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 Front Cover
 Table of Contents
 Post it
 Kenyan connection
 Administration
 Stroke therapy
 Clinic inequality
 Safety first
 Health care
 No. 1 social worker
 Pinching pennies for science
 Smoking and stress
 Research
 Groundbreaking building
 Perfect merger
 Gifts
 Distinctions
 Hana Yehia
 Back Cover


UF



The Post
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Permanent Link: http://ufdc.ufl.edu/UF00073869/00017
 Material Information
Title: The Post
Uniform Title: Post (Gainesville, Fla. 2001)
Physical Description: v. : ill. ; 28 cm.
Language: English
Creator: University of Florida -- Health Science Center
University of Florida -- Health Science Center. -- Office of Public Information
Publisher: HSC Office of Public Information
Place of Publication: Gainesville Fla
Creation Date: March 2008
Publication Date: 2001-
Frequency: biweekly
regular
 Subjects
Subjects / Keywords: Health occupations schools -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
periodical   ( marcgt )
serial   ( sobekcm )
 Notes
Statement of Responsibility: The University of Florida Health Science Center.
Dates or Sequential Designation: July 27, 2001-
General Note: Title from caption.
 Record Information
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 47826372
lccn - 2001229452
System ID: UF00073869:00017
 Related Items
Preceded by: Friday evening post (1989)

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Table of Contents
    Front Cover
        Page 1
    Table of Contents
        Page 2
    Post it
        Page 3
    Kenyan connection
        Page 4
    Administration
        Page 5
    Stroke therapy
        Page 6
        Page 7
    Clinic inequality
        Page 8
    Safety first
        Page 9
    Health care
        Page 10
    No. 1 social worker
        Page 11
    Pinching pennies for science
        Page 12
        Page 13
        Page 14
        Page 15
    Smoking and stress
        Page 16
    Research
        Page 17
        Page 18
    Groundbreaking building
        Page 19
    Perfect merger
        Page 20
    Gifts
        Page 21
    Distinctions
        Page 22
    Hana Yehia
        Page 23
    Back Cover
        Page 24
Full Text



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On the Cover


With more scientists applying for funding from the
National Institutes of Health and a stagnant federal
budget, the process of securing grant money for science
has gotten trickier in recent years. In this issue, the POST
explores how UF researchers are coping with the changes
and trying to study big ideas on a shoestring budget.
Photo by Sarah Kiewel.


Table of Contents


POST-it
Education: I -n,.i n i: :.lnn11: r1.:
Patient care: '.ii,:1 i- i .31: ,
Patient care: '..al-r, hi :r
(Extra)ordinary person: No. I social worker
Cover story: Pinching pennies for science
Research: Smoking and stress
Research: Cancer's emotional toll
Administration: Groundbreaking building
Jacksonville: Perfect merger
Distinctions
Profile: Rana Yehia


bases*


4U FRON


Policy

TALK
U.S. Democratic Sen. Bill
Nelson talks with UF physicians
and Republican Sen. Mel
Martinez (behind Nelson)
during a roundtable discussion
on health-care policy at Shands
at UF Feb 21. The discussion
focused on cuts that the Bush
administration has proposed for
the federal Medicare program.
The proposal would dramatically
cut government support to
teaching hospitals and medical
school practice plans. 0


2 *1 Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.


CONTENTS


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Looking after No. 1
You're going to love medicine in the 21st century because, of course, it's all about you. That's the basic
idea behind personalized medicine using information from an individual's unique genetic makeup to
provide a therapy or preventive intervention that is more or less tailor-made for that person. As
personalized medicine- also known as molecular medicine- slowly makes its way into medical
school curricula, physician's offices and diagnostic labs, UF will sponsor a major new symposium,
P "Molecular Medicine: Applying Current and Emerging Technologies" March 27-30 in Orlando. The
course, with a star-studded faculty, is being organized by the departments of pathology and laboratory
medicine in Gainesville and Jacksonville. This symposium is designed to serve a diverse audience,
including pathologists, medical directors of anatomic and clinical laboratories, laboratory
administrators, researchers, physicians and residents/fellows in training who are interested in
integrating new molecular technologies in their research and clinical practice. For more info orto
register, visit http://cme.ufl.edu/conf/molecular/letter.shtml



Visit us online @ http://news.health.utl.edu/ for the latest news and HSC events. I O 0 3


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...-









































By April Frawley Birdwell

I n a flash he was gone, the screen blank, eliciting furious

clicking and typing at the front of the room, where the students,

instructors and IT experts were huddled around a laptop.


A minute later, the line was ringing again, the
Woody Woodpecker tap-tap-tap of the tone
echoing in the vast room at the Digital Worlds
Institute in the UF College of Education.
Suddenly, the connection was lost again. Then
it was back. And then, as if magic had
intervened, the image of the Kenyan professor
once again filled one of the walls that serves as a
gigantic screen in the classroom.
"Can you hear me, Benson?" asked Jill
Sonke-Henderson, who teaches the course,
"Culture, Health and the Arts in sub-Saharan
Africa and the U.S.," with fellow instructor
Nina Stoyan-Rosenzweig.
"Hello?" asked Benson Njoroge, pausing to
wave at the screen. "Yes, I can hear you."
No one said linking via the Web to Kenya's
Kenyatta University for a lecture on herbal
medicine would be easy. But minor technical
glitches aside, the 40-minute connection
between professors in Nairobi, Kenya and a
class in Gainesville was a feat, especially given
the recent political strife and unrest that has
plagued the African nation.
"The connections allows our two cultures to
communicate face to face and in real time across
the Internet at a time when cross-cultural
communication is of the utmost importance,"
said Sonke-Henderson, a co-director of the UF
Center for Arts in Health-Care Research and
Education. "The conflict in Kenya reflects
cultural intolerance, and the kind of connection
we have developed with Kenyatta University


reflects cross-cultural connection and builds
awareness and understanding."
"I think that today's class gave our students
an understanding of the challenges and rewards
of such communication."
Sonke-Henderson and colleagues received a
$3,000 grant last year to start a cross-cultural
program with Kenyatta University. The
connection is an extension of a project started
in 2006 with the Mater Hospital in Nairobi to
establish an Arts in Medicine program there.
Because Kenyatta University is a
technological hub in Kenya, Sonke-Henderson
and Stoyan-Rosenzweig agreed with professors
there to share lectures and other programs via
the Web. After several unsuccessful tries to link
to the university in real time, the two
universities were finally able to establish a
connection in December. And then, after a
disputed election, violence broke out in Kenya,
leaving hundreds dead.
"Because of the post-election violence in
Kenya we were not able to open connections as
soon as we wished and we were saddened to hear
that this violence affected people we knew: One
of the people at Kenyatta lost his brother-in-
law," said Stoyan-Rosenzweig, who also serves
as director of the College of Medicine's medical
humanities program. "This connection and the
ability to see real people is especially important
when many Kenyans are cut off from the rest of
the world, and the world only sees the violence."
In the class last month, Kenyan professors


Njoroge and Nicholas Gikonyo described the
role herbal medicine plays in Kenya's health-
care system today. Because many Kenyans do
not have access to modern health care, the use
of herbal medicine is common there, Stoyan-
Rosenzweig said.
"I think as a doctor you have to understand
the ways different cultures practice medicine,"
said Avan Armaghani, a junior in the class who
will start medical school at UF this fall as part
of the Junior Honors Medical Program. "It's
important to get the whole picture."
UF junior Evan Garfield said connections
like the one he had just witnessed could make a
difference in increasing cultural awareness and
giving students a more personal understanding
of how the rest of the world lives.
"It's so hard to get an accurate portrayal of
what's going on in the world," he said. "It's
pretty surreal to have a connection like that."
If violence had not erupted in Kenya, the
class would have participated in several Web
lectures by now that would have involved
Kenyatta University students as well, Stoyan-
Rosenzweig said. But plans are in place to
continue and expand the lectures. The Digital
Worlds Institute is also coordinating an event to
promote discussion of Martin Luther King Jr.,
with Kenyatta and other institutions, Sonke-
Henderson said.
"The goals for the connection are to provide
UF's students, primarily fine arts and health
science students, with opportunities to develop
an understanding of diverse belief systems and
to learn to communicate with people who see
things from different perspectives," Sonke-
Henderson said. "I think that today's class gave
our students an understanding of both the
challenges and the rewards of such
communication."


4 |1 Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.









Children IN NEED

Kids' health agency pleads case for
funding, support to state legislators


By Melissa M. Thompson
When Tammy Caksackkar's son, Christian, needed a routine physical for
school in 2004, she was shocked to learn it would cost her $1,700 and that
her insurance wouldn't cover the cost.
The single mom had no choice but to borrow money and go forward with the
health screening required for her autistic son.
But like many parents of children with special needs, Caksackkar was
overwhelmed by the financial strain caused by tests and medicinal therapies to help
care for Christian. She learned three months later that the screening would have
been covered under the umbrella of care provided by Children's Medical Services.
"The hard part is I talk to at least 10 people a week who don't know about CMS,"
said Caksackkar, executive director of the Family Resource Coalition Inc., a
nonprofit organization that provides assistance to children and youth with special
health-care needs in Florida. "Now I go anywhere -Wal-Mart, Target, even Chuck
E. Cheese's and go into the whole spiel about what a great resource CMS is."
Now an advocate for the program, Caksackkar shared her story in front of nearly
30 health-care professionals, community advocates and government representatives
at the inaugural Children's Medical Services Legislative Day on Feb. 1 at the CMS
area office in Gainesville. The event aimed to raise awareness about CMS programs
and the organization's dire need for legislative support and funding.
Children's Medical Services provides coordinated, managed health care for
financially eligible children under 21 with serious or chronic physical,
developmental or emotional conditions who require health-care services beyond
what children generally require. The organization, which partners with UF
physicians to provide health care for its patients, serves residents in all Florida
counties from 22 area offices directed by board-certified pediatricians.
State Rep. Larry Cretul attended the event hoping to absorb all of the information
CMS employees and families had to offer.


CELEBRATING


Sark your calendars: The College of Public Health and Health Professions announces its 50th Anniversary Lecture Series, which will
bring some of the nation's top health policy and rehabilitation researchers to UF in celebration of the college's milestone anniversary.
More details on times, locations and topics for the fall lectures will be available at a later date. Visit the College of Public Health and
Health Professions' 50th anniversary Web site regularly for updated information, www.phhp.ufl.edu/50th-Anniversary.


"Scientific evidence and
improving the quality of
health care" by Donald M.
Steinwachs, Ph.D., a
professor of health policy
and management and
director of the Health
Services Research and
Development Center at Johns
Hopkins University 12:45
p.m. to 1:30 p.m., HPNP
Complex Auditorium


--
"The politics of health care
reform" by Gail R. Wilensky,


Ph.D., a senior fellow with
Project HOPE noon to 1 p.m.,
HPNP Complex Auditorium



Michael A. Morrisey, Ph.D., a
professor of health care
organization and policy at the
University of Alabama at
Birmingham

---

Thomas Rice, Ph.D., a
professor of health services and
vice chancellor of academic
personnel at the University of
California, Los Angeles


Karen Davis, Ph.D., president
of The Commonwealth Fund

--
"Becoming frail: Evidence
from the Hispanic established
populations epidemiologic
studies in the elderly" by
Kenneth J. Ottenbacher, Ph.D.,
O.T.R., the Russell Shearn
Moody Distinguished Chair, a
professor and director of the
division of rehabilitation
sciences at the University of
Texas Medical Branch


Lisa A. Cooper, M.D., M.P.H.,
a professor of epidemiology
and health policy and
management at Johns Hopkins
University (sponsored by the UF
Area Health Education Centers
program)



Deborah A. Freund, Ph.D., a
distinguished professor and
senior research associate at
the Center for Policy Research
at Syracuse University


Children's Medical Services held its first Legislative Day Feb. 1 in
Gainesville to raise awareness about the organization's programs and
need for state funding. Here, State Rep. Larry Cretul (left) listens to
speaker Tammy Caksackkar, a mother and advocate for the program.

"I'm here like a sponge," he said. "This has gotten a little more special to me now
because I have a 6-month-old grandson. It really puts children's health care in
perspective."
Thomas Chiu, M.D., the CMS North Central Florida regional medical director
and a UF professor of pediatrics, said the future of CMS depends on the response
from government representatives, whom he hopes will take the inspiring stories they
heard during the event back to the legislative budget meetings for consideration.
Chiu said the current budget for CMS is the same as it was 10 years ago, while the
organization's programs continue to expand. This means the workload for staff
members has doubled while the number of filled staff positions is decreasing due to a
hiring freeze.
"We lose good staff members who say they don't want to leave, but are paid $10 (an
hour) higher at a public health clinic," Chiu said. "A lot of people are asking if CMS
will disappear. We're trying to find money for our programs, and it's challenging.
We're doing this for the kids." 0


- -
Alan M. Jette, Ph.D., director
of the Health and Disability
Research Institute and a
professor in the departments
of rehabilitation sciences and
social and behavioral sciences
at Boston University

Support for the lecture series
is provided in part by Blue
Cross and Blue Shield of
Florida.


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events. I l 0 5


YEARS PHHP kicks off 50th anniversary lecture series


ADMINISTRATION












Learning to throw


... again


UF researchers help stroke patients relearn motor skills


By Melissa M. Thompson

avid Lowenthal, M.D., Ph.D., stared intently at his nemesis a dried red bean resting on
the table in front of him while his right hand, the stronger, more dominant hand, was
constrained by a thick white mitt equipped with a mesh compartment for his fingers.


After concentrating on the legume for
several seconds, he slowly raised his slightly
trembling left hand in an effort to pick up
the bean between his index finger and
thumb, missing once, but then emerging
victorious in his second attempt to pluck it
off the table and move it three or four inches
away from him.
For Lowenthal, an eight-year stroke
survivor, there are no small victories, only
baby steps in a long journey that has
propelled him toward his goal of improving
the function of the left side of his body that
was affected by the stroke.
"Going through rehabilitation is not for
sissies," joked Lowenthal, a UF professor of
medicine, pharmacology and exercise science.
"The journey has been arduous but highly
rewarding."
As a participant in the Improving Motor
Performance Applying Constraint Therapy
study for stroke survivors, Lowenthal, 66,
has endured an intense regimen of constraint-


induced movement therapy, or CIMT, in an
effort to regain the motor skills that will
allow him to write or throw a ball with his left
hand, his dominant hand before the stroke.
During this form of therapy, participants'
least-affected hands are constrained in mitts
for 90 percent of the time they are awake
while they use the most-affected hands during
repetitive exercises where even the smallest
improvements could have a significant effect
on their quality of life.
Kathye Light, Ph.D., P.T., a UF associate
professor in the department of physical
therapy in the College of Public Health and
Health Professions, is the principal
investigator of the study and principal author
of its research grant. She will examine the
benefits of CIMT home therapy versus therapy
done exclusively in a lab with a trainer.
Subjects are randomly selected for either
part of the study. Both sets of participants
spend six hours on CIMT exercises each day.
The home therapy group spends one hour of


this time working with a trainer in the lab
and the rest of the time doing the exercises on
their own. Patients selected for full lab
training perform the same program but do so
completely under the guidance of a trainer in
the clinic.
Light and her colleagues are interested in
discovering if performing exercises at home
and spending less time with a trainer can reap
the same benefits as those who work
exclusively with trainers or physical
therapists for several hours every week.
Another part of the study will evaluate if a
second course of CIMT, for survivors who
have previously received the treatment, yields
added benefit and improved function.



Many stroke survivors are shocked to find
out that a two-week CIMT program could
cost as much as buying a small car.
The time and labor-intensive nature of the


6 |1 S 1 Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.


PATIENT CARE









therapy account for the expense about
$10,000 to $15,000 for a two-week treatment,
Light estimated.
"Insurance will never pay for the expense
of sitting for six hours a day for 10 days with a
therapist," said Fran Greenberg, the study's
coordinator. "If this study shows that one
hour a day reaps the same benefits, stroke
survivors may have a better chance of an
insurance company paying for further
treatment."
Prior to I.M.P.A.C.T., Light served as
co-principal investigator for Extremity
Constraint-Induced Therapy Evaluation, a
study that showed CIMT helped stroke
survivors improve function years after their
strokes occurred.
"In the past, neurologists and other
physicians have suggested that patients can
make little improvement six months or more
after a stroke," Light said. "We've found
that's not true. We've worked with people 20
years after their strokes who were able to
make great progress and regain function."
Light began the I.M.P.A.C.T study in 2005
after she was awarded a five-year research
grant funded by the National Institutes of
Health. The multisite research study at UF,
the University of South Carolina and
Colorado State University takes the preceding
study one step further by examining the
parameters surrounding CIMT and will end
in June 2010.




In this study, the doctor has never been
happier to be the patient. Lowenthal knew he
would undergo aggressive physical therapy on


his left hand and arm the side most
affected by his stroke while the less-
affected hand would be placed in a mitt to
spur use of the weaker arm to perform
activities. Although participants are never
pushed to the point of discomfort, the
repetition and time in the lab can be mentally
and physically taxing.
"Since his stroke, he has become a napper,"
said Ronnie, 63, Lowenthal's wife of nearly 20
years. "There were times when he would train
in the lab all day and then go and do some
work in the office, which was extremely
tiring, but well worth it."
The lab itself is anything but the
stereotypical clinical setting.
There are no researchers in sterile-looking
white lab coats bustling around the room with
clipboards. Rather, participants work with
trainers, mostly physical therapy doctoral
students, in a room that resembles a place for
summer camp activities than a Mecca for
scientific research.
Here participants perform exercises, such
as Lowenthal's battle with the bean, designed
to improve fine motor skills, flexibility and
range of motion while trainers record daily
progress.
Jenga, checkers, Scrabble and puzzles are
stacked on lab shelves. In the corner, there is
a piano and a whiteboard for participants to
draw pictures using their most-affected
hands. Plastic containers and cans line the
countertops where subjects practice making
meals and eating lunch. One of the lab's
cabinet cubby holes holds the key to one of
Lowenthal's favorite exercises: the beanbag
toss.
He winds up like a seasoned pitcher on a


mound, clutching the bubble-gum pink
beanbag in his hand and then struggles to
maintain balance for a moment a reminder
of why he's there. Lowenthal points to the
ceiling but it's a fake-out, and he delivers
his best "fastball" to one of his trainers
standing across the room.
"This was one of my goals before I came
here to be able to write my name and
throw a ball," he said, in his low, soft-spoken
voice, a result of the stroke. "I will leave here
having accomplished both goals."




Before suffering two strokes within 24
hours in January 2000, Lowenthal was the
poster child for healthy living. He was an avid
long-distance runner who had completed 15
marathons and exercised at least an hour
every day. He watched what he ate, didn't
smoke or drink. He seemed to do everything
right.
In the hours following the stroke,
physicians doubted Lowenthal would make it
through the night, and if he did, they thought
he would never walk again.
After nine months of rehab, sweat and
determination, Lowenthal escorted his
daughter down the aisle at her wedding in
September 2000 without the use of a cane or
walker.
He applied the same determination during
his stay in Light's lab and said he feels other
stroke survivors should take advantage of
participating in the study, which is offered at
no cost for the subjects.
"I came here two weeks ago with significant
defects, and I leave here with a ray of hope,"
he said.
Lowenthal's wife agrees the therapy has
helped return a welcomed sense of normalcy
to her family's life.
"People should knock down the door to get
in there and get the treatment," Ronnie said.
"It showed me, and it will show other people
that you can reconnect the brain to function.
If David had to fly across the country to get
this treatment it would have been worth it.
Hands down." 0




Dr. David Lowenthal, who survived a
stroke eight years ago, participated
recently in the Improving Motor
Performance Applying Constraint
Therapy study for stroke survivors. As
part of the study, participants are kept
from using the hand least affected by the
stroke to rebuild motor skills and function
in the most-affected hand.


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Inequality in the clinic?

National leader urges UF docs to help

end racial disparities in health care


By Christa Wagers

sometimes even people

with advanced degrees

need a wake-up call.

In late January, the McKnight Brain Institute
auditorium was filled with academics, experts
and directors from the UF College of Medicine
who were urged to take responsibility for their
role in ending racial disparities in health care.
There is an overall lack of public and provider
awareness on the subject of health disparities,
said Garth Graham, M.D., M.P.H., a national
leader in health-disparities policy who spoke to
the UF crowd as part of the first installment of
the College of Medicine Dean's Lecture Series
on Innovations in Healthcare Access, Quality
and Safety. Dean Bruce C. Kone, M.D., said the
speech was "a call to action."
Eliminating health disparities is fundamental
to the growth of the United States, Graham
said.
The evidence of different races receiving
vastly different health care is "overwhelming,"
he said, especially regarding infant mortality
rates. In 2004, the infant mortality rate for
African-American infants was more than twice


the rate for non-Hispanic white infants,
according to the U.S. Department of Health and
Human Services.
Graham, the deputy assistant secretary for
minority health in the U.S. Department of
Health and Human Services, stressed how UF
faculty members and leaders can play an
important role in changing how minority
patients are treated. Academic institutions are
trendsetters for the health-care field, he said.
"Folks, the culture of medicine starts here,"
Graham said.
Inequalities in how different racial groups
receive health care can be greatly influenced
simply by physicians realizing they have a bias.
Graham suggested academics could train other
health-care professionals and advance medical
care through research.
Some of the major causes of health-care
disparities are out of providers' control, though,
Graham said.
Graham said that sometimes where patients
live has more to do with the health care they
receive than their race. Often, black patients
live near hospitals that offer low-quality health
care to all of their patients.
Other differences that affect health care
include how racial groups seek it and illiteracy.


Dr. Garth Graham, a national leader in
health-disparities policy, talked about the
challenges of making quality health care
accessible to all segments of the population
during a lecture in the McKnight Brain
Institute on Jan. 30.



At times the opportunities for adequate health
care are limited because the patient doesn't know
where to look, can't afford to look or can't read.
The good news is leaders in the medical
community can change the future, Graham said.
He gave the example of Margaret Heckler,
who became a leader in creating awareness
about infant mortality in the 1980s despite not
being directly affected by it.
All health-care workers are responsible
whether they think so or not, Graham said.
Although many physicians know minority
patients tend to receive worse health care than
white patients, they often believe it is not their
job to fix the issue.
"All of this starts with saying this is
somebody else's problem," Graham said.
While at UF, Graham also met with Health
Science Center and community leaders, faculty
and students to press his message and to advise
on strategic initiatives for reducing health-care
disparities locally and across the state.
Kone said planning is already under way for
two such initiatives expanding access to
health care through the Eastside Community
Practice clinic and related programs and
establishing a center of excellence in minority
health and health-care disparities. 0


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Shands and UF leaders held a series of workshops tor sludetz, ul
and faculty focused on teamwork and improving patient safety.


By Lauren Edwards

patient wakes up in his hospital bed after
undergoing an amputation of his left foot.
Slowly opening his eyes, he sees his wife
staring at him anxiously.

"How did it go?" he asks. "Did everything turn out all right?"
She looks away and starts to cry.
"I don't know how to tell you this," she says. "But they amputated the wrong foot."
A scene from "Grey's Anatomy"? Could be. A real-life situation at a hospital? Just
as likely.
When "To Err is Human: Building a Safer Health System" was published by the
Institute of Medicine in 2000, red flags were raised as readers learned that as many
as 98,000 people die each year in the United States due to medical errors. Five years
later, The Journal of the American Medical Association reported that the death rate
from medical errors has not changed much at all.
The statistics are staggering and certainly make one thing clear: Medical errors
happen, even at the best of institutions.
That's one of the reasons why the UF College of Medicine and Shands HealthCare
are striving to improve communication and teamwork in the operating room.
John Armstrong, M.D., an assistant professor of surgery, J.S. Gravenstein, M.D., a
professor of anesthesiology and Gail Avigne, director of surgical services at Shands
at UF, are leading a charge to improve the way doctors, nurses and other health
professionals work together to reduce the chance such medical errors will occur.
To do this, Armstrong, Gravenstein and Avigne created a series of workshops
focusing on teamwork and patient safety that were held in January and February in
the Center for Simulation, Advanced Learning and Technology. During the
sessions, participants played "Spot the Error," a game-like exercise that brings
surgeons, nurses, anesthesiologists, residents and medical students together to


reflect on team behavior as a way to reduce the potential for, and actual occurrence
of, errors in the operating room.
"It's an effort to make training in teamwork tangible, beyond a PowerPoint
lecture," said Armstrong, who received one of the College of Medicine's quality
improvement grants to fund the project. "This project focuses on getting everyone
in the operating room to look outside their lanes at the total situation affecting the
patient and to voice their concerns politely, yet firmly."
Using the department of anesthesiology's patient simulator, which looks and acts
like a real human, project organizers filmed a mock operating room scenario to
show to workshop attendees.
The video shows a medical team making errors ranging from administering a
medication to a patient with a known allergy to that drug to operating on the wrong
side. The surgeon's cell phone rings in the OR and background chatter distracts the
team. Laughter erupted in the audience as the "surgical team" made error after error.
But Avigne says these things really can and do happen in real-life situations.
"That's why there was laughter," she said. "Because it was so real. Even though it
was exaggerated, they know it happens."
One of the major thrusts of the "Spot the Error" exercise is to encourage medical
staff to recognize seemingly obvious errors and spot less noticeable ones, as well.
Just because experienced professionals perform a procedure doesn't mean it will
be error-free, either, Avigne said. Even surgical procedures can become routine after
a while.
"You do it on autopilot," she said.
Together, Avigne, Armstrong and Gravenstein hope the workshops help create a
safer environment for the patient and an overall culture of acceptance and open
communication among OR staff.
Often, a sort of social structure evolves in the OR, causing those who aren't at the
top of the food chain to keep quiet, even when a problem arises that should be
brought to attention.
"The barrier to communication across hierarchy lines is very pronounced in
medicine," Gravenstein said.
By gathering professionals from different disciplines together in the same room,
Armstrong and his colleagues hope they have created a foundation for an OR where
everyone will work as a unified group and be able to raise their concerns
comfortably.
"Our ultimate desire is a culture where everyone can recognize errors and speak
up," Avigne said.
Armstrong plans to do follow-up sessions after the workshops and review the
findings. He hopes that, through better communication and team practice,
hierarchy in the OR will fade in favor of patient safety.
"When you remember that the focus of care is the patient, other concerns like
hierarchy take a back seat," he said. 0


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Just say yc to




lCOLONO SSCOPY


New UF colorectal surgeons say

screenings could save lives


By Lauren Edwards

olon cancer. It's the
third most common
solid organ cancer and
the second most common
cause of cancer-related death.

Scary statistics? Certainly. But getting
regular colonoscopies and maintaining a
healthy lifestyle can dramatically reduce a
person's risk of developing, and dying from,
colon cancer. Yet many people put off, or
completely avoid, the colonoscopy an
internal screening to look for abnormal
growths in the colon.
"People don't want to talk about it they
think they're immune to it," said Sanda Tan,
M.D., a colorectal surgeon who joined the UF
College of Medicine faculty in October. "We're
aware of breast cancer and lung cancer, but
colon cancer affects both men and women and
is totally preventable."
That may be exactly why March has been
declared national Colorectal Cancer Awareness
Month.
According to the American Society of Colon
and Rectal Surgeons, only about 50 percent of
people diagnosed with colon cancer in its later


People don't want to talk about it they think they're

immune to it. We're aware of breast cancer and lung

cancer, but colon cancer affects both men and women


and is totally preventable.

stages will be cured, versus 80 to 90 percent of
those whose cancer is detected and treated at its
earliest stages. Additionally, studies have
shown that those who are treated by colorectal
surgeons have a greater chance of survival.
With the recent addition of Tan and Emina
Huang, M.D., the college's first fellowship-
trained colorectal surgeons, UF is poised to
help more patients avoid colon cancer through
screening, care and research of the disease.
First and foremost, Tan and Huang agree
prevention is key when it comes to colon
cancer. It takes about five years for a colon
polyp to develop into full-blown cancer, and
the earlier it is caught the better.
While doctors recommend that everyone 50
and older undergo an annual colonoscopy,
people with a family history or risk factors such
as inflammatory bowel disease need to start
earlier, says Tan, who came to UF after
completing a fellowship at Brown University.
If colon cancer runs in your family, Tan
recommends getting yearly colonoscopies at
least 10 years before the age at which your
family member was diagnosed. People who
suffer from longstanding bowel inflammation,
such as ulcerative colitis, are three to five times
more likely to get colon and small bowel cancer
than the average person and should start
screenings even earlier, Huang said.
In addition to her surgical duties, Huang
focuses a great deal on research. In her lab,
Huang and colleagues are investigating the role
S adult stem cells play in the development of
cancer.
Stem cells are prized for their ability to
develop into other types of cells and replenish


Sand Tan, M.D. J

them, but it's this ability to renew that Huang
suspects could affect the development and
spread of cancer. The discovery of solid organ
tumor-initiating cells, or "cancer stem cells,"
from colon cancer will assist in the
understanding of tumor biology and could
result in new targets for research and therapy,
Huang said.
With these stem cells in action, even a very
small population of cancer could grow quickly,
said Huang, who is working to decipher what
causes cancer.
Huang believes these cancer-initiating cells
are likely lurking in the body before the disease
develops, yet another reason why screening is
vitally important.
The bottom line, however, is that early
recognition of the disease remains a critical
factor in survival.
"It's a silent killer," Tan said. "You won't
know until it starts bleeding, and that may be
quite an advanced stage."
Even if diagnosed at a later stage, Tan says
there are still treatment options available,
including surgical removal of a tumor and
possibly chemotherapy and radiation.
Tan says that today, minimally invasive
procedures, such as laparoscopy using cameras
and a small incision, can be used to remove
tumors. An otherwise healthy person who has a
tumor removed can be home from the hospital
in four days.
"Colon cancer is no longer a death sentence,"
Tan said.
To learn more, visit the American Society of
Colon and Rectal Surgeons Web site, http://
www.fascrs.org/. 0


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The



other side



of illness

Shands social worker honored
for work with patients


Shands social worker Gail Greenhut was recently named Social
Worker of the Year by the Gainesville chapter of the National
Association of Social Workers.


By Anney Doucette

Gall Greenhut works quietly among the
swarming tide of patients, doctors and
nurses at the Shands at UF adult outpatient
clinics. As the physicians diagnose and treat their
patients' medical needs, Greenhut pauses to hear
their concerns.
How are their illnesses affecting their personal live? Can they afford their medications?
Do they have somewhere safe to go home at night?
After 18 years as a social worker at Shands, she knows the resources and how to
make them available to patients in need. And she's one of the best at her job: At a
March 6 ceremony, Greenhut was named Social Worker of the Year by the
Gainesville unit of the National Association of Social Workers.
About 40 social workers handle cases from Shands and the UF outpatient
medical clinics. As the largest hub of social workers in North Central Florida,
they are the safety net for underserved patients whose access to health care is
limited. Social workers address the whole patient, beyond their medical needs,
Greenhut said.
"The doctors may be looking at what is medically wrong with the patient, but
we look at the paths of what that might impact, not only the patient but their
family, finances and living situations," said Greenhut. "We pay attention to the
emotional side of the illness as well as the practical issues."
For some patients, just getting to a doctor's appointment is a big hurdle. Many
patients are uninsured and receiving and affording health care is difficult, if not
impossible. Some patients are unaware of the resources available to them, and
some have been turned away already. Social workers such as Greenhut address
these issues and help patients access support programs and community resources.
"The ER is clogged all the time with uninsured people who have nowhere else
to go," Greenhut said. "They may have a cold or they might have cancer, but they
have nobody else to see them. So we look at the whole range: access to health
care, accessing resources so they can apply to programs, finding support groups,
getting a diagnosis ... the whole gamut."
Social work has been Greenhut's calling since she volunteered at a 24-hour
crisis center in college, an experience she describes as life-changing. She
currently works at the Shands at UF adult outpatient clinics three days a week,
the rest of her week spent in private practice at the Gainesville Family Institute.
She says the two clinics provide a nice balance of social atmosphere. One-on-one
counseling is the norm at her private practice, where her patients can focus on
issues such as divorce and problems at work. Most of her patients there already
have a place to live and a doctor to treat their medical needs.
At the UF clinics, she carries a pager, sees walk-in patients and takes a lot of
phone calls. The needs of these patients are often more immediate many of
them don't have a doctor or the ability to pay for their medications. Some are
homeless. Meeting these challenges is what motivates Greenhut.
"There are people living under a bridge on 1-75," she said. "I've been involved
in helping these people get on disability and out from under the bridge. When
you have an impact on helping people, it's very rewarding."
In March, which is also National Social Work Month, Greenhut will be
rewarded for a lifetime of patient advocacy with special recognition from the
National Association of Social Workers. Greenhut is modest about accepting such
an honor.
"My peers are all very hard-working, talented people," she said. "I think I'm
very blessed." 0


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St








ig ideas ona


shoestring budget

NIH budget crunch forces scientists to get (even more) creative

By Ann Griswold I
c ence starts with
a blank page and
iS a big idea. Then
comes the hard part:
writing it all down. The
process of securing .
funding takes months -
sometimes up to a year
- and there's not always
a light at the end of
the tunnel. Sometimes
there's a brick wall. More
often, there's a closed
door and an open Maureen Goodenow, a UF researcher who studies HIV/AIDS, discusses science with fifth-year doctoral
window, student Joshua Bunger in her lab. Because the National Institutes of Health is funding a smaller
percentage of grants, some researchers across the country now struggle to keep their labs afloat.


COVER STORY









But one thing's for certain: The game has
changed. A few years ago, researchers might
have crossed their fingers and hoped for funding
after a first submission to the National Institutes
of Health. Now, they just hope their grant will
receive a score and perhaps a bit of positive
feedback to guide their next go-round.
The one thing that hasn't changed, it seems, is
that grant writing remains one of the toughest
parts of research.
"I've undertaken numerous administrative
and management activities over the years, but
this application was the most complex task I've
ever attempted," says Henrietta Logan, Ph.D., a
professor of community dentistry and behavioral
science in the College of Dentistry, who worked
from 4 a.m. to 10 p.m. for months last year on a
$17.5 million NIH proposal to establish the
Southeast Center for Research to Reduce
Disparities in Oral Health at UF. Logan expects
to hear a decision sometime this month.
"There's nothing like a little passion to make a
difference in the lives of others," Logan says.
"The passion is really what drove me, because I
got tired. Believe me I got tired and I got
discouraged."



Many irons in the fire
For most researchers, grant writing is a long
process punctuated with bouts of frustration and
angst. Yet more and more faculty researchers are
choosing to write not just one, but upwards of 10
grants each year, in hopes a couple will be
funded.
That process is all-too-familiar to Kirk
Conrad, M.D., a professor of physiology and
functional genomics and of obstetrics and
gynecology in the College of Medicine. One of



Krista Vandenborne, a professor in the College of
Public Health and Health Professions, sometimes teams
on research projects with her husband, Glenn Walter, a
College of Medicine researcher. Interdisciplinary
collaborations can sometimes inspire new research
ideas that pique the interests of grant reviewers.


his big ideas involves the pregnancy hormone
relaxin, which holds promise for treating women
with preeclampsia, a potentially life-threatening
hypertensive condition.
Last year, Conrad submitted six grants to the
NIH and other funding organizations. And he's
not done yet he plans to submit six more
proposals this year.
"It's a little bit like airplanes coming in for a
landing in LaGuardia. We're all circling,"
Conrad says. "You hope that your grant gets a
reasonable score so that the next time you might
get funded."
President Bush's proposed research budget for
2009 was released Feb. 8. While a $29.5 billion
NIH allowance might seem exorbitant to the
average nonscientist, many researchers were
disappointed. That inspires the obvious
question: How much does science cost, anyway?
"In an average month, a well-equipped
molecular biology lab spends around $6,000 on
reagents and consumables," says Chris
Browngardt, a senior biological scientist and
laboratory manager in the College of Dentistry.
But laboratories can easily surpass that to the
tune of $8,000 to $10,000 per month -
depending on the exact nature of the research
conducted, Browngardt added.
"There are no freebies in science," Conrad
says. "It's not a service. We're not seeing patients
or making consumable products and generating
all kinds of revenue."
In many cases, researchers balance several
grants at once to ensure a steady flow of income.
"You like to carry at least two or three grants
at a time because salaries are so expensive,"
Conrad says. "It's the salary component that's
hard to cover your own, as well as everyone's
in your lab."


Veena Antony, M.D.
Antony wants to detect lung
disease and mesothelioma at
an early stage using
nanoparticles. The particles
light up when they detect
cancer cells, eliminating the
guesswork that often
accompanies biopsies.


F


The waig game
It hasn't always been like this. During the past
eight years, the overall success rate for
applications submitted to the NIH decreased
from 32 percent to about 19 percent. Now,
applications submitted for the first time have a
mere 9 percent chance of getting funded.
Christiaan Leeuwenburgh, Ph.D., chief of the
division of biology of aging in UF's Institute on
Aging, says that "a few years back, it would have
been a no-brainer" to fund an interdisciplinary
program project grant to combat the effects of
aging, such as the one he recently submitted to
the NIH.
"Today, it's hard to say there's a 50 percent
chance or a 25 percent chance. Everything's
about a 10 percent chance these days," says
Leeuwenburgh, who submitted 15 grants last
year and landed four. "It's almost a given that
nothing will be funded the first time."
When the NIH budget doubled between 1999
and 2003, many scientists had high hopes their
chances for funding would improve. But more
researchers are applying for grants than ever
before: The NIH receives about twice as many


#1*


Kirk Conrad, M.D.
Conrad wants to establish a perinatal and
reproductive biology research program that
pools expertise from UF researchers in five
colleges. Much of Conrad's research focuses P
on the cardiovascular systems of pregnant
women, particularly those who conceive
using artificial reproductive technologies.


continued on pag(


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events. I I I* 0 1 13






0OE 0OTIUE


continued from page


applications now as it did 10 years ago. And with
more than 80 percent of the institutes' budget
devoted to existing projects, funding for new
studies is hard to get.
"It has been a very difficult time, not just for my
laboratory but for a lot of other people," says Veena
Antony, M.D., a professor of pulmonary medicine



Henrietta Logan, Ph.D.
Logan wants to establish the
Southeast Center for Research to
Reduce Disparities in Oral Health, a
seven-year program that involves
partnering with communities,
dentists, UF researchers and the
Florida Department of Health to
address racial and ethnic disparities
in oral health diseases.





and chief of pulmonary and critical care medicine
at the College of Medicine. "In some study sections,
the NIH triages up to 60 percent of all grants that
are sent in for the first time they don't even get
scored. I have a long list of grants that were just
sent back to me."
Antony uses nanotechnology to detect lung
disease at an early stage. Her big idea has a
potentially lucrative payoff for the 342,000
Americans who die from this condition every year.
But even with such promising work, the process is
slow: Antony applied for 10 grants last year and


received two.
Other researchers have experienced similar
setbacks, although none say they were surprised.
Conrad's proposal to study preeclampsia received
good feedback this year, but he's still waiting in line.
"It actually ended up getting a decent score the
first time around," Conrad says. "I was just happy it
didn't get triaged. In our study section, 55 percent
of the applications aren't even scored. And not only
was it scored, but it got a pretty good score just
not enough to be funded."
When asked if the score might have been
sufficient in past years, Conrad says, "Close,
absolutely. I think it might have been. But we'll
revise it and resubmit. Hopefully we'll get the same
reviewers."
Such cheerful acceptance might seem at odds
with the amount of hard work and effort that goes
into preparing an unsuccessful proposal. But there
are two sides to the coin: There's rejection ... and
then there's rejection accompanied by
encouragement to resubmit. For the researchers
lucky enough to make a good first impression,
upbeat comments temper the disappointment and
provide hope for future funding.
What to do in the meantime?
Conrad, like many researchers, expects his
proposals won't get funded the first time. Or the
second. Fortunately, most universities, including
UF, offer bridge grants that tide labs over until
funding resumes.
"If a person loses their funding, they lose their
technician because they can't pay them," explains
Elaine Young, Ph.D., interim director of the Office
of Research Development for the College of


Medicine. "When they get their funding back, they
have to rehire that technician or hire someone new
and train them. It just doesn't make sense."
Harald Messer, M.S., a senior biological scientist
in the College of Medicine, was informed in
December that his laboratory's funding had not
been renewed. He has since secured another job in
the college, but he says he was shocked to learn that
his position would be eliminated.
"The news was a mixed bag of sorts. I went
through the full range of emotions used to describe
a break up," Messer says. "Sadness, anger, denial
and finally acceptance."
Messer is not alone. With so many laboratory
personnel affected by the budget crisis, investigators
have begun looking for alternate sources of funding.
Small grants from individual universities, private
organizations and the state government have made
all the difference for many labs.
UF offers bridge grants on a competitive basis to
investigators who just miss the cutoff for funding
from federal agencies such as the NIH or the
National Science Foundation. The College of
Medicine provides up to $50,000, which is typically
matched by the researcher's department. The
money can be used to pay graduate students,
technicians and to cover the costs of research
supplies and equipment.



Strategies for success
In addition to providing supplemental funding
during tough times, many universities have
recognized the need to improve grant-writing skills.


UF professor Christiaan Leeuwenburgh submitted
15 grant applications last year and received
funding for four of them. Here, Leeuwenburgh,
who studies aging, prepares to perform a muscle
biopsy on Alice Hayes, with help from Dr.
Emanuele Marzetti and Dr. Luis Burgos.







Christiaan Leeuwenburgh, Ph.D.
Leeuwenburgh wants to slow the aging process
by boosting cells' ability to recycle damaged
parts so they can maintain efficient energy ..
production. Leeuwenburgh hopes the process
will increase health span by allowing people to
remain strong and independent well into old age.


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Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.


IMOTI0-0









Maureen Goodenow, Ph.D.
Goodenow wants to establish the FI:,l ~ii
Center for AIDS Research, a partner :liil:
between researchers at UF and five :,rh-li
Institutions around the state. The cl: iil:, ill : o':,
study the disease across the life spF i ii le-
goal of improving the quality of life o:,i
I adolescents and older individuals atl-: r-l I:.,
HIV/AIDS.





The success rate for new grant
proposals submitted to the National
Institutes of Health has declined from
32 percent to 9 percent in the past f.
eight years.
PHOTO BY SARAH KIEWEL


Iv


"When I went into research it used to be,
'Here's an office, here's a lab, write a grant, get
some money.' And you were basically on your
own," says Young, who worked as a basic science
researcher at Stanford University and Johns
Hopkins University before taking a research
administration position at the NIH and later
coming to UF.
"One of the reasons to help people and to train
them is that they don't realize how long it takes,"
says Young, who says she has been approached for
assistance by faculty members as little as three
weeks before a major grant deadline.
The NIH recommends nine months from
thought process to submission, but fellowship
applications and smaller bridge grants often
require less work.
"Some grants take a day to work on, some take
months," says Leeuwenburgh. His massive
319-page proposal took eight months, but he
didn't do it alone. He says there was a lot of
camaraderie among the 23 researchers involved,
many of whom had collaborated in a more
informal manner for about a year and a half
before the grant-writing process began.
The new focus on grant-writing skills may have
prevented UF from getting hit too hard by the
federal budget crisis, Young surmises, adding
that many departments have started screening
grants for potential problems before they go out.
That strategy worked well for Leeuwenburgh,
who solicited feedback from within his group, as
well as from a panel of outside faculty members,
before submitting his $11.5 million proposal to
the NIH.
"We really got some good insight from the
different investigators on how to make things
better," Leeuwenburgh says. "It was pretty harsh,
but that was good because we still had another
month to get things streamlined. It's a tough
game right now."
Other researchers have formed their own
strategies for success.
"Find a unique angle," says Krista


Vandenborne, Ph.D., P.T., a professor and the
chair of the department of physical therapy in the
College of Public Health and Health Professions.
"You can't just do the same old, same old."
Vandenborne applied this technique to an $8.5
million grant proposal she recently submitted to
the NIH. The idea? She hopes to uncover
whether muscle recovery after spinal cord injury
is improved by pairing pharmacological therapies
with locomotor training, a novel rehabilitation
intervention that helps people with spinal cord
injuries learn to walk again.
"You have to be a little savvier when there are
limited funds," Vandenborne says. "You have to
make sure your package gets a 'Wow!' not just,
'This is good science.' The reviewers are more
critical. They want something that stands out."



Millon-dolar ideas
More and more faculty members are choosing
to submit collaborative grants that pool expertise
from various UF colleges and departments.
"I think whenever you have big pictures, you
want to try to be as collaborative and
interdisciplinary as possible," Conrad says. "We
have all this talent around here. Let's bring
everyone together, come up with a unifying
theme and submit a grant together. The product
is better than if you go in individually."
Maureen Goodenow, Ph.D., the Stephany W.
Holloway university chair for AIDS research in
the UF College of Medicine, has gone one step
further. Goodenow is collaborating with
researchers at five institutions around the state to
apply for NIH funding to establish a Center for
AIDS Research.
The process started with a planning session last
summer. Now, the researchers are preparing to
apply for a start-up grant from the NIH to establish
a developmental CFAR. If all goes well, they'll
apply for NIH funding to establish a full CFAR
about five years down the road. It's a long process.


"One of our major goals this year is to develop
new collaborations, new scientific interactions
among investigators at each of the partner
institutions," Goodenow says.
To do that, the CFAR consortium awarded
three start-up grants totaling $50,000 to
collaborators Rolf Renne, Ph.D., a professor of
molecular genetics and microbiology in the
College of Medicine, Virginia Dodd, Ph.D.,
M.P.H., a professor of health education and
behavior in the College of Public Health and
Health Professions and Gail Fanucci, Ph.D., an
assistant professor of chemistry in the College of
Liberal Arts and Sciences.
Interdisciplinary efforts are becoming more
common as the NIH and other funding agencies



Krista Vandenborne,
Ph.D., P.T.
Vandenborne wants to improve
muscle recovery in patients
: suffering from spinal cord
injuries by teaming with other UF
researchers on a project
combining locomoter training
with pharmacological therapies.



put an emphasis on teamwork and collaboration.
"You can't just go in with great science
anymore. It's about partnering," says dental
professor Logan, who began building
partnerships with her collaborators immediately
after coming to UF in 1999.
Vandenborne agrees, saying, "I think they are
definitely looking at more interdisciplinary
projects; projects that move science into a
different direction.
"To do research, you have to be passionate
about what you do. It's not a 9-to-5. It's a lifestyle.
It's what you do. It's who you are. You're trying to
find answers." Q


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events. I I I 1 15
















away


THE STRESS?


UF researchers say smoking

reduces anxiety in brain


By Sarah Carey

If that smoker next to you seems more
relaxed than you, you might be right. UF
veterinary researchers say smoking reduces
stress because nicotine appears to mask the
brain's awareness of outside stimuli, thereby
reducing anxiety.

"Smoking may kill, but the stress-reducing effects of nicotine on the
brain are probably one reason why the habit is so prominent among college
students," said Paul Davenport, Ph.D., a professor in the UF College of
Veterinary Medicine's department of physiological sciences. "As many as 15
to 20 percent of college students are smokers, perhaps best exemplified by
the phenomenon of social smoking. These students often ignore the deadly
side effects in exchange for the trade-off of reduced anxiety."
Davenport is studying the effect of nicotine withdrawal on brain activity
and cough in one of four projects UF veterinary researchers have been
working on as part of a $1 million grant from the Florida Department of
Health's James and Esther King Biomedical Research Program. Data from his
study assessing how nicotine affects smokers' ability to sense their breathing
will be presented in May at the American Thoracic Society meeting.
"Chronic obstructive pulmonary disease is a common problem with
smokers," Davenport said. "Both animals and humans can have COPD. The
motivation to seek treatment is directly related to the patient's cognitive
awareness of their breathing status."
His study measured how respiratory stimuli are controlled by higher
brain centers responsible for thinking, reasoning and problem-solving.
Davenport found that individuals who are withdrawing from smoking
become more aware of their breathing and may even become fearful,
especially if their airway becomes obstructed.
"When you have individuals that abstain from smoking for a 12-hour
period, they get very agitated," Davenport said. "This is because while they
are smoking, smokers' brain activity is 'gated,' or controlled. Nicotine is
useful because it reduces anxiety, but it also helps mask certain brain
activity, so that if you withdraw from nicotine you are much more sensitive
to stimuli coming in."
Other research efforts, spearheaded by Donald Bolser, Ph.D., and Linda
Hayward, Ph.D., from the veterinary college and David Fuller, Ph.D., from
UF's College of Public Health and Health Professions, are examining the
effects of nicotine on everything from sleep patterns to newborns exposed
in the womb. In future studies, Davenport plans to examine how nicotine
affects the brain pathways that lead to consciousness.


Dr. Paul Davenport and his graduate student, Sarah Pei-Ying Chan,
apply a respiratory load to a subject. Davenport's recent nicotine
studies also examine the relationship between brain activity and
respiration.

"You don't constantly think about breathing, but when something
changes, you become aware of it," Davenport said. "With smoking, your
lungs change, but you're not aware of it. It's awareness of one's internal
environment that we are most interested in."
In a related study with Bolser, whose expertise is in the cough reflex,
Davenport has used capsaicin the hot ingredient in hot peppers to
induce the urge to cough. He and Bolser are interested in why smokers
don't cough in response to inhaling cigarette smoke, but nonsmokers do.
"This sensation of the need to cough comes before you actually cough,
which allows our consciousness to interact with the cough reflex,"
Davenport said. "If you're in a concert and you feel the need to cough, you
have the ability to suppress that cough by conscious mechanisms.
"That's why it's important that your brain knows your need to cough
before you actually cough," he added. "Nicotine is changing the way the
brain functions, probably by changing the way respiratory sensations are
gated into the conscious regions of the brain."
Davenport said it's clear that if breathing is obstructed in either animals
or humans, tremendous fear and anxiety occur, and in many cases, humans
experience a full-blown anxiety attack.
"Clinically, we need to treat the lung disease, but what we seldom treat is
the anxiety the patient has related to their lung disease," he said.
Anyone with COPD understands the feeling of breathlessness even upon
walking through a mall or mild exercise. Because of this, many people with
COPD become less and less active, Davenport said.
"When we fear we won't be able to breathe, we won't exercise," he said.
"So if we can figure out how to lessen the anxiety of those who suffer from
COPD, we can improve their rehabilitation from lung disease."
And as for those college students who smoke don't look for their habits
to change anytime soon.
"The use of nicotine to self-medicate for stress has serious side effects,
produces deadly disease and is extremely addictive," Davenport said. "When I
talk to young people, I tell them, 'You will get lung and heart disease; smoking
will kill you.' But we have to recognize that even with that knowledge, kids
still smoke because they feel the benefits exceed the risks." 0


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RESEARCH
















Prostate cancer


Wet sand poses health risk for beachgoers


By Sarah Carey
Attention snowbirds and spring breakers: Beachgoers who stay high and
dry may have healthier fun in the sun than those frolicking on wet sand
or in the water, according to a UF veterinary researcher.
"Our objective was to understand whether beach sand could pose a health risk
to beachgoers," said Tonya D. Bonilla, a doctoral student in the UF College of
Veterinary Medicine's department of infectious
diseases and pathology who studied three South a1


Florida beaches over a two-year period to see whether
human health risks appear to increase based on the
level of sand exposure.
"What we found was that there was no increased
health risk due to exposure to sand on the upper
beach," Bonilla said. "However, the longer the period
of time people spent in the water and in the wet sand,
the higher the probability that they would experience
some gastrointestinal illness."
Bonilla's research was conducted at Fort Lauderdale
Beach, Hollywood Beach and Hobie Beach. There
were 882 respondents who participated in the pilot


lb


TONYA D. BONILLA


epidemiological study and 609 who participated in the control group.
Beachgoers were made aware of the study and, if willing to participate, were
given a survey form to complete four days after their beach visit. The
questionnaire focused on type and duration of beach activity and inquired
whether participants became ill during the four days after the beach visit. The
control group consisted of people randomly chosen from the general population
who had not visited a beach in at least nine days.
"Our findings suggest that there is an increased risk of acquiring gastroenteritis
the longer a bather either sits in the wet sand or stays in the water," said Jay M.
Fleisher, Ph.D., an associate professor at Nova Southeastern University who
analyzed the data collected in the study.
While fecal indicator levels in the waters near South Florida's beaches are
routinely monitored, sand samples from the surf zone the wet sand and the
upper beach are not. Beach sand may become contaminated by gull droppings and
fecal-derived organisms that then diffuse into wet sand and water, said Bonilla,
whose research was published in the Marine Pollution Bulletin. Her work, part of
her master's thesis work at Nova Southeastern University, was funded by a grant
from the Environmental Protection Agency. O


treatment takes


T emotional toll


on patients



By Tracy Brown Wright
Men with prostate cancer who have their prostate removed cite
sexual dysfunction as the most common side effect after
surgery, but urinary dysfunction troubles these patients
most, reports a UF researcher. What's
more, many aren't emotionally prepared
to face these complications.
The study findings, published in a
recent issue of Urologic Nursing,
underscore the need for health-care
practitioners to educate their patients
c about the physical and psychological
/ effects the surgery will have on their
S everyday lives.
"The effects of this treatment are
quite immediate and can lead to
BRIAN WEBER, PH.D., A.R.N.P. depression and frustration," said Bryan
Weber, Ph.D., A.R.N.P., an assistant
professor in the UF College of Nursing and the study's lead author.
"After an initial diagnosis of prostate cancer, men may be so focused on
eradicating the disease that they don't realize the effects the treatment
will have on their quality of life, both for them and their families."
Prostate cancer is the No. 1 cancer among men, excluding skin
cancer, and with more baby boomers reaching their 50s and 60s, it's
expected to grow even more prevalent, with more than 200,000 cases
diagnosed in 2007. Men who undergo radical prostatectomy may
initially decide the risk of physical dysfunction is worth the benefit of
improved likelihood of survival. But many don't know what to expect
after surgery, Weber said.
Physical side effects of treatment limit daily activities and may
interfere with a man's self-confidence. Urinary incontinence, for
example, requires the use of pads, and sexual dysfunction interferes
with a man's sense of self and may limit his relationship with his
significant other, Weber said.
In the study, UF researchers evaluated 72 men six weeks after they
underwent prostatectomy.
"Within the first 100 days of diagnosis, men may be so distressed and
so focused on curing their cancer that they don't focus on these side
effects, which is what makes it imperative for health-care professionals
to educate them on ways that their lives will change and how they can
cope," Weber said. "Almost immediately after treatment, men may
experience depression, awkwardness and emasculation, which will have
a great effect on their quality of life." 0


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A


RESEARCH











rW


OMJOY GANESH


Next stop: Beringia?

Submerged land offers clues about spread of population from Asia to Americas


E' J, *in Pastor
he human journey from Asia to the New World was interrupted by a
20,000-year layover in Beringia, a once-habitable region that today lies
submerged under the icy waters of the Bering Strait.
Furthermore, the New World was colonized by approximately 1,000 to 5,000
people a substantially higher number than the 100 or fewer individuals of previous
estimates.
The developments, reported by UF Genetics Institute scientists in the Feb. 13
edition of PloS ONE, help shape understanding of how the Americas came to be
populated not through a single expansion event that is put forth in most theories,
but in three distinct stages separated by thousands of generations.
"Our model makes for a more interesting, complex scenario than the idea that
humans diverged from Asians and expanded into the New World in a single event,"
said Connie Mulligan, Ph.D., an associate professor of anthropology at the College of
Liberal Arts and Sciences and assistant director of the UF Genetics Institute. "If you
think about it, these people didn't know they were going to a new world. They were
moving out of Asia and finally reached a landmass that was exposed because of lower
sea levels during the last glacial maximum, but two major glaciers blocked their
progress into the New World. So they basically stayed put for about 20,000 years. It
wasn't paradise, but they survived. When the North American ice sheets started to
melt and a passage into the New World opened, we think they left Beringia to go to a
better place."
UF scientists analyzed DNA sequences from Native American, New World and
Asian populations with the understanding that modern DNA is forged by an
accumulation of events in the distant past, and merged their findings with data from
existing archaeological, geological and paleoecological studies.
I hL. !.,uI !i unriiniJ. iriL!iJid L!ip!hirji; [i \ h .\ I i h. "p ..pl!ir I i h, NLv'.


UF Genetics Institute researcher Connie Mulligan (left) estimates that
people spent about 20,000 years in a now-underwater land called
Beringia before they migrated to the New World.

World, which shows a gradual migration and expansion ..I p>..p l Ii.m ,\.,j
through Siberia and into Beringia starting about 40,001i \j'i i-... I.. rn
waiting period in Beringia where the population size rem irnJ iL'li iJ\ J Ihlc\ .
and finally a rapid expansion into North America through ,\iAkj ,r ( jrnjd
about 15,000 years ago. 0 ..
/


I I I SL I I h il .. I I I" .u- I- I -.l u-1 .' i I I Iii- II-' I i- .I H -. -- ,I


The weather in 4,000,000,001 B.C.

Scientists reconstruct proteins to gauge temperature of Precamlhian era

By Ann Griswold
U sing the genetic equivalent of an ancient thermometer, a team of scientists has determined that the Earth enduredJ m ..... .lirimn
period between 500 million and 3.5 billion years ago.
Reporting in the journal Nature, researchers from UF, the Foundation for Applied Molecular Evolution and th~ h.l..ILh nI ..-\
company DNA2.0 describe how they reconstructed proteins from ancient bacteria to measure the Earth's temperature o' hI a. ,
"By studying proteins encoded by these primordial genes, we are able to infer information about the environmental c.nJ I In..r .I I h,. I\
Earth," said Eric Gaucher, Ph.D., president of scientific research at the Foundation for Applied Molecular Evolution in ( iJirin Ill ndJ I he
study's lead scientist. "Genes evolve to adapt to the environmental conditions in which an organism lives. Resurrecting i h,.e ince I..n -
extinct genes gives us the opportunity to analyze and dissect the ancient surroundings that have been recorded in the g. n ,,qtyi, n1c I'h
genes essentially behave as dynamic fossils."
The team wanted to measure Earth's ancient temperature to learn more about life during the Precambrian period. Insi 6J ..I i jkn!g I h,
traditional route analyzing rock formations or measuring isotopes in fossils they opted to do what they knew best: pr..IL in
reconstruction.
"We've analyzed the temperature stability of proteins inside organisms that were around during those times," said Or-n.. \ (t Inr h. a
structural biologist in the UF College of Medicine's department of biochemistry and molecular biology. "The ancient oce n, L 'i V'. '. m'ri
For ocean organisms living during that time to survive, the proteins within them had to be stable at high temperatures.'
The scientists found a protein called elongation factor, which helps bacteria string together amino acids to form other pi..! I F a Inh
bacterial species has a slightly different form of the protein: Bacteria in warmer environments have elongation factors thii can a'. II hi anJ
high temperatures. The opposite is true for bacteria in cold environments.
By comparing the heat sensitivity of reconstructed proteins, scientists were able to discern how Earth's temperature cha nr J ..~\ i ihe a~e
"Remarkably, our results are nearly identical to geologic studies that estimate the temperature trend for the ancient ajn \ I he ra m
time period," Gaucher said. "The convergence of results from biology and geology show that Earth's environment has ..-n n u. .u, I hc n
changing since life began, and life has adapted appropriately to survive." 0


RESEARCH


4*
(:











NEW
UF building to house researchers stud\ ing e a di


.. oJfJ


UF broke ground on the new Pathogens Research Facility Feb. 27. Shown here is
an artist's rendering of what the building will look like when complete.


By Morgan Lamborn

As of Feb. 27, UF needed to change its campus
map ... again.
At 3:30 p.m. that day, a groundbreaking ceremony formally
commenced the construction of the $56 million Pathogens Research Facility. This
80,000-square-foot building will be home to the UF Emerging Pathogens
Institute.
Approximately 60 people attended the ceremony, which took place near the
southeast corner of the Cancer & Genetics Research Complex. The groundbreaking
included a ceremonial dig, with UF leaders and the event's speakers each putting
shovel to dirt.
The institute aims to "develop the research capability to be prepared to prevent
and contain outbreaks of new diseases that threaten Florida," according to its Web
site. This includes studying ways to prevent and predict emerging diseases,
developing better treatments and raising awareness about potential risks.
Researchers within the Emerging Pathogens Institute study the microorganisms
responsible for new and re-emerging diseases such as citrus canker in plants and
the avian flu in humans, said Joseph M. Kays, UF's director of research
communications.
During his speech, UF President Bernie Machen stressed the importance of
having this institute in Florida.
"While this is a global problem, we're uniquely vulnerable," Machen said.
"Florida is like a state-sized Petri dish."
With nearly 80 million tourists each year, a significant amount of trade with
South America and a climate that is just as attractive to new bugs as it is to people,
there is no better place to study pathogens, he said.
"Pathogens pose a threat to our health, the environment and our very way of
life," Machen said.


When you put such

a diverse group of

people together great

things wil happen."

Win Phillips, D.Sc.




The Florida Board of Governors approved funding for the new building last year
because the study of pathogens is vital for Florida and society as a whole, said
Carolyn Roberts, the board's chair.
"This project is important for quality of life," Roberts said. "It's more than just
the flu."
The original plan for the Pathogens Research Facility was devised about two
years ago and has been a cooperative effort throughout the university.
The building will house 16 labs and three rooftop greenhouses.
Scientists working in the new building will come from eight different colleges
and from other universities that will complement UF's strengths, said J. Glenn
Morris, M.D., M.P.H., director of the Emerging Pathogens Institute.
The depth of scientific expertise at UF is outstanding, said Morris, who has been
working to unite researchers from various fields to work together in the building.
Being in the same building should help scientists share ideas and collaborate.
Win Phillips, D.Sc., UF's vice president for research, was optimistic about the
future of the program.
"When you put such a diverse group of people together great things will happen,"
he said. 0


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events. I I L* 0 1 19


RESEARCH


L .;;;













lpIfect 11 ] U1ger


Grant, collaboration to help create more public health-minded docs


By Patricia Bates McGhee

ie gap has been there for

years and everyone knows
it needs bridging. So say
David Wood, M.D., M.P.H, and
William Livingood, Ph.D., both

faculty members in the College of
Medicine-Jacksonville.

"We've always had this schism between public
health and medical education," said Wood, an
associate professor of pediatrics. "Some people cross
over and do both but, believe me, you're in two
different worlds when you go from medicine to public
health, and it just shouldn't be that way."
Thanks to a new grant from the Association of
American Medical Colleges funded by the Centers for
Disease Control and Prevention, these two worlds can
merge.
The $25,000 grant one of only 13 awarded
nationwide is earmarked to establish and sustain
the Regional Medical-Public Health Education Center
at Jacksonville and boost the longtime collaborative
resources, experience and history between the college
and the health department.
"Medicine needs to think more in terms of
population health and prevention and really integrate
that into everything we do, and that's the whole point
of this grant," Wood said. "We also need to turn
physicians on to public health as a potential career
path because there's a huge deficit of physicians going
into that field."
The goal is twofold to integrate population-
health thinking into the medical resident experience
and to expand population and public health training
to all internal medicine and emergency medicine
residents in Jacksonville.
Until now, only the UF pediatric and medicine
residency programs in Jacksonville have partnered
with the health department for resident service-based
learning, scholarship opportunities and for faculty
development activities.
"First, we'll create an administrative structure -
one that is both interdisciplinary and representative of
the Duval County Health Department and the College
of Medicine-Jacksonville to oversee the program,"
said Livingood, an assistant professor of pediatrics
who also serves as director of the Duval County
Health Department's Institute for Health Planning
and Evaluation Research. "Then, within this structure


Merging medicine and public health is the goal of a new grant awarded to the College of Medicine-
Jacksonville. The grant allows UF faculty members William Livingood (left) and Dr. David Wood (right) to
collaborate with Duval County Health Department Director Dr. Robert Harmon to establish and sustain
the Regional Medical-Public Health Education Center at Jacksonville.


we'll provide experiential learning in a wide array of
population and preventive health content to all
residents in internal medicine and emergency
medicine."
The plan is to extend the model developed in
pediatrics to the internal medicine and emergency
medicine residency programs.
"We'll be able to integrate population/public health
and preventive health content into core didactic
conferences in (internal medicine) and (emergency
medicine), including grand rounds, noon conferences,
ward rounds, morning report and other didactic
educational opportunities," Livingood said.
The program's key objectives and tasks will be
measured using agreed-upon outcomes as targets and
will be reported to the CDC and AAMC at the end of
the one-year grant period.
Wood and Livingood will serve as committee
co-chairs, overseeing the program's initiatives.
Committee members also include the senior associate
dean for educational affairs, College of Medicine-
Jacksonville residency directors for internal medicine


and emergency medicine and the Duval County
Health Department director.
One of the educational opportunities the committee
will implement is a full-day symposium to expose
residents to existing projects in population and public
health that they could join for a longitudinal
experiential learning project. Residents' learning
goals will be matched with specific projects and
mentors. They also will be expected to produce and
present meaningful and/or scholarly work from their
projects in an academic forum.
The goal is to change the residents' thinking.
"When they think of a clinical issue we hope they'll
think beyond diagnosis and treatment and think
about the community implications, like what's causing
it, the community factors contributing to it and how
to prevent the problems from occurring in the first
place," Wood said. "We hope they'll get excited about
public health as they go out into their careers even
as clinical physicians and be willing to participate
in their community, address the population and public
health issues and see the bigger picture." 0


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.


A


JACKSONVILLE


IMPSTI03l8












A


Cattle ranch owners donate

$6 million to vet school


Cattle ranch owners Harriet and Robin Weeks
(from left) left $6 million to the UF College of
Veterinary Medicine in their estates.


By Sarah Carey
T he UF College of Veterinary
Medicine has received
nearly $6 million from the
estates of two South Florida cattle
ranch owners, Harriet Weeks and
her daughter, Robin Weeks. The
largest private gifts ever received
by the college, the monies are
eligible for matching funds from
the state of Florida major gifts
trust fund, which would raise the
total to $12 million.
The gifts will be used to create an endowed chair
in veterinary medicine and an endowed
professorship in bovine medicine, as well as an
endowed fund to support teaching, research and
programs at the college. UF veterinary
administrators say the gifts will be help bolster the
area of bovine health, which is facing critical
shortages in veterinary medicine in both the public
and private sectors. The bovine professorship may
help attract more students to this particular field
and enhance disease research in this area,
administrators say.
"In this time of decreasing state budgetary
support, endowments are critical," said Glen
Hoffsis, D.V.M., the college's dean. "For our college
to receive two endowed positions simultaneously is


just extraordinary."
A previous installment of $1 million from the Robin Weeks estate enabled the college to
meet its $4 million private funding goal and to obtain $57 million in state funding for a new
small animal hospital.
The most recent gifts consist of $3.5 million from Robin Weeks' estate and $950,000 from
the estate of Harriet Weeks, earmarked to the UF veterinary college. An additional gift of
approximately $500,000 is expected when the estates are totally settled.
"Harriet and Robin were both schoolteachers and part-time ranchers until Robin's father
and brother passed away," said accountant Robert Richardson, a trustee for the Weekses'
estate. "Not wealthy people, the Weekses sacrificed heavily to retain their land and to run a
300-head cattle ranch.
"Their family was not a typical one to make such a large bequest," Richardson added.
"Harriet and Robin made their decision because of their commitment to Florida agriculture
and love of small animals, as well as their desire to help veterinary students through
education and research."
Mike McNulty, a mixed-animal practitioner and a member of the college's class of '83,
was Robin Weeks' veterinarian and friend for many years. McNulty worked with Weeks'
four herds of Brangus cattle, advising her on health and production management.
"I'll never forget, a few years before she died, I was leaving her ranch late on a Saturday
afternoon and I told her, 'I'm going to stop and get a lottery ticket.' She immediately replied,
'You've already won the lottery.'"
McNulty added, "I looked at her quizzically and she explained, 'With your education,
you've already won the lottery.' She knew education was a sure ticket, if not to wealth and
riches, at least to a better life. I've never forgotten that afternoon and appreciate it greatly
every time I think about it."
Some time later, he met with Weeks at her home and shared with her his intent to include
the UF veterinary college in his own estate plans.
"I think that registered in her mind," he said. "She said she wanted me to give her
information about how to make a gift to the veterinary college. I then put her in touch with
the college's development office and her plans unfolded from that point."
Harriet Weeks died in February 2005 and Robin Weeks died shortly thereafter. The
majority of their estate assets consisted of agricultural real estate in Glades County.
"I'm pleased that Dr. McNulty has remained so loyal to the college, and that he felt he
received such a great veterinary education here," Hoffsis said. "He was able to use his
education for his clients' benefit, and in doing so, helped the Weekses create their legacy
through these substantial gifts." 0


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GIT










COLLEGE OF DENTISTRY

LINDA BARTOSHUK, Ph.D.,
a professor of community
dentistry and behavioral
science, was recently
appointed to a three-year term
on the Council of the National
Academy of Sciences. The
NAS is charged with providing
independent advice, outside Linda Bartoshuk
the framework of government,
to the nation's leaders on science, technology
and medicine issues that affect U.S. policy
decisions. Bartoshuk will represent the disciplines
of anthropology, psychology, social and political
sciences and economic sciences, serving as their
voice on the council.

COLLEGE OF MEDICINE


KEITH G. CHISHOLM, M.D.,
an adjunct assistant professor
of surgery, was recently named
a fellow of the American
College of Surgeons. Chisholm
was one of 1,291 surgeons
around the world to be named
a fellow of the organization in
November.


PHILIPP DAHM, M.D., an
associate professor of urology,
was recently named a fellow
of the American College of
Surgeons. Dahm also serves as
associate residency program
director and director of clinical
research in the department of
urology.

STEPHEN R. GROBMYER,
M.D., an assistant professor of
surgery, was named a Fellow
of the American College of
Surgeons this past November.
Grobmyer, who joined the UF
faculty in 2004, was named
one of the Best Doctors in
America last year.

JENNIFER MILLER, M.D., an
assistant professor of pediatrics,
was recently named a member
of the Society for Pediatric
Research. Miller was one of 117
researchers from across the
country elected into the society
in 2008.


MICHAEL W. MOSER, M.D.,
an assistant professor of
orthopaedics and rehabilitation,
was named a fellow of the
American College of Surgeons.
Moser, who specializes in
sports medicine, also serves
as a team physician for the UF
Athletic Association. Michael W. Moser

JACKSONVILLE


Stephen R. Grobmyer


r I
Jennifer Miller


Keith G. Chisholm


RUI P. FERNANDES, M.D.,
director of the Oral and
Maxillofacial Surgery Residency
Program, was named a fellow
of the American College of
Surgeons in November. The
ACS is the largest organization
of surgeons in the world, with
more than 72,000 members.


Rui P. Fernandes


ANDREW M. KAUNITZ,
M.D., associate chairman
and a professor of obstetrics
and gynecology, received
the William Heath Byford
Award from the Department
of Obstetrics and Gynecology
in the Northwestern University
Feinberg School of Medicine in Andrew M. Kau
Chicago. The award, presented
annually, recognizes an outstanding Northwestern
University alumnus in obstetrics and gynecology.


I I h i


I J, p 1ii h .'l jh 1jll I Id,. J II, 11h.- -
I I_ 1 1. 111 II _-J


KAYSER ENNEKING, M.D., a professor of anesthesiology and of orthopaedics
and rehabilitation, was named chair of the department of anesthesiology,
effective May 1. Enneking will replace Nikolaus Gravenstein, M.D., who has
served as the department's chair since 1997.
"Dr. Enneking's selection came after considerable
consultation with departmental faculty, College of
Medicine and Shands HealthCare leaders, national
experts in the field, and my personal experience
working with her as my assistant dean for clinical
affairs," Kone said. "She is an exceptional
physician, mentor and leader."
An alumna of the college, Enneking joined the
UF faculty in 1991. She has been named one of the
Best Doctors in America and has received several
teaching awards for her work with students and
residents.


MARK GOLD, M.D., an international
authority on addiction medicine, was named
chair of the department of psychiatry after
Serving as interim chair since August.
] "I feel extremely fortunate that Dr.
Gold has agreed to take on the ambitious
Stask of leading the department to great
National prominence," said Kone, who
.1 -. a cited Gold's extensive clinical and research
Mark Gold, M.D. accomplishments as well as his teaching
contributions in announcing the appointment.
Gold's work has changed the medical
field's understanding of how drugs of abuse function in the
human brain.


RICHARD BUCCIARELLI, M.D., a professor of neonatology, was named chair of the department of pediatrics after serving as interim
dean for almost a year.
"Dr. Bucciarelli has done an outstanding job as interim chairman of the department for the past 10 months," Kone said. "He has
earned the respect, admiration and praise of not only his faculty, but also faculty from across the College of Medicine, as well as
leaders and providers in the Shands HealthCare system."
Bucciarelli's affiliations and appointments are copious. He is past president of the Florida chapter of the American Academy of
Pediatrics and currently serves as UF's associate vice president for health affairs for government relations.


Kichard bucciarelli, M.U.


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events.


IM OS I 3-8





























=Aciass oS6

HER o n


UF medical student teaches course

merging clinical skills, humanism




By Christa Wagers

At a school the size and caliber of UF, it can be difficult
for students to stand out. Even when you're at the
top of your medical school class, like Rana Yehia, it's a
challenge to do something another Gator isn't already doing.
But Yehia did just that when she helped create a class that merges learning clinical skills with
understanding the ideals of medical humanism, exposing undergraduates to medicine and to
social and cultural issues not always emphasized in medical training. She began teaching the
class with course coordinator and co-instructor Nina Stoyan-Rosenzweig this semester, becoming
one of few, if any, fourth-year medical students to ever serve as a primary instructor for a course.
Stoyan-Rosenzweig, director of the college's medical humanities program, said many medical
students are teaching assistants but not instructors who lead the class, write the syllabus and
make lesson plans.
"I was a (teaching assistant), but this is vastly different than grading a chemistry lab," said
Yehia, 24.
What's almost as unique is what she is teaching and whom she is teaching.
The class is an elective designed to expose undergraduate students in the Junior Honors
Medical Program to a more humane approach to medicine. The honors program, a fast track into
medical school, selects up to 12 students per year to shorten their tenure at UF by combining
their fourth year as an undergraduate and first year as a medical student. Yehia, who graduates in
May, was also in the Junior Honors Medical Program.
Students in the program often have the chance to take medical humanities courses before they
enter medical school, but it was Yehia's inspiration to combine the material Stoyan-Rosenzweig
teaches with clinical instruction, giving students a complete view of what it means to be a
humane doctor.
"Sometimes we never get a chance to sit down and evaluate our experience with our patients,"
Yehia said.
In mid-February, the eight undergraduate students in the class were placed in staged scenarios


Fourth-year medical student Rana Yehia (left) began
co-teaching a class this semester with Nina
Stoyan-Rosenzweig, the College of Medicine's director
of medical humanities. The course merges clinical skills
with humanism.



with actors playing patients in the Harrell Professional
Development and Assessment Center. Because of the expense,
undergraduates don't usually get the chance to take part in
sessions like these.
During the following class period, Yehia critiqued the
recordings of the students' interactions with their "patients."
"It kind of gives us a head start into being a clinician," said
Annie Song, a junior in the class.
Song said she thinks the class is valuable for future doctors.
But the class wouldn't be the same without someone like
Yehia, Song said. Watching the same recorded sessions over
and over could have been boring with another instructor, but
Yehia kept the class riveted. During the recorded sessions,
Yehia frequently paused and used her whole body to explain
her point. She spoke feverishly and changed the pitch of her
voice, sometimes waving her arms to keep her class' attention.
The course is not perfect yet, Yehia said, but she is excited
to see what will happen to it in the future. She's searching for
third-year medical students to take over. Stoyan-Rosenzweig
plans to stay on as course director, to mentor the students
leading the class and to teach them how to plan a course. It
will, in particular, provide opportunities for students
specializing in the medical humanities track.
For Yehia, this course is a reflection of her view of medicine.
Sometimes doctors don't spend very much time with
patients, she said. Often they depend on diagnostic tests and
technology to make up for the lack of contact with the patient.
"The patient can tell you what's wrong with them," she said.
"Your diagnostic tests should be just that."
Some of what solidified this view of medicine for Yehia is
drawn from her mother's experience searching for a doctor. A
few years ago, Yehia's mother was diagnosed with cancer. At
times, Yehia said, her mother was treated like a number
instead of a person.
Yehia's brother, Baligh, was also involved in the Junior
Honors Medical Program at UF, but that wasn't what made her
want to be a doctor, she said. For Yehia, medicine was the
perfect combination of science and people.
Along with being in medical school and teaching a class,
Yehia is the national chair for the American Medical
Association Medical Student Section. Her other activities and
awards are enough to fill six pages in her resume. She even
finds time to run marathons, too. She thinks it would be a
shame to miss an opportunity.
"I just like to stay involved," Yehia said.
Yehia's co-instructor put her involvement in extracurricular
activities and campaign to change the face of medicine a
different way.
"She's sort of living proof of what can be done," Stoyan-
Rosenzweig said. 0


Visit us online @ http://news.health.ufl.edu/ for the latest news and HSC events. I II* 0 23


PROFILE









































A motorcade of four Studebakers traveling from the HSC to the UF
President's House were part of a ceremony held Feb. 28 in memory of Dr. J.
Robert Cade, who led the team that invented Gatorade and whose research,
philanthropy and leadership helped countless people during his more than
40 years at the UF College of Medicine.







Dr. Joseph Adrian Tyndall and his wife, Johanne, were welcomed by Dean
Bruce Kone and others at a Feb. 26 reception celebrating Tyndall's new role
as chair of the department of emergency medicine. He is the first
African-American department chair in the College of Medicine and has
served in an interim role since August.


Published by
UF Health Science Center
Office of News & Communications
Senior Vice President,
Health Affairs
Douglas J. Barrett, M.D.
Director, News &
Communications
Tom Fortner
Editor
April Frawley Birdwell


Senior Editors
Melanie Fridl Ross, John Pastor
Designer
Mickey Cuthbertson
Staff Writers
April Frawley Birdwell, Tracy Brown,
Sarah Carey, Anney Doucette, Ann
Griswold, Linda Homewood, Patricia
Bates McGhee, John Pastor, Jill
Pease, Karen Rhodenizer, Melanie
Fridl Ross


Contributing Writers
Lauren Edwards, Morgan Lamborn,
Melissa Thompson, Christa Wagers

Photo editor
Sarah Kiewel
Support Staff
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 afrawley@ufl.
edu or deliver to the Office of
News & Communications in the
Communicore Building, Room
C3-025.


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