First published on July 13, 2015 in observance of the COPH’s 30^th anniversary celebration.

Founded in 1997 by a training grant supported by the National Institute for Occupational Safety and Health, the Sunshine Education and Research Center at the USF College of Public Health stemmed from an industrial hygiene training program grant in the late 1980s.

“NIOSH has several charters,” explained Dr. Thomas Bernard, chair and professor in Environmental and Occupational Health and SERC (pronounced SIR-see) program director since 2008.  “One of them is to support and encourage the development of professionals in the field of occupational safety and health.  A mechanism for doing that is through training grants.”

After Bernard’s arrival in 1989, additional training program grants followed in occupational medicine and occupational health nursing.  Then the department began work on an occupational safety program.  Eight years later, the fledgling operation had grown enough to warrant centralization.

“In the mid-’90s,” Bernard said, “we decided that we would combine those training activities with a grant and ask for an education center.  The application required that it have training in at least three programs, and we had four: safety, industrial hygiene, medicine and nursing.  The application was accepted and funded under the leadership of Stuart M. Brooks and Yehia Hammad.”

Being headquartered at a university the size of USF naturally leads any interdisciplinary entity into an expansion cornucopia that Bernard is happy to enumerate, along with the USF colleges involved.

“Because they are multidiscipline programs, part of their value is the interdisciplinary training,” he said.  “We added, about seven years ago, occupational health psychology, so that’s now a funded program in Arts and Sciences.  We’ve expanded the safety program to include a degree out of engineering.  Obviously, we’re involved with the [Morsani] College of Medicine:  The clinical rotations and residency certificates come out of medicine, and then the academic training comes out of public health.

“With nursing,” he said, “we have three options.  One is a straight occupational health nursing degree, a second one is a dual degree in nursing and public health, and then we also have a third degree that’s strictly public health.”

Thomas Bernard, PhD

Another requirement under the grant from NIOSH, which is part of the Centers for Disease Control and Prevention, is a continuing education component,  which also has been added.  Additional expansion has stemmed from outreach activities, student recruitment and a pilot project in research training for doctoral students and junior faculty.

“We support these throughout the region,” Bernard qualified, “so they aren’t only for USF.  We have reached way beyond ourselves in terms of the arrangements that we have, but we engage the professional community more than the community at large.”

He added that the center is “very much engaged” in state and regional professional conferences, as well as in coordination with other ERCs in the state and the region.

“By and large, we have a very good national profile,” he said.  “There are just a couple of us that reach out globally, but those are more individual efforts.  The ERC is designed to serve primarily Florida, and in a larger sense, the Southeast region.  That’s our mission and our charter from NIOSH, not to go beyond that, but I think we have expertise in a number of areas that have national recognition.”

The highly technical nature of some of those areas probably help limit recognition to professional circles, but their significance would be difficult to deny. Respiratory protection from nanoparticles is one of them, but as Bernard pointed out, it’s not exactly a topic on most people’s minds.

“Few people are asking, ‘What happens when you breathe those in?’  Some of them have characteristics that are not unlike asbestos.  Others are easily transported across the air-blood barriers, so they move through the lungs into the blood and get transported elsewhere in the body.  So protecting individuals from nanoparticles is important,” he said.

And the list goes on.

“We have a major presence in the area of heat stress – how to evaluate heat stress, how to manage it, and especially, the effects of protective clothing.  We have fairly good recognition in Europe in the area of ergonomics,” he continued,  “and occupational health psychology clearly is one of our well-recognized programs.”

Workplace stress, safety climate and work-family balance are others, he said.

“And then,” he concluded with a nod that said he’d saved the best for last, “we turn out good students, and we’re recognized through the product of the quality of our students.”

SERC hosts a six-day Summer Institute for Occupational Health and Safety for students interested in exploring graduate studies.

Looking ahead is easy for Bernard, and he likes what he sees for his organization.

“I think that everything we do in public health, and everything we do within the SERC, is prevention – preventing people from being injured or having their health impaired,” he said.  “But I think our opportunity here at USF lies in translating research to practice and also expanding on the fact that a healthy workforce is healthy not only from controlling exposures to hazards in the workplace, but also from encouraging healthy activities outside the workplace.

“So, bringing these work and home lives together is an opportunity for us,” Bernard concluded, “and that’s where I see our future.”

Story by David Brothers, College of Public Health.

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The USF College of Public Health (COPH) has teamed with Purdue University and the University of Toledo to develop online training modules and research experiences for graduate students across the country studying industrial hygiene. 

The modules are being developed with the help of a nearly $250,000, 5-year National Institute of Environmental Health Sciences (NIEHS) grant titled Distance Education and Training on Emerging Contaminants and Technology (DETECT). Emerging contaminants to be covered include, but are not limited to, nanoparticles, bioaerosols and ototoxic compounds. Learning will be both lecture-based and hands-on.

The NIEHS, part of the National Institutes of Health (NIH), supports cutting-edge, innovative health science research. According to its website, “Prospective graduate students and graduate students from the DETECT consortium institutions and beyond will be encouraged to participate. These intensive sessions will include research training, laboratory tours, and the opportunity for participants to complete, analyze and present a short research project.

They will develop five online laboratories and at least one virtual reality laboratory. The online laboratories will be accessible using an internet browser and will be incorporated into the online educational modules. The virtual reality laboratory will be completed in-person by graduate students at the DETECT consortium institutions.”

Dr. Marie Bourgeois, a COPH research assistant professor and alumna of the college, is principal investigator of the USF portion of the NIEHS grant. Dr. Tom Bernard, a COPH professor, is co-investigator.

“We’re developing lectures with assessments built into them, disaster response training, online labs and an in-person, one-week summer research session,” Bourgeois said. “This training is designed to provide education on emerging contaminants and technologies so future industrial hygienists can help keep both themselves and the people they are responsible for safe.”

Bourgeois said some of the things she and her colleagues will seek to include in the modules range from basic training, such as how to properly take off personal protection equipment to reduce the risk of contamination, to technical advances, such as detecting harmful algae blooms.

“We’ll be giving students training and then we’ll present them with an industrial or environmental problem that they’ll have to handle,” Bourgeois said. “It could be a spill, a bloom or some sort of hazard that’s popped up and they’re going to have to work out a toxicity profile, how to characterize the risk and then how to deal with it.”

Bourgeois noted that development of the modules is still in the planning stages, with the group working not just on content, but also on how to present the information in a format that’s cohesive and uniform. 

“If this is successful, and we continually refine the modules and improve upon them, I’d really like to see this expand to a wider audience beyond just graduate students studying industrial hygiene,” Bourgeois said. “It could become open to others looking at a public health degree with a science slant.”

Story by Donna Campisano, USF College of Public Health

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The Florida Perinatal Quality Collaborative’s PROVIDE (Promoting Primary Vaginal Deliveries) Initiative has officially kicked off state-wide. As part of the initiative, trainers will be travelling the state to provide regional workshops to hospitals involved in the project that focus on training hospital staff on labor support skills.

The workshops review:

• The benefits of primary vaginal delivery and morbidity and mortality risks of cesarean sections
• Definitions, the most up-to-date evidence-based recommendations, and clinical implications related to the stages of labor
• The physiology and hormones of labor and techniques that promote labor progress in latent, active, and second stages of labor
• The evidence for the use of comfort techniques and hands-on practice with a variety of coping strategies for each stage, including promotion of optimal fetal rotation and descent
• Shared decision making/communication best practices for the stages of labor
• Patient and family education tips and resources related to each stage
• The evidence and current parameters for fetal heart rate monitoring, including intermittent auscultation, the use of Leopold’s maneuvers, and documentation tips

Training Group in St. Petersburg

The first workshop was held in January at Bayfront Health in St. Petersburg. Over 40 health care providers, mostly labor and delivery nurses, from 10 hospitals were in attendance. The workshop was led by Certified Nurse Midwives Jessica Brumley and Heather Murphy, and Birth Doula Childbirth Educators Emily Bronson and Christie Collbran.

Emily Bronson, Christie Collbran, Jessica Brumley, and Heather Murphy

A second workshop was held in February in Ft. Myers at Lee Health, and many more are being scheduled. Feedback on the trainings has been very positive; attendees loved having all the hands-on practice. Nurses expressed that this is a great training both for new nurses and as a refresher course to keep them up-to-date.

The FPQC team looks forward to bringing the workshop around the state for PROVIDE Initiative hospitals! For more information on the FPQC or the PROVIDE Initiative, visit FPQC.org.

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The USF College of Public Health’s Center for Global Health and Infectious Disease Research (GHIDR) is dedicated to improving the lives of people afflicted by infectious disease through the development of improved diagnostics, treatment and preventive mechanisms.

Distinguished University Professor and GHIDR assistant director Dr. John Adams hosted a two week vivax malaria workshop in late April and early May to train military collaborators from across the globe in the use of improved research methods developed in his lab.

Dr. John Adams with researchers, (from left to right) Supakit Wanasith , Medical Research Technician in the Department of Entomology at AFRIMS in Bangkok, Thailand; Alison Roth, PhD candidate; Waranya Buadok – Medical Research Technician in the Department of Entomology at AFRIMS (Armed Forces Research Institute of Medical Sciences) in Bangkok, Thailand; Samantha Aylor, Biological Scientist in the ET group at WARIR; LT. Danett Bishop, Head of Parasitology at NAMRU-6 in Lima, Peru; Dr. Gissella Vazquez, Deputy of the Entomology Department at NAMRU-6 in Lima, Peru; Captain Brian Vesely, Chief of Assay Design in the ET group at WARIR; Dr. Geral Christian Baldeviano, Senior Research Scientist in the Division of Immunology and Vaccine Development at NAMRU-6 (US Naval Medical Research Unit 6) in Lima, Peru. (Photo by Anna Mayor)

According to Adams, the military has an invested interested in the prevention and eradication of malaria since thousands of military troops are deployed to malaria endemic regions yearly, increasing their exposure to the disease.

“By collaborating with this network of well-trained, well-equipped scientists we will further the Center’s mission and bring the goal of malaria eradication one step closer,” Adams said.

Vivax malaria is a parasitic disease caused by Plasmodium vivax. Despite an estimated 13.8 million cases in 2014, it is considered a neglected disease due to serious research challenges and the relative lack of reliable funding and political attention.

Unlike other malaria parasites, Plasmodium vivax cannot be grown continuously in the lab. Researchers must have direct access to parasites from infected patients, usually from clinics in malaria endemic regions, in order to run experiments to develop new drugs and vaccines.

The research took place for two weeks at USF’s IDRB building using equipment from the GHIDR. (Photo by Anna Mayor)

Researchers examine parasites during lab work. (Photo by Samantha Barnes)

Researchers in Adams’ lab have been able to develop an improved system to freeze the transmissive stage of the malaria parasite, used for studying the asymptomatic liver stage, so that they can be shipped worldwide, broadening access to parasite samples.

According to Adams, access to healthy parasites is only half of the battle when working with vivax malaria.

He said it is exceedingly difficult to simulate the natural course of infection in the laboratory and that existing processes are arduous, time consuming, and prone to failure.

To combat this issue, Adams’ lab has collaborated with other groups to develop an improved method to recapitulate parasite invasion and development into liver cells which can then be used to test new potential drugs for activity.

This system, the most efficient of its kind, was enhanced in part by COPH doctoral candidate, Alison Roth.

“The availability of our improved invasion assay methods will hopefully allow progress against this disease to be made more quickly and efficiently. We are holding this workshop to train some of our closest collaborators in these methods,” Roth said.

The attendees at this workshop included two USF COPH alumni, Captain Brian Vesely Chief of Assay Design at the Walter Reed Army Institute of Research (WRAIR) and Samantha Aylor, Biological Scientist in the ET group at Walter Reed.

Three COPH alumni took part in the workshop. (From left): Captain Brian Vesely Chief of Assay Design at the Walter Reed Army Institute of Research (WRAIR), current doctoral student and alumna Alison Roth, and Samantha Aylor, Biological Scientist in the ET group at Walter Reed. (Photo by Anna Mayor)

Also in attendance:

Dr. Geral Christian Baldeviano
Senior Research Scientist in the Division of Immunology and Vaccine Development at NAMRU-6 (US Naval Medical Research Unit 6)
Lima, Peru

Danett Bishop
Head of Parasitology at NAMRU-6
Lima, Peru

Dr. Gissella Vazquez
Deputy of the Entomology Department at NAMRU-6
Lima, Peru

Ms. Waranya Buadok
Medical Research Technician in the Department of Entomology at AFRIMS (Armed Forces Research Institute of Medical Sciences)
Bangkok, Thailand

Mr. Supakit Wanasith
Medical Research Technician in the Department of Entomology at AFRIMS
Bangkok, Thailand

According to Dr. Adams, through strengthening our collaborative relationships with this workshop, researchers in the lab will have access to high quality parasite samples from field sites in Peru and Thailand, thus improving the quality of results and reducing waste.

“It highlights USF’s role as a frontrunner in vivax malaria research,” Adams said.

Story by Ashley Souza, USF College of Public Health

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The Florida Hospital Association office in Orlando was the site of the latest FPQC Quality Improvement 2-Day Training, a focused workshop for hospital teams to learn quality improvement science and techniques and apply them to a specific unit-based quality improvement project.

Teams of nurses and physicians from four hospitals gathered on October 20 to learn about change management, how to develop a problem statement, designing process maps, creating key driver diagrams, and using a prioritization matrix to guide the implementation of a quality improvement project. “The training is particularly useful when it is based on an actual issue or project in the team’s unit,” said Betsy Wood. “After two days, they come out with a well-defined and constructed QI project to work on to improve their unit.”

The workshop trainers, Dr. Maya Balakrishnan, FPQC Director of Quality, and Karen Fugate, Quality Specialist at Tampa General Hospital, provided interactive exercises and individual consultation with teams as they worked on learning quality improvement concepts and approaches.  The second day of the training was devoted to understanding data and determining measures and how to implement and assess small tests of change using plan-do-study-act (PDSA) cycles.  Each training topic session ended with a group review of materials each hospital team had developed to help improve their project and promote peer-to-peer learning.

As one participant commented: “[They] made sure we understood each piece of the process—if there was any question, we would work it out as a total group which helped all learn.”  Participants in the training unanimously rated it as excellent.

The same training was also held in May 2016 at Broward Health Medical Center. Feedback on the training has been overwhelmingly positive. Previous attendees noted “The trainers were extremely knowledgeable, willing to assist with individual projects, and provided a safe environment to learn.”

QI Trainers Karen Fugate (left) and Maya Balakrishnan (second from right), with Broward Health Team and Emily Bronson (third from left), in May 2016.

This training was described as providing “informative and in-depth information for creating and participating in QI projects.” FPQC plans to offer future QI trainings and is also planning a one day pre-conference seminar on quality improvement for FPQC 2017.

If your hospital team is interested in attending a perinatal-focused QI training, please contact FPQC@health.usf.edu

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On October 27 and 28, 2015, the Florida Perinatal Quality Collaborative piloted a brand new training in quality improvement for maternal and neonatal health care providers.

Developed by FPQC quality improvement leads Dr. Maya Balakrishnan and Dr. Karen Bruder, the curriculum incorporates Institute for Healthcare Improvement philosophy and TeamSTEPPS methodology to train care providers on how to improve quality of care and patient safety in their facilities.

Maya Balakrishnan and Karen Bruder assisted teams with their specific projects.

Attendees of the two-day training came from hospitals around the state in teams of 3 or more and brought with them a small-scope quality improvement project that they want to focus on in their hospitals. Coming with a project in mind made the training more relevant. They spent the first day learning about change management, identifying the problem and developing a problem statement, developing process maps, creating a key driver diagram, forming the project team and understanding team dynamics, and doing teamwork exercises. Day two of the training focused on understanding types of data and determining measures, generating solutions and sustaining change, understanding variation and Plan-Do-Study-Act cycles, reporting and interpreting data, and team communication.

A hospital team member shares her process diagram with facilitator Karen Fugate

Participants expressed that although they may have been part of quality improvement before, learning the nuts and bolts of how it is done and how to share with others was worthwhile. Teams will take the information back to their hospital teams and departments and begin to improve their quality improvement processes.

Many of the training sessions included time for teams to apply what they learned in hands-on sessions related to their projects with personal assistance from trainers and facilitators. Attendees really appreciated having this personal attention. Teams also greatly enjoyed the fun learning exercises that challenged them to work as teams with Mr. Potato Head families and spaghetti and marshmallow structures!

Mr. Potato Head PDSA exercise

Marshmallow Challenge team building exercise

The lead trainers will continue to offer assistance to training attendees throughout the course of the hospitals’ 6-month QI projects, and will incorporate lessons learned from this pilot into a future repeat of this training.

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Teams from Florida hospitals attended a TeamSTEPPS Master Training in Hollywood in March 2015 hosted by the Florida Perinatal Quality Collaborative and the March of Dimes.

TeamSTEPPS is an evidence-based set of teamwork tools aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals. Fully trained TeamSTEPPS Masters will be able to provide instruction, coaching, and leadership for implementing TeamSTEPPS methods in their facility.

Orlando Health Team

TeamSTEPPS Trainers Maya Balakrishnan, MD, Terri Ashmeade, MD, and Teresa Mahan-Etheridge, ARNP-BC led the Master Training, which was a full two day workshop that covered team structure, communication, leadership, situation monitoring, mutual support, change management, coaching, measurement, and implementation planning. Neonatal, obstetric, and health department care providers, including nurses, physicians, therapists, and educators, got a lot out of the training.

Teamwork Exercise

Attendees participated in fun teamwork exercises, practiced coaching and received feedback, and had the opportunity to work on applying concepts to their own facility’s quality improvement projects as a team. Participants expressed that they enjoyed the opportunities to apply and explore best practices within their teams and with other attendees.

Participants appreciated that the event was offered and have requested additional trainings. The FPQC is hoping to offer an additional quality improvement workshop this year. Check the FPQC Event page for more information on upcoming events.

Maya Balakrishnan, Teresa Mahan-Etheridge, and Terri Ashmeade

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As part of the Centers for Disease Control’s response to the Ebola outbreak in West Africa, the CDC has organized an instruction team to train health care workers before they deploy.  Dr. Donna Haiduven, associate professor in the Department of Global Health, USF College of Public Health, has joined the team.

The hands-on training that Haiduven and colleagues provide requires a building large enough to simulate an Ebola treatment center, she said, and another big enough to house the instructors.  Lacking the space at its Atlanta headquarters, the CDC holds the training sessions at the Federal Emergency Management Agency or FEMA’s Region IV headquarters in Anniston, Ala.

Instructors fly to Atlanta, then travel via rental car to Alabama for the four-day sessions.

“The students in the class are either deploying in the very near future or are trying to get scheduled to deploy,” Haiduven explained.  “It’s a three-day course for the people going to Africa and a one-day course for new trainers.”

The sessions began in early October and are scheduled through next April 30.  Haiduven has participated in four of the sessions, three in consecutive weeks, a week off over Thanksgiving week, then a final session the first week of December.  She plans to participate in several more in early 2015.

As part of the Centers for Disease Control’s response to the Ebola outbreak in West Africa, the CDC has organized an instruction team to train health care workers before they deploy.  Dr. Donna Haiduven, associate professor in the Department of Global Health, USF College of Public Health, has joined the team.

The hands-on training that Haiduven and colleagues provide requires a building large enough to simulate an Ebola treatment center, she said, and another big enough to house the instructors.  Lacking the space at its Atlanta headquarters, the CDC holds the training sessions at the Federal Emergency Management Agency or FEMA’s Region IV headquarters in Anniston, Ala.

Instructors fly to Atlanta, then travel via rental car to Alabama for the four-day sessions.

“The students in the class are either deploying in the very near future or are trying to get scheduled to deploy,” Haiduven explained.  “It’s a three-day course for the people going to Africa and a one-day course for new trainers.”

The sessions began in early October and are scheduled through next April 30.  Haiduven has participated in four of the sessions, three in consecutive weeks, a week off over Thanksgiving week, then a final session the first week of December.  She plans to participate in several more in early 2015.

Dr. Donna Haiduven (right) checks a trainee’s protective gear.  In photos below, she directs students in the proper procedures of safely moving a patient.

An infection preventionist by training, Haiduven responded to a call for trainers that went out through professional organizations including the Red Cross, the Society for Healthcare Epidemiology of America, and the Association for Professionals in Infection Control and Epidemiology, of which she is a member.

Potential instructors submit applications to the CDC, which then evaluates them and chooses the trainers, Haiduven said.

The training is all about health care worker safety, she said.  Manikins serve as patients, and workers learn how to safely perform procedures they otherwise already know in the simulated Ebola treatment unit.

“We don’t teach them how to draw blood.  They know how to do that,” Haiduven said.  “We teach them to safely perform their various tasks in an ETU setting, such as doing a blood draw safely, cleaning up a spill of blood and bodily fluids safely, transferring a body into a body bag safely, transferring patients from outside to inside safely, and learning how to triage patients safely, whether to bring them into the unit or send them away from the unit.”

Sessions are long and tiring, she said.

“We’re in there for nine hours.  We get a lunch break, but those of us assigned to the ETU pretty much stand for seven hours.  We have a script, and we’re all expected to keep to that script so that the students get a consistent message.  We want every student to be taught the exact same thing, and the goal is safety for them when they go to West Africa.”

Trainers and students even conduct debriefings after sessions, discussing what went right, what went wrong, and what could be done better.

“It’s rewarding, it’s exhausting, and it’s challenging,” Haiduven said.  “It also is challenging to keep up with work and do this class, but I’m willing to make the sacrifice, because I really want to do this.  It’s really important.”

During one session, she said, it was 18°F, and the zipper on her coat broke.  There are photos of her wearing the coat held together with duct tape wrapped all the way around.  But as taxing as the experience is on the trainers, Haiduven knows the trainees will bear the brunt of the situation in real life.

“No matter how cold or hot or uncomfortable we are standing there,” she said, “they’re going to have it a lot worse.”

Story by David Brothers, College of Public Health.  Photos courtesy of Dr. Donna Haiduven.

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