Focus Carolina Transcripts 3 - The Well : The Well

Focus Carolina: Angela Kashuba (A)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Angela Kashuba is a world renowned scientist whose research focuses on finding the optimal dosing and drug combinations for treating HIV infection. In May, she was appointed the Dean of the UNC Eshelman School of Pharmacy, the nation’s top ranked pharmacy school.

– Host

In her new role, Dr. Kashuba has already set three short term goals.

– Dr. Kashuba

So there’s no question that we’re an excellent school of pharmacy. What we need to do now is go beyond excellence. So I would like to continue for us to innovate in how we teach our students, how we practice pharmacy and how we approach pharmaceutical sciences research. My first priority is to take care of our people. I want to ensure that the school is a place where everyone who walks or who has walked through our halls feels valued and connected and that we’re really a school that loves people back. So this includes ensuring that our people are well. We recently had a report by our school’s wellness and resiliency task force. And so we’ll be working on those action items that they have. But specifically for our students that means expanding the experiences they need like leadership training and alumni mentoring, internships and our Global Scholars Program. So for faculty we have a wonderful Campbell mentoring program for junior faculty. And I’d like to expand that now to our mid-career faculty. And for staff, they’re asking for mentoring and leadership development programs and so we’ll be putting those into place. And for our alumni, it really means connecting and reengaging with them and developing meaningful connections to our students and our faculty. So that’s the first priority.

– Dr. Kashuba

The second one is investing in Inclusive Excellence. I want to ensure we’re meeting the needs of our state. To do that we need to expand our diversity initiatives through partnerships. Increase our partnerships with UNC Pembroke for example and other historically black colleges and universities both within the state and outside the state to ensure that we’re providing access for their students to our pharmacy program, our PhD program and our post-doctoral programs. So we’re currently developing a joint program with Mhairi Medical College in Nashville for a co-branded physician and PhD program. So those students will do their PhDs with us in Chapel Hill. And then the third one is focused on operational excellence and sustainability of both the school and the Eshelman Institute for Innovation that we now have within the school. Operational excellence is a theme and it’s being implemented across the UNC Chapel Hill campus and we need to ensure that we’re using best practices. And I also want to ensure that our operations team is right sized for the amount of work they have and that they have the tools that they need to optimize their efficiencies.

– Host

Dr. Kashuba also has three long term goals that reach outside of Chapel Hill.

– Dr. Kashuba

The first one is to make our expertise available to the state. Our second one is to make our innovation more impactful through strategic partnerships. And our third one is to increase our global impact. So in terms of making our expertise available to the state, one way I think we can do this is in digital learning where many North Carolinians can’t come to us but we have the tools and the technologies now where we can go to them. We can provide continuing education programs online to ensure that we are providing our students with lifelong learning opportunities. Also certificate programs and degree granting programs for North Carolinians and beyond. Another way we could do this is to further invest in our rural health initiatives. So 40 percent of our citizens live in rural counties and comprehensive medical services may be limited. And we’ve really started doing terrific things in this space. We’ve become a part of the UNC Health Sciences at MAHEC which is the mountain area health education center program. And the second is to make our innovation more impactful through strategic partnerships both for our school and also for the Eshelman Institute for Innovation.

– Dr. Kashuba

So there’s no question that we are a school of innovators thanks to the leadership of Bob Blouin and also the generosity of Fred Eshelman. So the final long term goal is to increase our global impact. We currently have a Global Scholars program for our students so that they can have an overseas experience. And I’d like to be able to expand that program to ensure that all of our students who want a global experience can have that opportunity. Approximately 30 percent of our students are able to take advantage of that opportunity. We also have a unique collaborative relationship with the pharmacy schools at the University College of London and also Monash University in Australia. And we call this farm alliance where we’re trying to do things together that we can’t do alone in teaching , research and Pharmacy Practice. And we’re looking to make bigger impacts globally in pharmacy.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Angela Kashuba (B)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Angela Kashuba is a world renowned scientist whose research focuses on finding the optimal dosing and drug combinations for treating HIV infection. In May, she was appointed the dean of the UNC Eshelman School of Pharmacy, the nation’s top ranked pharmacy school.

– Host

In Dr. Kashuba’s lab important research continues that is making it possible for those who have the HIV virus to live longer.

– Dr. Kashuba

I have a 20 person pharmacology lab that’s working primarily in HIV. Our research is focused and getting the right drug to the right place at the right concentration for the right amount of time. And so we really work on optimizing drugs or therapy for HIV treatment, HIV prevention and HIV cure. So this includes patients who are infected with HIV, people who are trying to avoid getting infected with HIV, and also working with the HIV Cure Center and CARE. That’s led by Dr. David Margolis in the UNC School of Medicine and CARE is the first public-private partnership company that has been established within UNC with aviv healthcare.

– Dr. Kashuba

AIDS is not a death sentence anymore. That’s been one of the miracles I think of the 21st century is that we have very good drugs that are formulated together now into one pill that people can take once a day and they can live just as long as someone who is not infected with HIV. Now being infected with the virus itself and taking these medications creates some additional problems for people living with HIV. So cardiovascular disease increases and diabetes and other things. There’s still a significant burden on them of the infection but it’s no longer a death sentence.

– Host

Due to the importance of her research, Dr. Kashuba’s lab is always active and has many global connections.

– Dr. Kashuba

My lab is really important to me and we still have a lot of work to do. There’s a lot of questions that we still want to answer. And my laboratory also works globally and we work with up to about 80 investigators a year and we help them with everything from generating preliminary data for grants all the way through to analyzing data and interpreting that for publications. So I highly value these collaborations and the contributions that we make in the HIV field and I don’t want that to go away. So one area that we’ve worked on is treatment as prevention. So Dr. Myron Cohen from UNC Chapel Hill, he oversaw a study called HPTN 052, and HPTN stands for the HIV prevention trials network, and this study was pretty exciting because it proved for the first time that if a person is prescribed antiretroviral therapy or medication for HIV and their infection is controlled to the point that there is no detectable virus in their blood then they don’t spread HIV to their partner. My lab spent a significant amount of time measuring different drug concentrations in body fluids that can spread HIV and identifying how HIV declines over time in those body fluids when people are exposed to drug.

– Dr. Kashuba

So we currently have a study that’s about to start that will allow HIV infected patients in our clinic to donate five strands of their hair. We then run the hair back to the lab where we analyze it and we provide a report within about two hours of how much drug is in their hair on a daily basis. We are currently providing them with about a month’s worth of information. So assuming a person has at least one centimeter of hair that’s about a month’s worth of growth. And this is important because normally if we’re trying to do this we take a blood sample and we analyze the blood sample for drug but it could take up to two weeks to get the results back for whether the right amount of drug is in the person’s blood or not. So we’ve had a very successful collaboration with Dr. David Maidment at NC State. He has allowed us to develop his technology for this purpose and he’s really been a wonderful generous collaborator with us. And one of the reasons I came to UNC 22 years ago was this collaborative multidisciplinary atmosphere. So we talk about UNC having low stone walls as the border around campus but it’s really a metaphor for how people work together seamlessly. From my own research, we work very closely with faculty and the Institute for Global Health and Infectious Disease, the School of Medicine, the School of Public Health, biostatistics, virology and immunology. And as part of the UNC Center for AIDS research, I run the clinical pharmacology and analytical chemistry core facility and as I mentioned earlier we collaborate with up to 80 investigators a year globally on their research and that is incredibly rewarding for me.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Dorothy Espelage (A)

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Dorothy Espelage joined the UNC School of Education in July 2019. One of the world’s leading experts on bullying, her research has led to interventions policies and laws intended to protect students and make schools safer.

Dr. Espelage recently had her sixth book published. This one comparing school bullying in various countries.

I think the media has paid quite a bit of attention to the school shootings and as much as researchers– my colleagues–want to say that you’re safer in schools than you are in restaurants the reality is is that parents out there are quite anxious about sending their kids to school every day or putting their kids on a bus. For many years researchers debated about what is bullying. And it’s become even more problematic because teachers and administrators will say that parents are calling everything bullying. From a research perspective we know that it’s a form of aggression that tends to be between unequals so there’s a power differential so not usually conflicts among friends.

It’s also seen that bullying is perceived to be repetitive and that it wasn’t a one time conflict where you punch somebody out but that you repeatedly the bully goes after the victim or the bully group goes after that victim over and over again. And what we do know about it is that when there’s normal peer conflicts or one off conflicts that kids tend to kind of get over it, that it’s not as adversive to them. It doesn’t lead to the negative mental health outcomes that we see like depression withdrawal and suicidality. For 50 years we’ve talked about bullying being more proactive and then physical fighting being more reactive. “You’ve upset me, I’m going to punch you.” We get over it we move on. Whereas proactive, also known as instrumentality, I’m going after something whether it’s your popularity or your belongings. Believe it or not there’s still extortion in our schools it’s just we’ve upped the ante that it’s your that your iPad or your iPhone.

I think that when we think about bullying oftentimes we think of those very, what we call ineffective aggressor, big kid lacking in social skills and certainly those kids are turned into the principal’s office. What we don’t recognize, and certainly we do as researchers, is that there’s another group of bullies that we don’t talk too much about. And those are the kids that we call them Machiavellian bully. That they have a heightened theory of mind, they can turn their behaviors on and off, they have high social capital and some of our schools are overrepresented in athletic groups are very popular, everybody wants to be friends with them. They will never be turned into the principal’s office. And so there are no consequences for those types of kids that engage in high rates of bullying because it works for them.

According to Dr. Espelage chronic bullying can lead to the most destructive personal behavior.

Our research has shown and others across this country that if you are chronically victimized in the form of bullying your rates of considering suicide are much higher. I’m not saying that when you’re victimized that that causes suicidal ideation or behaviors but we know that it is quite a potent strong predictor. What we want to do is to be able to create safe spaces in our schools and communities such that, one, when kids are victimized they feel supported by the adults to report it and that there’s the fear of retaliation, but the adults prevent that retaliation.

We also know that kids that are chronically victimized report high rates of depression when it’s unnoticed and when they go underground with it. It’s that lack of treatment and attention to mental health of the depression that leads to the consequences of suicidal ideation thinking about it and those that attempt. Let me make it very clear that adolescent suicide is a public health concern in this country; it’s the highest rates of adolescent suicide that we’ve seen. And notice I said adolescents however are seeing 10 and 11 year olds or early adolescents late childhood kids killing themselves.

Many kids are victimized in the form of bullying and do not consider suicide. But there are some kids that when chronically victimized over time or in the schools doing nothing about it or the parents are at a loss that untreated depression anxiety withdrawl may put them at risk for suicidal ideation. So it’s our roles not just as the schools but every community member that when we see these behaviors we talk to the perpetrators or those kids, those group of perpetrator bullies. I want parents to understand that if the school is not responding litigation might have to happen. Schools will often tell parents that they have this particular program or this is our approach to bullying, but if you’re a parent and you see that your child’s behavior is changing where you’re seeing your child withdraw more, they want to withdraw from sports or other types of activities then be very very concerned and be hyper vigilant as much as you can to make the school accountable for doing something.

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Dorothy Espelage (B)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Dorothy Espelage joined the UNC School of Education in July 2019. One of the world’s leading experts on bullying, her research has led to interventions policies and laws intended to protect students and make schools safer.

– Host

Dr. Espelage emphasizes how important the student-teacher and student-adult relationships can be.

– Dr. Espelage

We know that the best we can do and bullying prevention is to reduce about 20 to 25 percent. So people need to understand that we’re in no way close to eradicating bullying and that 20-25 percent is often achieved by implementing those types of programs that encourage school connectedness and belonging. So the teacher student relationship and the bonding there cannot be underestimated. The research is very clear that when kids have a single best friend in the school, but also a really close relationship with an adult in the building their depression is less, anxiety is less, there’s less aggression, there’s more connectedness and by the way they’re because their test scores are better. And so school belongingness and connectedness it doesn’t matter what paper we publish is always a strong strong predictor of our programs working, less bullying, less sexual harassment and less teen dating violence across the lifespan.

– Dr. Espelage

When we think about teacher education around bullying prevention oftentimes preservice teacher training programs and universities like the University of North Carolina. That the curriculum is so packed to train these teachers to be effective teachers that sometimes the curriculum doesn’t include them focusing on their own social emotional competencies, their empathy perspective taking the way that they can relate to children over time. And it’s not that they don’t have those competencies it’s just that this preservice curriculum is packed. And so what one role we play as faculty that work for the state is to be able to bring social emotional learning competencies to both teachers and the students.

– Dr. Espelage

And when you train the teachers to implement programs around empathy and perspective taking and relationship skills and emotion regulation they develop their competencies. But at the same time the kids develop competencies and together they emerge a stronger teacher-student relationship that’s critical. Remembering that being a teacher is one of the most stressful jobs that we’re asking anybody to do. And we need to think about how can we bring them more resources without overloading their plate. Often teachers will say that’s just another thing I have to do on top of all these other things that are mandates from the state. What we want to do here is to bring accessible, evidence-based, scientifically informed training to the teachers to lighten the load, if you will, on a daily basis.

– Host

In Dr. Espelage’s research finding the marginalized students who might be targets of bullies is often a challenge.

– Dr. Espelage

I think it’s important to understand that there are a number of marginalized youth and that varies by the context. But certainly students with disabilities, Gender and Sexual Minority Youth, more recently undocumented students or immigrant populations as well of kids of color are all at risk depending. But it’s not absolute either. There are certainly these same populations that are in very supportive schools. So this is not deterministic just because I have autism it doesn’t mean I’m going to be the target especially if I’m in a supportive school. But certainly when we’re thinking about the rates of those marginalized youth being victimized when the general population is 15 to 17 percent these other marginalized populations can be upwards of 30 to 40 percent of targets of bullying.

– Dr. Espelage

We also need to recognize that when those kids are targets within a school all of the kids suffer because they have to watch that torment. And so when we approach it we think about the school climate improvement process that we want to train the teachers to be safe in their schools. We want to give the kids skills to connect with the teachers and we want to understand those marginalized populations and give those extra supports. When we do that, everyone in the building benefits. One critical exercise that we do in each school that we work with as to, when we’re doing the training of the teachers, to have the teachers write the names of students on post it notes that they feel like they have a relationship with where that student might come to them and there’s a level of connectedness and trust if you will.

– Dr. Espelage

And the teachers will go off on the break and then we will collect the post its and we compare it to the roster and we have this program that very quickly takes the names of the students that were not on the post its and we scroll those names right on the screen as they come back in with their coffee and their muffin. And it tends to be 20 to 25 percent of the students we call them under involved not connected with adults in the building. I’ve done this hundreds of times across the nation and there hasn’t been a one time where there wasn’t this appreciation of wow we have overinvolved kids and on every club and every sports team but we never see this particular student engage and that’s validating in some ways. And then we sit down– all right how do we do this.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Andra Ghent (A)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Andra Ghent joined the Kenan-Flagler Business School in July 2019. As an expert in commercial real estate, she researches how investors decide where to invest and how those investments influence the cities they invest in.

– Host

The real estate crash of 2008 motivated Dr. Ghent to get into the field

– Dr. Ghent

Way back when I was in grad school I was actually a macro economist. And I started working on housing in grad school because I graduated in 2008 and right around the years kind of leading up to the global financial crisis we became aware that housing was a really important part of household balance sheets. That this was the biggest single expenditure item for most households and so we started studying that. And so I had this one paper on the housing market and I ended up getting hired into a real estate department and then I started working in real estate and eventually I sort of transition from residential real estate, so people owning houses, to commercial real estate or income producing real estate.

– Dr. Ghent

Now I want to preface this to say that there is still some amount of disagreement. In my view, the main cause of the global financial crisis was an asset price bubble. So everything else I think flowed from overly optimistic house price expectations. So people, as you’ve heard, thought that house prices will just keep going up. They had unrealistic long term expectations for house price growth. And when I say people I don’t mean just homeowners. I mean also lenders, so people who originate the mortgages and the people who invested in the mortgages. The way most of the residential market works in the United States is whoever originated the loan is not the final lender. It’s outside investors that then go purchase the loans as a mortgage backed security. So we did have a relaxation of underwriting standards in residential mortgage lending and we had maybe poorly structured mortgage backed securities but all of that flowed from the fact that investors did not pay careful attention to what was in the mortgage backed securities. Lenders did not pay careful attention to what they were originating because they all thought” well doesn’t matter if the loan goes bad I can go take the property and the property will be worth enough to cover it or the homeowner will be able to sell.” To me all of it flowed from these overly optimistic house price expectations.

That’s not to say that financing conditions didn’t exacerbate it. So it wasn’t just residential mortgage backed securities then commercial mortgage backed securities came to a halt there. There was a crisis in something called the repo market which is a short term funding market. A lot of this traced back to these residential mortgage backed securities. Then you got this sort of financial panic situation.

– Host

Dr. Ghent’s research found that the crisis wasn’t caused by too many loans being given to less qualified borrowers.

– Dr. Ghent

Some of the work I’ve done is looking at whether affordable housing legislation caused the crisis. So there was this view that it wasn’t a problem of markets that failed but rather that the government forced lenders to give loans to low income households. And so we looked at that in a paper we just found that was not binding at all. The very fact that what you often saw was that lenders would encourage borrowers to lie upwards about their income. And so if you’re trying to meet an affordable housing mandate you want to go the other direction, right? You want borrowers to understate so you meet your affordable housin mandate. I mean there a few pieces of evidence we found. If you think that the financial crisis was just caused by the government forcing lenders to make loans to unqualified borrowers then you think markets are perfect, right. So there’s this view out there and I think it’s quite ideological; that markets are perfect, markets don’t fail. And then you don’t do anything you say “let’s leave things as they are.” Whereas if you think that markets can fail periodically, you may take steps to sort of rein in financial excesses occasionally. And that’s not to say I agree with all of the steps that have been taken, but I think that was one piece we contributed. Some of the other work I’ve done is look at the more positive side of some of these what are now considered alternative mortgage products for low income or low initial payment mortgages. So for example, interest only for some period of time or at teaser rate initially those actually can be very good for households who face steeply sloped income profiles. So think for example of a medical student. So a medical student has very high income in the future. Right? They know they’re going to make a good living. They may want to buy a house today and so it may make sense to give them a product that has low payments today. So don’t they have to move again in two or three years, right. If they want to start a family or they want a house or something. There are a lot of people with income profiles like that. Now there’s risk of those products, but I think that was the other thing is demonstrating to the age profile of what mortgage products might work well for people.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Andra Ghent (B)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Andra Ghent joined the Kenan-Flagler Business School in July 2019. As an expert in commercial real estate, she researches how investors decide where to invest and how those investments influence the cities they invest in.

– Host

Dr. Ghent knew she was moving to one of the most educated areas in the country: the research triangle.

– Dr. Ghent

If you want to choose a single predictor of a city’s long term growth, you choose cities with a high share of college graduates. It’s that simple. There’s just no other predictor long term. And so institutional investors do choose those cities. But that in turn, the choice of where institutional investors go influences that city. The one things I love about real estate is that when an investor makes an investment in a city that doesn’t just sort of bring him money, it permanently changes the lives of the people who live in that city. When I walk around downtown Durham or downtown Chapel Hill, somebody built those buildings and that influenced what shops I can go into, how I interact with my neighbors, how walkable a city is. You know the only thing I don’t love about the triangle is it’s really not very walkable relative to other places I’ve lived it. I’m hoping that will change in the future. Developers can change that through targeted investments. Most people who work in commercial real estate recognize that. They’re not just excited about the return they have to give to their investors.

They’re also excited about wow like I built this apartment building or this mixed use building that people now come and go and people interact in a very different way with their neighbors and their workflows than they used to. I think there’s a really interesting national trend where we’ve known for some time that inequality is increasing. Of course everybody knows this. If we dig into the numbers on inequality the returns to a college education have really gone up since around 1980. And so if you look at the wages of college educated workers those have gone way up. If you look at the wages of workers with only a high school diploma they’re basically the same as they were in 1980. So this is where the polarization is come and what we sort of see is that technology seems to be a strong complement to skilled labor. So when I say skilled labor I basically mean college educated workers or maybe you know specialized workers you might say as well maybe a two year diploma and something. We call this job polarization where the hollowing out of these middle jobs. But what we’re finding now is there’s also a geographic dimension of that where certain cities are attracting college educated workers disproportionately.

The Raleigh Durham area is one of them. And so it used to be up until around 1980 we saw that cities that were poor would grow faster in terms of incomes. And we don’t see that as much anymore. What we see now is that the cities if anything are diverging were cities that we’re not well off in 1980. They’re not doing better today.

– Host

Dr. Ghent was immediately taken with her new colleagues, the mission of the business school and, of course, the weather.

– Dr. Ghent

I love being at Kenan-Flagler and my colleagues are excellent. They’re very engaged researchers, good teachers, and very committed to the Carolina community as well. I think people really do have a team attitude that is sort of cheesy as that sounds I think is very true. That’s my sense, I feel like everybody is on the same team. But aside from my very talented and bright colleagues in Kenan-Flagler, among the things that impressed me about how Kenan-Flagler is governed is they have a genuine commitment to diversity inclusion not just sort of lip service about it.

They seem to understand the importance of seeing different perspectives be it from women, be it from visible minorities underrepresented minorities. And for example, they have a course called Gender in the Workplace and I was delighted to hear this because it’s often very difficult to understand exactly what might be best. Especially people starting out their careers like they don’t really know how to handle some of these issues. It’s not that they’re not interested they just don’t know how to talk about it. And so I thought that was great that they have this course called Gender in the Workplace.

I was previously an associate professor at the University of Wisconsin Madison and I was pretty happy there. Madison is a fantastic city a little bit cold but a great city and great group of colleagues at University of Wisconsin great students. So there was only a few schools that would have called that I would have been like yes I’d be interested in potentially moving and so when I got a call from my colleague Jacob who I know very well said “might you be interested in joining?” I said yes, absolutely, because Keenan Flagler is an excellent business school. I knew a lot of the faculty in the finance department. They’re all very engaged, super bright researchers, hardworking and it was very attractive to me to be part of a great business school with good momentum. I am happy and I’m staying. Absolutely.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Paul Cuadros (A)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Paul Cuadros researches and writes about race and poverty in North Carolina. At the UNC Hussman School of Journalism and Media, he uses this experience to teach public affairs reporting.

– Host

Born in Ann Arbor, Michigan, Professor Cuadros’ journalistic journey began in the Midwest.

– Cuadros

My interest in immigration issues began back in Chicago when I was a reporter in the city and what we were seeing was an outmigration of Latinos from the West Side of Chicago into the western suburbs of Chicago. And they were facing housing resistance by those suburbs to keep them from purchasing new homes and from essentially changing the demographics of these very traditional western suburbs outside town. That really got me interested in immigration, migration and the forces at play sometimes when longstanding communities received newcomers. I moved to Washington D.C. to work for a place called the Center for Public Integrity and while researching a book on special interest money one of the industries that was spreading a lot of money on the hill at that time was the food processing industry. And what they were looking to do was regulate new standards for repetitive strain injuries of their workers. Workers in a poultry plant or a slaughtering house; they do the same repetitive motion over and over again, they get injured. And so in researching that it began to be very clear in the late 90s that the poultry industry and the meat processing industry generally was recruiting and hiring workers from south of the border, in some cases even transporting them into the interior of the United States to states like North Carolina, Georgia or to the Midwest like Nebraska.

That was a great story but you know in 1997-98 nobody was interested in immigration. Nobody was. But I could tell that that was gonna be a huge story later on as these communities began to change.

– Host

His next stop was North Carolina where Professor Cuadros found a migrant population that became a settler class.

– Cuadros

I moved to North Carolina on a fellowship mostly because I couldn’t find anybody to really pick up this story. But the fellowship supported me they bought into that idea that would be this demographic change and cultural change in the American South. So they funded me for a year and I essentially went everywhere in North Carolina. I went to a Christmas tree country out in western North Carolina. Hog country down in Dublin County, poultry processing of course in Chatham County and to other counties in which the food processing industry had hired large numbers of Latin American mostly Mexican immigrant workers into their plants.

The food processing industry needs workers. They have tremendous turnover each year. People don’t like to work in slaughterhouses. It’s dangerous job. It’s a dirty job. The environment is tough. There are parts of a plant that are very cold. There are parts of the plant that are very hot and people don’t last very long at a poultry processing plant or a meatpacking plant. And so companies are constantly looking for new workers and they’ve relied on immigrant workers for a very long time and this was no different in that sense. Except for the fact that they were asking people to come from across the border from Mexico into the United States to work.

And once that started it triggered a migration of other family members to come as well. So in 1990 there were maybe about 1 percent of the population in Siler City was Latino or Hispanic. The town’s entire population is about eight, nine thousand people. It’s the largest municipality in Chatham County. And there were two processing plants, a feed mill, a hatchery, some 300 chicken farmers around Siler City in Chatham County and nearby counties and really Chatham County at that time in the 90s was a poultry county. When I moved there in 1999 the Hispanic population had already grown to about a third of the population.

Today according to U.S. Census estimates the latest population is around 49 percent Latino or Hispanic. And of course the census always undercounts people and especially an immigrant population is always undercounted so more than likely the majority of people in Siler City today are Latino or Hispanic descent. The food processing industry poultry collapsed about 10 years ago. Both plants went bankrupt. I think everybody thought “hey that’s the end of this population they’re going to pick up and move.” But they didn’t. The immigrants stayed, their families stayed. They’d like Siler City. They liked Chatham County and they’ve become a settler class.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Paul Cuadros (B)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Paul Cuadros researches and writes about race and poverty in North Carolina at the UNC Hussman School of Journalism and Media. He uses this experience to teach public affairs reporting.

– Host

When Professor Cuadros moved to North Carolina in 1999, he began a new life amidst the end of food processing.

– Cuadros

When the industry collapsed in Siler City people stayed on, it became a bedroom community and people worked everywhere else. I had lived in Los Angeles. I’ve lived in Chicago and lived in Washington D.C.. I was a big city guy moving to the rural part of Chatham County and sort of experiencing a rural lifestyle. I wasn’t prepared for. I didn’t have any family here, I didn’t have any friends here. As a reporter that’s kind of what we do, we go to where the story is no matter where it is. Though I was kind of bored I started coaching youth soccer to alleviate that boredom and the next thing I know I’m hearing all this stuff inside the city about the high school not having a varsity soccer program from the boys themselves.

I did not mean to think that that was a cause of any kind. I thought it was hey you know we’ll talk to the principal, we’ll talk to some people at the school, we’ll get a program together and the boys will be happy and I certainly never saw myself coaching that team. I had stirred up all this trouble and quite frankly it was trouble because it was a new thing and it was another thing that the long standing community had to accommodate to. A new sports program at that high school that was traditionally football, baseball, and basketball.

Now these new kids that come in and they wanted something new and the longstanding community didn’t understand that. I just saw it as ‘hey let’s build a soccer team let’s get something for these guys going’. There was a moment in which the principal kind of looked at me and said “Okay now we need a coach who’s gonna do this?” You know there is this sort of like pregnant pause; who is going to do this? I said to myself you know I kicked up all this trouble so I better step up. And so I became the coach. It was 100 percent Latino. That was an amazing day I still have that clearly visible in my mind. The boys who had been advocating for years themselves desperately wanted to represent their school, their community finally had a chance to try out and to wear those school colors. It was a magical day for them. When I brought the uniforms out for them to take that was another magical moment that they were able to don the colors of their community.

– Host

The storybook season was 2004 when Jordan Matthews High School in Siler City fielded the first state championship team of all Latinos, the Los Jets which was eventually turned into a documentary TV series.

– Cuadros

And I knew it was a story but it wasn’t a big story yet. And so once we won the state championship and we were the first all Latino team to do so in North Carolina, maybe even the South, I knew there was a story there and then it was historic in some proportion and a great American story as well. It was a television series produced by Jennifer Lopez that premiered in 2014 and it happened over several years. And working the system in Hollywood and really trusting into one particular director Mark Landsman of the project he and I worked together for years on developing maybe a documentary film and that was the original sort of idea.

It’s not easy to get things produced in Hollywood especially if they center around stories of people of color. Especially I think really the sticking point was me, was my particular story. I think if I hadn’t been Latino myself to coach Latino and not some other person then it would have been an easier story to produce in Hollywood. You could have found an actor to have played that coach’s position but to have this sort of all Latino cast was radical back then and is probably radical today. You have to understand that when the program was started in 2002 Latino students at the high school just did not fit in. They were newcomers. They didn’t know if they belonged to the school. They didn’t have a real identity with the school. They didn’t have a real identity with their community with attachment or affiliation. They felt alienated from a lot of different facets in life and so many of the Latino students at Jordan Matthews just didn’t participate in a lot of things. The success of the soccer team helped to open up those doors for all those other activities for students.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Paul Lanier (A)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. In his work at the UNC School of Social Work, Paul Lanier develops and evaluates evidence based programs that create a positive impact on parenting. He strives to ensure parents, especially new fathers, have access to tools, skills and services they need to be successful.

– Host

Dr. Lanier first worked with adolescents and young adults with severe mental health and substance use issues in his native North Carolina.

– Paul Lanier

I got to know hundreds of these youth from across our state and many of whom shared stories with me about their experiences with their parents or with the foster care system. In most of the services that we provided focused on the kids behaviors and not as much about the adults responsible for them. The system seemed to be designed to wait until things got really bad instead of going upstream and working with the families earlier. My research focuses mainly on promoting child well-being and children’s mental health. I try to make the connection between investing early in childhood and the benefits to children as they become adults later in life.

So I’m really interested in child maltreatment prevention, child abuse prevention. So we work with programs across the state that help parents to properly care for discipline and raise their children using practices to best promote child development. I also think a lot about what we can do as a community in a society to make it easier to be an effective and loving parent. All my work currently is in North Carolina for the most part. It’s a really exciting time. Governor Cooper and his administration just recently released the North Carolina early childhood action plan.

So we’ve been working with the State Department of Health and Human Services to bring this plan to fruition. We have good programs and pockets of our state things like home visiting programs which involve bringing trained professionals to work with pregnant women and new parents in their homes. We also have some skills based parenting programs. So we’re trying make these programs more inclusive and develop a statewide vision and plan for these programs in North Carolina. So working with the Division of Public Health, North County Smart Start and UNC Chapel Hill the three main groups planning and leading these efforts to build systems and an infrastructure across North Carolina to focus on workforce development governance issues like that to really make the system work well.

– Paul Lanier

Dr. Lanier says North Carolina has problems but is already far ahead of many other states.

– Paul Lanier

The state overall has always had a very strong focus on early childhood. Our Smart Start program and system is a model for other states and really seen as kind of like the national leader in early childhood. So I think we have a strong reputation to build on. There’s always work to be done. Of course, you know, we’re a large and diverse state with rural areas and urban areas and a big focus on letting local communities kind of decide what the right programs are for their communities and try to help lift up and really good examples of best practices and make sure that they’re spread equally across the state. Ideally you would have several options in a community where a parent could sit down and someone with training about the different programs could talk the parent through the different areas of focus and what might fit best with the things that they want to strengthen and then help the parents pick the program that’s right for them. Maybe it’s something more intensive. Maybe it’s something that’s a lighter touch but really focused on the individual needs of the families. We’ve got a number of programs to talk about. A couple of our bigger ones in the state that are widespread would be the Nurse Family Partnership and the other being Parents as Teachers. Nurse Family Partnership was designed to focus on health–reaching health milestones for the infant and the mothers, things like breastfeeding and proper nutrition.

So a nurse will come to the home and visit regularly up until the child’s about 3 years old and doing basic health and wellness and also focusing on parenting practices like safety, baby proofing or how CPR. All the things that parents may not kind of instinctively know about caring for a new child. So the program focuses on first time moms, for that reason. They’ll also work with the mother on making a plan about going back to school, getting a job and birth planning. So it’s pretty holistic to try to help out the mom and the baby really be successful in those first years. Parents as Teachers, on the other hand, focuses more on early learning as the name kind of implies. Thinking about the parent as being the first and most important teacher in someone’s educational experience. How can a parent support positive development and prepare the child for preschool and ultimately kindergarten in the grade school. We think that starts really early. Teaching parents about reading to their children how to get on the same level and interact with them and play with them in a way that supports positive development.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Paul Lanier (B)

– Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. In his work at the UNC School of Social Work, Paul Lanier develops and evaluates evidence based programs that create a positive impact on parenting. He strives to ensure parents, especially new fathers, have access to tools, skills and services they need to be successful.

– Host

One of Dr. Lanier’s goals is to ensure that pregnant women and young mothers eventually have access to these programs.

– Paul Lanier

It really begins with having a strong system. So you have to build systems that are kind of locally grown but supported from above to make sure that there is access to programs, that there’s consistent funding, that there’s a workforce that’s available. These programs are considered evidence-based so there’s strong research from studies not necessarily conducted in North Carolina that we see better outcomes for maternal and child health and children’s development. To get federal funding for these programs, data must be available that shows results from the programs so the bar is actually pretty high to receive federal funds.

The best evidence we have in North Carolina for a program is a universal model called Family Connects which started in Durham County and now we have it in Guilford County and Forsyth County and I’m hearing more counties are taking a look at this model. And they’ve shown in several studies really good impacts on a lot of things related to emergency room visits, child abuse and neglect. So we tend to think about the outcomes being either maybe on the parent or the maternal side versus the infant. For parents, having better access to mental health services, reducing postpartum depression and having better access to prenatal care and other forms of health care. For the infant, basic things like weight gain and fewer injuries, developmental milestones.

So most the programs require some sort of long term observation or follow up in the research and actually some of the programs have looked at outcomes over 18 years or, so from birth up to a child is even in their 20s in some cases. And one study even looked at the life expectancy of mothers 18 years later and mothers were surviving at a higher rate for those who had been visited 18 years prior versus those who weren’t. There’s a large array of outcomes that the programs can impact on just by intervening in this brief period of time. Yhe federal government, state and local governments are investing in these programs because they can really return high dividends on these investments that we make early on.

– Host

Dr. Lanier is also focused on emerging programs that are more inclusive and available for fathers.

– Paul Lanier

Fathers have unfortunately been neglected in a lot of this research. The role of fathers in caregiving, especially in early childhood, is changing we’re seeing large increases in the number of fathers who are taking care of kids even especially young kids in the home. So we need to think about what it would mean to support male caregivers and father figures trying to care for young kids. The programs that I mentioned are inclusive of fathers. There are no programs that are specifically for fathers that were developed with fathers in mind. We recently completed a study for a group based program called Circle of Parents for fathers only at a Head Start program.

It’s an early childhood program in Wayne County. And so we tried to schedule these group meetings at the Headstart facility and it’s really difficult when we’re asking fathers obviously to focus on employment and making sure you’re at work and taking care of your responsibilities. But we also want you to be here once a week during this one hour specific time block. They need something more flexible than that. So when we talk to the fathers about what they would like they basically describe these home visiting programs. “It would be nice of someone to come to my house and spend time with me with my kid and the toys and the things that I have in my house. And teach me how to be a more effective parent kind of on my own turf.”

That’s something we’re thinking about to make sure that we’re developing programs, adapting programs with fathers in mind. Several programs in the state are really focusing on this. Lots of really interesting innovative ideas about how to engage fathers. Some programs like to work on the fact that dads can be well maybe a little more competitive and enjoy a playing video games and things like that so you’ll see kind of like a gamification of some of these programs to help engage fathers.

There’s another program that uses basically a word pedometer so they track the number of words that are said in a day. There’s a couple pilot projects going on say with this. And what we’re hearing is that bothers are really excited about increasing their word score. So this last week maybe you said a thousand words a day to your kid and you know I want to do better next week. So you know maybe that’s one way that all parents will get excited about increasing language exposure but maybe fathers in particular are like this idea of kind of competing against themselves and increasing their word counts with infants.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Dana Griffin (A)

– Provost Bob Blouin

– Host

Dr. Dana Griffin draws on her personal experience growing up to advocate for stronger partnerships between parents, children and their teachers. Her work in the School of Education is helping students succeed in the classroom and beyond. Dr. Griffin believes that if given the right opportunities and support historically marginalized students have the capability to be as academically successful as other students.

– Dr. Griffin

I got into the research that I do because of my experience growing up in rural Virginia with a single mom and realizing that even though she was very involved in our lives, the schools wouldn’t have seen her as being involved in our lives because she was working. I do owe where I am to her. My experience and the research that I’m interested in doing is reaching out to low income parents, mothers particularly, in rural environments and really working with them and working with the school system. Unfortunately not until I was in my own PhD program and looking at the research and realizing that hey you know my mom did a lot.

So really not seeing her value until after I was already out of the house made me realize that there are probably other families that same way. We are overlooking their value in what they contribute to the family and the research says that in low income families they are actually seen as not involved in their kids lives. So my mom basically told me that my job was to go to school. She wasn’t the one that will volunteer in the school. We didn’t have money to donate to the school so she never did any of those traditional type of involvement activities. But what she instilled in me about education, meaning that my job was to go to school and do the best that I could. I think that was very powerful and long lasting and that’s one of the things that I try to help other parents do is not see themselves in a negative way but really talk about education and instill that sense of educational attainment in their kids.

None of my teachers in any of my classes talked to me about going to college and for my mom that wasn’t on the radar. It was to get your high school degree and find a good job. So that was my motivation. I wanted to do well in school so I could find a good job, but because I was really a good student I don’t see myself as more intelligent than anyone else. I just did what I was supposed to do which was to go to school and do well. I try to let other parents know that if they didn’t go to school they may not be able to talk to their kids about going to school but they can talk to their kids about furthering their education and they may not know that they can do that. And the kids may not hear that but it doesn’t mean that parents do not care about their kids education. It just means that that’s not in their experience to talk about it.

– Host

Dr. Griffin fights to overcome obstacles so parents can help their children advance in school.

– Dr. Griffin

That was always given to me in my school. That we were not smart not intelligent, not worthy. Whether it was said outright, covertly or just in the communications from teachers or school counselors who never talked to you about any further education or higher education. And that’s another thing that I try to talk about with parents. What does success look like and it could look differently for your kids than it did for you and it doesn’t mean that you’re less than, but we want more opportunities for kids. The parents that I have worked with they have always been more open and receptive to feedback, advice strategies for how they can help their kids.

– Dr. Griffin

And that’s one of the myths out there is that parents don’t want the help. But I think that if we come to them and approach them as equals; that I’m not better than you are, but I do have more knowledge about how you can work with the school system and how you can help your kids and the things that you could talk about with your kids. But I think parents are more open and receptive. So one of the things that prevent parents from talking to teachers is a lack of trust. For some parents its that fear of being seen as stupid or not intelligent enough or just looked down upon. And so one of the things that I do is really try to help parents understand that regardless of how a school may view them or teachers may view them that they’re there for their kids. And they have a right to go to this school. They have a right to talk to teachers and even question.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill to hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Dana Griffin (B)

– Provost Bob Blouin

– Host

Dr. Dana Griffin draws on her personal experience growing up to advocate for stronger partnerships between parents, children and their teachers. Her work in the School of Education is helping students succeed in the classroom and beyond. Dr. Griffin uses focus groups and communities to start building the necessary relationships with parents and teachers.

– Dr. Griffin

If parents do not feel that school that teachers have their child’s best interest in mind and if teachers do not feel that parents support them there is a huge conflict and there is this barrier that’s not going to be crossed. One of the things that I do want is for parents to understand teachers perspectives and then for teachers to understand where parents are coming from like building that relationship is key. And trust is a part of that relationship. I do focus groups with parents and I get their perceptions and their barriers and things that they want.

And I actually will go to the school and say these are things that parents are saying. So my research affords me the opportunity to be out in the community and to work with parents where teachers they don’t have the time to do that. And some parents don’t have time to come into the school. And so my research affords me that opportunity to be that mediator. I don’t need approval from the school but I do want school buy in. I want the school support. I want the schools to say “yes come work with my parents and let’s try to find ways to develop better strategies.”

I first pick an area based on where it’s located. I prefer rural areas. And so I will find those areas and then make contact with schools and say “hey would you be interested in working with me?” I build relationships and I try to work with cultural brokers. That’s a person who’s from the community who knows the people in the community who can then build a relationship with the community members the parents and me. And so again everything that I do has a relationship component. And I don’t want them to see me as the expert.

I do tell parents I’m not the expert over their kids. I’m not the expert over their lives. I can’t tell them what they should be doing. I can tell them what research says works but I do not want to be seen as the expert. So I try not to use it as a way to build relationships with parents especially if I want them to see me as one of them.

– Host

In trying to find the right solutions, Dr. Griffin often has to go back to her own experiences.

– Dr. Griffin

When I was a junior in high school I was working at Rose’s department store part time and after graduation my career goal was to work full time at Rose’s department store and I thought I could be a manager like that was making it. A junior in high school, 16 years old, straight-A student, advanced courses.That was my goal. There was a special education teacher, I don’t know why but she came to me and said here’s this program at William and Mary, it was a summer program, you should apply to it. I applied to the program got accepted and went to William and Mary the summer after my junior year and then I became aware “Oh this is what college is and this is something that I can do.” So that started me on my college journey and it turned out OK. But that’s something that students should be aware of the opportunities that exist for them way before they even get to high school.

My senior year I applied to William and Mary I get in. And so I went there for undergrad and then how I got my PhD. It was —I call it chance and that’s what I want for students in school today. I want people in place that can guide them along the way so that they can be prepared and then for UNC when I was looking for jobs on the website they talk about a strength based approach the counseling program and the School of Education was all about social justice and equity and that’s who I am and what I am about.

And so I thought this is where I would be a good fit here. North Carolina reminds me of Virginia in the rural part. We get students from all over North Carolina and repeatedly I hear that they never had experiences with professors of color or people of color like they went to very segregated schools and live in segregated communities. And so I feel that I can be influential in helping them understand the need to really reach out and provide services for kids of color and those in low income environments. So it’s that I feel I can be influential with the students that we get here.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Bill Rivenbark (A)

– Provost Bob Blouin

– Host

In the UNC School of Government, Dr. Bill Rivenbark is helping local governments improve the efficiency and effectiveness of public services such as waste management and recycling. He also directs the school’s nationally ranked masters in public administration degree program.

Professor Rivenbark uses Chapel Hill as a great example of the pros and cons of single stream recycling.

– Dr. Rivenbark

We have a very tight mission at the School of Government and it’s actually to improve the lives of North Carolinians. Now how do we do that? The School of Government, we provide training, we provide advising and we write and research for public officials across the state. And although its public officials broadly we really concentrate on local government where we help them thinking about providing all of the services to their respective citizens within the law. And just as importantly within the best practices of providing local government services to be the most efficient and effective way possible.

For example, recycling. Most local governments do provide some form of recycling to their respective citizens. And on top of that over the past several years recycling has become very expensive for local governments. So we have been working on how to provide recycling in the most efficient way possible in order to keep the tax rate down obviously. But more importantly, how do we work with local officials to ensure that they’re actually diverting waste out of the waste stream and moving it into recycling? And this is extremely important today because if it is going to be an expensive service you want the outcome there. You want the impact on the community where your citizens are recycling and you can extend the life of landfills which are very expensive to operate. Do you put more of the burden on the citizen? Where I would have three recycling containers for example one for glass one for plastic one for etc.. Or do you put more of the cost back on the local government because once they have to physically separate those recyclable materials before they go to market with them. So it’s a tradeoff between a convenient and more importantly it’s a tradeoff between outcome.

And right now Chapel Hill has made the policy decision to make it the most convenient for the citizen on the idea that they want to divert the absolute most out of the waste stream. With the tradeoff being that’s going to be more expensive for the town of Chapel Hill. The Town of Chapel Hill is very committed to the environment, very committed to sustainability and because of this they’re wanting to absolutely divert as much waste out of the waste stream as possible.

– Host

How local governments deal with annoying and dangerous potholes is another common problem Professor Rivenbark studies.

– Dr. Rivenbark

One of the number one complaints that come in to local governments is around street, we call it the rideability rate, is these streets maintained in a way to ensure a smooth ride ability where you’re not going along and you hit the pothole and the coffee goes everywhere which can be common. That really tees up some of my work in performance management. US thinking about how many lane miles do we have within a jurisdiction. And looking at our repaving cycle. You know are we repaving all the streets on a 15 year repaving cycle, a 25 year repaving cycle, a 50 year repaving cycle. The more you repave the greater the cost is going to be. But the more you repave you’re going to keep those streets in excellent condition in the ride ability rate is going to be very high. And what I mean by the readability rate is where you have a vehicle with technology that can measure the ride ability of streets for you and you want that rate extremely high which hopefully constitutes into high citizen satisfaction with the street infrastructure that’s so important to our lives, as you know.

– Dr. Rivenbark

When a citizen does hit a pothole I would encourage that citizen to contact the town and one of the services that the town of Chapel Hill and most communities do provide is pothole repair. And we measure that in a way of timeliness and we would prefer a very very high percentage of potholes being repaired within 24 hours of the request. And that’s something that we measure and we’re not talking about just being responsive from timeliness, but we’re also talking about repairing that pothole for some longevity that it will be several years before you have that same problem in that same location.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Bill Rivenbark (B)

– Provost Bob Blouin

– Host

In the School of Government and the decorated masters of public service program Professor Rivenbark can be hands on locally and across the state.

– Dr. Rivenbark

You have some communities that just go through the process of the law tells us we’ve got to have a balanced budget in place and that’s what we’re gonna do. And then you have other communities that really take this idea of citizen input very seriously. They value citizen input and they seek citizen input. I’ll call out the city of Durham. I think does a very good job of doing its best to listen to its citizens. They’ve tried different strategies over there. One thing that prior mayors have done is have coffees around the city going out and talking about the budget. Listening to the citizens, trying to figure out what they want and then bringing that back into the political process so we can produce the right document, the right budget that’s going to reflect the goals and values of the community. I have opportunities in the School of Government not only to teach our local government administrators across the state of North Carolina. I also have the opportunity to teach elected officials at the local level. I have a tremendous amount of respect for all the public officials who work in local government who provide the critical services that citizens need.

– Dr. Rivenbark

And one of the reasons I like personally focusing local government is the level of government that provides the services that citizens can see and touch on a daily basis. It’s not more in the abstract where you think about some of the services may be provided by the state or the federal government. We start using local government services from the time we wake up in the morning. We use the water, to we put the garbage out on the curb, to we use the streets the sidewalks to go to work. We consume local government services on a daily basis.

– Dr. Rivenbark

Now I do encourage our local governments when they talk about measuring their services when they measure the efficiency when they’re measuring the effectiveness of the services to look at other local governments because other local governments may be doing things that’s more efficient that’s more effective. That maybe you can adopt or adapt to your respective community. With that said I always encourage local governments before we look to your neighbor to make sure you understand the strategic goals and the values of your respective community. Once you have that in place then start learning from your neighbor on how to provide services.

– Host

The master’s in public administration degree was created in 1966 through the traditional on-campus format. However with the improvement of technology an evolution has occurred.

– Dr. Rivenbark

In 2013 we decided to create an online format and it’s the exact same curriculum. Not only on campus and online in what we have found that we have given this accessibility to individuals who cannot leave their current job who cannot leave their current responsibilities and come here for Chapel Hill for two years to obtain our MPA degree. Now they can remain in their respective communities continue to work, continue to manage their responsibility and obtain the degree online. And what we have found: individuals who are coming through our on campus program continue to have two or three years of average work experience where the individuals who come through our online program typically have somewhere in the average of nine to ten years of work experiences and we have been successful with our online program.

We admit around 40 to 50 students a year who come through. A large percentage of our online students, somewhere in 85 percent who do enroll, end up completing the degree and then can remain in their respective communities and carry out their responsibilities. The technology today is fantastic. You can have breakout sessions on the technology where I’m going to electronically put three individuals in a breakout room here for this discussion. Three here three there. Go away. Work on this quick assignment and then I will bring you right back together for the full discussion.

Very much like you would do in a regular classroom that we’re going to have a work assignment. Each table works on various pieces and then we’ll talk it through. What it does is it allows all of our students both on campus and online come together in one classroom and having the structure provide a course on a particular topic to all of the student body.

– Provost Bob Blouin

Thank you for listening to Focus Carolina sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro.com and click on WCHL On Demand or visit unc.edu.

Focus Carolina: Sarah Stroud (A)

Provost Bob Blouin:

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Sarah Stroud teaches philosophy in the College of Arts and Sciences and is the director of the Parr Center for Ethics. The center organizes lectures on ethical themes, runs Fellows programs for Carolina undergraduate and graduate students and is home of the National High School Ethics Bowl competition.

Host:

One of the main goals of the Parr Center is getting students to engage in what Dr. Stroud calls ethical reflection.

Dr. Stroud:

We’re hoping just to connect it to the Parr Center is that if we can get to people early in their lives when their character is still being formed and kind of remind them that ethical reflection is part of how you need to navigate your life as a human being, it’ll become more habitual and less likely to be forgotten in the cacophony of social messages pointing in other directions. What we try to do is have a multi-pronged set of programs that are all designed to draw people and get them engaging in this activity of thinking through ethical questions and issues.

We do that in several different ways. We have about 15 speakers this year coming in to give lectures and have lunch with our students and discuss with our graduate students a really wide range of topics. Last year, we had someone who had worked at Uber talking about the ethics of flying cars and self-driving automobiles. We work a lot with students so we have a great group of undergraduate students that are called the Parr Center undergraduate fellows. They work at the Parr Center on projects connected to ethics.

Year round, they work as a team. They meet in the evenings to talk about ethical questions. They put on conferences so we’re very bottom up in the sense that if people are excited about a certain kind of question and they want to think about it more, we want to facilitate that and give them avenues to do that. We also run a local outreach program. We’re out in elementary schools, middle schools, high schools, retirement communities, you name it. We’re out there leading discussions on ethics with the people in those organizations and then we try to keep busy with all that stuff that’s based on campus constituencies.

At the same time as we’re reaching out to the local and national communities.

Host:

Dr. Stroud was recruited from McGill University and found what she calls her dream job at UNC.

Dr. Stroud:

That was in a lot of ways a great gig but even if I didn’t have the leadership position at the Parr Center, just the chance to join this group of people was so attractive. The quality of the other colleagues, the graduate students, the intellectual culture in the department—it’s very collaborative, very congenial. These are not the norm in most academic departments. So all that was hugely attractive and then the fact that it also gave me the chance to step into having my own shop leading something that was really in an area that I was passionate about because this is my research area.

It is just well known that Carolina’s philosophy department has a lot of excellent very renowned philosophers in it. We’re also particularly strong in ethics. That was another difference from my old department, where we didn’t have many people in my subfield, so I didn’t have that many people who were interested in the kind of work I was doing here. It’s much more the center of gravity so that all I knew and I had actually been here several times to workshops and conferences and had thought, ‘oh there’s a nice atmosphere.’ So I did suspect a lot of it and then I found out it was all true. I found out what I couldn’t really predict is what would it be like to actually be leading my own center.

I had done some academic leadership at McGill. I was an associate V.P. at the university so I had some experience with stepping outside just your little patch of grass. It was in a much more general role that didn’t have anything in particular to do with philosophy or ethics or my stuff so I couldn’t really predict how I would like that. But that’s been a thrill just knowing that we’re together building this great thing to advance stuff that I really care about and I get to invite in all these cool speakers. It’s been amazing.

Host:

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews visit Chapelboro dot com and click on WCHL on demand or visit unc.edu.

Focus Carolina: Sarah Stroud (B)

Provost Bob Blouin:

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Sarah Stroud teaches philosophy in the College of Arts and Sciences and is the director of the Parr Center for Ethics. The center organizes lectures on ethical themes, runs Fellows programs for Carolina undergraduate and graduate students and is home of the National High School Ethics Bowl competition.

Host:

Dr. Stroud is very excited to have inherited what can be best described as a tournament of thoughtful debate involving thousands of high schools across the country.

Dr. Stroud:

It’s a program where we write up a bunch of case studies of difficult ethical dilemmas. We try to stay away from the really easy black and white stuff to do things that really make you think. We write up a big set of these case studies every year. We suggest some study questions that students can think about. We send them out to high schools who want to participate across the country. And then after they’ve worked on the questions for a few months, they compete at these tournaments.

They’re a little bit like a debate tournament in the sense that they’re asked questions and they have to answer. But we’ve designed the scoring so that what is valorized is really different than what’s valorized in debate where it’s more sort of slash and burn refuting what your opponent says. Our scoring deliberately gives them points for things like picking up on an insight that the other team gave and developing it and asking more questions about it. The activity itself models the kind of ethical attitudes that we would hope our young people would have.

That’s been a huge success. That’s only gone on for seven years and it’s at least tripled or quadrupled in size since we started it. And we hold the national championships for that on our campus every year in April. It is a wonderful event. It’s 24 teams from all over the country who fly in or drive in with their coaches and who then compete in another tournament that we organize with judges from throughout the Triangle and throughout the Carolina community. And then at the end of the day there is a team that emerges as the champion. They get a big trophy and a lot of press. Last year’s winner was a team from Oregon. They had flown all the way across the country. It was the first time they had participated in the event and they won.

Host:

The ethics bowl sometimes uses real life examples, such as the one Dr. Stroud and her colleagues chose for last year’s competition.

Dr. Stroud:

One that was based on a true event, a girl who was 17 years old who had cancer and who wished to decline the chemotherapy. It didn’t fit in with her value system to have what she considered to be toxic chemicals polluting her body.

She was almost 18. Had she been 18 she would have been at the age of majority and her decision would have been respected. But because she was 17 it was more complicated. Her parents backed her up even though she would probably die without the chemotherapy and with the chemotherapy she’d probably recover. And in the end in the real case the government forced her to have the chemotherapy. But we wanted the students to talk about whether that’s ethically acceptable or whether she should have been allowed to make what might have appeared to most of us as a mistaken decision.

Under the law, If you’re a minor you don’t have an unqualified right to make decisions and no doubt that’s a good thing if we’re talking about a 4 year old or something. So it wasn’t a conflict between the child and the parents. It was a conflict between the child and the parents on one side and the courts and the government on the other, which I think just felt that her position wasn’t reasonable and that it would be a tragedy for a 17 year old girl to die because of what the adults viewed as a very short term or fleeting preference and we definitely get people on both sides of that issue. It’s not what answer they end up on that’s important. It’s can you articulate why you think so strongly that she shouldn’t have been forced. Or why was it legitimate for the government to force and there are many factors that come into that. It’s very interesting to hear what the students come up with they’re very thoughtful. Part of our message at the Parr Center is that ethics is everywhere. There is no domain of study or work where you don’t have to think through ethical questions. So part of my goal as the new director is to get much more connected to the whole campus and make sure that ethics is playing a role everywhere.

Host:

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews, visit Chapelboro dot com and click on WCHL on demand or visit unc.edu.

Focus Carolina: Lissa Broome 1

Provost Bob Blouin:

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill. An award-winning teacher, Lissa Broome is director of the UNC School of Law’s Center for Banking and Finance. She also heads the school’s Director Diversity Initiative, which works to increase gender, racial and ethnic diversity on corporate boards of directors.

Host:

Early on, Professor Broome pivoted from private practice to teaching and Carolina has been the beneficiary of that move.

Broome:

My husband and I were practicing law in Atlanta and we decided we were interested in exploring a different path and that was law school teaching. Our resumés arrived at UNC at the right time and we were both very fortunately offered jobs to teach here. After a few years my husband decided that he would rather practice law. I told him I love it here in Chapel Hill so find a job you can drive to. And he was able to get on with a firm in Raleigh and it’s a terrific story, I think, of us balancing our dual careers at the very highest level right here in the Triangle.

I love teaching. I love working with the young people… the opportunity to do the research. The opportunity to serve the state has really been a perfect fit for me. I am maybe one of the few people I know who really loves my job. I get out of bed every morning and run to work almost literally to get started on the things that I want to get done that day. When I came here, I taught contracts and commercial law. I had been in the banking law department of the law firm in Atlanta and given the importance of North Carolina to the banking industry suggested to the dean that would be a good idea to offer a banking law course. After a few years I was able to get that accomplished. It’s been a great ride ever since. Charlotte is the second largest financial center outside of New York City and it’s really been terrific to be in this state during this period of time when there has been so much growth and change and evolution in the financial services industry.

The mission of the center is to support the continual evolution of the financial services industry.

We do that three ways. We try to study the legal and policy issues related to banking and finance. We try to advance the teaching of banking and finance in particular including the professional development of our law students who are interested in careers in this area. Many law students come without an appreciation of banking and finance or transactional practice and it is really rewarding to help introduce them to that area of practice especially again given its importance in the state. And then third and probably most visibly for our center, we sponsor a number of conferences for industry professionals. many for lawyers who service the banking industry both in-house counsel and lawyers from private practice. Many of our attendees obviously are from right here in North Carolina.

Host:

Law school often presents graduates with the opportunity to jump right into legal careers in banking and financial services.

Broome:

I think that we provide a lot of important background, introduce them to a lot of important people in the industry as well. We have a very large board of advisors of banking industry professionals who really treasure the opportunity to get to know and work with our students. I invite a number of professionals each year to come to my banking law class and talk about the subjects that they are expert on. We have opportunities for the students to attend lunch with them and get to know them on a more personal level. We’ve had stories of people getting jobs as a result of that.

So we really do try to integrate the practicing attorneys in the area and give them exposure to our law students and allow our law students to learn about the breadth of practice areas and opportunities that are available not only in this state but elsewhere in this area.

Our upcoming Banking Institute program which we’re going to host in the springtime in Charlotte… that’s really our signature program that attracts about 200 attorneys. We’ve got a number of interesting topics on the agenda. One is how do banks interact with the cannabis and hemp industries. Marijuana sales are legal in many states and obviously not in others but importantly marijuana sales are not legal at the federal level.

Banks in the states where sales are legal are trying to navigate this tricky line of how do we service the businesses that are in the state while not violating federal law and not making ourselves subject to money laundering concerns which is associated with illegal proceeds of money. That’s a really tricky situation for banks. So it’s an issue that Congress is addressing now as well.

Provost Blouin:

Focus Carolina: Lissa Broome 2

Provost Bob Blouin:

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill. An award-winning teacher, Lissa Broome is director of the UNC School of Law’s Center for Banking and Finance. She also heads the school’s Director Diversity Initiative, which works to increase gender, racial and ethnic diversity on corporate boards of directors.

Host:

One of Professor Broome’s passions is to help qualified women and people of color find positions on the boards of corporations.

Broome:

We’ve been working on that since about 2003 and it’s an interesting story about how that got started. Henry Frye, who was the retired chief justice of the North Carolina Supreme Court and the first African American to serve in that position, and Tom Ross, who was then the executive director of the Z. Smith Reynolds Foundation and later president of the UNC system, came to the law school and said they would like the law school to provide some leadership around director diversity. Both of those gentlemen are UNC law school graduates so that’s why they thought that we might be in a position to do that.

I had already been working through the Center for Banking and Finance on something with the North Carolina Commissioner of Banks office called the North Carolina Bank Directors College, where we provide training to directors of banks and as part of that effort, we had been trying to identify women and people of color who might be good bank directors, invite them to that program in order to have the opportunity to learn more about what that would be like and to start forming networks with existing bank directors. That that had been a very successful way of getting more diversity on bank boards.

The dean asked me if I would like to work on this initiative as well and I said yes. So we are focused not just on bank boards but all corporate boards. Many people who serve on boards are rotating off of their day job and in retirement and have the opportunity and the time now to spend significant time on serving on corporate boards and using their experience to help other companies benefit from that. But many companies want people who are still active in their business roles to serve on corporate boards to bring the most current information into the boardroom and to help that company’s board be the best it possibly can be.

For instance, people who know stuff about cybersecurity are high in demand on corporate boards.

Host:

The director diversity initiative measures boards of the 50 largest public companies headquartered in North Carolina.

Broome:

In 2003, the 50 largest public companies headquartered in North Carolina 10.1 percent of their board members were female and only 5.3 percent were people of color. In 2018 that 10.1percent had gone up to 17.4 percent for female board members and for people of color the 5.3 percent had gone up to 9.2 percent. I just recently attended an event in Charlotte sponsored by 2020 Women On Board and they reported that just in that one year from 2018 to 2019, the female board diversity had increased from 17.4 percent to 20 percent and nationwide, we have achieved 20.4 percent female board members in the 3000 companies that are included in the Russell 3000 index. So that is extremely good news but certainly not where anybody I think ultimately wants to be with women as 50 percent of the population over 50 percent of the college graduates, 20 percent is a good number but not near what it should be at 50 percent.

Richard ‘Stick’ Williams is a now retired executive from Duke Energy and Charlotte and we invited him a number of years ago to attend the North Carolina Bank Directors College as a diversity candidate.

And at that time the college was six days over the course of a summer so it was a pretty significant commitment on his part to attend without being a bank director at that point in time. But because of those six days of interaction with other sitting bank directors, he was asked to be on a community bank board in Charlotte. That bank was later purchased by another bank. He went on that other bank’s board and then subsequent to that was asked to be on the board of Coca-Cola Consolidated Bottlers in Charlotte. He is a great success story of how when excellent people are identified and brought to the attention of corporate leaders, they are welcomed into the corporate boardroom and make significant contributions there.

So sometimes it’s companies that are looking specifically for women and people of color trying to diversify the board and gain the benefits from that diversification.

Provost Blouin:

Focus Carolina: Carolyn Thorpe 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share the series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Dr. Carolyn Thorpe’s research in the UNC Eshelman School of Pharmacy aims to improve quality and safety of medication use in older veterans receiving care in the VA health care system. Some of her recent work led to an important policy change that now requires the Veterans Administration and the Center for Medicare and Medicaid Services to share current information between the two agencies about what medicines are prescribed for veterans to prevent drug interactions and other drug safety problems.

Host

Dr. Thorp disputes the assumption that more drugs and more health care is always better. She says drugs often create more harm and problems than those they fix.

Dr. Carolyn Thorpe

Our study in the VA is focused on nursing home residents who have multiple chronic conditions, many of whom are really frail and only have a couple of months or maybe a year or two of life left. Many of them have advanced dementia. And so we’re really interested in seeing how their chronic diseases are being managed and whether or not we can back off on some of their medications without causing harm. As an example, patients who have diabetes might be prescribed medication that very tightly controls their blood sugar, which was appropriate for them when they were younger and had a long time horizon in terms of life expectancy. But as they approached the last years of their lives, the goals of treatment may change. And so in the case of diabetes, we’re concerned about the risk for hypoglycemia, which is really low blood sugar that is associated with the use of medications used to treat diabetes. And it can be life threatening. The risk of hypoglycemia actually goes up as patients age and become more frail and also with the more medications that they’re taking for diabetes. At the same time, we know that the benefits of tight blood sugar control are reduced as patients accumulate multiple co-morbidities or other chronic conditions, or if they’ve had the disease for a long time, they may not see the benefit of being very tightly controlled for their diabetes. So the goals might change to avoid the short term negative effects of hypoglycemia, rather than a focus on the long term benefits for controlling blood sugar that are not really achievable in these patients any longer. Right now, there’s guidelines that suggest that doctors could consider backing off very tight blood sugar control. But those guidelines aren’t really based on direct evidence from data of what happens when we actually reduce medications in these patients? They’re really just based on kind of what experts have decided. Our goal is to provide some of that missing evidence on what happens to older patients if you de-intensify some of their medications for chronic conditions, either by reducing the dose or maybe stopping one of the medications if they’re taking multiple different drugs to control the diabetes.

Host

Dr. Thorp’s research studies how those guidelines are being followed with some interesting results.

We’re also interested in how the guidelines are currently being followed and what makes doctors and patients and their family caregivers decide to reduce or discontinue medications because some families choose to do that while other patients and families decide not to do that. We’re using real world health care data to do this. So bringing together information from the electronic health record and the VA, as well as other sources of information to see how intensely patients are being treated over time and identifying patients who do decide to discontinue or reduce medications and then look at to see what happens to them in terms of outcomes. We’re bringing together several different sources of real-world health care Information that exists already. So we’re not enrolling patients and collecting new data for them or rather using their information that’s produced in the health care system as they get care. And we’re doing this for veterans, nursing home residents. So the VA has their own system of nursing homes. And so we’re bringing information together from the electronic health record, as well as something called the minimum data set, which is a comprehensive assessment that’s done with every nursing home resident when they’re admitted to the nursing home and then every 90 days going forward. And it provides very rich information on their functional status, their health status, cognitive status, different conditions and symptoms that they have. And this data is originally collected as part of the normal course of health care in order to inform providers how to treat the patients while they’re in the nursing home. The primary goal in this case is to see if we can reduce medications is really aren’t benefiting them anymore and are really only likely to have risks in the short term. It might be that these are medications that maybe you have to be on them for two, three, four or five years before you see a slight reduction in, let’s say, heart attack risk. But if you only have a couple of months or a year or two of life expectancy, you’re much more likely to have an adverse drug event in the short term. We’re trying to reduce the burden of medications and also negative events related to actually taking the medication.

Host

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews, visit chapelboro dot com and click on 97.9 The Hill on Demand or visit the well.unc.edu.

Focus Carolina: Carolyn Thorpe 2

Provost Bob Blouin

Host

Dr. Thorpe graduated from Carolina and later returned to follow what had become a passion in the study of medication and sometimes the overmedicating of patients.

Dr. Carolyn Thorpe

My training is actually in public health. I got my degree at the Gillings School of Public Health and Health Behavior, and so I was very focused on how do we get patients to take the medications that have been prescribed. In the course of studying that, it became very obvious to me that while that’s a really big problem, obviously we need people to take drugs for them to work. I also discovered that as big of a problem was taking drugs that were not necessary or they were possibly harmful. We are really good at talking to patients about starting medications, but when we do start a medication, we don’t really set an expectation for how long they should take that medicine or what might lead us to stop it later if something changes. We just say take this. There’s no time given. At some point this drug may not be appropriate anymore. So that really just leads to patients accumulating more and more medications over time, which I think if we look at family members that are older, we see that all the time. The medication list has just grown over time and there’s a mountain of pills that patients are taking. As you take more and more pills. It greatly increases the chance that you have a drug interaction or you have a side effect related to one of those medications. It’s also just a big burden for patients and caregivers to manage their thinking about medications all day long. They’re dosed at different times, take them with different food and instructions. I became a lot more passionate about reducing overuse and inappropriate use as I kind of got into the course of studying medication use more generally because I just have seen it be such a problem in loved ones as well as in the patients that I study as well. Because again, there’s this assumption that more is better in health care. And so to get people, both the providers and the patients, in the family to shift that perspective and think, well, more is not always better. And maybe in this case, less is better. That’s not a natural way for us to think about health care, especially in this country.

So I think the biggest thing is to be sure to ask the doctor or a pharmacist to review the medications periodically to see if patients really need all of the medications they’ve been prescribed. Again, it may have made sense at one point for them to take that medication, but as things have changed, it might make more sense to stop that medication. And along with that, I think being sure to understand the goal of each medication as it relates to the treatment of chronic conditions, so making sure that what that medication is being prescribed for and the goal of that medication is aligned with the goal of the patient and the caregiver.

Host

These so-called low stone walls of collaboration at UNC was a big reason Dr. Thorpe returned to Chapel Hill.

Dr. Thorpe

It was exciting to me because there’s a large number of people here in the school of pharmacy and the school of public health and school of medicine that are focused on improving the lives of older adults, which is the patient population that I’m passionate about. And we’re also focused on the quality and safety of prescribing in particular. I was really excited about working with colleagues that were thinking about the same things that I’m thinking about and also bring cutting edge methodological expertise across the different schools that can really help raise the bar in terms of the quality of the work that I’m doing. There’s a great infrastructure here around data science across the university and a commitment to developing data science capabilities at UNC. And that’s really important for me because my research relies on harnessing information from these existing real-world data sets so it can help advance my work in that way too. And then I was really excited about the opportunity to mentor the best and the brightest pharmacy and doctoral students in the school of pharmacy. Well, it’s interesting, having been a student here, that was always my impression that there were very few barriers to working with anybody across the university. And I’ve been lucky enough to be at a number of great institutions where there really has been a focus on bringing in different perspectives and helping people collaborate. But I do believe, yes, it can be that it is really easy to work with people across different schools and people are very excited about doing that. And so it was one of the major reasons why I was excited about coming back to the university. It’s hugely part of the culture. Everybody is very driven to do good work, but it’s in a very collaborative, not competitive, way. I never feel like I’m speaking with competitors when I meet with them. It’s more just, that’s a really cool idea. And what can I do to help? And it is absolutely a cultural norm at the university.

Host

Focus Carolina: John Bruno 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Dr. John Bruno grew up by the ocean and at an early age became interested in its conservation. Today, in the Department of Biology in the College of Arts and Sciences, he researches climate change and its effects on the marine habitats in our state, in the Galapagos Islands and Belize.

Host

As a child, Dr. Bruno migrated to South Florida with his family and fell in love with scuba diving, surfing and snorkeling amongst the coral reefs, which became his field of study and expertise.

Dr. Bruno

I was a co-author on the recent National Climate Assessment. We spent about a year synthesizing all there is to know about how climate change is affecting the U.S. waters. Our key finding was that ecosystems are already being disrupted and that’s due to a whole bunch of changes. So ocean acidification, a lot of you have probably heard of. That’s where the oceans are becoming more acidic because they absorb about a third of the carbon dioxide released from fossil fuel burning. And then the one hand, that’s a great thing because they’re kind of like a sponge. They pull it out of the atmosphere. So that reduces how much warming we’re seeing. The downside is that CO2 interacts with seawater. It forms a weak acid and it makes the oceans a little bit more acidic each year. And that’s a problem for sea animals that secrete external skeletons, things like crabs and oysters and mussels and corals, because the more acidic the seawater, the more energy they have to put into making these calcium carbonate shells. And so they’re spending the energy on doing that instead of reproducing or growing or avoiding their predators.

Temperature is probably the biggest driver of ecosystem disruption. So in a lot of communities, habitat types were losing the foundational species that kind of define and create the system. My specialty is coral reef ecology, and we’ve lost at least two-thirds of the world’s reef-building coral just since I’ve been here in Chapel Hill over the last 19, 20 years, primarily due to warming temperatures just exceed what corals can tolerate at the end of the summer. That leads to disease and the coral bleaching, the mass coral bleaching. You probably seen on the news some species migrate away from places that are too warm. Many marine species are moving polar and the rate of movement as astonishing, like some 10, 20, 30 kilometers a year. So that’s kind of changing the composition of these ecosystems and that leads to disruption. What we’re seeing is kind of remixing of who’s there. Lobsters have already left Connecticut and Rhode Island, and now they’re up in northern Maine and soon they’ll only be up in Canada. They’re really important predators. So that affects like the prey species in those waters. And in the absence of lobster as predators in coastal Connecticut, Maine, Massachusetts affects like the communities. All kinds of levers being pulled on the way the system works that leads to this kind of destruction. And that in turn is having really huge effects on coastal fishing communities that depend on the fishes and also things like the whales for tourism. Whale watching is a really big business in New England.

Host

Dr. Bruno uses what may be considered an old-fashioned way of taking inventory at the bottom of the world’s oceans.

Dr. Bruno

So mostly we know that climate change is impacting species in the way marine ecosystems function by tracking them through time. We go to places every single year and we’ll count the number of fishes in the system. In my work, we do a lot of videoing of the seafloor in Mexico, in Belize, in Cuba. On coral reefs, we swim along the seafloor and film it. So we’re literally measuring these changes and lots of systems we see declines annually. It might not be big, but it adds up over 20, 30, 40 years. So we essentially construct time series data so we can kind of track how changes are happening over the decades. You go scuba diving and you randomly swim in a direction usually for like 50 to 100 meters and you literally count every single fish within kind of an imaginary swath. And it depends on the sizes of the fish, how wide you’re counting. But generally you swim down like a corridor and you’re counting every fish within five meters to each side of like this line that you’re swimming along. And you’re not just counting them. You’re identifying every fish to species and then you estimate its length. So then you can transform that into like a biomass estimate. It’s challenging. Often you get a pretty precise estimate of who’s there. Then you do that every year, every decade and you can really see changes happening.

And it’s funny, I kind of dismissed that kind of science when I first got my Ph.D. as just bookkeeping ecology. I didn’t really expect to see transformational changes in that.

And yet, like every time I go back to systems, there has been changes. I mean, the changes are so drastic, you don’t need to be a scientist to see them.

Host

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews, visit chapelboro.com and click on 97.9 The Hill on Demand or visit the well.unc.edu.

Focus Carolina: John Bruno 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Dr. John Bruno grew up by the ocean and at an early age became interested in its conservation. Today, in the Department of Biology in the College of Arts and Sciences, he researches climate change and its effects on the marine habitats in our state.

Host

The National Oceanographic and Atmospheric Administration, or NOAH, is the main science agency that studies weather forecasting. Dr. Bruno says its work is crucial.

Dr. Bruno

We wouldn’t know whether hurricanes are coming if it weren’t for NOAH. They’re literally telling us where hurricanes are likely to go, how strong they are…they’re weaker Category 4 or 5…how quickly they’re moving, how much rain is likely to come from them. So we’d be back in the 15th century if it weren’t for NOAH. NOAH is also instrumental in monitoring the state of our fisheries in North Carolina, our oysters, our scallops, our shrimp fisheries. And then they work with state agencies to set catch limits to make sure that our fisheries are sustainable over the long term and also to maximize the productivity, including the economic productivity for coastal communities and for fishers.

We haven’t lost reefs, per se. What we’ve lost is the corals that build them, just like trees generate a forest. And then there’s all these inhabitants that depend on the corals. And in the case of reefs, it’s fishes and starfish and crabs and lobster. All the reefs that were around a couple of centuries ago are still there. They just have much less coral.

When I was growing up in South Florida, you could snorkel over their reefs in the Florida Keys and it was just like gliding over Kansas wheat field. It was just like golden corals and it went on for acres and acres. And so about 70 to 80 percent of the sea floor was covered by living coral and now it’s down to like three or four percent. So the corals are still there, but they’re really patchy and small. And that’s a problem for a number of reasons. Without the corals, there’s many fewer fishes. And if you’re a fisherman, whether commercial, recreational, that’s obviously problematic but affects coastal economies because then people stop going to reefs to look at the corals and the fishes. So it affects hotels and dive operations all around the world. When I visit tropical countries for work or for teaching, one of the striking things you see is coastal erosion. Palm trees are falling into the water and that’s in part due to sea level rise and increased storm activity. But it’s also due to the loss of these natural buffers. So the reefs build kind of a seawall around coastal villages without which the waves are just kind of keep going right to shore and crash on the shore and the way the beaches.

Host

One of the byproducts of this change in coastal economies is the increased mislabeling of fish by distributors and seafood restaurants all over the state and country. The research of this byproduct has led Dr. Bruno to create a brand new course at a UNC.

Dr. Bruno

So this wasn’t my primary area of research until four or five years ago. I got asked to develop what’s called a CURE class. So CURE stands for course based undergraduate research experiences. It’s one of the big education innovations that the College of Arts and Sciences is instituting. We’re doing away with cookbook laboratories, where students kind of like mix the red liquid and the blue liquid together and see what color it comes out. Students nowadays are doing real transformational science. In my class, it’s called seafood forensics, and these are usually first semester students, 18- 19-year-olds, their first day on UNC campus. They’ve never done science in their lives. And we give them a piece of flesh and it’s a piece of seafood. They have to identify what it is to species. And we teach them how to do that using what’s called DNA barcoding. Once they do that, they design a research project and the class is focused on measuring how much mislabeling there is in the seafood industry across the state. And each semester we choose a different type of seafood, a different species. We do shrimp a lot. You all have seen the coastal stands where it says North Carolina fresh shrimp. And about a third of that is actually farmed, frozen, imported from abroad from places like the Philippines or China or Ecuador. And the reason a lot of vendors do that is because you can buy it for four bucks a pound online. Right. And then they sell it for 14, 16, 18 dollars a pound. It’s fraudulent, right. You’re being ripped off in the marketplace. To be fair, like a lot of times, restaurants buy their seafood from distributors and so they don’t necessarily know what they’re buying. So they’re also being lied to as well.

Host

Focus Carolina: Jessie Smith 1

Provost Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I am Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9, The Hill WCHL. As a director of UNC School of Government’s Criminal Justice Innovation Lab, Jesse Smith educates stakeholders about how the criminal justice system works and brings them together to develop reforms to ensure the system is fair and effective for all North Carolina citizens.

Host

The stakeholders attending Professor Smith’s lab include professionals who intersect with the criminal justice system.

Professor Smith

The Criminal Justice Innovation Lab support stakeholders in their efforts to promote a fair and effective criminal justice system, public safety and economic prosperity. And we do our work in three primary ways. We educate stakeholders about the issues that are important to them. We work with them and help them come to consensus solutions to solve the problems that are facing their communities. Sometimes we also help with implementation. And then we follow up on the back end with empirical evaluations so that they can measure the impact of their efforts. They can see if they’re getting the criminal justice metrics that they’re looking for and also whether they’re creating unintended consequences from their actions. The stakeholders that the lab works with are broad and incredibly inclusive. They include a host of other folks that come in contact with the criminal justice system, mental health care providers, people who run services for folks that may be experiencing homelessness. Individuals who are impacted by the system, both defendants and victims. We try to have all of our projects be as engaged and multi-stakeholder as possible. So in the ideal world, the Gold Standard project has all those folks in it.

The lab is strategically focused on front end issues. And when I say front end of the justice system, what I’m talking about are the issues that impact who enters the system in the first place and sometimes how they enter it. So front end issues include bail, policing and overcriminalization. We’re also interested in back end issues that feed right back into that front end that, if not handled correctly, kind of create a revolving door of people exiting the system and coming right back in. Those issues include second-chance hiring for people who’ve been involved in the system or effective reentry programs so that people can become productive members of society as opposed to continue on a path that’s just gonna cycle them right through the justice system. All of that should add up to better public safety, economic prosperity and better lives for all North Carolinians.

Host

The bail system, both in North Carolina and beyond, has become a priority subject for stakeholders.

Professor Smith

They’re concerned that the system isn’t giving them the kind of public safety results that they want. It’s largely a money-based system. So let’s take a couple of examples of what that means. Let’s take John. He’s a serial rapist. The worst, most dangerous person that investigators have seen in years. And everyone is concerned about what he might do if he’s released from jail. And the judge sets an enormous bond with the idea of keeping him incarcerated pre-trial. He sets a $5 million bond. But John is involved in the venture capital world and he has a lot of money. And he can bond out and he can continue whatever his preferred activities are. That means that incredibly dangerous people who have money can get out. At the same time, that means people who may not be dangerous, but simply don’t have money end up in jail.

Let’s take Mary, for example. She’s a single mom. She has two kids under five. And she works at the local home improvement store. She lives paycheck to paycheck. It’s getting to the end of the month. And she’s running short on gas money, short on gas money to take her kids to daycare and to get to work. So she makes a really bad decision. She goes to the gas station and she pumps 10 dollars worth of gas and she drives off. An officer’s there, he arrests her. She has committed a crime of larceny, of a motor fuel. The magistrate sets a $500 bond. She can’t pay that bond. She didn’t even have $10 for the gas. So she ends up sitting in jail. But in many places in North Carolina, she can sit in jail for weeks until she first sees a judge. She probably lost her job. Remember, she had two little kids, so probably social services took them. She’s eventually going to get out. This is a relatively minor crime. She’s got no prior record. No one is saying she shouldn’t be responsible for that. But when people commit low level nonviolent crimes, when they’re not a risk of flight, when they don’t present a risk to public danger like Mary, do we want to keep the Marys incarcerated while we’re letting other really dangerous people out? And those are just two examples at the extremes that really highlight the kind of problems that stakeholders are seeing in the system.

Provost Blouin

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews. Chapelboro.com and click on 97.9 The Hill on Demand or visit thewell.unc.edu.

Focus Carolina: Jessie Smith 2

Provost Blouin

Host

Professor Smith launched the criminal justice lab out of frustration over a lack of efficiency in the justice system.

Professor Smith

I’ve been at the School of Government doing sort of what we would call traditional work at the school for over 20 years now. But one thing that I found in my 20 plus years at the school is that actors would change. Judges would retire and new judges would come in and new prosecutors would come in. And I was getting the same questions. The same issues were just recurring, year after year. And at the same time, I was hearing from a broad range of stakeholders the same frustrations about the same issues. As I continued to work with them and started to tease out, well, what are some ways that we can come together and address these issues? And the idea for the lab of bringing people together seemed to me to be a good solution. The seed for the lab really was this Raise the Age project. Former Chief Justice Mark Martin asked me to work with his new North Carolina Commission on the Administration of Law and Justice. He asked the commission to look at North Carolina’s juvenile age, which was set in 1919 at age 16. It didn’t get raised to 18 until December of last year. A hundred years later, that means that effective December 1 of 2019, 16 and 17 year olds are no longer routinely put in the adult criminal justice system. They go into the juvenile justice system. Now, the thing about that project was there had been many prior efforts to raise the juvenile age in North Carolina, but they all failed.

And as I worked on this project, the difference was, rather than coming from one side, from one perspective, from a purely advocacy position, the focus really was on evidence-based reform. So, for example, on the Raise the Age project, some of the evidence that turned out to be incredibly important and that really informed the discussion was evidence about recidivism. When we compared how kids who went through the juvenile system performed after they left that system vs. 16 and 17 year olds who went through the adult criminal justice system. And that data that was presented to the stakeholders was the first time they had seen that comparison. And it was really just the ocular proof that one system was functioning so much better in terms of public safety results than the other ones. And in all of our projects, what we seek to do is develop the best possible data to present to stakeholders so that they understand in a way that they haven’t been able to understand before exactly how the system is functioning.

Host

Citation in lieu of arrest is one of the initiatives that has arisen from the work done by Professor Smith and her colleagues.

Professor Smith

One of the things that people often asked me about is what are the options if we want to examine our bail system? What can we do without any change in state legislation? And the reality is there are a lot of things that local stakeholders can do if they want to, to improve their systems and they don’t all require a lot of money. And so stakeholders are looking at different types of procedures that apply at the arrest, discussing with law enforcement whether people should be given a citation, which is essentially a piece of paper that says come to court, as opposed to incarceration or we’re incredibly excited about our new citation project. It’s a collaboration with the North Carolina Association of Chiefs of Police, working with the Chiefs of Police Association to create a model citation in lieu of arrest policy. We’ll then offer it to departments statewide based on the applications. We’ll pick a certain number of departments that will pilot it, and then we’ll track them for a long period to determine what was the impact of these changes. And we’re really excited about it because this is an issue that’s been of tremendous interest nationally, because if the criminal justice system is about anything, it’s about public safety.

Provost Blouin

Focus Carolina: Javed Mostafa and Saif Khairat 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I am Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Dr. Javed Mostafa acts as a matchmaker for research collaboration at the UNC School of Information and Library Science as part of the Carolina Health Informatics Program. He connects with researchers like Dr. Saif Khairat in the UNC School of Nursing to use computer technology to help physicians interpret data faster and more accurately.

Host

Dr. Mostafa developed the Carolina Health Informatics Program, also known as CHIP, to begin allowing doctors, other caregivers and patients to communicate electronically.

Dr. Mostafa

My background is in computing and information science. I’ve always been very interested in processing complex data using different types of techniques, methods, algorithms. My specialty is in search engines and information retrieval. I’ve worked on that area for many years and then started to focus on medicine. And by medicine as a applied area to see how we can bring in some techniques and methods to improve information retrieval, to support scientists and practitioners in medicine and health care, to get at information quickly and find information that is relevant and help them in decision making. I don’t quite remember what triggered what. I think partly as I was getting into the field, I had a relatively traumatic experience and my father-in-law was living with us and he had a sudden stroke. At that point, I was just an assistant professor. My wife was a doctoral student and we were trying to handle this situation. And we saw from very close distance up front the level of engagement necessary from people, but also within finding the best information quickly in terms of making decision on a personal level. But also we found the providers and the groups involved in managing the care. There were a lot of fragmentation, different information, different pieces of information were in different places. CHIP was developed about nine years ago with the goal of essentially connecting computing and information technology to healthcare in a way that attends to some of the critical problems in healthcare. And quality of healthcare is as a major area from a provider perspective, from doctors and nurses and pharmacies and all those people who involve themselves in healthcare provision, computing and information technology are becoming very important also from a consumer side in terms of services to the point of actually researching their own condition and problems. In Carolina, we are so lucky to have an environment where we have a wide variety of excellent programs that cover the critical aspects of this field.

Host

Dr. Saif Khairat works on projects to improve patient conditions using electronic health records.

Dr. Khairat

I work in the field of electronic health records and patient safety, specifically focusing on the implications of electronic health records, use among providers and its association with medical errors occurring. Most hospitals in the US have adopted an electronic health record, and so that shift in technology has brought a lot of new errors to practice. And one of my areas of research is to investigate ways to minimize medical errors that occur as a result of using health information technology.

Personally, I have a drive or passion for this area of research. Like Dr. Mostafa, my grandfather was diagnosed with prostate cancer when I was a master’s student. He experienced a medical error. There were complications and then he passed away. That was the pivotal point in my life where I decided I want to investigate medical errors and to eliminate them if possible, and also to improve patient safety. From that came the idea of researching how to improve the usability of the electronic health records, specifically in the intensive care unit and critical care, but also throughout the hospital. The learning curve going from paper-based records to electronic records was very steep. It was a challenge for institutions, for leadership, but also for providers. It is becoming better now that we’re doing usability studies and we’re doing what we call user centered design, where we bring physicians and nurses and other health care professionals to the programming centers and say, OK, this is what it looks like. What would you like to change? So now they have more buy in. Their feedback is being recognized and implemented, and we’re seeing a significant improvement in the usability of these electronic records.

Provost Blouin

Focus Carolina: Javed Mostafa and Saif Khairat 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I am Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Dr. Javed Mostafa acts as a matchmaker for research collaboration at the UNC School of Information and Library Science as part of the Carolina Health Informatics Program. He connects with researchers like Dr. Saif Khairat in the UNC School of Nursing to use computer technology to help physicians interpret data faster and more accurately.

Host

Despite his years working with CHIP and other informatics programs, Dr. Mostafa acknowledges that further collaboration remains the key to his work.

Dr. Mostafa

We have highly ranked health care institutions and departments and programs in school of medicine, public health, pharmacy, nursing, dentistry. But we also have very solid, very good computing and information science programs. I was told by the leaders they wanted me to link these disparate, but in this context related disciplines somehow and create this program as well as to train next generation leaders in this field. So that’s where CHIP came from.

UNC was a pioneer actually in moving healthcare into the digital space. We forget UNC developed one of the earliest electronic record systems in the world. It created something called Web CIS, a platform created by experts inside the university. One could argue was that up to standard up the parr to support everything. However, UNC did take that leadership role and there were times when we had to maintain some duplication of record keeping. When we moved, for example, from web CIS to the new system, which is the EPIC system, it is almost a modern medical in terms of doing that kind of a transition. That kind of a change because UNC health care system is a very large, complex system. It supports hundreds and thousands of doctors and providers as well as, of course, millions of patients. Transitioning from one system to another while you maintain the service, you cannot stop your hospitals and clinics. And while you are making this change, it is an immensely difficult process. And I want to give credit to my colleague, Dr. Don Spencer, who is the chief medical informatics officer, for you can see he was one of the leaders involved in helping move us forward. We didn’t quite start with paper. When we moved to the current system. We had a digital platform, but yet it was a very complex process.

Host

The most efficient medical record system shares all patient information. Although Dr. Khairat says inherent problems remain.

Dr. Khairat

The good thing is we have everything there. And that’s why in this era of electronic records, one of the most powerful tools happening right now is A.I.—artificial intelligence — and machine learning, where we have a ton of data for every patient.

Can we use computerized algorithms that can search through all this data and extract the most meaningful and relevant information that we need for this diagnosis? That is what we’re trying to do right now, trying to optimize even the search process. So it is not cumbersome for the provider. One of the consequences of information overload is overlooking information, making errors. The accuracy of the decision making process can be affected and hindered. And also burnout, which is a very hot topic right now, is physician and nursing and burnout. They are feeling more and more fatigue, having to go through a ton of data for every patient they have to document so much to meet the requirements for reimbursement. And also when they search for information is very, very mentally taxing. So we’re trying to automate that process using different AI and machine learning.

University of North Carolina has about 16 or 17 urgent care clinics, primarily around the RTP area. But we were having visits in the far western side of the state from Wilmington all the way to the mountains. We were able to see patients in areas with high concentration of American Indians, African-Americans, areas with a high population of single mothers living on food stamps. So the point is tele-health can be a very powerful intervention for rural North Carolina, for disadvantaged populations, for vulnerable populations who are not able to see a provider, not just because they don’t have the means financially, but also they do have the access.

Provost Blouin

Focus Carolina: Jennie Brame 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share the series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Jennie Brame always wanted a career where she could help patients. Today, she is the director of the undergraduate and graduate dental hygiene program at the UNC Adams School of Dentistry, where she focuses on training dental hygienist to educate patients about oral health care. She is passionate about teaching and mentoring junior faculty.

Host

Dental hygienists are licensed care professionals focused on prevention and treatment of all diseases, as Professor Brame explains.

Brame

It’s much more than just a cleaning. We also work very closely with patients to teach them about overall health care and the role of oral health and how that intertwines. We do screenings for oral cancer, interpret dental radiographs. In addition to what most people think of as removing the plaque in tartar and an appointment, but there’s also education of patients about proper oral health care and how to maintain healthy teeth and gums. One of the most exciting things that’s happened recently in our state is on January 16, the North Carolina State Board of Dental Examiners approved a change that will provide more access to dental hygienists to help underserved populations.

And this change is going to allow dental hygienist to screenings and cleanings in some public schools and elder care and special needs facilities, even if a supervising dentist has not done an in-person exam of the patient. This change will enable more access to dental care for 2.4 million people in underserved areas of the state. In North Carolina, there are 13 dental hygiene programs. UNC offers a baccalaureate and master’s degree. Both are hosted within the School of Dentistry. Carolina’s program is the only full-time, on-campus dental hygiene program, and it offers a master’s degree that prepares individuals for education research administration.

The curriculum and meets the future needs of our profession and the state. Our graduates have access to a great alumni base, and our graduates from both undergraduate and the master’s program are highly sought after as clinicians and future leaders. Being in the School of Dentistry for some opportunities that they would not have in other learning settings, and some of these opportunities provides them with that rich experience to prepare them for leadership roles and advanced clinical roles. Dental hygienist from our program are well-respected not only in North Carolina but in other states as being highly-trained clinicians, critical thinkers, evidence-based practitioners that affords our students opportunities to work in professionally with other dental students and also interprofessionally with individuals from other disciplines.

In 2019, the dental hygiene program launched a strategic plan to empower lives through better health with an initiative of integrated care and collaborative scholarship.

Dental hygiene will be integrated into the curriculum with the dental students. While the dental hygiene program is located in the dental school, it hasn’t been fully integrated into classes and clinics with students that are training to be dentist. So going forward, we’re doing more interprofessional activities. Dental students and the dental hygiene students will work alongside each other, learning and treating patients together. Students will begin learning and working together, fall 2021 and the clinics where they will be providing care for patients together in the clinic.

They will be working together in simulation labs, much more like real practice. Much of the dental school and the dental hygiene programs overlap in the first two years of their classes. One example is dental anatomy class. And hopefully we will have our students integrated together. An integration is going to occur both in the classroom and in the clinic. We have been doing more interprofessional education as well as intraprofessional education and the ideas for students from different health related programs to learn from with and about one another and collaborate to improve person centered care.

Dental hygiene has been a part of several new projects on campus. We worked very closely with the Office of Interprofessional Education and Practice. One example is dental hygiene students going and teaching nursing students how to do head and neck exam. We’ve also partnered with audiology and in turn, their students and faculty come to teach our students about hearing health and how to communicate with patients who have hearing challenges. Another example that we are currently active in is a geriatric case study that brings together 11 disciplines from across campus, including dental, dental hygiene, nursing, nutrition, physical therapy.

They all learn together in groups how to deliver coordinated care to patients. And as we do these training programs across disciplines, we have found a great deal of synergy. Our students are energetic to be learning in this type of environment. We’re preparing them for a future practice and value-based health care delivery system.

Focus Carolina: Jennie Brame 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share the series of interviews with our Carolina faculty here on 97.9 The Hill WCHL. Jennie Brame always wanted a career where she could help patients. Today, she is the director of the undergraduate and graduate dental hygiene program at the UNC Adams School of Dentistry, where she focuses on training dental hygienist to educate patients about oral health care. She is passionate about teaching and mentoring junior faculty.

Host

Professor Brame is enthused about another collaborative project involving geriatric patients who benefit from seeing dental hygiene students and training dentists on the same visit.

Brame

The geriatric case study is an interprofessional learning activity where students from all of these different disciplines come together and they actually work on a case study together. They’re guided with faculty and they work in teams. They’re not performing patient care, but they’re working through a treatment plan. They’re working through a case scenario that would include things from all of their disciplines that would be important to that single patient. And the beauty of it is, dental hygiene student comes in and they think what their dental hygiene hat on, they’re thinking about the nutrition, the oral care of the patient.

But they get together at this table with physical therapy students and occupational therapy students, nutrition students. And then they all start to talk about from their perspective what the patient needs. And that’s where the beauty is when they start thinking about, oh, well, I didn’t even think about it from that perspective. It makes so much sense. So that’s where the case studies actually come together, bringing the students together and helping them to think about a patient’s care outside of their own scope.

The most important thing to note is that the students love the interprofessional education. It gives them such value in learning outside of their scope. But there’s so many more positive things that come from it, too, like development of professional respect for someone who they may never have crossed paths with in school. They learn how a nurse takes care of a patient, how a physician takes care of a patient, and how they can be part of that team. It truly builds a team effort, and ultimately that team is going to be the one that takes care of people.

So building that that patient care, that person centered care is really the most important thing that comes from these learning experiences.

Host

Professor Brame also loves the new technology being integrated into her teaching regimen.

Brame

We are using more evidence-based technology in our clinics. This is not only to teach our students, but also so that they have access to the latest technology to treat our patients with the high standards of care. One example is we’re using this new subgingival air polisher. Sounds really fancy. It’s kind of like a little pressure washer and it’s used in treating periodontal disease. It helps to remove stains and bacteria that cause gum disease. And using this treatment allows our patients to have improved gum health.

So in the past, our goal has been to get patients with periodontal disease to a place where their gums aren’t getting worse. This new technology allows us to show positive results and improving gum health by reducing bleeding and other issues. There have been results from multiple clinical trials and research sites over many years, so it’s really exciting that we are able to use this type of technology and evidence-based approach in our practice. We are always working to figure out the best way to teach students.

I view the classroom as my laboratory. I love getting the students involved in how best to help them. We get great ideas from our students in my field. Educational research has a direct influence on the care of a patient and ultimately that is what I’m doing. I’m teaching others to be health care providers. So what we do and why we do it is in service to person centered care. So educational research projects are aimed at improving communication and delivery of education.

I am so passionate about educational research because it is directly impacting how we are teaching to better prepare our students to be health care providers. All of our graduate students conduct original research projects and one really great example is a student that graduated a few years ago. She completed an educational research project on how we teach nursing students and dental hygiene students about care for those who are undergoing cancer therapy. She was inspired by her aunt with breast cancer, and when her aunt was undergoing therapy, she was having a lot of oral complications.

She was seeing her physician regularly and her nurse regularly. But there was not a lot of attention to those oral complications. So she developed a program with first year dental students and first year nursing students that eventually expanded a second year to include dental students. And this program was an educational presentation on oral complications for individuals undergoing cancer therapy. These students had a great deal of positive feedback from the experience. They learned a lot about treating the same patient from each of their perspectives. And from the cases, it was very clear how important collaboration across health professions is.

Provost Blouin

Focus Carolina: Amy Blank Wilson 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Amy Blank Wilson researches ways to improve how mental health services are provided to people with serious mental illness. As part of her work at the UNC School of Social Work, she is helping to develop a tiny homes community in rural Chatham County that now people with mental illness to live independently.

Host

A focus of Dr. Wilson’s work is to make sure voices of the mentally ill are heard in planning for their future.

Dr. Wilson

In terms of building interventions for people with mental illness, we as a field have had a tendency to focus on provider views for a number reasons. That view has held more value. And really what I have seen is, especially in my field of research, by not including people with lived experience, we are not building interventions necessarily that they want or need. And in almost every other area of intervention research, we focus on what we call the end user in making sure that the person is going to use either technology or services that is what they want. And it’s delivered in a way that’s palatable, that meets their needs. And that’s really been missing from early mental health services. And so one of the focuses of my career has been on how to ensure that we include the voices of people experiencing that we’re trying to help try to elevate so that we can all try to see and understand and learn with them. And that’s not to say that providers don’t have a viable point of view.

They do, and so do people with lived experience. And one of the things about the tiny homes. It’s a unique research project for me in that the idea was not mine. So typically university researchers were good with coming up with ideas and carrying them out. And in this project, I met my community collaborators and it was their idea. They were talking about how to build affordable housing and how to use tiny homes to do that. Initially, I was kind of hanging out and learning from them, which is something I get to do from time to time and to go visit my colleagues out in the community. And they actually caught my attention because they were like, we want to do things differently. We would really like you to join us and use your research skills to embed them early in the design of the homes so we get it as right as we can. The first time they had me, because we need to do more of that.

Host

Dr. Wilson’s most poignant experiences come from those incarcerated who were not prepared for reentry into society.

Dr. Wilson

What we knew were they weren’t getting to services and we had services, and we knew where they were. And then they got released and we didn’t know what was happening, why they weren’t getting the services. And there was no pre-made checklist of questions that was going to get us an answer to that question. People had tried talking to service providers and seeing what their thoughts were in use participant observation and interviewing and following along with the experiences of people that was able to identify some key issues we weren’t doing a good job of addressing. That was keeping people from being able to ever get to the door of the service center. And honestly, that initial period of time after somebody is released, especially from jail, which is a short term stay and people are released very unpredictably because most are pretrial, meaning that they’re there prior to a sentence so they can be bailed out or released with a lot of unpredictability, where prisons are different because you’re there on a sentence and you generally have a sense of when someone’s coming out.

So jail is a particularly frenetic space in terms of release. And we were really struggling to understand to find people at the point that they’re released and then hook them to services. And we were really focused when we said services as a field of mental health services, which are a critical part of the treatment that people with mental illness need, and probably particularly when they were leaving jail or prison. If we normalize it a little bit, it’s something about people analysis being different.

If we flip it and we say, well, when you’re really on the street and any type of day or night in the clothes that you were probably wearing in, your first questions are where am I going to say tonight, how am I going to find clothes that are weather appropriate and what am I going to eat? And that’s a fight for survival. And when people generally leave jail or prison, that’s a real thing for everybody.

And for people with mental illness is exacerbated because many, not all, but many have lost connections. So their loved ones or maybe they’re just a distance from their loved ones that might be able to help them. And whatever resources they had when they were arrested probably are gone to them. And until people can secure those basic resources, even when opportunities are available to connect to services, that doesn’t happen any day. During that time, people are really caught in this fight for survival and you can’t drive until you’re sure you can survive.

And we are really good at some very advanced clinical services that are really important in people’s lives, like advances in medicine. We have some state of the art mental health services. Here in Chapel Hill, they’re doing amazing things as well as around the country and from people who are living on the margins.

Provost Blouin

Thank you for listening to Focus Carolina, sponsored by the University of North Carolina at Chapel Hill. To hear more interviews, visit Chapelboro.com and click on 97.9 The Hill on demand or visit thewell.unc.edu.

Focus Carolina: Amy Blank Wilson 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina, Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. Dr. Amy Blank Wilson researches ways to improve how mental health services are provided to people with serious mental illness. As part of her work at the UNC School of Social Work, she is helping to develop a tiny homes community in rural Chatham County that now people with mental illness to live independently.

Host

Dr. Wilson knew very little about tiny homes when almost serendipitously, they became a central part of her life.

Dr. Wilson

It was a fateful day in 2015. I’d been at a task force meeting related to people with mental illness at work around the prison, trying to improve the conditions. And a colleague of mine decided to stop at the farm at Penny Lane on our way home because we had collaborators out there from the Center for Excellence in Community Mental Health. We’re talking about a couple ideas and we were listening in. It’s really one of the greatest gifts as an academic to get to leave the building and get to the real world and spend time with people.

You have to know: The first is that I didn’t know that tiny homes were a thing. We didn’t have cable TV at the time. I didn’t know I’d missed this cultural phenomenon that was going on.

And what I did know was that as they were describing these small homes, that they could be built on permanent foundations and that we could do this for like somewhere between 30 and 50 thousand dollars that had my attention because that was really novel in terms of what I have seen of housing options that are affordable for people with mental illness. They were looking for something with research skills who could embed research into the early development of the homes they had. They were in the process of building a model home with Habitat for Humanity at the Chatham County Fair in 2015.

And so we developed a plan pretty quickly to use a model home as a way to get feedback. And I was awarded the C. Felix Harvey Award from the university, which we were incredibly thankful for. I led an interdisciplinary team of researchers and community members where we conducted focus groups that elicited what I call like end user feedback. So we went and we found people with lived experience of mental illness and service providers. And we brought them in. We did focus groups at the beginning of this.

It was really focused on how can we get feedback. And we also hosted overnight stays in the model tiny home for people lived experience. Again, trying to get that feedback from the end user.

Host

For people with mental illness, living in an integrated community was very important to Dr. Wilson’s research.

Dr. Wilson

The goal was to have a community of homes for people with mental illness, because the thinking is that at least for some people with mental illness, they want to live in community with each other. That would provide benefits in terms of their health and well-being and mental health services. And we respect that. And that’s why we’re only building 15. If you want to receive certain types of federal funding and we do because they’re important. So we’ve invited national experts, some of my colleagues and peers who are experts on community inclusion and participation to be part of the conversation about how we build this village.

In fairness, the way that we’re building our model, it certainly could be integrated into larger communities in the push in most housing is actually what we call scatter site. Housing is to have people with mental illness live throughout the community. The issue is many people, a serious mental illness live on about seven hundred fifty dollars a month. That’s their income. And the reality is that the median rent around here is around nine hundred dollars. That’s for a modest one-bedroom apartment.

So most people are starting out in the red or they’re not stable. The intention isn’t so much to keep people of mental illness away. The intention is have proof of concept that we can build these homes, well-designed homes on a permanent foundation for $50000. That’s become a life mission. If I was going to be honest about it. We can do it. We’re going to do it. And then the second is building that within the context of a community that’s designed to support the health and well-being of the residents is what I think takes us to the next level.

And then doing this where the community is, is for people with mental illness, is really exploring what we need to do to ensure that people who live in this community are connected to each other and remain connected to the outside world. We said we want to create a lot of supports inroads, in and out of the community, both physically and virtually so that people can be in the community and of the community. And so that’s why we actually say tiny homes are huge for people with serious mental health, because it’s many ways a huge step forward for them.

Provost Blouin

Focus Carolina: Daniel Kreiss 1

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. The author of two books about political campaigns. Dr. Daniel Kreiss studies how digital communications and social media platforms are used to reach voters during elections. His research of the UNC Hussman School of Journalism and Media guides elections policy at the state and federal level.

Host

Dr. Kreiss finds himself teaching journalism students in what he considers a revolutionary era for the so-called free press and mainstream media.

Kreiss

It’s a really interesting time to be teaching in a journalism school where my students go on to jobs at The New York Times and The Washington Post and the News and Observer, et cetera. So what are the things that they think a lot about is: what is their role in the political world? How do they keep the public’s trust, keep the public’s confidence? How do they maintain their legitimacy as information producers, an information that’s essential to the functioning of democracy?

So we talk a lot about that. Well, we talk a lot about objectivity. We talk a lot about fairness. We talk a lot about the pursuit of truth. We talk a lot about how they handle rising tides of polarization and partisanship around them, of which journalists are caught a lot in the middle. And one of the biggest challenges, I think, for students who want to be journalists today is that the way that they’re seen is often out of their hands.

Political elites on both sides of the aisle can gain a lot of mileage in attacking the press. And they have incentives to do so because it means it’s harder to hold them accountable if they de-legitimize the press. The struggle for journalists is that they need to maintain this credibility and public trust. But there’s constantly political elites and actors that are looking to undermine that because they stand to gain the most when there’s not a free and independent and legitimate press in society.

We have a lot of those conversations. I try to prepare them as best they can for political dynamics. And at the end of the day, we rely on time honored methods of journalism and reporting, getting the facts right. Being transparent about the process, being fair, but never compromising the truth. And frankly, as a social scientists as well, those are pretty good values to live by when it comes to producing my own scholarship and research.

Host

As the director of the Center for Information Technology and Public Life at UNC, Dr. Kreiss studies how growing social media platforms can shape opinion and affect elections.

Kreiss

This gets to the core of what the Center for Information Technology and Public Life at UNC is working on. Broadly, what sorts of misinformation and disinformation is out there in our contemporary public sphere? How do we mitigate its effects? How do we craft effective policy both at the state level but also by platform companies like Facebook and Twitter and Google themselves in order to combat myths and disinformation? How do we reinvest social trust in journalism organizations? How do we create viable models for the press to reinvigorate local news, for instance, which has been disappearing across the country and which has been heightening these problems of myths and disinformation because people can’t get reliable facts about political or social life.

So I think there’s a couple of different categories of myths and disinformation, and this really is what sort of gets at the heart of what the center does, but also shows how complicated the issue is. In an era of social media, Facebook has 2 billion users and truly connects the globe. In an era where YouTube videos can be produced for almost zero cost and uploaded and quickly gain an audience into the hundreds of millions of people, the research community is trying to get their handle on it.

So at our new center, for instance, we have researchers that are looking at broadly what sorts of information is in the public sphere. How much of it is false or problematic? What should be the policies that platform companies have that both honor our free speech traditions in the United States while also trying to mitigate harmful speech that might do things like erode public trust or amplify social division? These are really difficult and complicated questions.

Blouin

Focus Carolina: Daniel Kreiss 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina at Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. The author of two books about political campaigns. Dr. Daniel Kreiss studies how digital communications and social media platforms are used to reach voters during elections. His research of the UNC Hussman School of Journalism and Media guides elections policy at the state and federal level.

Host

Dr. Kreiss has written two books on how the Internet and social media changed the campaigns for political candidates Howard Dean and Barack Obama.

Kreiss

I was actually a weird outlier in the research community at that point because my fundamental belief was always even when I started doing this work over a decade ago and started following the Dean campaign around Iowa in 2004 was that technology helps us to do things that were already organized to do. A lot of the ways the Internet got taken up early on in electoral politics was not to democratize campaigns or crowdsource policy ideas or make politicians more responsive to the citizenry. It was about raising money and it was about getting more volunteers to knock on doors, things that have been time-honored aspects of electoral campaigns for well over a century.

Technology has helped campaigns do much more efficiently. When Obama ran for office in 2008, I think a lot of democratic reformers had great hopes that we would see a president that would make policy based on millions of Americans around the country using the Internet to contribute policy ideas and that you would see new solutions to old social problems start to bubble up. Instead, the Obama campaign was ruthlessly effective at using the Internet to raise money and to organize volunteers to then organize their neighbors and help turn them out on Election Day.

Not so much in the policy department. That was the story I told them my first book. That was a story I told in my second. I think we’ve arrived at a much more realistic view in the social science literature that is sort of seen tech as being enrolled in pre-existing institutions or ways of doing things, even as undoubtedly there are lots of things that I didn’t anticipate. I didn’t expect foreign agents, for instance, to exploit vulnerabilities in platforms. That came out of nowhere for me.

I never anticipated the level of harassment and vitriol online that’s directed at particularly women and people of color who do the work of electing candidates by maintaining social media feeds. All those things were shocking to me, just as what was also shocking was just the rise of entirely new right and left wing media infrastructures online. So there’s a lot that I didn’t quite anticipate. There’s a lot that technology has made a new, but I don’t think it ever fundamentally change the calculus of political power.

Host

At his core, Dr. Kreiss is a teacher who loves to engage his students in real life passions to hold dear and problems to solve.

Kreiss

I teach a couple of different classes at the undergraduate level at the Hussman School, and in fact, one of my great joys has been both engaging students with a professional practitioner communities that the people are on the frontlines of this work, as well as engaging them in undergraduate research opportunities where they can ask these questions themselves. I teach a small seminar every fall called the Washington Experience, and it tends to be only for juniors and seniors. The hallmark of that trip is a weeklong fall break trip to D.C., where we visit Congress and meet with congressional staffers. We visit news organizations. We go to the RNC and the DNC. More we talk to digital directors of various campaigns and people who work in digital political consultancies. We met with journalism organizations. We met with Senator Burr’s office, for instance, where we talked a lot about information constituents have and what sorts of things they hear. And this crisis of public information, I think, makes the work of representatives harder, just as it makes the work of journalists harder.

The other thing I tend to teach is undergraduate research courses. I’m teaching one now that brought students to the Iowa caucuses. So we were there for four days and we were interviewing voters questions about social trust: What organizations do they trust to get political information and news from? What relationships do they have that are important in their political lives? So it’s not just about speculation, but giving them the tools that they need to be rigorous researchers to answer questions in full and complete ways, to try to think through evidence and standards of evidence to understand the social and political world around them.

Blouin

Focus Carolina: Greg Characklis 1

Provost Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina, Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. At the Gillings School of Global Public Health, Dr. Greg Characklis works to develop solutions to environmental challenges, using approaches that combine engineering and economic principles. These strategies help with managing the water supply and the financial risks of extreme weather events such as drought.

Host

Dr. Characklis also serves as director of the Center on Financial Risk and Environmental Systems, which spans both the Gillings School and the UNC Institute for the Environment.

Characklis

The purpose of the center is to help a lot of groups and businesses that experienced financial risk as a result of extreme environmental events. And here we’re talking about things like flood drought, high winds, extreme temperatures. So a lot of these organizations experience big fluctuations in their revenues or costs as a result of these events. And because we don’t know exactly when these things will happen or how bad they’ll be, it causes a lot of uncertainty that leads to financial risk.

Agriculture is a great example. If it doesn’t rain much, we experience a drought. There’s a reduction in crop yields. That’s a reduction in revenues that presents a financial risk. But it’s not often as simple as just rainfall. If we experience low rainfall and extreme temperatures, then we really have a problem. And so what we try to do is take our understanding of the probability of these events, of them occurring together and translate that into financial impacts. So this work is very interdisciplinary: It involves individuals from across Carolinas, campus engineers, scientists, economists, finance professionals, as well as policy specialists. One of the things that makes Carolina such an ideal place to do this work is the ease with which these sort of cross campus connections can be made. And so that’s been a major factor in our success in allowing us to become a global leader in this area as well as a lot of other areas. Nineteen years ago when I arrived, that was really an attractive element, particularly at the Gillings School of Global Public Health and the Department of Environmental Sciences and Engineering, very interdisciplinary.

Our department has engineers, economists, scientists, policy specialists, all within one department, and that’s fairly uncommon. And so that was one of the things that really attracted me to Carolina in the first place. I spent a lot of time at universities around the country, and the ease with which one can move between these disciplines on the Carolina campus is really a huge benefit to the type of work that I do relative to the challenges that I see in some other places.

Host

Dr. Characklis and his team work across the globe, but also pay close attention to what is going on in the local communities.

Characklis

A lot of work with water utilities right here in the triangle that includes Raleigh, Cary, Durham and Chapel Hill-Carrboro. All of them are concerned with meeting future water demands in what’s a rapidly growing region. And this is not as easy as it once was. The challenge with building new water supply reservoirs is that we’ve used many of the most cost effective sites. Those that remain are expensive. We’re also a fairly densely populated region and so we’d have to move some people around in many cases to build these reservoirs. And also society’s become less tolerant of the environmental impacts of these big projects. So while at present the utilities don’t have a lot of problems in meeting water demands, under normal condition. It’s become really difficult for them to maintain the sort of surplus supply needed to meet demands during droughts. And so as a result, we begin to rely much more heavily on conservation, which has some very positive aspects. Things like outdoor water use restrictions help us manage drought.

We’ve also worked closely with utilities, develop plans for transferring water amongst themselves during drought to alleviate some of the worst impacts. And that helps them make the best use of their existing supplies. But all this, while having some advantages in terms of lowering long term costs and environmental impact, it also presents some financial problems. More conservation means decreased revenue for utility. While the transfers amongst them increase their costs. And because we don’t know exactly when drought will come or how long it’ll last, this variability in costs and revenues is difficult to manage, and it introduces financial risks that might make it hard for utilities to pay its bills. And so as utilities increasingly rely on things like conservation and transfers, the problem has become worse. The people that lend money to utilities, places like the bond market, have started to become a little bit more nervous about getting paid back. And this can lead to higher interest rates. And because utilities rely on financing to pay for all the infrastructure that allows them to supply safe water to us. Any increase in interest rates can raise their costs and it means that we all pay a little bit more for water.

We help the utilities understand this risk and then we help them develop some strategies for managing it. In this day and age, if utilities can manage their risk, it makes it easier for them to encourage things like conservation, which we all view as a positive thing, while still maintaining their financial stability.

Blouin

Focus Carolina: Greg Characklis 2

Provost Bob Blouin

Welcome to Focus Carolina, an exclusive program sponsored by the University of North Carolina, Chapel Hill. I’m Provost Bob Blouin and I’m excited to share this series of interviews with our Carolina faculty here on WCHL. At the Gillings School of Global Public Health, Dr. Greg Characklis works to develop solutions to environmental challenges, using approaches that combine engineering and economic principles. These strategies help with managing the water supply and the financial risks of extreme weather events such as drought.

Host

The increase of storms and resultant flooding has moved to the top of the priority list for Dr. Characklis and his team of researchers.

Characklis

More recently, we’ve been doing some work to try and help communities in eastern North Carolina recover more quickly in the wake of flooding. This is work that’s been funded by the General Assembly through the North Carolina Policy Collaboratory. And while the public safety is always the first concern with flooding. Recovering financially after a flood can also be a difficult and lengthy process. So one of the challenges is understanding exactly who holds the financial risks of flooding. And once you know that, you can come up with some better ways to help them recover.

On the surface, it may seem obvious who holds the risk, but often it’s a bit more complicated. If you have flood insurance, most of which comes via federal programs, than the insured portion of your home’s risk is held by the U.S. government. But once damages begin to rise above the insured level, the homeowner ends up holding the risk. This ends up changing as flood damages increase above the level of the homeowner’s equity. At this point, there’s increased chance that the homeowner walks away and defaults on the mortgage. And if they do, then the financial risk begins to be transferred to the mortgage lender, which could be a big national lender up in New York or somewhere else. It could also be a community bank and that has local ramifications. Finally, if the property damage is so severe that it would cost more to repair than the home is worth, then the property may be abandoned and then the risk resides with the local government. And we saw a lot of this in New Orleans in the wake of Katrina.

It leads to many problems for local government because they need to not only pay to maintain these properties, but they also see reductions in their property tax revenues. So our models help them understand who holds the risk. And once we do that, we can target solutions to help them recover. This could be encouraging greater insurance coverage, insurance uptake in some areas, buyouts of homes in frequently flooded areas, or even helping community banks better understand and assess their risks.

And all these steps can help a community recover more quickly in the wake of some of the catastrophic flooding events that we’ve seen in particular in the eastern part of the state in recent years.

Host

Work at the Center on Financial Risk and Environmental Systems is done by a select group at the Gillings School of Global Public Health.

Characklis

The research is done primarily by graduate students, those that are pursuing their master’s and doctoral degrees, as well as postdoctoral researchers. Our center is ten people directly working under one roof, but we have collaborators, including graduate students, faculty and postdocs at a number of other institutions. So most of the students that come in have an engineering or science background, an undergraduate degree in one of those two areas. They have strong math skills as well as some programming skills, background and statistics.

They’re all paid by grants and contracts that we bring in from outside of the university. These are really talented and uniquely trained individuals, and many of them stay here in North Carolina after they graduate, contributing to a talented workforce here in the triangle in particular, but North Carolina as a whole. I teach a course on analysis of water resource systems that combines both engineering and economics. And then I teach a course on managing environmental financial risk, which is again a mix of both engineering, in this case, and finance.

I came out of industry and had exposure to a lot of these topics again in isolation. I really wanted to bring them together in an interdisciplinary way. And Carolina was the perfect place for me because it was set up to accommodate somebody with these less traditional interests. The Department of Environmental Sciences and Engineering had, as you might imagine, engineers and scientists, but it also had economists and people that were focused on policy. And having all this within the same department is not very common.

And that allowed me to pursue relatively unique set of research interests and then to branch out and work with others across campus. The topic of environmental financial risk was definitely outside the mainstream when I first started. But interest has grown dramatically in recent years and we have a considerable head start on the competition. So we’ve been able to establish Caroline as a leader in this area and it’s one that will become increasingly important as uncertainty with respect to environmental conditions continues to grow.