Heartbeat Spring 2023




Campaign Report: Human Trafcking Recognition Education 12 A look inside the school’s Ever Brighter campaign pillar to tackle a public health crisis.


Two D.N.P. students help area hospitals educate first responders. Scholarly Projects Aid Trafcking Victims



COVER STORY: SONHS – 75 Years of Excellence

From its humble beginnings to exemplary present day, SONHS has set the standard for health care education. This 75th anniversary special report captures the spirit of the school’s dramatic evolution through decades of photos and heartfelt reflections.



Dean’s Message


Studying ‘Don’t Say Gay’ and Mental Health 26 A six-figure grant is helping SONHS researchers launch a groundbreaking investigation into the psychological implications of Florida’s polarizing new public school policy.

Happy National Nurses Month! To all nurses around the globe,


Vital Signs

Endowment: Jorie Healthcare Partners Grants to Bolster Nursing Workforce

Research News from Associate Dean Santos New Hire Amplifies Diversity, Equity, Belonging Highlights from the Spring Lecture Series Keeping It 100 on the CRNA Licensure Exam Critical Care Presentations in Chile B.S.N. Students Explore Spanish Health System New Options for Public Health and Nurse Leadership National Public Health Program Reaccreditation Expected



for your commitment and dedication We are proud to celebrate 75 Years of Excellence

Marina Parada Senior Business Ofcer

Rochelle Broder-Singer Carlos Harrison Jennifer Hudak Yolanda Mancilla Marina Parada Robin Shear



Faculty Publications

Faculty Highlights

Rosa M. Lamazares-Romero Director, University Communications



Robin Shear Senior Editor

Class Notes Updates from the Alumni Association and SONHS grads

Faculty Profile Arsham Alamian

Heartbeat is published twice a year by the School of Nursing and Health Studies (SONHS). Heartbeat is distributed to alumni, faculty, staff, and friends of SONHS. Reproduction in whole or in part without permission is prohibited. Postmaster and others, please send change of address notication to Heartbeat , School of Nursing and Health Studies, P.O. Box 248153, Coral Gables, Florida, 33124; telephone 305-284-3666. Contributions of articles and artwork are welcome, but Heartbeat accepts no responsibility for unsolicited items. The comments and opinions expressed in this magazine do not necessarily reect those of the University of Miami or the staff of Heartbeat . Copyright © 2023, University of Miami. An Equal Opportunity/Afrmative Action Employer



Alumni Profile Ann Marie McCrystal, B.S.N. ’59

Student Profile John Paul “JP” Moyle

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UNIVERSITY OF MIAMI School of Nursing and Health Studies


Celebrating 75 Years of Excellence at SONHS This year marks a School of Nursing and Health Studies milestone—the 75th anniversary of our educational beginnings! As a cohesive community of lifelong learners and health professionals devoted to equitable care and well-being for all, we are proud of our school’s origins, committed to elevating its present success, and wholly invested in ensuring its thriving future. As you will see throughout this special 75th anniversary edition of Heartbeat , SONHS is only improving with age. I know you will enjoy reading about how our wonderful faculty, students, alumni, and community of supporters are innovating new educational offerings, advancing transformative solutions and interventions for improved health outcomes, establishing novel transcultural exchanges around the world, and preparing countless premier professionals to transform health care across our hemisphere. Our beautifully curated cover story on page 18 tracks the evolution of this special place. Due to space limitations, the photos curated give a glimpse into this incredible journey, but are not the whole story by any means. I am excited to share that a “75th Anniversary Memory Book” will be dedicated to celebrate the phenomenal trajectory of SONHS and all those who impacted it. Stay tuned! On pages 12 and 16, two feature stories explore the bold strides we are making to revolutionize human trafcking awareness education, a pillar of our ongoing Ever Brighter campaign. On page 26, you can learn about groundbreaking research SONHS faculty are pioneering on another timely topic, LGBTQ mental health in the state of Florida. Finally, please be on the lookout for news of upcoming activities commemorating 75 Years of Excellence at SONHS, such as a joint anniversary colloquium with the University of the West Indies in May and our Alumnus of Distinction and Homecoming festivities in November. This incredible journey—from 1948 to this very moment—would have been impossible without thousands of dedicated individuals like you uniting from all walks of life and every corner of the globe to create this special health care community day after day, decade after decade. You all can be proud of your part in making the exciting work of education, discovery, and innovation happening here at SONHS a reality for generations to come. Cindy L. Munro Ph.D., R.N., A.N.P.-B.C., F.A.A.N., F.A.A.N.P., F.A.A.A.S. Dean and Professor

Paul A. Metcalf, Ph.D. Director of Development ADVANCEMENT


LaToya J. Lewis, Ed.D. Associate Professor of Clinical Zhan Liang, Ph.D.

Cindy L. Munro, Ph.D. Dean and Professor Arsham Alamian, Ph.D. Associate Dean for Health Studies and Associate Professor Nichole Crenshaw, D.N.P.

Assistant Professor Yui Matsuda, Ph.D. Assistant Professor Mary E. Mckay, D.N.P. Professor of Clinical Nicholas Metheny, Ph.D. Assistant Professor Greta V. Mitzova-Vladinov, D.N.P. Associate Professor of Clinical and Director, Nurse Anesthesia Program Brenda Owusu, D.N.P. Assistant Professor of Clinical and Director, Adult Gerontology Primary Care Program Andrew Porter, Ph.D.


Debbie Anglade, Ph.D. Associate Professor of Clinical Victoria Behar-Zusman, Ph.D. Professor and Director, Ph.D. Program Rosina Cianelli, Ph.D. Professor

Associate Dean for Undergraduate Nursing Programs and Associate Professor of Clinical Ruth Everett-Thomas, Ph.D. Associate Dean for Simulation Programs and Assistant Professor of Clinical Mary Hooshmand, Ph.D. Associate Dean for Graduate Clinical Programs and Associate Professor of Clinical Johis Ortega, Ph.D. Associate Dean for Hemispheric & Global Initiatives and Professor of Clinical Tatiana Perrino, Psy.D. Associate Dean of Diversity, Equity, Inclusion and Belonging and Professor of Clinical

Giovanna C. De Oliveira, Ph.D. Associate Professor of Clinical Joseph P. De Santis, Ph.D.

Associate Professor Diego A. Deleon, M.D. Senior Lecturer Charles A. Downs, Ph.D. Associate Professor Yannine Estrada, Ph.D. Research Assistant Professor Ashley L. Falcon, Ph.D. Assistant Professor of Clinical Cynthia L. Foronda, Ph.D. Professor of Clinical and Assistant Dean for Innovation, Clinical Research and Scholarship Research Associate Professor Nicole A. Gonzaga Gomez, D.N.P. Assistant Professor of Clinical and Associate Director, Nurse Anesthesia Program Juan M. Gonzalez, D.N.P. Associate Professor of Clinical and Director, Adult-Gerontology Acute Care Nurse Practitioner Program Audrey Harkness, Ph.D. Assistant Professor Shayne D. Hauglum, Ph.D. Giselle M. Garcia Rivero, D.N.P. Assistant Professor of Clinical Karina Gattamorta, Ph.D.

Associate Professor of Clinical Guillermo (Willy) Prado, Ph.D. Professor Carmen Rosa Presti, D.N.P. Associate Professor of Clinical Saribel G. Quinones, D.N.P. Associate Professor of Clinical Régine Placide Reaves, Ph.D. Assistant Professor of Clinical Deborah A. Salani, D.N.P.

Hudson P. Santos, Jr., Ph.D. Associate Dean for Research, Dolores J. Chambreau Endowed Chair in Nursing and Professor Marina Parada, M.S. Senior Business Officer Joseph Tripodi, M.A.Ed. Executive Director of Student Services Zuny Fernandez, M.S. Executive Director, Finance


Associate Professor of Clinical and Director, Post-Master’s Psychiatric Mental Health Nursing Program Kenya F. Snowden, D.N.P. Associate Professor of Clinical and Director, Family Nurse Practitioner Program Beatriz Valdes, Ph.D. Associate Professor of Clinical

Mission Statement At the School of Nursing and Health Studies, we transform lives and health care through education, research, innovation, and service across the hemisphere. N ovel O ptimistic W orld-changing

Denise C. Vidot, Ph.D. Associate Professor

Christopher P. Weidlich, Ph.D. Assistant Professor of Clinical Renessa Shamar Williams, Ph.D. Assistant Professor Linda L. Wunder, Ph.D. Associate Professor of Clinical Erick Zarabozo, D.N.P. Lecturer

Associate Professor of Clinical Patricia Larrieu-Jimenez, D.N.P. Associate Professor of Clinical Cynthia N. Lebron, Ph.D. Assistant Professor

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Significant gift will fuel research innovations at SONHS starting today Endowment: Jorie Healthcare Partners

Two big awards will get more students into health workforce within a year New Grants Target Nursing Shortage

The U.S. Bureau of Labor Statistics projects 194,500 openings for registered nurses annually through 2030. In the Sunshine State, that shortage is especially acute, with the Florida Hospital Association expecting a shortfall of 59,100 nurses in the workforce by 2035. In order to counter this gap, SONHS is pursuing new ways to build capacity for its prestigious Accelerated Bachelor of Science in Nursing (A.B.S.N.) degree, an intensive three-semester program for students with a four-year undergraduate degree in another eld. Two substantial new grants are helping the school achieve its goal. “These new grants will empower us to address the state’s nursing shortage by increasing our capacity to graduate highly qualied new nurses into the profession,” says SONHS Dean and Professor Cindy L. Munro. “Moreover, because our A.B.S.N. graduates reect South Florida’s diversity, these programs will help us increase equity and diversity in the nursing profession while raising standards of care in multicultural service areas. The return on investment—for the students and our community—is high.” LINE Fund A new program pioneered by SONHS and Jackson Health System (JHS), Miami’s nonprot academic medical system, kicked off this year with a site visit from Dean Munro and other nursing leaders from both institutions. SONHS was one of just seven Independent Colleges and Universities of Florida recognized with a 2023 Florida Department of Education Linking Industry to Nursing Education (LINE) Fund grant, a platform designed to drive innovative educational collaborations addressing the labor shortage.

care by nding savings and improving the patient experience.”

A generous gift from Midwest-based Jorie Healthcare Partners will establish The Jorie Healthcare Partners Biobehavioral Research Laboratory Endowed Fund at the School of Nursing and Health Studies (SONHS). The endowment will fuel research innovations through an enhanced laboratory serving students, postdoctoral fellows, and faculty— an investment designed to provide sustainable support for consequential scientic inquiry in biobehavioral health care. The school’s cutting-edge biobehavioral research laboratory, located in the M. Christine Schwartz Center for Nursing and Health Studies on the Coral Gables campus, will be named The Jorie Healthcare Partners Biobehavioral Research Laboratory. The laboratory includes a cell culture room, microscopy room, and wet laboratory space where investigators test biomarkers, perform cell and bacterial cultures, study phenomena using preclinical models, work with human subjects, and much more. The laboratory is also equipped for conducting blood assays, determining gene expression, genotyping, and measuring telomere length, as well as assessing redox indicators and proteomics. The Jorie Healthcare Partners endowment will provide a stable source of funds to support research activities, personnel, supplies, and equipment for the laboratory, as well as future renovations and current enhancements to an already-planned expansion project to increase the size of the 1,100-square- foot laboratory by 400 square feet. The inclusion of a generous “endowment accelerator” provides immediate access to current-use funds in order to extend work

This endowment and newly enhanced laboratory will become the driving force and nucleus of the SONHS Biobehavioral Technology Core, a key priority of the University of Miami’s Ever Brighter campaign, ultimately leading to novel treatment options, new data to fuel innovations in the science of holistic, patient-centered care, and lasting improvements for public health. Complementing other leading-edge facilities at SONHS, the laboratory will attract top-ight faculty and postdoctoral fellows; facilitate research

taking place in the laboratory without delay. The gift will have an instantly positive impact while the endowment is being fullled. “This extraordinary gift from Jorie Healthcare Partners will supercharge the capacity of the laboratory and strengthen the research experience for students, postdocs, and faculty

With its $75,000 LINE grant, SONHS teamed with perennial clinical partner JHS to create a Care Partners Dedicated Educational Unit (DEU), an expansion of the existing Care Partners Program, which places SONHS A.B.S.N. students in clinical rotations at JHS. Participating students, called “Care Partners,” will complete intensive, year-long clinical placements on the newly launched DEU, with nurse preceptors ensuring their acclimation to the profession. SONHS and JHS are also helping pay for the initiative, with JHS providing $75,000 in matching funds. Scholarship support is particularly critical for A.B.S.N. students, who often have exhausted nancial aid eligibility with prior degrees; moreover, the program’s compressed timeframe restricts their ability to nance their tuition by working. Since its 2013 inception, the A.B.S.N. program at SONHS has experienced a 70 percent increase in enrollment, according to University of Miami records. This rapid growth has taxed the school’s ability to help students who meet demonstrated nancial need. “The new initiative will increase our enrollment capacity by 16 full-time A.B.S.N. students, each of whom will receive partial scholarships,” says Dr. Nichole Crenshaw, SONHS associate dean for undergraduate nursing

programs and associate professor, who is directing the DEU in conjunction with a clinical faculty coordinator from the hospital. “Participants will be ready to enter the workforce within a year and upon graduation will receive preferential consideration for nursing positions at JHS.” Hearst Scholarships A $250,000 grant from the Hearst Foundations will award $10,000 scholarships to 25 highly qualied, full-time A.B.S.N. students from SONHS who demonstrate nancial need. Hearst Foundations have long supported various areas at the U. That support includes the 1990 creation of a William Randolph Hearst Endowed Scholarship for 4-year nursing students and a subsequent naming gift for the William Randolph Hearst Operating Room in the School’s Simulation Hospital Advancing Research and Education (S.H.A.R.E.™). “The generosity of the Hearst Foundations will signicantly expand our ability to provide tuition assistance to an increasingly competitive and talented pool of applicants to our accelerated nursing program,” says Dean Munro. “As seasoned professionals making a career change, these students are driven, highly motivated, and altruistic. The vast majority nd employment quickly, lling nursing positions in South Florida and beyond.”

collaborations with renowned scholars, practitioners, and external partners in industry and academia; and support emergent lines of research in a wide range of critical areas.

“Jorie Healthcare Partners’ tremendous generosity will benet the lives of countless

families, students, and health care professionals across Florida and the nation,” says Dean Munro. “We will educate the next generation of health care researchers, bridge existing gaps in knowledge, and promote collective wellness.

We also will nd answers to pressing questions about patient health and translate those evidence-based answers into potentially lifesaving care improvements.” Headquartered in Oak Brook, Illinois, Jorie Healthcare Partners is a health care technology industry leader with innovators and entrepreneurs pioneering work in robotic process automation, data analysis integration, revenue cycle management, business process re-engineering, and holistic practice management.

for decades to come,” says SONHS Dean and Professor Cindy L. Munro. “The endowment ensures that the lab is forever outtted with the equipment and resources to conduct groundbreaking, world-class scientic research that will drive advances in holistic, patient-centered health care strategies with the potential to generate profound and lasting change.” Sal Lo, Jorie Health Care Partners CEO and co-founder, states, “We are excited to leverage our technology to transform and relieve administrative burden of patient

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SONHS Research Update

Associate Dean Hired New post to amplify diversity, equity, inclusion, belonging

News from Dr. Hudson Santos, Associate Dean for Research

Images: Courtesy of Dr. Santos

Prevention scientist Tatiana Perrino, Psy.D., was hired effective March 1 as the inaugural Associate Dean for Diversity, Equity, Inclusion, and Belonging (AD-DEIB) and professor of clinical at the School of Nursing and Health Studies. Dr. Perrino joins SONHS from the Miller School of Medicine’s Department of Public Health Sciences, where she was a professor on the educator track. As AD-DEIB, Dr. Perrino will collaborate with the SONHS community to envision, conceptualize, and promote an environment that embraces a broad and inclusive denition of diversity, equity, inclusion, and belonging, as well as one that highly values the many racial, ethnic, gender, and cultural differences found within the SONHS community. Additionally, she will provide guidance and direction for understanding historical and current nondiscrimination laws, focusing on access and equity for program planning in higher education institutions. She will oversee efforts to address broad and specic DEIB issues of SONHS faculty, staff, and students as well. “I am delighted to be joining SONHS,” says Dr. Perrino. “I very much look forward to partnering with everyone to continue advancing the school’s commitment to diversity, equity, inclusion, and belonging. This is so valuable and important. Diverse perspectives and inclusive excellence enrich and strengthen everything we do: education, research, innovation, and service.” Dean Cindy L. Munro founded a DEIB Advisory Committee in July 2020. “I am very grateful to our DEIB committee members for their work in facilitating this important new position for our

Dr. Santos (center)

Dr. Harkness

Dr. Williams

Kathryn Gerber

JUNTOS Referral Network for LMSM Dr. Harkness worked on previously. JUNTOS was among the community- engaged projects Dr. Harkness discussed during UM’s annual HIV Symposium , where she an invited speaker on a panel of rising-star Miami HIV investigators. Dr. Renessa Williams , assistant professor, also presented her poster “Employing the Use of a Participatory Photography Method to Explore Intersectional Stigma in Black Sexual Minority Men Living with HIV” at the HIV Symposium. Themed “Science Driving Strategy: Ending the HIV Epidemic,” the day-long event drew big names in HIV research, like Robert Gallo, best-known as co- discoverer of the virus. 3MT Competition Outstanding Ph.D. candidate Kathryn Gerber was one of just nine UM students selected to vie in the Graduate School’s 2023 Three-Minute Thesis (3MT) Competition. Her 180-second talk on “Traumatic brain injury during the rehabilitation stage,” was based on her dissertation, “Neuroinammatory biomarkers, symptoms and functional outcomes in individuals who have sustained traumatic brain injury.” “Kathryn was a great representative of the school,” reports Dr. Victoria Behar-Zusman , director of the SONHS Ph.D. in Nursing Science program.

program for use with individual Latino sexual minority men (SMM). The adaptation, known as Hombre a Hombre (Man to Man), will be pilot-tested among Latino SMM, who are at greater risk for HIV and sexually transmitted infections relative to heterosexual men and, in some cases, to white SMM. Sexual minority stress and intersectional oppression as sexual minority men of color could be among the factors driving these disparities. “There have been no adapted programs for Latino SMM designed to be delivered to individuals and no culturally adapted relationship education programs that address the Latino SMM community’s unique cultural needs,” states Dr. Harkness. Hombre a Hombre could potentially address demonstrated disparities and enhance Latino SMM’s romantic and sexual relationships. Dr. Harkness is also co-investigator on a federal Ending the HIV Epidemic (EHE) supplement for a proposal to develop a strategic alliance, SOMOS Alianza (San Juan Orlando Miami Organizational Strategic Alliance), aimed at addressing the sharp rise in HIV incidence among Latino Men Who Have Sex with Men (LMSM) in Florida and Puerto Rico. Both places are among seven jurisdictions accounting for 84 percent of the nation’s increase in HIV incidence from 2010 to 2014. To scale up HIV-prevention and treatment services for LMSM to two new jurisdictions, SOMOS Alianza will build on the

I am happy to introduce this new space in Heartbeat magazine for highlighting notable achievements from faculty and student scholars and scientists. My own updates include representing SONHS at the 2022 International Society of Nurses in Genetics (ISONG) World Congress. I gave the closing keynote, “Multi‐Omics and Mixed‐Approaches Are Needed for Precision Health,” and received ISONG’s Founders Award for Excellence in Genomic Nursing Research, one of the highest forms of recognition one can receive from the international nursing genomics community. Our school was recognized at the 2023 Southern Nursing Research Society (SNRS) Conference, as well, when a paper I am senior author on—“Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight” (doi.org/10.1002/ nur.22210)—was awarded the 2022 Paper of the Year by the SNRS ofcial journal Research in Nursing and Health. Addressing HIV Disparities Dr. Audrey Harkness , who joined SONHS as an assistant professor last June, continues making her mark in HIV prevention research. Most recently, she received a Mental Research Institute grant to culturally adapt an evidence- based relationship and dating skills

Dr. Perrino

school,” says Dean Munro. “Moreover, we have found in Tatiana Perrino an incredible person to lead us forward. She brings to this role what I can only describe as the perfect combination of community-based, clinical, scholarly, and leadership experience, not to mention a wealth of institutional knowledge from her two-plus decades at the U.” Dr. Perrino, a licensed psychologist and member of the National Hispanic Science Network, was identied as the lead candidate following a nationwide search. Since joining the Miller School of Medicine in 2000, she has collaborated on several National Institutes of Health studies aimed at reducing health disparities and preventing public health problems such as drug use, HIV, obesity, and depression. Her current research and community work focus on preventing depression and related mental, emotional, and behavioral health risks among adolescents, especially Hispanic immigrant and socioeconomically at-risk youth.

At the University level, Dr. Perrino serves as Associate Provost for Faculty Development and as faculty liaison for the Atlantic Coast Conference Academic Leaders Network. From 2016 to 2021, she was associate dean for the Graduate School. An experienced educator, she co-developed and directed the Graduate School’s Teaching Academy. Her courses have covered applied public health, health education and behavior, determinants of health and disparities across the lifespan, and other subject matter. In 2023, Dr. Perrino received the Faculty Senate’s Outstanding Teaching Award for her graduate-level teaching record, and in 2022 was honored by the Public Health Student Association with its Department of Public Health Sciences Faculty of the Year Award. She completed a National Institute of Drug Abuse-funded postdoctoral research fellowship on adolescent drug abuse prevention in 2000. Dr. Perrino is a three-time graduate of Rutgers University in New Jersey, having earned her bachelor’s degree in psychology, and master’s and doctoral degrees in clinical psychology there.

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Spring Lecture Series Highlights Exploring minority health, celebrating Black History Month certain neighborhoods ensured some groups were left behind, with mounting effects on their health, livelihood, life expectancy, and generational wealth. “It’s like you were going to play

Nurse Anesthesia Grads Achieve 100% Pass Rate Student prevails against all odds to realize her dream

Eliseo J. Pérez-Stable, M.D., presented “How Science Promotes Health Equity by Decreasing Disparities,” a virtual installment of the SONHS Spring Lecture Series in February. The director of the National Institutes of Health’s National Institute on Minority Health and Health Disparities (NIMHD) explained that telemedicine access, community engagement during public health crises, and efforts to address social determinants of health factors can impact health disparities. He also detailed NIMHD research priorities aimed at promoting health equity: implementing multilevel interventions, developing clinician- patient communication and trust, using structural change to modify behaviors, and identifying mechanisms such as biological pathways, the environment, and the health system. “It’s increasingly important to focus on intersectionality. Socioeconomic status, and race and

December 2022 graduates of the highly ranked B.S.N.-to-D.N.P. anesthesia track at SONHS are celebrating a newsworthy achievement: a 100 percent rst- time pass rate on the National Board of Certication and Recertication for Nurse Anesthetists (NBCRNA) National Certication Examination, the credentialing exam for Certied Registered Nurse Anesthetists (CRNAs). “As the COVID-19 pandemic unfolded, the Class of ’22 faced unforeseen challenges,” says Greta Mitzova- Vladinov, SONHS associate professor of clinical and director of the Nurse Anesthesia Program. “Still, they kept up with their didactic and clinical teachings thanks to our faculty’s innovative teaching and engagement strategies.” For Catalina Majilton, D.N.P. ’22, COVID-related hardships were only the beginning. The single mom of two special needs kids knew completing the demanding three-year program would be grueling. With retinitis pigmentosa and no peripheral vision, her adolescent son, who is also on the autism spectrum, can’t drive a car or see at night. Her daughter, who has Zellweger spectrum disorder, is deaf, legally blind, and requires total care. Majilton sat down with her son and laid out the challenges. They’d have to sacrice—downsize to a smaller apartment, live on a reduced income. “He said, ‘Mom, is this your dream? Then go for it!’” recalls Majilton. “He was my biggest supporter.” The family had almost made it to the nish line when Majilton’s mother was hospitalized with COVID-19, and Majilton suddenly found herself with no one to help care for her daughter.

Monopoly, but I said, ‘no, you can’t play yet, you have to wait,’” Dr. Pérez- Stable explained. “Then an hour into the game, after everyone’s already bought property and maybe even built houses and hotels, I say, ‘oh, now you can join.’ What kind of opportunity do you have with that?” At a watch party, graduate students and faculty had the chance to interact with Dr. Pérez-Stable about their own research interests. “Diversity of the workforce should be a priority,” he told them, adding that NIMHD offers opportunities such as its K award program and Summer Health Disparities Research Institute to increase the number of NIH-funded minority scientists.

Dr. Pérez-Stable

ethnicity as a social construct are the two pillars, and everything else rotates around it,” said Dr. Pérez-Stable, who earned his chemistry and medical degrees from the University of Miami. COVID-19 exacerbated long-standing disparities in minority communities nationwide, he added. Structural racism and economic barriers like “redlining”

From left, Dr. Hooshmand, Dr. Majilton, and Dean Munro

On Risk and Resilience

“I was missing classes, failing my regional anesthesia course,” she says. “I thought about dropping out of the program.” Ultimately, though, she reached out for help, and the SONHS community quickly rallied in support. “Dr. Mary Hooshmand helped me navigate the benets system and qualify for a home health aide,” says Majilton. “My professors guided me in the right direction—how to study, what books to use—and my classmates organized an online study group. I studied day and night, and I passed my nal and my oral board exams, too!” “Making it through the program isn’t easy even under the best of circumstances,” observes Dr. Hooshmand, associate dean for Graduate Clinical Programs, “but we have our students’ backs and make sure they have the resources they need to succeed.”

Her dream of becoming a doctorally prepared nurse anesthetist now realized, Dr. Majilton reports that she has accepted a clinical position as a CRNA at Stanford Hospital and relocated to California with her mother and daughter. Meanwhile her son—who graduated from high school the same year his mom earned her D.N.P.—continues his studies at the University of Central Florida. “It’s a happy ending!” she says. “My professors always challenged me to be the best I could be. By the end, I was a different person who had grown as a human being and professional. I can’t thank them enough.” Reecting on her own journey, Dr. Majilton encourages anyone thinking about taking that next step to do it. “Don’t be afraid. There’s always a way,” she says. “Once you have a dream, nd the right people to support you, and nothing can hold you back.”

Last year, Dr. Cheryl Woods Giscombé purchased 42.5 acres in North Carolina that had belonged to her great- grandmother. She was captivated by a beautiful tree on the land. “It reminded me of what I study, which is how to resolve stress in a culturally relevant way through mindfulness,” she said during her February lecture at SONHS. “Mindfulness and self-compassion may be particularly effective to help African- American women and other groups who experience disproportionately high rates of chronic illness—particularly chronic illness that’s related to contextually relevant stressors.” Woods Giscombé, Ph.D., R.N., P.M.H.N.P.-B.C., F.A.A.N., a Distinguished Professor

Dr. Woods Giscombé (center) with Dr. Santos and Dean Munro at SONHS in February

at the University of North Carolina at Chapel Hill School of Nursing, shared insights from her important disparities- related research, including the African American Women’s Health Project, the Superwoman Schema Conceptual Framework, the We Can Prevent Diabetes mindfulness-based intervention study, and the Harmony study, a culturally relevant

stress management intervention for African-American women at high risk for cardiometabolic conditions. Harmony study participants, she noted, “wanted us to incorporate strategies to help them overcome the guilt of putting themselves rst.” A reception honoring Black History Month followed Woods Giscombé’s presentation.

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Public Health Reaccreditation Efforts Underway

Conference: Critical Care in Chile

Carmen Presti, SONHS associate professor of clinical, spent Thanksgiving as a presenter at the 40th Congreso Chileno de Medicina Intensiva (Chilean Congress for Critical Care Medicine), hosted by Sociedad Chilena de Medicina Intensiva (SOCHIMI). SONHS alumnus Cristobal Padilla, Ph.D. ’21, a Chilean nurse scientist, connected conference organizers with her. “I was honored to be among the group chosen to speak,” says Dr. Presti, an experienced cardiovascular intensive care unit (ICU) nurse practitioner (NP) at Miami’s Jackson Memorial Hospital. “There were a lot of really amazing international speakers.” Her three talks addressed the nurse practitioner’s role in the ICU, the care of patients on ECMO (extracorporeal membrane oxygenation), and novel strategies for hemodynamic monitoring. “The nurses were really eager to learn from us,” she recounts. In addition, Dr. Presti contributed to an interdisciplinary panel discussing the pros and cons of integrating advanced practice

The Bachelor of Science in Public Health program at the School of Nursing and Health Studies—Florida’s only standalone baccalaureate public health program accredited by the Council on Education for Public Health—is seeking to extend the council’s important stamp of approval for seven years. CEPH accreditation is a signicant distinction, providing assurance that the school’s B.S.P.H. meets established standards and that its curriculum imparts the necessary skills. “It is paramount for any programs of public health, be it bachelor’s or masters or doctoral, to be accredited by the Council on Education for Public Health because this is the national accreditation agency,” says SONHS Associate Dean for Health Studies Dr. Arsham Alamian. “It speaks to the quality of the program, the quality of education students receive. The expectation is that we’ll do well.” CEPH, an independent agency recognized by the U.S. Department of Education, rst accredited the program in 2018. That ve-year accreditation is due to expire July 1. “Accredited

Dr. Presti in Chile, at center wearing blazer; Dr. Padilla is pictured far left.

literature.” Dr. Presti also presented at Ponticia Universidad Católica de Chile (UC) on the NP role. SONHS has been assisting that institution’s historic efforts to graduate Latin America’s rst ofcial NPs. Last year, SONHS associate professor Juan M. González taught advanced pathophysiology to the inaugural oncology NP cohort.

nurses into the ICU in Chile, where the advanced practice role is just being established. “It really made me appreciate how formalized our nurse practitioner role is here in the States,” she says. “What Chilean nurses are missing to expand their role is that research piece that validates how their additional training improves outcomes. That is going to change as more Ph.D. nurses from Chile contribute to the

programs are bound by a set of competencies and domains in the public health major,” says Dr. Alamian. “These have to be reviewed at different levels by different reviewers from the practice side and by academia.” As part of the rigorous evaluation, multiple standards, including study areas, faculty engagement, and student outcomes—the percentage achieving graduate school placement or employment after completing

their degree—are examined. So far, SONHS has submitted an extensive self-study report and undergone a preliminary review. On-site interviews with administration ofcials and faculty took place at the end of February. The reviewers’ complete report gets submitted to the CEPH board. School leadership can review and respond to that report before CEPH’s nal reaccreditation vote this summer.

Study Abroad Is Back!

study abroad programs,” he says. The 20 senior B.S.N. students from SONHS were guests of Universidad Francisco de Vitoria, where they attended lectures and anatomy lab. Clinicals took place at Hospital Universitario del Sureste and Hospital Universitario Quirónsalud Madrid. “Since we had the opportunity to do a lot of clinical rotations in so many different units while there, I saw a lot of procedures and gained a lot of experience I wouldn’t have during a typical rotation in Miami,” said participant Alison Skubik. Stropes is also grateful for the opportunity. Cultural experiences “are very important in creating a well- rounded person, especially a nurse,” she concludes. “Getting to see how other nurses operate and navigate their health care system was really fascinating. I certainly found myself learning lots from them that I plan to implement in my own practice.”

COVID-19 threw a wrench into Sydney Stropes’ plans to study abroad, so when SONHS resumed study abroad over winter break with an intensive transcultural nursing elective in Madrid, she was quick to opt in. “The group of 20 of us got to have the immensely unique and special opportunity to work within and observe the Spanish health care system,” she says. When her classmate Jerusha Jean walked into a hospital room at Hospital Universitario Quirónsalud Madrid, she found a patient crying, awaiting a doctor’s visit. Gently putting her hand on the patient’s shoulder, Jean offered consolation. Despite the language barrier, the Spanish patient understood her sentiment and reciprocated with a calming touch. In that moment, Jean felt a reinvigorated passion and pride for providing care. “Interacting with the patients on that level conrmed I

First-in-Florida Degrees Announced

SONHS and Miami Herbert Business School joined forces to create the Master of Science in Leadership (M.S.L.) / Doctor of Nursing Practice (D.N.P.) joint degree program designed to equip early- and mid-career nurse leaders with greater uency in key health sector management principles including negotiation expertise, marketing, health care nance, ethics, practice improvement, health policy, human resources, technology, and more. The rst M.S.L./D.N.P. cohort of Florida- licensed registered nurses started this past January, Spring 2023. “The program is the only one of its kind in Florida and

among the rst in the nation,” says Dr. Mary Hooshmand, associate dean for Graduate Clinical Programs at SONHS. The same pioneering claim can be made about a new joint degree offering from SONHS and the Miller School of Medicine’s Department of Public Health Sciences. The rst cohort for the 4+1 B.S.H.S./M.P.H. and 4+1 B.S.H.S./ M.S.P.H. will begin Fall 2023, says Dr. Arsham Alamian, associate dean for Health Studies at SONHS. “Academically qualied juniors or sophomores majoring in health science at SONHS now have

the unique opportunity to complete both their bachelor’s and master’s degrees in ve years,” says Dr. Alamian. “I encourage students interested in our health science program to consider this opportunity. Pursuing a medical career requires a well-rounded, multifaceted understanding of public health and its afliated concerns.” A similar 4+1 degree option for SONHS public health students has been very successful.

was in the right profession,” she says. “We spend a lot of time focusing on the books, but it is a completely different experience seeing it right before your eyes. It was truly such an incredible experience for me.” Associate Dean and Professor Johis Ortega led Global Health: Transcultural Nursing (NUR485) from January 2 to 15. “Students are very excited our school has reinitiated its enriching

Visit http://sonhs.miami.edu/msl-dnp and https://bshs.sonhs.miami.edu.

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SONHS puts human trafficking front of mind for clinicians in the region, an epicenter for this global health crisis Invisible No More

By Robin Shear

At 14, “Melissa” was abducted and forced into sex trafcking. “I got angry with God,” she said on video, recalling her lowest point before a local nonprot helped her escape. “I told [God], that’s it. I can’t survive this anymore. I was going to commit suicide...Most of the girls in there don’t think they could get out.” Tens of millions of human trafcking victims, from young to elderly, exist among us, forced to stay silent and invisible—blend in, shut up, or disappear forever. In the U.S., Florida, California, and Texas are the top three states impacted, with South Florida at the epicenter of the crisis statewide. “Despite this global epidemic, we are not educating our providers to recognize who they see in their practices,” said Dr. Deborah Salani. It is “very, very alarming,” she added, that 64 percent of trafcked individuals are seen by a health care provider while captive without being identied as such on examination—despite often-glaring “red ags” signaling the particularly brutal brand of long-term trauma and neglect they experience.

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jaw is still on the oor. They can really provide this curriculum quickly and efciently. I’m excited to see what’s going to happen going forward from here.” Drs. Salani and Valdes are equally eager to build the momentum SONHS has going. “Our goal is really getting out there and educating more providers to pick up the signs to recognize these individuals in clinical practice,” said Dr. Salani. In addition to nurses, they have begun to educate public health students, social workers, and medical students, among others. They now offer virtual simulations,

threatened with harm to their families, and forced to work in a health system without anyone outside the trafcking ring aware of their predicament. Statistics show that a majority of victims, in fact, are not getting help to escape trafcking when they visit the health care system. “These are difcult patients when they come in. They have learned how to survive,” she said. “Raising awareness but not equipping nurses is just creating moral distress. We need to make sure systems are in place to help nurses respond. Nurses are the greatest health profession poised

with major hospital systems such as UHealth and Jackson Health System, engage a consultant, form an advisory board, and establish reproduceable resources for the local, national, and international community. Lamas’s support helped create The Maria G. Lamas Featured Speaker Series for Human Trafcking Education and Prevention Endowment. Nurse practitioner Jessica Peck, a nationally recognized anti-human trafcking advocate and clinical professor at Baylor University in Texas, was the inaugural presenter for the series.

Dr. Salani

Dr. Valdes

Dean Munro has championed this curriculum from the beginning, making human trafcking awareness a pillar of the school’s goals for Ever Brighter: The Campaign for Our Next Century. Her support enabled Drs. Salani and Valdes to hire the 10 SPs they needed to enact emergency department patient scenarios addressing the sex, labor, and domestic servitude aspects of human trafcking. “It’s not something you can read about,” said Dean Munro. “You have to practice it. Recognizing human trafcking should be a skill set just like the one we have when we see someone collapse. When that happens, we know how to perform CPR. We roll right into action.” The Dean’s vision and blueprint includes establishing the Academic Center for Human Trafcking Education and Prevention at SONHS. The center will provide a permanent incubator from which faculty and students can continue developing, disseminating, and scaling up evidence-

This was the stark subject of a Beta Tau educational presentation made by Dr. Salani and her colleague Dr. Beatriz Valdes, both associate professors of clinical at the School of Nursing and Health Studies (SONHS), during Human Trafcking Awareness Month in January. The title of their lecture, “Do You See What I See? Recognizing Human Trafcking,” is also the powerful hybrid of simulation and classroom instruction—the two rst piloted at the Simulation Hospital Advancing Research and Education (S.H.A.R.E.™) in 2019. “If we could educate more health care providers about this topic, more lives would be saved,” said Dr. Salani. name of the evidence-based educational curriculum—a Education is key in helping health care providers become more condent, knowledgeable, and adept at identifying and assisting patients who may be human trafcking victims, according to scholarly projects conducted by two recent SONHS doctoral nursing students (see page 16). To that end, over 600 nursing students in a variety of degree programs at SONHS have completed the “Recognizing Human Trafcking” course since its ofcial launch in Spring 2021. The simulation portion of the course requires students to engage unknowingly with a trauma-informed Standardized Patient (SP) portraying a potential trafcking victim. Simulation educators Michelle Arrojo, D.N.P. ’18, and Amauri Quintana,

D.N.P. ’20, run the scenarios that immerse students in complex encounters with varying indicators, challenges, and symptomatology. “The overall response has been excellent,” said Dr. Arrojo. “The students appreciate having the professional patients. They say it makes it more real.” Dr. Valdes agreed. “Some students are so into it that they walk out of the room to call 9-1-1,” she said. “They forget they are in a simulation.” At least two alumni spoke up during the Q&A portion of the lecture to say that what they learned in the course helped them identify a human trafcking victim during a subsequent clinical encounter. “The simulation and accompanying curriculum ensures that when our students are exposed to an event like this in the clinical arena, it won’t be their rst time,” said Dr. Quintana. “Many say they now feel more comfortable in what to do if they suspect someone is being trafcked or exploited.” Teaching providers to identify and responsibly assist human trafcking victims in culturally appropriate ways that don’t retraumatize or endanger them is part of a concerted mission under way at SONHS, led by Dean and Professor Cindy L. Munro, to make evidence-based tools and resources available to as many area health care professionals as possible.

“Human trafcking is one of the most egregious human rights violations there is,” said Dr. Peck during her November address. “This is happening in your back yard, in my back yard, all the time, all around us.” Emphasizing how shockingly commonplace the problem is, she said, “Sadly, it is easier to order a person than a pizza on the Internet.” Even health providers are not immune from being victimized. Dr. Peck shared the story of a group of nurses from the Philippines lured to another country with promise of work then abused, stripped of immigration papers,

too. “We train as many people as we can,” she said. “We want that number of unidentied trafcking victims to go down.” If you need help or suspect a case of human trafcking, call or share the Stop Human Trafcking hotline at 1-888-373- 7888.

for prevention—that’s what we do,” she continued. “But we have to be organized as a profession.” To help SONHS continue leading the way, Dr. Peck is sharing her expertise as a consultant and working with Dean Munro to assemble an advisory board. “The University of Miami has the ability to be an international leader in simulation-based learning,” Dr. Peck said. “What Dean Munro has proposed here with simulation is very innovative, immersive, and much more impactful for long-term behavioral change.”

based curricula and research to national and international levels.

Critical support to date has come from The Harcourt M. and Virginia W. Sylvester Foundation, Maria G. Lamas, Heidi Schaeffer, M.D. ’98, and the UM Citizens Board, among others. The generosity of the Harcourt M. and Virginia W. Sylvester Foundation, for example, will enable SONHS to signicantly expand its efforts over the next two years to educate frontline health care professionals, collaborate

Mentioning her tour of S.H.A.R.E.™ earlier in the day, Dr. Peck added, “My

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RAFT: Rapid Appraisal for Trafcking

love nurses to feel more comfortable having those difcult conversations with patients.”

Identifying Human Trafficking D.N.P. students put scholarship into practice

Hattie Runzheimer, M.S.N. ’19, D.N.P. ’22, an acute care and psychiatric nurse practitioner, also elected to aim her scholarly project at this clinical practice problem with her SONHS faculty mentor Dr. Deborah Salani. “Human trafcking (HT) was on the rise during COVID,” she says. “I chose this project because it was compelling, after having talked about it with Dr. Salani for a year.” Out of almost 100 health care sites interviewed, Runzheimer found just one had a human trafcking screening protocol in place. She developed a PowerPoint presentation designed to teach nurses to better identify human trafcking victims. She also sought to introduce an evidence- based assessment tool. She then initiated the training phase of the project with ED nurses at Jackson Memorial Hospital. June Ellis, the Associate Chief Nursing Ofcer of JMH’s Emergency Department and Critical Care Unit, sent Runzheimer’s PowerPoint training to all ED nurses with the survey linked to it. A total of 23 nurses completed the training, as well as pre- and post-test surveys. Runzheimer concluded that there is need for standardization of HT training in the clinical setting and need for improved collaboration with community partners and key stakeholders. “Knowledge and condence go hand in hand—to know the resources out there and be able to refer to a specialized clinic,” she says. Local specialized resources for referring patients suspected of being trafcked include THRIVE Clinic at UHealth, led by SONHS alumna JoNell Efantis Potter, M.S.N. ’87, Ph.D. ’03, and Glory House of Miami, she adds.

By Carlos Harrison, Robin Shear, and Yolanda Mancilla

Working as an emergency department nurse early in her 20-year career, Aileen Alvarez, D.N.P. ’22, saw rsthand the challenge of dealing with suspected human trafcking. Too often, she felt, its victims turned up in emergency departments (EDs) with acute problems but were never referred to authorities who could help them. The problem is, like any disease, trafcking can only be identied if health ofcials can recognize the symptoms. “There’s a signicant need, so I feel passionately about trying to do something to make a change,” says Alvarez. The mother of four was able to do that last fall as she earned her Doctor of Nursing Practice (D.N.P.) at the School of Nursing and Health Studies while working full-time as an adult-gerontology primary care nurse practitioner Collaborating with SONHS faculty members Deborah Salani and Beatriz Valdes for her third-semester quality improvement project, “Implementation of clinical guidelines, screening, and referral program,” Alvarez interviewed hospital staff in Miami-Dade and Broward County hospitals to see if any had an established screening tool for human trafcking. “It was somewhat alarming to nd out that most places don’t screen for human trafcking,” says Alvarez, who graduated this past December. Especially, she continues, because “Florida ranks number three in the country for human trafcking and Miami-Dade has the highest reports per county.” Lack of screening guidelines is not unique to South Florida. “In our literature reviews, we found there’s not really an established tool nationwide,” she adds. “There are very few vetted tools.” Alvarez went beyond analyzing the problem. EDs, she notes, may frequently be the rst, and perhaps

1. 2. 3. 4.

It is not uncommon for people to stay in work situations that are risky or even dangerous, simply because they have no other option. Have you ever worked or done other things in a place that made you feel scared or unsafe?

In thinking back over your past experience, have you ever been tricked or forced into doing any kind of work that you didn’t want to do?

Aileen Alvarez, D.N.P. ‘22

sleeve nurses can hang behind their badges for easy reference. The card contains the nationally accepted Rapid Appraisal for Trafcking, or RAFT, screening tool. “It’s only four questions they had to ask,” says Alvarez. In scholarly presentations to peers and providers, she offered actions for health professionals suspecting human trafcking to take: immediately contact ER Social worker, interview patient alone, obtain an interpreter, complete screening and health history. Now she is working on publishing the article she wrote about her project’s ndings. Signicantly, she showed that educational intervention increased health care provider knowledge and self-reported condence from health care providers in human trafcking identication and treatment and that establishing protocols and procedures further enhances the impact of anti-trafcking efforts. “We need more standards for mandatory screening for human trafcking, in the same way we screen for depression and domestic violence,” says Alvarez. “In general, I just would

only, point of contact with authorities. She identied four objectives: Increase health care provider (HCP) knowledge on human trafcking (HP) and assessment, increase HCP assessment skills related to identifying HT victims, increase HT screening by implementing a screening tool as part of the electronic health record (HER), HT identication pre- and post-screening tool implementation. She then arranged visits to local emergency departments to teach nurses ways to spot potential human trafcking victims. “Serious things they [emergency personnel] see on a frequent basis which are red-agged are things related to the sexual organs,” she says. “Frequent UTIs [urinary tract infections], any type of sexually transmitted infection or disease, pregnancy. Those are the things that, for the most part, ED providers are seeing. Also things that are going to impair their function, their performance. There’s a car accident, there’s anything of that nature, where there is no choice but to bring them in.”

Sometimes people are prevented from leaving an unfair or unsafe work situation by their employers. Have you ever been afraid to leave or quit a work situation due to fears of violence or threats or harm to yourself or your family?

Have you ever received anything in exchange for sex (for example, a place to stay, gifts, or food)?

Hattie Runzheimer, D.N.P. ‘22

“In implementing research to practice, you need your champions in the system, and you need the stakeholders’ buy-in,” says Runzheimer. “June Ellis was my champion. Dr. Mary Hooshmand at SONHS and Dr. Carol Biggs [Senior VP and Chief Nursing Executive at JMH and a faculty member at the SONHS] also supported the project.”

She went further still, creating a “badge buddy,” a card in a plastic

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