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On the Cover
Teamwork is key to new discoveries in
science and advances in health care.
This month, The POST brings you a few
stories about how the art of teamwork is
flourishing at UF
Table of Contents
O Administration: Shands Cancer Hospital
9 Patient Care: Electronic medical records
* Extraordinary Person: Cuc Tran
O Education: FDA scholarship
Q Education: Advocates for kids
4 5 Questions: American Pharmacy Month
0 Cover Story: Team HSC
Q Research: Science of snakebites
( Research: Benefits of tai chi
0 Jacksonville: Phyllis Hendry
1 Profile: Peter Lang
A vision of medicine's future
imagine nano-size devices that measure thousands of blood
elements, and DNA sequencers that rapidly and cheaply decode
personal genomes. Throw in advanced computers to sort
through these huge amounts of data, now stored in our medical
histories. It is just a matter of time, according to Leroy Hood, Ph.D.,
who invented the sequencing technology that decoded the human
genome in 2001. He will talk more about medicine's future at 5 p.m.
Oct. 28 at the HPNP Complex auditorium for Florida Genetics 2009,
the annual symposium of the UF Genetics Institute. All are invited
to attend Hood's presentation. Hood thinks medicine will become
far more nimble and proactive in the next 20 years, freeing health-
care professionals from simply reacting when people get sick. "The
...- average doctor's office visit today might involve bloodwork and a
few measurements, such as blood pressure and temperature," Hood
said recently in Newsweek. "In the near future physicians will
collect billions of bytes of information about each individual-
genes, blood proteins, cells and historical data. They will use this
data to assess whether your cell's biological information-handling
circuits have become perturbed by disease, whether from defective
genes, exposure to bad things in the environment, or both." 0
Visit us online @ http://news.health.ufl.edu for he iciest news end HSC events I
FREE VEHICLE CHECKS FOR OLDER DRIVERS
The PHH P department of occupational therapy will offer CarFit, a free national program that
gives older adults the opportunity to check howtheir personal vehicles "fit" them. CarFit will
be held from 9 a.m.to 3 p.m. Nov. 13 in the parking lot at Carrabba's Italian Grill, 3021 SW
34th St., Gainesville. Trained occupational therapy students will lead mature drivers through
a 12-point checklist with theirvehicles, recommend personal vehicle adjustments and
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SCIENCE = ART
Ever marveled at the beauty of a blueberry pollen tetrad under a microscope? OK, maybe
you haven't, but chances are if you're a scientist you've found beauty in places people
may not always see. Now, UF's Marston Science Library is giving you your chance to
show others the art of science through the second annual Elegance of Science contest.
Faculty, staff and students are invited to enter 2-D artwork and images produced during
research or that "incorporate tools and concepts from science." Prizes range from $50 to
$200. Entries must be received by Dec. 21. Awards will be presented in the spring. For
more information, visit www.uflib.ufl.edu/msl/art.
--- --------' ----~
Employee artwork on display at the Shands
By Allison Wilson
When Shands Arts in Medicine Director Tina Mullen went searching for
artwork to display in the Shands Cancer Hospital at UF, she realized she
wouldn't have to look far.
"I decided to ask employees to contribute their creative selves to the decorating of this
new building," Mullen said. "The idea was, 'Let's communicate to patients that their
health-care providers at all levels are more than just health-care providers. Let's decorate
the new building with their artwork."'
Mullen issued a 30-day "call to employee artists" to submit their best nature
photography to be considered for display in the hospital. After poring over more than
1,000 submissions, she and her team chose 68 artists and 300 photos that will decorate
patient rooms, waiting rooms, corridors, exam rooms, consult rooms and the cafeteria.
The work came from Shands employees and UF Health Science Center faculty and staff.
"Everyone submitted such wonderful work," Mullen said. "It was special to realize that
our employees and medical staff would take this kind of time to submit something, and
we wanted to be respectful of all those submissions. We went through each one diligently,
and really what eliminated 90 percent of the photos was simply a matter of the file size not
being large enough. The work was professional quality." Q
October offers chances to get
inside look at the Shands Cancer
throughout October, Shands HealthCare, UF Physicians and
UF Health Science Center employees are invited to attend
open houses and special events on the new Shands at UF
South Campus, where the Shands Cancer Hospital at UF and the
Shands Critical Care Center at UF are located. The following is a
list of several events leading up to the hospital's Nov. 1 opening.
Oct. 19: All-Employee Open House
When: 7 a.m-9 a.m., 11 a.m.-1 p.m., 4 p.m.-6 p.m.
Where: Shands Cancer Hospital Lobby
Details: This event is for all Shands HealthCare, UF Physicians,
HSC employees, medical staff, students and volunteers. Activities
include building tours, prize drawings and music. Light
refreshments will be served.
Oct. 24: Public Open House
When: 9 a.m.-noon
Where: Shands Cancer Hospital Lobby
Details: This will be the largest event for the grand opening of the
new hospital and the only event that is open to the entire
Oct. 25: Candlelight Celebration Program
When: 6:30 p.m.
Where: Shands at UF South Campus
Details: Employees, medical staff, students and volunteers are
invited to the Shands at UF South Campus. Join state, community,
Oak Hammock and Garden of Hope donors for a short program
and candlelight celebration to mark the opening of the new
medical center. Please see Shands News and Shandsgiving.org for
more details leading up to the event. O
Meet the College of Pharmacy
iguring out how to get accepted into pharmacy school may be stressful, but the College of Pharmacy is easing the
stress by hosting its annual open house to help inform interested students. The event begins at 1 p.m. Nov. 1 in the
HPNP Complex auditorium, Room 1404. Speakers will present information and answer questions until 4:45 p.m.
Other topics of interest will include application procedures, pre-pharmacy coursework, distance education sites, financial
aid, college and Health Science Center facilities, career opportunities, student life and doctor of pharmacy curriculum. For
more information, call the UF College of Pharmacy Office for Student Affairs at 352-273-6219. Q
Visit us online @ http://news.health.ufl.edu for he latest news and HSC events I
College of Medicine clinics making
switch to electronic medical records
By Laura Mize
Fh we switch to electronic medical records at the clinics run
by UF's College of Medicine began at what some might
consider an unlikely location: Family Medicine at Old
Town, a small clinic tucked behind a Hardee's restaurant off
U.S. Highway 19 about an hour outside of Gainesville.
The move puts the clinic ahead of many medical facilities in the nation, said Marvin Dewar,
M.D., J.D., chief medical officer and interim senior associate dean of UF Physicians.
"I do think we're a little ahead of the curve," Dewar said.
Staff at the clinic began using Epic, an electronic medical records system, in August. Shani
King, C.M.A., a medical assistant at the clinic who's been trained as an Epic "super user" to help
her colleagues with their problems with the program, said the transition has had its share of
missteps, but she's optimistic about the end result. .
Switching to the new system means clinic staff members have to enter information from old
paper records into the electronic system, a time-consuming task. Despite some glitches that are
still being worked out and the work of entering information from old files, King said she
believes using the new system will benefit patients.
"Everything will be documented," she said. "Nothing will get thrown away on a piece of paper
by accident or anything like that. I'm not saying there won't be holes that ... things will fall
through, but I think, in the long run, I think it's going to be better."
Dewar agreed, saying the new system should mean "safer care, higher-quality care, more
"We've got sites (from) Vero Beach to Lake City and ... in many different specialties," he said.
"So without a single unifying record, it's easy to understand how communications sometimes
isn't what it needs to be."
Dewar said the initial cost to install the system will be $8 million, but he anticipates the Shani King is a medical assistant
college will get much of that money back in stimulus payments the federal government has College of Medicine in Old Tow
promised to begin making in 2011 to organizations using electronic medical records. began using electronic medical
Clinics run by the college and Shands should all be using Epic by early 2011, Dewar said. first clinic run by the college to n
In addition to Family Medicine at Old Town, Family Medicine at Fourth Avenue and Family
Medicine at Haile Plantation have begun using Epic. Family Medicine at Hampton Oaks is
scheduled to begin using the program in late October.
"(It's) an exciting time," Dewar said of the switch to electronic medical records. "The EMR
rollout comes after several years of planning and preparation." 0
EMR across the HSC and Shands:
Shands HealthCare: Is working on a contract with Epic for its facilities. Widespread use of electronic medical records will begin in 2011.
College of Veterinary Medicine: Began using Idexx Cornerstone in November 2007.
College of Public Health and Health Professions: Clinics in the college's department of clinical and health psychology are moving towai J
using the Epic system chosen by the College of Medicine. Clinics run by the college's department of communicative disorders transit !..nJ
to a system called SmartChart in mid-August.
College of Dentistry: Does not use electronic medical records but plans to begin using them in the future.
College of Nursing: Is negotiating the purchase of a new electronic medical record system to be implemented at Archer Family Health ( a~i
in early 2010. It will replace the existing electronic medical records system.
College of Pharmacy: Does not manage any medical records, but faculty and staff do use electronic medical records in clinical setting,
Students are trained to use electronic medical records.
Visit us online @ http://news.health.utl.ed'" .
t at a clinic run by the
n, Fla. The clinic, which
records in August, was the
nake the switch.
The journey to ho ePHHP grad, Vietnamese refugee
'i~ *for the flu. Composed of students and faculty from the EPI and the colleges of
R Medicine, Nursing, Pharmacy and PHHP, the group hopes to immunize 70
h W d percent of local children. After spending the past two months educating
A- parents and children about FluMist, an inhaled form of the vaccine, the group
By April Frawley Birdwell
ie fishing boat was small, just big enough for the
fishermen and the 86 people packed into the hull,
each person lying flat and still to avoid being seen.
If the Vietnamese authorities caught them, they could
be sent to prison or possibly killed.
Cuc Tran, then 3, huddled on top of her mother's chest. It was 1988, about 13 years
after the fall of Saigon, and Tran's mother had decided to flee with her tiny daughter. It
wasn't the first time she had tried to escape. Her family thought her choice was foolish,
but attempt after attempt, the schoolteacher and her daughter kept trying in hopes of
finding a better life.
"The communist government oppressed us under their rule," said Tran, now a
project manager for the UF Emerging Pathogens Institute. "They tried to control
everything our way of life, our economic situation and our point of view. Having a
50-50 chance at opportunity is much better odds than no chance at all, and my mother
felt that taking the risk was the only option when faced with the prospect of slowly
wasting away under oppression."
They almost didn't make it. Miles from shore in the middle of the ocean, the boat
broke down during a typhoon, leaving the 86 people who were packed in the vessel like
sardines to survive with no water and only powdered porridge to eat.
"We were close to dying when the fishermen from Malaysia saved us," Tran said.
Tran's memories of this time in her life are vague snippets from her year in a
refugee camp in the Philippines, the class she took to learn English, the shock of
moving to the United States in 1990 but these memories, however fuzzy, have
shaped who she is.
She wants to help people the way she has been helped throughout her own life. It's
one of the reasons she chose to pursue public health after earning her undergraduate
degree in food science and human nutrition from UF.
Now 25, Tran graduated with a master's in public health from the College of Public
Health and Health Professions in August and is working for the Emerging Pathogens
Institute, helping lead a project to immunize all of Alachua County's schoolchildren
Visit us online @ http://news.health.ufl.edu for he iciest news end HSC events
is just beginning to administer the immunizations this month.
"No other group has been able to immunize 70 percent. We're hoping to be
the first in the nation," Tran said.
Tran got her start in public health after she joined the Gator Launch
program while a UF undergrad. The career development program paired her
with a mentor at the Alachua County Health Department, George Gibbs, a
regional project manager for the Centers for Disease Control and Prevention
who is based at the health department. Gibbs remembers how Tran jumped in
and was an immediate help to his office, which oversees STD outreach efforts
for 16 counties in North Florida. For her work there, she received the Gator
Launch award for outstanding mentee, Gibbs said.
"I have met many students and Cuc is in my top 5 percent of all the students
I have ever mentored," said Gibbs. "Cuc is very mature, self-motivated. We
were very impressed with her.
"I have seen her grow and develop from a student to an M.P.H. We're lucky
to have someone like Cuc in public health now."
Tran began working on the flu project about a year ago while analyzing data
for UF researchers Parker Small, M.D., and J. Glenn Morris, M.D, M.P.H.,
director of the Emerging Pathogens Institute. Since then, she's been involved
in almost every phase of the project and has spent the past couple months
going into schools and helping educate students and parents about the
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finds solace helping others
During a visit to a middle school, she spent some time talking with a female
student, not about the flu, but about her life. Typical stuff like college plans,
hopes and dreams.
"I saw myself in her when I was younger," Tran said. "She needed someone to
encourage her and let her know that she can make a difference and achieve all her
goals if she set her mind to it."
The conversation reminded Tran of her fourth-grade teacher, Mrs. English.
After immigrating to the United States at 5, Tran didn't fare so well in her new
school. She had to take a test before she started school on color knowledge. She
knew every color except one: gray. She didn't know the word for it.
"They gave me a bad score and I was so upset," Tran remembered.
But everything changed in fourth grade. Mrs. English took the time to explain
why Tran missed certain answers and recognized that she no longer needed to
take the English class for non-native speakers
"She was a big influence in my life," Tran said. "She was one of the first people
to say 'You're really bright' and to help me. If my teacher didn't do that for me,
my life would have turned out really differently."
It's not much of a surprise then that Tran's goals center so much on helping
other people. After she pursues her doctorate, she hopes to become a professor,
providing opportunities to empower people who want to change their lives and
communities through public health.
"People often don't realize how big an effect their small acts of kindness can
have on a person," Tran said. "My life is proof that little changes people make do
help. Because of those little changes, I'm now making a big change through the
flu program." Q
Recent College of Public Health and Health Professions graduate Cuc Tran
is part of a team at UF working to immunize local school children for the
flu this fall. Tran, who now works for the Emerging Pathogens Institute came
to the United States when she was 5, a little more than a year after she and
her mother (opposite page) escaped from Vietnam.
By Kim Libby
H SC students may find themselves studying with a whole new
sense of focus in the 24-hour study hall.
After summer renovations, the center's 3,100-square-foot
"Blue Room" reopened for student use Sept. 28. Located on the second
floor of the Communicore Building, it now features new carpet,
ceilings, furniture, doors and freshly painted blue on the walls to keep
true to its name.
According to Marie Brown, a project manager and interior designer
for UF's Facilities, Planning and Construction Office, the changes were
necessary to rid the room of its old, shabby vibe.
"Whenever someone didn't know what to do with a chair, they just
stuck it in there," she said. "The furniture was very random and the
lighting was bad, which made people start to complain."
The changes were managed by a planning advisory committee that
consisted of Brown, Dennis Hines from the Office of the Senior Vice
President of Health Affairs and Laverne Burch from the HSC Library.
Students were also on the committee, including then fourth-year
medical student and current resident Omayra L. Marrero and Kathy
Janion, a College of Dentistry student.
Old study carrels were replaced by new ones in addition to long,
wooden tables. The committee picked out a color scheme, lighting, type
of carpet and wood. They wanted the setting to ensure a quiet space,
particularly for studying for board exams, instead of a lounge
Lauren Rittenbaugh, a second-year pharmacy student, said she had
only been in the Blue Room once or twice before the renovations
because she did not like the tiny carrels and old, tile floors. She said she
now enjoys the new, bright lighting and comes to the room often to get
her work done.
The construction work was completed by the HSC Construction
Auxiliary, headed by Danny Moore, and continues to be administrated
through the HSC Library. O
An FDA-APPROVED program
UF teams with FDA to train clinicians in pharmaceutical
outcomes and policy sciences
By Kimberly Buchholz
his fall, the UF College of Pharmacy
enlisted a few good men and women
into graduate studies in drug evalua-
tion, policy and safety issues through a new
The Food and Drug Administration's Center for Drug Evaluation
and Research, working with the U.S. Public Health Service
Commissioned Corps, had been seeking an educational partner that
could help attract scientists and health professionals to fill a growing
industry need. Capt. Greg Wood, director of the CDER Academic
Collaboration Program, came to UF last year with a new partnership
"This partnership is the first of its kind for our agency," Wood said.
The scholarship program provides tuition, salary and housing, and
guarantees a job with CDER upon graduation.
Working collaboratively with industry, academia and other part-
ners is an important agency goal, Wood said. Improving the drug de-
velopment and review process is vital to improving public health for
In addition to meeting UF graduate admission requirements, stu-
dents must be commissioned as officers in the U.S. Public Health
Service Commissioned Corps. For class and program events, they
wear the same service khaki uniform as the U.S. Navy, with a special
Commissioned Corps insignia. They must also be full-time students
and agree to work for CDER for two years in return for each year of
The federal agency's public health directive and mission are to ap-
prove safe and effective drugs and to provide consumers and health-
care practitioners with accurate drug information. This requires a
greater demand for scientists and health professionals trained in reg-
ulatory and safety sciences, said Russ Abbott, director of the CDER
Office of Management.
"Working closely with a graduate health science educational pro-
gram like the one at UF is a good way for the agency to achieve its
goals," Abbott said.
Danielle Smith, who graduated with a doctor of pharmacy degree
from Florida A&M University in spring, learned she was one of five
students accepted into the new program at UF.
"It will allow me to further my education and will guarantee a job
with the organization that I want to work with upon graduation," said
Smith. "It's a win-win situation."
In July, Smith and her classmates all commissioned officers in
the U.S. Public Health Service participated in a one-week FDA
orientation in Silver Spring, Md., before attending two weeks of offi-
cer basic course training in Lansdowne, Va.
Jonas Santiago, a student from the Washington, D.C., area, learned
of the program while working for the FDA during a student rotation
to complete his doctor of pharmacy degree at Howard University.
"The program specializations in pharmacoepidemiology, patient
safety and risk evaluation directly correlate to certain offices and divi-
sions within CDER. The advanced training and completion of this
program will help make me an important asset for the center,"
Starting in fall 2010, up to 20 new students will be admitted to the
program. Almut Winterstein, Ph.D., director of the UF FDA/CDER
Scholarship Program, is encouraging qualified students to visit the
college's Web site, www.cop.ufl.edu, for application information un-
der the department of pharmaceutical outcomes and policy.
Winterstein, an associate professor in pharmaceutical outcomes
and policy at UF, added the college was honored the FDA selected it
as an educational partner. In addition to its existing curriculum, the
college will tailor class projects to FDA research needs to ensure that
students have the best preparation possible for a career with CDER
and beyond, Winterstein said.
"I believe that the expertise in our department and the portfolio of
our specializations fits well with the FDA need for clinical research
capacity," Winterstein said. O
(/ for kids
UF pediatric residents focus on advocacy
By April Frawley Birdwell
When a baby is born, new parents are bound to agonize
over every question: How often should the baby dirty
its diaper? What happens if the baby bleeds when the
umbilical cord falls off? What is considered a fever in a baby? The list
could go on.
But while these common questions are
important, they're not necessarily concerns that
justify rushing a baby to the emergency room. To
help answer common questions parents have, a
group of UF pediatric residents put together a
small brochure, which was passed out at UF
pediatrics clinics. Last year, then third-year
pediatrics resident Sara Slovin, M.D., took parent
education a step further, teaming up with a
community group for new moms to offer the class
"Babies Don't Come With Instructions." Basically,
"It was to improve parents' knowledge base
about normal newborn care and improve their
comfort level," said Slovin, who finished her
residency in July and is now a fellow at the Johns
Hopkins University School of Medicine.
For pediatric residents, teaching parents is just
one facet of an important role they are learning to
play as pediatricians patient advocate. While
most doctors and specialists are advocates for their
patients, the role of advocacy in pediatrics is even
more pronounced, says Michele Lossius, M.D., a
UF assistant professor of pediatrics. Why?
Children are too young to vote for policies that
affect them and cannot advocate for themselves.
"As pediatricians, we are constantly doing
advocacy," Lossius said. "You're affecting each
child who comes in your office, but you're also
trying to create local awareness and health change."
To better prepare residents to advocate for
patients, UF pediatric residents in Gainesville
spend one month during their second year in an
advocacy rotation. During this time, the residents
work on projects they are passionate about for
Slovin it was the newborn class as well as visit
legislators in Tallahassee and learn about local
issues that affect their patients. Each year, at least
two residents also get the opportunity to attend a
legislative day in Washington, D.C., sponsored by
the American Academy of Pediatrics. Jacksonville
pediatric residents are also extensively involved in
"Because kids don't vote, politicians who decide
where the money goes don't always worry about
them," said Jay Roberson, M.D., a third-year
resident who attended the AAP Legislative
Conference in April with fellow resident Karen
Bodnar, M.D. "They should. (Children) are the
future of the country and world but they get
thrown on the backburner by a lot of larger
groups, even by some hospitals and health-care
systems because they are not necessarily a
profitable sector as far as inpatient medicine goes."
In recent years, pediatric residents have worked
with the Florida chapter of the AAP to advocate
for more stringent safety belt laws, have helped
organize UF's first Sports Medicine Jamboree to
educate young athletes and have stood outside in
the rain to protest the possible veto of extending
funding for the state's Children's Health Insurance
Plan. And this is just a taste of their involvement.
Last year, Lossius, who oversees the advocacy
rotation and is a graduate of UF's pediatric
residency, added a new component to the program
to beef up the advocacy residents do during their
time here. Instead of only working on a project
during their monthlong rotation, residents now
start a long-term project in their first year.
But it doesn't always take a giant project for
residents to make a difference. Writing letters to
the editor and taking the time to call a
congressman to voice an opinion on a health-care
bill that affects children can effect change, too.
"It can be little tiny things, like fliers to parents
or calling to give an opinion on legislation,"
Roberson said. "It takes minutes and ultimately
makes a huge difference."
Although she's no longer a UF resident, Slovin
still thinks about "Babies Don't Come with
Instructions." The newborn class has since
transitioned into the hospital, which Slovin says is
a better location for moms.
"A lot of residents may not realize the impact
they can have on their community," said Slovin,
who plans to stay in community pediatrics and
continue her advocacy work. "This advocacy
rotation gives residents the opportunity to develop
skills and tools to take with them when they
practice so they can advocate for their own
patients and teach parents how to advocate for
their children." O
UF pediatrics residents spend a month in an advocacy rotation, overseen by Dr. Michele Lossius (center). Two residents each year also get the chance to
attend a national AAP legislative conference, a major advocacy event. Residents Dr. Jay Roberson (right) and Dr. Karen Bodnar (left) attended this year.
Drug extends life of older mice, has
potential for application in humans
By Czerne M. Reid
Extending the lifespan of humans is a goal
that has attracted many researchers world-
wide. A UF group including assistant pro-
fessor Christy Carter, Ph.D., and Marco Pahor,
M.D., director of the Institute on Aging is taking
part in a National Institutes of Health program to
test a variety of drugs to see if they can lengthen
life in mice.
Called the National Institute on Aging Interventions Testing Program, the
initiative recently met with success: a cancer drug was found to extend the life
of older adult mice.
As reported in the journal Nature, middle-aged mice fed the drug, called
rapamycin, lived up to 14 percent longer than
mice that were untreated or given different
The findings show that drugs can potentially
increase lifespan even if given late in life. That
work, led by researchers at The Jackson
Laboratory in Maine, and similar efforts could
eventually lead to life-extending drug therapies
The biochemical pathway on which rapamy-
cin acts is present in flies, worms, mice and hu-
mans. While the drug was previously shown to
extend life in flies and worms, this is the first CHRISTY CARTER, PHD.
time it has been shown to have a life-lengthen-
ing effect in mammals.
"That is important for translational research,
because this is the next step of the evolutionary
chain, so to speak," Carter said. "So if we can ma-
nipulate the pathway in humans the same way as
in mice, it may have the same effect on us."
Other dietary and pharmacological interven-
tions aimed at increasing longevity in mammals
have had negative results, or results that were
difficult to reproduce.
But the current study used large numbers of
animals more than 1,900, at three different MARCO PAHOR. M.D.
"It's very convincing," said Andrzej Bartke, Ph.D., a Southern Illinois
University College of Medicine professor of physiology and internal medicine
who, in mouse studies, first demonstrated that the mutation of a single gene
can extend life in a mammal.
UF's contribution to the NIH testing program is suggesting the investiga-
tion of enalapril, a blood pressure medicine shown in human studies to im-
prove physical function in older adults independently of its blood pressure-
controlling effects. enalapril reduces inflammation and oxidative stress, two
processes that are associated with aging and possibly contribute to the devel-
opment of many diseases and the shortening of the lifespan.
But mice treated with that compound did not outlive untreated ones.
"While we were a bit disappointed that it didn't have an effect on longevity,
we're still working to see what other effects it can have," Carter said.
enalapril has already been shown to decrease body weight, so the researchers
plan to investigate the changes in the body over time in mice treated with it.
The compound that did extend life rapamycin was fed to 600-day-old
mice an age that corresponds to 60 years in humans. The researchers found
that not only was the median age of mice extended, but also the greatest age
reached before dying was extended as well. Normally, the type of mice used
would live about 32 months.
Extending the median age of death suggests there were improvements in
the rates of disease occurrence. But extending the highest age reached before
death suggests that longevity wasn't just a result of curing disease but of al-
tering the aging process itself. That was borne out by the fact that when
treated mice eventually died, their cause of death was similar to that of un-
"They're intervening late in life with these animals, so that's exciting it's
not like you have to have lifelong intervention with these compounds," Carter
said. That's important since the pathways involved affect normal develop-
ment processes such as cell growth, which might be inhibited if the drugs are
given throughout life.
"The fact that you can do something in middle age and still get benefit is
very impressive and has a lot of practical implications," said Bartke, who stud-
ies the genetics and endocrinology of aging. Bartke also had in his laboratory
the longest-lived mouse, which lived for almost five years twice as long as
genetically normal mice.
Carter says people should not just look to drugs but to proper diet and exer-
cise to improve their health. Increasing lifespan is not the only goal, she said.
It is also important to improve "healthspan" the length of time people re-
main in good health as they age.
"Who wants to live longer if you're going to be diseased and dysfunctional
for a longer period of life?" she said. 0
Visit us online @ http://news.health.ufl.edu for he latest news and HSC events I
By Monica Vigo
Celebrated in October, American Pharmacists Month
highlights pharmacists in all practice settings for their
contributions to health care and commitment to patient
care. As part of the celebration, the American Pharmacists
Association-Academy of Student Pharmacists at UF invited
Gainesville Mayor Pegeen Hanrahan to the college Oct. 9
.to issue a proclamation and share a few personal words
about the impact of pharmacy on her family and the
Gainesville community. In this month's 5 Questions, Tom
j:Munyer, M.S., the APhA-ASP student adviser and a clinical
associate professor in the UF College of Pharmacy, gives
us the inside scoop on what it means to be a pharmacist.
Tom Munyer, a clinical associate professor in the UF College of Pharmacy, accompanied pharmacy students Sebrina Chan, Megan Kloet and
Crystal Mason to meet Mayor Pegeen Hanrahan at Gainesville City Hall.
Why is there a month proclaimed for
The American Pharmacists Association's 2009 message "Know Your
MEDICINE, Know Your PHARMACIST" for American Pharmacists
Month recognizes the vital contributions made by pharmacists to
health care in America and enhances the image of pharmacists as
medication experts not just dispensers of medication. Pharmacy
month also aims to educate policy makers and the public about the
key role played by pharmacists in reducing overall health-care costs
by improved medication use and advanced patient care
Beyond filling prescriptions, what exactly
is the pharmacist's role?
Many people believe all pharmacists do is count and distribute pills.
A few of our students even start out with that misconception. UF
pharmacy students quickly learn that their role is to help the patient/
customer understand medications, how to take them and what the
patient can do if they develop concerns. Physicians determine what's
wrong with the patient and prescribe a treatment. Pharmacists help
the patient in their prescribed drug therapies. Pharmacy students
spend fouryears learning drug therapy in human systems. They learn
the difference between symptoms related to the drugs patients are
taking and symptoms related to a disease. Medical students do not
have enough time in their curriculum to focus solely on drug training,
which is why in professional practice doctors and pharmacists create
a perfect team.
How has the pharmacist's job changed
in recent years?
The pharmacist's most important function is to promote safe and
effective use of medications. Trained side-by-side with physicians for
the past 25 years, pharmacy students today are finding that new
opportunities are opening up for pharmacists. For example, medi-
cation therapy management, or MTM, is a new key phrase used in
health care. The pharmacist promotes safe and effective use of drugs
prescribed, helping the patient to achieve the best therapeutic out-
comes. I see the medical team relying on the pharmacists more and
more. Not just in short-term health care, but also in hospital clinics
where patients are being followed on a long-term process. We're
also seeing it on a consultant basis by community physician groups. I
think that role is going to continue to expand because of the proven
health benefits and cost-effectiveness of pharmacists.
Can pharmacists give flu shots?
Yes. Pharmacists are the most accessible health-care clinicians. In
one year, a patient may only visit their doctor or clinic two or three
times, but they will visit the pharmacy many times for prescription fills
and over-the-counter remedies. Pharmacists are trained extensively
on medications more than any other health-care practitioner.
Pharmacists who administer immunizations have to receive special
additional training certification specific to immunizations and all the
possible surrounding emergency procedures.
How are student-pharmacists trained for
Pharmacy students start out taking basic science and chemistry class-
es. Beginning in their third year, they have gained the knowledge and
qualifications to participate in patient care in-class activities that ad-
dress health concerns like diabetes, high blood pressure, vaccination
and acid reflux. The focus their senior year is patient-centered and
therapeutic. This is when they go on pharmacy practice rotations
where they work alongside doctors and nurses on rounds. Their pro-
fessors help them understand the health-care system, including the
strengths and concerns that exist within the system. Students also
take courses that expand their horizons within the profession and
learn about research that investigates the benefits and cost-effective-
ness of pharmacist interventions. 0
A pharmacist's life
- 5 Ij r-L .j_ jJ j I iJ
* r r' i
F rl r
r' II H HJj
collaboration is not easy. It's true. Working with a team of people who all
have their own ideas and visions will always be harder than just doing it
yourself. But think about it this way: Who wants to watch the triangle player
without the rest of the band? In health care, when experts come together,
new discoveries are made, patients are saved and students learn. That's
why this month, The POSTis highlighting just a few of the new ways HSC
leaders are working with their colleagues in patient care and education.
There are possibly hundreds of collaborations across campus, but here we
bring you the stories of a novel liver cancer clinic in the College of Medicine,
a new class and focus on collaboration in the College of Public Health and
Health Professions and a new format in College of Dentistry clinics that has
increased patient visits by 25 percent.
Visit us online @ http://news.health.ufl.edu for he latest news and HSC events
jI f- I!
Each week a
diverse group of
to discuss cases
brought to a
novel UF clinic
that helps cancer
The battle in the conference room
A By Czerne M. Reid
t 54, Bob House is rediscovering the world through the eyes of his
17-month old grandson, Calvin. He delights in the first sighting of
a chipmunk or snake and revels in the shrieks of laughter of a
toddler being chased around the house.
"It's just such a beautiful thing and it gives me reason to live,"
But he might not be alive to share these moments with his
grandson if not for a special team of UF doctors that has tried a
variety of treatments to help keep him alive, he says.
"Every day that they give me, every new thing that we try, it
encourages my spirit," he said.
House contracted hepatitis B in the 1970s while serving in the
U.S. Air Force in Southeast Asia. Decades later, the infection led
to cirrhosis of the liver. Then in 2007 he was diagnosed with a very
large liver tumor.
He found his way to the UF hepatology liver cancer clinic to see
Ron Cabrera, M.D., M.S., after a doctor in his hometown of Tampa
told him he'd run out of options and should enter end-of-life
UF has programs that offer hope to patients who have hard-to-
treat liver disease and cancer and feel that they have nowhere else
to turn. Doctors are able to offer many potential treatment
alternatives, including liver resection and transplantation. In
addition, various experimental therapies are made available
through clinical trials to patients with otherwise limited treatment
"I was just absolutely blown away, because I had no idea there
were other therapies, or that I would be eligible for a transplant,"
The liver clinic Cabrera helps run is a unique one where
hepatologists play a key role in the simultaneous management of
the cancer and the severely diseased liver from cirrhosis. Tackling
cancer in patients who also have underlying liver disease requires
skillful and sensitive handling, as some treatments could worsen
their underlying cirrhosis. Other centers around the country have
looked to UF as a model to start this type of clinic, and the
division of gastroenterology and hepatology has entered a
partnership with Bayer Pharmaceuticals to create continuing
medical education training modules to teach other institutions
about the approach.
The clinic serves as a hub for translational research, where, for
example, patients donate blood to be used for research aimed at
developing new cancer markers and therapies that use a patient's
own immune system. Some of the work includes a collaboration
with the H. Lee Moffitt Cancer Center and Research Institute.
Cabrera took House's case to a discussion group called the
hepatobiliary conference, another novel UF program that provides
a one-stop shop where a panel of experts from a range of medical
specialties meets to discuss complex cases and come up with a
treatment plan. That streamlines the process both for patients and
physicians and gets people into care fast, saving them time, money
and emotional trauma.
To enhance the chances of a good outcome, people who have a
potential liver cancer need to get evaluated and treated quickly.
But generally, patients might see a gastroenterologist in their
community before being referred to a radiologist, then an
oncologist and then a surgeon before a treatment plan is decided.
"That whole process just took three or four months, and you
may have missed a critical opportunity to offer potentially curative
therapy," said Dave Nelson, M.D., director of liver transplantation
One visit is all it takes at UF.
Every Monday at 7:15 a.m., the physicians -hepatologists,
hepatobiliary surgeons, gastroenterologists, oncologists,
interventional and diagnostic radiologists, transplant surgeons and
pathologists gather to discuss eight to 16 cases. Patients are
referred to UF from around Florida and other Southeastern states.
The week before, Colleen Booker, R.N., coordinates with
Visit us online @ http://news.health.ufl.edu for the latest news and HSC events
physicians to gather patients' names and medical histories. Lab test results for
liver function, tumor markers, past and current radiological studies and
biopsy results are compiled, along with a full patient physical history.
Diagnostic radiologist Patricia Abbitt, M.D., organizes images from an
alphabet soup of scans MRI, CT, PET, HIDA, US and others and
projects them onto a large screen at the front of the room as each patient is
"Imaging has become such a huge part of taking care of people, and
sometimes interpretations are adjusted a little when we have the pictures right
there so people can see how extensive the disease is or how small," Abbitt said.
Each expert comes to the discussion with his or her own approach,
knowledge of the scientific literature in a given field, and biases about what is
the best approach to a problem.
"That's where the art of medicine comes in a lot of this is also finesse,"
said Robin Kim, M.D., director of UF's Center for Hepatobiliary Surgical
Diseases, who leads the discussion groups. "We're getting everyone involved
and getting their input on what they have to offer. That can give patients the
best customized approach."
And more options.
Doctors consider patients not just for routine procedures, but for ones that
are rarely done, and clinical trials for people who do not have standard
"The nice part too is that when I'm through and I can't do any more and my
treatments failed, I can always re-channel the patients and say 'Does anybody
have any suggestions?'" said James Caridi, M.D., chief of the division of
Each discussion leads to a plan of action.
Patients are directed to appropriate divisions for further testing, liver
transplants, liver resections that involve removing all or part of a liver lobe, or
other treatment such as chemotherapy, embolization and/or antiviral therapy.
Nurse practitioners and physician assistants so-called mid-levels play
a key role in educating and communicating with patients and their families
about those treatment plans and ensuring that they are carried out.
House's plan called for antiviral medication to suppress the hepatitis B, a
pill for systemic treatment for the cancer and embolizations radiation to
burn away portions of the liver tumor until it was small enough for House to
be eligible for a transplant.
When he got word he was relieved.
"There was a light that I could see and possibly stay vertical a little bit
longer," he said. "Everybody knows that this disease is terminal, but if you
don't have to leave right away that's a good thing."
He was monitored closely and tested frequently to ensure that the
embolizations didn't cause worsening of his cirrhosis and a flare-up of his
After more than a dozen embolizations the tumor began to decrease in size,
but unfortunately, new ones developed, making him ineligible for a
transplant. When the side effects of the initial systemic treatment proved too
severe, Cabrera switched him to another experimental drug.
"I appreciate the workarounds they try to do, and the different ways that
they try to attack these tumors," House said. "They never give up, and they
say that as long as I'm willing to keep trying different things they're willing
to keep trying too."
He won't stop trying, because every new effort means one more moment to
share with Calvin.
The college that collaborates together ...
O By April Frawley Birdwell
n a random Friday in early October, faculty members from the College of
Public Health and Health Professions snacked and mingled in a reception
area in the HPNP Complex. The purpose of the seemingly casual meeting? To
meet new faculty whose department in the College of Liberal Arts and
Sciences recently merged with PHHP.
But the meeting also had a larger goal: It was the first of what will be many
socials the college will hold in coming months to get faculty members talking
to each other, a step leaders hope will lead to new partnerships and
The socials are actually just one example of how PHHP leaders are working
to encourage more collaboration across the college. In February, the college
established a Collaboration Committee, which is working on numerous
projects to get more people in the health professions and public health
working together, said Sherrilene Classen, Ph.D., M.P.H., O.T.R./L., who
chairs the committee.
"We want to make sure we provide opportunities for collaboration within
our college, as well as across different colleges in the university, and
eventually with other universities around the country and around the world,"
Classen said. "Through collaboration we don't have to reinvent the wheel. We
can tap into partnerships and share expertise so all who are involved benefit."
14 Visi us online http://news.health.ufl.edu for he latest news and HSC events
Dr. Ron Watson works with fourth-year dental student
Tedra Thomas in one of UF's five student dental
clinics. Last year, the college changed the structure
of its dental clinics, a change that has resulted in a
25 percent increase in patient visits. (Opposite page)
Dr. Ron Cabrera (front) helps run a novel clinic at
UF where hepatologists play a key role in managing
cancer and underlying liver disease.
The committee also helped organize a new class in the college to help bring
students studying health professions and those studying public health more on
the same page. Several College of Public Health and Health Professions faculty
members teamed up during the past year to develop the new course, which is
led by Mary Peoples-Sheps, Ph.D. The class, now a requirement for almost all
new PHHP students, gives students a foundation in public health and shows
them how that discipline applies to other health fields in the college and across
the Health Science Center.
"It gives students the bigger picture," said Susan White, M.Ed., a
curriculum developer for the college who worked with faculty to develop the
course. "There are five modules and each has two to four lectures by a public
health professor and two lectures by a health professions professor, who take
the public health information and apply it to how it affects patients."
It's also the first class to bring together professors from every discipline in
the college, and it probably won't be the last. Because the practice of health
care brings together specialists from various fields and is becoming
increasingly more integrated, the education and training of health-care
providers is only going to become more integrated, too, said Ronald Rozensky,
Ph.D., a professor of clinical and health psychology who teaches two of the
lectures in the class.
"The future of health care is going to be integrated care from the bedside
and research lab to the clinic and the community," Rozensky said. "Every one
of us practices side by side with other professionals. This course is just a
natural step in the evolution of health care and our college."
In her portion of the class the introductory lecture Classen explains
how findings from a public health study, in which a vehicle crash database was
analyzed, may help therapists and health providers advise seniors when they
come into the clinic. For example, one of her studies showed that older drivers
are more likely to be involved in crashes at intersections and when making left-
hand turns. Teaching older drivers how to better plan their driving routes
could help them avoid situations more likely to trigger wrecks.
"Public health is one of those underrated, yet very important services,"
Classen said. "You walk outside and breathe the air, and you expect to breathe
good quality air. You don't know if you do. But it's because of public health
approaches that you probably are breathing air of an acceptable standard. So,
public health is a behind-the-scenes discipline, taking care of people when
they do not even realize it."
we go further
C ---^ S
Time for change
By April Frawley Birdwell
ear after year, UF College of Dentistry administrators heard the same
complaint from students: The structure of the student dental clinics was
causing gridlock. Students couldn't always get chairs where they could see
their patients, and as a result, patients couldn't always get in for treatment.
Of course, the solution turned out to be so simple Ron Watson, D.M.D.,
almost dismissed it when he first thought of it one night in his kitchen.
Unlike a private dental office where patients are treated for multiple
problems in one place, UF's student dental clinics were organized by
specialty. Each dental specialty had its own clinics, held on certain days
throughout the week, and it was up to students to schedule their patients
on the right day and time and try to get space in the clinic.
"It was stressful for students because they needed to see so many
patients to get enough experiences," said Watson, an associate professor of
operative dentistry and one of 10 team leaders of the student dental clinics.
"It was hard for patients because they didn't always know how many chairs
we were going to have available."
Watson's solution? Get rid of the specialty-centered structure and turn
all five clinics into general dentistry clinics, with specialists coming in to
see the patients. Instead of patients shuffling from clinic to clinic, they
would always go to the same place. The revised structure would also free
up more spots for dental students to work. Treatment coordinators were
also hired to set up patient appointments instead of students making the
After a few years of negotiating and fine-tuning the idea, last year the
College of Dentistry made the change. Since then, the clinics have seen a
25 percent increase in patient visits and last year's crop of graduates raved
about the change during exit interviews, said Boyd Robinson, D.D.S,
associate dean for clinical affairs.
"Now there is virtually no problem ever getting a chair and this is
something we battled for 20 years," Watson said. "It's so crazy how simple
Another perk has emerged, too. With specialists rotating in and out of
the clinics at the same time, they're communicating more on patient cases,
giving students a more complete look at dental care than they saw before
when specialists were segregated in their own clinics, Robinson said.
"My biggest goal was putting everybody in the same clinic thinking
about the education of the student," Robinson said. "During this
conversation you are bettering the student's educational process so you are
getting a better product at the end of their clinical years.
"All the faculty have come together and started talking a lot more than
they ever have. I don't think we will ever go back. It makes too much sense
the way we are doing business now."
Darryl H.-m .i 4 H n ai o.;.t.- I:' f.i : i [. I II _IF
a Ph.D candidate 11 I:.._I ..i1 Io: II... I. 1.,.. t.
develop a safe, .-1..,l:.I. and ... .,,ii. b. .. -i :i'."- I1
collecting venom from c tt 1111 .tl, :n ::-1 t,.i
i:.I. t of the process of making I.Jii .: i .1 I:,lt-
victim s. (O opposite i:.. I .: l , '.ii :1 . 1 l
his twa'basset hounds, Margari.., ii I .i, i..I Ii .
companion, Mariah, at home in C..1111 : ,11 .-
What's in a snakebite?
Study of isolated snakes could shed light on
By Sarah Carey
While studying a way to more safely and effectively collect
snake venom, UF researchers have noticed the venom
delivered by an isolated population of Florida cottonmouth
snakes may be changing in response to their diet.
Scientists used a portable nerve stimulator to
extract venom from anesthetized cottonmouths,
producing more consistent extraction results and
greater amounts of venom, according to findings
published in August in the journal Toxicon. The
study of venoms is important for many reasons,
"The human and animal health benefits include
understanding the components of venom that
cause injury and developing better antivenin," said
Darryl Heard, B.V.M.S., Ph.D., an associate
professor in the UF College of Veterinary
Medicine's department of small animal clinical
sciences. "In addition, the venom components
have the potential to be used for diagnostic tests
and the development of new medical compounds."
But in addition to showing the extraction
method is safer, more effective and less stressful to
both snake and handler than the traditional
"milking" technique, Heard and Ryan McCleary, a
Ph.D. candidate in UF's College of Liberal Arts
and Sciences, discovered the venom from these
particular snakes differs from that of mainland
snakes, likely because of their unique diet of dead
fish dropped by seabirds.
Heard and McCleary collaborated to develop a
safe, reliable and humane technique for collecting
venom from cottonmouths as part of a larger study
on a specific population of snakes that reside on
Seahorse Key, an isolated island near Cedar Key
on the Florida's Gulf Coast.
The venom collection study included data from
49 snakes on Seahorse Key.
"Snakes on this island are noted for their large
size," said Heard, a zoological medicine
veterinarian with additional expertise in
anesthesia. He added that Harvey Lillywhite,
Ph.D., a professor of biology at UF and McCleary's
predoctoral adviser, has confirmed that
cottonmouths on Seahorse Key eat primarily dead
fish dropped by birds in a large seabird rookery.
Lillywhite also directs UF's Seahorse Key Marine
Laboratory, located in the Cedar Keys National
Wildlife Refuge. McCleary hopes to build on earlier
studies about the snakes' ecology and to explore
whether evolutionary changes may have affected the
composition of the snakes' venom.
"My interest is in the evolutionary aspect,"
McCleary said. "If these snakes already have an
abundant source of dead prey, why do they need
Preliminary findings show some differences in
venom components, he added.
Traditionally, venom has been collected from
venomous snakes by manually restraining the
animal behind the head and having it bite a rubber
membrane connected to a collecting chamber.
"This requires the capture of an awake, nIakL,
which increases the risk of human envenomation
and is also stressful to the snake," Heard said,
adding that manual collection of venom also does
not guarantee that all of the venom is collected.
The nerve stimulator is used in human anesthesia
to measure the effect of muscle relaxants.
"It delivers a series of electric stimuli, of very low
voltage and amperage, and causes no pain or tissue
injury," Heard said. "The electrodes are placed
behind the eye, across the area of the venom gland.
The nerve stimulator sends a current across the
gland, causing reflex contraction and expulsion of
The technique allows collection from snakes that
might not otherwise give up their venom, which is
an essential in the process of creating antivenins for
victims of snakebite, Heard said.
"The stimulator is battery-powered and relatively
inexpensive," he said. "In addition, the anesthetic
we used, known as propofol, can easily be
Propofol, which has been prominent in news
headlines recently as being linked to the death of
singer Michael Jackson, is a short-acting anesthetic
administered by intravenous injection. The drug is
commonly used to anesthetize animals in veterinary
clinical practice, but it is not believed to have been
used to anesthetize snakes for venom collection.
y 11ah C1i a warrior
W A hen Margarita, a 10-year-old basset hound, was bitten by a
/IJ cottonmouth snake recently, her quick-thinking owner rushed
Sthe dog to the UF Veterinary Medical Center for treatment.
In doing so, Sandra Fields Seymour, Ph.D., A.R.N.P., a recently retired
associate professor in UF's College of Nursing, and her husband, Larry,
followed a cardinal rule in preventing death or lasting tissue damage from
,nrJk~hil in an animal: They sought immediate evaluation by a veterinarian.
Margarita, whose owners have nicknamed her "Snakebite Warrior,"
survived her bites and today appears no worse for the wear.
Margarita arrived at the UF VMC on July 3 with two strike wounds. Soon,
her signs of swelling, or envenomation, had increased. Veterinarians quickly
decided to administer antivenin six vials, in fact.
The side effects of snakebite can vary greatly. Bites from rattlesnakes,
cottonmouths and copperheads can result in severe tissue swelling, blood-
clotting abnormalities, heart arrhythmias, organ damage and tissue death
around the bite.
Although antivenin can be lifesaving, how much to give is a judgment call,
UF, UW researchers
cure color blindness
in two monkeys
Two squirrel monkeys housed at
the University of Washington
were recently cured of color
blindness using a gene therapy
technique developed at UF.
as the amount of venom in a snake's bite is unknown. In general, however,
the more antivenin received quickly, the better, veterinarians say.
"Unfortunately, antivenin is quite expensive and can be cost-prohibitive
for some owners to administer several vials," said Kate Ogawa, D.V.M., an
intern in small animal medicine and surgery who treated Margarita.
"Additionally, antivenin for veterinary medicine is currently not being
manufactured in this country."
Thanks to the efforts of UF snake envenomation expert Michael Schaer,
D.V.M., UF was able to procure an antivenin product from Mexico. Although
the antivenin was manufactured for people, UF obtained permission for
animal use from the Food and Drug Administration. Reactions to antivenin
are possible also, which is another reason why victims of snakebite need to
be monitored carefully for several days.
"I would urge people to protect themselves as much as possible from
venomous snakes, and as such I cannot recommend killing the snake for
identification," Ogawa said. "The antivenin contains antibodies against the
venom of most snakes, so knowing exactly what snake it was is not nearly as
important as getting treatment as soon as possible." Q
Researchers from the University of Washington and UF used gene therapy to
cure two squirrel monkeys of color blindness the most common genetic
disorder in people.
Writing online in the journal Nature, scientists cast a rosy light on the potential for
gene therapy to treat adult vision disorders involving cone cells the most
important cells for vision in people.
"We've added red sensitivity to cone cells in animals that are born with a condition
that is exactly like human color blindness," said William W. Hauswirth, Ph.D., a
professor of ophthalmic molecular genetics at the UF College of Medicine and a
member of the UF Genetics Institute and the Powell Gene Therapy Center.
"Although color blindness is only moderately life-altering, we've shown we can
cure a cone disease in a primate, and that it can be done very safely. That's extremely
encouraging for the development of therapies for human cone diseases that really are
Millions of people around the world are colorblind, including about 3.5 million
people in the United States. The problem mostly affects men, leaving about 8 percent
of Caucasian men in the United States incapable of discerning red and green hues
that are important for everyday things such as recognizing traffic lights.
The discovery comes about 10 years after Jay Neitz, Ph.D., and his wife Maureen
Neitz, Ph.D., both professors of ophthalmology at the University of Washington,
began training two squirrel monkeys named Dalton and Sam. Working with the
makers of a vision-testing technique, the Neitzes devised a way to test what colors the
monkeys were seeing.
Likewise, Hauswirth and UF colleagues spent decades developing a gene-transfer
technique using a harmless adeno-associated virus to deliver corrective genes to
produce a desired protein.
In this case, researchers wanted to produce a substance called long-wavelength
opsin in the retinas of the monkeys. This particular form of opsin is a colorless
protein that works in the retina to make pigments that are sensitive to red and green.
About five weeks after the treatment, the monkeys began to acquire color vision,
almost as if it occurred overnight.
"Nothing happened for the first 20 weeks," Neitz said. "But we knew right away
when it began to work. It was if they woke up and saw these new colors. The treated
animals unquestionably responded to colors that had been invisible to them." Q
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College of Nursing professor Beverly Roberts (far right) and Rhayun Song (far left) of Chungham
National University discovered tai chi can help lower blood glucose levels during a study of
Korean women. During her year as a UF visiting professor in 2008, Song led an informal group
that practiced tai chi outside the HPNP Complex.
By Tracy Brown Wright
A regular tai chi exercise
program can help
people better control
their diabetes and lower
glucose levels, according to a
In a study of adults diagnosed with type 2
diabetes, those who participated in a
supervised tai chi exercise program two days a
week with three days of home practice for six
months significantly lowered their fasting
blood glucose levels, improved their
management of the disease, and enhanced
their overall quality of life, including mental
health, vitality and energy.
"Tai chi really has similar effects as other
aerobic exercises on diabetic control. The
difference is tai chi is a low-impact exercise,
which means that it's less stressful on the
bones, joints and muscles than more strenuous
exercise," said Beverly Roberts, Ph.D., R.N.,
the Annabel Davis Jenks endowed professor at
the UF College of Nursing.
Roberts, with Rhayun Song, Ph.D., R.N., of
Chungham National University, studied tai
chi's effect on older Korean residents. The
research was featured in the June issue of The
Journal ofAlternative and Complementary
About 23.6 million children and adults in
the United States, or 7.8 percent of the
population, have diabetes. It occurs when the
body does not produce or properly use insulin,
a hormone that is needed to convert sugar,
starches and other food into energy needed for
Risk factors include obesity, sedentary
lifestyle, unhealthy eating habits, high blood
pressure and cholesterol, a history of
gestational diabetes and increased age. Many
of these risk factors can be reduced through
"People assume that for exercise to be
beneficial you have to be huffing and puffing,
sweating and red-faced afterward," Roberts
said. "This may turn people off, particularly
older adults. However, we have found that
activities like tai chi can be just as beneficial
in improving health."
Tai chi is an ancient Chinese martial art
that combines deep breathing and relaxation
with slow, gentle circular movements. This
low-impact exercise uses shifts in body
position and stepping in coordination with
Sixty-two participants, mostly Korean
women, took part in the study. Half the group
participated in at least 80 percent of two
supervised sessions one hour per week, with
three days of home practice for six months,
and the other half served as a control group.
Those who completed the sessions had
significantly improved glucose control and
reported higher levels of vitality and energy.
"Those who participated in the tai chi
sessions actually had lower blood glucose at
three and six months," Roberts said. "Those
individuals also had lower hemoglobin Alc,
which means they had better diabetic control."
In addition to improved blood glucose
levels, participants also reported significantly
improved mental health. This was very
encouraging especially because people with
less depression are typically more active and
independent, Roberts said.
Tai chi has also been used for people with
arthritis and disabilities to increase balance,
muscle strength and mobility and to reduce
the risk of falls. It is worth investigating its
effects in other conditions, especially in older
people, Roberts said.
"Tai chi provides a great alternative for
people who may want the benefits of exercise
on diabetic control but may be physically
unable to complete strenuous activities due to
age, condition or injury," Roberts said.
"Future studies could examine if tai chi could
similarly benefit conditions such as
osteoporosis or heart disease."
Because tai chi is an exercise that involves
so many parts of the body and also helps to
relax the mind, it is more likely participants
will adhere to the exercise, said Paul Lam,
M.B.B.S., a lecturer with the University of
South Wales School of Public Health and
Community Medicine and a practicing family
physician in Sydney, Australia.
"This study shows that tai chi can have a
significant effect on the management and
treatment of diabetes a significant and
growing health challenge for all Western
countries," Lam said. Q
18 n Visit us online @ http://news.health.ufl.e
*du for the iciest news cnd HSC events I
Scientists join forces to explain H IV
spread in central and east Africa
S scientists studying biology and geography
may seem worlds apart, but together they
have answered a question that has defied
explanation about the spread of the HIV-1
epidemic in Africa.
Writing in the September issue of AIDS, a research team led by UF
scientists explained why two subtypes of HIV-1 the virus that causes
acquired immunodeficiency syndrome, or AIDS held steady at relatively
low levels for more than 50 years in west central Africa before erupting as an
epidemic in east Africa in the 1970s.
Essentially, the explanation for the HIV explosion obscured until now
- involves the relative ease with which people can travel from city to city in
east Africa as opposed to the difficulties faced by people living in the
population centers of the Democratic Republic of Congo, the point where HIV
emerged from west central Africa in its spread to the east.
Later, as the epidemic raged in the east, cities in the Democratic Republic
of Congo a vast country almost as big as all of Western Europe remained
disconnected and isolated, explaining why the virus affected only about 5
percent of the country's population, a level that has not changed much since
"We live in a world that is more interconnected every day, and we have all
seen how pathogens such as HIV or the swine flu virus can arise in a remote
area of the planet and quickly become a global threat," said Marco Salemi,
Ph.D., an assistant professor of pathology, immunology and laboratory
medicine at the UF College of Medicine and senior author of the study.
"Understanding the factors that can lead to a full-scale pandemic is essential
to protect our species from emerging dangers."
Investigators used databases, including GenBank from the National Center
for Biotechnology Information, as well as actual DNA samples, including
samples recently collected in Uganda the vicinity where HIV entered east
Africa to follow the virus' molecular footprints since its emergence in
UF scientists Marco Salemi (center), Rebecca Gray and Andrew Tatem
led an international team of researchers exploring genetic and
geographic factors to explain how HIV spread across the continent.
"HIV mutates rapidly," said Rebecca Gray, Ph.D., a postdoctoral associate
in the department of pathology, immunology and laboratory medicine. "This
is a successful strategy for the virus, because it evolves quickly and develops
drug resistance. But we can use these changes in the genome to follow it over
time and develop a history of its progress."
Researchers wanted to know why the virus smoldered during the 1950s and
1960s, before spreading like wildfire through east Africa in the 1970s.
A fateful piece of the puzzle came in the form of geographic information
system data, which uses satellite imagery and painstakingly takes into account
the availability and navigability of roads between population centers,
transportation modes, elevation, climate, terrain and other factors that
"We were able to use geographic data to interpret the genetic data," said
Andrew J. Tatem, Ph.D., an assistant professor of geography in the College of
Liberal Arts and Sciences and a member of UF's Emerging Pathogens
Institute. "Genetic data showed once HIV moved out of the Democratic
Republic of Congo, it expanded fast and moved rapidly across Uganda, Kenya
and Tanzania, all while staying at low levels in the DRC. What was happening
was the virus was circulating at stable levels in the urban centers of the DRC,
but these centers were isolated. Once it hit east Africa, connectivity between
population centers combined with better quality transportation networks, and
higher rates of human movement caused HIV to spread exponentially."
HIV was prevalent in about 15 percent of the population in Kenya in 1997,
although it has since dropped to about 7 percent, according to the Kaiser
Family Foundation. As of 2007, an estimated 22 million people were living
with HIV/AIDS in sub-Saharan Africa. About 1.1 million Americans have
HIV or AIDS, and an estimated 5.1 million people in India are HIV-positive.
In Eastern Europe, HIV infections more than doubled from 420,000 in 1998
to 1 million in 2001.
"If we can predict the specific routes of an epidemic, we can find the
geographic regions more at risk and target these areas with medical
intervention and strategies for prevention," Salemi said. "In terms of health-
care applications, coupling genetic analysis with geographic information
systems can give us a powerful tool to understand the spread of pathogens and
contain emerging epidemics." 0
Inside the life of a pediatric emergency medicine physician
By Betty Poole
hyllis Hendry, M.D., keeps a framed photo of
a young leukemia survivor in her office. She
has other homey knickknacks there, like her
comical plaques and family photos. But the photos
of her patients represent what means most to her
as a pediatric emergency physician saving chil-
dren's lives and making families happy.
"The most challenging is how to balance being a good clinician and adminis-
trator, learning the field of research, taking care of the house and children and
paying the bills," said Hendry, who has worked at the UF College of Medicine-
Jacksonville for 20 years. "The work is never really done."
Fresh off her term as president of the UF COM-Jacksonville Faculty Council,
Hendry's life lately has been a lesson in balance. She hasn't seen a typical day in
two decades, wedging council committee meetings into her already bulging
schedule. She works an average of two to three evening shifts a week in the pedi-
atric emergency department at Shands Jacksonville, serves as assistant chair of
research and is passionate about teaching pediatric emergency medicine to resi-
dents. She also has helped develop numerous national pediatric resuscitation
courses and has served as medical director of the state health depart-
ment's Emergency Medical Services for Children Program.
But fitting the council in her life was definitely worth it, she says.
After 20 years, her perception of the college is, in many ways, brand
new because of the time she spent on the council.
"I came away so impressed with the quality of people who run this
campus," she said. "It made me want to be involved with UF leadership
and represent the needs of our faculty. We have a lot of great programs,
physicians and diversity."
David Vukich, M.D., chair of the department of emergency medi-
cine, explains Hendry's ability to deftly juggle multiple tasks, leader-
ship roles and projects like this: "Phyllis has the ability to focus like
few others; it's not finished until it's right," said David Vukich, M.D.,
chair of the department of emergency medicine. "She accomplishes
huge amounts of work and is tireless."
Vukich and Hendry have worked together since the late 1980s, when
she was a fellow in pediatric emergency medicine.
"We connected because she was extremely helpful to me as the de-
partment leader," he said. "Her skills were obvious from even this
early stage of her career. Fortunately for us, she never left, joining the
faculty in 1991. I wanted her on my staff for several reasons: she is
thoughtful, kind, intense, dedicated, fast, serious, painfully thorough
and accurate. I cannot think of better attributes for an academic emer-
Pursuing degrees in microbiology and food science and technology
at a time when most girls from her Minden, La., hometown shied away
from studying science, Hendry received a doctor of medicine degree
from Louisiana State University School of Medicine in Shreveport. She
chose UF COM-Jacksonville because of its impressive pediatric emer-
gency medicine fellowship program, the people she met here and the
opportunity to live at the beach for the first time.
As a fellow, Hendry parked in a dirt field, had no duty hours or meal
card, and tossed an old mattress into her makeshift office in the pediat-
ric ER to nap when she could. Back then, pediatric AIDS was just com-
ing to the forefront and sudden infant death syndrome, septic shock
and haemophilus influenza still killed many children.
"Pediatrics has changed so much because of preventative medicine,"
Hendry said. "We did not have the training we have now."
Since her days as a fellow, Hendry has held numerous leadership
roles and even helped work on a major emergency medicine textbook,
serving as the section editor on pediatric emergency medicine.
At one point, Hendry took a diversion into children's hospice care for
a year, fulfilling a career-long dream to work with chronically ill and
dying children and their families. She served as medical director of
"Phyllis had a particular ability for this but in the end she knew she
needed to return to the emergency department," Vukich said.
She begins her third decade in emergency medicine particularly ex-
cited about her new research opportunities. At her 20-year milestone,
Hendry briefly considered moving closer to Louisiana.
"But this is home," she said. 0
Visit us online @ http://news.health.ufl.edu for he latest news and HSC events I
Jax campus named site for disaster training course
By Betty Poole
hands Jacksonville was named a National Disaster Life Support Course Regional Training
Center in August. This designation allows Shands Jacksonville and the faculty of the UF
College Of Medicine-Jacksonville to offer the Disaster Life Support course to both the
campus and the community.
Joseph Sabato Jr., M.D., an assistant professor and director of field operations and disaster
management, and Julie A. Lewis, M.D., a June 2009 graduate of the emergency medicine residency
program, completed the application over the course of the academic year as a senior resident
The NDLS course focuses on a comprehensive approach by physicians and other health
professionals to dealing with all catastrophic emergencies, from terrorist acts, explosions and fires
to natural disasters and infectious disease outbreaks. The overarching goal is to standardize
emergency response training nationwide and strengthen the nation's public health system.
The National Disaster Life Support Foundation established the training program in conjunction
with the American Medical Association to better prepare health-care professionals and emergency
response personnel for mass casualty events.
Sabato and Lewis collaborated with Andy Godwin, M.D., associate chair for emergency medicine
and director of Jacksonville's UF Center for Simulation Education and Safety Research, on the
grant. Ashley E. Booth, M.D., associate program director for the emergency medicine residency
program, and Thomas A. Kunisaki, M.D., associate professor of emergency medicine, helped
facilitate the first course provided to emergency medicine department faculty and residents. O
ROBERT C. NUSS, M.D., dean
of the regional campus and
associate vice president for
health affairs, received the
Florida Medical Association's
highest award, the Certificate
of Merit, during the group's
annual meeting in July. Chosen
by the FMA Board of Governors, Robert C
Certificate of Merit recipients are
members who have made significant contributions
to the association, to the medical profession and
to the public.
KAMELA SCOTT, Ph.D., was one
of five people across the country
to receive the Kamangar Ethics
Award for Surgery Residents
Training Program in Medical
Ethics. Scott is an associate
professor in the department
of surgery's division of acute
care surgery. These awards are Kamela
designed to assist surgical training programs in
developing and implementing ethics training for
residents by providing funds to support regular
surgery ethics discussions as well as training
MOBEEN H. RATHORE, M.D.,
professor and chair of the
department of pediatrics and
chief of pediatric infectious
diseases and immunology,
was unanimously selected for
the Beals Award for Medical
Research in the Original
Investigations category by the Mobeen H. Rathore
Duval County Medical Society's
Beal/Shahin Award Committee. Rathore was
chosen for the award based on his involvement in
a study investigating the continuous improvement
of the immune systems of children infected with
HIV. He received the award Sept. 22.
JAY SCHAUBEN, Pharm.D.,
director of the Florida Poison
Information Center Jacksonville
and a courtesy professor of
emergency medicine, has been
elected a 2009 at-large board
member for the American
Association of Poison Control
Centers. Jay Schauben
department wins grant
The UF College of Medicine-
Residency Program was one of
eight institutions awarded the 2009
Pfizer Visiting Professorships in
Ophthalmology grant. This nationally
competitive grant provides an
opportunity for the institution to host
a prominent medical expert. Kakarla
V. Chalam, M.D., Ph.D., M.B.A.,
professor and chair of the department
of ophthalmology and program
director of the ophthalmology
residency program, selected
Deepak P. Edwards, M.D., an ocular
pathologist with the Summa Health
System, as the visiting professor
because of his expertise and excellent
mentoring in the area of ocular
Hail to the chief
Samuel Low, D.D.S., M.S., an associate dean and a professor in
the department of periodontology was recently named president of
the American Academy of Periodontology board of trustees during its
95th Annual Meeting in Boston. Low also serves as an advisory faculty
member to the Pankey Institute for Advanced Dental Education, a
dental school that focuses on hands-on educational experiences and
a highly developed dental curriculum.
COLLEGE OF DENTISTRY
NERY CLARK, D.M.D., an
associate professor in the
department of operative
dentistry, was selected as
a semifinalist for the 2009
Examples of Excelencia, a
national award give by the
Excelencia in Education, which
focuses on improving Latino Nery Clark
educational success. Clark
received the award in recognition of her directorship
of the Internationally Educated Dentist Program.
GLENN TURNER, D.M.D.,
M.S.D., director of the
Service and an associate
professor in the department
of prosthodontics, is currently
serving as president of
the American Academy of
Maxillofacial Prosthetics and Glenn Turner
will preside over the 57th annual
meeting in October in San Diego. Turner has been
director of maxillofacial prosthetics since 1984.
COLLEGE OF MEDICINE
M.D., an assistant professor
of medicine, recently co-
edited the textbook Cancer
Therapeutic Implications, which
was published in April. The
book, which he collaborated
on with scientist Gianfrancco Christopher Cogle
Baronzio, centers on the cancer
microenvironment all the interactions around
and among cancer cells. Cogle also wrote one of
the book's chapters.
JAMIE BETH CONTI, M.D.,
has been named chief of the
division of cardiovascular
medicine in the department
of medicine. For the past
year, Conti has served as the
interim chief of the division
of cardiovascular medicine
and currently is a professor of Jamie Beth Conti
medicine. Conti is a graduate of UF's College of
Medicine and completed cardiology and cardiac
electrophysiology fellowships at UF before joining
the UF faculty in 1994.
LYLE L. MOLDAWER, Ph.D.,
a professor and vice chair of
research for the department of
surgery, recently was honored
with the Shock Society Scientific
Achievement Award. The
award is presented annually to
an outstanding scientist with
lifetime contributions to the Lyle L. Molda'
study of shock. Moldawer, who
joined UF in 1993, established the Laboratory
of Inflammation Biology and Surgical Science,
which seeks to translate current developments in
molecular biology, gene therapy and functional
genomics into the treatment of critically ill patients.
WILMER NICHOLS, Ph.D., the
director of basic cardiovascular
research, received the Lifetime
Achievement Award from'
ARTERY, the Association for
Research in Arterial Structure
and Physiology. Nichols, who
grew up working on farms
as the son of sharecroppers, Wilmer Nicl
joined the Navy at 17 and
served in the Philippines during the Korean War.
He earned a general equivalency diploma and,
later, a Ph.D. in physiology and biophysics, worked
for NASA on the first manned flight into space as
well as the Gemini and Apollo flights, and co-
edited four editions of McDonald's Blood Flow in
Arteries, a well-known hemodynamics textbook.
The department of psychiatry
recently added a seventh
division, extending its
commitment to patient care,
research and education to the
national obesity epidemic.
Researchers and faculty of
the new eating disorders and
obesity division will expand on
the years of work done within Richard Shri
the division of addiction medicine. The division
is headed by RICHARD SHRINER, M.D., a
double-boarded internist-psychiatrist who joins UF
after years spent in private practice.
COLLEGE OF PHARMACY
JULIE JOHNSON, the
V. Ravi Chandran professor of
pharmaceutical sciences and
chair of pharmacy practice, has
been selected by the American
College of Clinical Pharmacy
as its 2009 Therapeutic
Frontiers Lecture Award winner.
The Therapeutic Frontiers Julie Johnson
Lecture Award, the highest
honor in the ACCP, is presented to an outstanding,
internationally recognized scientist whose research
is actively extending pharmacotherapy into new
COLLEGE OF VETERINARY MEDICINE
ELLIS GREINER, Ph.D., a
professor of infectious diseases
and pathology, has received
the American Association of
Parasitologist Award. Greiner
has served on UF's veterinary
faculty for more than 30 years. Ellis Greiner
His research has involved
reptiles, birds, livestock and domestic pets, but
mostly has centered on sea turtles and marine
mammals. Earlier in his career, he worked
extensively with bluetongue, a viral disease
affecting sheep and cattle, and with a devastating
neurological disease that affects horses, known as
equine protozoal myeloencephalitis, or EPM.
Keepin' computers secure
The PHHP Information Technology team,
along with Andrea Burne as the college's
information security administrator, received the
2009 Security Shining Star Award from Health
Science Center SPICE. Award criteria include
technology competency, a good track record
of protecting information, teamwork with unit
administration and the ability to be effective
security leaders in their college and in the HSC.
Visit us online @ http://news.health.ufl.edu for he latest news and HSC events I
UF professor lays foundations
in the psychology of emotion
By Laura Mize
Peter Lang was on the cusp
of earning his Ph.D. in
psychology in the 1950s when
the U.S. military came calling.
He was drafted into the Army. Instead of finishing his
degree then, Lang, now executive and research director
of the Fear and Anxiety Disorders Clinic in the College
of Public Health and Health Professions and director of
the National Institute of Mental Health's Center for the
Study of Emotion and Attention, served as a clinical
psychology technician in the neuropsychiatry ward of a
stateside military hospital.
"I never got out of Fort Knox, Ky.," Lang said of his
Army career. "Of course, many patients were veterans or
were active in the Korean War. (They) wound up as
patients with PTSD posttraumaticc stress disorder) and
other mood or anxiety disorders, although that wasn't
the diagnosis at the time."
Lang saw previously mentally stable soldiers deal with
mental illness brought on by the war.
"You saw clinical phenomena then that you can still
find in the old textbooks, but which you almost never see
now because the present wide use of psychotropic drugs
masks the more flamboyant symptomology that then
characterized schizophrenia and other psychotic
After the war, Lang finished his Ph.D. and pursued
his research, focusing initially on schizophrenia. But a
new treatment for fear and anxiety disorders caught his
attention and shifted his focus. "Desensitization
therapy," developed by the late Joseph Wolpe, a well-
known South African psychiatrist, involves exposing
patients to an increasing amount of stimuli that cause
fear until the patient is no longer afraid.
"If somebody was a phobic in regard to snakes, then
maybe it would be just writing the word snake," said
Lang, also a graduate research professor in the college.
"And then (Wolpe) would build a hierarchy with the
patient of different situations and then have them
imagine them successfully."
Lang tested the new therapy to see if it stood up in a
"We began studies of systematic desensitization, and
they were probably the first comprehensive studies done,
certainly the first studies funded by NIMH, in behavior
therapy," he said. "They were quite successful."
Lang continued to study treatments for fear and anxiety and determined that a better scientific
understanding of emotion was necessary. He developed a set of factors to measure emotion, which include
language, behavior and physiology. With the advancement of technology, brain imaging has become a big
part of the study of emotion.
"You can't ever know another's feelings, but you can measure what one says, how one behaves, how the
body's organs react and increasingly how the brain orchestrates this complex expression of emotion,"
Greg Miller, Ph.D., a professor of psychology at the University of Illinois who studied under Lang, said
his former professor "has made pioneering contributions in each of these areas and has provided leadership
in how to integrate these different kinds of data."
Methods of measurement Lang developed have become standards in the field of emotion science.
In September 1994, UF's Center for the Study of Emotion and Attention, founded by Lang, became a
National Institute of Mental Health center. Today the center supports investigators at the University of
Chicago, the University of Minnesota, Emory University and Karolinska Institute and Hospital in
Stockholm, Sweden. There are also affiliated researchers working at institutions in the United States,
Belgium, Brazil, Germany, Spain, Italy and other countries.
Lang has been awarded four honorary doctoral degrees from universities in Germany, Spain and Sweden.
Miller said Lang's work in the field has been "extensive and trend-setting." Lang developed a well-known
paradigm about the startle reflex, which states that a person's mood can dictate the intensity of his or her
reaction when startled. Lang also developed the International Affective Picture System, a series of images
used in psychological experiments worldwide that Miller described as the "most commonly used stimulus
set" in emotion research.
Miller said one way Lang affected him was by teaching him how to think about and organize ideas into
"What's a wise way to go about testing this idea you have? What's a really careful way to test a creative
idea? I'm still kind of realizing how much I learned from him about that," Miller said. Q
The Fear and Anxiety Disorders clinic offers free assessments
for qualified people suffering from fear and anxiety. Call 352-294-FEAR
(3327) for more information
Crew members from the documentary "Darius
Goes West" visited UF in September for the
largest screening ever of the award-winning
movie, which chronicles Darius Weems' (second
from left) trip across the country to get his
wheelchair "pimped" and raise awareness about
Duchenne muscular dystrophy. The day after the
screening, crew members came to the HSC to
discuss what life was like behind the scenes.
UF dental students (from left) Danielle Poole,
Tori Brown, Allison Robbins and Brittney Stokes
peek at dental artifacts stored in the College of
Dentistry's museum, located on the first floor of
the Dental Building.
Florida's Surgeon General, Dr. Ana M. Viamonte Ros, led a healthy
discussion on the state's current health priorities. Ros' September visit was
part of the HSC fall Diversity Dialogue and College of Medicine Dean's
UF Health Science Center
Office of News & Communications
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Cassandra Mack, Beth Powers,
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
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