Children and Adults; Clinical Neurophysiology; Forensic Psychiatry; Psychiatry
Wearing many hats, my work include administrative, clinical, academic, and research responsibilities. Administratively, I oversee our department’s forensic faculty and staff, forensic programs, and the forensic psychology training program. Clinically, I (or my team) conduct psychological evaluations that address clinical and forensic questions (e.g. emotional problems, cognitive issues, risk, competency, criminal responsibility, etc). Using social-psychological-physiological methods, I help clients overcome psychological and emotional problems and optimize their performance. Academically, I teach and supervise students at all levels, with the ultimate goal of facilitating scholarly thinking and work. All students are encouraged to get involved in my research program, which focuses on the neurobiological, behavioral, and societal factors that underlie human emotions, aggression and impulsivity.
Children and Adults; Internal Medicine - Pediatrics
Born and raised in Western New York, I graduated from UB medical school and trained in the Combined Internal Medicine-Pediatrics Residency Program at University at Buffalo. I have now been a faculty member for two decades, working in primary care of both adults and children at the Elmwood Health Center. I became the Program Director for the Med-Peds Residency in 2006 and the Division Chief for Med-Peds in 2008. At my primary care clinical practice at the Elmwood Health Center, I care for patients in an underserved community of Buffalo with a variety of backgrounds and socioeconomic statuses. The center specializes in caring for individuals with developmental disabilities and I see many patients with complex social and medical issues. I have an interest in transitional health care for pediatric patients with chronic diseases, whom this practice allows me to continue caring for into adulthood. My research focus recently has been on Med-Peds medical education. I worked with other Med-Peds program directors across the country to research the support provided to Med-Peds programs since being recognized as separate categorical residencies by the ACGME in 2006. I also supervise and mentor Med-Peds residents on their individual research projects. In addition, I earned my Masters of Epidemiology in 2005 with a thesis on the knowledge, attitudes, and beliefs about influenza vaccine administration. Much of my role as a faculty member and program director is focused on teaching and medical education is of particular interest to me. I supervise Med-Peds residents at both the Elmwood Health Center and the Linwood Med-Peds site. I teach Medicine and Pediatric residents and medical students on the inpatient wards at Buffalo General Medical Center and Women and Children’s Hospital of Buffalo while on service several weeks throughout the year. I lecture several times a year at the monthly Med-Peds conferences and have given evidence-based medicine lectures to pediatric residents in the past. In the larger Department of the Medicine, I lead the Internal Medicine Teaching Interest Group which focuses on faculty development of teaching skills. I also recently formed the Transitional Care Interest Group in cooperation with both adult and pediatric physicians throughout Jacobs School of Medicine and Biomedical Sciences. Together, we work to improve transitional care for patients in Western New York through development of clinical protocols, research, education, and administrative support.
Children and Adults; Psychiatry; Molecular and Cellular Biology; Neuropharmacology; Signal Transduction
Research Interests: Calcium Metabolism in Affective Disorders; Psychopharmacology; Psychosomatic Medicine; Medical Education. Clinical specialties: mood disorders, psychosis, interactions between medical and psychiatric disorders, psychopharmacology, difficult diagnoses, complex clinical entities
Child Neurology; Children and Adults; Developmental Neurology; Neurology; Pediatrics
My research was focused originally on using astrocyte cell cultures to shed light upon processes related to astro-gliosis, the key response of developing and mature brain to injury. The laboratory succeeded in modeling many immunochemical features of gliosis in primary brain cell culture. More recently, I have been involved in the clinical care of, and research regarding, children with leukodystrophies. This includes coordinating several clinical research projects in roles as Clinical Director of the Hunter James Kelly Research Institute (HJKRI), and as President of the New York State Krabbe Disease Consortium. Projects include expansion of the World Wide Registry for Krabbe Disease (WWR), a database maintained at HJKRI that now has clinical and genetic information for over 150 affected patients afflicted with this rare disease, and examining ways to involve the WWR in national data-sharing initiatives promoted by the NIH, including the Newborn Screening Translational Research Network (NBSTRN). HJKRI is also conducting long-term follow-up studies of affected children, in conjunction with the Rare Clinical Disease Research Network (RDCRN) examining neuro-developmental parameters before and after therapeutic transplantation. Additional projects include exploration of the genotype/phenotype relationship in Krabbe, including exome and whole genome analyses with collaborators, and participating in research to uncover new biomarkers and to develop novel therapies. I am also the Director of the Headache and Concussion clinics at Children’s Hospital of Buffalo. These clinical leadership roles in Western New York and New York State can facilitate significant recruitment into multi-center research studies.
Children and Adults; Forensic Psychiatry; Psychiatry
My time is split between the Erie County Forensic Mental Health Service (ECFMH) and the Erie County Medical Center (ECMC). At ECFMH I conduct Article 730 competency evaluations for the courts, along with other requested evaluations from the criminal justice system. I complete clinical rounds on the Constant Observation units (suicide watch) at the Erie County Holding Center (ECHC). At ECHC I oversee a Residential Treatment Unit for inmates who have a serious mental illness and may benefit from a higher level of care. Working within a treatment team consisting of mental health staff, a psychiatrist, a nurse practitioner, a psychologist, and students, staff provide weekly individual counseling, weekly groups, and comprehensive psychiatric care. We conduct psychological assessment with inmates and track clinical outcomes over time. Further, we conduct research from this information on an ongoing basis. I also help to supervise graduate and undergraduate level students. At ECMC I am the Unit Chief of a new, specialized psychiatric inpatient unit--Transitions--for individuals at imminent risk for aggression or recently became aggressive primary to a mental illness. A interdisciplinary team of licensed mental health counselors, nursing, a clinical manager, a psychiatrist, an occupational therapist, and a psychologist work to stabilize patients and prevent incidents of aggression. I provide oversight of clinical programming (individual and group psychotherapy) and assessment activities. In the future we will provide all patients with assessment and track outcomes over time. This unit will also be a training unit for students and will conduct research. My other clinical and evaluation interests include sex offender treatment and risk assessment, work with individuals who have serious mental illness, particularly Schizophrenia, and mood disorders. When I primarily conducted psychotherapy in the past I specialized in working with individuals who had depression and anxiety disorders. I have also specialized in working with domestic violence, both victims and offenders throughout my career. My research interests are varied, but include aggression, violence, well-being, positive psychology topics, countertransference management, sex offender work, therapist effects, and mood disorders.
Children and Adults; General Neurology; Movement Disorders; Neurodegenerative disorders; Neurology; Parkinson's; Tourette's Syndrome
I received my medical degree from the University of Otago Medical School in New Zealand in 1977 and, following further advanced training in general medicine and Neurology was elected to Fellowship of the Royal Australasian College of Physicians in 1984. On completion of a Neurology residency and fellowship in Movement Disorders at the University of Rochester (1988), I joined the faculty of the Department of Neurology at the University at Buffalo. As a Clinical Professor at UB, I am engaged in patient care and the teaching of students, residents and fellows at the VA Medical Center. I also have a focused Movement Disorders clinic at the Brain and Spine Center (Williamsville, NY). My interests include not only disorders of voluntary movement but also the associated cognitive, behavioral and psychiatric dysfunction commonly accompanying such disorders. Accordingly, I conduct clinical studies in Movement Disorders not only with my Neurology and Neuroimaging colleagues at UB, but have also collaborated on clinical studies in Tourette syndrome with colleagues from the UB Department of Psychiatry, where I have a secondary appointment, and with members of the Division of Developmental and Behavioral Neurosciences. My publications include co-editing a textbook on “Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders” (Guilford Press, 2001). I am an active member of the American Academy of Neurology, the Movement Disorders Society, the Tourette Syndrome Association, the American Neuropsychiatric Association, and the Royal Australasian College of Physicians.
Adolescent Medicine; Children and Adults; Internal Medicine; Pediatrics
As a specialist in adult and pediatric care, I practice general primary care for both children and adults. I also provide specialized care for adolescents and young adults who have a wide range of health and psychosocial conditions and concerns, including eating disorders, gynecologic issues, sexual health concerns and complex chronic disease. My academic interests focus on adolescent resiliency, i.e., a teenager’s ability to overcome adversity. Those with more resiliency tend to cope better with chronic disease or negative experiences and are less likely to engage in risk-taking behaviors. I am particularly interested in the role resiliency plays in my patients’ quality of life in the face of their chronic health conditions. I am also interested in its role in preventing risk-taking behaviors—specifically, high-risk sexual behaviors that lead to teenage pregnancy. My resident research project focused on the relationship between resiliency and perceived quality of life in adolescent mothers, a research area that I continue to explore. My goal with these research foci is to develop ways to improve resiliency among adolescents in our community, through coursework in our high schools, perhaps, or through after-school programs. As a faculty member in internal medicine and pediatrics, I am involved in resident and medical student education. I teach evidence-based medicine and its clinical application, keeping current with journal articles and reviews, using data to modify my clinical practice, when indicated--and encouraging these practices in residents and medical students. I participate as well in introducing both first- and second-year medical students into the clinical setting via the Clinical Practice of Medicine (CPM) course they are required to take. Students come to my primary care office to shadow me and to practice their history-taking and physical-exam skills. I also lecture at the monthly medicine-pediatrics conferences; recent topics have included contraception and proteinuria in pediatric patients.
Clinical Genetics; Pediatrics; Children and Adults; Dysmorphology; Pediatric Genetics
I specialize in the evaluation of children and adults with birth defects, developmental disability, autism and genetic disorders and/or syndromes. My goal as a clinical geneticist/dymorphologist is to make specific overall diagnoses in order to provide patients and their families with information regarding prognosis and recurrence risks, i.e., the likelihood that a trait or disorder present in one family member will occur again in other family members. In addition, I help coordinate patient care in conjunction with patients’ primary care physicians and other specialists. I also work closely with genetic counselors who evaluate patients for a variety of concerns and help to coordinate genetic diagnostic testing as indicated. As a UBMD physician working at the Women and Children‘s Hospital of Buffalo, I direct the Williams Syndrome Clinic and serve as the clinical director at the Craniofacial Center of Western New York. The Craniofacial Center provides comprehensive, interdisciplinary evaluation and management of individuals from birth through adulthood with congenital and acquired craniofacial abnormalities. Common diagnoses include clefts of the lip and/or palate, craniosynostosis and ear anomalies. We hold monthly conferences that focus both on teaching and communication amongst providers in an effort to optimize patient care. My particular interest in the care of individuals with Williams Syndrome led me to start a multidisciplinary Williams Syndrome clinic in 1994. This is one of only twelve such clinics in the country. The clinic is held monthly, and it is organized by patient age groups; the format allows families to interact and share their experiences. Geneticists, genetic counselors, cardiologists, pediatric psychiatrists and pediatric dentists contribute their expertise at these clinics, and every patient sees a provider from each of these specialties. Additional evaluations for our Williams Syndrome patients are provided by other specialists such as ophthalmologists, nephrologists and neuropsychologists, depending on individual patient needs. I have coordinated a number of research studies in this patient population, and I have published extensively in this field. As a UB faculty member, I also teach residents and medical students during their month-long genetics elective.
Children and Adults; Internal Medicine - Pediatrics
I provide adult and pediatric health care with a primary focus on caring for individuals with developmental disabilities. My clinical expertise draws from over a decade of primary care practice at the Elmwood Health Center, a clinic located in an underserved area of Buffalo. The center specializes in caring for individuals with developmental disabilities and providing primary care to residents in the surrounding city neighborhoods and adjacent suburbs. I see children and adults from a wide variety of backgrounds, many with complex social as well as medical issues. I care for patients from an increasingly diverse population due to the growth of immigrants in the Buffalo area; this gives me the rich experience of treating and communicating with patients from different cultural backgrounds. I am committed to health care equity, and I strive to understand the needs of all my patients. My research is dedicated to increasing advanced directives in the medical charts of developmentally disabled adults. I serve frequently as a consultant to hospital health care providers in assessing the decision-making ability of intellectually impaired adults. I teach in a number of settings: I present endocrine topics to medical students during inpatient rotations at the Buffalo General Medical Center (BGMC) and the Women and Children’s Hospital of Buffalo (WCHOB), and I give endocrinology lectures to our Medicine-Pediatrics residents. I oversee inpatient and outpatient clinical training of medical students and residents in internal medicine and pediatrics at Elmwood Health and at the inpatient services at BGMC and WCHOB. I also teach the second-year Clinical Practice of Medicine course as a preceptor at the Elmwood Health Center. Additionally, I have served as the quality improvement officer within our academic division, and I organized a Web-based residency curriculum for our training program. I periodically advise residents on quality improvement projects.