By Meredith Fraser
June 2010

An undergraduate student participating in one of the College of Medicine’s research labs has won the John C. Johnson Award from the TriBeta National Biological Honor Society. The award, recognizing the best research presentation by an undergraduate, was presented at the society’s national convention in Colorado last month.

The Florida State University Biological Science Department chose junior Kourtney Graham to represent the university at the convention with her honors thesis project, which she completed alongside graduate student Molly Foote in associate professor Yi Zhou’s College of Medicine biomedical sciences research lab. Graham’s award underscores the mutually beneficial results that are possible with the college’s open, collaborative attitude toward research.

Graham originally impressed Zhou with her work as a student in directed individual study. Following that research undertaking, he offered to have her conduct an honors thesis project in his lab.

“I have seen the outstanding progress she has made in my lab, and I am especially impressed with her knowledge and understanding of our research projects,” Zhou said. “These qualities set her apart from most of her peers.”

According to Zhou, Graham has carried out several projects to investigate the function of the 14-3-3 proteins in the nervous system. With help from Foote, their studies have led to the discovery of “intriguing neurological changes” in genetically altered mice, and their findings should provide important insight into the role of the 14-3-3 proteins in the brain.

The TriBeta is a society for primarily undergraduate students dedicated to understanding and appreciating biological study and research.

CONTACT: Robert Glueckauf
(850) 645-1541
robert.glueckauf@med.fsu.edu

July 2010

TALLAHASSEE, Fla. – With a rapidly expanding population of elders, the number of dementia caregivers in Florida is increasing exponentially. Finding the best way to support them, especially with fewer state resources available, is the focus of ongoing research at the Florida State University College of Medicine.

The researchers are looking for 40 to 45 African-American caregivers to complete their study. As a reward for their participation, caregivers will receive up to $100 — and, judging from the early results, they also will benefit psychologically, physically and spiritually.

The study, which has been under way for more than a year, is being conducted by Robert Glueckauf, professor of medical humanities and social sciences. Awarded a three-year, $743,000 grant from the National Institutes of Health, Glueckauf is heading the African-American Alzheimer’s Caregiver Training and Support (ACTS) project.

The 12-week program provides skills training and support to African-American dementia caregivers with depression, either by phone or face to face. ACTS helps caregivers find creative ways to improve difficult caregiving problems and, at the same time, enhance their own emotional well-being and physical health. The primary purpose of the study is to compare the effects of telephone-based versus face-to-face cognitive-behavioral therapy (CBT), an evidence-based, skills-building and support program. Early participants’ outcomes indicated that both modes of therapy were equally effective and led to substantial reduction in depression and anxiety, as well as improvement in caregivers’ physical health.

“The pilot study results were very promising,” Glueckauf said, “but they are preliminary. It will be important to confirm whether the current trends in the data hold at the mid- and final phases of the study.”

The study to date includes 75 adult African-American caregivers and involves researchers from Florida State University, Tallahassee Memorial HealthCare, Mayo Clinic in Jacksonville and James Madison University in Virginia.

African-American adults who live within 60 to 70 miles of Tallahassee or Jacksonville, including South Georgia, and who care for a loved one with dementia at least six hours a day are eligible to participate. For more information, contacting the ACTS project staff at (850) 645-2745 or (866) 778-2724 (toll-free), or e-mail william.davis@med.fsu.edu.

TALLAHASSEE, Fla. – Nancy Hayes, Ph.D., a neurobiologist whose research has focused on genetic regulation of variability in the brain, has accepted an offer to fill the newly created position of director of clinical foundations (year 1 and 2) at the Florida State University College of Medicine.

Her appointment in the Department of Medical Humanities and Social Sciences will take effect Sept. 1.

Hayes, currently associate professor of neuroscience at the Robert Wood Johnson Medical School in New Jersey, will serve to develop and implement an effective review process for the Florida State College of Medicine curriculum.

“I am very pleased to welcome Dr. Hayes to our College of Medicine. She has superb academic credentials and was one of the early developers of an integrated curriculum in New Jersey in her role as Neuroscience Course Director,” said College of Medicine Dean John Fogarty. “I look forward to her innovative and collaborative approaches to ensuring that our curriculum meets the needs of future medical students.”

She will work with Curtis Stine, M.D., associate chair in the Department of Family Medicine and Rural Health and director of clinical programs (year 3 and 4). They will evaluate courses, clerkships, and the four-year curriculum to ensure that it is integrated, developmental- and competency-based. Working in collaboration with the Year 1 & 2 and Year 3 & 4 curriculum sub-committees they also will make recommendations to the curriculum committee, and to the Office of Medical Education, for the resources needed by faculty to implement the curriculum.

Hayes has served as chair of the first-year course directors committee at Robert Wood Johnson Medical School, where she also is a member of the curriculum task force.

“One of the things that attracts me to the College of Medicine at Florida State is its openness to new ideas and commitment to continual improvement,” Hayes said. “Medicine, contrary to common opinion, is the oldest profession, but its demands are always new."

Hayes, as a decorated neuroscience teacher, will be involved with teaching and mentoring medical students, along with her responsibilities with the curriculum.

In 2009, she received the RWJ Medical School’s Excellence in Teaching Award. Earlier this year, she was selected to receive the 2010 Professor Richard A. Harvey Excellence in Teaching Innovation Award. The honor recognizes the medical school faculty member who has made the most innovative contributions to teaching during the previous year.

Hayes was recognized for having produced significant advances in the medical school’s existing web-based system for the neuroscience course. She added tutorials and self-assessment modules to allow students to evaluate their understanding of the subject.

“Not only is Nancy an excellent and exciting lecturer with incredible mastery of her subject, but she turns students into active learners and critical thinkers,” said Siobhan A. Corbett, M.D., associate professor of surgery and chair of the curriculum committee at RWJ Medical School.

Hayes has shared her curricular innovations in workshops for local colleagues and at the "Gateway to Where?" symposium of the Northeastern Group on Educational Affairs of the Association of American Medical Colleges.

"Medical education needs to evolve to accommodate the explosion of medical knowledge. To be a good physician, you have to be a good scientist,” Hayes said. “That means being able to ask good questions and evaluate the available information. Our job as educators is less about the transfer of information than about developing a culture of inquiry in our classrooms and in our students. I've been enormously impressed by the faculty at Florida State and by their commitment to education."

Hayes took a non-traditional path to her current position and looks forward to applying dual perspectives in research and teaching to her new role at Florida State.

“People are usually surprised when they learn that I went from an undergraduate major in Russian literature to neurobiology, but it makes perfect sense,” Hayes said. “The nervous system is what allows us to communicate with our environment, just as language and storytelling allow us to communicate with one another. It's not surprising that communication skills are one of the cardinal competencies for physicians."

Dr. Charlotte Maguire has another framed certificate to hang on her already crowded walls. On July 25, the Capital Polio Association gave her a “Spirit of ADA” award for a lifetime of advocating for children with disabilities as well as treating them.

“She was there in the trenches during the polio wars in the years of the worst epidemics,” wrote Mark Ravenscraft, association president, in a letter to members also marking the 20-year anniversary of the Americans with Disabilities Act. “She knows what a tremendous victory was won with the Salk and Sabin vaccines – she was part of it and remains part of it today by speaking out on public health issues and using her resources to give back to the community.”

In the 1940s Maguire became one of Florida’s first female pediatricians. She went on to have a distinguished career in private practice, state and federal government and much more. In the late 1990s her generous donations to Florida State University helped to pave the way for the creation of the university’s College of Medicine, which she has continued to support in numerous ways. The medical school’s electronic library and simulation center are named for her.

So is the building at Westminster Oaks retirement center, where she gratefully received her award. She has lived at Westminster Oaks for 18 years.

“If you don’t live here,” she told the audience with a smile, “I feel sorry for you.”

She got up to the stage by using the Maguire Center’s mechanical lift, the kind of device that was much less common in the days before ADA. Ravenscraft, who had polio when he was a child, recalls what those times were like.

“All of us [with disabilities] can remember the days before ADA, when any outing required research, phone calls, and careful planning to find the ‘back entrance,’ or the ‘freight elevator,’ or the least number of steps or obstacles to get where we wanted to go,” he wrote. “And sometimes, more often than not, it simply wasn’t possible.”

The ADA, he said, “was a tremendous leap forward.”

PENSACOLA, Fla. – The Florida State University College of Medicine Obstetrics and Gynecology Residency Program at Sacred Heart Women’s Hospital was recently awarded a $3,000 Community Awards Program grant from the Florida Chapter of the March of Dimes. The goal of the community awards program is to identify and fund community-based programs addressing the health concerns of pregnant women in the state of Florida.

The grant monies will be used to fund a group prenatal care program at the Sacred Heart Women’s Hospital Seton Center for Obstetrics & Gynecology, a community clinic that offers OB/GYN care to uninsured and underinsured women in Northwest Florida.

In this program, each patient will have a traditional obstetrical intake visit, including a physical exam, labs and ultrasound. The patient then will be assigned to a prenatal group that consists of several other women with a due date in the same four-week time period. The groups will meet nine to 10 times throughout their pregnancy for follow-up prenatal visits and to discuss issues such as genetic screening, lactation, and prepared childbirth.

Recent studies have shown that group prenatal care reduces the rates of preterm births, increases the rates of breast feeding, improves patient satisfaction, and significantly reduces waiting times. Patients participating in group prenatal care spend an average of 20 hours of face-to-face time with their physician, as opposed to two hours in a traditional clinic.

For more information or to make an appointment at the Seton Center, please call (850) 416 – 2400.

For more information on OB/GYN services at Sacred Heart Women’s Hospital, please call (850) 416-1600 or visit us online at http://www.sacred-heart.org.

About the Seton Center for Obstetrics & Gynecology

Sacred Heart Women’s Hospital is dedicated to serving the healthcare needs of all women in our community, regardless of their ability to pay. The Seton Center accepts patients by referral from other clinics, physicians or by direct calls from individuals. The Seton Center is staffed by 12 full-time resident physicians working in conjunction with board-certified physicians and faculty members with the Florida State University College of Medicine. In addition to our OB/GYN physicians, our staff includes a genetics counselor and physicians who are specially trained in maternal and fetal medicine.

TALLAHASSEE, Fla. – After a national search, The Florida State University College of Medicine has hired Ricardo J. Gonzalez-Rothi, M.D., as professor and chair of the Department of Clinical Sciences.

Gonzalez-Rothi, whose leadership of the department will officially begin Jan. 1, currently is a professor of medicine and pharmaceutics at the University of Florida College of Medicine and is Chief of Medical Service at the North Florida/South Georgia Veterans Health System.

“I am particularly interested in FSU’s emphasis on innovative ways of preparing a new generation of physicians trained with the needs of the public in mind,” Gonzalez-Rothi said. “We need scientifically well-trained doctors who are prepared to function with safety and confidence in a health system which has become increasingly technically complex.”

Gonzalez-Rothi brings a wealth of teaching, practice, research and leadership experience to the Florida State College of Medicine, where he replaces interim chair Harold Bland, M.D. Bland will continue in his role as professor and pediatrics education director.

For 25 years Gonzalez-Rothi, who was born in Cuba and is a graduate of Cornell University and the New York University School of Medicine, has volunteered as a physician in an evening rural health clinic. He is a charter member of the UF College of Medicine’s Society of Teaching Scholars, recognizing faculty members who have excelled in teaching excellence and educational scholarship.

In 2009, he received the UF Department of Medicine Excellence in Teaching Award for Medical Students, Residents and Fellows. Gonzalez-Rothi is a fellow of the American College of Chest Physicians.

“I am very excited to welcome Dr. Gonzalez-Rothi to the College of Medicine,” said Dean John Fogarty, M.D. “He is an exemplary teacher and scholar who will bring great passion and energy to his role as chair of Clinical Sciences and as a member of the teaching faculty.

“His background and interests are a great mission fit for the college as we prepare the next generation of physicians for practice in rural and underserved communities in Florida.”

Following completion of his medical degree at NYU, Gonzalez-Rothi completed residency training in internal medicine and a fellowship in pulmonary medicine, both at the University of Florida Shands Teaching Hospital.

He said he is eager to devote more time to medical student education and educational leadership.

“I find it greatly appealing to be in an environment where innovation and bold approaches to learning and teaching are embraced in the context of a primary care platform,” Gonzalez-Rothi said.

“While taking students to remote villages in Yucatan, or to area migrant farmworker health fairs, I have come to appreciate the complex unnatural causes that conspire to create health disparities,” he said. “I have ideas of how to integrate these economic and socio-cultural issues with the education of our future physicians.”

FOR IMMEDIATE RELEASE
Aug. 11, 2010

Contacts:
Warren Jones, Tallahassee Memorial HealthCare, (850) 431-5875
Doug Carlson, Florida State University College of Medicine, (850) 645-1255

Tallahassee, Fla. – The Tallahassee Memorial HealthCare Board of Directors and the Florida State University College of Medicine today announced plans to pursue a joint internal medicine residency program for the Big Bend region. The Tallahassee Memorial and Florida State University Internal Medicine Residency Program would be housed at Tallahassee Memorial's main campus and The Florida State College of Medicine would be the institutional sponsor. The program could begin accepting applications for resident physicians as early as fall 2011.

Florida ranks No. 4 in population but No. 44 in the number of graduate medical education slots for residency programs. Recent legislation will soon allow many vacant residency slots to be transferred to new regions and hospitals. While the number of residency training slots remains capped at 100,000 through 1997’s Balanced Budget Act, according to the Association of American Medical Colleges, about 1,000 slots are expected to shift toward states with a shortage of slots compared to overall population. Florida is expected to receive approximately 300 slots. The bill also gives preference to teaching hospitals that focus on primary care and general surgery residencies, emphasize community-based training, and are located in areas with growing populations, criteria that Tallahassee Memorial Hospital satisfies on all counts.

“Tallahassee Memorial Hospital has the opportunity to expand medical training and care on our campus for the benefit of our region’s citizens and graduating medical students. The program will also complement Tallahassee Memorial’s already strong Family Medicine Residency Program, which has served our community so well,” said Mark O’Bryant, president and CEO of Tallahassee Memorial HealthCare.

Since 1973, 301 physicians have completed their training through the Family Medicine Residency Program with more than half selecting to practice in Florida, including 97 in the Tallahassee community. As studies show that roughly 60 percent of doctors practice where they complete their residency, a second program at Tallahassee Memorial would bring many new physicians to our region, aiding the state in facing its longstanding challenge to retain doctors.

“While the FSU College of Medicine is committed to training the kinds of doctors that Florida needs the most, we can do only part of the job,” said College of Medicine Dean John P. Fogarty, M.D. “This year, 60 percent of our graduating seniors left the state to pursue their residency training. It is critical that we develop new programs to train these residents locally to keep them here in Florida.

“It is wonderful to partner with TMH in this endeavor and build on the record of success they have had with the family medicine residency program. Internal medicine is the next logical step to increase the primary care workforce here in Tallahassee.”

Graduates of the program would be equipped with three years of training in the field of internal medicine, a specialty dealing with the prevention, diagnosis, and treatment of adult diseases. These physicians would have the expertise to help solve puzzling diagnostic problems and could use their comprehensive medical knowledge to serve as primary care doctors or specialists in fields such as cardiology or endocrinology.

“The Tallahassee Memorial and Florida State University Internal Medicine Residency Program will attract a greater number of physicians to the Panhandle, improve access to care and eventually pave the way for additional joint residency initiatives in specialties such as general surgery and emergency medicine,” O’Bryant said. “We are elated that the Florida State College of Medicine is united with us in this common goal.”

“As the nation’s newest medical school with graduates, we see the development of additional residency training programs as a natural next step for us,” said Alma Littles, M.D., senior associate dean for medical education and academic affairs at the College of Medicine.

“In addition to the fact that doctors are more likely to practice where they complete residency, residency programs also serve as the only access to care for many patients in the area where they are located.”

 Anxiety disorders afflict women twice as often as men, but estrogen might not be the reason. Testosterone, though, could be.

That is one of the preliminary findings in the lab of Florida State University researcher Mohamed Kabbaj, associate professor in the College of Medicine. He recently was awarded a five-year, $1.8 million grant from the National Institute of Mental Health to investigate the sex differences in anxiety. His research team also is working to identify the role of a gene called zif268.

"It's a very important molecule," Kabbaj said. "So far, zif268 plays a major role in learning, memory and drug addiction. I think our work shows for the first time that it's also implicated in anxiety."

Years from now, the result may be drugs that can reduce anxiety more effectively.

In their lab, Kabbaj and his team exposed male and female rats to situations that provoked anxiety. They knew stress would activate the zif268 gene, so they explored the brains of the rats to see how the gene had expressed itself. Kabbaj called it "a fishing expedition."

The results surprised them. Only one part of the brain showed a difference in gene expression between males and females: the medial prefrontal cortex, the part of the brain that allows humans to experience emotions and the meaning of things.

"We were not expecting to see that," Kabbaj said, "so we wanted to follow up with functional studies to see if this difference between males and females has any significance in terms of anxiety and difference in social interaction."
Males have more zif268 in their prefrontal cortex than females do. Males also are less anxious. So the researchers reduced the expression of zif268 in the prefrontal cortex of the males. Result: The males became as anxious as the females.

"One of the questions you have to ask," Kabbaj said, "is why males have more zif than females. We think it's because of testosterone. Testosterone is keeping that level of zif very high.

"Our recent findings show that the hormone estrogen is not implicated in sex differences in anxiety. However, our preliminary data show the male hormone testosterone may be protecting male rats from developing anxiety. The fact that females do not have a lot of testosterone may put them at risk of developing anxiety disorders."

Kabbaj and his team think testosterone activates receptors in the prefrontal cortex, which in turn activate various molecules, and those molecules lead to the increased expression of zif, which then activates a series of other molecules. Their project also involves determining the exact molecular targets of zif268 that are relevant to sex differences in anxiety. They refer to these as the gene's downstream targets.

"If we could demonstrate the role of zif in anxiety, then we could design drugs that affect either its upstream or downstream targets to hopefully reduce anxiety in women," Kabbaj said. "If we increase zif expression in men who have some level of depression or anxiety, maybe we can help them, too."
 

Paola Dees, M.D., shown here as a medical student in 2006, is among the residents and physicians quoted in a Sarasota Herald-Tribune story detailing how well the College of Medicine’s distributed model produces top-notch doctors.

CONTACT: Leonard LaPointe
(850) 644-6314; lllapointe@fsu.edu
By Jill Elish
September 2010

TALLAHASSEE, Fla. – We’ve all heard the saying about people who can’t walk and chew gum at the same time, but it turns out that walking and talking is difficult enough, especially for people with Parkinson’s disease who are at increased risk for falls with injury.

A new Florida State University study found that older adults with Parkinson’s disease altered their gait — stride length, step velocity and the time they spent stabilizing on two feet — when asked to perform increasingly difficult verbal tasks while walking. But the real surprise was that even older adults without a neurological impairment demonstrated similar difficulties walking and talking.

A disruption in gait could place Parkinson’s patients and the elderly at an increased risk of falls, according to the Florida State researchers.

Francis Eppes Professor of Communication Science and Disorders Leonard L. LaPointe and co-authors Julie A.G. Stierwalt, associate professor in the School of Communication Science and Disorders, and Charles G. Maitland, professor of neurology in the College of Medicine, outlined their findings in "Talking while walking: Cognitive loading and injurious falls in Parkinson’s disease." The study will be published in the October issue of the International Journal of Speech-Language Pathology.

"These results suggest that it might be prudent for health care professionals and caregivers to alter expectations and monitor cognitive-linguistic demands placed on these individuals while they are walking, particularly during increased risk situations such as descending stairs, in low-light conditions or avoiding obstructions," LaPointe said.

In other words, don’t ask an elderly person or someone with Parkinson’s to give directions or provide a thoughtful response to a complicated question while walking.

"One of the most common dual tasks performed is talking while walking," the researchers wrote. "In isolation, neither talking nor walking would be considered difficult to perform, yet when coupled, the relative ease of each task may change."

Twenty-five individuals with Parkinson’s disease — six women and 19 men — participated in the study. The mean age of participants was 67.4 years. Thirteen people who matched in age and education but without a reported history of neurological impairment made up the control group.

The researchers used the GAITRite Portable Walkway System, a 14-foot mat containing 13,824 sensors that measures, interprets and records gait data as participants walk on it. After establishing a baseline, the participants were asked to walk while completing a"low load" task, counting by ones; a "mid load" task, serial subtraction of threes; and a "high load" task, continuation of an alpha numeric sequence, such as D-7, E-8, F-9, etc.

While there were no significant differences between the two groups in stride length and step velocity, members if the control group significantly increased the time they spent stabilizing on two feet from the low load to high load tasks. The researchers theorized that the control group used the "double support time" as a compensatory strategy to gain greater control of gait and balance. The Parkinson’s group did not use this strategy and therefore placed themselves at greater risk for falls, they said.

Among older adults, falls are the leading cause of injury deaths, according to the Center for Disease Prevention and Control. They are also the most common cause of non-fatal-injuries and hospital admissions for trauma.

The Florida State researchers are affiliated with Tallahassee Memorial Healthcare and conducted the research at the Neurolinguistic-Neurocognitive Rehabilitation Research Center (NNRRC) at the Tallahassee Memorial Rehabilitation Center. The NNRRC is a collaboration of the Tallahassee Memorial NeuroScience Center and the Florida State University College of Medicine and the Department of Communication Science and Disorders in the College of Communication and Information.