Ty’rique has spent the past couple of months filling up his own scorecard with stamps and signatures that verified his participation in physical activity. Football, kickball, relay races, playing in the park; these were some of his choice activities. At the finale, he was among the three dozen young students from two area elementary schools who had filled the 24 spots on at least one scorecard and could now be in the running for one of the grand prizes: two bicycles, a Wii console and games, scooters, tickets to USF basketball and football games and to the Florida Aquarium.

Scorecard Community Coordinator Bonnie Salazar with Ty'rique Brock, his mother Andrenna Brock, and a full scorecard.

The Florida Prevention Research Center (FPRC) at the USF College of Public Health helped Robles and Sulphur Springs Elementary Schools implement the Scorecard program, which offers elementary aged students action outlets for physical activity in their community. The program encourages youth to try new activities with an emphasis on fun rather than health or skill.

“It’s all about providing an opportunity for them to try new things, to spend time with friends and family, to find something they like to do, and to have fun,” said Robert J. McDermott, PhD, professor of public health and co-director of the FPRC with Carol Bryant, PhD.

Students use the card to track their physical activity. When they have been active for a designated period of time (typically one hour) at a Scorecard site or at home, an adult stamps or signs one of the 24 squares on the card. Once all of the squares are filled, the card is redeemed for physical activity related prizes (such as Frisbees, beach towels, water bottles, backpacks), and makes them eligible for grand prizes.

The Scorecard program began in 2004 in Lexington, KY, and USF’s FPRC earned a grant from the Centers for Disease Control and Prevention in 2006 to fund Scorecard locally.

The FPRC ran a pilot Scorecard program for middle school students in Sarasota County in 2006, then the full program for elementary school students in Hillsborough County last spring.

“One key point we learned from the Sarasota program was that it is better to target younger kids because as the kids start to enter their teens, they start to favor sedentary activities, like video games and television,” Dr. McDermott said.

“So the point is to interest them in activities earlier because by the time students are teenagers, it might be too late.”

During the past year, the FPRC worked with Robles and Sulphur Springs Elementary Schools, as well as other community partners in the Sulphur Springs and Robles areas, to build a comprehensive plan for tailoring the Scorecard program to fit local needs, with the goal of helping Tampa’s youth become more physically active throughout the year.

Prior to choosing the schools that would participate, Dr. McDermott’s team assessed the environment surrounding the schools, looking for those that were more kid friendly, with parks that had amenities like bathrooms and benches, and with ample venues for planned activities, such as bowling alleys, skating rinks, etc.

“We want the kids to feel safe, so if the nearby park is littered with broken bottles or drug paraphernalia, we weren’t likely to include that school,” he said.

Local venues participated by hosting regularly scheduled events for the students. Terrace Sports, for example, hosted weekly timeslots when students could bowl for $1 per game with a $1 shoe rental. Weekends were filled with events, such as track meets or baseball clinics at local parks, or activities like the Too Good For Drugs Walk and KidFest at MOSI.

Much of the support provided by FPRC came from public health graduate students John Trainor, Emily Koby, and Alyssa Mayer, Dr. McDermott said. They staffed many of the events and evaluated the programs to provide feedback to the school. In addition, the graduate students collected data from last spring’s program and presented it this month at the annual meeting of the American Public Health Association. Students will also be involved in the data analysis from the fall program, and will probably present or publish those results, as well as share the results with the schools as feedback.

“They learn something new from participants’ feedback and refine the program each time,” Dr. McDermott said.

From left: Alyssa Mayer (MPH student COPH), John Trainor (PhD candidate Applied Anthropology), Andrenna Brock-Cadet (mother of Scorecard student), Emily Koby (master's student Applied Anthropology), Bonnie Salazar (Scorecard Community Coordinator), and Susan Carrigan (USF Social Marketing Ctr.).

In addition to the graduate students, the program received much support from Tonya Thomas as the neighborhood Scorecard coordinator and Sulphur Springs resident.

Next spring, however, the goal is for the schools to take the program and run with it, Dr. McDermott said.

“We have built an infrastructure with the schools and community organizers so that they could run the program on their own.”

Beyond that, the next task is to apply basic marketing principles and develop a tool kit that can be used in schools around the country, he said.

As for Ty’rique and the grand finale celebration, he didn’t win one of the grand prizes but still came away feeling like a winner. His mother Andrenna Brock-Cadet said that the Scorecard program was great for Ty’rique.

“Sometimes we’re surrounded by a lot of negative and this program was a positive thing for my son,” she said.

“As a parent, I enjoyed seeing him participate. And it helped me get out and move, too. Sometimes I would get in there and run around and play. They definitely need to keep this program going.”

Playing up the grand prizes at the Scorecard Finale Celebration are DJ Ekin (left), radio host for WBTP 95.7 the BEAT, and Acafool, a local hiphop artist.

Students get in the mix at the Scorecard Finale Celebration.

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

Dr. Alan Zelicoff (front center) with, from left to right, Wil Milhous, PhD, associate dean for research in the College of Public Health; John Sinnott, MD, director of Infectious Disease and International Medicine; and Phil Marty, PhD, associate vice president for USF Health Research.

A little-known smallpox outbreak in the Soviet Union years ago and its implications for biological weapons defense today was the topic when physician-scientist Dr. Alan Zelicoff visited USF Health last week. His Nov. 3 lecture in the College of Public Health Auditorium was sponsored by the USF Health Office of Research.

Dr. Zelicoff, a smallpox expert, is the former senior scientist at the Center for National Security and Arms Control at Sandia National Laboratories. He and experts from the Monterey Institute of International Studies linked a 1971 outbreak in the Kazakh Republic to a Soviet field test of weaponized smallpox. The Soviet Union did not report the outbreak to world health officials as required by law.

In an interview in the New York Times, Dr. Zelicoff called the outbreak a “watershed” because it demonstrated that the smallpox virus was more easily spread than previously thought and that there may be a vaccine-resistant strain.

“His lecture was a reality check on our continued need for diligence in areas of infectious diseases, disaster preparedness and biowarfare,” said Phillip Marty, PhD, associate vice president for the USF Health Office of Research.

Dr. Zelicoff’s current interests include risk and hazard analysis in hospital systems and office-based practice and technologies for improving the responsiveness of public health offices and countering biological weapons and terrorism. His latest book is Microbe: Are We Ready for the Next Plague?, a comprehensive account of the public health threat posed by microbial pathogens, including naturally emerging disease threats, such as severe acute respiratory syndrome (SARS) or West Nile virus.

A special forum at USF on Wednesday, Nov. 4, will focus on how water usage and responses to shortages here in Tampa Bay can have global environmental and health implications. The Tampa Bay chapter of Physicians for Social Responsibility and the USF College of Public Health are sponsoring “The Global Water Crisis: Solutions from Tampa Bay,” at the USF College of Public Health auditorium, 13201 Bruce B. Downs Blvd, in Tampa. Refreshments will be served at 6:30 p.m. and the event starts at 7 p.m.

The keynote speaker, Dr. Noel J. Brown, president and CEO of Friends of the United Nations, is an internationally recognized expert on global water issues and champion of environmental sustainability. Dr. Brown and others have noted the unprecedented demand on water resources can have profound implications for the world’s water supply, protection of human health and the viability of aquatic ecosystems.

A panel discuss will feature Mary Mulhern of the Tampa City Council and Karl Nurse of St. Petersburg City Council, as well as Frank Mueller-Karger, PhD, of the USF College of Marine Science, Dr. David Randle, managing director of Waves of Change, and Phil Compton, regional representative of Sierra Club Florida.

For more information go to www.psr.org/tampa.

COPH students provided the health education materials, while trained USF nursing and medical students supervised by USF Health and health department nurses and physicians, administered the vaccines.

Dr. Donna Petersen gets her shot from nursing students Natalie Bercini and Courtney Abreu.

Photos by Eric Younghans, USF Health Office of Communications

A USF College of Public Health researcher has received a highly competitive National Institutes of Health grant to create and evaluate a web-based training program to help dentists and dental hygienists identify patients with eating disorders and refer them for treatment. Rita DeBate, PhD, associate professor in the Department of Community and Family Health, was awarded the two-year NIH Challenge Grant through the American Recovery and Reinvestment Act (ARRA). The ARRA funding is expected to be $985,517 over two years.

NIH AARA Challenge Grants were designed to spur new areas of research and trigger an influx of research dollars into communities across the nation starting in September 2009. With NIH receiving 20,000 challenge grant applications, competition was called “fierce.” While Florida universities received 177 awards through the ARRA, only a few were awarded in Florida.

Eating disorders, such as bulimia and anorexia nervosa, have potentially serious health consequences that can contribute to, or cause, death, according to the U.S. Center for Disease Control’s National Center for Health Statistics. Most people diagnosed with an eating disorder are under age 25, but deaths from eating disorders are highest among those between the ages of 25 and 64, NCHS statistics show.

Early identification, referral, and treatment significantly increase the likelihood of recovery, said Dr. DeBate. “Oral health providers play a fundamental role in the early detection, patient-specific oral treatment, and referral for care of eating disorders, because they are often the first health professionals to observe overt health effects. However, few dentists and dental hygienists are practicing this important clinical responsibility.”

Rita DeBate, PhD, received one of three highly competitive NIH ARRA Challenge Grants in Florida.

Over the two NIH-funded years, Dr. DeBate, the project’s principal investigator, and co-principal investigator Herbert Severson, PhD, senior research scientist at Oregon Research Institute, will customize their prototype web program, “Eating Disorders and Oral Health,” for use within dental and dental hygiene academic training programs. Adaptation of the prototype will be guided by input from dental and dental hygiene faculty and directors, an expert consultant panel, previous pilot data, and current e-learning methodology. Evaluation of the adapted web-based training program will involve 12 dental schools and dental hygiene programs across the country.

Damage to teeth, gums and oral tissue from disordered eating behaviors can begin as early as three months after excessive dieting or vomiting.

“The state of one’s oral health can be considered an early warning system for numerous health issues, including eating disorders,” Dr. DeBate said. “Consequently, oral health professionals can be among the first to observe the effects of eating disorders, but may not intervene for a variety of reasons. For instance, they may lack training and skill in identification of oral and physical symptoms of eating disorders, such as signs of malnutrition, dehydration and vomiting.”

Dr. DeBate’s previous research, which included focus groups with dentists and dental hygienists, revealed that they often felt uncomfortable approaching patients on sensitive topics such as an eating disorder.

“They realize that this is an important oral/systemic health issue, but also noted that they lacked confidence in patient approach, communication, and referral for treatment,” Dr. DeBate said. “In part, this program aims to improve skills in patient communication regarding this sensitive topic.”

Many dental health professionals also felt they could not start an oral treatment program with patients who, because of the secretive nature of their behavior, might be denying their eating disorder, she said. “Treatment can only begin when patients are ready for it. So assessing patient readiness to address disordered eating behaviors and secondary prevention are linked.”

Dr. DeBate and colleagues hope that the training program will increase dental professionals’ capacity to deliver eating disorder-specific secondary prevention and, ultimately, increase the rates of early treatment for people with eating disorders.

- Story by Randolph Fillmore, Florida Science Communications
- Photo by Eric Younghans, USF Health Communications

It was all part of a gala to launch the public phase of the most comprehensive capital campaign in USF’s history. The goal: to raise $600 million. More than 500 donors, alumni, faculty, staff and friends were on hand to hear the announcement by Judy Genshaft, president of the USF System, USF Foundation CEO Joel Momberg and Campaign Chair Les Muma.

The USF Health exhibit presented a vision of Health 2020.

So far, the campaign has raised $317 million in donor gifts and pledges.

“Tonight is a night to celebrate two things: perseverance and promise,” said Genshaft. “Our students are solving big problems. Our faculty is changing the world. USF is building the university of the future. We believe our mission to serve the educational, economic and health needs of our community, Florida and the world are too important to be deterred or delayed.”

President Judy Genshaft displays a test tube full of USF Health's favorite beverage: a Health-tini.

Two of the campaign’s most significant early gifts have gone to benefit projects at USF Health. Frank and Carol Morsani donated $10 million, used to help build the Frank and Carol Morsani Center for Advanced Healthcare, as well as for sports facilities.

Muma and his wife, Pam, donated $6 million to fund neonatal research, as well as to build an neonatal intensive care unit at Tampa General Hospital. They gave another $3 million to athletics.

At Tuesday’s event, the USF Marshall Student Center was transformed by nearly two dozen exhibits showing off USF programs. At the USF Health exhibit, guests were treated to the “Health-tinis,” full of pomegranate antioxidants and delivered in mock test tubes. Video monitors featured Dr. Stephen Klasko, CEO of USF Health and dean of the College of Medicine, sharing USF Health’s vision for the future of health care, Health 2020, along with a montage of images from medicine, nursing and public health.

NBC News correspondent Kerry Sanders gets his balance checked by physical therapy students Heather Matako, left, and Elizabeth Morgan.

Physical therapy students helped guests measure their balance using a Biosway Balance machine. Guests who stood on the machine’s platform – including a spell with their eyes closed, teetering on a block of foam – got to see how they compare to others their age on several measures of balance. Physical therapists can use the data to develop therapies to improve balance and prevent falls.

He may be the CEO, but Dr. Stephen Klasko still delivers babies...real or, in this case, simulated.

The star of the show may have been the exhibit’s youngest member: the simulator baby. Faculty members from the College of Nursing dressed the baby in a “Future Bull” T-shirt and named him Rocky to mark the occasion. A steady stream of visitors came to play with Rocky, hearing him cry, feeling his heart beat, and even watching him turn blue because of breathing difficulties. Each time, of course, he was swiftly rescued by clinical instructor Jenny Molloy and teaching lab assistant Freida Lahti, who demonstrated some of the skills that nursing and medical students learn by caring for Rocky.

Dee Jeffers, program director in the College of Public Health’s Chiles Center for Healthy Mothers and Babies, stopped by and was captivated. She donned a stethoscope and listened to Rocky breathe.

“I didn’t know we did this,” she said. “There’s so much happening at USF, you just can’t keep up with it. The knowledge explosion for students – it’s amazing.”

Freida Lahti helps Baby Rocky's simulated breathing return to normal.

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

      Chances are, the federal government spends nearly twice as much on the Miami retiree as the Tampa one.

      Those are among the findings of a project called the Dartmouth Atlas, an ongoing examination of differences in health care spending around the U.S. On Friday, Jonathan Skinner, senior author of the Dartmouth Atlas John Sloan Dickey Third Century Chair of Economics at Dartmouth College, discussed those differences at a talk presented by the USF College of Public Health.

     Health economist Jonathan Skinner, PhD, chats with Donna Petersen, ScD, MHS, dean of the College of Public Health

       The nation’s most expensive Medicare patients are in Miami, where Medicare spends $16,351 per enrollee each year. Compare that to Tampa, where spending is $8,911 per enrollee.

      Those cost differences mount up, Dr. Skinner said.

      “You start ending up with enough money for, if not a new Ferrari, at least a used Ferrari,” he joked.

      The cost differences are particularly puzzling when you look at health quality measures , Dr. Skinner said. For example, Medicare spends far less per enrollee in San Francisco than in Miami.

     “Yet by all measures,” he said, “San Francisco is at least as good as Miami.”

      Those differences have important policy implications, Dr. Skinner said – both for reining in Medicare’s spiraling costs and for health care reform. What if we could deliver the same quality of care across the country on a San Francisco budget instead of a Miami one?

      “Could we get closer to universal coverage?” he asked.

      Dartmouth Atlas researchers have tried to find non-medical ways to explain the cost disparities. But possible differences in patients in different cities don’t seem to explain the gaps, Dr. Skinner said. Researchers have adjusted for differences in age, sex, race and income without explaining the disparities.

      What does have an effect? In some places, what Dr. Skinner describes as “entrepreneurial surgeons” – doctors who are aggressive adovocates for a particular procedure – can affect costs. Cardiologists in Elyria, Ohio, for instance, attracted national publicity after Dartmouth Atlas research showed that residents there were getting angioplasties at four times the national average.

      Similarly, another factor that explains regional differences is the amount of money each region spends on health care during the last two years of life -- how chronically ill patients are treated and how often they’re hospitalized.  Small differences in how doctors make decisions about whether to send a patient to a hospital or a specialist can add up to big changes in spending.

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

Dr. John Adams was recognized for the publication of “Comparative Genomics of the Neglected Human Parasite Plasmodium vivax Illuminates Malaria Parasite Biology” in the journal Nature and two articles in Public Library of Science Pathogens (PLoS Path). A member of the USF College of Public Health’s Global Health Infectious Diseases Research team, he studies protein ligands that help malaria parasites bind to a person’s red blood cell wall. His team uses advanced analytic technologies to pursue effective vaccine and mosquito-based therapies to prevent malaria caused by P. vivax and P. falciparum, the most common types of malaria. Dr. Adams contributed to a major international research initiative comparing the genome of the malaria parasite P. vivax with other sequenced Plasmodium genomes. Comparing similarities and differences between parasites’ genomes can help determine genetic targets for new drugs and vaccine development. Dr. Adams oversees the Vector-Borne Pathogen Laboratory, or insectary, where researchers study the complex life cycle of the malaria parasite transmitted by mosquitoes.

Dr. Russell Kirby was recognized for receiving the Godfrey P. Oakley, Jr. Award by the National Birth Defects Prevention Network for his significant contributions to the field of birth defects and his senior leadership in several collaborative research projects undertaken by the network. Dr. Kirby is a doctorally-trained geographer with extensive training and experience in public health practice, academic medicine and academic public health. While his research interests in maternal and child health are quite broad, he focuses on population-based research in birth defects and developmental disabilities epidemiology and prevention, as well as on risk factors for adverse pregnancy outcomes. He recently co-authored the book Perinatal Epidemiology for Public Health Practice, and collaborates extensively with professionals from a variety of disciplines, including medicine, nursing, public health, economics, sociology and psychology. Dr. Kirby is president of the Society for Pediatric and Perinatal Epidemiologic Research and of the Association of Teachers of Maternal and Child Health.

Dr. Hamisu Salihu was recognized for publication of a novel theory called “event memory hypothesis,” which suggests a possible molecular memory-recall programming pattern in human gestation using epidemiological and molecular evidence. The groundbreaking theory suggests that when fetal death occurs the event is retained (memorized) as a program that is replayed in future pregnancies. In 2008 this theory was published in the journals Medical Hypotheses and Obstetrics & Gynecology, and may help to understand and prevent the causes of fetal death. Dr. Salihu, director of the Center for Research and Evaluation at the Chiles Center for Healthy Mothers and Babies at USF, is a leading researcher in the field of infant mortality. He is a key player in the Black Infant Health Practice Initiative – a statewide collaborative to address the racial gap in infant deaths in Florida and to recommend policy changes at the local and state levels. He has authored more than 100 journal articles; including recently published studies that shed new light on obesity’s role in the black-white gap in infant mortality.

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

Timothy Bender and Desiree Del Orbe are among the USF undergraduate students learning about the ecology of Eastern equine encephalitis with the help of Hassan K. Hassan, MSc (center), a research associate in Dr. Thomas Unnasch's laboratory.

While we spent the summer and entered the fall abuzz over the potential for H1N1 virus, or the ‘Swine Flu,’ to sweep the nation, some University of South Florida students and one high school student found employment that put them in search of mosquitoes carrying a rarer but deadlier virus, Eastern equine encephalitis, or EEE.

“Eastern equine encephalitis is rare, but when humans get the disease the fatality rate is 50 to 70 percent,” says Thomas Unnasch, PhD, a professor in the USF Department of Global Health, College of Public Health. “It is nearly 100 percent fatal for horses. The ecology of EEE in the Southeastern United States is not well understood.”

Beneficiaries of NIH stimulus funding

Dr. Unnasch, who has had ongoing funding from the National Institutes of Health to study the ecology and transmission of EEE and several other diseases, received additional funding under the “American Recovery and Reinvestment Act of 2009” which allocated $21 million nationally over two years for educational supplements to existing research programs. The stimulus funding has provided extended summer employment for more than 3,000 undergraduates and high school students nation-wide.

With his supplemental grant, Dr. Unnasch was able to hire six USF undergraduates and one high school student to take an active role in tracking down which of the 60-plus varieties of mosquitoes in the Tampa Bay area carry EEE. In addition, his collaborators at Auburn University were also able to hire student summer researchers.

The goal of the research is to identify the vectors (the mosquitoes) carrying the EEE virus and identify their feeding sources. Some EEE carrying mosquitoes feed exclusively on birds, says Dr. Unnasch, while others may feed on mammals of several varieties. Because of suburban development, mosquitoes carrying EEE may be coming into closer contact with people, especially in rapidly developing areas such as Hillsborough and Pasco Counties, where USF undergraduate student Timothy Bender and Raphael Shattenkirk, a student at Tampa Preparatory School, trap mosquitoes several days a week.

“Raphael sets the traps in the evening and I pick them up in the morning,” explains Bender, a biology major.

Mosquitoes caught in netted traps left overnight in developing areas of Hillsborough and Pasco counties are frozen and brought to the laboratory for analysis under the microscope. The researchers want to identify the mosquitoes carrying EEE and their feeding sources.

The traps attract mosquitoes using a small light bulb, the release of carbon dioxide from dry ice left overnight, and a small fan that sucks them into the netted traps. In the morning, Bender pops the trap bag in the freezer, which kills them, and then he delivers them to the USF lab where USF undergraduate student Desiree Del Orbe puts the dead mosquitoes, up to 60-100 per day, under the microscope and sorts them by sex, species, and which of the females (the only mosquitoes that bite) have had a recent “blood meal,” evidenced by their swollen bellies. These are the mosquitoes of interest, the ones that may be carrying EEE.

“Ultimately, we want to determine which mosquitoes carry the virus, the source of their blood meals, and the ecological area where the mosquitoes were active,” says Del Orbe. “This information will help the counties with mosquito spraying when they can target specific areas.”

According to Dr. Unnasch, Florida spends $75 million annually on mosquito control, but the efforts are not as efficiently targeted as they could be if we understood more about the ecology of the virus.

Hands-on Research Experience

Students in the lab, under the supervision of Hassan K. Hassan, MSc, research associate, run a battery of tests, including real-time Polymerase Chain Reaction (PCR) to look for virus RNA, and DNAPCR tests on the blood meal to determine meal source. Their results are shared with both the state Department of Health and the county mosquito control offices. In this win-win summer research project not only do the counties get good data, but students learn the research process from field to bench.

“They get to learn about lab safety,” says Hassan. “They learn why we use this chemical or that one, they learn to use the lab equipment and how to avoid sample contamination. Many students would not learn these things until graduate school.”

Christy Ottendorfer, PhD, a post-doctoral fellow in the lab, says that 2009 has been a “big year” for EEE because of the rainfall amounts and the increased mosquito populations. “Fortunately there have been no human cases, but Florida is leading the nation in equine deaths from EEE,” says Dr. Ottendorfer.

There is a “known unknown” in EEE research. The big issue for the research team is to find what they call the “bridge species” of mosquito. “If mosquitoes carrying the virus feed on birds and non-human mammals, how do people get it?” asks Ottendorfer.

According to Dr. Unnasch, the student researchers are indispensable.

“The real hard part of this research is getting people out there to do the field work, the sample collections,” he says. “It helps to have a bunch of enthusiastic people willing to get out there to set the traps and collect samples. Their help has allowed us to increase the number of collection sites.”

The other benefit to having student help is that with an increase in good data, the NIH is more likely to continue funding the project. The stimulus funding runs through Oct. 31, and then many of the students will continue to work on the project as volunteers, says Hassan.

- Story and photos by Randolph Fillmore, Florida Science Communications

Led by Yiliang Zhu, PhD, professor in the College of Public Health, the USF team draws upon a wide array of expertise from researchers at Colleges of Public Health, Medicine, Nursing, Moffitt Cancer Center, Jaeb Center for Health Research, and Tampa VA hospital.

The summer institute, which will open in the summer of 2010, is a part of a national effort to train the next generation of biostatistical scientists. Its aim is to address a persistent shortage in biostatistics training and to support medical and health research.

Undergraduate and graduate students interested in pursuing an academic program or a professional career in biostatistics should consider applying to participate in the six-week summer institute. For more information, email Yiliang Zhu at yzhu@health.usf.edu.

TAMPA, Fla. (Aug. 3, 2009) – The University of South Florida system has asked its dean of public health to lead and mobilize the university's strategic initiatives in global affairs.

After extensive study by a faculty task force, USF President Judy Genshaft, has appointed Donna Petersen, ScD, as the interim executive director of USF World and of the Patel Center for Global Solutions. Petersen is dean of the USF College of Public Health and will launch the new role. She will make recommendations for a permanent position.

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Dr. Robert Brooks

Tampa, FL (July 20, 2009) -- Dr. Robert Brooks, a nationally recognized patient safety, health informatics and policy scholar, researcher and educator, has been recruited from the Florida State University to USF Health. Dr. Brooks will build upon his well-established research and teaching record and will be professor of medicine and public health and associate vice president for health leadership at USF.

Robert Brooks, MD, MA, MBA, MPH, brings to USF an extensive and intricate working knowledge of academic medicine, curriculum development, student recruitment and advisement, health policy and practice.

“USF will tap Dr. Brooks’ distinctive and well proven academic talents. He will play a directive role in the medical student admissions process as we seek to bring diversity, competence and exceptional quality to our student body. Dr. Brooks will also be responsible for building the health leadership program at USF Health,” said Dr. Stephen Klasko, dean of medicine and CEO of USF Health. “We are exceptionally fortunate to bring Bob Brooks’ talents, knowledge and experience to USF Health.”

A former secretary of health for the state of Florida and a former Florida state legislator, Dr. Brooks has played a significant role in formulating and administering health policy.

“Dr. Brooks brings the rare combination of real scholarship and pragmatic, national leadership to our students and faculty. He will be designing and participating in health policy and leadership research and courses that will provide our public health, medical, nursing and graduate students with insight, knowledge and skills that will benefit them throughout their careers,” said Donna Petersen, ScD, dean of public health at USF.

“Bob is a gifted and dedicated teacher, a highly productive researcher, and a policy architect who has made vital contributions to health improvement in Florida. He has been a singular force in advancing patient safety, health informatics research and data-driven health policy decisions,” said Jay Wolfson, DrPH, JD, USF professor of public health and medicine.

Dr. Brooks will also work with USF’s clinical and research team to design a new system of care to more effectively manage diabetes and other chronic disorders, and to build upon the program of patient safety research with which he has previously collaborated.

USF’s recently announced partnership with the Lehigh Valley Health Network is expected to benefit from Dr. Brooks’ leadership training for medical students. In that program, students from Pennsylvania will attend USF for their first two years of medical school, then return to Lehigh Valley for their third and fourth years of clinical medical education.

At USF Health, Dr. Brooks also will serve as a professor of medicine in the Division of Infectious Diseases (Department of Internal Medicine) in the College of Medicine and as a professor in the Department of Health Policy and Management in the College of Public Health.

“I am excited to have the opportunity to join the already outstanding executive team assembled by Dean Klasko and to assist USF in its mission to train and equip world-class physicians and other health care professionals to be leaders in the 21st century,” Dr. Brooks said.

Dr. Brooks has served as the associate dean for health affairs at Florida State University, where he helped establish the first new allopathic medical school in the United States in more than 20 years. Since joining FSU in 2001, he has started five separate Centers of Excellence on Terrorism, Public Health, Patient Safety, Rural Health and Global Health.

Dr. Brooks was appointed Florida’s secretary of health in 1999. He had previously served in the Florida House of Representatives and as chief of infectious diseases at Orlando Regional Medical Center.

A Michigan native, Dr. Brooks received his B.A. and M.D. degrees from Wayne State University. He is board certified in internal medicine, infectious diseases, and preventive medicine and general public health. He also holds an MPH from the Harvard School of Public Health, an MBA from Auburn University and an MA in theology from the Reformed Theological Seminary.

- 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

- News release 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

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.

The research is published in the May 19, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology.

For the study, researchers followed for eight years 1,836 Japanese Americans in Washington state from the Kame Project in Seattle. The average age of the study participants was 72. During that time, 129 people developed dementia.

The research found that people with lower body mass index (BMI) scores at the beginning of the study were 79 percent more likely to develop dementia than those with higher BMI scores.

In addition, those who lost weight over the study period at a faster rate were nearly three times more likely to develop dementia than those who lost weight more slowly over time. This result was more pronounced in those who were overweight or obese to start; those with a BMI of 23 or higher had an 82-percent reduced risk of developing the disease compared to those who were normal or underweight. The results were the same after testing for other health risk factors such as smoking, exercise and gender.

“Our finding suggests that losing weight quickly in older age may be an early sign of dementia,” said study author Tiffany Hughes, PhD, MPH, who is now with the University of Pittsburgh School of Medicine but conducted the research while she was a dual degree doctoral student in Aging Studies and master’s student in public health (epidemiology) at the University of South Florida. “This doesn’t mean that being obese or overweight is healthy for the mind or body, but losing weight may be a sign of emerging brain disease.”

Dr. Hughes says other current research shows that, in contrast, a larger belly in midlife may be a risk factor for dementia.

“Dementia has been shown to develop in the brain decades before any symptoms develop,” Dr. Hughes said.“These findings likely reflect that process. In middle age, obesity may be a risk factor for dementia, while declining weight in late life may be considered one of the first changes from the disease that occurs before it actually affects a person’s memory.”

The mechanisms for why weight loss may increase risk for dementia in late life are unknown, said study co-author Amy Borenstein, PhD, a professor at the USF College of Public Health. “But, it’s possible that brain areas that control weight are affected before people develop cognitive symptoms."

Dr. Borenstein was the co-principal investigator for the Kame Project in Seattle before joining USF. She has drawn upon data from the large-scale prospective study for other research, including an earlier study showing that antioxidants abundant in fruit and vegetable juices may play an important role in reducing the risk of Alzheimer’s disease.

Other USF College of Public Health collaborators on the study were Yougui Wu, PhD, assistant professor in the Department of Epidemiology and Biostatistics, and Elizabeth Schofield, a doctoral student in biostatistics.

USF SafetyFlorida, a workplace consultation program for Florida’s small businesses, is offering these enterprising teen workers a website dedicated to helping them remain safe on the job. The online workplace safety course, accessed through www.safeteenjobs.com, was developed under the direction of the National Institute for Occupational Safety and Health (NIOSH).

Through real-life stories and interactive games, teens will learn how to identify and reduce job hazards and know their rights in the workplace. For example, a teen working in a fast-food restaurant will be given techniques for avoiding burns and other kitchen hazards.

“Teens are highly susceptible to occupational injuries,” said Charlene Vespi, program director of USF SafetyFlorida. “They often lack the knowledge of workplace dangers. Safeteenjobs.com is an important resource for teens in understanding potential hazards and empowering them to make smart decisions while working this summer.”

Upon successful completion of the six-lesson course, participants receive a certificate of completion from USF SafetyFlorida. The cost is $39.95, and group rates are available through the American Safety Council, which hosts the website.

For more information, visit www.safeteenjobs.com

About USF SafetyFlorida
USF SafetyFlorida, headquartered in Tampa and with consultants across the state, is a workplace safety consultation program for Florida’s small businesses. It is funded by OSHA and the State of Florida and is operated as a service of the University of South Florida’s College of Public Health. The consultation program offers complimentary, confidential and comprehensive assistance throughout Florida. To help employers profit from a safer workplace, the program identifies workplace hazards, offers solutions for safety and health problems, provides training and education, and assists in creating safety and health management plans. To learn more about the USF SafetyFlorida Consultation Program or to request a confidential consultation, visit its website at www.usfsafetyflorida.com.

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

The University of South Florida College of Public Health has lined up a full week of events and activities for 2009 National Public Health Week, from March 27 through April 7, which is World Health Day.

Taking a cue from the national celebration with its theme “Building the Foundation for a Healthy America,” COPH is kicking off the week with a focus on youth in a public health teach-in. The week also includes activities centered around wellness with a fun walk and health fair on March 27 featuring Nicole Johnson, Miss America 1999 and a USF alumna.

These are just a few of the many options taking place. Click here to check out the full schedule of USF's Public Health Week activities.

Donna Petersen, (far right) ScD, dean of the College of Public Health, and Miss America 1999 Nicole Johnson (second from right), a USF alumna, led a Fun Walk around the college's campus, ending with a health fair outside the Chiles Center (below).

- Photos by Eric Younghans, USF Health Communications (top) and Ellen Kent

Tampa FL (March 13, 2009) -- In Florida, black young adults are hospitalized for stroke at a rate three times higher than their white and Hispanic peers, a new study by University of South Florida researchers reports. The study was presented today at the American Heart Association’s Council on Epidemiology and Prevention Annual Conference and appears in an advance online version of the international journal Neuroepidemiology.

Disparities in stroke outcomes between black and white patients have been widely reported for years. While overall death rates for stroke are down, blacks bear a disproportionate burden of disease, disability and death from strokes, said lead author Elizabeth Barnett Pathak, PhD, associate professor of epidemiology at the USF College of Public Health.

“Our study shows this black-white disparity hasn’t improved. In fact, it’s clear that the gap emerges even at relatively young ages – among adults hospitalized for strokes in their 20s and 30s – and widens with increasing age,” Dr. Pathak said. “It points toward an urgent need for primary prevention of hypertension, obesity, and other stroke risk factors among African Americans to eliminate disparities in stroke.”

While most strokes occur among the elderly, stroke in young adults can lead to chronic illness and disability that places a terrible burden on the victims and their families, said Michael Sloan, MD, professor of neurology and director of the USF Stroke Program at Tampa General Hospital. “If the stroke is severe it can be very debilitating, impacting the ability of young people to work and raise their families.”

And even in young adults strokes can be fatal. The Florida study found 8 to 10 percent of stroke patients died before discharge from the hospital.

The USF researchers examined more than 16,000 stroke cases of young adults hospitalized for stroke in Florida from 2001 through 2006. The study included men and women, ages 25 to 49, from the three largest ethnic groups in Florida: whites, blacks and Hispanics. Among the findings:

• The age-adjusted stroke hospitalization rate for blacks was three times higher than for whites or Hispanics. Stroke hospitalization rates for Hispanics were similar to those for whites.

• The rates at which hospitalized stroke patients died were 15 percent higher for blacks than whites, but this disparity was explained by a greater prevalence of stroke risk factors and complicating illnesses such as diabetes, coronary artery disease and heart failure.

• In contrast, Hispanic stroke patients were 27 percent less likely to die in the hospital than whites after taking risk factors and other illnesses into account. More studies are needed to determine whether Hispanic ethnicity actually confers any sort of protective advantage, the researchers said.

• Black stroke patients were more likely than whites and Hispanics to have been diagnosed with high blood pressure, morbid obesity or drug abuse. White stroke patients were more likely to have been diagnosed with high cholesterol, alcohol abuse or cigarette smoking.

• The majority of black stroke patients (56 percent) where women, while the majority of Hispanic and white patients were men.

• Hispanics were more likely than blacks and whites to suffer a hemorrhagic stroke, triggered by the rupture of a blood vessel in the brain. As with the elderly, the most common type of stroke in younger adults, known as ischemic stroke, was caused by the obstruction of blood flow to the brain.

While the USF study did not find an increase (or decrease) in young adults hospitalized for stroke in Florida, Dr. Sloan is concerned that tough economic times could lead to rise in strokes and other cardiovascular incidents. “If people stop taking their blood pressure pills and other medications because they can no longer afford it, they may have a stroke or heart attack,” he 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 $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

Matthew Tucker and Marissa Zwald, both graduate students in the College of Public Health, will be presenting their research projects at the 2009 Research Day, starting at 8 a.m. in the USF Health Rotunda.

COPH students Matthew Tucker and Marissa Zwald.

PhD student Tucker works with Dennis Kyle, PhD, professor in the Department of Global Health. His project - titled "Examination of the Molecular Basis of Resistance to Artemisinin Drugs in Plasmodium falciparum" - invloves genetic studies to determine which genes are responsible for causing the parasite responsible for the most lethal form of malaria to become resistant to our most promising malarial drugs.

Currently, the parasite Plasmodium falciparum is not resistant to the drug artemisinin, which provides rapid relief from malaria symptoms, faster clearance of the parasite, and is the best medicine available today. In Dr. Kyle's laboratory, Tucker developed a parasite that is resistant and is using those genetic lines to determine the molecular basis of drug resistance, which will help in the development of better drugs.

"Currently the World Health Organization recommends artemisinin combination treatment for countries that experience resistance to conventional monotherapies. Therefore, it will be a problem if Plasmodium falciparum becomes resistant because we need to preserve the effectiveness of artemisinin," Tucker said. "So finding the genes responsible for the resistance has significant public health importance."

Graduate student Zwald is working with Rita Debate, PhD, associate professor in the Department of Community and Family Health. Her research project - titled "Changes in Psychosocial Factors and Physical Activity Frequency Among Participants of Girls on the Run" - tracked the data of a national youth sports program and found that young girls who participated in physical activity felt better about themselves.

Zwald set out to assess the short-term impact that Girls on the Run (a national youth sports program designed for girls in 3rd to 8th grade) had on self-esteem, body image, commitment to physical activity and the frequency of activity. Her findings showed that the program produced beneficial changes in self-esteem, body size satisfaction, commitment to physical activity and frequency of activity.

'This is a really exciting project to be a part of," Zwald said. "These girls experienced positive changes in their self-esteem and had a better perception of self. That improved perception could carry forward into adolescence, especially with continued physical activity."

These two students are among the 166 poster presentations on display throughout the USF Health Rotunda. In addition, the outstanding work of eight researchers has earned them an invitation to present their work in an oral session. One of those eight is Marissa Zwald.

Click here to learn more about the events surrounding Research Day.

- Story by Sarah Worth, USF Health Communications
- Photos by Eric Younghans, USF Health Communications/Media Center

USF Health's Amina Alio, PhD, was lead author of the new study in Lancet, finding a strong link between spousal violence and fetal loss.

Women victimized by spousal abuse are at significantly increased risk of losing at least one pregnancy.

A study of more than 2,500 women in Africa by the University of South Florida College of Public Health’s Amina Alio, PhD, and colleagues found that women who experience domestic violence of any kind were 50 percent more likely to have a least one episode of fetal loss (stillbirth or spontaneous abortion) than women reporting no partner violence. The findings were reported in the January 24, 2009 issue of the journal Lancet.

It is estimated that half of African women suffer abuse by their partners.

“Violence against women by their male intimate partners is a violation of human rights and an important public health problem worldwide,” said Dr. Alio, lead author and an assistant professor of Community and Family Health at the USF College of Public Health. “Our findings support the need to screen women in Africa for spousal violence not only during routine prenatal visits, but also following a miscarriage or stillbirth. These events signal a 50 percent probability that the woman is the victim of some sort of physical, emotional or sexual violence by a partner.”

The authors analyzed data from the Cameroon Demographic Health Survey. In the violence module of this survey, women were questioned about their experience of physical, emotional, and sexual violence inflicted by their spouses. Respondents were also asked about any stillbirths and spontaneous abortions. From detailed questions, violence was categorized into subtypes: (1) physical violence, including instances of pushing or shoving, throwing objects, slapping, arm twisting, punching, hitting with an object, kicking, dragging, attempting to strangle or burn, threatening with a weapon, and attacking with a weapon; (2) emotional violence, referring to verbal or physical public humiliation and verbal threat to the woman or her family; and (3) sexual violence, incorporating being forced to have sex or to undertake sexual acts. The authors included all women who responded to the violence module questions by referring to their “husband” or “spouse”.

Of the 2,562 women who responded to the violence module, those exposed to spousal violence (1307) were 50 percent more likely to experience at least one episode of fetal loss compared with women not exposed to abuse. Repeated fetal loss was associated with all forms of spousal violence, but emotional violence had the strongest association. If the prevalence of spousal abuse could be reduced to 50 percent, 25 percent, or eliminated completely, preventable excess recurrent fetal loss would be 17 percent, 25 percent, and 33 percent respectively.

“Spousal violence increases the likelihood of single and repeated fetal loss. A large proportion of risk for recurrent fetal mortality is attributable to spousal violence and, therefore, is potentially preventable,” the authors concluded. “Our findings support the idea of routine prenatal screening for spousal violence in the African setting, a region with the highest rate of fetal death in the world.”

Providing commentary for the study, Dr. Claudia Garcia-Moreno of the World Health Organization’s Department of Reproductive Health and Research in Geneva, Switzerland, wrote: “More support is needed for education and information for healthcare providers and the integration of intimate-partner violence and sexual violence into existing initiatives for maternal, infant, and child health. There is also a major need for more research on primary prevention interventions.”

Hamisu Salihu, MD, associate professor of epidemiology at the USF College of Public Health, and Philip Nana, MD, of the University of Yaounde in Cameroon were study co-authors.

- A news release by Lancet was used in this report.

USF Health has earned the Award of Excellence from the AAMC (Association of American Medical Colleges) for its podcast "Straight Talk with Dr. D."

Featuring Deanna Wathington, MD, MPH, director of the Public Health Practice Program and interim associate dean for COPH Academic and Student Affairs, the podcast was created by USF Health Communications as part of an iTunes U experiment with Apple, Inc., in targeted marketing. The primary goal of the project was to encourage young African Americans to enter health careers, even those who may not follow the traditional science route. In addition, the project helped test the use of iTunes U in health education (that effort resulted in USF Health hosting the Digital Media in Health Care conference with Apple, Inc., last November).

In the podcast, Dr. Wathington (who practices boxing for exercise and stress relief) wears boxing gloves, taking jabs and punches to help make her point that promising physicians do not always take the same route to get to medical school. Sharp angles and quick cutaways give the podcast a modern look, while testimonials from "Dr. D." help drive home the point that various interests and talents bring people to study medicine.

AAMC considered the entry exemplary and its judges noted it to be a "Very novel idea; good result, great message to students, kudos for thinking creatively."

USF Health will be acknowledged for the award March 26 at AAMC's Group on Institutional Advancement National Professional Development Conference in New Orleans.

In addition to Dr. Wathington, the creative team included Michael Hoad, vice president for Communications and Marketing; Klaus Herdocia, Art Director for USF Health; Lissette Campos, former director for Strategic Communications at USF Health and now community affairs director at ABC Action News; and Elizabeth Peacock, branding education specialist for USF Health. Videography and editing for the podcast was done in collaboration with Ren Scott Productions.

This podcast is available on iTunes U [ Subscribe via iTunes U ]

What motivates you? from USF Health, Univ. of South Fl on Vimeo.

What motivates you? Aids... diabetes... or a sick family member... Deanna Wathington, MD, MPH, reflects on the forces in her own life that lead her to pursue medicine - first as a doctor and now as an academic in public health too! By asking the basic question - what motivates you - "Dr. D" shows you how picking your future career can also make a difference in the world.

Career Options from USF Health, Univ. of South Fl on Vimeo.

What do you want to be when you grow up? How do you answer that question? Do you even have a clue as to what direction you might take, where your journey might begin. "Dr. D" takes you beyond the obvious roles of doctor & nurse - which have become the proverbial "tip of the iceberg" in today's health world. Today's career options in health offer a variety of dynamic and exciting options for you to pick from.

Click here to link to Straight Talk with Dr. D. and USF Health's other podcasts.

The following is what was submitted to AAMC by Michael Hoad and helps explain the project further.

Narrative:
"Straight Talk with Dr. D" an iTunes U experiment in targeted marketing.

Project:
Primary goal: Encouraging young African Americans to enter health careers, especially reaching out to individuals who may not be following the traditional biochemistry major pathways. These podcasts were designed after focus groups with the target market. They used camera techniques intended to be engaging and modern, used a script and "star" to portray key emotional messages about life decisions, and were broadcast not only through the new medium of iTunes U, but also through the tours and lectures given by our Area Health Education Program.

Secondary goal: To test the use of iTunes U for both formal and informal education in health, including medical learning, leading to our hosting the "Digital Media in Health Care" conference with Apple, Inc., in Nov 2008.

Problem:
The project took its inspiration from the AAMC's "aspiringdocs.org," which uses the non-traditional media of webpage supported blog with traditional advertising to drive potential physician applicants to that blogging site. The aspiringdocs.org project provided the statistical basis for the project for potential medical students - specifically the decline of traditional biology and chemistry majors as a source for African American applicants to medical school.

In this case, we elected to test the utility of using iTunes U, and specifically podcasting, to reach out in new ways - designed to appeal to a researched and targeted audience.

iTunes U is an untested way to reach millions of people. Repeatedly, our contacts at Apple Inc. told us they wished every university on iTunes U would take the time to research and target audiences for their audio or video casts.

Description:
All planning was done by our in-house public and media relations staff, working closely with the "star," Deanna Wathington - physician, public health educator, faculty member in both our colleges of public health and medicine, ballerina, boxer and recently Florida's officer for minority health. We conducted focus groups with help from members of the Area Health Education Staff, who conduct "access days" on campus with high and middle school students.

It became clear that many of these students are "traditional" in many of the psychographics of an audience. And their greatest motivation for entering health careers is clearly experience with illness in their own families. Caring for family is powerful, and the script reflects that. In addition, they have heard messages that they "can't" achieve those goals, but they are not drop-outs - they're tough and they want to keep going. Cultural assumptions are dangerous in terms of designing video - these are often people who play classical music in the high school orchestra.

We decided to use a very "YouTube" style of photography: Close up, lots of movement, hand held. But unlike YouTube, we elected to hire a videographer who owned and could provide high definition video and editing equipment. He shot and edited under direction of our team.

The resulting videos were formatted for iTunes (they play perfectly on an iPod) as well as the web and for public display to groups.

Evaluation:
During editing, we did a focus group with African American young women in our athletic training degree program. I have to report my initial reaction: I was so intent on watching the videography decisions we'd made, I wasn't looking at the focus group. When I realized no one was saying anything I looked around: They were all crying. In our subsequent showings of the video, that's been a repeated reaction.

A second lesson is that the video itself doesn't complete the behavior needed. The next step will be adapting or duplicating the aspiringdocs.org site to work with this series.

On balance, however, the project captured the core value of USF Health: To see health as a spectrum that crosses all our colleges and disciplines, from the environment, to government policy, to community and family health, to wellness, to emergency, acute, chronic and end of life care. The messages contained within the podcast reflect that core value.

Bottom line: This was a total blast for everyone involved, and to see its effect on people is powerful. It makes us all the more determined to surround it with a recruiting package for all of our health disciplines in USF Health.

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

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

“There is an increasing trend for institutions of higher education to go where their alumni are -- on line,” said Natalie Preston-Washington, MPA, manager of Career Development and Field Placement for COPH. “The USF COPH group on LinkedIn was born on November 3. In a little over two months, membership has grown to include more than 80 people -- including students, alumni, faculty, HR representatives and friends of the college.”

For more information on the USF-COPH LinkedIn group, including a link to the site, click here.

Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, welcomed faculty and staff to the anniversary dinner.

Click here for list of all anniversary award recipients.

More than 230 employees -- including three founding members of the USF College of Medicine’s clinical group -- were honored Oct. 30 at the annual USF Health Faculty & Staff Anniversary Dinner. The event, held this year in the newly reconstructed USF Marshall Student Center, recognized faculty and staff members’ continued dedication and contributions in the success of USF Health.

Among the 35-year anniversary recipients were three physicians who helped establish USF’s clinical group practice, now known as the USF Physicians Group – Juergen Nord, MD, Internal Medicine; Leon Prockop, MD, Neurology; and Allen Root, MD, Pediatrics. Thomas Klein, PhD, professor in the Department of Molecular Medicine, was the fourth 35-year recipient.

Dr. Juergen Nord, left, receives his 35-year award from Dr. John Curran

Dr. Nord, professor of medicine, was a founding faculty member of the USF Division of Digestive Diseases and Nutrition. He has been chief and director of USF Gastroenterology Service at Tampa General Hospital since 1977. He built the USF Endoscopy Center, one of the country’s first ambulatory endoscopy centers affiliated with an academic medical center.

Dr. Leon Prockop, right, with wife Fran Prockop.

The theme of the evening for Dr. Prockop, professor and former chair of the Department of Neurology, was “Only in America.” Proud of his heritage, Dr. Prockop was born to Ukrainian parents who only received six years of education in the Austro-Hungarian empire. He went on to become a leading neurologist and diplomat of the American Board of Psychiatry and Neurology. Only at USF, Dr. Prockop noted, could such a collection of faculty from around the world come together to build a medical school.

Dr. Allen Root, left, and Dr. Curran.

Dr. Root, professor of pediatrics and one of the world’s leaders in pediatric endocrinology, helped founding chair Dr. Lewis Barness build the USF Department of Pediatrics. Several of his fellows have gone on to chair departments at other medical centers.

A charter faculty member of the College of Medicine, Dr. Klein worked closely with Herman Friedman, PhD, long-time chair of the Department of Medical Microbiology and Immunology, to establish the college’s core of basic science research. He later served as department chair.

Faculty and staff in the College of Medicine, Nursing and Public Health and USF Health Administration also celebrated milestone anniversaries of 30, 25, 20, 15, 10 and 5 years of service.

Michael Hoad, vice president of USF Communications and Marketing, was the evening's master of ceremonies. He received his own 20-year anniversary award from Donna Petersen (left), ScD, dean of the College of Public Health.

June Lake, right, a faculty administrator in the College of Public Health, celebrated 20 years of service.

Patricia Gorzka, PhD, left, an associate professor in the College of Nursing and manager of continuing nursing education at USF Health, was presented her 20-year award by Mary Webb, PhD, right, professor of nursing.

A University of South Florida College of Public Health project investigating the impact of post traumatic stress disorder (PTSD) on the pregnancy outcomes of women in the military has been funded as part of the Pentagon’s unprecedented $300-million initiative to study PTSD and traumatic brain injury.

Kathleen O’Rourke, PhD, professor of epidemiology, and Elizabeth Barnett Pathak, PhD, associate professor of epidemiology, were awarded the 18-month, $214,357 contract from the Department of Defense to study the association between PTSD in military women and adverse pregnancy outcomes, including low-birth weight, premature births and other complications. The researchers will analyze data from the newly established Armed Forces Health Surveillance on women soldiers deployed to Iraq and Afghanistan from 2001 through 2006.

Approximately 14 percent of U.S military personnel are now women, the majority of whom are childbearing age.

“We’ve never before had such large numbers of U.S. women serving in the military, and more than 3 percent of those deployed to Iraq and Afghanistan have been screened positively for post traumatic stress disorder,” said Dr. O’Rourke, the study’s principal investigator and an expert in perinatal epidemiology.

More women are serving in the U.S. military than ever before.

“The military will be an important place to look at PTSD and pregnancy outcomes because enlisted women have similar levels of education as their civilian counterparts but unlike many civilian communities, they have the universal access to health care despite differences in race and ethnicity.”

Studies in the general population have shown a link between poor pregnancy outcomes and maternal stress, although the effect of stress is difficult to measure. Dr. O’Rourke says the military study will benefit the civilian population as well by increasing the overall understanding of the effects of stress on reproductive outcomes.

- Story by Anne DeLotto Baier, USF Health Communications
- Photos courtesy of Army.mil photostream

John Adams, PhD, is a member of the USF Global Health Infectious Disease Research team.

Tampa, FL (Oct. 13, 2008) -- University of South Florida global health professor John Adams, PhD, contributed to a major international research initiative comparing the genome of the malaria parasite Plasmodium vivax with other sequenced Plasmodium genomes. Comparing similarities and differences between parasites’ genomes can help determine genetic targets for new drugs and vaccine development.

The comparative analysis of P. vivax by Dr. Adams and malaria research teams from 25 other institutions worldwide was published as the Oct. 9 cover story in the prestigious journal Nature.

While seldom as deadly as Plasmodium falciparum -- the most lethal strain of malaria -- P. vivax is the major cause of malaria outside Africa. Endemic in the tropical regions of Asia and Central and South America, it causes recurring bouts of severe and incapacitating illness, most often among poor people in developing countries. Furthermore, drug resistance to this form of malaria appears to be spreading, hindering clinical management of the disease.

“If our goal is to eradicate malaria worldwide, we can’t do that without getting rid of P. vivax,” said Dr. Adams, a professor in the USF College of Public Health. “This species poses a greater threat to people living in Europe and North America, regions with temperate climates not tolerated by P. falciparum.”

In the Nature paper, the scientists compare the genetic description of P. vivax with the genomes of P. yoelii yoelii (a rodent parasite) and P. knowlesi (a primate parasite) as well as the more virulent P. falciparum. While resembling the other malaria parasites in gene content and metabolic potential, P. vivax includes new gene families and alternative pathways of invasion, the researchers found.

"The biggest surprise was that the biological structure of P. vivax was more complex than we originally thought, which means vaccine development will be more complicated,” Dr. Adams said.

The researchers noted two major differences in the biological features of P vivax, compared to P. falciparum, which challenge global efforts to eliminate malaria. The infectious stage of P. vivax can lay dormant in a person’s liver for years before resurfacing as full-blown malaria, Dr. Adams said. In addition, he said, the malaria parasite is transmitted from human hosts back to the mosquitoes that bite them very soon after humans are infected, extending opportunities for the spread of P. vivax.

“Understanding the genetic makeup of the major causes of malaria will help coordinate efforts for new therapies to prevent or cure both types of infections,” Dr. Adams said.

“Since genetic information is the common language of modern science, the completed genome allows researchers from other disciplines to analyze the parasite in ways not previously possible," he said. "For example, metabolic pathways can be scrutinized for potential drug targets and these targets can be studied in many laboratories.”

Malaria parasite infecting a human red blood cell. Many vaccines in development are designed to block this critical phase of parasite development.

Dr. Adams, a member of USF’s Global Health Infectious Diseases Research team, studies protein ligands that help malaria parasites bind to a person’s red blood cell wall. His team uses advanced analytic technologies to pursue effective vaccine and mosquito-based therapies to prevent malaria caused by P. vivax and P. falciparum, the most common types of malaria.

- 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.

- Women, the elderly and weekend admissions less likely to get same-day treatment in Florida -

Tampa, FL (Oct. 8, 2008) – Women, the elderly, and patients admitted to the emergency department on weekends are all less likely to receive same-day coronary angioplasty for a life-threatening heart attack in Florida, University of South Florida researchers found. Their study was published this month in the American Journal of Cardiology.

Angioplasty, also known as percutaneous coronary intervention (PCI), uses a catheter-guided balloon to open a blocked artery and restore blood and oxygen to the heart. A stent is usually placed to hold open the artery. The procedure is the recommended treatment for the most serious and deadly of heart attacks known as ST-elevation myocardial infarctions or STEMIs, according to guidelines published by the American College of Cardiology and the American Heart Association. Studies show that rapid access to PCI can reduce heart muscle damage, hasten recovery, improve survival and prevent long-term disability better than clot-busting drugs alone.

Elizabeth Pathak, PhD, and Joel Strom, MD, both of USF, examined same-day PCI rates in over 58,000 acute heart attack patients who were admitted to emergency rooms in more than 200 Florida hospitals from 2001 to 2005.

The study included men and women ages 18 and older from the three largest ethnic groups in Florida: whites, blacks, and Hispanics. The researchers found that the use of same-day PCI for heart attack patients more than doubled -- from 20 percent to 40 percent -- during the study period.

Despite this increased use of the clinically proven procedure, statewide most patients admitted to emergency rooms still did not receive same-day PCI by the end of 2005.

The researchers identified several barriers to treatment, including:

• Some patients were admitted to hospitals that do not perform PCI.

• At PCI-providing hospitals, patients ages 55 to 64, were on average about twice as likely to receive same-day PCI as patients 75-years-old or older.

• Men were more likely to receive same-day PCI than women throughout the study period.

• While black patients were less likely to receive same-day PCI than whites in early 2001, the racial disparity disappeared by the end of the study.

• Even by late 2005, patients admitted on weekends were 25 percent less likely to receive same-day PCI than those admitted on week days.

Hospital PCI volume was also a significant factor in receiving same-day procedures. Patients admitted to medium to high-volume hospitals that performed at least 200 PCIs a year were five times more likely to receive same-day PCI than those at low-volume hospitals performing fewer than 200 procedures a year.

“The trend is positive, but the state still has a long way to go before all heart attack patients receive the optimal level of care,” said lead investigator Dr. Pathak, an associate professor of epidemiology at the USF College of Public Health. “Many leading hospitals in Florida and across the nation are putting into place new policies and protocols that are eliminating the ‘weekend problem.’ However, the reasons behind the apparent age and gender disparities shown in our study and others are likely more complex and require further focused research.

“As a woman, if I had a heart attack I would want to be treated just as aggressively as a male patient. But I don’t think this is a matter of simple discrimination – the answer is going to be more complex,” Dr. Pathak said.

“Future research will need to examine more detailed medical data to evaluate whether some patients were excluded from PCI for legitimate clinical reasons such as certain risk factors or complications.”

Supported by a new grant from the American Heart Association, Dr. Pathak will be examining the feasibility of a statewide system for routing STEMI patients to high-volume PCI hospitals. She will examine hospital, geographic (rural) and financial barriers limiting patient access to PCI, continue to track PCI use, and investigate patient outcomes.

The study has implications for shaping future state and national policies related to heart attack care.

"Today national standards recommend that patients with STEMIs should be identified and treated by balloon angioplasty within 90 minutes of first contact with medical personnel, ideally an EMS paramedic,” said Dr. Strom, professor of medicine and chemical and biomedical engineering at USF.

Dr. Strom serves as cardiology co-chair for the AHA’s state-level STEMI task force and co-chairs a local committee, including representatives from all hospitals and EMS services in Hillsborough County, which established the county’s STEMI triage and care program.

“Florida needs to develop a regional network for STEMI care that integrates Emergency Medical Services and PCI-capable hospitals, similar to the current statewide systems governing stroke and trauma care,” Dr. Strom said.

“It’s extremely critical to act quickly in delivering treatment to patients suffering life-threatening heart attacks because time is heart muscle. Within two hours of the onset of a heart attack, you’ve lost 50 percent of the affected heart muscle and by six hours it’s gone altogether.”

- 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.

Perinatal epidemiologists Wendy Nembhard, PhD, (left) and Kathleen O'Rourke, PhD, supported by faculty across the USF College of Public Health, worked behind the scenes for four years to ensure USF had a major role in the NIH's historic Children's Health Study.

Tampa, FL (Oct. 3, 2008) – The University of South Florida has been awarded $28.8 million to participate in the National Institute of Health’s comprehensive study on the interaction of genes and the environment on children’s health.

NIH officials today named 36 new and existing National Children’s Health study centers that will recruit study volunteers from a total of 72 locations across the United States. The University of Miami, Miller School Medicine was awarded $54 million as the Study Center hub for the National Children’s Study in Florida, a consortium of universities and their community partners across the state.

USF was awarded $28.8 million to oversee the NIH-sponsored research contract in Hillsborough and Orange counties – two of three Florida study sites coordinated by UM -- for the first five years of the study.

The other Florida site participating in the National Children’s Study is Baker County; the University of Florida will oversee work there. If funded, Miami-Dade County would be the fourth and final study site in Florida and would start next year under the direct supervision of UM.

In collaboration with the UM Study Center, USF will recruit participants from Hillsborough and Orange counties, collecting genetic, biological and environmental samples, and compiling information for study analyses investigating how genetic and environmental factors influence childhood health and disease.

Study volunteers -- women who are pregnant or likely to have a child in the near future -- will be recruited from rural, urban, and suburban areas, from all income and educational levels, and from all racial groups.

The National Children’s Study will span more than 20 years. The study is expected to follow 100,000 children, from before birth to age 21, at more than 100 study locations nationwide. In Florida, researchers will follow 3,600 children -- including 1,000 each in Hillsborough and Orange counties. They will begin enrolling study participants in about two years.

“This is a phenomenal opportunity to help shape child health policy and interventions for generations to come,” Kathleen O’Rourke, PhD, professor of epidemiology at the USF College of Public Health. “The results of this long-term study will be very powerful because it involves a nationally representative sample with large numbers of children. It will answer important questions about children’s health for children in Florida, the nation and the world.”

Dr. O’Rourke will lead the NCS study in Hillsborough County with co-leader Lewis Rubin, MD, professor and Muma Endowed Chair in Neonatology at the USF Department of Pediatrics, College of Medicine. She will lead the Orange County study with co-leader David Keefe, MD, professor and chair of USF Obstetrics and Gynecology. Wendy Nembhard, PhD, assistant professor of epidemiology at the USF College of Public Health, will also have a lead role in both counties and will assist in oversight of the research projects and administrative activities.

“The fact that USF is playing a critical role in this landmark study is a credit to how far we’ve advanced as a research university and recognition of our expertise and strong community outreach initiatives in maternal and child health,” Dr. Nembhard said. “We spent a tremendous amount of time and energy working on this project, securing USF’s role in this historic study. If we can improve the life of just one child or help improve the quality of life for one family with children it will be worth all of our hard work and sacrifice.”

USF will work with many community organizations, such as the Hillsborough and Orange County Health Departments, Healthy Start, Florida Birth Defects Registry and Children’s Medical Services, to ensure diverse constituencies have a voice in the study.

In Orange County, USF will also partner with the University of Central Florida to recruit study participants and collect data. The University of Florida will provide expertise in environmental exposure and management of laboratory specimens. The Battelle Memorial Institute will assist with screening and enrolling study participants in all counties.

The study will investigate physical, genetic, biological, chemical, psychosocial, geographic and other environmental factors influencing the development of such conditions as autism, cerebral palsy, learning disabilities, birth defects, diabetes, asthma, and obesity.

Throughout its 25-year span, the study is expected to shed light on factors that impact health and development before birth and as infants grow into young adults.

Researchers will address such questions as:
• Can very early exposure to some allergens actually help children remain asthma-free?
• Do household pesticides have adverse effects on brain development?
• How do neighborhood factors contribute to the risk of injury?
• How do genes and the environment interact to promote or prevent violent behavior in teenagers?

"The National Children’s Study will be to child and maternal health what the Framingham Heart Study has been to cardiovascular disease,” said Dr. Rubin, a neonatologist. “Over the last several decades the Framingham Study has revolutionized our understanding of the risks, causes and preventive strategies for heart disease.

"The National Children’s Study will provide a similarly rich database for testing hypotheses about what is beneficial and what is damaging to children’s growth and development,” Dr. Rubin said. “For the pediatrics community, it has enormous potential for clarifying the causes of childhood diseases – both before and after birth – which may ultimately lead to new preventions, treatments and cures.”

Within just a few years, the study will provide information on disorders of pregnancy and birth. Since women would be recruited before they give birth, and in some instances even before they become pregnant, the study will offer insight into the causes and contributors of preterm birth. More than 500,000 premature infants are born each year in the United States. Infants born prematurely are at risk for early death and a variety of health problems, such as cerebral palsy, mental retardation, and learning disabilities. Health care costs for preterm infants total $26 billion a year.

Other USF College of Public Health and Chiles Center faculty involved in the Hillsborough and/or Orange County projects include Dr. Julie Baldwin, Dee Jeffers (community engagement activities), Dr. Hamisu Salihu (secondary data analysis), and Dr. Linda Detman (study coordinator). Other College of Medicine faculty participating in the projects include Dr. Rubin Quintero, Dr. Douglas Holt, Dr. Karen Bruder and Dr. Jennifer Takagishi. The population-based study will rely heavily on community partnerships, and USF will work closely with the Hillsborough County Health Department, directed by Dr. Holt, and the Orange County Health Department, directed by Dr. Kevin Sherrin.

“I am so appreciative of everyone coming together in such a tremendous effort not only to assure that we could be a part of this landmark study but to make certain that the issues specific to Florida families would be represented in this national study," said Donna Petersen, ScD, dean of the USF College of Public Health.

Authorized by Congress in the Children’s Health Act of 2000, the National Children’s Study is being conducted by a consortium of federal agencies. This includes two NIH institutes, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Environmental Health Sciences, the Centers for Disease Control and Prevention, and the U.S. Environmental Protection Agency.

More information about the National Children’s Study is available from www.nationalchildrensstudy.gov.

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- 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

To view USF World Initiative Podcast click below. (6 minutes)

A Closer Look: Dean Donna Petersen on Internatioanl Experiences
(3 minutes)

Special thanks to Daragh Gibson, Graduate Student, USF College of Public Health who was interviewed for the USF World Initiative Podcast.

Executive Producer: Lissette Campos/ Videographer & Editor: Jean Rene Rinvil
USF Health Communications

The USF College of Public Health's Dr. Kay Perrin has been awarded a Fulbright Scholar Award. Dr. Perrin, Phd, MPH, is the Director of Academic Affairs & Associate Professor. She will be teaching at the University of India, Symbiosis College of Nursing, located in Pune, India.
Dr. Perrin will be in India from January 2009 until May 2009 teaching courses in adolescent health and research methods for graduate nursing students.

"I am thrilled to represent USF Health in India," said Perrin. Asked about her family's reaction to this prestigious assignment in India, she said "My husband, Kevin, will be joining me on this adventure. We are both very excited. My 87 year old mom, who lives at John Knox Village, is telling everyone. Our children's reaction span from 'Wow, that is so cool. I hope I can come and visit over spring break' to 'How long are you going to be gone and can I still call your cell phone?' They range in age from 19 to 28."

The nursing school at the University of India will be tapping into Perrin's expertise in adolescent health. "I am preparing by gathering the some of my favorite textbooks to cover the topics of adolescent health, anatomy and physiology, and research methods," she explained. "The message that I will convey to my Indian students is that I am a guest in their country and I expect that I will learn as much as I will teach. We will discover and share the similarities as well as the differences between our countries. Also I want to form lasting collaborations with the university. USF Health already has numerous connections with India. I intend to build on those partnerships, because I believe that this will be merely the first of many trips that I will make to India in the future."

Stay tuned for Perrin's blog from India. She plans to establish & maintain a blog during her international stay so that folks can log on and read about their day-to-day adventures. Her husband, Kevin, will be in charge of uploading photos to the blog.

Other links:
Dr. Kay Perrin Background
USF College of Public Health

Newsbrief by Lissette Campos, USF Health Communications

The outstanding contributions and internationally-recognized scholarly accomplishments of four USF Health professors have earned them the university’s highest honor -- recognition as 2008 distinguished professors. One faculty member -- Laurence Branch, PhD, College of Public Health -- was awarded the title Distinguished University Professor. Three have been named Distinguished University Health Professor – C. Hendricks Brown PhD, College of Public Health, Susan McMillan, PhD, College of Nursing; and David Sheehan, MD, MBA, College of Medicine.

Originally established in 1998, the Distinguished University Professor (DUP) award recognizes USF senior faculty across all disciplines who have distinguished themselves among their peers both within and outside the university through their research, scholarship and creative activity. Selection is based on a process of nomination to the provost and external peer review. The recipients will have their titles formally bestowed at the university’s Fall 2008 Honors and Awards Ceremony.

The Distinguished University Health Professor (DUHP) award was established and presented for the first time in 2007. The award recognizes USF Health faculty members for their highly distinctive achievements in research, teaching and service. Like the DUP award, the DUHP is selected through a rigorous process of internal recommending review and external peer review. DUHP recommendations are forwarded to the senior associate vice president for USF Health. Each awardee will receive a commemorative medallion and be invited to present at the 2008-09 USF Health Lecture Series scheduled to begin this fall.

As leading experts in their fields, these distinguished professors attract millions of federal research dollars to USF, publish in prestigious journals, teach and mentor students who have earned top spots as health leaders in their disciplines, and share their time and talent with the community.

Distinguished University Professor

Laurence Branch, PhD
Department of Health Policy and Management
College of Public Health

Dr. Branch shares the Distinguished University Professor award with Authur Bocher of the Department of Communication, College of Arts and Sciences. Dr. Branch is an internationally-recognized researcher in the field of gerontology -- one of only four scholars at USF to make the coveted Institute for Scientific Information list of “highly cited researchers.” He has been credited with conceptualizing the widely-used term “active life expectancy” to describe the time period during which the elderly are fully functional and independent. He has received external funding of more than $12 million to support his various research programs. His research interests include successful aging, life expectancy, quality of life, functional status of the elderly, long-term care needs and use, alternatives to institutional care, gerontologic epidemiology and intervention trials.

In recognition of his excellent teaching at the doctoral level, Dr. Branch had an award named in his honor -- the “Laurence G. Branch Doctoral Student Research Award” -- by the American Public Health Association’s Gerontological Health Section. The award is presented at the APA’s annual meeting. In addition to his exemplary scholarship and teaching contributions, Dr. Branch has served with distinction in several roles in professional organizations and is President-Elect of the USF Faculty Senate. He is a fellow of the Gerontological Society of America.

Distinguished University Health Professors

C. Hendricks Brown, PhD
Department of Epidemiology and Biostatistics
College of Public Health

Dr. Brown is an international leader in prevention science methodologies and statistics -- routinely consulted by other top faculty in his field at other universities. His landmark work has been a major influence in the development of prevention science, which uses statistical theory to evaluate prevention strategies in community settings and requires close collaboration with research teams conducting field trials. The Prevention Science and Methodology Group he directs is testing several different approaches to reducing suicides in youth, evaluating the long-term impact of school-based prevention programs on mental disorders and substance use disorders, and testing new implementation strategies for widescale evidence-based programs, particularly in the foster care system. The PSMG has received continuous funding from NIH for 20 years, and over the past several years, he has been the principal or co-principal investigator on 10 NIH-funded grants. Dr. Brown is a member of and presenter on Institute of Medicine committees on prevention, and an advisor to CDC’s Injury Prevention Center.

Dr. Brown’s collaborative research showed the dramatic, long-lasting effects of a first-grade behavioral intervention, known as the Good Behavior Game, through young adulthood. This work, recently published in a special issue of the Journal of Drug and Alcohol Dependence, found that diagnosable disorders of alcohol and drug dependence or abuse, antisocial personality disorder, and suicidal behavior were reduced 13 years after the first-grade intervention. This randomized trial is one of the few studies that have demonstrated such long-lasting effects of a prevention program.

Dr. Brown and colleagues across the country are also examining the role that antidepressants may play in youth and young adult suicides. They found that the Food and Drug Administration’s urgent warning about increased suicide risk among youth taking newer antidepressants was soon followed by a marked reduction in both antidepressant use and diagnoses of depression, along with a 13-percent increase in youth suicides. These findings suggest that the FDA warning may have had the unintended consequence of reducing treatment for depression among the most severely affected children and adolescents.

Dr. Brown has been instrumental in helping develop the Biostatistics Master’s and PhD programs in the College of Public Health, playing a particularly important role in mentoring students, fellows, and junior faculty members. He gets outstanding student reviews for his teaching of biostatistics, a very difficult subject that he succeeds in making interesting and informative.

Susan McMillan, PhD
College of Nursing

Internationally known for her contributions to oncology nursing and quality of life at the end of life, Dr. McMillan is the Lyall & Beatrice Thomson Professor of Oncology Quality of Life Nursing at USF. She was inducted into the prestigious American Academy of Nursing in 1993 in recognition of her national and international stature as a nursing leader – making her one of only 1,500 nurses out of nearly 3 million nationally who have received this honor. Dr. McMillan was named American Cancer Society Professor of Oncology Nursing from 1990 to 2000, the maximum time allowed for any professor to hold the award. At USF, she has garnered many honors, including the Jerome Krivanek Distinguished Teacher Award, the Theodore and Venette Askounes-Ashford Distinguished Scholar Award, and the College of Nursing’s Outstanding Graduate Faculty Award. Currently the principal investigator for two large NIH grants, Dr. McMillan is recognized worldwide for her research and development of tools to measure symptom management and quality of life in patients with cancer.

Dr. McMillan founded and continues to direct the Oncology Nursing Program that prepares advanced practice nurses in oncology – a field of nursing in great demand. Her NIH training grant in cancer care was among the first to provide interdisciplinary education for nurses and physicians. She founded and played a key role in successfully transforming an interdisciplinary research group into the USF’s Center for Hospice, Palliative Care and End of Life Studies, which partners with hospices across West Central Florida.

Dr. McMillan has been active in research at Moffitt Cancer Center since its inception and is affiliated with the hospital’s Psychosocial Oncology Program, where she mentors post-doctoral fellows.

David Sheehan, MD, MBA
Department of Psychiatry and Behavioral Medicine
College of Medicine

One of the world’s leading authorities on anxiety disorders, Dr. Sheehan came to USF from Harvard Medical School where he contributed to the conceptualization and classification of panic disorder as a biological illness and conducted the first controlled trial of Xanax for panic disorder. He was a pioneer of psychopharmacology research evaluating several classes of antidepressants (including SSRIs) in the treatment of anxiety disorders. Dr. Sheehan’s structured diagnostic interview, The Mini-International Neuropsychiatric Interview (MINI), has been translated into 48 languages and has become the most widely used diagnostic interview in psychopharmacology research and clinical settings. Modules of the MINI have been adopted by the U.S. government to screen and track the mental health of American troops, and the child and adolescent version of the MINI is being used in the largest epidemiological study on the mental health of China’s youth. Several of his psychiatric rating scales are widely used in international studies.

Director of the COM’s Depression and Anxiety Research Institute, Dr. Sheehan has been awarded more than $16 million in grants for psychopharmacology, pharmaco-economics and epidemiology studies. His bestselling book The Anxiety Disease (which has sold more than a half-million copies) draws upon his research and his own pioneering breakthroughs in treating panic disorder. Dr. Sheehan is widely sought as a lecturer internationally and has served as a consultant to the World Health Organization, the World Federation of Societies of Biological Psychiatry, the International Academy for Biomedical and Drug Research, the U.S. Congress, the U.S.Food and Drug Administration, and the National Institute of Mental Health, to name a few.

He was elected as a member of the American College of Psychiatrists and is a Distinguished Fellow of the American Psychiatric Association.

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

USF public health researcher Dr. Hamisu Salihu directs the Center for Research and Evaluation, Chiles Center for Healthy Mothers and Babies.

Black infants are more than twice as likely as white infants to die before their first birthday, and the racial disparity gap in infant mortality is widening.

This disproportionate burden is a major problem in Florida, where the death rates for black infants climbed between 2000 and 2004, defying an overall national decline. In some counties in Florida, including Hillsborough, the black infant mortality rate is more than four times the white infant mortality rate.

“We won’t solve this problem overnight,” said Hamisu Salihu, MD, PhD, associate professor of epidemiology at the University of South Florida College of Public Health. “But we have a growing understanding of some of the major medical and social factors causing these high infant mortality rates, including prematurity and very low birth weights. Now, we have to transform the research findings into effective, innovative strategies to identify women at high risk for poor birth outcomes and intervene early to reduce the horrible impact of infant mortality among blacks.”

A leading researcher in the field of infant mortality, Dr. Salihu is a key player in the Black Infant Health Practice Initiative, which was approved last year by the Florida Legislature.

The legislation established a statewide collaborative -- the Black Infant Health Practice Collaborative (the Collaborative) -- to address the racial gap in infant deaths in Florida and to recommend policy changes at the local and state levels.

The black-white disparity in infant mortality rates rose from 1.9 in 1970 to 2.3 in 2006, according to the Florida Department of Health. Researchers have consistently shown that higher rates of premature births among black women, regardless of their class or income, help drive this persistent gap.

Recent studies by Dr. Salihu have also shed new light on the role of maternal obesity in the black-white gap in infant mortality. Those studies showed that infants of obese black mothers not only had a higher risk of stillbirth than infants born to white women, but also were more likely to die within the first 27 days after birth.

To continue the work of the Collaborative, Dr. Salihu was recently awarded a one-year, $254,000 W.K Kellogg Foundation grant to help community coalitions develop evidence-based action plans to reduce high black infant mortality rates in eight Florida counties -- Broward, Dade, Duval, Gadsden, Hillsborough, Orange, Palm Beach and Putnam. He is working with a team of diverse multidisciplinary faculty and staff at the USF College of Public Health, the Lawton and Rhea Chiles Center for Healthy Mothers and Babies, Florida A&M University, and Florida Healthy Start. The Kellogg project is training community coalitions how to effectively collect, analyze and interpret data so that it can be most effectively used in shaping culturally-relevant strategies for reducing black infant mortality.

The goal is to arm communities with the tools needed to prevent and combat diabetes, hypertension, obesity, stress or other factors that may increase the risk of low birth weight or premature births.

The Collaborative, supported by the Kellogg grant, gathered at the statewide Minority Health Disparities Summit in Tampa Aug. 12 and 13 to discuss research findings and each team’s plan to impact infant mortality in their communities. The Collaborative also met with 30 black community leaders who will take an active role in championing ways to improve birth outcomes among women who are pregnant and help serve as advocates for needed policy changes. In addition, members shared integrated strategies to improve maternal health before conception, which was identified as the single most important factor compromising fetal-infant health.

“Three maternal health factors were repeatedly mentioned as being critical -- single motherhood and lack of the father’s involvement, maternal obesity, and absent or poor breastfeeding practices,” Dr. Salihu said.

High infant death rates are not just a threat to the black community, but to society as a whole, Dr. Salihu emphasized. “Poor infant health impacts the overall societal goal of achieving quality health – an ingredient that is capital for the social, political and economic development of our nation.”

Dr. Salihu is the principal investigator for the Kellogg grant. Other team members include Dr. Charles Mahan, Dr. Deanna Wathington, Dr. Amina Alio, Dee Jeffers, Estrellita Berry, Dr. Deborah Austin, Dr. Alfred Mbah, Dr. Lakshminarayan Rajaram, Christina Bernadotte and Alice Richman.

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

Dr. Liller has been a member of the USF College of Public Health faculty for 20 years, the last four years as Associate Dean for Academic and Student Affairs of the college. She led many vital and successful initiatives in the College, such as the development of dual degree programs, including the Master of Public Health and the Doctor of Jurisprudence (MPH/JD), the undergraduate minor in public health, and the revamping and refinement of the Office of Academic and Student Affairs.

Dr. Liller also spent several years in the College of Education as a graduate student, earning her advanced degrees from USF: a master’s degree in technical education along with Ed.S. and Ph.D. degrees in curriculum and instruction.

She is a nationally-and internationally-known researcher in children’s injury prevention and control with 100 peer-and editorially-reviewed publications, several book chapters, more than 45 published project and technical reports, 140 professional presentations, and the text, “Injury Prevention for Children and Adolescents: Research, Practice, and Advocacy,” to her credit.

Dr. Liller will lead the growth and success of graduate education at USF through building teams across the university to enhance interdisciplinary education, research, and innovation.

"We fully anticipate Dr. Liller will be calling on many faculty and administrators across the university to partner with the Graduate School to achieve the bold and ambitious goals set forth in the strategic plan," said Ralph C. Wilcox, PhD, Provost & Senior Vice President for Academic Affairs at USF. "Dr. Liller has articulated a strong vision for graduate education and for bringing together the University’s breadth of graduate programs."

"She has many innovative ideas and understands the important intersection that exists between research and graduate education," said Karen A. Holbrook, PhD, Vice President for Research & Innovation at USF.

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

Dennis Kyle, PhD, professor of global health, looks through a portal door of the new insectary, which will soon house malaria-carrying mosquitoes.

Most days you can't just walk into the laboratories where members of the College of Public Health's Global Health Infectious Disease Research (GHIDR) team do their work, seeking to unravel the secrets of viral and parasitic infectious diseases transmitted by insects. But, July 28, GHIDR welcomed visitors for tours of the team's offices and state-of-the-art laboratories, covering nearly 15,000 square feet of space in the Interdisciplinary Research Building at USF's Research Park.

The team's faculty core is comprised of five scientists who together have accumulated more than 120 years of expertise in global infectious diseases research -- John Adams, PhD; Dennis Kyle, PhD; Wil Milhous, PhD; Thomas Unnasch, PhD; and Alberto van Olphen, PhD, DVM. They collaborate with the neighboring USF Center for Biological Defense and the Florida Department of Bureau of Laboratories, among others.

The tour stopped outside the newly commissioned, top-security BSL-3 Lab, for a brief glimpse in the window. But, visitors did get to go inside the recently completed Vector-Borne Pathogen Laboratory, or insectary, where the hot, humid air will soon welcome swarms of carefully contained, blood-sucking mosquitoes that transmit the malaria parasite.

Read more about the GHIDR Team...

Photo Gallery

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

University of South Florida senior medical student Lonna Gordon knows a thing or two about medical mistakes. Gordon worked as a retail pharmacist before entering medical school.

“So many times I received prescriptions to fill and the amount was dead wrong – the dosage was actually toxic,” said Gordon.

She recalls one time she had to be very persistent about calling and talking her way through several emergency room staffers before she was finally able to speak to the physician who had written a prescription for 0.5 mg of Clonidine three times a day – an exceedingly high dosage for that blood pressure medication. Noticing that the patient waiting in the pharmacy for her to fill the prescription appeared agitated, Gordon questioned whether the ER doctor meant to write the script for Klonopin, a medication used to treat anxiety. He had.

Gordon was one of the first students to sign up for USF’s new interdisciplinary course Human Error and Patient Safety, which will bring together graduate students from the Colleges of Medicine, Nursing, Public Health, Engineering (industrial engineering), and Arts and Sciences (aging studies, anthropology, communication, psychology, social work). The three-month course, starting Aug. 27, will be the first of its kind at USF, and possibly the country, said Peter Fabri, MD, PhD, associate dean for graduate medical education at USF.

Part of the “Year of Patient Safety” initiative at USF, the course is intended to be one important step in laying the educational foundation needed to promote a culture of patient safety.

“I’m really excited about this course,” said Dr. Fabri, a surgeon who holds a doctorate in industrial engineering with an emphasis on patient safety. “We have a unique ability to make a real difference.”

A leading cause of death and injury

The 1999 Institute of Medicine report To Err is Human estimated that avoidable errors in U.S. hospitals were killing 44,000 to 98,000 Americans a year and injuring thousands more. These “adverse events” include everything from wrong-site surgery, anesthesia-related mistakes and treatment delays to medication errors, patient falls and deaths related to patient transfers.

“If you accept the data in the IOM report, that would be the equivalent of one jumbo jet filled with passengers crashing every day for a year.” Dr. Fabri said. “And that doesn’t count hundreds, if not thousands of near misses that occur in our hospitals every day.”

Dr. Fabri will co-direct the course with Jay Wolfson, JD, PhD, a distinguished service professor of public health and medicine director of the Suncoast Center for Patient Safety at USF. They are assisted by a steering committee of multi-college faculty instructors comprised of Karen Liller, PhD, associate dean of public health; Mary Webb, PhD, associate dean of nursing; Eric Eisenberg, PhD, interim dean of arts and sciences; and Jose Zayas-Castro, PhD, professor and chair of industrial and management systems engineering.

Combining lectures, case study discussions and renowned visiting experts in patient safety (see link to experts at end of story), the course is designed to promote teamwork by putting students in interdisciplinary groups to work on patient safety projects. In fact, the first class will be launched with a session and practical exercises, led by Michael Brannick, PhD, of USF Industrial/Organizational Psychology, on how to function effectively as a team member. Over the semester each team will develop a recommendation to resolve a real patient safety problem identified by Tampa General Hospital.

Typically, medicine has viewed all errors as failings – expecting clinicians to be fault-free and blaming and shaming individuals when a mistake occurs.

Some have argued this punitive approach provides an incentive for health care professionals not to report their mistakes or those of colleagues. In addition, the “captain of the ship” culture in which physicians are trained and practice may inhibit other health care workers from speaking out when they notice an error is about to occur.

Improving patient safety a team effort

The IOM report prompted legislative and regulatory initiatives designed to analyze, report and monitor medical errors and search for solutions. But the educational aspect needed to create a cultural shift toward patient safety has lagged, said Dr. Fabri.

“In spite of all the rhetoric about teamwork, our country’s medical students are still trained to be autonomous, not team players. So we’re preparing highly competitive individuals, when what we need are professionals who can work together for a common good -- the best outcome for the patient,” he said. “The only way you can change culture is to bring people with different skill sets together so they can begin talking about patient safety problems and thinking outside the box of their traditional disciplines.”

Medical student Gordon is looking forward to learning other students’ perspectives about ways to improve patient safety. “Physicians don’t have enough time or all the expertise to do everything their patients need. In order to effectively and safely deliver care you have to collaborate with others, and most of us have not been trained how to do that…. It’s important for health professionals not to antagonize each other, but to help strengthen and act as checks and balances for one another.”

Students from each discipline will bring something of value to the table when it comes to strategies for reducing health-related errors, say faculty involved in the new course.

USF surgical residents at Moffitt Cancer Center use a whiteboard to list specifics such as site of impending surgery, any medications that could affect the operation's safety, medical risk factors and names of all the staff working the OR case.

While physicians and, to some extent nurses, are primarily focused on the health and well being of individual patients, public health professionals take a broader, population approach and emphasize prevention, said the College of Public Health’s Dr. Liller. “How could this one improvement impact the safety of the patient population? What might we do in the first place that could prevent that error from ever happening again?”

Industrial engineers are trained to figure out how to do things better. They consider aspects of human behavior when engineering systems to improve quality and productivity in working environments, said the College of Engineering’s Dr. Zayas-Castro. When it comes to designing patient safety solutions, getting to know the challenges, constraints, concerns and viewpoints of health care professionals who work on the frontlines of patient care is as valuable as being able to quantify processes and measure data, he added. “The level of complexity in any clinical organization or healthcare facility today makes it extremely difficult to derive the best solution with just one viewpoint or discipline.”

Confronting the inevitability of error

Dr. Wolfson goes so far as to say the course might actually help protect future physicians from malpractice suits -- maybe even save their licenses. “Doctors talk to people all day long, but they don’t communicate very well,” he said. “The single most significant variable associated with adverse events and the bringing of successful malpractice cases to court has been poor communication.

“Our goal is to help students understand that patient safety is an interdisciplinary issue requiring them to think critically before they act, communicate with lots of people, and take nothing for granted," Dr. Wolfson said.

While there is no entirely risk-free environment, Dr. Wolfson said, much can be done to mitigate error through such measures as changing medication shapes or colors to help prevent mixups and confusion about dosages and developing standardized checklists for surgery. “Health professionals can’t prevent all errors, but we can certainly identify where and when most errors occur and build in better systems to reduce their likelihood,” he said. “And, equally important, we have an obligation to fix something as soon as we realize it’s wrong. By exercising that obligation we’ll help create more trust in the health care system.”

The slogan for the USF Year of Patient Safety initiative is “Measure Twice, Cut Once.” The proverb originated with carpenters as a reminder that if you cut wood improperly the piece is ruined. In other words, it’s faster and better to double-check than make a mistake.

Dr. Fabri says that finding ways to make impending errors transparent may be the most effective way to prevent more errors from happening. Before they can do that, physicians, nurses and other health professionals need to accept the idea that error is an inevitable part of the human condition, even among highly trained, conscientious individuals. “Overconfidence in the system can be disastrous,” he said. “Human beings, by their very nature, will always make mistakes. So, we need to train our students to recheck what they do and recheck what their colleagues do, to speak up if they have doubts, and to be constantly vigilant.”

- Story by Anne DeLotto Baier/USF Health Communications

Related links:

- Course features leading experts in patient safety

- Applying airline safety standards to the OR

Ocean view from Downtown Panama City.

Miraflores locks of the Panama Canal - access point to and from Pacific Ocean.

View of Miraflores locks from USF Health International Foundation Offices located in the City of Knowledge, Panama.

Panama City, Panama.

• Linda Emanuel PhD, MD, director of the Patient Safety Education Project at Northwestern University

• Karen Frush RN, MD, chief patient safety officer for the Duke University Health System

• John Gosbee MD, MS, a human factors engineering and healthcare
specialist with a special interest in design of equipment and processes, University of Michigan

• Ben-Tzion Karsh, PhD, director of human factors engineering, University of Wisconsin

• Donald Moorman, MD, director of simulation crew resource management, Harvard University

• Greg Ogrinc, MD, director of the Institute for Healthcare Improvement Collaboration, Dartmouth University.

In addition, experts from USF and its affiliates will address such topics as applying aviation safety practices to the surgical/medical environment, the public health and legal aspects of safety, identifying high risk areas in health care and patient safety research, and medication errors.

The week of June 2nd, I had the pleasure of visiting Panama for the first time. I was there on assignment to write about the official opening of the USF Health International Foundation and to write about our student programs there in public health and nursing. I traveled on assignment numerous times during my years in tv news and didn’t really expect any surprises on this trip.

Was I wrong!

Many of you have probably heard the phrase ‘an AHA! moment’. Well, I had mine overlooking the Miraflores locks of the Panama Canal.

Standing on that observation deck, shoulder to shoulder with tourists from all over the world, I finally realized what this thing called public health is all about. Watching two huge cargo ships inch their way in & out of the water compartments, I understood how health conditions in one part of the world, can yield consequences for others, near and far. I understood how public health impacts my every day life, not just someone else’s.

On that observation deck, the sound of clicking cameras and ‘ooo-ing’ tourists was coupled by conversations – in many languages – marveling at ‘what cargo might be inside’ the containers floating by. Strangely, I didn’t care. Instead, I wondered about viruses or ‘super bugs’ that might be onboard the many ships that pass through. After all, the canal serves as a shortcut to ships from all over the globe. Any viruses or epidemics spread here, could have repercussions throughout Central America and then spread north and south, east and west. It’s something canal administrators take very seriously - special teams of canal employees board every vessel to check for ‘outbreaks’ or any dangerous health conditions before granting safe passage.

More than one-hundred years ago, U.S. General William Gorgas realized that in order to finish the canal he had to keep the workers alive! Their predecessors, the French, had lost some 20,000 men to malaria and yellow fever. Turning his sites from explosives and diggers carving out the canal, the general focused on living conditions – unlocking the mystery of what it was about that particular place that killed so many with disease. Understanding that, he took action - draining marshes, paving the roads, and ‘oiling’ the mosquitos to death in the fields. With no breeding ground for disease-carrying mosquitos, his workers survived. The canal was finished. Public health was born.

Back home now, I see how folks in public health are at work changing the world every day - and for the better. It’s not just the stereotypical PH project building sewers overseas or the dispensing of vaccinations. From workplace safety and occupational health; to helping design communities with more areas for outdoor & physical activity; to their efforts with child restraint seats that keep my kids alive during car accidents – public health professionals are quietly at work...every day...making things happen. I see that now. Clearly.

Reporter's Notebook by Lissette Campos, USF Health Communications

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...

At right, Donna Petersen, Dean of the USF College of Public Health, during a prior interview.

WEDU DOCUMENTARY: The Uninsured- Help & Hope

Donna Petersen, MHS, ScD, Dean of the USF College of Public Health, is featured in a WEDU documentary entitled "The Uninsured: Help & Hope". "This documentary does a wonderful job illustrating that the uninsured look like you and me – any of us can be caught in a desperate health care situation at any time," said Petersen. "Even with insurance health care can be a complex maze – without it, people really struggle to get the care they need to stay alive, feel well, go back to work, lead productive lives."

To date, the largest group of uninsured in this U.S. includes young adults, ages 18 - 24. Dean Petersen is part of the hour long broadcast focusing on the growing problem of uninsured residents, as well as raise awareness of the caring volunteers who help create access to health services to those most in need. In Florida, the nation's 4th largest state, an estimated 3.5 million residents lack health insurance. That's 1 in 4 Floridians without health insurance. In Hillsborough and Pinellas counties, an estimated 278,000 local residents are uninsured.

TO VIEW DEAN PETERSEN'S INTERVIEW, CLICK HERE.

Please note: Once on the WEDU webpage, click on "Watch Video".

"I hope many people are able to watch this compelling show. My daughter and her friend watched the entire program with me – they were fascinated and asked lots of questions and offered many insightful comments. It is an important conversation for us, as a community, to have – how important is it to all of us to make sure that truly caring health care is available to each of us?" said Petersen. "After watching this show I hope others are compelled to speak out on this issue or to give something back as so many of the generous people depicted in this show have done. It really is about our health."

Newsbrief by Lissette Campos, USF Health Communications
Link courtesy of WEDU

Discurso: "La Salud de las Américas"
2 de junio de 2008
Ciudad del Saber, Panamá
Por la Decana Donna Petersen - Universidad del Sur de la Florida, Escuela de Salud Pública
Discurso con motivo de la inauguración de la oficina de USF Health International Foundation - Fundación Internacional de la Universidad del Sur de la Florida-Salud.

Resulta totalmente apropiado que estemos aquí conmemorando la inauguración de una oficina de Salud de la Universidad del Sur de la Florida en las Américas, una oficina dedicada a mejorar las salud de toda la gente en esta región y por ende, alrededor del mundo.
Es apropiado que lo hagamos aquí en Panamá el sitio de algunos de los más profundos descubrimientos en salud pública de los últimos 200 años.

El General William Gorgas tenía un trabajo que realizar -un canal que era necesario construir para proveer una ruta comercial del este al oeste y viceversa - pero ese trabajo no podía haberse realizado hasta que él hubiese completado una tarea, tal vez, de aun mayores proporciones- la tarea de mantener a los miles de trabajadores vivos y saludables, libres de enfermedades, en un ambiente que estaba totalmente a favor de las enfermedades y en contra de él y sus trabajadores. Conociendo, quizás conscientemente, quizás de manera inconsciente, que este esfuerzo monumental para el desarrollo económico, era enteramente dependiente de la salud, el General Gorgas, se puso buscar una forma para proteger a sus trabajadores de la enfermedad y encontró que podría hacerlo reduciendo la ruta de transmisión, reduciendo la exposición al transmisor de la enfermedad. En el logro de esta tarea, él fue no solamente capaz de completar el trabajo al cual había sido enviado, sino que además lanzó una revolución en el control de las enfermedades que ha salvado millones de vidas por más de 100 años. Las enfermedades a las que se estaba enfrentando, ya no son comunes en muchas partes del mundo, y sus descubrimientos estimularon a otros a desarrollar sus propias investigaciones para disrumpir el ciclo de la transmisión de la enfermedad, cosechando aún por ello innumerables beneficios.

Nosotros también tenemos un trabajo que hacer. Sabemos que el mundo está cambiando, que los poderes económicos están cambiando, y aunque sabemos ahora empíricamente que desarrollo y salud humanos están inequívocamente ligados, no actuamos siempre basados en este conocimiento y algunas veces nuestros esfuerzos de buena intención tienen consecuencias no intencionadas.

¿Quien pudiera haber anticipado que los incentivos para producir biofluidos para reducir los contaminantes ambientales dañinos pudiesen desencadenar una escasez mundial de alimentos?
¿Quien hubiese pensado que los aditivos diseñados para preservar los alimentos y hacer más fácil su transporte generarían tasas crecientes de obesidad?
¿Quien hubiera creído que drogas diseñadas para curar podrían más bien matar?

Y así en la medida en que nuestro trabajo continúa se anticipan nuevas amenazas, batallando con viejos enemigos, limpiando los remanentes de nuestras buenas intenciones. La búsqueda de la salud es como la búsqueda de la verdad, podemos llegar cerca pero nunca podremos realmente alcanzarla. Creceremos en sabiduría pero nunca lo sabremos todo.

Un viejo proverbio dice "aquel que tiene salud tiene esperanza y quien tiene esperanza lo tiene todo". Abrimos esta oficina con la mayor de las esperanzas y con un robusto equipo de profesionales entusiasmados de entregarse todos al propósito de la Salud en las Américas, aquí, en Panamá, en la Ciudad del Saber. Nuestras metas son realmente simples- proporcionar un nexo para la integración del conocimiento a través del descubrimiento, convertido en aprendizaje de tecnología avanzada, adecuado para la acción hacia resultados.

Lo haremos aquí en Panamá, no sólo debido a que nuestros antecesores hicieron de este un centro de excelencia en ciencias de la salud, sino porque Panamá ya es un centro de tantas cosas que son buenas en las Américas. La gente pueden venir aquí fácilmente, la información puede ser transmitida desde o hacía aquí fácilmente, bienes y servicios pueden ser intercambiados aquí fácilmente, descubrimientos y aprendizajes puede suceder aquí cada día. Es el sitio adecuado para nosotros estar a fin de realizar el trabajo que necesitamos hacer.

¿Cuál es ese trabajo? La ampliación del canal de Panamá sirve como una metáfora perfecta para el desarrollo incesante de esta región del mundo en la prosperidad del siglo 21. Como el general Gorgas antes que nosotros, no podremos hacer el trabajo hasta que no dominemos la otra tarea, la de mantener a millones de trabajadores, líderes y luminarias vivos y saludables, libres de enfermedad. Ah, pero esta tarea no es tan simple como lo fue una vez. Mientras todavía combatimos con las enfermedades infecciosas, el barnizado de la civilización después de todo es aún bastante delgado, - tendremos que conciliar con ingenio la creciente gama de enfermedades crónicas, incluyendo los nacidos en el exceso y los nacidos en la miseria. Un reciente reporte de la organización panamericana de la salud (OPS) revela asombrosas estadísticas. En los países latinoamericanos las enfermedades crónicas son la causa primaria de la mortalidad prematura en casi todos los países representando dos de cada tres muertes. ¿Las raíces causales de este cambio de enfermedades infecciosas a crónicas? Yo quisiera poder decir que fue debido a nuestro éxito al controlar las enfermedades infecciosas, pero mientras esto puede ser parcialmente correcto, la creciente marea de enfermedades crónicas es impulsada por una combinación de mala alimentación, actividad física inadecuada, consumo excesivo de tabaco y la desigualdad en el acceso a cuidados preventivos y primarios en salud. Añádale a esto otras preocupaciones emergentes en las áreas de la salud mental, la degradación ambiental, seguridad de transporte, el ambiente de construcción urbano, la preparación para las emergencias y la gestión para el manejo de desastres y tendremos una mezcla potente que desafiará a lo mejor de nosotros.

Pero lo mejor de nosotros es lo que traemos para asociarlo con lo mejor ustedes, aquí en Panamá y a través de América Central y Sudamérica para forjar un nuevo camino hacia LA SALUD- donde, trátese del mejoramiento de los profesionales clínicos, de una fuerza de trabajo en salud pública mejor formada, de la construcción de bases del conocimiento científico o de comprometer una comunidad a trasladar investigaciones y aprendizajes en acciones reales nosotros vendremos aquí a realizar el trabajo necesario para terminar la tarea.

También traemos un nuevo modelo de SALUD, un modelo que reconoce que las fuerzas que conspiran para robarnos la salud no trabajan de manera aislada, ellas trabajan en combinación y así debemos hacerlo nosotros. Si esperáramos a que una condición se presente por sí misma en el hospital ya sería muy tarde. Si exhortamos a nuestros pacientes a tener comportamientos más saludables sin asumir si ellos tienen los medios para hacerlo, habremos perdido nuestro tiempo y los habremos hecho sentir peor.
Si nuestro esfuerzo para construir infraestructura en los niveles ambientales y comunitarios falla en incluir los componentes del cuidado la salud, habremos hecho poco para contribuir con un sistema de salud ya fragmentado.

En la Universidad del Sur de la Florida-Salud, nosotros creemos en un modelo holístico que reconoce las contribuciones de la biología, de las ciencias de la conducta y el ambiente socio/económico/político/estructural de la salud.
Creer en este modelo nos lleva a una conclusión inevitable: Debemos preparar nuestros futuros médicos, enfermeras, terapeutas y profesionales de la salud pública a trabajar concertadamente para ayudar con estas miríadas de amenazas a la salud.

Nuestra investigación debe ser trans-disciplinaria y trasladable del laboratorio a la cama, al patio y a la sala de convenciones. El objetivo de todo lo que hacemos debe ser mejorar la salud.

Un reciente análisis de datos de mortalidad en 31 países de las Américas pone de manifiesto la amplitud y la profundidad del reto al que nos enfrentamos y deja en claro por qué una asociación de cooperación entre nosotros es tan importante:
• La enfermedad isquémica del corazón fue la causa principal de muerte en 13 países
• La enfermedad cerebrovascular fue la principal causa de muerte en 6 países
• La diabetes en 3 de los paises.
• La insuficiencia cardiaca y las enfermedades del corazón en 2 países
• Influenza y neumonía en 2 países
• La hipertensión arterial en 2 países
• El VIH / SIDA, homicidio y paro cardiaco fueron cada una la principal causa de muerte en un país.

Entre las 3 principales causes de muerte, otras incluyeron las infecciones intestinales, las condiciones del período perinatal, los tumores malignos de tráquea, bronquios y pulmón, cirrosis del hígado, enfermedad respiratoria crónica inferior, enfermedades del sistema urinario y los accidentes de transporte terrestre.

Pero las estadísticas de mortalidad sólo nos muestran la punta del iceberg. El resultado final de nuestros intentos es promover con éxito la salud y asegurar a todos la oportunidad de disfrutar de una vida plena, llena de buena salud, y libre de malestar y de enfermedad. Una mirada de los tres últimos números de la Revista de la Organización Panamericana de la Salud nos da una visión diferente de la preocupación en las cuestiones de salud pública en todas las Américas.

Voy a mencionar algunas:
• La hipertensión arterial en adultos en México, las conductas de riesgo de VIH en hombres en América Latina y el Caribe
• La costo-efectividad de la vacuna contra la hepatitis A en Chile y de la vacunación de rutina por rotavirus en Brasil
• La ingesta de alcohol y los problemas de conducta de los jóvenes en edad escolar en Puerto Rico
• La implementación de una nueva ley del tabaco en Chile
• Los hábitos alimentarios y el acceso a los alimentos de las familias desplazadas por el conflicto armado en Colombia
• La comparación del P.C.R. y cultivo bacteriano para la detección de salmonela presente en el pato Muscovy en Trinidad y Tobago
• El medio ambiente epidemiológico y la respuesta a la epidemia de VIH en Bolivia
• La elevada mortalidad producida por gastroenteritis por rotavirus en Nicaragua
• Hacer que los servicios de atención secundaria sean una preocupación primordial: el hospital rural en Ecuador
• Los usos terapéuticos de los medicamentos usados en investigación: la extensión de la investigación, el uso compasivo y la expansión del acceso.

La lista de los asuntos de salud pública que preocupan a los ministros de salud en las Américas es una última forma de ilustrar la naturaleza de nuestra oportunidad para trabajar colectivamente en el objetivo común de mejorar la salud y el desarrollo de todas las naciones y todas las personas en el Continente. También deja en claro la amplitud de la salud pública y el enorme espacio de influencia que los que trabajamos en salud poseemos para mejorar la seguridad económica, promover calidad de vida y apoyar la paz continuando asi con la prosperidad de esta región.
• El VIH / SIDA, la tuberculosis y la malaria siguen siendo preocupaciones, pero se están fortaleciendo los esfuerzos en todas las Américas para reducir su impacto.
• El acceso a una buena nutrición y alimentación, sobre todo en los países prioritarios de Bolivia, Guyana, Haití, Honduras y Nicaragua, son prioridades, porque es evidente que atender a la salud de la población en estos países es fundamental para que puedan lograr su éxito económico
• El posterior desarrollo y la difusión de las vacunas como las de VPH, rotavirus y la neumonía
• Continuar con la planificación para casos de emergencia, incluida la pandemia de la gripe y para nuestra rápida y eficaz respuesta en el caso de los desastres cuando estos sean inevitables
• La erradicación de la fiebre aftosa en el ganado
• La promoción de la igualdad de género y la igualdad en el acceso a la atención médica, el costo y la calidad
• El acceso al agua potable y saneamiento
• Atención a la salud mental
• Y por último, la atención a nuestros más vulnerables - las mujeres embarazadas, los niños, los adolescentes, los ancianos y las poblaciones indígenas.

En la identificación de estos asuntos prioritarios, los ministros de salud en las Américas también han dejado bien claro su comprensión colectiva que es imperativo que trabajen en solidaridad para tener éxito en mejorar la salud y el desarrollo de cada uno, con el fin de hacerlo para todos. Venimos aquí de USF Salud con una misión similar - para trabajar en colaboración con ustedes, aquí en este lugar, para descubrir, para aprender, a contribuir, a compartir conocimientos e ideas hacia nuestro objetivo común de garantizar a cada uno la mejor oportunidad de salud, prosperidad y esperanza.

Nos sentimos honrados y agradecidos por su cálida bienvenida y le damos las gracias por permitir unirnos a ustedes en este humilde propósito.

Decana Donna Petersen 2 de Junio del 2008, Ciudad del Saber, Panamá

Tampa, FL (June 10, 2008) -- A study led by the University of South Florida sheds new light on obesity’s role in the black-white gap in infant mortality. While maternal obesity appears to have no impact on the early survival of infants born to white women, the situation is different for black women, researchers report in the June 2008 issue of the journal Obstetrics & Gynecology.

Infants of obese black mothers had a higher risk of death in the first 27 days following birth than newborns of obese white mothers, the researchers found. Furthermore, this black disadvantage in neonatal infant mortality widened with an increase in the body mass index (BMI).

“Even if the infant of an obese black woman survives pregnancy, labor and delivery, that baby is at greater risk of dying than a baby born to an obese white woman,” said the study’s lead author Hamisu Salihu, MD, PhD, associate professor of epidemiology at the USF College of Public Health.

The researchers analyzed more than 1.4 million births recorded from Missouri’s vital records database, covering the period 1978 through 1997. The database linked black and white mother-infant pairs. Among all women, the likelihood of neonatal death (up to 27 days following death) and early neonatal death (up to six days following death) was 20 percent greater than for nonobese women, the researcher found.

Further analysis revealed that the higher risk of neonatal deaths among newborns of obese mothers was confined to blacks only. The rate of neonatal deaths increased significantly with rising BMIs of black women (ranging from 50 to 100-percent increments). However, the offspring of obese white mothers, regardless of the severity of maternal obesity, had no greater risk of neonatal death than the newborns of nonobese women.

The black-white disparity in infant mortality persisted even when the researchers adjusted for certain obesity-associated medical complications more prevalent in black women -- high blood pressure, diabetes and preeclampsia.

“This further confirms our findings that high BMI is an independent risk factor for neonatal mortality among blacks but not whites,” Dr. Salihu said.

The researchers also controlled for the amount of prenatal care received since another possible explanation for the black-white disparity may be that obese white women have better access to prenatal care than black women. Their results suggested otherwise, but Dr. Salihu cautions that more study is needed. “We cannot dismiss access to care as a factor because the quantity of prenatal care does not take into account the quality of care received,” he said.

Dr. Salihu suggests that differences in the way fat is distributed in white and black women may play a role in their newborns’ survival. Studies have shown that fat tucked deep inside the waistline may be worse for adults’ health than fat padding the rest of the body. “If we can understand more about the potential association between fat distribution in mothers and likelihood of death in their babies, we might have an avenue for prevention and narrowing the persistent black-white gap in infant mortality,” he said.

The latest study builds on another published last year by Dr. Salihu and colleagues, which reported that the risk for obesity-associated stillbirth was 50 percent greater among blacks than whites.

Dr. Salihu is director of the Center for Research and Evaluation at the Chiles Center for Healthy Mothers and Babies at USF. The study was supported by a young clinical scientist award to Dr. Salihu by the Flight Attendant Medical Research Institute. Researchers from UMDNJ School of Public Health in New Jersey and the University of Alabama in Birmingham were coauthors of the study.

- 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.

During the June 2 Inaugural Gala of the USF Health International Foundation, Dean Donna Petersen, USF College of Public Health, gave credit to Panama researcher Dr. Arlene Calvo for turning the college's sites on Panama. Calvo graduated from the USF College of Public Health with a master's degree in 1996 and her PhD in public health in 2005. Dean Petersen recounted how Calvo had invited college leaders to explore opportunities in her homeland and concluded by saying "Once you come here, you want to come back." Dr. Calvo's specialty is in cervical cancer and is currently researching social cultural aspects to the vaccine commonly referred to as "HPV". Her study in Panama is funded by the National Institutes of Health.

USF President Judy Genshaft with the delegation from the USF College of Nursing. The group of 15 students and two members of the faculty have been in Panama since mid May for their exchange program with the Universidad de Panama's School of Nursing. The group took a break from their community clinical course work in Panama City and rural areas to join Dean Burns and President Genshaft in the City of Knowledge on June 2.

USF Nursing students Shadae Llewelyn, in her senior year, and Caitlin Brock, also in her senior year, delighted the crowd on June 2 by delivering their greeting from the nursing school in Spanish - proudly holding up their cards in Espanol afterwards. Llewelyn, at left, plans to become a nurse anesthetist. Brock, at right, plans to specialize in cardiac care and geriatrics.

USF President Judy Genshaft presented Profesor Jorge Arosemena, Executive Director of the City of Knowledge, with a special edition of USF's commemorative book marking its 50th anniversary.

The June 2 Inaugural included the participation of experts in public health, nursing and medicine from USF, Panamanian universities and other officials. At far left is Dr. Maria Crummett, Dean of USF International Affairs. Also present was Dr. Carlos Callegari, former Dean of Medicine in Venezuela, now Senior Advisor on Ibero-American Programs for USF Health. (Callegari not shown in this photo.)

Among the distinguished guests that traveled from the U.S. for the opening of the USF Health International Foundation was Dr. Sterling Williams, at far right. Dr. Williams is Vice President for education for the American College of Obstetricians & Gynecologists (ACOG).

Dean Patricia Burns, USF College of Nursing, with her counterpart at the Universidad de Panama College of Nursing, Dean Elba De Isaza. Dean Isaza and other invited guests from the University of Panama's nursing school were present for the inauguration of the USF Health International Foundation in Panama.

Ciudad del Saber, which in English means City of Knowledge, is located within view of the Miraflores locks of the Panama Canal. See photos below.

The City of Knowledge sits on the historic site formerly part of the U.S. military controlled zone overlooking the Panama Canal. The historic site contains buildings dating back to the early 1900's. To preserve its history, City of Knowledge restricts renovations to the exterior of buildings. The USF Health International Foundation Offices are located in what used to be military housing for families. The street, Calle Vicente Bonilla, overlooks the Miraflores locks controlling access to and from the Pacific Ocean.

Dean Donna Petersen, at right, celebrates the official opening of USF Health International Foundation with Dr. Arlene Calvo, a foundation officer.

Below: full text of Dean Petersen's speech...

It is entirely fitting that we are here commemorating the opening of a USF Health office in
the Americas, an office dedicated to improving the health of all people in this region
and indeed, around the world. It is fitting that we do this here in Panama, the site
of some of the most profound discoveries in public health in the last 200 years.

General (William) Gorgas had a job to do - a canal needed to be built to provide a much-needed trade route from east to west and back again - but that job could not have been done until he had completed an almost more daunting task- the task of keeping thousands of laborers alive and well, free of diseases, in an environment that was stacked entirely in favor of the diseases and against him and his workers. knowing, perhaps consciously, perhaps unconsciously, that this monumental effort toward economic development was entirely dependent on health, General Gorgas set about to find a way to protect his workers from disease and found he could do so by reducing the route of transmission, reducing exposure to the disease carrier. By accomplishing this task, he was not only able to complete the original job he was sent to do, but he launched a revolution in disease control that has saved millions of lives for more than 100 years. The diseases he was dealing with are no longer commonplace in much of the world, and his discoveries spurred others to engage in their own research in disrupting the cycle of disease transmission, reaping countless benefits still.

We too have a job to do. We know that the world is changing, that the economic powers
are shifting, and while we know now empirically that human development and human health
are inextricably linked, we don't always act on this knowledge and sometimes our well-meaning efforts have unintended consequences. Who would have anticipated that incentives to produce bio-fuels to reduce harmful environmental pollutants would trigger a world food shortage? Who would have thought that additives designed to preserve food and make it easier to transport would contribute to the rising rates of obesity? Who would have believed that drugs designed to cure would ever instead kill? And so our work goes on - anticipating new threats, battling wits with old enemies, cleaning up the remnants of our good intentions. The pursuit of health is like the pursuit of truth, we can get close but we can never quite reach it. We grow wiser but we are never all knowing.

An old proverb says, “He who has health has hope and he who has hope has everything.” We open this office with the greatest of hope and a robust team of professionals eager to give their all to the pursuit of health in the Americas, here, in Panama, at the Ciudad del Saber. Our goals are quite simple really – to provide a nexus for the integration of knowledge through discovery, translated into state of the art learning, tailored toward action for results. We do it here in Panama, not only because our forefathers made this a center of excellence in the sciences of health, but because Panama is already a center for so many things that are good in the Americas. People can get here easily, information can be transmitted to here and from here easily, goods and services can be exchanged here easily, discovery and learning can happen every day. It is the right place for us to be to do the job we need to.

What is that job? The widening of the Panama Canal serves as the perfect metaphor for the continued development of this region of the world into 21st century prosperity. Like General Gorgas before us, we cannot do that job until we master the other task, that of keeping millions of laborers, leaders and luminaries alive and well, free of disease. Ah, but the task is not so simple as it once was. While we still battle infectious diseases – the veneer of civilization is after all quite thin – we now must also match wits with a burgeoning array of chronic diseases, including those born of want and those born of excess. A recent report by P.A.H.O. reveals staggering statistics: in Latin American countries, chronic diseases are now the leading cause of premature mortality in nearly every country, representing 2 out of every 3 deaths. The root causes of this shift from infectious to chronic disease? I wish I could say it was due to our success in controlling infectious diseases, but while this is partially true, the rising tide of chronic disease is powered by a ruthless combination of poor diet, inadequate physical activity, excessive tobacco use, and inequitable access to preventive and primary healthcare.

Add to this other emergent concerns in the areas of mental health, environmental degradation, traffic safety, the built urban environment, emergency preparedness, and disaster management and you have a potent mix that would challenge the best of us.

But it is the best of us we bring to partner with the best of you, here in Panama and across Central and South America in forging a new path toward HEALTH – whether it’s better trained clinical professionals, a better educated public health workforce, the building of the scientific knowledge base or an engaged community working to translate learning and research into real actions, we come here to do the work necessary to finish the job.

We also bring a new model of HEALTH, a model that recognizes that the forces that conspire to steal our health do not work in isolation, they work in combination and so must we. If we wait for a condition to present itself in the hospital, it is too late. If we exhort our patients to engage in healthier behaviors without assuming that they have the means to do so, we have wasted our time and made them feel worse. If our efforts to build infrastructure at the environmental and community levels fail to include the healthcare components, we have done little more than contribute to an already fragmented system.

At USF Health, we believe in a holistic model that recognizes the contributions of biology, behaviors and the socio/economic/political/structural environment to health. Believing in this model leads us to an inevitable conclusion: we must prepare our future physicians, nurses, therapists and public health professionals to work in concert to address these myriad threats to help. Our research must be trans-disciplinary and translatable from the bench to the bedside to the backyard and to the boardroom. The goal of everything we do must be to improve health.

A recent analysis of mortality data in 31 countries of the Americas reveals the breadth and depth of the challenge we face and makes clear why a collaborative partnership among us is so important:
- Ischemic heart disease was the leading cause of death in 13 countries
- Cerebrovascular disease was the leading cause of death in 6 countries
- Diabetes in 3
- Heart failure and heart disease in 2 countries
- Influenza and pneumonia in 2 countries
- Hypertension in 2 countries
- HIV/AIDS, homicide and cardiac arrest were each the leading cause of death in 1 country

Other causes in the top 3 leading causes of death included intestinal infections, conditions of the perinatal period, malignant neoplasms of the trachea, bronchus and lung, cirrhosis of the liver, chronic lower respiratory disease, diseases of the urinary system and land transport accidents.

But mortality statistics only show us the tip of the iceberg. The end result of our attempts to successfully promote health and assure everyone an opportunity to enjoy a full life, full of good health, and free of disease and complaint. A glance of the last three issues of the Pan-American Journal of Public Health gives us a different glimpse into the public health issues of concern across the Americas.

I will mention a few:
- Hypertension in adults in Mexico, HIV risk behaviors of Latin American and Caribbean men
- The costs effectiveness of hepatitis A vaccine in Chile and of routine rotavirus vaccination in Brazil
- Alcohol use and problem behaviors among school aged youth in Puerto Rico
- Implementing a new tobacco law in Chile
- Dietary patterns and access to food among families displaced by armed conflict in Colombia
- Comparing P.C.R. and bacterial culture for salmonella detection in the Muscovy duck in Trinidad and Tobago
- The epidemiologic environment and response to the HIV epidemic in Bolivia
- Rotavirus gastroenteritis with high mortality in Nicaragua
- Making secondary care a primary concern: the rural hospital in Ecuador
- Therapeutic uses of investigational drugs: research extension, compassionate use and expanded access

A list of the public health issues of concern to the ministers of health across the Americas is one last way to illustrate the nature of the opportunity for us to work collectively on the shared goal of improving health and development of all nations and all people in the Americas. It also makes clear the breadth of public health and the huge span of influence that those of us working in health possess to improve economic security, promote quality of life and support peace and continued prosperity in this region.
- HIV/AIDS, tuberculosis and malaria remain concerns but efforts are being strengthened across the Americas to reduce their burden
- Access to good nutrition and food, particularly in the priority countries of Bolivia, Guyana, Haiti, Honduras and Nicaragua, priorities because it is clear that attending to the health of the people in these countries is critical to their economic success
- The further development and dissemination of vaccines like those for HPV, rotavirus and pneumonia
- Continued planning for emergencies, including pandemic flu and for our rapid and effective response to disasters when they are unavoidable
- The eradication of foot & mouth disease among livestock
- The promotion of gender equality and equality in healthcare access, cost and quality
- Access to clean water and sanitation
- Attention to mental health
- And finally, attention to our most vulnerable – pregnant women, children, adolescents, the elderly and indigenous populations.

In identifying these priority issues the ministers of health in the Americas also made clear their collective understanding that it is imperative that they work in solidarity in order to be successful in improving health and development for each in order to do so for all. We come here from USF Health with a similar mission – to work in partnership with you, here in this place, to discover, to learn, to contribute, to share knowledge and ideas toward our mutual goal of assuring everyone the best opportunity for health, prosperity and hope.

We are honored and grateful to you for your warm welcome and we thank you for letting us join you in this humble pursuit.

Dean Donna Petersen, June 2, 2008, Ciudad del Saber, Panama.

The USF Health International Foundation is the only health sciences academic center with a presence on the City of Knowledge campus in Panama City, Panama.

City of Knowledge, Panama -- On June 2, 2008 the USF Health International Foundation officially opened its doors in the country of Panama. Their mission: to increase collaboration in education, research and patient care between USF faculty and students and Panama, as well as other health professionals and organizations throughout the region.

"It is fitting that we do this here in Panama, the site of some of the most profound discoveries in public health in the last 200 years," said Donna Petersen, ScD, dean of the USF College of Public Health.

"General William Gorgas had a job to do. A canal needed to be built to provide a much needed trade route from East to West and back again, but that job could not be done until he had completed an almost more daunting task - keeping thousands of people alive ... in an environment stacked entirely in favor of the diseases,” Dr. Petersen explained. "By accomplishing this task, the general not only completed the original job he was sent to do, he launched a revolution in disease control that has saved millions of lives for more than 100 years."

Overlooking the Panama Canal, the USF Health International Foundation sits on the old Fort Clayton built by the U.S. military to protect the canal´s strategic Miraflores locks which guard canal access to the Pacific Ocean. The fort is known today as "Ciudad del Saber,” the City of Knowledge in English. The historic site sits on approximately 300 acres of land -- the USF Health International Foundation stands as the only health sciences academic center, to date. With neighbors the likes of the International Red Cross, United Nations UNESCO, Organization of American States, Nature Conservancy and Spanish Embassy, the re-purposed fort serves as a hub to a growing number of international organizations.

"This is one of the most beautiful examples of hammering swords into plow shares that I´ve ever seen," said Ann De Baldo, PhD, associate vice president of international programs, USF Health, and associate dean of international programs, USF College of Public Health.

The foundation´s hopes extend beyond students and faculty at USF Health to reach researchers, scientists, educators and health professionals across South and Central America. Among its ambitious goals, leadership development programs for participants in the private and public health sectors, as well as non-profit organizations.

"When we look, together, at establishing best practices, we can make life better for countless numbers of people," said USF President Judy Genshaft. Drawing her inspiration from seven words engraved on the Panama Canal´s museum, Genshaft told Panamanian officials gathered for the inaugural "They were words that made all the difference in their efforts: hope, effort, courage, determination, perseverance, spirit and tenacity. The same applies to USF Health. Together, we can make a difference for the future."

Serving as president of the foundation, Deborah Sutherland, PhD, described the foundation´s official opening after three years of efforts between USF Health, USF and Panamanian officials in the City of Knowledge. "To see this dream come true has been a very exciting time for all of us," Dr. Sutherland said.

The USF Health Associate Vice President and Associate Dean for Continuing Professional Development said talks are already underway to create courses, conferences, and other resources to bring continuing professional education within reach of more health professionals than ever before in Latin and Central America.

"We have met with the University of Panama and with the Universidad Latina de Panama to discuss their needs for short courses," she explained. "Specifically, we´ve spoken about family practice -- family medicine with a focus on emergency medicine. We´ve spoken with representatives from departments of general surgery, orthopedics, and obstetrics and gynecology. Our 'short courses' will initially focus on those specialty areas."

"We're hoping to improve the performance of physicians who practice in Panama by offering courses right here in this country," Dr. Sutherland said. "Presently, the physicians are usually taken outside the country and they are industry-sponsored courses and provide training in industry specific labs there. If we can offer those courses here in Panama, collaborating with Panamanian faculty, it not only helps improve the performance of the practicing physician but we’ll reach more physicians. By reaching more physicians we hope to have an impact on the quality of care that is provided here. Plus it helps them establish countrywide prominence for their universidades and their specialties. They get recognized as the experts in training other Latin American physicians."

For Steven Klasko, MD, MBA, senior vice president of USF Health and dean of the USF College of Medicine, Panama sets the stage for innovations with far reaching implications in medicine, nursing and public health. "We believe the Center of Knowledge can be a base for us to build a true clinical simulation lab in this part of the world," Dr. Klasko said.

With the potential for more simulation labs like the one developed in Tampa, the foundation hopes to work with medical societies and associations to establish universally recognized metrics in simulation to help train physicians in new and emerging treatments and technology, as well as assess technical competencies. "We can use simulation technology to improve the capacities of physicians, nurses and ALL health professionals. This isn´t just something that we do, we´re PASSIONATE about it," Dr. Klasko said.

Joining Dr. Klasko and President Genshaft was Dr. Sterling Williams, vice president for education for the American College of Obstetricians & Gynecologists (ACOG).

USF nursing students, including Jason Merry and Christine Doherty (pictured above), conducted a Community Clinical Experience course in Panama where they visited a maternity ward and observed births. The students were guests of honor at the foundation's inaugural ceremony.

Among the guests of honor at the foundation´s inaugural ceremony, were 15 students from the USF College of Nursing already in Panama for their Community Clinical Experience Course.

For Patricia Burns, PhD, dean of the USF College of Nursing, Panama has served as a classroom for her students since 2006 thanks to its exchange program with the nursing school at the Universidad de Panama.

"The students and faculty who have participated in 2006 and 2007 could not say enough about the quality of the experience they had and the wonderful people they worked with during their stay in Panama!" said Dr. Burns, visibly proud of her students who handily stole the show, so to speak, during the foundation’s inaugural ceremony. Their charm and enthusiasm bolstered the aspirations of academics, scientists and health professionals representing several countries.

Nursing students Shadee Llewelyn and Caitlin Brock received a big round of applause, speaking on behalf of the students, they delivered a message of thank you in Spanish, holding tight to their note cards written in big letters, all in Español.

Taking it all in, the City of Knowledge´s Executive Director declared "USF not only excels in sports -- we follow the Bulls from Panama -- USF excels in its scientific research and its contributions to health in the community and society," Dr. Jorge Arosemena said.

- Story by Lissette Campos, USF Health Communications

Other links:

PHOTO GALLERY - June 2, 2008

Health in the Americas - Speech by Dean Donna Petersen, USF College of Public Health.

Discurso en Español: La Salud de las Américas

Click here for more on Office of International Programs, USF College of Public Health

Click here for more on the City of Knowledge, Panama.

John Adams, PhD, and his team study the complex life cycle of the malaria parasite (on computer screen) to try to find ways to block transmission of the deadly infection.

Tampa, FL (May 28, 2008) -- The protein MAEBL is critical for completing the life cycle of malaria parasites in mosquitoes, allowing the insects to transmit the potentially deadly infection to humans, a University of South Florida study has shown. The research may ultimately help provide a way to better control malaria by blocking development of the malaria parasite in the mosquito.

Researchers with the USF Global Health Infectious Diseases Research team found that the transmembrane protein MAEBL is required for the infective stage of the malaria parasite Plasmodium falciparum to invade the mosquito’s salivary glands. Their findings were published May 28 in the online journal PLoS ONE.

“The mosquito is the messenger of death,” said the study’s principal investigator John Adams, PhD, professor of global health at the USF College of Public Health. “If we could eliminate the parasite from the mosquito, people wouldn’t become infected.”

Plasmodium falciparum causes three-quarters of all malaria cases in Africa, and 95 percent of malaria deaths worldwide. It is transmitted to humans by the bite of an infected mosquito, which injects the worm-like, one-celled malaria parasites from its salivary glands into the person’s bloodstream.

Dr. Adams, center, with his team including, l to r, Steven Maher, Fabian Saenz, PhD, lead author of the PLoS ONE paper, and Sandra Kennedy.

The study was done by genetically modifying the malaria parasites and feeding them in a blood meal to uninfected mosquitoes. Parasites in which MAEBL was deleted were not harbored in the salivary glands of mosquitoes, even though an earlier form of these parasites was observed in the gut of the mosquitoes. The researchers concluded that the transmembrane form of MAEBL is essential for the parasite to enter the mosquito’s salivary glands.

While more studies are needed, lead author Fabian Saenz, PhD, said the finding suggests that silencing the receptor for MAEBL in the mosquito salivary gland might block passage of the parasite through the mosquito, thereby preventing human infection through mosquito bites.

“Our study shows that MAEBL is a weak link in the parasite’s biology,” Dr. Adams said. “This could provide a potential way to block transmission in the mosquito, before the parasite ever has a chance to infect a new person. It is better to prevent the malaria infection from occurring in the first place than having to kill the parasite already inside humans with vaccines or drugs.”

The study was supported by a grant from the National Institute of Allergy and Infectious Diseases. Other study authors were Dr. Bharath Balu, Jonah Smith and Sarita Mendonca.

Microscopic view of an Anopeheles mosquito infected with malaria parasites.

- 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.

Outstanding Staff Awards
Held Monday, May 19
3:30pm Ceremony
USF Health Rotunda
Open to all USF Health
Speaker: Joann Strobbe, Chief Financial Officer, USF Health

Honorees are:
Christine Tam
Jo Ann Pugh
Sandy Miller
Gary Bentley
Eileen Dinerstein
Susan Orellana
Luis Battistini
Phyllis Ridgeway
Daisy Martinez (not shown)

Nine faces that are familiar to many around USF Health belong to nine dedicated employees whose work has earned each of them a 2008 USF Outstanding Staff Award.

Each year, USF employees from across campus are selected to win the award, which recognizes those who demonstrate excellence and performance that supports the overall values and standards of USF. The award includes a plaque and a check for $500.

This year, the employees from USF Health (listed below) included six state employees and two MSSC employees. Daisy Martinez is also listed because, although her department resides on main campus, her work is centered at USF Health.

On May 19, the winners from USF Health will be treated to an open house, hosted by the USF and MSSC departments of human resources. Come by and congratulate them yourself. Here are the details for the event.

A big congratulations to the all of the winners throughout USF. The USF Health employees recognized for a job well done are as follows.

Luis Battistini
Senior computer support specialist
IT, College of Nursing

Nominated by: Denise Passmore
“Luis has brought a level of technical sophistication to the College of Nursing beyond the scope of his job description.”

A quote from a letter of recommendation:
“…I believe Mr. Battistini has the ability, motivation and passion to strengthen our IT Department and inspire his coworkers. He is a sincere, intelligent, and mature individual who, I believe, embodies the qualities that the Outstanding Staff Awards at USF Health represents.”
Jason Beckstead, PhD
Associate professor, Quantitative Methodologist

Gary T. Bentley, PhD
Biological scientist
Department of Internal Medicine, College of Medicine

Nominated by: Dr. Shyam S. Mohapatra
“Dr. Bentley enjoys the challenge of developing new techniques and designing experiments to test a specific hypothesis. Thinking outside the box is one of his strong points and his ideas always have merit and are listened to with interest.”

A quote from a letter of recommendation:
“His enthusiasm for science is obvious and it is apparent that he wants others to experience just how exciting it is. These are exactly the characteristics I believe that USF Health needs in its educators and scientists.”
Richard Lockey, MD
Joy McCann Culverhouse Chair in Allergy and Immunology
Distinguished University Health Professor

Eileen Dinerstein
Executive administrative specialist
Academic and Faculty Affairs, College of Medicine

Nominated by: Dr. John S. Curran
“Ms. Dinerstein demonstrates daily a responsive style of quiet leadership and customer service to faculty, administration and staff in facilitation of academic ranked appointments, the support of the Faculty Appointment Promotion and Tenure process.”

A quote from a letter of recommendation:
“Ms. Dinerstein is always eager to take on new challenges. She has been an integral part of establishing an electronic voting system for the Faculty Council.”
Samuel Saporta, PhD
Professor, Department of Pathology and Cell Biology
President, USF Health Faculty

Daisy Martinez
Custodial worker (assigned to USF Health)
USF Physical Plant

Nominated by: Sonja Jacobs
(From L to R: S. Jacobs, Daisy Martinez & Sheila Burgess, Custodial Supervisor)
“Daisy demonstrates consistent commitment to her department and to the university through being dependable, accountable, and dedicated to continuous improvement.”

A quote from a letter of recommendation:
“She is kind and courteous to everyone she comes in contact with – without imposing on others’ time and work schedules.”
Lissette Campos
Director of Strategic Communications, USF Health

Sandy Miller
Fiscal and business analyst
Dean’s Office, College of Public Health

Nominated by: Jay Evans
“I am truly convinced that Sandy believes in USF and the College of Public Health. We have many staff who like to work at USF and a few that really enjoy it. Finding those who believe in it are special.”

A quote from a letter of recommendation:
“Soon after Sandy assumed responsibility for coordinating the annual budget process, the State announced a significant reduction in funding requiring the Colleges to quickly provide budget reduction plans. Sandy ‘stepped up to the plate’ and spent the extra hours required to provide the data that was so critical to the management decision making process and in responding to the USF Health and the University budget officer deadlines.”
Donna J. Petersen, MHS, ScD
Dean, College of Public Health
Senior Associate Vice President, USF Health

Susan Orellana
Bariatric coordinator
Department of Surgery, College of Medicine

Nominated by: Dr. Michel Murr
“Ms. Orellana has driven herself towards continuous understanding of patient’s disease process and learning about medical issues beyond what is required to perform her duties.”

A quote from a letter of recommendation:
“She has a great sense of purpose and an unwavering loyalty to her patients and our institution. In a time of transformational change at USF, she has kept delivery of clinical and support services of her team seamlessly smooth and efficient.”
Alexander S. Rosemurgy, MD
Professor of Surgery and Medicine
The Vivian Clark Reeves/Joy McCann Culverhouse Endowed Chair for Digestive Disorders and Pancreatic Cancer

Jo Ann Pugh
Administrative assistant
Department of Surgery, College of Medicine

Nominated by: Monica Jackson and Joseph Smith
“Jo Ann’s professionalism in her interactions with others is a true image of excellence in customer service.”

A quote from a letter of recommendation:
“…I can tell you what an outstanding worker and person Jo Ann is. She is tireless, helpful and resourceful. Her calm demeanor affects everyone around her. She anticipates our departmental needs on a variety of levels and frequently solves problems before anybody else becomes aware of them.”
Richard C. Karl, MD
Chair, Department of Surgery
Richard G. Connar Professor of Surgery

Phyllis Ridgeway
Office manager
Student Affairs, College of Medicine

Nominated by: Dr. Steven Specter
“Phyllis is the epitome of collegiality. After 28 plus years at this institution I have not encountered another individual with whom I would prefer to work. Her reliability, excellent work ethic, wonderful interpersonal skills and general caring for her co-workers truly make her a model employee.”

A quote from a letter of recommendation:
“Ms. Ridgeway oversees two of our most important activities for our senior medical students, the residency application process and graduation. For years she has consistently done an exemplary job on behalf of our students. These two activities that are so important to our students and our college are but a simple example of the many tasks she undertakes and completes with excellence on a consistent basis.”
Bryan Bognar, MD
Interim Vice Dean for Educational Affairs, College of Medicine

Christine Tam
Assistant director
Office of Research, USF Health

Nominated by: Dr. Abdul Rao
“She is a devoted team member who has never produced anything that is below the benchmark of highest quality.”

A quote from a letter of recommendation:
“Christine exhibits a very positive professional attitude and has matured into a trusted and highly valued colleague. She is truly an outstanding asset to the division and has played a substantial role in assisting senior staff to accomplish the transformation of the research and graduate education missions in the College of Medicine.”
Dr. Michael Barber
Distinguished University Health Professor of Molecular Medicine
Associate Dena for Graduate and Postdoctoral Affairs
President, USF Faculty Senate
Member, USF Board of Trustees

Story by Sarah Worth, USF Health Communications

Dr. Salihu, Researcher and Associate Professor of Epidemiology in the USF College of Public Health, was interviewed regarding the importance of fetal autopsies, given the limited research that exist to date on the causes of stillbirth.

Stillbirth is defined as the death of a fetus at 20 weeks of gestation or more. Nationwide, experts say in nearly half of all stillbirth cases the cause remains a mystery, leaving couples to grapple with the frightening possibility that this may happen again and again. In the New York Times article, Dr. Hamisu stressed that a fetal autopsy is the single most important step a couple can take in order to know what caused their tragedy to occur and the likelihood it may happen with future pregnancies. "If autopsies were done routinely, we'd know a lot more about the causes of stillbirth and, probably, more about how to prevent them," said Dr. Salihu, an obstetrician-gynecologist and researcher. The reasons for not having the fetal autopsy vary. In many cases, medical insurance companies may not cover the cost of the autopsy - about $1,000 or more. In other cases, the couple fails to authorize it, overwhelmed by grief.

"a leading researcher in the field..."
USF's Dr. Salihu, identified in the national story as "a leading researcher in the field", said physicians should not engage in the common practice of reassuring couples that stillbirth is unlikely to recur, even in cases where the cause of their stillbirth is unknown.

Interviewed at USF Health about the New York Times article, Dr. Salihu had this to say: "My team has been studying stillbirth and stillbirth recurrence for several years now, and as reflected in the New York Times Report, my published work in the field remains a leading reference not only in the United States but the whole world. We and others have delineated certain characteristics that stand out as markers for stillbirth recurrence, and these include: a prior history of stillbirth, a prior history of small for gestational age (SGA) baby, chromosomal or genetic fetal anomalies, and persistent maternal medical conditions which may be genetic or non-genetic. However, in the majority of cases, we do not know the cause (the so-called unexplained stillbirth), and this is perhaps the most frustrating thing for affected couples. This underscores the need for more in-depth research in this relatively neglected area of Infant Health if we are to advance in knowledge and intervention that will be effective in preventing stillbirth or its recurrence."

National prominence in research...
Dr. Salihu recently received a one-year, $254,000 W.K Kellogg Foundation grant to help community coalitions develop evidence-based action plans to reduce high black infant mortality rates in seven Florida counties. He will work with a team of diverse multidisciplinary faculty and staff at the USF College of Public Health, the Lawton and Rhea Chiles Center for Healthy Mothers and Babies and Florida A&M University.

Click here to view New York Times article/ April 1, 2008/ "Seeking Answers to Stop Another Stillbirth" by Jane E. Brody

Story by Lissette Campos & Anne DeLotto Baier, USF Health Communications