8:35 a.m., March 19, 2009----The University of Delaware has signed a general agreement with the Azienda Unita Sanitaria Locale 11 di Empoli (AUSL11), a local health authority in the Tuscan region of Italy, to establish linkages and create the foundation for mutual cooperation and collaboration in research, teaching and faculty/student exchanges.

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The agreement was signed by UD President Patrick Harker on Jan. 6 and by AUSL11 Director General Eugenio Porfido on Jan. 19 during a ceremony in Empoli, Italy.

The ceremony in Italy was attended by Steven Stanhope, interim dean of UD's College of Health Sciences; Veronica Rempusheski, Jeanne K. Buxbaum Chair of Nursing Science; Velio Macellari, direttore Dipartimento Tecnologie e Salute, Istituto Superiore di Sanita (the Italian equivalent of the National Institutes of Health); Francesco Benvenuti, director of the Department of Rehabilitation and Frailties, AUSL11; Ingrid Pretzer-Aboff, assistant professor in UD's School of Nursing; and Gregory Hicks, assistant professor in the Department of Physical Therapy, among others.

The ceremony kicked off a week-long process of joint meetings among the University of Delaware delegation and representatives from the faculty of medicine, University of Florence, Tuscany Health District, AUSL11 Department of Rehabilitation and Frailties, and local governments in Florence, Empoli, San Miniato and Castelfiorentino.

AUSL11 is one of the 12 local health authorities of Tuscany - which has a population of nearly 3.7 million -- and includes 15 municipalities with 229,000 residents, 22 percent of whom are 65 or older, in an area of 383 square miles.

AUSL11 and the State of Delaware are geographically similar and share similar challenges related to rapidly aging populations and the provision of health services across rural communities, Rempusheski said.

The Rehabilitation and Frailties Department of AUSL11 has a unique, innovative model care system for persons with chronic motor disabilities, she said, adding they have implemented a community-based Adaptive Physical Activity (APA) program for addressing the disabling functional decline in persons with chronic health conditions - the only program of its kind in the world.

Nearly 10,000 citizens in AUSL11 have been evaluated for inclusion in the APA program in the past four years and currently, the estimated number of regularly attending APA participants is 4,500.

The APA program provides a rich resource and an ideal clinical environment for answering research questions of interest to clinicians and clinical researchers, Rempusheski said.

Just prior to the signing of the UD-AUSL11 agreement, researchers in UD's College of Health Sciences were invited by the National Institutes of Health (NIH) to respond to a request for applications for Patient Reported Outcomes Measurement Information System (PROMIS) research sites, an initiative spearheaded by the NIH Roadmap for Medical Research.

In the four weeks that followed the homecoming of the UD delegation, a team of seven investigators -- including Benvenuti, Pretzer-Aboff and Hicks, and led by principal investigator Rempusheski - prepared a proposal and met a March 3 deadline.

The proposed study, Globalization of the PROMIS Scales: Implementation in Italy, is to translate the physical function PROMIS scale into Italian and evaluate the translated scale in a clinical population where established assessment scales are routinely used.

Consequently, the UD-AUSL11 agreement framed their first collaborative scientific effort in aging and physical function and now sets in motion future international research studies that build upon the Italian experience in an aging population and replicate the APA community-based program in the United States.

Rempusheski said this is of particular importance in states like Delaware where those 60 and older are projected to comprise 30 percent of the state's population by 2030 and 41.5 percent of persons over age 65 has a disability.

“UD and AUSL11 began on our path to collaboration with a Global Health and Aging Forum in Delaware in October, 2008, when the cross college cluster in aging workgroup invited Dr. Benvenuti to UD,” Rempusheski said. “Through our intensive NIH proposal preparation process, UD researchers and AUSL11 clinical scientists engaged in laying the foundation for an initiative that has broad implications for public health in the United States and in Italy.”