USF Health Service Corps student volunteers gain invaluable interdisciplinary training while serving communities in need

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

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

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

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

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

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

USF medical students conduct blood sugar screenings.

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

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

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

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

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

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

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

By The Numbers*

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

$11,245 Funds raised for nonprofit health organizations

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

*2007-2008 USF Health Service Corps Facts

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

USF Health prepares next generation of clinical and translational investigators

Dr. Jamie Winderbaum Fernandez, a psychiatrist, will investigate cellular mechanisms of Alzheimer’s disease with the aim of developing treatments to help rid the brain of memory-robbing toxins. Dr. Celso Silva, an obstetrician-gynecologist, wants to know whether a non-invasive test to measure the length of chromosomes tips could predict the success of in vitro fertilization among women experiencing infertility. Dr. Xiaohong Zhang, a molecular biologist, hopes to pinpoint an enzyme inhibitor that could help ovarian cancer patients overcome resistance to chemotherapy.

While their scholarly interests and backgrounds are diverse, the three newest members of USF Health’s K-30 Scholars in Patient-Oriented Research Program (K30 Scholars Program) are all excited about the prospect of learning new skills to help advance their research careers.

K30 Scholarship Boost from Dean

They are recipients of the first K30 Program Dean’s Faculty Scholar Awards in Clinical and Translational Research to support junior faculty members participating in the two-year research career development program. Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, and Patricia Emmanuel, MD, Associate Dean for Clinical Research, have designated $60,000 for each of the three scholars to help subsidize departmental salaries to the faculty members while they dedicate three-quarters of their time to research.

“We are committed to growing our own talented clinical and translational investigators -- faculty who are passionate about tackling intellectual challenges and creating new knowledge that will lead to better products and therapies for patients,” said Ken Zuckerman, MD, co-director of the K30 Scholars Program for USF Health. “This program is considered so crucial to the future of USF Health research efforts that Drs. Klasko, (Phil) Marty and Emmanuel have extended the commitment to provide similar salary support for up to four faculty members a year, on a competitive basis.”

Growing Our Own

The K30 Scholars Program began at USF Health in 2005 with the support of a National Institutes of Health Clinical Research Curriculum Award. It is preparing the next generation of clinical researchers by arming them with critical skills needed to accelerate medical discoveries to improve health. When the new class begins this July, 22 junior faculty and senior subspecialty fellows will have been enrolled in the highly competitive program, which leads to a Master’s of Science in Medical Sciences degree with a concentration in clinical and translational research. Drs. Fernandez, Silva and Zhang will join a diverse contingent of scholars from interdisciplinary oncology, obstetrics and gynecology, pathology, pediatrics, physical therapy, psychiatry, nursing and surgery.

The K30 scholars complete a rigorous curriculum that includes courses in ethical and regulatory aspects of clinical research, cultural and diversity issues, epidemiology, biostatistics, and science communication. They learn the nuts and bolts of how to do competitive research, something not typically taught during medical school or residency training. The scholars prepare and critique grant applications and design, conduct and analyze clinical trials and translational studies. They hear from faculty at different stages of their academic research careers and learn practical strategies to help them map out successful careers in patient-oriented research.

“One of the things we did not anticipate and of which we are most proud,” Dr. Zuckerman said, “is how easily these scholars from such diverse areas of interest and expertise have interacted and contributed to each others’ research and career development – essential skills for becoming critical members of interdisciplinary research teams that will drive scientific discovery in the 21st century.”

Jumpstarting Research Careers

K30 Scholars Program graduate Brian Giunta, MD, MS

The intense training pays off. Brian Giunta, MD, MS, a graduate of the inaugural class of K30 scholars, was awarded a prestigious four-year $629,500 Mentored Clinical Scientist Development Award from NIH even before completing the program last year. Dr. Giunta continues to work with his mentor USF neuroscientist Jun Tan, MD, PhD, and colleagues out of the neuroimmunology laboratories in the Department of Psychiatry. Using a mouse-model for HIV-induced Alzheimer’s disease, they are investigating whether flavonoids -- natural substances found in citrus, dark berries, green tea and red wine -- may protect the brain against dementia. Dr. Giunta has been promoted from instructor to assistant professor and is working toward a PhD degree. The talented young translational scientist has recently published two peer-reviewed papers directly related to his grant as lead author, and others are in the pipeline.

“I never would have been able to jumpstart my research career without having a portion of my time blocked out to participate in the K30 Scholars Program,” Dr. Giunta said.

Information about the three inaugural K30 Scholar Program scholarship recipients follows:

Jamie Winderbaum Fernandez, MD

Dr. Fernandez is an instructor in the Department of Psychiatry and Behavioral Medicine and attending physician at Tampa General Hospital. While a medical student at Cornell University, she won a spot in the highly selective Howard Hughes Medical Institute-National Institutes of Health Research Scholars (Cloister) Program. She spent two years at the NIH campus in Bethesda, MD, conducting mentored research in lipid signaling and defects in cellular trafficking associated with Lowe syndrome, a rare genetic disorder that causes physical and mental disabilities and medical problems.

Dr. Fernandez completed a residency in adult psychiatry at Stanford University before joining USF this year. She is interested in geriatric psychiatry and neurodegenerative diseases like Alzheimer’s. For her K30 research project she plans to examine the role of amyloid precursor protein (APP) in the accumulation and clearance of Alzheimer’s plaques in the brain.

“There seems to be a huge push now for neuroscience research. It’s an area of medicine that for years remained largely unstudied,” Dr. Fernandez said. “With recent advances in laboratory techniques, animal models, vaccine-mediated approaches and neuroimaging, there is hope that we’ll be able to broaden our understanding of the brain and brain disease.”

“For Alzheimer’s disease, studies are suggesting that catching the disease early, even before symptoms are apparent, will be important for effective treatment… otherwise, it’s like trying to treat diabetes after medical complications have already occurred.”

Dr. Fernandez’s K30 Scholar mentor will be Jun Tan, MD, PhD, the Silver Endowed Chair in Developmental Neurobiology at USF Health.

Celso Silva, MD

Dr. Silva is an assistant professor in the Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility. He earned his MD degree in Brazil and completed a residency in obstetrics and gynecology at Brown University and a fellowship in reproductive endocrinology and infertility at the University of Pennsylvania. His postgraduate research in reproductive medicine was supported by the National Institutes of Health (NIH) Research Training Program.

From the laboratory to the clinic, Dr. Silva focuses on the issue of aging and fertility – specifically the ability of stem cells to generate the oocytes (eggs) that decrease dramatically in numbers and/or quality among older women. For his K30 research project, he plans to study the effectiveness of several ways --including testing blood and the fluid inside ovarian follicles – to measure the protective tips on the ends of chromosomes known as telomeres. Shortened telomeres have been implicated in age-related decline in the developmental potential of eggs. Working with the USF IVF research team, he hopes to validate a diagnostic test to measure telomeres, and determine whether telomere length actually predicts which women are more likely to conceive an IVF baby before patients commit to the demanding treatment regimen.

The best translational research is a two-way street, not just a bench-to-bedside enterprise, Dr. Silva said. “It goes beyond applying knowledge gained from basic science studies to the care of patients. Before you can develop viable diagnostic tools and treatments, you need to bring observations and insights from day-to-day clinical experiences back to the laboratory to re-evaluate and enhance your original findings,” he said.

“This approach requires a multidisciplinary team where there is constant dialogue between clinicians and basic scientists.”

Dr. Silva appreciates having more time to devote to research. “For clinicians in academic medicine and teaching hospitals, the pressures to see more patients and educate students and residents can be tremendous,” he said. “To promote the development of translational research you really need to be somewhat shielded from other activities… The K30 program accommodates that.”

Dr. Silva’s K-30 mentor will be David Keefe, MD, chair of Obstetrics and Gynecology.

Xiaohong (Mary) Zhang, PhD

Dr. Zhang is an assistant professor in the Department of Pathology and Cell Biology. She holds a PhD in molecular biology from the University of Texas, M.D. Anderson Cancer Center, and completed a postdoctoral fellowship in molecular oncology at Moffitt Cancer Center.

Dr. Zhang is looking forward to interacting with other K30 scholars who bring different perspectives to the table.

“Good research requires thinking outside the box, and that means it’s important to communicate and collaborate with researchers outside your field,” she said. “I strongly believe the K30 Scholars Program will be a great opportunity to enhance my career as an ovarian cancer researcher. I want to bridge my basic science knowledge about histone deacetylases to help clinicians restore chemotherapy sensitivity in patients with ovarian cancer.”

Dr. Zhang’s K-30 mentors will be Santo Nicosia, MD, chair of Pathology and Cell Biology, and Jonathan Lancaster, MD, PhD, associate professor of Oncologic Sciences and director of the Center for Women’s Oncology at Moffitt Cancer Center.

For more information on the K30 Scholars in Patient Oriented Research Program, contact Sandy Anderson at sanders2@health.usf.edu, or visit http://health.usf.edu/research/k30/

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

Medical students Kiran Kondaveeti, Ani Chawdry and Christian Robles lead a presentation at Thursday's Diversity Learning Lunch.

Bringing more minorities into the health care professions will do more than just make those professions more diverse, a group of USF medical students said at a campus forum Thursday.

It could save lives.

When doctors and patients can’t understand each other, whether because of language or cultural barriers, the patients suffer, said three first-year medical students who led Thursday’s Diversity Learning Lunch seminar. All three students – Christian Robles, Ani Chawdry, and Kiran Kondaveeti – are studying in the medical school’s scholarly concentration in health disparities.

The trio presented a video about the difficulties that Florida farm workers face in getting access to health care. They also reminded their audience of some sobering statistics, showing that death rates for young adult Hispanics and African-Americans are signficiantly higher than those for young adult whites.

Part of the answer to solving that problem, they said, is to bring more minorities into the health care field.

“If you don’t have good communication between doctors and patients, it’s going to create problems,” Kondaveeti said.

That task has challenges as well. African-Americans represent over 12 percent of the U.S. population, but only 4.4 percent of doctors; Hispanics, 12.5 percent of the population and only 5.1 percent of doctors. Those groups lag behind in medical school enrollment as well.

Students attending Thursday's lunch included Alyssa Brown, right.

Minority students face more obstacles in education, income and language on the path to medical school, the Council on Graduate Medical Education has found. But Robles pointed out that the council noted a bright spot. Those students who stay in school are just as likely as their white counterparts to go on to medical school.

The group discussed ways to help minority students reach medical school.

“Maybe having students like us go out into the community and show them that it is possible to become a doctor,” Robles said. “No one is showing them what they can become.”

Group members also stressed that every medical student needs to think about diversity. African-American doctors will see Asian and white patients as well as black ones, pointed out Alyssa Brown, a third-year medical student who attended Thursday’s forum.

“As a physician, it will be important that I’m comfortable treating all my patients,” she said.

The event was organized by the Office of Student Diversity and Enrichment.

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

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.

Richard Karl, MD, who retired as chair of the Department of Surgery at the USF Health in October, writes about the transition from administration back to working surgeon in the June 2009 issue of Flying magazine. Dr. Karl, who served 25 consecutive years at the medical school, continues to operate at Moffitt Cancer Center and is assisting in recruitment of USF’s next surgery chair.

A contributing editor to Flying, Dr. Karl is an avid pilot type rated in the Boeing 737. In the recent issue’s “Gear Up” column he writes about new experiences in both is new job and newfound leisure time.

For full article, click here.

May 27, 2009 -- A drug approved for smoking cessation may hold promise for people suffering from Friedreich’s Ataxia (FA), an inherited disease that causes progressive damage to the neuromuscular system.

A new clinical study, sponsored by the Friedreich’s Ataxia Research Alliance (FARA), will investigate whether varenicline (Chantix®) improves neurological symptoms that can lead to frequent falls in patients with FA. Chantix® is approved by the U.S. Food and Drug Administration to help cigarette smokers stop smoking. Currently, there is no effective treatment for FA. The double blind, randomized, placebo-controlled pilot study will be led by principal investigator Dr.Theresa Zesiewicz, professor of neurology at the University of South Florida College of Medicine, and co-investigator Dr. David Lynch, associate professor of neurology and pediatrics at Children’s Hospital of Philadelphia.

Dr. Zesiewicz noticed that the uncoordinated movements (ataxia) and balance problems of a patient with fragile X tremor /ataxia syndrome improved greatly after he started varenicline in an attempt to quit smoking. The symptoms worsened when the medication was discontinued. Dr. Zesiewicz found similar results when treating patients with other types of ataxia, and several of her case reports were published last year in medical journals.

“Our preliminary findings with varenicline in ataxia patients provided information that warrants further formal clinical research. Varenicline has a possible novel mechanism of action in the nervous system that we were unaware of,” said Dr. Zesiewicz, who developed a protocol for the clinical trial and applied to FARA for funding.

The pilot study aims to determine whether the findings Dr. Zesiewicz observed in a few ataxia patients can be replicated in a larger group of adults diagnosed with FA.

Chantix®, a Pfizer drug, acts at sites in the brain affected by nicotine. “We do not completely understand how Chantix® may be working to improve symptoms of ataxia, however it is clearly different from the other agents under development for FA,” Dr. Lynch said. “If Chantix does prove beneficial, it would offer a complementary approach for treating FA.”

The researchers do not recommend that those with FA or other types of ataxia begin off-label use of Chantix®, which requires a prescription. Clinical trials are needed to determine the effectiveness, proper dose and potential side effects of Chantix® in this population, they say.

“This is the first clinical trial that FARA has supported through a research grant. We are grateful to our talented team of investigators who have moved quickly to bring this discovery to FA patients in an organized and rigorous study and to the Pfizer corporation for providing the drug for this study,” said FARA Executive Director Jennifer Farmer.

“Clinical studies are needed to determine the risks and benefits of a drug. In such cases where the drug has been approved for another indication, all too often proper trials do not occur and patients are taking risks with a drug without understanding the real potential benefit.”

For more information on this study – “Double-Blind, Randomized, Placebo-Controlled Pilot Study of Varenicline in the Treatment of Friedreich’s Ataxia” -- go to www.curefa.org/registry and select Clinical Trials or visit www.clinicaltrials.gov and search for “Friedreich’s ataxia”.

About FA
FA is a degenerative, neuromuscular disease that gradually robs patients of their ability to walk, compromises speech, hearing, and vision, and often comes with complications of serious diabetes and heart disease. Although rare, FA is the most prevalent inherited ataxia, affecting about one in every 50,000 people in the United States.

About FARA
The Friedreich's Ataxia Research Alliance's (FARA’s) mission is to marshal and focus the resources and relationships needed to cure FA by raising funds for research, promoting public awareness, and aligning scientists, patients, clinicians, government agencies, pharmaceutical companies and other organizations dedicated to curing FA and related diseases. For more information, go to www.CureFA.org.