Away with words - UF Health Podcasts - University of Florida

THE07/08•05AwaywithwordsWriting takes flightin health care10Healthy stateof mind-body6UF Health ScienceC E N T E RMedicalSnoring spousehumanitarian trips keeping you up?7 16D e n t i s t r y • M e d i c i n e • N u r s i n g • P h a r m a c y • P u b l i c H e a lt h & H e a lt h P r o f e s s i o n s • V e t e r i n a r y M e d i c i n e

Up frontTable of Contents3POST it7Community – Medical Humanitarian Trips18 Education – Pharmacy in Belgium4Patient care – Fluoride Fight10 Cover feature – Words for the Wise19 Distinctions – Service Pin Ceremony5Five questions – Strep and OCD14Research – Manatee Tears20 Distinctions – Research Day Awards6Profile – Dr. Deidre Pereira16 Research – Snoring Keeping You Up?22 Distinctions7 1419ON THE COVER: Writing in its many forms, rooted in the ancient healing arts, has begun to enjoy a modern-day renaissance among patients,students and faculty alike. And an increasing number of researchers acknowledge that the simple act of putting pen to papercan help people travel great distances, emotionally and physically.Housestaff Open HouseIn July, about 200 new College ofMedicine and College of Dentistryresidents, also known as housestaff,started work in one of 57 differentresidency and fellowship trainingprograms offered at Shands at UF inGainesville.To help orient them to the medicalcenter, the Office of Housestaff Affairsheld an open house June 29 in theShands at UF Atrium to “bringeverything to them for one-stopshopping,” said Sharron Wallace,coordinator of housestaff affairs andevent organizer.From 9 a.m. to 3 p.m., the Atrium wasfilled with about 65 information boothsto provide one-stop shopping for thenew residents’ start-up needs.Everything from ID badges,personalized prescription pads,parking decals and hospital IDnumbers to access codes for scrubmachines, computer logins, healthPhoto By Dwight Bennettscreens and e-mail accounts wasavailable, along with information fromthe HSC libraries, bookstores, cellularphone companies, banks and varioushospital and UF departments.With all the information in one place,residents who were preparing to begintheir graduate medical educationtraining programs signed up andsigned on in one easy twirl around theAtrium.They can only hope the remainder oftheir residencies will be as easy.— Denise TrunkPOST 07/08•05

Post itHurricane hotlinesWith hurricane season upon us, the group practice administration has issued areminder about UF clinic closings should we experience severe weather in our area.Although UF may close, clinics will be open during regularly scheduled hoursunless an explicit decision is made to close. Physicians and other providers, facultypractice clinic managers and staff, and any UF employees who staff clinics or areresponsible for making appointments or taking patient calls are expected to come towork if at all possible.The decision to close a clinic or clinics will made by Director of Faculty PracticeClinics Kelly Kerr, in collaboration with clinic managers and medical directors whenpossible.Two telephone lines have been established to provide status reports:Clinic staff, physicians and other employees should call the Staff Hotline at 265-0900 for clinic status updates. The message will be kept up-to-date and will provideinformation about clinics in general and, if needed, about specific clinics.The patient hotline is 265-0008. Patients may call this number to hear a messagethat will provide information on clinic closures and reopenings.Reserving research information in cyberspaceThe HSC Libraries now have electronic reserves available. Faculty may now placeon EReserves items such as professor- or student-generated materials, bookchapters and journal articles, PowerPoint presentations, Word documents from printor online sources, and more. Traditional hard copy reserves will remain availableand are listed on the Libraries’ ERes Web portal at http://eres.hscl.ufl.edu/eres/.Marine lab gets new name and new buildingUF’s venerable Whitney Laboratory,perched on the intracoastal waterwaynear Marineland, celebrates its 30thanniversary with a name change and anew building.The lab changed its moniker toThe Whitney Laboratory for MarineBioscience to better reflect its researchfocus on biomedical/biotechnological An artistic rendering of the new buildingaspects of human health and disease.Construction for the new 17,650-square-foot building for the laboratory will beginin August. When the two-floor structure is complete by May 2006, it will houseoffices, labs, classrooms and an auditorium for its faculty, staff and students.Using marine organisms such as sea slugs, lobsters, horseshoe crabs, jellyfish,coral and the freshwater zebrafish, Whitney investigators work to determine how thehuman body functions and malfunctions. Their research includes projects to discoverhow brain neurons are wired, what the sensitive mechanisms of vision and olfactionmean, identifying genes that cripple muscles, mapping proteins with fluorescentmarkers and finding a safe mosquito larvicide.Free tours of the UF-Gator Tech Smart HouseA floor that can detect a senior’s fall and contact emergency services. A smartphone that acts as a remote control for all appliances and media players. See thesehigh-tech devices and more at the UF-Gator Tech Smart House, a project of theRehabilitation Engineering Research Center on Technology for Successful Aging atthe College of Public Health and Health Professions. The recently opened research/demonstration home is now open for free tours and features a state-of-the-artdriving simulator and smart technologies for “aging in place” that are designed tomake living easier and safer for seniors.The UF-Gator Tech Smart House is located at 2701 S.W. 53rd Lane at OakHammock at the University of Florida. Please call (352) 273-6817 to sign upfor a tour.HSC collegesexplore educationin BrazilThe College of Public Healthand Health Professions andthe College of Pharmacysent a small delegationto the Universidade DeFortaleza in Brazil onJune 27 to discuss futurecollaboration in researchand teaching. The group,led by Robert Frank, Ph.D.,dean of the College ofPublic Health and HealthProfessions, touredthe university’s newlyconstructed multi medicalintegrated clinic. The clinic, comprising audiology, occupational therapy, physicaltherapy, nursing and pharmacy departments, offers therapy and medical services tothe community.Faculty from each university met over several days to exchange ideas for ways toadvance educational initiatives between Brazil and the United States. The meetingended with an official signing of a cooperative agreement that provides for visitsof faculty/students to either institution, research or teaching ventures at eitherinstitution, and the interchange of ideas regarding the development of programs ateither institution. Plans were discussed for the Brazilians to reciprocate with a visit toUF in September.Health care gets creativeUF’s Center for the Arts in Healthcare Research and Education is hosting its annualthree-week summer intensive “The Arts in Healthcare” July 11-29.The session explores the healing potential of the arts and will include dailyworkshops and instruction in the visual arts, writing, movement, music and theatrefor healing, clinical experience in facilitating the arts at the hospital bedsidewithin the Shands Arts in Medicine program, and lectures and workshops in Artsin Medicine history, philosophy and physiology, program implementation andadministration, among other offerings.The center’s mission is to facilitate research, education and training in the use ofthe arts to enhance the healing process, to further develop career options for artistsinterested in the arts and health care, and to promote art and creativity as catalystsfor developing healthy lifestyles.Privacy rules!Randal Martins Pompeu (left), vice rector ofextension, and Carlos Alberto Batista, rectorof University of Fortaleza, sign a cooperativeagreement with College of PHHP DeanRobert Frank.For more information, call 265-0768.Starting July 1, UF students, faculty, staff and other university constituents joined agrowing segment of the public who are gaining more privacy rights.The university’s IT Security Team and Privacy Office have been working diligentlyto prepare for a new law, formerly Florida House Bill 481, which passed in the statelegislature this spring.The law requires organizations to notify clients within 45 days of a security breachif their sensitive personal information has been compromised.Sensitive personal information is defined as a name in combination with a socialsecurity number, driver’s license number or financial account number includingaccess security code.The UF Privacy Office maintains the privacy policy and must be notified of all UFprivacy incidents. The Privacy Office manages internal communication, coordinatesnotifications and handles other issues regarding privacy incidents. In the case of abreach, the affected members of the public must be notified in writing or by e-mail,conspicuous posting on a website or via statewide media.Failure to do so can result in a fine from $1,000 per day to a maximum fine of$500,000.07/08•05POST

PATIENT CAREUF dentist helpssolve fluoridefight in EustisBy April Frawley BirdwellJames Rotella never wanted to be known as ananti-fluoridation crusader. He never eventhought much about the fluoride added to histown’s water until a few of his patients asked himabout it earlier this year.“I didn’t want to create any fears in the community,”said Rotella, a podiatrist and city commissioner inEustis. “I just wanted to have a thoughtful discussion.”But when he publicly questioned whether Eustisshould continue adding fluoride to its water,something the city has done for 20 years, heinadvertently stepped into a hornet’s nest ofcontroversy that has raged since the first drop offluoride was added to a Michigan community’s water60 years ago.Years of research have shown that fluoride preventscavities. Experts tout the practice of adding fluoride topublic water as one of the greatest health achievementsof modern time. Yet fervent activists still protest it,claiming fluoride causes everything from cancer to lowIQ, links experts say are unsubstantiated.That’s why when seeds of an impending fluoridedebate were sown in Eustis, Scott Tomar, D.M.D., Dr.PH., a UF associateprofessor of dentistry in the division of public health services and research, spoketo the Eustis City Commission in May to defend a policy he believes saves teethand money.“It’s probably the most well-researched public health measure in history,”Tomar said. “It benefits virtually everybody.”Fluoridation, dental experts say, fights tooth decay, the condition that accountsfor most of the country’s dental costs. Fluoride is added to 67 percent of water inthe country, and the Centers for Disease Control and Prevention actually hasmentioned plans to increase that figure by 2010.Fluoride reduces demineralization — when acids from bacteria in dental“[Fluoride] is probably the most wellresearchedpublic health measure in history.It benefits virtually everybody.”plaque dissolve needed minerals from tooth enamel — and works best if it isalready in the mouth when these acids are produced, Tomar said. This makesfluoridated water ideal for cavity fighting, because drinking water and foodsprocessed in fluoridated communities will provide low yet constant levels offluoride throughout the day.Before the first community fluoridated its water in 1945, nearly everyonePhoto By lisa baltozerDr. Scott Tomar, an associate professor of dentistry, spoke to the Eustis City Commission inMay to support water fluoridation, a public health measure he says saves teeth and money.Commissioners voted to continue adding fluoride to the city’s water after listening to Tomarand other dentists.— Scott Tomar, D.M.D.experienced tooth decay, said Howard Pollick, a University of California at SanFrancisco dental professor.Things are better 60 years later, but tooth decay is still a problem, and for somepeople among lower socioeconomic levels, fluoridated water is the best dental carethey receive, Pollick said.But a quick Internet search yields more than a dozen Web sites devoted tostopping water fluoridation. Most of these sites, like The Fluoride ActionNetwork, link to research that claims fluoride causes cancer and other diseases.Most of these articles, however, are not from peer-reviewed scientific journals, astandard for accepted and credible research today, Tomar said.Other groups have different reasons for opposing fluoridation, like not wantinggovernment to add anything to water or not trusting “the so-called experts,”Pollick said.“Ever since someone proclaimed the earth is round, there have been peopleopposed to it and there still are, even to this day,” Pollick said.Rotella voted to keep fluoridation in Eustis after listening to dentists duringthe May meeting, but he is skeptical.“There are a lot of unknowns,” he said. “We thought drugs like Vioxx were safe… Is it possible that one day we’re going to wake up to find (fluoride) is not safe?”Fluoride does have one side effect. Too much of it can cause white flecks orstains to appear on teeth, called fluorosis. But this is merely cosmetic, Tomarsaid, and more noticeable types of fluorosis usually occur when children swallowtoo much fluoridated toothpaste, which has a much higher concentration offluoride than drinking water.But there’s no credible research linking fluoride to other diseases or healthproblems, Tomar said.“At those levels, it’s just been found time and again to be safe,” he said. “So thehealth concerns, I think, are not really concerns. Which is why water fluoridationremains strongly endorsed.” PPOST 07/08•05

Five questionsStrep and OCD, is there a connection?A surprising number of children have gone to bedwith a sore throat only to wake up the next day withobsessive-compulsive disorder, leading some doctorsto warn that a streptococcalinfection might trigger thedebilitating psychiatric condition insome young patients. Doctors havelabeled this phenomenon PediatricNeuropsychiatric AutoimmuneMurphyDisorders Associated withStreptococcus, or PANDAS. Some pediatricians havealready begun placing strep-infected children onlong-term antibiotic regimens in an effort to preventOCD, a practice that worries researchers on bothsides of the debate. Tanya Murphy, M.D., an associateprofessor in the department of psychiatry who hasbeen studying PANDAS for 10 years, clears up somequestions for the POST.QDoes research point to connections between other bacterial infectionsand psychiatric disorders, or it is just group A strep and OCD?aThe ones that we’ve classically looked at have been obsessive-compulsivedisorder and tic disorders, but it’s thought that it can also include disorders likeattention deficit disorder, separation anxiety disorders and maybe fine motorskill deterioration. But the ones that have gotten the most support have beenOCD and Tourette’s. A child who wakes up from being a normal straight-Astudent the day before to washing her hands 100 times and day and saying“I can’t stop, I can’t stop” is so dramatic that I think you are going to find thebest association looking at the more obvious presentations. Strep has beenthe infection that has been the easiest to look at partly because it’s easy toculture it in the pediatrician’s office. Strep is the one most studied, but afterfollowing these children over time, I have also found some children have aclear-cut worsening of behavior and tics following a common upper-respiratoryinfection. I don’t think anything does it quite as clearly or dramatically as strep,though.Q aWhy is PANDAS so controversial?Many people think that this association is just coincidental because strep isso common. Obsessive-compulsive disorder is also fairly common, about 2percent of children have it. Probably about 20 percent or better of all childrendevelop tic symptoms at some point. So they are fairly common disorders andmaybe it’s just a chance association. That’s probably the biggest controversy.Another issue is the lack of a one-to-one relationship between infection andthe onset of neuropsychiatric symptoms. Some children flare without evidenceof strep, many children develop strep without developing any neuropsychiatricsymptoms. I think we just need to research it more.Q aHow effective is putting a child with PANDAS on long-term antibiotics?Q aQ aWe don’t know yet because we haven’t really studied it. We are doing apenicillin study so we can have a better answer to that question. There areclearly some children that I have seen who do much better on antibiotics, butthere are also children that do worse on antibiotics. I really don’t think we knowenough to prescribe prophylactic antibiotics.In what direction is research going right now?There are a lot of people who don’t believe in PANDAS who are veryoutspoken about it, but if you look at the summary of the literature that is outthere, most of it is hinting that there is something going on. There is certainlyenough support to warrant looking at it further. I think it will still be about fiveyears until we have better answers, because it will take that long to do some ofthe bigger antibiotic trials.How should these patients be treated while research is ongoing?I always recommend standard of care treatment for all of these children. ForOCD, the first thing you want to consider is doing cognitive behavior therapy,even if it’s a child that has a PANDAS-type presentation. What you are givingthat child is a skill to resist these symptoms even if those symptoms may beimmune-triggered, but at least they have a way to fight back the OCD. P07/08•05POST

ProfileHealthy state of mindResearcher examines the relationship between psychological and physical healthBy Jill PeasePhoto By lisa baltozerDeidre Pereira, Ph.D.The mind-body connection, while oft studied, remains mysterious. A number of studies havedemonstrated that a person’s thoughts and emotions can affect his or her physical health.But can the mind also influence health outcomes and mortality? That’s a questionpsychologist Deidre Pereira, Ph.D., and others in her field hope to answer.“There is still some skepticism about how the mind can affect clinical outcomes,” said Pereira,an assistant professor in the department of clinical and health psychology in the College of PublicHealth and Health Professions. “I share in the skepticism about the effect on mortality becausewe just don’t know the relationship yet. But there is ample evidence that factors such asdepression, stress, sleep quality and social relationships affect neuroendocrine and immunefunctioning. We absolutely know this.”Pereira’s clinical and research interests lie in two relatively new fields: psycho-oncology andpsychoneuroimmunology.“Dr. Pereira’s research focus in psychoneuroimmunology is truly forward thinking and bringsthis area of study to the university,” said Ronald Rozensky, Ph.D., chair of the department ofclinical and health psychology. “She is building a strong program of research that will put us onthe map as a health science center that excels in this field.”Psycho-oncology includes two main areas of interest — the effect of the cancer experience onemotional and physical quality of life, and how a person’s psychological state can influence cancerrisk and clinical outcomes. Psychoneuroimmunology is the study of the mind-body relationshipand the effect of the psyche on the body’s neuroendocrine and immune functioning.In addition to her busy psycho-oncology clinical practice, Pereira is working with UF ShandsCancer Center colleagues Daylene Ripley, M.D., and Linda Morgan, M.D., to conduct research onendometrial cancer, the most common gynecological cancer and the fourth most common canceroverall among women. She is studying the relationship between psychological factors, immunefunctioning, stress hormones and health outcomes.“For example, women with endometrial cancer will have hysterectomies as part of theirtreatment,” Pereira said. “We want to find out if psychological factors influence their ability toheal after surgery.”Pereira’s work in mind-body research studies began during her graduate studies at theUniversity of Miami under the mentorship of Michael Antoni, Ph.D., a leadingpsychoneuroimmunology researcher. Together they studied women who have both humanpapillomavirus, which can be linked to cervical cancer, and HIV, which suppresses the immunesystem.Their research has yielded important findings. Women in the study who were more pessimisticabout their futures had worse natural killer cell functioning in their immune systems, which mayimpair their ability to fight viruses and the spread of tumors. Women who reported more stresshad an increased risk for progression or persistence of cervical dysplasia, a precancerouscondition.Antoni and Pereira also have preliminary data suggesting that women who received grouppsychological therapy had a much lower risk for the progression or persistence of dysplasia.There are countless other areas of mind-body research that have yet to be explored, Pereirasaid, citing that and two other aspects of her work as motivators.“The patients I work with in the clinic or in research are very inspiring and give me the energyto do what I do,” Pereira said. “It amazes me when an 80-year-old woman with cancer is eager toparticipate in the research, completing a two-hour interview and testing her saliva at home forstress hormones. I find that incredible.“Also, sitting down with the research data to crunch the numbers and seeing right there onyour computer screen how closely the mind and body are related is thrilling,” she said. “You can’tbelieve it. It’s exciting to get your research out in the literature so you can get feedback and takeyour work in new directions.” PPOST 07/08•05

CommunityInternational programs take medical care on the roadTo improve health and medical education globally, UF students andfaculty work with UF partners in developing countries to provideintegrated grass-roots medical outreach to those most in need ofhealth care.Students and faculty of the HSC colleges conduct numerous healthextension and research visits each year to other nations, and, in doing so,gain a hands-on, integrated, multidisciplinary educational experience.This outreach was initiated by UF students, and founded on theexpertise of UF faculty and the integrated and interdisciplinary structureof the HSC.In 2005, HSC students have delivered medical care to communities inthe Dominican Republic, Mexico, Haiti, Ecuador and Nicaragua. In thenext three pages, we’ve provided a glimpse of some of the internationalprograms that took place this year.College of NURSINGCollege of DENTISTRYNursing studentsjoined the annual UFinterdisciplinary outreachgroups that traveled tothe Dominican Republic,Ecuador and the Yucatan.Baccalaureate nursingstudents performedhealth screenings forunderserved patientsof all ages andcollaborated with localhealth-care personnelto improve interventionsand strengthen patienteducation efforts.Photo COURTESY OF LEIGH GREERNursing student Leigh Greer screens ayoung patient in the Dominican Republicas part of the DR HELP outreach trip.The college sponsored three international educational and service trips tothe countries of Dominican Republic, Mexico and Ecuador. While theDominican Republic trip was not affiliated with a foreign university, theEcuador and Yucatan, Mexico trips built on academic ties with sisterinstitutions in other countries to broaden the educational experience ofUF dental students. The college has established ongoing exchanges withUniversidad San Francisco de Quito (USFQ) in Ecuador and UniversidadAutónoma de Yucatan Facultad de Odontologiá (UADY) in Mexico.USFQ hosted 14 dental students early March, pairing them with USFQstudents to provide restorative and oral surgery treatment to about 150patients. The December trip to the Dominican Republic included 21dental students who were joined by three private dentists and two dentalassistants. Trip participants treated more than 500 patients, many ofwhom were malnourished or children with HIV. The UF trip to the Yucatanincluded two faculty and nine UF dental students who partnered withUADY students to provide treatment to more than 400 children in largelyrural and underdeveloped areas.Photo By Sara WilsonPhoto By Fernando Sandoval, USFQNursing student Sara Wilson (center) is pictured with other membersof the Project H.E.A.L. team in Ecuador.UF dental junior Jennifer Larson (left) and senior Sundeep Rawal(right) extract diseased teeth from an Ecuadorean mother as herdaughter looks on. Fourteen UF dental students journeyed to Ecuadorin March during Project HEAL, partnering with dental students fromUniversidad San Francisco de Quito in Quito, Ecuador, to provide freedental care to about 150 patients.07/08•05POST

CommunityCollege of medicineNicaraguaFourth-year medical students and College of Medicine faculty traveledto Nicaragua for two weeks in February to treat patients in two of thisCentral American country’s remote villages as part of Project Nicaragua.The 15 medical students split into two groups to set up temporary clinicsin the villages of Ocotal and Matagalpa. During their stay, they providedmedical care to 1,423 patients, one-third of whom were children.The students also traveled to other smaller surrounding villages andtreated farm workers at a nearby coffee plantation. The group donatedtoothbrushes, toothpaste, children’s toys, medications and vitaminsto the villagers and brought stethoscopes and blood pressure cuffs toclinics in the surrounding towns. Donald Eitzman, M.D., a UF professoremeritus of pediatrics, and Larry Rooks, M.D., a UF clinical associateprofessor of community health and family medicine, accompanied thestudents on the trip.Photo COURTESY OF JAY POONKASEMElizabeth Jungst (left), Rahul Chopra, Nadia Noor, Jay Poonkasem, JoseSoberon, Dr. Donald Eitzman, Phoung Nguyen and Run Gan on their wayto treat needy patients while in Nicaragua this February.Photo By Pamela kothariChristy Milsted Cavanagh and NasrinAldawoodi spent some time with localchildren during their mission trip to Haiti.Photo By Pamela kothariHaitiStudents and faculty from the colleges of Medicine, Pharmacy, and Public Health and HealthProfessions visited Haiti during spring break to treat patients at a hospital near the poverty-strickencountry’s southern border. Serge Geffrard, M.D., a University of Miami cardiology fellow, started ProjectHaiti when he was a second-year medical student at UF in 1996. Students have been making the tripeach year since then. The 25 students, faculty andphysicians who went to Haiti this year worked in a smallhospital in Fond Parisienne, a medically underservedarea ravaged by flooding last year. The group stayedin the Dominican Republic because of safety concernsin Haiti but traveled each day to the hospital. Whilein Haiti, the group saw patients of all ages and hadto handle several life-threatening emergencies, suchas heart failure and critical injuries, with limitedequipment.Toriseju Binitie treats a tiny patient in Haiti.College of Veterinary MedicineYucatanTen veterinary students, one veterinary technician and two veterinarians, includingthe course coordinators from the veterinary college’s Office of InternationalStudies, visited the Yucatan to conduct a rabies vaccination campaign in the ruralcommunity of Tunkas, as well as set up a spay/neuter clinic for dogs and cats.Ecuador/Project HEALOne veterinary student joined students from the College of Medicine and Collegeof Dentistry in March’s interdisciplinary program.Ecuador/Student International Veterinary OrganizationSeven veterinary students joined a trip to Ecuador in June 2005 that combinedsmall animal veterinary work with opportunities to work with large animal herds tolearn more about foot and mouth disease.ChileOne veterinary student is conducting a project relating to tuberculosis andbrucellosis in cattle will leave in July for the Austral University of Chile to completeher research.POST 07/08•05

CommunityCOLLEGE OF PUBLIC HEALTH AND HEALTH PROFESSIONSAudiologyFaculty and students from theDoctor of Audiology, or Au.D.,program made their third annualtrip to Yucatan, Mexico asmembers of Project Yucatan. Theaudiology students performedscreening tests that assessed thefunction of the middle ear system,measured levels of hearingsensitivity, and assisted UFmedical students in the cleaningand health care of the outerear. The UF Au.D. program alsodonated hearing aids, hearingaid batteries, cleaning suppliesand portable equipment thatcan be used by local, trainedhealth-care professionals tocontinue long-term audiologiccare in rural clinics. More than500 children and 100 adultsAudiology students Kristin Letlow (left), Meghan Miller and Michellereceived care from members ofCramer are joined by local children at a hearing screening site inthe UF audiology group whocollaborated with AsociacionYucatan, Mexico.Yucateca Pro-Deficiente Auditivo,a local organization established by parents of children who are deaf to provide hearing services and rehabilitation.Physical TherapyMembers of the physical therapydepartment provided instructionto the faculty of the only physicaltherapy education program inNicaragua. The UF group presentedinformation on shoulder impingementevaluation and treatment tofaculty and local clinicians at theUniversidad Nacional Autonomade Nicaragua in Managua, thenation’s capital. This is the UFgroup’s third visit to Nicaragua inan effort to provide information oncurrent physical therapy techniquesand treatments. Limited access tocontinuing education and Spanishlanguage textbooks has put theNicaraguan physical therapycurriculum 10 to 15 years out ofdate.Public HealthMaster of Public Health students joined the annual UF interdisciplinary outreach groups that traveled to the DominicanRepublic, Ecuador, Haiti and Mexico. The public health students designed and implemented educational programsfor small groups of clinic patients. Topics included the prevention of tuberculosis, diarrheal and mosquito-transmitteddiseases, and health issues surrounding improved sanitation and infection control. The students also evaluated patientunderstanding and awareness of the transmission and disease process of tuberculosis.Public healthstudent and DRHELP teammember HelenaChapman providescommunityeducation toresidents ofJarabacoa, CampoPaso Bajito in theDominicanRepublic on theprevention andsymptoms ofdengue, amosquitotransmittedvirus.Nicaraguan physical therapistsreceive hands-on instructionon treating shoulderimpingement during alaboratory session taught byUF physical therapy facultymembers Terri Chmielewskiand Claudia Senesac.07/08•05POST

Cover storyWords for the wiseMapping life’s great adventures through the art of writingBy Melanie Fridl RossPagers beep. Cell phones trill. Lab equipmenthums. Overhead, helicopters roar to a landing.Inside trauma rooms, orders are shouted.Patients laugh. Families weep.Every day, hordes of doctors and students and staffnavigate the hallways of the Health Science Center,bustling along at hospital pace.But listen ever so carefully, and amid the cacophonyyou’ll hear from those who are quietly going places,too, with the scritch-scratch of a pen on paper or thequiet click of fingers tapping out stories on a computerkeyboard.In unprecedented numbers, they’re trading poemsand prose for prescriptions, a book for the baggagethat can come with the long, often exhausting daysthat are part of learning and living. And they’refinding the journey to health is often more than justphysical, the path to becoming a health practitioner isstudded with self-reflection, and the trip into theexam room to give the news — good and bad — cansometimes be handled all the better one small word ata time.A reason to rhymeResearch is increasingly showing that writing isplain good for you, in ways that are as yet largelyunexplained. The therapeutic effects aren’t justpsychological. They include physical benefits suchas reduced use of pain medications among patientswith arthritis to improved lung function amongpatients with severe asthma. Studies also have linkedwriting to positive immune system effects, fewerdoctor’s visits, less stress and improved grades,among other benefits.Michelle M. Bishop, Ph.D., is working with JohnWingard, M.D., deputy director of the UF ShandsCancer Center at the Gainesville campus, to studywriting’s effects on the quality of life of spouses orcaregivers of cancer survivors who underwent bonemarrow transplantation.“What we realized from another study was that insome ways the spouses are even worse off than thesurvivors in terms of quality of life, even years aftertransplant,” says Bishop, a clinical and healthpsychology researcher at UF. “Expressive writingmay be particularly useful for people who have arestricted outlet for talking. If their primaryconfidante is their spouse who is very ill, they maynot feel like they can share their own thoughts andForget the stereotype that the closest somepractitioners come to composing the printed word isthe barely legible prescription-pad penmanship theydash off daily. Writing in its many forms, rooted inthe ancient healing arts, has begun to enjoy a moderndayrenaissance among patients, students and facultyalike. And an increasing number of researchersacknowledge that the simple act of putting pen topaper can help people travel greatdistances, emotionally andphysically.“There’s an awful lot of us whobelieve that the most crucialthing for success as measured byinner satisfaction and happinessin the long run — linking thepassion of your heart to theNeimspurpose of our lives — is selfreflection,”says Allen Neims, M.D., director of UF’sCenter for Spirituality and Health. “That’s the heartof it for a patient writing, it’s the heart of it forstudents writing, and it’s the heart of it for a doctor orfeelings; they may feel guilty if they complain. It maybe that expressive writing would be a great tool to helppeople identify stressors and cognitively andemotionally process them.”She and Wingard are studying caregivers who writefor 15 minutes once a week for four weeks. Theycomplete questionnaires about their quality of life atthe outset of the study and three months after the finalwriting session.“Some of the things they’ve described to us sofar is they found the writing to be intense buthelpful, meaningful, revealing of feelings they werenot aware of, and an outlet for bottled up feelings theymight not feel comfortable sharing with other people,”Bishop says.Other UF research is focusing on students. InJune, the Arnold P. Gold Foundation, a leadingsupporter of humanities in medical education,granted funds for continued teaching and evaluationof the College of Medicine reflective writing electivetaught by Gail Ellison and supported by Arts inMedicine, UF’s Center for the Arts in Healthcare,Research and Education, and the Maren Foundation.The course, open to first- and second-year students,is part of the Narrative Medicine program directed byany kind of health professional writing, because thekind of writing that seems to make the most differencereally is when you take something that’s going on inyour life or in someone else’s life and reflect on itsinner significance to you.“This need to go inside as best as we can, to be onthat inner journey of reflection, leads us to a placewhere we’re more at peace and wiser,” he adds. “Goinside, the answer’s there. I think reflective writingreally gets at that.”Medicine for the mindFrom reflective writing to the art of narrativemedicine — the practice of chronicling patientencounters in a journalistic fashion by delving intodescriptive details beyond the normal notes scribbledin a medical chart — the trend is sweeping the globe.Dozens of academic institutions have launchedliterary medical journals and are incorporatingwriting into the curricula. Web sites devoted to poetryin medicine have multiplied into the thousands.But you don’t have to go great distances to witness itfirst-hand. The Health Science Center has been at itNina Stoyan-Rosenzweig.“In creating programs in the Maren ReadingRoom, one of the things I immediately felt was animportant way to involve students but also to reallyencourage the growth of empathy in health-careprofessionals was to incorporate writing into thecurriculum in whatever ways possible,” says NinaStoyan-Rosenzweig, the Health Science Center’sarchivist. “I realize the importance of writing forreflection and as a form of therapy and self-care forphysicians. And the whole focus of narrative medicineis that if you understand the patient’s story and seethe story as a narrative, then you will focus on thatand be better able to elicit information from thepatient, better able to understand their needs andbetter able to diagnose their problem.”Goals of the writing elective include enhancingobservational and listening skills, increasing selfawareness,improving physician-patientcommunication, and developing a healthy lifelongwriting practice, Ellison says. The new grant monieswill be used to evaluate the course’s effects onphysician-patient communication skills and physicianand medical student self-care.— Melanie Fridl Ross10POST 07/08•05

Aging Gratefully‘You are old, Father William,’ the young man said,…’and yet you incessantly stand on your head…’— Lewis Carroll, Phantasmagoria, 1869Ah! So you do look your age? Welcome it. Waive the rules:don’t grow elderly, grow old. Don’t get graceful, get greedy.Don’t get delicate, get bold. Live your age with lust.Take your teeth out if you want to. Don’t cover yourbald beauty with a wig. Don’t cream those creases.Flaunt them: these highways on the map of your life.So your skin’s gotten thin? Love its wens and wrinkles:mementos to your life’s commotions. You’re not so firm?Fatness is fine: sway that elegant belly, juicy as a Botticelli.Dance! Caper with the teenyboppers. Oil that creak,bop that crunch. Strut that wrinkle, rap that bulge.Link arms, you redwoods that ride down our millennium,Your roots broadening with each weathering season. Though yourbows are bent they are hardier than the stripling’s green,And their lengthening sights espy their targets plainer.Why sit and wait on death? The future’s marvelously unsure.So turn hoary cartwheels into a hundred suns. We’re all at it,hoarding stories as we go; and there’s work for us all to do.— John Graham-Pole, M.D.Professor of Pediatrics, UF College of MedicineMedical Director of Pediatric Palliative Care,Hospice of North Central Floridasincethe inception ofthe Shands Arts in Medicineprogram more than a dozen years ago. Today,physicians and nurses are sharing their own poetrywith patients as a way to open communicationabout their ailments. Other faculty members writeas a form of personal expression, a way to gleangreater understanding of their calling or to copewith especially difficult circumstances.Patients themselves are increasingly encouragedto write as an outlet. For those who are gravely illand tethered to a hospital bed for months on end,writing can help them escape to other places andhappier times. Recognizing the importance of thisform of self-expression, Shands HealthCare hasplaced two writers-in-residence in its facilities, onedevoted to working with patients awaiting a hearttransplant, their families and the health providerswho care for them, and the other to detailing thelife stories of elderly hospitalized patients.Students are benefiting from the writing process,too. In the College of Medicine, the third-yearmedical clerkship requires them to keep a portfoliothat includes reflective and narrative writings andto participate in related small-group discussions. Athird-year medical student, meanwhile, has justpublished “Panacea,” the university’s first literarypublication featuring the works of students, facultyand staff who work in the health sciences.Reflective writing seminars also explorethe intersection of metaphor andmeaning, observation and listeningskills, and self-awareness. A crosscollegeemphasis on journaling andlogging patient encounters isacknowledged as increasinglyimportant. And similarly, manystudents are encouraged to keepdiaries that describe theirexperiences on internationalhumanitarian trips.“I hope they are learning alifelong practice that’s useful inself-care,” says Gail Ellison,Ph.D., who teaches the reflectivewriting elective for medicalstudents and is the writer-inresidenceat Shands at UF.“Instead of just beingoverwhelmed in theexperience they findmetaphor. The hero’s journeycomes up a lot in theirwriting. They have goneinto unknown territory.One student wrote aboutgoing into the body andlikening it to a jungle.There have been explorers therebefore, and she had a map, but she herself hadnever been there.”Post-it poemsJohn Graham-Pole, M.D., frequently finds hisoffice becoming plastered in Post-it notes. It’shis favorite way to jot down the snippets ofpoems that come to himduring his busy dayscaring for childrenwith cancer.Other facultymembers share hispassion. RobertLawrence, M.D.,pens poems heGraham-Pole sometimes shareswith patients. Pharmacy researcherIssam Zineh, Pharm.D., writes and alsohas participated in a therapeuticwriting course for heart transplantpatients at Shands at UF. Nurses,following a decades-long tradition ofkeeping clinical logs, also areencouraged to write about theirchallenges and achievements on thefloor.Graham-Pole has writtenhundreds of poems and published four books.He keeps a gratitude journal that he writes in everyday.“I found that writing was a way of expressing myown feelings about my work; it was really almost asafety valve,” Graham-Pole says. “I work with a lotof seriously ill patients and their families, and Ifound the need to speak about that really for myown benefit. And in time as I discovered otherphysicians doing the same thing, I realized wekind of wanted to hear each other. I also wouldshare writing with patients quite a bit andencourage them to write.”That patient voice is something he cares aboutdeeply.“We need to hear their stories. As the director ofhospice palliative care, I spend my whole timealmost basically listening to patients’ stories,”Graham-Pole says. “And much of my writing isinspired by the stories I hear day to day, reallyextraordinary stories that don’t get into themedical charts.”College of Nursing Week 3: Clinical LogClinical this week involved more opportunities to notonly talk to my own patient but other patients aswell. This week was also particularly challengingfor me because my patient was not engaged in ourconversation. She would respond to the questionsthat I asked her but would not provide any additionalinformation or start a new topic. This made it veryhard for me because I had to bring up all thequestions and when an awkward silence would comeup I often found myself searching for the next thingto say. My patient was also very standoffish to me; Igot the impression that she was suspicious and didnot trust me, or my intentions.This week I was more comfortable with talking to apatient but I need to come up with a better “plan ofattack” when it comes to talking to them. When mypatient this week did not respond to my questioningI found the silences to be very distracting to mebecause I was unable to fill the space with anotherquestion right off the bat. I also was aware that theway in which I started the conversation was probablynot the best way. Towards the end of the night Iwent out and colored with my patient and thenbegan talking to her and I found that she was morereceptive to me and less suspicious. Maybe if I canestablish some sort of relationship with them beforegoing right into the questions I could get more outof them. This is still a hard rotation for me becauseI do not feel like I am making a difference. Usuallyat my other rotations I feel that I have made somesort of impact on my patient. That is what is so hardabout psych because you want to see as a nursesome progress and in most cases that is not goingto happen right away. That is what I need to thinkabout and not feel like I am going to change theclient on only one visit.— Amanda PavlockStudent, College of Nursing07/08•05 POST11

Cover storyAs he began to write with regularity, often aboutrecent experiences, other events from his years as adoctor in training and from his childhood camesweeping to the surface. Thus a poem he wroteabout 10 years ago was actually about his first yearas a medical intern, in 1967.The Annals of InternalMedicinepublishedthat poem,about a“horribleexperience Ihad as a very‘wet-behindthe-ears’intern,”Graham-Polesays, andwriting it was “ahuge help, arelease, acatharsis.” He was24, caring for a 20-year-old cancerpatient at a timewhen virtuallyeverybody died of thecondition. He wasdesperately trying torestart his intravenousline.“He was a big, big guyI remember, and itproved almost impossibleMetamorphosis on the Heart Transplant UnitI’ve got big plans for what’s ahead. My family is going to seethe United States of America. We’re going to enjoy thethings that supposedly aren’t important: sitting on a parkbench watching the frogs jump.We’re going to see the day instead of trying to make itthrough the day. We’re going to enjoy each other…to start his IV again,” Graham-Pole says. “I foundmyself kind of weeping really, and I was cursinghim under my breath, I blamed him for having noveins. Of course they’d all been used up, you see.Then the senior resident happened along and putthe IV in his foot and helped me. Years later Iwrote a poem called ‘Vena Puncture,’ and the lastsentence was ‘God, why this tiny vessel in thisgargantuan frame?’ It was sort of like theblasphemy of blame, is what I call that really. I justcouldn’t do it. The poem just popped out 33 yearslater.”Graham-Pole says much of art, and certainlywriting, is inspiring.“I did write some pretty gloomy poems to beginwith, but I’ve found increasingly that I can findhumor in the setting of very severe or lifechallengingproblems, and I could certainly findinspiration and hopefully celebrate that inwriting.”And, he says, writing has just as much a role inpatient care as it does in helping practitionersprocess difficult experiences, or in heralding happyones.“A mother of a patient called me at home in themiddle of the night,” Graham-Pole says. “The boywas stable, but the mother called me and startedalmost screaming down the phone. I didn’t knowwhat to say so I said nothing, and gradually by mysilence she found it comforting and she started tosoften. After awhile, shestarted to laugh. Thenabout 48 hours afterthis whole experience,this outburst ofThe important thing is being here and thinking and talkingabout things, and the way I’ve changed my mind. I was“metamorphized” while I was waiting for my heart. I am anew creature along with the new heart. I want to be kinder,gentler, not vain-glorious. Not seeking things for me, butlooking out for the needs of others. I just want to be amore people person. I always did like people — I think Iliked talking. But when you really like being with someone,you can just sit there and be with each other and be totallycontent.It’s really night and day. It was dark. Now it’s so bright. I justwant to walk out of this hospital and tell people “You don’thave to get sick to do it; you don’t have to get a physicalnew heart; you’ve just got to change your mind.”— Donald IngramHeart transplant patientExcerpted from “In-house Wisdom,” a collection of writingsby patients, faculty and staff at Shands and the HSC.phone line, shegave me apoem, whichbasicallymust havebeen herfirst poemin 20years. Soin themiddle ofthe night sheinstinctively startedturning to poem making.”Zineh, an assistant professor ofemotion leaping allover me down thepharmacy practice and pharmaceutical sciences,says writing has helped him sort out his place inthe world on a personal and a professional level.Science, he says, “informs his writing,” with hispoetry taking on a biological bent. About five yearsago, one of his poems was published in JAMA: TheJournal of the American Medical Association, and hiswork also has appeared in other literary journals.“On the other hand, my creative side fuels myability to write scientific manuscripts in a waythat’s not boring,” he says.Sappho in CaliforniaWe can only imagine the rubiesThe write stuffThe interest in writing comes at a time wheneffective physician-patient communication isincreasingly valued and students must demonstratecompetency in this area.“Basically there’s a return to the art of medicinein the old doctor’s ‘black bag’ style,” Ellison says.“Medical schools realize that there’s more totraining healthy, compassionate physicians thancoursework in biochemistry and pathology.”Writing helps students become “moreconscientious and mindful of their own experiencein medicine, from first-years working withcadavers to having a patient die for the firsttime to observing theirmentors andlistening tophysicianstalk,” shesays. “In apositive way, alot of theirwriting isseekingunderlyingmeaning in whatthey are doing, theethics and socialramifications, andtheir own fears anddoubts and strengths.”Second-year medicalstudent Anitha Jain saysthe reflective writingelective was meaningfulbecause it placed value onwriting as an emotionaloutlet, as an art.“Medical school is veryhard, physically andemotionally, and having thiswriting class was an amazingoutlet,” Jain says.Says Nicole Paulson, who tookthe seminar last year as a first-yearmedical student, “I think that sooftentimes as a medical schoolstudent you get obsessed with schooland grades and things that in the longterm matter but don’t necessarilycompose who you are. I think that writing reallydoes help put things in perspective when you’restudying for hours on end, to take time out toreally reflect on what you’re thinking and feeling.It allows room for growing and learning.”Three years ago, Heather Harrell, M.D., whodirects the third-year College of Medicineclerkship, began requiring students to ponderanything that has happened to them in medicalAnd pearls that were Los Angeles at night.The plane touching down like a toe testingThe black top pool of where the city starts.This is where it might start. We can be sureAs the swallows of San Juan Capistrano.She doesn’t know about the swell of sea saltThat we’ve mistaken for loops of gullsAround San Francisco. Everything growsWild. Everything is like a cherry.Poets come here. No one asks them to come.Some hate Ashbery, some love him. And sheBuries hate like two thoughts, the passive handsOf the Pacific. Buries what is herIn the thought of a young girl, the absenceOf grace. The other, the thought of LedaBurying a swan’s egg in a pillow.In any case, we shouldn’t expect muchFrom this place. This coast will never say, “YouHave moved me.” Children will be born.The oranges will still grow without us.— Issam ZinehAssistant professor of pharmacy practice andpharmaceutical sciences,College of Pharmacy12POST 07/08•05

school, goodor bad, andwrite aboutit. Then theymeet in smallgroups withHarrell and JayLynch, M.D., aprofessor ofoncology, to sharetheir writing.“It’s a verydifficult year for thestudents,” Harrellsays. “They’re facedwith a lot of life-anddeathissues. I wascurious about what theirperspective was, andhopefully it will promotethis type of reflection in thefuture.”Harrell says common topics“I don’t know…”“I don’t know…,” you and I are well acquainted…we danced together for hours during that lasthematopathology test…and we lamented together with frustration as Iangrily told you“I didn’t know how to continue,”include facing a dying patient for the first time,breaking bad news, and feeling rather powerlessyet wanting to effect change.“Dr. Lynch and myself, after all these sessions,come away feeling like we get more out of this thanthe students,” she adds. “We’re so impressed by thestudents and their thoughtfulness and theircompassion. It gives us a lot of hope for the futureof medicine.”In the College of Public Health and HealthProfessions, Stephanie Hanson, associate dean foracademic affairs, has students keep a daily journalof their experiences when they take a courserequiring them to shadow health-care providers.“The purpose of the journal is for students tocomment on what they are learning and observingas well as how they are reacting to the situation,”Hanson says. “The goal of the latter part is to helpstudents increase their own awareness of theirvalues, biases and reactions to specific patientcircumstances.”College of Dentistry students are encouraged towrite about the humanitarian trips they take tocountries such as the Dominican Republic orMexico. And nurse researcher Jodi Irving assignsher beginning nursing students to write essaysabout the nursing-related artwork lining the wallsof the HPNP Building in an activity designed tointegrate reflections on health care and the value ofthe humanities.“Nursing has a long history of doing what arecalled personal logs that review experiences inclinical situations and their relationship to theprocess of learning to be a nurse,” Irving says. “Iteach psychiatric mental health nursing, and a bigpart of our requirements for our students are toand we rode around on that black cloud together…afraid to rain down on our future patients…what if I don’t know a single thing when I look themin the eye?What if you and I are ripped into a twister together,Right thereAnd I can’t pull you from their embrace…?— Anitha JainStudent, College of Medicinedeal with their own issuesof stigma and reactions tomental health and mentalillness. We do use(writing) in almost allthe clinical courses inour college.”In addition,nursing students whowork withpsychiatric patientsare instructed toencourage themto chronicletheir feelings,describe issuesthey areconfronting,and writethoughts down beforethey act on them.In the hospital setting, nurses promote similarwriting exercises with patients of all kinds.“What we unfortunately tend to focus on whenyou become a patient is you as an illness, and itreally doesn’t define an individual completely,”says Tina Mullen, director of the Shands Arts inMedicine program. “What the creative writing hasbeen doing for this adult population is giving themback a sense of their healthy self through theircreative writing experiences. Some patients havebeen in the hospital for months and months, andthe opportunity to even just wax poetically abouttheir feelings of the beach they haven’t seen oreven their home and to put these things down onpaper makes them very real and very tangible.”Ellison, reflecting on her role as writer-inresidence,says the stories she hears and poems shereads aloud “encompass the entire humanexperience; they require me to be in there laughingand crying, commiserating and demonstratingoptimism — bearing witness and serving as ascribe for posterity.”“Patients write to their spouses and to eachother; they express their thanks to the staff,” shewrites. “They tell their stories, which get posted ondoors and bulletin boards, so that physicians andnurses can see the person behind the hospitalgown. In turn, physicians and nurses write abouttheir fears, foibles and silliness — giving patients aglimpse of the empathic, human side of caregiverswho are too often on the run.“As the writing program spreads, it carries amessage that I reinforce with regular postings,trying to build a bridge between sick people andtheir families and those who devote their lives tocaregiving: We are all in this together. We will allknow sickness and death and suffer deep loss. Wewill all experience times of bliss, calmness andsheer joy. We can all listen, witness, be with,contain, communicate, celebrate and grieve.Together.” PFind more writing samples atwww.news.health.ufl.eduWriter-in-residenceLast month GailEllison, a writer inresidence at Shands atUF, received anhonorable mention inthe Blair SadlerInternational Art andHealing Competition forEllisonthe writing program atShands and the Health Science Center. Theaward was presented at the InternationalConference of the Society for the Arts inHealthcare, at which Ellison spoke aboutreflective writing in health-care settings.As writer-in-residence at Shands at UF,Ellison has helped compile a variety ofresources for patients, faculty and staff, andstudents, including the following:• In-house Wisdom: Writing by Patients,Families, Staff, and Students. Acollection of poems and essays placed inShands and Health Science Center waitingareas.• Writing for the Health of It. An 8 1/2 x11-inch writing pad distributed to patientsto encourage the kind of reflective writingthat promotes health.• Reflective Writing in Health-careSettings. A handbook of ideas for peoplewho want to write with patients and staff,but don’t know where to start.• Write-on Shands. Small notepadsdesigned to be placed with a pen at thebedside of each new patient.• Poetry & Medicine in Cyberspace. A CDof links to Web sites where physicians,medical students and other health-careprofessionals share their writing, as wellas programs that promote the humanitiesin medical education.• Polecats’ Prattle. A patient-inspirednewsletter published on the Status One(heart transplant) unit.• Poetry Tents for Nurses’ Week. Selectedpoems placed in nurses’ stationsthroughout the hospital and on tables inthe cafeteria.07/08•05 POST13

ResearchManatee eyes could be window to health statusBy Sarah CareyPhoto By MIKE GARRISONFor Florida manatees, the eyes may have it,say UF researchers studying whether themammals’ unusually thick tear film helpsprotect against disease and could be used to gaugethe endangered sea cows’ ability to fight stressfrom cold water temperatures.Manatees depend on bothnatural and artificial warmwater refuges like thosefound near coal-burningpower plants to survive coldwinters. As older coalburningpower plants arephased out in the next 10 to20 years, researchers fearSamuelsonchronic exposure to cooler waters could weakenthe large herbivores’ immune system, and theycould sicken or even die.By sampling manatees’ tear film in addition toperforming other standard tests, scientists thinkthey might be able to more efficiently evaluatemanatees’ immune system function and betterdetermine strategies for rescue, treatment andrehabilitation.The current tear analysis project, believed tobe the first of its kind, builds on work UFveterinary scientists published recently in thejournal Veterinary Ophthalmology that describedthe abundance of blood vessels found in manateecorneas. Blood vessels could have a tendency tomove into the cornea to supply oxygen becausethe tear film creates a barrier so thick thatoxygen present in air can’t penetrate it, said DonSamuelson, Ph.D., a professor of ophthalmologyin the Marine Mammal Medicine program atUF’s College of Veterinary Medicine.Manatees are believed to have the thickest tearfilm of any sea mammal, and possibly of anyanimal, Samuelson said. In general, mammalsproduce tears to protect against infection,because the eye itself does not have immunesystem components.“Through this protection against the potentialfor infection, the manatee is able to enter murkywaters just rich with potential pathogens,”Samuelson said. “For that reason, we think thisvery thick tear film, undoubtedly rich withantimicrobial components, serves to protect inThe unusually thick tear film found in manatees may one day provide clues to their health status.areas that could otherwise be devastating.”Researchers speculate that tears, which can becollected without removing manatees from thewater using a small, soft cotton swab, may oneday be used along with or instead of blood teststo assess health status and to gauge whether themammals were recently exposed to health threatssuch as red tide. Ongoing UF studies areexploring the relationship between the tear filmand blood vessel formation.“One of the findings of our earlier work wasthat there is absolutely no pathology involved inthe formation of these manatee blood vessels,which in other species occur predominantlybecause of trauma or disease,” Samuelson said.“So the question is, why do these mammals havesuch thick tears that corneal blood vessels formnaturally, even in the fetus?”Samuelson collaborated with Roger Reep,Ph.D., a UF professor of neurology, and JennyHarper, Ph.D., a recent doctoral graduate who isnow an assistant professor at Coastal GeorgiaCommunity College. Together they examined 26eyes from 22 individual manatees andconstructed 3-D images of the corneas.“We’ve completed the evaluation and mappedthe blood vessels, so we know where within thecornea they are located and how many there are,”Samuelson said. “Our next goal is to startexamining the tears and evaluate them withregard to the whole animal’s health status.”He added that the recent study clearlydocumented the fact that these blood vessels arepresent, do not appear to interfere with manateevision and appear to be a part of manateeanatomy beginning in the embryo.“With that in mind, we are examining thetears to see what they exactly consist of,particularly with regard to the anti-infectiouscomponent,” Samuelson said. “This mayeventually be an opportunity to examine anindividual manatee’s state of health with regardto their immune system by analyzing theirtears.”Tear analysis is being used in humanophthalmology and is in its early stages inveterinary medicine, he said.Kendal Harr, D.V.M.,assistant director of UF’sMarine Mammal Medicineprogram, is collaboratingwith Samuelson on a largefederal Fish and WildlifeService research initiativeto assess the immuneHarrfunction of manatees atHomosassa Springs State Park. She iscoordinating sample and data collection for theUF veterinary college as part of the project.“We suspect that manatees’ thick, mucusytear film likely contains proteins, such asantibodies, that would prevent bacteria and otherpathogens from causing disease,” Harr said. “Weare currently developing qualitative assays tomeasure antibodies in blood as well as in tearfilm and milk.” P14POST 07/08•05

ResearchExperts warn of rising death ratetied to pain patch abuseBy Denise TrunkPhotos By lisa baltozerDrug abusers are increasingly turning to aslow-release form of a powerful painkiller fora quick and dangerous high, University ofFlorida researchers warn. The trend is raising alarmas the number of people dying from an overdose ofthe drug fentanyl, an opioid 100 times more potentthan morphine, rises.Addicts are misusing a clear patch that transfers acontrolled dose of fentanyl through the skin into theDr. Bruce Goldberger in his UF laboratory.bloodstream over thecourse of a few days, UFexperts say. The adhesivepatch is typicallyprescribed to treatpostoperative pain orchronic pain conditions,but in some cases is beingmisused, often with deadly consequences.“Because the patch is a sustained-release form ofthe drug, if one withdraws the 72 hours’ worth ofdrug and uses it in a form that it wasn’t designed toA clear patch attached tothe skin slowly releases apowerful painmedication to the patientover a 72-hour period.be used for, then it can rapidly result in death,” saidthe study’s lead researcher, Bruce Goldberger, Ph.D.,director of toxicology and an associate professor inthe department of pathology, immunology andlaboratory medicine and of psychiatry in UF’sCollege of Medicine.Patients who are prescribed the patch must bemade aware of the potential dangers of misuse,Goldberger added.Florida Department of Law Enforcement recordscited in the UF study, presented this month inOrlando at the annual meeting of the College onProblems of Drug Dependence, show abuse of thepatch resulted in the death of 115 people in Floridalast year.While the number of fatalities linked to the patchis still one-quarter the number associated with otherdrugs abused, such as methadone or hydrocodone,the number of sudden deaths from overdosing onfentanyl has been on the rise during the past fewyears — not just in Florida but also nationwide,researchers found.“We have seen an increased use and abuse of thepatch form of fentanyl for the past five years or so,”Goldberger said. “This is a recent finding related tothe prescription of fentanyl patches.”In many cases, people who died from overdosingon the drug were able to easily remove the full doseof fentanyl from the patch and take the entire threedayamount at once, either by injecting, ingesting orsmoking it.In some cases, the deceased sought a state ofeuphoria by applying multiple patchessimultaneously.It is not always clear from the law enforcementrecords where people who overdosed obtained thedrug, whether from a prescription of their own orfrom one that had been stolen or otherwise not usedaccording to doctor’s instructions, the groupreported.“Oftentimes we don’t know where the patch comesfrom. Sometimes it is from someone who had aprescription or it was purchased on the street oracquired from a friend, so it has been diverted tothem,” Goldberger said.Goldberger’s team, which includes Mark Gold,M.D., a distinguished professor with UF’s McKnightBrain Institute and chief of the division of addictionmedicine, has been focused on the use and abuse ofprescription drugs. In the past few years his team hasseen increased abuse of methadone, and nowfentanyl.“Based on our study we’re recommending thatphysicians better educate their patients on the use ofthe patch, and, as a result, we might see lowernumbers in fentanyl-related deaths in the state ofFlorida,” Goldberger said. PResearchers create way to generate brain cells in labRegenerative medicine scientists at the University of Florida’s McKnight BrainInstitute have created a system in rodent models that for the first time duplicatesneurogenesis — the process of generating new brain cells — in a dish.Writing in the Proceedings of the National Academy of Sciences, researchersdescribe a cell culture method that holds the promise of producing a limitlesssupply of a person’s own brain cells to potentially heal disorders such asParkinson’s disease or epilepsy.“It’s like an assembly line to manufacture and increase the number of braincells,” said Bjorn Scheffler, M.D., a neuroscientist with UF’s College of Medicine.“We can basically take these cells and freeze them until we need them. Then wethaw them, begin a cell-generating process, and produce a ton of new neurons.”If the discovery can translate to human applications, it will enhance effortsaimed at finding ways to use large numbers of a person’s own cells to restoredamaged brain function, partially because the technique produces cells in fargreater amounts than the body can on its own.In addition, the discovery pinpoints the cell that is truly what people referto when they say “stem cell.” Although the term is used frequently to describeimmature cells that are the building blocks of bones, skin, flesh and organs, theactual stem cell as it exists in the brain has been enigmatic, according to DennisSteindler, Ph.D., executive director of the McKnight Brain Institute and seniorauthor of the paper. Its general location was known, but it was an obscure speciesin a sea of cell types.“We’ve isolated for the first time what appears to be the true candidate stemcell,” said Steindler, a neuroscientist and member of UF’s Program of Stem CellBiology and Regenerative Medicine.— John Pastor07/08•05 POST15

ResearchIs excessive snoring keeping you up…or bringing you down?By Lindy McCollum-BrounleyIf you answer yes to having any of the following symptoms — restless nights,loud snoring or daytime sleepiness — you may be suffering from sleep apnea,a condition where the soft tissues in the back of the throat relax during sleepto obstruct breathing. Those with sleep apnea may stop breathing hundreds oftimes during the night, leading to frequent nighttime awakenings and subsequentdaytime sleepiness.Richard Berry, M.D., a professor of pulmonary medicine in the College ofMedicine, and Charles Smith, D.D.S., associate clinical professor of operativedentistry in the College of Dentistry, collaborate to offer medical options anddental appliances that work together to result in a good night’s sleep for many oftheir patients.Sleep apnea affects 12 million Americans, according to the National Institutesof Health, and can have serious consequences such as cardiovascular disease andhigh blood pressure — not to mention separate bedrooms so sleepy spouses canrest in peace. Men, people who are overweight, and those who are overweight andover 40 are the groups most at risk for suffering from sleep apnea, but anyone,including children, can suffer from the affliction.Fortunately, Berry and Smith can offer several options to greatly diminishsleep apnea, the most effective of which is Continuous Positive Airway Pressure.CPAP patients wear a mask while sleeping that is connected to a machine thatfunnels a continuous flow of air into the nose and mouth at a pressure highenough to keep the airway open.Some patients, however, find sleeping with CPAP uncomfortable and reject itin favor of other options. This was the case of a 45-year-old woman who wasreferred to Berry and Smith by her primary physician. They published a report ofher unusual experience in a recent issue of the Journal of Clinical Sleep Medicine.The patient found herself falling asleep at her desk at work in the afternoonsbecause her sleep apnea kept her up at night. After trying CPAP and finding it tobe too uncomfortable, the patient was referred for uvulopalatophyryngoplasty, orUPPP, surgery to remove excess, fatty soft tissue from her palate.After surgery, the patient’s snoring and sleep apnea were dramaticallyimproved, but the patient still experienced some sleep apnea five months after thesurgery. Berry and Smith decided a mandibular repositioning device should beused to alleviate the patient’s occasional postsurgery apnea. MRDs are dentalappliances used to adjust the angle of the lower jaw, pushing it forward to keepthe airway open. Smith — an international expert in the fabrication andapplication of MRDs to relieve sleep apnea — adjusted the MRD over the courseof several weeks to achieve optimum performance, resulting in the patientreporting no afternoon napping at work three months after beginning use of theMRD. A follow-up sleep study demonstrated thepatient’s arterial blood oxygenation wassignificantly improved during sleep as aresult of the combined UPPP/MRDtherapy. PPhoto By sam brillDr. Charles Smith demonstrates how the CPAP is fitted. The CPAPblows a continuous flow of air into the airway while the patient sleeps,preventing soft tissues from relaxing enough to close the airway.What’s your snore score?According to the American Sleep Apnea Association, youranswers to this sleep quiz will help you decide whether you maysuffer from sleep apnea:1. Are you a loud, habitual snorer?2. Do you feel tired and groggy on awakening?3. Are you often sleepy during waking hours, and/or can youfall asleep quickly?4. Are you overweight and/or do you have a large neck?5. Have you been observed to choke, gasp or hold yourbreath during sleep?If you or someone close to you answers yes to any of thequestions above, you should discuss your symptoms with yourphysician or sleep specialist.For more information, visit theAmerican Sleep Apnea Association at www.sleepapnea.org.Photo courtesy of Charles SmithA dental appliance called a mandibular repositioning device, or MRD, can be fitted to sleep apnea patientsto help maintain an open airway. The MRD relieves sleep apnea by pushing the lower jaw down and out,tightening soft tissues that would otherwise close during sleep to block the airway.16POST 07/08•05

ResearchDeadly aortic disease difficult for doctors to detectBy April Frawley BirdwellAortic disease kills nearly15,000 people in the UnitedStates each year, but the rarityand complexity of this deadlydisorder make accuratelydiagnosing it difficult fordoctors in the health-caretrenches, UF researchers haveBeaverfound.UF surgeons who specialize in treating thedisease studied the charts of 100 patients who weretransferred to Shands at UF medical center withsuspected aortic ailments and found that about onequarterof them initially had been misdiagnosed,delaying treatment for some and sending othersinto the operating room needlessly.The study, which appears this month in TheAnnals of Thoracic Surgery, suggests many doctorswho do not routinely treat aortic disease havedifficulty distinguishing between the two mostcommon culprits, an aortic aneurysm and an aorticdissection. An aneurysm is a bulge in the aorta thatcan rupture, while a dissection is a sudden tear inthe arterial wall. “Three’s Company” star JohnRitter died in 2003 after suffering an aorticdissection, drawing national attention to aorticdisease.But even a slight variance in diagnosis can meanthe difference between medical treatment andemergency surgery, said Thomas Beaver, M.D., aUF assistant professor of cardiovascular andthoracic surgery in the College of Medicine and thestudy’s lead author.“When you start talking about doing majorthoracic aortic surgery on somebody, you reallywant to be sure what you’re doing and where itstarted,” he said. “For people who aren’t as familiarwith it, it can be more challenging. There are subtlenuances.”According to the National Center for HealthStatistics, 14,746 people died in 2002 from either anaortic dissection or aneurysm, but most communitydoctors are not exposed to these disorders oftenenough to discern the subtleties between them,Beaver said. At Shands, where many patients arereferred for aortic disease treatment, thoracicsurgeons perform nearly 200 aortic procedures ayear.Increased education in medical schools and morecontinuing education for practicing physicianscould improve how doctors diagnose aortic disease,the researchers suggest.Genetics could be the best indicator right now forpreventing and treating aortic disease before anaortic tear or rupture, Martin said. People withrelatives who have had aortic aneurysms ordissections should be examined for signs of thedisease.“It’s a curable disease,” said Tomas Martin,M.D., a UF associate professor of thoracic andcardiovascular surgery. “And it’s much bettertreated on an elective basis than on an emergencybasis.” PFulbright Fellow leaves lastingimpression on UF colleaguesEDUCATIONBy Jill PeaseFulbright Fellow Judith Dirk has made remarkable strides since arriving at UFlast August from Germany.Hosted by the department of clinical and health psychology at the College ofPublic Health and Health Professions, Dirk has taken a number of classes,finished her thesis, developed several manuscripts for publication and becomeinvolved socially in the department, said her mentor Michael Marsiske, Ph.D.,an associate professor of clinical and health psychology.“The most amazing thing about Judith is — despite the fact that she worksDirkvery hard — she also really soaked up the culture and colleagues,” Marsiskesaid. “She’s been a fixture at several colloquia and is known by name by people throughout thecollege and university. She has really made the most of this experience.”Dirk has been working with Marsiske to examine the relationship between older adults’ dailyactivities and their cognition, mood and pain. She analyzed the daily activity diaries completed by agroup of older adults over a 60-day period. Jason Allaire, Ph.D., of North Carolina State University,was another collaborator on the project.“We found that the more active seniors are, the more likely they are to feel emotionally positiveand to report less pain,” Dirk said. “If an older adult is experiencing positive mood, he or she willparticipate in more leisure activities like reading books, going to the theater and visiting withfriends. These kinds of activities are important because they can help to maintain and enhancephysical and cognitive skills.”The daily activity diaries also gave Dirk a crash course on American life.“I didn’t know what a Sam’s Club was,” Dirk laughed. “This experience has been a real culturaljourney for me.”Although Dirk will return to Germany this summer to complete her psychology degree(equivalent to a master’s) at Dresden University, she plans to make good use of e-mail to continuecollaborating with UF researchers. She will soon be applying to doctoral programs in Europe andthe United States, and UF is high on her list. P07/08•05 POST17

EducationPhoto By linda homewoodGlobal Gators meetin Belgium for newdevelopments inclinical pharmacyThe College of Pharmacy held its fifthsymposium for new developments in clinicalpharmacy June 4 in Leuven, Belgium. Morethan 50 pharmacy educators and researcherswho call themselves Global Gators attendedthe collaborative meeting hosted by UF andKatholieke Universiteit Leuven. Thesymposium, organized by HartmutDerendorf, Ph.D., a UF professor andchairman of the pharmaceutics department,is held biennially at a European university.Pharmacy researchers from Belgium,Germany, Austria, Poland, Iceland and theUnited States presented clinical pharmacyresearch findings related to drug delivery,drug quality and safety, and pharmacyeducation topics.At the close of the daylong meeting,attendees were transported to a reception atthe Leuven Town Hall, where Mayor LouisTobback welcomed the educators and visitorsto his city. Symposium organizers Guy Vanden Mooter, Ph.D., from the University ofLeuven, and Derendorf presented to themayor a gold gator pin declaring him anhonorary Global Gator. PWilliam Millard, Ph.D., (left) executiveassociate dean of the College ofPharmacy and Hartmut Derendorf,Ph.D., UF pharmaceutics departmentchairman, along with Guy Van denMooter, Ph.D., of the University ofLeuven, present a gator pin to LeuvenMayor Louis Tobback (right).Florida VeterinaryMedicine AssociationScholarshipsDr. Deke Beusse, (left),with Shale Kenney, CathyEngel and Dr. StephenShores, FVMA president.Kenny and Engel receivedFlorida VeterinaryMedicine Associationscholarships this year inhonor of Beusse, a retireddirector of UF’s MarineMammal MedicineProgram and a longtimemember of FVMA.UF veterinary college names 2005 Distinguished Award winnersBy Sarah CareyLarge and small animal medicine were equally represented in the 2005 UF College of Veterinary MedicineAlumni Council Distinguished Awards program with the selection of a dairy reproduction specialist and asmall animal internist and hospital administrator for two key awards.The program spotlights distinguished alumni, faculty andfriends of the college. This year, two awards were given:one for alumni achievement and one for distinguishedservice to the veterinary profession.Carlos Risco, D.V.M., a member of the college’sclass of 1980 — its first graduating class — receivedthe Alumni Achievement Award. Risco, a professor in thecollege’s department of large animal clinical sciences, is aninternationally recognized lecturer on dairy cattle. A boardcertifiedtheriogenologist, Risco has twice been selectedLarge Animal Clinician of the Year by UF veterinarystudents. He also received the Daniels PharmaceuticalsYoung Clinical Investigator Award in 1996.For many years, Risco has been actively involved in thecollege’s alumni council, serving as a liaison betweenmembers of the class of 1980 and college faculty andadministrators. Prior to coming to UF, Risco spent 10 yearsin private practice at a premier dairy practice in California.Photo By Sarah CareyDr. Michael Schaer (left) and Dr.Carlos Risco.Michael Schaer, D.V.M., a professor of small animal medicine at the college and associate chairof the department of small animal clinical sciences, received the Distinguished Service Award. Schaer, whoalso serves as associate chief of staff of UF’s Small Animal Hospital, oversees the day-to-day workings ofan organization that provides veterinary services to more than 10,000 companion animals a year. Prior tocoming to work for UF in 1978, Schaer worked at the prestigious Animal Medical Center in New York City.Schaer, who is double-boarded in veterinary internal medicine and in emergency and critical care, hasreceived multiple Teacher of the Year and Clinician of the Year awards from UF veterinary students and was a1994 recipient of the university’s Superior Accomplishments Award. He also received UF’s Blue Key Award forDistinguished Teaching in 2001.The awards were presented May 28 at the college’s commencement. PPhoto By Sarah Carey18POST 07/08•05

DistinctionsHSC Service Pin AwardsOn June 2, HSC employees were recognized for their long-term commitment and dedication to the University of Florida with mementos of the university. The five-, 10- and15-year recipients received a service pin, as did the 20- and 25-year recipients, who were also given a Gator hat and a paperweight. The 30-year recipients received the samegifts as the 20- and 25-years recipients plus a $100 check, and the 35-year employees received the same mementos and a $150 check.Dentistry15 YearsRonda AndersonCynthia BachusOpal FullmoreJennifer GollwitzerLinda KubitzPatricia Matthews20 YearsBeverly MaysLee MintzCarolyn PeragineMitchell Salisbury25 YearsJacqueline HopkinsGloria PagingtonJerilynn StillwellKen Tomlinson30 YearsJoan RidgellMedicine15 YearsJudith AllenPatrick AnthonyCynthia BatieMary BlundellAlice BoyetteElizabeth BruceVince ChiodoLinda CurryDonna DavisDorothy DavisBarbara DebarrMargaret DermottBridget DesueJana DewLaura DickinsonMargaret DukesMary EckertPamela FeasterNigel FlinchumCandace FossumNancy HargroveLaurie HartnettShirley HatchMary HoffmanJessie HoffnerMary HoytErin JacksonDonna JohnsonSonga JonesKendra KuckInez LucasLesley MyersMary NewmanGlennice PetersDavid PittmanGlenda RaileyRhoda ReedLori RobinsonVicki SabatellaHazel ShawRonald SmithRobbie StringfellowSherri SwilleyWendy WaltersRebecca WichmanNaomi WilliamsCharlotte Wood20 YearsJudith AdamsSandra ClarkRonald DearingerKirsten FairclothShirley FilerLinda GallowayJudith HarrellShirlene HarveyMary HeflinLettie HermanCynthia KarleSalli KimberlyMargo KramerPatricia McKeySharon Milton-SimmonsDeana NanceWinston PoultonShirley RushingImogene SeegerPatricia SiterBeverly WatsonBarbara West25 YearsFaye BrownDonna Desmund-KuhnVicki DurranceFred GrantDeborah HodgeValerie HolmesGeorgia JohnsonMary OpelLynn Raynor30 YearsRuth KlockowskiJerilyn StonerDeborah Wetherington35 YearsKathryn SmithNursing5 YearsKenneth Foote15 YearsCornelia Frazier35 YearsDorothy JosephPharmacy5 YearsSusan Griffith10 YearsLaura FauxDeborah KempJanet True15 YearsSamuel AlgeeYun-Ju He20 YearsGladys KallmanTim Vinson30 YearsTerry WhisenantPublic Health andHealth Professions5 YearsChiara Carmolli-AndersonKevin HansonVera HemphillMary PorumbescuHoliday RogersRobin ShenkWendy Thornton10 YearsSarah HaydenTonia Lambert15 YearsDiane Johns20 YearsJessie Runge30 YearsVikki CarterVeterinary Medicine15 YearsJudy ChastainSharon HewettElise LeeDanielle MauragisMary RingBrenda Sigmon20 YearsJay GilbreathSandra KingBrett RiceAnthony RossAna Zometa25 YearsDebra CouchFrances EdwardsKathleen McCartinVirginia Simmons30 YearsAnnie HahnAnimal Care Services15 YearsAngie BoykinJoanne GordonLeonard McDonaldPhoto By BMSDorothy Joseph, a senior accountant with the College ofNursing, Ulysses Ellis Jr. with the Physical Plant Division andKathryn Smith in the College of Medicine were recognizedfor 35 years of service.20 YearsAlex TrappPhysical PlantDivision5 YearsKenneth BerryAyesha BrittDonald BlairSteven CraigTamiru GebremariamJames GibsonGary Morrison10 YearsRodney RuckerDonald Wood15 YearsLeslie BeckerDavid CrabtreeIra CruceLeo GenglerIke Smith IIILuis VazquezAllen Wade20 YearsJeffrey FletcherClifford PeglerJimmy Singletary Jr.25 YearsGerald HoytEarnestine MurphyWilliam RichardsonMary SmithDorothy Strong30 YearsSarah BradleyBennie CrawfordAdell DavisWilliam PrivettMae RichardsonJoann RylesLewis R. ScottJames Taylor35 YearsUlysses Ellis Jr.Senior Vice President,Health Affairs15 YearsDonald DavidWilliam PeelDorothy Smith20 YearsDaniel ArringtonGeorge BarnettAnn CaseCassandra JacksonRobert LockwoodLisa VannockerKatharyn Ward25 YearsLisa BooherWilliam SilkGriffen Sundeen30 YearsMae O’NealFor a complete list of winners and additional photos, visit www.news.health.ufl.edu.07/08•05 POST19

Distinctions2005 Research Day Award Ceremonies2005 Research Day Award CeremoniesCollege of MedicineCollege of Medicine Research Day’s 30th annual Medical Guild-sponsored graduate student researchcompetition was held April 27. Six students received a cash award from the UF Medical Guild based onthe judges’ final rankings: one Gold Medal finalist ($1,000), two Silver Medal finalists ($400), and threeBronze Medal finalists ($300).From left, Sean Kearns, Ann Griswold, Christina Norris, Padraic Levings, StephanieAmici, Antonio Amelio.Gold Medal FinalistAntonio Amelio, GeneticsIdentification of a Chromatin Insulator Locatedwithin the Herpes Simplex Virus Type-1 (HSV-1)LAT RegionSilver Medal Finalists:Stephanie Amici, NeurosciencePeripheral Myelin Protein 22 is a Novel BindingPartner for the a6b4 Integrin Complex in SchwannCellsChristina Norris, Physiology &PharmacologyImpact of Tumor Vascularity on Response toRadiation TreatmentBronze Medal Finalists:Padraic Levings, Biochemistry & MolecularBiologyIn Vitro Analysis of the Establishment andMaintenance of b-globin Locus ChromatinStructureAnn Griswold, Immunology & MicrobiologyIdentification of a Novel Mechanism forAmmonia Production in Streptococcus mutans:Implications for VirulenceSean Kearns, Molecular Cell BiologyA More Complete In Vitro Parkinson’s Model:Slice Culture Bioassay for Modeling Maintenanceand Repair of the Nigrostral CircuitThree faculty awards were given:Basic Science AwardNasser Chegini, Ph.D.Department of OB/GYNClinical Science AwardWestley H. Reeves, M.D.Department of MedicineLifetime Achievement AwardRichard T. Smith, M.D.Department of PathologyCollege of Public Health andHealth Professions18th Annual Research FairSixteen winning research posters were chosenfrom 50 entries. The winners each received $500to use toward travel expenses to a scientific orprofessional conference. They include:Behavioral Science CategoryAdam HirshSex differences and construct redundancy of thecoping strategies questionnaire – catastrophizingsubscaleLindsey KirschExamining apathy and depression in Parkinson’sDiseaseMohan KrishnanRelationships between medication levels anddepressive symptoms in the active pilot studyMichael J. LarsonCognitive control dysfunction in severe TBI: anERP investigationVanessa A. MilsomWeight loss improves functional mobility in olderobese womenMary E. MurawskiTreatment of obesity in underserved rural settings(TOURS): effects on quality of lifeEva R. SerberDepression and quality of life amonghypertrophic obstructive cardiomyopathy patientsUtaka SpringerStartle modulation via processing of emotionalsematic knowledge conveyed by facesDavid A. Stigge-KaufmanBehavioral and neural correlates of workingmemory interference due to anxiety and affectiveprocessingHealth Services CategoryKezia AwadziAdherence to breast cancer screening guidelinesamong women in the rural SouthPraveen SaxenaForecasting the demand for emergencydepartment services: a comparison of threeforecasting modelsRehabilitation Science CategoryChitralakshmi K. BalasubramanianFast walking speeds: implications for improvingfunctional mobility after strokeNeeti C. PathareIn vivo bioenergetics of the mouse hindlimbmuscles following immobilizationAmy D. RodriguezIntensive semantic treatment of anomia in fluentaphasia: preliminary dataPrithvi K. ShahLoading-induced changes in te soleus musclefollowing incomplete spinal cord injury usingmagnetic resonance imagingMichelle WoodburyCan “normal” post-stroke upper extremity reachbe trained?Faculty Leadership AwardChristy Harris Lemak, Ph.D.Associate professor, department of health servicesresearch, management and policyCollege of NursingResearch DayTop Honors, Graduate ResearchDoctoral student Amanda Floetke, M.S.N.,A.R.N.P.Age Differences in Self-Reported Pain AmongOlder AdultsTop Honors, Undergraduate ResearchB.S.N. senior Kamila PilcickaAn Analysis of the Effects of Arginine on WoundHealingCollege of DentistryThird Annual UFCD Research DayD.M.D. DivisionD.M. Yates, Z.T. Wen and R.A. Burne,Microbial Cell-Cell Interaction and VirulenceRegulation by Streptococcus mutansDepartment of Oral BiologyM.S./Resident DivisionB. Jafarnia, K.J. Söderholm and M.Guelmann, Light Penetration and BondStrength of Magicfil to Primary MolarsDepartment of Pediatric DentistryPh.D./Postdoc DivisionC.M. Campbell, R.R. Edwards, B.A. Hastieand R.B. Fillingim,Age and Sex Differences in Pain Perception: TheRole of Gender Role Stereotypes20POST 07/08•05

DistinctionsDepartment of Operative Dentistry, Division ofPublic Health Services and ResearchCollege of Pharmacy18th Annual Research Showcase & AwardsRecognition DayOral Competition – $600 awardSenior DivisionKe RenMechanisms Underlying 7 Nicotinic ReceptorMediated CytoprotectionPharmaceuticsSenior DivisionAleksandar TodorovicDiscovery of Potent mMC1R Agonists withProlonged Activity at Human MelanocytesMedicinal ChemistryJunior Division – $600 cash awardJames SaccoSulfonation of Environmental Chemicals and theirMetabolites in the Polar Bear (Ursus Maritimus)Medicinal ChemistryLevitt DivisionTobias GerhardPotential Benefit of Nesiritide after Adult OpenHeart SurgeryPharmacy Health Care AdministrationPoster CompetitionGraduate Student – $300 awardNathalie ToussaintDevelopment of Brain Tumor OrganotypicCultures for Characterizing DNA Polymer/PlasmidMediated Gene TransferPharmaceuticsPreeti YadavaPharmaceutics of siRNA DeliveryPharmaceuticsPharmacy Student – $300 awardAngela HatterEvaluation of Novel Anti-inflammatory Activity ofSigma Receptor Ligands in Brain Immune CellsPharmacodynamicsStormy UyA Retrospective Study of Drotrecogin Alfa(activated) for the Treatment of Severe SepsisSt. Petersburg CampusPostdoctoral Fellow Division$300 awardDr. Li-Quan WangSulfotransferase 2A1 Forms Estradiol-17-sulfateand Celecoxib Switches the Dominant Productfrom Estradiol-3-sulfate to Estradiol-17-sulfateMedicinal ChemistryBest Overall Graduate Student PosterColeen Martinez, B.S.Low-intensity exercise therapy for women withperipheral arterial disease: is it beneficial, andcan it be performed in community-based clinicsand fitness centers?Department of Health Education and BehaviorBest Poster on Reproductive HealthTheresa Medrano, M.S.Activation of th1 pro-inflammatory cytokineexpression by aryl hydrocarbon receptor (ahr)ligands in human uterine endometrial cellsDepartment of Pharmacology and TherapeuticsBest Poster on Cardiovascular HealthRhonda Cooper-DeHoff, Pharm D.Blood pressure control and cardiovascularoutcomes in Hispanic women with coronaryartery disease hypertension: findings from theInternational Verapamil-trandolapril StudyCollege of MedicineDivision of Cardiovascular MedicineBest Poster on Health Behavior ResearchBarbara Hastie, Ph.D.Gender differences for Latinos in cancerscreenings and preventive careCollege of DentistryPublic Health Service & ResearchBest Poster on Cancer ResearchAmal Khoury, Ph.D.Predictors of breast cancer screening in AfricanAmerican and white womenDepartment of Health Services Research,Management and PolicyBest Poster on NeuromusculoskeletalResearchBarbara Hastie, Ph.D.Reliability and sex differences of experimentalpain responses across multiple sessionsCollege of DentistryPublic Health Service & ResearchCollege of VeterinaryMedicine Research Day AwardsPresentation, poster and publication Phi Zetawinners.Best Platform Presentation by aVeterinary StudentKevin D. ColemanRegulation of the transporter SNAT1 by hypoxia:A possible mechanism for neuroprotection duringcerebral hypoxia-ischemia.Best Platform Presentation by aGraduate StudentLara R. DeRuisseauRecombinant adeno-asociated virus containingacid-alpha glucosidase as a possible treatementfor respiratory and central nervous systempathologyin a mouse model of glycogen storage diseasetype II.Best Platform Presentation by a ResidentLeanne N. TwomeyThe effect of intense exercise and excitement onneutrophil phagocytosis and oxidative burst inracing greyhounds.Best Poster Presentation by a VeterinaryStudentAmy Cuda TanisThe role of the periaqueductal gray inmediating hemorrhagic sympathoinhibition inunanesthetized rats.Best Poster Presentation by a GraduateStudentYang-Ling ChouRespiratory load perception with elevatedbackground airway resistance: RREP with resistivebackground in healthy adults.Best Poster Presentation by a Resident/InternSandra TouEchocardiographic estimation of systemicsystolic blood pressure in dogs with mild mitralregurgitation.Best Clinical Research Publication of2005 AwardJames WellehanHis research paper on varanid herpesvirus 1in green tree monitors was selected as bestacademic paper by a postgraduate veterinarianin training from the College of VeterinaryMedicine.Third Annual Women’sHealth Research Day PosterPresentationBest Overall Faculty PosterRita Torto, Ph.D.Central leptin insufficiency produced byovariectomy stimulates hyperphagia and adiposityPhysiology and Functional GenomicsWinners of the 3rd annual Women’s Health Research Day Awards from left: Amal Khoury, Ph.D.,M.P.H.; Barbara Hastie, Ph.D.; Rhonda Cooper-DeHoff, Pharm.D.; Rita Torto, Ph.D.;Kathleen Shiverick, Ph.D., standing in for Theresa Medrano, M.S.; and Colleen Martinez, B.S.07/08•05 POST21

DistinctionsDentistryIkramuddin Aukhil,B.D.S., M.S., has beenappointed chair of the departmentof periodontology. Aukhilcomes to UF from the Universityof North Carolina at ChapelHill School of Dentistry, wherehe served as professor of periodontologyand director ofUNC’s predoctoral program inperiodontology. The college’s search committeeselected Aukhil based on his clinical and administrativeability and the opportunity to create newcollaborations between clinician-scientists and thecollege’s internationally respected molecular andcell biologists. Aukhil assumes the chair fromHerbert Towle, D.D.S., who has stepped down toserve as director of the periodontics residency program.Arthur E. “Buddy”Clark, D.M.D., Ph.D., M.E.,has been appointed chair ofthe department of prosthodontics,assuming the position fromArthur Nimmo, D.D.S., whostepped down as chair for personalreasons. Clark, who hasserved as associate chair of thedepartment since 2001 andpreviously served as chair between 1991 to 1996,is a former executive associate dean of the college.Nimmo will remain on the college’s faculty,concentrating his efforts on D.M.D. curriculuminstruction and prosthodontic research.Thomas C. Porter, D.M.D.,clinical associate professor ofcommunity-based programsand director of the college’s St.Petersburg Clinic, has beenrecognized as a diplomat of theAmerican Board of SpecialCare Dentistry with proficiencyin the areas of hospital dentistry,dentistry for persons withdisabilities and geriatric dentistry.Daniela Rodriques P.Silva, D.D.S., M.S., anassistant professor of pediatricdentistry, has been appointedinterim director of the pediatricdentistry residency program.Silva, originally from Brazil,earned her dental degree fromthe University of São Pauloand her master’s in pediatricdentistry from the University of Michigan. Shebecame board-certified in pediatric dentistry in2003. She joined UF in 2004.MedicineAllison Arthur, Kristy Breuhl,Matthew Butler, Karen Crevier,Matthew Cunningham, Eric Edwards,Cyrus Monroe, Alan Tesson andBaligh Yehia, all third-year medical students,were selected for membership in UF’s chapter ofAlpha Omega Alpha in April. The studentsdistinguished by the AOA, a national medical honorsociety, were eligible for election based uponacademic achievement, service to the university andcommunity, and personal character.Allison Brindle, M.D., aco-chief resident of pediatrics,was named the Florida medicalresident of the year May 20 atthe Florida Medical BusinessGolden Stethoscope Awards.Brindle came to the universityin 2001 to complete herresidency training. While hereshe has implemented a mortalityand morbidity conference for pediatrics, developedcurriculum for the advocacy and communitypediatrics rotation, and improved an onlineteaching conference so users could access it fromremote locations. Brindle has also worked with hercolleagues to promote healthier choices in schoolvending machines.Firas Kobeissyand FangliangZhang were eachhonored with anAlec Courtelis Awardat the InternationalStudent AcademicAwards April 21.The Alec Courtelis Award is presented to justthree international students from the entire universityeach year to honor their academic accomplishmentsand community service.Kobeissy (L) and Zhang are doctoral candidates inthe interdisciplinary program in biomedical sciences.Kobeissy is completing his dissertation researchin the departments of neuroscience and psychiatry.Outside of research, he organized Gainesville’sfirst Palestinian Film Festival.Zhang is completing his dissertation research inthe biochemistry and molecular biology department.He has volunteered for the Friendship Associationof Chinese Students and Scholars and for the PrideCommunity Center of North Central Florida.Eloise M. Harman, M.D.,a professor in the division ofpulmonary and critical caremedicine, was honored May 20with an Outstanding ClinicianAward at the American ThoracicSociety’s 100th AnniversaryConference in San Diego.It’s the second year in arow Harman has received theaward.A native of Brooklyn, N.Y., Harman graduatedfrom the Johns Hopkins School of Medicine in1970. She stayed at Johns Hopkins to complete herresidency and then moved on to Cornell Universityafter obtaining a fellowship there. She came to UFin 1976.Harman said she is “committed to providingexcellent and compassionate patient care” andspreading her passion for clinical medicine tomedical students, residents and fellows.Neuroscientist receives Research Foundation professorshipRoger Reep, Ph.D., a neuroscientist at the College ofVeterinary Medicine and a researcher with UF’s McKnight BrainInstitute, has received a UF Research Foundation professorship.Sponsored by the university’s Division of Sponsored Research,the professorships are awarded to tenured faculty memberscampuswide for distinguished research and scholarship. Thehonor includes a $5,000 salary increase each year for threeyears and a one-time $3,000 award for research support.Reep, a professor in the college’s department of physiologicalsciences, studies spatial neglect, a syndrome that robs strokevictims of the awareness of half their world. During 20 years ofresearch, Reep and his colleagues developed and used a modelin rats that allows for the study of spatial neglect syndrome.Reep also studies evolution of the brain and recently hasfocused on the manatee brain, in hopes of developing insightsthat can help in conservation of the protected animals.The UF Research Foundation professorships were createdby the foundation to recognize faculty members who haveestablished a distinguished record of research and scholarshipthat is expected to lead to continuing distinction in their field.Reep has been a member of the UF veterinary facultysince 1984.— Sarah CareyPhoto By Kristen Bartlett22POST 07/08•05

DistinctionsMarvin A. Dewar, M.D., J.D., has beenappointed associate dean of continuing medicaleducation. He replaced the interim associatedean, Floyd Pennington, June 1.Dewar has been a faculty member in thedepartment of community health and familymedicine since 1988. He remains an associateprofessor in this department and also serves asvice president for affiliations and medical affairsfor Shands HealthCare.Dewar has been listed among “The Best Doctorsin America” and “The Best Doctors in Florida” andhas received several teacher-of-the-year awards.He also has served as a medical consultant for theGovernor’s Academic Task Force for the Review ofthe Insurance and Tort Systems. As associate deanof continuing medical education, Dewar said hewould like to further improve continuing medicaleducation at the university.nursingLinda Sigsby, MS, RN,CNOR, an assistant professor,recently received the 2005Association of PerioperativeRegistered Nurses Journalwriting award. The annualaward is sponsored by theMedi-Flex company andrecognizes excellence inwriting.Sigsby was honored for her 2004 article“Perioperative Clinical Learning Experiences.”The article described how perioperative clinicalexperiences for nursing students meet academicaccreditation standards set by the Commission onCollegiate Nursing Education and the NationalLeague for Nursing.Know a personof distinction?Please send your informationto dtrunk@ufl.eduPublic Health & Health ProfessionsSarah Cook, a graduatestudent in the department ofclinical and health psychology,received a $10,000scholarship from the AARPScholars Program to supporther research on neurocognitivepredictors of older driverbehavior. She works withAssociate Professor MichaelMarsiske, Ph.D., and the UF National OlderDriver Research and Training Center.Michelle Harwood, agraduate student in thedepartment of clinical andhealth psychology, is one ofthree nationwide winners ofthe 2005 Dissertation Award,presented by the MelissaInstitute for ViolencePrevention and Treatment.Harwood received $2,000 tosupport her pediatrics research.Alice Holmes, Ph.D., aprofessor in the department ofcommunicative disorders, hasreceived specialty certificationfor cochlear implant audiologistsfrom the American Boardof Audiology. Fewer than 25audiologists nationwide havebeen awarded the certification,which verifies broadbasedknowledge of cochlear implants and competencyin several key areas of the implant processincluding counseling, device operation, troubleshootingand rehabilitation.Billy Jeffries, a student inthe Master of Public Health andsociology doctoral programs,was awarded the AmericanPublic Health Association’s2005 Excellence in AbstractSubmission award for studentmembers. He also receivedthe association’s HIV/AIDSSection Student Scholarship.Atkinson receives nationaldiabetes awardMark Atkinson, Ph.D.,a UF diabetes researcher,has been given theJuvenile Diabetes ResearchFoundation’s highest honor,the David Rumbough Award.The annual award,established in 1974 byactress Dina Merrill inhonor of her late son, David,acknowledges outstanding achievement andcommitment to diabetes research and service tothe foundation.Atkinson is the Sebastian Family/AmericanDiabetes Association professor for diabetesresearch at the College of Medicine and directsthe Center for Immunology and Transplantationand the JDRF Gene Therapy Center for thePrevention of Diabetes and Its Complications at UFand the University of Miami.He is an internationally recognized authorityon type 1 diabetes, with particular interests indisease prediction and prevention, the role ofenvironment in initiation of the disease, stemcells and pancreatic regeneration, and the use ofgene therapy as a means to cure the disease andprevent its complications.Atkinson was among the first to show thatadministering insulin to mice genetically destinedto develop diabetes could thwart the errantimmune system’s battle to destroy insulinproducingcells in the pancreas. His publishedfindings helped pave the way for the massiveNational Institutes of Health Diabetes PreventionTrial, which tested the approach in people.He also was one of the earliest investigators ofglutamic acid decarboxylase, or GAD, an enzymegenerated by the insulin-producing islet cells ofthe pancreas. Patients with type 1 diabetes oftendevelop autoantibodies to GAD as the immunesystem turns against the body’s islet cells. Atkinsonthen helped develop a standardized way to use thepresence of these GAD autoantibodies to predictdiabetes.— Melanie Fridl RossEducators from the Medical University of Gdansk, Poland visit the College of NursingJanusz Morys, M.D., Ph.D., dean of the faculty of medicine at the Medical University of Gdansk andAleksandra Gaworska-Krzeminska, dr n. med., head of the department of nursing at the Medical University ofGdansk, recently visited the University of Florida to discuss future educational collaborations with the College ofNursing. During their four-day visit, the faculty toured many areas of campus, notably HSC facilities such as the IonaM. Pettengill Nursing Resource Center and the McKnight Brain Institute, in addition to Shands at UF. The faculty atthe Medical University of Gdansk welcomed Dean Kathleen Ann Long and Eminent Scholar Carol ReedAsh to their campus last fall.During their visit, Gaworska-Krzeminska was inducted as the first international member of the Alpha Theta Chapterof Sigma Theta Tau International, a worldwide nursing honor society.Dr. Janusz Morys, left, Dean Kathleen Ann Long, Dr. Gaworska-Krzeminska and Alpha Theta ChapterPresident and UF faculty Dr. Rose Nealis after the Sigma Theta Tau induction ceremony.07/08•05 POST23

Lookin’ at youRecent graduates of the College of Public Health and Health Professions— bachelor of health science degree students Kelly Haskin (left), AmeenBaker, Claudia Mena and Lynette Guimond — were honored duringgraduation week at UF President Bernie Machen’s annual receptionrecognizing outstanding students. Students were selected for theirsignificant contributions to UF through academic, leadership or servicework.POSTTHE07/08•05Published byUF Health Science CenterOffice of News & CommunicationsSenior Vice President for Health AffairsDouglas J. Barrett, M.D.Director, News & CommunicationsTom FortnerEditorDenise TrunkSenior EditorsMelanie Fridl Ross, John PastorDesigner/PhotographerLisa BaltozerStaff WritersTracy Brown, Sarah Carey, Tom Fortner,April Frawley Birdwell, Linda Homewood,Lindy McCollum-Brounley, Patricia McGhee,John Pastor, Jill Pease, Melanie Fridl Ross,Denise TrunkUF Health ScienceC E N T E RSupport StaffCassandra Jackson, Beth Powers, Kim SmithInternLeah CochranThe POST is the monthly internal newsletter forthe University of Florida Health Science Center,the most comprehensive academic health centerin the Southeast, with campuses in Gainesvilleand Jacksonville and affiliations throughoutFlorida. Articles feature news of interest for andabout HSC faculty, staff and students. Contentmay be reprinted with appropriate credit.Ideas for stories are welcome. The deadlinefor submitting items to be considered for eachmonth’s issue is the 15th of the previous month.Submit to the editor at dtrunk@ufl.edu ordeliver to the Office of News & Communicationsin the Communicore Building, Room C3-025.www.news.health.ufl.eduPhoto By denise trunk Photo By denise trunkWade Douglas, the project superintendent with the constructioncompany Milton J. Wood, prepares a pedestrian walkway aspart of a traffic detour that will reroute vehicles on CenterDrive.Sammie Brooks, a program assistant for the Dean’s Office inthe College of Nursing, takes a pause to smile for the POST.New digitsNews & Communications getsnew phone numbers on August 1.Main number: 273-5810POST editor: 273-5819