2005 Impact Award Winners

The Graduate School is pleased to announce the 2005 winners of the Graduate Education Advancement Board's Impact Awards, which honor graduate students whose research has a direct impact on the state of North Carolina. (More information about the Impact Awards.) The breadth of these students' work reaches from one end of North Carolina to the other. You are sure to find a student who is working directly in your community or whose work directly affects the lives of North Carolinians. Full press release

2005 Impact Award winners:


Semra A. Aytur, Epidemiology
Relationships of Land Use and Transportation Policies to Physical Activity and Obesity

Physical activity helps reduce the risk of major chronic diseases and obesity, yet 30 percent of adults in North Carolina do not engage in any leisure time physical activity. More than half of North Carolinians are overweight or obese.

A way to increase physical activity is through communities that promote walking, bicycling, and the development of accessible recreation facilities. These communities also have land use policies and transportation policies that encourage the creation of sidewalks, bikeways, and green-ways and the use of non-motorized transportation.

Semra, a Carolina Ph.D. student in Epidemiology, is studying how land use and transportation policies can be coordinated to support an activity-friendly community. She examined relationships between physical activity, non-motorized transportation, and land use policies in several North Carolina counties. Semra found North Carolina counties that had at least four supportive land development policies, along with non-motorized transportation improvements and mixed land use had significantly higher levels of leisure-time activity and transportation-related physical activity. These counties also scored higher in the number of their citizens who met public health guidelines for physical activity.

Semra's research shows that by expanding collaboration between the fields of public health and urban planning, local policy makers can create communities that are more amenable to active, healthy lifestyles.


Joan R. Cates, Journalism and Mass Communication
Setting the News Media's Agenda on Youth and Sexually Transmitted Diseases

North Carolina has some of the highest rates of sexually transmitted diseases (STDs) in the United States. Young people (ages 15-24) acquire half of all new STDs each year and one of every two sexually active youth will have an STD by the time they are 25 years old.

Joan, a Ph.D. student in Journalism and Mass Communication, focused her research on the role of the news media in drawing the public's attention to the issue of youth and STDs. She was the lead investigator on a landmark project that resulted in a nationally recognized report, "Our Voices, Our Lives, Our Futures:Youth and Sexually Transmitted Diseases."

For this project, Joan's research team worked with focus groups of North Carolina parents, teens, and health care providers. These individuals were encouraged to tell their stories and offer their opinions about why the epidemic of STDs in youth has occurred,what needs to change, and what role the media play in stimulating public discussion about solutions. Joan also researched the scope and impact of STDs in American youth ages 15-24, with estimates of incidence, prevalence, and direct medical costs related to infection. In addition, the report examined the psychosocial aspects of having an STD and proposed solutions to the problem.

The resulting report of Joan's findings, "Our Voices,Our Lives, Our Futures," received extensive national news coverage. A three-part television series based on Joan's research was produced by Carolina journalism students and aired on UNC-TV. Joan worked with UNC-TV on a Web poll that allowed viewers to answer whether confidential counseling and testing for STDs should be available for students in NC schools. Through this broad outreach, Joan integrated public health education and mass media survey research. She is pioneering efforts to determine public awareness about the prevalence of STDs among North Carolina's young people.

Katherine (Kate) Eschelbach, City and Regional Planning
Statewide Risk Assessment Methodology for the North Carolina Natural Hazard Mitigation Plan

North Carolinians do not have to go back very far in history to remember the devastating effects that natural disasters can have on their livelihoods, their homes and their families. Hurricanes Isabel (2003), Floyd(1999), and Fran (1996) brought flooding, severe wind damage, and the loss of life and property. Risk assessment the identification of vulnerabilities in a community for natural hazards can not take away these disasters, but it can help minimize future damage.

The state of North Carolina recently completed a Hazard Mitigation Plan,which includes strategies to reduce the state's vulnerability to natural hazards,and was approved by FEMA in late 2004.The foundation for the state's plan was based on the background risk assessment that Carolina graduate student Kate Eschelbach developed.

Kate's research involved the review of considerable amounts of historical records and discussions with meteorological and geological experts so she could identify, describe, and assess the various natural hazards that affect North Carolina. Once this background data was assembled, Kate applied HAZUS-MH, FEMA's loss-estimation database, to incorporate the scope, frequency, intensity, and destructive potential of all the natural hazards. With this information, the state could compare various natural hazards' exposures against each other. This process was essential to allow the state to focus on those hazards that posed the more severe threats to special populations, economic activity,infrastructure and critical facilities, and environmental resources.

Kate's work will provide valuable information to local planners and guide the state in many years to come on the best way to proactively mitigate natural hazards before they strike.

Chandra L. Ford, Health Behavior and Health Education
Perceived Racism, Neighborhood Characteristics, and Human Immunodeficiency Virus (HIV) Testing Among African Americans

Almost 17,000 North Carolinians are infected with HIV, and African Americans account for about 70 percent of that total. Research suggests that negative attitudes about HIV preventive services, such as HIV antibody testing, are prevalent among black North Carolinians and are associated with their perceptions of racism. Without antibody testing, HIV patients are usually diagnosed later and have poorer prognoses.

Carolina doctoral student Chandra Ford has explored the social determinants that contribute to this wide racial disparity in HIV cases by carrying out a sophisticated study of perceived racism and HIV status, and factors enabling or hindering HIV services use by African Americans in North Carolina. Chandra's study has the capacity to discover why many African Americans who visit area clinics decline to get tested for HIV. She has also identified some of the dimensions of "institutional racism" and its effect on minority group members' access to care. She has collected primary data in both an STD clinic and in a southeast Raleigh community.

Chandra hopes to share her findings with STD clinics in communities across North Carolina as they design programs and outreach efforts that are more sensitive to the needs and barriers of the populations they serve ones often at highest risk for the spread of HIV.


Sarah B. Knowles, Epidemiology
Incidence and Severity of Injury among North Carolina High School Athletes

Approximately 155,000 young athletes in North Carolina play interscholastic sports each year. While research has shown that roughly three in 1,000 student athletes will receive an injury during play, no one has looked at the economic costs of those injuries.

Previous research has outlined the number of injuries to high school athletes in 12 different sports. Carolina graduate student Sarah Knowles is adding to that knowledge by determining the medical costs associated with those injuries and their impact on North Carolina families.

For example, Sarah found that in football, where most high school sports injuries occur, injuries were relatively minor (sprains and strains), yet resulted in approximately $2.2 million in medical costs, $9.8 million in direct costs, and $32.5 million in total costs.

With so many young athletes participating in sports in North Carolina, it is important to know both the injury risk and the potential economic costs of an injury. The injury-cost information gathered by Sarah can be used by North Carolina's public health practitioners to develop intervention strategies targeted at the most expensive injuries.


Maria Mirabelli, Epidemiology
Exposure to Airborne Emissions from Industrial Hog Operations as a Trigger of Childhood Respiratory Symptoms

During the past two decades, the livestock industry in North Carolina has expanded to include more than 2,000 large-scale hog farms operating throughout the state today. Previous research has suggested that adult neighbors of industrial hog farms experience eye irritation and respiratory problems, but the extent to which younger residents experience physical symptoms has not been investigated.

Research conducted by Carolina graduate student Maria Mirabelli addresses the health concerns of exposure to airborne pollution on adolescents attending public schools near industrial hog farms. Maria looked at publicly available data about schools and farms to generate estimates of exposure for each school.

Maria found that for students reporting allergies, the prevalence of wheezing within the past year was five percent higher at schools located within three miles of a swine farm and 23 percent higher at schools in which livestock odor is noticeable indoors twice per month or more.

These findings can help state education and health officials, clinicians, and parents better understand potential asthma triggers and adolescents' respiratory health in school environments in North Carolina.


Mahyar Mofidi, Health Behavior and Health Education
The Impact of a State Children's Health Insurance Program on Access to Dental Care

Access to dental care for low-income children in North Carolina is a serious issue. The North Carolina Health Choice for Children (NCHCC) is a new health insurance program that affords poor families access to dental care for their children. Carolina doctoral student Mahyar Mofidi is examining the effect this new program actually has on children's' access to dental care.

Mahyar looked at 639 uninsured children, ages 6 to 18, to see how often they had dental care prior to enrolling in NCHCC and after one year of enrollment in the program. Among his findings is that the proportion of children reported to have a consistent source of dental care increased from 77 percent before enrollment to 90 percent after the NCHCC program began.

Mahyar's findings show that the North Carolina Health Choice for Children program has made a significant impact on children's access to dental care and could be used as a model by other states that seek to improve access to dental care for underserved children.


Melissa Nelson, Nutrition
Obesity, Physical Activity, and the Neighborhood Environment

Over half of North Carolina adults are overweight or obese, and nearly one in every three high school students is at risk for being overweight. This weight crisis costs the state over $6.2 billion each year.

Carolina graduate student Melissa Nelson is trying to better understand the origins of obesity at what age is obesity most likely to begin? Does obesity strike in some populations more than others? Does the environment in which a child is raised affect their ability to choose a healthy, active lifestyle?

By analyzing survey data of over 20,000 U.S. middle- and high school students, Melissa was able to find several trends. She found that adolescence is a critical period in which obesity and unhealthy behavior patterns first emerge. Also, the household environment of a child has a substantial long-term impact on adult weight gain, healthy activities, and fast food intake. Adolescents who took "active transportation" (walking, biking) were shown to be less likely to become obese as an adult. Melissa also found that in higher socioeconomic neighborhoods, there were twice as many facilities for physical activity.

These findings can help North Carolina policy makers in addressing the obesity problem in this state. In particular, Melissa's research could help provide important justification for continued support of the flourishing NC Walks to School Program and the creation of the legislation to expand physical activity in North Carolina schools.


Matthew Savage, Pediatric Dentistry
Early Preventive Dental Visits: Effects on Subsequent Use and Cost

Early dental care starting in infancy has its benefits. Many dental groups believe that early visits to the dentist can provide oral health counseling for the parents and timely interventions for the infant before dental diseases develop. But this advice has been based on a concept, rather than evidence until now.

Matthew Savage, a Carolina graduate student in pediatric dentistry, looked at the cost-effectiveness of early dental visits for Medicaid-enrolled babies in North Carolina. He found that high-risk children who saw a dentist by age one were more likely to seek preventive care and less likely to have restorative or emergency dental visits. As a result, these children and their parents required less financial help from the Medicaid program.

Since North Carolina has one of the largest per capita numbers of children born on Medicaid annually, Matthew's findings could have a major impact on both Medicaid and oral health policy in North Carolina. His findings have already received national attention and were published in Pediatrics.


Thomas C. Terry, Journalism and Mass Communication
W. Horace Carter The Life Outside: A Weekly Newspaperman's Pulitzer Prize-winning Campaign against the Ku Klux Klan, 1950-1953

In the early 1950s, W. Horace Carter was owner and editor of a weekly newspaper, the Tabor City Tribune, in Columbus County, North Carolina. He was only 29 years old when he took on the task of fighting off a resurgence of the Ku Klux Klan in his town. Carter's writing campaign against the KKK earned him death threats. However, his efforts culminated in the arrests and imprisonment of 62 Klansmen and a Pulitzer Prize for Public Service.

Carolina Journalism graduate student Thomas Terry examines the life and actions of W. Horace Carter in a historical study. Through an examination of news-paper articles of the time and inter-views with Carter and others,Thomas shows how one small town weekly paper became the leader in the fight against the KKK.

Thomas offers a detailed content analysis of all the coverage about the Klan in the Tribune, augmented by Carter's written recollections. He also looks at Carter's motivations and the effects his work had on the racial atmosphere in North Carolina. Thomas' study of Carter's work against the KKK offers a lesson on the true racial environment in twentieth-century North Carolina and helps explain how the civil rights agenda was set in the 1950s.


Arianne Theiss, Cell and Molecular Physiology
Mediators and Mechanisms of Inflammation-induced Intestinal Fibrosis

Crohn's disease an incurable, debilitating, chronic inflammatory disease of the gastrointestinal tract affects an estimated 15,000 people in North Carolina, and the prevalence of the disease continues to increase sharply. An incurable complication of Crohn's disease is fibrosis, an excessive deposition of scar tissue within the bowel wall, which is thought to be an over-active, irreversible wound-healing response to chronic inflammation. Often,surgery is the only therapy for fibrosis; however, surgery is not considered a cure since fibrosis can recur.

Arianne Theiss, a Carolina doctoral student in Cell and Molecular Physiology, is examining a way to possibly alleviate the pain and presence of fibrosis associated with Crohn's disease. Growth hormone is used to treat growth delay in children with Crohn's disease and is being tested as a therapy in adult patients with Crohn's. While growth hormone appears to benefit some patients with Crohn's, there are concerns that growth hormone could exacerbate fibrosis.

Arianne's research has had a surprising observation that growth hormone actually reduced fibrosis in a rat induced with Crohn's disease. Her research could identify a novel pathway to reduce fibrosis, eliminating a serious complication of Crohn's disease.


Sacoby Miguel Wilson, Environmental Sciences and Engineering
Environmental Monitoring and Spatiotemporal Assessment of Atmospheric Ammonia Levels near Hog CAFOs in Eastern North Carolina

Confined animal feeding operations (CAFOs) raise large numbers of animals in small spaces and dispose of liquid waste in lagoons and spray fields. Since 1990, hog production in North Carolina has increased from less than three million hogs to over 10 million hogs with over 2,000 CAFOs operating in the state.

There is concern for health hazards dues to the release of gases from the CAFOs, such as ammonia. Carolina graduate student Sacoby Wilson wanted to better understand the human exposure to ammonia by measuring ammonia levels in areas near hog CAFOs in eastern North Carolina. By monitoring ammonia levels over a year-long period, Sacoby found that atmospheric ammonia levels were above normal at many sites and reached even higher levels in high-emission counties such as Duplin and Sampson during the summer.

Using this information, Sacoby was able to create a map of North Carolina showing the distribution of ammonia and the exposure to residents who live near hog CAFOs. This map will be valuable to show the potential exposure risks of communities, in particular, disparately burdened poor communities and susceptible populations, including young children and the elderly.