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The six clusters deal with issues that impact on function and quality of life in older adults, whether through chronic disease or through health systems that care for patients with chronic illnesses. We have added a cluster devoted to metabolic bone disease research, in recognition of the tremendous strength the University of Rochester has in this area, including being the number one NIH-funded Orthopaedics department in the country, as well as developing one of the first divisions devoted to geriatric care (the Division of Oncology, Metabolic Bone Disease, and Geriatric Care). By training fellows in an environment that incorporates these different pathways to a final outcome in an interdisciplinary environment, trainees gain new perspectives and benefit from training together.
Cardiology Research Cluster
Arthur J. Moss, MD is Professor of Medicine and Professor of Community and Preventive Medicine. He is the Director of the Heart Research Follow-up Program at the University of Rochester Medical Center, and his clinical research relates to cardiac arrhythmias and heart failure complicating chronic ischemic heart disease due to coronary atherosclerosis. The research involves risk factor identification in patients who have had a prior myocardial infarction in order to risk stratify patients for appropriate prevention of secondary morbidity and mortality complications of coronary disease. This research is multicenter in scope and involves active training and participation of pre-doctoral medical students, post-doctoral physicians, and students working towards a master’s degree in public health (MPH). His study populations and research activity are heavily weighted towards geriatric cardiac patients.
Thomas Pearson, MD, PhD, MPH (Co-PI) is the Albert D. Kaiser Professor of Community and Preventive Medicine and Senior Associate Dean for Clinical Research. He is the former Chairman of the Department of Community and Preventive Medicine, and current co-PI of the University’s CTSA. His major research interests are in the epidemiology and prevention of atherosclerotic cardiovascular disease, with a special interest in the international trends of coronary heart disease and stroke. Dr. Pearson has a long track record of training successful clinical researchers at Johns Hopkins, Columbia, and the URSMD.
Faculty Advisor for this cluster include William Barker, MD, Professor Emeritus of Preventive Medicine and Gerontology and Jill Quinn, RN, PhD, Assistant Professor of Nursing and recent graduate of the T32 training program.
Neuropsychiatry Research Cluster
Yeates Conwell, MD is Professor of Psychiatry, and Vice Chair the Department of Psychiatry. He is the past recipient of level I (K07) and level II (K24) career development awards from NIMH, current director of another NIMH T32 that focuses specifically on suicide prevention research training, and a core faculty member of the Cornell-NIMH Advanced Research Institute. As Vice Chair Dr. Conwell has oversight of the department’s extensive junior faculty career development program, and he has an outstanding track record of research mentorship (including having served as a mentor to Drs. Lyness, Duberstein, and many others at the UR and elsewhere). The primary focus of Dr. Conwell’s work has been suicidal behaviors, with special emphasis on suicide in older adults. A second, closely related focus of Dr. Conwell’s work is the creation of partnerships for research in collaboration with aging services providers, extending opportunities for prevention to vulnerable elders in the community. In 2003 Dr. Conwell and colleagues joined with the area’s largest aging services providers to form the Senior Health and Research (SHARE) Alliance. This partnership received an Interventions and Practice Research Infrastructure Program (IP-RISP) grant from NIMH, the goal of which is to develop and disseminate new evidence-based models of behavioral health care for older adults that are centered in the aging services sector and incorporate mental health and primary care service providers in collaborative care designs.
Paul Duberstein, PhD is PI on an NIMH-funded research education program called the Rochester Program of Research and Innovation in Disparities Education (Rochester PRIDE). Rochester PRIDE aims to enhance the a) racial diversity of researchers committed to careers in mental health research and b) capacity to conduct community based participatory research. He currently holds a K24 from the NIMH to serve as a mentor to clinical scientists interested in the psychological, social, cognitive, and macro-level influences on treatment initiation, adherence, and outcomes in older depressed patients. He has received the UR School of Medicine & Dentistry’s Faculty Mentoring Award for his mentorship of junior faculty.
Charles J. Duffy, MD is Professor of Neurology, Neurobiology & Anatomy, Ophthalmology and Brain and Cognitive Sciences. Dr. Duffy studies the neuronal and perceptual mechanisms of spatial orientation; how people know where they are and how they find their way through the visual environment. His current focus is on studies of perceptual involvement in the syndrome of visuospatial disorientation in Alzheimer's disease. He is the Assistant Editor of the journal Neurology.
Robert Dworkin,PhD is Professor of Anesthesiology. A primary goal of Dr. Dworkin’s research has been the identification of risk factors for the development of chronic neuropathic pain. His research has been funded by the National Institutes of Health, the Department of Defense, and various pharmaceutical companies, and one of the major findings has been that patients with greater acute pain are more likely to develop chronic pain. This suggests that attenuating acute pain might prevent chronic pain, and a primary focus of Dr. Dworkin’s current research has been the development of approaches to test this hypothesis. In addition, in his role as co-chair of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials, he directs a large database project that is analyzing the methodologic features and outcomes of analgesic clinical trials for acute and chronic pain.
Robert G. Holloway, MD is Associate Professor of Neurology & Community & Preventive Medicine. Dr. Holloway's research encompasses a broad range of issues related to the provision of health care to individuals with neurological diseases. Investigations include a project to develop and test quality of care indicators for acute stroke patients. In addition, he is developing a method to reliably evaluate the five core steps in the practice of evidence-based medicine. He is leading the efforts for an American Academy of Neurology project to develop a quality improvement program for outpatient neurological practices across the United States, including stroke prevention practices. He has also published a systematic review of cost-effectiveness research of stroke-related technologies and treatment, and is exploring the variability found in those studies addressing the optimal management of patients with asymptomatic carotid stenosis. He is involved in other projects including a clinical-economic randomized controlled trial assessing the 4-year costs and clinical outcomes of treating early Parkinson's disease with levodopa or pramipexole.
Jeffrey M. Lyness, MD is Professor of Psychiatry, Associate Chair for Education and Director of the Geriatric Psychiatry Program.and leads the Laboratory of Depression and Medical Comorbidity. The bulk of this Lab’s research, supported by an R01, is devoted to the study of mood disorders in older patients seen in primary care settings. Current projects focus on the complex comorbidity of depression and medical disorders. A NARSAD-supported study is underway to test a model in which atherosclerosis contributes to depression mediated by the effects of cytokines on brain monoamine function. Lab projects under development include the use of psychosocial interventions for primary or secondary prevention of depression in medically ill at risk patient populations, such as those seen in low vision clinics.
Mark Mapstone, PhD is an Associate Professor and clinical neuropsychologist who studies cognitive neuroscience of the aging brain. The goal of his research is to understand mechanisms of healthy brain aging and to develop tools to detect and quantify brain aging trajectories which deviate from healthy aging. His approach includes laboratory-based studies of patients with brain disease and large-scale population-based studies. Current work examines frontal contributions to visual perceptual changes in aging and Alzheimer’s disease, working memory in patients treated with subthalamic nucleus stimulation for Parkinson’s disease, leukocyte-derived protein expression profiles in community dwelling adults at risk for Alzheimer’s disease, and cognitive effects of cancer chemotherapy.
Kathy P. Parker, PhD (co-PI), is Professor and Dean of the School of Nursing. Her ongoing program of research is dedicated to the study of sleep/wake cycle disturbances in patients with chronic illness and the development and testing of population-specific interventions. Translational research is a major focus of her work. In her most recent NIH competing continuation, she is testing the effectiveness of using a thermo-therapeutic intervention to stabilize the sleep/wake cycle of hemodialysis patients.
Bethel A. Powers, PhD, RN, is Professor and Associate Director of the Elaine C. Hubbard Center for Nursing Research on Aging at UR School of Nursing. She has mentored many pre- and post-doctoral students and faculty. Her research focus is on care of older persons, including those with dementia, in institutional settings. Currently she serves as PI on a recently completed NIH/NINR-supported clinical trial of an intervention to improve outcomes of hospitalized elders and family caregivers and as Co-I (Norton, PI) on an ongoing NIH/NINR-funded ethnographic study of a palliative care consultation service within the context of the acute care hospital.
Nancy M. Watson, RN, PhD, FGSA is the Founding Director of The Elaine C. Hubbard Center for Nursing Research on Aging in the School of Nursing. In this role, she has been responsible for developing and leading a research agenda to address critical issues in aging by faculty, post-doctoral and doctoral level students; as well as enhancing the academic and clinical preparation of master’s and baccalaureate students in geriatric care and policy issues. Her own funded research has focused on evaluating and enhancing the care of older persons – especially those in nursing homes and those with dementia (e.g., use of innovative therapies to manage behavioral symptoms, incontinence assessment and treatment, palliative care).
Kevin McCormick, MD, PhD, Associate Professor of Medicine and Director of Geriatrics outpatient services for Highland Hospital, and Dolores Tetreault, MD, will serve as Faculty Advisors for this cluster.
Infectious Diseases Research Cluster
Ann Falsey, MD, Associate Professor of Medicine, has focused her research on the epidemiology and immunology of influenza and RSV in older persons. Respiratory infections are a major source of morbidity and mortality in the elderly and an understanding of the epidemiology, pathophysiology and immunology is critical to vaccine development. Dr. Falsey’s work has spanned from the bench to the bedside, investigating respiratory infections in several health care settings, including adult day care, nursing homes, community-dwelling elderly and hospitalized adults. Her current projects encompass several related topics: First, investigating those factors associated with severe RSV infection in older persons, second, defining the epidemiology and immunology of Human Metapnuemovirus Infection, a newly discovered respiratory pathogen in adults, and, third, studies to reduce unnecessary antibiotics in hospitalized adults by the use of viral diagnostics.
William J. Hall, MD (Program Director), Paul Fine Professor of Medicine, has been involved in collaborative research with the Division of Infectious Diseases at the URSMD for many years, including major studies on the functional significance of viral respiratory tract infection in older individuals. One of the key findings from this collaboration was the characterization of Respiratory Syncytial virus as a major pathogen in older adults. Currently, he is mentoring one of our T32 trainees in a study of functional decline in HIV / AIDS patients over age 50.
Amneris Luque, MD is the Clinical Research Site Leader for the URSMD’s NIH-funded AIDS Clinical Trials Unit. She previously conducted a 10 year longitudinal study of human papillomavirus infection and disease in HIV-1 infected women. This study contributed to the understanding of the high frequency of HPV disease among HIV-1 infected women highlighting the association with high HIV RNA plasma levels. Through the years she has been involved in the evaluation of novel therapies for the treatment of HIV-1 and exploratory proof-of-concept clinical studies of new HIV therapeutics.
John Treanor, MD is Professor of Medicine and Associate Professor of Microbiology and Immunology. He is the Principal Investigator and Director of the University of Rochester Vaccine and Treatment Evaluation Unit (VTEU). Recent studies include evaluation of smallpox, anthrax and genital herpes vaccines in healthy adults, and evaluation of novel inactivated influenza vaccines and of protein-conjugate pneumococcal vaccines in ambulatory elderly adults. In collaboration with Ed Walsh and Ann Falsey, the unit also evaluates the immune response to respiratory syncytial virus (RSV) in adults using a recently described human infection model. Dr. Treanor has a long standing interest in influenza pathogenesis and vaccine development. He has collaborates on studies evaluating aging and the immune response to influenza vaccine, on the effect of lipid supplementation on influenza vaccine responses in the elderly, and on the effects of stress on influenza immune responses in elderly residents of nursing homes.
Edward Walsh, MD is Professor of Medicine and Pediatrics. Dr. Walsh is internationally recognized for his work in the epidemiology, immunology and therapy of respiratory viruses, especially influenza and respiratory syncytial virus (RSV). Over the past 20 years his laboratory has defined the key characteristics of RSV infection in older adults, demonstrating the previously unrecognized clinical importance of RSV infection in populations of older adults residing in long term care settings. In addition to clinical studies in specific anti-viral therapy, Dr. Walsh defined the safety and immunogenicity of an RSV sub-unit vaccine in older adults. His laboratory also developed the first reverse transcriptase polymerase chain reaction techniques for rapid diagnosis of RSV in clinical samples. In addition to his laboratory work, Dr. Walsh has been recognized as a master clinician and teacher at the URSMD.
Mary Wilde, PN, PhD is Associate Professor of Nursing. She has developed a program of research related to community dwelling long-term urinary catheter users. Her work has been developed inductively from descriptive and qualitative research to a current R01 RCT intervention teaching self-management to people with catheters (2008-2012).
Faculty Advisors for this cluster include: Robert M. McCann, MD, Professor and Chairman of Medicine at Highland Hospital; Annette M. Medina-Walpole, MD, Associate Professor and former Director of the Geriatric Medicine Fellowship; and James McMahon, PhD, a faculty member of the School of Nursing.
Oncology Research Cluster
Richard I. Fisher, MD is the Durand Professor of Medicine at the URSMD. He has served as chairman of the Lymphoma Committee of the Southwest Oncology Group since 1985, and is the author of more than 260 scientific papers dealing with the diagnosis and treatment of lymphomas, melanoma, ovarian and adrenal cancers. He is the former Director of the Cardinal Bernadin Cancer Center at Loyola University Stritch School of Medicine in Chicago. In September 2000 he became the Director of the James P. Wilmot Cancer Center at the URSMD and is Director of Cancer Services for Strong Health.
Jonathan Friedberg, MD is Chief of the Division of Hematology/Oncology at the University of Rochester James P. Wilmot Cancer Center. His interests include investigating novel agents in the treatment of Hodgkin's and non Hodgkin's lymphoma. He recently presented results of a trial involving an inhibitor of Syk, a kinase involved in signaling through the B cell receptor, and is currently evaluating novel combinations using this agent. His clinical interests include lymphoma and stem cell transplantation. He was associate director of the hematology/oncology fellowship program, and serves as faculty on the URSMD’s T32 award in hematology.
Sally Norton, PhD, RN, is an Associate Professor of Nursing who studies palliative care and end-of-life questions with a focus on process and practice patterns of care delivery, and on the effects of organizational structure on care processes. An expert in qualitative and mixed methods, her research has examined how treatment decisions are made, negotiated, and reconciled. A co-investigator on two R01s examining decision making in treatment limitation cases and quality of care in ICUs and nursing homes, she also is principal investigator of an R01 ethnographic study to understand the culture of an adult-focused palliative care consultation in an acute care setting.
Timothy E. Quill, MD, Professor of Medicine, Psychiatry, and Medical Humanities, is the Director of the Palliative Care Program at the University of Rochester. He is internationally known for his work in end-of-life care, and has authored 5 books and numerous articles related to end-of-life and palliative care.
Faculty Advisors for the Oncology cluster: Daniel Mendelson, MD, MS, is a geriatrician who is board-certified in palliative care and is Director of Highland Hospital’s palliative care service. Supriya Mohile, MD, MS, is a board-certified geriatrician and oncologist with a research focus on the evaluation of patterns of care, health outcomes, and quality of life related to treatment for systemic cancer in older patients; she is a recent CTSA K-12 awardee.
Geriatric Health Systems Research Cluster
Bruce Friedman, PhD, is Associate Professor in the Department of Community and Preventive Medicine, and the Director of Research for the Medicare Primary and Consumer-Directed Care Demonstration. He is the PI of an AHRQ T32 Training Grant in Health Services Research and Policy. Dr. Friedman is working with students on a longitudinal comparison of the sustainability of the American Heart Association Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) Program hospitals vs. non-GWTG-CAD hospitals, an urban-rural comparison of the prevalence and incidence of cardiovascular disease among Medicare beneficiaries, and a study of the relationships between human management practices in nursing homes and end of life residents’ risks of hospitalization and feeding tube use.
Jurgis Karuza, PhD is Professor of Psychology with interests in caregiver support, prevention, and nursing home care. He has collaborated extensively with Paul Katz, MD, in evaluating the role of physicians in nursing homes, and is funded through the VA system to evaluate care correlates and staff models in nursing homes. He regularly gives lectures to the Geriatric Medicine fellows on the fundamentals of research in Geriatrics, and provides informal support and feedback for research projects completed by the fellows.
Paul Katz, MD (Co-PI) is Chief of Geriatrics & Aging, and has longstanding expertise in long-term care. His research is both health services and clinically focused. He has worked to define medical staff organization in the nursing home setting and explored the impact of different organizational models on quality of care. Dr. Katz has focused on organizational models both in VA and non-VA settings. He has also served as co-investigator on a number of projects related to health care delivery in the long term care setting and is currently working on a randomized control trial utilizing chiropractic care in older adults with low back pain. Dr. Katz is the PI for two HRSA training grants: the Finger Lakes Geriatric Education Center of Upstate NY and the Geriatric Training Program for Physicians, Dentists and Mental Health and Behavioral Specialists.
Alice Pentland, MD is the James H. Sterner Professor and Chair of Dermatology and NIH funded researcher in the area of photobiology and skin cancer. As founder and director of the Center for Future Health, she facilitates creation of inexpensive advanced technologies for self care. In the Center, teams of physicians, engineers, biological scientists and computer scientists work together to create and prototype these helpful technologies. A key project currently is the Center’s Smart Home Environment for the Elderly. The concept is to create a language-based interface for older adults that can help them stay independent longer. The environment can provide support for individuals with early memory loss, using memory protheses that are based on user-friendly interfaces such as a radio-console, watch or glasses. The assessment laboratory is a full-scale apartment, in which study subjects are evaluated.
Helena Temkin-Greener, PhD, MPH is a health services researcher with a focus on aging and outcomes research. She is an Associate Professor in the Department of Community and Preventive Medicine and the Director of Research and Quality Improvement at the Center for Ethics, Humanities, and Palliative Care. She is currently the PI on two NIH-funded R01s. One examines the relationship between organizational performance and quality of care in nursing homes. The other R01 is to develop and validate individual indicators and a composite measure for assessing end-of-life quality of care in nursing homes, and to identify characteristics of facilities associated with better end-of-life quality of care. Dr. Temkin-Greener is the PI of an on-going study on risk- adjustment and Medicare reimbursement funded by the National PACE Association. She runs the PACE Data Analysis Center (PDAC) to which 61 PACE organizations from across the country contribute data on an ongoing basis. Dr. Temkin-Greener also directs the Population Data Laboratory, a research support center located in the Department of Community and Preventive Medicine. The Laboratory was developed with seed funding from the Agency for Healthcare Research and Quality (R25 HSO9799-01) to enable the students, fellows, and faculty researchers to access clinically relevant databases, and to facilitate the interest in outcomes and health services research.
Gail Ingersoll, PhD, is Loretta Ford Professor of Nursing and Director of the School of Nursing’s Center for Outcomes Measurement and Practice Innovation. Dr. Ingersoll has served as research mentor to doctoral and postdoctoral students for over 20 years. Her areas of research interest focus on organizational redesign, outcomes of innovative practice models and research translation. She has expertise in mixed method program evaluation designs and instrument development procedures and testing.
T. Franklin Williams, MD, former Director of the National Institute on Aging, is Professor Emeritus, with a wealth of experience in developing health care systems for older adults. Thomas Caprio, MD, MPH is a graduate of the T32 training program and current Assistant Professor and Geriatric Medicine Fellowship Director, with a research focus on organizational models of nursing home care. Manish Shah, MD, MPH is Associate Professor of Emergency Medicine and Community and Preventive Medicine, with a research interest in optimizing care of older adults in the emergency room, for which he has received NIH, HRSA, AHRQ, and CDC funding. Suzanne Gillespie, RD, MD, Assistant Professor, is a geriatrician and expert in quality improvement in long-term care. Ying Xue, PhD is an Assistant Professor in the School of Nursing, with a research focus on quality and cost outcomes of hospital supplemental nursing staffing. They will serve as Faculty Advisors for this cluster.
Metabolic Bone Disease Research Cluster
Susan Friedman, MD, MPH (Program Director) is the Director of Geriatric Fracture Center Research based at Highland Hospital. In this role, she has been responsible for developing and leading a research agenda to evaluate outcomes in the Center, setting the stage for large-scale replication of this novel approach to care. Research has focused on defining the model of care, demonstrating clinical and financial outcomes compared to usual care, and evaluating comorbidities among patients who present with hip fractures. Dr. Friedman has mentored pre-medical and medical students, residents and fellows in projects related to the Geriatric Fracture Center.
Jeffrey Houck, PT, PhD is an Associate Professor whose research focuses on integrating biomechanics and outcomes to understand responses to treatments in subjects with lower extremity musculoskeletal problems. Two current NIH-funded areas of focus include posterior tibial tendon dysfunction and hip fractures. Because both of these problems involve elderly subjects an interest in the normal aging process has also evolved. The laboratory is equipped to capture 3D movement analysis (kinematic and kinetic), electromyography as well as integrating, novel, custom made, measurement systems to evaluate movement and muscle performance. The current research in posterior tibial tendon dysfunction and hip fractures arose from strong collaborations with the Department of Orthopaedics, Department of Biomedical Engineering and School of Nursing.
Debra Nawoczenski, PT, PhD is a Professor of Physical Therapy at Ithaca College. Her research laboratory has two primary focus areas of musculoskeletal research. The first research focus is directed to the biomechanical study of normal and abnormal foot function and interventions for common pathologies including foot arthritis, abnormal and painful foot pronation (flat foot deformities), diabetes and other musculoskeletal disorders. The second focus in the laboratory is directed to the study of shoulder mechanics and the optimization of shoulder health for wheelchair users, especially those with spinal cord injury. The long term goal is to provide recommendations for non-operative interventions that minimize debilitating shoulder pain.
Regis O’Keefe, MD, PhD is Professor and Chairman of the Department of Orthopaedics. He directs the Center for Musculoskeletal Research at the University of Rochester. Active areas of research include articular cartilage growth and reproduction, effects of lead on fracture healing and bone health, effect of cigarette smoke on fracture healing, molecular basis for fracture healing and molecular basis for osteoporosis. A biomechanic study division of the lab studies bone strength and tissue strength after various molecular treatments.
Randy Rosier, MD, PhD is Professor of Orthopaedics and Rehabilitation, and Biochemistry and Biophysics at the University of Rochester. Dr. Rosier established a molecular biology research program in the area of growth factor regulation of cartilage development and regeneration, and an Osteoporosis Center for the treatment of metabolic bone diseases. In 2000, Dr. Rosier became Chairman of the Department of Orthopaedics, and established the Center for Musculoskeletal Research which he directed. The Orthopaedic research program of the Center, which focuses on bone and cartilage healing and regeneration, arthritis and gene therapy, tissue engineering, osteoporosis, and treatments for implant loosening and cancer bone metastasis, has become ranked as the number one NIH funded Orthopaedic research program, growing from 3 to 17 scientists in the group.
Stephen Kates, MD, is an Orthopaedic surgeon and founder of Highland Hospital’s Geriatric Fracture Center. Susan Bukata, MD, is an Orthopaedic surgeon with an active research program in osteoporosis and Vitamin D deficiency. They will serve as Faculty Advisors for the Metabolic Bone Disease cluster.
Links of Interest
American Medical Directors Association (AMDA)
The American Geriatrics Society (AGS)
State Society on Aging of New York (SSANY)
VA Healthcare Network Upstate NY - VISN 2
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Division of Geriatrics & Aging
Phone: 585.760.6352
Geriatric Medicine Fellowship Program
Phone: 585.760.6353
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