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BRAINSTORMS Quarterly Publication of the University of Miami Department of Psychiatry and Behavioral Sciences
OUR BIGGEST ISSUE! In This Edition: Center for Cognitive Neuroscience and Aging Launches Dr. Rosie Curiel Cid Garners $3M NIH Grant for Alzheimer’s Disease Research Psychiatry Residents Dominate at APA Annual Meeting Department Members Awarded for Their Exceptional Work
A Message from the Chairman he summer has arrived in full force in South Florida and earlier this month we celebrated the graduation of our psychiatry residents and fellows. A great time was had by all at a lovely venue, the Rusty Pelican. This is always a bittersweet time in which we celebrate this milestone with our graduates and their families as they move on to the next stage in their careers. They are entering a landscape in medicine and psychiatry that has changed quite a bit in the years that have elapsed since they graduated medical school.
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Psychiatry is now the number one or two shortage area among medical practitioners in the United States (family medicine is the other) and current estimates suggest that this shortage of psychiatrists will worsen for several reasons. First, the approximately 28,000 psychiatrists in the United States are aging and the workforce will decline in number; and second, the shortage is not evenly distributed throughout the country. Third, the population is growing and aging, increasing the demand. The fields of psychiatry and medicine have changed in other ways over the last several years. The electronic medical record is now considered the standard of care and with that “innovation” are both potential major upsides such as electronic prescribing and billing, but also downsides such as added time to document encounters that can eat away at quality time with patients.
On the very positive side of the past several months is the very generous allocation by the US Congress of funding for the National Institutes of Health (NIH), including the National Institute of Mental Health (NIMH), the National Institute of Drug Abuse (NIDA), the National Institute on Aging (NIA) and the National Institute for Alcohol Abuse and Alcoholism (NIAAA). All of these NIH institutes fund research in areas directly relevant to psychiatry including basic and clinical studies to better understand the causes and treatments for the major psychiatric and substance abuse disorders, as well as Alzheimer’s disease and related neurodegenerative disorders. Our department has witnessed this beneficence in the form of newly awarded grants to a handful of our faculty particularly in the areas of Alzheimer’s disease research, treatment of comorbid depression and alcoholism and post-traumatic stress disorder. We are excited to welcome Raul Poulsen, M.D. who completes his child fellowship and will stay with us to direct our inpatient child psychiatry unit at the Jackson Behavioral Health Hospital. We also have to say goodbye to Sara Czaja, Ph.D., our beloved director of the Center on Aging, who is relocating to the Weill Cornell Medical School in New York City. My best wishes to all of you for a happy and thoroughly enjoyable summer. Sincerely,
At the APA Research Colloquium for Young Investigators with Dr. Diana Clarke, APA Office of Research
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INTRODUCING: the Center for Cognitive Neuroscience and Aging By Richard Westlund he University of Miami Miller School of Medicine has renamed the Center on Aging as the Center for Cognitive Neuroscience and Aging (CNSA), reflecting a growing emphasis on brain research, diagnostic and clinical services, and educational programs. “Our mission is to be a national and international leader in cognitive neuroscience by developing state-of-the art strategies and new paradigms for studying the aging brain and identifying biomarkers of early disease processes,” said newly appointed director David Loewenstein, Ph.D., a professor in the Department of Psychiatry & Behavioral Sciences. “We also want to be a destination center for the evaluation, management, treatment and care for older persons and their families with memory and other brain disorders affecting cognition,” Loewenstein said. “We are committed to training the next generation of leaders in the fields of gerontology, geriatric psychiatry, clinical neuropsychology and cognitive neurosciences.” Charles B. Nemeroff, M.D., Ph.D., is delighted with Dr. Loewenstein’s appointment to his new role. “Dr. Loewenstein has been one of the leaders in Alzheimer’s disease research in the United States for the past two decades. This appointment is a much needed and well-deserved recognition of his expertise in the field.” Along with its expanded program, the center’s faculty bid farewell to Sara Czaja, Ph.D., formerly director of the Center on Aging, who has accepted a position as Professor of Medicine within the Division of Geriatrics and Palliative Medicine and Director of a new Center on Aging and Behavioral Research at Weill Cornell Medicine in New York City. In almost three decades at the COA and Department of Psychiatry at UM, Dr. Czaja became an international leader in aging, technology and interventions for older adults and their care partners, creating outstanding programs at the COA.
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Czaja will be appointed emeritus professor at UM and continue some of her research grants involving the Department of Psychiatry. “It was amazing to have the opportunity to work with my close friend and colleague Sara Czaja, for more than 25 years,” said Loewenstein. “I greatly look forward to our many collaborative endeavors in the future.” Located in the Miller School’s Mental Health Building, the CNSA’s core faculty includes the following specialists: l
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Elizabeth Crocco, M.D., Associate Professor of Clinical Psychiatry, Director of the State of Florida Memory Disorders Center at UM and Chief of the Division of Geriatric Psychiatry Rosie Curiel Cid, Psy.D., Assistant Professor of Psychiatry and Behavioral Sciences Philip D. Harvey, Ph.D., Professor of Psychiatry and Behavioral Sciences, Chief, Division of Psychology Daniel Jimenez, Ph.D., Assistant Professor of Psychiatry and Behavioral Sciences Charles B. Nemeroff, M.D., Ph.D., Leonard M. Miller Professor and Chairman of the Department of Psychiatry and Behavioral Sciences, Clinical Director, Center for Cognitive Neuroscience and Aging Dolores Perdomo, MSW, Ph.D., Assistant Professor of Psychiatry and Behavioral Sciences Samir Sabbag, M.D., Assistant Professor of Clinical Psychiatry, Associate Program Director Psychiatry Residency
The CNSA will play a key role in supporting the Miller School’s Neuroscience Pillar, and foster internal collaborations with the McKnight Brain Institute, Clinical and Translational Science Institute, Department of Neurology, Bascom Palmer Eye Institute, Departments of Radiology and Nuclear Medicine and other UM departments and programs, Loewenstein said. “Our expertise in aging, cognitive neuroscience, brain disorders, and novel assessments and interventions put the Department of Psychiatry in a unique
Drs. Curiel Cid, Loewenstein and Crocco
position to work with our partners at UM and contribute to advances in this dynamic field,” he said. One of the center’s goals is to expand the role of the 1Florida Alzheimer’s Disease Research Center, a statewide consortium funded by the National Institutes of Health (NIH) that includes UM, University of Florida and Mount Sinai Medical Center and other universities in Florida. “We are preparing a joint proposal to expand this initiative,” Loewenstein said. “We need to gather the best minds in our state together to fight this horrible disease.” The CNSA’s faculty members have already made major contributions to the diagnosis of preclinical Alzheimer’s disease, including the development of the Loewenstein-Acevedo Scales of Semantic Interference and Learning [LASSI-L]. Funded by grants from the NIH and the State of Florida, this test has been validated in multiple studies nationally and internationally and is highly related to Alzheimer’s disease brain biomarkers. Now, Curiel Cid is collaborating with the UM Computer Science Department, using funding from another NIH grant to develop cognitive stress tests for early detection of Alzheimer’s disease. “The goal is to develop state-of-the-art models that can be shared with professionals on a secure website,” Loewenstein said. “Convenient access to a new diagnostic instrument will help clinicians deliver interventions to patients and their family members as well as to assess outcomes in new clinical trials.”
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American Psychiatric Association Annual Meeting e were thrilled to have dozens of Department members attend the American Psychiatric Association's annual meeting from May 5-9 in New York City. This year’s theme, ‘Building Well-Being Through Innovation,’ addressed two major issues facing psychiatrists today: physician burnout and the role of technology and innovation in mental health care. We are
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Presenters Dr. Lujain Alhajji Teaching Neurobiology in Psychiatry Dr. Rebecca Arana Treatment Outcomes of Veterans Accepted into a PTSD Clinic With: Drs. Ashley Beattie, Giselle Brito, Daniella David Dr. Yasin Bez A Quality Improvement Project to Overcome Insomnia in Adolescents: A 1-Hour Sleep Training for Adolescent Inpatients on an Acute Psychiatric Unit Characteristics of Early Readmissions to Child and Adolescent Psychiatry Acute Inpatient Unit
Dr. Durim Bozhadraj Finding Calm Before the Storm: A Hurricane Preparedness Model With: Dr. Ashley Beattie Dr. Mousa Botros QTc Prolongation by Psychotropic Drugs and the Risk of Torsade De Pointes With: Krystal Nicht Nicolle Castañeda The Intersection of Mental and Oral Health: A Review of the Issues (Dept of Public Health Sciences) With: Ekom Eyoh, Shelby Graff, Jermaine Walls Dr. Zelde Espinel Dr. Mackenzie Jones
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excited to be on the forefront of these issues, as our Interactive Screening Program (ISP) launched last year has proven a significant help to medical students, serving as a first line of defense for stopping burnout before it starts; and our investigators continue to pursue novel research regarding the integration and efficacy of technology in treatments. Check out the photos below of some of our poster presenters!
Dr. Amalia Martinez Game of Drugs: Teaching Psychopharmacology to Psychiatry Residents With: Drs. Samir Sabbag, Vanessa Padilla, Lujain Alhajji, Mousa Botros Dr. Jared Mendelsohn Delayed Onset of Serotonin Syndrome in a 16-Year-Old Female After Intentional Sertraline Overdose
Drs. Samantha Saltz & Nils Westfall Association of Cyberbullying With Other Forms of Maltreatment, Anxiety, and Depression in Adolescents: Inpatient versus Outpatient Population Zachary Schwartz A Critique of Biological Rhetoric in Psychiatric Education With: Juliet Silberstein
Dr. Rahul Patel A Critique of Biological Rhetoric in Psychiatric Education
Dr. Shariful Syed Leukocyte Telomere Length Interaction with Kynurenine-Metabolic Pathway Following Early Life Stress (ELS) in Adult Nonhuman Primates With: Drs. Kathryn K. Ridout, Audrey R. Tyrka, Hung-Teh Kao, Barbara Porton, Charles B. Nemeroff, Jeremy D. Coplan
Dr. Raul Poulsen Electroconvulsive Therapy (ECT) in Children With Autism: A Systematic Review of the ECT Practice/ Psychiatric Re-Admissions for Inpatient Stabilization, Evaluation of Youth: A Review of the Literature
Dr. Monica Vega Meta-Analysis of Prenatal Antidepressant Exposure as Risk Factor for Autism: Impact of Comparison Group Definition With: Drs. Durim Bozhadraj, Samantha Saltz, Charles Nemeroff, Jeffrey Newport
Dr. Samantha Saltz Yoga, Mindfulness and Breathing Exercises as Coping Mechanisms for Children on an Acutre Inpatient Psychiatry Unit; A Quality Improvement Project
Dr. Nils Westfall Evidence-Based, Collaborative Care Model for Treating Chronic Military-Related PTSD: Three Decades of Experience at the Miami VA PTSD Clinic
Dr. Lisa Oliveri and Dr. Stephen McLeod-Bryant Alcohol Detoxification Complicated by Previous Withdrawal Seizures and Psychogenic Nonepileptic Seizures
Some of the resident team at APA!
Dr. Rebecca Arana
Dr. Lisa Oliveri
Zachary Schwartz, medical student
Dr. Amalia Martinez
Dr. Durim "Buzz" Bozhdaraj
Dr. Raul Poulsen
Dr. Lujain Alhajji
Drs. Mousa Botros, Vanessa Padilla, Liz Crocco, Director of the State of Florida Memory Disorders Center at UM, Chief of the Division of Geriatric Psychiatry, and Dr. Stephen McLeod-Bryant, Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences
Drs. Mousa Botros, Nils Westfall, Radu Saveanu, Professor and Executive Vice Chair for Clinical Services and Education, and Yasin Bez
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Florida Psychiatric Society 2018 Spring Meeting number of our department members participated in the Florida Psychiatric Society's Spring Meeting in Orlando, FL. This year’s theme was ‘After the Shock... Treating Trauma’ and the meeting was devoted to providing the latest understanding of etiology, multi-modal treatments, and resources for trauma-related disorders.
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Dr. Ana Campo, Chief, Medical Student Education and Professor, Clinical Psychiatry, gave The Herman Selinsky, M.D. Memorial Lecture Introduction on Intergenerational Transmission of Trauma, and Dr. Jeffrey Newport, Professor of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology; Director, Women’s Reproductive Mental Health, presented on The Neurobiology of Trauma and PTSD.
Drs. Heather Lee, Mousa Botros & Dante Durand (not pictured) Perphenazine-Induced Sialorrhea Successfully Treated with Sublingual Atropine
Dr. Raul Poulsen Online Residency Training in Tobacco Use Disorders and Psychiatric Re-Admission for Inpatient Stabilization and Evaluation of Youth: A Review of the Literature
Drs. Samantha Saltz & Nils Westfall Small Study Shows Increases In Depression, Anxiety Among Adolescent Psychiatric Patients Who Were Recent Victims Of Cyberbullying
Dr. Robert Leahy Visual Hallucinations in Non-Psychotic Patients
Additionally, the following residents also presented at FPS!
Quality Improvement & Patient Safety Showcase n May, residents, fellows and faculty were invited to participate in the Quality Improvement and Patient Safety Showcase run by General Medical Education Subcommittee on Quality and Safety. They were required to meet certain criteria such as the projects must address patient safety or quality improvement, and residents or fellows must be leads or be major contributors to the project. Dr. Mousa Botros represented Psychiatry, sharing his project Opiate Detox Protocol Order Set on the electronic medical record system CPRS. Dr. Botros’s quality improvement project aimed at facilitating the process of
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providing treatment for patients presenting with opioid withdrawal symptoms. Different therapeutic interventions were reviewed in the literature. The set of orders was developed to tailor the resources, needs and safety of patients at the Miami VHA. It is currently available on the electronic medical record system at the VHA. Surveys and anonymous online feedback forms were used showing almost 80% satisfaction and convenience with the new order set. The quality improvement project was presented in the JMH resident/ fellow poster showcase.
Addressing the Suicide Epidemic | By Dr. Charles Nemeroff But as I said during our recent Facebook Live session, “No one is exempt from this.” No one is exempt from mental illness. It affects people of different socioeconomic status, profession, race, ethnicity, gender and religion. It even affects icons.
n June, we learned of two tragic suicides of well-known figures, fashion designer Kate Spade and chef, travel host and author Anthony Bourdain. In the days since, there have undoubtedly been even more suicides and countless attempts, though they have not been publicized. As a nation, we are in uncharted territory facing the largest suicide epidemic possibly ever.
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Suicide remains the 10th leading cause of death in our country with 45,000 suicides each year—and rising. Recently, the CDC released a report reviewing the drastic increase of suicides in nearly every state between 1999–2016. The results are astounding.
Kate Spade and Anthony Bourdain were iconic in their respective fields.
Suicide is the 10th leading cause of death in the U.S.
Each year, 45,000 Americans die by suicide
We don’t have all of the answers, but we are working tirelessly to find them. We do know it is imperative we work together. We must stay informed and educated so as to look out for our friends, families and peers.
Know the signs of mental health disorders and suicide, ask questions, and encourage someone who may be at risk to seek help. Conversation is key— don’t be afraid to ask someone how they’re feeling. This simple gesture alone could save a life.
On average, there are 123 suicides per day
For every suicide, 25 attempt
Suicide costs the U.S. $69B annually
In Florida: On average, one person dies by suicide every 3 hours Nearly twice as many people die by suicide in Florida annually than by homicide
Suicide cost Florida a total of $2,841,739,000 of combined lifetime medical and work loss cost in 2010, or an average of $1,018,910 per suicide death
Reference: Suicide Statistics. (n.d.). Retrieved June 21, 2018, from https://afsp.org/about-suicide/suicide-statistics/ Florida State Fact Sheet: Florida State Fact Sheet. (2018, June 1). Suicide Facts & Figures.
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Dr. Rosie Curiel Cid Receives Prestigious $3M NIH Grant for Research in Alzheimer’s Disease
r. Rosie Curiel Cid, Assistant Professor of Psychiatry, joined the Miller School faculty in 2011. As a geriatric neuropsychologist, her expertise lies with the assessment of neurodegenerative conditions particularly Alzheimer’s disease and related disorders. With Alzheimer's disease being the sixth leading cause of death in the United States currently affecting 5.7 million people, the number is expected to reach 14 million by 2050. Dr. Curiel Cid has devoted her research to combating this terrible disease, and was recently awarded a prestigious $3 million grant by the NIH/NIA. Read on to learn more about her important work and how she obtained such a coveted award.
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You’ve achieved a major career milestone at a very young age. How does it feel? It is difficult to explain. I feel like I’ve been scaling a mountain and can finally pause to take a breath of fresh air and enjoy the scenery; a true sense of gratification. Then, I feel a deep sense of responsibility and duty to properly carry out worthwhile aims. Mostly, I feel grateful. Gratitude for the opportunity, and the support and guidance I’ve received. Can you tell us about your research interests and your specific project that has been funded? I am very interested in studying new ways to assess cognitive processes such as memory and executive functions that are sensitive to detecting subtle neurodegeneration, and developing user-friendly instruments that can reliably measure these changes. This project focuses on validating new computerized cognitive assessment instruments to detect early cognitive change associated with Alzheimer’s disease and related disorders. To challenge the status quo, we are forming a direct comparison of our measures to the “gold standard” in AD research. Our pilot data suggests that our experimental measures may be sensitive enough to detect subtle deficits specific to preclinical Alzheimer’s disease, and may be highly associated with biological markers of early AD pathology. Another primary aim of the project includes the computerization of these assessments to
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make them user-friendly and remotely deliverable clinical outcome measures with the goal of advancing cognitive assessment efforts in clinical trials targeting preclinical AD. As a bilingual and bicultural clinical researcher, it’s also very important for me to ensure that these instruments are generalizable to the growing Hispanic elderly population in the US and abroad. R01 grants are notoriously difficult to earn. In fact, only 1-2% of faculty in your age group receive this level of award across all health specialties. Had you ever applied for one previously? Knowing the arduous application process, how did you decide this was the project to submit for funding consideration?
I have been very actively involved with writing grants since I joined the faculty in 2011 and have contributed to existing R01s as a co-investigator. In fact, our team has jointly submitted nearly a dozen applications in the last several years to the NIH and other funding agencies, so it’s a process that I’ve grown quite accustomed to. Writing an R01 application is arduous work. It requires a well-formed idea, a solid and complete presentation of why your project is necessary to advance the field, strong preliminary data, excellent methodology, and a well-versed study team. It takes months to put together and culminates in weeks of working around the clock to ensure that every detail that goes into the application is pristine. This particular award was my first R01 submission as PI.
The decision was motivated by several factors including feeling confident that I could lead a project given the experience I had acquired, as well as the recent increase in pay lines in Alzheimer’s disease research. I submitted this particular project twice. Initially, it wasn’t even discussed or scored, but the reviews were favorable so I decided to go back to the drawing board and resubmitted it during the next cycle. The second time around, it scored well within the funding range! This project was years in the making, and a natural extension of the research that Dr. Loewenstein and I had been focused on for years. Taking sensitive cognitive assessment into the digital age was always a goal, and this project’s time had arrived. Our Miller School of Medicine has identified a number of focus areas for strategic research over the next few years. One of those areas is neuroscience, which encompasses Alzheimer’s disease; with said support, it seems like this could be a great opportunity to advance research. What are some of your goals? The neuroscience focus area is critically important, particularly as it relates to advancing the way we detect, monitor,
and treat Alzheimer’s disease as we brace ourselves for the aging boom. This is a serious problem that has become a global priority. Alzheimer’s disease is a devastating illness for the patient and their loved ones, and I don’t believe that we as a society are prepared to successfully and
“Receiving a five-year R01 grant from the NIH is seen in academia like getting drafted into the NFL. I am especially proud to be a member of the Department of Psychiatry who is a University-wide leader in state-of-the-art AD clinical research.” Dr. Rosie Curiel Cid
(clockwise) Drs. Curiel Cid, Crocco and Loewenstein celebrating receiving the R01 grant.
humanely meet the needs of so many older adults that will be affected by this illness if a disease modifying treatment, prevention, or cure is not found. I have every intention to continue to do my part and am confident that our program of research at the Center for Cognitive Neuroscience and Aging will generate relevant knowledge that can contribute to advancing these efforts. I am increasingly confident that the Miller School leadership recognizes the scientific headship of the Department of Psychiatry when it comes to AD research, and consider it an exciting time to grow our cognitive neuroscience program. How did you celebrate when you found out you received the grant?! The celebration has been ongoing since I received my score. At that moment, I went straight into Dr. Crocco’s office where she and Dr. Loewenstein were meeting and began to jump for joy! I couldn’t help myself, and they were overjoyed with me! Several toasts were shared with my husband, family, friends and colleagues, and when we received the formal Notice of Grant Award, I was treated to a fancy lunch on the Miami River.
NIH R01 Grant The NIH defines a Research Project (R01) grant as an award made to support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing the investigator’s specific interest and competencies, based on the mission of the NIH. It is considered the highest funding mechanism offered to individual scientists.
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Department Achievements rom residents to faculty, members of the Department are receiving accolades for their terrific work. Congratulations to everyone recently recognized!
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Awards American Psychiatric Association 2018 Annual Meeting
Dr. Monica Vega won the Area V Resident Award for her work on SSRIs in pregnancy. Co-authors Drs. Graham Newport, Durim Bozhadaraj, Samantha Saltz, Charles Nemeroff and Jeffrey Newport did a meta-analysis of prenatal antidepressant exposure as a risk factor for autism. Dr. Vega accepted the award at APA.
The Resident Recognition Award is presented annually to outstanding psychiatry residents or fellows from each department or institution who exemplifies one or more APA values. Congratulations, Dr. Vega!
Dr. Shariful Syed was named an APA Research Colloquium Awardee for his poster Leukocyte Telomere Length Interaction with Kynurenine-Metabolic Pathway Following Early Life Stress (ELS) in Adult Nonhuman Primates.
The Research Colloquium for Junior Investigators includes a one-day, immersive, research experience for junior investigators in an intermediate-level of their research training in psychiatry. It is an important opportunity for
Dr. Monica Vega
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mentorship, guidance, information on research career development and grantsmanship.
Florida Psychiatric Society Spring Meeting
1st Place Winner: John E. Adams Psychiatry RFM Scholars Poster Competition Research conducted by University of Miami Miller School of Medicine’s, Dr. Nils Westfall and Dr. Samantha Saltz, with the mentorship of Dr. Philip Harvey, won first place in the John E. Adams Award Psychiatry RFM Scholars Poster Competition. Drs. Saltz and Westfall presented research studying the relationship between cyberbullying with other forms of maltreatment, anxiety, and depression in adolescents while comparing inpatient versus outpatient populations. The UM team collaborated with Dr. David Pogge at Four Winds Hospital in New York. FPS Alliance Grant The alliance grant is a travel award meant to honor select applicants to help with expenses to attend the FPS meeting. The grant is made available by the Tom and Donna Buchanan Resident grant. Dr. Samantha Saltz accepted the grant at the FPS Spring Meeting.
The 2018 Chair’s Choice Travel Award recognizes excellence in scholarly activity by junior researchers by providing the opportunity to attend the annual meeting and participate in special programming for the awardees. Congratulations!
UM Awards Dr. Ana Campo Presented with 2018 George Paff Teaching Award On April 23, Dr. Ana Campo, Chief, Medical Student Education and Professor, Clinical Psychiatry, received the 2018 Paff Teaching Award. The award is named after the university’s legendary professor of anatomy George Paff, Ph.D., and recognizes outstanding instructors. Recipients are nominated and winners selected by medical students on the Paff Awards Committee. Congratulations, Dr. Campo!
At the recent SOBP 73rd Annual Scientific Convention, Dr. Shariful Syed received another award for his poster!
Department of Psychiatry and Behavioral Sciences Recognized As Best Clinical Department At the 2018 graduation banquet for the senior medical students, the Department of Psychiatry and Behavioral Sciences received the Mitchell Wolfson Sr. Department of Community Service (DOCS) award for best clinical department! The department was recognized for its service at health fairs and the student-run clinics, the San Juan Bosco and Lotus House!
Dr. Campo receiving her award with firstyear MD/MPH student Khushali Shah
Dr. Campo with Dr. Nikesh Doshi, co-director of DOCS
Society of Biological Psychiatry 73rd Annual Scientific Convention NYC
Lifetime Achievement Award Presented to Dr. Mahendra Kumar he Society of Neuroimmune Pharmacology (SNIP) has granted its Lifetime Achievement Award to Mahendra Kumar, M.Sc., Ph.D., Professor of Psychiatry and Behavioral Sciences at the University of Miami Miller School of Medicine, in recognition of the advances he has made in the understanding of HIV and AIDS. Kumar’s research sheds light on the important role hormones, neurotransmitters and cytokines play in disorders of the immune axis in people with HIV and AIDS. The award involves a different form of peer review. Researchers cannot apply for the award, and colleagues cannot nominate a co-worker for the recognition. Instead, SNIP employs a committee of internationally known scientists to choose a colleague whose lifetime contribution significantly advanced neuroimmunology. The “Outstanding Lifetime Contribution to the Advancement of the Mission of the Society (Research on HIV)” award is a great honor, Kumar said, because “it is recognition of my research work by my peers. The Society chose me because they
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recognized that my work explains to some extent the basis of neuroendocrine abnormalities that occur in HIV infection.” Kumar and team have made numerous discoveries. “We were first to show that HIV infection leads to significant disturbances in response to stressors of various types,” he said. His team was also among the first researchers to demonstrate difference in brain function according to different subtypes of HIV. These neurologic effects differed by strain and geography— between HIV clade C in India and clade B in the United States and other western countries, for example. The research has attracted outstanding extramural funding from the National Institutes of Health over the years. SNIP is an association of researchers that aims to promote advances and serve as a reliable source of information on the pharmacology, immunology and neuroscience of the neuroimmune axis. The society encourages the exchange of related information and ideas among
From left: SNIP President Johnny He, Ph.D., Mahendra Kumar, Ph.D., and ISNV President Igor Koralnik, M.D.
researchers at its annual conference. Kumar received his award at the society’s conference in April, held in conjunction with the International Society of NeuroVirology. “I felt great receiving the award,” said Kumar, who is also chief of the Psychoneuroendocrinology/ Psychoneurotransmitters Lab at the Miller School, “and I am thankful to my co-workers and the Miller School of Medicine for giving me the opportunity to establish my lab here in 1986.” This article originally appeared in InventUM.
Teen Launches Campaign at Miami Country Day to Raise Funds for Child & Adolescent Psychiatry Unit igh school is hard enough, but add mental illness to the mix and for some it can become unbearable. Oftentimes, health curriculum does not address mental health, and students are left uninformed or scared – about broaching the subject. Until someone personally experiences an issue or witnesses a friend or family member struggling, exposure to mental illness can be very limited. One teen is fighting to change that. We recently met Paul Clifford, a sophomore at Miami Country Day School, who came to us with an idea to help raise funds for our CAAP unit through a campaign at his school. He shares what motivated him to undertake this incredible project.
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There is a certain stigma in our society regarding individuals, especially adolescents, with mental health issues. This stigma affects peoples’ perception of an individual in a negative manner as soon as they hear the words “mentally ill.” This lingering stigma that some still believe mental disorders are uncommon and self-treatable is simply another item on the long list of obscure tragedies in life. I admit, initially I had a vague understanding of mental illness. While I felt sorry for people suffering, I was mostly in the dark about the topic. Then came the day when my close friend was hospitalized for mental health issues. The news hit me like a bus barreling down the freeway, and it hurt. Her hospitalization
not only affected myself but many of her relatives and friends. It was then that I realized the stigma surrounding the subject of mental illness in teens needs to end. It needs to end because every day, many best friends, sons, daughters, students, athletes, and siblings are lost to issues associated with mental disorders. Of the 15 million young people who suffer from mental illness, 70% do not receive help. We must help these people find a voice so they find help for their struggles. These are a few of the reasons why I decided to start a project to raise funds and awareness about mental health in adolescents. For more about Paul's campaign, please email psychiatry@med.miami.edu
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Faculty Feature | Dr. David Loewenstein | Director, Center for Cognitive Neuroscience & Aging and Professor, Psychiatry & Behavioral Sciences ou have a long history with UM. Tell us about your ties to the university. I have considerable ties and affection for the University. I was born at Jackson Memorial Hospital, my parents worked and taught at UM. As a kid I went to some of the UM football games and this is my 32nd year as a faculty member.
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There are some exciting changes taking place in the department; recently, the Center on Aging was renamed the Center on Cognitive Neuroscience and Aging (CNSA), and you were named director. How will your role change? The UMMSM has designated neuroscience as one of Four Pillars that is part of the strategic plan. My goal as the Director of the CNSA is to leverage cognitive neuroscience, brain disorders such as Alzheimer’s disease (AD) and novel assessments and interventions for older adults. This ultimately puts our Department of Psychiatry in a unique position to be an integral part of our Neuroscience Pillar and the University of Miami’s strategic plan. What are some of the goals for the CNSA? l To be national and international leaders in cognitive neuroscience by developing state-of-the art novel paradigms for studying the aging brain and biomarkers of early disease processes l
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Provide state-of-the-art treatments for older adults and their families to improve interventions and outcomes
Lead the University of Miami to be part of a prestigious Alzheimer’s Disease Research Center and make UM a major destination for older adults at risk for Alzheimer’s disease and Related Disorders
Continue to develop and maintain essential collaborations with other UM Departments and Centers as well as to maintain and expand our international collaborations.
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You developed something called the Loewenstein-Acevedo Scales for Semantic Interference and Learning, or LASSI-L; a cognitive stress test to address the concern that current neuropsychological measures may not capture the earliest stages of AD. How will this new scale affect the intervention and/or treatment of the disease? Drs. Rosie Curiel Cid, Elizabeth Crocco and myself strongly believe that the earliest manifestations of AD occur many years before clinical symptoms. LASSI-L is a cognitive stress test, akin to an exercise electrocardiogram. It is highly related to biological AD changes in the brain before the emergence of clinical symptoms such as amyloid load, fMRI functional connectivity and loss of volume and cortical thickness in the brain. Early detection leads to a better understanding of the pathogenesis of AD, preventive and earlier interventions and helps better screen participants who may benefit from these newer interventions. The LASSI-L has
“Early detection leads to a better understanding of the pathogenesis of AD, preventive and earlier interventions and helps better screen participants who may benefit from these newer interventions. The LASSI-L has been showing tremendous promise in national and international investigations and is a very sensitive clinical tool.”
Dr. David Loewenstein
been showing tremendous promise in national and international investigations and is a very sensitive clinical tool. What do you most enjoy about your job and/or working in psychiatry? I absolutely love devoting my career to studying the brain, by far the most complex organ in the body and key to unraveling many mysteries that will ameliorate disease and enhance quality of life. My colleagues in psychiatry at the CNSA are so talented and working with them is such an honor and pleasure. How do you like to spend your free time? I have a wife and two lovely children and spending time with them is a joy. I love reading, bible study in and out of church, running and collecting coins (which I have done since I was a small boy.) I also love creative writing and sports. Words to live by? I frequently tell my patients that truly important relationships are characterized by sacrificial love, respect and communication. I try to improve in these areas every day and recognize success without humility and gratitude often hollow.
Staff Stars | Gabriela Vargas | Project Manager, Research Support he Staff Stars column highlights the commitment and accomplishments of an individual in the Department of Psychiatry and Behavioral Sciences. Nominations may be submitted to Samantha Richter at psychiatry@miami.edu. Please include a brief description of the nominee’s job responsibilities and why you believe they should be the next Star!
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Are you from Miami? How long have you been at the U? Originally, I am from Lima, Peru. I came to South Florida at a young age and spent most of my childhood and adolescence in Broward County, FL. I experienced a bit of a learning curve when I moved down to Miami after graduating from Duke University in quaint North Carolina. I started my first job at the U in the Department of Nephrology in 2009 so I have been a Miami Hurricane for almost nine years now. When I interviewed here, I was drawn to the amazing diversity and talent that the University brings from across the nation. I felt more at home than anywhere else I had interviewed. Nine years later, I feel the same way. I am so humbled and appreciative of working with wonderful and brilliant faculty members, administrators, and team members here in the Department of Psychiatry. Tell us about your role in the department. What do you most enjoy about your job and/or working in psychiatry? My role is to support our brilliant investigators by providing the resources and support to initiate, maintain, and closeout trials involving human subjects. My main focus now is to develop the BRAC to its fullest potential as a comprehensive center dedicated to clinical research. My role is multi-faceted in that it involves human resources, training, project management, research finance, business operations, clinical trial management, research compliance, and, recently, communications. Every day looks a little different but that is what keeps my job exciting. Thankfully, I have an amazing
team that truly represents what we are hoping to achieve in our research mission. Moreover, I have wonderful mentors in the Department of Psychiatry including Maggy De Tullio, Joyce Sadler, and Patricia Galvis that provide me with their guidance and wisdom when a new situation or project comes up. What is the BRAC? Due to the Department’s growing research portfolio, the concept of having a dedicated center and staff became a pressing need. The Behavioral Research and Assessment Center (BRAC) is a dedicated center for clinical research staffed by knowledgeable and passionate research assistants and coordinators. From Phase I to Phase IV clinical trials, our team is committed to ensuring participants have the best experience when participating in our cutting-edge research whether its related to schizophrenia, treatment-resistant depression, post-traumatic stress disorder, or Alzheimer’s disease. Did you pursue an education that prepared you for your current position? In retrospect, I can say that my MBA has given me an advantage in my current role. Although my accounting and finance courses are invaluable, I feel my operations management, organizational behavior, and leadership courses have been the most relevant. For example, developing the BRAC requires understanding of how it would fit within the Department’s mission, identifying the stakeholders, and operationalizing the goals we are trying to achieve. To reduce processing times with new studies and modifications at the IRB, we implemented an initiative in which we designated a team member whose focus would to be expedite all IRB submissions. As a result, clinical trials are starting much more quickly giving us more time to enroll subjects, and the rest of the research team can spend time on their subjects and everyday operations thus improving quality and compliance. Although developing the BRAC is important to me as a manager, my most
important asset is my team. I have implemented initiatives learned through my coursework, but I have learned from my team too, tailoring my approach as we enter our second year together. I hope I have demonstrated to my team that they have the opportunity to learn and grow professionally here and that they feel supported by their teammates, the Department, and myself. Clinical trials are complex and can be quite difficult to manage. What are some obstacles you face in establishing one pertaining to mental health? The most challenging aspect of clinical trials is recruitment. The perception of participating in clinical research is not very positive. Some patients may feel they are part of an experiment as opposed to being part of a process in the development of new treatments. One of our key initiatives is education about clinical trials. By informing the public about what we do and how participation in clinical research allows successful assessments or treatments come to market or to standard clinical practice, we can chip away at the barriers related to future participation. How do you like to spend your free time? I love to run, particularly outdoors. There is something almost meditative when the music is blaring in my ear buds but all I can feel is my breathing and the rhythmic thumping of my footsteps. I have completed a few half marathons and a fullmarathon. Early next year, I hope to run a 5K. I spend most of my time with my family. My fiancé and I go to Miami Heat or Hurricane games or check out restaurants in the area. But, for the most part, we enjoy the comfort of just being together with our three-year old daughter.
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Resident Recognition ach quarter, faculty and residents have the opportunity to nominate residents they feel deserving of recognition; people who have gone above and beyond to fulfill their duties as a physician, colleague, or compassionate human-being.
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Below, read why peers and colleagues thought these residents should be recognized this quarter. The Department is grateful for their hard work and dedication! *Note: some of these were edited for length.
Dr. Yasin Bez PGY-1 “He has been a tremendous help for his fellow resident, covering different services whenever there is shortage in staff. He’s humble, down-to-earth and truly a great person, colleague and friend.”
Dr. Josh Delaney PGY-1 “Josh went above and beyond on the night float month with a great attitude. We have nice peer-peer discussions and clearly he cares for the patients.”
Dr. Areej Alfaraj PGY-2 “She wholeheartedly took on the responsibility of the senior resident on the service; directing us when appropriate, volunteering to take on a heavier load of patients to help her juniors. I felt lucky to have Areej as a senior resident during a challenging rotation.”
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Dr. Jonathan Parker PGY-2 “Jonathan Parker did a heroic job seeing about 6 crisis admissions on the CAAP unit — patients who weren’t really supposed to be his to do. There was a glitch in the insurance office and none of the new admissions who came the night before showed up in the system until after 8am that morning, leaving a lot of crisis notes to be done during the day to catch up. He happily helped and did all the notes.”
Dr. Javier Reyes PGY-3 “He is by far the hardest working resident in the clinic this year. The amount of hard work and dedication he exhibits to his patients is exceptional.”
Dr. Ashley Beattie – Chief Resident PGY-4 “Ashley has served as a true leader, works tirelessly for our program, and always does so with a smile on her face. She tries her best to make everyone happy, while maintaining organization in the program.”
Dr. Nils Westfall PGY-5 “He has gone out of his way planning activities and volunteering. He also has worked on organizing residents to lead grief and coping sessions in Deerfield after the Stoneman Douglas tragedy. He is a friend, a colleague, and certainly a role model to many of us.”
Clinical trials are the backbone of evidence-based medicine. Broadly speaking, clinical trials evaluate the safety and effectiveness of a medical strategy, treatment, or device. Moreover, clinical trials provide an opportunity for the general public to participate in the process of developing novel treatments for a variety of conditions. The results from these clinical trials provide the data necessary to assist in future medical decision-making. The Department of Psychiatry & Behavioral Sciences is dedicated to generating the scientific knowledge behind the clinical best practices we incorporate in the treatment of difficult and complex mental health conditions. The Behavioral Research Assessment Center (BRAC) is the research hub that fulfills the Department’s mission to develop the next line of treatments. For more information on participating in available clinical trials, please email brac@miami.edu or call 305.243.5840.
Congradulations, Residents!
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What to Do & Where to Go For a Mental Health Emergency, CALL 911 if you believe someone is in danger of hurting themselves or others. University of Miami Hospital (UMH) Mental Health Admissions/ER 305.689.4444 Jackson Behavioral Health Hospital Triage 305.355.7332
Silver Alert If your loved one has gone missing, please CALL 911 immediately. Silver Alert is a statewide initiative to involve the public in locating a cognitively impaired person who has gotten lost driving or while on foot. For more information visit florida silveralert.com. Office Numbers Main Psychiatry Appointment Scheduling 305.355.9028 *Option 1
Common Purpose
Transforming lives through teaching, research and service.
Chairman’s Office 305.243.6400
Soffer Clinical Research Center 305.243.2301
Jackson Behavioral Health Hospital 305.355.9028 *Option 2
Courtelis Center 305.243.4129
University of Miami Hospital 305.689.1352
Deerfield Beach 954.571.0117 Center on Aging 305.355.9081
Boca Raton 561.939.4044
Brain Fitness Pavilion 305.355.9080 *English, Option 3
Child & Adolescent 305.355.7077
Memory Disorders Clinic 305.355.9065
The University of Miami Leonard M. Miller School of Medicine Department of Psychiatry and Behavioral Sciences is committed to: Conduct research that deepens our understanding of the development, pathophysiology, and prevention of psychiatric illness and the nature of human behavior, and apply this knowledge to the development and delivery of more effective, evidence-based treatments.
Offer comprehensive treatment and consultation to our patients, their families, and the community. Provide outstanding mental health education and multidisciplinary training to the next generation of healthcare providers and investigators. DIRECCT Core values l Diversity l Integrity l Responsibility l Excellence l Compassion l Creativity l Teamwork
SAVE THE DATE!
FRIDAY, OCTOBER 19, 2018 Q2| 2018
BRAINSTORMS Quarterly Publication of the University of Miami Department of Psychiatry and Behavioral Sciences Executive Editor Samantha Richter Soffer Clinical Research Center 1120 NW 14th Street | Suite 1457 Miami, FL 33136
www.GolfUMPsych.com
Health
UNIVERSITY OF MIAMI HEALTH SYSTEM Psychiatry & Behavioral Sciences
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