ATTENTION: All USF Health Faculty, Staff and Students

Oct. 29, 2009 -- USF Health has received a very limited quantity of the H1N1 Vaccine and has begun vaccinating our patients, employees, and students who meet the criteria established by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices and the Florida Department of Health. Because the vaccine is currently available in limited quantities, the following TARGET GROUPS will receive the vaccine before others, in the following order:

1) Pregnant women
2) People who live with or care for children younger than 6 months of age (e.g., parents, siblings, and daycare providers)
3) Healthcare and Emergency Medical Services personnel with direct patient contact (OB & Pediatric patient contact first).
4) Children 6 months through 4 years of age
5) Children 5 through 18 years of age who have chronic medical conditions.

Once the demand for vaccine for these target groups has been met, we will begin vaccinating all others in the following order:

1) All Healthcare personnel
2) Persons between the ages of 4 and 24 years old
3) People ages 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems
4) All other people ages 25 through 64 years
5) People over the age of 65

We do not expect that there will be a shortage of 2009 H1N1 vaccine and anticipate that vaccine will be available for all patients, employees and students who choose to get vaccinated. This vaccine is offered free of charge to all eligible USF Health employees, faculty, staff and students. We will keep you informed of the vaccine supply and availability and how you can obtain your vaccination.

USF Health employees and students:

If you fall in one of the top 5 target groups, the vaccine will be available to you at the South Tampa Center on the 3rd floor beginning Thursday, October 29th at 1 pm. Please review the H1N1 Vaccine Information Statement (VIS) for 2009 prior to coming for your immunization, and contact us ahead of time if you have any questions regarding your eligibility to receive the H1N1 influenza shot. If you are pregnant, you will need clearance from your OB/GYN provider and must bring the verification with you. The consent form you will complete is a duplicate. You will be given a copy for your records and we will keep the original copy to verify you have received the H1N1 influenza vaccination. Employees and students who are normally at the North Tampa Clinical sites and meet the criteria for one of the top 5 target groups, should contact the Medical Health Administration office (Employee Health) at 974-3163 or by email at llennert@health.usf.edu.

Patients:

If one of your patients falls in one of the top 5 target groups, you must write a prescription for the H1N1 vaccine and give a copy to the patient. The patient must present this order to receive the vaccine. The vaccine will be available for eligible Adult patients at the South Tampa Center on the 3rd floor beginning Thursday, October 29th at 1 pm. All eligible pediatric patients at the South Tampa Center will receive the H1N1 influenza vaccine in the Pediatric Clinic. If your patient is located at one of the North Tampa Clinical sites, the H1N1 vaccination will be handled through the clinic appointment system. If you have any further questions regarding patient vaccination at the North Tampa Clinics, please contact clinic administration at 974-2252.

It is anticipated that the Department of Heath will audit all sites who receive and distribute the vaccine. Therefore, we must ensure that we are keeping accurate records and entering the data into the Florida Shots Program.

Remember, Influenza is spread by direct and indirect contact and by droplet contact so the virus is easily spread from person to person via coughing, sneezing, and contact with contaminated items. Don’t forget to wash your hands properly and frequently and follow proper cough etiquette http://www.coughsafe.com/index.html to minimize the spread of influenza. Remind those around you, also! Stay healthy and thanks for doing your part this Flu Season!

________________________________
Linda R. Lennerth, RN, MSN
Associate Director, Medical Health Administration
Infection Prevention & Control
Employee/Student Health & Wellness
USF HEALTH - MDC 19
College of Medicine / Department of Internal Medicine
Division of Infectious Disease & International Medicine
Email: llennert@health.usf.edu

Tampa, FL (Oc.t 28, 2009) -- You don’t have to look any further than backyard to see that there’s a regional water crisis. A three-year drought has dried up rivers and other water sources, pumping threatens wells and wetlands, and officials have imposed the toughest watering restrictions in the Tampa Bay area’s history.

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

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

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

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

The USF arm of the NIH trials will be performed at Genesis, Tampa General Hospial and USF clinics.

Tampa, FL (Oct. 26, 2009) -- The University of South Florida is participating in two federal studies to see whether the H1N1 vaccine can safely elicit a protective immune response in pregnant women, as well as in children and young adults, all of whom are HIV-infected.

USF will be one of 35 sites and eight sub-sites in the United States and Puerto Rico participating in the two studies, which are sponsored and funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both part of the National Institutes of Health. Investigators plan to vaccinate about 130 HIV-infected women and 140 HIV-infected children and young adults around the country.

USF is participating in both studies as part of its role as a site of the International Maternal-Pediatric-Adolescent AIDS Clinical Trials Group (IMPAACT) network, a project of NIAID and NICHD that develops and implements multi-center HIV treatment and prevention research trials.

In the first study, on HIV-infected pregnant women, about 10 women are expected to be enrolled in the Tampa Bay area, said Dr. Karen L. Bruder, USF assistant professor of obstetrics and gynecology and the principal investigator for USF’s study site. Dr. Bruder also is medical director of the Genesis at HealthPark clinic of Tampa General Hospital.

The study is particularly important for this group of women because pregnant women already are at greater risk of suffering serious complications from the H1N1 virus, largely because their immune systems do not function at their normal levels. If a pregnant woman also is infected with HIV, her immune system is further compromised.

“She is already immuno-suppressed,” Dr. Bruder said.

Dr. Karen Bruder leads the USF study site testing whether the H1N1 vaccine protects HIV-infected pregnant women.

The study will look at how the vaccine affects the woman and her infant -- for instance, how many antibodies to the H1N1 influenza virus does the woman develop in response to the vaccine? Are those antibodies transferred to the fetus? After the baby is born, does it still have antibodies to the virus?

The study will also evaluate whether the vaccine affects the woman’s HIV viral load or the cells in the immune system that are often affected by HIV.

Women in the study will receive two doses of vaccine. The women’s response to the vaccine will be evaluated during pregnancy, at delivery, and at 3 and 6 months after delivery. The babies will be evaluated when they are 3 and 6 months old.

USF’s work in the study will be performed at Genesis, Tampa General and at USF clinics.
In the second study, at least four HIV-infected children or young adults will receive the H1N1 vaccine at the USF clinics, said Dr. Jorge Lujan-Zilbermann, associate professor of pediatrics and principal investigator for the USF site of the study.

This study will divide subjects into three age groups: ages 4 to 9, 10 to 17, and 18 to 24. As in the first study, the children and young adults will receive vaccine in two doses three weeks apart. Study subjects will be followed for seven months.

The study will examine how safe the vaccine is, how effectively it stimulates the immune system to make antibodies to the H1N1 influenza virus, and how long children and young adults maintain these antibodies in their blood after being vaccinated. The study will also look at other immune responses.

The vaccine all study subjects will receive contains inactivated virus, so it will not be possible for them to contract H1N1 influenza from the vaccine. Because of the increased vulnerability of HIV-infected pregnant women, children and youth, the trials will test whether doses of the licensed 2009 H1N1 influenza vaccine that are higher than doses being tested in other groups can safely elicit protective immune responses in these populations.

The IMPAACT sites participating in these studies will receive vaccine from Novartis Vaccines and Diagnostics of Cambridge, Mass, through the Office of the Assistant Secretary for Preparedness and Response for the U.S. Department of Health and Human Services.

For more information about NIH-sponsored clinical trials of H1N1 influenza vaccine in HIV-infected pregnant women, children and youth, see http://www3.niaid.nih.gov/news/newsreleases/2009/H1N1HIVTrials.htm and http://www3.niaid.nih.gov/news/QA/H1N1VacHIVChildYouthPregWomenqa.htm

- USF Health -

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $380.4 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

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

The USF Health Rothman Center for Neuropsychiatry in St. Petersburg is conducting a two-year federal trial testing the effectiveness of behavioral psychotherapy in treating anxiety among young adolescents with autism.

USF is one three sites for the $1-million study, sponsored by the National Institute of Child Health and Development (NICHD) through the American Recovery and Reinvestment Act. The other two sites are the University of California at Los Angeles and the University of Miami. The USF arm of the study will receive approximately $500,000.

USF's Eric Storch, PhD, is principal investigator for the multi-site behavioral therapy trial.

Autism spectrum disorders, collectively referred to as autism, cause pervasive impairment in thinking, feeling, language and the ability to relate to others and can range from a severe from (called autistic disorder) to a much milder form known as Asperger syndrome. Anxiety disorders affect as many as 80 percent of children and adolescents with autism spectrum disorders, triggering distress and impairment over and above that caused by an autism diagnosis alone, said Eric Storch, PhD, principal investigator for the multi-site trial and associate professor of pediatrics and psychiatry at USF Health.

“As yet, there are no tried-and-true methods for treating the anxiety that often accompanies autism,” Dr. Storch said. “Cognitive behavioral therapy has worked very well for typically developing kids with anxiety. The goal of this study is to adapt this therapy for use in early adolescents with autism and co-occurring anxiety.”

Cognitive behavioral therapy (CBT) involves exposing a patient to what they fear in controlled, graduated doses in an attempt to decrease their anxiety over time and prevent a compulsive or avoidance response. It has become a gold standard treatment for youngsters with anxiety disorders who do not have complicating conditions like autism or attention deficit hyperactivity disorder.

The researchers will first adapt a CBT protocol they have developed for younger children to meet the characteristics and clinical needs of early adolescents (ages 11 to 14) with autism. They will accomplish this by treating numerous youngsters and consulting with other autism experts. Then, the team will enroll 32 adolescents with autism in a randomized trial across the sites. The participants will receive either the newly developed CBT protocol or a modified relaxation training protocol (control group). Those who receive the control treatment will receive CBT afterwards.

“Considering the rising number of young adolescents diagnosed with autism, and the lack of proven treatment options for those suffering from anxiety,” Dr. Storch said, “our work developing a treatment protocol could substantially help address the mental health needs of early adolescents with autism.”

USF co-investigators for the NICHD study include Tanya Murphy, MD, professor and Rothman Endowed Chair of Developmental Pediatrics in the Departments of Pediatrics and Psychiatry; and Adam Lewin, PhD, and Jane Mutch, PhD, both assistant professors of pediatrics.

- Story by Anne DeLotto Baier, USF Health Communications

The USF College of Public Health, in collaboration with the Hillsborough County Health Department, provided 1,340 free seasonal flu shots Oct. 23 at its annual drive at the college, as well as about a 100  more at the USF Unstoppable Campaign event on Oct. 20. 

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

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

Photos by Eric Younghans, USF Health Office of Communications

Recovery Act funds COPH study and pilot training program

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

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

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

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

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

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

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

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

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

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

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

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

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

The $117-million award will go to the data coordinating center at USF and 19 consortia

The National Institutes of Health recently announced a second phase of its Rare Disease Clinical Research Network (RDCRN), which includes a Data Management Coordinating Center led by the University of South Florida’s Jeffrey Krischer, PhD. The USF center and 19 new and returning consortia will be awarded $117 million over the next five years. The research conducted with this second round of funding will explore the natural history, epidemiology, diagnosis and treatment of more than 95 rare diseases.

Dr. Krischer, professor and chief of epidemiology and biostatistics for the USF Department of Pediatrics, has been principal investigator for the RDCRN’s data coordinating center from its start. Under his leadership, USF has become the hub for epidemiological research in both rare diseases and juvenile diabetes and garnered world-wide attention as a model for large-scale clinical research. The consortia within the RDCRN funnel their data to USF for collection, storage, management and analysis.

USF has received nearly $15.3 million for the NIH’s rare diseases research initiative over the last five years. With this second phase of funding, Dr. Krischer expects to receive another $15 million over the next five years as data from the new studies come in.

"The great success of the first five years meant we coordinated 10 networks of studies. We'll now nearly double this to 19 networks,” Dr. Krischer said. “We built a foundation that we're now expanding to many more diseases, many more countries, and designing studies that will help many more patients. It’s a testimony to the methods we’ve developed at USF that we can now expand into new areas of study.”

“We built our strength in autoimmune disorders,” Dr. Krischer added. “This new funding will expand our scope to primary immune disorders and immune-mediated disorders, as well as many others that we don’t understand well. Some are genetic and some simply have unknown causes. By looking at these rare diseases, we can look at the different facets of the immune system and the role it plays in health.”

"The progress made by researchers through the network is important and impressive," said NIH Director Francis S. Collins, MD, PhD. "We have shown that this approach can be a catalyst for progress in meeting the challenge of rare diseases, and we are eager to launch this next phase of the program."

Since its creation in 2003, the RDCRN has enrolled more than 5,000 patients in 33 clinical studies of various rare diseases, ranging from ataxias and primary immune deficiency disorders to inherited neuropathies and mitochondrial diseases. A rare disease is defined as a disease or condition affecting fewer than 200,000 persons in the United States. Approximately 6,500 such disorders have been identified, affecting an estimated 25 million Americans.

The RDCRN is unique in its approach to addressing rare diseases as a group. Previously, the NIH's institutes and centers funded research on individual rare diseases in their respective disease-type or organ domains. The RDCRN is the first program that aims to create a specialized infrastructure to support rare diseases research.

Patient recruitment for clinical studies is a fundamental challenge in rare diseases research because typically so few patients are affected in any one area. The RDCRN was designed to address this problem by fostering collaboration among scientists and shared access to geographically distributed research resources. Network consortia have also established training programs for clinical investigators who are interested in rare diseases research.

"Collaboration is a critical element of rare diseases research and the partnerships represented in this program have tremendous potential to make great strides in understanding these diseases," said Stephen C. Groft, PharmD, director of NIH's Office of Rare Diseases Research (ORDR). "The network emphasizes collaboration not just among investigators from multiple research sites but between investigators and patient advocates as well."

The direct involvement of patient advocacy groups in network operations, activities, and strategy is a major feature of the RDCRN. Each consortium in the network includes relevant patient advocacy groups in the consortium membership and activities. These patient advocacy group representatives serve as research partners within their own consortia.

Funds and scientific oversight for the RDCRN will be provided by ORDR and seven NIH Institutes, which will also contribute considerable administrative support to the network: the National Institute of Neurological Disorders and Stroke (NINDS), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the National Heart, Lung and Blood Institute (NHLBI). Several consortia will also receive financial support from their associated patient advocacy groups.

In the RDCRN's first phase, the network's Data and Technology Coordinating Center (DTCC) led by Dr. Krischer developed a management system for the collection, storage, and analysis of RDCRC data, and additional systems to address needs of individual studies, such as a laboratory data collection system, a specimen tracking system, and a pharmacy management system (to support blinded distribution of study agents and placebos).

The DTCC also created RDCRN's central public Web site, developed as a portal for the rare diseases community, including patients and their families and health care professionals, to provide information on rare disease research, consortium activities, RDCRN-approved protocols, disease information, and practice guidelines. Located at http://rarediseasesnetwork.epi.usf.edu/, the Web site had over 3.4 million visits in 2008. The RDCRN DTCC also developed a unique voluntary patient registry that provides ongoing contact with approximately 5,000 individuals from over 60 countries representing 42 diseases, alerting them when new studies are opened in the network or when ongoing studies expand to new sites.

In this second phase of the RDCRN, USF will continue these data management efforts, under a new name and with a slightly different charge, as the Data Management Coordinating Center (DMCC). The DMCC will develop uniform investigative clinical research protocols for data collection in collaboration with the RDCRN Steering Committee, monitor protocol adherence, data collection and data submission, and work with the each consortium's Data and Safety Monitoring Boards to establish protocols for adverse events notification and reporting.

Supporters of USF Health kicked off the USF: Unstoppable campaign Tuesday evening, Oct. 20, by toasting with pomegranate “Health-tinis,” playing with a simulator baby used to teach nursing and medical students, and getting free flu shots.

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

The USF Health exhibit presented a vision of Health 2020.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

     Imagine two retirees, both in Florida, both with similar lifestyles and health conditions. The only difference: one lives in Miami, the other in Tampa.

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

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

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

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

      Those cost differences mount up, Dr. Skinner said.

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

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

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

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

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

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

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

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

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

Some of the USF Health faculty awarded federal research stimulus funds.

Since this spring, USF Health faculty submitted 116 proposals for economic stimulus funding available through the American Recovery and Reinvestment Act (ARRA). The ARRA applicants gathered Oct. 6 in the USF Health Rotunda to celebrate the fruits of their collaborative efforts – 21 federal research awards totaling more than $4.2 million.

The stimulus grants help support a wide variety of projects, from College of Medicine professor Gary Litman’s studies of the evolutionary origins of genes of immunity to College of Public Health researcher Rita DeBate’s work to create and evaluate a prototype web-based training program that will help dentists and dental assistants identify patients with eating disorders. Maureen Groer, director of the College of Nursing’s Center for Women’s Health Research, will use the award to supplement research examining the influence of breast feeding on postpartum stress and immunity.

Dr. Phil Marty spoke about research on the rise at USF.

“This was an opportunity in which faculty and staff from both sides of campus came together and put in tremendous time and energy needed to get a lot of excellent research proposals out the door quickly,” said Phillip J. Marty, PhD, associate vice president for the USF Health Office of Research. “Our efforts were successful.”

Stephen Klasko, MD, MBA, vice president for USF Health and dean of the College of Medicine, also thanked all who collaborated to submit proposals under a time crunch. “I’m proud of our faculty and appreciate very much all the hard work by the USF Health Research Office and Sponsored Research staff,” he said. “Even the grants we did not get have raised some opportunities for us.”

ARRA funds were dispersed from various institutes and centers across the National Institutes of Health (NIH) by Sept. 30 with the goal of moving the economy and stimulating jobs through research.

Dr. Stephen Klasko thanked all applicants and awardees for their hard work.

The reception recognizing ARRA applicants and awardees was part of ResearchONE, a week of events, Oct. 5-9, highlighting USF’s vast research enterprise and showcasing cutting-edge projects by both the campus community and the Tampa Bay region.

ResearchONE this year came on the heels of USF being named in The Chronicle of Higher Education as the fastest-growing university in the nation for federal research expenditures between 2000 and 2007. Simply translated, that means that during those seven years, no other group of faculty had a faster rate of earning new federal sponsorship for the discovery and creation of knowledge.

Research staff from USF Health and USF Sponsored Research worked with faculty to help get ARRA proposals out the door within a tight timeframe.

USF also recently announced a new record in research funding, $380.4 million in 2008-09 -- a $20 million increase over the previous year. USF Health’s colleges of medicine, nursing and public health attracted more than $232-million in research awards, or 61-percent of USF’s total awards.

For a full list of USF's NIH stimulus grant recipients (as of Oct. 2, 2009) compiled by the U.S. Department of Health and Human Services, click here.

L to R: Thomas Unnasch, PhD; who received ARRA awards supplementing his research with onchocerciasis and Eastern equine encephalitis, chats with Boo Kwa, PhD, and Matt Rollie of the Department of Global Health.

- Story by Anne DeLotto Baier, USF Health Communications
- Photos by Gil Williams, Gil Williams Photography