For a career dedicated to improving the lives of others, East Carolina University professor Carmen Russoniello has received the 2015 Governor James E. Holshouser, Jr. Award for Excellence in Public Service by the University of North Carolina system.
The annual award recognizes public service by faculty of the 17 UNC institutions. ECU is the only university with three recipients since it was first awarded in 2007.
“I’m awed by all that Governor Holshouser accomplished as a public servant and truly humbled to be recognized in his honor,” Russoniello said. He accepted the award to a standing ovation Oct. 30 during the monthly Board of Governors’ meeting in Chapel Hill.
Russoniello’s contributions have spanned decades, beginning with his service as a Marine Corps machine-gunner and decorated Vietnam combat veteran. He has since focused on the use of recreation therapy in the form of biofeedback and video games as an alternative to medicine for people with stress-related medical disorders, including veterans and victims of Hurricane Floyd.
“At ECU, we do value service. I’m a clinician, and as a clinician, I’m always looking for ways to help people,” Russoniello said. He has undergraduate and master’s degrees in recreational therapy and interdisciplinary studies from Eastern Washington University and a doctorate in educational leadership from Gonzaga University. He has more than 20 years of clinical experience as a therapist/counselor and works as scientific advisor to Biocom Technologies.
“What I learned through public service is what my mom tried to teach me: that doing for others is expected, and the rewards are the thoughts and feelings that maybe I’ve made as much of a difference in other people’s lives as they’ve made in mine,” Russoniello said.
At ECU, he is a professor in the Department of Recreation and Leisure Studies in the College of Health and Human Performance and director of the Center for Applied Psychophysiology.
Using biofeedback—the ability to view nervous system responses on-screen—in combination with recreational gaming, Russoniello has proved significant advances in the treatment of post-traumatic stress disorder and traumatic brain injuries. Since 2000, he has been providing free services to residents of eastern North Carolina.
“That program saved my life,” said U.S. Navy Corpsman Dustin “Doc” Kirby. “It gave me the tools that I needed to help myself instead of just numbing the pain and pushing it away.” After four years of treatment in ECU’s biofeedback lab, Kirby was able to attend college and start a family.
Severe anxiety, flashbacks, nightmares and uncontrollable thoughts are all symptoms of PTSD. The prevalence of it among previously deployed Operation Enduring Freedom and Operation Iraqi Freedom service members is 13.8 percent, according to the U.S. Department of Veterans Affairs. Traumatic brain injuries are also common in veterans and are similarly incapacitating.
Russoniello knows this well. He developed PTSD after losing a mentor, friend and fellow machine-gunner in his infantry platoon during the Vietnam War.
Years later, the experience would spark what he described as a “passion to determine the underlying physiological benefits of recreation or fun activities.” Once he put his finger on that, he knew he would be able to use it to help people cope in significant ways.
Biofeedback technology turned out to be a big piece of the puzzle.
In 2006, a program director from Camp Lejeune in Jacksonville asked him for help with treating Wounded Warrior Marines as they transition back into civilian life. He described the request as what he “had been preparing for (his) whole life.”
Soon, a partnership formed between Russoniello’s biofeedback lab at ECU and the Wounded Warrior Battalion-East at Camp Lejeune. It has since improved the lives of hundreds of veterans.
His work at ECU started in 1999 after Hurricane Floyd devastated eastern North Carolina. Russoniello had just accepted an assistant professor position when he received a call from a social worker at an elementary school in Tarboro. The school and many students’ homes had been destroyed, and the fourth- and fifth-graders were distraught.
Russoniello and his students found that 73 percent of the children had moderate to severe symptoms of PTSD. Using their stress intervention techniques, they helped the children reduce their PTSD symptoms 11 percent faster during the time they delivered services than with no intervention.
Russoniello has created four smartphone apps for the U.S. Department of Defense using the phone’s camera as a sensor for biofeedback. In 2012, he developed a tool for service members during combat: a wireless ear clip that collects sophisticated stress data in remote locations so professionals can analyze it instantly.
Russoniello was raised by a single mother in Scranton, Pennsylvania. By his teenage years, he was living part-time on the streets and getting into trouble with the law. He dropped out of school by the 10th grade and joined the Marine Corps at 17, returning from his Vietnam deployment with no education, skills or direction.
He was soon homeless, working odd jobs at an oil rig and picking fruit. Encouragement from friends and counselors eventually led him to take a few classes at a community college.
“For me, education was a ticket to make something of myself,” he said. “I realized I could be successful at something that could help me build a career.”
Cole Cruz paints a wall near campus as part of the Art + Community initiative. (Photo by Cliff Hollis)
ECU, partners unite community through art
A colorfully painted cinderblock wall near campus helps illustrate an ongoing partnership between ECU and its neighbors.
The initiative, called Art + Community, brings ECU and the surrounding neighborhood together through the creation and installation of art. On Sept. 19, an estimated 500 people turned out at Third and Jarvis streets in downtown Greenville for a block party that included painting the wall, live music and fellowship.
“Some people painted for 10 to 15 minutes and others for two to three hours,” said Kate Lamere, associate professor of art in the ECU School of Art and Design. “There was a sense of ownership.”
ECU students and volunteers led by Scott Eagle, associate professor of art and director of graduate studies, spent several days outlining a whimsical underground scene on a retaining wall at the intersection, leaving lots of white space for block party guests to paint.
On Sept. 18, Eagle and Tim French, ECU graduate and art instructor at Pitt Community College, and ECU students Zack Cleghorn, Ritvik Verma, Lupita Nava and Shayla Thornton worked to finish the outline.
French, who is known for painting gnomes, had painted two or three on the wall. “I tend to hole up in my studio, so this was a chance to get outside and do something cool,” French said.
Verma, a sophomore majoring in sports medicine, was out to gain extra credit for a class. “I’m not very good at art, but I love watching how art is made,” Verma said. “I’m just going over the stray parts and outlining since I’m art challenged.”
Cleghorn, a junior majoring in industrial engineering technology, said he loves helping people and giving back to the community. The Marine Corps veteran served seven years before a roadside bomb caused a brain injury that ended his military career. “So many people have put their hands on me and helped me along this path,” said Cleghorn, who is the first in his family to attend college. “I have an awesome peer support group at ECU.”
He is one of five ECU students picked as an inaugural Public Service Fellow, an outreach of the Art + Community initiative. The students will work 300 hours in local nonprofit or not-for-profit agencies this semester and will conduct a research project for the community. The fellowships are made possible by a $100,000 grant from the State Employees Credit Union Foundation.
Art + Community started more than two years ago when a Greenville Police Department officer walked into the Jenkins Fine Arts Center, Lamere said.
The officer, Niki Cates, was seeking artists to create work for the force’s Property Protection Initiative to reduce crime near campus based on the principles of Crime Prevention through Environmental Design.
The thought is that residents who meet one another and get involved in making art will monitor and protect it, creating a sense of ownership and leading to a decrease in crime in the neighborhood.
ECU’s Misun Hur, assistant professor of planning, had already formed a research team that was primed to work with Cates. Faculty in art and design, geography, planning and the environment and ECU Off Campus Student Services joined efforts with the police department, Tar River University Neighborhood Association, Pitt County Arts Council at Emerge, University Neighborhood Association and Christy’s Euro Pub to form Art + Community.
For more information, visit www.facebook.com/artandcommunity or email firstname.lastname@example.org.
ECU was recognized for efforts and success in diversity and inclusion by INSIGHT into Diversity magazine.
For the fourth consecutive year, ECU has been recognized by INSIGHT Into Diversity magazine with its Higher Education Excellence in Diversity Award.
National institutions are recognized with the HEED Award for exhibiting “outstanding efforts and success in the area of diversity and inclusion,” according to the award’s citation.
ECU is the only North Carolina institution to receive this distinction four years in a row.
“This award speaks volumes about the efforts across campus to increase diversity and inclusion at East Carolina University,” said LaKesha Alston Forbes, associate provost for equity and diversity. “We have initiatives and leadership in place at ECU that warrant the national recognition.”
Various committees and offices work toward making sure ECU has a diverse and inclusive environment, Forbes said, including the Chancellor’s Diversity Leadership Cabinet, the Chancellor’s Committee on the Status of Women and the Diversity Committee in the Staff Senate.
ECU has prioritized diversity at every level, as shown in the 2014-2019 strategic plan. In the plan, 25 colleges and divisions include diversity as a goal.
In addition, the admissions office works with local minority organizations and Upward BOUND programs to provide local students with exposure to a higher-education environment and information about the university. The office also works with grade-school and community college students to ensure that information about ECU is reaching underrepresented and minority students.
ECU Board of Trustees Chair Steve Jones (Photo by Cliff Hollis)
Board initiates fundraising plans for Heritage Hall
ECU trustees voted Sept. 25 to raise $300,000 by Dec. 1 to begin developing Heritage Hall, the place where the university will recognize people of historical significance to the university including the namesake of Aycock Residence Hall.
Trustees also voted to transition the Aycock name from the building as soon as possible once the money is pledged.
It’s estimated the hall will cost $500,000.
“We as a board need to get behind Heritage Hall,” said Steve Jones, chair of the trustees. “We really need to get out and put some energy around raising this $300,000.”
Jones asked that each board member consider making a personal donation. “If we don’t raise the amount by December, we need to keep working toward it and transition the name as soon as possible,” he said.
The vote came after concerns were raised at the trustees’ lunch meeting the previous day about a possible delay in transitioning the name since the hall will be part of a new Student Services Center that won’t be completed until 2018. The eventual Heritage Hall is intended to occupy a physical space in the student center as well as virtual space in a yet-to-be-developed timeline website.
Board members had not decided on a location for the hall when they voted to create it in February. A working group was formed to make a recommendation on the location, which was approved by the board this summer.
Mark Matulewicz, Student Government Association president and ex-officio member of the board, said he was pleased with the board’s decision. “It’s a perfect example of how voicing student concerns can make a difference on the university as a whole,” Matulewicz said.
At the request of students and others, the board began discussions in 2014 about renaming Aycock Residence Hall, which honors Charles B. Aycock, a former governor, federal prosecutor and school superintendent who served as a spokesperson for white supremacy campaigns at the turn of the century.
In other news, the board voted to discontinue three centers and institutes whose work will be transitioned to existing departments. They are the Center for Health Systems Research and Development, the Center for Diversity and Inequality Research and the N.C. Center for Biodiversity. The board voted to keep the Center for Natural Hazards Research.
Trustees also approved hiring the firm LS3P (with AECOM) of Wilmington to design a new press box for Dowdy-Ficklen Stadium.
—Crystal Baity and Kelly Setzer
ECU enrollment in Fall 2015 reached a record high of 28,289 students. (Photo by Cliff Holllis)
ECU enrolled 28,289 students this fall, the most in its 108-year history.
Undergraduate enrollment reached a historic high of 23,039, 3.54 percent above last year’s undergraduate enrollment, said John Fletcher, associate provost for enrollment services.
The new freshmen who entered ECU this fall are the best prepared in the university’s history with an average SAT of 1,061 and a weighted high school GPA of 3.76, Fletcher said.
Total graduate student enrollment remained steady at 4,731 students while first-time graduate students increased by 11 percent, said Paul Gemperline, dean of the Graduate School.
Enrollment figures are considered preliminary until reviewed and approved by the University of North Carolina General Administration.
—ECU News Services
ECU biology student Molly Albecker is among a new generation of researchers who use social media and the web to share research with others. (Photo by Cliff Hollis)
Graduate students share research on social media
Chances are ECU doctoral students are either in the field, in the lab, headed to one or just back from the other.
To find out, just log on to their social media accounts.
Biology students Molly Albecker, Daniel Newhouse and numerous others are among a new generation of researchers—graduate students and early career professors—who are embracing social media, blogs and websites to communicate with the public and their peers.
According to a 2014 Pew Research Center survey of scientists connected with the American Association for the Advancement of Science, 98 percent of scientists talk with the public about science and research. Fifty-one percent speak with reporters, 47 percent use social media to discuss or follow science, and 24 percent have blogged about science and research.
Twenty-two percent described it as either “very important” (4 percent) or “important” (18 percent) for career advancement in their discipline to promote their findings on social media such as Facebook or Twitter.
“People are telling their stories sooner and see that need to tell their stories,” said Katie Mosher, communications director of N.C. Sea Grant. “They do want to share their science with broader audiences. It’s extremely important, and I think the graduate students and early career faculty are recognizing that in greater numbers.”
Albecker, a doctoral student in the Institute for Coastal Science and Policy, said using social media allows researchers to communicate discoveries to people outside of academic circles. Social media also connects the researchers’ personality to the work they are doing, she added.
“I find that it is the easiest way to send out links to neat articles, display pictures of my research-in-progress, and other science-based things I find interesting or funny,” said Albecker, who uses her Twitter account (@Island_Frogger) as her primary means of science-based communication.
It also allows scientists to show their excitement and passion for their work, she added.
“In particular, connecting a face, a sense of humor and a real person to the research is especially important in recent times when scientists are sometimes portrayed as distant, unconnected and even untrustworthy,” she said. “Instead, researchers can show that they are regular people that are curious and motivated to understand our world and our place in it.”
Ariane Peralta, (@ArianePeralta) an assistant professor of biology, was one of a trio of biology faculty members who earlier this year spoke with students about using social media to talk about science.
“The pros are that online networking through social media works for many types of personalities, it evens out the playing field—as an early career person you can connect with very established scientists in your field—(and) your reach is in real-time and global,” said Peralta. “Embracing social media as part of science allows you to enhance visibility of your work, curate your online presence and helps you keep up.”
Social media also makes it easier to stay in touch with colleagues and scientists in other disciplines.
But be careful, she warned. “There are no ‘take backs.’”
Nate Holland (@onecynicmedic), a doctoral student in the Department of Physiology at the Brody School of Medicine, says it’s important to give the public a chance to know what scientists are doing—and in terms the public can understand.
“I think services like Twitter are great for communicating with the lay public because the concise nature of the messages, such as character limits, really force me to distill my message to something easily digestible by the lay public and fellow researchers alike,” he said.
Newhouse (@oldhouse5), a biology doctoral student, said he uses social media because it allows him to reach a much wider audience.
“Twitter is used by everyone, so it makes discussing research with scientists and the general public quite easy,” he said in an email. “Furthermore…I’m able to engage in discussions with researchers from all over the world.”
Social media also allows scientists to receive instant feedback about their methods and findings. “I see questions about which methods to use and how to analyze data every day on my Twitter feed,” Newhouse said. “Often times, several researchers will respond within minutes each offering their ideas.”
But social media feedback can go only so far.
“Nothing posted on social media is likely to reveal the nitty-gritty experimental and statistical methods that ultimately determine whether your conclusions are accurate and appropriate,” Albecker said.
Instead, she said, tweet links to publications.
Some scientific methods never get old.
Chuck Bangley pilots the skiff with Ryan Mackenzie, graduate student, at left. (Photo by Cliff Hollis)
Sharks put ECU graduate student in the spotlight
If you were at a North Carolina beach this summer, you might have wondered if a shark was swimming just beneath the waves.
With eight shark bites reported along the state’s coast during a span of about four weeks in May and June, many people, including news reporters, were asking that same question. For shark expert and East Carolina University doctoral student Chuck Bangley, that meant more chances to talk about his work.
“North Carolina’s not a very crowded market for shark people,” he said. “I definitely appreciate being able to be helpful.”
He guesses he did 15 media interviews during the summer, and he’s also appeared on two National Geographic Wild specials, “When Sharks Attack” and “United Sharks of America.”
In August, Bangley wrote a blog post for N.C. Sea Grant about his experiences with the media this summer following the shark bites. On Aug. 13, he spoke at a public gathering at the N.C. Museum of Natural Sciences. A week earlier, he spoke at the N.C. Estuarium in Washington about his research of sharks in Back Sound near Beaufort.
“It seems overwhelming, but ultimately it’s one of our jobs as scientists to provide answers to people when they need them,” Bangley wrote in the Sea Grant blog.
Katie Mosher, communications director for N.C. Sea Grant, said Bangley is well-suited for that role. “Chuck has a natural ability to put research in terms the public can understand and he has an affinity—a need—to do that,” she said.
In his media interviews, Bangley has emphasized one main point: Warmer ocean temperatures brought sharks to North Carolina this year sooner than expected.
From 2003-2014, coastal water temperatures rose 4 degrees Celsius in May and 1-2 degrees in June.
“It seems like we get these summer temperatures earlier, then they’re here,” Bangley said. “We’re getting hotter faster.”
What that means is sharks that would normally come into the area in midsummer are arriving in late spring—at a time when swimmers are just beginning to hit the water. Then as spring turns into summer, the sharks continue up the coast to New England.
“It’s really a bright, clear connection to temperature,” he said. And with 25 confirmed shark bites between 2005 and 2014, North Carolina ranks fifth in the nation for bites, according to National Geographic.
The warmer waters also appear to have created a new nursery for baby bull sharks: the Pamlico Sound. Looking at data from the North Carolina Division of Marine Fisheries, Bangley has identified bulls along the west side of the sound and even into the rivers that feed it. He’s found as many as 36 juvenile bull sharks in or near the sound.
“What it’s showing is this species has the ability to find new nursery habitat if it has to,” he said.
There is a benefit to having the sharks around. They keep patches of young aquatic plants free of fish that would feed on the juvenile fish that live among the plants.
But when a hot spring brings people to the beach at the same time the bulls are arriving, conflict is bound to occur.
“They’re the apex predator shark that’s most likely to overlap with people in the water,” Bangley said. “They’re big and powerful enough that an accidental bite can remove an arm.”
Bangley contributes to the science blog Southern Fried Science at www.southernfriedscience.com.
Follow him on Twitter at @spinydag. He blogs about “spiny dogfish, grad school and life” at yalikedags.southernfriedscience.com.
ECU researchers are using an acoustic wave glider to gather research data in the ocean. (Photos by Cliff Hollis)
Wave glider listens to and records ocean data
ECU scientists have been sending a small craft to navigate the North Carolina coast studying underwater noise and keeping tabs on tagged marine life all to better understand the ocean environment.
Called an acoustic wave glider, the device is an ocean-going robot that gathers data on acoustically tagged fish such as tuna, flounder and sharks; whales; plankton; and ocean environmental conditions. It’s manufactured by Liquid Robotics and was funded by a $281,393 grant from the National Science Foundation. ECU researchers have nicknamed the craft “Blackbeard.”
ECU is among a handful of universities that have a wave glider and the only UNC-system school with one. Joseph Luczkovich, a biology professor and specialist in the sounds fish make, said the device will provide a step forward in ECU’s coastal research capabilities.
Cruising along the surface, it’s about the size of an ironing board. ECU researchers tested it in August near the Queen Anne’s Revenge shipwreck near Morehead City and Beaufort and deployed it again in September in the same area. Part of its initial work has been surveying an artificial reef established by the N.C. Division of Marine Fisheries.
Important feeding grounds for endangered species of right whales are in the area off Shackleford Banks, and ECU researchers hope to document the songs of northern right whales as they swim past the coast, along with other fishes such as red drum, spotted seatrout and weakfish.
“There are less than 400 individuals of the northern right whales left on Earth, and most of them pass by our coast on their migration from the Arctic off Greenland to the tropics,” Luczkovich said.
It also will provide data on the potential effects of oil and gas exploration and wind turbine development in coastal waters. These projects must be conducted and sited in ways that avoid or minimize impacts to whales and fish such as Atlantic sturgeon, an endangered species of ancient fish, Luczkovich said.
“Many of these fishes are tagged acoustically, so we can detect their movements with the wave glider as well,” he said. Acoustic tags are small, surgically implanted sound-emitting devices that allow the detection and remote tracking of fish for fisheries research.
The wave glider can act as a stationary platform or be propelled to specific points using GPS technology. A submarine unit with wings or fins generates forward motion by wave action. Two solar panels provide energy for sensors.
ECU’s model has a unique suite of sensors including a system for listening to and recording ocean soundscapes and sound-producing fishes and whales; an acoustic tag-detection system for finding tagged animals such as many fish species and sharks; and a fluorometer for measuring ocean color and plankton.
It also has a conductivity, temperature and depth sensor with oxygen-measurement capabilities. On the surface float are instruments for monitoring waves, currents and surface meteorology.
“So far, we have detected bottlenose dolphins and striped cusk eels (a sound-producing fish) in our first deployments,” Luczkovich said. “We are still analyzing the data; there was an acoustic algorithm match for right whale sounds, but that match has to be confirmed with our team after some additional work.”
Blackbeard is operated over an Internet connection via a satellite link and reports regularly on its location and sends data to shore. It can be at sea for monthlong missions.
ECU researchers are collaborating with scientists at Duke Marine Lab in Beaufort and at St. Andrews University in Scotland. Scientists from the NOAA, N.C. State University, UNC Wilmington and the UNC Institute of Marine Science are also being kept abreast of the work the wave glider is doing.
“In addition, we are alerting the U.S. Coast Guard about the general location of these proposed wave glider deployments so they can produce a local notice to mariners,” Luczkovich said. Boaters and commercial fishermen are urged to leave the wave glider alone. The device has warning labels on it, and people have been pulled overboard trying to grab a wave glider from a boat.
The public may follow the wave glider’s deployments and key findings at its Facebook group, “Blackbeard Sails the Seas for Science.”
Rachel Roper, right, and research specialist Gwen Jones conduct research on human-virus interaction. (Photo by Cliff Hollis)
Researchers aim for better vaccines, medicines
Scientists at ECU are taking a closer look at the intercellular war that goes on between viruses and the human immune system in an effort to design better drugs to target the germs.
Rachel Roper, an associate professor of microbiology and immunology at the Brody School of Medicine, is a principal investigator on a National Institutes of Health grant totaling nearly $2.6 million to study the human-virus interaction.
“There’s a competition between a virus and the immune system as to which can amplify itself fast enough to beat the other,” Roper said. “If the virus wins, the human dies. If the immune system wins, the virus is—usually—eliminated from the body.”
She brings special expertise to the research. In 2006, she discovered a poxvirus gene, A35R, which blocks the first step in the immune response. Methods of removing the gene from poxviruses, thereby increasing their safety and effectiveness, are now patented.
Her collaborator is Laurence “Ike” Eisenlohr of the University of Pennsylvania. At the time the grant was awarded, he was a faculty member at Thomas Jefferson University in Philadelphia. Eisenlohr is an expert in immunology.
Researchers will focus on the relationship between CD4+ T cells—a certain type of lymphocyte, or white blood cell, which is critical for protection against most viruses—and two prototypical poxviruses that have developed ways to avoid being recognized by CD4+ T cells. Scientists will look to uncover those detection-avoidance methods and gain insight into how the immune system circumvents them.
What scientists learn about how A35R works inside the cell and how it blocks immune cell functions could point to improved vaccines and new ways to treat autoimmune diseases, Roper said.
Poxviruses have been commonly used to develop vaccines in humans, but a key limitation has been what is called a “virulence gene.” Viruses, having co-evolved with humans over millennia, are adapted to exploiting vulnerabilities in human immune systems. These genes, including A35R, suppress the immune system to allow the virus to proliferate in the human host.
In addition, poxviruses are used to create vaccines for many other diseases—rabies, malaria and Middle East respiratory syndrome, to name three. Poxvirus-derived vaccines are also used to treat cancer and are the only ones thus far that have protected humans from HIV in clinical trials.
“Our data indicate that the use of our A35 discovery will improve the safety and efficacy of all these vaccines,” Roper said.
A35R may also provide a target for drug design. “If we can find a drug that blocks A35, we will have a new antiviral drug,” Roper said.
Finally, Roper said, if scientists can find out how to use A35R or mimic its actions, they might be able to turn off the responses that cause autoimmune diseases such as lupus or prevent rejection of transplanted tissues and organs.
Roper’s lab will receive approximately $624,000 from the four-and-a-half-year grant. The title of the study is “MHCII cross-presentation as a driver of CD4+ T cell responses to poxviruses.”
Sonya Hardin works with patient Geraldine McCombs. (Photo by Cliff Hollis)
ECU awarded $2.5 million to boost geriatric health care
North Carolina’s geriatric population is the fastest-growing segment of the state’s population. If projections hold, the number of adults over the age of 65 living in the state will double by 2030.
To help address the pressure these demographic shifts will put on the state’s health care system, the U.S. Department of Health and Human Services is giving the ECU College of Nursing a three-year, $2.5 million grant through its Geriatrics Workforce Enhancement Program. The grant will allow ECU to implement an interprofessional education model focusing on geriatrics, train primary care providers to meet the specific needs of elderly patients and deliver community-based programs that address the needs of older adults and their families.
“We’re building a comprehensive approach to caring for our region’s older adults,” said Sonya Hardin, the grant’s primary investigator and interim associate dean for graduate programs in the College of Nursing. “We’ve lacked this in primary care and it’s going to become very important as we have more patients with chronic illnesses needing more specialized resources.”
Here are the objectives of the ECU program:
- Implement interprofessional education where nurse practitioner, physician assistant and medical students treat patients together at retirement communities.
- Train primary care providers through geriatric screening offices at regional facilities and through podcasts.
- Provide community-based education for farmers, loggers and fishermen.
- Extend dementia and Alzheimer’s education to students, faculty and the primary workforce of the region.
The College of Nursing will partner with the Brody School of Medicine Division of Geriatrics, the Department of Physician Assistant Studies, the ECU-based N.C. Agromedicine Institute and multiple regional partners. Together, their work will focus on eastern North Carolina—a rural, underserved region where citizens are in poorer health than the rest of the state. Although the state ranks 38th in premature mortality, if only the 41 counties of eastern North Carolina were represented, it would rank 45th nationally.
Aging patients present specific challenges for the health care system. They often have additional diseases that can complicate treatment. Geriatric patients also tend to take more routine medications, lack support systems and be at heightened risk for injury or death from accidents such as falls.
“This is a tough group of folks to take care of,” said Dr. Kenneth Steinweg, director of geriatrics at Brody. “They’re very frail, and they have reduced reserves, so you have to be very careful making adjustments for that.”
Mary Pinion, Anthony Thomas and Dr. James Powell are shown above. (Photo by Cliff Hollis)
ECU a critical partner in nationwide blood pressure study
ECU has played a leading role in a clinical trial that may change the way health care providers treat high blood pressure.
Landmark research involving Brody School of Medicine faculty and patients has shown that more aggressive use of medications to lower systolic blood pressure below common recommendations significantly improves cardiovascular outcomes.
Nearly one in three American adults has high blood pressure, or hypertension, according to the Centers for Disease Control and Prevention. The condition is a leading risk factor for heart disease, stroke, kidney failure and other health problems. Blood pressure levels can be influenced by genetics, diet and lifestyle.
The National Institutes of Health sponsored the multifaceted Systolic Blood Pressure Intervention Trial—the largest study of its kind to date. Launched in 2009, it includes more than 9,300 participants ages 50 and older with high blood pressure and an increased risk of heart or kidney disease. Approximately 250 of those participants—the second-largest group within the national trial—are receiving care at the Brody School of Medicine.
“Due to the large representation of our patients in this trial, we feel very comfortable translating these findings into the patient population we serve here in eastern North Carolina,” said Dr. James Powell, ECU chief of general internal medicine and the primary investigator for ECU’s trial site, who enrolled the first patient of the entire trial.
According to the 2013 Behavioral Risk Factor Surveillance System —managed by the N.C. State Center for Health Statistics—approximately 35.5 percent of adults reported being “told by a doctor that they had hypertension.” In the East, that rate was even higher at 38.9 percent. Even more alarming was the percentage of African-American respondents in the region who reported being told they had hypertension: 46.6 percent.
Patients in the SPRINT study were randomly divided into two groups. One group received an average of two medications to keep their systolic blood pressure at 140, while the other group was given “intensive treatment”—averaging three medications—to lower their blood pressure to 120.
Systolic blood pressure is the “top number” in a blood pressure reading that measures the pressure in the arteries as the heart muscle contracts.
Initial findings demonstrate that intensive treatment reduces the rate of heart attacks, strokes and heart failure by a third—and the risk of death by almost 25 percent—in the patient population studied. Reaching that conclusion before the trial’s scheduled closure date prompted researchers to end this particular arm of the study earlier than expected.
“Optimum blood pressure targets have been debated by experts in recent years, but this is the first trial of any size that provides evidence of improved outcomes in all participants as a result of reducing systolic blood pressure to below 140,” said Dr. Paul Bolin, chair of the Department of Internal Medicine at Brody and sub-investigator for the trial.
Although the results still need to be confirmed, Bolin believes this study could potentially increase the number of hypertension diagnoses in America. “The financial consequences of that are enormous, so we need to get it right,” he said.
Bolin cautioned people to talk to their primary care providers to determine whether this lower goal is best for their individual care.
“Every time you add a medicine, you add the chance of a side effect. And every person is different. We have to remember that we’ve only been treating hypertension in this country for a relatively short period of time,” Bolin added. “This study may change the way we practice medicine in the future, but not the way we practice it today.”
Each patient in the study was prescribed medication based on medical history and protocol that would help the patient achieve their blood pressure goal.
“You look at potential side effects, you look at the patients and try to find the right (medication),” Powell said. “Every medicine that was used in this study is medicine that we have been using for a number of years. We were using meds that had been tried and true, and that’s what adds a lot of weight to the findings.”
Over the next several months, Brody’s SPRINT trial participants will transition back to their primary care providers for their health care. Bolin stressed that ECU researchers will maintain close communication with these providers as the remaining arms of the study unfold.
—Amy Adams Ellis and Alyssa Gutierrez
ECU researcher Eban Bean is working to improve water quality by filtering stormwater runoff. (Photo by Cliff Hollis)
Project slows, filters stormwater before it reaches stream
Three areas designed to hold stormwater runoff back from Greens Mill Run on the ECU campus are helping improve the water quality in the urban waterway.
Called bioretention cells, they are areas crews have excavated, rebuilt and planted with native plants to help hold runoff water, filter it and then let it soak into the soil or flow to the stream with fewer toxins.
“A lot of development at ECU began before we better understood how to manage stormwater,” said Eban Bean, an assistant professor of engineering and member of the Institute for Coastal Science and Policy at ECU. “The idea was to get it offsite as quickly as possible. It used to go straight into the storm drain, which goes straight into Greens Mill Run.”
ECU’s Main Campus is within the Greens Mill Run watershed, an impaired stream due to stormwater runoff. Named for the 19th-century mill it powered, the stream drains to the Tar River, which receives excess nutrients. About half of Main Campus has impervious surfaces, such as rooftops or parking lots, and is a major contributor of stormwater runoff to Greens Mill Run, Bean said.
That meant petroleum products, minerals such as lead, zinc and cadmium, sediment, nutrients and other pollutants went to ditches and streams that flowed to the Tar. Now, thanks to a $100,000 grant from Sound Rivers (formerly the Pamlico-Tar River Foundation) and the N.C. Department of Justice, ECU has retrofitted three areas with bioretention cells and a stormwater wetland during the past six months.
According to Bean and co-investigators Michael O’Driscoll of the Department of Geological Sciences and Charlie Humphrey of the College of Health and Human Performance, preliminary results show the project is reducing runoff volumes and pollutants entering Greens Mill Run and the Tar River.
Capturing, treating and filtrating stormwater into the soil reduces the impact of campus on local waterways. Toward that end, Bean began working with ECU grounds staff in March to install the three bioretention cells, or rain gardens, and converted a dry retention basin to a stormwater wetland.
The bioretention cells are within a parking island in front of the Student Recreation Center, on the east side of Umstead Residence Hall and behind the Carol Belk Building on Charles Boulevard.
ECU’s grounds department and a contractor excavated and graded the areas—which used to be relatively flat and covered in turfgrass—and layered sand, mixed media, silt and clay as a base to manage water filtration. Perforated pipe was also installed to move the water once it drains through the media. Topsoil went on the surface, and Bermuda grass and native plants selected for their ability to hold soil and filter water were added.
The stormwater wetland is at the back of the park-and-ride parking lot across from the Belk Building. Unlike the image of sandy soils in eastern North Carolina, the wetland area was heavy clay, so the water that collected in the dry basin tended to run off before it had a chance to infiltrate the ground.
Among the wetland’s plants is pickerelweed. Altogether, students, faculty and staff planted approximately 1,000 plants there.
“One concern we had initially was mosquitoes due to the standing water,” Bean said. “However, we planted tall plants to attract dragonflies, which are a natural predator to mosquitoes.”
In addition to plenty of dragonflies, many frogs have moved into the wetland, and they also prey on mosquitoes. Stephanie Richards, who studies vector diseases in the ECU Department of Health Education, put traps out and found very few mosquitoes in the wetland and plans to use the site for her classes. The peninsula extending into the wetland was designed to separate inflow and outflow and serves as a gathering spot for discussions and teaching.
“It’s good for our students to see …ECU be an example of what we should be doing with our stormwater management,” Bean said.