joint Affiliation Board as an ex officio member.

The partnership will help consolidate resources and services and leverage the talent of both institutions. John Ekarius, chief administrative liaison to Stephen Klasko, MD, MBA, vice president for USF Health and dean of the College of Medicine, told board members that Dr. Klasko would work with Huntington Potter, PhD, CEO and scientific director of the Byrd Alzheimer's Institute, to map out the research and clinical resources of both institutions by mid-August.

The Joint Affiliation Board is comprised of three board members appointed by the Byrd Alzheimer's Institute and four members appointed by USF. The three board members appointed by Pamela Vergara, PhD, PE, chair of the Byrd Alzheimer’s Institute Board of Directors, are:

• Johnnie B. Byrd, Jr, JD, member and former chair of the Byrd Alzheimer’s Institute Board of Directors, former speaker of the Florida House of Representatives, attorney in private practice.

• Kathy Harris, MA, JD, vice-chair of the Byrd Alzheimer’s Institute Board of Directors, General Counsel and Chief of Staff for the Supervisor of Elections

• Pamela Vergara, PhD, PE, chairman of the Board of Directors, president of Skyshadow Ventures, Inc. and faculty member at Hillsborough Community College

The four board members appointed by Rhea Law, JD, chair of the USF Board of Trustees, are:

• Wayne Goodman, MD, director of Division of Adult Translational Research and Treatment Development, National Institute of Mental Health, Bethesda, MD.

• Karen Holbrook, PhD, vice president for Research and Innovation at USF and member of the Washington Advisory Group

• Frank L. Morsani, trustee of the Frank and Carol Morsani Foundation, Inc., and member of the USF Foundation Board of Trustees

• Sherrill M. Tomasino, president of Sherwood Forest of Temple Terrace, Inc. and member of the USF Board of Trustees

The Joint Affiliation Board was created to develop the USF-Byrd partnership as an academic research and patient care initiative to find treatments for Alzheimer's disease. The existing Byrd Alzheimer’s Institute Board of Directors would take on an advisory and advocacy role, maintaining focus on the institute’s statewide mission.

Related Links:

Read biosketches of Joint Affiliation Board members.

Read Tampa Tribune story...

About the Byrd Alzheimer’s Institute
The mission of the Johnnie B. Byrd, Sr. Byrd Alzheimer's Center & Research Institute is to collaborate with researchers throughout the State of Florida and the wider global research community to develop treatments to cure and prevent Alzheimer's disease. The Institute provides a physical location—the world's largest freestanding research center dedicated to Alzheimer's research—that conducts state-of-the-art research, in addition to serving as the site for coordinating and facilitating Florida's various efforts to diagnose, treat and prevent the disease.

About 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 $308 million in research funding last year, USF is one of the nation’s top 63 public research universities and one of Florida’s top three research universities.

- Photo by Eric Younghans/USF Health Media Center

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=537 http://hscweb3.hsc.usf.edu/health/now/?p=533 http://hscweb3.hsc.usf.edu/health/now/?p=533#comments Mon, 14 Jul 2008 16:08:00 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=533

Click here to read Dr. Curran's Message to the HCMA.

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=533 http://hscweb3.hsc.usf.edu/health/now/?p=525 http://hscweb3.hsc.usf.edu/health/now/?p=525#comments Mon, 30 Jun 2008 01:47:18 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=525

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

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=525 http://hscweb3.hsc.usf.edu/health/now/?p=520 http://hscweb3.hsc.usf.edu/health/now/?p=520#comments Thu, 19 Jun 2008 21:03:49 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=520 - Grant from American Academy of Dermatology will help build shade structure -

A local elementary school that partnered with USF Health dermatologist Neil Alan Fenske, MD, is one of 37 organizations nationwide to receive a 2008 Shade Structure Program Grant from the American Academy of Dermatology.

The $8,000 grant will support Cecile B. Essrig Elementary School’s fundraising initiative to build a pavilion that will cover the school’s existing outdoor basketball court. Essrig was one of only three schools in Florida receiving the AAD grant this year, and the only one in Hillsborough County.

The Proud Panther Pavilion is intended to help protect the school’s 800 students and their families and faculty from the damaging ultraviolet rays of Florida’s sun. The school currently has no gymnasium and all recreational activities are outdoors. The pavilion will be used during physical education and other outdoor classes, after-school recreational activities and school-wide events – many which occur during the peak sun hours of 10 a.m. to 4 p.m.

Dr. Fenske, endowed chair of the Department of Dermatology and Cutaneous Surgery and a long-time fellow of ADD, wrote the letter in support of Essrig’s Shade Structure Program grant. Grant applicants must be sponsored by an AAD dermatologist.

Over the last two years the school and its Parent Teacher Association (PTA) have raised more than $80,000 toward the $130,000 pavilion, and Essrig expects to break ground for the structure sometime this fall, said Kathy Murphy, PTA board member and grant writer.

"Dr. Fenske and his team at the USF Department of Dermatology have been very responsive and supportive of our sun safety protection program,” Murphy said. “Having a local academic dermatologist who is internationally known as a sponsor definitely adds credibility to our educational initiative."

“The grant is a real tribute to this PTA and school, which have been so proactive in demonstrating their commitment to sun safety,” Dr. Fenske said.

“It’s easier to persuade younger kids to use sunscreen, hats and other measures to protect their skin from sun overexposure than to try to convince teenagers,” he added. “Intervening early in life is best, because 80 percent of lifetime exposure to the sun occurs before age 18, and most skin cancers are caused by skin damaged in childhood.”

In late May, Dr. Fenske was interviewed about sun protection and skin cancer prevention by two elementary school students from Essrig – brothers Matthew, 10, and Daniel, 7, Lydon. The videotaped interview aired over the school’s closed circuit TV system the last week of school and will be rebroadcast for new students this fall.

Dr. Fenske also spoke with parents at the school’s end-of-the-year PTA family night on June 3, encouraging them to incorporate sun safety into their children’s outdoor activities and providing AAD brochures and bookmarks on the ABCs of safe fun in the sun. The Dermatology Department also plans to disseminate information to community sports programs frequented by Essrig students.

The AAD’s Shade Structure Program is supported by Johnson & Johnson. It is open to non-profit organizations or educational institutions serving children and teens under age 18, for permanent shade structures over outdoor locations not protected from the sun, such as playgrounds, pools, and other recreational areas.

This year more than 1 million new cases of skin cancer will be diagnosed in the United States. The American Cancer Society ranks Florida second in the country for incidents of skin cancer.

- Story by Anne DeLotto Baier, USF Health Communications

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=520 http://hscweb3.hsc.usf.edu/health/now/?p=512 http://hscweb3.hsc.usf.edu/health/now/?p=512#comments Tue, 17 Jun 2008 22:23:55 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=512

Pilot Pablo Palencia & Attorney Sofia Palencia, host family in Panama to students traveling from the USF College of Public Health.

Albrook, Republic of Panama. June 2008 - Helicopter Pilot Pablo Palencia and his wife Sofia walk through their house in Panama pointing up, down, here and there. All around them are reminders of the USF public health students they’ve hosted in the last year-and-a-half. There is the painting from Tada, a collection of teas from Rachel, the photo album from Harley and Jenny – not to mention the countless number of photos of their “USF kids”.

“Pablo was away on business for a couple of weeks one of the times…the students staying with us were all girls…and it was like having a house full of daughters,” says Sofia with delight. The couple has only boys, two sons ages 6 and 24. “The girls and I spent a lot of time together, on social outings, shopping and just plain talking. They became part of our family. We feel that way about all the kids.”

Their USF kids are students from the University of South Florida’s College of Public Health who stay in their home as part of their International Field Experience in Panama. The couple, who live in a suburb of Panama City, can host up to 5 USF students at the same time. Depending on their assignments, these graduate students in public health and global health stay with the Palencia family anywhere from one to three months.

Plenty of humor & Spanglish...
“From the beginning, it’s been a wonderful experience for us,” says husband Pablo, the entire family sitting down for our interview, most of it happening in Spanish. “We do speak to the students in English, but some of them want to learn or practice their Spanish with us.” The result is plenty of Spanglish exchanges – a combination of English and Spanish words laced together in the same sentence. “It can be very funny,” says Pablo. “My English is very…uh, basic…I’ll leave out an ‘S’, forget a ‘you’. I can’t always come up with the entire sentence in English, so I’ll speak in phrases. It’s the same with students and their Spanish.”
Q: Just like in the movies – ‘Me Tarzan. You Jane’?
“Right!” says Pablo, now laughing hard. “Pero la gente entiende! Eventually, they understand me!” he says sheepishly.

Remembering one funny exchange with a student, Pablo and Sofia tell the dinner time story. The student wanted to go out for dinner but what rolled off her tongue in Spanish was “Tu comer. Me, yo ir.” which translated to English is “You eat. Me, I go.” After some back and forth and plenty of laughing, Pablo asked, “Do you want us to take you out to dinner?”

Inspiring students...
“They have hosted the stay of a number of public health students and every single one of them has absolutely loved staying with them,” says Dr. Arlene Calvo writing from Ciudad del Saber, the City of Knowledge. Calvo earned her master’s degree and PhD in public health form the USF College of Public Health and is now a public health researcher in her native Panama.

Pablo and Sofia Palencia with sons Jonathan, 24, and Pablito,6.

The Palencia home is located in Albrook, one of five areas alongside the Panama Canal that were occupied and controlled by U.S. Military, as well as the canal. After the U.S. handover of the canal on December 31, 1999, those five areas reverted back to the republic and were opened to civilians. The Palencia’s modern day home in this historic area of Panama is part of the students’ total immersion of Panama, past and present - their time together providing experiences and memories that no academic dorm, hostal or hotel ever could.

“I think it’s absolutely indispensable. I think it’s probably the most important part of their whole experience, honestly!” says Dr. Ann DeBaldo, Associate Dean of International Programs in the USF College of Public Health and Associate Vice President of International Programs, USF Health. “What we’re trying to do with the students is not just teach them the content of their discipline, be it lab work in tropical disease research or issues in maternal & child health that they’re studying in Panama. What we really want them to do is absorb the whole cultural and environmental milieu and hopefully be turned on to working in public health internationally.”

The Palencias began serving as a host family in the spring of 2007. To date, they’ve received a total of 8 USF public health students and await the arrival of the ninth in July. Their decision to ‘host’ was certainly not born out of a sense of boredom or financial need. Pablo is a helicopter pilot and flight instructor. Sofia is an attorney specializing in business law – living professional lives at ‘full throttle’ and raising children of their own, 24 year old Jonathan and 6 year old Pablito.

Don Felipe & the family's fan mail...
‘Don Felipe’ is the grandfather in the house. Now a retired accountant, ‘Don Felipe’ juggles his unofficial job keeping track of students’ transportation needs, their comings & goings with Facebook, MySpace and email lingo. The constant flow of messages and photos from past exchange students keeps him busy…all of them, really, and happily so. “Uno se encarina con ellos. One becomes emotionally attached to the students,” says Don Felipe in Spanish. “We love them and they love us. Then when they leave, es una lloradera, it’s a crying fest.”

“I get emails from them (USF public health students) all the time and we love it,” says Sofia, eyes shining bright, visibly proud of the strong friendships they maintain with the exchange students long after they’ve left Panama.
Q: How long do you think you’ll keep hosting USF public health students?
“As long as the college wants us to! No problem at all!” says Sofia.

“Each of them is like a part of our family during the time that they are here. It doesn’t matter how old they are, or how long they stay with us. They call us their Panamanian familia. That’s how they see us and that’s what we like because we feel the same way about them,” says Pablo.

Life lessons & lasting friendships...
“There are lessons here that they can draw from for the rest of their lives,” says Pablo. “We’re not directing them…instructing them…but they see the unity of our family, how we’re together as much as possible. In this world that we live in with so much destruction and negativity, where men leave their families to go out to have a good time and drink, I drink my agua ardiente at home. I have a good time by sharing my time and energy with my family! I think we transmit that sense of family unity to all who stay with us and that’s something they can benefit from in their own lives.”

They are life lessons not lost on these young men and women, who return home with a treasure trove of stories. “The students continually comment that the hospitality they receive from this family surpasses anything they could imagine,” says Karen Liller, PhD, Associate Dean of Academic & Student Affairs, USF College of Public Health. “…we want the student to fully experience public health in Panama and what better way than to spend time with this family. In this way, the practice of public health becomes a reality. “

“When they meet people like the Palencia family and they welcome them with open arms, it’s way past learning the topic, way past learning Spanish or even learning the culture. It ignites a student’s desire to really be out in the world as a global citizen, as a global public health professional. That’s why we require this experience for our international, global practice students because we want them to be totally immersed to the point where they really get it!” says DeBaldo. “...those are the students who then go out and land great careers and are quite capable of making big changes in the world. I just break out in goose bumps when I think about it!”

Story by Lissette Campos, USF Health Communications
Part II of ongoing series from Panama

Other Links:

Reporter's Notebook: The Aha! Moment at the Panama Canal

Part I of series: USF Health International Foundation Opens in Panama

Office of International Programs, USF College of Public Health

Photo Gallery Below

The Palencia home is located in a suburb of Panama City that used to be home to tens of thousands of U.S. military families connected with the operation of the Panama Canal. The modern construction of their townhome contrasts with the barracks and military housing doting the landscape there - structures that date back to American control of the canal.

The Palencia family opens its doors to exchange students throughout the year. When USF public health students are not in Panama, the family plays hosts to students and researchers from Spain's language school (Ilisa) as well as a research division of the Organization of American States in Panama. Almost everyone spends the bulk of their time in the Palencia's open-air family room/dining area.

The family's hammock in the outdoor family room/dining area is a favorite with students. "This is so different from the places some of them were raised in...not everyone was raised in Florida," says Pablo. "We had one student from Montana!"
Q: Did you say Montana?
"From Montana and he was a cowboy!" says Pablo with a chuckle.

Painting was a gift to the Palencia family from Fall 2007 student Tadahiro Sasaki, PhD student in Global Health.

Teak case w/collection of teas was a gift from Dec. 2007 student Rachel Pyngolil, honors undergraduate student from USF. The only undergraduate student allowed, to date, to participate in the college's international field experience program, Rachel arrived with her father in Panama, who helped her settle in with the Palencias before departing.

Coming Soon...
Part III of series:
USF Nursing Students in Delivery Room of Panama City's Largest Public Maternity Ward...

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=512 http://hscweb3.hsc.usf.edu/health/now/?p=507 http://hscweb3.hsc.usf.edu/health/now/?p=507#comments Mon, 09 Jun 2008 22:30:07 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=507

USF Health's Dr. Steve Morris (center back) and friend Awing Saawat (yellow shirt and glasses), a nurse midwife, pose with a group of refugees who fled to Thailand from Myanmar after the devastating cyclone. Dr. Morris and Saawat made a risky humanitarian journey into a remote southern region of Myanmar to aid cyclone survivors.

The same day he recorded an interview with WUSF-FM’s Carson Cooper on disaster preparedness for the upcoming hurricane season, Steve Morris, MD, received a phone call from a long-time friend who was planning to travel to Myanmar to provide medical assistance in the aftermath of the deadly cyclone and its storm surge. Dr. Morris, codirector of Bioterrorism and Disaster Training at USF College of Nursing, spent a month volunteering in southern Mississippi in the wake of Hurricane Katrina and has extensive experience working in a variety of disasters and disaster scenarios. After some initial reservations, he agreed to accompany his friend to Myanmar. He made the trip May 11-16. So that he would not call attention to himself and possibly put his Thai friends at risk, Dr. Morris left his camera behind. His only photo, the group shot above, was taken at an airfield in Thailand. The story of his Myanmar experience, in his own words, follows:

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Listen to Audioclips


Cyclone devastation in Myanmar

Three boys at clinic doorstep

What happens to the boys...

 

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Fateful call from an old friend
“Call it fate; call it a coincidence; but I guess some things were meant to happen. Ironically during my interview with Carson Cooper, he asked my opinion about the situation in Myanmar. We reflected upon the devastation and the disappointment in the Myanmar government for not allowing disaster relief and assistance from the international community.

Later that day, a long-time friend of mine, Awing Saawat of Thailand, called me. Awing is a nurse midwife. She has provided services in the northern regions of Thailand for more than 25 years. She has a special interest in caring for the immigrant mothers who travel the sometimes dangerous routes from Myanmar (formerly called Burma) to cross the border illegally into Thailand. Most of these immigrants risk the travel to Thailand to find work and escape the desperate conditions in Myanmar.

Awing and I are friends from my time in the country in 2002 and 2003, when I volunteered with her non-profit organization. She often calls to say hello and to get an occasional internal medicine consultation on one of her many patients. This call was no different; she and I discussed a young refugee patient who had recently crossed the border. Unfortunately, according to Awning, this patient would be quickly returned back to Myanmar. Awing told me that she was planning a trip of her own to the impacted cyclone area of Myanmar in the next week. Since she had provided service to the area for many years, she had many well established contacts and had made the journey on multiple occasions.

I casually mentioned to Awing that I would love to share the experience, and surprisingly she responded, 'Come on!' My mom always said, be careful what you ask for.

I couldn’t believe it. I had heard on the news about the problems foreign aid workers were having getting into the region, so, of course, I started speaking of passports and visas, which I knew would take time. Awing informed me that there were ways to expedite the process. When I expressed safety concerns, she reassured me that her contacts were solid and that I would have no problems. Just keep your mouth shut, she told me -- an inside joke we often shared when she was allowing me to observe the birthing process years ago with her. Like then, she would do all the talking. She again reassured me that I would be fine.

Map courtesy of Google Earth

The long journey to Myanmar
With that, I packed my bags for what would turn out to be one of the most remarkable experiences of my professional career. The flight to Bangkok, Thailand, was 26 hours with stops in Detroit and Japan. I then traveled two hours by bus from Bangkok to Nakhon province, where I met up with Awing. The rain delayed our departure to northern Thailand for a day; but soon we were off on another bus ride to an area just south of the town of Chang Mai, Thailand. The next leg of our trip to Myanmar began early in the morning hours. Since there is literally a 12-hour time difference between Florida and Thailand, I was wide awake. Add the time difference to my anxiety, and I was literally on pins and needles.

Travel into Myanmar was quite unofficial. My U.S. passport was left in Thailand with Awing’s associate.

We departed from a small airfield in two light aircraft for a 500-plus mile flight from Thailand into Myanmar. We were accompanied by 10 other people. I did not know their names or what their roles on this trip would be, and following Awing’s lead, I did not ask.

One of the pilots was a relative of Awing’s. They had long conversation prior to our departure. Their cordial manner eased my mind and I was again reassured that I would have no problems.

Though the smell of insect replant permeated my clothing, Awing beared it and stayed close by my side the entire journey. It was important that I look somewhat disheveled as not to stand out. She added to my blending-in process by sharing a local skin powder/insect repellant to put on my face, arms and legs. My wrist watch was left behind and replaced with a simpler watch that I kept in my pocket. It had no wrist band and a scratched dirty face. Because I am African-American, we both felt, that as long as I did not open my mouth, few if any, would know my nationality. (Don’t misunderstand, I am a proud American, but in this instance, waving the U.S. flag was not an option.)

Our planes were old but appeared to be in good shape. They were designed to haul cargo, but other than us, a few personal items, drinking water and the meager provisions prepared by Awing there was no other cargo. Our diet for the next three days consisted of cooked pork and rice. The cargo area of the plane was stripped and had an intense moldy smell. There were no interior lights and no formal seats, just some tarp-like material that we fashioned into seats. I expected to see large quantities of supplies.

My memories of Hurricane Katrina led me to expect a tremendous outpouring of relief supplies. To my dismay, there were no medical supplies, no fresh water, no meals-ready-to-eat or food of any kind, no clothing … absolutely nothing to indicate that we were on a relief mission.

Trying to bring in supplies was not an option according to Awing, whatever we would use would be provided to us by our host when we got there.

Greeted by armed guards
We landed after a little more than two hours on an even more remote airfield in the mid-south region of Myanmar. Nothing was there other than a small abandoned tin-covered structure. We sat at this location for another hour and a half, before I heard the sounds of vehicles approaching. Three large short-bed trucks (the kind you would typically see livestock in) pulled up. Two or three heavily armed men exited each truck. The pilots of our planes and the people in the trucks obviously knew each other. They greeted and talked for a period of time. There was an occasional look in my direction, but I never had any indications that caused me to worry. Awing was completely at ease, so I was able to remain calm.

When the time came, the men directed us to climb into the back of their trucks. Though our view was somewhat obscured by wooden boards lining the sides of the truck bed, we could easily see between them. As the early morning hours faded the heat of the day could be felt. The truck was not covered. The heat and the humidity reminded me of Florida. The terrain was extremely rough. I know I am spoiled by paved roads, but this was a difficult journey. I can see the need for the big trucks. Any organized relief mission into this area would be difficult by ground.

I suppose, I thought my relief work with Hurricane Katrina on the Mississippi Gulf Coast would have somewhat prepared me for what I about to witness in Myanmar, but I could not have imagined the incredible destruction I would see.

Through the side boards of our truck, I could see vast areas laid waste by the storm. What must have once been towns looked like garbage dumps. People appeared to be sifting through these heaps of debris. Many sat hopelessly by the roadside or under improvised structures made from the debris. I saw no begging, no outstretched arms; the people just simply looked beaten.

Many wore rags; some had no clothing at all. I saw all ages from the very young to the very old; however, there seemed to be many more children.

Most remarkable was the horrible smell. So foul, so pungent, that at times it would cause me to gag. I have experience with death in my profession; but death, hopelessness and despair at this magnitude was just unbelievable. The pictures on television and in the newspapers could not possibly capture this suffering.

Waiting patients, sparse supplies, long days
The truck ride was about 90 minutes from the air field. We arrived at a stone-and-wood structure that would be our home for the next 60-plus hours. This was a clinic. It had been built by a mission group many years ago, and withstood the test of time. Awing had worked from this location before. Surprisingly, there were a few medical supplies -- a few old stethoscopes, antiseptic and basic bandages; but no medications. Awing told me that we would be receiving a few additional supplies later. There was a generator with fuel and a few working lights, but nothing on the scale of the Disaster Mobile Assistant Team that I had worked with in Katrina.

The patients were already waiting. Awing told me that our host had selected the people that we would see. How that process worked, I guess I will never really know. The people we cared for clearly had a relationship with the people who had arranged this trip. Going into the village to offer services clearly was not an option.

The complexities of the problems were many. Without any necessary equipment and supplies, the task was extremely difficult. Awing translated for me promptly along with doing a million other things. No one ever seemed to complain; there was no crowd; few people even spoke unless addressed by our guards or by us.

We worked continuously until the night. Awing and I took our first break after about six hours. Following her lead, I would pause for a break only when she did. We were with armed guards the entire time, though they seemed quite relaxed. There were several groups of people all around the clinic area, but we never had contact with them. I am still not sure if the guards were there to protect us or to keep us from exploring on our own, but I suppose, probably both. It’s not like exploring would have been an option for me anyway. I didn’t speak the language, I had no idea where I was, and I certainly did not want to get lost. We slept on the floor inside the clinic. Throughout the night, there was conversation and activity outside.

Three small boys
The next morning we awakened to see three small boys, probably ages- 8 to 10. They were asleep at the door of the clinic. Two sat up immediately when we opened the door. One child was lying on a piece of tin, which had been fashioned as a sled. I could surmise that the two other children had pulled him there on the sled.

I don’t know how far the children traveled, but I don’t think they would have been allowed at our clinic door if the guards had seen them. I am not even sure how they slipped past our guards. Awing began to talk with the boys as one of the guards approached to chase them away. I had already starting assessing the child on the sled. Awing argued with the guard for a bit. He backed away and left us to our work.

According to Awing, the child on the sled was injured during the storm. None of the three had known one another before the storm. Two boys met immediately after the storm, and they found the injured child a few days later in a field of debris. Since he was unable to walk, they made a sled from the piece of tin to pull him around. The three had been together for many days, but they were not sure how long. They could only assume that their families were dead. There was nothing left of the village where they stayed. They lived off scraps that they found or whatever they could get by begging.

The child on the sled appeared extremely ill and near death. It did not take an X-ray for me to determine that the injured boy had a compound fracture of his right tibia and fibula. Distal to the fracture his leg was cold and to a point of decay. His eyes were sunken, jaundiced and his body was wasted. He was dying from sepsis, dehydration and malnutrition. His fate had been written when the storm struck.

His needs were far beyond our capabilities and resources. Even with hospitalization, an amputation, massive doses of IV antibiotics, nutrition and hydration, I doubt he would have survived. It was simply too late; and we obviously had no way to provide any of those needed services.

A small degree of peace and overwhelming sadness
Awing and I could find only a small degree of peace in the fact that at least the young child was in no pain. He could not feel the injured leg. Awing fed the boys from our provisions. The injured boy was too weak to eat very much at all. Unfortunately, we had to move on to our already waiting patients, and we did not want to upset the guards anymore than they were already.

Awing reluctantly motioned for the guards and with that the boys were scurried off; pulling their injured friend behind them. We never saw them again.

The next day and a half brought more of the same. The sad and sometimes horrifying stories were endless.

I left feeling like a drop of water on a searing desert. Our promised supplies never came. I had to ask myself, did our little mission make a difference? I knew it would not be for me to judge.

Awing and I spoke few words on the truck and plane ride back to Thailand. I know we were tired and hungry, but I know she and I both felt depressed that we could not do or provide more. The Thai people refer to Myanmar as “paan má-noh” or “bad heart” -- a term that certainly reflects a government that refused to allow aid to reach its people in dire need.”

Since Dr. Morris returned from Myanmar, he has spoken several times to his friend Awing, who plans to return to on another humanitarian trip. The situation in Myanmar is still precarious, as the country’s military junta continues to refuse offers of outside support including the use of military helicopters to ferry aid to remote regions. Unfortunately, Dr. Morris says, many donated supplies never reach the people who need it – much of it taken by the military or black market agents who will sell it for a profit. With the monsoon season beginning, hundreds of thousands of cyclone survivors remain without shelter. “I had tremendous support from the College of Nursing and Dean Burns in supporting my decision to make this trip on short notice," Dr. Morris says. "and I owe special thanks to my colleagues Sandra Cadena, PhD, RN, and Fred Slone, MD, who covered for me while I was away."

- Story edited by Anne DeLotto Baier/USF Health Communications

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=507 http://hscweb3.hsc.usf.edu/health/now/?p=480 http://hscweb3.hsc.usf.edu/health/now/?p=480#comments Fri, 30 May 2008 15:29:47 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=480

Dr. Shaukat Chowdhari, a volunteer faculty member from 2002 - 2004 in the USF College of Medicine Anesthesiology residency program.

Shaukat Chowdhari, MD, and wife Antonina Chowdhari, MD, have made a quarter of a million dollar commitment to the USF College of Medicine's Gross Anatomy Laboratory. Signing a five-year commitment to the university, the Chowdhari family gift will help transform a critical space utilized in the medical school's student-learning environment, paving the way for renovations and technological upgrades to the Gross Anatomy Lab. Their first installment of the $250,000 total contribution was delivered earlier this month – a $50,000 check presented to members of the USF Health Office of Development & Alumni Affairs. For gross anatomy students and faculty, it is a gift 'that keeps giving'. All facilities renovation projects are eligible for a 1:1 match in funding from Florida's Courtelis Facilities Enhancement Grant.

The lab was built in the 1970s as an integral part of the USF College of Medicine- built with the look and instrumentation "standard" for that era. More than two decades later, the lab had seen few changes until now. The gift by doctors Chowdhari will allow the medical school to update the anatomy facilities with the latest in medical education technology.

"Our family's way of showing appreciation"...
"This is our family's way of showing appreciation to the University of South Florida, and in particular, the USF College of Medicine, for the training Dr. Chowdhari acquired there when he did his fellowship," said Antonina Chowdhari, referring to her husband's fellowship training in pain management at USF. Dr. Chowdhari ties to the college also go back to 2002 – 2004 when he was a volunteer faculty member in the USF College of Medicine and assisted with the anesthesiology residency program. Mrs. Chowdhari adding "We also want to set an example for our children and show them the importance of being involved and giving back to the community they live in."

The Chowdhari family decided to make the donation after touring the lab this spring with Dr. Bryan Bognar, Interim Vice-Dean for Educational Affairs.

“One of the many things that come from a gift like this is the ability to design a lab that has expansive applications in the clinical arena,” says Dr. Bognar. “This will allow us to translate the basic knowledge of anatomy into ultrasound and radiology training for our students, as well as train them in emerging imaging technologies.”

Elaborating on the positive impact to clinical care, Bognar says “If you fold into that heightened ultrasound & radiology training, procedures based anatomy, the results are amazing. You have clinicians coming in conducting dissections and surgical procedures in class – which can be video taped and possibly video-streamed ‘live’ on the web. Our students can tune in and study that again and again, anytime, anywhere. It’s hard to argue these things have no clinical relevance. It’s applied anatomy!” says Bognar, visibly excited about enhancements to the lab and grateful to the Chowdhari family for their contribution to the medical school.

Technologies being considered in lab upgrade...
Key components and technology upgrades may include:

• Fully-equipped dissection workstations
• State-of-the-art LCD high-resolution projection and screens throughout the lab
• Digital recording system and state-of-the-art sound system
• Professional grade video cameras for capturing video & possibly live-streaming lectures, presentations, lab courses,etc.
• Video-conferencing capability
• Create a wireless environment

The state-of-the-art technology enhancements will also help to introduce evolving educational technologies such as ‘virtual dissection’. “With less availability of cadaver specimens for medical students to learn from, this upgrade to the gross anatomy lab will create efficient ways of imparting the most important aspects of anatomy education,” says Bognar. “Dr. Chowdhari understands and supports the vision of what anatomy education needs to be in the 21st century and we thank him for supporting the advancement of that vision here in our medical school.”

The gross anatomy lab is located in an extremely high-traffic area and utilized by all medical students, residents, and students in the Doctor of Physical Therapy (DPT) program. With a state-of-the-art gross anatomy lab, the college can also expand its Continuing Medical Education (CME) opportunities and continuing professional development for health professionals.

“Through this laboratory upgrade, USF Health will be able to deliver integrated medical education using cutting edge technologies and expand on its existing innovative teaching modules. We envision a future anatomy laboratory, through a new architectural design and multimedia capabilities, as a vibrant center for basic and continued medical education,” said Orhan E. Arslan, DVM, PhD, Associate Professor, Director of Anatomy & Director of Anatomy Educational Services at the USF College of Medicine. “It will certainly further the national exposure of our institution and attract diverse talents and innovative ideas. We are confident that this worthwhile project will have a long lasting impact on the direction of the educational program here at USF Health and will undoubtedly strengthen multidisciplinary vertical curricular integration,” added Arslan.

The Chowdhari family...
Dr. Shaukat Chowdhari is the President and Medical Director of University Pain Management Center and a former faculty member in Anesthesiology at the University of South Florida, College of Medicine.

He received his M.D. from Dow Medical College in Karachi, Pakistan in 1982. He completed his internal medicine residency at Cornell University's Wyckoff Heights Medical Center in New York. In addition, he completed his anesthesiology residency at the Albert Einstein College of Medicine's Long Island Jewish Medical Center, and Stony Brook University's Nassau County Medical Center New York. Dr. Chowdhari also participated in a specialized fellowship in pain management at the University of South Florida between 1995 and 1996.

Dr. Chowdhari is board certified in Pain Management and Anesthesiology by the American Board of Anesthesiology and the American Academy of Pain Management. He is a Member of the Hillsborough County Medical Association, the Association of Pakistani Physicians of North America, the Florida Association of Physicians of Indian Origin, and the Florida Chapter of the American Academy of Pain Management. He holds staff privileges at University Community Hospital, Tampa Bay Surgery Center, and Town & Country Hospital.

Dr. Chowdhari is married to Antonina Canlas Dijamco Chowdhari, MD, Manager and Owner of UPMC Investment Group, L.L.C. and UPMC, L.C., real estate companies with primarily commercial properties in Hillsborough, Pinellas, and Pasco Counties.

Antonina earned her medical degree from the University of the East-Ramon Magsaysay Medical Center in Quezon City, Philippines in 1983. She is a board certified pediatrician by the American Board of Pediatrics. She completed an internship in internal medicine and her residency in pediatrics at Jersey Center Medical Center in New Jersey. She completed a fellowship in neonatal/perinatal medicine at Albert Einstein College of Medicine's Long Island Jewish Medical Center. Currently, she does not practice medicine, instead operating the family’s real estate businesses.

Doctors Shaukat and Antonina Chowdhari have four children. Their oldest daughter, Mariam, currently 16 years old, has an interest in pursuing medicine. Their 14 year old son, Adam, attends Saddlebrook Golf Academy and is said to be an excellent golfer. Their son Sean is 11 years old. Their youngest child is daughter, Sara Mumtaz, who is 10 years old.

Story by Mandelyn Hutcherson & Lissette Campos, USF Health

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=480 http://hscweb3.hsc.usf.edu/health/now/?p=498 http://hscweb3.hsc.usf.edu/health/now/?p=498#comments Wed, 28 May 2008 20:22:21 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=498

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

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=498 http://hscweb3.hsc.usf.edu/health/now/?p=489 http://hscweb3.hsc.usf.edu/health/now/?p=489#comments Wed, 21 May 2008 22:30:00 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=489

L to R: Dr. Dennis Penzell, an attending physician at the BRIDGE Healthcare Clinic, graduate medical student Shelby Kent, COM Dean and USF Health VP Dr. Stephen Klasko, Gov. Charlie Crist, a BRIDGE student director Fariha Esmail, and graduate medical student Sam Crane.

Tampa, FL (May 21, 2008) -- Gov. Charlie Crist created a flurry of excitement at the BRIDGE Healthcare Clinic this afternoon. The governor used the University Area Community Health Center, the county facility housing the USF student-run clinic, as the setting to sign legislation intended to provide affordable health care coverage to uninsured Floridians. The BRIDGE clinic, opened last year, offers free primary care to uninsured adults living in the low-income neighborhood just west of the USF Tampa campus

As he signed the bill, Gov Crist was joined by several USF medical students who volunteer at the clinic and Stephen Klasko, MD, MBA, dean of the College of Medicine and senior vice president for USF Health. He was also flanked by legislators and a family who will benefit from the new law.

Gov. Charlie Crist admires Michelle Fisk's 4-month-old baby Ava before the bill signing. The Fisk family will benefit from the new "Cover Florida" law.

Known as “Cover Florida,” the law will allow insurance companies to offer scaled-back plans covering basic health care needs, including some screenings, drugs and physician office visits and surgery, without all the usual mandated coverages. The bill also allows families who make too much money to qualify for the state's KidCare program to pay full premiums so they can cover their children.

“It’s not the Cadillac of health care plans, but it offers something very important to the people of our state. It will help take away a lot of worry,” said Crist, adding that the bipartisan legislation provides the opportunity to reduce the number of 3.8-million Florida residents without health insurance. The coverage could cost $100 to $150 a month, depending on whether a person selects the more generous plan that includes emergency care and inpatient hospitalization, he said.

Crist, whose father is a family physician in Pinellas County, identified increasing health care access as a top priority for the 2008 session.

Following the bill signing ceremony, Florida Sen. Victor Crist and Rep. Arthenia Joyner presented Dr. Klasko and the students with a $5,000 donation for the BRIDGE clinic from the University Area Community Development Corporation, Inc. The senator is the chair and volunteer CEO of UACDC.

Sen. Victor Crist, far left, and Rep. Arthenia Joyner, second from right, presented Dr. Klasko and BRIDGE clinic volunteers with a $5,000 clinic donation from the University Area Community Development Corporation.

Newsbrief by Anne DeLotto Baier/USF Health Communications
Photos by Eric Younghans/USF Health Media Center

]]> http://hscweb3.hsc.usf.edu/health/now/?feed=rss2&p=489 http://hscweb3.hsc.usf.edu/health/now/?p=485 http://hscweb3.hsc.usf.edu/health/now/?p=485#comments Tue, 20 May 2008 14:29:24 +0000 abaier http://hscweb3.hsc.usf.edu/health/now/?p=485

USF graduate nursing students gain insight from an innovative program promoting earlier diagnosis

L to R: Ovarian cancer survivors Kris Walker, Carole Martinez and Joel Valdes spoke candidly about the challenges of interacting with health care practitioners during diagnosis and treatment.

Their stories were all different, but they shared a common thread. At different times during their journeys through the health care system, the three woman – all ovarian cancer survivors – experienced symptoms that were unrecognized or dismissed by health care professionals.

The women – Kris Walker, Carole Martinez and Joel Valdes – brought the innovative Survivors Teaching Students (STS): Saving Women’s Lives program to Tampa for the first time May 13 when they spoke to nearly 100 graduate nursing students taking Advanced Health Assessment in the USF College of Nursing. Carla Jimenez substituted for Martinez during the afternoon sessions.

Among gynecological cancers, ovarian is the deadliest – one of the five leading causes of cancer death among U.S. women. Early symptoms are frequently ill-defined and may mimic other conditions, so by the time most cases are detected the cancer is advanced and often incurable.

Kris Walker

Walker, diagnosed with ovarian cancer in 1999 following several misdiagnoses, said the key message the STS team wanted to convey to students is the importance of checking out even vague symptoms like bloating and back pain.

“It’s so important to listen to the patient,” she said. “Yes, the symptoms could be anything, but remember that they might also be ovarian cancer. Health practitioners need to keep it mind and rule it out.”

The STS program, started by the survivor-led organization Ovarian Cancer National Alliance (Alliance), has been conducted in more than 50 medical schools across the United States. Recently expanded to nursing schools, the program aims to promote the earlier diagnosis of ovarian cancer by increasing the number of health care professionals who recognize its symptoms and risk factors.

This year, the Florida Department of Health Comprehensive Cancer Control Program, in partnership with the Alliance, received a grant from the Centers for Disease Control and Prevention to begin offering the program to medical and nursing schools in three regions – Tampa, Tallahassee and South Florida.

The nursing school at USF is the third in Florida to host the STS team, said Mary Shafer, a health educator for the state’s Comprehensive Cancer Control Program. The state also hopes to bring the presentation to USF medical students in the third-year women’s health rotation during fall semester, Shafer said. “The student feedback has indicated this is a valuable way to help put a face and voice to ovarian cancer.”

During the recent morning session in their Advanced Health Assessment class, the graduate nursing students listened attentively as the panel of survivors shared the stories of their experiences with the disease, including the risk factors, symptoms and how physicians and nurses communicated (or failed to communicate) with them throughout their diagnosis and treatment. The women demonstrated their resilience – while undergoing chemotherapy one continued to care for an ailing mother-in-law while another lost her father.

The survivors touched on the ever-present concern that their cancer could recur and what the diagnosis means for their children. They stressed the importance of health professionals providing a sense of hope to patients facing a daunting disease.

Carole Martinez, a retired school media specialist, said that a work accident, which she initially thought was the cause of severe back pain, led to a series of doctors’ visits ultimately culminating in a diagnosis of ovarian cancer in February 2003. “The accident actually proved to be a blessing in disguise that resulted in my ovarian cancer being diagnosed early,” said Martinez. “If the disease is found at an early stage, the prognosis is much better.”

Even before the accident, Martinez had visited a primary care physician complaining of unusual weight gain, pelvic pain and fatigue. “She told me it was my age, my diet, stress,” she said. “She failed to do a manual palpation of the abdomen.”

Carole Martinez

Because of changes in insurance or disease recurrences, the women often ended up seeing several physicians during the course of their treatments, which often included more than one surgery and several rounds of chemotherapy. Walker recalled one gynecological oncologist “who proved to be the bane of my travels through this journey with ovarian cancer.”

"He was very crass and didn’t have time to talk with you about anything,” Walker said. “It was pretty much ‘Here’s the types of chemo you can have – pick one.’ I said, ‘Hey, wait a minute. I need a little more input from you regarding what direction I should take, considering what I’ve already been through.’”

Following their presentations, the survivors – all members of the ovarian cancer support and advocacy group Ovacome – invited the students to ask questions and complete evaluations of the program.

USF graduate nursing students listened intently to the survivors' stories.

Student Maria Gallo, an oncology nurse at Fawcett Memorial Hospital in Port Charlotte, said it made an impression on her when Martinez said her blood test for the tumor marker CA125 came back normal before she was diagnosed, despite other symptoms associated with ovarian cancer.

“It just reinforces that you can’t rely on one lab value,” Gallo said. “You need to evaluate lab reports and test results in light of the patient’s comprehensive history.”

Student Lori King, a maternal child health nurse at St. Joseph’s Hospital in Tampa, said the presentations offered insight into how each woman reacted differently to the same disease and its treatment. For instance, Martinez described the hair loss associated with chemotherapy as “very disturbing” and disliked the hot, scratchy feel of wigs. But, fellow survivor Valdes, called the hair loss her “Mrs. Potatohead” stage and joked with co-workers who critiqued the different styles and colors of wigs she wore.

“It really emphasizes the importance of treating each patient as an individual, with individual concerns and different ways of coping, instead of as a disease state,” King said.

Nadine Connor, MSN, ARNP-BC, USF nursing instructor for the Advanced Health Assessment class, said patient presentations such as STS are an important adjunct to students’ academic studies on cancer and other chronic diseases. “If you truly believe patients are partners in their care, then it’s important to hear their stories, to understand their perspectives of care,” said Connor, a family nurse practitioner. “These women have been through a devastating diagnosis... We need to learn from their experiences what we can do to better help our patients live with an acute or chronic illness.”

Ovarian cancer resources for health care professionals are available at the National Cancer Institute’s website, www.cancer.gov/cancertopics/types/ovarian.

- Story by Anne DeLotto Baier/USF Health Communications
- Photos by Eric Younghans/USF Health Media Center