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 Front Cover
 Storming UF
 News to use
 The corner drug store
 Education briefs
 Motorcycle noise
 Research briefs
 (Extra)ordinary people
 Rising to level 1
 Rare tumor treatment
 Patient care briefs
 Battling breast cancer
 Storm stories
 Distinctions
 Jacksonville
 Nursing grant


UF



The Post
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Permanent Link: http://ufdc.ufl.edu/UF00073869/00020
 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: October 2004
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: UF00073869:00020
 Related Items
Preceded by: Friday evening post (1989)

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Table of Contents
    Front Cover
        Page 1
    Storming UF
        Page 2
    News to use
        Page 3
    The corner drug store
        Page 4
    Education briefs
        Page 5
    Motorcycle noise
        Page 6
    Research briefs
        Page 7
        Page 8
    (Extra)ordinary people
        Page 9
    Rising to level 1
        Page 10-11
    Rare tumor treatment
        Page 12
    Patient care briefs
        Page 13
    Battling breast cancer
        Page 14
        Page 15
    Storm stories
        Page 16
        Page 17
    Distinctions
        Page 18
    Jacksonville
        Page 19
    Nursing grant
        Page 20
Full Text






TRAUMA ONE
UF/Shands take life-saving
care to the next level

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UFHat cec


UF Health Science
CENTER
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Fa s it Sto pin BratSor tre








UP FRONT


TABLE OF CONTENTS

O UP FRONT Storming UF

O POST IT News to Use

EDUCATION The Corner Drug Store

Q RESEARCH Motorcycle Noise


& EXTRAORDINARYY PEOPLE


0 STORM STORIES


COVER FEATURE Rising to Level 1 DISTINCTIONS HSC Achievers

PATIENT CARE Rare Tumor Treatment JACKSONVILLE


9 COMMUNITY- Battling Breast Cancer


0 PARTING WORDS Nursing Grant


HURRICANES SPARE CAMPUS...


But take a toll on the home front


he concept of a long weekend, usually savored,
took on an ominous meaning when Hurricane
Frances blew through Gainesville and the
Health Science Center campus over the Labor Day
holiday. And since then, Jeanne visited, though at
least she waited until after the Gator football game.
Having dodged a bullet by the name of Charley,
university officials took Frances seriously and all
in all emerged relatively unscathed. But the storm
took a greater toll on individual staff, faculty and
students. Many lost power for several days or had
property damaged by water or windblown trees.
"Almost everyone in the Health Science Center
has been affected in one way or another," Douglas
Barrett, M.D., senior vice president for health
affairs, wrote in an e-mail to the HSC community
after the storm passed. "Please know that we
appreciate your incredible efforts to deal with this
catastrophe, assisting each other, and maintaining
your dedication."
On the HSC campus, Frances hit the McKnight


HSC staff shares storm

stories on pages 16-17


Brain Institute hardest, according to Eric Cochran,
assistant director for the UF physical plant division.
Water penetrated walls and flashing, damaging
ceiling tiles and equipment. To make matters worse,
water leaked onto the electrical switch that shifts
loads to a backup generator, shorting it out. The
normal power supply was never interrupted, but the
red-colored outlets that supply both regular and
emergency power were disabled for about 12 hours.
Ironically, the Brain Institute is one of the few
nonclinical buildings equipped with backup power
that can be relied on in such situations to protect
materials requiring refrigeration.
"It was a freak accident," said Douglas Anderson,
Ph.D., interim director of the Brain Institute. "We
won't know the true extent of the damage until the


researchers pull all of the reagents out of the
refrigerators and run assays. So far I'm not getting
reports from people saying they had something
delicate in a refrigerator or freezer and it was
ruined."
"We made a conscientious effort to reach people
and plug in freezers," Anderson said. "We removed
material from disabled freezers and placed it into
freezers with live plugs, but when the power is out 12
hours, I expect some losses."
Elsewhere at the HSC, Frances damaged the
Dental Sciences Building, blowing water between
wall joints and flashing on the east facade. Water
also seeped through exterior walls into the
basement.
Cochran estimated the damage from Frances at
$70,000, although waterproofing to prevent future
leaks would cost far more.
The 15 to 20 building and grounds crew members
who pitched in immediately before, during and after
the storm deserve special praise, said Tom Harris,
associate vice president for administration.
"Those people put in a heck of a lot of time,"
Harris said. "We appreciate that."
The hurricane's arrival at the end of a long
holiday was fortunate for educational programs.
Many students were gone and classes were canceled
Sept. 7. Providing clinical services, however, was an
expectation.
Jane Schumaker, chief executive officer of the UF
Clinics, said her managers prepared all week for
Frances and then worked the phones over Labor
Day to determine whether clinics could open the
next day and to communicate that information to
patients. Of more than 40 clinics, only six could not
open due to loss of power, debris in parking lots or
inaccessibility from fallen trees or water. Only one
of those sites was closed Sept. 8. Staff showed up for
work Sept. 7, even though many of their own homes
were damaged or without power.
Schumaker said Hurricane Charley served as a
helpful dry run for Frances, and Frances was a wet
run for Jeanne.


"We refined our Charley planning for Frances,"
she said. "And if Ivan had come our way, we'd have
done better yet. We learned a lot about
communication with providers, as well as some
important facilities lessons."
At the Student Health Care Center, a campus-
based patient-care service under the auspices of the
HSC, staff kept the facility open 24 hours a day for
four consecutive days to serve UF students and
employees. Staff worked 12-hour shifts, although
"there were many who stayed for the duration," said
Toni Ratliff, associate director. Nursing and mental
health staff also worked in the two campus-based
shelters.
-Tom Fortner


C2








A POST IT
~ ~ ~ ~ ~ r j P ., ,


PARKING IS TRICKY ON THE FRIDAY
BEFORE HOME FOOTBALL GAMES,
Be aware of Friday evening parking '
restrictions. Before home football games on
Oct. 9, Oct. 16 and on Homecoming on
Nov. 13, vehicles must be moved from some "..'
lots by 6:30 p.m. "
If vehicles are not moved, they risk being .
towed from the following lots:
0 Drill Field (O'Connell Center- *:, '
main lot and first floor of garage)
Q Track Parking Lot
Q Johnson Hall Lot
Q Women's Gym Lot
Q Lot across from the Reitz Union (Engineering Sciences)
Q West and East Murphree Lot
Q Commuter Garage on North-South Drive top level
The areas listed below are reserved for the Motor Home Program. All vehicles
must be moved from the following areas by 6:30 p.m. each Friday before the game
days listed above. If vehicles are not moved, they risk being towed:
Q Commuter Lot
Q Pony Field Lot
Q Commuter Lot across from Transportation and Parking Services
Q Orange Decal Lot behind Transportation and Parking Services
Q All Decal Triangle Lot by Archer Road
The top level and ramp leading to the top level of Garage 5 will be closed by
12:01 a.m. each Friday night before the game days listed above. These spaces are
reserved for the University Athletic Association.
Call Transportation and Parking Services at 392-8048 with any questions.


SLEEP (OR TRICK OR TREAT) A LITTLE LONGER
Daylight saving time ends Sunday, Oct. 31. Set your
clocks to "Fall Back" one hour, sleep a little longer Saturday
night and wake up ready for Halloween on Sunday.


MEDICAL FELLOWSHIP DEADLINE

College of Medicine faculty members
can explore the world of medical
education research while improving
their teaching skills through the Master
Educators Fellowship, formerly known
as Master Educators in Medical
Education. The 18-month certificate
program includes classroom instruction,
hands-on practice and an education
research project chosen and developed
by each participant. The deadline for
application is Oct. 29, and the program
begins in January 2005. Contact Kyle
Rarey, Ph.D., or Cari Hernandez, M.D.,
at 392-5998 for information. The
program welcomes both Gainesville
and Jacksonville faculty.


ANIMAL WELFARE WORKSHOP
On Oct. 12-13, the HSC Libraries
will host a workshop on Meeting
the Information Requirements of
the Animal Welfare Act. It will help
researchers create successful grant
applications by teaching strategies
for database searching and reviewing
alternatives to animal research.
The registration deadline is Oct. 6
and space is limited. Register at www.
library.health.ufl.edu/forms/classreg
AWIC04.htm.
This seminar is cosponsored by these
UF organizations:
Office of the Senior Vice President,
Health Affairs
Office of the Vice President for
Research
Institutional Animal Care and Use
Committee
Genetics Institute
HSC Libraries


SUPERIOR ACCOMPLISHMENT AWARDS NOMINATION IS UNDER WAY


Know someone superior?
UF's Superior Accomplishment Awards Program, which recognizes TEAMS and
USPS employees who have contributed outstanding service in their fields during
the academic year running from of Aug. 1, 2003 to July 31, 2004, is calling for
nominations.
Please don't miss this chance to recognize those among us who make the extra
effort to contribute. This year's nomination period began Sept. 9 and runs through
Oct. 15.
Division-level winners each receive $200 along with a certificate of appreciation
and memento coffee mug. Each division winner then is eligible to be selected for
one of six university-level awards of $1,500 each or one of eight $500 awards.
In addition, each of the six category winners and his or her guest will be invited to
attend a UF football game in the President's Box.
For information, nomination criteria and nomination forms, visit www.hr.ufl.edu/
recognition/saa.
Nomination packets should be routed through your respective college committee
member: 'son
College of Dentistry Cheryl O'Quinn
College of Public Health and Health Professions Bonnie Pommeroy
College of Medicine M. Louise Brophy
College of Nursing Joan Hill
College of Pharmacy Terry Whisenant
College of Veterinary Medicine Ron McKeever
Office of the Senior Vice President, Health Affairs Dennis Hines
UF's Superior Accomplishment Awards program was developed to recognize
deserving university employees and is coordinated by the Division of Human
Resources.

3








EDUCATION


CHAIN


REACTION


College of Pharmacy

event supports the

corner drugstore

By Linda Homewood

he corner drugstore, commonly thought of as
an American icon of the past, struggles to
survive today with increasing market
competition in pharmaceutical sales. The College of
Pharmacy hopes to help preserve the future of
independent ownership with the creation of the
Institute for Pharmacy Entrepreneurs.
A three-day workshop designed by business and
financial experts, under the guidance of Earlene
Lipowski, R.Ph., Ph.D., an associate professor in the
College of Pharmacy, uses a combined approach of
educating and networking to facilitate independent
pharmacy ownership. The workshop, offered for the
first time this August at the college, was designed
with two curriculum tracks. One track benefits
pharmacists who are current business owners and
the other track targets recent graduates and
pharmacists working for others who may be
interested in becoming independent pharmacy
owners.
Theresa Wells-Tolle, president of the Florida
Pharmacy Association, worked with business leaders
and College of Pharmacy educators for the past year
to devise a quality program that provides business
education to pharmacists and students.
As an independent owner of Bay Street Pharmacy
in Sebastian, Fla., Wells-Tolle identifies a major
issue that community pharmacy owners
face.


"What happens to their business as
they approach retirement? They want
to know how their business can go on
as the neighborhood drugstore without
being bought out by national
drugstores," Wells-Tolle said.
The National Community Pharmacy
Association reports that between 1991
and 2001, the number of all retail
pharmacies remained relatively unchanged, w
about 55,000 drugstores in the United States.
that period, however, the number of privately
stores decreased 32 percent. Chain outlets acc
for about 12 percent of the shift in market sha


Pharmacists from the southeastern United States interested in independent ownership, attend UF
College of Pharmacy's Institute for Pharmacy Entrepreneurs weekend workshop.


while the remaining 20 percent of the market was
taken by mass merchants and supermarkets adding
pharmacy departments to their stores.
Workshop presenter Robert H. Buchanan, J.D.,
from PCE Stratus Valuations, notes that when a
large mass-merchant store like Wal-Mart appears, it
usually displaces more than one small drugstore in
the area. However, Buchanan points to an industry
trend, new since 2001, in which independent
pharmacies are beginning to make a comeback and
regain their share of the market.
"As a patient-care service, there is a demand for
the community pharmacy with its personalized
service," Buchanan said. "They aren't as easily
replaced as the local hardware store and this creates


The three-day workshop designed by business

and financial experts uses a combined

approach of educating and networking to

facilitate independent pharmacy ownership.



ith a great opportunity to keep independent pharmacies "One of tl
During alive in the community." facilitate int
owned Wells-Tolle sees education about the business side buyers and s
mounted of the pharmaceutical industry as the key to help them c
re, exploiting this new opportunity. Students are exchanges,"


exposed to many career opportunities in clinical
experiences and in internships for retail pharmacies,
but they typically don't learn about their own
business opportunities, she said.
Designed to meet the needs of working
pharmacists, the workshop was planned as a
weekend event. The curriculum, offering continuing
education credit, teaches pharmacists how to
implement a business and financial plan, make
"build vs. buy" decisions, prepare a succession plan,
and develop exit strategies.
With its first-time offering, Institute organizers
hoped to attract at least 50 participants who could be
split into the two curriculum tracks. The response
was so favorable that registration was closed after 86
pharmacists from Florida, Georgia
and Alabama signed up, Lipowski


said.
Dinner and evening social
activities were included in the
weekend so that pharmacists could
begin to develop networking
relationships and collaborations
for possible future business
ventures, crucial to the succession
plan of independent ownership.
ie long-term goals of the institute is to
eraction between the two groups -
ellers to see if this might be a way to
connect for business opportunities and
Wells-Tolle said. 0


C4


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'








EDUCATION BRIEFS


UF MEDICAL, DENTAL STUDENTS RAISE

THE BAR WITH HIGH TEST SCORES


UF medical and dental students are doing their part
to help boost the Health Science Center's national
recognition, posting impressive scores on recent
required exams.
For the second year in a row, College of Medicine
students earned the school's highest-ever scores on the
United States Medical Licensing Examination Step 1.
The class of 2006 scores averaged 231, up four
points from last year. The national average, though
not yet compiled, is expected to be about 217. UF
also boasted a pass rate of 100 percent, and 25
percent of the class had scores in the top 10 percent
of national scores.
"It's incredible, I'm almost speechless," said Robert
Watson, M.D., College of Medicine senior associate
dean for educational affairs. "I can only conclude
that it's a combination of good students, good faculty,
good teaching, good curriculum."
All U.S. medical students are required to take
the Step 1 exam at the end of their second year of
medical school, Watson said. It's the first of three
USMLE exams students must pass to become licensed
physicians. Last year's UF average score was 227.
College of Dentistry 2004 doctor of dental
medicine graduates achieved the highest first-time
pass rate since 1998 on the Florida Dental Licensure
Exam this summer. With 65 of 70 UF candidates who


took the exam passing, the graduates accomplished
a "first attempt" pass rate of 92 percent, the highest
since 1997, when 97 percent of UF grads passed.
The achievement of the class of 2004 on the exam
exceeded the college's goal of an 85 percent "first
attempt" pass rate for UF graduates and surpassed
the unofficial statewide passing average for the June
exam, estimated to be 78 percent.
Associated Professor Carol Stewart, D.D.S., the
college's licensure board liaison, credits the 5.5
percent improvement over the pass rate of the
college's 2003 pass rate to "enhanced preparation
and a better understanding of performance
expectations" attributed to the college's innovative
"mock board" course.
The Senior Mock Board Course is a class all
D.M.D. students must pass before graduating. The
course uses identical criteria to test students under
the same pressures they would experience during the
actual board exam. By the time graduates take the
real board exam, many may have already taken two
"mock boards" in preparation.
"They know exactly what they need to do at every
step of the examination," said Associate Dean for
Education Robert Primosch, D.D.S., of the students. "I
think that gives them an advantage."
-Tom Nordlie and Lindy Brounley


F7 1 _


College of Medicine student Jennifer Rehm,
class of 2006, studies in the HSC library.


HSC STUDENTS PARTNER TO PREVENT SUBSTANCE ABUSE

A staggering number of American teenagers have experimented with drugs or
alcohol -all before graduating from high school.
According to the U.S. Department of Health and Human Services, 70 percent of
adolescents have smoked cigarettes, 81 percent have drunk alcohol, 47 percent
have used marijuana and 24 percent have tried other illegal drugs.
The good news is that substance abuse education helps prevent teenage drug
abuse, especially if the person offering the education is someone to whom teens
can relate.
That's the idea behind the Partners in Prevention of Substance Abuse, or
PIPSA, initiative, sponsored by UF's North Florida Area Health Education Centers
Program.
Each fall semester since 1998, PIPSA involves 500 to 600 students from the
Health Science Center colleges of Dentistry, Public Health and Health Professions,
Medicine, Nursing, Pharmacy and Veterinary Medicine in substance abuse
education and outreach. Professional students participate in group lectures about
substance abuse diagnosis and management, addiction, adolescent development
and classroom management.
Armed with persuasive strategies and sobering statistics, the students team up
Oct. 23-31 to take the PIPSA message into middle-school classrooms during
National Red Ribbon Week for a Drug-Free America. This year, more than 75,000
adolescents in the community will hear the PIPSA message.
The message is more than "Just Say No." It's about thinking through and making
healthy choices, even in the face of intense peer pressure, that will last a lifetime.
Venita Sposetti, D.M.D., assistant dean for Admissions and Financial Aid and an
associate professor of Prosthodontics, helped found PIPSA.
"For our first semester dental students, PIPSA provides an 'Aha!' moment,"
Sposetti said "This is their first experience in the role of being a health care
provider. They discover that just by virtue of being dental students they have
something to say and these kids will listen. So the PIPSA program is an important
part of our students' professional development."


MANNEQUIN MEDICINE IN THE E. R.
His pulse races. His breathing slows. His temperature skyrockets. Welcome to
mannequin medicine.
Fourth-year medical students have swapped a day in lecture for an interactive
encounter with an adult male mannequin that mimics a variety of scenarios
patients might display in department of emergency medicine's new Human Patient
Simulator laboratory. The students interact with the mannequin, which responds
like a living patient would to trauma or treatment.
The department of emergency medicine developed its new simulator lab
over the past few months with a system purchased from Medical Education
Technologies Inc. The technology was developed and patented by UF.
The mannequin not only mimics symptoms but also responds directly to
treatment administered by trainees, including oxygen, intravenous drugs and
defibrillation. A control room technician runs the mannequin through its computer-
programmed scenarios. When a student conducts a physical exam, queries the
"patient" or administers medication, the technician programs the mannequin to
respond to the treatment and acts as its voice. The student gauges what happens
to the "patient" by watching changes in its vital signs.
"The simulator lab makes the experience as close to the real thing as possible,"
said Ken Marx, business manager for emergency medicine. "The more the student
has to do, to recreate the clinical experience as realistically as possible, the better.
So when they go into the clinic for real, it is not as big a leap."
Medical residents also train on the simulator. Students are sometimes
videotaped as they interact with the mannequin and can review the tapes as a kind
of medical instant replay.
Marx said the department also wants to research the educational effectiveness
of the simulator to continue to improve and standardize student-patient scenarios.






flEmek 5


-- -----








RESEARCH I


BIKERS


BEWARE


Motorcycle noise may

cause hearing loss

By Jill Pease



W h en the band Steppenwolf sang of heavy
metal thunder in "Born to be Wild,"
their classic ode to the freewheeling biker
lifestyle, they equated rocking out to the new electric
music of their time with the ear-pounding
experience of riding a motorcycle.
The notion that loud music can damage hearing
is common knowledge, but the noise produced by
motorcycles poses similar risk to riders, UF experts
caution.
In a pilot test of 33 motorcycles, audiologists at
the College of Public Health and Health Professions
have found nearly half produced sounds above 100
decibels when throttled up equivalent in
intensity to a loud rock concert or a chain saw. The
ongoing UF effort is the first scientific study aimed
at producing quantifiable data on noise levels for
motorcyclists.
The National Institute for Occupational Safety
and Health cautions that exposure to noise at 100
decibels is safe for only 15 minutes. Permanent
hearing loss can occur with prolonged exposure to
any noise measuring 85 decibels or above.
"Almost all of the motorcycles we tested reached
action-level noise, which in the workplace would
require ear protection," said Joy Colle, one of the
study's researchers in the department of
communicative disorders. "The loudest bike we
tested measured 119 decibels with the engine
revved, and the recommended exposure time at that
level is only 11 seconds.
"Potentially, the vast majority of motorcyclists
could be exposed to dangerous levels of noise," Colle
said.
More than 5 million Americans are registered
motorcycle owners, according to the U.S.
Department of Transportation. Of the 28 million
Americans who have some degree of hearing loss,
about one-third can attribute their hearing loss to
excessive noise exposure.


Audiology graduate student Andrea Pierce uses a noise dosimeter to measure the loudness of
Dano Roller's motorcycle in downtown Gainesville. In a pilot test of 33 motorcycles, the UF team
found that nearly half the bikes produced sounds above 100 decibels when throttled up.
Exposure to 100 decibels of noise is considered safe for only 15 minutes before permanent
hearing loss can occur.


In addition to sound levels, the UF researchers
are noting the make, model, engine size, year
manufactured and any modifications to the engine
and exhaust systems of each motorcycle. They will
then develop an online database to provide
motorcyclists with bike-specific data on noise
exposure so riders can make informed decisions
about hearing protection.
"At this time, if consumers were to try to find a
measure of how loud their motorcycle is, they'd find
misinformation," Colle said. "An Internet search for
motorcycle noise levels will yield a 20- to 25-decibel
range, with the interested motorcyclist coming away
with no useful information. That's not good
enough."
In the UF study, noise levels were tested at riders'
ear levels from stationary motorcycles when idle and
throttled up. Further research should include
measurement of noise levels when the motorcycles
are driven at cruising speeds to account for the
effects of wind noise, Colle said.
Although noise-induced hearing loss is


permanent, it is entirely preventable, Colle said.
Motorcyclists should limit the amount of exposure
they have to high-decibel levels, and although
motorcycle helmets don't provide any significant
protection against noise, inexpensive foam earplugs,
available at drug stores, can reduce sound levels by
20 decibels to 25 decibels.
Riders should pay attention to the warning signs
of noise-induced hearing loss: a ringing sound in
the ears immediately after exposure, and hearing
voices and other sounds as muffled.
"These new data about the sound levels to which
motorcyclists are exposed will help audiologists and
others who work in hearing conservation advise
their clients about healthy choices when it comes to
how long to ride and when to wear hearing
protection," said Ted Madison, president of the
National Hearing Conservation Association.
"Consumers may also benefit directly if they have
better information about the sound levels created by
motorcycles when they go to buy or modify their
bikes." 0


C6









RESEARCH BRIEFS



UF RESEARCHERS URGE CAUTION WITH SUNSCREEN-DEET COMBINATIONS


Products combining sunscreen and the bug
repellent DEET can be convenient, but in studies in
mice UF researchers found the mixtures greatly
boost absorption of the chemical through the skin.
"DEET has an unbelievably superb safety record;
it's been used on millions of people and it's critical
that people don't get the wrong message," said
Edward A. Ross, M.D., an associate professor of
medicine and the lead author of a paper published in
Drug Metabolism and Disposition. "People should
continue using DEET because of the very real risks
of mosquito-and insect-borne illnesses, such as West
Nile encephalitis, but use it in the lowest effective
concentration, especially when you use it in
combination with other topical lotions or in
children."
Compared with adults, children may absorb more
DEET because their skin surface area is
proportionally larger relative to their weight, Ross
said. DEET, the synthetic chemical N, N-diethyl-m-
toluamide, was developed in the 1950s for use by
military personnel. Today it is the active ingredient
in many consumer products, in concentrations
ranging from 7 percent to 100 percent.
UF researchers said their findings call attention to
the potential "unappreciated toxicity" of mixtures of
chemicals traditionally studied individually and
suggest manufacturers should reassess their
sunscreen/DEET formulations. In the study, they
applied DEET alone and commercial sunscreen


products containing DEET to skin samples taken
from hairless mice. They used newer
instrumentation that can detect multiple drugs
passing through the skin simultaneously and
measured the chemical's penetration. In the presence
of the sunscreen, DEET passed through the animals'
skin three times faster, rapidly boosting its
concentration, Ross said. The researchers also used


Eva Egensteiner applies insect repellent
containing DEET to her 3-year-old son Julian
McCoy.


"microemulsion" products designed to slow
absorption but found they were only minimally
effective at best.
"The products we tested were not the magic
answer to the problem," Ross said. "Overall, this is a
case where a little bit is good and less is better, not
more. The technology is so simple and
pharmaceutical companies already test skin
absorption. This is a call for companies to test these
common topical compounds together instead of
individually. These can be complex interactions."
The American Academy of Pediatrics advises that
DEET should not be used in a product that combines
the repellent with a sunscreen, as sunscreens must be
repeatedly applied because they wash off, and
repeated applications may "increase the potential
toxic effects of DEET," which is not water-soluble
and can last up to eight hours.
The academy recommends using the lowest
concentration of DEET possible and says DEET
should not be applied more than once a day. In
addition, the group does not recommend using
DEET on children under 2 months and suggests
applying it to older children's clothing, not their
skin.
The complications of DEET overexposure
physicians are most concerned about in children are
subtle, mild, temporary and reversible behavioral
effects, such as headache or confusion, Ross said.
Melanie Ross


ALPHA-1 GENE THERAPY SAFELY TESTED IN FIRST THREE PATIENTS DURING UF CLINICAL TRIAL


A gene therapy to combat one of the most common hereditary disorders, alpha-1
antitrypsin deficiency, appears safe in the first three patients to participate in a
landmark clinical trial, UF researchers have found.
"It is very reassuring to have data from human patients that suggests that they
are not producing antibodies to fight the therapeutic gene product," said Terence
Flotte, M.D., a pediatrician, geneticist and microbiologist with UF's College of
Medicine and a member of the Powell Gene Therapy Center and the UF Genetics
Institute.
Flotte, who presented the findings in September at the international Parvovirus
Workshop in St. Petersburg, said the trial represents the first time gene therapy has
ever been tested in people with alpha-1 antitrypsin deficiency, a disorder that can
cause liver and lung disease in children and adults.
About 100,000 Americans have alpha-1 antitrypsin deficiency, according to the
Miami-based nonprofit Alpha-1 Foundation. The trial is funded by a $1.4 million
National Institutes of Health grant, but the Alpha-1 Foundation played a key role
in helping to build the infrastructure to support the research, Flotte said.
The experimental strategy used in the UF study relies on a molecular vehicle
known as the adeno-associated virus, or AAV, which already exists without
symptoms in many people. The main purpose of the phase 1 study is to test the


safety of the therapy, a crucial step that must take place before determining the
therapy's effectiveness and the best dose to treat patients.
"We don't show that we are at a final treatment dose, but we are defining the
limits of the dose we can work with and can begin to see the effects," said Flotte,
who works closely with Mark Brantly, M.D., a UF professor of medicine and of
molecular genetics and microbiology. "There was some immune response to the
AAV capsid, the outer protein shell of the virus, but that was expected and
shouldn't affect the gene transfer."
In this phase of the trial, physicians inject three consecutive doses of 1.1
milliliters of the virus containing the gene for alpha-1 antitrypsin into each
patient's upper arm. The procedure takes less than 30 minutes. Since the trial
started in late March, three patients have been injected with the gene therapy
agent. In all, 12 patients will receive the therapy.
"Without the Alpha-1 Foundation, this work could never have begun so quickly,"
Flotte said. "There are millions of dollars of basic costs that had to be met before
we could do a phase 1 trial. The gene therapy facility at UF had to be upgraded
with the personnel, supplies, equipment and environmental monitoring necessary
to produce the reagent and meet Food and Drug Administration certification."
John Pastor



-3i


" '''--








RESEARCH





FAT AND FIT TRUMPS LEAN AND LAZY


Lack of physical fitness poses weighty problem for heart health

By Melanie Fridl Ross


Women who are fat yet fit appear less likely to suffer a heart attack or
die than those who are slender but slothful, UF researchers
WV reported in the Journal ofthe American Medical Association.
The study suggests body weight may not be as crucial as regularly
pounding the pavement with a brisk walk, staking out a spot at the
gym or simply doing household chores. But don't view the news as a
reason to soothe a snack attack with fatty favorites or to pile on a
second hefty portion at mealtime it's best to aim for trim and
in shape, says cardiologist Timothy R. Wessel, M.D., an
investigator at UF's Health Science Center and the report's lead
author.
"Our study accepts the fact that obesity is a cardiovascular
risk factor," Wessel said. "It is and has been shown to be so in
multiple studies. But what this study suggests is that simply
modifying weight without mc.J I\ !irn \..ui phi\ .i!I lii n.. '. l
is not addressing a perhaps rn-..i imp ..rI ni i k .nJd I n I..n
cardiovascular events; that is. p.. i phi\ il !iirnL "
The researchers say their r, ull > !LiLl \ hLmph a,!/L i h
need to assess an individual's jal ii\ !i\ 1 .l a.a j
routine part of the medical exam ,\ I 2-l rne
questionnaire used in the stuJ\ i .. ., i hS
women's perceived level of fitn>.. !. 3
powerful tool that easily could Kh
adopted by physicians to ider I \ I
patients prone to future probm. r..
said Carl J. Pepine, M.D., chk I, I
cardiovascular medicine at the
College of Medicine and the pjpip '
senior author.
The UF study is important hce au.
it shows that a patient's own i'o1i:jn::i H-en:lley
perceived physical activity le:. college of imediConi
alone appears to predict hear: cl:;ss of 2C0-
disease risk, even after account ir
for weight, traditional
cardiovascular risk

measurements,
such as body mass
index, waist
circumference or
waist-to-hip ratio,
Pepine said.
"There's no doubt
that increasing levels of
obesity are associated with
many potential medical
problems over time, not the least of
which are cardiovascular disease,


diabetes and hypertension. The latter conditions can lead to
serious heart disease," Pepine said. "But it seems from this
research that at least women may be able to negate some of the
adverse effects of obesity and being overweight by increasing
their levels of fitness."
UF researchers studied about 900 middle-aged women
who were enrolled in the National Heart, Lung and
Blood Institute-sponsored Women's Ischemia Syndrome
Evaluation, or WISE. WISE seeks to define the
prevalence, extent, severity and complexity of heart
disease in women and also aims
to find ways to better predict
it.
All the women had
symptoms suggestive of
reduced blood flow to
the heart. About 41
percent of study
participants were
obese, defined as a
body mass index
greater than or equal
to 30; all told, three-
qu a Iors were overweight.
I h.e %.mnn completed a questionnaire
Ihl rnJl mMasuIt of fitness, including
\ hil hLu Ih.\ plil I lpaJld in light sports, could
lmh J IIhl ,h I ,I II ,. iarry groceries up stairs or
[un a ,h., I dilan n
IhL Uil IL I hc! IIunrd that lower fitness levels
\ LIL J..ujidJ % i h A h !hi -than-expected rate of heart
JIIJ ki. ki ,.kc, h,,pil h/aj. !.n and death during follow-up.
)\ c! a[., h, ,iul hallI hc ,liud\ participants developed heart-
!clalcJd dJ\c!.e .\n, ( )I Ih.,,, about 28 percent of the
\ .r.mn L[iilhcJd a, -h.,. \l !I i \perienced heart problems,
Ilul h !4hi II mic I han Ih, 24 p!e nt of women who were lean
jnd III In c nl ,. al IjiIn 43 percent of thosewho
\wcl Il an hul u nii J loped events, comparable to
he 42 pIln ~-rI .I hose who were obese and
u!ii %,. h. a iso fared poorly.
Ihe suggestion is that it's
actually better to be in
shape even if you are
obese. If you were
out of shape,
being thin did
not offer
protection,"
Wessel said.
O


I:iuiu i, LIA BALTOZER


r8J-*m














































HFL '


Dr. Glenn Turner (left) and anaplastologist Robert Mann display a range of prostheses parts they have constructed for patients mimicking eye color, skin
color and tone, hair color and congruity to existing features.


By Lindy McCollum-Brounley


As any artist familiar with working with live models understands, it's not
always easy for a person to pose unmoving for minutes on end. Yet model
Robert Seaman is riveted to his chair, watching with such intensity he
almost seems to hold his breath as the artist before him applies confident brush
strokes to the unusual canvas balanced on his fingertips.
Robert Mann's brush stills for a moment as he pauses to gaze into
Seaman's face. Then he resumes his brushwork delicate, liquid-
blue strokes on a porcelain-white canvas.
Mann is an anaplastologist, a medical artist who specializes in the i
preparation and fitting of prosthetic devices, at the College of
Dentistry. His canvas on this day is a remarkably lifelike rendering of
Seaman's sky-blue eye. Even tiny red blood vessels have been
represented in the white of the prosthetic eye, making the object
appear so real that most people would never guess otherwise once it is
placed in the empty right eye socket of Seaman's smiling face.
Seaman is one of about 80 patients a year who benefit from the artistry and
surgical expertise of dentistry's Maxillofacial Prosthetic Services, a division of the
college's department of prosthodontics directed by Associate Professor of
Prosthodontics Glenn Turner, D.M.D.
Turner oversees the division's efforts in creating lifelike prostheses for patients
missing eyes, noses, ears, cheeks, chins even fingers because of cancer
surgery, traumatic injury or congenital birth defects. He's one of a handful of
maxillofacial prosthetic specialists nationwide who work to restore the one aspect


of personal identity most of us take for granted our facial features.
As part of an interdisciplinary surgical team, Turner helps prepare patient
tissues to support prostheses. This preparation can include sculpting and
smoothing remaining tissues, implanting metal rods onto which the prostheses clip
or even implanting magnets to grip those embedded within the prostheses.
The techniques used to support and fabricate the prostheses have to
be innovative, Turner said, to give patients with varying degrees of
r disfigurement realistic-looking artificial features.
Gunshot wounds, for instance, have very ragged edges that are
difficult to match with the edges of a prosthesis. Cancer surgery
survivors may have entire sections of bone and tissue removed, leaving
sinus cavities exposed or very little bone structure in place to support a
prosthesis.
"One thing that every maxillofacial prosthetic patient has in common
is that not all tissue is present and the anatomy of remaining tissue
varies widely," Turner said.
Each prosthesis has to be a completely custom job, but Turner and his team don't
stop at fabricating and fitting prostheses they also monitor healing, disease
recurrence and teach patients how to properly care for and clean their wounds and
their prostheses.
"We are not changing any of the laws of physics, but we are having to apply them
in unique ways to construct prostheses that work for patients," Turner said. "What
we really do is make fancy bandages." 0

*Ur 9


__ _____








COVER STORY


TAKING


TRAUMA


CARE


TO


THE


NEXT


LEVEL


Dr. Lawrence Lottenberg in the new 24-bed trauma ur

By Tom Nordlie
In many ways, North Central Florida is an ideal
place, blessed with warm weather and natural
beauty.
But even the most idyllic place does not spare
residents and visitors from high-speed car accidents and
other tragedies. The result is trauma injury caused by
external force widely cited as the leading killer of
Americans ages 1 to 44.
For years, people in North Central Florida who
suffered grave injuries were flown by helicopter to
trauma centers in Jacksonville or Orlando, the distance
increasing the chances their lives would slip away before
hospital treatment could begin.
That's about to change.
After a yearlong effort by UF's Health Science Center
and Shands at UF, the state granted Shands provisional
Level 1 trauma center status in Oct. 1, for both adult


and pediatric cases. Formal designation is contingent on
a favorable review of the center's performance by the
state Department of Health, and could happen as early
as July 2005.
"Clearly the communities of Gainesville and the
surrounding areas have felt they've needed a Level 1
trauma center for some time," said Douglas Barrett,
M.D., UF senior vice president for health affairs. "So
we've had a sense of obligation that this is something we
need to do."
For years, the emergency department of Shands at UF
has provided excellent trauma care to many patients, but
the most serious cases had to be transported to the
nearest centers, which kept trauma-only facilities and
treatment teams ready around the clock.
Florida's trauma centers handle everything from
broken bones to worst-of-the-worst gunshot and burn


cases. Currently, there are six Level 1 trauma centers
and 14 Level 2 centers in the state, but none are located
in Trauma Service Area Region 4, an 11-county chunk
of North Central Florida that includes Alachua County.
Reaching those centers consumed valuable time,
something critically injured patients cannot afford, said
Shands HealthCare Chief Executive Officer Timothy
Goldfarb, M.H.A.
Since January, the trauma facilities at Shands at UF
have been steadily developed and improved, said
Lawrence Lottenberg, M.D., director of trauma surgery
for UF's College of Medicine. Provisional status is
granted only when a trauma program delivers care that
meets Level 1 requirements, a goal Shands at UF
reached this summer.
"We've upgraded our process through the emergency
department, through the intensive care unit and
through the operating room, and we are taking care of
patients just as any Level 1 trauma center in the
country," said Lottenberg, who has spent the past year
directing the UF/Shands effort to bring their combined
facilities, personnel, equipment and protocols into
compliance with Level 1 requirements.
"I can't say enough about the huge commitment, both
from Shands and the College of Medicine, for this
effort," he said. "We intend to show everybody that the
outcomes in this region will be far superior, now that we
are providing Level 1 care."
Trauma patients now receive:
Rapid and expedited care in the emergency
department;
Operating rooms staffed around the clock by
multidisciplinary teams of physicians and
nurses with trauma certifications;
Bedside surgical procedures in the intensive
care unit;
Lab results available within minutes and blood
available prior to the patient's arrival;
A new 24-bed trauma unit, the destination for
all trauma patients except those going to an
intensive care or intermediate care unit.
Beginning Oct. 1, severely injured people in the 11-
county area who meet specific criteria to be classified as
"trauma alert" patients will be transported directly to
Shands at UF, Lottenberg said. Upon arrival, each
trauma alert patient will be met by a team of physicians,
nurses and ancillary personnel that includes an
emergency medicine physician and an attending trauma

surgeon. The team will immediately work to stabilize
the patient, take blood samples and order tests.
When fully operational, the Shands at UF trauma
center will add about 1,600 additional patients per year


to the existing load of more than 40,000 emergency
cases seen annually by the Shands at UF emergency
department, said David Vukich, M.D., a UF professor
and chairman of emergency medicine.
The number of trauma cases admitted already has
doubled, from 50 per month in January to 100 per
month in August, and will increase to reach the center's
full capacity of 130 or 140 patients per month in
October, Lottenberg said.
UF's department of emergency medicine, an academic
unit in the College of Medicine, is responsible for much
of the staffing in the Shands emergency department,
said David Seaberg, M.D., a UF professor and associate
chairman of emergency medicine. The project has
presented several unique challenges.
First and foremost, the Shands emergency
department physical plant was renovated to add nine
new beds, Seaberg said. The nursing staff was increased
and trained for trauma, and patient management
protocols were developed in conjunction with the
department of surgery's division of trauma, burns and
emergency surgery.
"We've made tremendous inroads in the emergency
department," Lottenberg said. "The average time of a
patient who needs to go immediately to the operating
room when they come here is 15 minutes. That is the
benchmark time of any Level 1 trauma center, not only
in the state but in the country. The average time for
arriving patients to reach the intensive care unit or the
trauma unit is 30 minutes."
The UF emergency medicine department already
helps operate the Level 1 trauma center at Shands
Jacksonville, and some coordination will be needed
between the two centers, Vukich said. For
communities located

Jacksonville where the '
centers' service areas
overlap, a system will be
developed to quickly -
determine which
patients should go to
which center.
Similarly,
protocols will be
devised to track the
patient-care activities
at the Gainesville
and Jacksonville
centers in real time,
making it possible
to send some


patients to the less busy of the two facilities when
circumstances warrant.
Several other College of Medicine academic units are
heavily involved in the Level 1 project, notably the
departments of anesthesiology, medicine, neurosurgery,
pediatrics, orthopaedics and rehabilitation, radiology
and surgery.
Pediatric trauma care will be overseen by attending
physicians with the department of surgery's division of
pediatric surgery, said division chief Max Langham Jr.,
M.D., a UF professor of surgery.
Because current treatment protocols for pediatric
trauma emphasize nonsurgical options when possible,
the division's attending physicians will first assess
which young patients require surgery.
"Our focus is to return the child to health as rapidly
as possible with as little additional trauma as possible,"
Langham said.
Though the Level 1 project has required time,
planning and allocation of resources, the departments
expect to benefit from it, said William Cance, M.D., a
UF professor and chairman of surgery. Cance, who
arrived at UF in January 2003, has made development of
the Level 1 trauma center a cornerstone of his
leadership duties and was instrumental in recruiting
Lottenberg.
"Trauma centers raise the pulse of the institution,
which helps patients throughout the institution," Cance
said. "Everyone moves more quickly on everything. It
has a ripple effect. Even getting a CT scan is faster."
Care for nontrauma patients will improve as well,
Cance said, because the entire hospital system will be
transformed. Myriad routine tasks will have been
analyzed and adjusted for maximum efficiency, then
inc.-rp..-rtcd into specific protocols.
t n .f the department's biggest contributions
,, a, s expanding its division of burn surgery to
include trauma and emergency surgery in July
2003, said division chief David Mozingo,
M.D., a professor of surgery and director
of the Shands Burn Center.
As for trauma research, UF is well-
prepared, with several College of
Medicine units already engaged in
relevant work, Mozingo said. The
department of surgery has a surgical
metabolism laboratory funded for basic
science studies of burns and trauma,
under the direction of Lyle Moldawer,
Ph.D., a professor of surgery and an
international authority on the effects of trauma on
the immune system; the department already is part of a


multi-institution study of the immunology of burns and
major trauma.
The center also will present new possibilities for
resident education, said Peter Gearen, M.D., a UF
associate professor and chairman of orthopaedics and
rehabilitation. For orthopaedic residents, it's especially
important to learn about the patient management
protocols used in cases where multiple injuries are
involved.
"Residents will get in the flow of managing them in
that way," he said. "And they are learning with each
additional case that comes through."
Despite the increased volume of trauma patients,
clinical departments may find that the Level 1 center
actually makes their work easier, said William
Friedman, M.D., a UF professor and chairman of
neurosurgery, because they will be part of a highly
organized system.
But the bottom line is that Level 1 care will result in
better patient outcomes.
"I'm glad the day has finally come when we're able to
do it," Friedman said. "Dozens of studies show that
patients do a lot better if they're taken to a Level 1
center, due to requirements for 24-hour staffing by
neurosurgery and general surgery and immediate
availability of other specialities and written protocols to
organize the care.
"So it's the kind of care we want for ourselves, our
families, our friends." Q


IBEI 4 i L


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PATIENT CARE


UF SURGICAL TEAM PREPARED


TO TREAT RARE TUMOR


Dr. David Pincus chats with Tricia Worthington. Pincus was part of a surgical team that operated
on her 2-year-old son Nicholas for hypothalamic hamartoma.


By Tom Nordlie


hanks to a globe-trotting Australian
neurosurgeon, UF now is one of two U.S.
institutions offering an innovative surgical
procedure to treat hypothalamic hamartoma, a rare
brain tumor that causes seizures, rage attacks and
learning disabilities.
Jeffrey Rosenfeld, M.D., a professor and director of
neurosurgery at the Alfred Hospital and Monash
University in Melbourne, developed the procedure
and has traveled to numerous countries to share it. In
August, he demonstrated the procedure to UF
physicians in the College of Medicine's pediatric
epilepsy program, completing three successful
operations along the way.
"It completes our being at the forefront of epilepsy
surgery, and we're already one of the most complete
epilepsy surgery centers in the nation," said Paul
Carney, M.D., division chief of pediatric neurology.


Hypothalamic hamartoma strikes one child in
every 1 million to 2 million, Rosenfeld said. The
condition occurs when a mass of nerve cells presses
against the hypothalamus, a brain structure that
controls emotion and many basic survival functions.
The cells fire electrical impulses that cause repeated
seizures and epilepsy.
"Because the kids have multiple seizures, their
brain development slows down," Rosenfeld said.
"They also develop severe behavioral problems -
aggression, temper tantrums, rage attacks."
Because hypothalamic hamartoma was discovered
only 20 years ago, treatments are in their infancy.
The seizures are resistant to medication, Rosenfeld
said, and the standard surgical approach, working
from below the tumor through a maze of crucial
blood vessels, sometimes results in poor outcomes.
Rosenfeld's answer was to take a longer route


downward through the skull, giving better access to
the tumor with less risk. To date he has performed 52
operations and achieved what could be called miracle
cures.
"If you can operate when the kids are young they
can start learning again," he said. "Talking improves,
behavior improves, aggression stops. It's like they're
a new kid."
Just two days after his operation, 7-year-old
Nathan Veatch showed only one outward sign of the
surgery a sutured incision a few inches long near
the top of his head.
Nathan's mother, Sheila Veatch, is a Florida native
who moved with her husband to Nairobi, Kenya,
where they teach school. They adopted Nathan at age
6 months and soon noticed he suffered fits of rage
and uttered a strange, unnerving laugh another
common symptom. Eventually he was diagnosed
with hypothalamic hamartoma.
"I learned about hypothalamic hamartoma from
the Internet, e-mailed several doctors and only one
responded," she said.
That doctor was Carney. Seeking ways to help
Nathan and two other children whose parents had
sought him out via the Internet, Carney spoke to
David Pincus, M.D., Ph.D., a UF assistant professor
of neurosurgery, who was aware of Rosenfeld's new
approach. Pincus worked with department of
neurosurgery Chairman William Friedman, M.D., to
invite Rosenfeld to UF and, soon after, the Veatches
bought plane tickets.
None of the three youngsters treated in Gainesville
has experienced seizures since the surgery, although
it will take months to know the full extent of their
recovery, Rosenfeld said.
UF's Comprehensive Pediatric Epilepsy Program
includes specialized pediatric epileptologist
consultations, drug trials, an inpatient monitoring
unit and a complete epilepsy surgery program,
Pincus said.
"We're pleased to be only the second place in the
U.S. to offer this surgery," Pincus said. "We hope to
be doing the procedure here in the future and
become a center for treatment of this condition." 0

TO LEARN MORE ABOUT HYPOTHALAMIC
HAMARTOMA AND TREATMENT OPTIONS
VISIT WWW.HHUGS.COM,
AN ONLINE COMMUNITY FOR FAMILIES
TOUCHED BY THE DISEASE.


CI 2








PATIENT CARE BRIEFS


RELIEF AND REUNION


Dog injured in hurricane returned to owner


Thanks to UF veterinarians, a German shepherd
named Lady that was badly injured during
Hurricane Charley is getting a second wind.
Lady's story has special meaning to many who
weathered the recent storms.
A team of UF veterinary pathologists, technicians
and students responded to a request from the Office
of the Governor to aid in the animal relief efforts and
joined forces with a disaster response vehicle
dispatched by FEMA to provide shelter and
treatment facilities.
The team traveled from Bartow to Wauchula in
central Florida, treating a variety of animals brought
to the makeshift veterinary clinic.
The UF team treated one injured German
shepherd whose owner could not be located and


Bridget McVay and her dog, Lady, visit at the
Veterinary Medical Teaching Hospital Sept.
1, more than two weeks after being
separated during Hurricane Charley.


determined it was likely the dog had been hit by a
car.
After team leader Jennifer Maners, D.V.M., a
second-year pathology resident, made an
impassioned plea to the college's surgery service to
provide additional care to the animal, the female dog,
nicknamed Charley, was brought to Gainesville for
major surgery.
Maners admits she became attached to the quiet,
gentle creature in part because her own German
shepherd passed away last year but added that it was
a team effort that ensured Charley's survival.
"This dog would have been euthanized had Dr.
Jason Wheeler of our surgery service not been
willing to donate his time to perform the needed
operations on the dog's hind legs," Maners said.
Meanwhile, employees of the company that
operated the FEMA truck had photographed all the
animals brought to the facility and distributed the
images to various shelters and Web sites to help pet
owners locate their displaced animals.
On Aug. 27, less than a week after the dog's arrival
at UF, Maners received a call from a woman claiming
to be the dog's owner.
In tears, the woman told Maners she had gone
from shelter to shelter and finally seen a photograph
of the dog she knew instantly was hers.
"They asked if I knew of any characteristics that
were unique," said Bridget McVay, a cafeteria worker
who is a lifelong resident of Wauchula.
"I told them her left fang tooth was chipped off
and they said, 'Well, this is definitely your dog.'"
McVay said the dog, whose real name is Lady, had
gotten out during the storm.
Wheeler said Lady's surgery, which was paid for
privately by individuals wanting to help, requires two


Dr. Jennifer Maners, who arranged for Lady
to be brought to Gainesville for life-saving
medical treatment, poses with the dog prior
to its departure from an animal-relief site in
Wauchula.



months of postoperative care.
"She came through the procedure really well," said
Wheeler.
In September, McVay visited her beloved pet and
the people who saved the animal.
"Jennifer Maners is my sweetheart," she said. "I
just can't believe all that everyone has done. They let
me drive Lady around and I got her some of her
favorite treats. I missed her so much."
SSarah Carey


SHANDS AT UF OFFERS PROCEDURE FOR 'CARPAL TUNNEL' OF THE FOOT

A relatively simple but seldom-performed procedure to treat diabetic neuropathy of the feet is now being
performed by surgeons at Shands at UF.
Tibial nerve decompression surgery treats "carpal tunnel of the foot," which occurs when high blood sugar levels
associated with diabetes cause nerves to swell or degenerate, making them vulnerable to pressure when they
pass through the ankle or the foot. This neuropathy may cause severe pain and burning in the feet. The feet may
eventually become numb, making it difficult or impossible for a person with this condition to sense other injuries.
The tibial nerve travels down the leg and through the interior of the ankle. During an outpatient procedure, a
surgeon makes a small incision at the ankle, then cuts the ligaments surrounding the tibial nerve to make more
room for it, relieving the pain.
"It's like doing a carpal tunnel operation on the foot," said H. Hollis Caffee, M.D., College of Medicine
professor and chief of the division of plastic and reconstructive surgery. "The surgery we do for diabetic
neuropathy is a relatively simple operation. However, most physicians and very few surgeons know about it.
Consequently, few patients ever get treated because of this lack of knowledge."
-Lance Skelly, Shands at UF


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COMMUNITY


Sole


S HSC staffers step


S i te breast cancer


By Adrianna C. Rodriguez
F or four Health Science Center women,
stomping out breast cancer starts one step at a
time, with a bit of wit and fancy footwear to
boot.
Through a recent fund-raising project dubbed
"Sole Sisters," they joined others in the Gainesville
community in an effort to gain a toehold on the
deadly disease, the second-leading cause of death
among American women.
The project, created by local photographer Randy
Batista, raised $55,000 to benefit the mammography
fund of the Alachua County Organization for Rural
Needs Inc., known as the ACORN Clinic. It
culminated April 16 in a photography exhibit and
auction featuring community leaders sporting shoes
with an artistic flair.
ACORN Clinic is a not-for-profit organization
located in Brooker. More than 100 health
professionals volunteer their expertise at the clinic to
extend $1.5 million in low-cost health and dental
care services to the uninsured, working poor of
North Central Florida.
"I was honored that I was asked to serve as a
'sister,' said dentistry Dean Teresa A. Dolan,
D.D.S., M.P.H., a 12-year member of the ACORN
Clinic board of directors.
Dolan was photographed wearing "Gum Shoes,"
pink platform sandals with dental floss straps and
pearly white teeth at the toes created by local artist
Dixie Biggs.
Other Health Science Center community members
who participated in the Sole Sisters project included
radiation oncologist Cherylle Hayes, M.D.,
radiologist Linda Lanier, M.D., and Tina Mullen,
director of Shands at UF's Arts in Medicine
Program.
Hayes posed for the portrait "On the Fringe." The
abundant hair featured in the image was meant by
artist Mary Park-Smith to represent the hair that
cancer patients lose during chemotherapy treatment.
.Mullen, whose mother died of breast cancer 15 years
ago, designed the shoes she sported in her portrait,
titled "Bunny Slippers and Sweet Memories." "Penny
Loafers," created by Lanier and modeled by Dawn
Burgess, a mental health counselor at Community
Behavioral Services, consisted of two hollowed-out
loaves of rosemary bread accented with bright copper
pennies on the shoe-tongues.
ACORN had been funding free mammograms
using $20,000 raised through Batista's first project






COMMUNITY


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;-


9J Vi'A L U ;1'J A


for the clinic, "Chairwomen." For that campaign, local women leaders were photographed posing with their
favorite chairs. The fund provides mammograms, diagnostic tests and ultrasound tests for uninsured women
ages 30 to 50. Recently, however, the fund ran out of money, and the clinic had to begin paying for the
mammograms out of its operating budget.
"It was perfect timing," said ACORN Director Candace King of the infusion of support from the Sole
Sisters proceeds.
Thanks to all the "sole" sisters and brothers who contributed to the project, the ACORN mammography
fund will continue to help combat breast cancer, King said. And it couldn't have happened at a better time -
October is National Breast Cancer Awareness Month. 0


SI I4 EI


FOR MORE INFORMATION ABOUT THE SOLE SISTERS PROJECT AND THE ACORN CLINIC MAMMOGRAPHY FUND,
VISIT WWW.SOLESISTERS.ORG OR WWW.ACORNCLINIC.ORG.

U____L15








STORM STORIES


RIDING THE STORMS) OUT


Winds whip the UF family
Storms Jeanne, Ivan, Frances and p ,
Charley all left their mark on the
HSC family. How did your neighbors
make it through and what did they
learn in the process? POST readers
share their perspectives and
experiences of spending time with
Florida's rough visitors.
ICE, ICE, BABY
We received a call from friends living near
Hawthorne: no power for three days -where could
they get ice? Latest news report: No Alachua County
ice giveaways scheduled; ice couldn't be had for love
or money. The situation was desperate!
Mark said, "Help is on the way!" I live in
Gatorwood Apartments (20 buildings; 12 units
each). Mark grabbed new trash bags and headed
out. Knocking at each door, he explained his friends
needed ice, "Buddy, can you spare a tray?" Three-
and-a-half buildings later, my freezer was so full we
needed a bungee cord to close it!
Elaine V. Cronheim Hurricane
Coordinator midnight
Administrative Services Venitc
Department of Pediatrics Assistc
ALL CREATURES BIG AND SMALL
My kitty, Chikitica, (otherwise known as my
associate) and I were fortunate and fared well
through the hurricanes. We moved from Oregon less
than 24 hours before Charley. I spent my second
night in Gainesville at the Southwest Recreational
Center, but my kitty was taken in her airline carrier
to the designated Alachua County animal shelter.
For Frances, we were able to stay together at the
Kanapaha Middle School shelter. There, the Humane
Society and DART (Disaster Animal Rescue Team)
staff provided crates, litter, litter boxes, cleaning
supplies, food and their knowledge so that we could
be together and know our dear companions were
safe, too. I spent my shelter time (three nights and
four days) helping out and caring for 24 cats, two
hamsters, one Guinea pig, one tortoise and a handful
of baby squirrels. A nearby science classroom housed
a large number of rambunctious dogs. Meanwhile,
the Red Cross and community volunteers ably cared
for 200 humans.
For me, these hurricanes were such the opportunity
to meet wonderful people, and be busy with my kitty
and many other wonderful creatures, all thanks to the
sensitivity of the community of Gainesville to whom
we owe our gratitude.
Maria Mercedes Panqueva
Doctoral Student
Rehabilitation Science
Communicative Disorders


C16 .*


...












,,,


SFrances redecorated our master bedroom and patio, giving it a more open look and feeling. The
event was loud and scary, but no one was hurt.
SJ. Sposetti, D.M.D.
nt Dean for Admissions and Financial Aid


Cosmo the cat evacuated to the home of Yankee the dog
during Hurricane Frances. They are pictured here discussing
strategies to keep their humans entertained during the
storm.
- Michelle Woodbury
Rehabilitation Science Doctoral Student
College of Public Health and Health Professions


People in line for gasoline at 2 a.m., at the Texaco
in Micanopy, County Road 234 and 1-75. Those
same gasoline customers in line for the bathroom.
You know something's up when there's a line for the
bathroom at 2 a.m.!
- Wayne Cope
LMT Videoconferencing Technician,
HSC Teaching Laboratory Resources


- --~--








STORM STORIES


A tree top broke off and impaled our
garage during the height of Hurricane
Frances on Sept. 6.
- Chris Sistrom, M.D., M.P.H.
Assistant Professor
Department of Radiology


Before Frances
(top) and after
Frances (right).
These are photos
of our dining
room. We had
extensive damage
in a few other
rooms but feel
grateful that we
can continue living
in our house.
- Yvonne
Brinson
Project Director
Women's
Health Initiative
Department of
Medicine


Our neighborhood flooded. View of
my front yard from the street looking at
my mailbox.
-Janet Haire
Office Manager
Department of Rehabilitation
Counseling


HURRICANE REVEALS COUNTY'S
VULNERABILITIES
A few trips by my family around
Gainesville after Hurricane Frances passed
through revealed our region's two greatest
vulnerabilities. The first risk is that the trees
that we prize for beauty and shelter from
the sun can also be missiles that puncture
our homes or cleavers that topple onto
roofs with startling devastation. Water
oaks and several other species with
especially shallow roots were among
the most frequently blown over. The
second risk comes from flooding in areas
improperly zoned for residential housing,
which should have been designated solely
as water recharge zones.
- George Papadi
Senior Biological Scientist
Veterinary Medicine
Department of Pathobiology


FREIGHT TRAIN COMETH
Sunday, Sept. 5: It sounded nothing like
the slow-moving train that regularly passes
by on its tracks across the lake from my
house. This was much louder and moving
much faster -more like a locomotive
come loose from its rails. Louder and
louder this sound grew, filled with limbs
cracking and popping, large objects
hitting the ground with a thud. Then within
a minute, it faded as quickly as it came at
a little past midnight. I thought I saw light
outside but when I looked out the window
the sky went dark. Then, like someone
switched on the lights, the sky got bright,
the ground lit up and I could see my car in
the drive. It was distant lightning reflected
in the low, heavy cloud cover.
When I walked outside in the morning
light I realized the runaway locomotive
I thought I'd heard had actually been a
tornado -a powerful storm that ripped
through my neighborhood, picked up huge
oak trees to the right and left of me, but
left my house untouched.
- Carolyn Whitford
Systems Programmer
Department of Physiological Sciences


DIAPER DUTY IN THE DARK
We lost power for 12 hours. A trifling
amount to be sure compared to those
still without power, but long enough to
make you realize how much you take it for
granted. Changing the baby at 4 a.m. by
candlelight was an interesting experience
that I'll not soon forget.
- Chris Morris
Department of Radiation Oncology
College of Veterinary Medicine


~j~4j17
1 1 0 1


Ilk%








DISTINCTIONS


DENTISTRY

SAMUEL B. LOW, D.D.S., 7r --n o.
associate dean of faculty
practice, continuing education
and allied health, and professor
of periodontics at the College
of Dentistry recently was
installed as president of the
Florida Dental Association.
Low, who was sworn in during
the association's annual meet-
ing, the Florida National Dental Congress, is the
first academician in the association's history to
serve as president. With a membership of about
7,000 Florida-licensed dentists, the Florida Dental
Association represents nearly 80 percent of all
licensed dentists in the state.

MEDICINE

The College of Medicine's Office
for Program and Faculty
Development has named
CARIDAD HERNANDEZ,
M.D., a UF clinical assistant
professor of medicine, its
associate director for faculty
development. Hernandez,
who currently is completing
a general medicine/faculty
development fellowship at the University of North
Carolina, will oversee several initiatives for the
office, including two teaching improvement
programs, the Master Educator Fellowship and
Residents as Educators.

WAYNE GOODMAN, M.D.,
chairman of the department
of psychiatry, has been re-
apointed chairman of the Food
and Drug Administration's
Psychopharmacologic Drugs
Advisory Committee. He will
serve a two-year term. The
committee provides indepen-
dent expert scientific advice
to the FDA. In September, the committee recom-
mended that antidepressants should carry the
government's strongest warning about the poten-
tial for the medications to spur suicidal thoughts in
children and adolescents.


Psychologist JAMES R. RODRIGUE, Ph.D., has been
appointed to the National Kidney Foundation's
National Donor Family Council. Rodrigue, a
professor in the departments of clinical and
health psychology, surgery and pediatrics at the
College of Public Health and Health Professions
and the College of Medicine, also has been
named the Region 3 representative to the United
Network for Organ Sharing's Ethics Committee.
For the past 15 years, Rodrigue has served as
director of psychological services for the solid
organ and bone marrow transplant programs
and the live kidney and liver donor programs at
Shands at UF medical center. He also directs UF's
Center for Behavioral Health Research in Organ
Transplantation and Donation, which examines
ways to enrich the lives of transplant patients and
to increase organ and tissue donation.

The Florida Heart Research Institute has named
UF cardiologist DANIEL PAULY, M.D., Ph.D.,
the Stop Heart Disease Researcher of the Year.
Pauly was lauded for improving the understanding
and treatment of coronary artery disease and
congestive heart failure through the study of
gene therapy and cell signaling mechanisms.
He received $25,000, to be applied to future
research efforts.

Cardiologist DAVID SHEPS, M.D., has been named
president-elect of the Academy of Behavioral
Medicine Research. He will serve a one-year term
before assuming the presidency in June 2005.
Sheps is a professor of medicine at the College
of Medicine and the Malcom Randall Veterans
Affairs Medical Center. The academy strives to
foster research efforts in the field of behavioral
medicine.

LUCIA NOTTERPEK, Ph.D.,
is the winner of the
American Society for
Neurochemistry's 2004
Jordi Folch-Pi Memorial
Award, given annually to an
outstanding young investi-
gator who has demonstrat-
ed a high level of research
competence and original-
ity while significantly advancing knowledge of
neurochemistry. Notterpek seeks to understand
how misexpression of a certain gene leads to
hereditary degeneration of myelin, a fatty mate-
rial that often surrounds nerve fibers. An assistant
professor of neuroscience at the McKnight Brain
Institute, her research efforts receive support from
the National Institutes of Health and the National
Muscular Dystrophy Association.

Gov. Jeb Bush has awarded grants totaling almost
$2.9 million to seven College of Medicine faculty
members as part of the James and Esther King
Biomedical Research Program. The recipients
were VEENA ANTONY, M.D., HIMANGSHU
BOSE, Ph.D., JAMES DEMPSEY, Ph.D., IAN
ELDER, Ph.D., RICHARD MELKER, M.D., Ph.D.,
DANIEL PAULY, M.D., Ph.D., and SERGUEI
JARIKOV, Ph.D. The research program supports


Florida investigations involving basic and clinical
research of diseases caused by tobacco. It was
named in honor of Senate President Jim King's
late parents, both of whom died of cancer.

NURSING

College of Nursing Associate
Professor JENNIFER ELDER,
Ph.D., R.N., recently was
named chairwoman of the
college's department of
environmental health care and
systems. Elder, who has been
with the college since 1990,
is a nationally known autism
expert who has focused her career on parental
and dietary interventions for children with autism.
She is a co-founder of Arbor House in Gainesville,
a shelter for pregnant homeless women, and is a
fellow of the American Academy of Nursing. She
replaces Karolyn Godbey, Ph.D., R.N., who retired
after a 30-year career with the college.

Gov. Jeb Bush recently re-
appointed ANDREA GREGG,
D.S.N., R.N., College of
Nursing associate professor
and Jacksonville campus
director, to a new term
on the Florida Center for
Nursing Board of Directors.
Gregg currently serves as
chairwoman of the board of
directors, a position she assumed this summer,
and was one of four nursing leaders reappointed
by Bush for a second term on the board. The
Florida Center for Nursing is an organization that
addresses strategies on dealing with the state's
critical nursing shortage.

ANN HORGAS, Ph.D., R.N.,
assumed the role of the
College of Nursing's associate
dean for research this summer.
Horgas, an associate professor
who has been at UF since
2000, is one of the country's
leading nurse researchers
on pain and aging and is
currently conducting an NIH-
funded study on methods to assess pain in nursing
home residents with dementia. Horgas is a fellow
of the Gerontological Society of America and
has been awarded the Nightingale Award for
Excellence in Nursing Research. She replaces Dr.
Carolyn Yucha, who took a position as dean of
the School of Nursing at the University of Nevada
Las Vegas.

College of Nursing Clinical
Assistant Professor GLORIA
MCWHIRTER, M.S.N., R.N.,
was named the 2004 05 chair
of UF's University Minority
Mentor Council, which governs
the University Minority Mentor
Program. The program links


, -eM








JACKSONVILLE


minority students with professional mentors, both
UF faculty members and a student peer mentor. In
her role with the College of Nursing, McWhirter
devotes full-time effort to the recruitment,
mentoring and retention of students from minority
groups or disadvantaged backgrounds. The
UMMP is aimed at improving the retention rate
for African-American and Hispanic students by
personalizing their experiences in their first year of
college and providing a supportive and nurturing
experience for the personal and intellectual
development of these students as they transition
into college life.

PUBLIC HEALTH & HEALTH PROFESSIONS

ADRIENNE AIKEN, a clinical
and health psychology
doctoral student at the
College of Public Health and
Health Professions, received
a research supplement for
underrepresented minorities
from the National Institute on
Aging. Aiken studies cognitive
aging in minority populations.

VONETTA DOTSON, a clinical and health
psychology doctoral student at the College of
Public Health and Health Professions, received
a minority dissertation grant from the National
Institute on Aging. Dotson studies the combined
effect of aging and depression in older adults and
whether it leads to greater cognitive decline.

Parent Child Interaction Therapy, developed by
SHEILA EYBERG, Ph.D., a professor in the Public
Health and Health Professions' clinical and health
psychology department, was one of three therapies
named by the Ewing Marion Kauffman Foundation
and the National Call to Action as a best practice
for helping children heal after abuse.

VETERINARY MEDICINE


ELEANOR GREEN, D.V.M., a professor and
chairwoman of the College of VeterinaryMedicine's
department of large animal clinical sciences,
has received the College of Agriculture and Life
Sciences' 2004 Award of Distinction. The award
is given for outstanding contributions to UF, IFAS
and Florida's food, agricultural and life sciences,
as well as to natural resources industries. Green
also serves as chief of staff of UF's Alec P. and
Louise H. Courtelis Equine Teaching Hospital.


UF JACKSONVILLE

PEDIATRICS DEPARTMENT

LAUNCHES NEW CHILD

PROTECTION DIVISION

By Tom Nordlie

Adding a new dimension to its efforts to protect
Florida's children, the department of pediatrics at
UF's College of Medicine Jacksonville has established
one of the nation's first divisions devoted to fighting
child abuse.
Launched in July, the division of child protection
and forensic pediatrics will pursue research,
clinical services and training programs designed to
reduce the incidence of maltreatment and provide
expert evaluation of suspected cases, said Randell
Alexander, M.D., a professor of pediatrics and chief
of the new division.
"Having an academic division gives us the chance
to process cases and think about how we can
slow down and turn the tide of child abuse," said
Alexander, who arrived at UF Aug. 1 from Morehouse
School of Medicine in Atlanta. "Agencies can't take a
larger view to stem child abuse, but we can."
That larger view will involve geographic expansion,
Alexander said, with help from division colleagues
Andrew Barrett, Ph.D., the department's director of
telemedicine, and Jay Whitworth, M.D., a professor
of pediatrics who cofounded the statewide Child
Protection Team system in the mid-1970s. The
system uses interdisciplinary groups of health-care
professionals to evaluate injuries that may have been
caused by child abuse.
One of the division's initial goals is to add more
Florida cities to the pediatrics department's existing
telemedicine consult service, he said. Using video
technology, physicians can evaluate cases by
examining injuries and interviewing children, parents
and health-care providers in 22 cities, without leaving
the College of Medicine Jacksonville campus.
Alexander will continue to serve as director of a
similar telemedicine service for the state of Georgia
and hopes to begin offering UF consults to hospitals
in Georgia and Alabama, he said.
"We're trying to think regionally," said Alexander,


Dr. Randell Alexander, chief of the new child
protection division of the College of Medicine
Jacksonville, examines a case photo.



who is one of the world's leading experts on shaken
baby syndrome and Munchausen-by-proxy syndrome.
Upon arrival at UF, Alexander also was appointed
statewide medical director of the Child Protection
Team system. He succeeds Whitworth, who served
in the position for more than 30 years and who
will receive the Award for Outstanding Service to
Maltreated Children from the American Academy of
Pediatrics Oct. 9 at its national conference in San
Francisco.
"Jay has made a great success of it and I want to
build on his work," Alexander said.
Because Alexander and Whitworth are
internationally recognized experts, their presence
in the division can help draw notoriety and funding,
said Thomas Chiu, M.D., a professor and associate
chairman of pediatrics at the Jacksonville campus.
"I don't think the opportunity exists very often to
have two top people together," Chiu said. "I want to
really challenge them to move the progress of child
protection and forensic pediatrics to the next level."


EXPERTS SCREEN PATIENTS FOR SIGNS OF EARLY DEMENTIA
Geriatrics expert George Wilson, M.D., an associate professor and associate chairman of community health
and family medicine at UF's College of Medicine Jacksonville, has received a three-year grant for $75,000 from
Pfizer to investigate whether elderly patients entering long-term care have early dementia or minimal cognitive
impairment that has not been recognized by their families and health-care providers.
Wilson believes the structured environment typical of long-term care facilities could
mask loss of memory and other signs of cognitive impairment. Using two simple cognitive
testing formats, Wilson and his team will screen all patients admitted to long-term care at
River Garden in Jacksonville. Those patients exhibiting signs of cognitive impairment will
be examined further. The study also will compare the screening results to the perceptions
of health-care providers at the facility a disparity could indicate the need for greater
assessment during the admissions process.


Bjf 4j1 19


" '''--








PARTING WORDS


College of Nursing wins

grant extension to reduce

health disparities

By Tracy Brown Wright


a =--


Generations of caring: Alice Poe, D.S.N., C.N.M., College of Nursing assistant
professor and nurse midwifery track coordinator, looks on as a new mother
bonds with her child. Poe, a certified nurse midwife, delivered both the mother
and her child.


- -q


Published by
UF Health Science Center
Office of News & Communications
Senior Vice President for Health Affairs
Douglas J. Barrett, M.D.
Director, News & Communications
Tom Fortner
Editor
Denise Trunk
Senior Editors
Melanie Fridl Ross, John Pastor
Art Director
Lisa Baltozer






UF Health Science
CENTER


Staff Writers
Tracy Brown, Sarah Carey, Tom Fortner, Linda
Homewood, Lindy McCollum-Brounley, Tom
Nordlie, John Pastor, Jill Pease, Melanie Fridl Ross,
Denise Trunk
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
dtrunk@ufl.edu or deliver to the Office of News
& Communications in the Communicore Building,
Room C3-025.

WWW.NEWS.HEALTH.UFL.EDU


he U.S. Department of
Health and Human
Services has awarded a
2-year continuance to an $831,000
grant awarded to the College of
Nursing in 2001 to expand its
nurse midwifery track. The goal
is to increase health care for
underserved populations.
These funds, provided by the
department's Bureau of Health
Professions' Division of Nursing,
will significantly increase the
nurse-midwifery workforce by
recruiting students from
disadvantaged backgrounds,
medically underserved areas and
underrepresented populations. A
cooperative degree with Florida
State University will also be
implemented to increase access
to midwifery education for
individuals in the Florida
Panhandle and southern Georgia.
As part of the grant, UF
educator/recruiter Norma
Cooper, M.S.N., R.N., visits
culturally diverse and medically
underserved areas to encourage
students of all ages and cultures
to consider nurse-midwifery as a
career. Her audiences range from
children in kindergarten to new
graduates of nursing programs at
colleges with large enrollments of
underrepresented populations.
The cooperative degree
program with FSU was modeled
on a similar program with the
University of South Florida. It
offered UF's core nurse
midwifery classes via distance
education technology to students
on the USF campus who
otherwise could not access the
midwifery track. This agreement
ended in June because USF has
decided to begin its own nurse


midwifery track.
The College of Nursing will
transmit nurse midwifery classes
to the FSU School of Nursing's
Tallahassee campus and its
Panama City site. The students
will take core graduate nursing
classes at the FSU School of
Nursing and attend the UF nurse
midwifery classes via distance
education technology.
Clinical experiences are
usually arranged in the student's
home city with the cooperation of
UF midwifery faculty who make
on-site visits before, during and
after their clinical rotations. The
cooperative degree program with
FSU will begin offering
teledistance classes in January.
"The grant awarded by the
Department of Health and
Human Services has allowed us
to continue our work in
recruiting individuals from
culturally diverse, underserved
and underrepresented groups,"
said Alice Poe, D.S.N., C.N.M.,
an assistant professor and
coordinator of the UF nurse
midwifery track.
"Every county in Florida has a
shortage of health professionals
who care for underserved groups,
and nurse midwives are fully
prepared to provide primary
health care, in addition to
women's health care for pregnant
and nonpregnant women," she
said. "By recruiting and
mentoring students who may
otherwise not have access to
nurse midwifery education, we
can be a resource for those who
can help to fill those health
disparity gaps in underserved
rural and urban communities."