Front Cover
 When health care gets politica...
 Post it
 Behind the scenes of a bust
 Education briefs
 A horse named Livello
 In memoriam
 Skipping doses
 Research briefs
 (Extra)ordinary person
 New to health care
 Kayser Enneking
 Acting out
 Stem cell pioneer
 The new Americans
 Over the hill for the pill?
 Reshaping rural America
 Caring for cows
 Back Cover


The Post
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00073869/00038
 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: May 2008
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: UF00073869:00038
 Related Items
Preceded by: Friday evening post (1989)


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Table of Contents
    Front Cover
        Page 1
    When health care gets political
        Page 2
    Post it
        Page 3
    Behind the scenes of a bust
        Page 4
    Education briefs
        Page 5
    A horse named Livello
        Page 6
    In memoriam
        Page 7
    Skipping doses
        Page 8
    Research briefs
        Page 9
        Page 10
    (Extra)ordinary person
        Page 11
    New to health care
        Page 12
        Page 13
        Page 14
        Page 15
    Kayser Enneking
        Page 16
    Acting out
        Page 17
    Stem cell pioneer
        Page 18
    The new Americans
        Page 19
    Over the hill for the pill?
        Page 20
    Reshaping rural America
        Page 21
        Page 22
    Caring for cows
        Page 23
    Back Cover
        Page 24
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On the Cover

For the nearly 2,000 UF students graduating in May from the
Health Science Center's six colleges, the time has come to
transition from childhood dreams of being a veterinarian,
nurse or doctor to the reality of being professionals in fields
where lives are on the line. In this month's issue of the
POST, we talk to residents, students and faculty members
about this transformation from student to rookie to pro
and how UF eases it along. Photo by Sarah Kiewel.

Table of Contents

0 POST-it
O Education: Behind the scenes of a bust
O Patient Care: A horse named Livello
O Research: Skipping doses
) Research: Clam conundrum
( Extraordinary Person: An undergrad in the lab
( Cover Story: New to health care
Q Five Questions: Kayser Enneking
Q Education: Acting out
) Administration: Stem cell pioneer
Q Grants: Reshaping rural America
) Distinctions
) Profile: Caring for cows

S** ** ** ***SS SS SSS SS *** ** ** *** ** *** SS S *** ** ** *** **** *** *S SS S S ** **


When health

care gets political
hat is the fate of health-care reform if Democrats
win the 2008 presidential election? What if the
Republicans win office? And how will the
nation's deficit affect reform attempts? Those were the
topics of an April 11 talk by leading economist and health
policy expert Gail Wilensky, Ph.D., who discussed "The
politics of health-care reform" as part of the College of
Public Health and Health Professions 50th Anniversary
Lecture Series.
Wilensky is shown here with (from left) College of
Medicine pediatrics chair Richard Bucciarelli. M.D.;
interim dean of Public Health and Health Professions
Michael Perri, Ph.D.; and Ira Gessner, M.D., of the College
of Medicine.
To view a video of Wilensky's lecture, visit

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Joseph V. Simone, M.D., an internationally recognized leader in cancer care, research and education, has been
named director of the UF Shands Cancer Center and physician-in-chief of cancer services for Shands at UF,
effective July 1. Simone, who has held leadership positions in some of the country's top cancer programs, is
making a second stop at UF. He served as a consultant in the planning for the Shands at UF Cancer Hospital and
the university's overall cancer program in 2006 and 2007, briefly holding an appointment as a UF associate vice
president for health affairs. A pediatric oncologist, Simone worked for 25 years at St. Jude Children's Research
Hospital, is a former president of the Association of American Cancer Institutes and has been an adviser for
\ nthe H. Lee Moffitt Cancer Center, which recently partnered with UF and Shands. At UF, Simone's key goals
include leading a redesign of UF and Shands clinical cancer services to better align them with Moffitt's patient-
centered programs. He will also work to integrate UF and Shands patient-care and research activities with

hiJI .SMO E-.. Comprehensive Cancer Center core grant.

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A different kind of

field trip

Local law enforcement officers ke
pharmacy students inside drug busts

By Christa Wagers

unmarked van
prowls the streets of
Gainesville on a quest for the
latest drug deal.
No, this isn't an episode of "Cops."
It's a UF class going on a field trip.
The eight-week pharmacy course called
Drugs and Society, which was held this
semester, took the 15 students on drug busts
as part of their "other" drug use education.
Sgt. Shawn Brooks, of the Alachua County
Sheriff's Office, doesn't remember any other
UF classes all going on what he calls a "buy
bust" together. However, individual ride
along are common.
Brooks was in the van with the students,
along with another officer from the
Gainesville/Alachua County Drug Task
Force. The other officer is not named because
he still works undercover. Brooks, 36, has
moved to the uniform patrol department.
Through the busts and talks the sheriff's
department gave, the students gained an
understanding of what law enforcement really
does to combat drug abuse.
"It's not the excitement of television
shows," said Viviane Barry, 37, a student in
the course.
There is a lot of patience and waiting
involved during the bust, Barry said. There's
also much planning done for safety. The
students arrived at a buy bust scene after the
situation had been controlled by law
enforcement officials, Brooks said.
"For their safety, we keep them out of the
area," he said.
Drugs and Society was started about 15
years ago by Paul Doering, M.S., a UF

distinguished service professor in the
College of Pharmacy.
"Since there is seemingly a pharmacy on
every street corner, it follows that parents,
children and adolescents will go to the
pharmacist with their questions about some
aspect of nonmedicinal drug use," he said.
Although the students have knowledge of
the drugs, they don't necessarily know the
terminology, he said.
One of Doering's favorite parts of the class
is going on the drug busts.
"It is fun to see the wide-eyed excitement
that the students show when they work with
the law enforcement officers dressed in

obtained by individual users.
The sheriff's office brought in cocaine and
prescription drugs such as OxyContin into
the class for the students to see what the
drugs look like on the street.

"It qives them the understanding for the

potential for drug abuse for the drugs they

are responsible for dispensing.
-Sgt. Shawn Brooks, Alachua County Sheriff's Office

combat fatigues or undercover clothing," he "It gives them the understanding for the
said. "It is truly a first-rate 'peek behind the potential for drug abuse for the drugs they
curtains' that very few people get to are responsible for dispensing," Brooks said.
experience." Another thing Barry learned during the
During some of the busts the group got to class was that illegal drug use isn't a problem
see a glimpse of the families, Barry said. that can be attributed to race, gender, age or
There was still cocaine on a table inside one economic standing.
apartment. A baby and a toddler were there, "As a professional caregiver, we have to be
too. concerned about that," Barry said.
"It's really sad when you see this whole Barry said she will be able to take this
family of people where there are children knowledge, use it to recognize symptoms and
involved," she said. help others.
Students went on drug busts toward the end "It gives me a lot more knowledge to talk to
of the course. Up until that point, Barry said people about this usage with real information,
the students had been learning about how the not just giving them an empty slogan," she
drugs got into the country and how they were said. 0

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Erica Fernandez and fellow UF pharmacy students
recently visited five area high schools to talk with
students about the dangers of abusing illegal and
prescription drugs.

Message in a Sk ttle

Pharmacy students bring new spin to drug abuse message

By Lauren Edwards
i.,'mber Nancy Reagan's "Just Say No" campaign? Drug abuse isn't a new issue in America, and many
.iii Ilority figures from the White House on down have attempted to curb drug use. Yet millions of teens are
-1 11 trying -and habitually using -both illegal and prescription drugs, sometimes with fatal consequences.
For Erica Fernandez, president of the College of Pharmacy class of 2010, the reality of drug abuse hit a little too
close to home when a friend of her younger sister died of a drug overdose last November.
Fernandez felt compelled to action, and along with some of her fellow pharmacy students, came up with a novel
way to present the dangers of drug abuse to local high schoolers using the popular candy Skittles.
While many drug-education programs are heavy on the scary statistics, Fernandez's group of 31 presenters
structured theirs to be less lecture and more fun.
"We didn't want to hit them with stats," said Fernandez. "We wanted it to be more of an interaction ... we're not
telling them what to do, but trying to treat them as peers."
On April 14, Fernandez and her team visited five area high schools, where they spoke about the dangers of using
and abusing illegal and prescription drugs to more than 1,000 students.
In their presentation, each colored Skittle represented a different drug. Every student received a random handful,
and Fernandez and her team spoke to the students about how such drugs affect the body and the dangers of mixing
them together or with alcohol.
Fernandez says she felt the visits were a success.
"(Their) questions were very insightful," she said of the mostly freshman participants. "It went really well.
Everyone had a good time."
And that attitude went both ways. The pharmacy school presenters impressed local teacher Maria Randell so
much, she told the group she hoped they could come back twice a year.
"The presentation was outstanding," said Randell, a teacher at Oak Hall School, in a written evaluation. "They
were extremely comfortable and receptive to the students' questions."
More important, however, were the students' reactions.
When Fernandez had a chance encounter with one of the participating students a few days later, the young
woman recognized the pharmacy student and told her how the presentation had affected her.
"I wouldn't have done drugs before," the girl said. "But now, I definitely won't." 0

Their own Hippocrates

Medical students give prestigious
award to oncologist

By April Frawley Birdwell
ames Lynch, M.D., quickly wiped his eyes as he stood in a narrow lobby just
off the Founder's Gallery, listening to some of the reasons why, just
moments earlier, senior medical students had named him their choice for
the 2008 Hippocratic Award.
"He never speaks with a flair of arrogance or a tone of superiority ... He is a model
"He is especially adept at reading patients, in knowing what they were thinking without
them having to say it and answering the questions patients were too afraid to ask."
The Hippocratic Award, a distinction the senior class awards each year to the
UF professor they feel best models the qualities of a good, compassionate
physician and teacher, is generally considered one of the highest honors in the
college. The award was established in 1969.
"I don't even know what to say," Lynch said to the crowd of medical students,
staff and faculty clustered in front of him. "Today, you've shown me grace."
With the award, Lynch joins a select trio of UF medical professors -Patrick
Duff, M.D., the late Hugh Hill, M.D., and Gene Ryerson, M.D. -who have
received the honor three times.
Lynch, a professor of medicine who specializes in the treatment of lymphoma

1A' 1



The College of Medicine's graduating class awarded Dr. James Lynch with
the 2008 Hippocratic Award in April.

and breast cancer, has been named one of the Best Doctors in America, has
received numerous awards for his teaching and was one of the first faculty
members inducted in the Chapman Society, the UF chapter of the Gold
Humanism Society.
"It shows you his teaching ability and his compassion," said Bhavin Adhyaru,
president of the College of Medicine Class of 2008, of Lynch's many honors.
"Oncology is one of the few classes we get to hear from patients (in the first two
years of medical school). He brings in his own patients and they always mention
what a wonderful doctor he is," Adhyaru added. "Every single patient always
mentions that." 0

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Horse tale

Brazilian Olympic team horse

recuperating after treatment at UF

By Sarah Carey

after surviving an odyssey of difficult
surgeries and complicated medical
problems, a Brazilian Olympic dressage
horse named Livello has lived to train another
day and is recuperating back in his home country,
thanks to UF veterinarians.

UF equine surgeon David Freeman, who played a key role in Livello's
amazing story and eventual turnaround, discharged the horse on April 11 to
one of his Brazilian veterinarians, who flew home with him.
"This horse is all quality," Freeman said. "Everyone who dealt with him
here did a wonderful job, and this is a horse that came all the way from Brazil
because we had the technology to treat him."
Freeman said Livello's case illustrated the importance of powerful imaging
equipment, particularly UF's MRI unit, in guiding effective medical
"Radiology, specifically Drs. Matt Winter and Shannon Holmes, did a
wonderful job with interpreting the images," Freeman said, adding that
clinicians and technicians from the radiology, surgery, ophthalmology and
anesthesia services were all extremely helpful.
"Livello actually came here because the owners were aware we had CT and
thought that could be used to help him, but it turned out that the MRI was a
better imaging tool for his problem," Freeman said.
Brazilian veterinarian Fernanda Bicudo Cesar said the horse's owner, Dr.
Jorge de la Rocha, and his family were "very thankful for everyone involved."
Cesar spent two weeks at UF with Livello when his primary veterinarian,
Patricia Brossi, had to return home after spending two months in Gainesville.
"The owners haven't seen him for three months, but now they can sleep well
and finally feel that things are going to be OK," Cesar said.
Brossi said Livello was a fighter, and so much more than that to those who
know him.
"You have only to go through his medical records to appreciate how much of
a fighter he is," she said. "Besides that, he talks to you, he makes it really clear
how much he appreciates everything you do for him.
"Livello is the horse we dreamed of back in our childhood, when we first
realized we loved horses, those huge creatures, their smell, the noise from
their hooves, the feeling of being on top of them," Brossi said. "He is special to
Dr. Jorge because he fits him, with his size and his personality, as no other
horse ever did."
Livello's story began in Brazil last October with a bad tooth. A tooth
extraction procedure damaged the horse's tear duct and intraorbital nerve,
veterinarians said.
"Tears were coming down his face, and he had nerve damage that was
causing him to rub his face and sneeze," Freeman said, adding that a
subsequent procedure involving a veterinary surgeon from Tennessee and a
world-renowned equine dentist who were flown to Brazil to help did not
resolve the problem.
"The surgeries went well, but never cleared up the infection Livello had

.f IN I.
Equine surgeon David Freeman treated Livello, a Brazilian Olympic
dressage horse, at the UF College of Veterinary Medicine's Alec P.
and Louise H. Courtelis Equine Hospital. The horse returned to
Brazil in April.

developed in his sinuses," Freeman said.
Because of his infection, Livello subsequently developed facial swelling and a
malodorous nasal discharge.
Desperate to help him, his owners and their veterinarians, who had heard of
Freeman and UF's imaging capability through veterinary meetings in Brazil,
decided the horse needed to be treated at UF. In February, de la Rocha, who
also has ridden Livello as part of the Brazilian Olympic dressage team, flew the
horse and Brossi, his veterinarian, to Florida's Alec P. and Louise H. Courtelis
Equine Hospital.
"We had some idea based on Livello's history and clinical signs that there was
probably some necrotic bone that needed to be removed," Freeman said. "But
we didn't know the exact location or extent of it, and that is where both the CT

and our new MRI unit came in."
An initial surgery resulted in the removal of a lot of dead bone and tissue, but
Livello's sinus drainage continued, as did the nasal discharge.
"So we did another MRI on him about three weeks later and then another
surgery after that," Freeman said. "The MRI images helped us find the sites
where we needed to go, and the site was not an easy area to gain access to. We
were somewhat reserved by then in terms of our level of satisfaction because we
knew there might still be more bone left."
By the time Livello left, he had undergone three surgeries at UF, with the last
one being the most difficult. Within two weeks of his last procedure, however,
Livello began showing signs of improvement.
"His attitude definitely improved," Freeman said. When Livello's nasal
discharge vanished, Freeman and his colleagues knew they had turned a corner.
"This was a tough case," he said. "Every now and then we get cases that test
us and test our general ability to handle very serious veterinary challenges, and
this was one of them."
Freeman added that he gave a lot of credit to Livello's owner, de la Rocha, for
his unwavering commitment to the horse.
"He was not going to be deterred by the cost of treatment but he was realistic
and committed and most of all, he did not want this horse to suffer," Freeman
said. "He wanted the very best for him, and he did all the right things. That
didn't replace any of our caregiving for the horse, but it made it a lot easier." 0

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On the move
UF, Shands relocate services to meet patients' needs

By Karen Dooley
F and Shands have moved all pediatric inpatient services back under one roof, just
one change that took place in April as part of a massive realignment of services at four
of the health-care system's patient-care sites.
The move, which brings pediatric inpatients back to Shands at UF, comes less than two
years after many of the department's clinical services were sent to Shands AGH.
"Some very good things came out of the move of pediatrics to and then from Shands
AGH," said Richard Bucciarelli, M.D., chair of the department of pediatrics. "We learned
that we were not able to fit all the pediatric services at AGH. There was additional support
that just wasn't available, and we found it necessary to transport some kids to UF.
"We were not happy with the inconvenience and the stress this may have caused on the
kids and their families. It wasn't meeting our expectations of highest quality of care. We
knew we had to move to a different setting."
The reconsolidation of pediatrics services is one part of a broader plan -the Quality
Access and Care Realignment -that was sparked by an intensive investigation to find the
appropriate patient mix for each Shands venue.
"About 25 people worked diligently and strategically for months to make sure it was a
smooth transition for staff, physicians and patients," said Mike Good, M.D., senior associate
dean for clinical affairs in the College of Medicine. "Twenty-one pediatric patients were
moved from AGH in two days to the fourth floor of Shands at UF beginning (April 15), and
surgeons began operating in their new ORs with new schedules that same day."


Outpatient pediatric surgery will occur at the Ayers
Medical Plaza.
Orthopedic outpatient surgery for hand and shoulder was
moved to Shands AGH. Knee and hip surgery will soon
* Ophthalmologic outpatient surgeries, which took place at
Shands at UF, were relocated to the Florida Surgical Center
March 17.
* With pediatric patients moved to Shands at UF, less
significantly ill adult patients will now go to Shands AGH.
The Shands at UF and Shands AGH emergency departments
are working to ensure ambulances get to the appropriate
hospitals. They aim to launch a central dispatch so EMS
personnel can call one number to be directed to the
appropriate hospital for the patient's needs.




Arthur Otis, first UF chair of physiology, passes away

By April Frawley Birdwell
rthur B. Otis remembered it took him all day to get to UF. But the trip was worth it.
"The university campus was beautiful," said Otis, the first chair of physiology in the UF
College of Medicine, during a 2005 interview about the college's early days. "It had a lot of
gardens and flowers and little ponds."
Otis, who served as a department chair for more than 20 years and spent the rest of his career at UF,
passed away April 4.
He was 94.
A native of Grafton, Maine, Otis earned his doctorate from Brown University in 1941. He began
studying what would become his specialty, respiratory physiology, at the University of Rochester School
of Medicine, where he accepted a position as an instructor in 1941. There he worked with researchers as
part of a project studying positive pressure breathing for the U.S. government during World War II.
After a year as a Fulbright Visiting Research Scholar at Cambridge University and four years as a
professor at the Johns Hopkins School of Medicine, Otis was selected to lead the new UF College of
Medicine's department of physiology.
"This I thought was a chance to build up something more on my own," Otis said in 2005. "I didn't find
another place that was better. I liked the job. It gave me personal freedom."
He served as department chair until 1980 and as a professor until he retired in 1986.
A member of Phi Beta Kappa and several professional societies, Otis continued to focus on
experimental respiratory physiology throughout his career. His studies led to dozens of journal articles
as well as books and book chapters. O

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1 05/06-0


F SkippingDoses

New device could help docs track drug adherence

By Ann Griswold I

Most of us have .. .,
missed a dose
of antibiotic or .
forgotten to take a daily
vitamin. But when the stakes
are higher as they are for
skipped pill could mean
the difference between health and hazard for
the entire population. Now, a breath-monitoring
device developed by scientists at UF and Xhale
Inc. could help prevent the emergence of drug-
resistant strains of HIV by monitoring medication
adherence in high-risk individuals.
"For HIV, it's been shown that if you don't take a very high percentage of
your medication, you may as well not take medication at all," said Richard
Melker, M.D., a professor of anesthesiology at the UF College of Medicine and
chief technology officer for Xhale.
Patients who take some but not all of their medication increase the
likelihood the virus will mutate into a deadlier, drug-resistant form. Experts
have tried literally hundreds, if not thousands, of ways to monitor drug
adherence, ranging from daily log books to blister packs that record the time
each pill is dispensed. Despite the money, time and effort devoted to these
methods, Melker said only one works well: directly observed therapy, or DOT.
"If you have a disease that is deemed to be a public health risk, authorities
can put you into a program where you have to come to the clinic every day and
be observed putting the pill into your mouth and swallowing it," Melker said.
But that process is inconvenient for patients, as well as for clinic personnel

who have to track them down when they fail to show up. A breath-monitoring
device developed by UF scientists and Xhale could change that, allowing
patients to participate in a type of virtual DOT from home.
"The machine sits in your home and when it's time for you to take your
medication, it makes a beeping noise. If you don't hit a button after about five
minutes, it's going to beep louder and louder until you come," Melker said. "If
you don't come after a certain amount of time, the machine can call the
clinical trial coordinator and indicate that subject or patient didn't take the
medication as prescribed."
The device, which is slightly smaller than a shoebox, records the results of
each breath test, allowing patients to bring a memory card or USB key to the
clinic once a month and receive a printout of their results. Eventually, the
researchers hope to reduce the size of their detection device to fit inside a cell
phone. But for now, they're satisfied the technology works.
"The doctor can see how often you took it and exactly what time. If it made
the patient really sick or dizzy and they didn't take it, they can find out why,"
Melker said. "It's not just a question of did I or didn't I take it, but when you
took it or why you didn't take it."
The researchers developed the adherence monitor by incorporating minute
amounts of an alcohol into a gel capsule. The additive, called 2-butanol, is one
of many GRAS -Generally Recognized as Safe -compounds approved by
the Food and Drug Administration for use in foods.
"We wanted (patients) to swallow a chemical and have it transform into
something else that's easy to monitor," said Matthew Booth, Ph.D., an
assistant professor of anesthesiology at the UF College of Medicine and an
investigator in the study. "When it hits the stomach lining and liver, an
enzyme converts the alcohol to a gas that can be measured in the breath."
To determine how well the byproduct could be detected, six healthy
volunteers swallowed empty pills in which the capsules contained trace
amounts of 2-butanol. After five to 10 minutes, the scientists could measure
the volatile byproduct in the volunteers' breath using a small detector. The
scientists say their device could also be used to monitor medication adherence
in patients with other communicable diseases, such as tuberculosis.
"It is encouraging that the biological and chemical elements of the
adherence system work as predicted," said Donn Dennis, M.D., the Joachim
S. Gravenstein professor of anesthesiology at the UF College of Medicine and
an investigator in the study. "We were able to conclusively show who
swallowed the capsules containing the 2-butanol. With further optimization,
we are optimistic the device will perform very well." Q

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SHeart attacker

Stress can be deadly for patients with genetic variation

By Melanie Fridl Ross
F researchers have identified a gene variation in heart disease patients who appear especially
vulnerable to the physical effects of mental stress to the point where blood flow to the heart
is greatly reduced.
"Searching for the presence of this gene may be one way to better identify patients who are at an
increased risk for the phenomenon," said David S. Sheps, M.D., a professor and associate chairman of
cardiovascular medicine at UF's College of Medicine and the Malcom Randall Veterans Affairs
Medical Center.
Those with the gene variation are three times more likely to experience dangerous decreases in
blood flow to the heart -a condition doctors call ischemia -than heart disease patients without it. J
Ischemia increases the chance these patients will suffer a heart attack, heart rhythm abnormalities or
sudden death, UF researchers reported April 14 in the Archives of Internal Medicine. DAVD S M
"There's no question that in certain populations it is associated with worse prognosis than in
patients who do not have mental stress-induced ischemia in terms of overall adverse events and also
mortality," Sheps said. "And it has become apparent that it is far more prevalent than we initially thought."
UF researchers studied 148 patients with coronary artery disease. Participants were asked to perform a public speaking test
designed to induce stress. Images were taken of blood flow to the heart at rest and during the speech task. Blood samples also were
collected and analyzed for five common gene variations.
About a fourth of the patients experienced mental stress-induced reduced blood flow to the heart, and about two-thirds of them
harbored a particular variation of the adrenergic beta-1 receptor genotype that was associated with a three-fold increased risk of this
phenomenon, said Mustafa Hassan, M.D., the study's lead author and a research fellow in UF's division of cardiovascular medicine.
This receptor typically helps the body respond to stress by regulating blood pressure and heart rate, but a common variability in its
gene may make certain patients more vulnerable to the effects of psychological stress.
"We should focus our research on two areas," Sheps said. "One is better identification of patients who are prone to have this
problem and two is looking for effective treatments once we know they have it. We need to know whether we can reverse this
phenomenon. We are embarking on other treatment studies fairly soon." 0

Targeting cancer's force field

ByJ ennifer Brindise
ew therapies must target a key protein interaction to destroy aggressive cancer cells' protective force field, UF
scientists reported in April at the American Association for Cancer Research's annual meeting in San Diego.
The barrier deflects damage from radiation or chemotherapy, making some cancer cells difficult to destroy,
but researchers from UF and the University of North Carolina at Chapel Hill may have discovered why. Their study
revealed that mutations in the tumor suppressing p53 protein lead to an overabundance of a second protein called focal
adhesion kinase, or FAK, which makes the cells less vulnerable to attack.
"These findings are significant to future cancer research and the development of new therapies," said Vita
Golubovskaya, Ph.D., an assistant professor in the UF department of surgery, who presented the findings. "The high
correlation between these two markers is critical for predicting patient prognosis."
The next step will involve developing cancer therapies that target this interaction,
Golubovskaya added. Pictured here is a sample of a colon cancer cell.
Both p53 and FAK are found in low levels in normal, healthy cells. The p53 protein The yellow sections indicate where the two
ensures that cells strike a balance between growth and death. In its normal state, p53 proteins, focal adhesion kinase and p53, have
suppresses the FAK protein and weakens the molecular force field around cancer cells. merged.
But mutations in the p53 protein can interfere with this regulatory function.
Mutations in the p53 gene are commonly found in patients with cancer, and those with
more aggressive forms of the disease boast particularly high levels of p53 and FAK. Most cancer therapies are largely ineffective against the
resulting FAK force field, which has been identified in melanoma and most solid tumors of the breast, lung, brain, thyroid and colon.
Scientists are still unsure what causes mutations in p53 and why FAK binds to the damaged protein. But the study revealed that the interaction
interferes with the signaling process that normally induces cell death, allowing cancer cells to grow unchecked.
UNC researchers, led by Kathleen Conway Dorsey, Ph.D., an assistant professor of cancer epidemiology, analyzed mutations in tumor tissue
VITA GOLUBOVSKAYA, PH.D. samples from 600 breast cancer patients. UF researchers then identified the FAK protein in the samples and performed a statistical analysis,
finding that the p53 mutation is associated with an overabundance of FAK. O

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Words can

never hurt me?

Effects of social bullying could
linger in adults

By April Frawley Birdwell
reading rumors and gossiping
may not cause bruises or black
eyes, but the psychological
consequences of this social type of
bullying could linger into early
adulthood, a new UF study shows.
In a study of 210 college students,
UF researchers discovered a link
between what psychologists call
relational victimization in adolescence
and depression and anxiety in early
adulthood, according to findings
published in the April issue of ALLISON DEMPSEY
Psychology in the Schools. Rather than
threatening a child with physical violence, these bullies target a
child's social status and relationships by shunning them,
excluding them from social activities or spreading rumors, said
Allison Dempsey, a doctoral student in the UF College of
Education and the study's lead author.
"Even though people are outside of high school, the memories
of these experiences continue to be associated with depression and
social anxiety," said Dempsey, who graduated from Columbine
High School in Colorado one year before the 1999 school shooting
there and now studies school prevention programs. "It was
interesting to see these relationships still continue to exist even
though they are in early adulthood now and in a completely
different setting."
To uncover the relationships between social bullying and
loneliness, depression and anxiety, researchers surveyed
undergraduates between 18 and 25 and asked them to recall their
high school experiences. They found no gender differences and
discovered that having friends or other positive social
relationships in school didn't lessen rates of depression and
anxiety in adulthood, a finding that surprised researchers,
Dempsey said. For some children, having friends and positive
support can help make them more resilient to the slings and
arrows from bullies, said Eric Storch, an assistant professor of
psychiatry in the UF College of Medicine and a co-author of the
study. But other children take the words and abuse more to heart
and begin to believe what's being said about them.
"Those types of negative thoughts are actually believed to be at
the core of things like depression and anxiety," Storch said.
"Behaviorally what starts happening is you avoid interactions and
situations that could be quite positive for you.
"I think many people have the belief that victimization is a
normal rite of passage in childhood," Storch said. "While it
certainly does happen to most kids, it's not acceptable. And while
I think it would be difficult to completely curtail it, by reducing it
you're going to help someone a tremendous amount to not have to
go to school and be plagued by this environment of being tortured
day in and day out." 0

Trouble in the aquarium

Researcher discovers foreign disease in
imported reef clams

Veterinary pathologist Barbara Sheppard inspects a group of ornamental reef clams
in her laboratory March 21. Sheppard recently discovered a reportable foreign
disease in a similar colony of clams that were part of a student research project.

By Sarah Carey
ividly colorful giant clams officially called tridacnids decorate many an upscale
aquarium. But now experts say they boast an exterior beauty that masks an ugly
truth: their potential for carrying foreign diseases.
In findings that may impact the reef clam industry as well as international trade, a UF
veterinary pathologist recently discovered Perkinsus olseni, an internationally reportable
foreign pathogen, in aquacultured clams imported from Vietnam.
While not believed to be a threat to human health or other reef aquarium species, the
pathogen's presence concerns scientists as well as aquaculture industry representatives and
points out the largely unregulated environment in which the importation of aquacultured
reef clams from Asia occurs.
"I had 30 clams in my lab as part of a student research project," said Barbara Sheppard,
D.V.M., Ph.D., a clinical associate professor of pathology at the UF College of Veterinary
Medicine. "Then they started looking sickly, and within four months, all of them were
Sheppard began investigating the cause of death by freezing tissues, putting them into
formalin and conducting histopathology and DNA tests in her laboratory. Her findings,
which appeared recently in Diseases oflAquatic Organisms, showed the presence of Perkinsus
olseni along with a new species of Perkinsus that has yet to be characterized.
"This is an important finding," said Ralph Elston, Ph.D., president of AquaTechnics, a
Carlsborg, Wash.-based company that provides veterinary, laboratory and environmental
assessment services to the shellfish industry. "It indicates the potential risk of the spread of
animal disease when health monitoring is not in place to control such risks."
Sheppard is now collaborating with other researchers to further characterize the new
exotic species of Perkinsus discovered in her clam colony.
Giant clams are the largest bivalves in the world. These clams represent an increasingly
large proportion of the live invertebrates imported to become aquarium specimens.
"This is not a zoonotic disease, transmissible to people," Sheppard said. "No one is going
to get sick from this, as far as we know. The problem here is economic and international
trade. We know that Perkinsus is a pathogen of aquatic shellfish, and the reason it is so
important is that it makes animals very vulnerable to dying when the weather gets hot or
when they get stressed in some other way." Q

IOS10Ta 05/60 hh






i LUF undergrad finds her calling in the lab

By Lauren Edwards ,
hani Isaac didn't expect to be performing brain
surgery on rats at 18 years of age. She didn't
expect to one day get accepted into the top
medical school in the nation or to work side-by-side
with a Nobel Prize winner while still in college. But
that's exactly what happened.
Isaac, who graduated this month with a bachelor's degree, came to UF as a
freshman in 2004 with interests in neurosurgery, psychiatry and addiction
medicine. During the fall of her first year, she went online to search for
researchers in her fields of interest and stumbled upon the name of Mark Gold,
M.D, chief of addiction medicine in the College of Medicine's department of
Though she had no prior research experience, Isaac decided to contact Gold.
"I didn't expect him to let me come into his lab, because I had no skills
whatsoever," Isaac said. "But he e-mailed me back in 20 minutes and said there
was a spot for me (to do research.)"
Isaac began in the lab that first semester, conducting experiments and
performing electrode-implantation surgeries on rats to learn more about the
effects of addiction and withdrawal. It was there she met Adriaan Bruijnzeel,
Ph.D., an assistant professor of psychiatry who would later become her mentor.
Isaac worked in the lab alongside Bruijnzeel to find ways to block withdrawal
symptoms in the hope of creating smoking cessation treatments.
Bruijnzeel says Isaac was a natural from day one.
"I showed her how to do surgeries, and she picked it up really easily," he said.
"It was pretty exceptional ... I'd never seen that before."
UF soon took notice of Isaac's abilities and awarded her a University Scholars
Program fellowship, which permitted her to conduct her own research project
and present it at the annual Society for Neuroscience meeting. Then, in 2007,
Isaac was chosen to be a part of the UF/Howard Hughes Medical Institute's
prestigious Science for Life Extramural Research Program, which gave her the
chance to spend seven months with Nobel laureate Susumu Tonegawa, Ph.D., at
the Massachusetts Institute of Technology, researching memory pathways in

relation to addiction.
Isaac said Bruijnzeel helped her choose Tonegawa's lab by looking into all the
possibilities and letting her know whose research he thought best suited her
interests and abilities. Although it was rare for Tonegawa to accept
undergraduates, Bruijnzeel encouraged Isaac to try.
"I was really lucky," she said of Bruijnzeel's help. "He's extremely supportive
of my research ... He trained me from ground zero, which a lot of investigators
don't do."
Bruijnzeel says he enjoys mentoring students like Isaac and watching them
grow. Since he came to UF from San Diego's Scripps Research Institute in 2004,
he's mentored Isaac, along with 15 other students.
"I think it's one of your duties as an academic researcher," he said. "I had
great mentors myself ... and when you help people and they become successful,
that really adds to your job."
Isaac also credits Randy Duran, Ph.D., as a great help in her academic career.
Duran, a UF chemistry professor, is the director of the UF/Howard Hughes
Medical Institute Science for Life program, the largest program for early
undergraduate research in Florida.
Together with Bruijnzeel, Duran has helped Isaac get to where she is today: a
future student at Harvard Medical School, the nation's top medical program.
And it is the mentoring, Isaac says, that has made all the difference.
"There's a major shortage of people going into the fields of science," she said.
"I think a major part (of fixing that) is starting them early."
Isaac says it takes effort to get an inexperienced student involved in research,
but it's what is necessary "so that they won't be intimidated."
Bruijnzeel agrees.
"I like working with undergraduate students and seeing how they grow," he
said. "It's nice to see people transform in three years."
Of Isaac, Bruijnzeel smiles when he talks about one of his first -and most
successful -students.
"She's very easy to work with," he said. "I think she can focus really well.
That's probably why she has such good results. The quality of her work is so, so
Isaac echoes this sentiment about the mentor who has helped her for the past
four years.
"He has been absolutely amazing," she said. O

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-****** jn' f l 's::: ^^^^^^^^^


Impending grads may have mastered the books,
but many wi I I learn it takes years to cope with
the pressure of professional I ife when their
reputations and patients' I ives are on the I ine.

Pi' e Pic

Dr. Amanda House (right) says she
approaches cases differently now than at
the beginning of her career. Here she
talks with UF veterinary medicine
students during rounds in the equine unit
at the College of Veterinary Medicine.

Nestled on a foam mattress with blankets draped over her frail,

60-pound frame, Tulip, a 3-week old premature filly, struggled

to take each breath. Patches of chocolate-brown fur were

missing from her bony flanks while feeding and oxygen tubes jutted

from her nostrils. The rhythmic drip ... drip ... drip of intravenous lines

delivered a laundry list of medications throughout her body.

As she lay in the neonatal intensive care unit
at the University of Georgia's Large Animal
Hospital, battling symptoms from a blood
infection, seizures and diarrhea, some
veterinary interns caring for the filly saw a
heart-wrenching but inevitable death. Amanda
House, D.V.M., saw an opportunity to save a
young life.
"At one point, she had such severe acidosis
and hypernatremia (a condition where blood pH
is too low and sodium is too high) that she was
blind," says House, a UF assistant professor of
equine extension in large animal clinical science
in the College of Veterinary Medicine, who was
the senior clinician handling the case in 2005.
"Many students, and probably a couple of
veterinarians, thought she should be
After using the drug tris-hydroxymethyl
aminomethane, a product used in human
intensive care cases to help improve blood pH
without increasing sodium levels in the body,
and nearly four months of seesawing in and out
of treatment at the hospital, Tulip slowly
improved, eventually making a full recovery.

"If I was at the beginning of my career, I may
not have been inclined to give the foal a
chance," House says. "Today she's doing great,
galloping around in a beautiful pasture and
having a great life."
Like House, most health-care professionals do
not walk off the stage at graduation with
Zen-like patience and the ability to solve every
medical crisis with the skill and ease of Doogie
Howser, M.D. -if it was that easy, the medical
industry would be inundated with physicians
and there wouldn't be a nursing shortage.
Rather, students and recent grads will learn that
it can take years to feel comfortable in their
professional skin and that real-life lessons begin
beyond the confines of a 2,000-page medical
textbook. It's the sleepless nights spent drafting
detailed nursing care plans. The 18-hour
marathon shifts in the ER and the beaming
smile from a pediatric patient who learns she is
cancer free.
"You get a lot of practice as a senior resident,"
says Sarosh "Shawn" Batlivala, a third-year
pediatrics resident. "You get to see how
everything you do helps kids get better."

[Training Day]

K endyl Atkinson's living room looks more
like a science library than a place to watch
"American Idol." Her coffee table holds
pharmacology reference books, while a 5-inch
thick text about nursing care management rests
on top of a school-bus yellow beanbag across the
room. Her laptop has become a permanent
extension of her body as she stays up for hours at
night writing detailed nursing care plans. This
has been life for the past nine months since she
started classes as a first year student in the
College of Nursing.
"I thought my first semester of undergrad was
hard, but when I went into nursing school it was
more difficult than anything I had ever done
before," Atkinson says. "The first shot I ever
gave I was shaking because I was so nervous. But
the more patients I see, and the more
experiences I have, I learn that there are so
many areas I might want to go into. Right now, I
like the Neuro ICU."
In 2007, UF awarded nearly 1,700 degrees to
students from its six professional colleges, where
future nurses, physicians, pharmacists and
physical therapists receive intense, hands-on
training from day one. As incoming health-care
hopefuls begin classes, these students are more
likely to look patients in the eye and ask how
they're feeling earlier on in their educational
experience than students 30 years ago.
"That's something I never had," says Richard
Davidson, M.D., M.P.H., chair of the College of
Medicine curriculum committee who was a
medical student at Vanderbilt University in the

Visit us online @ http://news.health.ufl.edu for the latest news and HSC events 13



late 1960s. "We started to see patients in our second semester of our second
year. The way we now introduce clinical medicine on the first day of
medical school hopefully helps (students) get a lot of practice from day one."
First year students complete three-week preceptorships where they are
linked with community-based primary care doctors. In another course,
students visit families in their homes along with other health professions
students to help foster interdisciplinary work early on. The Harrell
Professional Development and Assessment Center also offers an
opportunity for students to train, allowing them to interact with
standardized patients, individuals trained to simulate symptoms of
ailments or who have stable abnormal physical findings.
Students across the health-education spectrum climb a carefully
structured ladder of increasing responsibility. They begin by teetering on
the bottom rung, slowly building a solid foundation of knowledge from
course plans largely based on objective exams and carefully supervised
clinical experiences. In the College of Medicine, third year students edge
closer to the top when they are assigned to monitor two to three patients
under the supervision of an attending physician. As a culminating
experience in their fourth year, students serve as sub-interns, an experience
that Davidson describes as "Internship 101." Students take on duties similar
to first year interns, ordering nutrition plans, medications, lab tests and
other treatments under the supervision of attending physicians.
"I didn't know what it meant to be an intern until my fourth year,"
Batlivala says. "I had two really great senior residents who took me under
their wing."
Davidson says he agrees that most students don't open their eyes to the
reality of the resident lifestyle until their last couple of years of school.
"The first two years of medical school is traditionally similar to
college," he says. "Sometime during their third year they realize they're
really going to have to take care of very sick patients in the middle of the
night, and that it's really not negotiable. That can be sobering."

t was late at night in April when most students in Gainesville
with the exception of some procrastinators typing last-minute
papers in a caffeinated buzz -were sleeping under a blanket of
darkness. But Melanie Wexel, D.D.S., a third-year orthodontics
resident, didn't have that luxury. Under the glow of her office lamp
at the UF College of Dentistry, Wexel was busy compiling her
patient review, a written summary of the progress and outcomes of
many of the patients she has treated over the past two to three years.
Spending extra time on important projects comes with the
territory of being a senior resident, where some days are spent going
beyond the call of duty. But when she first moved to Gainesville in
2005 to begin her residency, Wexel dealt with more than adjusting to
fluctuating schedules during her transition from dental school to a
residency program in an unfamiliar place.
"It took time to get adjusted because I had no family or friends
here," says Wexel, who attended dental school at Virginia
Commonwealth University in Richmond, Va. "In the beginning
you're overwhelmed. Orthodontics was like learning a whole new
language for me because in my dental school orthodontics was not
the primary focus."
For Wexel, time and experience was the best prescription to
become adjusted. As a third-year resident, she said she enjoys how
faculty members place their trust in the senior residents' hands,
allowing them to have a large level of independence. Just three years
ago, she would treat four to six patients a day. Today, she sees
between 10 and 20 patients, while delegating tasks to orthodontic
assistants and juggling more than one complex case at a time. Now,
she says she is finally seeing the results of patient cases she began
two years ago.

Third-year pediatrics resident
Sarosh "Shawn" Batlivala says
senior residents took him under
their wing when he was an
intern. Here Batlivala checks
on Devan Dempsey.

Dr. Tim Flynn, associate dean of graduate medical
education for the College of Medicine, keeps photos of
every resident he has ever trained on the wall in his office.

"You see (patients) at age 11 and then, all of a sudden, the little boy
you're treating is suddenly taller than you," says Wexel, who completes
her training in May. "It's a major source of accomplishment in my life
right now."
Relationships between senior faculty mentors and residents help
increase the new professionals' confidence, allowing them to feel more
comfortable as they become more independent. This is at the heart of
many of UF's professional residency programs, where new physicians,
dentists and veterinarians practice medicine alongside pioneers in their
fields and specialties.
Pointing at his office wall plastered with more than a dozen framed
photographs, Timothy Flynn, M.D., associate dean of graduate medical
education for the college's 650 residents, rattles off the names of young
surgeons he has mentored throughout his 24 year career, never missing
a beat. Some have gone on to positions at Brown, University of
Tennessee and Vanderbilt, while others have forged careers where they
began, at UF. But they all share one common mentor.
"You develop a strong bond with these people," Flynn says of his
former students. "You're spending so much time with them, and they're
there because they want to be just like you one day."
As much as medical students want to end up as successful as their
mentors, it takes several years to get there, constantly practicing and
building relationships with patients. Six months ago, Batlivala, a
pediatrics resident, used a calm, soothing voice to coax a 2-year-old
with a cut above his eye to remain still. With the reassurance of his
mother, the toddler didn't cry or struggle as Batlivala moved toward
him with a needle to suture his wound, something that probably
wouldn't have gone so smoothly in his days as a medical student.
"Medical school is designed so it gives you the basis to jump," Flynn
adds. "You don't learn to be a healer there. That's the beauty of residency."



o, how long does it really take for a nurse to feel like a nurse and a pharmacist
to feel like a pharmacist? The truth is it all depends on the individual.
For Hannah Palmer, Pharm. D., a 2006 College of Pharmacy alumna, the
compilation of the lessons she learned at UF hit her in a series of "Ah-ha" moments
she later shared in an e-mail she sent to Paul Doering, M.S., a distinguished service
professor in the department of pharmacy practice, in May 2007.
"I was the one who you may remember making a bit of a scene one time in the
middle of our literature review class," writes Palmer, who was completing a pharmacy
practice residency in Charlottesville, Va., last year. "At the time, I could not
understand why we took so much time reviewing these studies. I have learned many a
thing this year, but if I could pinpoint one thing I have truly perfected it would be my
ability to evaluate literature. I wanted to personally thank you for not reprimanding
me at the time of my outrage. I now truly understand the importance of this and often
think back to my attack of literature evaluation and wonder how I was so naive."
It's moments of clarity, like Palmer's, where residents and newly christened
professionals realize that when they're on their own, the white coat or stethoscope are
much more than symbols of a profession.
For Flynn, a veteran vascular surgeon, it took about six to eight months after
completing residency to feel like an expert confident in his ability to handle the cases
that came his way.
"It might take 10,000 hours to learn to play the violin," he says. "It can take 10
times as long to learn how to be an expert in your field."
Remembering Tulip, one of the more intense cases of her postresidency professional
career, House said she feels there will always be cases that surprise doctors, whether
they are in their third or 30th year of professional practice.
"I think all of us can relate to a time when we were stressed or panicked about a
critically ill case," she says. "Even as a faculty member, that case taught me a lot. Early
on in my career, I wanted to jump to conclusions and know the answer right away.
Now I realize how essential it is to keep an open mind and investigate all of the
possible diagnoses and options for treatment." 0

a"le MI

*Slfl -05/ t O I 15

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Ready not ...

New anesthesiology chair
Kayser Enneking recalls her
days as a medical 'newbie'

By Ann Griswold
The evolution from student to doctor can be intimidating:
Goodbye Human Patient Simulator, hello world! Having
experienced this transition herself, UF alumna Kayser
Enneking, M.D., chair of the department of anesthesiology,
says there's no better preparation for the real world than the
training med students receive at UF's College of Medicine.
Originally from Gainesville, Enneking attended college at
Vanderbilt University and returned to UF for medical school.
She later completed an anesthesia residency at the University
of Texas and a fellowship at Harvard Medical School. Since
joining the UF faculty in 1991, Enneking has been named one
of the Best Doctors in America and has received several
teaching awards for her work with students and residents.

Why did you go into the
medical field, anyway?
Well, the obvious answer would be my Pop (William F. Enneking, M.D.),
who was the chairman of the orthopaedics department here. But, really,
I wanted to be a teacher. I liked science. I wanted to help people. I had a
great role model, and itjust kind of all made sense.

How shocking was it to wake up one
morning, as a new physician, and realize
that everyone was taking you seriously?
Let me tell you that first year as an attending all of a sudden you're
the one signing everything and making all the decisions. I probably didn't
begin to feel that lead physician role until my last year of residency.
I always had somebody holding my hand and helping me until then.
And then in my last year of residency, and certainly in my fellowship, I
transitioned to the responsible party.

What advice do you have for recent
graduates, especially those who haven't
yet experienced that transition?
People used to say to me that anything that's really important they'll tell
you 10 times in medical school, and that's really true. As you get more
confidence in your skills and your abilities, people begin to take you more
seriously because they recognize that confidence.

What was the most nerve-wracking
part of your transition from student
to physician, and what gave you
that initial boost of confidence?
Part of what made me most anxious was that I was afraid I would miss
something. I was worried that I would get bored doing the same thing all
the time and then miss something. But what I found in anesthesia was that
it's so stimulating all the time it's the kind of job where you're maximally
stimulated while you're doing it and then when you're done, you're done.
What made me more confident is realizing that (UF) prepared me
extremely well. When I got to my internship, I looked around and realized I
was better prepared than kids from lots of different schools. I realized they
didn't have anything on me, that I had been extraordinarily well-trained
and all those hands-on experiences had really served me well.

What insights have you gained
from these experiences?
It's probably more important how nice you are and how hard you're willing
to work than how smart you are. I used to think I got passed along because
I wasjust a nice person and I was willing to work hard, but it turns out
there's a lot of value in that. We need really bright people in medicine, but
we also need folks who work hard and play nicely with other people. 0

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Medical students bring 'Beauty and the Beast' to local school

The White Coat Company, UF's medical student acting troupe, recently performed "Beauty and the Beast" at the Sidney Lanier School in Gainesville. Here,
pre-kindergarten student Tina Kelly watches as "Belle" and "Beast," played by Cheryl Shaffer and Farokh Demehri, dance on stage. Afterward, Kelly got to meet "Belle."

By April Frawley Birdwell

lie lights grew dim in the packed cafeteria.
The shades were drawn to block the hazy mid-
afternoon light and the chairs were arranged for
the 3-year-olds to sit near the stage.
In minutes, Belle would be singing about books, Gaston would be serenading her
with a song about himself and a kicking chorus line of utensils would be crooning
about the merits of hospitality as the students at Sidney Lanier School watched in
wide-eyed wonder.
Rebecca Gomez didn't imagine scenes like these -she and other UF medical
students putting on a musical at a local school -when she founded the White Coat
Company in 2005. She thought she and other thespian-minded medical students
would get together, do some skits, act out a few scenes. Maybe a little improve, even, just
for fun to take a break from their hectic studying. But sets, music, elaborate costumes
and -gasp -choreography? Well, Gomez never imagined the little medical student
acting troupe that could would become quite the production it is now.
This year's production of "Beauty and the Beast," which they performed at Sidney
Lanier April 25 and then again at the hospital and in the HPNP Auditorium, is the

third musical the group has done since its inception.
So what spurred the turn toward musicals? Talent. Gomez said. In short, medical
students can act. And sing.
"We have always been blown away by the talent (of the medical students) who show
up at the auditions," she said. "We're not in school for our acting and singing
And once they did one big production "The Wizard of Oz" was their first -it
was easy to do it again, Gomez said. Last year's play, "The Lion King," was particularly
elaborate, Gomez added.
This year is the first they have taken a production out of the HSC and into a local
school, though, Gomez said. They chose Sidney Lanier, a Gainesville school focused
on educating students who have developmental disabilities.
"I think this is so special for our children," said Cathy Costello, the school's
principal, before the performance. "Our kids are so appreciative of this."
For Gomez, who graduates from medical school in May, "Beauty and the Beast"
also spells the end of her White Coat Company days. But she's found other medical
students happy to take over the leading role in the group next year.
"I'm excited people want to take over the group," said Gomez, who is headed to
Orlando for a family medicine residency. "I hope I can come back for a
performance." 0

Visit us online @ http://news.health.ufl.edu for the latest news and HSC events. 11111111u 111 17


Stem cell pioneer

Top stem cell research er joins
College of Medicine, Brain Institute

ByJohn Pastor
I, scientist whose work triggered the modern stem cell era in
I ain research has joined UF's College of Medicine and Evelyn F.
.,i d William L. McKnight Brain Institute.
Brent Reynolds, Ph.D., recently from Australia's Queensland Brain
Institute, will lead the MBI's efforts to use adult stem cells in efforts to
develop drugs to treat cancer and a variety of other diseases.
As a graduate student at the University of Calgary in 1992, Reynolds
and neuroscientist Sam Weiss discovered that mice continue to produce
brain cells throughout their lives. The finding helped topple the belief
that mammals, including people, are born with a fixed number of
irreplaceable brain cells.
"Pretty much everything that's happened in neural stem cells can be
traced to the 1992 resurrection of the field by Brent Reynolds," said
Dennis A. Steindler, Ph.D., executive director of the McKnight Brain
Institute. "As a grad student he had the 'eureka' paper on stem cells
published on the cover of Science. That began the whole stem cell
renaissance. When I saw that article I stopped everything I was doing
and started studying the same thing in humans. We found in humans
what he had discovered in mice."
Reynolds discovered cells in the brains of mice that divided to produce
new cells, suggesting that throughout life, the brain's natural stem cell
population works to repair damage. The discovery opened up the
possibility that medicines could be developed to bolster the brain's stem
cell reserves, or clinicians could culture donor cells for implantation into
the brain.
At UF, Reynolds, an associate professor of neurosurgery in the College
of Medicine, intends to discover whether a cell with the ability to
self renew and produce specific tissue actually drives tumor growth or
the spread of cancer. He's also teaming with brain tumor researchers at
the Preston A. Wells Jr. Center for Brain Tumor Therapy and will run
the Adult Stem Cell Engineering and Therapeutic Core at the Brain
"While other research institutes have many of these elements, very
few, if any, have all of them in one place in a highly collegial,
collaborative environment," Reynolds said. "At this point in time I don't
think there's a better place in the world for doing cancer stem cell work
than right here." 0

Wonder women

Program helps academic women succeed

By April Frawley Birdwell
hen the UF College of Medicine graduated its first class 48 years ago, there
were only three female medical students in a class of 40. Overall, only 5
percent of medical students in the country were women at that time,
according to The New England Journal of Medicine.
How times have changed. About half of medical students today are women. The
numbers are similarly on the rise in U.S. dental schools. Yet, the number of female faculty
in the upper echelons of these professions is still inching upward at a snail's pace.
That's one of the reasons the Executive Leadership in Academic Medicine program
at Drexel University was established in 1995 -to give women in medicine, dentistry
and public health the tools to move ahead in their institutions, said Roslyn Richman,
ELAM's director, during a talk she gave at the HSC's Diversity Dialogue in March.
Several UF faculty members are graduates of ELAM's selective yearlong program,
which gives academic women a chance to learn and gain professional development
skills in a woman-only environment.
"It gives women the opportunity to learn about themselves, academic health centers
and leadership in an environment that feels comfortable to them," Richman said. "We
would never say that what we're teaching isn't applicable to men, but we believe, at this
point, men have such an advantage to getting positions of leadership that we want to
do as much as we can to help women gain equity."
The HSC's Diversity Dialogue series was established to highlight issues of equity
and diversity. The March session focused on mentoring, which is, in a sense, what
ELAM is all about.

Roslyn Richman, director of the Executive Leadership in Academic Medicine
program, spoke to faculty and students in March.

"It's amazing the change we notice from the fall session, when the fellows first come
together, and the spring session. By spring they have definitely incorporated a lot of
what they are learning over the course of the year," Richman said. "A lot of what they
are learning about is themselves and how they fit into their institution and how their
leadership can impact their institution."
Aside from sessions on issues management and leadership skills, fellows also work
with coaches to develop their skills and take part in extensive evaluations.
Although already dean of the UF College of Dentistry when she was an ELAM
fellow, Teresa Dolan, D.D.S., said she still felt she gained a lot from the program,
especially from exchanging ideas with classmates from other fields.
"Even if you come to ELAM with a lot of experience there is still so much to learn,"
Dolan said.
Aside from Dolan, other ELAM "elums" include College of Medicine faculty
members Nancy Hardt, M.D., Maureen Goodenow, Ph.D., Susan Frost, Ph.D., and
Rebecca R. Pauly, M.D. 0

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Pediatrics professor and wife become U.S.
Pediatrics professor and wife become U.S.


q *

4 /

Dr. Vikas Dharnidharka and his wife, Dimple, became American citizens April 17 during a naturalization ceremony at the
federal courthouse in Gainesville.

By April Frawley Birdwell
hey stood, each keeping one hand in the air, as they recited the words that would
change everything.
"I hereby declare, on oath ..."
When Vikas Dharnidharka, M.D., his wife, Dimple, and 28 other people entered the federal courtroom in downtown Gainesville the
morning of April 17, they had been citizens of somewhere else. Some, like UF pediatric nephrologist Dharnidharka, were from India.
Others hailed from countries as far away as Vietnam and as close as Cuba.
They all left as Americans.
"We have dreamed many dreams over the years. We dreamed of liberty, a chance for a better life, a chance to provide for the next
generation," said Dharnidharka, who was chosen from the group of new citizens to give a short speech during the ceremony. "We all came
here many years ago and settled in America because we saw opportunities to make good on those dreams. We came from different
countries, from varying backgrounds and varying stages of life. But the dreams were not different, they were and even now, remain the
same dreams for each of us."
Dharnidharka, the division chief of pediatric nephrology in the College of Medicine, lived in the United States for several years as a child
but eventually returned to India with his family. There, he attended college and medical school. He and his wife moved to the U.S. 15 years
ago so he could complete his training in pediatric nephrology at Children's Hospital Boston. He joined the UF faculty in 1999.
For Dharnidharka and his wife, the decision to start the process to become American citizens was an easy one to make.
"We made this country our home many years ago and we want to participate fully in the country," he said. "(I feel) fortunate that I can do
what I love as my everyday job. This is not always true in other parts of the world." 0

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Over the h

for the pill?

Researcher says women over 40 can still use oral contraceptives

By Kandra Albury
SIder women can safely choose birth control pills or an intrauterine
device for contraception, according to a paper published in the

./' March issue of The New England Journal of M
women and physicians believed the pill was for the you
necessary for women who had reached premenopausc

That's not the case, reports Andrew M.
Kaunitz, M.D., a UF College of Medicine
Jacksonville professor of obstetrics and
gynecology and the review's author.
Women in their 40s still have unplanned
pregnancies and are more prone to
problems when they conceive than women
in their 20s and 30s, Kaunitz writes. Birth
control could be the answer many older
women are looking for to prevent
unplanned pregnancies, Kaunitz said.
s According to the National Center for
ANDREW M. KAUNITZ, M.D. Health Statistics, the number of women
taking oral contraceptives in their 40s rose
from 6 percent to 11 percent between 1995
and 2002, but many still may not realize birth control is an option for
them, Kaunitz said. Lean, healthy, non smoking women actually can use
oral contraceptives into their mid 50s, he added.
"Healthy women who are non smokers can take advantage of both the
contraceptive and non contraceptive benefits of the pill," Kaunitz said.
"Women over 40 who take the pill are less likely to experience symptoms
that are commonly associated with menopause, such as hot flashes, night
sweats and irregular menstrual bleeding. The pill also reduces hip
fractures and ovarian cancer."
There is often misunderstanding about the use of oral contraceptives,

medicine. For years
singer set and not

not only among patients but also
physicians, Kaunitz said. Because there
are some health risks associated with
taking the pill, many physicians do not

believe women can remain safely on the
pill beyond age 40, he added. But women
who use low-estrogen oral contraceptives have at least a 50 percent lower
risk of developing ovarian cancer than women who have never used these
The pill is not appropriate for all women over 40, though. Factors such as
obesity and smoking could increase the risk of blood clots, heart attack or
stroke. Other health problems such as diabetes and hypertension can also
cause problems. In these instances, women should consider an alternative
method of contraception, such as the IUD. Kaunitz said the IUD, which is
widely used in Europe, is becoming more popular in the United States.
Kaunitz said there are two myths commonly associated with women over
40 taking oral contraceptives. The first myth is that the pill increases a
woman's chance of developing breast cancer.
"The pill does not elevate the risk of breast cancer," said Kaunitz, citing
the Women's Contraceptive and Reproductive Experiences Study.
This population-based case-control study showed no increased risk of
invasive or in situ breast cancer among women who were current or
previous users of oral contraceptives as compared with women with women
who had never used them. The study included an analysis limited to
women who began to use oral contraceptives in their 40s.
The second myth, as previously mentioned, is that women in their 40s
are too old to take the pill.
"I keep my lean, healthy, non-smoking patients on the pill until their
mid-50s. By that time they no longer need birth control," Kaunitz said. "At
that point the patient can come off the pill." 0

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Reshaping nr. ArIrica

UF researchers to study obesity treatment for rural residents

ByJill Pease

people living in rural America have higher rates of heart disease
and obesity than those in urban areas, yet few weight-loss
research trials have been conducted in rural settings.
A UF research team plans to tackle the unique weight-loss challenges faced by rural residents in a new
study called Rural Lifestyle Intervention Treatment Effectiveness Trial, or Rural LITE. The research is
supported by a $3.6 million grant from the National Heart, Lung and Blood Institute.
"Most weight-loss trials have been efficacy studies conducted with middle-class, urban participants
and delivered by teams of experts working in academic medical centers," said principal investigator
Michael G. Perri, Ph.D., interim dean of the College of Public Health and Health Professions. "But
serious health disparities exist in rural areas where there are higher rates of poverty, more residents
without health insurance, a greater percentage of people with chronic disease and fewer health
professionals to treat them."
The UF researchers will offer a weight-loss program at UF/IFAS County Extension Offices in eight
rural counties in north Florida. In addition to measuring weight loss, researchers will also evaluate how
well the lifestyle intervention program affects the participants' blood pressure, lipid profiles and blood
sugar levels -all important indicators of overall health.
The Rural LITE research program will build on the success of a previous study led by Perri that tested
the effectiveness of a weight-loss program with long-term follow-up counseling services for women in
rural counties.
"We found that the participants who received extended care were able to maintain their weight loss at
higher levels than those participants who only received printed health education as a follow-up," Perri

said. "In addition, telephone counseling was as
successful as in-person counseling, giving us a
cost-effective alternative to face-to-face visits that
is more convenient for rural residents who may
need to travel long distances for care."
In the new study, researchers hope to determine
the minimum intensity of treatment required to
produce clinically meaningful, long-term weight
loss in underserved community settings.
The UF study will include 542 men and
women between the ages of 21 and 75 who are
considered obese -those who have a body mass
index of 30 or higher, which usually means a
person is about 30 or more pounds overweight.
The participants will be randomly assigned to
one of three lifestyle intervention programs that
will be conducted over a two-year period: eight
treatment sessions and eight follow-up sessions
by phone or in-person; 16 sessions and 16 follow
up meetings; or 24 treatment sessions and 24
follow-up appointments.
Researchers have tailored the content of
instructional materials to address particular areas
of concern expressed by rural residents who
participated in the previous study, such as cooking
demonstrations of low-fat, low-calorie versions of
traditional Southern dishes, coping strategies for
stress and a lack of social support, and tips for
eating away from home.
Participants will also be instructed to walk at a
moderate intensity for 30 minutes most days of
the week.
"We hope the results of this study will address
two major barriers to research translation to
underserved rural populations: the lack of
infrastructure to offer services and the absence of
an empirical database indicating the treatment
dose that will produce the most significant long
term weight loss," Perri said.
The multidisciplinary UF team includes
Marian Limacher, M.D., of the College of
Medicine; Linda Bobroff, Ph.D., from the
Institute for Food and Agricultural Sciences; and
David Janicke, Ph.D., Danny Martin, Ph.D., and
Michael Daniels, Sc.D., of the College of Public
Health and Health Professions. 0

The Rural LITE program builds on the success of Perri's previous study in which 234 women in rural north Florida counties participated in an
obesity treatment program with a long-term follow-up component. Clinical and health psychology graduate student Mary Murawski (right), served
as a group leader for the Levy County program. Here she provides instruction on how to examine nutritional labels to participants Sarah Miller
and Patricia Daniels.

Visit us online @ http://news.health.ufl.edu for the latest news and HSC events 21



M.P.D., an assistant professor
of pediatric ,i. ,,ii ii recently
became a member of the
College of Diplomates of the
American Board of Pediatric
Dentistry after passing the
group's board examinations.
The American Board of Abi Adewumi
Pediatric Dentistry is the only
certifying board recognized by the American
Dental Association for the specialty of pediatric
dentistry. Adewumi joined the college in 2004 as
a fellow and became a faculty member in 2005.

Ph.D., an assistant professor
of periodontology, was
selected as one of five
emerging scientists to present
at the American Association
for Dental Research's annual
meeting in Dallas. Yilmaz's
presentation, "Age of
Uzlem Yilmaz
Exploration in Oral Sciences:
Has P. Gingivalis Discovered the Fountain of
Youth in the Gingiva?," dovetailed with the
symposium's focus of oral health research and
scientific inquiry across a broad field, from the
basic sciences through translational research to
social and behavioral sciences.


a professor of orthopaedics
and rehabilitation and
division chief of sports
medicine, was selected as
the Sports Medicine Person
of the Year for 2007 by the
Athletic Trainers Association
of Florida. He was honored Peter Indelicato
at the group's annual meeting
April 26 for his contributions to the field of sports
medicine and rehabilitation. Indelicato is also
the head team physician for the UF Athletic

an associate professor and
vice chair of pediatrics, was
recently named associate
dean for medical education.
Novak, who specializes in
adolescent medicine, has
been on the UF faculty
since 1993 and also serves Maureen Novak
as director of the pediatrics
residency and pediatric clerkship. She has
received numerous awards for her teaching,
including the 2006-07 Clinical Science Teacher
of the Year Award.

associate professor of
medicine and associate vice
president for health affairs,
equity and ,ii i1 was
awarded the 2008 Woman
of Distinction Award by the
UF Association for Academic
Women during a March 25 Rebecca Pauly
ceremony. Pauly wears many
hats for the college, including that of instructor
and faculty council member and has liaison
positions between UF and several national


Ph.D., P.T., an assistant
professor in the department
of physical 'I, i i received
the James A. Gould
Excellence in Teaching
Orthopaedic Physical Therapy
Award. This national award
recognizes excellence in the Terese Chmielewski
instruction of orthopaedic
physical therapy principles and techniques.
Chmielewski was honored at the Physical
Therapy Association's combined sections annual
meeting in Nashville in February.

Ph.D., a professor and
the associate dean for
international programs, has
been appointed by Michael
O. Leavitt, U.S. Secretary
of Health and Human and
Services, to the Health
Resources and Services Ronald Rozensky
Administration's Advisory
Committee on Interdisciplinary, Community
Based Linkages. The committee will advise the
secretary on health care workforce policy and
program development.



Nursing student wins

campus research


Andrea Pe Benito, a nursing student who
graduated this month with her bachelor's
degree in nursing, recently won a universitywide
competition for her paper on aging. Pe Benito
was the recipient of the Leighton E. Cluff
Award for Aging Research for her paper titled
"Sleep Poverty in Caregivers of Individuals with
Alzheimer's Disease." She received the award
for the best undergraduate paper.
The Cluff Award is designed to encourage
both graduate and undergraduate students to
research any topic within the area of aging.
Students submit various projects, including
empirical studies, scholarly reviews or other
creative work that display their research on
aging. A faculty review committeejudges the
work and awards one graduate student $1,200
and one undergraduate student $600.
Pe Benito's paper was based on her research
and work as a university scholar. Working with
her mentor, UF nursing professor Meredeth
Rowe, R.N., Ph.D., Pe Benito investigated
whether the sleep patterns of caregivers who
take care of individuals with Alzheimer's disease
is different from those of individuals who do not
care for these patients.

Students win scholarships
Weston Davis, Claire Ryan, D.V.M., and Ben Stoughton,
all students in the College of Veterinary Medicine,
recently received scholarships from Gulfstream Park to
further their studies in equine medicine, surgery and
research. Established after the death of 2006 Kentucky
Derby winner Barbaro, the scholarship program provides
$12,500 to two senior UF veterinary students committed
to careers in equine medicine and surgery and $5,000
to a veterinary graduate student conducting equine
research. Davis and Stoughton received the D.V.M.
student scholarships. Ryan, a board-certified internist in
large animal medicine, received the graduate student
scholarship. Shown from left are Stoughton, Ryan, trainer
Michael Matz, his son Alex Matz, Gulfstream Park
executive Mary Milu, Davis and Dr. Mary Scollay-Ward.

22|g 066h / hh8uBd




By Sarah Carey

an Shearer, D.V.M., is an innovator who
has been honored by institutions ranging
from the U.S. Department of Agriculture
to his alma mater, Ohio State University, for
contributions to agriculture and animal health.

Whether in the trenches teaching hoof care to dairy workers or suited
up behind a lectern lecturing on bovine welfare, Shearer, the UF College
of Veterinary Medicine's dairy extension veterinarian and chair of the
American Association of Bovine Practitioners animal welfare committee,
doesn't do anything halfway.
People notice.
Geni Wren, editor and associate publisher of Bovine Veterinarian
magazine, is one of them. An admirer of Shearer's, Wren approached him
about a subject she felt needed to be discussed in her magazine
euthanasia and personal beliefs.
"She came to me and said, 'We need to put together and discuss some
bovine welfare issues, and one pretty important topic is euthanasia,'"
Shearer said. "So she sent me a few questions, and I responded."
The result was a cover story titled "The Kindest Act" in the
publication's January issue, which also contained an editorial Wren wrote
stressing that euthanasia, while an uncomfortable subject to many
people, is a crucial part of veterinary medicine.
"The hardest part of euthanasia is getting over the emotional aspect
and coming to grips with doing it," Shearer said. "It's not something
anyone wants to do, but it is what you have to do to relieve animal
suffering. It's not always easy, but you have to be able to do it."
As a member of the college admissions committee, Shearer said he

TPOlJIo ve

UF vet, animal welfare expert teams with

magazine to tackle sensitive subject

Dr. Jan Shearer, shown here on the cover of Bovine Veterinarian magazine,
shared his thoughts on euthanasia with the magazine in its January issue.

often asks prospective students whether they would be capable of conducting
"While students need to learn how to save lives, it's absolutely essential that they
know how to end it when there is no medical means to relieve the suffering," he said.
"Euthanasia is something we don't talk about enough here."
So Shearer, who travels extensively for his extension and AABP duties, takes his
message on the road. Just this year, he has given talks to students at Iowa State
University's College of Veterinary Medicine and the Ohio State University.
He also sees bovine lameness and animal welfare as interrelated.
"Part of the problem is that livestock producers don't understand that prey
animals like cattle instinctively hide their pain and discomfort," he said.
An article he read in the Journal of the American VeterinaryMedical Association in
2004 by Cydria Manette, D.V.M., helped spur Shearer to become an advocate for
better communication about euthanasia.
"What she pointed out, and what was so helpful, was how we deal with this issue
as veterinarians," Shearer said.
But is euthanizing an animal ever easy? Shearer said it isn't, nor should it be.
"All of us have had to face the paradox of our roles," he said. "We nurture and care
for our animals knowing they will one day be slaughtered for food. Or we must deal
with the reality that some pets must be euthanized."
Therein lies the subject of an inner conflict that is so difficult, Shearer said.
"I know that I am still going to struggle, but knowing that I am treating them
humanely and with the respect they deserve authenticates my true feelings," he said.
These days, Shearer spends about half his time on his Master Hoof Care Program,
for which the USDA honored him in 2003. The program offers training to dairy
workers and aims to aid in the early detection and treatment of potential lameness
disorders in cattle, before problems become critical.
The remainder of his time is spent on his work in animal welfare communication.
"The lameness issue has brought me to a greater sensitivity and awareness of
animal welfare issues," Shearer said. "It's something I couldn't have anticipated, but
the last five to 10 years in particular, I've started to focus a lot more on these issues."
When he started in food animal medicine years ago, the primary objective was to
look out for the client's economic welfare.
"This was almost to the extent that this was the highest priority, while animal
welfare was somewhere second," Shearer said. "That's going to sound strange to
some. But I see today that this is becoming entirely different. What I try to share
with people I work with today is that those things need to be coupled.
"The vet's responsibility is to look out for the welfare of livestock. That's got to be
paramount," Shearer said. "My objective is to share that message as best I can.
Improved animal welfare and improved profitability, I think they can go hand in
hand." 0

Visit us online @ http://news.health.ufl.edu for the latest news and HSC events 23


Priscilla Santos, a writer for the College
of Medicine development and alumni
affairs office, poses during a photo
shoot for this month's POST cover story.

Behind the


College of Veterinary Medicine public relations
director Sarah Carey checks in on a foal
during a photo session with UF veterinarian
Amanda House for the POST cover story.


ft- ."



David Ostrov, an assistant professor of pathology in the
College of Medicine, took this photo of HSC photographer
Sarah Kiewel after she spent the afternoon snapping
pictures of him at Kanapaha Park for a UF magazine.


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
Kandra Albury, April Frawley Birdwell,
Tracy Brown, Sarah Carey, Anney
Doucette, Ann Griswold, Linda
Homewood, John Pastor, Jill Pease,
Karen Rhodenizer Melanie Fridl Ross

Contributing Writers
Lauren Edwards, Melissa
Thompson, Christa Wagers
Photo Editor
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 Southeastr

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 'iiI.II.i Room

F Health Science Center