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Permanent Link: http://ufdc.ufl.edu/UF00073869/00047
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Title: Post
Physical Description: Serial
Creator: Office of News and Communications, UF Health Science Center
Publisher: HSC Office of Public Information,
Publication Date: May 2009
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Bibliographic ID: UF00073869
Volume ID: VID00047
Source Institution: University of Florida
Holding Location: University of Florida
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Resource Identifier: 47826372 - OCLC

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    Table of Contents
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On the Cover
Seven of the top 20 fastest-growing jobs are in health
care. But this year, even new graduates from the HSC's six
colleges are facing challenges posed by the economy as
they search for their first jobs. This month, the POST looks
at how the economy is affecting grads and what they're
doing about it. Photo by Sarah Kiewel.


STable of Contents

0 POST-it
0 Patient Care: Flu vaccine for kids
( Five Questions: About pandemics
0 Education: Studying herbal remedies
9 Administration: Green computing
SPatient Care: The art of being a social worker
0 Cover Story: Job prospects for grads
Q Extraordinary Person: Beryl Greywoode
SResearch: Public health in Haiti
) Research: The origins of preeclampsia
SJacksonville: Saving Vickie
I Distinctions
Profile: Marcia Miller


Solving a deadly mystery
P ostmortem testing conducted by UF College of Veterinary Medicine
pathologists and toxicologists on a group of prized polo horses that
a. collapsed and died April 19 in Wellington, Fla., drew international
attention, with riveted members of the public and press wanting answers
about the mysterious cause of death. Initial necropsies performed at UF and
*" at another state lab yielded no answers. However, subsequent tests
conducted by UF toxicologist David Barber (left) verified the presence of
life-threatening concentrations of selenium in the horses' blood and liver
samples. The concentrations were found to be 10 to 15 times higher than
normal in the blood and 15 to 20 times higher than normal in the liver.
After four days of testing, the break in the case came April 22 when a
spokesperson for a private pharmacy said the horses had received an
incorrect dose of one of the ingredients used in a vitamin compound with
which the horses had been injected. This allowed Barber to isolate the
selenium. John Harvey, the college's executive associate dean and a
board-certified pathologist, said UF's testing not only pinpointed the
overdose but also ruled out other drugs that could have killed the horses,
helping investigators rule out malicious intent. Other College of Veterinary
faculty involved in testing the ponies included: Lisa Farina, Jeff Abbott,
Michael Dark, David Hall (center) and Richard Sams (right). O


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


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STILL ROCKING THE RANKINGS
For the third year in a row, the UF College of Medicine held steady at No. 48 in the U.S. News & World Report
rankings of medical schools. These competitive rankings are based on everything from Medical College
SAdmission Test scores to the number of research dollars obtained by college researchers each year.
U.S. News & World Report ranks medical schools each year and also periodically ranks other graduate
programs in the health sciences. There were no new rankings in other health disciplines this year.


http://news.health.ufl.edu


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MARCO SALEMI, PH.D.


Project: Immunization

Group hopes to vaccinate county kids for the flu

By April Frawley Birdwell

This fall, UF Health Science Center faculty and students will team

with Alachua County schools and the Alachua County Health

Department to try to accomplish something that has never been

done in the United States: The group aims to immunize 70 percent of local
schoolchildren for the flu.


"If you can get an immunization rate in schools of 70
percent, then the mathematical models suggest at that
level there will be so many immunized people in the
key spreader group kids that the flu will stop
transmitting within the community," said J. Glenn
Morris, M.D., M.P.H., director of the UF Emerging
Pathogens Institute and the program evaluation chair
for the project. "You can prevent the epidemic if you
immunize that many kids."
All children in Alachua County in grades
kindergarten through eighth will be eligible to receive a
free FluMist immunization. If the group is able to get
70 percent of these children to participate their
parents must sign a consent form it could prevent 31
deaths from the flu, 27,000 illnesses and nearly $2
million in direct health-care costs, Morris says.
"The CDC recommends all schoolchildren be
immunized, it's just that most parents don't take their
kids to be immunized for the flu," Morris said.
Aside from helping the community, the project will
also allow researchers to discover whether vaccinating
this large a group of kids will have as significant an
effect as mathematical models suggest, Morris says.
UF researchers decided to start the project after the
success of a similar program in 2007, when 25 percent of
Alachua County children were immunized for the flu.
The year after the vaccines were administered,
researchers noticed a drop in absenteeism in schools,


even though that year's virus did not match the vaccine
from the previous year.
To pull this project off, the group has formed a
coalition that includes everyone from school nurses and
community leaders to faculty and students from the
colleges of Nursing, Pharmacy, Public Health and
Health Professions and Medicine. One College of
Pharmacy class is even going to incorporate the program
into its curriculum, says Cuc Tran, a master's student in
the College of Public Health and Health Professions who
has been involved with the organization of the project.
Under the supervision of faculty, nursing and
pharmacy students will help school nurses administer
the vaccines. Students will also help educate parents
about the vaccine and help with consent forms.
Initially, the group was struggling to secure enough
donations to vaccinate all the children the inhaled
vaccine is pricier than traditional shots but help
came in the form of an unexpected call from the Florida
Department of Health. Because of the federal stimulus
package, the department was able to spend more on
immunizations this year and donated 17,500 doses to
the project. The group also received a donation from
Avmed, among others.
"We're a very unique community where this can
happen," Tran said. "We have so much support. In
another community I don't know if this would be
successful." 0


Exploring swine

flu's origins

By Czerne M. Reid

origin of the current swine flu
outbreak, a group of the world's
experts on evolutionary biology, including a
UF team, set aside some academic traditions
to work together toward a solution.
Rather than publish individual findings
on the current flu outbreak, the
computational biologists have opened their
work in progress to each other and the public
through a Web site: http://tree.bio.ed.ac.uk/
groups/influenza.
Researchers in Britain came up with the
idea, but are joined by contributors from
institutions around the world, including the
University of Oxford, the University of
Edinburgh, UF, the University of Arizona,
the University of California-Los Angeles, the
University of Hong Kong and Belgium's
Rega Institute.
"It's a really new concept, because
basically there is a worldwide emergency, so
this is a very fast way to have data circulating
very quickly in the scientific community,"
said Marco Salemi, Ph.D., a UF assistant
professor of pathology immunology and
laboratory medicine, who has contributed
results to the Web site.
Site creators caution that the findings are
preliminary and corrections likely needed
but say there is great value and a sense of
community in displaying the information.
Their analyses are based on viral DNA
sequences generated and published by the
National Center for Biotechnology
Information, and the nonprofit Global
Initiative on Sharing Avian Influenza data.
Analyses done so far point to the virus'
immediate origins in swine flu variants with
links to avian and human strains through a
process called reassortment, in which gene
segments from different viruses shuffle and
reassemble into new viruses.


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


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FIEQESIN


Understanding

PANDEMIC


By April Frawley Birdwell

When the H1NI virus, also
called the swine flu,
spread rapidly from
Mexico to other countries, it initially
triggered fears that the planet could
be facing another deadly pandemic
like the Spanish influenza in 1918.
Luckily, the illness the disease caused
was mild. But the incident did provide
public health agencies with what J.
Glenn Morris, M.D., M.P.H., calls "a nice
test case" to measure how well certain
services work in times of crisis. This
month, Morris, director of the UF
Emerging Pathogens Institute, answers
our questions about pandemics and
what leaders have learned from the


swine flu.


What causes and defines a pandemic?
Pandemic diseases are defined by their ability to spread rapidly across continents, causing serious
illness as they progress. Characteristically, they have an animal or environmental reservoir, where
the microorganism can undergo genetic changes before emerging, or re-emerging, in human
populations. However, probably the most critical factor is the ability of the disease to be efficiently
transmitted person-to-person. Transmission of the current swine flu virus is no better than, and
actually may be not quite as good as the regular seasonal flu. But watching as maps on the TV news
showed cases popping up all over the globe, you begin to understand how rapidly any flu strain can
spread to different parts of the world.

Why was the Spanish influenza so deadly?
We are still not able to completely answer that question. However, over the past several years, with
the elucidation of the Spanish flu genome, there have been some very elegant studies that have
allowed investigators to hone in on possible virulence factors, including the ability of certain viral
genes to increase the ability of the strain to multiply in human respiratory epithelial cells. At a clinical
level, what was particularly devastating about this strain was its ability to cause disease, and death,
in young, healthy adults. And its impact, at a public health level, was profound. When you look at
mortality curves for the U.S. during the 1900s, the one thing that stands out is this huge spike in
1918 reflecting the mortality associated with the Spanish flu. The number of deaths on a global basis
was even more staggering, with estimated mortality in the range of 50 million persons.

Because of advances in science and medicine, are we
better prepared to handle a pandemic like the Spanish flu?
Yes and no. We can very rapidly identify new flu strains and figure out what's going on. The
international communication and public health networks are excellent, as demonstrated by the
Mexican outbreak. Within a matter of days, (scientists) had the complete genome sequenced. The
world knew what was happening and was poised to do what was necessary to prevent transmission.
However, there is still the possibility a killer pandemic could occur. This outbreak underscored the fact
that flu strains move rapidly, and that unexpected gene recombinations can appear out of nowhere.
There is some concern that while we have excellent hospital facilities, do we have sufficient facilities to
handle a major epidemic? Also, this past year, the seasonal flu strains were resistant to Tamiflu, our
major antiviral drug. The nightmare scenario is the sudden emergence of a new, killer strain with avian
or swine flu genes that can cause severe disease in humans, that has resistance to Tamiflu and that
spreads rapidly. It could happen. We hope with our good communication, our good science and all
the positives we have now we can keep it from happening, or at least limit its impact.

Is it important that emerging threats receive the level of
caution the swine flu initially received?
I think the level of caution that was exhibited with this outbreak was appropriate. The initial evidence
that the CDC and other agencies had was this was a nasty strain of flu that was causing mortality in
healthy adults. You need to move fast if you are going to have a chance to slow something like this
down. In many ways, this was a nice test case. It let us see how well the system worked. We need
to fine-tune some things, such as our approach to TamiFlu distribution, but, in general, the system
worked extremely well.

How does the work of the EPI help to prevent outbreaks of
new diseases?
Our role is to try to understand why and how new diseases emerge. Part of it is predicated on
the idea that there are certain common pathways through which new strains emerge, and if you
understand the basics of why an epidemic occurs or a pathogen emerges, you can apply that
knowledge to reduce future risks. Our work ranges from basic evolutionary genetics to modeling
transmission pathways. The modeling allows us to assess how certain interventions would change
the course of an epidemic. It lets you try different scenarios and see what works. We don't man the
ambulances, but we provide critical research capacity and expertise for the health department and
other frontline responders as they work to slow a pandemic. O


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EDCTO


In the shadow of


Hippocrates

By Christine Velasquez
Patricia Abbitt, M.D., a professor in the department of radiology and
chief of the abdominal imaging division for the College of Medicine,
was honored with the 2009 Hippocratic Award, which was given by the
college's graduating class.
It was the 40th anniversary of the award and the second time Abbitt was
nominated and selected by fourth-year medical students as the physician who
best exemplifies the ideals of Hippocrates.
"Every day I had the chance to work with Abbitt I learned a great deal
about radiology, but more than that, I saw the characteristics of a teacher a
physician and member of this community who I want to emulate," said TJ
Ward, a medical student who spoke at the award ceremony April 24.
Established by the graduating class of 1969, the Hippocratic Award
recognizes and honors physicians who represent the highest ideals of
professionalism, humanism and teaching talent. Abbitt has instructed
thousands of UF medical students during her 20 years with the college and
first received the award in 2004.
Abbitt said few words during the ceremony. But later, under the shade of
the London Plane tree, a sapling of the tree under which Hippocrates taught,
she shared her thoughts on new challenges facing the graduates.
"We are in very difficult economic times right now. These students will,
out of necessity, be very involved in working on problems regarding health-


By Jessica Metzger
On May 1, the UF College of Nursing graduated its first class of
students to earn a Doctor of Nursing Practice degree, a new degree
in the nursing field.
The D.N.P. is essentially doctoral education for advanced practice nurses,
said Karen Miles, Ed.D., R.N., an associate dean of the UF College of
Nursing. The degree was a national initiative, led by the American
Association of Colleges of Nursing, which called for transforming the
education of professional nurses who practice at the most advanced level.
The program, which began in 2006 and was one of Florida's first, focuses
on innovative and evidence-based practice, Miles said. Evidence-based
practice involves making treatment decisions based on the latest clinical
research, said Stefanie Coffey, a nurse practitioner and new graduate.
"Most of us didn't have an evidence-based background to be an expert in
our fields," Coffey said. "This program helped us broaden our arena. We can
contribute more to our patients."


I"

Dr. Patricia Abbitt (right) and medical student Omayra Marrero pose
under the shade of the tree that was given to UF by Greece's minister
of agriculture in 1969 to commemorate the establishment of the
Hippocratic award. The sapling is cut from a tree in the Isle of Cos,
Hippocrates' hometown.

care access and health-care reform.
"Our students are very committed to addressing these issues by
involvement and hard work," she added.
Ask Abbitt's students about her likeness to Hippocrates' ideals and you will
hear stories about how the physician dispels the myth that radiologists are
disconnected from their patients; how she spends her time outside of UF's
walls by working with Gainesville Harvest to feed the homeless, advocating
for the Saint Francis House homeless shelter and local churches, all while
inspiring students to do the same.
"It says a lot about the culture of our class having voted Dr. Abbitt as our
honoree," said Omayra Marrero, academic chair for the class of 2009. O





Top nurses

College of Nursing graduates first Doctor
of Nursing Practice students


The group started in Fall 2006, completing the program in Spring 2009.
One of the degree's requirements was a research project, usually in the
student's specialty or area of interest.
Megan Weigel Barrett said she gained more from the program than she
expected.
"I feel like I am prepared to accept a large number of challenges like
financial problems, quality management and electronic management. I feel
much more capable and prepared for all level of problems rather than just
patient care," Weigel Barrett said.
Fifty-nine students will enter the program in the fall. These include 44
students in the B.S.N. to D.N.P. program, which allows students with
bachelor's degrees to directly enter the D.N.P. program.
Miles said these new standards for nursing are not deterring people from
pursuing careers in the field.
"If you look at other health-care fields like medicine, dentistry and
veterinary medicine, and beyond to physical therapy, occupational therapy
and pharmacy, all of these professions have doctorates as entry level to
practice," Miles said. "Nursing is a vital part of our growing and changing
health-care system, and these highly educated advanced practice nurses, at
the doctoral level, will be prepared to improve practice, educate new
clinicians and elevate our profession." 0


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EDCTO


R scu re edy for



erbal research


By Monica Vigo


T through the meticulous, yearslong
process of research in her UF
herbal medicine lab, Veronika
Butterweck, Ph.D., an assistant professor
in pharmaceutics, has discovered one
new remedy that just may speed up the
process.
Her remedy comes in the form of 12 international students
with lab skills from universities in Germany, Switzerland and
Austria who help Butterweck keep up with the fast-paced
competitive world of research and drug discovery.
In 2007, Americans spent $4.8 billion on herbal and botanical
supplements, drugs that are not required to be regulated by the
Food and Drug Administration in order to be sold. Normally, it
takes up to two years for new UF graduate students to be ready
to conduct lab research, Butterweck said, and by then other
herbal researchers have begun racing to market.
Through academic associates in her home country, Germany,
where she earned her Ph.D., Butterweck arranged to host
pharmacy students seeking internship experiences. For the next
six months, all of the international students will assist
Butterweck's research at UF. Some have just graduated from
their universities and are completing their practical training
requirements. Others are in their final year, completing a
master's thesis required for graduation.
"The visiting international students are a big help because
they already know how to use lab equipment and perform
common tasks associated with research without having to
relearn them," Butterweck said.
But Butterweck is not the only one winning the students
are as well. While Butterweck gets help completing her research
faster than she could alone, the students continue to work
toward completing their necessary requirements for graduation.
Pharmacists in Europe have laboratory training early in their
studies and typically graduate with a master's degree, which
prepares and allows them to work in research labs. The U.S.
doctor of pharmacy education is more clinical, or patient-
centered, rather than lab-focused.
European research experiences are limited, mainly
concentrating on chemical extraction from plants. This is why
the European students prefer more varied research experiences
in America, Butterweck explained.
"I heard of UF's excellent reputation for its pharmacy school.


Veronika Butterweck, an assistant professor in the College of Pharmacy,
recently took on 12 international students who are helping and learning in
her herbal research lab.


I was more than happy when my professor in Vienna offered to
establish ties with Dr. Butterweck," said Stefanie Weinoehrl, a
student from the University of Vienna.
The students are helping her research herbs such as valerian
for anti-anxiety and sleep-inducing effects and Russian tarragon
for anti-diabetic effects. Having more students to work on
several small projects helps Butterweck to work more effectively
because those combine into bigger projects, she said.
Learning how drugs are researched and developed firsthand
rather than just in theory is an important experience they get at
UF, Weinoehrl said. The students also gain insight on their
future plans as pharmacists, she added. Most of them are
undecided on what to do next and working in the lab can help
them make a decision.
Michael Fretz, a student from the University of Basel in
Switzerland, said the greatest benefit to him was working in an
international environment at UF in a college with a good
reputation.
"I haven't decided yet if I will go into research," Fretz said.
"But after my experiences here, I definitely would be
interested." 0


http://news.health.ufl.edu


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lOOmiles.


Scott Erker (left) is participating in the Best Buddies Challenge to
raise money for Best Buddies, an organization that helps his
stepson Jonathan (right).

By April Frawley Birdwell
wice a week, Scott Erker runs up and down the stadium steps at
Ben Hill Griffin Stadium. He lifts weights, too, and cycles for miles
four days each week.
Erker, a Shands at UF catering coordinator and UF doctoral student in
anthropology, is training for a 100-mile bike ride from Boston to Hyannis
Port, Mass., on May 30. He's cycled for 100 miles before centuries, as
they're called in bikespeak but he hopes to get his best time this year.
And more importantly, he's hoping to raise money for Best Buddies, an
organization that helps his 15-year-old stepson, Jonathan.
The Best Buddies program pairs children and adults who have
intellectual disabilities with volunteers, usually students in high school
or college. The new friends spend time together each week.
Jonathan, who has Down syndrome and was born with a neurological
defect called hydrocephalus, has a UF buddy also named Jonathan,
Erker says.
"He loves it and it's great for him to bond with someone outside the
family," Erker said. "It's a great program and that's why I wanted to raise
money for it. It's helping Jonathan and other kids like him."
Ensuring that children with special needs get enough opportunities to
socialize outside of school with friends or other people closer to his own
age can sometimes be difficult, Erker says. That's one of the reasons he
feels the Best Buddies program is so important.
"We're hoping that whatever his potential is he will reach it," Erker
said. "We don't want to hold him back in any way, especially socializing
with other people."
So far, Erker has raised $2,600 and he hopes to raise more by the May
30 race, officially titled the Best Buddies Challenge.
To donate to Erker's effort, visit the Best Buddies Challenge Web site at
www.hpchallenge.org and click on "sponsor participant" to enter Scott
Erker's name. You can also visit his participant page directly at
http://tinyurl.com/ScottErker. 0


am


Am


College of Dentistry says goodbye
to longtime staff member


Lydia Maree, a dentistry staff member, dressed as Sam Brill for his
retirement party. Maree is sporting a prosthetic nose made from a
casting of Brill's nose.


By Karen Rhodenizer
There were no green eggs and ham on "Sam I Am" Day. No Dr.
Seuss stories either. Rather, on March 23, faculty and staff in
the College of Dentistry told their own stories about Sam Brill.
Brill, an audiovisual specialist who joined UF in 1977 and the
College of Dentistry in 1980, retired March 31. Brill wore many hats
during his employment with the college but will be best remembered
as the college's official photographer.
Brill said one of his strongest memories about the college is how he
and others gathered to watch the events of Sept. 11, 2001 unfold on a
TV he set up in a hallway on the third floor of the Dental Tower.
"We sometimes tend to describe where we work by the physical
location, as in Dental Tower, but it was obvious on that day we are
really 'family,'" he said. "We were separated from our real families
until we were given administrative leave. As people gathered, we
comforted each other as best we could."
Brill served on the Special Event Planning Committee for the
college for many years and until his retirement, and threw himself
into the events, wearing costumes to match the theme that were
always topped off with a camera around his neck. He even took
photos at his retirement party.
He says he is proud of his service to a college that always shows its
"heart" when it comes to helping others, such as supporting the UF
Community Campaign, Relay for Life, trips to foreign countries to
provide dental care, the Heart Walk and many more.
"Although I won't be part of the daily activities of the college, it'll
always be a part of me. I truly treasure the bonds we built together,"
he said. 0


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AD II 0RTO


IT GOES




green


ByJessica Metzger


With sustainability and cost-cutting high priorities these
days, it's not surprising that even the UF HSC IT Center
has taken some green measures of its own.
The biggest change IT made was the switch to virtualization, said Dick Deason, team leader of IT
systems administration. Virtualization reduces the amount of physical servers that keep HSC data
and systems running from about 45 servers to just six.
Most servers only use 10 percent of their capabilities, said Trey Johnson of IT systems
administration. Virtualization allows multiple applications and systems to be run on the same
machine, using them more efficiently.
Benefits of virtualization include saving power and space, Deason said. Both cut costs to UF, as
well as produce less waste to the environment because there are fewer computer parts to throw away
in the long run.
Also, technologically, virtualization improves disaster recovery. Deason said with physical
hardware servers, recovery from crashes could take weeks. Now, failures due to hardware are almost
nonexistent. Operating-system and application-level recoveries can be completed in mere hours. He
also said virtualization allows for more memory, with more capacity and faster processing.
Because of the switch, IT saved about $80,000 on its servers, including the cost of powering and
cooling them. This will be continued annual savings, not just a one-time recovery, Deason said.
Deason said there is more to be done in the HSC. Next, they are looking to change personal work
stations. IT has begun making small changes, starting with something as simple as shutting off the
power to computers.
IT recently won a sustainability award from UF for both its virtualization of servers and turning
off workstations when not in use that's 12 hours a night and 48 hours each weekend amounting
to $45,000 in annual cost savings for UF, Deason said.
Their next step is virtualizing workstations, Deason said. Called View Portal, the program allows
users to access their own desktop on any PC. All users would need is their username and password,
and they could access their desktop (just the way they left it, icons, open windows, programs and all)
basically anywhere.
This prevents people from having to save work on a USB drive or a disk and transferring the data
from computer to computer, reducing the potential for exposing sensitive information, such as
protected health information.
Several departments at the HSC are already using View Portal. This program is safe and secure
because the data never leave the data center, Johnson said.
Deason said the IT Center has worked hard to be economical, but also to ensure the safety and
security of the HSC's servers and data. He said big things are still coming, like IT's new storage
support solutions.
For more information on the HSC IT Center and its services, visit www.health.ufl.edu/itcenter. 0


And the award
goes to ...
She UF Office of
SSustainability
recently
awarded its first-ever
Sustainable Solutions
Awards. The HSC IT
Center received an
honorable mention for
its energy conservation
efforts. Other HSC
winners included Rizan
Yozgat, A.R.N.P.,
(pictured) of Student
Mental Health Services, who received the
Bright Idea Award for her idea to eliminate
the use of paper fliers on cars in the Stephen
C. O'Connell Center parking lot before
events. The change will reduce litter and
save paper. Yozgat proposed using digital
signs, e-mail and perhaps a Web site to
announce events that could affect parking.
Shands HealthCare also received an
honorable mention for its efforts in
conjunction with the Physical Plant
Division to reduce waste.


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Beyond


New UF Plastic

Surgery office
UF plastic and reconstructive surgeons
offer a full range of both reconstructive
and cosmetic surgical procedures. The
surgical group opened a new office, UF
Plastic Surgery, this spring to offer
patients the convenience of easy access
and free parking. Located at 908 N.W.
57th St., Suite D-6, the office is just off
Newberry Road in the Park Avenue
Office Complex. Fresh Faces, the office's
skin rejuvenation program, offers a
range ofnonsurgical methods to help
clients refresh their look. Learn more at
floridaplasticsurgery.ufl.edu.


101 i


the facade

The good works of plastic surgery

ByJessica Brandi

A ny surgeon can repair a broken rib, but not
every surgeon can take that same rib and
build you an ear.
In today's Hollywood-obsessed culture, it's easy to forget the world of plastic
surgery reaches far beyond nose jobs and facelifts. Reconstructive plastic surgery
can put a woman back into a bikini after a battle with breast cancer or give a child
with a cleft lip the ability to smile.
Of the 12.1 million plastic surgery procedures performed in 2008, 4.9 million
were reconstructive surgeries, according to the American Society of Plastic
Surgeons. Reconstructive surgery is performed to improve or correct
abnormalities caused by trauma, injury, infection, tumors or disease. This can
include everything from creating skin grafts for burn victims to removing
cancerous tumors and reconstructing the area with flaps of tissue and blood
vessels taken from other parts of the patient's body.
"The biggest thrust of what we're involved in is restoring form and function
and trying to take that to the highest level possible," said Matthew Steele, M.D.,
an assistant professor of plastic and reconstructive surgery in the UF College of
Medicine.
He said one of the reasons he was attracted to plastic surgery was the chance to
be innovative and find new solutions to medical problems.
"It's not the same cookbook kind of surgeries," he said. "There's not necessarily
a right answer all the time."
Dr. Brent Seagle (center), One of his cleft palate patients, a young girl, couldn't smile because of her
chief of plastic and condition. Whenever she laughed or felt happy she couldn't show that emotion on
reconstructive surgery, her face, Steele said. Her doctors weren't able to use the nerves they normally
operates with fellow Dr. would for a similar procedure, so they found a way to use the nerves associated
Mark Clayman (left) as with chewing instead.
student Lee Ferguson The recovery was gradual, but she eventually learned to use her chewing
watches, muscles to smile and show emotion. Steele said the first time she passed a mirror
in a store and realized she was smiling she ran around laughing and yelling to her
mother.
"They came back and told everyone the story," he said. "They were really happy."
M. Brent Seagle, M.D., chief of reconstructive and plastic surgery at UF, said helping children like this and
helping people get their lives back, in a sense, are the most rewarding aspects of reconstructive surgery.
"It's really rewarding when you get someone back to a place of normal function ... when you get someone close to
who they were before cancer or an accident," he said.
Seagle said the public still harbors some misconceptions about plastic surgeons and what they do.
"There's a good bit of misunderstanding," Seagle said. "The cosmetic side is sensationalized on TV, in newspapers,
all over the place."
He says another large part of the misunderstanding is that people assume cosmetic surgery is always performed
by plastic surgeons, and when they hear about botched surgeries, they don't realize it wasn't necessarily a plastic
surgeon who performed the failed procedure.
To achieve board certification, plastic surgeons are required to attend a U.S. accredited medical school and are
subjected to a rigorous examination process that assesses everything from their surgical skills to their ethics and
advertising practices, according to the American Board of Plastic Surgery.
"Real plastic surgeons aren't like 'Dr. 90210,'" Steele said in reference to the popular reality show following an
eccentric cosmetic surgeon in Beverly Hills.
The field is constantly changing and innovating to find new solutions and develop less-invasive procedures with
shorter recovery times. In the future, Steele hopes to see more developments in stem cell research and genetic tissue
engineering so plastic surgeons can use genetically engineered body parts rather than taking flaps from other parts
of the body or using donor transplants, which the body can reject.
"When you get more experience you're constantly making changes, and your work improves," he said. 0


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J 05/06-09 1







PATIN CAR


The


calling

Social workers an

important part of

cancer care



By April Frawley Birdwell

s she lay in the dark
room, the thoughts
came, whirring through
her brain like an engine.

Am I going to live to see my grandchildren
grow up?"
Am I going to be able to work?"
For years, she had heard these questions from
patients in the Shands at UF Bone Marrow
Transplant Unit, where she works as a social
worker. Battling multiple myeloma and staying in
the hospital while she waited for her own
transplant, Gale Smith, L.C.S.W., began thinking
these thoughts herself.
Smith, who has worked as a social worker for
the Bone Marrow Transplant Unit for 17 years,
was diagnosed with the blood cancer about five
years ago. She underwent a stem-cell transplant
in 2005 but a search has yet to yield a bone
marrow match. She's still battling the disease.
"In the beginning it seemed surreal, like,
'O.K., God, what am I supposed to do here? What
lesson am I supposed to learn?'" Smith said. "It
has taught me so much about the human spirit
and how strong we are. We can get so low and
have some of the lowest moments and fearful
moments and then hope comes."
This battle has given Smith a unique
perspective on her job. As a social worker, she
helps bone-marrow transplant patients through
every step of their own journeys.
There are 47 social workers working at Shands,
and several of them, like Smith, focus specifically
on patients with cancer. It's a unique population
of patients to work with, and for most who do, it's
a calling, says Victoria Pearson, L.C.S.W., a
clinical social worker who has worked with
outpatients at the UF Shands Cancer Center for
16 years.
Because a cancer diagnosis and treatment can


Social worker Gale Smith spends a few minutes with Duane Bennett, a patient in the Shands at UF
Bone Marrow Transplant Unit.


be so overwhelming, social workers often go over
what doctors say with the patients to make sure
they understand what's going on. Patients don't
always speak up and ask questions when they talk
to doctors, especially not when they're already
scared, Pearson says.
"I see it time and again. A patient will be
crying with me and then a doctor comes in and
asks how they are doing and they say 'fine,'"
Pearson said. "If we don't have social workers to
provide counseling and resource management
then those patients are lost out there. Without
social workers you lose a real caring, holistic view
of the patient."
And this is just one small part of how oncology
social workers help patients.
Generally, social workers devise a plan for
patients depending on their needs. This is
important because not addressing patients' social
and psychological needs can negatively affect care,
according to a 2007 Institute on Medicine report.
Jennifer Adams, L.C.S.W., also a Shands social
worker, says it's sort of like cold-call sales. With
each patient she starts over. Some need help
finding affordable medications. Others need
services to help them with family issues and
financial concerns while they're sick. They also
spend time talking about issues like body image,
a concern for many cancer patients who
sometimes lose their hair during chemotherapy.
But often, what patients most want is to know
someone is on their side, Pearson said.


"They are scared to death," said Adams, who
has worked at the cancer center for three years.
"They want someone to get it right for them.
Here, the most valuable service (for patients) is
knowing things are going to get taken care of.
"We're like the tack holding all the papers on
the wall."
Often, it's not only the patients they're helping,
either. They help caregivers and families, too.
And sometimes doctors and nurses need support
to handle the emotional toll and stress.
"Sometimes people will come knock on my door
and I will invite them in to sit on the couch," says
Smith, who also runs a support group in the BMT
unit for patients. "Sometimes 15 minutes can make
the difference in someone's day."
People have asked Smith why she works in the
Bone Marrow Transplant Unit. It's dreary, they
say. People die.
Smith doesn't see it that way. She's learned
about living from people during their last
moments. And she shares in happy moments, too.
"For every death I have witnessed, I can think
of two or three absolute miracles, people who
were not given a chance who survived death's
door several times," Smith said. "I can be with
one family through their loss, but I also know
there is one person down the hall who is
celebrating, their counts are coming up. Or when
someone comes back, and they are years out from
transplant and feeling good. That is what keeps
me going." 0


http://news.health.ufl.edu


1 0/0B-c091






COVERmSTOR


--I-


The ar


of


hunting


By Laura Mize


When Dani McVety entered veterinary
school, professors told her incoming
class that demand was high for new
veterinarians.
But as McVety and her classmates prepared for graduation, they met a
different reality.
"One place I e-mailed literally wrote ... 'We are getting by with relief
veterinarians until the economy turns around,'" McVety says. "I mean, that's
amazing. When we got into vet school they told us that there were more
positions than veterinary students could fill."
This year, new graduates in health-related fields are finding that positions
are available, but perhaps not in the abundance or variety they had expected.
The changing market has tested their perseverance and creativity.
With an infant at home and her husband graduating from law school and
also looking for a job, searching for a position also requires finding the right
situation for her family. Originally, McVety sought something in the north
Tampa area. But when an offer came in March, she declined because it wasn't
a good fit.
McVety decided instead to work in emergency veterinary medicine because
the typical schedule of three weekly night shifts would mean more time to
spend with family.
"I'm looking in Port Charlotte, Fort Pierce and south Miami," McVety
writes in an e-mail. "You never know. I'm the main breadwinner for the first
few years out of school so we'll go wherever I get the best offer for emergency
medicine."
With limited options, McVety is considering ways to set herself apart from
colleagues.
"I have actually seriously considered going to law school, even if it's part
time," McVety says, "and in five years doing animal law, doing patent law for
pharmaceutical companies, you know, different things to make myself more
marketable."
Mike Chaddock, D.V.M., deputy director of the Association of American
Veterinary Medical Colleges, says that with some imagination, new
veterinarians should get jobs.
"The job market is much tighter, absolutely. But (it depends) on where a
person wants to find work and being a little bit creative are they looking at
industry, are they looking at government, are they looking at the nonprofit
sector?"


II


How this year's health science graduates are
displaying flexibility in a tightening job market


r









--
frft-;- L
I-
"ZI
r
;-Slro
r;:,i,
:P ~~i


- Karen Miles, Ed.D., R.N.


NEW GRADS: MEREDITH PARNS, COLLEGE OF PUBLIC
HEALTH AND HEALTH PROFESSIONS (OPPOSITE PAGE)
AND MICKEY LETH, COLLEGE OF DENTISTRY


The Waiting Game
Many of this year's UF health science graduates face similar challenges. People looking for
health jobs are still faring better than those in other types of fields. Seven of the 20 fastest-
growing jobs are related to health care, according to the Bureau of Labor Statistics. But the
contracting economy and growing unemployment mean more competition for jobs even in the
most in-demand health-care occupations.
"Providers, which include the physicians, physicians' assistants, nurses, lab techs and
others, will stay pretty strong," says Russell Armistead, M.B.A., C.P.A., UF's associate vice
president of finance and planning for health affairs. "The business office and overhead
personnel will be the first area that will experience a reduction in employment. But
employment has held up reasonably well so far."
Like McVety, Meredith Parns' personal life has been intertwined with her search for a
position after graduation. A graduate of UF's master's in health administration program in
the College of Public Health and Health Professions, Parns learned she landed a fellowship
spot with Poudre Valley Health System in Fort Collins, Colo., in late February. Students are
normally awarded fellowship positions in November, she says.
Parns says the extended wait made her very nervous and affected her personal life. She and
her fiance, a UF police officer, informally planned to marry this fall and stay in Gainesville.
The sudden news of her new position changed that. Parns' fiance is looking for jobs in
Colorado. Now, they're not sure when they'll get married.
But Parns is just glad to have a fellowship.
"It's been frustrating. I'm very relieved now that I have a job. But it took me six months to
find one."
Parns says fewer students in her 18-person graduating class found fellowship positions than
in past classes. This year seven students got fellowship positions and six accepted jobs. The
remaining graduates are either still looking for jobs or have other postgraduation plans.
"Clearly this year's placement process has been tighter than historically has been the case,"
says R. Paul Duncan, Ph.D., a professor and chair of health services, research, management
and policy in the College of Public Health and Health Professions. "On the other hand ... 15
of the 18 are in outcomes that are kind of normal for people finishing a master's degree
program like this and three of them are still looking."
He says finding fellowships in health administration is not impossible right now, but it isn't
surprising that it can be challenging, either.


According to the American
Hospital Association, a
recent survey of 1,078
hospitals revealed
troubling trends
nationwide. The report
indicates that most
hospitals are seeing fewer
patients for inpatient


services and elective care.
Meanwhile, a larger
percentage of patients
either can't pay for care or
are dependent on public
support. Also, in late 2008
and early 2009, almost half
of the hospitals surveyed
cut staff and nearly a
quarter decreased services.








Continued ON PAGE 14


http://news.health.ufl.edu


I
ll"^l,


1 05/06- 09 1


a~j,"t U13








0OE 0TR


NEW GRAD: SYDNEY VANDEVEER, COLLEGE OF NURSING



"Certainly it is the case that when hospitals are faced with budget
constraints, administrative fellowships are one of the things that
might get cut."
For students in the college's occupational therapy, physical
therapy and audiology programs, Joanne Foss, Ph.D., O.T.R./L.,
says the number of open jobs is growing.
"Anybody who's going into elder care ... especially here in the
state of Florida, or (working with) children that are at risk for
disabilities, those are ever-increasing (professions)."
She says the college's career day in February saw a record turnout
of organizations looking to hire students.
"We had a significant increase in the number of vendors, and
they were all actively recruiting."



Veteran Workers Return

Sydney Vandeveer, who recently graduated with a bachelor's
degree in nursing, doesn't have the same family-related concerns as
McVety and Parns. She just wants to find a job.
Last fall, she began inquiring about training programs for new
nurses at hospitals near her hometown, West Palm Beach. Rookie
nurses usually work alongside experienced nurses before they can
work independently.
They "gave me the impression that there weren't really a lot of
spots available and they weren't really hiring new graduates,"
Vandeveer says.
Orienting new nursing graduates tends to be costly for hospitals,
and in a tough economic climate employers may steer more toward
hiring more experienced nurses. Vandeveer has applied at five
hospitals in the area and expanded her search to include any
hospital nursing positions. She originally applied only for
emergency or critical care positions.
Vandeveer has had one job interview, in early May. She feels


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a very promising career forecast," Miles said. "Nursing graduates,
especially from UF, will still continually be sought out because
people will always need quality health care. It just may be a bit more
difficult than in years past for graduates to find their ideal positions.
They may have to broaden their horizons with regard to specialty
or location."
Similarly, new dentists are also seeing some crowding in their
field from veteran dentists, says Mickey Leth, a recent UF College
of Dentistry graduate. But their challenges are different.
"It's much tougher to get loans at the current time to open a
dental office," Leth says. "Now, it wasn't even an option (to buy
property and start a practice)."
Unable to start practices, Leth says, associates are continuing to
work for other dentists. That means fewer associate jobs available
for new dentists.
Still, he says he doesn't think the economy's negative effect on
his profession is significant. With some flexibility, his classmates
are getting jobs, though maybe not in their preferred geographic
areas.
Boyd Robinson, D.M.D., associate dean for clinical affairs at the
College of Dentistry, says it's unclear how the dental field overall is
affected by the recession, but there is still plenty of opportunity.
"It's a mixed market now," he says. "I don't think it's a closed
market in any specific sense."
Some types of practice offer more opportunity than others for
dentists.
"The areas that are slowing down are the general practice, fee-
for-service areas," Robinson says, emphasizing that community
health organizations may be the most surefire places to find work as
a dentist.
Leth is proof that finding a position in a private practice is
possible. He'll begin work at a dental practice in his hometown of
St. Augustine this summer.
"The practice ... (belongs to) a dentist who's got a five-year
retirement plan, basically," Leth says.
Leth will take over the practice when the owner retires.


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


1 05/06-09


S141 r











Pharmacy Supply

And Demand
Julie Justo, a new pharmacy graduate, landed a one-year residency
position at the University of Illinois at Chicago without much trouble. But
she does see a change in the market for pharmacists right now. She always
planned to pursue a residency but says a saturated market for pharmacists
in her preferred location, South Florida, intensified her desire for a
residency spot.
Justo applied to eight programs, instead of the typical four or five. The
program at University of Illinois was one of her top choices.
Justo and William Riffee, Ph.D., dean of the College of Pharmacy, say
pharmacy programs in South Florida such as those at Nova Southeastern
University and Palm Beach Atlantic University exacerbate the job crunch
for pharmacists there.
An experimental new business approach at Walgreens, one of the state's I
largest retail pharmacies, is having effects statewide. The retailer plans to
establish a "central pharmacy" in Orlando to fill many prescriptions, such
as those ordered in advance. Florida is the first state where the company
is implementing this system.
Riffee says it may mean layoffs and fewer jobs available for new
pharmacy grads, though it's too early to tell. He says there have been fewer
pharmacists hired at Target and in hospitals, too.
"Something's going on in Florida that appears to be replicating itself

Riffee says he thinks demand for pharmacists in Florida is still higher NEW GRADS: JULIE JUSTO COLLEGE ORAR MEDICINE (TO ) AN
than the supply, but the balance is changing. DANI MCVETY, CO G OF
"It is my opinion from anecdotal evidence only that we are closing in on
being 'in balance,"' Riffee writes in an e-mail. "Only the next year will
really show if this is a trend or an unusual blip."


Finding The Right Fit
Despite the challenges of getting a job in the struggling economy, some
new health science graduates are finding exciting opportunities and hope
for the future.
After months of uncertainty, Dani McVety, the veterinary medicine
graduate, finally found a position in mid-April. She'll start work at Animal
Emergency Clinic of Brandon as an associate veterinarian in early June.
Though it required some compromise, McVety says in many ways the
job is just what she needs.
The salary is "a bit less than my previous offer, but learning the
medicine is the most important part of being a new graduate and the -
hours will allow me more time to spend with family in addition to
pursuing other entrepreneurial ventures with my husband," she writes in
an e-mail. -
"To me, it's the best of both worlds. Ideally, we'd like to open or purchase
a practice in about five years." -l


Of Medicine seem

Of the six health science colleges, graduates o the Colee i cie
least affected because medical students enter predetermined residencies
e graduation. Congress com its a set amount of money to fund
aftresidency positions for escors-in-train g so the number of positions won't
residency ss reduce funding "There's a general sense that there's


a shortage of physicians in the country, says Tim lynts M.D., the college'ut
senior associate dean for clinical affairs. doubt residents will be ou of
work when they finish their residency.







(EXRAORDNR PESO


A








in need

Medical student starts

project to combat infant,

maternal mortality in

Sierra Leone


Beryl Greywoode recently went to Sierra Leone to launch Project RAIN, an initiative she
founded to help reduce infant and maternal mortality in the country.


ByJessica Metzger

At 26, Beryl Greywoode is at
the top of her game, and it
keeps getting better.

Aside from graduating medical school in May and
being selected to complete her residency at Harvard
Medical School's Children's Hospital Boston, the UF
medical student also has started her own nonprofit
organization.
Project RAIN (Relieving Areas in Need) launched
its first efforts at the end of March, when Greywoode
and others from the U.S., Sweden, Canada and
England went to Freetown, Sierra Leone, to run a
children's clinic at a hospital for a month. The project
aims to create a partnership between the Princess
Christian Maternity and Children's Hospital in
Freetown and providers in London and at UF to
combat the childhood mortality rate, Greywoode said.
Greywoode, whose family is from Sierra Leone,
started Project RAIN while a first-year medical
student. She was in New Orleans, taking a break from
volunteering after Hurricane Katrina, when she
thought about doing more to help people. So, she
decided to Google "how to start a nonprofit
organization."
"The country I come from has the highest infant
mortality rate and rate of women dying in childbirth,"
Greywoode said. "It was a desire to go back, realizing I
owe it to my country to go back and help out."
The biggest challenge was determining the
country's most vital medical needs. Sierra Leone
experienced a civil war, which began in 1991 and


ended in 2000. Its aftermath is still affecting the
country, especially health care.
"Postwar, there's nothing," Greywoode said. "It's
hard knowing what to take, what are the needs, what's
most effective?"
At the clinic, the primary focus will be on teaching
oral rehydration and implementing interventions for
anemia and diarrhea. Greywoode said the goal is to
make Project RAIN sustainable by giving vaccines
and educating people on proper hygiene and
breastfeeding.
The organization has raised about $35,000 to
purchase essential supplies such as vitamins, vaccines,
antibiotics, bandages and more.
Greywoode's mother, Eudora Greywoode, said she is
proud of her daughter and her ambitions.
"I am very happy for her. We don't tell them (the
children) what to do, they choose based upon their
interest. It's something she wants to do and she is
successful at it," Mrs. Greywoode said. "I am very
pleased she came up with a plan and was able to carry
it out. It's a very good idea and very needed."
Greywoode said she feels blessed to be helping
others. Her roots trace back to Africa. She was born in
Nigeria in 1983, the second of five children.
Greywoode's parents had left Sierra Leone before she
and her siblings were born, uncomfortable with
raising children in a climate that soon turned to
civil war.
The family moved to Gainesville when Beryl was 5.
Her father, Emile, focused on earning a doctorate in
computer science at UF. It wasn't always easy. At one
point in 1993, her family was homeless. But she said


she was always happy.
"I feel like we've come into our own. I'm grateful for
all the trials and struggles," Greywoode said. "I'm
thankful for the fact that I don't look at life and expect
things. I take care of the things I have."
Greywoode vividly remembers the moment she
knew she wanted to be a doctor.
"I was in fourth grade, and my mom was picking my
friend Kristen and I up from school," Greywoode said.
"A doctor had come to speak at our school. I remember
ranting to Mom about healing all the people in the
world."
Greywoode decided on pediatrics after her second
year of medical school. She was speaking with Kendall
Campbell, M.D., assistant dean of minority affairs,
after one of his lectures.
"He said you don't pick a specialty, you are called to
a path in medicine. I thought about it, and said it's
always kids. I've been a camp counselor and a medical
volunteer on the pediatric wards," Greywoode said.
Greywoode also volunteered at the UF Shands
Eastside Community Practice with Campbell.
"She's an outstanding student, very compassionate,"
Campbell said. "She's very altruistic. She is a visionary
in where she wants to see health care for patients go."
Greywoode credits her accomplishments to
encouragement from friends and family, especially her
parents' faith and character.
"We're an immigrant family, and it was a lot of hard
work and sacrifice on behalf of my parents,"
Greywoode said. "There were times without jobs,
times we were homeless. I am blessed to be able to give
back to others." 0


I ,161 ,l


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IJO5/f0 91 O



























t the Christianville Medical Clinic.
Providers treat more than 20,000 patients a year at the Chstianvie Medica nic.
Malaria researcher Bernard Okech plans to collaborate with clinicians to research
malaria drug resistance and to train local people in malaria screening and treatment.


Help for Haiti

UF researchers begin public

health projects in Haiti

ByJill Pease
E dsel Redden has been volunteering in Haiti for 20 years to assist in
the production of protein-rich foods for young children. Today,
1,800 children a day receive farmed fish and eggs at the
Christianville School in Gressier, Haiti.
But more work needs to be done, said Redden, director of the UF
Institute of Food and Agricultural Sciences Putnam County Cooperative
Extension Service.
"Public health programs to address issues like malaria, clean water and
latrines are pretty much nonexistent," Redden said. "I knew the expertise
was here at UF to help us with these problems."
Redden recruited faculty from the College of Public Health and Health
Professions and the Interdisciplinary Family Health program to
investigate potential public health projects during a trip to Haiti in April.
Group members toured the Gressier area, conducted interviews with
health professionals and led two community needs assessment groups
with parents. The UF group then identified four project areas for future
trips to Haiti: malaria detection and screening; clean water assessment;
health education for teachers, parents and children; and health data
tracking and basic medical care for children in a local orphanage.
With input from locals, the UF group named their initiative "Sant6 pou
Lavi," Creole for "Health for Life." 0


RSARC


Slande Celeste, an internship coordinator for the M.P.H. program,
leads a community needs assessment with a group of parents. The
group will develop health education programs for teachers,
students and parents on topics such as good hygiene practices.


UF Sant6 pou Lavi team members (kneeling) Andrew Kane, a PHHP
associate professor; (standing left to right) Michael G. Perri, PHHP's
interim dean; Bernard Okech, a PHHP research assistant scientist; Edsel
Redden; Gina Murray, educational coordinator for Interdisciplinary Family
Health; Slande Celeste, public health internship coordinator; and
Rhondda Waddell, associate director of Interdisciplinary Family Health.


http://news.health.ufl.edu


1 05/06 09 11







RSARC


Lessons from

kill Scientists discover how smallpox
a ller may derail immune system


ByJohn Pastor
U F researchers have learned more about how smallpox conducts its
deadly business discoveries that may reveal as much about the
human immune system as they do about one of the world's most
feared pathogens.
In findings published recently in the online early edition of the Proceedings of
the NationalAcademy of Sciences, scientists describe how they looked at all of the
proteins produced by the smallpox virus in concert with human proteins, and
discovered one particular interaction that disables one of the body's first
responders to injury inflammation.
"This virus that has killed more humans than any other contains secrets
about how the human immune system works," said Grant McFadden, Ph.D., a
professor of molecular genetics and microbiology at the College of Medicine
and a member of the UF Genetics Institute.
With researchers from the University of Alberta, the Centers for Disease
Control and Prevention and a private company called Myriad Genetics, UF
researchers for the first time systematically screened the smallpox proteome -
the entire complement of new proteins produced by the virus during


interactions with proteins from human DNA.
These protein-on-protein interactions resulted in a particularly devastating
pairing between a viral protein called G1R and a human protein called human
nuclear factor kappa-B1, which is believed to play a role in the growth and
survival of both healthy cells and cancer cells by activating genes involved in
immune responses and inflammation.
"One of the strategies of the virus is to inhibit inflammation pathways, and
this interaction is an inhibitor of human inflammation such that we have never
seen before," McFadden said. "This helps explain some of the mechanisms that
contribute to smallpox pathogenesis. But another side of this is that
inflammation can sometimes be harmful or deadly to people, and we may learn
a way to inhibit more dangerous inflammation from this virus."
Smallpox is blamed for an estimated 300 million deaths in the 20th century,
and outbreaks have occurred almost continuously for thousands of years. The
disease was eradicated by a worldwide vaccination campaign, and the last case
of smallpox in the United States was in 1949, according to the CDC. The last
naturally occurring case in the world was in Somalia in 1977. 0


Probing the evolution


of HIV-related dementia


By Czerne M. Reid

drugs, in the developed world an HIV or
AIDS diagnosis is no longer the swift death
sentence it once was. But although deaths rates
have fallen drastically, there has been no
corresponding decline in the rates of dementia
associated with HIV.
Twenty-five to 30 percent of persons infected
with HIV develop an aggressive Alzheimer's-like :
dementia even if they are taking anti-HIV drugs.
Those figures are about the same as they were in
the mid-1990s when highly active antiretroviral
MARCO SALEMI, PH.D.
therapy, also known as HAART, was introduced.
Although HIV-associated dementia doesn't kill
people, it can quickly impair those who have it. And with people with HIV
living longer, the overall number with minor HIV-related cognitive impairment
appears to be on the rise.
There is no effective therapy for HIV-associated dementia. But a UF
evolutionary biologist is exploring the problem by investigating what genetic
changes happen during HIV infection of the brain.
Marco Salemi, Ph.D., an assistant professor in the department of pathology,


immunology and laboratory medicine at the UF College of Medicine, has won a
five-year, $3.5 million grant from the National Institutes of Health to probe the
genetic origins of HIV-associated dementia, using animal models and
computational studies.
"It will give us the unprecedented opportunity to study the interaction
between HIV and the brain and what causes dementia in HIV-infected people,"
Salemi said. "It definitely opens a new way of looking at HIV infection in the
brain."
The research findings could ultimately lead to the development of new tools
for diagnosis and treatment of HIV-associated dementia and other AIDS-
related neurological disorders. They will also give insights into brain processes
involving Alzheimer's disease.
The multidisciplinary effort is a collaboration between UF and Boston
College researchers, including co-principal investigator Kenneth C. Williams,
Ph.D. The team will include theoretical and experimental researchers in the
fields of virology, neurobiology, computational biology and bioinformatics and
computer-based analysis of DNA sequences.
The work is also a project of the Florida Center for AIDS Research, which,
under the leadership of Maureen M. Goodenow, Ph.D., is working to gain
designation from the National Institutes of Health as a center of excellence for
HIV/AIDS research. 0


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ri 05/06-09 1














Getting tote



of preeclampsia


By Czerne M. Reid

regnancy-induced hypertension, which generally occurs in

the third trimester of pregnancy, might have its roots in gene

malfunction during placenta development in early pregnancy,

according to new findings from UF and the University of Pittsburgh.


Kirk P. Conrad, M.D., a professor in the College
of Medicine, and collaborators are the first to report
altered expression levels in at least three dozen genes
in the placenta as early as six months before the
condition also called preeclampsia develops.
"Some of the affected gene products might be
proteins secreted into the blood that could serve as
first trimester biomarkers," Conrad said. "Using
these, we might soon be able to predict who will
become preeclamptic."
That would enhance research efforts and, in time,
help to improve the care patients receive.
"This is an interesting observation, but ultimately
we have to find out what those gene products do
during the onset and progression of pregnancy," said
Nasser Chegini, Ph.D., a professor in the department
of obstetrics and gynecology. "Comparing this
information with gene profiles already obtained in
other pregnancy complications might help us do
that."
The researchers hypothesize that during the first
trimester in women destined to develop
preeclampsia, gene malfunction prevents proper


placenta development, which is critical for adequate
oxygen and nutrient supply to the fetus.
Preeclampsia's cause is unknown, there are no
preventive measures, and the only cure is to deliver
the baby and placenta. It is a leading cause of
maternal and fetal death in the United States.
Mothers and children who survive it face increased
risk of cardiovascular disease.
The condition occurs in 3 percent to 8 percent of
all pregnancies, according to the American College
of Obstetricians and Gynecologists and the National
Institute of Child Health and Human Development.
"The socioeconomic impact of it is very high,"
Chegini said, citing the millions spent on neonatal
care of infants from preeclamptic or preterm labor
patients.
Previous studies evaluated second- and third-
trimester placental tissue collected after delivery.
Because those studies were done after the onset of
the condition, it has been difficult to distinguish
cause from effect.
In the current study, however, placental tissue was
obtained at a very early stage of pregnancy, and well


before delivery, so the results likely point to causes
of preeclampsia and not effects of a disease that has
already set in.
To examine the origins of the problem, Conrad's
group conducted a pilot study using placental tissue
left over from prenatal genetic testing of 160 women,
age 34 to 44, who were in their 10th to 12th week of
pregnancy.
Four of the women went on to develop
preeclampsia. Their tissues were compared with
samples from women with normal pregnancies and
no underlying medical disorders.
Analyses called DNA microarray studies were
used to determine overall patterns of gene
expression and potentially reveal links between
underlying biological processes and clinical
manifestations of disease.
Although fetal chromosomes were normal in
number and appearance in the preeclamptic
mothers, at least 36 genes in the placenta were
expressed differently compared to normal
pregnancies: Thirty-one genes had lower expression
than normal, while five had higher expression.
Conrad, a member of UF's Reproductive and
Perinatal Biology Research Group, and colleagues
had expected to see overexpression in genes involved
in the body's response to oxygen depletion or
production of harmful "reactive oxygen species."
That's because previous preeclampsia studies found
indirect evidence for depleted oxygen levels in the
placenta, as well as signs of so-called oxidativee
stress" resulting from stoppage and restarting of
blood flow. Those studies used placental tissue
obtained after delivery.
But analysis of pre-delivery tissue from the end of
the first trimester showed that genes involved in
those processes were unaffected at that point.
"To me this is one of the most unexpected results
because of current beliefs," Conrad said, adding that
the time sequence suggests that previously noted
oxygen effects likely are later events not primary
causes in the disease process.
The results, published recently in the journal
Placenta, might not apply to younger women -
those included in the study were at relatively
advanced age, and therefore considered to have
at-risk pregnancies.
The findings need to be corroborated by a larger
study, but getting enough samples is a challenge.
"This study was a labor of love it took us four
or five years to get 160 samples, and we had to enroll
160 patients to get four that became preeclamptic,"
Conrad said. "We couldn't wait anymore." 0


http://news.health.ufl.edu


1 0/0B-c091






R A


Promising


findings for


muscular


dystrophy


ByJohn Pastor
researchers have cleared
a safety hurdle in efforts
to develop a gene
therapy for a form of muscular
dystrophy that disables patients
by gradually weakening muscles
near the hips and shoulders.
Described as the first gene therapy trial in BARRY BYRNE, M.D.
muscular dystrophy to demonstrate promising
findings, researchers from UF, Nationwide
Children's Hospital in Columbus, Ohio, and The Ohio State University report
how they safely transferred a gene to produce a protein necessary for healthy
muscle fiber growth into three teenagers with limb-girdle muscular dystrophy.
The findings, which have relevance to genetic disorders beyond muscular
dystrophy as well as conditions in which muscles atrophy, were published online
in April in the Annals of Neurology.
"We think this is an important milestone in establishing the successful use of
gene therapy in muscular dystrophy," said Jerry Mendell, M.D., director of the
Center for Gene Therapy in The Research Institute at Nationwide Children's
Hospital and the lead author of the study. "This trial sets the stage for moving
forward with treatment for this group of diseases and we are very pleased with
these promising initial results. In subsequent steps we plan to deliver the gene
through the circulation in hopes of reaching multiple muscles. We also want to
extend the trials over longer time periods to be sure of the body's reaction."
Limb-girdle muscular dystrophy actually describes more than 19 disorders
that occur because patients have a faulty alpha-sarcoglycan gene. In each of the
disorders, the muscle fails to produce a protein essential for muscle fibers to
thrive. It can occur in children or adults, and it causes their muscles to get
weaker throughout their lifetimes.
The trial evaluated the safety of a modified adeno-associated virus an
apparently harmless virus known as AAV that already exists in most people -


as a vector to deliver the alpha-SG gene to muscle tissue.
"The safety data is accumulating because this is the same type of vector that
we and other research groups have successfully used in gene therapy trials for
other diseases," said Barry Byrne, M.D., a UF pediatric cardiologist who is a
member of the UF Genetics Institute and director of the Powell Gene Therapy
Center. "In this effort, although proof of safety was the main endpoint, the
added benefit was that this was an effective gene transfer. Even though we were
dealing with a small area of muscle, the effect was long-lasting, and that has
never been observed before."
Research subjects received a dose of the gene on one side of the body and
saline on the opposite side. Neither the researchers nor the patients knew which
of the foot muscles received the actual treatment until the end of the
experiment.
The volunteers were evaluated at set intervals through 180 days, and therapy
effectiveness was measured by assessing alpha-SG protein expression in the
muscle, which was four to five times higher than in the muscles that received
only saline.
The volunteers encountered no adverse health events, and the transferred
genes continued to produce the needed protein for at least six months after
treatment.
In addition, scientists actually saw that muscle-fiber size increased in the
treated areas, suggesting that it may be possible to combat the so-called
"dystrophic process" that causes muscles to waste away during the course of the
disease.
Beyond muscular dystrophy, the discovery shows muscle tissue can be an
effective avenue to deliver therapeutic genes for a variety of muscle disorders,
including some that are resistant to treatment, such as inclusion body myositis,
and in conditions where muscle is atrophied, such as in cancer and aging.
"These exciting results demonstrate the feasibility of gene therapy to treat
limb-girdle muscular dystrophy," said Jane Larkindale, portfolio director with
Muscular Dystrophy Association Venture Philanthropy, a program that moves
basic research into treatment development. "The lack of adverse events seen in
this trial not only supports gene therapy for this disease, but it also supports
such therapies for many other diseases."
The research was supported by the Muscular Dystrophy Association and the
National Institutes of Health. O


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


1 05/06-09


201 ~~






































Vickie Green-Smallwood was treated at Shands Jacksonville after suffering a gunshot wound.


By Kandra Albury


O n the morning of Feb. 2, 2007,
Vickie Green-Smallwood, 43,
was commuting to her office in
downtown Jacksonville when a stray bullet hit
her in the face.

"I didn't know what was happening," Green-Smallwood said. "The
paramedics came and they rushed me to Shands."
Green-Smallwood was taken to TraumaOne, Shands Jacksonville's
Level I Trauma Center, where a multidisciplinary team of UF
physicians treated her. She woke up three weeks later after being in a
drug-induced coma. She could barely remember what happened but
realized that a huge portion of her lower jaw was missing.
One of the leading oral and maxillofacial surgeons in the region, Rui
Fernandes, M.D., a UF College of Medicine-Jacksonville assistant
professor of oral and maxillofacial surgery, took on the challenge of
reconstructing Green-Smallwood's jaw.
"She needed to have a new lower jaw made, as well as facial muscles
and the inside of her mouth remade," Fernandes said.
In May 2007, Fernandes transplanted some of Green-Smallwood's
lower leg bone, skin and muscle, along with an artery and veins, to
rebuild her jaw. The procedure took about 10 hours.
"The surgery is very difficult and the technique is sensitive because
of the detailed work needed to reconstruct the jaw and make it look like
normal," Fernandes said. "It's the microvascular portion that is most
challenging as it requires suturing with needles that are thinner than a
human hair."


Behind the numbers: TraumaOne at Jacksonville
30: Counties inI Florida and Georgia that TiaumaOne at Shands
Jacksonville ser es
2,392: Admissions in 2008
4,019: Resuscitation ,'olurne for 2008
53: Aveiage daily census at the Jacksonville trauma center
Two: Helicopters to transport patients in Florida and Geoigia
1,011: Patients who are airlifted to Shands Jacksonville each year

Fernandes said after undergoing this major operation, she underwent
a second for tooth implants.
Fernandes does this type of microvascular procedure often and is the
only surgeon in North Florida currently able to perform it.
Green-Smallwood said she was concerned about how her face would
look after the operation and whether there would be any noticeable
scarring.
"People don't notice my face that's just how good of a job he did,"
Green-Smallwood said. "Dr. Fernandes is my hero. I will never forget
him because he's not only talented, but he is a kind and awesome
doctor."
Since the tragedy, Green-Smallwood said she's hopeful and always
looks forward to spending quality time with her 14-year-old daughter.
Now, she plans to attend Florida Community College at Jacksonville to
become a registered nurse.
"I would not have wanted another trauma center to treat me other
than Shands Jacksonville, because they really took care of me,"
Green-Smallwood said. 0


http://news.health.ufl.edu


1 05/06- 09 1











COLLEGE OF PHARMACY

RHONDA COOPER-DEHOFF,
Pharm.D., M.S., an associate
professor of pharmacy and
medicine, is one of nine
presenters out of 376 whose
work was selected as a featured
poster in May at the 2009
meeting of the American
Society of Hypertension in San Rhonda Cooper-DeHoff
Francisco. The award honors
scientific merit, research quality and creativity.
Cooper-DeHoff's poster outlines a new mechanism
for how blood sugar metabolism is disrupted by
diuretic drugs also called water pills in patients
with high blood pressure and metabolic syndrome.

HENDRIK LUESCH, Ph.D., an
assistant professor of medicinal
chemistry, has been selected as
one of 10 inaugural recipients
of the Jack Wessel Excellence
Awards for Assistant Professors.
Wessel, a friend of UF, wished
to recognize the research
productivity of faculty members
early in their academic careers.
Each award is a one-time allocation of $5,000
in support of research and can be used to fund
travel, equipment, books, graduate students and
other research-related expenses.

GREG WELDER, Pharm.D., who
graduated in May, and WILL
ROBERTSON, a third-year
pharmacy student, each received
the American Society for Clinical
Pharmacology and Therapeutics
Presidential Trainee Award in
March at the annual ASCPT
meeting in Washington, D.C.
Each student displayed a poster
and gave a short presentation
at the meeting. Welder received
the award for the second time.
His winning research abstract
was "Atorvastatin reduces ENA-
78 chemokine concentrations
independent of LDL-C changes
in a cardiovascular disease
free population." Robertson Will Robertson
also presented his research,
"CXCL5/ENA-78 Genotype Progression to Death or
Transplantation in Heart Failure Patients."


PUBLIC HEALTH AND HEALTH PROFESSIONS

WILLIAM MANN, Ph.D.,
O.T.R./L., a distinguished
professor and chair of
occupational therapy and
director of the Ph.D. program in
rehabilitation science, was the
co-winner of this year's Institute
for Learning in Retirement
Outstanding Research Mentor William Mann
award. Mann was recognized
for his work mentoring graduate students with an
emphasis on aging research and improving the
quality of life for older adults.

COLLEGE OF MEDICINE

PHILLIP BARKLEY, M.D.,
director of the Student Health
Care Center, received the C.
Arthur Sandeen Improving the
Quality of Life Award, which
honors individuals who have
demonstrated a commitment
to improving the quality of life
for UF students. A committee Phillip Barkley
composed of the student body
president, the dean of students and Dr. Sandeen
chose Barkley for the award.

ALEXANDER C. WAGENAAR,
Ph.D., a professor of
epidemiology and health
policy research, will receive
the Society for Prevention
Science's annual Prevention
Science Award at the group's
annual meeting in May. The
award is given to recognize AlexanderC.Wagenaar
a researcher whose work
has made significant contributions to prevention
research. Wagenaar, a social epidemiologist,
studies the ramifications of policy changes and
other public interventions. He was also recently
named associate director of a new Robert Wood
Johnson Foundation-funded initiative. The project
supports research that will examine legal and
regulatory solutions to current public health issues
such as infectious and chronic diseases, and health
emergencies such as floods, bioterrorism and
various health epidemics.


PETER R. NELSON, M.D.,
M.S., an assistant professor
of surgery, will speak in May
in Australia as the Association
for Academic Surgery's
international visiting professor.
The professorship award is
part of a leadership exchange
program between the AAS and Peter R. Nelson
the Younger Fellows Committee
of the Royal Australasian College of Surgeons.
Nelson, a vascular surgeon, will give three
talks in Australia and will moderate a research
poster competition. His talks will focus on issues
confronting the field of surgery, research program
development and the important role of research in
training future surgeons.

JACKSONVILLE

MICHAEL SUK, M.D., J.D.,
an assistant professor of
orthopaedic surgery and chief
of the division of orthopaedic
trauma surgery, has been
appointed by the Orthopaedic
Trauma Association to serve on
its Health Policy and Planning
Committee through March Micl
2012. Suk is also an associate
program director for the orthopaedic surgery
residency program at the UF College of Medicine
Jacksonville.

SENIOR VICE PRESIDENT, HEALTH AFFAIRS

DOUGLAS J. BARRETT,
M.D., UF's senior vice
president for health affairs,
was recently named a member
of the Institute of Medicine
Committee to Review Vaccine a
Safety. Composed of experts
from across the country, the
committee is charged with Douglas J. Barrett
reviewing evidence related to
negative effects of certain vaccines, including the
varicella zoster vaccine, influenza vaccines, the
hepatitis B vaccine and the human papillomavirus
vaccine. Barrett, a pediatrician who specializes in
immunology, has served as senior vice president
for health affairs since 2002. He is set to step
down from this position later this year. He plans
to resume teaching and practicing medicine
and hopes to spend more time advocating for
children's health services.


Three students from the UF College of Veterinary Medicine have received financial awards from Gulfstream
Park to further their equine studies. Established after the death of 2006 Kentucky Derby winner Barbaro, the
award program is in its third year. Magna Entertainment Corp., which owns the park, provides $12,500 in
financial assistance and professional mentoring through the American Association of Equine Practitioners to
two senior UF veterinary students committed to careers in equine medicine and surgery. Those scholarships
are known as the Gulfstream Barbaro Awards, and this year's recipients are Megan Lamb and Erica
Rosen. The park also provides $5,000 through the Barbaro Research Award to a UF veterinary graduate
student who is conducting equine research. This award went to Astrid Grosche, a board-certified
internist in large animal medicine. Shown here (from left) are committee member Kas Willis, veterinary
student Erica Rosen, jockey Kent Desormeaux, veterinary student Megan Lamb, committee member Jan
Hansen, graduate student Astrid Grosche, and committee members Jeff Humke and Shirley Horn.
(Photo courtesy of Gulfstream Park)


i221 1j


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


1 05/06-09







PRFIE


The spirit of caring


Planetree winner Marcia Miller recognized for compassionate patient care


ByJessica Brandi
Physicians are trained to
establish bedside manner,
to be respectful and deliver
diagnoses in a non-threatening
way. But for some doctors, there
are more personal ways to connect
with patients.

"It's usually a hand on their shoulder and listening
- a very light touch, but there's that connection that
goes beyond words if it's done in the appropriate
manner," said Marcia Miller, M.D., an assistant
professor in the department of community health and
family medicine.
Miller was the recipient of this year's Planetree
Spirit of Caring Award in recognition of her
commitment to patients and her personal approach to
medicine. In 1998, Shands AGH became the first
hospital in Florida to affiliate with Planetree, a
nonprofit organization committed to the development
of patient-focused health care.
Miller said humanistic medicine means looking at
everything that contributes to a person's well-being,
including their life stressors and family and spiritual
needs in addition to their physical ailments.
"It's about encompassing the whole person, not just
their disease and their diseased state," she said. "You
can't take care of a patient with that narrow focus."
The Planetree philosophy focuses on human needs
and taking a more holistic approach to medicine.
Patients are given choices and are encouraged to be
actively involved in their health care.
Department Chair R. Whit Curry Jr., M.D., said the
Planetree model is incorporated into all aspects of a
hospital from the staff's attitude toward patients to the
way the rooms are designed. Some of these touches can
include the use of wood floors and warm colors over
sterile white hospital tile and rehabilitating patients
with art and music.


"It's an attempt to make a hospital, a rather frightening environment, a more user-friendly place for
patients, by making patients feel more at home and by encouraging more family involvement," he said.
While empathizing with a patient's condition and making them feel comfortable about treatment is
important, Miller said that sometimes it's "just the pleasantries" that make a difference, and it is
equally important to laugh and connect with patients on a personal level.
"I saw a lady last night in the emergency room who I had taken care of three years ago. She walked
in the door and said to me, 'Hey girlfriend!' It was just nice to elicit that response. She obviously
remembered me, and it was a nice feeling," she said.
Miller said community health and family medicine allows her to establish continuing interactions
with patients who come back to her over the years. She said she likes when patients give her updates
about their jobs and families and share parts of their lives with her.
"You have these ongoing relationships, which you don't really think of when you're just doing
hospital medicine, and it's a nice way to still be involved with the patient, with their life," she said.
"You kind of go in and out, but that's OK too."
Curry said Miller stands out because she is consistently recognized as a gifted healer and an
inspiring role model by students, staff and patients.
"What can I say about a doctor that sits on the bed next to you, holds your hand, shares M&M's and
lets you cry and calms your fears? Awesome!" a patient's daughter said in a past evaluation. "I watched
her soothe out all the wrinkles of worry in my mom's face and leave her with smile lines." 0


http://news.health.ufl.edu


1 05/06- 09 1







SE A


During the College of Medicine Class of
2009's "last lecture" May 8, Dr. Jay Lynch, a
UF oncologist, read from several essays
medical students had written about their
experiences with patients. The lecture
covered a range of topics, centering mostly
around what it means to be a good doctor.


Shands at UF recently celebrated the grand opening of the Shands Children's Surgical
Center at Ayers Medical Plaza. Dr. David Kays (left), the division chief of pediatric surgery,
was one of several leaders who spoke at the grand opening.


Dr. Maureen Novak wears many hats in her roles as a
pediatrician, the associate dean of medical education
and in her home life. She explained this point by
donning a hat during her talk at the College of
Medicine Medical Education banquet in April.


Published by
UF Health Science Center
Office of News & Communications
Senior Vice President,
Health Affairs
Douglas J. Barrett, M.D.
Interim Director,
News & Communications
Melanie Fridl Ross

Editor
April Frawley Birdwell
afrawley@ufl.edu


Senior Editors
Melanie Fridl Ross, John Pastor
Designer
Mickey Cuthbertson
Staff Writers
Kandra Albury, April Frawley Birdwell,
Jennifer Brindise, Tracy Brown Wright,
Sarah Carey, Karen Dooley, Linda
Homewood, Laura Mize, John
Pastor, Jill Pease, Czerne M. Reid,
Karen Rhodenizer, Melanie Fridl Ross,
Priscilla Santos, Christine Velasquez


Contributing Writers
Jessica Brandi, Jessica Metzger,
Monica Vigo

Photo Editor
Sarah Kiewel
Support Staff
Cassandra Mack, Beth Powers,
Kim Smith

The POST is the monthly internal
newsletter for the University of
Florida Health Science Center, the
most comprehensive academic
health center in the Southeast,


with campuses in Gainesville
and Jacksonville and affiliations
throughout Florida. Articles feature
news of interest for and about
HSC faculty, staff and students.
Content may be reprinted with
appropriate credit. Ideas for stories
are welcome. The deadline for
submitting items to be considered
for each month's issue is the 15th
of the previous month. Submit to
the editor at afrawley@ufl.edu
or deliver to the Office of News
& Communications in the
Communicore Building, Room
C3-025.


F Health Science Center

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