By Susan James
Coordinator of International Programs, USF Health

Dr. Paul Farmer, noted physician, medical anthropologist, author and activist, spoke March 28 at the USF Health Auditorium about the mission to bring free health care to people affected by poverty and diseases throughout the world. About 400 attended his University Lecture Series talk, which was preceded by an informal meeting with USF Health students interested in global health.

Dr. Farmer, who specializes in infectious disease, is committed to transforming health care at all levels—the individual, the country, and the world. As an example, he showed an amazing transformation of two patients with HIV/AIDS and tuberculosis, from skeletal to hearty individuals who now advocate for better health in their communities and beyond. This can be done, he pointed out, with a comprehensive approach, using HIV/AIDS-dedicated funds to treat whole communities and patients with the whole range of needs, like treating diseases, women’s health, family planning.

He discussed the need to challenge inequity in the world, giving the example of worldwide HIV prevalence, and contrasting this with physicians per capita. The key to resolving this inequity is the more equitable distribution of health care -- not just physicians, but community health care, medical supplies and medications as well. “You don’t go to medical school to protect the Intellectual Property of pharmaceuticals,” he said.

Working with other organizations and the support of the Clinton Foundation, Dr. Farmer managed to negotiate dramatically reduced prices for HIV/AIDS treatment through his non-profit organization Partners in Health. PIH, which began as a small clinic in the midst of a squatter's settlement in Haiti, has brought basic health care to developing countries, including Rwanda, Peru and Haiti.

In Haiti, where PIH has been active 20 years, Dr. Farmer is working with the public sector to rebuild hospitals and the health system (coordinating with other NGOs in all parishes), building Haitian staff including community health workers, providing improved medical records, building a reliable inventory of pharmaceutical supplies, and promoting broader prevention, public health and poverty reduction strategies. In fact, he believes this approach will help transform other countries’ health and health systems.

Universities can play an important role in this process by emphasizing the service aspect of their mandate, he said. He encouraged USF to expand its community service approach to balance its commitment to health-related teaching and research.

In 1995, former President Bill Clinton proclaimed the first full week of April as National Public Health Week (NPHW). Each year since then the public health community has focused on issues that are important to improving the public’s health. Now, in its 12th year, NPHW is celebrated in every state across the nation. This year’s theme is “Preparedness and Public Health Threats: Addressing the Unique Needs of the Nation’s Vulnerable Populations.”

You are invited to join the College of Public Health at the University of South Florida as we celebrate National Public Health Week April 1-7.

Click here for a listing of the week's events.

COPH graduate Richard Hartman, PhD, has been appointed director of Policy Analysis and Forecasting Services for the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA).

As a member of the Senior Executive Service, Dr. Hartman will provide guidance to the Undersecretary of Health in matters related to health policy changes, monitoring of strategic objectives, and program evaluation for legislatively mandated health care delivery programs within the Department of Veterans Affairs.

As director of Policy Analysis and Forecasting, Dr. Hartman will exercise a major leadership role for planning, developing, executing, and promoting program policy in support of health care.

This appointment, a top policy and analysis position regarding health services within the VA, places Dr. Hartman at the hub of health care finance, delivery and management issues associated with all veteran’s health services.

Dr. Hartman graduated in 2002 from USF’s Occupational Health program in the College of Public Health. His dissertation research served as the basis for key Department of Defense policy decisions about active warfighters’ adverse health exposures and risks. His major professor, Jay Wolfson, DrPH, JD, said that Dr. Hartman has enjoyed a continuous set of promotions within the federal government into positions of increasing national responsibility relating to health services and the health status of service men and women.

“This appointment is of considerable national significance, particularly in light of the growing number of injured and disabled persons returning from theaters of war in the middle east,” Dr. Wolfson said.

“Dr. Hartman brings his strong background in occupational health, and policy analysis to one of the most challenging issues affecting our nation: the care and treatment of injured soldiers, sailors, airmen and marines. We at USF Health should be exceptionally proud of Dr. Hartman’s continued success.”

Deborah Sutherland, PhD, executive director for Continuing Professional Education for USF Health, was appointed vice chair of the Accreditation Review Committee of the Council of Medical Specialty Societies, a parent of the national Accreditation Council for Continuing Medical Education. She is also treasurer for the Society for Academic Continuing Medical Education.

“This is a substantial and prestigious position obtained through the quality of her work and is truly a step to national prominence,” said John Curran, MD, associate vice president for Academic and Faculty Affairs for USF Health and senior associate dean for the USF College of Medicine.

Dr. Maria Pardo, (right) a preceptor for the USF AHEC program, and Amy Bradley, senior dental hygiene student at Manatee Community College, treat a patient.

Tampa, FL (March 27, 2007) – The University of South Florida Area Health Education Center recently reached a milestone in its history of serving medically underserved populations across West Central Florida. The program surpassed 1 million clinical training hours for more than 5,500 students who provided health care at medically underserved and community-based sites since July 2001.

“AHEC has provided great opportunities for me to give back to the community,” said Peter Chang, a third-year USF medical student who recently completed a clinical rotation at the Dover Health Center, one of USF AHEC’s 45 community partners in nine counties. “You’re helping to care for patients who would not receive care otherwise. And they are so grateful for anything you can do to help them.”

The USF College of Medicine administers one of five AHEC programs in Florida. The program coordinates the placement of medical, nursing and other health professions students in underserved communities to expose them to the rewards and challenges of working in rural and inner-city areas – and just maybe influence their career decisions. All third-year USF medical students rotate through an AHEC-sponsored community health site as part of their primary care clerkship. USF nursing and public health students may elect to do field experiences at the community health sites. The AHEC sites bring health disparities to life for students, who see first-hand the needs of uninsured and underinsured patients.

There is perhaps no better ambassador for USF’s AHEC program than Chang, an Indian/Chinese American whose parents emigrated from Trinidad. As a high school student, he attended USF’s Access Day, an AHEC program to introduce disadvantaged and underrepresented students to career opportunities in the health professions. As a USF premed student, he served as a Health Careers Camp counselor for Gulfcoast North AHEC. He also participated in AHEC’s Interdisciplinary Health Scholars Program, as a member of a team of USF health professions students who worked with the Manatee County Health Department to educate children about the link between obesity and cardiovascular disease.

“We have quite a few students, like Peter, with the values and commitment to work in underserved communities – providing the kind of comprehensive primary care that makes a difference in the lives of people in rural and inner-city areas,” said Cynthia Selleck, DSN, director of the USF AHEC Program. “Our hope, of course, is that they will carry that enthusiasm with them once they graduate, and practice as doctors, nurses and public health professionals in the areas where they are most needed.”

At the Dover Health Center, part of the federally-funded Suncoast Community Health Centers, Chang provided physician-supervised care to the center’s clients – including many poor working people who face barriers to care and whose unmet health needs represent a growing cost to the nation. About a third are migrant farmworkers and their families. Growing up in Plant City, Chang said, many of his friends were the children of migrant workers.

Chang helped evaluate and counsel patients whose high blood pressure, high cholesterol and elevated blood sugars put them at high risk for heart disease, stroke and diabetes. The center’s physicians, nurses and other staff work with patients to try to alleviate risk factors before they develop into full-blown chronic diseases and to reduce the severity of costly health conditions like asthma, diabetes and high-risk pregnancies. The combination of poor living conditions, lack of transportation and affordable daycare, language barriers and other complexities can make this a daunting task for health care providers.

“Most of our patients do the best they can given their situation,” said family physician Dana Perrin, MD, who serves as an AHEC preceptor for USF medical students at the Ruskin Health Center. “For example, when we see a patient with diabetes who missed the last few appointments and their blood sugar is out of control, there is usually a reasonable explanation.

“It’s sometimes difficult caring for patients who constantly face the decision of whether to buy medicine or to pay for gas to get to their job or to feed and clothe their families,” said Dr. Perrin, a graduate of the USF College of Medcine. “The message we try to convey to students is the importance of being caring to everyone – to try to understand patients’ limitations, to accept their failings, and to offer support, encouragement and further health education.”

Most federal and state health care dollars support hospitals, medical technology, highly specialized and end-of-life care – with a smaller portion left for primary and preventive care, said USF AHEC’s Dr. Selleck. Meanwhile, many states, including Florida, face a critical shortage of primary care practitioners – particularly in inner-city and remote rural communities.

“The problem of recruiting students to work in rural and inner-city areas must be understood in the broader context of declining student interest in primary care careers, because family physicians, general internists, nurse practitioners and physician assistants provide the majority of care in underserved areas,” Dr. Selleck said. Studies also show students from underrepresented minority groups and low-income backgrounds are more likely to care for uninsured and indigent patients.

In Chang’s case, at least, the AHEC experiences helped affirm his primary care career aspirations. After earning his MD degree, he plans to conduct a residency in either family medicine or general internal medicine and pediatrics and to apply for a spot in the National Health Service Corps. The NHSC program he’s considering offers loan repayment to primary care practitioners in return for a two-year commitment working in a priority health professional shortage area. Chang wants to return to the Dover Health Center or another federally-funded community health center in Florida.

“Now that I’ve gotten a chance to know the patients at the Dover Health Center I want to help them even more when I’m a physician,” he said. “They are good people who struggle to take care of their families. They need more patient advocates.”

- About AHEC -

The University of South Florida AHEC Program within USF Health began in 1993 and covers nine counties on the central west coast of Florida: Citrus, Hernando, Pasco , Pinellas, Hillsborough, Manatee, Sarasota, DeSoto and Charlottes. The mission of the USF AHEC program is to establish community academic partnerships that increase access to quality health care for the medically underserved. Specific objectives include: 1) extending academic resources to medically underserved communities, 2) influencing health professions education, 3) providing information and support for community health professionals and 4) influencing the future health professionals' workplace.

- About USF Health -

USF Health is a partnership of the University of South Florida’s colleges of medicine, nursing, and public health; the schools of basic biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. It is a partnership dedicated to the promise of creating a new model of health and health care. One of the nation's top 63 public research universities as designated by the Carnegie Foundation for the Advancement of Teaching, USF received more than $310 million in research contracts and grants last year. It is ranked by the National Science Foundation as one of the nation's fastest growing universities for federal research and development expenditures.

Tampa, FL (March 22, 2007) -- The University of South Florida Parkinson’s and Movement Disorders Center will participate in a large-scale national clinical trial to determine if the nutritional supplement creatine can slow the progression of Parkinson's disease (PD). While creatine is not an approved therapy for PD or any other condition, it is widely thought to improve exercise performance. The potential benefit of creatine for PD was identified by Parkinson’s researchers through a new rapid method for screening potential compounds. The trial, which begins today, is sponsored by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NIH-NINDS).

The double-blind, placebo-controlled, phase III study is one of the largest PD clinical trials to date. The USF Parkinson’s Disease and Movement Disorders Center is one of 51 medical centers in the United States and Canada that will be recruiting patients as part of an effort to enroll 1720 people with early-stage PD. USF is the only site on the West Coast of Florida.

“This is a landmark trial that will explore whether we can improve long-term outcomes for patients with Parkinson’s disease,” said local principal investigator Robert A. Hauser, MD, professor of neurology and director of the USF Parkinson’s Disease and Movement Disorders Center. “We want to identify therapies that will slow, and perhaps one day stop, the progression of the underlying disease process.”

“This study is an important step. We are pleased to have so many sites participating in this study, which may help us move more quickly toward developing a therapy that could change the course of this devastating disease," says Elias A. Zerhouni, M.D., director of the NIH. "The goal is to improve the quality of life for people with Parkinson's for a longer period of time than possible with existing therapies." Currently no treatment has been shown to slow the progression of PD.

The trial is the first large study in a series of NIH-sponsored clinical trials called NET-PD (NIH Exploratory Trials in Parkinson's Disease). USF has been affiliated with the program since 2002, and Dr. Hauser has served on the steering committee that identifies promising therapies and designs trials to test them since 2005. The NIH has organized this large network of sites to allow researchers to work with PD patients over a long period of time, with a goal of finding effective and lasting treatments. NET-PD builds on a developmental research process ― from laboratory research to pilot studies in a select group of patients to the definitive phase III trial of effectiveness in people with PD.

PD is a degenerative disorder of the brain in which patients develop symptoms such as progressive tremor, slowness of movements, and stiffness of muscles. It affects at least 1 million people in the United States. Although certain drugs, such as levodopa, can reduce the symptoms of PD, there are no proven treatments that can slow the progressive deterioration in function.

Creatine is marketed as a nutritional supplement. Studies have suggested that it can improve the function of mitochondria, which produce energy inside cells. It also may act as an antioxidant that prevents damage from compounds that are harmful to cells in the brain. In a mouse model of PD, creatine is able to prevent loss of the cells that are typically affected.

The study will enroll people who have been diagnosed with PD within the past five years and treated for two years or less with levodopa or other drugs that increase the levels of dopamine in the brain. Many symptoms of PD result from the loss of dopamine, a neurotransmitter that helps to control movement. Half of the participants will receive creatine and half will receive a placebo. Neither participants nor their doctors will know which treatment they receive. The investigators will measure disease progression using standard rating scales that measure quality of life, ability to walk, cognitive function, and ability to carry out other activities of daily living.

Avicena Group, Inc. will provide the creatine and the placebo for the study.

People interested in participating in this study locally can call (813) 844-4455. For additional information, call NINDS at 1-800-352-9424, email info@parkinsontrial.org, or visit http://www.parkinsontrial.org/ to see a list of study sites.

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The NINDS is a component of the NIH within the Department of Health and Human Services and is the nation’s primary supporter of biomedical research on the brain and nervous system.

The National Institutes of Health — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

USF Health is a partnership of the University of South Florida’s colleges of medicine, nursing, and public health; the schools of basic biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. It is a partnership dedicated to the promise of creating a new model of health and health care. One of the nation's top 63 public research universities as designated by the Carnegie Foundation for the Advancement of Teaching, USF received more than $310 million in research contracts and grants last year. For more information visit, www.health.usf.edu.

Co-Medical Director of USF Athletic Training Education Program receives national recognition.

Eric Coris, M.D., Assistant Professor in the Department of Family Medicine, is among a select group of 53 doctors in the nation nominated for the Association of American Medical Colleges (AAMC) 2006 Humanism in Medicine Award. The annual award is a partnership of the AAMC and the Pfizer Medical Humanities Initiative to recognize physicians who serve as caring and compassionate mentors to their students and who practice patient-centered medicine. What made the nomination a special honor to Dr. Coris was that the nomination came from our medical students who chose him above all other faculty members. Dr. Coris received his official AAMC Humanism in Medicine Recognition plaque on March 16th, when representatives from Pfizer’s Medical Humanities Initiative traveled to the USF campus to join the Department of Family Medicine for the recognition ceremony and luncheon.

Dr. Coris' background in family medicine and sports medicine has lead him to key leadership roles at USF Health. In addition to being an Assistant Professor in the medical school's Department of Family Medicine, he is also the Director of the Sports Medicine Division within the Dept. of Family Medicine. Dr. Coris is also the Co-Medical Director of the USF Athletic Training Education Program, which is anchored in the Dept. of Orthopaedics & Sports Medicine and is one of the founding members of the Sports Medicine & Athletic Related Trauma (SMART) Institute at USF Health. He serves as Head Medical Team Physician for the University of South Florida Dept. of Athletics.

Dr. Coris with Dean Klasko holding AAMC Humanism in Medicine plaque.

Dr. Coris personally thanked student leaders who nominated him for the AAMC 2006 Humanism in Medicine Award.

Vice President for USF Health Stephen Klasko, MD, MBA, and the USF Health Diversity Workgroup will unveil two large photo murals 4 to 5 p.m. this Thursday, March 22, in the USF Health breezeway connecting the College of Medicine to Moffitt Cancer Center. All faculty, staff and students are invited to attend. The murals entitled: “Many Faces One Community. USF Health Celebrates Diversity” are part of a multi-year campaign to celebrate and encourage diversity at USF Health.

Currently, USF is ranked 18th in the nation for having an ethnically diverse student body and a diversity friendly campus – ranked by the Princeton Review. The USF Health Diversity Workgroup is helping to increase those rankings with diversity initiatives across the three colleges – including innovative ideas like the Lunch n Learn Series launched earlier this year. (To learn more about the Lunch n Learns, see news story, visit www.health.usf.edu. Category: Creative Educational Models. )

Join us Thursday to learn more about the various projects celebrating diversity at USF Health. Those interested in obtaining poster reproductions of the murals may do so by contacting Seema Rampersad in the Office of Academic Enrichment - (813) 974-4707 or via email srampers@health.usf.edu. The posters can be ordered in two sizes: 24 x 36 or 20 x 32.

See 3.2-ton hyperbaric chamber moved!

Tampa, FL (March 20, 2007) -- USF Health recently became home to one of the country’s leading hyperbaric cell biology laboratories – where researchers are probing the effects of too much oxygen on the central nervous system (CNS).

Jay Dean, PhD, one of the world’s leading experts in hyperbaric neurophysiology, has attracted more than $4 million in external funding since 1997 from the National Institutes of Health, the Department of Defense, the Office of Naval Research (ONR), and private foundations. Dr. Dean, a professor in Molecular Pharmacology and Physiology, came to USF this summer from Wright State University, where he was the Brage Golding Distinguished Professor of Research. His research at USF continues to be funded by the NIH and soon the ONR Undersea Medicine Program, for a total of $1.2 million.

“The hyperbaric biomedical core research laboratory directed by Dr. Dean is second to none in the United States and a great asset for this University and this region,” said Abdul Rao, MD, MA, DPhil, senior associate vice president for USF Health and vice dean for research and graduate affairs at COM. “He joins our Interdisciplinary Signature Program in Neurosciences as a leader in his field, a very entrepreneurial faculty member, and a successful competitor for federal research funding. His team will work with existing faculty to advance our strategic efforts to continue to improve USF’s research capacity.”

Dr. Dean’s laboratory houses five different styles of pressure chambers, which mimic the environmental conditions challenging divers who breathe pure oxygen under high barometric (hyperbaric) pressure. As divers swim deeper the oxygen pressure in their lungs and blood increases along with outside water pressure. Breathing high-pressure oxygen for long periods increases the likelihood of CNS oxygen toxicity, which can ultimately result in grand mal type seizures. Besides affecting deep-sea divers, oxygen toxicity can be a severe complication for patients undergoing hyperbaric oxygen therapy for burns, non-healing wounds, acute gas embolism, certain infections and other conditions.

“Most people think of oxygen as a good thing, but too much oxygen for too long is actually dangerous to the brain, lungs and retina,” Dr. Dean said. “We’ve discovered that the brain cells that control breathing and blood pressure are extremely sensitive to excess oxygen. We’re investigating at the cellular level what makes these cells so sensitive to excess oxygen and why that stimulus is harmful.”

Such research may lead to the development of tools to predict which divers or patients are most vulnerable to CNS oxygen toxicity and prevent the onset of seizures. The researchers are also studying the neurophysiological effects of other gases such as nitrogen and carbon dioxide under varying pressures on brain cell function.

The researchers’ findings have implications for not only hyperbaric and diving medicine, but also for understanding how oxidative stress, in general, affects the neural control of respiration and cardiovascular function. Oxidative stress—an excess of renegade oxygen generated molecules called free radicals—can damage the body and induce neuron injury and death. Understanding the effects of oxidative stress on neurons regulating breathing has implications for understanding such disorders as sleep apnea and Sudden Infant Death Syndrome (SIDS).

Using fine-tipped electrodes inserted into thin slices of rat brain, Dr. Dean and his colleagues measure electrical impulses produced by single brain cells during their exposure to increasing levels of hyperbaric oxygen and observe how the brain cell functions change. In the past, the basic design of hyperbaric chambers hindered effective electrical recordings of brain cell activity because researchers had trouble quickly accessing the electrodes without disrupting carefully controlled gas pressures and temperatures inside the sealed chambers. But over the years Dr. Dean has worked with manufacturers on redesigns to improve recording stability.

“The design of our chambers lets us open or close them in about 20 seconds, so that the electrodes can be changed or manipulated as needed,” Dr. Dean said. “We can control physical stability inside the chamber and limit vibrations, which previously disrupted brain cell recordings.”

Dr. Dean is now adapting atomic force microscopy (AFM) to his most recently acquired 3.25 ton hyperbaric chamber. The use of hyperbaric AFM will enable Dean and his colleague, Dr. Dominic D’Agostino, to investigate the effects of hyperbaric gases on the physical properties of the cell membrane and other cellular structures.

Dr. Dean is writing a book on the physiology of high altitude flight during World War II, tentatively titled Aviator versus the Environment: Learning to Protect the Health of the High Altitude Aviator During WWII. His impressive collection of historical documents, books, films and other artifacts details the history of hypobaric and hyperbaric medicine and high-altitude flight. Dr. Dean became interested in the history of aviation medicine while working on his PhD in physiology at The Ohio State University. His interest was further stimulated by 15 years of living and working near Ohio’s Wright Patterson Air Force Base, which served as a military epicenter for the aviation medicine during WWII.

At 6,500 pounds, Dr. Dean's newest hyperbaric chamber, shown here being transported to his lab, is the largest of five. It is designed to be used with an atomic force microscope and patch clamping apparatus to help researchers determine how gases and anesthetics with different lipid solubility affect brain cell function. The design, fabrication and installation of the chamber was supported by the Department of Defense and Office of Naval Research, Undersea Medicine Program.

- USF Health -

USF Health is a partnership of the University of South Florida’s colleges of medicine, nursing, and public health; the schools of basic biomedical sciences and physical therapy & rehabilitation sciences; and the USF Physicians Group. It is a partnership dedicated to the promise of creating a new model of health and health care. One of the nation's top 63 public research universities as designated by the Carnegie Foundation for the Advancement of Teaching, USF received more than $310 million in research contracts and grants last year. It is ranked by the National Science Foundation as one of the nation's fastest growing universities for federal research and development expenditures.