solutions magazine april 2016

Seeking newtherapies to

preserve andrestore sight

EBOLA WARRIORWhen Dr. Patrick Moonan arrived in Western Africa, in the epicenter of the Ebola hot zone,he wasn’t afraid.

ROAD SCHOLARLike all good country doctors, Dr. Kevin Blanton is prepared to handle almost anything that comes his way.

YOUNG GAMERIsiah Lanphear just wants to play with hisfriends. But when you’re missing your right hand, that isn’t so easy.

Issue 1, Volume 1

UNT HEALTH SCIENCE CENTER

APRIL 2016

Solutions is a publication of the Office of Communication at UNT Health Science Center.

Editor Kerry Gunnels

Designer Marco Rosales

Contributing Writers Alex Branch, Sally Crocker, Betsy Friauf and Jan Jarvis

Photographer Jill Johnson

Senior Director, Marketing & Design Amy Buresh

Senior Vice President, Innovation & Brand Monty Mohon

To our readers:Welcome to the redesigned new Solutions magazine! We’ve updated our look and broadened our story offerings – all to better showcase the amazing things that are happening on our campus in Fort Worth’s Cultural District and to introduce you to the impressive array of work and talent represented by our team. This issue includes stories about our ground-breaking research, the innovative ways we’re teaching the next generation of health care providers and how our alumni are changing lives in their communities for the better. We hope these stories and the ones that follow in future issues will expand your interest in Fort Worth’s Health Science Center. If you’d like to receive regular updates about the work we’re doing, send your email address to [email protected].

For more information about UNT Health Science Center and its educational, research and health care efforts, go to www.unthsc.edu.

To find out how you can support Fort Worth’s Health Science Center, contact the Office ofInstitutional Advancement, 817-735- 2254 or [email protected].

Concise information on a variety of health care topics

Short Takes

FEATURES

01

From scientist to comforter08

In the Ebola hot zone10

Clear-eyed research14

New endowment 20

Juggling act28

Back in the game30

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Road scholars22

30

Building bridgesfor new refugeesEmelda Thein hiked at night through the

Burmese jungle to escape her war-ravaged country when she was only 9.

Today, Thein, 31, who arrived in the U.S. in 2010 after years in a Thailand refugee camp, works with UNTHSC’s Building Bridges program to fill gaps in health services for the 1,500 refugees who arrive in Tarrant County annually.

Building Bridges is funded by a $1.3 million grant from the Cancer Prevention and Research Institute of Texas.

“I got off the plane here, and I was so scared and confused,” Thein said. “I want to teach them what I wish someone had taught me.”

From left, Radhika Subedi, Halimo Mudey, Laurette Rudasingwa and Emelda Thein help newly arrived refugee women navigate the health care system.

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Change is inevitable, and the best way to manage it is to get out front and lead it.

That’s the message President Michael R. Williams delivered to faculty, staff and students in outlining his goals for the next five years.

He called for transformative change

that will turn UNT Health Science Center by the year 2020 into a nationally recognized leader in education, research and health care innovation.

Dr. Williams said he sought for UNTHSC to be recognized as one of the “Great Places to Work” in the U.S., to be a nationally

acknowledged leader in interprofessional education and practice and to add two high-performing schools or institutes to the five that make up UNTHSC today.

One of those schools will be the new MD school UNTHSC is creating with TCU. It will represent “a new direction in medical education,” he said. “We will be in the forefront of new trends.”

UNTHSC should be recognized on a national level as a convener of experts, a place where the best minds in health care gather to share ideas and plan bold initiatives, Dr. Williams said. “My vision is that we be an extraordinary team committed to excellence and unafraid to challenge conventional wisdom,” he said.

“WE WILL BE IN THE FOREFRONT OF NEW TRENDS.”

A call for innovation and excellence

Imagine teams of extraordinary researchers and clinicians from different

disciplines working together to confront the biggest health problems facing Texas.

Each scientist or physician contributes his or her own unique skills, knowledge and ideas, collaborating to push the boundaries of discovery.

To make that vision real, UNT Health Science Center has launched a major reorganization to transition it from a

traditional department structure to one formed around multidisciplinary health institutes and centers.

Researchers, educators and physicians in each institute will concentrate their capabilities and resources on a specific health area, such as healthy aging, cardiovascular disease, blindness, or mental health.

In the new model, the Health Science Center’s five schools will each function as

the University’s primary teaching divisions.This transformation aligns the

Health Science Center’s research and education endeavors with its areas of excellence. “This new structure will empower our university to thrive in this shifting landscape and allow us to focus our greatest strengths on solving the most complex medical problems,” said Glenn Dillon, PhD, Vice Provost for Health Institutes.

A transformation in health education

President Michael Williams outlines his goals for UNTHSC.

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short takes

Interpersonal violence impacts thousands of Tarrant County residents each year. In 2013, 12,446 family violence

incidents were reported to police in Tarrant County, with an estimated 58 percent involving injuries.

To help address the problem, a screening and intervention program at UNT Health Science Center has been awarded $2.2 million in funding over the next three years by the U.S. Department of Health and Human Services’ Office on Women’s Health.

Technology Enhanced Screening and Supportive Assistance (TESSA) integrates services between primary health clinics and organizations serving interpersonal violence victims.

Poverty and homelessness place women at a higher risk for IPV.

“The goal of TESSA is to increase immediate safety and promote long-term health among individuals who have experienced IPV, particularly persons who are homeless and living in poverty,” said Emily Spence-Almaguer, MSW, PhD, Associate Professor of Behavioral and Community Health.

Targeting interpersonal violence

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short takes

Putting new skills in

providers’ hands

A failed hip surgery performed elsewhere had left Dr. Anthony Capobianco’s

patient with a leg that would not straighten, forcing her to walk painfully on the toes of her right foot for more than 10 years.

Then a technique that the New York family practitioner learned at a workshop organized by UNT Health Science Center’s Professional and Continuing Education Office (PACE) helped his patient walk without pain for the first time in a decade.

“Nothing had ever worked as effectively and dramatically,” Dr. Capobianco said.

The June workshop attended by Dr. Capobianco was the brainchild of Jerry Dickey, DO, a retired UNTHSC faculty member and historian of osteopathic medicine. Dr. Dickey is particularly interested in Still Exaggeration, a series of osteopathic manipulative treatment techniques perfected in the 1880s by Dr. A.T. Still, founder of osteopathic medicine.

By the early 20th century, those techniques were mostly abandoned. But Dr. Dickey is determined to keep them alive.

On his first day home after the workshop, Dr. Capobianco saw his patient with the bad hip. He performed the techniques he learned, and within seconds, the tension in her leg released.

“My first day back,” Dr. Capobianco said, “and what I learned was already making a difference in my patients’ lives.”

Regents Professor:A rare honor

His dedication to making people’s lives better has earned a UNT

Health Science Center genetics expert the rare designation as a UNT System Regents Professor.

Jamboor K. “JK” Vishwanatha, PhD, is only the fifth Regents Professor at UNTHSC in its 45-year history. The UNT System Board of Regents has named fewer than four dozen in the past 27 years.

Dr. Vishwanatha is Professor of Molecular and Medical Genetics and Special Assistant to the Provost for Minority Affairs. He has been recognized as a national role model in mentoring people from diverse backgrounds in research professions.

He noted that the demographics of the biology faculty in the United States haven’t changed in 30 years, and the National Institutes of Health, a major source of grant money, has instituted new programs to address the problem.

“In Texas, by 2040 we will need many more biomedical and behavioral scientists of different backgrounds, and we are not on track to reach that goal,” Dr. Vishwanatha said.

Dr. J.K. Vishwanatha

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Grandma fell twice. She wasn’t badly hurt, but her family was shaken.

Nicoleta Bugnariu knew what to do. She used her physical therapy expertise to create a rigorous exercise program for her “Bunica,” Romanian for “grandmother.”

Dr. Bugnariu, PT, PhD, Associate Dean at UNT Health Science Center, chairs the Falls Prevention Task Force of the Fort Worth Safe Communities Coalition.

“My grandmother is my role model,” Dr.

Bugnariu said. “This work is in her honor.”Every year, one in three people 65 and

older takes a fall. Falling accounts for 13.5 percent of emergency room visits among people 65 and older.

Each year, the work of the Falls Prevention Task Force culminates in Falls Prevention Day in Fort Worth.

As for Dr. Bugnariu’s grandmother, she lived to see her 98th birthday. She was active until the last week of her life.

Masks worn by those with sleep apnea can leak at night and be

so uncomfortable that they often drive users away from treatment.

But a new system being developed by researchers at UNT Health Science Center and The University of Texas at Arlington could make it easier for the estimated 18 million people with sleep apnea to get a good night’s rest.

The user-friendly system alerts the individual whenever there’s an airflow leak in their PAP (positive airway pressure) machine, said Brandy M. Roane, PhD, Assistant Professor of Internal Medicine.

The alert system might be just what it takes to motivate the roughly 50 percent of sleep apnea patients who give up on the treatment to keep using it.

“The hope is that people who use this will benefit from PAP therapy by waking up with more energy,” Dr. Roane said. “And they won’t fall asleep at work.”

Making sleep apnea maskswork better

18MILLION

Estimated number of people who suffer sleep apnea in the U.S.

Keeping seniors on their feet

Dr. Brandy Roane

Dr. Nicoleta Bugnariu

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short takes

Each year, about 800,000 people suffer a stroke in the United States. For many, initial rehabilitation

focuses on regaining the ability to walk. But up to two-thirds also experience impaired hand function.

That can leave hand muscles contracted, a condition that can be difficult to overcome. But a new, soft robotic glove that can open and close a patient’s hand

may bring stroke victims some relief.The glove is being developed through the Texas

Medical Research Collaborative at the UT Arlington Research Institute in Fort Worth. A team led by Muthu Wijesundara, UTARI principal research scientist, and UNT Health Science Center researchers Rita Patterson, PhD; Nicoleta Bugnariu, PhD; and Timothy Niacaris, PhD, MD, won a $99,000 grant to move their current prototype into a clinical setting. Development of this device will be conducted at UTARI, while UNTHSC collaborators will evaluate the system’s safety and usability.

“Part of the focus in this development is to create a portable and independent system, capable of applying therapy without the constant supervision of a therapist,” Wijesundara said.

A robotic glove toassist stroke victims

Muthu Wijesundara, left, and Mahdi Haghshenas-Jaryani demonstrate how the robotic glove can help rehabilitate post-stroke patients.

Photo by UT Arlington

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Behold a model health care team of the future tasked with caring for an

older patient just home from the hospital with a new joint replacement and serious problems getting around.

There’s the nurse who makes home visits to monitor vital signs and dress the wound. An occupational therapist who trains the patient to safely bathe, dress and prepare meals. A pharmacist

who spots medications likely to cause a fall due to side-effect dizziness. A lawyer who persuades the landlord to comply with regulations requiring a ramp to the entrance.

Subtract any member of the interprofes-sional team and the patient’s risk of going back to the hospital skyrockets, said Bar-bara Brandt, PhD, Director of the National Center for Interprofessional Practice and Education at the University of Minnesota. She praised UNTHSC's IPP/E initiative.

“I’m blown away by what’s going on here,” she said.

It takes a villageto keep people healthy

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short takes

Dr. Rebecca Cunningham

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community outreach

From scientistto counselorand comforterF

or seven days, Rebecca Cunningham lay in bed, radioactive and isolated.

“No one could get within six feet of me,” said Cunningham, PhD, who

was undergoing radiation therapy for thyroid cancer. “I watched Netflix, slept and sucked on sour candy.”

The isolation was hard. Even harder was the restrictive low-iodine diet that she had to follow before her radiation.

But there was one advantage she had over many of the 62,000 people with thyroid cancer: Her background as a scientist helped her better understand the diagnosis she faced as a patient.

It’s that unique perspective that Dr. Cunningham, UNT Health Science Center researcher, has brought to the Low Iodine (LID) Life Community, a support group she founded on Facebook last year. Since then, the site has expanded to nearly 2,000 members and 45 administrators from as far away as Canada, United Kingdom and Australia.

The online posts illuminate the isolation, confusion and desperation of individuals facing thyroid cancer, sometimes known as a “good cancer” because of its high survival rate. On the Facebook site, patients have found a place to vent, celebrate and ask questions that

previously had gone unanswered.It started with a simple shopping list Dr.

Cunningham posted to help her in selecting foods for the low-iodine diet she was going on for two weeks to increase the effectiveness of her radioactive iodine treatment.

“I put the photo album of low-iodine foods on my timeline so when I went shopping I knew what to buy,” she said. “The next thing I knew, all these people were friending me.”

The diet is tough to follow and requires the elimination of many common foods. Dr. Cunningham identified hundreds of low-iodine foods and contacted restaurant chains to see what options they offered.

Dr. Cunningham is cautious not to offer medical advice to her Facebook audience and always defers to each person’s physician. But this research scientist and Assistant Professor in the Center for Alzheimer’s and Neurodegenerative Disease Research now has added counselor and comforter to her many credentials. She understands in a way few can.

“There is an area between the doctor and the patient where there’s often a big divide,” she said. “I feel like I stand in that big divide because I understand thyroid cancer as a patient and researcher.”

By Jan Jarvis

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community outreach

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our alumni

Public health expert keeps his cool as he’s deployed to battledeadly disease

By Alex Branch

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our alumni

For years, Patrick Moonan has pursued tuberculosis outbreaks across the world, from urban neighborhoods in the United States to remote villages in southern Africa.

In September 2014, the senior epidemiologist at the Centers for Disease Control and Prevention took on a new adversary — the Ebola virus.

Dr. Moonan, a UNT Health Science Center graduate, was deployed to West Africa at the peak of the Ebola outbreak that would kill more than 10,000 there, serving as the CDC’s team leader in Bong County in central Liberia.

“I am well trained and have a lot of experience working in dangerous public health settings,” Dr. Moonan said. “But my family and I were apprehensive because the scale of the Ebola outbreak might make it difficult for me to get back home quickly.

“I promised my family I would be home for Christmas.”

The sick and dyingThe training that prepared Dr. Moonan for

his critical mission began 16 years ago in Fort Worth. He worked at Tarrant County Public Health as a tuberculosis contact investigator

and earned a Master of Public Health from UNTHSC in 2002. He earned his Doctor in Public Health from the school in 2005 and immediately went to work for the CDC.

He is one of 1,114 UNTHSC School of Public Health graduates working to prevent disease in Texas, the U.S. or around the world.

As CDC team leader in Bong, Dr. Moonan visited the homes and neighborhoods of people who had gone to medical clinics and were believed to have Ebola.

Frequently, he found the patient’s family members already ill and transmitting the virus to other relatives. With few options for isolation, infected people were quarantined in a nearby former leper colony.

“It was very emotional,” Dr. Moonan said. “I’d see sick and dying children and try and stay grounded by checking in back home to see how many goals my son or daughter scored in their soccer games.”

Although Dr. Moonan was supplied with a protective suit before he left for Liberia, he worked in a support role and not a clinical one, and he never wore it.

“Sometimes, we were hiking five hours to get to a village, crossing streams and shin-deep mud, so it just wasn’t practical,” Dr. Moonan said. “Also, some people there had never seen an American before, and I would have arrived looking like I was from outer space.”

He wasn’t afraid. Dr. Moonan has plenty of experience around deadly diseases.

At the CDC, he led a team to rapidly identify tuberculosis outbreaks throughout the U.S. As TB cases in the U.S. fell, he transferred to the CDC’s

With limited options, a former leper colony was used to isolate those infected with Ebola.

“It was very emotional, and I tried to stay grounded by checking in back home to see how many goals my son or daughter scored in their soccer games.” —Dr. Patrick Moonan

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international TB research and programs branch, where his expertise could have bigger impact. In that role, he interacts with people sick with multidrug-resistant TB that is just as dangerous as Ebola, if not more.

“You can get TB from someone breathing on you,” he said. “Fortunately, that’s not the case with Ebola.”

Fear and hysteriaHis family, however, worried a lot. Sometimes,

days would pass before Dr. Moonan could contact home. Meanwhile, U.S. TV news was filled with terrifying stories, ominous warnings and images of people dying in the streets in Africa.

“My 13-year-old son Collin emailed me a lot,” Dr. Moonan said. “He saw all the media coverage and understood that his Dad was putting himself at risk. But I think it was a coming-of-age moment for him. He seemed older when I came home.”

When an infected Liberian man brought Ebola to Dallas and transmitted the disease to two hospital nurses, Dr. Moonan found the resulting fear and hysteria interesting. The U.S. has some of

the best hospitals in the world, antiviral medicines and isolation rooms.

“In Liberia, I was happy just to isolate someone in an open tent,” he said. “But what came out of Dallas was that it raised awareness of the need for more resources and a very strong public health surveillance system.”

In all, Dr. Moonan estimated that he encountered 200 people with Ebola. When he flew back to the United States, a Border Control agent met him at the gate, handed him a thermometer and a cell phone, and asked him to stay home for three weeks.

He returned home on Dec. 21, just in time to spend the holidays with his family. He had kept his promise.

Dr. Patrick Moonan

A graveyard in Bong County, Liberia, is filled with victims of the Ebola virus.

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Scientific visionaries

The vision loss was hardly noticeable at first. But gradually, Roy Ryan’s world grew darker.

“Now I can’t drive a car or play golf,” he said. “Most of the time my wife reads to me.”

For 14 years, age-related macular degeneration slowly robbed the Keller, Texas, great-grandfather of his sight. At 83, he relies on medication injected into his eyes every six weeks to stave off the disease’s progression.

But Ryan knows what’s likely ahead. There is no cure for macular degeneration, the leading cause of irreversible vision loss.

Still, he remains optimistic that in the years to come, new therapies will be developed that preserve or restore eyesight lost to the disease. Some of those therapies could come from the laboratories at UNT Health Science Center.

More than a dozen UNTHSC scientists are dedicated to unraveling the mysteries of the eye, a complex and confounding organ that processes light, interprets shapes and allows humans to see the world. At the North Texas Eye Research Institute (NTERI), founded in 1992, scientists strive for research outcomes that will lead to the development of new and effective treatments for ocular diseases such as glaucoma, macular degeneration, diabetic retinopathy, optic neuritis, and dry-eye disease.

Understanding how this window to the brain works

From macular degeneration to glaucoma, UNTHSC researchers embark on new approaches to common eye diseases

By Jan Jarvis

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discovery

and what goes wrong has been the life’s work of these researchers, who together bring decades of expertise from academia and industry to their labs. And discoveries made in those labs could one day change the way eye diseases and other conditions are treated.

‘It can happen overnight’Age-related macular degeneration

sneaked up on Ryan, much the way it does for some 11 million Americans.

He had never heard of it until 2002, when his eye doctor diagnosed the dry form of macular degeneration. About 80 percent of cases fall into this category, which can go on for years without vision loss from retinal cell death.

But in 20 percent of those cases, the disease progresses to the wet form, which can lead to sudden vision loss, said Sai Chavala,

MD, Professor of Surgery and Director of Translational Research for NTERI.

“It can happen overnight,” he said. “I’ve had patients go to sleep seeing well, and wake up the next day with a large dark spot in their central vision.”

Monthly injections into Ryan’s eyes have helped, but he lives each day knowing he could lose his sight at any time. To prevent such damage, UNTHSC is taking a different approach.

Dr. Chavala’s group has identified a novel method to generate retinal replacement cells without using embryonic stem cells.

“My dream is to one day grow a patient’s stem cells in a petri dish and convert them into retinal cells using a special ‘cocktail,’” he said. “I would then perform surgery to transplant these cells into the retina to rehabilitate vision.”

This therapy would be tailored to each

“I’ve had patients go to sleep seeing well, and

wake up the next day with a large dark spot in their

central vision.”– Dr. Sai Chavala

Dr. Sai Chavala examines Roy Ryan, who suffers from age-related macular degeneration.

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patient. Since the cells are a genetic match, the risk of rejection is theoretically reduced, said Dr. Chavala, who is also an ophthalmologist with Retina Center of Texas.

Ryan and his family have financially contributed to Dr. Chavala’s research in an effort to help move this discovery from bench to bedside.

“We’re working on therapies right now that I hope will be available in the next decade,” Dr. Chavala said.

Innovative approachFor years Laura Carter has worked as a

production coordinator for UNTHSC, staring at a computer screen for hours, without so much as a hint of vision problems. But during a routine visit to her eye doctor, she learned the pressure in her eye was elevated.

Carter was diagnosed with glaucoma, the second-leading cause of irreversible blindness worldwide. An estimated 3 million Americans have the disease, but only half know it. African-Americans and Hispanics are at a higher risk for developing it.

Glaucoma is a slow-progressing, painless disease that over time causes someone’s visual field to get smaller and smaller, said Weiming Mao, PhD, Assistant Professor in NTERI. The center of one’s vision remains intact up until the person becomes blind.

While there is no cure, the disease is

THE PROBLEMMillions of Americans suffer from such ocular diseases as glaucoma, macular degeneration, diabetic retinopathy, optic neuritis and dry-eye disease. Many face the prospect of irreversible vision loss.

THE TEAMMore than a dozen scientists at UNTHSC’s North Texas Eye Research Institute have dedicated their careers to unraveling the mysteries of the eye – how it works and what happens when things go wrong.

THE GOALResearchers are seeking ways to treat eye diseases and to reverse the damage they cause. Efforts include generating retinal replacement cells for macular degeneration patients and understanding the mechanisms of glaucoma that cause pressure buildup in the eye.

At a glance

• In the time it takes to read a sentence, the eye completes 100 billion operations.

• The average adult human eye has a diameter of 24 millimeters and weighs about 7.5 grams.

• The eye is composed of 6 grams of water and 1.5 grams of cell tissue.

• The human eye can distinguish 10 million colors.

• Each eye has six muscles that control movement.

• Having two eyes allows the brain to determine the depth and distance of an object.

Eye Facts

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discovery

treatable with medications that indirectly reduce elevated pressure. But that’s not the underlying cause, and therapy eventually fails.

A signaling pathway that damages the front of the eye may provide an explanation. Growing evidence that glaucoma is a degenerative nerve disorder rather than just an eye disease could lead to treatments that not only spare vision but save lives, said Abe Clark, PhD, Professor and Executive Director of NTERI.

“We’re convinced this pathway is a major player in glaucoma and could lead to ways to inhibit or reverse the disease process so an individual ends up with a much healthier eye,” Dr. Clark said.

Glaucoma also damages the retina, optic nerve and vision centers in the brain.

“To really treat glaucoma, you have to

protect all the areas that are damaged,” Dr. Clark said.

Researchers are closing in on several theories surrounding what goes wrong. Although the research is still in the early stages, growing evidence suggests that glaucoma might be an early warning for dementia, Dr. Clark said.

UNTHSC researchers from different disciplines are collaborating to find answers. Biomarkers that have been linked to Alzheimer’s disease are being studied by researchers in the Center for Alzheimer’s and Neurodegenerative Disease Research. Those same biomarkers have been linked to glaucoma and could lead to confirmation that eye disease is a major risk factor for Alzheimer's, Dr. Clark said.

“If glaucoma turns out to be an early warning sign, then that means we may

“Our team is committed to our institute’s mission and goals to improve the vision health of our community.”

– Dr. Abe Clark

Tackling a complex disease like glaucoma requires a number of different approaches.

At the North Texas Eye Research Institute (NTERI) at UNT Health Science Center, a team of scientists is exploring different theories to solve this ocular puzzle.

• Thomas Yorio, PhD, Provost and Executive Vice President for Academic Affairs

The Health Science Center’s provost and one of its longest-serving faculty members received the International Society for Eye Research’s 2014 Ernest H. Bárány Prize, awarded for his outstanding contributions to research that have increased the understanding of ocular pharmacology.

“Many people who take steroids do not respond to steroids with an increase in eye pressure, but 95 percent of people with glaucoma do,” Dr. Yorio said. “Why steroids produce this effect in those with glaucoma may tell us something about the disease.”

• Abe Clark, PhD, Professor and Executive Director, NTERIThe cellular and molecular mechanisms responsible for

glaucoma long have been the focus of Dr. Clark’s research.His lab has discovered numerous disease pathways that

increase intraocular pressure.

• Weiming Mao, PhD, Assistant Professor, NTERIIn healthy individuals, a safety valve controls pressure in

the eye. But when that valve malfunctions, it causes fluid to stop draining, which in turn leads to the buildup in pressure and irreversible cell damage that characterize the disease. Dr. Mao’s research focuses on this aspect of glaucoma.

• Gulab Zode, PhD, Assistant Professor, NTERIDr. Zode’s lab is looking at a transparent fluid called aqueous

humor that provides nutrition to the eye structures and drains through a specialized tissue called trabecular meshwork.

“When there’s a function failure of the trabecular meshwork tissue, pressure increases, causing glaucoma,” he said.

• Colleen McDowell, PhD, Assistant Professor, NTERIWhile glaucoma typically strikes older adults, one of

the most dangerous types occurs in babies. Dr. McDowell is trying to determine why some eye cells die faster than others, a breakthrough that could lead to new therapies to treat the disease in infants

“In children with the disease, eye pressure gets really high, really fast,” she said. “This kills cells in the back of the eye that are responsible for vision.”

Unlocking the riddle of glaucoma

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be able to delay the onset of dementia using the same drugs we use for this eye disease,” he said.

Improving vision healthWhen Fort Worth optometrist Jennifer

Deakins looks into the eyes of an older patient, she’s searching for more than vision changes.

“We can see indicators of brain disease,” she said. “You can look right into the pupil and see it.”

On Fridays, Dr. Deakins and Dr. Clark screen for vision changes through the Health & Aging Brain among Latino Elders (HABLE) study, a program that examines aging trends among Mexican-American men and women ages 50 and older.

For most participants, it’s a chance to get their vision screened at no cost. But for some, the test could lead to diagnoses they never saw coming: diabetes, hypertension, Alzheimer’s. The underserved Hispanic population is at especially high risk for

glaucoma, diabetes, heart disease and other conditions that can be identified through the eye screenings.

“I’ve seen people who didn’t know that they had diabetes,” Dr. Deakins said. “But I can tell they most likely do based on what I see in their retina. Sometimes when I look at their eyes I see little hemorrhages and fluid leaks. Their vision can be 20/20, so they don’t realize they have a problem – but they do.”

NTERI is dedicated to bringing vision screenings to the community so the most vulnerable populations, from the youngest to the oldest, get the care they need to improve their lives, Dr. Clark said.

“Our team is committed to our institute’s mission and goals to improve the vision health of our community,” Dr. Clark said. “Our eye research and community outreach efforts are part of a bigger effort at the Health Science Center to push the boundaries of discovery and transform lives.”

Dr. Sai Chavala and ophthalmic technician Jennifer Herrera study a patient’s records.

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Professor Emeritus Terry Gratton, DrPH, remembers his years of teaching at UNT Health Science Center’s School of Public Health as one of the most rewarding times of a long career in

environmental health.As a result, he and his wife of 42 years have established

the Terrence and Ramona Gratton Endowed Scholarship to help doctoral students in Environmental and Occupational Health along their career path and to honor the history and future of public health.

When Dr. Gratton retired from the federal health service in 2000, he began a new career teaching full-time at UNTHSC. Even now, officially retired for a second time since 2010, Dr. Gratton continues to lead one of SPH’s spring core courses each year.

He has been involved in the field since 1969, starting out with the San Antonio Metropolitan Health District and then spending 18 years with the U.S. Public Health Service traveling through Oklahoma, Kansas and Arizona for the Division of Indian Health Service, before making his way to Fort Worth to serve as infection control officer with the Federal Bureau of Prisons. He also served as a licensed sanitarian for 44 years.

He remembers the early years at UNTHSC teaching a cross-disciplinary Border Health course that took students to Laredo for spring break, providing elements of social and behavioral concepts along with environmental aspects of life and health.

“This was probably one of the most unique courses I taught, because it offered students what I call the ‘OMG’ experience,” he said. “Complementing the classroom topics, students saw firsthand, through field experience, what their work would be like in real practice. We met only twice before packing up for the trip, where they learned from actual situations.”

Over the years, Dr. Gratton saw the School of Public Health grow and the profession advance in meaningful ways.

“Environmental health is very interesting and broad,” he said. “Even those who practice the profession – those who teach the concepts and those who make the policies, laws, regulations and guidelines – can’t come up with a concise, all-encompassing definition.”

“Our students here at the School of Public Health will be important in taking the field into the future, to help build healthier communities around the world,” he said. “Ramona and I are happy to be a part of encouraging students through this new scholarship opportunity.”

New endowment helps doctoral

students on their career path

By Sally Crocker

Ramona and Terrence Gratton

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giving

Dr. Kevin Blanton says he’s found the life he wanted in small-town Clifton, Texas.

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in the community

From the piney woods to the Panhandle, UNTHSC rural docs reach every corner of Texas to care for

those who otherwise would go withoutBy Alex Branch

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in the community

LIFTON, Texas — Dr. Kevin Blanton rises at 4:30 a.m., makes his coffee and breakfast

and fires up his computer to glance at patient charts, lab results and X-rays.

Soon, he climbs into his GMC Sierra pickup and makes the 5-minute drive from home across the two-lane bridge over the Bosque River, past grazing cattle and groves of cottonwood trees to the Clifton Medical Clinic.

Inside, he passes a wall covered in photographs of children he has delivered during his 11 years in this small central Texas town. A shelf in his office is stocked with medical books about countless specialties: Radiology. Pediatrics. Geriatrics. Cardiology. Colonoscopy. Public Health Emergencies.

A good country doctor is prepared to

handle it all.“You never know what’s going to be

behind the next door,” Dr. Blanton said. “You see a 2-day-old in this room and a 102-year-old in the next.”

Since its beginning, the Texas College of Osteopathic Medicine at UNT Health Science Center has trained and prepared physicians like Dr. Blanton (TCOM ’02) to practice medicine far away from the sprawling medical complexes and countless specialists in the city.

UNTHSC’s Rural Osteopathic Medical Education of Texas program is crucial for the state’s underserved rural communities. There are 35 counties in Texas without a practicing physician, according to a 2015 study by the consulting firm Merritt Hawkins. At least 80 Texas counties have five or less physicians.

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Dr. Blanton examines a patient at the Clifton Medical Clinic.

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Today, you can find UNTHSC rural scholars on clinical rotations in the piney woods of East Texas, the arid mountains out west, border towns along the Rio Grande and prairies in the Panhandle.

At each stop, students learn to provide critical health care services to people who may otherwise go without. They also get insight into the life of rural medicine, said John Bowling, DO, Professor of Family Medicine and Assistant Dean of Rural Medical Education.

“There is a common misperception that the lifestyle of a rural physician is less desirable,” said Dr. Bowling, who founded the program. “The truth is that it offers many physicians the opportunity for a financially successful practice and to make a very rewarding impact on their community.”

Staying flexibleDr. Blanton found his path to rural

medicine later in life.In his 30s, working as a purchasing

officer for a company in Denton, he was tasked with finding a new contractor for company first-aid kits. One of the companies he interviewed offered a first-responder course for medical emergencies, and he signed up.

“It just lit me on fire,” he said. He quit his job, returned to school and

graduated from TCOM. Today, he is a family medicine physician at the Clifton Medical Clinic in a town of 3,442 about 90 minutes southwest of Fort Worth. Some of his patients travel two hours from West Texas for care.

But that’s not all he does. His other duties include:• President of the local physician’s association.• County medical officer.• Medical director in the hospital emergency room and for North Bosque County EMS.• Medical director for first responders in unincorporated Laguna Park.

• Medical director at Clifton Care Center Nursing Home.• Adjunct clinical assistant professor at UNTHSC.

Not to mention he’s the father of three children.

In those roles, he treats folks from town with coughs and fevers, performs C-sections at the hospital, clamps the wounds of bloody farmers in the emergency room and confronts public health issues – such as the time he diagnosed two locals with dengue fever.

Like all country doctors, he must improvise. He advised a cash-strapped mother that she can buy the same ointment he would prescribe for her children’s skin condition for a better price at Clifton’s feed store.

“The closest specialists are almost an hour away in Waco,” Dr. Blanton said. “Even if you tell a patient they need to go directly to a specialist, often they won’t go. It takes time and gas to make the trip. A rural doctor has to stay flexible.”

Dr. Blanton often breaks for lunch with son Teage, a third-grader at Clifton Elementary School.

Russell Stanley

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Trusting your instinctsRussell Stanley, a fourth-year medical

student at UNT Health Science Center, spent three weeks in Clifton in 2015 working under the supervision of Dr. Blanton, and he will spend eight more weeks there in 2016. He came to TCOM with an interest in rural medicine.

When UNTHSC’s rural medicine track was first developed, TCOM students were recruited into the rural program after they arrived on campus. Today, the program recruits students before they are accepted to TCOM, looking for candidates genuinely interested in rural medicine.

Dr. Bowling personally interviews prospective students, considering factors such as their hometown zip code, altruistic characteristics and parental income. UNTHSC’s rural scholars come from all over; the 2015 class graduated students who hailed from Texas, Oklahoma, Iowa, Minnesota and Maryland.

Research shows that students who grew up in rural areas are more likely to return there to practice medicine. Students whose parents are both professionals are less likely to practice in rural communities.

“Of course, there are exceptions to all the rules,” Dr. Bowling said. “Sometimes you just trust your instinct.”

Building special relationshipsRural medicine students such as Stanley

spend their entire third and fourth years of medical school on rotation in rural communities. Dr. Blanton is one of dozens of UNTHSC preceptors across the state and beyond who welcomes TCOM students for training and supervision. Preceptors include surgeons in Crockett and Plainview, obstetricians in El Paso and internal medicine clinics in every corner of Texas.

Accommodations at rotations vary. Some students sleep in beds at hospitals where they work. In Clifton, Stanley stays in a 1,100-square-foot garage apartment attached to Dr. Blanton’s house.

He eats breakfast and dinner with Dr.

Blanton. If the hospital emergency room summons Dr. Blanton at 2:30 a.m., the medical student is minutes behind in his own car.

Like other Clifton residents, he enjoys shows at Tin Roof Theater and, on special occasions, black-angus ribeyes at Mitchell’s Grille downtown. He often makes the short drive with Dr. Blanton to Clifton Elementary School, where the doctor eats lunch with son Teage, a third-grader, or daughter Bryn, a kindergartner.

“I can’t imagine many city doctors can zip over to the kids’ school at lunchtime,” Stanley said. “It’s a great experience being out in town and getting to know the people you care for. It creates a special relationship.”

Those relationships are built at rotations across the state. Karen Duong, a fourth-year rural medicine student in TCOM, plans to practice psychiatric care. At least 185 Texas counties don’t have a single psychiatrist.

She did her first rotation in summer 2014 in the Panhandle town of Hereford, about 375 miles from Fort Worth. She was the first UNTHSC student ever to train in the “Beef Capital of the World.”

While there, she joined a church, a Bible study group and formed an exercise group with friends. She was no longer a visitor; she was part of the town. Before long, residents lobbied hospital administrators to hire her after she completes her residency.

“In April, I’m getting married in Fort Worth, and all the great friends I made on rotation are making the trip here for it,” Duong said. “I tell other students interested in rural health that it’s a lot of extra work, but the experience is invaluable.”

Those relationships mean a lot to Dr. Blanton. At some point during the 11 years he has spent in Clifton, the town became home. He has no plans to leave the open roads, friendly people and freedom he enjoys as a country doctor.

“I found what I wanted right here,” he said.

Karen Duong

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“You never know what’s going to be behind the next door. You see a 2-day-old in this room and a 102-year-oldin the next.”—Dr. Kevin Blanton

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Foster parents Chandler and Emily Sparks play with their children, ages 1 and 3.

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our students

Chandler Sparks lives a busy life. He’s earning a medical degree at Texas College of Osteopathic Medicine while also pursuing a Master of Public Health degree.

Moreover, he’s a second lieutenant in the U.S. Air Force who will serve at least four years after completing his medical training. And he’s a Rural Scholar, taking additional training to prepare him for practice in a rural community.

But perhaps his most rewarding – and taxing – role is that of a foster parent, taking in children whose families aren’t able to care for them.

Combining a rigorous medical education with parenting a changing set of youngsters is demanding. But parenthood enhances his education, said Sparks, 24.

“I have a totally different perspective from students who aren’t parents,” he said. “I’m dedicated in multiple places. I have more challenges. It’s enriching, and it’s a juggling act, but it’s completely worthwhile.”

Sparks and his wife, Emily, are the foster parents of a baby born in fall 2015 whose mother left him at the hospital. He went into foster care immediately, and his mother hasn’t visited him since.

The Sparkses also have two biological children, a 3-year-old son and a 1-year-old daughter. Over the winter holidays, they temporarily cared for more children. For a while, they had six children under age 6 in their home.

During Sparks’ first year of medical school, the couple took the Texas Department of Family and Protective Services’ foster training and became

licensed in May 2015 to care for foster children.What makes a young person so dedicated at a

time of life when many are overwhelmed by school alone and unsure of their career path?

“A lot of people inf luenced me,” he said. “I was brought up in a Christian home, and I feel that it’s our responsibility as people with education and privilege to stand in the gap for families in need. My wife cultivated in me a love for orphan care.”

Soon, the Sparks household will expand once again. Emily is expecting their third child in August.

Chandler says he hopes his story will inspire more people to become foster parents.

“If you have room in your home and in your heart for a child in need,” he said, “please consider foster care.”

Juggling act

By Betsy Friauf

During the winter holidays, the Sparkses had six children under age 6 in their home.

Chandler Sparks, a TCOM student and the father of two, still has time in his life to be a foster parent. It’s sometimes complicated, ‘but completely worthwhile.’

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Isiah Lanphear is finding other uses for his custom prosthetic attachment, originally made to help him play hockey.

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making lives better

Isiah Lanphear’s wish list is pretty simple.

The 7-year-old Wisconsin boy says he wants to play baseball, ride his bike and play hockey. But such activities aren’t so easy when you’re missing your right hand.

That’s where UNT Health Science Center stepped in. Todd Dombroski, DO, Associate Professor of Family Medicine, is collaborating with a Fort Worth-area prosthetist to provide Isiah with custom-made attachments that allow him to wield a hockey stick, throw a baseball and safely grip handlebars.

“I made a promise to Isiah that I would figure out a way for him to play hockey, ride his bicycle and hit a baseball,” Dr. Dombroski said.

Back in the gameBy Betsy Friauf

A 7-year-old Wisconsin boy, who lost his hand in a home accident, just wanted to be able to ride his bike and play sports. Thanks to a UNTHSC physician, he’ll be able to do just that.

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“I was able to establish the network, machines and personnel to undertake the first phase, hockey, which takes minimal wrist movement.”

A retired U.S. Army colonel who came to UNTHSC in 2014 after more than two

decades in the military, Dr. Dombroski already has established a Department of Defense-funded apprenticeship program that trains veterans to make prosthetics. With assistance from the Massachusetts engineering firm Mentis Sciences, he also has secured a computerized alignment machine used for making lower-limb prosthetics.

His relationship with Isiah dates to 2014, when the two met while Dr. Dombroski was working as a medical 3D printing consultant at Oak Ridge National Laboratory in Tennessee. A year earlier, Isiah had lost his hand in a riding-mower accident on his family’s 22-acre property near Green Bay, Wis.

The accident was devastating to Isiah and his mother, Lisa Lanphear, but, ultimately, the boy proved resilient. He immediately wanted to resume riding his bicycle.

“Amputation does not define him,” Lanphear said. “He already was riding a bike when he first lost his hand. Afterward, we attached a cup on the handlebar that he stuck his nub into, but it wasn’t satisfactory.

“He just wants to do what all boys want to do.”Creating comfortable, custom-fit prostheses

for amputees is never simple – and for children it’s more complicated. They quickly can outgrow them. If the material is too heavy or cumbersome, the prosthesis is uncomfortable and the child may refuse to use it.

It’s a difficult challenge, but UNTHSC was up to the task. Isiah recently was fitted for a custom hockey attachment – painted black with orange flames. His mom says the hand attachment even helps him move faster on the ice.

Phase Two will be a new 3D-printed wrist so he can use a baseball bat and ride his bicycle on the rough trails near his home.

“I don’t know whether Isiah’s more excited, or his hockey coach,” Lanphear said. “It’s a great improvement, and Dr. Dombroski was instrumental.”

“He just wants to do what all boys

want to do.”

Isiah’s new hockey attachment has made him faster on the ice – and on his bike.

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LEARNING TO LEAD

Leadership challenges do not go away. Learning to deal with them head-on and purposefully can have powerfully positive results for your organization.

The UNT Health Science Center has created a Leadership Institute with the sole purpose of helping you and your organization develop better leaders.

Let us help you develop a leadership strategy based on values, provide you executive and professional coaching and create effective succession plans.

For more information on learning to lead, please contact [email protected], and we will get back with you promptly.

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