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UP FRONT

TABLE OF CONTENTS
UP FRONT
O POST IT News to Use
EXTRAORDINARYY PEOPLE Dr. Santa
O 5 QUESTIONS Children & antidepressants

O EDUCATION Mixing medical compounds
O RESEARCH Piercings & gender
COVER FEATURE Simulation in Med Ed
O PATIENT CARE Florida's uninsured

G DISTINCTIONS HSC Achievers
( ADMINISTRATION New MBI director
@ EXTRAORDINARYY PEOPLE Renato Salazar
( NEWS Libraries' Rx

0I I THE CO', EP Toimm, E ulio.nc 1.1 D (iight) assist'nrt i:r:fessor .f -onesthlesl:j, le'ds fourth-veor min-eIcal stldets through their p.es
on the Humin P tntt .imulot.:r (Ph- t.: I:, Liso E'.,-lt,,er)

Veterinary Medicine

Horse Farm

Public Health and Health Professions
The Horse Farm 100, an annual noncompetitive bike fundraiser sponsored by the Gainesville Cycling Club, took place on Oct. 24. The Colleges of
Veterinary Medicine and Public Health and Health Professions assembled large teams and were led by their deans, Joe DiPietro and Robert Frank,
through the horse country surrounding Ocala. Before leaving for their optional 25-, 55- or 100-mile legs, the teams posed for group photos. Team
PHHP, which is in its third year of raising funds for student scholarships through private and corporate sponsorships, collected nearly $12,000.

24#~s

POST IT

Repaving project causes Center Drive lane closings
Repaving of Center Drive from Archer Road to an area just south of the
Public Health and Health Professions/Nursing/Pharmacy Complex began
Nov. 29, affecting vehicle and pedestrian traffic. Commuters who
use Center Drive may need to give themselves a few extra minutes
in the mornings.
The project will proceed in four phases, each taking
approximately 30 days, with completion planned for March
2005, said Jeff Bair, project manager for the Physical Plant
Division.
The initial phases to be performed, labeled Phase 3 and Phase
4 in the diagrams, involve the area from Mowry Road to the parking lot entry for the
Biomedical Engineering Building, which is located just south of the HPNP Complex, Bair
said. The final phases to be performed, labeled Phase 1 and Phase 2, involve the area
from Archer Road to Mowry Road.
Each phase requires the closure of one lane of Center Drive. During each phase, the
open lane will be used for one-way vehicle traffic. Pedestrian traffic will be re-routed in
some areas as the project proceeds, he said.
To promote traffic safety, vehicles will be allowed to exit Archer Road onto Center
Drive throughout the project, he said. Similarly, service drives in the affected areas
will remain open continuously, as will the handicapped parking lot on the west side of
Shands.

West entrance reopens
After six months of closure, the HSC's West Entrance officially reopened in November to reveal the renovated
lobby of the Dental Sciences Building. The $820,000 renovation project included installation of a new fire
sprinkler system, ceiling panels, light fixtures, carpet and wallpaper, as well as sliding double-entry doors.
Although the West Entrance information desk has been returned to its sentinel position just inside the lobby, the
dental clinic reception and waiting area is undergoing final touches, expected to be complete by mid-December.
Perhaps the most anticipated and greatly appreciated feature of the reopened lobby is the Java City coffee
kiosk -now open for business and pleasing staff and visitors alike with the wonderful aroma of fresh-brewed,
steaming-hot joe.

Students prepare with college career fairs
With Gator Nurses in high demand, the College of Nursing
is bringing the best hospitals and health-care companies
in the Southeast to Gainesville to meet UF nursing students
and graduates. On Jan. 14, the UF Nursing Career Fair
will take place in the Public Health and Health Professions/
Nursing/Pharmacy Complex Atrium. Opportunities for
one-on-one interviews also will be available. For more
information on the event, contact Erika Borg Heeb at
eheeb@vpha.ufl.edu or 265-8097.
The College of Pharmacy is holding its 2005 career
fair Jan. 21-22. Pharmacy organizations will provide
information on Jan. 21 and personal interviews can be
scheduled for Friday afternoon and all day Saturday. Friday
evening, there also will be a reception in the faculty dining
room for students interested in internships at Shands at UF.
Second-year pharmacy student Aaron Hall said the 2004
fair allowed him to improve his interviewing skills and to find
out firsthand what each company had to offer.
"It's a great convenience for the student looking for an
internship or a job because everyone is under one roof."

At the 2004 career fair, second-year
pharmacy student Aaron Hall jokingly
demonstrated that students like getting
free stuff.

Semester break parking
From Dec. 20 to Jan. 2, all lots except for those
designated as brown and gated will be available for
parking without a decal.
All reserved spaces, service drives, handicapped
and no parking zones will be enforced at all times.
Parking restrictions will be enforced again
beginning Jan. 3.

For more info visit: www.parking.ufl.edu

HSC Libraries holiday hours

Extended hours for finals:
Dec. 10 11 7:30 a.m. midnight
Reduced hours pre-break:
Dec. 19 noon -5 p.m.
Dec. 20 23 8 a.m. 5 p.m.
Dec. 24 Jan. 2 CLOSED

Bioinformatics events on campus

Free National Center for Biotechnology
Information Classes
On Dec. 9-10, scientists from the National
Center for Biotechnology Information will
visit the UF campus to provide instruction in
NCBI resources. Choose from two lectures (a
three-hour general overview or a one-hour
"What's New") and two types of hands-on
computer sessions. The HSC Libraries and the
UF Genetics Institute sponsored the free event.
Registration is required.

www.library.health.ufl.edu/forms/classreg_
NCBI 04 1.htm

Call for Posters and Participation:
Florida Bioinformatics Workshop 2005
All aspects of bioinformatics, including
functional genomics, proteomics, phylogenetics
and systems biology, will be addressed at
a Feb. 21-22 bioinformatics workshop in
the Reitz Union. Students, faculty and staff
are encouraged to participate. Abstracts for
the poster session are due Dec. 15. Authors
may submit new posters or those that have
been presented at previous conferences.
The workshop is sponsored by the Colleges
of Engineering, Liberal Arts and Sciences,
and Medicine; IFAS -Florida Agricultural
Experiment Station; the Office of Research
and Graduate Programs; and the UF Genetics
Institute. Registration is free, but pre-
registration is required.

www.cise.ufl.edu/-suchen/fbw2005/

-33

2004 pinning ceremony
HSC employees recognized for their years of service to UF at the June Service Pin Awards Ceremony can see
photos from the event online at http://news.health.ufl.edu/stories/2004/Nov/Pinning.shtml.

EXTRAORDINARYY PEOPLE

The Consummate Claus:

UF scientist develops knack for merrymaking

By Leah Cochran

Se has a long, white beard, rosy cheeks and a jolly laugh, and he works right here in
the Health Science Center.
When the time is right, Hugh McDowell, Ph.D., an associate research scientist
in the department of ophthalmology, dons his homemade red velour suit and becomes
Gainesville's own Santa Claus.
This holiday season is only his second as Santa, but McDowell is no amateur. He is a
graduate of the Charles W. Howard Santa School in Midland, Mich., where he spent a week
a fine-tuning his Santa personality.
"My first appearance was at 'Christmas in July' at my church, where I did the children's
sermon as Santa," he said.
1 Since then, McDowell has been Santa at the mall, in elementary schools and at several
private parties and events.
The idea came from a clerk at the Sunflower Health Food store who said that McDowell
could be Santa if he let his beard grow.
With that remark in mind, McDowell thought it might not be bad to have a back-up
plan, especially since he worked in the Scroogelike world of grant applications and
scientific funding.
"I thought, well, if grant money really becomes a problem, I'll have some extra income,"
I he said. "So that was some motivation to start. In the meantime the grants came through."
But the scientific bounty did not spell an end to Santa.
McDowell realized how much fun it was to be the man in red, and he plans to continue
his hobby well into retirement.
One of his favorite stories of his jolly work involves a little girl he met at the mall. After
telling her to be sure to leave cookies for Santa, her reply was, "My Daddy says that by the
time you get to my house, you'll need a beer."
He finds most of his work through the Center Stage costume shop, where he was
recruited when its regular Santa was injured. He also works with a startup company in New
York and a modeling agency called Florida Stars. His two children joke that their father is
a male model.
When McDowell first started making the rounds as Santa, his wife held back.
"My first reaction was, 'Well that's kind of nice, good for you sweetie,'" Betty McDowell
l '. said. But when she saw all the parties she was missing, she started going as Mrs. Claus.
This year, not only have their bookings doubled between Thanksgiving and Christmas,
they also have launched a new project aimed at getting adults to join in on the Santa Claus
Ifun.
"We go to places where there are not as many children but a lot of adults," McDowell
said. "They are usually kind of shy about having their picture taken, but in fact they have a
good time with it."
Although his schedule is hectic around the holidays, McDowell said that it does not
interfere with his work. In fact, he has used his image to his advantage.
"I had this huge pile of paperwork that I needed to take through several offices," he said.
"So I went in my red shirt with candy canes and chocolate. They were all a big help."
Mrs. Claus aka Betty McDowell adds with a smile, "Yes, they were all on the good-
girl list that year."
Perhaps that should serve as a reminder.
This holiday season, if you see a man who looks remarkably like Santa Claus walking
along a Health Science Center hallway, you'd better watch out. You'd better not cry. Because
he just might be making a list and checking it twice. 0

Mrs. Claus, Betty McDowell, checks the accuracy of her husband's list. Madison Smith,
daughter of Dr. W. Clay Smith, an assistant professor in the ophthalmology department,
gets a kick out of Dr. McDowell's real beard.

I

C4'J.*

FIVE QUESTIONS

Children and

antidepressants:

Wayne Goodman discusses
"black box" warnings

Wayne Goodman, M.D., chairman of the psychiatry department at the College of
Medicine, recently spoke to POST staff about his experience as chairman of a
Food and Drug Administration advisory panel. In September the panel
recommended all antidepressants used to treat children and adolescents should
carry a oI: I box" warning on the label bold type surrounded by a black border
that warns of the antidepressants' linkto increased suicidal thoughts and actions,
particularly in children. Black box warnings are designed to highlight special J
problems and to give health-care professionals a clear understanding of a
potential medical complication associated with a drug. In October, the FDA
adopted the panel's recommendations.

The black box warning garnered 15 supporters and eight dissenters among
FDA advisers. What were the conflicting viewpoints?
A black box warning may scare parents and have a chilling effect on prescribing. On the other hand,
it forces a dialogue between the physician and patient about both risks and benefits. It corrects a past
pattern of complacency about possible side effects that could evolve if not monitored adequately.

Your vote supported the warning. Is the panel chairman's role to remain neutral in that
kind of debate or is there an opportunity to express your individual point of view?
Although the chair's primary role is to facilitate exchange of ideas and summarize the
discussion, I made my position known. At a public meeting, there are no secret votes.

News reports say pediatricians and family doctors are becoming more
reluctant to prescribe antidepressants for children.
The number of new prescriptions for antidepressants in children does seem to be decreasing since
initial warnings were issued in March of this year. Whether this is a salutary development or not
is too early to know. Fear of litigation may be an unintended consequence of these hearings.

Did all the media attention given to the black box warning overshadow
other important actions taken by the panel?
The relative risks and benefits need to be placed in perspective. The increased risk of suicidality
associated with antidepressants in children is estimated to be about 2 percent more than
those who receive placebo. The majority of children treated with fluoxetine (the only FDA-
approved drug for pediatric depression) experience a reduction in suicidal thinking. The
paradox may be explained by individual susceptibility to adverse behavioral effects induced
by antidepressants in a small minority of kids, especially early in the course of therapy.

What would your advice be to colleagues who might find themselves in
a similar role on a high-profile advisory committee?
Prior experience in a NIH study section is an excellent training ground. As much as possible, let the
data drive the discussion. However, the FDA hearing process differs in a fundamental way because
of public input. Although anecdotal in nature, testimonies from bereaved parents of teenage suicide
victims have an impact when they fit a pattern. You need to be open to this type of evidence, too.

-5I

EDUCATION

What's cooking' at the College of Pharmacy?

By Linda Homewood

he College of Pharmacy skills lab is filled on
random weekends with bustling pharmacists
in lab coats, mixing, measuring and weighing
ingredients beakers and burners ready at hand.
The state-of-the-art facility used to train beginning
pharmacy students now is also a training facility for
experienced pharmacists mixing up medical
compounds.
The pharmacist's role of preparing drug mixtures
and ointments and recording their
own formulas, or compounding, dates
back to early civilization, when a
mortar and pestle was a primary tool
of the trade. The Latin phrase
secundum artem "to make favorably
with skill"- was used to describe the
task of combining medicines to
address a patient's particular needs.
The familiar symbol Rx, still used
today, comes from the Latin
abbreviation for "recipe."
But with the Industrial Revolution
came the founding of pharmaceutical
companies, which manufactured
drugs in mass quantities. The
modern pharmacist's role shifted
from drug mixing to distributing.
The number of pharmacists
practicing compounding began to
decline by the 1940s. Even so, 60
percent of prescriptions dispensed
required skill in compounding to
prepare pills, powders, ointments and
medicated waters.
Today, the pharmacy profession is
returning to its roots, with patients
and doctors again realizing the need
for specific doses and customized
medications. By the turn of this
century, with more than 40,000
compounded drugs being dispensed
each day, there has been a renewed Anthon)
demand for this specialized skill. Inc. in
The college, partnering with a course.
pharmaceutical supplier, Medisca
Network Inc., offers the
comprehensive pharmacist training
certificate program. The program curriculum begins
with a self-study section for 26 hours of continuing
education credit. Upon completion, the pharmacist
attends a four-day live program at UF for an
additional 30 hours of credit.
"Licensed pharmacists from anywhere in the
world can benefit from continuing education in

compounding by studying from home and then
traveling to UF for further hands-on interactive
training," said Art Wharton, M.S., director of
continuing education and clinical associate professor
in the College of Pharmacy.
Compounding, simply put, is customizing a
prescription. The pharmacist creates in
consultation with the prescribing physician a
pharmaceutical alternative that is better suited to a

J. Campbell, a compounding pharmacist for Franck's Pharr
)cala, mixes a topical gel while participating in UF's compou

specific patient need. Routine compounding
performed by pharmacists may include creating a
topical cream to replace an analgesic tablet,
preparing a liquid medicine alternative for patients
who have difficulty swallowing, mixing a child-
approved flavor to help a parent and even altering a
medicinal form or flavor for improved veterinary use.

There are several important roles the
compounding pharmacist plays in partnership with
physicians, said Neil Cohen, director of technical
operations at Medisca Network Inc.
The primary role is to assist the physician by
reinforcing positive therapeutic outcomes. "Non-
compliant behavior" is a phrase used by medical
practitioners in describing a patient who does not
adhere to a prescribed drug regimen. Compounding
is often the solution to improving
compliance by tailoring the medicine to
the patient's needs or preferences, Cohen
said. When the pharmacist becomes
skilled at this, doctors will come to
depend on him for compounding advice.
Besides being a consultant, the
compounding pharmacist must also be a
technical expert, researcher and business
developer. The live CE program focuses
on these varied topics. Led by Wharton,
sessions are also taught by College of
Pharmacy faculty Cary Mobley, Ph.D.,
Jeff Hughes, Pharm.D., and Paul
Doering, M.S.
Offered periodically throughout the
years, the class is limited to 15 students
for optimal lab instruction. College of
Pharmacy alumnus Eric Russo, Pharm.
D., a pharmacist at Hobbs Pharmacy in
Merritt Island, attended the CE program
in September.
"It's tremendous that UF has worked
with Medisca to build such an excellent
program," Russo said. "Compounding
pharmacists particularly in the
Southeast can really benefit from the
education and technical support offered
for the first time in this region."
Tony Dos Santos, president of Medisca
Inc., created the educational corporation
Medisca Network to form alliances with
macy, reputable universities to provide
ending compounding education, supplying
formulas and technical support services.
To further support academia, Dos Santos
is donating $500 to the college in the
name of any UF alumni who register for
the CE course or who refer another student.
Dos Santos views the baby boomers as a driving
force in the rebirth of compounding.
"The generation of baby boomers has always
changed the world," Dos Santos said. "The idea of
getting old is not easily accepted by them. They are
placing a demand for customized medication." 0

C6 'J i-g

EDUCATION BRIEFS

Genetics researchers win

international award

By John Pastor

Two UF Genetics Institute researchers won first
place in their respective categories at the annual
American Society of Human Genetics meeting,
topping competitors from schools such as the Johns
Hopkins University, the Massachusetts Institute of
Technology and Case Western Reserve University.
Sara Rodriguez-Jato won the Postdoctoral Basic
Research award and Ahmad Khalil won the
Predoctoral Basic Research award in Toronto at the
October meeting, often described as the largest
annual genetics gathering in the world.
Rodriguez-Jato's research shed light on the
mechanisms that regulate genomic imprinting,
particularly in Prader-Willi and Angelman
syndromes, which are neurological diseases that
are caused by an irregularity in chromosome 15.
The difference is if the defect is passed through
the father, the child has Prader-Willi syndrome,
which is characterized by obesity and mild
retardation. But if the defect is inherited from the
mother, the child has Angelman syndrome,
characterized by severe mental retardation and an
inappropriately happy demeanor.
Rodriguez-Jato's research, conducted under the
direction of biochemistry and molecular biology
professor Thomas Yang, Ph.D., director of the
Center for Mammalian Genetics at the College of
Medicine, revealed insights in genomic imprinting,
a process that plays a crucial role in fetal growth
and development.

Ahmad Khalil and Sara Rodriguez-Jato search for the underlying explanations of genetic diseases.

Khalil's research, which was conducted under
professor Daniel J. Driscoll, Ph.D., M.D., in the
department of pediatrics and the Center for
Mammalian Genetics, sought to discover
mechanisms of gene regulation by studying sex
chromosome inactivation in mammals. Females
inactivate one of their two X chromosomes in their
somatic cells. By contrast, males inactivate and
then reactivate both the X and Y chromosomes,
but only during germ cell development.
Studying sex chromosome inactivation in male

and females has led to the "discovery of an
epigenetic mark that tracks profiles of gene
expression. This mark could help us identify
abnormal parts of the genome in epigenetic
diseases such as various birth defects, genetic
conditions and cancers," Khalil said.
Also, studying X and Y inactivation in male
germ cells has "provided a novel and unique
system to monitor epigenetic changes as they
unfold, providing us with valuable insights into
mechanisms of gene regulation," Khalil said. 0

Lynn Romrell, associate dean for medical
education, is inducted into the AOA.

Medical honor society AOA inducts Romrell, residents, students
UF medical education expert Lynn Romrell, Ph.D., has been elected to the national medical
honorary society Alpha Omega Alpha, along with residents Donna Hill, M.D., and Javier
Cartaya, M.D., and 12 senior medical students. They were inducted Oct. 25 at a banquet at
the Reitz Union.
Romrell, the College of Medicine's associate dean for medical education and a professor
of anatomy and cell biology, is a familiar face to medical students. Besides teaching,
Romrell has helped the college implement technological advances in medical education,
such as paperless exams and online class material.
"One of the stated goals of Alpha Omega Alpha is 'to recognize and perpetuate
excellence in the medical profession,'" Romrell said. "I am extremely pleased to be
considered worthy of this honor and look forward to working with our local chapter to
promote scholarship and professionalism in medicine."
Hill, the chief resident in the department of neurology, is in her fourth and final year of
residency. She plans to complete a one-year fellowship in neuro-ophthalmology at Emory
University in Atlanta before pursuing a career in academic medicine. Cartaya, a third-year
psychiatry resident, is considering a fellowship in child psychiatry or addiction psychiatry and
hopes to pursue a career in academic medicine at UF.
Fourth-year medical students admitted to the society were Christopher Baker, Roxana
Baratelli, Christopher Barker, Adam Brank, Karly Kaplan, Angela Kruger, Jonathan Palma,
Maryam Rahman, Cheryl Slone, Damon Welch, Candice Whitney and Christina Wright.
-Tom Nordlie

EmriIUEfSJk S

" '''--

RESEARCH

Piercings are a girl's best friend?

Body art study shows gender preferences

By Tom Nordlie

F or college students anxious to rebel against their
parents' fashion sensibilities, getting a tattoo or piercing
may be the modern-day equivalent of the 1960s-era
fascination with long hair and love beads.
As with the hippie look, body art has caught on with both
genders. But the motivations fueling a trip to the tattoo and .y
piercing parlor can vary dramatically between men and
women, and between individuals. Some may be thrill-seekers,
said Eric Storch, Ph.D., a UF assistant professor of pediatrics
and psychiatry. Others might want to work through a
traumatic life experience or just find romantic partners.
Storch co-authored a study published recently in the journal
Personality and Individual Differences that examined gender
differences and personality traits among college students who
had at least one tattoo or "nontraditional" piercing defined
as located anywhere other than the earlobe. Popular
nontraditional piercing sites include the eyebrows, nose, lips,
tongue, chin, nipples, navel and genitals.
"Fifty years ago, generally Americans did not have tattoos or any alternative
body modification," Storch said. "Times have really quite quickly changed."
But maybe they haven't changed that much. The new UF study, based on a
written survey of about 280 UF undergraduates, suggests at least one gender
stereotype that tattoos are strictly for men may still wield influence in the
body-art community.
More than 80 percent of the 160 women surveyed were pierced, but less than 20
percent were tattooed, Storch said. In contrast, half the men in the study had
piercings and half had tattoos.
"My initial interpretation is that this very much reflects
societal points of view," he said. "That is, it is very
acceptable for a woman to have piercings in multiple
places and a bit less so for men."
Regardless of gender, he said, both men and women
with multiple piercings, rather than multiple tattoos,
reported greater incidence of stressful life experiences,
such as serious illness or injury, abuse or the death of a
loved one. Piercings might help some people work
through past trauma by giving them a permanent

Tattoo artist Rob Barnes applies ink to the left
ankle of UF soil and water science graduate
student Sarah Chinault at BodyTech in
Gainesville. Chinault, 23, already has 17
tattoos and more than 30 piercings. This new
addition has the words "powered by tofu" and
shows a smiling block of bean curd. Shown
above, Sarah has a hoop earring replaced
with a straight barbell.

reminder of a difficult event in their lives, he said.
"We were slightly surprised that it (a stressful experience)
was not predictive of the number of tattoos people get," Storch
f said. Because tattoos can communicate more visual
information than piercings, he said the researchers expected
to find a correlation between multiple tattoos and stressful
experiences.
But for many students, a tattoo or piercing is simply a way
to show off their wild side.
The UF study found men had higher scores than women on
parts of the survey measuring their sensation-seeking
tendencies, Storch said. Sensation seeking, the drive to have
new, unique and intense life experiences, is associated with
participation in activities such as extreme sports, illicit drug
use or dangerous driving.
When it comes to romance and long-term commitment,
sensation seekers tend to seek each other out, said Marvin
Zuckerman, Ph.D., a professor emeritus of clinical psychology
with the University of Delaware and a renowned authority on sensation seeking.
Easily visible tattoos and piercings can help sensation seekers identify like-
minded individuals and save time in the mating game, he said.
The important thing to remember, Storch said, is that there's more to a person
than a tribal tat or facial piercing.
"Regardless of the meaning behind it," he said, "body modification is a way to
express your individuality, to explore and to experiment with really being an
adult for the first time." 0

C8 1 5J j.

RESEARCH BRIEFS

UF researchers to study treatment for

patients with swallowing disorders

By Jill Pease

A UF research team will evaluate the effectiveness of a new therapy for the
treatment of swallowing disorders in a series of ongoing clinical trials.
Led by Michael Crary, Ph.D., a professor of communicative disorders at the
College of Public Health and Health Professions, the team will investigate how
useful electrical stimulation is in treating patients who are unable to swallow food
or drink following disease or illness.
The therapy involves placing electrodes on the patient's neck, which put out very
low electrical currents, with the goal of stimulating inactive muscles.
Electrical stimulation has been used for years in physical therapy and other
rehabilitation medicine fields, Crary said. And, although it has shown promise for
the treatment of swallowing disorders, electrical stimulation has never been
evaluated scientifically for its effectiveness with swallowing disorders.
"Electrical stimulation may be a good technique, and it certainly is supported by
a lot of anecdotal evidence, but we need to systematically study the outcomes of the
therapy and identify who might benefit most from this approach," Crary said.
An estimated 15 million Americans suffer from swallowing disorders. The
condition can affect patients with stroke, Parkinson's disease, traumatic injury or
head and neck cancer.
"Eating and drinking at gatherings with family and friends and business
functions is so important in our culture," Crary said. "People who no longer have
that ability are separated from others."
Researchers will test VitalStim, the only electrical stimulation device approved
by the US Food and Drug Administration for this use, with funding from the
Chattanooga Group, VitalStim's manufacturer.
Participants enrolled in the study will receive electrical stimulation therapy five
days a week for up to three weeks. At the end of treatment, the patient's swallowing
ability will be re-evaluated to measure his or her progress.

Clinical speech pathologist Cynthia DuBose works with Kurt Berry, a
research participant in a study of electrical stimulation for treating
swallowing disorders.

Researchers also will conduct two national surveys of swallowing therapists to
gather information on how many practitioners are using electrical stimulation for
their patients and the outcomes of the treatment.
Researchers are looking for participants in the study. To be eligible, subjects
must be between the ages of 21 and 90 and have experienced swallowing difficulties
for at least six months. Interested participants can contact Crary at 273-6159
or mcrary@phhp.ufl.edu. 0

-i 9

Gatorade inventor Cade retires after 43 years
Nephrologist J. ROBERT CADE, M.D., inventor of Gatorade
and father of the sports-beverage industry, retired Nov. 1 after
serving 43 years with UF's College of Medicine. At the time of his
retirement Cade was a professor of medicine in the department
of medicine's division of nephrology, hypertension and renal
transplantation, and he will remain with the division as a professor
emeritus.

Cade is pictured at his retirement dinner Nov. 16 at Mulberry
Landing in Alachua, a favorite restaurant. At the dinner,
speakers -including College of Medicine Dean Craig Tisher,
M.D., department of medicine Chairman Edward Block, M.D.,
nephrology division Chairman Richard Johnson, M.D., and
Cade's longtime assistant Malcolm Privette -hailed Cade's
achievements and shared favorite anecdotes.

-Tom Nordlie

COVER STORY

Plans for. c

simulation center

will take HSC

back to the future

By Tom Fortner

Like all medical students, Colin Brown will never
forget the very first time his patient coded. It
was during his third year of medical school.
The patient developed an unusual arrhythmia that
Brown didn't recognize.
"What do you want to do?" asked his professor.
Brown chose to give a certain medicine only it was
the wrong call, and the patient immediately started
going downhill.
Brown felt overwhelmed by his confusion and,
almost at the same time, enlightened.
"It's a wake-up feeling," recalled Brown, now a
fourth-year student. "You see where you went wrong
and it all makes sense."
His experience speaks volumes about the power of
simulation as a teaching tool. Because in this case
Brown's patient was not a person, but a 6-foot-long
mass of plastic and wires a fact that didn't seem to
detract from the lesson.
"We're all good at studying and learning from
books," Brown said of himself and his classmates.
"How do we bridge the gap between the lecture hall
and the patient? [Without the simulator] the jump
would have been even longer and more unforgiving.
It's a great stepping stone."
Today, simulation is in full flower at the HSC.
Nursing students start IVs on "trainer" arms. Plastic

heads, their mouths agape, await the probes and drills
of dental students. Emergency medicine and
anesthesiology residents sharpen their critical
thinking and resuscitation skills on mannequins in
extremis. Surgical residents use virtual reality
techniques to practice suturing.
Veterinary medicine students don't have a life-sized
model of a horse yet, but they benefit from simulation
as well, because the devices can be programmed to
mimic animal physiology. And, on simulation's softer
side, 1,000 health science students hone their history-
taking and communication skills in work with
standardized patients.
As pervasive as it is now, the technology's pedagogic
potency is only expected to grow in importance at the
HSC and other academic health centers because of the
emergence of several interrelated imperatives:
the recognition that medical errors represent
a fundamental problem that demands an
outside-the-box solution
the need to train health science students as
part of multidisciplinary teams
the unevenness of the training experience,
which makes it difficult to expose students to
enough patients with the breadth of problems
they will need to master before entering
practice
the growing ethical consensus that real-life
patients are not merely a commodity for
indiscriminate use to advance teaching
objectives

Of course, simulated education both mechanical
and in the form of standardized patients will never
replace the "see one, do one, teach one" experience
gained at the side of a seasoned faculty member. But
with far more practice on a simulator under their belts,
HSC students of every flavor will be that much better

Fourth-year medical student Sean Phillips
prepares to defibrillate his simulated patient as
part of the anesthesiology clerkship.

prepared when they finally encounter a patient.
"I think the future of learning, at every level of the
continuum medical student, resident, fellow,
practicing physician I honestly believe it's going to
be simulator-based," said Robert Watson, M.D., senior
associate dean for education in the College of
Medicine. "I believe that the providers are going to
have to be able to demonstrate that they have mastered
a skill before they attempt it on a patient."
This conviction, coupled with major advances in
computing, virtual reality and microengineering, has
once again helped make simulation a new frontier for
health education and research. Lined up along the
edge of that frontier are many institutions ready to
stake a leadership claim. And that has helped push an
investment in simulation high up the to-do list of
Senior Vice President for Health Affairs Douglas J.
Barrett, M.D., and his academic leadership group.
"All six of our Health Center deans share my belief
that after research space, this is our next greatest need
- a high-tech, interdisciplinary teaching environment
where the student, the patient and the evidence-based
information are brought together for real-time
learning," said Barrett.
The centerpiece of their vision is a leading-edge,
interdisciplinary simulation center that will provide a
high-tech home for many of the activities that are
today scattered across the institution, often in cramped
quarters and with too many students pursuing too few
resources.
The price tag for such a center is estimated at $20
million, with several million more for badly needed
improvements that will keep current programs robust
until a new facility comes on line. The money, for the
most part, will need to be raised from private
philanthropic sources.
"This has become a strategic priority that is
consistent with our commitment to join the top 10
public universities," Barrett said. "If we don't take this
step, it will be an opportunity missed. The best
academic health centers of the next decade will all be
using patient simulation to train physicians and all
health-care providers in a more realistic, relevant,
efficient and safe fashion."

10
II~

Second-year dental
student Meenal Hilali
works on the mouth of
her mannequin in the
Dental Sciences
Preclinical Simulation
Laboratory. First- and
second-year dental
students complete
preclinical studies in the
lab, which features
multimedia instructional
resources and 84
student work stations.

A PROUD HISTORY
In the mid-1980s, UF anesthesiology faculty J.S.
Gravenstein, M.D., Michael Good, M.D., Samsun
Lampotang, Ph.D., and others pioneered the
development of the simulator that is today the most
advanced and widely used whole-body device in the
country. Their patented technology is in use at
hundreds of hospitals, medical and nursing schools,
community colleges and military bases worldwide.
On a similar track, the College of Medicine was the
first in the Southeast to fully integrate standardized
patients into teaching and testing. The two teaching
methodologies standardized patients and simulation
- go hand-in-glove, Watson said.
As an educational tool, simulation's experiential
approach is hard to beat, said Tammy Euliano, M.D.,
an anesthesiologist who handles most of the teaching
duties involving the human patient simulator.
"I think it's a wonderful way to teach," she said.
"And if you asked most medical students, the things
that stick the best are the things they learned at the
bedside. They remember that forever, and the disease
next to it in the book they don't remember at all. And
this gives us the opportunity to give them bedside
teaching in a controlled way without risking anybody."
Keeping patients out of harm's way is a key driver of
the recent interest in simulation. Five years ago this
fall, the Institute of Medicine produced its seminal
report, "To Err is Human," sounding the alarm on
medical errors in health care. Since then, increased

College of Nursing undergraduate students
run a patient scenario assessing
cardiovascular response on "Sim Man," the
college's simulated patient technology.

attention to drug labeling and analyzing
process issues that contribute to errors
have marginally improved rates.
But to really reduce errors, Watson
believes, it's necessary to go upstream
and provide better training to health
professionals in basic skills and, just as
important, to assess how well those skills
have been learned. This is true not only
for students but also for current
practitioners.
"For any skill, I really think you ought
to have done it at least 10 times on a
simulator," he said. "Every one of the
competencies I think you could help
teach and more importantly you could
objectively, reliably and validly evaluate."
Error reduction is also a product of

teamwork, which is enhanced as students train together
on the simulator. Confronting a patient in crisis, even a
staged one, serves as a crucible that not only forges
emotional bonds among students but also tends to burn
away distinctions of gender, race and profession.
"We never educate professionals together," said
Watson. "And then we wonder why they don't
communicate well when we put them into the
workplace together. [This is] a model that might make
interprofessional learning actually possible."
That teamwork aspect also appeals to Maxine Hinze,
Ph.D., R.N., who is involved with simulation at the
College of Nursing. She likes the fact that simulation
permits interdisciplinary teams to practice much
like a sports team technical skills and cognitive
abilities that put a premium on cohesiveness.
"It gives interdisciplinary health-care teams a venue
to practice their interaction and skills in complicated
situations that require repetition and coordination,"
Hinze said.
Finally, changing ethical standards are providing a
further impetus toward the technology of simulation.
Recent controversies have !i nJ n i. n rijll \ ".i
the practice of allowing trial n r I ,
perform pelvic
exams on
anesthetized
patients or

4 T1i1

permitting exams on the recently dead. More broadly,
though, the traditional use of live patients on which
students can "practice," juxtaposed against the
obligation to "do no harm," is increasingly being
questioned on the grounds of patient autonomy and
informed consent.
An article in the August 2003 issue ofAcademic
Medicine concluded: "The use of simulation wherever
feasible conveys a critical educational and ethical
message to all: Patients are protected whenever
possible and are not commodities to be used as
conveniences of training."

A VIRTUAL FUTURE
With all its possibilities, the technology still has
limitations. Many are technical: the machines break
down, "skin" can be punctured only so many times, the
realism is not quite there. The limitation that a
simulation center might best address, Euliano said, is
inefficiency. She trains students in groups of three,
with another nine looking on, waiting their turn. At
that rate, it takes a long time to accommodate 100
students in a single medical class.
She and others envision a simulation center having a
small auditorium where every student has a handheld
device that reflects the mannequin's vital signs. That
would help engage onlookers until it's their turn.
Another activity, tentatively called "Spot the Error,"
would have teams of health-care workers watch a real-
time simulation in which critical mistakes are
embedded. The teams would identify errors through a
computer interface in a sort of competition.
"We have a bad outcome, and then we do a
demonstration of a root-cause analysis," said Euliano.
The exercise promotes communication and teamwork.
The crown jewel of a
simulation center would
be a large auditorium
that is in reality a
television studio.
SProjected on the
h background is
1 any one of
several

0 11

PATIENT CARE

Number of uninsured

Floridians on the rise

By Jill Pease

he rate of Floridians without health insurance is climbing,

a new UF study finds, setting the stage for more serious
illness and higher downstream health-care costs.
Researchers in the College of Public Health and Health
Professions discovered that nearly 3 million residents, or more
than 19 percent of the state's population under 65, lack health
insurance, up from 16.8 percent when the study was last
conducted in 1999.
Nationally, the uninsurance rate is 15.6 percent.
The study looked at Floridians under age 65, since virtually
all Americans 65 or older have health coverage through
Medicare.
"Health insurance coverage is an important issue nationally
and in Florida, in part because insurance clearly has an impact
on our health," said lead researcher R. Paul Duncan, Ph.D.,
chairman of the department of health services research,
management and policy.
"Many argue that the reason more people are uninsured in
2004 than in 1999 is an economic issue, citing the poor economy
of recent years," said Duncan, the Louis C. and Jane Gapenski
professor of health services administration. "But I believe more
is going on. Employers repeatedly indicate that they want to
offer health insurance, but they are increasingly skeptical of the
value. On the other hand, employees, especially those with
moderate incomes, simply cannot afford to buy health insurance
unless the employer is bearing part of the cost."
The nature of Florida's economy also contributes to
uninsured rates that are higher than the national average.
Employers in the tourism, agriculture and service industries
prevalent in the state frequently don't offer health insurance,
Duncan said.
But the consequences of high rates of people without health
insurance are serious.
"Health insurance is related to health care and health care is
related to health," Duncan said. "They are all tied to each other.
If Florida has low rates of insured people, we suffer lost
productivity and wages because people don't have access to the
health care they need.
"A second consequence is that when people without health
insurance get sick, they are likely to delay care as long as
possible and then go to a hospital emergency room," he added.
"Typically, hospitals don't turn these patients away, they are all
treated. The costs of treating patients who are uninsured are
borne in the short run by other patients at that hospital. Since
many hospitals are community-based organizations, those costs
are ultimately borne by the entire community."
The UF study was funded by a contract from Florida's
Agency for Health Care Administration. Telephone interviews
were conducted with 17,435 households, collecting data on
46,876 Floridians. 0

Dr. R. Paul Duncan is a longtime researcher of access to medical and dental care and
issues involving health insurance and the uninsured.

THE STIjD, i KE FINDINGS INrLU_1DE

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C124i-g

PATIENT CARE BRIEFS

Dr. John Verstegen and Dr. Karine Onclin with a group of dachshund
puppies brought to UF's Small Animal Hospital recently by a
prospective client.

Good breeding means good planning:

UF launches small animal reproduction service

By Sarah Carey

When it comes to making babies, the animal world is not so different from the
human one planning is everything. In an effort to help animal breeders better
manage reproduction-associated diseases and improve pregnancy success rates, the
College of Veterinary Medicine has launched a new service focused solely on small
animal reproduction.
"We will offer cutting-edge methods to diagnose and treat both reproductive
diseases and infertility cases in male and female animals, mostly dogs and cats,"
said John Verstegen, D.V.M., Ph.D., who heads the service in partnership with his
wife, Karine Onclin, D.V.M., Ph.D. Verstegen, is a founding member of the
European Society for Small Animal Reproduction and of the European College for
Animal Reproduction. The couple moved to Gainesville last summer from
Belgium, where they had worked at the University of Liege. Their UF clinic
opened for business in early September.
Among the tools the couple plans to offer breeders are a variety of hormone tests,
as well as vaginal smears, vaginoscopy, uterine endoscopy and endoscopic uterine
drainage.
"We also will be able to provide sonography of the reproductive tract, including
sonographic detection of follicular growth and ovulation to improve fertilization
and artificial insemination success," Verstegen said, adding that the service's main
activities will include pregnancy monitoring through Doppler ultrasonography,
endocrine testing, parturition monitoring and neonatal care. O

New service seeks to improve postsurgery memory loss
A new UF&Shands service is the first in the nation to address the cognitive
deficiencies older people may experience after major surgery.
Neuropsychologists in the College of Public Health and Health Professions'
department of clinical and health psychology are offering a monitoring and
intervention program to reduce the impact of postsurgical memory, attention or
mood disturbances.
"Older age is the greatest risk for cognitive decline after surgery," said Catherine
Price, Ph.D., a research assistant professor. "Unfortunately, older adults often do not
report changes in memory or thinking until a problem or significant accident occurs.
This is especially true for patients who already have memory or thinking problems
prior to surgery or for patients who have limited family support."
Research led by anesthesiologist Terri Monk, M.D., a former UF faculty member,
showed that 40 percent of patients age 65 or older undergoing major surgery had
cognitive deficits at the time of discharge. When the patients were tested again three
months later, 15 percent still had problems.
Although theories abound, the cause of postoperative cognitive dysfunction is
unknown, Price said.
With the help of College of Medicine faculty and staff in the departments of
orthopedic surgery, anesthesiology and cardiology, at-risk patients who may benefit
from the service are identified prior to surgery. The neuropsychologists perform
baseline testing, make recommendations to the physicians, monitor patients' abilities
after surgery through additional testing and provide interventions for patients who
experience difficulties.
Jill Pease

Shands Transplant Center and staff remain in
national spotlight
The Shands Transplant Center at UF ranked in the top 20, 19th overall, in
the United States for solid-organ transplants performed in 2003, according
to transplant statistics gathered from the United Network for Organ
Sharing. Two programs within the transplant center ranked in the top 10
nationally the heart program and the lung program both ranked seventh.
"These rankings underscore the dedication that our transplant center has
to the field of transplantation. To rank as high as seventh in more than one
program is a testimony to our progress and to our outstanding physicians,
surgeons, psychologists, nurses, coordinators and other support staff," said
Richard Howard, M.D., Ph.D., a professor in the College of Medicine and
director of the Shands Transplant Center at UF.
The Shands Transplant Center at UF is the region's leading referral center
for heart, kidney, liver, pancreas and lung transplants for adult and pediatric
patients. UF transplant surgeons performed 286 solid-organ transplants in
2003, up from 257 performed in 2002.
In addition to being one of the largest transplant centers in the country,
the center's physicians and surgeons often serve on national transplant
committees and occupy leadership positions in national transplant
organizations.
Garrett Hall
Communications Coordinator for Shands HealthCare

For more information on the process call 352-265-0294

13

DISTINCTIONS

Authors
examine peptide
pharmacotherapy

The challenges posed bythe blood-
brain barrier a mechanism that
blocks some substances, such
as certain drugs, from entering
brain tissue while other substances d
are allowed to enter freely are
examined in a book edited by
Laszlo Prokai, Ph.D., of the College
of Pharmacy, and Katalin Prokai-
Tatrai, Ph. D., of the College of
Medicine.
Peptide Transport and Delivery
into the Central Nervous System,
a theme-based volume in the prestigious Progress in Drug Research series, consists of eight reviews by
internationally known experts, including the editors, on important aspects of an emerging field that examines
ways to turn peptides into potential drugs to treat central nervous system maladies.
The book, which discusses the state of the art and future trends in the use of peptide pharmacotherapy
involving the brain, is published by Birkhauser, Basel, an international academic publishing house.
John Pastor

Visit www.cop.ufl.edu/prokai/ for more information

LIBRARY

BETH LAYTON, HSC
Libraries' deputy
director, was named a
2004-05 Leadership
Fellows Program
fellow. Sponsored by
the National Library of
Medicine/Association
of Academic Health
Science Libraries, the
Leadership Fellows Program, now in its third year,
prepares emerging leaders for director positions
in academic health center libraries. Layton, one
of only five people chosen annually for this honor,
will work during the next year with a mentor
William Garrity, (next to Layton), director of
Biomedical Libraries at Dartmouth College/
Dartmouth Medical School and Dartmouth-
Hitchcock Medical Center.

MEDICINE

PAUL CARNEY, M.D., chief of pediatric neurology
at the College of Medicine, has been selected
as the first research term professor at the B.J.
and Eve Wilder Center for Excellence in Epilepsy
Research. The appointment is for three years.
The professorship will allow Carney to devote a
minimum of 75 percent of his time in the pursuit of
basic research related to epilepsy.
The epilepsy research center was established
under the auspices of the McKnight Brain Institute
in February through a private gift from Eve and
B.J. Wilder, M.D., an emeritus professor of
neurology and neuroscience. The center's purpose
is to establish a framework in which basic and

clinical scientists can interact, leading to a better
understanding of epilepsy in children and adults,
as well as to the discovery and implementation of
new treatments.

STEVEN GHIVIZZANI, Ph.D.,
a UF associate professor
of orthopaedics and reha-
bilitation and of molecular
genetics and microbiology,
is co-recipient of the 2004
Nicolas Andry Award from
The Association of Bone and
Joint Surgeons. Gene therapy
expert Ghivizzani and collabo-
rators Paul Robbins of the University of Pittsburgh
and Chris Evans of Harvard University were hon-
ored for their research on gene therapy treatments
for orthopaedic disorders.

W. STRATFORD MAY JR.,
M.D., Ph.D., director of the
UF Shands Cancer Center,
was elected to the governing
body of the national board of
trustees of The Leukemia & ,
Lymphoma Society. The newly
elected 36-member board of
directors replaces the society's
board of trustees Jan. 1.

JOHN R. WINGARD, M.D.,
has been named deputy di-
rector for Gainesville at the
UF Shands Cancer Center. -
Wingard, a professor and the
Price eminent scholar in the
department of medicine, di-
rects UF's Blood and Marrow

LINDSAY SHERILL (left) and SAMANTHA
REYNOLDS (right), pictured with Florida
Nursing Student Association chapter adviser Joan
Castleman, recently were elected officers of the
FNSA at the organization's annual convention.
The FNSA is the student branch of the Florida
Nurses Association and represents all nursing
students throughout Florida. UF nursing senior
Reynolds was elected FNSA treasurer and senior
Sherill became the FNSA Region 2 director. They
will serve yearlong terms.

PUBLIC HEALTH & HEALTH PROFESSIONS

HELENA CHAPMAN, a pub-
lic health student, received
a student scholarship from
the American Public Health
Association's Environment
Section. The award cov-
ers Chapman's registration
and travel costs associated
with attending the APHA's
recent annual meeting in
Washington, D.C. In addition, Chapman's entry
in the UF Hispanic Graduate Student Association
symposium was recognized as the best poster pre-
sentation.

r144i-g

Transplant Program. In his new position, Wingard
will oversee all Cancer Center research and clini-
cal activities on the Gainesville campus.

NURSING

CAROL REED ASH, Ed.D.,
the Kirbo endowed chair in
oncology nursing, professor
and eminent scholar, was
recognized recently for her
efforts in cancer prevention
and education and in the
international community.
The Climb for Cancer
Foundation awarded Ash a
$2,500 gift to be used in oncology nursing. The
foundation supports a cancer researcher's explo-
ration of new ideas that have potential to lead to
important developments in cancer research, treat-
ment and prevention.

DISTINCTIONS

JOANNE JACKSON FOSS,
Ph.D., a clinical assistant
professor and director of
professional graduate pro-
grams in the department of
occupational therapy, has
been named the college's
assistant dean for academic
affairs.

RONALD ROZENSKY, Ph.D.,
chairman of the department of
clinical and health psychology,
has been elected to a three-
year term on the American
Psychological Association's
board of directors. He is the
former chairman of APA's
Board of Professional Affairs
and Board of Educational
Affairs.

HORACE SAWYER, Ph.D.,
chairman of the department
of rehabilitation, received the
Lifetime Achievement Award
from the International Associa-
tion of Life Care Planning.
Sawyer is considered a
pioneer in the field and he
is the co-author of the first
textbook to include life-care
planning, "Guide to Rehabilitation."
A life-care plan is prepared to project the future
needs, services and equipment a person with
a catastrophic injury or illness will need for the
rest of his or her life. This can include medical
care, rehabilitation, home care, medication,
transportation and structural renovations to the
home.
The award cites Sawyer's contributions to the
innovation of life-care plans and his commitment
to advocating for families affected by the many
challenges of a family member with severe

disabilities. The association also recognized
Sawyer as an outstanding role model for others as
an educator and practitioner.

VETERINARY MEDICINE

DONALD FORRESTER, Ph.D.,
a professor emeritus in the
department of pathobiology,
received the Wildlife Disease l
Association's Emeritus Award.
The WDA is an international
nonprofit organization whose P v'"'
mission is to acquire, dissemi-
nate and apply knowledge
of the health and diseases of
wild animals in relation to their biology, conser-
vation and interactions with human and domestic
animals. The Emeritus Award, established in 1969,
grants an honorary category of membership in the
association. Forrester is the 26th recipient of the
semiannual award in 35 years.

simulation, continued from p. 11

environments a hospital operating room, an emergency room, the site of a mass
casualty accident or bioterrorist attack.
A team of learners students or experienced practitioners taking part in
continuing medical education are present to deal with a critical event. The whole
scene is televised to an audience of peers, who vote electronically on what to do as
the next step in the resuscitation. The instructor tallies the vote and demonstrates
the outcome for each course of action.
For all these learners, a virtual library of information will literally be at their
fingertips. With one click on a laptop or palm device, relevant patient histories,
scans, labs and evidence-based literature will be available for real-time
consultation.
Computers can be expected to play an even larger role in the future through
virtual reality simulations. UF medical college faculty members are working with
the department of computer and information science and engineering in the
College of Engineering to develop a virtual patient that students can interview.
Led by Benjamin Lok, Ph.D., computer scientists and physicians scripted a
scenario involving a woman experiencing
abdominal pain. "Diana" relies on voice
recognition software and a database of likely
questions and answers to carry on an
amazingly lifelike conversation about her
symptoms in a 10-minute interaction with a
medical student.
The approach, which will be evaluated in
December in comparison with student
experiences with standardized patients, is still
a decade away from routine use, Lok said. Yet
as one of only a half-dozen people working on
virtual characters internationally, he said he
feels confident that UF can make a name for
itself through this technology.
"This is how we can be different from every
place that has standardized patients in the
world," Lok said.

Lok symbolizes the collaborative energy

that's being directed toward simulation at UF. Nowhere is that more evident than
in the department of surgery, whose chairman, William Cance, M.D., has
championed the virtual character project and other collaborations with the College
of Education, the department of biomedical engineering, the Digital Worlds
Institute and the VA. The department, which has assigned a full-time faculty
member, Sergei Kurenov, Ph.D., to conduct simulation research and education, is
using the technology to train residents and nurses to do colonoscopies and
bronchoscopies and is teaching medical students and residents suturing technique
with a simulator it developed.
"I think that given the breadth of excellence at UF across its different colleges
we can forge collaborative interactions that will allow us to move to a leadership
role (in simulation), as Dr. Lok is already demonstrating with his virtual
characters," Cance said. "The critical step is having the interdisciplinary
collaboration that can advance the field much more quickly by virtue of the
expertise we have in multiple different areas."
It's a grand vision that's not too wild a leap for an institution that, after all, was
there at the beginning.
"We used to be light years ahead of
everyone else," Euliano said. "Now everybody
is catching up. If we got a simulation center
soon we certainly have the critical mass here
to move forward. I think we could really do
amazing things to improve tomorrow's health
care."

http://simdot.org, http://www.mbi.ufl.
edu/facilities/sims.php

"Diana" is a virtual character designed
to carry on a life-like dialogue with a
medical student about her abdominal
pain. She's the product of a
collaboration between the Colleges of
Medicine and Engineering.

[8jJ115

ADMINISTRATION

New director outlines vision

for McKnight Brain Institute

By John Pastor

people whose lives are affected by neurological
diseases are prominent in the thoughts of
Dennis Steindler, Ph.D., the new director of
the Evelyn F. and William L. McKnight Brain
Institute of the University of Florida.
In fact, his five-point plan for the direction of
the Brain Institute is driven by the idea that
researchers need to quickly develop new treatments
and methods to help people with brain and central
nervous system disorders.
"We are making progress in new genetic,
molecular, cellular and rehabilitative therapies for
neurological disease," Steindler said. "People need
to embrace the new field of regenerative medicine
and be optimistic, because treatments are in the
pipeline."
A leading authority in adult stem cell research
and a professor of neuroscience and neurosurgery
at the College of Medicine, Steindler, 52, took the
reins of the McKnight Brain Institute on Dec. 1,
according to Douglas Barrett, M.D., senior vice
president for health affairs at the UF Health
Science Center.
"Trauma, degenerative diseases, stroke and
cancer are unfortunate but not uncommon in
Florida and throughout the world," Steindler said.
"But the McKnight Brain Institute can make a
dent in these problems with its multidisciplinary
approach that utilizes the
incredible talents of the
faculty at the University. ITF IN [LI I
of Florida and the
11 N -, 1- 1, IN
emerging technologies
developed in the -ii
McKnight Brain -
Institute. Our goal is to '' -' .
become a world leader in
neurodiagnostics and the
development of novel
neurotherapeutics." I _,
Steindler's appointment
comes after an 11-month
search that involved about
30 applicants from the United States and around
the world. He becomes the McKnight Brain
Institute's second permanent director, replacing
neuroscientist William Luttge, Ph.D., who retired
in February. Douglas Anderson, Ph.D., chairman
of the department of neuroscience, served as
interim director.
"I think Dennis will be able to lead the institute
in new and exciting directions," Luttge said. "The

terrific thing about him is he has an
insightful understanding of stem cells, cancer
and the brain, which will help him serve as
glue for major projects under way at the
University of Florida. I think he will strive to
get more than the sum of the parts."
The MBI director works to integrate the
talents of more than 300 faculty members
from 51 academic departments and 11
colleges to tackle all aspects of basic, clinical
and translational neuroscience, Barrett said.
"I'm very pleased that Dennis has agreed
to accept this post," Barrett said. "He has a
compelling and exciting vision that promises
to move the McKnight Brain Institute
further into world prominence. We were able
to recruit from a pool of the most visionary
and capable neuroscience leaders in the
world. It was extremely gratifying that after
such an extensive search, we found that Dr.
Steindler was the clear leader."
Steindler joined the UF faculty in March
2001 as an established authority in adult stem
cell research, a field that looks at ways to tap
the potential of chameleonlike cells to repair
the body. He will continue to play a role in
the Program of Stem Cell Biology and
Regenerative Medicine at the College of
Medicine and the UF
Shands Cancer

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Center.
Before coming to
UF, Steindler was a
professor in the
neuroscience
program at the
University of
Tennessee-Memphis.
He and colleagues
broke scientific
ground when they
showed that they
could isolate living

stem cells from adult cadaver brains, and they
coined the term "brain marrow," now commonly
used in neuroscience circles to describe a substance
in the brain that is rich in stem cells.
A native of Wisconsin, Steindler earned a Ph.D.
in neurobiology and anatomy from the University
of California-San Francisco and a bachelor of arts
degree in zoology from the University of
Wisconsin.

UF's Brain Institute began in the early 1990s as
a campuswide initiative to harness UF's research,
clinical-care and educational skills to confront
brain disorders. It was named for Evelyn F. and
William L. McKnight in 2000 to commemorate a
$15 million gift from the McKnight Brain
Research Foundation to support research to find
ways to alleviate memory loss associated with aging
in people. O

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EXTRAORDINARYY PEOPLE

Keeping It Real

Renato "Sal" Salazar presides over dentistry's Preclinical Simulation Laboratory

By Lindy McCollurn-Brounley

On any given day, visitors to the UF College of Dentistry Preclinical
Simulation Laboratory will find it bustling with the activity of dental
students engrossed in the work of learning. The sounds of quiet
consultation between faculty and students, high-speed drills, water suction and
the occasional ring of laughter are harmonious with the light-filled openness and
cleanliness of the lab.
"Sim Lab gives us the ability to teach competencies to students, so by the third
year they have the confidence and basic clinical skills they need to work on
patients in the clinics," said Teaching Lab Specialist Renato "Sal" Salazar.
Salazar is the staff person responsible for managing the college's preclinical
simulation, undergraduate prosthodontics and polishing labs. A retired Navy
chief petty officer, he's run a tight ship in the Sim Lab since 2000 but he does
it with humor and genuine concern for the students in his charge.
"Sim Lab is where our students interact the most," said Salazar. "The open
environment itself develops cohesiveness in the class. Each class has its own
character, but if you allow them to share experiences that's what really makes
them a team."
It is in the Preclinical Simulation Laboratory where first- and second-year
dental students bond while learning the skills that will become their future bread
and butter. Students are assigned workstations in the lab for the two years of
preclinical curriculum. Each of the 84 stations is equipped with a head-and-
shoulders mannequin fitted with anatomically correct upper and lower jaws, a
full array of handpieces, a computer monitor and laptop Ethernet connection for
Internet access. If a student has a question, there's even a button-activated red
light to summon an instructor.
Students are issued instruments, restorative materials such as amalgam,
composites, impression material and their own set of teeth. The replaceable
plastic teeth screw into upper and lower ridges (gums) formed over a metal,
spring-hinged jaw. This "mouth" rests inside the mannequin's head and a flexible
rubber skin stretches over it to simulate lips and cheeks.
Students devote the majority of their time in Sim Lab laboring over this
facsimile of the human mouth first learning how to hold instruments, position
patients and "dress-out" for safety in gloves, protective eyewear and masks.
By the end of their second year in dental school, students will have drilled,
filled, root-canaled, cast, crowned and discarded more than 200 teeth. These two
years of Sim Lab instill in students the confidence and clinical competencies
necessary for their transition to working on actual patients during the third year
of dental school.
Salazar believes group cohesiveness developed during those first two years in
the Sim Lab plays an important role in the success of a class. Class instruction
may emphasize self-development through learning, but the support class
members give each other helps everyone through the tough times.
"Achievements are shared and they may get through a stressful week by
planning celebration of a class milestone," Salazar said. "They learn from each
other, the mentoring of senior students and faculty, and they have fun."
Perhaps the best Sim Lab resource is Salazar himself. Students from every year
of dental school trickle in and out of the lab to ask Sal's advice on materials,
techniques and instrument use. He reinforces what faculty wants them to learn
and guides them in meeting their lab-work criteria.
After 22 years in the Navy, Salazar retired with an advanced rating for dental
laboratory technician, as well as certification in dental radiology. His years in the

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Navy are missed, but he sees parallels in his position as teaching laboratory
specialist.
"My Navy experience taught me how to teach others. That's what Chief Petty
Officers do, they train others," Salazar said. "But I'm learning as well. I see a lot
of opportunities for growth here."
For himself as well as the Sim Lab students. O

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Bernie Machen
Why Are All the Black Kids S r g Together in the Cafeteria? And Other Conversations About Race
by Beverly Daniel Tatum, Ph.D.

This is the inaugural book for President Machen's innovative Faculty Reading Initiative,
specifically chosen to raise awareness of diversity issues. It examines the varieties of
Americans' experience with race and racism in everyday life. The president has invited
all faculty members to read this book and consider how it might be used to enhance their
research, teaching and campus service.

The author is president of Spelman College in Atlanta and former professor of psychology
and dean of Mount Holyoke College. She is an acknowledged expert on race relations in the
classroom and the development of racial identity, and is a consultant to school systems and
community groups on teaching and learning in a multicultural context.

Favorite book are a

prescription for

knowledge

By Denise Trunk

Wat is orange and blue and read all over?
The HSC libraries' award-winning "RxEAD:
Prescription for Knowledge" poster campaign.
The poster series was a brainchild of the HSC Libraries'
Reference Department and Libraries' Director Faith Meakin, and
is designed to promote ongoing positive relationships with HSC
faculty, staff and students. The RxEAD poster itself was adapted
from a successful American Library Association poster campaign
that uses celebrities to endorse the idea of the "excellence of
reading." The HSC Libraries' variation substituted UF President
Bernie Machen, Doug Barrett, senior vice president for health
affairs, and college deans as the celebrities, added the 'Rx' symbol
and also inserted the "prescription for knowledge" slogan to bring
the campaign home to the HSC.
Meakin said the campaign was one way to get HSC leaders to
feel personally connected to the library a bond that is essential
for an academic health science center library.
The HSC Libraries enlisted the deans of all six Gainesville HSC
colleges, as well as the program directors for the four colleges
served by the Borland Library in Jacksonville, and asked each of
them to sit for a photo to create personalized RxEAD posters and
bookmarks.
The participants were asked to pose with a book that was
important to them personally or professionally. All the deans and
program heads were able to participate and the director and
associate director of the HSC Libraries also participated.
Participants said they were glad to help the libraries and were
honored to be asked. Positive comments increased once the 20" x
30" color posters were displayed throughout the libraries and
copies were given to the colleges. Library patrons and students
said they were glad to see their dean and college represented.
The program will continue to grow and introduce the students
to HSC faculty and staff as well as the range of knowledge
contained in the libraries, Meakin said.
"The RxEAD poster and bookmark campaign has been a
wonderful way for our libraries to connect with the colleges we
serve. It has won two awards from the national Medical Library
Association and several other medical and health science center
libraries have asked to use the idea at their own institutions,"
Meakin said. "We are certainly going to continue the campaign
next year and the years to come. We hope to feature prominent
staff and students, award-winning faculty members, directors of
HSC centers and institutes and emeritus faculty ... Really, the
possibilities are endless."
For 2005, Meakin said they are finalizing their choices for
models and will be sending out invitations to participate.

See all the posters: www.library.health.ufl.edu/images_temp/
READposters_thumbsl.html

&18 I w -

NEWS

NEWS

Faith Meakin
A Gift Upon The Shore by M.K. Wren

Faith Meakin picked A Gift Upon The Shore for many reasons. One of her
interests is science fiction written by women about women. This book was
written by M. K. Wren a talented female science fiction writer. The book's
focus is preservation of knowledge, which is a subject she said is especially
important to her as a librarian.

Publishers Weekly wrote the following description: "Unsparing but ultimately
hopeful, this elegiac novel, set in the near future, traces the first generations
to survive nuclear war and ensuing plagues. Writer Mary Hope and Rachel
Morrow, a painter, eke out a meager existence at a farm on the Oregon coast.
As they struggle through the Long Winter following The End as the nuclear
disaster is simply called their desolation is succeeded by a determination
to collect and preserve for a new civilization the great books of Western
culture."

Doug Barrett
A River Runs Through It by Norman Maclean
Good To Great by Jim Collins

"A River Runs Through It is a favorite personal book of mine that explores the
complexity of family relationships, especially that of siblings. It describes the
mystery of how we can come to respect and love each other, even when we
don't fully understand each other.

"Good to Great is a book about how really outstanding organizations be
they large companies or complex universities often share certain common
characteristics related to leadership, purpose and vision, cultural ethic, and
strategy. To achieve lasting distinction, the great institutions have found
unique ways to effectively and persistently integrate these characteristics into
the day-to-day culture of their organizations."

jJ N 19

LOOKING' AT YOU

Injured deer heads home for the holidays

Dr. Christine Fiorello, a second-year resident in the UF College of Veterinary
Medicine's zoo medicine service, shares a close moment and says goodbye on
Nov. 2 to Della, a white-tailed deer. Della went home to the Wildlife
Rehabilitation of Hernando County organization in Brookville with her owner,
rehabilitation specialist Linda Christian, after receiving four months of care at
UF's Veterinary Medical Teaching Hospital to repair a badly broken leg.

I U-

Christmas Tree
Jim DaRoza, a facilities operations carpenter, puts tinsel on the
Christmas tree in the UF&Shands atrium.

Published by
UF Health Science Center
Office of News & Communications
Senior Vice President for Health Affairs
Douglas J. Barrett, M.D.
Director, News & Communications
Tom Fortner
Editor
Denise Trunk
Senior Editors
Melanie Fridl Ross, John Pastor
Art Director
Lisa Baltozer
Staff Writers
Tracy Brown, Sarah Carey, Tom Fortner, Linda
Homewood, Lindy McCollum-Brounley, Patricia
McGhee, Tom Nordlie, John Pastor, Jill Pease,
Melanie Fridl Ross, Denise Trunk

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

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

www.news.health.ufl.edu

UF Health Science
CENTER

Wild Art
Third-year medical student Samih Elchahal displays a photograph
from his exhibit, "Worlds, Traveled," which can be seen in the
Thomas H. Maren Medical Student Reading Room through the
semester's end. The photo, "Prayers in Motion," shows Buddhist
prayer wheels at a monastery in Nepal, where Elchahal spent a
semester as an undergraduate.

	Front Cover
	The Horse Farm 100
	News to use
	(Extra)ordinary people
	Children and antidepressants
	Mixing medical compounds
	Education briefs
	Piercings and gender
	Research briefs
	Simulation in Med Ed
	Florida's uninsured
	Patient care briefs
	Distinctions
	New MBI director
	(Extra)ordinary people
	Libraries' Rx
	Back Cover