University of Texas Houston Health Science Center,
School of Public Health, Brownsville Campus
Location:
Brownsville, Texas, is a low-income, 94% Hispanic community
at the tip of South Texas on the Mexican border. It lies directly on
the Rio Grande River with three major border crossings to Mexico; two
of which are in the downtown area. The town established in 1848, has
grown rapidly since NAFTA, but is still both safe and inexpensive. The
climate is tropical and the campus is 25 miles from the South Padre
Island on the Gulf Coast. This is one of the poorest areas in the United
States. The School of Public Health is on the campus of the University
of Texas Brownsville which occupies the original site of Fort Brown
and whose administration buildings occupy the original yellow fever
hospital. The site offers the opportunity of working both sides of the
border in a community with many features of the developing world, but
with state-of-the-art facilities, including a BSL3 laboratory.
The school:
The campus, led by the Regional Dean, Dr. Joseph McCormick
(Duke MD ’71), established several NIH funded programs in 2003.
These are chiefly focused on diabetes and tuberculosis which are highly
prevalent in the area. Other diseases of importance are HPV associated
cancer and the many complications of diabetes, and recently dengue which
is reemerging locally, particularly across the border. The programs
are interdisciplinary involving clinical medicine, epidemiology, basic
microbiology and immunology and behavioral science. The campus hosts
a Clinical Research Unit, located at the central hospital, and has field
sites and trained field workers. A computer laboratory with sophisticated
ITV and internet connections to Houston and elsewhere complement the
facilities. 10 faculty and over 50 bilingual staff mentor students and
support research. Weekly seminars and journal clubs supplement the teaching,
with frequent outside speakers. Students from Duke, Cornell, Rochester,
Washington University and University of Texas at Austin have been hosted
as summer or academic year interns. The school teaches an MPH and an
MD/MPH with UT San Antonio, and also has some doctoral students in various
disciplines. Dr. Blanca Restrepo leads a field and laboratory based
program in the pathogenesis of tuberculosis in diabetes, and Dr. Belinda
Reininger leads a comprehensive community outreach program with a lively
media based education program using behavioral journalism. Opportunities
for students include clinical research, epidemiology, molecular microbiology
and immunology, behavioral science and data analysis. Spanish classes
are offered, and opportunities to work in Spanish abound.
Epidemiology and infectious diseases opportunities
Mentors: Dr. Sue Fisher-Hoch, Dr. Rose Gowen, Dr. Blanca I. Restrepo,
Dr. Joseph McCormick
Cameron County Hispanic Cohort: Between 2003 and 2007 we collected a
cohort representative of the populationof Brownsville, called the Cameron
County Hispanic Cohort(funded by NIH). This consists of 1700 randomly
selected Mexican Americans representative of the adult population of
Brownsville. All individuals complete a physical examination with questionnaires,
anthropometric and clinical and mental health measurements at our Clinical
Research Unit (CRU) which is part of the University of Texas Houston
Health Science Center Translational Research Award (NIH funded CCTS-CTSA).
Data from this cohort show that rates of obesity and diabetes are the
highest in the US. Over half have BMI over 30 (obese), and fully 20%
of people over 18 have diabetes. This well-characterized cohort is now
available for a number of studies in Mexican Americans. Early in 2008
we will start to call back these cohort participants and enroll them
in a studies of diabetes and related diseases, as well as intervention
studies. Visiting students could be involved in one or more studies
involving this cohort, and could gain experience in the field, the clinic,
the laboratory and in data collection, management and analysis.
Tuberculosis program: Our tuberculosis team in Brownsville, Texas offers
a special international training opportunity. The experience is quite
unique because it is binational (US/Mexico), allowing the student to
experience the contrasts of the developing and developed world within
walking distance, good quality of science, excellent mentoring and a
good working environment. We are confident this will prepare and provide
the trainee with a competitive advantage for your future career. One
of our major areas of interest in out tuberculosis program is understanding
the impact that the epidemic of type 2 diabetes is having on infectious
diseases, particularly tuberculosis. We are therefore interested in
the implications these two co-morbidities may have in making the host
more prone to multi-drug resistant tuberculosis, and having TB patients
that may be more infectious for longer periods of time, hence making
an important contribution to disease spread in the community. From the
basic science perspective we are interested in the biological basis
of the association between both diseases through immune response studies,
and the early detection of drug-resistant TB through point mutations.
The trainee will receive a one-on-one mentoring when they participate
“hands-on” in one of these projects, and expected to provide
an important contribution. The experience includes field sites in Mexico
and Texas, and our BSL3 laboratory (see below), where we also perform
state-of-the-art molecular and immunological studies using fresh specimens
from the patients seen in our clinics. Even though the proposed training
topic has a focus, participation in the project will provide the student
a better understanding of disease pathogenesis and public health, that
can be later extrapolated to any other disease process.
Laboratory studies
Our new 6000 square foot laboratory includes a BSL3 for handling pathogens
such as Mycobacterium tuberculosis and West Nile Virus. We have real
time PCR which is heavily used in a number of studies. We also have
immunological facilities, and are using techniques such as Luminex and
bead array to study cytokine responses in patients with infectious diseases
and diabetes. In addition to the well established tuberculosis laboratory
studies, we will be working with dengue and West Nile patients, and
possibly with infections such as systemic candidiasis in neonates of
mothers with uncontrolled diabetes.
Clinical Research Opportunities
Mentors: Dr. Rose Gowen, Dr. Sue Fisher-Hoch, Dr. Joseph McCormick
Students at our campus have the opportunity of working in clinical programs
as well as epidemiological studies and the laboratory. As part of our
CTSA aware, Brownsville has a Clinical Research Unit at the main Brownsville
hospital, staffed by a medical director, two nurses and a field staff.
In addition to studies using the Cameron County Cohort, we have several
clinical studies including studies of HPV associated cancer, studies
of the consequences of obestity and diabetes in pregnancy, and some
neonatal studies, also looking at the impact of maternal diabetes and
obesity. Some of these studies include therapeutic as well as behavioral
interventions.
Students may also spend time in the OBGYN office of our Medical Director,
Dr. Gowen, where they would have an opportunity to participate and interact
on several levels. They would be encouraged to interact from the time
the patient enters the office to the time she leaves. Triage interviews
& vital sign evaluation would be observed and learned. Assisting
with exams & procedures would also be part of the usual day. Understanding
the basic insurance issues and aspects of billing would be touched upon
as well. Outside of the office, there will be opportunities to observe
surgery in the hospital and follow the usual post operative care in
the hospital. By interacting at each level the student will have an
opportunity to understand the “whole picture” of health
care at the primary care level. Certainly, the Hispanic area and its
inherent influence on society and health care will be appreciated.
Opportunities in Community and Behavioral Science:
Mentors: Dr. Belinda Reininger, Dr. Cristina Barroso
1 Intervention studies in diabetes and obesity: media program (Tu Salud
Si Cuenta)
The National Institutes of Health have funded the School of Public Health
to carry out a research project entitled Project EXPORT: Creation of
a Hispanic Health Research Center in the Lower Rio Grande Valley. One
part of this research is associated with providing health information
to the Lower Rio Grande Valley through the activities of the Community
Outreach Core. The three main aims for the Community Outreach Core and
their associated goals are
Aim 1. Develop and disseminate culturally sensitive health information
in a culturally sensitive manner to communities and professionals.
Goal: Assess health promotion programs shown to be culturally appropriate
and examine the in/effective manners for health information dissemination.
Aim 2. Encourage and equip communities to participate in research and
for partnering in evidence-based disease prevention / intervention activities.
Goal: Support other core activities with their recruitment and retention
efforts, create local research efforts of interest to the community.
Aim 3. Support science education outreach activities in the Valley.
Goal: Enhance development activities for science teachers and encourage
Hispanic youth to enter scientific careers.
The scope of the student’s internship will entail working directly
with the faculty and staff of the Community Outreach Core as we conduct
literature reviews, plan programs, and implement activities to enhance
culturally competent health programs and science education in the Lower
Rio Grande Valley. Specifically, the intern will carry out a project
developing materials for a Spanish language media campaign on the topics
of physical activity and healthy food choices among Hispanics. The student
will help to design TV and radio segments, write and distribute newsletters,
and conduct market research. Additionally, the student will provide
assistance in the development of a website promoting healthy eating
and physical activity.
2 Intervention studies in diabetes and obesity: surveys and data analysis
The scope of the student’s internship will entail working directly
with the faculty and staff of the Community Outreach Core as we conduct
literature reviews, plan programs, and implement activities to enhance
culturally competent health programs and science education in the Lower
Rio Grande Valley. Specifically, the intern will carry out a project
analyzing data from a physical activity and nutrition survey. The student
will use computer software to conduct statistical analysis of the data
and create graphics to summarize the findings. Additionally, the student
will provide assistance to the development of a website promoting healthy
eating and physical activity.
Contact information
For further information please contact us by email:
Sue Fisher-Hoch, MD susan.p.fisher-hoch@utb.edu
Joseph McCormick, MD joseph.b.mccormick@utb.edu
Blanca Restrepo, PhD blanca.i.restrepo@utb.edu
Belinda Reininger, DrPH Belinda.m.reininger@utb.edu
Rose Gowen, MD Rose.m.gowen@uth.tmc.edu
Cristina Barroso PhD Cristina.barroso@uth.tmc.edu
