Front Cover
 Retiring library director to get...
 Post it
 Wanted: more docs
 The power of care
 New dean named for College...
 Patient care and administratio...
 New inhalers work well, cost...
 Is bigger better?
 Program helps pets, people feel...
 Trimming childhood obesity...
 Pets get fat too
 Cost vs. care
 Bringing up babies
 Comic relief
 Dawn Bowers shares why she studies...
 Back Cover

The Post
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00073869/00032
 Material Information
Title: The Post
Uniform Title: Post (Gainesville, Fla. 2001)
Physical Description: v. : ill. ; 28 cm.
Language: English
Creator: University of Florida -- Health Science Center
University of Florida -- Health Science Center. -- Office of Public Information
Publisher: HSC Office of Public Information
Place of Publication: Gainesville Fla
Creation Date: April 2007
Publication Date: 2001-
Frequency: biweekly
Subjects / Keywords: Health occupations schools -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
periodical   ( marcgt )
serial   ( sobekcm )
Statement of Responsibility: The University of Florida Health Science Center.
Dates or Sequential Designation: July 27, 2001-
General Note: Title from caption.
 Record Information
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 47826372
lccn - 2001229452
System ID: UF00073869:00032
 Related Items
Preceded by: Friday evening post (1989)


This item has the following downloads:

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Table of Contents
    Front Cover
        Page 1
    Retiring library director to get back to basics
        Page 2
    Post it
        Page 3
    Wanted: more docs
        Page 4
        Page 5
    The power of care
        Page 6
    New dean named for College of Medicine
        Page 7
    Patient care and administration
        Page 8
    New inhalers work well, cost more
        Page 9
    Is bigger better?
        Page 10
    Program helps pets, people feel at home
        Page 11
    Trimming childhood obesity at UF
        Page 12
        Page 13
        Page 14
    Pets get fat too
        Page 15
    Cost vs. care
        Page 16
        Page 17
        Page 18
        Page 19
    Bringing up babies
        Page 20
    Comic relief
        Page 21
        Page 22
    Dawn Bowers shares why she studies brain disorders
        Page 23
    Back Cover
        Page 24
Full Text


page 12


heaviest U jjL j
is tackling the obesity epidemic in children

Education: Florida needs more residency slots, deans say
.' Education: Devoted donor helps UF build better doctors
Administration: New dean named for College of Medicine
Research: New inhalers work well, cost more
.- c Patient care: Advocates lend a helping paw
Cover story: Trimming childhood obesity at UF
Five questions: Pets get fat too
*". Research: Size does matter ... to cells
El C Jacksonville: New library director on books and "Dobermans"
Just for fun: Baby's first photo
Just for fun: Dilbert's no joke in this dentistry office
Profile: Dawn Bowers shares why she studies brain disorders
.F '"'9(111m. l
-I I

Retiring library director to get back to basics

he day of her retirement at hand, Health Science Center
I. libraries Director Faith A. Meakin, M.L.S., said she was
I. oking forward to getting back to the three R's "reading,
resting and really getting back into shape."
Meakin bid farewell to friends and colleagues in the familiar
environs of the HSC library on March 8, with Assistant Vice
President for Health Affairs Gerald Kidney thanking her for 13 -W
years of service and talking about her illustrious career as a
medical librarian, which spanned more than four decades.
Her work has taken her from a summer internship at Harvard's
medical library and a postgraduate fellowship at the University of
California at Los Angeles Biomedical Library to leadership "
positions at the University of California at San Diego School of
Medicine, the World Health Organization in Geneva and the
National Network of Libraries of Medicine at the University of
Maryland at Baltimore.
She became director of the UF Health Science Center Libraries
in 1994.
"I started in California and finished in Florida," Meakin said.
"Any profession that can take you on a journey like that is a good
one. I was fortunate to discover a real passion and a wonderful
profession to invest my life in."
Meakin plans to travel with her husband, Skip. She also
mentioned three more R's she wanted to work on "retooling,
mentioned three more R's she wanted to work on "retooling, Retiring Health Science Center Libraries Director Faith A. Meakin (left) receives
reorienting and rethinking."
Read the comments in Faith's guestbook at congratulations from Jean Shipman, president of the Medical Library Association.
www.library.health.ufl.edu/pub/faith.htnm Shipman presented Meakin with a letter of thanks on behalf of the MLA.
www.Iibrary. health.ufl.edu/p ub/fa ith.htm

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Post it

The art of medicine

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Got expired drugs? Toss 'em
Doing some spring cleaning this year? Battling your messy closet monster may take a few hours or days but UF
pharmacy experts say it's also the perfect time to take stock of what lurks in your medicine cabinet. Many
I American families hold onto out-of-date drugs, sometimes stockpiling them for that next illness. But experts say
it's wise to toss all expired medications, especially antibiotics, which have a short shelf life. Most liquid
suspensions used for children lose potency in as little as two weeks, even when refrigerated. "A lot of people feel
like they've paid good money for these medicines and they want to keep them around just in case," said Paul
Doering, a UF professor of pharmacy. "That makes sense on the surface, but in the future it very well may be
that the condition is different, that that condition doesn't warrant that strong of a medication."
S After the medicine cabinet is cleared, Doering says you may want to relocate what's left to a new location. The
temperature and humidity shifts in bathrooms can contribute to the chemical breakdown of some medications.
A resealable plastic container kept in an out-of-the-way place is better for long-term storage. Experts also
recommend families tally their household medicine chest's contents each year and review the list with their
physician. Ask your pharmacist for the best way to dispose of your prescriptions.
For more on this story, visit http://news.health.ufl.edu

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WANTED: More docs

State needs more residency slots to

counter looming physician shortage

" '-t, -
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By Tom Fortner
he deans of Florida's medical schools have
banded together to support legislation co-
sponsored by Sen. Bill Nelson, D-Fla., and Sen.
Harry Reid, D-Nev., that would expand residency
training in Florida and 23 other states where physician
shortages are predicted.
On March 13, deans of the new medical schools being established at the University
of Central Florida and Florida International University joined those at UF, the
University of South Florida, the University of Miami, Florida State University and
Nova Southeastern College of Osteopathic Medicine in calling for passage of the bill
and its companion bill in the House, which was filed by Rep. Kendrick Meek, D-
Fla., and co-sponsored by Kathy Castor, D-Fla.
If passed, Florida hospitals would gain 347 new residency positions more
than any other state. Residency is a period of three to five years after medical
school when physicians train in a specialty.
"There's a very clear and indisputable line between needing to have more
residency positions and the future supply of physicians in the state of Florida,"

said Robert Watson, M.D., UF's senior associate dean for medical education.
Two days after the announcement of the deans' endorsement, a familiar pattern
was repeated on Match Day, when medical students found out where they will
complete their training. Fewer than half of Florida's graduating medical students
will be staying in the Sunshine State for their residencies. The percentage of
medical students staying in-state for residency at each of the allopathic schools
shook out this way: UF, 37 percent; Miami, 34 percent; FSU, 43 percent; and USF,
50 percent.
Once medical graduates leave the state, it's less likely they'll return to practice.
Statistically, doctors tend to remain in the area where they do their training;
therefore, increasing the number of physicians-in-training in a state is essential to
increase the physician workforce.
Watson has no doubt that more Florida graduates would remain in the state for
their residencies if more slots were available. Since he can personally attest to the
caliber of doctor UF produces, he hates to see them leave, he said.
"It makes no rational sense to me not to find places for them," Watson said.
The root of the current problem lies in the way the federal government helps
meet the nation's demand for doctors. The Medicare program has traditionally
paid for most physicians' residencies, the final step in a doctor's training. But in
1997, federal law capped the number of Medicare-supported medical residents for
hospitals. A decade later, the number and geographical distribution of federally

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Before the Match Day festivities begin, envelopes containing residency assignments
await each of the 125 senior medical students (right). UF College of Medicine senior
Charisse Ricord (far left) pins her residency location on the map after announcing her
destination to the crowd. Dr. Patrick Duff, associate dean for student affairs, stands
behind her on the stage. Fellow seniors Bernadette Schoneburg and Ambar Patel
(middle) search for their envelopes. At the end of the day, pushpins in the map show a
large number of residencies clustered in the Southeast (below).

supported medical residents do not reflect recent population growth or shifts.
Growth states like Florida with large numbers of elderly people and baby boomers have
been hit hardest. Florida ranks 46th nationally in the number of total residency positions per
100,000 population, according to the Council for Education Policy, Research and Improvement,
or CEPRI, which estimated that Florida would need an additional 2,700 residency positions
to meet the national ratio of medical residents to 100,000 population.
Watson frequently refers to the CEPRI report, which in 2004 made seven recommendations
to guide the state with respect to investments in medical education, ranked in order of their
cost-effectiveness. The first two dealt with establishing a health-care practitioner database to
provide accurate workforce data on which to base policy decisions. The third and fourth
recommendations called for expanding residency positions, including provision of state
funding for new slots.
Some relief should come from the Veterans Administration, which funds its own residency
program and is currently in an expansion mode. Also, hospitals can and do fund their own
residency positions, usually in areas that match their particular clinical needs.
Even with the additional federal funding for residency slots envisioned in the Nelson-Reid
bill, that may be only a temporary fix. Watson said Florida will continue to lag below the
median for residents per population because of the state's future growth and the aging of the
millions of baby boomers who already live here. That will result in longer waits to see a doctor,
inappropriate use of the emergency room and greater patient morbidity due to delays in care.
"Being at the median is not going to be enough," Watson said.

Match madness

UF medical students

match to top residencies

By April Frawley Birdwell

standing by the makeshift stage, Jennifer Tromberg
surveyed the nearly empty Reitz Union ballroom.
Rumblings of a celebration at The Swamp had
circulated through the crowd and most of the other medical
students had already left, filtering out with parents and
significant others.
Crumpled napkins, half-eaten pieces of yellow cake,
empty plates smudged with white frosting and boxes -
leftovers from the 410 tiny boxes Tromberg and her mother
folded to hold orange and blue M&Ms were all that
remained of the Class of 2007's Match Day ceremony. And
Tromberg, who helped organize this year's event, couldn't
quite grasp it.
"I feel like I was in anatomy not that long ago," she said.
"And now I am at my own Match Day. It's hard to believe."
Each year, at the same time at medical schools across the
country, students receive sealed envelopes that tell them
where they will complete their residencies, the next step in
their medical training. This training lasts at least three
years and determines the trajectory of their careers. Of
UF's 125 graduating medical students, 28 will stay at UF,
either in Gainesville or Jacksonville, said Patrick Duff,
M.D., the college's associate dean for student affairs.
Ripping into her own envelope, Tromberg gaped as she
read the words she'd agonized over for nights: the
University of Virginia and dermatology. Tromberg hoped
she'd match there, but because dermatology is one of the
most prestigious and difficult specialties to land, she knew
there was a chance she wouldn't.
"It's huge for me just to match in dermatology,"
Tromberg said. "It's surreal to get my first choice."
Best friends Stephanie Romero and Jessica Versage
didn't think they would both match with their first choice,
an obstetrics and gynecology residency at a hospital in the
middle of the mountains in North Carolina. There were
only four spots in the program.
Versage and Romero looked at each other after opening
their envelopes. Neither could believe it. They both got in.
"We thought there was no way," said Versage, whose
boyfriend and fellow medical student, David Nguyen, also
matched at the hospital. "We've been hoping for it,

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Devoted donor helps college teach students art of empathy

Mrs. Annie Lou Chapman congratulates an awardee during the Chapman Society
banquet. Established in her late husband's name, this UF medical humanism
society honors medical students, residents and faculty who show compassion and
kindness toward their patients.

By April Frawley Birdwell

A nnie Lou Chapman rose gingerly from

her seat, steadying herself on the arm
of the man seated next to her in the
Paramount Hotel banquet hall. She only had
one thing to say.

"All of you be like Dr. (Robert) Watson and you'll be fine," she instructed
the medical students, residents and faculty who'd just been inducted into
the UF medical humanism honors society named after her late husband,
Dr. Jules B. Chapman.
Simply put, doctors need to show their patients they care. Understanding
this aspect of medicine is just as important as memorizing facts like what
the septum pellicidum is or knowing where to find the left subclavian
artery, says Robert T. Watson, M.D., senior associate dean for educational
affairs, the Jules B. Chapman professor of clinical care and humaneness
and most likely Mrs. Chapman's favorite doctor next to her late
For more than 10 years, Mrs. Chapman, now 93, has helped the college
train its students to become the sort of caring physicians her late husband
was and Watson is. Disappointed with the way doctors treated her husband

when he was ill, Mrs. Chapman established a trust after he died to fund
humanism-focused projects in the college to help ensure that new doctors
will treat their patients with dignity and caring.
Mrs. Chapman's support has led to a scholarship, awarded to a medical
student who shows promise for becoming a caring doctor; to the Chapman
Society, UF's chapter of the Gold Humanism Society, which honors medical
students, residents and faculty for how they treat patients; and to a one-of-
a-kind endowed professorship in clinical care and humaneness, which
Watson currently holds.
These programs have helped shape the sort of caring environment
Watson says is crucial to producing caring, humane doctors. He emphasized
it when he wrote his first strategic plan in 1991.
"Everyone knows there's something about medical school that makes
people more cynical," Watson said. "It's the environment. It's bad role
models. What can you do to counteract this cynicism? Support them.
Protect them. Love them. It's made, in my mind, a huge difference."
When Mrs. Chapman told students to be like Watson, it wasn't because
she thinks he is a caring doctor. She knows he is. He was the one who
diagnosed her with a serious illness more than a decade ago.
"She liked my bedside manner, that's what it boiled down to," Watson
Later, after Mrs. Chapman had recuperated and was back home in Fort
Myers, Watson received a call. Mrs. Chapman, who had already established
the scholarship fund, wanted to change the amount she donated to the
She wanted Watson and other UF leaders to meet with her at her home to
discuss it.
"I remember thinking, 'She might donate $25,000,'" Watson said,
recalling when Mrs. Chapman's financial planner told him about the trust.
"I don't remember the exact amount because I was so shocked. It was a few
With matching funds from the state, that trust now exceeds $4 million,
Watson said.
The Jules B. Chapman professorship in clinical care and humaneness
was established out of that fund, Watson said. Just having an endowed
professorship devoted to humanism shows how important the concept is to
the college, but Watson says the money also allows him the extra time to
show students what it means to be a caring doctor when he sees his own
patients. Often, that means just listening.
"I think he models someone who has respect for the patient and
understands the complexity of the diagnosis," said Juliessa Pavon, a fourth-
year medical student who received the Leonard Tow Humanism in
Medicine award at the Chapman Society banquet last month, along with I.
Keith Stone, M.D., chief of obstetrics and gynecology. "I think
communication is key."
With the Chapman Society, the bourgeoning medical humanities
program, the Maren Medical Student Reading Room, an on-site counselor
and other programs, the college does "a better job than anyone else does" at
giving students the tools they need to become caring doctors, Watson said.
There are a lot of people to credit for that, but none of it would have been
possible without Mrs. Chapman, Watson added.
"Her big thing is physicians ought to communicate more," Watson said.
"People don't care how much you know until they know how much you
care. There's a lot of truth in that."

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l MI i9 14- lll1i1

Once an unlikely choice for a medical dean, Kone makes way to top

By Tom Fortner

sa high school senior, Bruce Kone's peers and
teachers might well have imagined he'd become

an Olympic swimmer or a college English

professor. Dean of a major medical school, however,
was about as far off the Ouija board as a snowfall in
Fort Lauderdale, where he lived at the time.

Those prognostications notwithstanding, Kone emerged from a deep and rich pool
of applicants to be named the eighth dean of the College of Medicine March 23. He is
set to begin work May 15.
Kone, 49, is chairman of the department of internal medicine at the University of
Texas Medical School in Houston. He was one of four candidates named in February
as finalists to succeed outgoing dean C. Craig Tisher, M.D., who will return to the
faculty after five years in the post.
An accomplished nephrologist and scientist whose research the National Institutes
of Health has funded continuously for two decades, Kone also demonstrated a strong
commitment to medical and graduate education. Indeed, it was Kone's strength in all
three mission areas that was most convincing to Douglas Barrett, M.D., UF senior
vice president for health affairs.
"I believe Bruce Kone is the perfect fit to sustain our national prominence in
medical education and to build on the work Craig Tisher has done to lead the college
to elite status in research and clinical activities," Barrett said. "Bruce stood out in a
field crowded with talented candidates in part because he's so well-rounded."
His appointment is a return engagement for Kone, who earned his medical degree
with honors in research at UF and later joined the faculty as an assistant professor of
medicine in the early 1990s.
"I'm very excited and humbled by my selection," Kone said. "I was attracted by the
opportunity to come back to my medical school alma mater and serve it in this way.
I've been extremely impressed with the faculty, students and trainees and the
enormous potential of the institution. Having said that, I recognize that there are
important challenges ahead."

Kone's father was in the military, so he's one of those people who doesn't claim any
single place as home. His family finally settled in Fort Lauderdale so that he could
pursue his passion for swimming. At Princeton, he was captain of the swimming
team and graduated with honors as an English major. He didn't become interested in
medicine as a career until late in college and said he avoided science classes until he
discovered an interest in biology.
He matriculated at UF's College of Medicine and since then there's been no holding
him back. After graduating with research honors from UF, he completed a residency in
internal medicine at The Johns Hopkins Hospital in Baltimore and fellowship training
in nephrology at the Brigham and Women's Hospital at Harvard Medical School.
After completing two more years of training in molecular biology at Hopkins,
Kone came back to UF as a faculty member. In four years here, he said he had the
opportunity to be mentored by "wonderful faculty attending" like Tisher, Peter
Stacpoole, Ph.D., M.D., and Charles Wingo, M.D., among many others.
"They taught me how to be a doctor, the importance of medical education and
value of an academic career," Kone said.
Kone joined UT-Houston's medical school as an associate professor in 1995 and
was appointed chairman of the department of internal medicine in 2004. He is chief
of the internal medicine service at the school's teaching hospital, where he was also
medical director of patient care management. In addition, he served as chief of the
nephrology section at the University of Texas M.D. Anderson Cancer Center.
Kone's research focuses on the molecular mechanisms of inflammation, injury and
repair to the kidney, blood vessels and intestine, and he has authored more than 80
original scientific articles. Involved in medical education at all levels, he is a four-
time winner of his school's award for excellence in teaching.
Barrett said he was impressed by Kone's efforts to enhance faculty diversity at UT-
Houston by recruiting racial and ethnic minorities and women.
"Dr. Kone didn't just talk about the importance of diversity and equity in the
faculty," Barrett said. "He put strategies in place that led to positive change."
Kone's wife, Daisy, is a former faculty member at UF's College of Design,
Construction and Planning. An architect by training, she is the author of a book on
land development and a frequent editorial contributor to the Rice University
architectural magazine. The Kones have three daughters: Natalie, Justine and

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X-ray marks the spot

New clinic offers less invasive treatments

using imaging, advanced technology

By Stephanie Fraiman
he patients called for help, and the vascular and interventional radiologists
College of Medicine radiologists who specialize in using imaging technology
to perform minimally invasive procedures recently opened the first outpatient clinic
of its kind at UF to help guide patients through a variety of treatment options.
"The clinic is important because there has been an explosion of new technology in
the field and an increase in the number and complexity of procedures offered," said
Scott Peterson, M.D., clinic director and vascular and interventional radiology
specialist. "In order for patients to get the best care, it's important for us to see them
before and decide on the best technique available."
Previously, the department operated completely on physician referrals. Vascular
and interventional radiology specialists met the patient for the first time while
performing the procedure and did not have an opportunity to discuss treatment
options, risks and alternatives beforehand. With the opening of the clinic, patients
can discuss treatment options in advance and contact the clinic directly.
"The clinic gives us an opportunity to see patients for consultations and follow-up,
which we were not able to do before it opened," said Harry Meisenbach, M.D., one of
several UF radiologists who offer services in the clinic.
The clinic opened officially in the fall and since then, patients have come from as
far away as Miami, Tallahassee and even Georgia for treatment. The clinic offers
many treatment options, including chemotherapy, thermal ablation (a less-invasive
option for removing a tumor), fibroid embolization (a less-invasive alternative to a


UF radiologists Darren Postoak and Harry Meisenbach read a digital image
of a patient. Patients come from all over the state to visit the Vascular and
Interventional Radiology outpatient clinic at UF. Radiologists can now meet
with patients prior to performing minimally invasive alternatives to surgery.

hysterectomy), the removal of varicose veins and many other minimally invasive
Often, these procedures can be an alternative to the invasiveness of and recovery
time involved with traditional surgery. For instance, varicose veins can now be
removed with a laser treatment.
Currently the clinic is open for half a day on Thursdays. By next fall, however, the
schedule will expand to up to two days per week.
"The clinic helps patients to get an understanding of the procedures, as well as
risks involved and alternatives available," Peterson said. "Through the clinic, we
have greater access to help more people."

New cancer leader to expand clinical trials at UFSCC

By Melanie Fridl Ross

armen Allegra, M.D., a specialist in the study of colorectal cancer, has been
named associate director for clinical and translational research at the
University of Florida Shands Cancer Center, effective April 9.
He will oversee the center's Cancer Clinical Trials Office.
"In this capacity, he will be a member of the executive committee that provides a
vision and sets annual goals and the budget for the center," said W. Stratford May,
M.D., Ph.D., UFSCC director. "His expertise as a cancer clinical trials expert will
enhance our capacity to develop new and novel therapies for patients with cancer."
Allegra will also serve as professor and division chief of hematology and oncology
in UF's College of Medicine and continue as co-director of the Foundation Research
Program for the National Surgical Adjuvant Breast and Bowel Project as a means of
rapidly expanding UF clinical trial offerings.
"Offering state-of-the-art therapy to our patients through the conduct of clinical
trials that leverage the latest technologic and scientific advances will be a critical
area of expansion and development at the University of Florida," Allegra said.
Most recently, he served as chief medical officer for the Network for Medical
Communication and Research and, prior to that, worked for nearly 20 years at the
National Cancer Institute, starting as a senior investigator and then as section chief
of Biochemical and Molecular Pharmacology at the NCI's Medicine Branch. In
1991 he was named chief of the NCI's Navy Medical Oncology Branch. He later

served as deputy director of the NCI's Division of
Clinical Sciences as well as chief of the NCI's
Medicine Branch. In 2000, he was named vice
deputy director for extramural sciences.
Allegra's studies have led to improved
understanding of how cancer grows resistant to
anticancer drugs. In addition, he has spearheaded .
research to enhance the efficacy of chemotherapy
agents. He is presently the principal investigator
of an NSABP-led study to determine the benefit
of adding an anti-angiogenic antibody to standard
chemotherapy for the adjuvant treatment of
patients with colon cancer.
Allegra also patented a U.S. Food and Drug
Administration-approved drug therapy for the
treatment of pneumocystis carinii pneumonia,
once the most common cause of death in patients with HIV.
He is a graduate of the University of Pennsylvania School of Medicine, where he
completed his residency. He is board-certified in internal medicine and medical

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By Lyndsey Lewis

Common asthma inhaler powered by
a new propellant is safe and effective
but could come at nearly triple the
cost to consumers until a generic version hits
the market, according to a review in the New
England journal of Medicine last month.

The price of breathing

CFC-free asthma inhalers

work but will cost more

Conducted by two university professors and a director for the Food and =
Drug Administration, the review examines the consequences of switching
to hydrofluoroalkane, which is replacing chlorofluorocarbon, or CFC, as a
key ingredient in albuterol inhalers designed to relieve asthma. The FDA
has ruled that U.S. sales of CFC albuterol inhalers be prohibited after
About 52 million prescriptions are filled for albuterol each year in the
United States, with most containing a generic version of CFC. But because
of rising global concerns about CFC's ozone-depleting effects, "medically
essential" inhalers are finally joining a list of banned products that started
in 1978.
The researchers say their analyses show that inhalers with CFC and the
new brands that contain hydrofluoroalkane, or HFA, are equally effective
at treating asthma.
"Hopefully, by communicating with health-care professionals, we'll be
able to reassure patients," said Leslie Hendeles, Pharm.D., a UF professor
of pharmacy and pediatrics who spearheaded the review.
Albuterol, one of the medicines that relieves asthma attacks, is the
seventh most commonly prescribed drug in the United States. Because it's
so widely used, the report predicts Americans will spend an additional $1.2
billion a year on three patented inhaler brands containing the new
propellant (Ventolin, ProAir and Proventil) until generic versions reach
pharmacies, probably after 2012. Patients who pay for their own medications
will probably be hit hardest by new costs paying on average $26 more per
prescription, or $312 more per year. People with prescription benefit plans
will likely face higher co-pays as well, according to the review.
Additionally, while the new inhalers are just as effective as their
traditional CFC counterparts, a few differences have been reported. One
brand, for example, comes sealed in a protective pouch. After that pouch is
opened, the drug carries a shelf life of just two months, while most inhalers
can typically be stored for 15 to 24 months, Hendeles said.
Consumers will also notice that only the Ventolin brand of HFA inhaler
comes with a counter to track how much medicine is left. For that reason,
Hendeles suggests keeping a backup inhaler handy if physicians prescribe
a device without a counter.
"There isn't any reliable way of estimating when they're going to run
out," said Hendeles, who also serves as a consultant to the FDA.
The review also reports that some HFA inhalers tend to clog more easily.
To prevent clogging in HFA inhalers, Hendeles advised, patients should
remove the devices' metal canister once a week and clean the plastic

Leslie Hendeles, a UF professor of pharmacy and pediatrics, explains
the differences between one of the new hydrofluoroalkane albuterol
inhalers (left) and a generic chlorofluorocarbon albuterol inhaler (right),
which will be withdrawn from the U.S. market after 2008 because of
rising global concerns about CFC's ozone-depleting effects.

actuators with warm water.
Not all of the new HFA inhaler products are ideal for everyone and
health-care providers and their patients should be aware of important
differences. Two brands of HFA inhalers contain ethanol. It may not be an
appropriate therapy choice depending on the patient's religious beliefs, and
can temporarily cause a false reading on breath alcohol tests performed by
law enforcement agencies, Hendeles said.
Hendeles noted that CFC inhalers release negligible amounts of the
propellant, and do not pose a threat to ozone depletion. However, the
United States joined more than 185 other countries in signing the Montreal
Protocol, an in ternational treaty requiring complete withdrawal of all CFC
products. The inhaler, deemed medically necessary, was exempt until new
market replacements using HFA became available.
Hendeles said he hopes the review will dispel myths about HFA for
doctors and patients. Still, even though HFA inhalers are safe for the
environment and effective at treating asthma, some people may feel
uncomfortable when making the switch. HFA inhalers spew slower and
warmer plumes of medicine than their CFC counterparts, so asthma
patients may fear their new inhalers aren't strong enough.
"There undoubtedly will be some people who are absolutely certain it
doesn't work as well," Hendeles said, adding that patient education is the
key to proper care.
Rachel L. Miller, M.D., an assistant professor of clinical medicine and
public health at Columbia University, said she would urge asthma patients
to consult their pharmacist or health-care provider if they're nervous about
using the new inhalers.
"It's really the same drug," said Miller, who has worked with both CFC
and HFA inhalers. "I have found both of them, in my personal experience,
seem to work fine."

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Is better?

Breast surgery boosts

self-esteem, sexuality in

some women



iiiiliil i

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iiil iiii

By Tracy Brown Wright

Women who undergo

breast enlargement often
see a sizable boost in

self-esteem and positive feelings

about their sexuality, a UF nursing
researcher reports.

Although plastic surgery should not be seen as a
panacea for feelings of low self-worth or sexual
attractiveness, it is important for health-care practitioners
to understand the psychological benefits of these
procedures, says Cynthia Figueroa-Haas, Ph.D., a clinical
assistant professor at UF's College of Nursing who
conducted the study. The findings which revealed that
for many women, going bigger is better appear in the
current issue of Plastic Surgical Nursing.
"Many individuals, including health-care providers,
have preconceived negative ideas about those who elect
to have plastic surgery, without fully understanding the
benefits that may occur from these procedures," said
Figueroa-Haas, who conducted the study for her
doctoral thesis at Barry University in Miami Shores
before joining the UF faculty. "This study provides the
impetus for future studies related to self-esteem, human
sexuality and cosmetic surgery."
In 2005, 2.1 million cosmetic surgical procedures
were performed, according to the American Society for
Aesthetic Plastic Surgery. That figure is expected to
grow. The number of breast augmentation procedures
alone has increased a staggering 476 percent since 2000,
according to the American Society of Plastic Surgeons.
More than 2 million women in the United States have
breast implants, and this year more than 360,000

American women will undergo breast augmentation.
Figueroa-Haas studied 84 women ranging in age
from 21 to 57, assessing their perceptions of self-esteem
and sexuality before and after cosmetic breast
augmentation. Study participants had been previously
scheduled for breast augmentation and were undergoing
the procedure solely for cosmetic purposes. Eligible
candidates were mailed a consent form, a demographic
questionnaire and tests asking them to rate their self-
esteem and sexuality. They were then mailed a similar
test two to three months after the surgery.
Improvements in the women's self-esteem and sexual
satisfaction were directly correlated with having
undergone breast augmentation.
Figueroa-Haas used two widely accepted scientific
scales to measure self-esteem and sexuality. The
participants' average self-esteem score increased from
20.7 to 24.9 on a 30-point scale, and their average female
sexual function score increased from 27.2 to 31.4 on a
36-point index. She also found substantial increases in
the women's ratings of sexual desire (a 78.6 percent
increase from initial scores), arousal (81 percent
increase) and satisfaction (57 percent increase) after
their procedures.
Figueroa-Haas did note that a small number of
participants showed no change in levels of self-esteem
or sexuality after surgery.
With a heightened interest in men's sexuality issues in
recent years, the research sheds light on women's
sexuality, and how plastic surgery can improve and
enhance this important area of life, Figueroa-Haas said.
"We have all seen countless commercials on drugs
and therapy devoted to improving men's sexuality,"
Figueroa-Haas said. "Unfortunately, very little is
discussed regarding women's sexuality issues. I strongly
believe that my research shows that interventions such

as cosmetic plastic surgery can address these sorts of
issues for some women. For example, those women who
may have breast changes due to nursing or from the
inevitable natural aging process. These women may not
feel as attractive, which could ultimately negatively
impact their levels of self-esteem and sexuality."
But Figueroa-Haas warned that women should not
view plastic surgery as a cure-all for any self-esteem and
sexuality woes. In fact, ethical plastic surgeons should
screen for this type of behavior and rule out potential
patients who may have more serious psychological
issues, she said.
"There may be patients who will never be satisfied
with their bodies no matter how much surgery they
receive or feel that their life will completely change
after plastic surgery," Figueroa-Haas said. "These are
not ideal candidates for surgery and should seek further
counseling to address their underlying psychological
issues. But for women who seek improvements in certain
physical areas, plastic surgery can be a very positive
Further research is needed to assess psychosocial
issues that may arise after plastic surgery, said Figueroa-
Haas, adding that health-care providers need to be able
to better predict outcomes in these patients.
"Since plastic surgery is increasing dramatically, my
intention for researching this topic was to evaluate
nurses' attitudes toward cosmetic surgery patients and
make recommendations for increasing awareness of the
factors surrounding these patients," Figueroa-Haas
said. "Nurses should display compassion and understand
an individual's reason for seeking cosmetic surgery
instead of dismissing or stereotyping these patients.
This study shows that there are genuine psychological
improvements that follow plastic surgery, and these
issues must be understood and respected."

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fi111'. %1 7

Volunteer advocate Carol Ash makes friends with Ginger, a 5-year-old greyhound owned by Robert Randa (left), while she checks to make sure all is well in
the client waiting area at UF's Veterinary Medical Center.

Program helps pets, people feel at home

By Sarah Carey

Many hands make light work.
That expression captures the spirit of the small animal hospital's
Volunteer Advocate program, which began in July and has brought
new faces as well as helpful hands to the client services area.
Volunteers greet pets and their owners at the door, direct them to the check-in
counter, offer a set of arms to hold an animal while a client signs in and serve as
liaisons between hospital clients and service technicians and students.
The program began to take form after Carol Ash, a retired eminent scholar from
the UF College of Nursing, told former Dean Joe DiPietro about her interest in
volunteering at the UF Veterinary Medical Center. A casual conversation led to a
lunch meeting between Ash, DiPietro and small animal hospital chief of staff Colin
Burrows, B.Vet.Med., Ph.D., after which Ash was invited to help get a formal
volunteer program off the ground.
"I said I didn't know anything about setting up a volunteer program, but I'm
willing to give it a shot," said Ash, who recently helped list the new program with
the Volunteer Center of Alachua County. "It's a challenge, but I like a challenge."
Burrows then asked Jo Ann Hostetler, the small animal hospital's coordinator of
administrative services, to work with Ash to coordinate the program. Hostetler had
visualized having such a program and was delighted when it was formalized.
So far, the program includes a handful of volunteers from Oak Hammock
community, where Ash lives, and a few others from the area who work in two- to
four-hour slots performing various tasks aimed at enhancing a client's experience
in the hospital.
"They converse with clients in the receiving area to see if they have concerns

about their waiting time, have any general questions, would like a cup of coffee or
directions to the nearest mall, anything that will help make their visit as pleasant
and comfortable as possible," Hostetler said.
"If anyone voices a concern, the advocate comes out to talk to a member of the
client service team, which has the appointment schedule and a record of the student
who has picked up the medical record for that case," she added. "We call the
student on their Nextel phone and ask for an update on the waiting time and relay
that information to the client."
In most cases, clients are happy just to feel they have not been forgotten and
someone is paying attention and is aware of their situation, Hostetler added. Other
tasks patient advocates perform include helping the clients at discharge.
"The clients may have dog food or medication in hand, holding on to their pet
and trying to write a check, all at the same time," Hostetler said. "The advocate is
there to give them a hand, or just ask how everything went with their visit. Often
clients will be busy cashing out and then they will think of something they forgot
to ask the student or the doctor. So the advocate might contact the student again."
The hospital's most visible patient advocate to date has been Ash, who worked as
the director of nursing education at the Memorial Sloan-Kettering Cancer Center
in New York prior to coming to UF in 1992.
"People are just so grateful for the help," Ash said. "Particularly if they have
never been here before, they're confused and bewildered. When they say 'Thank
you so much,' it makes you feel like it's all worthwhile."
Burrows added that he already sees the benefits of the program.
"The volunteers have made themselves invaluable in just a short while," he said.
"We just wish we had more of them."

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/ '\


Expanding waisttlnes mean kids today may have tower tife expectancies

than their parents. But UF experts are trying to change that.

Susie Miller can't pinpoint exactly how it happened, but looking at her daughter Kimberly's clothes, she knew something
didn't fit.
"Everything she put on was really tight," Susie remembered. "She said, 'Mom, I need a bigger size."'
O At the doctor's office during Kimberly's annual physical last December, Carolyn Carter, M.D., confirmed what the
Millers already suspected: Kimberly was gaining weight. Too much weight. Her body mass index, the calculation doctors use to
gauge whether a person is overweight, had swelled to 27.5, high for an 11-year-old, Carter said.
Miller knew there was really only one thing to do. Her family had to change. That meant trading sugary sodas and sports
drinks for bottled water, packing grapes in her daughters' lunches instead of oatmeal cream pies and getting out of the house in
the afternoons instead of sitting on the couch.
It paid off. In March, when Kimberly checked back in with Carter, her BMI had dropped nearly a point.
"That's a big drop on the chart," said Carter, a UF professor of pediatrics. "She's doing great, and they're still working on it."
In some ways, Kimberly's progress isn't all that surprising. If weight loss were an equation to solve, adding apples, water and
daily bikes rides and subtracting oatmeal cream pies and soda would equal weight loss. It sounds simple. But like any equation,
often it isn't. There are variables involved in equations and weight loss, and sometimes it isn't so easy to solve for X or XXL.
often it isn't. There are variables involved in equations and weight loss, and sometimes it isn't so easy to solve for X or XXL.

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More than a third of U.S. children and teens are overweight or obese about 25 million a statistic that has swelled during
the past two decades, according to the Centers for Disease Control and Prevention. Considering that 70 percent of overweight
teens stay overweight as adults, stopping the problem in childhood is key to keeping kids healthy, say UF experts who work
with obese children. But getting to the root of the problem takes time, something that's in short supply in clinics. Some
children wait months for an open appointment in a UF pediatric endocrine clinic held weekly for children who are overweight
and at-risk for complications such as type 2 diabetes, and often doctors only have time to see the most severe cases, said Janet
Silverstein, M.D., a UF professor of pediatric endocrinology who has been working to combat childhood obesity for years.
That's one of the reasons UF experts hope the state Legislature will fund a multidisciplinary obesity center, one of several
proposals university leaders have listed as a priority this year. The center would offer services to children both at UF and in
rural areas, where kids are apt to be heavier, and train students to work in the field, said David Janicke, Ph.D., an associate
professor of clinical health and health psychology in the College of Public Health and Health Professions and one of the
researchers who proposed the center.
"What we're trying to do is bring experts together," said Janicke, who studies childhood obesity in rural populations. "We
have our fingers crossed, so we'll see what happens."
But helping patients in the clinic is just one aspect of what needs to happen to curb rising childhood obesity rates. UF
researchers are also trying to find the best treatments for kids and ways to stop childhood obesity before it becomes a problem,
even in children who are genetically predisposed to becoming overweight. Finding these treatments and helping families make
changes is only one part of the solution, though, Janicke said.
"There needs to be change on so many levels," he said. "What's marketed to kids, what types of foods are available in schools,
the walkability of neighborhoods, how much exercise kids are getting. There are so many different levels that we need to
intervene at that it's going to take a while."

The problem
In 1971, only 7 percent of adolescents and
4 percent of children between the ages of 6
and 11 were overweight. By the early 1990s,
those numbers had passed the double-digit
mark. By 2004, those percentages had
reached nearly 20 percent, according to the
NationalHealth andNutrition Examination
Survey results from those years.
The rising rates of obesity led researchers
to a startling conclusion in 2005. Today's
children would probably be the first
generation whose life expectancies would
not eclipse their parents because ofobesity,
scientists reported in the New England
Journal of Medicine.
Everyone has an opinion on why kids
are getting fatter even as doctors shed
more light on the health problems obesity
can cause: too many snacks, processed -
food, fast food, boot-shaped chicken
nuggets, video games, less safe
neighborhoods keeping kids inside,
fattening school lunches, more parents who
are overweight, high fructose corn syrup,
marketing junk food to kids, 700 cable channels and
an endless list of other problems. But the truth is. it's nor one thing. lanicke
said. It's everything.
"It's a very complex problem and a vicious circle," said Milagros Huerta,
M.D., a UF assistant professor of pediatric endocrinology who studies
obesity's effects on endocrine disorders such as diabetes.
And although overweight children are primarily concerned with looking
normal and fitting in, the problem is really the effects obesity has on the body.
Type 2 diabetes used to be considered an adults-only disease, but today more
children have it than ever, said Silverstein, the chief of the College of
Medicine's pediatric endocrinology division. Heart disease, high cholesterol,
sleep apnea and psychological problems affect more obese children too,
Huerta said.
Huerta decided to start her own study examining this problem when she

was working as a pediatrician at a clinic in Brownsville, Texas. She noticed
that many of the obese children she saw already had rvpe 2 diabetes.
"As a fellow, most of what I had seen before 1997 was type 1 diabetes,"
Huerta said. "It's always heartbreaking to tell someone your child has diabetes.
And as much as researchers have tried, we can't prevent it. But type 2 diabetes
is preventable, and to be seeing these kids, it felt like we were not doing
something to help them prevent it."
And more so than any other health issue, obesity is a family issue, not a
child-only problem, Silverstein said.
"If you just target the children you can make an impact, much as the tobacco
initiative made an impact," Silverstein said. "But the parents are still the ones
who cook, they're still the ones who go shopping.
"They say food is addicting. Most addictions you get rid of by not using
them, like cigarettes or recreational drugs. With food, you can't stop eating."

Continued on page 14

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Continued from page 13

The solutions?
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llhave some families where the parents. are making more progress than the kids, but
it helpsn.hJ Even ifthe child is not engaged, ifthe parent is changing the environment,
making it i alhi.er, it's mki\ it hlep kiJ' r the ci.hild."
TnJ program is\p ey fr families tnJ h!len bec e I h it us t ig
for selecting food. Foods are divided into categories based Ion fat content. For

example, green for broccoli or apples, yellow for lean meats and red for more
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program Janicke uses in his own study, that covers
everything from healthy cooking to helping parents motivate and support their
"It's really nice to see the families start helping each other," Huerta said. "We
have oe families where the parents are making more progress than the kids, but
it helps. Even if the child is not engaged, if the parent is changing the environment,
making it healthier, it's making it easier for the child."
The program is easy for families to learn because it uses the "stoplight" method
for selecting food. Foods are divided into categories based on fat content. For
example, green for broccoli or apples, yellow for lean meats and red for more
fattening foods such as pizza or a hamburger. During the program, counselors
work with children and families on individual goals and encourage them to cut
back on the number of red foods they eat.
"The last thing you want to do is badger kids into making changes," said Janicke,
whose study with families in rural areas examines whether including both the
parent and child in group treatment leads to more changes in the child's diet and
exercise habits compared to working only with parents. "This is something that's
going to take a long time. We don't want to push dramatic, large-scale changes all
at once because those things don't last and kids resist. We want parents to really be
positive and work with kids and meet them where they are."
But both Janicke and Huerta say the key to really helping more children, in
urban and rural areas of the state, is getting the funds to establish a
multidisciplinary obesity center.
"You really need the expertise from the psychologist and the social worker and

the nutritionist, not just the physician," Huerta said.
Silverstein has other goals she's been thinking about for awhile too. She'd like
to start retreats similar to the ones held for children with type 1 diabetes to help
families battle obesity. As part of a group that recently helped improve nutritional
standards in local schools, Silverstein is involved in a new group that wants to
continue to help school wellness committees with programs aimed at keeping kids
healthy. The group also wants to work with other local agencies to establish
afterschool programs that get kids off the couch.
"Inactivity is a huge piece of the puzzle," Silverstein said. "You can't do it with
food alone."
But UF researchers aren't solely focused on helping children. Other UF
researchers are trying to find ways to prevent obesity and battle it in people who
are genetically predisposed to it, like those who have Prader-Willi syndrome or
early-onset morbid obesity.
Carrie Haskell-Luevano, Ph.D., an associate professor of medicinal chemistry in
the College of Pharmacy, is working on discovering what causes a gene to go awry in
about 6 percent of morbidly obese adults and children that prevents them from ever
feeling full. A study she and others in her lab completed last year shows that
mutations of the melanocortin-4 receptor, a gene in brain cells that plays a role in
regulating hunger, cause it to miss signals that tell the body to stop eating. This
discovery placed scientists a step closer to finding a treatment for this defect.
"If I can help improve the quality of life for people, especially for kids, then it's
really exciting," Haskell-Luevano said. "That's what we're trying to work on."

S I I ; I
Fik iae in

Kimberly isn't the only one in her family who's benefited from the changes she
and her mother decided to make after her doctor's appointment in December. It's
actually helped the whole family, said Miller, a nurse at Shands at UF.
"It's the exercise," Miller said. "You feel so much better after you exercise."
Kimberly's main motivation to stick with the changes has actually been her
clothes, her mother added. As her waistline shrinks, her wardrobe expands; she
can now fit into a lot of her old clothes.
"She was excited," Miller said of when her daughter first realized she was
shedding pounds. 'She said, 'Mom, I can get back into my pants again.'"

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The pudgy


Our nation's waistlines continue to expand
and humans are not the only ones affected
by the phenomenon: U.S. pets are
increasingly becoming obese. A recent study by
Purina found that six out of 10 pets are overweight
although almost half of their owners believe their
pets are in ideal shape. UF College of Veterinary
Medicine associate professor Richard Hill tells us
how to identify the warning signs of pet obesity and
the best methods to combat this growing trend.

Dr. Richard Hill, a veterinary nutritionist at the College of Veterinary
Medicine, prepares to examine Andy, an overweight tabby cat. Andy is
rather displeased with this arrangement and expresses himself by
hissing and swatting at Hill.

Body fat produces inflammatory mediators, so obesity can
be regarded as an inflammatory condition and has been
associated with many diseases. The best study in dogs is a long
one conducted by Purina, which showed that modest increases
in body weight reduced the lifespan of Labrador retrievers
prone to osteoarthritis by two years. The best study in cats
showed that cats that are overweight are more likely to develop
diabetes and joint disease.

Feed less food and increase the amount of exercise.

Adjust the amount of food to maintain a lean body shape. A
lean body shape means that the ribs can be felt easily but not
seen or can only just be seen, and so that the waist is visible
from the side and above.

Compare the shape of your dog or cat to the shapes shown at
the Purina Web site: www.purina.com.

It is best to consult with your vet to come up with the best plan
for you and your dog. There are special veterinary diets that are
designed to ensure that adequate protein and other essential
nutrients are consumed while calories are restricted. This
method is very safe and remains the only treatment option in
cats. The new diet drug is an additional tool to help with weight
loss in dogs. It reduces fat absorption in the intestine and
reduces appetite. It does cause side effects (mostly vomiting) in
some dogs and should only be used in conjunction with food
restriction using an appropriate diet. The drug is due to be
released in May.

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Cost vs. care

UF researchers studying benefits of costly

drug for dangerous virus

By Lisa Emmerich

While respiratory syncytial
virus most often causes
symptoms similar to the
common cold in adults, it can lead
to serious respiratory problems in
young children.
At its worst, the highly contagious virus, commonly I |
called RSV, can lead to severe diseases such as
pneumonia or bronchiolitis, which can cause lasting
damage or even death. Officials from the Centers for
Disease Control and Prevention estimate that RSV
results in more than 125,000 hospitalizations and
4,500 deaths every year.
At present no vaccine exists, but the antibody drug
palivizumab has been shown to prevent the disease.
Clinical trials show palivizumab reduces RSV
hospitalizations by more than half. Unfortunately
the drug costs $1,200 a dose, heightening concerns
that it may be prescribed to patients who won't
benefit from it and underused by those who need it. Lori Bonczek, R.N., a nurse in the Neonatal Intensive Care Unit at Shands at UF, comforts
That's why UF researchers studying the effectiveness 3-month-old Belinda after administering a drug that prevents respiratory syncytial virus.
of palivizumab in Florida Medicaid infants are
trying to determine who benefits most from the
treatment. hospitalizations related to RSV and compared it with the use of palivizumab.
"Since it is costly, it is important to determine who benefits most and under Preliminary results show use of the medication during peak RSV season
what conditions optimal effectiveness is achieved," said Almut Winterstein, decreased RSV-related hospitalizations. But during the off-season the
Pharm.D., an assistant professor in the UF College of Pharmacy who is decrease was much more subtle.
leading the study. The RSV season varies depending on the state. In Florida, the season is
In collaboration with the UF Center for Medicaid and the Uninsured and difficult to pinpoint because it differs across regions. Winterstein's team is
the Agency for Healthcare Administration, Winterstein and other UF using geographic mapping software to analyze RSV infection rates,
researchers are exploring the effectiveness of the costly drug and trying to immunization usage and effectiveness for different counties across the state.
pinpoint whom it helps and during what season. Typically, the medication is Because the preventive medication only lasts for 30 days, it must be used
recommended for children under 2 who are most at risk for infection, monthly throughout a patient's period of high risk to provide maximum
including those with chronic lung disease or congenital heart disease and effectiveness. Winterstein said many children receive only one dose during
premature infants. It is typically given over a period of five months during the season, which likely would not prevent infection.
RSV season, which is similar to flu season. Winterstein's full study will evaluate the effects of palivizumab
Understanding how effective the drug is in these patients is important, immunization on RSV infection rates and the cost in various high-risk
Winterstein says, because while palivizumab has been shown to reduce the groups. She also plans to assess the effects of gaps in use of the drug.
risk of RSV infections in certain high-risk groups of children during clinical "The number of patients who are receiving the immunization has increased
trials, it is unclear whether the same level of effectiveness can be achieved in steadily and infection rates have clearly decreased," Winterstein said.
real-life populations. "However, it seems that the growth in the number of immunized children
The researchers analyzed 12 years of Florida Medicaid data on during the off-season has less effect in RSV infection rates."

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

Size does matter

ByJohn Pastor

ells from the smallest to the largest of mammals
often seem to be "one size fits all." Now a
closer look reveals that whether a cell lives in an
elephant, mouse or something in between can make
a big difference in its life.

Researchers from the University of Florida Genetics Institute, Harvard Medical
School and other institutions developed mathematical models that they used to
examine 18 cell types from mammals ranging from mice to elephants. They found
two basic categories cells that stay the same size but have drastically different
energy needs that depend on the size of the mammal, or cells that grow larger in
larger mammals and use energy at the same rate, no matter the mammal's size.
The discovery, published online this month in the Proceedings of the National
Academy of Sciences, begins to answer questions about how the size of an organism
helps determine the life span of its cells, a finding that could help cell biologists and
physiologists understand cell and organ function and their relation to disease.
"Although cells are basic building blocks, their metabolic rates depend on where
they find themselves living," said Van M. Savage, Ph.D., the lead author of the
research and an instructor in the department of systems biology at Harvard Medical
School. "Conceptually this is important because huge amounts of research on human
diseases are done on single cells or cultured cells that come from other animals and
little is done to place these findings within the context of the size or other whole-
body properties of the animals."
Generally, the size of a species of mammal sets the pace of its life, Savage said. The
life spans of a mouse and elephant can differ by more than 70 years, and it takes a
mouse 20 days of gestation before delivering a baby compared with more than 600
days for an elephant. The larger the animal, the slower its cellular metabolic rate
- the speed at which it burns oxygen and life processes. The question of whether
cells are bigger in larger mammals than in smaller ones think of an elephant's
liver cell compared with a liver cell from a mouse is usually answered by saying
that larger mammals don't typically have bigger cells, they just have more of them.
Liver cells, red blood cells and other cell types that frequently replace themselves

College of Medicine Research Day

UF Genetics Institute researchers are answering questions about how the
size of an organism helps determine the life span of its cells. Their findings
could help cell biologists and physiologists understand cell and organ
function and their relation to disease.

are about the same size, but more permanent cells, such as brain and fat cells, are
indeed larger in large mammals.
"The reason brain and fat cells grow bigger could be because they live longer and have
important long-term functions," said James Gillooly, Ph.D., a UF assistant professor of
zoology. "In these cases, the properties of the cell are linked to the whole organism. But
the sizes of quickly dividing cells are independent of the organism."

Dr. Charles Rosser (left), an assistant professor in the College of Medicine's department of urology, and Dr. Ali Kasraeian, a urology resident, discuss their
study on primary care physicians and prostate cancer screening at Research Day in the Founder's Gallery (left photo). In the HPNP foyer (right photo),
Susan Leon, a doctoral candidate in the College of Liberal Arts and Sciences' department of communication sciences and disorders, stands near a poster
displaying her research on cognitive-cholinergic therapy in Alzheimer's disease patients.

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

. .

e husband and wife scoured through the books, magazines and
medical journals Kathy Moeller had stacked on the table for them.
uThey'd come to the medical library to research prostate cancer,
which the man had.


ready to


New library

director leaves

retirement to head

back to books

By Patricia Bates McGhee

Kathy Moeller, the new director of the Borland Health Sciences Library, loves to answer unusual
questions especially from a certain basketball team recovering from the pain of losing to the
Gators in this year's NCAA championship game. Albert the stuffed Alligator, part of the library's
permanent collection, assists Moeller with all Gator sports queries.

reference desk questions, but because we're dealing
with individual physical conditions, the questions
don't repeat," she said.
Before joining UF in January, Moeller spent 30
years in the medical library at Overlook Hospital,
an 850-bed teaching hospital in New Jersey's
largest health system. There, she worked her way

As she usually does, Moeller checked on them to
see if they needed anything else.
"Did you know that they even have a microwave
treatment for prostate problems?" the husband said
when Moeller approached the couple. The wife,
considering the idea, replied, "Well, we have a
After more than 30 years as a medical librarian,
Moeller has learned from situations like these that
there's no such thing as a "typical" question in a
medical library. That's part of why Moeller who
came out of retirement to be the new director of the
Borland Heatlh Sciences Library in Jacksonville -
loves it. To her, combing the world's latest medical
information for answers is, well, fun, even when the
questions are a little wacky.
"Public libraries have files of frequently asked

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up from library assistant to director and started
one of the first open-to-the-public consumer health
information libraries. She earned a master's degree
in library sciences from Rutgers University and
was named a fellow of the Medical Library
Association. She also earned the Lifetime
Achievement Award from the MLA's New York/
New Jersey chapter.
Then Moeller retired and moved to Jacksonville
in 2005. But her retirement lasted only a year and a
"I just wasn't happy being retired and decided I
really wanted to go back to work," she said. "This
job at the Borland Library came up, and it was
exactly what I wanted it's a perfect job for me at
a library that's truly a treasure!"
The library the Jacksonville branch of the UF
Health Science Center Libraries originally was
a public health library and some of the collections
go back to the 1800s. "When the library evolved
into the Borland, we took over the books from the
City of Jacksonville, some of which are invaluable
and not available anywhere else," Moeller said.
Today, the Borland holdings provide excellent
access to medical literature, Moeller said. "The
virtual collection is wonderful, thanks to our
access to the electronic databases and journals the
Gainesville HSC library has concentrated on and
maintained," she said. "It's just an amazing array
of what's there."
For Moeller, retiring from retirement was just
what she needed. It's not that her time wasn't
occupied when she was retired; it's just that she
got fidgety and restless and something was
"Libraries are in my blood," she said, "and
there's something about being on a medical
campus, too, where new things are being learned
every day that can really change somebody's life.
"When I took this job, Dean (Robert C.) Nuss
asked me how long I thought I'd work here,"
Moeller said. "I replied, 'If you make the medical
advances fast enough, maybe I'll be here forever,
who knows?"'
Maybe she'll even be there long enough to learn
about the mysterious medical condition,
"Dobermans in the blood." A woman called her
once to ask about this problem because she thought
her daughter had it. Moeller probed the woman for
a little more information. "After much detective
work, we determined it was dopamines in the
blood," Moeller remembered. "People ask anything
and everything, and it certainly makes my job

Florida senator works to

boost Florida's medical

residency numbers

By Patricia Bates McGhee

n a March 19 tour of UF's Center for Simulation Education & Safety Research,
U.S. Sen. Bill Nelson, D-Fla., talked with UF College of Medicine-
Jacksonville residents, physicians and administrators about one of his favorite
topics his new bill to curb Florida's physician shortage by funding more slots in
Florida's medical residency training programs (for more on this topic see page 4).
The Resident Physician Shortage Reduction Act, which Nelson co-sponsored with
Sen. Harry Reid, D-Nev., would expand medical residency training in Florida and 23
other states. If passed, Florida hospitals would gain 347 new residency positions -

U.S. Sen. Bill Nelson, D-Fla., and UF College of Medicine-Jacksonville
emergency medicine residents discuss the legislation Nelson and U.S. Sen.
Harry Reid, D-Nev., introduced in February to increase the number of
residency slots in 24 states, including Florida. Pictured (left to right) are
Nelson, third-year chief resident Dr. Paul Chillar and second-year resident
Dr. Kerry Bachista.

more than any other state.
"When you compare Florida to the other 49 states, we have the greatest deficiency,"
Nelson said. "If we are not getting the number of doctors to practice here for the size of
our population, the quality of that medical care is going to go down."
Key to getting doctors to practice in Florida is getting them to complete their
residencies here because most residency graduates stay and work where they train, he
"But at the University of Florida College of Medicine this year they'll graduate 125
medical students and 60 percent of them will have to train out of state because there are
not enough slots here," Nelson said. "We paid for their education, and they're gone."
Passing the bill will be a challenge budgetwise, he said.
"We're in a very tight budgetary environment in which the administration is trying
to cut Medicare instead of increasing it," Nelson said. "It's going to be a fight."

College names new

chief of adolescent


By Patricia Bates McGhee

teven C. Matson, M.D.,
has always been
interested in taking care
of adolescents, especially those
who fall through the cracks.
There's a real need for
specialized care for
adolescents, said Matson, the
new chief and associate
professor of adolescent
medicine in the College of
department of pediatrics, who
also serves as director of UF's
adolescent clinic.
"There's a lot of normal STEVEN C. MATSON, M.D.
health care to be done just for
adolescents I call them 'kids' and we're used to seeing basic sick
kids, kids with reproductive health and contraception questions and
kids who are just bummed out," he said. "And it's always satisfying
when you see a kid who's really scared about health issues and use it as
an opportunity to educate them and get them to be a little more
But Matson's favorite part of working with the 12-to-21 age group
reveals the different role adolescent medicine physicians play from
the kids' point of view.
"Something clicks in the patient-physician relationship when the
kids realize that a professional is working and talking with them rather
than with their parents," he said. "They're kind of ready to not have
their parents there in the doctor's office, telling them to sit up
Board certified in pediatrics and adolescent medicine, Matson
attended Mayo Medical School in Rochester, Minn., and completed a
pediatrics residency at University of Iowa Hospitals and Clinics and
two fellowships one in adolescent medicine at Cincinnati Children's
Hospital Medical Center and a second in primary care faculty
development at Michigan State University. He came to UF after two
years as an associate professor of pediatrics and adolescent medicine at
the University of Arkansas for Medical Sciences in Little Rock.

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

abies abound at the UF College of Veterinary
Medicine this spring. Clockwise from upper
right, senior student Will Dunaway carries
a puppy in the shelter medicine surgery suite. In
the large animal barn, a 2-week-old foal reunites
with its mother after a separation due to an illness.
Dr. Ellen Wiedner cares for Tiffany, a premature
newborn Boer goat. A triplet, Tiffany needed a
blood transfusion, oxygen and antibiotics because
her mother didn't have enough milk for all three
babies. Tiffany recovered and went home three
days later. Student Becka Williams holds a Bengal
kitten named Elvis in the Small Animal Hospital,
while fellow senior Courtney Riley looks on from
a treatment room.


Visit us online @ http://news.hethul.ed r the latest news and


But step up to Tomlinson's office door and you'll find Dilbert and Tomlinson
do have at least one thing in common an interest in the foibles of pointy-
haired boss guy, the cartoon character who "stuporvises" Dilbert and his quirky
office mates.

Tomlinson's door has become a repository of pointy-haired boss guy
clippings and other memorabilia, some taped up by Tomlinson and others
posted by staffers who've joined in the fun.
"I think the current one out there is the best," said Tomlinson, referring to a
cartoon clipping mounted on a magnet and posted to his metal door-jam. "I
have no idea where it came from, it just showed up one morning. That one I
thoroughly enjoyed."
The anonymous clipping, which shows pointy-haired boss guy cornering a
reluctant employee, is just one of many that have appeared in the seven or eight
years since one of Tomlinson's staff members started the tradition with a gift
of a stuffed, pointy-haired boss guy figure. It remained perched on Tomlinson's
mail pocket until last month when its Velcro finally gave out.
When asked about his connection with pointy-haired boss guy, Tomlinson
said, "Actually, you'll notice I've got quite a few cartoon characters people have
given me over the years. It's not just the Dilbert character."
Indeed, Tomlinson playfully displays Disney "Grumpy" and "Happy"

figurines given to him by staffers to warn visitors of his mood, and an
assortment of character banks are arranged on his bookshelf.
But the pointy-haired boss guy seems to be the one with which people have
the most fun. Even dentistry Dean Teresa Dolan has contributed to
Tomlinson's Dilbert collection with the gift of a Dilbert desk calendar.
"I have to assume she was implying something," Tomlinson said with a grin.
"But it's all in good humor."

'^ __________________

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



assistant professor of pediatric
neurology and director of the
Neuroprosthetics Research
Group, and his collaborators
in the College of Engineering
have received $2.5 million from
the National Institutes of Health
for their work developing and Justin Sa
studying neuroprosthetics.
Sanchez, who is also an affiliate professor of
neuroscience and biomedical engineering, will
receive $400,000 from this award for the project
"An Ultra-Low Power Wireless Neural Recording
Implant Based on Novel Pulse Representation."
His engineering collaborators include Jose
C. Principe, Ph.D.; John G. Harris, Ph.D.; Toshi
Nishida, Ph.D.; and Rizwan Bashirullah, Ph.D.

assistant professor of psychiatry,
recently received a grant from
the National Institutes of Health
to research new ways of treating
obsessive-compulsive disorder in
The $75,000 grant allows him
and several other UF researchers Eric
to study whether a new kind of
medication can augment behavioral therapy for
OCD. He and his team are pairing behavioral
therapy with a non psychotropic drug that spares
patients of most side effects.

DEAN C. CRAIG TISHER, M.D., was honored
in March by the Florida Society of Addiction
Medicine for promoting addiction medicine,



education, prevention,
treatment and research in
"On behalf of all the staff and
faculty of this great college who
are committed to the programs ,.
associated with addiction,
whether it's on the front lines ".
dealing with addiction in c. Craig Tish
all types of patients or in the
laboratory developing translational research for
all of these people I accept this award," Tisher said.


has been named a recipient
of the Spring 2007 Howard
Hughes Medical Institute
Distinguished Mentor award,
recognizing excellence in
undergraduate mentoring.
Elder, an associate professor
and chair in the department of Jennifer EIc
health care environments and
systems, was one of six awardees at UF and will
receive $10,000 over two years.
Elder teaches mental health nursing and
research at the undergraduate and graduate levels
and has spent the last 25 years studying autism
and related child neuropsychiatric disorders. With
an interdisciplinary team of researchers and
clinicians, she has developed and tested a variety
of interventions for children with autism.
Dr. Elder has employed and mentored 16
undergraduate students in her research projects.
In addition, she has provided research experiences
for five undergraduate research scholars and 44


honors students. Dr. Elder's students frequently
co-author and present with her at local, state, and
national research conferences. Four students have
presented internationally.



GREG WELDER, a second-year
pharmacy student, received
the Presidential Trainee Award
from the American Society
f:, Clinical Pharmacology
II.:1 Therapeutics at its
:,uijal meeting in March.
supervisedd by Issam Zineh,
'I, )., an assistant professor Greg Weld
:I pharmacy practice,
.---g conducts research on hypertension and
:1-,: lesterol-lowering drugs.
'CPT, the largest professional scientific
: :i.:nization serving clinical pharmacology,
I,.:l.:tionally presents the award to a member
I- :l:ling a professional doctoral degree in pharmacy
:. medicine, said William Millard, Ph.D., executive
::::ciate dean for the College of Pharmacy.


I:..--i named assistant director
I:i research programs and
:- ,ces in the Office of
I.--:arch Affairs at the Health
i -nce Center-Jacksonville.
I : Ilni's appointment is a
I .:,3-;fer from her previous
I:.: :,ion as director of research
Tina Bott
.:iI.:1 program development for
il.- Neuroscience Institute at HSC-Jacksonville/
Sl,.:nds Jacksonville. Before joining UF in 2001,
:I,.- Nas director of administration in the office
:t ile executive associate dean of research at
I I: thwestern University Medical School.

i w II .i *'1F I- I. I, u- I I-ii I I -.. Iu I. I ii- I'l- I I -F ii ..I H .-_7 -.- i I:

By Stephanie Fraiman

When Dawn Bowers, Ph.D., set out to study

psychology as an undergraduate, she had no
idea what drove her to the major. It wasn't until

she was working on her doctorate in neuropsychology,

the study of brain and behavior, that she finally began to

realize the subconscious motive behind her decisions.

Bowers' sister suffered from anoxia, a lack of oxygen to the brain during birth. Her
brain injuries were so severe she could not talk or care for herself. She died when she
was only in her 20s. Thinking of how her sister's condition affected her family,
particularly her mother, Bowers realized she wanted to know more about how to help
those suffering from brain disorders.
"There are many interesting disorders of the brain," said Bowers, who earned her
undergraduate degree and doctorate from UF. "I love learning about individuals with
striking disorders and how to help them."
Now a professor of clinical health and health psychology in the College of Public
Health and Health Professions and director of the Cognitive Neuroscience Laboratory,
Bowers studies the emotional and cognitive symptoms of Parkinson's disease patients.
"Many think of Parkinson's disease as a disease of motor symptoms, but some of the
worst symptoms are emotional and cognitive," she said.
Her research seeks to help patients suffering from "masked face," which causes
Parkinson's patients to experience a lack of facial expression. A breathing exercise
program developed by one of her colleagues was found to improve patients' facial
communication during a pilot study. They now have an ongoing clinical trial to learn
whether this program can increase a patient's ability to communicate nonverbally.
"This research is important because we can find ways that can improve patients'
relationships with others and, in return, their well-being," Bowers said. "These patients
are often seen as being sour and unpleasant because of their inability to show emotion."

Dawn Bowers, a neuropsychologist at UF, studies the emotional and cognitive
symptoms of Parkinson's disease. Through the research Bowers conducts,
approaches to helping patients improve their nonverbal communication and
relationships with others are becoming a reality.

Bowers explained that much of what people perceive about a person is through
nonverbal communication. Often, a patient's inability to communicate through facial
expression affects their relationships with others, especially health-care providers.
In addition, the same patients often suffer from apathy, a loss of interest and
motivation, which can often be confused with depression. Right now, there is no known
treatment for apathy. However, Bowers is hopeful about a new treatment she and her
colleagues are studying with funding from the Michael J. Fox Foundation.
Through the research conducted in Bowers' lab, approaches to help these patients
improve their nonverbal communication and relationships with others are becoming a
But it won't be the first time Bowers' research has helped patients. Ten years ago,
after a patient's right temporal lobe was removed during surgery, Bowers received a call
from the man's wife a few weeks later. Something was different about her husband, she
said. Because surgeons had removed his amygdala, a control center for emotions in the
temporal lobe, he no longer responded to stressors in normal ways. On the basis of this
reaction, Bowers conducted a study on other patients who had the same surgery and
found that the removal of this portion of the brain resulted in a small change in the
patients' personalities. They no longer felt panic when in a stressful situation.
"Her research ideas are genius," said Lindsey Kirsch-Darrow, a doctoral student in
clinical and health psychology who is specializing in neuropsychology. "I came to UF
to do my Ph.D. because I wanted to work with Dr. Bowers."
Bowers said she only wants to continue to help her patients.
"My future goal and research project is to develop better treatment for emotional
symptoms of Parkinson's patients, particularly apathy, because current medications don't
work," Bowers said. "And of course, I want to have fun while I'm doing this."

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

Dr. Madeline Yamate, an acupuncture intern at UF's Veterinary Medical Center, gives an acupuncture treatment to CJ, an American Quarter Horse, for
skin sores. Photo by Sarah Kiewel.

Published by
UF Health Science Center
Office of News & Communications

Senior Vice President,
Health Affairs
Douglas J. Barrett, M.D.

Director, News &
Tom Fortner

April Frawley Birdwell

Senior Editors
Melanie Fridl Ross, John Pastor

Mickey Cuthbertson

Staff Writers
April Frawley Birdwell, Tracy Brown,
Sarah Carey, Anney Doucette, Linda
Homewood, Lindy McCollum-
Brounley, Patricia Bates McGhee, John
Pastor, Jill Pease, Melanie Fridl Ross

Contributing Writers
Lyndsey Lewis, Stephanie Fraiman

Sarah Kiewel

Support Staff
Cassandra Jackson, Beth Powers,
Kim Smith

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

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