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 Front Cover
 Up front
 Sun Terrace renovations
 (Extra)ordinary people
 Smart house opens
 Tooth decay decoded
 Herbal meds complications
 Rats know when to say when
 Cold heats up blood pressure
 Overcoming Parkinson's
 Chapman Society recognition
 Education briefs
 Saying farewell to pediatrics
 Patient care briefs
 Distinctions
 Sheppard steers applicants
 Back Cover


UF



The Post
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Permanent Link: http://ufdc.ufl.edu/UF00073869/00023
 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 2005
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: UF00073869:00023
 Related Items
Preceded by: Friday evening post (1989)

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Table of Contents
    Front Cover
        Page 1
    Up front
        Page 2
    Sun Terrace renovations
        Page 3
    (Extra)ordinary people
        Page 4
    Smart house opens
        Page 5
    Tooth decay decoded
        Page 6
    Herbal meds complications
        Page 7
    Rats know when to say when
        Page 8
    Cold heats up blood pressure
        Page 9
    Overcoming Parkinson's
        Page 10
        Page 11
    Chapman Society recognition
        Page 12
    Education briefs
        Page 13
    Saying farewell to pediatrics
        Page 14
    Patient care briefs
        Page 15
    Distinctions
        Page 16
        Page 17
        Page 18
    Sheppard steers applicants
        Page 19
    Back Cover
        Page 20
Full Text








Brain Mappir


Scientists Answer Parkinson's Challenge


UF Health Science
CENAATER
*~~~ E N T E R ****







UP FRONT


TABLE OF CONTENTS


O POST IT Sun Terrace Renovations
EXTRAORDINARYY PEOPLE Clark Hodge
SRESEARCH Smart House Opens
SRESEARCH Tooth Decay Decoded



*
.I


O RESEARCH Herbal Meds Complications
@ RESEARCH Rats Know When to Say When
RESEARCH Cold Heats Up Blood Pressure
0 COVER FEATURE Overcoming Parkinson's












12


@ EDUCATION Chapman Society Recognition
@ PATIENT CARE Saying Farewell to Pediatrics
@ DISTINCTIONS Iraqi Veterinarians Visit
@ PROFILE Sheppard Steers Applicants


5


'I


Senior dental
student, Brandon
Alegre (left), gets a
, closer look at the
cavities of an
I Alachua County
elementary school
student in
- preparation for
filling them during
the Give Kids a
Smile treatment day
Feb. 4.


Giving Kids a Smile


College of Dentistry junior Shea
Sammons (at right) uses a
dental hygiene puppet to explain
good oral habits to a student
from Stephen Foster Elementary
School during the college's Jan.
21 screening phase of the
annual Give Kids a Smile event.


I,.


Eighty children receive care
The cost of dental care can take a bite out
of the wallets of many families with young
children. A national program launched by
the American Dental Association has local
children smiling without any price to their
parents.
The College of Dentistry, Santa Fe
Community College, the Alachua County
Dental Association and Project Dentists: We
Care Inc. partnered to provide free dental
care to 80 Alachua County schoolchildren
Feb. 4 as part of the American Dental
Association's Give Kids a Smile event during
National Children's Dental Health Month.
Of the 100 schoolchildren screened at
the College of Dentistry on Jan. 21, 80 kids
were selected to receive comprehensive
treatment during the Feb. 4 event. UF faculty
and students provided care to 45 children in
the college's clinics, while 18 private dentists
from the Gainesville community treated 35
children at the Santa Fe Community College
dental clinic, which is managed by the
College of Dentistry.
More than $55,000 in free dental care
was provided to the children at UF and Santa
Fe during this year's activities. This marks the
third year of the UF event, which has been
designated by the ADA as one of the top 10
Give Kids a Smile programs nationwide.
-Lindy Brounley


C2


ON THE COVER: Microrecording of cell activity in the brains of Parkinson's patients during surgeries such as deep brain stimulation takes place along a path
carefully mapped through imaging and guidance technology developed at UF by Frank Bova, Ph.D., and William Friedman, M.D., of the
McKnight Brain Institute. The probe trajectory is derived by first fusing patients' stereotactic CT scans with their volumetric MR scans, then
mapping the combined clataset to an anatomic reference. The cover illustration shows a single view, but UF neurologists and neurosurgeons
can see the pathway from multiple perspectives. For more about UF efforts to battle Parkinson's disease, please turn to Page 10.


Si-
.








POST IT


Sound off this spring


Given to griping? Well, now you can give in to it.
Sounding off about workplace pros and
cons has never been so easy ... or so
anonymous.
From March 25 until April 15, university
TEAMS and USPS employees will have a
chance to voice their opinions about the
UF work environment by completing the Staff
Opinion Survey. President Bernie Machen
commissioned the survey to learn how staff rates
the university work environment, and he hopes
the confidential survey will assist the university in
identifying two or three priority areas that will
become the focus of campuswide discussion and
action for improvement.
International Survey Research, the private firm used to
conduct the faculty opinion survey last year, developed
the staff survey based on input from the Administrative and Professional
Assembly Staff Survey Task Force and insights gained from staff focus groups
held Jan. 19. ISR has customized survey questions to reflect specific campus


issues involving benefits, recognition and reward,
career development, working relationships,
communication, resources and efficiency,
and quality of life.
1 More than 8,200 full-time and part-
time TEAMS and USPS employees will receive
the paper survey on March 25, either directly
delivered in a sealed envelope via campus mail
or through bulk delivery to employment units. Staff
will have until April 15 to anonymously complete
the survey and drop it in campus mail for delivery
to a dedicated P.O. Box at UF Document Services.
The completed surveys will be forwarded to ISR for
tabulation and reporting. Individual responses to
the survey will remain completely confidential, but
reports of overall results will be made available for public review
and comment in early June.
Lindy Brounley

For more information and continuing updates,
visit www.president.ufl.edu/staffsurvey/.


Center Drive renovations near completion
Motorists, pedestrians and bicyclists accustomed to workers, paving equipment and barricades clogging Center Drive may be glad to know road renovations should be
completed by mid-March, according to Jeff Bair, project manager for UF's Physical Plant Division.
Hipp Construction is working on the fourth and final subsection of the renovated area, he said. Afterward, a final layer of asphalt will be applied to the entire
resurfaced area and then the only task remaining will be painting lane markers on the new road surface. For the first time, this section of Center Drive will include bicycle
lanes.
"Speaking for the Physical Plant Division, I really appreciate the level of cooperation, understanding and patience we've received from everyone affected by this
project," Bair said.


Take a bite out of this
The Sun Terrace Dining Center in the HSC is going
on an extended spring break and will come back in
early August with more than a tan.
The outdated space will reopen with fresh menu
options and a new food delivery service.
"It will look pretty snazzy," said Bill Weltner,
construction project manager for UF facility planning
and construction.
Two food vendors, Chick-fil-A and Einstein Bros
Bagels, will bring in their own designers. Then
builders will knock out interior walls and give the
space a contemporary look as they build a space for
the full-service chicken chain and the bagel, soup,
sandwich and salad spot.
Jerry Victorian, project manager with the local firm
Brame Architects, will oversee the design. He said the
individual vendors will build spaces according to their
own motifs, color schemes and style.
The space will look more like the food court area
in the HUB, a UF food service area up the hill,
Victorian said.
A third designer, STBP Architects out of Baton
Rouge, La., will design the new common area, which
will remain roughly the same size with the same
number of seats.
There are no plans for changes to the outside
area surrounding the eatery. Jim Morgan, director
of UF Business Services, said his department has
shouldered the $1.2 million cost of renovations to the
building's interior.


Qualitative research in health,
illness and disability has its day
A free conference on using qualitative research
methods features Gay Becker, Ph.D., a professor
in medical anthropology, University of California
at San Francisco. Her keynote address, "Using
Qualitative Approach to Understand Ethnic
Disparities in Health Care," will anchor the March
18 event. Becker is regarded as perhaps the
leading qualitative researcher in the study of stroke.
The main theme of her research is disruption to
life, the process by which people acquire and live
with health conditions that create unforeseen paths
in the course of life. Becker is currently principal
investigator on a 10-year Merit Award study funded
by the National Institute on Aging. This study
examines the daily life experience of people age
50 and older with chronic illnesses in four ethnic
groups: African-Americans, Filipino-Americans,
Latinos and Cambodian-Americans.
The conference program, held in the Reitz Union,
includes 18 papers in concurrent sessions and
roundtable discussions.
The event is sponsored by the VA Rehabilitation
Outcomes Research Center of Excellence, the VA
Brain Rehabilitation Research Center of Excellence,
UF's College of Nursing and the UF Brooks
Rehabilitation Research Center of Excellence.


Exercise that works
for you and others
Rather than running from something, run for it.
The College of Medicine's Equal Access Clinic is
organizing a 5K Run April 2 to benefit the operation
of the student-run free clinic.
All race entry fees will go toward helping the
clinic, which is staffed by medical students and
provides free medical care to those who need it.
The race, one of the biggest fundraisers for the
clinic, makes it possible to get fit and improve
health care options for Gainesville's low-income
residents at the same time.
Hosted by the Florida Track Club, the 3.1 -mile
run will start at 8 a.m. from the parking lot behind
the North Florida Regional Medical Center. Online
registration closes on March 29. Fees are $15 for
adults and include a free race T-shirt ($8 without a
T-shirt). Add $2 for late registration. Kids under 17
are free.

For more information see www.active.com/
eventdetail.cfm?eventid=1200817 or call the
Florida Track Club hotline at 352-3789-TRAK.









U U *O3


-- -----








EXTRAORDINARYY PEOPLE


Hip with high-tech


To the delight of students, orthodontic case review gets "with it"

By Lindy McCollum-Brounley


lark Hodge is an orthodontist who should have gone into comedy. His
quiet drawl delivers funny one-liners and entertaining stories in the
finest tradition of Samuel Clemens. He is an outgoing man, and his easy
Southern charm is utterly engaging.
"Six years ago, I was 62 years old and received my first Social Security check,"
Hodge said. "I got a letter from Timothy Wheeler (chairman of UF orthodontics)
asking me if I was interested in teaching part time. My daughter said, 'Daddy,
you ought to do that.' I pulled the letter out of the trash and showed it to my wife,
B.J., and she said, 'Yeah, you should do it.' "









. ,























Hodge had been an orthodontist in Gainesville for 40 years. When he received
Wheeler's invitation, Hodge was already slowing his practice and beginning to
contemplate what he might do for retirement. Teaching part time in the
university's department of orthodontics seemed to Hodge like a pretty good way
to ease into retirement. In 1998, Hodge joined the College of Dentistry's faculty
with the intention of teaching for a year or so until a full-time orthodontic faculty
member could be recruited. He's stayed for more than six years.
Teaching students was a new adventure for Hodge. But as satisfying as it was, it


did have its challenges. In preparation for one of Hodge's classes, students needed
to have access to orthodontic patient records from the college's orthodontic clinic.
They checked out the case records from the clinic several days before Hodge's
class, and returned them afterward.
"You can imagine, those records got returned pretty beat up," Hodge said.
"Pages all dog-eared and models broken."
Hodge and Wheeler came up with the idea to develop an interactive digital case
library to reduce the wear and tear on patients' paper records. Hodge, with help
from the college's instructional resource staff, developed a program that students
could access online.
"The first prototype was Web-based, and it worked, but not well," Hodge said.
For the second phase of the case library development, Hodge envisioned an
interactive CD-ROM containing selected cases from the orthodontic clinic to
illustrate the basic concepts of orthodontic diagnosis and treatment.
Despite his self-deprecating statement of being "an analog guy trying to get
along in a digital world," Hodge familiarized himself with the program Flash to
develop a digital library of 25 orthodontic cases on CD-ROM.
When the orthodontic digital case library CD debuted in spring 2004, it was a
hit with the seniors in Hodge's class.
"Before the CD, we had to check out charts and borrow models from the ortho
department," said Marci Berger. "I liked the new digital library because it has
complete information and photos for each patient, which makes it much more
clinically relevant, and, I didn't have to worry about the ortho department closing
and not having a case to present."
The new Flash format is programmed to be intuitive and is very simple to use.
Once loaded into the computer, the disk opens the program to show a list of cases.
Select a case and the record displays on the screen initially as front and side view
photos of the patient's face. Tabs at the top of the screen allow the user to open
other records in the case, such as history, panoramic radiographs and
cephalograms, cephalometric tracings and measurements, and exterior and
interior e-model views of the patients' bite. As the cases age, treatment outcomes
are added to the files.
Eventually, everything that would normally be found in the actual patient
record with the exception of personal data such as name, contact information
and Social Security number will be placed in the library for each of the cases.
Whether the cases are replaced with new ones as they age will be up to the next
guy, Hodge says. After more than six years at UF, he's ready to retire for real.
Once again, the department is recruiting new faculty and Hodge is pondering
what to do with his time after retirement. His tennis game and real estate
business need his attention, but Hodge has other ideas about retirement that have


better punch lines.
"I used to think about being a bag boy at Publix," Hodge joked. "But then I got
to watching and that's heavy lifting! I've decided to go to Wal-Mart and be a
greeter instead."


C4









RESEARCH


Smart House features high-tech for assisted liv


By Jill Pease

inette Hendler, 77, toured
the UF Gator-Tech Smart
House during the grand
opening celebration in January with
special interest.
After all, Hendler will be one of the
first seniors to live in the Smart House
for a short period of time and provide
feedback on the house's assistive
technology, designed to make living
easier and safer for older adults.


Minette Hendler demonstrates
the "smart wave," a microwave
oven that knows how to cook
frozen foods and shows the user
how to prepare them.


Among Hendler's favorite features
in the home is the "smart wave," a
specially programmed microwave that
recognizes specific frozen packaged
foods. A display above the smart wave
provides a step-by-step demonstration
of how to prepare the particular meal
and the smart wave automatically
cooks it for the appropriate amount of


time. If the food finishes cooking
while the resident is in another room,
the house will make an announcement
to the occupant that the food is done
and ready to enjoy.
Located on the campus of Oak
Hammock at the University of
Florida, the 2,800-square-foot UF
Gator-Tech Smart House is a research
project of the Rehabilitation
Engineering Research Center on
Technology for Successful Aging,
directed by William Mann, Ph.D.
"There are other smart houses that
have been built in the United States,
but for the most part they are not set
up for people to actually come and live
in them," said Mann, who is also the
chairman of occupational therapy in
the College of Public Health and
Health Professions. "The Gator-Tech
Smart House will have older people
actually living in it for short periods
of time, interacting with the
technology and giving us feedback on
the technology before we move it into
product form."
The center's work is supported by a
$4.5 million grant from the National
Institute on Disability and
Rehabilitation Research.
Working with Sumi Helal, Ph.D., a
professor of computer and information
science at the College of Engineering,
Mann and the Smart House research
team are developing and testing
several fascinating features,
including:
A floor that identifies and tracks the


location of all house occupants. It
can also detect falls and contact
emergency services, if necessary.
A home security monitor that
continually tracks all windows and
doors and can relate the status to the
resident, such as an unlocked or
open door or window.
A refrigerator that monitors food
availability and consumption,
detects expired food items and
creates shopping lists automatically.
A bed that monitors sleepless nights
and sleep patterns.
The smart phone, which acts as a
remote control for all appliances and
media players in the home.
A front door that allows keyless
entry by the occupant. When a
visitor rings the doorbell, monitors
within the home display the image
of the visitor and the resident can
ask the house to open the door.
A driving simulator in the home's
garage used in evaluating older
drivers' abilities, a research project
of the UF National Older Driver
Research and Training Center.
Of the 76 million Baby Boomers,
the leading edge of the generation is
on the brink of reaching 60. There is
no better time to investigate new

Smart House Researcher Youssef
Kaddoura demonstrates the
sensors beneath the home's floor,
designed to track residents'
movements.


technology t
independence
A study cc
Council on I
that 80 perce
assistive tech
reduce their
Half those si
dependence
were able to
homes.
"We're apl
specifically t
who may hav
cognition or
"It assists th
independence
their quality
shown to red


ing



hat can maximize
:e.
nducted by the National
Disability demonstrated
ent of seniors who used
nology were able to
dependence on others.
surveyed reduced their
on paid helpers, and half
avoid entering nursing

plying these technologies
o a population of people
ve more difficulty with
movement," Mann said.
em in maintaining their
:e longer, which improves
of life and has been
Luce health-related costs."


























.


I








RESEARCH


A map that might save your teeth


Researchers chart bacterial proteins that cause tooth loss

By Lindy McCollum-Brounley


he human mouth teems with millions of
enamel-eroding, gum-inflaming microbes,
like it or not.
One of these, Porphyromonas gingivalis, is a
bacterial homesteader that stakes a claim deep
within the spaces between teeth and gums. It's
also the leading cause of tooth loss secreting
proteins that destroy the soft tissues and bone that
support teeth to cause periodontal disease.
Now scientists have identified the thousands of
proteins the bacterium produces, shedding light
on how it interacts with healthy cells in order to
thrive, according to dental researchers from UF
and the University of Washington. They describe
their findings in the February issue of the journal
Proteomics.
"Determining which proteins are expressed in
greater levels in the mouth has allowed us to gain
clues as to how P. gingivalis might be causing
disease, and what we might be able to do with
drugs or vaccines to prevent it," said Richard
Lamont, a professor of oral biology at the College
of Dentistry and study investigator.
The National Institute of Dental and
Craniofacial Research estimates 80 percent of
adult Americans have some form of periodontal
disease, their symptoms ranging from mild gum
irritation to complete tooth loss.
People with periodontal disease also are at
increased risk of stroke and heart attack, and the
disease makes it difficult to control blood sugar
levels in people with diabetes. If that's not bad
enough, pregnant women with periodontal disease
are seven times more likely to deliver low-birth-
weight, preterm babies.
Proteins are important to study because they
are the foundation of the cellular structure of
every living organism, Lamont said. They carry
on the day-to-day biology of life, going about their
business as enzymes and antibodies. They can also
cause disease.
"The genes themselves are only important in
that they encode the proteins," Lamont said. "It's
the proteins that are most responsible for disease,
and, in most cases, it's proteins that are vaccine and
drug targets."
The scientists have been trying to understand
how P. gingivalis interacts with healthy oral tissues
to cause such devastation. In this study, they used
cutting-edge molecular research techniques to map
all the proteins known as the proteome -


produced by P. gingivalis. Ultimately, the
researchers were able to fill hundreds of gaps in the
organism's sequence of roughly 2,000 proteins.
"The approach used in this study is very
exciting," said Hansel Fletcher, an associate


that," Lamont said. "We've identified the complete
protein complement of the organism, and we've
looked at how those proteins are expressed when
the organism is in an environment that closely
mimics an oral situation."


'F-


Richard Lamont examines a culture of the oral pathogen, P. gingivalis, grown within the sterile confines
of an anaerobic chamber housed in his ground-floor laboratory. Lamont is considered to be one of the
leading experts on the biology of P. gingivalis. The bacteria for periodontal disease is implicated in
coronary artery disease and pre-term delivery of low birth weight babies.


professor of microbiology and molecular genetics at
Loma Linda University in Loma Linda, Calif.
"For the first time, we are able to see that the more
than 200 so-called 'hypothetical' proteins in P.
gingivalis are expressed and have specific
functions."
Until now, scientists had identified less than
2 percent of the pathogen's proteins and had to
guess at what other proteins might be present in
the proteome based on similarities to other known
proteins, said Fletcher.
"This study has done two things to advance


To do this, Lamont and his colleagues compared
the proteins secreted by P. gingivalis when grown
in a medium containing human gum cell proteins
with the proteins produced by the bacteria when
grown in a neutral medium. Bacterial proteins
from the two conditions were separated using a
new technique called Multidimensional Protein
Identification Technology, or MudPIT.
Once separated, mass spectrometry was used to
measure each protein's mass and charge, identifiers
as unique to proteins as the whorls of fingerprints
are to people.


C6


~s~








RESEARCH


Taking herbs with other drugs may harm health

By Tracy Brown Wright


Older black women who use herbal medications
view themselves as healthier than their
counterparts who don't use the preparations, yet
many aren't clearly informed of the products'
true benefits or their potential dangers, UF
nursing researchers report in a recent issue of
Clinical Nursing Research.
Building on a similar study they conducted of
nearly 90 white women, UF researchers evaluated
patterns of herbal product use among 57 black
women ages 65 and older who took them for
perceived health benefits or to manage an
existing medical condition, such as arthritis,
heart problems or back pain.
"What we are finding is that a significant
portion of older African-American women were
mixing prescribed, non-prescribed medications,
and herbal products such as garlic or
glucosamine, and not discussing this with their
health-care providers, which may possibly cause
adverse health effects," said Saunjoo Yoon, Jeanette Jackson, a par
Ph.D., R.N., an assistant professor at the College herbal use study, takes
of Nursing and the study's principal investigator.
"Even if the herbals are not dangerous, they may
not be necessary, wasting their money."
The researchers also compared them with older black women who did not use
herbal medicines and with the older white women previously studied.
Many were combining as many as seven herbs, prescription drugs and over-the-
counter medicines, a practice that may threaten to cause physical and financial
harm, the researchers say. Scientific studies increasingly show some herbs alter


ticipant
her dai


the way the body metabolizes other drugs,
triggering symptoms as severe as bleeding in the
brain or high blood pressure.
Ultimately, Yoon said, she would like to use
the study findings to educate health-care
providers about the importance of obtaining a
more complete medication history for all
patients, especially older ones. As part of that
effort, researchers aim to conduct a study with a
larger, randomly obtained sample of older black
women to confirm the findings and to ensure
they can be generalized to the population at
S i large.
"We found that both African-American and
Caucasian women use herbal products to manage
: their health, but African-American women were
much more likely to obtain recommendations
from friends, family and community members,
whereas Caucasian women were more likely to
read health magazines and watch health
in Dr. Saun-Joo Yoon's programs to find out about herbal medications,"
ily dosage of medication. Yoon said. "This is important because we find
that family and friends are more trustworthy
sources of information for African-American
women and can be used as a conduit of information in their communities."
Study findings "suggest that health-care providers specifically ask older women
what they use to manage their health, clearly inform them regarding self- and
health-care provider-prescribed treatments, and realize that all of their health
information does not come from professional health-care sources," the authors
stated in their paper.


Buddies make the best medicine

Size, strength of social networks influence heart disease risk

By Melanie Fridl Ross


Weight, cholesterol and blood pressure aside,
women might be wise to factor in yet another
barometer of heart health: the size and strength of
their social circle.
Casting a wide net when it comes to friends and
family appears to be associated with a dramatically
lower risk of suffering a heart attack or stroke,
landing in the hospital or dying from heart disease,
reports a national team of researchers from UF and
seven other institutions that studied 503 women
with chest discomfort. In contrast, women who did
not have strong relationships with others were
more than twice as likely to die as their more
sociable counterparts in the study, described in the
journal Psychosomatic Medicine.
The findings, gleaned from the Women's
Ischemia Syndrome Evaluation, build on more than
30 years of medical research that reinforces the
relationship between the mind and major illness.
Scientists know that married men and women live
longer, and they theorize that larger social


networks lessen disease risk by reducing negative
health habits such as smoking, by boosting immune
system responses and by yielding socioeconomic
benefits and greater social support to offset
emotional distress associated with illness.
The National Heart, Lung and Blood Institute-
funded study, however, is among the first to link
social isolation to increased risk of death in women
with suspected heart disease.
"It's important to recognize that for centuries
there has been a group that believes there's a strong
interaction between the mind and the heart,
though the exact relationships are not clear," said
Carl J. Pepine, M.D., chief of cardiovascular
medicine at the College of Medicine. "In my view,
the No. 1 take-home message is that if you're a
woman with chest discomfort, have a lot of
friends."
Marriage proved beneficial for women in the
study, but simply having one or two casual friends
also was associated with better health outcomes,


Pepine said. The larger the social circle, however,
the healthier the women were.
Study participants had signs characteristic of
coronary artery disease, such as chest discomfort,
and underwent a battery of tests to assess whether
they had blocked arteries. Most did not have severe
heart disease, but many did suffer from depression
or other forms of psychological distress. They also
completed standardized questionnaires designed to
quantify how many friends they had and how
frequently they engaged in social and recreational
activities. Researchers then tracked their health for
two to four years.
Researchers also found that women with smaller
social networks tended to weigh more and had
higher rates of smoking, diabetes, high blood
pressure and depression and were 2.4 times more
likely to die. Of the women studied, 30 died during
the follow-up period. Low income and heart disease
risk also were associated, particularly for women
earning under $20,000 a year.


7








RESEARCH


Beer-drinking rats know when

to stop snacking, unlike some people

By John Pastor


ports fans faced with frosty beers and stadium hot dogs
often act like a cleanup batter with the green light: They
.- 1,, F,, il
SIul Incight-conscious people should
hcd I hc humble rat, which stays trim by
inil tinl vely cutting calories when
ind bulging in alcoholic drinks, say
S!cearchers at UF's psychology
department and the Evelyn F. and
William L. McKnight Brain Institute.
Rats also know how to say no to the brew,
stopping at what would amount to two or three
drinks in most people, according to a paper in
Pharmacology, Biochemistry and Behavior. Many people
ignore the same instinct a shortcoming that can spell dietary disaster.
"Behavior in humans is complicated because we are bombarded by social and
marketing factors that stick food in front of our face every which way we turn,"
said Neil Rowland, a professor of psychology who studies the neural mechanisms
of obesity, eating disorders and alcohol abuse. "It's difficult to say no."
People cannot simply cut food calories while they're drinking without also
considering the effect it will have on their sobriety, researchers caution. But it's
also important that they consider the effect that drinking has on their waistlines.
A Centers for Disease Control and Prevention analysis shows Americans
consume more calories than they did 30 years ago. On average, women increased
their daily calorie consumption 22 percent between 1971 and 2000, from 1,542
calories per day to 1,877 calories. During the same period, men increased their
calorie intake 7 percent, from 2,450 calories per day to 2,618 calories.
UF scientists, who monitored the food, fluid and alcohol intake of six male and
five female rats over several days in three separate experiments, said their work
supports the idea that people don't consider the nutritional aspects of beer, liquor,
mixed drinks and even soft drinks.
"I think it tells people to watch what they are .
eating," Rowland said. "Outside factors are
overriding the natural signals that we've eaten "
enough or have had too much to drink. That's
not a novel concept, but it is a good description of
what's happening. Some folks stand by the chip bowl nJ r-d
consume a lot of food with their alcohol, when they r!nJ ..
think about drinks in general as components of their
energy intake. The rats can count these calories very ,. 1
People can be educated to think about these internal ir n
that the rats are so aware of, and eat one less sandwich
and have one less drink."
More than 50 years ago, scientists noticed that Americans
think of alcoholic beverages as a drug, not as a source of nutrition, Rowland said.
Since then, researchers have studied caloric compensation in humans and in
animals, noting that rats instinctively manage their weight by not eating as much
when they receive calories from alcohol.
But the rodent imbibing experience in previous experiments didn't parallel the
human one. Rats would drink the ethanol and water that scientists mixed for


them only if nothing else were available not the typical atmosphere you'd find
at a tailgate party. In addition, people usually prefer a variety of ingredients in
their drink selections, which makes the matter of assessing calories far more
complicated.
In the current study, UF researchers made alcohol more palatable by adding it
to decarbonated, non-alcoholic beer, which also allows scientists to precisely
measure the alcohol content. In a separate test they presented the alcohol mixed
into a sweet gelatin.
Both male and female rats cut back on their calories from food
and maintained a consistent intake of overall calories during the
experiments, even with access to plenty of food, fresh water and
palatable alcohol.


--
Psychologist Neil Rowland weighs a gelatin-alcohol mixture used in
experiments to determine whether rats effectively adjust their food
calorie intake while indulging in alcohol.


8
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RESEARCH


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M





Physiologist Dr. Zhongjie Sun has identified a gene that contributes to blood pressure increases
during cold weather.


Receptor helps hike blood pressure in cold weather

By Tom Nordlie


When winter arrives and temperatures drop, there's
one place the mercury actually rises in blood
pressure gauges.
A survival mechanism in people and other
mammals constricts blood vessels in cold weather, to
conserve heat and maintain body temperature. But
with less room for blood to move, pressure rises -
along with the risk of fatal heart attack and stroke,
which peaks during winter.
A UF study in mice published in the February
issue of the American Journal of Physiology -
Regulatory, Integrative and Comparative Physiology
shows, for the first time, that a receptor activated by
the vessel-constricting hormone angiotensin II helps
trigger cold-induced hypertension, said study co-
author Zhongjie Sun, M.D., Ph.D., an assistant
professor of physiology and medicine.
The receptor, known as angiotensin II receptor
type 1A, or AT1A, is part of the renin-angiotensin
system, which regulates blood pressure in mammals,
Sun said. Because there is at least one drug, losartan,
that blocks the receptors from receiving angiotensin,
it may be possible to design therapies that could save
lives in cold weather, he said.
"We plan to collaborate with clinicians to look at
blood pressure changes in hypertensive patients in
all four seasons and see if renin-angiotensin system


control is a good way to control cold-induced
hypertension," Sun said.
People especially at risk for cold-induced heart
attack and stroke include those who are already
hypertensive, and patients with health conditions
that require strict blood-pressure maintenance, such
as diabetes and chronic kidney disease.
Blood pressure, considered a key indicator of
overall health, is the force blood exerts against artery
walls. New, stricter U.S. guidelines issued in 2003
state that a healthy person at rest should have a blood
pressure below 120/80, according to the American
Heart Association. High blood pressure is defined as
140/90 or more.
In the study, 12 healthy mice were kept at a
constant 41 degrees Fahrenheit and experienced a 50
percent increase in blood pressure after five weeks,
Sun said. An experimental group of 12 mice that
lacked the AT1A receptor experienced only an 11
percent blood pressure increase under the same
conditions.
"That's not terribly cold," Sun said. "It's about the
average temperature of a Gainesville winter."
People can take simple precautions to help lower
risk, such as dressing in layers to conserve body heat,
easing into outdoor physical activity and avoiding
extreme exertion or heavy lifting, he said.


Genetics researchers

match DNA codes

with drug response

Medical science is continuing to work to find
ways to match drug treatments with a patient's
individual genes through a statistical method
being developed by UF Genetics Institute
researchers.
Writing online in the current
Pharmacogenomics Journal, UF statisticians
describe a model that may one day be used to
detect the subtle differences in individual DNA
codes that affect drug response.
"We want to derive a model that can be used
to identify genes associated with drug response,
because people may respond differently because
of varying genetic sequences," said Rongling
Wu, Ph.D., an associate professor of statistics
affiliated with the UF Genetics Institute and
the Institute of Food and Agricultural Sciences.
"This will help make it possible to test for a
specific DNA sequence in a patient and find out
whether the sequence may be associated with
sensitivities to a specific drug."
Wu and colleague Min "Annie" Lin, a
graduate student in the department of statistics,
used their model to analyze heart-rate
responses, DNA sequences and the cardiac
drug dobutamine in 107 patients. They found a
particular sequence of DNA in two patients that
corresponded to greater sensitivity to the drug.
Researchers hope the model will one day lead
to personalized medications based on each
person's genetic constitution.
The work is part of the International
HapMap Project, an international effort to
identify and catalog genetic differences and
similarities in human beings. The work builds
upon the Human Genome Project, which was
completed in 2003.
Where the Human Genome Project basically
identified the 20,000 to 25,000 genes and
determined the complex sequences of the
chemicals that make up human DNA, HapMap
seeks to make the results of genomic research
applicable to individuals.
HapMap's goal is to determine how the 3
billion bits of DNA in the human genome are
organized into sequence variations, or
haplotype blocks, shared by many people.
Using the information in the HapMap,
researchers will be able to find genes that affect
health, disease and individual responses to
medications and environmental factors.
John Pastor

For more information on the
International HapMap Project, see
http://genome.gov/10001688.


S 0414&9


























































Marilyn Walton, 78, enjoys the pond she tends at her home in Archer. She said she doesn't let Parkinson's disease slow her down.


By John Pastor


Marilyn Walton still recalls the day she glanced in the mirror and noticed her
head was bobbing. But she wasn't moving on purpose. It was as if she were
seeing someone else nodding slightly, over and over again. She'll never
forget the moment, even though it was 15 years ago.
"I wondered what in the world was going on," Walton says. "I asked my husband
about it. He said, 'You've been doing that for about two years.' I had never noticed."
Walton's husband and brother-in-law, both retired doctors, suggested that she
might have Parkinson's disease. Later, in the mid-1990s, a doctor in San Antonio -
one of many she had seen diagnosed Walton with essential tremor. Not Parkinson's
disease.
But the reflection in her mirror kept nodding.


A NEW UNDERSTANDING
Parkinson's disease is hard to identify. The symptoms rigidity, tremors, poor
posture, poor balance can be caused by anything from osteoporosis to old age.
After years of not being diagnosed correctly, Walton learned the truth at the


Movement Disorders Center at UF's Evelyn F. and William L. McKnight Brain
Institute and UF&Shands.
"Of course I was surprised when I found out," says Walton, who tends to her house
and three-acre farm, which includes a koi pond she and her husband built when they
moved to Archer from Texas more than eight years ago. "I didn't believe it for so long,
and I also had been to several neurologists who told me I didn't have Parkinson's. But
when I finally found out I did, I decided to go ahead and live with it. Sometimes I'm
not quite as steady, but I manage to get things done."
About a half million Americans struggle with Parkinson's disease, including former
Attorney General Janet Reno, former heavyweight boxing champion Muhammad Ali
and film star Michael J. Fox, according to the National Institute for Neurological
Disorders and Stroke. Pope John Paul II was recently hospitalized because of
breathing problems that were complicated by advancing Parkinson's disease.
But the disease is not the crippler it once was, according to Dr. Michael Okun,
M.D., a neurologist and co-director of the Movement Disorders Center.
Furthermore, doctors now realize they must take a more comprehensive approach
to care. They must consider the social problems patients face because of their


cio










symptoms, which include whisper-soft voices, expressionless faces and poor mobility.
Simply put, patients get the blues.
"Here's the old way," says Okun, who determined Walton had Parkinson's disease.
"A doctor would say, 'Well, we think you've got Parkinson's disease. Here is a
prescription and good luck. By the way, five years down the road, you're going to
develop complications because of the medicine, but we're not going to offer you any
medical or surgical ways to deal with those complications."'
"That's just not the way we approach the disease anymore," says Okun.
Low energy, helplessness, poor quality of life the often-ignored aspects of
Parkinson's disease that Okun calls the "dwindles" are addressed clinically as well
through the center's research program. Even now, with support from the Michael J.
Fox Foundation, scientists are investigating whether doses of the hormone
testosterone can curb some Parkinson's disease symptoms.
"In general, when people come to us, they feel lousy," Okun says. "Every minute of
the day, their gas tanks feel half empty instead of half full. If we can make them feel
better, their outlook is different, even though their motor function may be unchanged.
They become just fine."


THE SHAKING PALSY
An English physician named James Parkinson first described Parkinson's disease in
1817. In an essay called "The Shaking Palsy," Parkinson described "involuntary
tremulous motion, with lessened muscular power ... with a propensity to bend the
trunk forward, the senses and intellect being uninjured."
The disease arises when cells die in an area of the brain known as the substantial
nigra. These cells produce a vital brain chemical known as dopamine, which carries
messages that tell the body how and when to move. When there is no longer enough
dopamine to carry brain messages, speech and walking become difficult. People


become stiff, and their dependence on others rises dramatically.
During the greater part of two centuries, Parkinson's was
fatal. But in the 1950s, scientists discovered in experiments
with animals that when dopamine was not present, the
animal had movement problems. So they wondered if putting
dopamine back would fix the problems.
That led to the gold standard of present therapy, the drug
levodopa. A simple chemical found naturally in plants and
animals, levodopa enables nerve cells to replenish the brain's
dwindling supply of dopamine, sidetracking the destructive
course of the disease.
In fact, people who have Parkinson's today generally live
just as long as people who don't have it. The catch: Most
people who take levodopa after about five years develop
flailing movements that many people think are symptoms of
the disease, but which are actually a side effect of the drug.


SEARCHING FOR SOLUTIONS
Scientists such as Ron Mandel, Ph.D., and others at the
McKnight Brain Institute, the UF Genetics Institute and the
Program for Stem Cell Biology and Regenerative Medicine
continue to look for ways to protect the brain or repair
damage.
Working with internationally renowned Parkinson's expert
Anders Bj6rklund and neurobiologist Deniz Kirik, of Lund
University in Sweden, UF brain and genetics researchers used
gene therapy to renew brain cells and restore normal
movements in monkeys with a drug-induced form of
Parkinson's disease.
The research, detailed online in January in The Journal of
Neuroscience, essentially describes a strategy to halt
Parkinson's disease at its onset. By inserting corrective genes


Dr. Nicholas Muzyczka
Ron Mandel, research
McKnight Brain Institut
Genetics Institute, were
international team of s
gene therapy in two se
renew brain cells and r
movements in monkeys
drug-induced form of
disease.


Dr. Michael Okun, Dr.
Kelly Foote and Dr.
Hubert Fernandez of the
UF Movement Disorders
Center at the McKnight
Brain Institute lead an
interdisciplinary team
dedicated to treating and
researching Parkinson's
disease and similar
disorders.


into the brain via a commonly
occurring virus, scientists
prevented brain damage by
producing therapeutic levels of
GDNF, short for glial cell
line-derived neurotrophic
factor, a protein that nourishes -
brain cells.
By introducing the
promising protein via gene therapy, researchers are causing the body to produce it
naturally at manageable levels, potentially avoiding difficulties scientists elsewhere
have encountered when working with the molecule.
"Our strategy is a neuroprotective concept and would only be amenable for early
stage patients to keep a good quality of life. It would be a huge change in the way
treatment is done," says Mandel, an associate professor of neuroscience in the College
of Medicine. "We know GDNF protects the neurons in
primates from the model that we use, so that's good. We
now know we can use very low doses that are still effective,
so that's good. But we need a safety net. Once we turn it on,
it's on for life. So we have to control it, and we're working on
this as we speak."
Meanwhile, in an article soon to appear in the print
edition of the journal Brain, researchers describe a strategy
to treat the devastating side effects that occur when treating
the Parkinson's in its later stages.
Using gene therapy once again, researchers completely
reversed abnormal movements called dyskinesias in some of
the rats, suggesting a new way to combat the flailing
movements produced during drug treatment for Parkinson's
disease.
"Levodopa generally works great for several years, but
then it actually starts creating movement problems,"
S Mandel says. "Our idea is that instead of taking pills that
create detrimental fluctuations of L-dopa levels, a
continuous, therapeutic dose would be better for you."
The next step in the evolution of therapies may involve
(left) and Dr the introduction of genetically engineered stem cells into
rs with UF's the brain using the delivery viruses pioneered by UF
Sand the UF genetics researchers. Stem cells, whether they already live
e and the UF
in our bodies or come from donors, have a natural ability to
part of an
s t u target and repair an injured site. The challenge is to direct
scientists that used
the cells and boost their performance.
parate studies to ,
e The home run is a drug or combination of drugs that
store normal
will, as any cell starts to die in your brain, activate your own
3 and rats with a indigenous stem cell population," says Dennis Steindler,
Parkinson's Ph.D., executive director of the McKnight Brain Institute.




U U *Owr 11


- -








EDUCATION


New COM honorary recognizes compassion

By Tom Nordlie


Senior medical students pose with Mrs. Chapman and Dr. Robert Watson (upper left) after their


induction, held Feb. 2 at the J. Wayne Reitz Union.


ood bedside manner is perhaps the only
medical treatment that always helps.
A physician's thoughtful words and
deeds can reassure patients and their families, or
provide comfort when science offers little hope.
These ideals guide The Chapman Humanism
Society, a College of Medicine honorary that
recognizes medical students, residents and faculty
for exemplary compassion.
The society, which inducted its third class in
February, demonstrates UF's commitment to
producing well-rounded physicians, said Robert
Watson, M.D., the Jules B. Chapman M.D. professor
in clinical care and humaneness, a professor of
neurology and the college's senior associate dean for
educational affairs.
"It's terrific to be recognized for academic
progress," said Watson, one of the society's
founders. "But the thing we're missing from
medicine is not how smart we are, but how kind
we are."
This year's inductees included 19 senior medical
students, five residents and three faculty members -
Watson, Eloise M. Harman, M.D., a professor of


This year marked the first time the society
inducted residents, using a process similar to the
one already in use for faculty inductions, said
McCormack, a selections committee member and
recent inductee to the Gold Humanism Honor
Society. Candidates are nominated by peers,
supervisors or Chapman Humanism Society
members and selected by a committee drawn from
the society's members.
Regardless of their place in the academic world,
all candidates must demonstrate the same character
traits sound moral reasoning, respect for others,
patient advocacy, communication skills, learning
ability and commitment to humanistic goals.
"We're trying to show the rest of the community
'these are your role models, these are the people that
you want to be like,"' McCormack said.
The society's ultimate role model is its namesake,
the late Jules B. "Chappie" Chapman, M.D., a
Florida native who earned his undergraduate degree
at UF in 1932 and his medical degree from the
University of Tennessee, Watson said.
Trained as an ophthalmologist, Chapman spent
most of his career in the U.S. military, said Annie
Lou Chapman, who was married to Dr. Chapman
from 1940 until his death in 1991.
Dr. Chapman was a humble man who always
treated patients kindly, Mrs. Chapman said. When
they met he was a resident and she was a nurse at
Jackson Memorial Hospital in Miami, and she had


medicine and Patrick Duff, M.D., a professor of
obstetrics and gynecology.
The society's parent organization, the Gold
Humanism Honor Society, boasts chapters at
42 universities, said Wayne McCormack, Ph.D.,
a UF associate professor of pathology,
immunology and laboratory medicine. He is
one of The Chapman Humanism Society's
faculty advisers and founders. Only four other
institutions established chapters of the Gold
Society before UF.
About 15 percent of UF senior medical
students are invited to join The Chapman
Humanism Society each spring, he said.
Selections, made by a committee of UF medical
education experts, are based primarily on peer
evaluations.


Mrs. Annie Lou Chapman
congratulates fourth-year medical
student Maryam Rahman on her
induction to the Chapman Humanism
Society.


CI~








EDUCATION


Training a new kind of nurse

begins in summer 2005

By Tracy Brown Wright

How do you tackle the nursing shortage and patient-care crisis when the number of nurses falls far
short of those needed to work in the increasingly complex health-care settings of the future? The
answer: Educate a new kind of nurse.
As part of a national pilot program beginning in summer 2005, the College of Nursing will admit its
first class of students to become that new kind of nurse, the clinical nurse leader.
UF is among 74 participating colleges nationally that was chosen to pilot the CNL program. UF's five
practice partners include UF&Shands Gainesville, UF&Shands Jacksonville, the Malcom Randall
Veterans Affairs Medical Center, Wolfson's Children's Hospital in Jacksonville and Baptist Medical
Center in Jacksonville.
The CNL will be a master's degree-prepared generalist clinician who effectively coordinates,
manages and evaluates care for individuals and groups of patients, and functions as part of the client's
health-care team.
"Nursing education must attract and retain the best clinical nurses for our health-care settings," said
Kathleen Ann Long, Ph.D., A.PR.N., F.A.A.N., dean of the College of Nursing. "The new CNL
program will attract nurses who want to advance their knowledge and abilities while retaining a focus
on direct patient care."
The national CNL pilot program was developed by the American Association of Colleges of Nursing,
in consultation with its members, nursing practice leaders, regulators and other health professions.
The CNL program is a 15-month full-time graduate program that culminates in an intensive
residency on model units at each of the college's practice partner sites. Students will have both faculty
members and clinical mentors to guide them through the residency.
The College of Nursing will admit the first class of CNL students this summer on both of its
Gainesville and Jacksonville campuses. Potential students are expected to be recent BSN graduates and
experienced BSN nurses.
Graduates will be eligible to sit for the CNL national certification examination. Future plans for the
CNL include a new legal scope of practice and professional license.

To learn more about the master's CNL track, visit the College of Nursing Web site,
www.nursing.ufl.edu, or call (352) 273-6366 in Gainesville
or (904) 244-5166 in Jacksonville.


Mrs. Chapman congratulates internal medicine
resident Dr. Rahul Aggarwal on his induction as
Dr. Wayne McCormack looks on.


Women in medicine
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many opportunities to see him interact with others.
"I admired Chappie for his compassion," Mrs. Chapman said. "He didn't think about himself first, he
thought about others."
During the final years of Dr. Chapman's life, the couple was dismayed to find that some of the physicians
who treated Dr. Chapman were brusque and uncommunicative, Mrs. Chapman said. Consequently, they
decided to fund educational projects at the College of Medicine. Dr. Chapman died shortly afterward.
Today, Mrs. Chapman supports numerous efforts at the college, including the endowed professorship Watson
holds, a student scholarship and The Chapman Humanism Society, which was launched in 2003, Watson said.
In appreciation, the college has renamed its education center which comprises four offices and the Harrell
Professional Development and Assessment Center the College of Medicine Chapman Education Center.
"And in every way we can, we infuse this idea of humanism and professionalism and altruism throughout the
environment of the college," he said.
Student members of the society demonstrate their commitment to humanistic ideals via a service project
carried out during senior year, said Nina Stoyan-Rosenzweig, Ph.D., the UF Health Science Center archivist
and a Chapman Humanism Society faculty adviser. This year's project is an after-school program for Alachua
County high school students, giving them an inside look at the college.
Offered in March, the program is titled "Teaching the Art and Practice of Medicine," she said. Its goal is to
foster students' interest in health care careers.
"We especially want to encourage students who are members of minorities that historically have been
underrepresented in health-care professions," said Stoyan-Rosenzweig, a recent Gold Society inductee who,
along with McCormack, helps coordinate the project. "Efforts to increase minority representation not only
lessens that disparity, it also can help provide better health-care to all Americans."


I


13








PATIENT CARE


Culture Clash:


Kids with chronic illness face difficult transition to adult care

By Denise Trunk


or young patients who grow to adulthood with
a chronic illness, leaving behind the
pediatrician who may have saved their lives
can be a tough transition.
More than half a million children with special
health-care needs will turn 18 this year, the first
generation to reach adulthood since sweeping
medical advances ensured an unprecedented
number would survive congenital conditions that
until recently would have killed them. The influx is
straining an already burdened health-care system,
and patients and their physicians are feeling the
added stress, according to a study by researchers at
the UF's Institute for Child Health Policy appearing
in the current issue of Pediatrics.
"We are looking at the very beginning of that












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rl use


Susan Horky, a faculty social worker in the
pediatric pulmonary division at the College
of Medicine, discusses the transition to adult
medicine with Chad Brady, 17, a cystic
fibrosis patient, in early February. Horky
explains a questionnaire designed by Dr.
John Reiss, policy and program affairs chief
at UF's Institute for Child Health Policy, to
survey the experience of young adults with
chronic illness as they leave pediatric care
and transition into adult medicine.


wave, because this is the first generation to turn 18
since the technology and treatments have allowed
them to survive to adulthood," said lead researcher
John Reiss, Ph.D., policy and program affairs chief
at UF's Institute for Child Health Policy. "That
number will grow, and this will put phenomenal
pressure on adult medicine."
Doctors liken it to a culture clash, as adolescents
and families adjust to a very different style of health
care.
Young patients must say goodbye to the
physicians they trust and who often took a team
approach to their care by incorporating the opinions
of many specialists to optimize a treatment plan for
ailments such as cystic fibrosis, sickle cell disease or
congenital heart conditions. Many adult
practitioners tend to work more independently and
are less familiar with how to manage these complex
cases because they haven't routinely encountered
them in standard practice. The issue can be costly
for patients, both physically and financially, said UF
research associate Robert Gibson, Ph.D.
"It is like waking up in France one day," Gibson
said. "You don't speak French and you have no idea
how to get around the city and you say, 'Wait a
second. How did I get here?'"
Pediatric hospital systems or practices generally
stop serving patients at the ages of 18 or 21, and
about 600,000 patients with chronic illnesses are
now reaching adulthood every year, Reiss said.
Nearly 40 percent of the patients living with
childhood-onset cystic fibrosis, for example, are 18
or older, according to the Cystic Fibrosis
Foundation's National Patient Registry. As these
patients age, their care can be complicated by
reproductive issues and other ailments, such as
diabetes.
Past studies have shown the transition isn't easy
even for the average healthy adult often because
of lack of insurance and many drop out of the
health-care system until they become sick. However,
a smooth shift is vital for young adults with chronic
illness, who cannot afford to experience a lapse in
care, Reiss said. Yet these patients often must switch
doctors at a time when they, too, are least likely to be
covered by health insurance, in part because of their
higher rates of underemployment and
unemployment.
Until recently, physicians may have handled one
or two such individuals a year, and it was possible to
work around the system, Reiss said.
"You didn't need to think about a population-
based approach to handling the problem. You could


take an individual patient-based approach," Reiss
said.
To learn how patients move into adult medical
care, UF researchers conducted 34 focus groups,
involving 143 patients, families and health
providers, to gather information about participants'
experiences with health-care transitions. Study
participants also answered questions about which
factors made transitions successful or unsuccessful.
Researchers said many patients reported
differences in care, such as difficulty in receiving
adequate pain relief after making the transition into
adult practice. Others were concerned about quality
and comprehensiveness of care; some were the first
patient their adult physician had ever seen with
their particular health condition.
Researchers also found that a mutual trust forms
among pediatric patients, their families and their
health-care providers. Saying goodbye to the doctor
who has handled their care since they were
diagnosed can be difficult for patients, and that
bond can present a barrier to effectively
transitioning into adult-oriented medicine. Patients
and families surveyed said they perceived pediatric
staff to be more available for questions and
emotional support.
Patients and families whose outlook focused on
the future were more likely to experience a smooth
transition, the study showed. Gibson, who
conducted the study's data analysis, said it was
necessary for patients and their families to look at
the change as part of the developmental process.
"The people that we talked to who were most
successful understood transition from the moment
the child received the diagnosis," Gibson said. "Just
like with a healthy child, you anticipate they are
going to go to college or live independently in a
community. There are things you do
developmentally throughout their childhood to
prepare them for that early on."
UF researchers say the results suggest the medical
community may need to create a more consumer-
friendly medical system that would break down
barriers to age-appropriate care, improve doctor-
patient communication and incorporate a protocol
for handling the transition, Reiss said.
Educating patients, their families and medical
personnel is necessary to address the needs of this
growing population of special needs patients, Reiss
said.
"It may require the medical system to reorient
itself toward the needs of patient, rather than the
provider," he said, "to the benefit of everyone."


14
II~








PATIENT CARE


Medical students spread free health care

By Denise Trunk


Patient Tobias Bellar describes his
symptoms to pre-med student,
Rhiannon Smith, in the Family
Practice Medical Group building
during the college of medicine's
free Equal Access Clinic. Students
offer medical care as well as
dental care referrals from 6 to 9
p.m. each Thursday to an average
of 20 low income and indigent
patients.


Speaking to peers and professors from across the nation, two
UF medical students, Karen Bodnar and Jessica Versage,
described the College of Medicine's student-run free medical
clinic and answered questions about its operation.
The two acting clinic co-directors made their January
presentation on features of the Equal Access Clinic to the 31st
Annual Pre-doctoral Education Conference of the Society for
Teachers of Family Medicine. The presentation was part of a
session to provide information to universities and medical
colleges who may want to begin student-operated clinics of
their own.
"The audience had questions, and it was kind of a give and
take presentation," said Versage, a second-year medical
student. "Other students talked about how they run their
clinic, and it helped us with ideas on how to run our clinic
better."
The students presented data that included a summary of
the patients how many are homeless, number with
psychiatric problems, and dependency on alcohol or drugs at
their clinic in downtown Gainesville.
The equal access clinic is one of about only 20 among the
nation's 120 medical colleges and universities. The clinic is
run entirely by students, with volunteer faculty supervising
clinical care. David Feller, M.D., of the Department of
Community Health and Family Medicine, is faculty advisor
for the clinic. Feller and Rob Hatch, M.D., contributed to the
presentation.
Established by UF medical students in 1992, the weekly


clinic is open in the Family Practice Medical Group building,
at the corner of Southwest Fourth Avenue and Southwest
Sixth Avenue, at 6 p.m. each Thursday to provide an average
of 20 people a night with medical care as well as dental care
referrals.
With 33 percent of Alachua County's population of 215,414
below the federal poverty level, according to the Department
of Health, the students perform a vital community service.
Pre-med students, medical students, attending physicians
and residents volunteer to staff the clinic. Specialty clinics in
psychiatry, pediatrics and women's medicine are offered on
one Thursday each month.
Much of the equipment and medical supplies are given to
the clinic. HIV testing is donated by the Alachua County
Health Department. The Alachua County Commission
recently voted to give proceeds from the quarter cent sales tax
to fund the clinic, Karen Bodnar said.
As details ofUF's Equal Access Clinic were discussed at
the recent conference, Versage said, students talked seriously
about starting clinics at their own medical schools.
That did not surprise Versage, who said she and the other
students involved in the clinic are interested in developing
and applying their skills in a useful way.
"Something gets swallowed up in doing school work," she
said. "This is a way for students to enhance their education
and this reminds you why you are in medical school in the
first place."


The VA given near-perfect score
on patient research oversight

The research program of the North Florida/South Georgia Veterans
Health System, which includes Gainesville's Malcom Randall Veterans
Affairs Medical Center and its affiliated UF departments, has recently
received top marks for its oversight of human patient research by an
independent auditing agency.
The National Committee for Quality Assurance awarded a 99.7
percent score and a full, three-year accreditation to the VA and
associated UF departments for its human research programs. It was
the first ever audit since new federal requirements mandated them.
"Our near perfect score reflects well on the teamwork and the
cohesiveness of the group of investigators and staff," said Charles
Wingo, M.D., associate chief of staff for research and development
for the NF/SG Veterans Health System. "It is a reflection of the
stellar effort in performing high-level research at the VA hospital and
affiliated university."
About 77 percent of the accreditation survey involved the
On han,
Institutional Review Board, which oversees all human subjects research
at UF and the VA, and the rest focused on the VA Research Service. Phillips,
Together the two groups prepared for more than a year and a half for
their first review.
Kristine Wynne, coordinator for research programs and services,
spearheaded the project for the IRB. Katie Yeckring, research compliance officer,
handled the process for the VA.
Yeckring said preparations began with the agreement that the ultimate goal was
the assurance that the human patient would benefit from the process.
"One of the actual accolades we received from the NCQA was that the VA has a
seamless relationship with the IRB and works so well with the affiliate university and


d for the presentation of the certificates were Peter lafrate, Fred Malphurs, Win
Charles Wingo and Brad Bender.



IRB," she said.
The review focused on the actual process of approving patient research to be sure
it met federal guidelines.
"This reaffirms the IRB does what we thought we should be doing," said IRB
Chairman Peter lafrate, Pharm.D. "It lets others know that we are running a
good IRB."
Denise Trunk

15


" '''--








DISTINCTIONS


RAPHAEL EUPPAH, the 2005 Cunningham
International Fellow of the Medical Library
Association, will study at the HSC Libraries from
Feb. 25 to Mar. 12. Euppah is head of the Nairobi
Hospital Library in Kenya, a small library with 43
medical journal subscriptions, about 3,000 older
textbooks and five computers. While here Euppah
hopes to gain useful knowledge about database
creation, maintenance and other electronic
information access strategies. The four-month
Cunningham fellowship is designated for health
science librarians from countries outside the
United States and Canada to study and work in
several American health science libraries.



SHAHLA MASOOD, M.D.,
a professor and associate
chairwoman of pathology,
receivedthe2005NFLPlayers'
Wives' "Women's Medical
Miracle Worker" award Feb.
4. Masood, one of nine
Jacksonville women honored
for making a difference in
their community, received the
award for her "pioneering work in breast cancer
diagnosis and treatment" at the group's annual
Super Bowl Fashion Extravaganza, held on the
cruise ship Miracle.


STEVEN GHIVIZZANI,
Ph.D., an associate profes-
sor of orthopaedics and
rehabilitation and of molecu-
lar genetics and microbiology,
has received a Kappa Delta
Award, one of the most pres-
tigious honors in orthopaedic
research.


Ghivizzani, a molecular
orthopaedics researcher, and colleague Paul
Robbins, Ph.D., of the University of Pittsburgh,
received the Ann Doner Vaughan Award for
their collaborative investigations of gene delivery
approaches to the treatment of orthopaedic
disorders. The award was presented at the
Orthopaedic Research Society annual meeting
Feb. 22 in Washington, D.C.

KELLI KOMRO, Ph.D., M.P.H.,
a UF associate professor of
epidemiologyand health policy
research, has been appointed
to the scientific committee
of the United Kingdom's
National Prevention Research
Initiative, a multidisciplinary
project aimed at improving
prevention strategies to fight
cancer, coronary heart disease and diabetes.
Komro, who arrived at UF from the University of


Minnesota in October, will contribute to the five-
year, $23 million effort by evaluating proposals
for disease prevention research funding.


ZHONGJIE SUN, M.D.,
an assistant professor of
medicine and physiology and
functional genomics, is editor
of "Molecular Cardiology:
Methods and Protocols."


Moleula


The text, recently published
by Humana Press, details
gene therapy and stem cell
techniques for studying and
treating genetic and acquired heart diseases.
Molecular cardiology is a new discipline that aims
to apply molecular biological techniques for the
investigation, diagnosis, prevention and treatment
of cardiovascular disease.


1 P


DAVID FREEMAN, M.V.B., Ph.D., associate chief
of staff of the Large Animal
Hospital and service chief
of large animal surgery,
presented the Sir Frederick
Hobday Memorial lecture
at the Dec. 15 meeting of
the British Equine Veterinary
Association in London.
Freeman spoke on advances
in diagnosis and treatment of
colic.


I


WENDY STAV, Ph.D., a
research assistant professor in
thedepartmentofoccupational
therapy, has been selected to
serve on the American Society
on Aging's DriveWell National
Experts Speakers' Bureau for
promoting older driver safety
and mobility. She will serve
as a resource on older driver
issues for the Southeastern United States.



CLAUS D. BUERGELT,
D.V.M., Ph.D., a professor of
pathology, recently received
the 2004 Charles Louis Davis
Foundation's Harold W. Casey
Teaching Award.
The award is given to recog-
nize distinguished teachers of
veterinary pathology and was
presented during the November
annual meeting of the American College of
Veterinary Pathology in Orlando.

COLIN BURROWS, B.Vet.
Med, Ph.D., chairman of
the College of Veterinary
Medicine's department of
small animal clinical sciences
and chief of staff of UF's Small
Animal Hospital, has received
the 2005 Royal Canin Award
from the American Animal
Hospital Association.
Royal Canin, formerly known as Waltham, gives
the award to recognize outstanding contributions
by a veterinarian that have resulted in improved
well-being of companion animals in the
international veterinary community.
The award is presented each March during the
association's annual meeting in Baltimore.


HILLARY HART, sophomore veterinary student,
and EDWARD MACKAY, veterinary graduate
student, received top honors for a poster they
developed during the recent annual meeting of the
American College of Veterinary Ophthalmologists
in Washington, D.C.
The poster described the discovery of a protein
associated with inherited glaucoma in dogs.
Identification of the protein and the genetic
mutation that produces it could lead to a better
understanding of the mechanisms that gradually
elevate fluid pressure within the eye in both dogs
and man.


ELIZABETH A.
SHENKMAN



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DISTINCTIONS


Major pediatrics research award goes

to UF gene therapy pioneer Flotte

By Tom Nordlie


F pediatrics chairman and gene therapy expert Terence R. Flotte,
M.D., is being recognized for his research efforts with one of the
most prestigious awards in pediatrics.
The Society for Pediatric Research has named Flotte, a UF Nemours
eminent scholar, professor of pediatrics and a professor of molecular
genetics and microbiology, a 2005 recipient of the prestigious E. Mead
Johnson Award for Research in Pediatrics.
He will receive the award May 16 at the Pediatric Academic Societies'
annual meeting in Washington, D.C.
The Johnson award is one of the most competitive academic honors,
said Douglas Barrett, M.D., UF senior vice president for health affairs and
immediate past chairman of the UF pediatrics department.
"It's an outstanding recognition of the impact of Dr. Flotte's work by
the nation's academic pediatric community," said Barrett, who also is a
professor of pediatrics. "He has made major contributions to the fields of
genetics, gene therapy and childhood lung diseases such as cystic fibrosis.
We are fortunate indeed to have Dr. Flotte as a leader within UF's College
of Medicine."
Flotte is perhaps best known for his pioneering work on gene therapies
for cystic fibrosis and alpha-1 antitrypsin deficiency, which were the first
to use the apparently harmless adeno-associated virus, also known as
AAV, as a vehicle to transport missing genes to cells.
Cystic fibrosis, which affects about 30,000 U.S. children and adults, is a
lung disorder in which bronchial tubes produce excessive amounts of
thick mucus, interfering with respiration. Patients with alpha-1
antitrypsin deficiency lack a lung-protective protein normally made in the
liver and can suffer serious lung infections. One of the most
underdiagnosed conditions, it strikes about 100,000 Americans.
Clinical trials currently are under way on gene therapy treatments for
both conditions. Ongoing efforts are pushing AAV-based gene therapies
for other genetic defects and for diabetes closer to clinical application,
Flotte said.
"To me, this award is a recognition of our team's efforts to bring the
power of molecular biology directly to bear on the health and well-being
of children and adults with genetic diseases," Flotte said.
Presented annually since 1939, the Johnson award recognizes
individuals whose recent work has contributed significantly to the overall
field of pediatrics, according to the Society for Pediatric Research. The
award is presented to two researchers each year.
Flotte joined the College of Medicine faculty in July 1996 as an assistant
professor of pediatrics and molecular genetics and microbiology.
Promoted to associate professor in August 1998 and professor in July 2001,
he has served as pediatrics department chairman since July 2002.
"He's had remarkable success at both bench and bedside," said diabetes expert
Desmond Schatz, M.D., a UF professor of pediatrics. "Dr. Flotte has brought
national and international recognition to the gene therapy program and the
department of pediatrics at the University of Florida."
Flotte is an assistant program director for the UF General Clinical Research
Center and is affiliated with UF's Evelyn F. and William L. McKnight Brain
Institute, and previously directed both the UF Genetics Institute and the UF
Powell Gene Therapy Center.
Since arriving at UF, Flotte has secured research grants totaling more than $11.5


million in funding. He holds four gene therapy-related patents, and during his
career has published about 100 research studies and 11 book chapters.
"The work which is being recognized (by the Johnson award) would not have
been possible without the ongoing support of a number of key leaders and groups
within our UF community," Flotte said.
Flotte is the second UF pediatrician to receive the award. The first was Richard
T. Smith, M.D., the College of Medicine's founding chairman of pediatrics, who
received it in 1963. Smith was honored for his research in pediatric immunity,
notably his demonstration that newborn babies are able to produce disease-fighting
antibodies.



c17)


-- -----









DISTINCTIONS


Iraqi veterinarians soak up information at conference, visit to UF


Two Iraqi veterinarians say not to believe everything
you see in the news.
Positive change is occurring in Iraq, and
opportunities for continuing education are present
now that were never possible under Saddam Hussein,
say the two men whose recent presence in Florida was
cited as evidence.
Drs. Antoon S. Antoon and Bilal Abdul-Jabbar
visited the College of Veterinary Medicine Jan. 14 for
brief appointments with various faculty members after
attending the North American Veterinary Conference
in Orlando.
They returned to Iraq the next week with equipment
and thousands of dollars worth of books donated by
NAVC board members.
Ken Braun, professor emeritus of large animal
medicine at UF, met with the men and gave them
a colostrometer to take back with them. Professor
emeritus Paul Nicoletti, D.V.M., who has traveled to
Iraq and once worked in the United Arab Emirates,
shared information about brucellosis, one of several
diseases regularly encountered in food animals in the




A TEAM APPROACH
It's the mix of therapists, neurosurgeons,
neurologists and basic researchers, combined with
patients who volunteer for experimental treatments,
that will cure Parkinson's disease, says Hubert
Fernandez, M.D., who joined founding directors
Okun and neurosurgeon Kelly Foote, M.D., as a co-
director of the Movement Disorders Center in
October 2003.
Faculty members ranging from speech pathologists


Sarah Munson, the administrative clinical and
research director for the UF Movement
Disorders Center, interviews Alma Holcomb,
72, about essential tremor, a disorder that often
runs in families and causes involuntary
trembling. Holcomb believes it is important to
increase public awareness of essential tremor
and other movement problems.


Middle East.
NAVC offered full scholarships to Antoon, who
is a professor in the department of microbiology at
the Al-America in Baghdad's College of Veterinary
Medicine, and Abdul-Jabbar, who describes
himself as a liaison between Iraqi and American
veterinarians.
With help from United States military
veterinarians and a great deal of effort and
expense on their own part, the two Iraqis were
able to get their visas approved to make the trip.
Antoon consults with dairy farmers in the
Baghdad area. He said he learned a lot about
large animal viral and bacterial disease "because
under Saddam, we had virtually a scientific
boycott."
"The Americans have helped very much to
rebuild the veterinary college in Baghdad,"
Abdul-Jabbar said, adding that looters made off with
everything from wiring to carpet.
The men said large animals, particularly cattle,
sheep and horses, together with poultry, make up




to psychiatrists and more than 30 residents and
students are affiliated with the UF Movement
Disorders Center, offering an array of patient
treatments and research capability. Furthermore, UF
is one of 60 institutions involved in a multicenter
trial sponsored by the National Institutes of Health
that is investigating different neuroprotective agents
for Parkinson's disease.
"No matter what the disease, almost all cures are
stumbled upon during the process of looking for the
cure," Fernandez says. "So when you increase traffic,
you increase the chance of someone stumbling into
the magic formula. That's why it's favorable to have
so many scientists working from different angles."
In the meantime, Parkinson's patients and families
should allow themselves to hope, researchers say.
"Whether 10 years from now we're actually going
to take something off the shelf, tell someone, 'OK,
you have Parkinson's but don't worry about it, you're
going to die from something else before you die from
this,' I don't know," says Nicholas Muzyczka, Ph.D.,
an eminent scholar and professor of molecular
genetics and microbiology. "In principle, what we see
in animals says we will have that within a 10-year
time span."

RELIEF TODAY
It wasn't the typical request to open your mouth and
say "ah."
This occasion called for a group response. Urging
it on was Neila Donovan, a speech language
pathologist and doctoral student in the College of
Public Health and Health Profession's rehabilitation
science doctoral program. The room was filled with
members of Gainesville Parkinson's Support Group.


Two Iraqi veterinarians who visited the college
Jan. 14, Dr. Bilal Abdul-Jabbar and Dr. Antoon
S. Antoon.


most of Iraq's animal industry. Few people focus on
small animals or have pets, although that mentality is
slowly changing, they said.
"When we have good security, more people will
have pets," Antoon said.
Sarah Carey


"Get big, get loud, muster your breath," Donovan
cajoled.
Parkinson's patients and their family members
traded wary glances. Then out it came, on cue, a
group "Ahhh."
Donovan was pleased.
"This builds lung capacity and vocal cords," she
explained. "The muscles of respiration that's the
power of your voice."
In the audience was Alex Macgregor, M.D., a
former UF assistant professor of surgery who was
diagnosed with Parkinson's disease in 1995. At the
time, he had a thriving surgical practice and was an
authority on gastric bypass in the Southeast.
"I remained independent for a couple of years," he
smiles, speaking in the whispery tones common to
many Parkinson's patients. "Eventually I got to the
point where I couldn't walk on my own."
Neurosurgeons from the College of Medicine
began treating Macgregor in 2000. William
Friedman, M.D., chairman of neurosurgery,
performed a brain operation called a pallidotomy,
which relieved some tremor in Macgregor's right
hand and improved his speech and walking.
Immediately after the Food and Drug
Administration approved an experimental procedure
called deep brain stimulation in 2002, Foote
performed the first of two surgeries on Macgregor.
"It went without a hitch and we were home the
next morning," says Christine Macgregor, who
introduces support group speakers while her husband
watches from the audience.
Was it worth it?
Macgregor speaks in his gentle voice: "I'll walk
today."


18
II~








PROFILE


Easing students into medicine


Robyn Sheppard helps med school applicants find their way

By Tom Nordlie


t's Interview Day again at the College of Medicine, and Admissions Director
Robyn Sheppard is clearly having fun.
She sails happily into a conference room and greets a group of 20 medical
school candidates, part of the 325 or so she'll see as the college selects its Class of
2009.
The candidates, impeccably dressed, are braced to begin a full day of events
that will help determine whether UF's program is a good fit for them and vice
versa. Though they are among the 15 percent of applicants who have made it this
far, they're probably nervous about the one-on-one interviews scheduled for the
afternoon.
Sheppard, along with admissions Program Assistant Denise Chichester and
Financial Aid Administrator Eileen Parris, launches into an hour's worth of pep
talk and rapid-fire presentations about the college and options for financing a
medical education.
All three women are so jovial and informal that an observer could almost forget
this is a pivotal day in the candidates' lives. That's no accident, Sheppard said.
"Today is the only time these kids are scheduled to be here in person," she said.
"The day is structured the way it is to try to get them to relax."
Relaxed candidates are more likely to be themselves and open up to
interviewers, Sheppard said. And if the admissions team can help these future
physicians feel good about their visit, they're more likely to make UF their top
choice.
Afterward, the group visits several of the college's notable facilities and then
breaks for lunch. They finish their meal while hearing from several longtime
faculty members who share their feelings about the college and the medical
profession.
All morning, Sheppard and Chichester lead the group from site to site, keeping
the mood light and the energy level high. At 1 p.m. they get a well-earned break
as the candidates troop off to begin their interviews and tour the college and
UF&Shands clinical facilities. Barring any lost students or other minor crises,
things will be quiet around the admissions office until 5 p.m., when the day
concludes with closing remarks from Medical Selection Committee Chairman Ira
Gessner, M.D.
Each year, Sheppard organizes 17 or 18 Interview Days, which take place from
August or September until March, she said. These events are one of her biggest
responsibilities, but as she says, "It's all so important."
About 2,000 applications pass through the admissions office every year, each
one representing someone's dream of a medical career, Sheppard said. This fall,
the first-year class will number about 135. The Medical Selection Committee
determines who receives an offer of admission, but Sheppard makes sure every
applicant is duly considered.
"My goal is to make the application process as smooth and painless as
possible," she said.
A fifth-generation Gainesville resident and a UF graduate with a bachelor's
degree in anthropology, Sheppard has directed the admissions office since 1997.
Her job operates on a 15-month cycle that begins each July, when applications
begin arriving, and ends in September when the first-year class begins its studies.
Sheppard reviews applications and communicates with applicants on myriad
subjects. About 325 applicants are invited to an Interview Day. Perhaps two-


thirds of those will be offered a place in the class, though some decline.
Not surprisingly, Sheppard says she loves speaking with candidates who have
just been accepted. Offers of admission are communicated in writing, so she
doesn't usually get to break the news herself. But she follows up with the lucky
candidates shortly afterward and reaps the benefits.
"Many times, when people get the news they're so happy they've just got to hug
someone," she said. "It's great to be a part of that."


College of Medicine Admissions Director Robyn Sheppard
(seated) shares a light moment with Program Assistant Denise
Chichester. Files on the desk hold applications and other
materials received from some of the 2,000 individuals who apply
to the med school each year.






iT 19


" '''--









LOOKING' AT YOU


Nobel laureate Hamilton Smith, M.D., (back row) poses with a group of graduate students and post-doctoral associates in the Academic Research
Building after his recent lecture on designing a synthetic bacterial genome. Smith, the director of the synthetic biology research group at J. Craig
Venter Institute in Rockville, Md., won one third of the Nobel Prize in medicine in 1978 while he was with Johns Hopkins University for the discovery of
restriction enzymes and their application to problems of molecular genetics. The UF Genetics Institute arranged for Smith's visit.


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
Staff Writers
Tracy Brown, Sarah Carey, Tom Fortner, Linda
Homewood, Lindy McCollum-Brounley, Patricia
McGhee, Tom Nordlie, John Pastor, Jill Pease,
Melanie Fridl Ross, Denise Trunk


Support Staff
Cassandra Jackson, Beth Powers, Kim Smith
Intern
Leah Cochran

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


UF Health Science
CENTER