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Medical center faces flu vaccine shortfall
News to use
Slim down, live longer
Hormone therapy revisited
Profile: Miles Albertson
U.S. drug czar visits
An old partnership gets a new name /
UF Health Science
TABLE OF CONTENTS
O POST IT News to Use
O EDUCATION Palliative Care
SRESEARCH Slim Down, Live Longer
O COVER FEATURE Rebranding Shands
O PATIENT CARE Hormone Therapy Revisited
G PROFILE Miles Albertson
G EXTRAORDINARYY PEOPLE
O DISTINCTIONS HSC Achievers
@ COMMUNITY U.S. Drug Czar Visits
O POINT OF VIEW Nursing Education
Medical center faces flu vaccine shortfall
UF doctors hope that a severe shortage of influenza vaccine
hasn't set the stage for a disastrous flu season this year.
In the past two weeks, UF&Shands staff has scrambled to
find every available dose to provide to established patients at
risk for health complications. The hunt began when it was
learned that the medical center would receive virtually none of
the vaccine it ordered for this year's flu season.
At the POST's press time, 2,040 doses had been lined up,
about 15 percent of the 13,000
units originally ordered. The
doses were obtained from a
variety of public and private
sources, according to Alan
Knudsen, director of Shands
That's enough vaccine to
cover two groups of high-risk
patients organ transplant
recipients and infants ages 6 to
23 months but not other at-
risk groups, including elderly
patients with underlying
Fred Southwick, M.D., UF
chief of infectious diseases,
said the medical center
ordered all its vaccine from
Chiron, the company whose
manufacturing plant in
England was decertified to sell 1
vaccine because of evidence of
bacterial contamination. One
of two suppliers to the U.S.
market, Chiron had been
expected to provide about half
of the 100 million doses ordered
"We bet on the wrong horse," said Southwick. "This is a bad
system when providers are forced to choose between just two
suppliers of vaccine."
The flu kills about 36,000 people in the United States each
year. Most of those deaths are among the frail elderly so
weakened by the illness that they succumb to pneumonia and
Although some public health officials predict a mild flu
season this year, Southwick said there's really no way to tell at
this point. And with fewer people vaccinated, the potential is
far greater for more people to catch and spread the flu.
That risk may be magnified in Florida, with a
disproportionate share of elderly residents and vaccine
supplies in the state running far below the 50 percent level of
what was initially ordered and what
federal officials say should be available.
When the shortage was recognized,
Southwick began working with his
counterparts at medical schools at the
University of Miami and the
University of South Florida to bring
attention to the threat. They want the
federal government to declare a
national emergency and recall all the
vaccine now in the hands of
commercial vendors not affiliated
with an established health-care
system, so that it can be distributed to
those most in need of protection.
"Although it is claimed there is no
crisis, we disagree," wrote Southwick
and the others in a letter to the news
media. "We know that if our high-risk
patients are not vaccinated, the
consequences could be grave."
Meanwhile, clinic managers began
calling patients deemed to be at
H highest risk the week of Oct. 25.
l Arrangements were being made for
the patients to come in for shots.
At UF&Shands, only a handful of
front-line clinical employees was
expected to be vaccinated. That says a lot
about the organization, said Knudsen, who's lately spent a lot
of time on the phone seeking vaccine.
"I think it's admirable," he said. "This is a health system
that says if high-risk patients get sick, they might not make it,
so they should get the doses, not the employees."
-Tom Fortner and John Pastor
DO YOUR HEALTH A FAVOR
Driving in place on Archer Road every morning
doesn't have to be a complete time-waster. At
7:50 a.m. each weekday -and again just before
noon -you can do your health a favor by tuning
your radio to "Health in a Heartbeat."
The two-minute award-winning program,
which airs on campus-based public radio stations
WUFT-Classic 89 and WJUF-Nature Coast 90
and on more than 50 other public radio affiliates
in 13 states, is a daily dose of useful medical
information. Topics include the latest medical
research findings from around the world and
news on everything from Alzheimer's disease to
zoonoses -diseases you can get from your pet.
Now in its fifth year, Health in a Heartbeat will
air its 500th script Nov. 30. The program is an
in-house collaboration of the communications
offices of the HSC and Shands at UF, together
with WUFT. Each month staff and freelance writers
produce 20 to 25 scripts, which Sue Wagner,
WUFT's director of communications, records for
distribution. R. Whit Curry Jr., M.D., chairman
of the department of community health and
family medicine, serves as the program's medical
Beginning this month, Health in a Heartbeat
is completing a transition, but it's one that won't
likely be audible to its faithful listeners. Since its
launch in January 2000, Shands Marketing and
Public Relations staffers Kim Rose and Lance
Skelly have shepherded the program. Now they've
passed the baton to the HSC's Office of News &
Communications, which will operate the program
under Assistant Director Melanie Fridl Ross,
M.S.J., E.L.S., who will serve as its senior producer
and managing editor.
"Health in a Heartbeat is a useful source of
health information that listeners know to trust,"
Ross said. "Together with our colleagues at
Shands and WUFT, we will continue to meet the
growing need for convenient, quality consumer
health information through the clear, colorful
writing that has become the program's hallmark."
For more information about the program
or to access script archives,
HAZMAT LIFE SUPPORT COURSES
OFFERED IN JACKSONVILLE
ORTHOPAEDICS AND SPORTS MEDICINE
INSTITUTE OPENING EVENT SET
The public is invited to an opening event at the
University of Florida Orthopaedics and Sports
Medicine Institute from 3 p.m. to 6 p.m. Friday,
The free event will feature a look at some
of the institute's facilities, health screenings,
a chance to meet Gator sports coaches and
former players, photos with team mascots Albert
and Alberta, an appearance by the ShandsCair
flight team, kids' activities, refreshments and
The Institute is located at the intersection of
Southwest 34th Street and Hull Road.
Dr. Nigel Zheng (left), director of the UF
Biomechanics and Motion Analysis Laboratory,
and biomedical engineer Bryan Conrad monitor
Matt Benge as he demonstrates his golf swing
for the lab's three-dimensional imaging system.
The white dots on Benge and the club are light-
reflective markers. The lab, part of UF's new
Orthopaedics and Sports Medicine Institute,
will be open to visitors Nov. 12.
Coral Sun tries out the new piano Oct. 20 in
the Thomas H. Maren Medical Student
Reading Room, CG-38. Sun, a fourth-year
medical student, provided background music
prior to a reception honoring Mrs. Emily
Sabah-Maren for donating the piano. At the
event, titled "Remember the Muse," 16
medical students and transplant surgeon Dr.
Shiro Fujita showed off their musical talents.
Attention first responders and first receivers
the Florida Poison Information Center Jacksonville
has announced its 2005 sessions of the nationally
recognized Advanced HAZMAT Life Support
provider and instructor courses.
The two-day provider course is geared toward
working professionals who must evaluate and
stabilize patients suffering typical hazardous
materials exposures. The one-day instructor
course trains students to communicate the
provider course materials to others.
FPIC Jacksonville is one of the few facilities
in the Southeastern United States offering AHLS
courses. The 2005 dates are: March 9-11, June
8-10, Aug. 35 and Nov. 8-10.
For more information, visit
NEW GROUP WILL HELP WITH
INTERNATIONAL OUTREACH TRIPS
International health outreach trips have become
a spring break tradition for UF HSC students, and
a new student group aims to make it easier to
organize and fund those excursions.
Health Outreach Assemblies serves as an
umbrella organization to handle financial affairs
and student government representation for all
HSC international interdisciplinary health outreach
projects, said President Alex Cuenca, a third-year
"Our main goal is to facilitate these trips,"
The group, part of UF's Office of Global
Health, recently showcased its constituent projects
-Project Haiti, Project Yucatan, DR HELP and
Project HEAL -at UF's 2004 Symposium on
The international projects bring small,
interdisciplinary teams of health-care students to
impoverished areas in Haiti, Mexico's Yucatan
Peninsula, the Dominican Republic (DR HELP) and
Ecuador (Project HEAL) to help local residents.
Participating students and faculty advisers
offer clinics, provide medical supplies and
immunizations and conduct educational events.
They gain experience working with other health
professionals and patients from other cultures
and get the satisfaction of helping medically
For information on
Health Outreach Assemblies, visit
For information on
UF international health outreach projects, visit
FINDING A WAY THROUGH
How doctors address end-of-life care
By Melanie Fridl Ross
ob Hatch, M.D., was more than halfway
through medical school when he first held a
dying patient's hand. Already he had
mastered countless classes on the structure and
function of the human body, learned CPR, studied
reams of material on infection and disease, and
absorbed a truckload of information on treatments
for an endless array of conditions.
But no one had prepared him to sit at the
bedside of a young mother who was fighting a
losing battle with breast cancer.
"She was steadily going downhill, and it soon
became obvious she was going to die within
days," recalls Hatch, now an associate professor
of community health and family medicine at
UF's College of Medicine. "I spent quite a bit of
time with her. She knew she was dying, and I
think I always had hope there'd be one more
treatment I just didn't know about yet. But in a
period of a day or so my attending said there
was nothing else we had to offer, and she also
said something to me that indicated she
realized she was going to die soon. That night it
really hit me.
"I had never heard anyone talk about these
things," he adds. "And so I didn't know what
was OK to talk to her about and what wasn't OK to
talk about, which made it awkward. I remember
being so deeply affected by it."
At most medical schools, the curriculum is,
understandably, overwhelmingly focused on life and
the living. Yet if technological advances and new
pharmaceutical frontiers comprise the heart of
medicine these days, an increasing number of
educators argue that the emotional and spiritual side
of the profession must be its soul.
Dramatic shifts in public sentiment about end-of-
life issues have spurred educators to rethink the
traditional approach to teaching medical students.
UF's College of Medicine is leading the way to
define this new formula.
"UF is developing ways to facilitate that process
so people can die with dignity, comfort and some
feeling they're in control of their own living as they
approach death," says Bill Allen, Ph.D., director of
the Program in Bioethics, Law and Medical
"UF is trying to teach medical students better
ways of thinking about this making them more
concerned about evaluating pain, for example, as
part of the whole picture and being more aggressive
about pain management and palliative care in the
terminal phase of an illness rather than last-ditch
heroic efforts to cure or extend life without quality
Death is a certainty, but its definition and even
our control over its timing have changed
wholesale in the past 50 to 100 years, says Allen
"In the presence of a terminal
illness, hope lies not
but a way through,"
in a way out
- Robert Frost
Neims, M.D., Ph.D., former dean of the College of
Medicine and a professor of pharmacology.
"When medicine couldn't do much about some of
these conditions 100 years ago, the emphasis was
better distributed between cure and care or relief of
suffering," Neims says. "My own feeling is we've
come as a culture to see death as an enemy to be
fought at all costs. This is a massive shift in what's
going on and how we look at it. Rather than serving
patients, the medical profession has developed a
sense of obligation to fix patients' bodies."
Some of the most important teaching takes place
when students go on rounds with faculty to visit
terminally ill patients. These visits offer both faculty
and students valuable opportunities faculty can
model how to handle end-of-life issues appropriately
and students can gain real-world insight.
Bob McCollough, M.D., a 1962 graduate of the
College of Medicine and the medical director of
Hospice of North Central Florida, is one such role
model. He frequently returns to his alma mater to
talk to students about hospice care.
McCollough, an endocrinologist, says he tells
students things have changed since the first time he
had to tell family members a loved one was dying. It
was the summer between his second and third year
in medical school. A 12-month-old infant with a
severe congenital heart anomaly went into cardiac
"I was sent out to inform the parents that there
was a problem and that the child might not live,
and of course I had no formal education about how
to do that or what to say," McCollough said. "I
remember being terrified at having to give this
news and also very anguished at their
overwhelming grief. At that time we didn't have
the formal courses on death and dying. One
learned from the faculty about how to deal with
these situations, but it was on a case-by-case basis."
Today, students' firsthand experiences on the
wards are bolstered by the formal curriculum itself.
In the first year, students receive an introduction to
end-of-life issues, through an integrated series of
lectures on palliative care and pain management,
geriatric and end-of-life issues, and dealing with
Second-year coursework includes a medical
ethics course related to terminal illness and end-of-
life care planning. An elective course in end-of-life
issues also is offered. Third- and fourth-year students
continue with electives and workshops topped with a
12-week, required clerkship rotation that includes a
workshop on hospice that addresses pain
management and hospice philosophy.
A monthlong end-of-life issues elective is open to
fourth-year students and it explores the personal and
professional challenges physicians confront in
caring for patients with life-threatening illnesses.
Other electives explore religious and cultural issues
in medicine. A pharmacology course addresses
cancer pain management.
John Graham-Pole, M.D., a professor of pediatric
oncology and an affiliate professor of clinical and
health psychology, says physicians need to stop
viewing death as an enemy.
"It's part of our lives and part of our culture, and
we need to embrace it," says Graham-Pole, also the
medical director for the pediatric hospice program
through Hospice of North Central Florida. "It's very
relevant to take these things out of the closet and
talk about the dying process as part of life, so
patients can live fully until the moment they die." Q
Dr. Watson is helping shape
the future of medical education
The nation's leading academic medical organization has recruited Robert
Watson, M.D., the UF College of Medicine's senior associate dean for educational
affairs, in its efforts to improve the quality of medical education in the United
Watson will serve on one committee to aid the Association of American
Medical Colleges' Institute for Improving Medical Education and another that
will review the performance of the association's Division of Medical Education.
"It's very nice that UF will be sitting there in the committees, that says a lot,"
said Watson, who has overseen UF medical education since 1990, helping to
install a competency-based curriculum and standardized patient program. "I
wasn't asked because of anything I've done but because of the accomplishments of
our great faculty, staff and students."
The Institute for Improving Medical Education was created in 2002 to foster
educational innovations at every stage of physician education, according to
AAMC President Jordan Cohen, M.D., writing in the August 2004 issue of The
AAMC Reporter. Michael Whitcomb, M.D., senior vice president of the AAMC's
Division of Medical Education, is the institute's director.
Watson is among 19 people on the institute's external advisory committee who
reviewed four-year medical degree programs, residency and fellowship training
and continuing medical education for practicing physicians. The committee will
help make sweeping changes recommended by a group of ten medical school
"One of the things I liked about the report is that at UF we're already doing a
lot of the things recommended for medical student education," Watson said.
The recommendations include broadening clerkship training for medical
students, exposing residents to a wider range of patients and increasing the rigor
of continuing medical education, he said.
"I think the committee will be incredibly important," Watson said. "We're
trying to operationalize what is maybe the most significant thing that's come out
of AAMC in a long time and which could potentially have the kind of impact the
1910 Flexner Report had."
Written by Louisville, Ky., educator Abraham Flexner, the 1910 report
"Medical Education in the United States and Canada" was a scathing criticism of
North American medical education as it existed in the early 20th century and
triggered much-needed reforms.
Meanwhile, Whitcomb tapped Watson and three other top medical educators to
critique the Division of Medical Education's organizational structure and
direction, Watson said.
"We'll be asking, 'where is the AAMC going in the future?'" Watson said. "I
hope we can make a difference and reinforce that the Division of Medical
Education is critical to the future of medical education in this country."
-By Tom Nordlie
Dr. Robert Watson takes a moment to talk with class of 2006 students
(from left) Melissa McNally, David Chan and Rachana Patel. Watson
has been tabbed to help improve American medical education.
PHARMACY RESEARCHER APPOINTED TO PROFESSORSHIP IN PHARMACEUTICAL SCIENCES
A UF pharmacy researcher
who studies the relationship
between genetics and
drug responses has been
appointed to a newly funded
Julie A. Johnson, Pharm.D., a
College of Pharmacy professor
and department chairwoman,
was named the V. Ravi Chandran, Ph.D., professor
in pharmaceutical sciences this September by
College of Pharmacy Dean William H. Riffee, Ph.D.
"Dr. Johnson's extraordinary leadership and
excellence in research has been recognized
by her peers in the academy and now by our
college through her appointment to the Chandran
professorship," Riffee said.
Johnson joined UF in 1998 and three years later
was appointed professor of pharmacy and also of
medicine, in cardiovascular medicine. In July 2002,
she was appointed chairwoman of the department
of pharmacy practice. Her current research focuses
on pharmacogenomics and cardiovascular disease-
gene associations and the influence of race and
ethnicity on drug responses.
UF Alumnus V. Ravi Chandran, Ph.D., established
the professorship in 2000 with a $100,000 gift
to the college. This year, he contributed another
$100,000, which, combined with other donations
and matching funds, has brought the endowment to
more than $400,000.
While acknowledging the honor in being selected
for an endowed professorship, Johnson credits the
valued support of alumni who make it possible.
"It's former UF graduates like Dr. Chandran who
give so much back to their college that really make
a difference," Johnson said.
Gene therapy helps mice
slim down, live longer
By Tom Nordlie
Doctors have said it for years maintaining a healthy weight can help you live
Now, a UF gene therapy study provides further proof that doctors are right, say
researchers who measured the lifespans of mice that were twice as heavy as their
The mice lacked a crucial weight-control gene, and when the gene was restored
to a group of the mice they not only slimmed down, two-thirds of them outlived
every mouse in an untreated group, said Satya Kalra, Ph.D., a UF professor of
neuroscience. The results, presented recently at the Society of Neuroscience
annual meeting in San Diego, suggest it's never too late to benefit from proper diet
"Our study very clearly demonstrates for the first time that if you can reduce
obesity or the fat load you have a greater chance of living longer," Kalra said.
Obesity is scientifically defined using a mrnlj hm~rni iajIl I I mulj >jIlkJ h,,J\ mrn
index that compares weight with heigl- I P..,pl v. iih j h ,J\ rn ma mnJ\ ..I I,..
more are considered obese, and have irn !JJ i !,k I..i a!rmini., Iu h j, high h....J
pressure, type 2 diabetes, heart
disease, stroke and some forms of
cancer, according to the Centers for
Disease Control and Prevention.
UF researchers put the missing
gene where it was needed most: into
cells in a part of the brain called the
hypothalamus, which controls
many basic body functions, Kalra
said. The gene controls production
of a protein called leptin, which
signals the hypothalamus to reduce
appetite and increase metabolism.
Leptin is produced in the fat
tissue of all mammals, including
people, he said. It is normally
released when a mammal eats,
traveling to the hypothalamus
through the bloodstream. Without
adequate leptin, mammals overeat
and gain weight.
Some people may carry excess
weight because their bodies don't
produce enough leptin, a theory that
could be demonstrated by future research, Kalra said.
"If it is demonstrated then there's a good chance that leptin gene therapy may
also be beneficial clinically," he said. He emphasized clinical trials for human
patients would be years away.
The treatment involved a single application of gene therapy, yet produced
beneficial results that lasted for the remainder of the animals' lives more than a
year, he said. Because many human diseases are caused by missing or faulty genes,
the study offers hope similar treatments may eventually provide long-lasting
results in people.
Kalra conducted the study with his wife and longtime research partner Pushpa
Kalra, Ph.D., a UF professor of physiology and functional genomics, and UF
Dr S :iiyi Kol :o id:.o.' e) in:l his wife and
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iece-ni ;si.-.. tlh Ko:lir.:o fo.-nd genetically
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Stephane Boghossian, Ph.D.
In the study, 24 male mice aged 8 to 10 weeks were
divided into two groups of 12. All the mice lacked the gene that controls leptin
production, so they weighed between 40 grams and 50 grams, about double the
weight of a normal mouse.
Mice in the treated group were injected with a harmless virus modified to carry
a gene that controls production of leptin. The untreated group received the same
virus, but it carried a gene that produces a protein that glows bright green but has
no therapeutic effect.
After the injection, body weight and food intake were monitored weekly for each
mouse. The mice treated with leptin ate an average of 15 percent less than the other
mice, and eventually returned to normal weight. After 595 days, two-thirds of the
mice treated with leptin remained alive, but all mice in the other group had died. Q
Reeve inspired UF with hope, lessons in courage
Neuroscientist Paul Reier poses with
Christopher Reeve when Reeve visited
the Reier lab on April 26, 2001. The
lab's goal is to find ways to help
patients with spinal cord injuries and
other neurological disorders.
The day that changed Christopher Reeve's life
forever was May 27, 1995.
The athletic actor was riding in a Virginia horse
show. As he approached a routine three-foot jump, his
chestnut Thoroughbred abruptly stopped, launching
Reeve headfirst onto the ground.
The accident rendered Reeve a quadriplegic, and that
was how members of UF's McKnight Brain Institute
found him in December 1999 paralyzed and
confined to a ventilator but still gracious and full of
"In terms of overall persona, he was an awesome
individual," said Paul Reier, Ph.D., an eminent scholar
of neuroscience at the College of Medicine. "Even in a
wheelchair, at 6-foot-4, he dwarfed most people. And he
was brilliant. He could piece together information as a
layman in absolutely short order."
Reeve died Oct. 10 of heart failure, brought on by a
raging infection that had spread from a bed sore. Along
the way he became a crusader for spinal cord injury
patients and a worldwide emblem for courage.
Reier, along with Danny Martin, Ph.D., an associate
professor of physical therapy at the College of Public
Health and Health Professions, and Paul Davenport,
Ph.D., a professor of physiological science at the College
of Veterinary Medicine, were invited to attend private
memorial services for Reeve in Manhattan on Oct. 29.
The scientists worked with Reeve's therapists to help
train the actor's respiratory muscles, Reier said.
During a session with speech scientist Christine
Sapienza, Ph.D., a professor in the College of Liberal
Arts and Sciences, Reeve managed to speak while free
of his ventilator.
"Watching him, it was like he was hanging on for
dear life while trying to perform a very simple task,"
Reier said. "He was almost in tears. Later, all the
conversation at dinner with his wife Dana was about
how he could count '1-2-3' without his ventilator."
Shortly after that, Reeve underwent an experimental
procedure to have electrodes implanted into his
diaphragm to help him breathe on his own.
"When we started working with Reeve, he was
completely dependent upon the ventilator and able to
come off of it only for a matter of a few seconds to allow
tubing changes, suctioning and nursing care," Martin
said. "At the end of the training, he was able to breathe
for one-and-a-half to two hours off the ventilator.
Unfortunately, we weren't able to get him to breathe
beyond that because his injury was so severe."
But by working on his diaphragmatic strength, Reeve
helped prepare that muscle to function more effectively
once he had the pacer implanted by a group at Case
Western Reserve University, Martin said.
"You couldn't ask to work with a better patient,
because if he thought a therapy had merit, he would try
it, even if there were chances it might not work,"
Davenport said. "He had an incredible optimism that
In that regard, his strength inspired scientists,
including UF neuroscientist Margaret "Jo" Velardo,
who was among the researchers from the Reier lab who
met Reeve for lunch when the actor visited UF to give a
When she met Reeve, she gave him a clock on behalf
of the researchers inscribed with a quote from Yoda, the
sage of "Star Wars": "Do or do not. There is no try."
"I told him that we knew he didn't need another
clock," Velardo said, "but we wanted him to have
something he could put on his desk that reminded him
that we knew that every minute we weren't working was
an eternity for someone who was in a wheelchair."
Researcher unearths reports of child serial killers
They leave multiple clues at the scene of the murder. They are impulsive and less
adept at hiding their weapons. And they confide in friends who just can't keep a
secret. In short, they are inexperienced at covering their tracks.
Yet until now, the disturbing details of a half-dozen children's serial killing
sprees have remained well hidden, concealed in 150 years worth of medical
literature, true-crime tales, newspaper clippings and history books, says a UF
The stories surfaced only recently, shedding light on a previously unknown
psychopathic phenomenon, reports Wade C. Myers, M.D., writing in the journal
Behavioral Sciences and the Law. Myers initially began studying cases of sexual
murder by children and adolescents after he was asked on occasion to evaluate
them for the legal system.
"I wanted to see what I could learn from the scientific literature about kids who
do these sorts of crimes," Myers said. "When I went to the textbooks to learn more,
I found there was almost nothing written about them. That was the impetus for my
studies of children who commit sexual homicides. With time, I began to wonder
whether there actually were children who had independently committed serial
murder, so I hunted through innumerable articles, crime books and other sources
in a quest to better understand this form of juvenile murder."
From actor Anthony Hopkins' chilling portrayal of Hannibal Lecter to accounts
of the multiple murders of Ted Bundy, Aileen Wuornos or John Wayne Gacy, serial
killers both disgust and fascinate. And while cases of children perpetrating such
heinous crimes are exceedingly rare, Myers said their stories nonetheless speak to a
wider societal issue: the effect of an unstable or abusive family life on juvenile
delinquency in general.
"One of the biggest factors in helping to decrease delinquency or violent acts by
children is to arrange for children to have the most stable, caring, loving
upbringing possible, with positive role models," said Myers, an associate professor
of forensic psychiatry at UF's HSC.
In contrast, the children described in Myers' paper, five boys and a girl, were
commonly subjected to cruel discipline, neglect, and physical and emotional abuse.
Three were from the United States, two from Europe and one from Central
America. All murdered before they turned 18, killing at least two victims -
usually other children most often by cutting, stabbing or strangling them.
"In some ways, you could see how the abusive background of these children
ended up becoming a factor," said Myers, who is now writing a book on the subject.
"They had little capacity to feel guilt and displayed psychopathic personality
features, such as being emotionally cold, callous and manipulative. What is harder
to explain with these children is what actually creates in them a fascination with
sadistic acts, that is, pleasure in the harming or killing of others. That's harder to
answer. We still don't know where these feelings, urges and fantasies come from."
Melanie Fridl Ross
Researchers reveal secret lives
of genes during spinal injury
By John Pastor
The body attempts to heal a damaged spinal cord
in much the same way it repairs skin after simple
cuts and scrapes, an insight that may lead to new
treatments for the thousands of people paralyzed
each year because of spinal cord injuries, UF HSC
Writing in the Journal ofNeuroscience, scientists
deliver the first-ever glimpse of how thousands of
genes swing into action during the weeks and
months after a spinal cord injury, suggesting there
may be many more chances to treat the injury than
Using a microarray, a powerful tool that screens
the activity of more than 8,000 genes simultaneously,
researchers checked at six time points after spinal
injury in rats and found that 3,638 genes turned on
or off in response. The first genes to enter the fray
are remarkably similar to those that drive clot
formation and the mobilization of immune cells that
fix skin wounds.
"Dermal wound healing has been studied for
decades," said Margaret "Jo" Velardo, Ph.D., an
assistant professor of neuroscience and member of
UF's McKnight Brain Institute and the UF Genetics
Institute. "Now, with the insights furnished by our
study, perhaps spinal injury researchers may take
advantage of techniques developed by our wound-
healing colleagues and apply them. Our experiments
Corinna Burger (left) and Margaret "Jo" Velardo
of the McKnight Brain Institute and UF Genetics
Institute review a list of 3,638 rat genes that
changed over the 90 days after a spinal cord
injury. The list is color coded and organized by
showed that the gene families for
tissue, vascular and immune system
repair mechanisms appear to follow
the same pattern as seen in healing
A quarter of a million Americans
currently live with spinal cord
injuries, which usually begin with a
sudden, traumatic blow to the spine
that fractures or dislocates
vertebrae, according to the National
Institute of Neurological Disorders
and Stroke. The number of new
injuries each year is relatively small,
but they injuries usually occur in
young people, striking them down Margar
in the prime of life and leaving them batch o
to survive for many years afterward experirr
with a devastating, debilitating or nylor
injury. The cost of managing the arrange
care of spinal cord injury patients
approaches $9 billion a year.
Researchers Henry Baker, Ph.D.,
and Corinna Burger, Ph.D., of the molecular genetics
and microbiology department and the UF Genetics
Institute assembled more than 280,000 bits of
information that revealed how armies of genes
activated or shut down to deal with the spinal injury,
not just within a few days of the injury but for as long
as three months afterward.
"The patterns told us that something orderly and
amazing was happening," Velardo said. "That
motivated us to perform an in-depth analysis so that
we could infer the actual biological events occurring
at various time intervals after injury."
On the first day, researchers found protective
genes turned on to preserve what functional tissue
remained at the injury site. By the third day, the
character of the genes changed dramatically, with
growth and repair genes turning on simultaneously
with a huge number of cell division genes.
"It is as if the body creates thousands of cellular
machines to move in and manufacture what is
needed to repair the damage," Velardo said. "At day
10, we could see the genes increase in expression to
repair the ground substance and reform the damaged
blood vessels of the spinal cord. From 30 to 90 days,
at the gene expression level, we can actually observe
the maturation of these new blood vessels and the
manufacture of a new type of ground substance that
occurs as a wound ages and restructures itself." Q
et "Jo" Velardo (left) and Corinna Burger display a
f DNA chips, which are used in microarray
ients. The chips usually consist of a piece of glass
n on which hundreds of pieces of DNA strands are
The boxes represent what several particular
genes are doing from one to 90 days after
spinal cord injury, with red boxes indicating
relatively active genes. Immediately beneath
each set of boxes are spinal cord sections
taken from animals at each post-injury time
Secondhand exposure to drugs may be an
occupational hazard for anesthesiologists
On-the-job exposure to low doses of powerful
anesthetics commonly administered to patients
intravenously may be a factor leading some
anesthesiologists to abuse drugs, according to a
theory UF researchers presented at the Society for
Mark Gold, M.D., a distinguished professor with
UF's McKnight Brain Institute, said
anesthesiologists who sit near a patient's head during
surgery are exposed secondhand to anesthetic drugs
as they are exhaled by the patient. Blood sampling
and further studies are necessary to determine if
anesthesiologists truly suffer ill effects from inhaling
trace amounts of the drugs, just as nonsmokers are
adversely affected by secondhand smoke, Gold said.
"Most people thought that in the evolution of
anesthetic practice from inhaled gases nitrous and
ether and so forth to drugs that are administered
intravenously, there wouldn't be secondhand
exposure," Gold said. "[Now we see] that those
narcotics, which may be 1,000 times more potent
than heroin, get into the air, may reach their brain,
may change their brain and make it more likely that
they'll crave and want drugs."
Gold said the unintentional exposure may be
determined to be an "occupational hazard" for
Anesthesiologists who as a group are up to four
times more likely to be treated for drug addiction
than other physicians may
become sensitized to the
intravenous drugs fentanyl and
propofol after repeated exposure
during long surgical procedures,
said Gold, chief of the division of
addiction medicine and a
professor in the departments of
psychiatry and neuroscience.
In 2003, anesthesiologists
represented only 5.6 percent of .
physicians in Florida but
accounted for almost 25 percent f
of physicians monitored for
substance abuse, according to
Gold's research. National
statistics show a similar
anesthesiologists among drug-
Gold theorized reasons other than access to drugs
caused anesthesiologists to be overrepresented
among addicted physicians and that the presence of
analgesic and anesthetic agents in the air in
operating rooms might be one of them.
UF anesthesiologists Donn Dennis, M.D.,
Timothy Morey, M.D., Richard Melker, M.D., Ph.D.,
and Kimberly Frost-Pineda worked with Gold to
measure and analyze multiple operating room air
samples for fentanyl and propofol molecules.
They found the drugs present throughout the
operating room, with the largest concentrations over
the patient's mouth.
"We don't know what doses they are exposed to at
this time," Gold said. "We will do blood sampling of
anesthesiologists to learn that. But fentanyl and
related analgesics are very powerful opiates.
Anesthesiologists may become sensitized."
GROUP FORMS TO TEST NEW CANCER DRUGS IN CHILDREN
UF physicians have partnered with eight other academic medical centers to
form a national consortium aimed at testing new cancer therapies in children
who fail to respond to traditional treatments.
The Pediatric Oncology Experimental Therapeutics Investigators Consortium,
or POETIC, launched its first clinical trial in September of an investigational
anticancer drug supplied by the National Cancer Institute.
"The importance of the consortium is that there haven't been a lot of
opportunities for children with cancer to access drugs in the earliest stages of
development," said Stephen P. Hunger, M.D., chief of the division of pediatric
hematology/oncology at UF's College of Medicine. "There is nowhere else in
the state of Florida where such trials are available. This gives patients throughout
Florida and elsewhere in the Southeast opportunities that didn't exist otherwise.
This particular trial is the first of a number of trials the consortium will conduct."
Each year, an estimated 12,000 patients under the age of 20 are diagnosed
with cancer in the United States, Hunger said. Of those, about 20 percent do not
respond to first- and second-line therapies, he said.
During the past 25 years, many breakthroughs in the treatment of childhood
cancer have arisen out of the collaborative efforts of research groups across
the United States. UF, for example, is one of the statistical centers for the
international Children's Oncology Group, a federally supported consortium
that pools resources to design, conduct and analyze studies of pediatric cancer
therapies worldwide. Most COG studies focus on research protocols to test
established, widely available chemotherapy drugs. In contrast, POETIC focuses
on newer agents being tested in people for the first time.
-Melanie Fridl Ross
BACKGROUND NOISE JUMBLES BRAIN CIRCUITS
Background noises don't just cover up conversation, they may actually
scramble brain activity, a discovery that helps explain why even perfectly loud
speech can be hard to understand in a noisy room, say McKnight Brain Institute
researchers writing in the Proceedings of the National Academy of Sciences.
The insight from experiments with rats could influence the design of hearing
devices, MP3 music players and virtually any audio transmission technology, say
"Some people have a tremendously difficult time understanding speech in a
noisy environment and we've all had the experience of hearing someone tell us
something, but we can't tell what it is they are saying," said Purvis Bedenbaugh,
Ph.D., an assistant professor of neuroscience with the College of Medicine. "This
research is a first step toward looking at why that would be."
Scientists examined how brain cells in alert rats responded to specific
sounds while one of three standardized noises played in the background. They
discovered that brain activity actually decreased in the presence of background
noise. Furthermore, background noise didn't simply cover up sounds, it interfered
with the brain's ability to process or interpret information about a sound, even
though the sound was heard. Essentially, the brain couldn't understand what the
ear told it.
Electrodes were implanted in the auditory thalamus of the rats to detect brain
activity. Beeps and sharp shushing noises were target sounds, akin to specific
words in conversation, and scientists used standardized sounds for background
noise similar to static, conversational murmur and the disjointed whir of a
rewinding tape recorder.
0 9_I H
UNITED IN NAME AND MISSION
By Denise Trunk
The University of Florida and Shands HealthCare have
given their partnership a new look and name -
UF&Shands, The University of Florida Health System.
At the heart of the makeover is the ampersand, an
unassuming piece of punctuation that literally means
"and" but, symbolically, speaks volumes in terms of
unity: UF and Shands stand together for excellence in
health care and the medical research that keeps these
institutions at the forefront of clinical medicine.
They stand so close together, in fact, that there are no
spaces on either side of the ampersand. In the new
terminology, UF and Shands visually become a single
word: UF&Shands. The curvy symbol bridges two
organizations that are legally separate and culturally
distinct but, according to administrators, come together
in a single-minded focus on the patient.
This new brand, the result of more than a year of
planning, launched Nov. 3 with the kickoff of a regional
advertising campaign. Over the next few months, it will
chance the lnk and lanu3ree f the r aniz7atin on
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"I think it is better for both organizations," I ihh a!ij
"Overall, the tagline of the new brand -The tin i\i i i\
of Florida Health System is a powerful message to the
public. I think employees from both organizations will
see we will only be successful if we are working together."
For their part, Shands officials stressed that the new
brand merely gives \ pi L.i"n to the way UF and Shands
are already viewed by other,. p i lli\ p jl ents.
"When you focus on the pr icrni. 11 h~.. mes very
simple," said Janet Meeks, ShainJd I I.lih( are senior vice
president for strategy, market in ig nJ hu !incss
development. "The general puhIMi. rei i i irn physicians,
patients and consumers, alr jJ\ Ie u a' ..ne team.
Clearly we are unique in our region through the tripartite
mission of research, academics and clinical services."
A LITTLE HISTORY
UF opened the state's fi i I lcLh!-.ir h.,pii al I n '-5i-.
But beginning in the 197, ,. ~iull J.&\ 1.p--J h,.i I n ih
patient-care mins ion and Il" aJL. i mJrr m!,!,ii.n Ini 1-'-'.
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The University Of Florida Health System
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"\\ hard Icir lm ,u!\i\, ihi pl.pk l think \c' aj! ihe
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Shared clinical enterprise
is romancing a new brand
playing a lead role in discovery, they should feel
confident that they will receive leading-edge care
That problem is analogous to a political
campaign not "getting its message out." And over
time, as the state's need for health care increased,
competitors who more clearly communicated their
potential benefits to customers enhanced their
standing. This shifting market landscape
prompted a re-evaluation of the medical center's
branding strategy in the spring of 2003.
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well as our vulnerabilities."
AN UNCLEAR IMAGE
In :! i L a! h. I. '. .. n rni; L m iI rbl i i i hinri
that -!Jd NhinJi. Jiiluirni I!..m .. hi h.-pii ua in
North I I !d i J 11i ad~j mirL -..mprn-In i \.
overl(k"'kLJ h\ u mi raii \ ..I Ih.1Le 'u\i \I J. I jIJ
Wh m-. r p.,,ple pO!c!\dJ hinJ,. anJ Uil as
one tue m. ih 'ui i\ \, I lunJ ih i ..n I I p-iP Lni
ofcorIurnLm idJdnii .J 'hn~nJri ij i i jLhinr
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- :- pOi eni I I h.1 ul 'i\ d aJ d I h \ Jdidni
kn.w'. ,.hal ii ',. j,
"In .'ul pJ aitulaj marilk iamrn g ih i iLir ni,
, .I N i ih I 1-i id i h -r i .1 si IIn h l. ni pi..p..i i..n
''I 1nLIru mer i who do not know of our depth and
'.. p ..'I \Lllence," Meeks said. "They don't
kn.r'. ihaFi ,. have renowned specialists here."
.\JJdiii ..nj v, the surveys found that patients
n..iJ p.!hhlkms with access to various clinics and
h-,.piil ,\ i ask force will address those barriers
in ihL .hI. nrri weeks.
I h, j iI L challenges for which every medical
LniIi L mpl ..ie ee should feel a sense of ownership,
,jid M.1 k,
"\W'h i parking like here? How friendly are
pL ..'rpl 1).. i hey offer guidance and support to
\ ,..! !I, hrn Ihey look like they are lost?" she
li! !ii, aiJJcd that the new brand reflects a
un i\ I .I pu i pose that should make the members of
aL h i.i ir nation sensitive to the needs of the
",\ imip.. tant as the change is externally, the
m,, j. ha i we will communicate to the people
h.. h ,..i- k in the health center is that when we
mrkL a Ju Liion related to the clinical practice-
h\ Ih, Jd.' 'I r, the dentist, the psychologist, etc. -
ih i haj an impact on Shands," Barrett said. "And
i. h, n sh n ds HealthCare board of directors makes
j JL i.iin. ii has an impact on the colleges."
1 i m i h painter in the sign shop to the folks in
hbillini. h, .aid, employees can consider they are
puil I hu d rLJ. n! i pi!! nJ he Jj\-I"-JJi V
Jd !i-l n.. nI J i hI ihe h 'ui'hi I I -ih ai an"&".
"Ii i! l1 & ,hjnj,." lia !!i l sjid. "anJ '., have
I aijii Ihinkirn ih i i,'.\ Ihc pr.nhl mrr,, ., lace
Si L L-mmn pi..hlkmi ain pai iail lui i.n, don't
'.. ik "
What does it mean to you?
How will UF&Shands be used?
UF&Shands will be the name that initially rolls out
in a new branding campaign. Advertising messages
will appear in newspapers and magazines, and
on TV/cable, radio and billboards. Our multiple
missions of patient care, research and education
will be highlighted. We will begin to explain what
makes us different from other health-care providers
throughout the region.
You also will begin to see the brand appear on
signs throughout the clinical enterprise. UF's new
Orthopaedic and Sports Medicine Institute and
Shands Jacksonville will be among the first to have
the new brand go up on signage. Our plan is to
eventually have the brand name extended to all of
our hospitals, clinics and ancillary facilities. However,
it will take time to work through the logistics of this.
How long will the campaign run?
Branding efforts typically take several years to
change consumer perceptions. We'll periodically
check our progress through follow-up market
research to compare how we're positioned at that
point in time.
What should employees and physicians to
The physicians and employees who make up
UF&Shands set the standard for medical excellence
throughout the region. The services we provide
include leading-edge medical discoveries that result
in hope for patients and families.
Will UF&Shands become one organization?
No. The University of Florida and Shands
HealthCare will remain two separate legal entities.
We will visually link UF and Shands HealthCare
through one brand name UF&Shands.
Will my paycheck now say UF&Shands?
No. Employees will continue to be paid by the
respective organization for which they work.
Will name badges carry the new brand
We are currently evaluating this.
How will we improve access and enhance
the patient referral process throughout the
entire health system?
During the next several months, teams of
employees and physicians throughout UF&Shands
will work to improve access throughout the system.
As part of the strategic plan, several subgroups
will work to improve access to emergency services,
physician clinic and ancillary appointments, direct
admissions, phone access, hospital-to-hospital
transfers and wayfinding.
Women misinterpret health benefits,
hazards of hormone therapy
By Melanie Fridl Ross
enopausal women continue to
overestimate the real risks and benefits of
hormone replacement therapy and so
do their doctors, UF researchers report in the
American Journal of Obstetrics and Gynecology.
As a result, some women with debilitating hot
flashes, night sweats and other symptoms who might
be good candidates for the treatment go without, the
The findings dovetail with
renewed interest in who should
take hormones and what the
risks might be for those who
do. The American College of
Gynecologists recently released
a guide aimed at helping
Dr. R. Stan Williams women make educated
decisions about whether to use hormones. The group
also published recommendations for physicians after
reviewing research studies published before and
after the landmark Women's Health Initiative
results were released in 2002.
The current confusion stems from widespread
news accounts detailing findings from that federally
funded, large-scale study, which assessed the major
health benefits and risks of the most commonly used
hormone preparations. The study showed that
estrogen plus progestin increased the risk of heart
disease, stroke, breast cancer and blood clots in
postmenopausal women who had used the combined
therapy for about five years.
The bottom line: Many women whose menopausal
symptoms are severe can indeed benefit from
hormones, although those who take them should use
the lowest effective dose for the shortest duration
"Despite the really large amount of media
attention given to the Women's Health Initiative
results, there is a huge amount of misunderstanding
about what it actually said," said R. Stan Williams,
M.D., the Harry Prystowsky professor of
reproductive medicine and associate chairman of
obstetrics and gynecology at UF's College of
Medicine. "Our study essentially shows that women
have a very poor understanding of what the real risk
and benefits are of hormone replacement therapy,
and so they dramatically overestimate both the risk
and the benefits of hormones."
UF researchers mailed a survey to 6,468 middle-
aged Florida women that was designed to assess
their opinions and understanding of hormone
replacement therapy. Most of the 1,076 respondents
were menopausal, and more than half had taken
hormones, primarily for menopausal symptom relief.
A third said they took it for other perceived benefits
as well, including protection from heart disease,
Alzheimer's and osteoporosis. Of those who took
hormones, most 80 percent had a positive view
of the treatment, and only a third of respondents
said they would not recommend the therapy to a
Nonetheless, many women greatly overestimated
the risks, with a third of those surveyed believing
hormone replacement therapy hikes the risk of heart
disease 10 percent to 30 percent per year.
Furthermore, 81 percent of all respondents believed
breast cancer risk increases for women on hormones,
with slightly more than half believing the increase
was as high as 10 percent to 30 percent per year.
Although the survey, sponsored by Wyeth,
suggests the Women's Health Initiative results did
not affect attitudes about hormone replacement
therapy in most women who were already taking it,
the UF findings highlight the need to educate others
who construed the magnitude of the risks associated
with treatment to be much greater than they actually
are, Williams said. The risk for developing heart
disease, stroke or breast cancer, for example, actually
increased minimally for every year hormone therapy
The misconceptions stem from the fact that the
media and even the original published findings from
the WHI primarily focused on describing the results
in terms of a percent increase or decrease in relative
risk, a definition of risk used by scientists but not
usually by the general public, he said.
More specifically, relative risk is the rate of
occurrence of a disease or condition among those
receiving a treatment divided by the rate among
those not receiving it. The average woman, however,
is interested only in her personal risk of developing
a certain disease if she is taking hormones compared
with her risk if she is not.
In the paper, UF researchers pointed out that
some media reports cited a 24 percent increased
relative risk of breast cancer per year in those who
received hormone replacement therapy.
"The general public, not understanding the
concept of relative risk, probably interpreted this
statement as a 24 percent chance of developing
breast cancer each year on HRT," the UF authors
wrote in their paper. "In the current survey, 53
percent of respondents thought that the increase in
breast cancer in women on HRT was 10 percent to
30 percent per year, although the WHI attributable
risk reported was 0.08 percent per year."
In other words, in any given year, only about one
additional case of breast cancer occurs among every
1,000 women receiving the treatment.
Patient and physician education will be key to
conveying study results in a way that will help
women make informed decisions about whether to
take hormones, Williams said, adding that UF
researchers recently completed a similar survey of
community physicians and found that they, too,
misconstrue the risks and benefits of the therapy.
Those findings will be presented at a scientific
meeting in January.
"Obviously, if women have a gross misunder-
standing of what the risks and benefits are, they
can't make an informed decision," he said. "They
clearly really [want to] talk about absolute risk:
What is your risk of having an event over and above
the natural incidence of these events in people who
are not on hormones. That's their real risk.
"For each one of the risk categories, less than 0.1
percent per year are going to have an adverse event,"
he added. "They have to weigh, 'Are my severe hot
flashes bad enough to warrant taking hormones?'
with that risk profile. The majority of women say
clearly, 'Yes, I'm willing to take that remote risk for
alleviation of my menopausal symptoms.' "
In the same issue of the journal, Dr. Murray A.
Freedman, an Augusta, Ga., physician, authored a
discussion of the UF paper and reiterated the need
to dispel common misconceptions about health risks
of all kinds.
"Although the publication of the WHI has
certainly contributed to the confusion, women have
remained notoriously misinformed about their
health risks for quite some time," Freedman wrote.
"Women have had the erroneous impression that
breast cancer is a much more prevalent health
hazard than cardiovascular disease and that breast
cancer mortality exceeds that of all other cancers
combined. Furthermore, as demonstrated in the
current survey, most women have a very imprecise
understanding regarding the actual magnitude of
the risks and benefits associated with HRT." 0
~~ prr -~-~r t
PATIENT CARE BRIEFS
Driven to help horses: a new mobile
equine diagnostic program
By Sarah Carey
No more driving Miss Daisy long distances when she's sick. UF veterinarians
are launching a new program that aims to reduce horse owner travel hassle by
taking veterinary diagnostic services on the road.
The Mobile Equine Diagnostic Service, known as MEDS, targets equine
veterinarians in private practice and officially kicks off in November. The program
is believed to be the only such service in the United States to offer a sophisticated
collection of equipment coupled with the ability to consult in real time with
experts at a veterinary hospital.
Say Miss Daisy, a 26-year-old mare owned by the same family all her life, is in
need of referral-level diagnostic services. Unfortunately, she is two hours from the
closest hospital and her owners and veterinarian worry about the potential stress of
transporting Miss Daisy in a trailer for two hours during the hottest days of the
Enter the MEDS program and Michael Porter, D.V.M., Ph.D., a board-certified
internist, who communicates directly with Miss Daisy's referring veterinarian and
schedules an appointment to perform an abdominal ultrasound and gastroscopy on
the horse. One gastroscopy with intestinal biopsies and one abdominal ultrasound
later, Miss Daisy is diagnosed with the equine version of inflammatory bowel
disease. Miss Daisy's owners opt to begin a medication program immediately.
Within several weeks, Miss Daisy is doing better.
"The collaboration between modern medicine and digital technology has
advanced the field of medical diagnostics such that diagnoses that previously could
be made only in a hospital setting can now occur at a distant location," Porter said.
As director of the MEDS program, Porter will respond to calls from referring
veterinarians and provide diagnostic services to their clients throughout the state
of Florida and southern Georgia.
Florida alone is home to 170,000 horses and the horse industry generates product
valued at $2.2 billion annually.
Porter said the comprehensive diagnostic package MEDS will offer far exceeds
what most clinicians are able to access without visiting a referral veterinary
"We'll have all the important diagnostic capabilities, including digital radiology,
ultrasound, endoscopy, gastroscopy and echocardiography, plus the ability to share
images and data via satellite technology while in the field," he said.
Dr. Michael Porter, director of the UF College of Veterinary Medicine's
new MEDS program, stands beside a truck similar to the one he will
use to visit farms and veterinary hospitals requesting his services.
ACTRESS, SINGER AND NURSE KATHRYN CROSBY TO VISIT UF AS ADVOCATE FOR FACIAL PAIN DISEASE
Kathryn Grant Crosby, R.N., an accomplished theatrical
performer, author, artist and nurse, will place the spotlight
on the world's most painful disease a facial nerve
disorder known as trigeminal neuralgia -during an
upcoming visit to the UF HSC and Shands at UF.
Crosby is the widow of world-famous entertainer
Bing Crosby, whose life she commemorates in three
popular books. She will visit the HSC Nov. 8 and 9 as a
spokeswoman for the Trigeminal Neuralgia Association, a
national society based in Gainesville, and as a crusader for
expanded research into the chronic disease, which occurs
TN afflicts one in 20,000 people, occurring most often
after age 50. Pain strikes in sudden bursts that have been
described as similar to electric shocks affecting the eyes,
forehead, lips, teeth, cheeks and nose. Some patients are
disabled by the pain, but once the disease is accurately
identified, most individuals can be treated effectively with
medicine, surgery and/or alternative therapies.
During her visit, Crosby will tour Shands and HSC
facilities where patients with trigeminal neuralgia undergo
neurosurgery, research laboratories of the UF's McKnight
Brain Institute, the College of Nursing and the College of
Crosby will tour Shands with Albert Rhoton Jr., M.D.,
the R.D. Keene family professor and chairman emeritus of
neurosurgery. He is a widely known expert in the treatment
The two will meet again at the Trigeminal Neuralgia
Association's fifth national conference Nov. 11-14 at Walt
Disney World Resort in Orlando, an event co-sponsored
by the UF Colleges of Medicine and Dentistry, and Shands
at UF. Rhoton, who has improved the accuracy, gentleness
and safety of surgical procedures for TN, will host the
national conference and join other leading health-care
professionals in reporting improved therapies for the
Kathryn Grant Crosby and
husband Bing Crosby.
SSTICKS AND BRICKS
Miles Albertson keeps UF's Health
Le Science Center growing
By Tom Nordlie
As the HSC's highest-ranking administrator for building projects, UF Facilities Planning
and Construction Associate Director Miles Albertson has accomplished big things during his
19 years at UF.
You want big? He's helped build the new Orthopaedics and Sports Medicine Institute seen
behind Albertson in photo at left, and the McKnight Brain Institute in Gainesville. In the
works is the proton-beam cancer treatment facility being built at UF's Jacksonville campus.
"I think that one of the main reasons I've been in building during my career is that the end
product of construction is a tangible thing," said Albertson, who has worked for UF's Office of
Facilities Planning and Construction since 1986 and was promoted to associate director in
f ,, ,; ,2000.
lAlbertson isn't responsible for drafting blueprints or laying bricks. He manages projects and
oversees a team of project managers who coordinate all HSC construction jobs budgeted at less
than $1 million, typically about 50 to 70 jobs each year.
"That encompasses everything from 'build me a door' to 'gut this lab and build me an all-
new one,'" he said. "It's different every day; there is no typical day."
Project managers, who usually have expertise in fields such as architecture, engineering or
construction, make sure everyone involved in creating new HSC facilities lawyers, fiscal
experts, deans, department chairs, contractors, design teams and the UF Physical Plant
employees cooperate to bring the projects in on time and within budget.
UF construction projects budgeted at $1 million or more have traditionally been managed by
project managers in the stadium office of facilities planning and construction, led by Director
Carol Walker, he said. But Albertson and colleagues Gene Brandner, Bill Weltner and Bill
Smith often act as project managers on HSC jobs of that magnitude because of their knowledge
of the people and the facilities there.
S The HSC office is involved in about 15 major construction projects per year in some stage,
with each project lasting several years, he said.
S ,. "Oftentimes, getting to the starting point takes much longer than the time from when you
,0 put the spade into the ground 'til when you move somebody in the door," Albertson said.
For example, the recently opened UF Orthopaedics and Sports Medicine Institute took about
two years to plan and 14 months to build, Albertson said.
i;".. As project manager for the institute, Albertson's to-do list as construction neared completion
.- .0. provides a glimpse of the countless details that need attention.
.a( L He was constantly in touch with the contractors and future tenants, answering their
questions and concerns. He coordinated manufacture and delivery of furniture, installation of a
7, food-service area, technical training for Physical Plant staff, security-system installation,
telecommunications wiring, water service for the fire sprinkler system and various health and
The to-do list often threatens to grow higher than the building itself. That's big.
Married with three stepdaughters, Albertson is a youth counselor and Sunday school teacher
S at Trinity United Methodist Church. Professionally, he spends much of his free time working
with the Construction Owners Association of America, an organization that serves public and
private business owners.
His lifelong interest in all things mechanical, particularly motorcycles and cars, guided his
career. A 1974 graduate of UF's College of Building Construction, he worked for a South
Florida contracting firm, then ran his own company in Stuart before returning to UF in 1986.
In the end, all his projects are fundamentally "sticks and bricks," Albertson said.
"Everything's still a building," he said. "Some are more complicated and demand more
tightly configured tolerances than others, but it's all concrete and wood." C
IT'S GREAT TO BE A 'REAL' FLORIDA GATOR
By Linda Homewood
Note from the Editor...For our homecoming edition of The POST, we have chosen Alberta to feature as one of our (Extra)Ordinary People. Our "Inside
Edition" correspondent has discovered her secret identity. But, in keeping with Gator Spirit's long-standing UAA tradition to preserve mascot
identity, you the reader must be sworn to secrecy!
Sure, you've seen her at football games and at other events on the arm of her
beau, Albert, but you probably never knew that Alberta has a real life studying to
be a pharmacist. Yes, our very own pharmacy student who shall remain
unnamed is completing her fourth and final year as a part of UF's Spirit Mascot
program. Sadly, after this year, she must shed her reptilian costume and don her
new uniform a white coat to complete clinical rotations to become a real
But don't be surprised to see Alberta next year, because the costume is shared, as
the responsibilities are so great. It gets rather confusing in the "world of Gators,"
where reality and identity are relative.
Besides being Alberta, the real student's other accomplishments include serving
as vice president of the Gainesville campus chapter of Rho Chi National Pharmacy
Honor Society, a member of the Academy of Student Pharmacists and the 3PD
College of Pharmacy class representative.
Alberta recalls several great experiences during her tenure as a 'real' Gator. One
was a tailgate wedding, in which friends of the Gator-fan couple surprised them
with an appearance of Alberta and Albert. However, Alberta said her most
memorable experience was two years ago at the New Hope For Kids Celebrity
Mascot Games in Orlando. Professional and college sports mascot teams from all
over the United States competed against each other in games like tug of war,
tricycle races and wheel-barrow races.
"It was a great weekend of fun for a great cause," Alberta said.
But wait, we have still more secrets to reveal...the real Alberta is really dating
Albert! Who are these mystery UF students leading double lives? Well, we can tell
you that "our" Alberta and her Albert were high school sweethearts at Lemon Bay
High School (really!)
About her years as a real Gator, Alberta said she met great people along the way
and saw how special the mascots are to UF and the surrounding communities.
"I was amazed that two characters could have such an impact on people,"
Alberta said. 0
ROBERT A. BURNE, Ph.D.,
chairman of the department of
oral biology, has been elected
a fellow of the prestigious
American Association for the
on his contributions to the field
of oral microbiology. Burne
was one of 308 outstanding
scientists nationwide who were
welcomed as fellows into the association, and one
of only two in the section on dentistry and oral
NICK MINDEN, D.M.D.,
an associate professor of
restorative dentistry, has been
awarded fellowship in the e m
American College of Dentists.
Minden joins approximately .L
3.5 percent of his dental
colleagues nationwide who
have met the organization's
criteria of excellence, ethics
and professionalism in dentistry. He is also a
member of the American Dental Association and
the Florida Dental Association.
VICTOR MCKUSICK, M.D., of Johns Hopkins
Hospital, presented the Department of Pediatrics'
2nd Annual DeBusk Lecture titled, "The Legacy of
Jonathan Hutchinson (1828-1913): Syndromology
and Dysmorphology meet Molecular Genetics."
McKusick, a 2002 National Medal of Science
awardee, is widely regarded as the "father of
medical genetics." McKusick, creator of the
seminal work "Mendelian Inheritance in Man"
and its online counterpart OMIM, met informally
with librarians from the HSC Libraries to discuss
his many contributions to the literature.
MICHAEL GOOD, M.D., a professor of
anesthesiology, has been appointed the College
of Medicine's first senior
associate dean for Veterans
Affairs affiliations. A former
chief of staff at Malcom
Randall Veterans Affairs
Medical Center in Gainesville, .
Good will work to strengthen
the college's relationship with
the Malcom Randall center
and expand its relationships
to include VA facilities throughout the state of
ALEXANDER C. WAGENAAR,
Ph.D., who recently joined the
College of Medicine as a pro-
fessor of epidemiology and
health policy research, has /
been named a Highly Cited
Researcher by the Institute for
Scientific Information. The des-
ignation reflects Wagenaar's
position among the 250 most-
cited researchers in the field and is awarded to
less than one-half of 1 percent of published
scientists. Wagenaar is the principal investigator
on four major research projects and serves as a
scientific reviewer for two dozen journals.
KAY HOOD, Ph.D., A.R.N.P.,
a recent graduate of the
College of Nursing, received
a postdoctoral fellowship from
the Association of Teachers
of Preventive Medicine and
the Centers for Disease
Control and Prevention.
This two-year fellowship is a
collaborative program of the
College of Nursing, the Florida State Department
of Health, the Bureau of Sexually Transmitted
Disease Prevention and Control, and the CDC.
In addition to clinical experiences at a variety of
sites in Florida, Hood will spend up to six months
in Atlanta working on a project with the CDC in a
PUBLIC HEALTH AND HEALTH PROFESSIONS
SHERRILENE CLASSEN, Ph.D.,
an assistant professor in the
department of occupational
therapy, received a three-
year $490,000 career
development grant from the
Centers for Disease Control
and Prevention. Classen will
research and develop a public
health intervention plan to
promote safe driving for seniors.
JOSEPH A. DIPIETRO, dean of the College of
Veterinary Medicine, has received a number of
distinctions. Most recently, he was appointed to
the National Agricultural Research, Extension,
Education and Economics Advisory Board.
The board functions as the key advisory arm to
the Secretary of Agriculture
on matters pertaining to
In July, DiPietro became
president-elect of the
American Association of
Veterinary Medical Colleges
for a one-year term beginning
in July 2005.
DiPietro also recently
received the Dr. Erwin Small
Distinguished Alumni Award from the University
of Illinois College of Veterinary Medicine and its
VICE PRESIDENT FOR HEALTH AFFAIRS
RANDY GRAFF, IT Center trainer, received in
Septemberthe Jack Kelly Outstanding Educational
Technology Award for Creating and Maintaining
Exceptional IT Training Programs from the Florida
Association of Educational Data Systems. The
Florida professional association was founded in
1964 and is dedicated to the advancement of
STEVEN D. MUNGER, Ph.D., now an assistant
professor of anatomy and neurobiology at the
University of Maryland, was honored for his
research into the sense of taste. A former student
at the Whitney Laboratory and the neuroscience
department at the College of Medicine, Munger
has received the Presidential Early Career Award
for Scientists and Engineers, the nation's highest
honor for professionals at the outset of their
independent research careers, according to the
He received his doctorate under the mentorship
of Barry Ache, Ph.D., director of UF's Center for
Smell and Taste and a distinguished professor of
zoology and neuroscience, and Barbara-Anne
Battelle, Ph.D., a professor of neuroscience and
"I feel a strong sense of responsibility to live up
to the confidence that has been shown in me,"
said Munger, who will receive a two-year grant
extension and an additional $750,000 in funding
to continue his research.
Dentistry receives a $4 million infusion
for research base
By Lindy McCollurn-Brounley
The College of Dentistry will enhance its
research infrastructure and capacity with a $2
million award from the National Institutes of
Health's National Institute of Dental and
Matching funds from the state of Florida will
result in a $4 million infusion of capital into the
college's research enterprise, enabling it to better
balance its missions of education, research and
"We will be investing the resources in people -
new faculty who can complement existing areas of
strength in research programs in the college and
elsewhere in the Health Science Center, and in
career development opportunities for our existing
faculty to ensure they have the tools to conduct
cutting-edge oral health research," said Robert
Burne, Ph.D., chairman of the department of oral
biology in the College of Dentistry and author of
the winning award proposal.
Currently ranked No. 6 among the nation's 56
dental schools in federal funding for research, the
college has become a nationally recognized
research powerhouse in a remarkably short period
of time. Based on the efforts of a growing group of
faculty, sponsored research in the college has
exploded from $6.3 million in 2001 to more than
$14 million at the end of 2003.
This burgeoning expansion has been mostly
within the department of oral biology's research in
the areas of molecular genetics, bacterial
pathogenesis, physiology, pharmacology and
infectious diseases. The department is the leading
oral biology department in the nation in terms of
NIH funding and has experienced an increase of
more than 200 percent in federal funding in the
past two years. Also flourishing are research efforts
in the areas of pain and neuroscience,
orthodontics and bone biology, craniofacial studies,
biomaterials, cancer and clinical studies.
"The growing pains associated with this
unprecedented expansion of research in the college
have been substantial," said Dean Teresa A. Dolan,
D.D.S., M.P.H. "This award will enable us to
implement a research infrastructure enhancement
plan that will harness and focus the energy of our
growing research enterprise."
The plan calls for strengthened ties through joint
research initiatives with the HSC's Genetics
Institute, the Diabetes Research groups, the UF
Shands Cancer Center, the McKnight Brain
Institute and the university's General Clinical
Recruitment of new basic science researchers in
the areas of cell and molecular biology will
underpin expansion of clinical and translational
research. In addition, a training and mentoring oral
health research "pipeline" has been established to
enable existing faculty to develop clinical research
programs that will be competitive for NIH funding.
"This award can be viewed as an investment by
the National Institutes of Health in the future of
the College of Dentistry and the University of
Florida," Burne said. "We're dedicated to using
these resources to build a world-class research
enterprise that unites basic and clinical scientists
in a mission to translate new discoveries in genetics
and molecular biology into tangible improvements
in human health."
PATENT PROFITS REINVESTED IN PHARMACY RESEARCH
Raymond Bergeron, Ph.D., the Duckworth professor of drug development,
has turned drug patent profits into an investment in research at the College of
Pharmacy. The department of medicinal chemistry received a patent royalty
payment of more than $400,000 from Genzyme Corp. and used the money
to purchase a nuclear magnetic resonance spectrometer.
Patent income like this is extremely desirable, Bergeron said, because it
would take $12.6 million in grant awards to generate comparable revenue to
purchase the device.
The state-of-the-art NMR, with a superconducting magnet and a UNIX
workstation, is used by researchers to determine chemical structure in the
same way microbiologists use a microscope to examine cell structure.
Pharmacy researchers now will have immediate access to the highly sensitive
equipment necessary for analysis. Previously, they had to reserve time on
similar equipment through UF's McKnight Brain Institute. Because of the large
number of researchers in the College of Medicine it sometimes meant waiting
weeks, Bergeron said.
"Having this equipment will be quite a benefit to our department," said
Margaret James, Ph.D., department chairwoman. "It will make us more
competitive in securing future grant awards and in recruiting top researchers."
College of Pharmacy representatives (from left) William Riffee, dean,
Margaret James, department chairwoman, Tim Vinson, senior chemist,
and Raymond Bergeron, graduate research professor, inspect the
department of medicinal chemistry's new NMR spectrometer after its
focus on children,
U.S. drug czar tells
By John Pastor
P people who think today's marijuana is little more than a
nostalgic reminder of the 1970s need to take a closer look.
It's far more potent, its addictive qualities are severe and it
devastates children, said John Walters, director of the White House
Office of National Drug Control Policy, who spoke recently at the
McKnight Brain Institute.
As the nation's "drug czar," Walters coordinates federal drug
programs and spending, according to Dr. Wayne Goodman, M.D.,
chairman of the department of psychiatry in the College of
Medicine. Walters met with MBI members, then publicly outlined
his office's treatment, prevention and intervention efforts, which
include reducing illicit drug supplies from overseas and providing
more money and facilities for the 100,000 or so addicts in the John
United States who seek help. Policy,
He emphasized if the problem is stopped where it so often starts 2001
- with children "we can change the face of substance abuse in policy
the United States for generations." Good
The effort is complicated because so many social issues are tied distinct
into public opinion of marijuana, it's tough to talk objectively about
marijuana's place as the preeminent drug in the world of illegal
drugs, Walters said.
"When we talk about marijuana, we're not even talking about the drug itself,
we're talking about your opinion of the '60s or of a certain segment of our culture
that is seen as being cool," Walters said. "The problem is, it is difficult to discuss
illegal drugs in the United States without talking about marijuana because it is
the drug of choice by the overwhelming majority of illegal drug users. It is the
single most important illegal drug by a factor of two. The next is cocaine."
Making marijuana even more
insidious is that the drug's strength "(Marijuana addiction)
grew dramatically beginning in the
1990s, with the content of THC, the lie, A friend brings it to
active ingredient, rising from less
than 5 percent to highs around 14 fun, everybody does it,'
percent, Walters said.
"I think the director showed by young people who (
convincingly that as the potency of become victims them
marijuana has increased, the
number of young people who go on victimize Others,"
to need treatment, who are
marijuana dependent, has
increased," said Mark Gold, M.D., a
distinguished professor of psychiatry
in the College of Medicine. "His message that addiction is a disease that has a
pediatric age of onset, often beginning with the smoking of marijuana or a
cigarette, is important for the medical community to hear. The time to start
Walters (center), director of the White House Office of National Drug Control
said the nation saw an 11 percent decline in drug use by teenagers between
and 2003, the largest drop in almost a decade. Walters outlined key drug
issues to members of the UF medical community at the invitation of Dr. Wayne
man (left), chairman of the department of psychiatry, and Dr. Mark Gold, a
guished professor and an addictions specialist.
asking about drugs is 8 or 9, not 18."
As Walters described it, addiction is not spread by viruses or bacteria but
"It generally starts with a lie," Walters said. "A friend brings it to someone and
says, 'it's fun, everybody does it.' The disease is spread by young people who are
at risk and who become victims themselves, then they go on to victimize others."
One way Walters' office is attacking the problem is through a $200 million
national ad campaign. One television
commercial shows a boy removing a
?rally starts with a cigarette paper from a pack, finding a note
none and says, 'It's on it from his mother that says, "We need
to talk." The point is to get parents, some of
disease is spread whom may have smoked pot in their
younger days, to talk to their children
t risk and who about drugs.
A more controversial solution deals with
then they go on to random drug testing in schools, Walters
said. His office has set aside $25 million for
communities that wish to do drug testing,
John Walters with the provision that students who test
positively receive help, not punishment.
"The kids in schools that have testing
say they feel safe," Walters said. "What the test does, among other things, is give
kids permission to do the right thing. When they're tested they can say to their
peers, 'I can't do that, we're going to be tested.'" 0
POINT OF VIEW
education to improve
By Kathleen Ann Long
Dean, UF College of Nursing
The nationwide nursing shortage may have
dropped out of the headlines, but the need for
nurses has not gone away and it's expected to
increase. While enrollment in nursing schools is up
and vacancies for hospital nurses are filling,
advances in biomedical science, as well as the aging
of our nation's population, are factors that indicate
a growing need for more and better nursing care
long into the future. The National Center for
Health Workforce Analysis projects that by 2020,
Florida will need 61,000 more nurses than will be
available. Nationally, there will be a need for more
than 800,000 additional nurses.
"Quick-fix" approaches will not provide long-term solutions. Years of reports by
groups such as the Institute of Medicine, the American Hospital Association and
the Robert Wood Johnson Foundation confirm the need for a better-educated
nursing workforce and for general reforms in health-care delivery. While there is a
need for more nurses to alleviate shortages, simply increasing numbers of nurses
will not address the critical problems. Real improvement will only come when
there are changes in the education, recruitment and retention of nurses.
There is a growing consensus: Our system of health-care delivery requires
reform, including more fully engaging nurses in planning, managing and
evaluating patient care. Nurses need a stronger voice in decisions regarding
patient-care delivery, but they also need stronger educational preparation as a basis
for such complex decision-making.
In a recent study published in the
Journal of the American Medical
Association, UF College of Nursing
alumna Linda Aiken, Ph.D., and her
colleagues at the University of
Pennsylvania found that hospitals
with a higher proportion of nurses
educated at the baccalaureate level
experience lower patient mortality
rates. The study showed that a 10
percent increase in the proportion of I IIlI V LIUI1 OUU,UL
registered nurses holding a bachelor's
degree was associated with a 5 percent
decrease in the likelihood of patients
dying within 30 days of admission. In addition, a higher proportion of better-
educated nurses increased the likelihood that patients would be protected from
adverse events and complications.
In 2000, the American Association of Colleges of Nursing, the national
organization representing baccalaureate and higher-degree nursing education,
initiated an examination of nurse education, regulation and practice issues. After
consulting with AACN members, nursing practice leaders, regulators and other
health professionals, the study's authors recommended a new kind of nursing
The National Center fo
Clinical Assistant Professor Sandra Wolfe-Citty guides accelerated BSN
students as they screen a patient at one of their clinical rotations.
professional one specifically educated to coordinate, manage and evaluate care
for groups of patients in complex health systems.
This new Clinical Nurse Leader, prepared at the master's degree level, will serve
as a generalist provider who takes primary responsibility for the comprehensive
care management of patients. Applying evidence-based practice, the CNL will
serve as a guide, protector and advocate for the patient. The CNL will be a nursing
professional prepared for clinical leadership, able to implement nursing practices
based on patient outcomes, form quality improvement strategies, and be prepared
to create and manage care that is responsive to the needs of individuals and
The College of Nursing has a history of pioneering leadership in nursing
education by offering Florida's first nurse practitioner programs and first doctorate
in nursing science. Recent innovations
include an accelerated R.N. to Master
of Science in Nursing, and an
r Health orkorce accelerated Bachelor of Science in
Nursing to doctoral track. All
educational programs have a common
goal: better-educated nurses for better
Building on a tradition of
innovation, the College of Nursing
currently is one of 77 schools
nationwide that will pilot the CNL
program with the cooperation of five
area practice partners beginning in
2005. The college's practice partners include Shands at UF, Shands Jacksonville,
the Malcom Randall Veterans Affairs Medical Center and Wolfson's Children's
Hospital and Baptist Medical Center, both in Jacksonville. Practice partners have
committed to designing model units where nursing care using CNLs will be
delivered in new ways. As part of the national pilot project sponsored by AACN,
each college-practice setting partnership will also collect and report data on
selected patient outcomes to assess progress toward the ultimate goal improved
patient care. Stay tuned for further developments in this exciting new endeavor! O
Analysis projects that by 2020, Florida will
need 61,000 more nurses than will be
available, Nationally, there will be a need
4 y 0v\ -" s o yi 1!,
0 additional nurses,
LOOKING' AT YOU
Smile or no smile you might be next. POST staffers will get you when you
least expect it. Fortunately, we caught these employees hard at work...
Charley Mills, senior computer support specialist in the VPHA IT Center, Dr. William Drummond (left) and Walter Webb keep patients and visitors
prepares a laptop for wireless connection in the HSC. heading in the right direction. Stationed in the Shands Atrium, both are
volunteers for the Auxiliary at UF.
UF Health Science Center
Office of News & Communications
Senior Vice President for Health Affairs
Douglas J. Barrett, M.D.
Director, News & Communications
Melanie Fridl Ross, John Pastor
UF Health Science
Tracy Brown, Sarah Carey, Tom Fortner, Linda
Homewood, Lindy McCollum-Brounley, Patricia
McGhee, Tom Nordlie, John Pastor, Jill Pease,
Melanie Fridl Ross, Denise Trunk
Cassandra Jackson, Beth Powers, Kim Smith
The POST is the monthly internal newsletter for the
University of Florida Health Science Center, the
most comprehensive academic health center in
the Southeast, with campuses in Gainesville and
Jacksonville and affiliations throughout Florida.
Articles feature news of interest for and about
HSC faculty, staff and students. Content may be
reprinted with appropriate credit. Ideas for stories
are welcome. The deadline for submitting items to
be considered for each month's issue is the 15th
of the previous month. Submit to the editor at
firstname.lastname@example.org or deliver to the Office of News
& Communications in the Communicore Building,
Yahna Young is seen here responding to the needs of a patient.
Yahna is the senior secretary for Dr. Lawrence Lottenberg in the
College of Medicine's department of trauma.