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

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

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

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

Newbrief by USF Pediatrics.

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

Background: USF Pediatrics' Care Mobile Program

USF neuroscientist Svitlana Garbuzova-Davis and colleagues showed that a moderate dose of HUBC cells proved most effective.

Tampa, FL (June 25, 2008) -- A study at the University of South Florida has shown that transplants of mononuclear human umbilical cord blood (MNChUCB) cells may help patients suffering from Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s disease. A disease in which the motor neurons in the spinal cord and brain degenerate, ALS leaves its victims with progressive muscle weakness, paralysis and, finally, respiratory failure three to five years after diagnosis.

In this study, USF researchers transplanted human umbilical cord blood (hUCB) cells into mouse models with ALS. Cells were transplanted at three different dose strength levels -- low, moderate and high -- to determine the degree to which dose levels of transplanted cells might delay disease symptom progression and increase lifespan.

In results published today online at PloS ONE (Public Library of Science), researchers determined that the moderate-strength dose of HUCB cells was most effective in increasing lifespan and reducing disease progression.

“Our results demonstrate that treatment for ALS with an appropriate dose of MNC hUBC cells may provide a neuroprotective effect for motor neurons through active involvement of these cells in modulating the host immune inflammatory system response,” said the study's lead author Svitlana Garbuzova-Davis, PhD, DSc, of the Center of Excellence for Aging and Brain Repair at USF.

According to the research team, modulating immune and inflammatory effectors with HUCB cells could have a protective effect on dying motor neurons. The team had previously shown that hUBC cell transplants reduced inflammation and provided neuroprotection in models of stroke and Alzheimer’s disease.

“This pre-clinical study indicates that MNC hUBC cells may protect motor neurons by inhibiting an immune inflammatory response by decreasing pro-inflammatory cytokines, signaling proteins in the brain and spinal cord that play a role in immune response,” Garbuzova-Davis and colleagues wrote. “Proinflammatory cytokines may be indirect mediators for glial cells’ contribution to motoneuron death and the decrease in these cytokines might be due to a reduction of activated microglia, the cells that form active immune defense in the central nervous system.”

The research team noted, however, that the mechanism underlying the beneficial effect of hUBC cells for repairing diseased motor neurons in ALS still needs more clarification.

Suggesting that ‘more is not better,’ it was the moderate, not the high, dose of hUBC cells that proved most effective. Researchers speculated that the high dose may have been less effective because it induced an immunological conflict within the mouse model.

“Future studies should look at multiple injections of smaller doses over time, in order to help translate this research to clinical trials,” according to co-author Paul R. Sanberg, PhD, DSc, director of the center.

“Developing an effective treatment for ALS is complicated by the diffuse nature of motor neuron death,” concluded Garbuzova-Davis. “However, cell therapy may offer a promising new treatment.”

The study was supported by a National Institutes of Health STTR Phase 1 grant. The other co-authors were Cyndy Davis Sanberg and Nicole Kuzmin-Nichols from Saneron CCELL Therapeutics, Inc., and Alison E. Willing, Carmelina Gemma, Paula C. Bickford, Christina Miller, and Robert Rossi from USF.

- 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.

News release by Randy Fillmore

View WUSF-TV University Beat segment...

Dr. Alexander Rosemurgy, founder and director of Division of General Surgery's Academic Summer Program, and Dr. Sharona Ross, one of the surgeon mentors, with some members of this summer's class -- the largest ever.

Each summer they arrive with primarily one common goal - a career in medicine. By the time the summer ends they know if that's what they really want.

"When they come into our program most students don't know a pneumothorax from a pneumovax", said Alexander Rosemurgy, MD, professor of surgery for USF Health and surgical director of the Digestive Disorders Center at Tampa General Hospital. By graduation, he adds, they not only know what a pneumothorax is, they likely have observed the insertion of a tube thorocostomy to treat the condition.

Each Friday at 7:30 a.m., students and mentors meet in the TGH/USF Digestive Diseases Office conference room to critique research projects.

Largest Class Ever
Over the last five years, 48 participants have rotated through the Division of General Surgery's Academic Summer Program, which educates and mentors students interested in careers in medicine. The program, founded and directed by Dr. Rosemurgy since the late 1980s, provides a wide range of supervised research and clinical experiences to undergraduates, recent baccalaureate graduates, and beginning medical students. This summer the program is hosting its largest class ever -- 25 students -- overseen by Dr. Rosemurgy; Dr. Sharona Ross, a GI endoscopy and minimally invasive surgeon (MIS) at TGH/USF; and Dr. Michael Albrink, an MIS surgeon in the Division of General Surgery. They come from various universities across the country, including USF, Auburn, Columbia, Cornell, Emory, Purdue, the University of Michigan, University of Florida and Florida State University.

During the intensive three-month program, students learn medical terminology; attend lectures and conferences; produce videos of surgical procedures; collect and manage data; learn statistical analysis; prepare, edit and submit abstracts and papers; present their research results; and shadow USF surgeons in the operating room, on rounds, and in outpatient clinics at Tampa General Hospital. Putting in 10 to 12-hour days is not unusual.

Paul Harold shows off a video depicting a single-incision laparoscopic removal of the gall bladder. Students have the opportunity to produce surgical videos used for instruction.

While many academic medical centers across the country may have similar programs, Dr. Rosemurgy said, what helps distinguish the TGH/USF program is the volume of student contributions to abstracts and papers presented at national and regional surgical conferences and published in high-impact medical journals like the Annals of Surgery, Journal of the American College of Surgeons, Gastroenterology, and Surgical Endoscopy, to name a few. Within the last five years, participants have co-authored 112 national presentations, 46 published abstracts, 57 peer-reviewed published manuscripts, and more than 20 videos presented at national meetings.

"This program is highly productive," Dr. Rosemurgy said. "Students can't do everything that needs to be done to research and write a paper without learning something in the process. Productivity is used as a surrogate marker of learning and mentoring."

L to R: Andrea Marcadis, Paul Toomey, Kenneth Luberice and Connor Morton in the research room.

Medicine’s Next Thought Leaders
The continuing research projects students are tackling this summer include investigating whether a more aggressive approach to removing pancreatic cancer based on tumor margin information impacts patient outcome, evaluating how to best distinguish between benign and cancerous pancreatic tumors before undertaking resection, and determining whether patterns of reflux affect symptoms before and after laparoscopic operations to treat gastroesophageal reflux disease (GERD).

The rigorous studies require creativity, critical thinking, and plenty of painstaking work to complete and meet the criteria worthy of being submitted and accepted to peer-reviewed journals or for national presentation, Dr. Rosemurgy said. "Our goal is to influence the career choices of bright young students interested in medicine, medical research, or related fields, and to encourage them to become thought leaders who will improve health care research and delivery in the years to come."

______________________________________________

I'm so proud of these kids. They're going to do great things!"
- Dr. Alexander Rosemurgy, program director
______________________________________________

A recent study by the Division of General Surgery indicates the program's efforts are paying off. A blinded survey of the 48 participants over the last five years found that their scholarly skills improved after the summer research program. The overwhelming majority (92 percent) of the students developed more favorable opinions of careers in medicine, and only 8 percent reported the experience deterred them from a career in medicine because of lifestyle or studious demands. In addition, more than three-quarters of students felt the program promoted a career in surgery, and 82 percent reported it elevated their goals to become leaders in American medicine.

Paul Toomey, starting a USF surgery residency in July, looks over some research data with Marcadis. A graduate of the summer program, Toomey returned this year to help mentor new students.

Student Returns As Mentor
Program veteran Desiree Villadolid, MPH, began in summer 2001 as a USF undergraduate in biomedical sciences. She has worked with Dr. Rosemurgy to develop, refine, and maintain databases tracking the characteristics, treatments, and outcomes of hundreds of patients with achalasia (a rare disorder of the esophagus), GERD, portal hypertension, bile duct cancer, and pancreatic cancer. She continued the extracurricular summer research full-time while pursing a graduate degree in epidemiology and biostatistics at the USF College of Public Health, returning to mentor other program participants. This will be Villadolid's last summer as a mentor -- helping students to collect, input, and make sense out of complex patient data -- before heading off to the University of Miami to begin medical school. She plans to be a surgeon.

"I know there aren't many woman surgeons, but Dr. Sharona Ross has been a tremendous role model for me. She's married with four children and still has a career she loves in surgery," said Villadolid, who already has more than 20 published papers, 19 abstracts and five presentations to her name as well as a production credit on a surgical video used to teach residents.

The Gee-Whiz Factor
Villadolid helped Dr. Rosemurgy cull the 100 ideas for this summer's research projects that the division's faculty and residents began identifying in the spring - narrowing the topics down to the most fascinating and clinically-relevant hypotheses for students to test.

_____________________________________________

"It has to pass the gee-whiz factor. That means, if we study this, will the findings likely add something we didn't already know to the body of knowledge in medicine?"
- Desiree Villadolid, student mentor
_____________________________________________

Paul Toomey, a 2008 graduate of the USF College of Medicine who will begin a general surgery residency at USF in July, is helping Villadolid mentor students this summer. Toomey participated in the summer academic program between his first and second year of medical school. He worked on a project with Dr. Rosemurgy, Dr. Ross, Villadolid and others evaluating whether preoperative therapy for achalasia (botulinum toxin injection to relax the sphincter muscle, balloon dilation of the sphincter, or both) impacts the difficulty or outcome of laparoscopic Heller myotomy. This minimally-invasive surgery, which allows food and liquids to pass into the stomach, is intended to improve the swallowing difficulties of patients with achalasia. The findings were presented at the 2006 International Congress and Endo Expo Society of Laparoendoscopic Surgeons Annual Meeting. "We found preoperative therapy did not make the operation more difficult or adversely affect its outcome," he said.

With a background in biomedical engineering (his bachelor's degree is from Duke University), Toomey wants to apply research to help solve clinical problems. "The summer research experience definitely helped solidify my decision to become an academic surgeon," he said.

Above: Dr. Rosemurgy reviews a case with students Demetri Arnaotakis, Andrea Marcadis and Kenneth Luberice, l to r, shadowing him at the General Surgery Clinic. Below: The students listen as Dr. Rosemurgy consults with the patient.

First-Hand Look at Surgery
Andrea Marcadis, 19, and Kenneth Luberice, 20, are among the undergraduate students in the summer program's 2008 Class.

Marcadis, who will be a sophomore at Emory University in the fall, plans to major in chemistry and apply to medical school. "This has made me think more about specializing in surgery," said Marcadis, whose father is a plastic surgeon. "I like that surgeons can go in and directly fix something that's wrong. For instance, they can take a patient into the OR and take out the cancer."

Luberice will be a USF senior this fall and is majoring in biomedical sciences. A linebacker for the USF Bulls football team, he jumped at the chance to get a head start on his medical education when a counselor from USF Academic Enrichment Center told him about the General Surgery summer program. Luberice, who underwent a shoulder operation to repair a high school football injury, recently observed his first operation -- Dr. Rosemurgy undertaking a laparoscopic Nissen fundoplication, a surgical procedure to prevent the back flow of stomach acid into the esophagus.

"I was surprised at how many people were in the operating room. It was really amazing to see how everyone worked together as a team," Luberice said.

Dr. Ross leads students in a discussion of their ongoing surgical research projects.

Dr Ross, one of the surgeon mentors, said Dr. Rosemurgy has been and remains a very influential person in the development of her surgical career and in the lives of many students he has mentored.

__________________________________________________

"Very rarely do students have the opportunity to test the waters of a profession the way this research program affords."
- Dr. Sharona Ross, academic surgeon-mentor
__________________________________________________

“A career in academic medicine, and surgery more specifically, is a life commitment to the disciplines of dedicated patient care and unending scholarly pursuit," she said. "I look forward to the opportunity to share Dr. Rosemurgy’s lessons together with my experiences as a woman surgeon and mother of four children with the annual research program participants.”

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

- Grant from American Academy of Dermatology will help build shade structure -

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

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

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

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

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

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

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

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

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

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

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

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

- Story by Anne DeLotto Baier, USF Health Communications

Dr. Anne Curtis, USF chief of cardiology, reviews an EKG.

USF Chief of Cardiology Anne Curtis, MD, weighs in on the setbacks in rhythm control for atrial fibrillation in the June 19 issue of the New England Journal of Medicine.

Dr. Curtis and colleague Michael Cain, MD, Dean of the School of Medicine and Biomedical Sciences, University of Buffalo, comment on the results of the international multicenter Atrial Fibrillation and Congestive Heart Failure trial comparing a rhythm-control strategy with a rate-control strategy in patients with congestive heart failure and a history of atrial fibrillation, a common heart rhythm disorder. The first therapeutic strategy aims at restoring and maintaining sinus (normal) heart rhythm with antiarrhythmic drugs and electrical cardioversion when appropriate. The second focuses on using drugs to optimize the ventricular heart rate.

The study results, reported by Roy et. al in the same NEJM issue as Drs. Curtis and Cain’s editorial, indicated no significant difference in cardiovascular death rates in the rhythm-control group and the rate-control group. Furthermore, deaths from any cause and worsening heart failure were not significantly different in the two groups.

“Studies thus far haven’t been able to demonstrate that rhythm control is superior to rate control,” Dr. Curtis said. “Cardiologists use antiarrhythmic drugs to try to turn an abnormal rhythm into a normal rhythm, yet these drugs don’t work as well as we’d like and they can have toxic side effects.”

The NEJM editorial submission preceded the recent release of ATHENA trial results indicating that the investigational drug dronedarone, envisioned as a safer alternative for maintaining sinus rhythm, seemed to cut the risk of cardiovascular hospitalizations or death. In addition, clinical trials planned and in progress are testing the effectiveness of ablation, a procedure in which the source of a patient’s irregular heartbeat is mapped, localized and destroyed (ablated) by radiofrequency energy or freezing.

“The optimal treatment for atrial fibrillation is still a moving target. The best advice we can give to patients at this point is that the treatment strategy will ultimately depend upon the characteristics of the arrhythmia, the patient’s symptoms, and the presence or absence of structural heart disease,” Dr. Curtis said. Whether medical management or a catheter ablation procedure is the best course of action should be discussed with the patient’s physician. When patients have symptoms that are difficult to manage, referral to an electrophysiologist (a cardiologist who specializes in heart rhythm disorders) may be appropriate, she added.

Dr. Curtis is a past president of the Heart Rhythm Society.

Atrial fibrillation is a major cause of hospitalization and death, affecting about 2.5 million people in the United States. Without appropriate management, the disorder can lead to serious complications, such as stroke and congestive heart failure.

- Story by Anne DeLotto Baier, USF Health Communications

- USF becomes the first Florida university to earn the AAHRPP distinction -

Tampa, FL (June 19, 2008) -- The Association for the Accreditation of Human Research Protection Programs Inc, (AAHRPP) has granted full accreditation to the University of South Florida -- the only university in Florida to achieve this milestone.

The AAHRPP is a non-profit organization that works with universities, hospitals, independent review boards, research institute and contract research organizations to raise the level of protection of research study participants and to promote ethically sound clinical research. AAHRPP accreditation is considered the “gold standard” for protection of human subjects involved in clinical research, demonstrating that its member institutions meet safeguards that surpass the threshold of state and federal requirements.

Currently, seeking accreditation by AAHRPP is voluntary. Since AAHRPP was established in 2001, only 129 organizations representing more than 550 entities have earned the credential. The latest accreditation of 22 new members, including USF, was nationally announced on June 19 in Washington, DC.

“USF sought AAHRPP accreditation because it is the right thing to do,” said USF President Judy Genshaft. “Many people volunteer their valuable time to be part of studies that ultimately could improve the health and quality of life of future generations. Their trust and confidence are very important to us, so we’ve taken the lead in putting their safety first and voluntarily embracing standards that are higher than those required by law.”

“USF now joins an elite group of academic institutions in the United States that have successfully obtained full AAHRPP accreditation, including Harvard, Johns Hopkins, University of California San Francisco, the University of Pittsburgh, University of Pennsylvania and Stanford, to name a few,” said Abdul Rao, MD, MA, DPhil, Senior Associate Vice President, USF Health and Medical Director, Tampa General Hospital. “It is a testament to the quality of our Human Research Protections Program that serves not only the patients and investigators at USF/USF Health but also at Tampa General Hospital, Moffitt Cancer Center and Research Institute, James Haley VA Hospital, Shriners Hospital and our other affiliate sites.” Dr. Rao oversees this program at USF.

“This monumental achievement is the culmination of much hard work by our university research community, which met all the challenges of a long and rigorous accreditation process,” said Caroline Fultz-Carver, PhD, MHA, interim director of the USF Division of Research Integrity and Compliance. “We have unequivocally demonstrated -- and the AAHRPP has independently confirmed – our unwavering dedication to the protection of human research participants and our belief in ensuring the integrity and excellence of research.”

USF has approximately 3,600 active research studies involving thousands of human participants. Cutting-edge research is conducted in the areas of medicine, nursing, public health, biomedical, and social and behavioral sciences.

Every project involving human subjects is monitored by one of six Institutional Review Boards (IRBs) established at USF and supported by the voluntary time and effort of faculty, staff, students and community members.

Applicants for AAHRPP accreditation must demonstrate that they have built extensive safeguards into every level of their research operation and adhere to the highest standards of translational and clinical research. AAHRPP’s standards exceed federal regulations by requiring organizations to address conflict of interest, provide community outreach and education, and apply the same stringent protections to all research involving human participants. Under federal regulations, such protections are mandated only for federally-sponsored or regulated studies.

Since last summer, staff of USF’s Human Research Protections Program and its IRBs spent countless hours establishing five major accreditation domains covering organization, research review, investigators, research sponsors and participant outreach.

This painstaking work included ensuring a formal process to evaluate and continually improve research involving human participants; educating researchers and staff about their ethical responsibilities; addressing requirements of the USF’s Human Subject Research Protection Program with sponsors that fund the research studies; providing mechanisms to respond directly to concerns of study participants; to ensure the independence of ethical review and oversight; and to determine and improve the competence of investigators.

Members of USF’s AAHRPP Accreditation Task Force, which was led by Dr. Rao, included John Arnaldi, PhD, coordinator of education; Barry Bercu, MD, chair of Biomedical IRBs; Norma Epley, assistant director for IRB Administration; Dr. Fultz-Carver, Camille McWhirter, JD, director of Research Compliance, USF Health; Lesley Spencer, document control; Paul Stiles, PhD, chair of Social & Behavioral Sciences IRB; Vinita Witanachchi, JD, assistant director, HIPAA and Conflict of Interest, Research Integrity and Compliance; and Henry Zych, IRB coordinator.

AAHRPP accreditation is valid for three years, and accredited organizations submit yearly reports on the status of their human research protection programs. The federal Office of Human Research Protections, Food and Drug Administration, and the Association of American Medical Colleges, among other organizations, support this accreditation process.

For more information about AAHRPP, visit www.aahrpp.org.

- USF -

The University of South Florida is among the nation's top 63 public research universities and one of 39 community engaged public universities as designated by the Carnegie Foundation for the Advancement of Teaching. It is one of Florida's top three research universities. USF was awarded more than $300 million in research contracts and grants last year. The University offers 219 degree programs at the undergraduate, graduate, specialist and doctoral levels, including the doctor of medicine. The University has a $1.8 billion annual budget, an annual economic impact of $3.2 billion, and serves more than 45,000 students on campuses in Tampa, St. Petersburg, Sarasota-Manatee and Lakeland. USF is a member of the Big East Athletic Conference.

Panama Sets Stage for ‘Aha!’ Moment on Public Health

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