The U.S. Centers for Disease Control and Prevention estimates that 76 million Americans have foodborne illness annually, leading to  approximately 5,000 deaths each year, and Chapman notes that holiday turkey meals have been linked to outbreaks of bacterial diseases caused by Salmonella and Campylobacter.

“The biggest risk comes from undercooking,” Chapman says. “Color is not an indicator of safety or doneness. We see suggestions in recipes about making sure ‘the juices run clear,” but that’s a myth. You also have to worry about cross-contamination – which can happen when countertops, sinks or utensils aren’t being cleaned properly between use with raw meats and other foods.”

Chapman is available to field questions from news media at 919/809-3205 or benjamin_chapman@ncsu.edu.

More information on food safety is also available on Ben Chapman’s blog.

-shipman-

The bulk of neuron production in the central nervous system takes place before birth, and comes to a halt by birth. But scientists have identified specific regions in the core of the brain that retain stem cells into adulthood and continue to produce new neurons.

NC State researchers, investigating the subventricular zone, one of the regions that retains stem cells, have identified a gene that acts as a switch – transforming some embryonic stem cells into adult cells that can no longer produce new neurons. The research was done using mice. These cells form a layer of cells that support adult stem cells. The gene, called FoxJ1, increases its activity near the time of birth, when neural development slows down. However, the FoxJ1 gene is not activated in most of the stem cells in the subventricular zone – where new neurons continue to be produced into adulthood.

Genetically labeled FoxJ1+ cells (green) in a culture dish. These cells differentiate into a unique subset of cells that is distinguishable from known cell types in the adult stem cell niche in the mouse brain (the blue and red cells).

“Research into why and how some stem cells in the subventricular zone continue to produce new neurons is important because a biological understanding of how these cells function can contribute to new treatments to replace damaged or diseased brain tissue, hopefully in regions that cannot do this by themselves,” says Dr. Troy Ghashghaei, an assistant professor of neurobiology at NC State and the senior author of the research. “This research helps us understand brain development itself, which is key to identifying novel approaches for treatment of many neurological disorders.”

When the FoxJ1 gene is activated, it produces a protein that functions as a transcription factor. Transcription factors swim through the nucleus of a cell turning other genes on and off, turning the embryonic stem cell into an adult cell. Some of the adult cells will function as stem cells, creating new neurons, but most will not – instead serving to support the adult stem cells by forming a stem cell “niche.” This niche has a complex cellular architecture that allows adult stem cells to remain active in the subventricular zone.

Ghashghaei’s lab is now moving forward with new research to determine what activates the FoxJ1 gene and how the FoxJ1 protein regulates the expression of other genes. This understanding will reveal how the activation and inactivation of genes controlled by FoxJ1 orchestrates the development of the adult stem cell niche. Ghashghaei’s laboratory is a recent recipient of funding from the National Institutes of Health to support this line of research.

The research was co-authored by members of the Ghashghaei laboratory at NC State including graduate students Benoit Jacquet and Huixuan Liang, research associates Raul Salinas-Mondragon, Blair Therit and Michael Dykstra, as well as a biochemistry undergraduate student Justin Buie. The work was in part a collaboration with investigators from the Cincinnati Children’s Hospital Medical Center, UNC at Chapel Hill, and Washington University in St. Louis. The paper, “FoxJ1-dependent gene expression is required for differentiation of radial glia into ependymal cells and a subset of astrocytes in the postnatal brain,” is a featured article in the current issue of the journal Development.

-shipman-

Note to editors: The study abstract follows.

“FoxJ1-dependent gene expression is required for differentiation of radial glia into ependymal cells and a subset of astrocytes in the postnatal brain”

Authors: Benoit V. Jacquet, Raul Salinas-Mondragon, Huixuan Liang, Blair Therit, Justin D. Buie, Michael Dykstra and H. Troy Ghashghaei, North Carolina State University; Kenneth Campbell, University of Cincinnati; Lawrence E. Ostrowski, UNC-Chapel Hill; and Steven L. Brody of Washington University.

Published: Nov. 11, 2009, Development

Abstract: Neuronal specification occurs at the periventricular surface of the embryonic central nervous system. During early postnatal periods, radial glial cells in various ventricular zones of the brain differentiate into ependymal cells and astrocytes. However, mechanisms that drive this time- and cell-specific differentiation remain largely unknown. Here, we show that expression of the forkhead transcription factor FoxJ1 in mice is required for differentiation into ependymal cells and a small subset of FoxJ1+ astrocytes in the lateral ventricles, where these cells form a postnatal neural stem cell niche. Moreover, we show that a subset of FoxJ1+ cells harvested from the stem cell niche can self-renew and possess neurogenic potential. Using a transcriptome comparison of FoxJ1-null and wild-type microdissected tissue, we identified candidate genes regulated by FoxJ1 during early postnatal development. The list includes a significant number of microtubule-associated proteins, some of which form a protein complex that could regulate the transport of basal bodies to the ventricular surface of differentiating ependymal cells during FoxJ1-dependent ciliogenesis. Our results suggest that time- and cell-specific expression of FoxJ1 in the brain acts on an array of target genes to regulate the differentiation of ependymal cells and a small subset of astrocytes in the adult stem cell niche.

“This research illustrates international disparities in treatment for a disease that we know how to address,” says Dr. Jeff Stonebraker, an assistant professor of business management at NC State and lead author of two new studies on hemophilia prevalence and treatment. “What we’ve found highlights the work that needs to be done by governments, health officials and pharmaceutical manufacturers to address the needs of those suffering with hemophilia in the developing world.”

Type A hemophilia is a hereditary bleeding disorder that affects about 400,000 people – predominantly men – around the world. The disorder prevents blood from clotting normally, creating the risk of serious bleeding or internal bleeding. Ultimately, the disorder can result in severe pain, joint deformities and death in childhood or young adulthood. But the condition can be treated by replacing the missing clotting factor VIII, which enables those suffering from hemophilia A to live relatively normal lives. Unfortunately, the treatment is expensive and new research shows that access to that treatment is severely limited.

“This is the best data there is on a relatively small global population,” says Mark Skinner, president of the World Federation of Hemophilia. “It will be incredibly useful to our members, to manufacturers of treatment products, ministries of health and researchers. These two very important papers help us see where progress is being made and how we can learn lessons that will help us continue to improve care and work toward our goal of treatment for all.”

In the first study, the researchers found that prevalence of hemophilia A in high-income countries was approximately 12.8 per 100,000 males. The prevalence in lower-income countries was approximately 6.6 per 100,000 males. “The medical community tells us that the incidence of hemophilia A – or the number of people born with the condition – is the same around the world,” Stonebraker explains, “so the difference in prevalence – or the number of people living with the condition at any given moment – appears to be due to much higher mortality in developing countries.”

The study also showed that prevalence of hemophilia has increased over the past 30 years, as treatments for the disorder have improved. In other words, better treatment is helping those with hemophilia A live longer. For example, the United Kingdom had a prevalence of 9.3 per 100,000 in 1974, but it had risen to 21.6 per 100,000 by 2006.

In a second study, Stonebraker and his colleagues found that decreased mortality related to hemophilia A is tied to a willingness – by government health-care agencies or private insurers – to pay for treatment. Correspondingly, the consumption of factor VIII drugs has increased significantly in developed countries – and that trend appears poised to continue, with high-income countries expected to consume more and more factor VIII drugs in the future.

Stonebraker says the two studies should be incredibly helpful as budget-planning tools for insurance companies and those countries that provide national health care, as well as for pharmaceutical companies that will want to project the amount of factor VIII drugs they will need to make to meet market demand. But, Stonebraker says, “the studies also show how much more needs to be done to address hemophilia in the developing world.”

The first study, “A study of variations in the reported hemophilia A prevalence around the world,” was co-authored by Stonebraker, Paula H.B. Bolton-Maggs of the Manchester Royal Infirmary, J. Michael Soucie of the U.S. Centers for Disease Control and Prevention, Irwin Walker of McMaster University and Mark Brooker of the World Federation of Hemophilia. The second study, “A study of reported factor VIII use around the world,” was co-authored by Stonebraker, Brooker, Robert E. Amand of the Biotherapeutic Modeling Group, Inc., Albert Farrugia of the Plasma Protein Therapeutics Association and Alok Srivastava of Christian Medical College. Both studies will be published in a forthcoming issue of Haemophilia.

-shipman-

“There has been a great deal of research into the use of manufactured carbon nanomaterials in various products, but there are still a lot of questions about how these materials will interact with biological systems,” says Dr. Nancy Monteiro-Riviere, a professor of investigative dermatology and toxicology at the Center for Chemical Toxicology Research and Pharmacokinetics at NC State and lead investigator of the study. “There is a crucial need to understand how these manufactured carbon nanomaterials will act once they are in the body – particularly where environmental or occupational exposure can occur.”

The two-year research project, which is being funded by NIH at approximately $658,000, has several specific goals. First, the researchers will determine how and whether the size and surface charge of four fullerenes – or specifically shaped carbon nanoparticles – effects how the fullerenes interact with the body. “Our hypothesis is that the size and charge of these fullerenes will dictate how the nanoparticles are absorbed by the body, how they are distributed within the body, how the body metabolizes the nanoparticles and – ultimately – how and whether the body can eliminate the nanoparticles,” says Monteiro-Riviere.

A second goal is to determine how fullerene size and surface charge affect the distribution of the nanoparticles in the body’s organs and plasma, when the fullerenes are injected intravenously. This component of the study will be performed in animal models that are well understood, and where the findings can then be extrapolated to humans. Researchers will also identify any adverse health effects resulting from acute exposure to the nanomaterials.

Finally, the researchers will assess how the body absorbs fullerenes when exposed to the nanomaterials orally or through abraded skin – two routes of exposure that are particularly relevant to real-world scenarios, such as exposure in the workplace.

“The work being done in this project will not only improve our understanding of how nanomaterials behave in the body, but will also help us identify in vitro assays, which can be performed in a laboratory, that predict how the nanomaterials will behave in the body,” says Monteiro-Riviere.

NC State’s research team working on the project includes Drs. Nancy Monteiro-Riviere, Jim Riviere, Burroughs Wellcome Fund Distinguished Professor of Pharmacology and director of the Center for Chemical Toxicology Research and Pharmacokinetics, Xin Xia, research assistant professor of pharmacology, and Keith Linder, assistant professor of pathology.

-shipman-

Using mice in an animal model study, the researchers set out to determine what happens when multi-walled carbon nanotubes are inhaled. Specifically, researchers wanted to determine whether the nanotubes would be able to reach the pleura, which is the tissue that lines the outside of the lungs and is affected by exposure to certain types of asbestos fibers which cause the cancer mesothelioma. The researchers used inhalation exposure and found that inhaled nanotubes do reach the pleura and cause health effects.

Inhaled carbon nanotubes accumulate within cells at the pleural lining of the lung as visualized by light microscopy.

Short-term studies described in the paper do not allow conclusions about long-term responses such as cancer. However, the inhaled nanotubes “clearly reach the target tissue for mesothelioma and cause a unique pathologic reaction on the surface of the pleura, and caused fibrosis,” says Dr. James Bonner, associate professor of environmental and molecular toxicology at NC State and senior author of the study. The “unique reaction” began within one day of inhalation of the nanotubes, when clusters of immune cells (lymphocytes and monocytes) began collecting on the surface of the pleura. Localized fibrosis, or scarring on parts of the pleural surface that is also found with asbestos exposure, began two weeks after inhalation.

The study showed the immune response and fibrosis disappeared within three months of exposure. However, this study used only a single exposure to the nanotubes. “It remains unclear whether the pleura could recover from chronic, or repeated, exposures,” Bonner says. “More work needs to be done in that area and it is completely unknown at this point whether inhaled carbon nanotubes will prove to be carcinogenic in the lungs or in the pleural lining.”

The mice received a single inhalation exposure of six hours as part of the study, and the effects on the pleura were only evident at the highest dose used by the researchers – 30 milligrams per cubic meter (mg/m3). The researchers found no health effects in the mice exposed to the lower dose of one mg/m3.

The study, “Inhaled Carbon Nanotubes Reach the Sub-Pleural Tissue in Mice,” was co-authored by Bonner, Dr. Jessica Ryman-Rasmussen, Dr. Arnold Brody, and Dr. Jeanette Shipley-Phillips of NC State, Dr. Jeffrey Everitt who is an adjunct faculty at NC State, Dr. Mark Cesta of the National Institute of Environmental Health Sciences (NIEHS), Earl Tewksbury, Dr. Owen Moss, Dr. Brian Wong, Dr. Darol Dodd and Dr. Melvin Andersen of The Hamner Institutes for Health Sciences. The study is published in the Oct. 25 issue of Nature Nanotechnology and was funded by The Hamner Institutes for Health Sciences, NIEHS and NC State’s College of Agriculture and Life Sciences.

-shipman-

Note to Editors: The presentation abstract follows.

“Inhaled Carbon Nanotubes Reach the Sub-Pleural Tissue in Mice”

Authors: Jessica Ryman-Rasmussen, Arnold Brody, Jeanette Shipley-Phillips, James Bonner, Jeffrey Everitt, North Carolina State University; Mark Cesta, National Institute of Environmental Health Sciences; Earl Tewksbury, Owen Moss, Brian Wong, Darol Dodd, Melvin Andersen, The Hamner Institutes for Health Sciences.

Published: Oct. 25, 2009, Nature Nanotechnology.

Abstract: Carbon nanotubes are shaped like fibres and can stimulate inflammation at the surface of the peritoneum when injected into the abdominal cavity of mice, raising concerns that inhaled nanotubes may cause pleural fibrosis and/or mesothelioma. Here, we show that multiwalled carbon nanotubes reach the subpleura in mice after a single inhalation exposure of 30 mg m-3 for 6 h. Nanotubes were embedded in the subpleural wall and within subpleural macrophages. Mononuclear cell aggregates on the pleural surface increased in number and size after 1 day and nanotube-containing macrophages were observed within these foci. Subpleural fibrosis unique to this form of nanotubes increased after 2 and 6 weeks following inhalation. None of these effects was seen in mice that inhaled carbon black nanoparticles or a lower dose of nanotubes (1 mg m-3). This work suggests that minimizing inhalation of nanotubes during handling is prudent until further long-term assessments are conducted.

This metabolic switch also has implications for the deadly liver disease cirrhosis in humans. A counterpart human gene contributes to a shift from metabolizing alcohol to the formation of fat in heavy drinkers. This shift can lead to fatty liver syndrome – a precursor to cirrhosis.

In the study, published in the October print issue of the journal Genetics, the research team measured the time it takes for flies to stagger due to alcohol intake while simultaneously identifying changes in the expression of all their genes. They used statistical methods to identify genes that work together to help the flies adapt to alcohol exposure. In looking at corresponding human genes, a counterpart gene called ME1 was associated with alcohol consumption in humans, as people with certain variations of the gene showed a tendency to drink stronger alcoholic beverages.

Dr. Robert Anholt, William Neal Reynolds Professor of Biology and Genetics at NC State and the senior author of the study, says the research has possible clinical implications.

“Our findings point to metabolic pathways associated with proclivity for alcohol consumption that may ultimately be implicated in excessive drinking,” he said. “Translational studies like this one, in which discoveries from model organisms can be applied to insights in human biology, can help us understand the balance between nature and nurture, why we behave the way we do, and – for better or worse – what makes us tick.”

Anholt conducted the study with Dr. Tatiana Morozova, a post-doctoral researcher in biology; Dr. Trudy Mackay, William Neal Reynolds Distinguished University Professor of Genetics; Dr. Eric Stone, an assistant professor of statistics; and graduate student Julien F. Ayroles. Researchers from Boston University’s School of Medicine also contributed to the study.

The study was funded by a grant from the National Institute of Alcoholism and Alcohol Abuse, a unit of the National Institutes of Health.

- kulikowski -

Note: An abstract of the paper follows.

“Alcohol sensitivity in Drosophila: translational potential of systems genetics”

Authors: Tatiana V. Morozova, Julien F. Ayroles, Katherine W. Jordan, Laura H. Duncan, Mary Anna Carbone, Richard F. Lyman, Eric A. Stone, Robert R.H. Anholt, Trudy F.C. Mackay, North Carolina State University; Diddahally R. Govindaraju, R. Curtis Ellison, Boston University

Published: October 2009 in Genetics

Abstract: Identification of risk alleles for human behavioral disorders through genome-wide association studies (GWAS) has been hampered by a daunting multiple testing problem. This problem can be circumvented for some phenotypes by combining genome-wide studies in model organisms with subsequent candidate gene association analyses in human populations. Here, we characterized genetic networks that underlie the response to ethanol exposure in Drosophila melanogaster by measuring ethanol knock-down time in 40 wild-derived inbred Drosophila lines. We associated phenotypic variation in ethanol responses with genome-wide variation in gene expression and identified modules of correlated transcripts associated with a first and second exposure to ethanol vapors as well as the induction of tolerance. We validated the computational networks and assessed their robustness by transposon-mediated disruption of focal genes within modules in a laboratory inbred strain, followed by measurements of transcript abundance of connected genes within the module. Many genes within the modules have human orthologues, which provides a stepping stone for the identification of candidate genes associated with alcohol drinking behavior in human populations. We demonstrated the potential of this translational approach by identifying seven intronic SNPs of the Malic Enzyme 1 (ME1) gene that are associated with cocktail drinking in 1,687 individuals of the Framingham Offspring cohort, implicating that variation in levels of cytoplasmic malic enzyme may contribute to variation in alcohol consumption.

The researchers have created a computer model that “helps people who manage colonoscopy facilities, such as hospitals and clinics, find the best combination of physicians, staff, rooms and equipment needed to cater to the number of patients they can expect,” says Bjorn Berg, lead author of the paper outlining the new tool and a Ph.D. student in the Edward P. Fitts Department of Industrial & Systems Engineering at NC State. The model can also be used to determine the optimum number of patients a facility can see in any given day.

“Colonoscopy facility managers can try out different ideas in the model to see how they work before trying them in the real world – which is an expensive place to experiment,” says Dr. Brian Denton, an assistant professor of industrial and systems engineering at NC State and co-author of the paper. “For example, a manager could see whether it is worthwhile to hire another endoscopist who can perform colonoscopies, hire another nurse, or add another recovery bed for the facility.”

Denton explains that finding the right combination of staff, equipment and rooms can be particularly challenging for colonoscopy facilities because of uncertainties related to how long it takes to perform the procedure and how long it takes a patient to recover from it.

The model could be a boon for patients, because “it could lead to efficiency gains for practices,” Denton says, “and ultimately lower the cost for patients.” It also predicts the amount of time patients will spend waiting for the procedure, and can be used to improve scheduling.

The researchers utilized operations research methods to develop their model, which uses mathematics as a way of studying systems in order to make them more efficient and effective.  They are now working with University of North Carolina Hospitals to implement the model, and ultimately hope to make it available for general use.

The research, which was funded in part by the National Science Foundation, was co-authored by Berg and Denton from NC State, Dr. Hari Balasubramanian of UMass, and Dr. Heidi Nelson, Dr. Keith Lindor, Ahmed Rahman and Angela Bailey of Mayo Clinic. The paper, “A Discrete Event Simulation Model to Evaluate Operational Performance of a  Colonoscopy Suite,” was published online by the journal Medical Decision Making.

-shipman-

Note to editors: The study abstract follows.

“A Discrete Event Simulation Model to Evaluate Operational Performance of a Colonoscopy Suite”

Authors: Bjorn Berg, Brian Denton, North Carolina State University; Hari Balasubramanian, University of Massachusetts; Heidi Nelson, Keith Lindor, Ahmed Rahman and Angela Bailey, Mayo Clinic.

Published: Online September 2009, Medical Decision Making

Abstract: Background and Aims. Colorectal cancer, a leading cause of cancer death, is preventable with colonoscopic screening. Colonoscopy cost is high, and optimizing resource utilization for colonoscopy is important. This study’s aim is to evaluate resource allocation for optimal use of facilities for colonoscopy screening. Method. The authors used data from a computerized colonoscopy database to develop a discrete event simulation model of a colonoscopy suite. Operational configurations were compared by varying the number of endoscopists, procedure rooms, the patient arrival times, and procedure room turnaround time. Performance measures included the number of patients served during the clinic day and utilization of key resources. Further analysis included considering patient waiting time tradeoffs as well as the sensitivity of the system to procedure room turnaround time. Results. The maximum number of patients served is linearly related to the number of procedure rooms in the colonoscopy suite, with a fixed room to endoscopist ratio. Utilization of intake and recovery resources becomes more efficient as the number of procedure rooms increases, indicating the potential benefits of large colonoscopy suites. Procedure room turnaround time has a significant influence on patient throughput, procedure room utilization, and endoscopist utilization for varying ratios between 1:1 and 2:1 rooms per endoscopist. Finally, changes in the patient arrival schedule can reduce patient waiting time while not requiring a longer clinic day. Conclusions. Suite managers should keep a procedure room to endoscopist ratio between 1:1 and 2:1 while considering the utilization of related key resources as a decision factor as well. The sensitivity of the system to processes such as turnaround time should be evaluated before improvement efforts are made.

“This is the kind of project I’ve wanted to be involved with for a long time – using my knowledge of textiles and the sciences to make a real impact in the underserved parts of the world,” says Dr. Marian McCord, associate professor of textile engineering chemistry, science and biomedical engineering at NC State. McCord was contacted by Sustainable Health Enterprises (SHE), a social enterprise dedicated to developing a franchise model led by young women to manufacture and distribute affordable, high-quality and environmentally friendly sanitary pads in underserved parts of the world.

Former President Bill Clinton recently named the SHE project one of the “commitments to action” at the Clinton Global Initiative’s annual meeting in September. Established in 2005, the Clinton Global Initiative brings together a community of global leaders to devise and implement innovative solutions to some of the world’s most pressing challenges.

A prototype of the sanitary pad, produced by textile engineering student David W. Allen, is made from banana stem fibers.

McCord and colleagues across NC State are using their knowledge in areas such as nonwovens, wood and paper science, and medical textiles to develop a sanitary pad from materials readily available in local areas – such as the fiber from banana stems in Rwanda. The pads will be sold by community health workers for 30 percent less than the available brand.

“In some of these areas of Africa, a month’s supply of imported sanitary pads cost more than a day’s worth of wages. The donations they receive from individuals help, but they simply are not a long-term solution to the problem,” says Elizabeth Scharpf, founder and CEO of SHE. “Our goal is to create affordable pads that are able to be easily manufactured for a low cost at the local level – and the research being conducted at NC State helps us do that.”

Researchers in the Department of Wood and Paper Science at NC State – Drs. Lucian Lucia, Medwick Byrd and Hasan Jameel – took  banana stem fibers, which are easily accessible in Rwanda, and put them through a series of chemical treatments and mechanical actions in order to change their composition from coarse, waxy fibers into soft, billowy materials that are more amenable to absorbing liquid. Students in a textile engineering senior design course, led by Dr. Russell Gorga, associate professor of textile engineering, then incorporated the material into comfortable, effective and environmentally benign covers to create the prototypes currently under evaluation. The final prototype was produced by David W. Allen, a senior in textile engineering at NC State.

“The idea behind our research was to keep this process extremely simple – we employed materials that were cheap and easy to work with,” Lucia says. “In order for this project to be successful, it was imperative that the process could be replicated in other parts of the world – and that the average person, not necessarily a scientist, could create these sanitary pads. Our part in this important project was to show that turning banana stem fiber into an absorbent material is possible – and we’re very pleased that was exactly what we were able to do.”

“Our hope is that through this research, we’ll take a step toward improving the lives of millions of impoverished women in Rwanda, and perhaps all of Africa,” McCord says. “This project is just one of many examples of how a university without a medical school like NC State can have a major impact on global health.”

-barnhill-

“Hand washing is a significant preventative measure for many communicable diseases, from respiratory diseases like H1N1 to foodborne illness agents, such as norovirus,” says Dr. Ben Chapman, assistant professor of family and consumer sciences and food safety extension specialist at NC State. The new study, which examined student compliance with hand hygiene recommendations during an outbreak of norovirus at a university in Ontario, finds that only 17 percent of students followed  posted hand hygiene recommendations – but that 83 percent of students reported that they had been in compliance. Norovirus causes gastrointestinal problems, including vomiting and diarrhea. Every year there are 30 to 40 outbreaks of norovirus on university campuses, affecting thousands of students.

Chapman, who co-authored the research, says this is the first study to observe student hygiene behavior in the midst of an outbreak. Previous studies examined self-reporting data after an outbreak – and the new research shows that the self-reporting data may be inaccurate.

“Typically, health officials put up posters and signs and rely on self-reporting to determine whether these methods are effective,” Chapman says. “And people say they are washing their hands more. But, as it turns out, that’s not true.

“The study shows that while health authorities may give people the tools we think they need to limit the spread of an outbreak, the information we’re giving them is not compelling enough to change their behavior. Basically, it doesn’t work. But we do it again with every outbreak, and we’re doing it now with H1N1.”

Chapman says the study shows that health officials need to target specific audiences, such as students in a particular dorm or who eat at a particular cafeteria, and tailor their information to those audiences. For example, telling them where the nearest washrooms are, or pointing out where hand sanitizer units are located. “The more specific the information is for an audience, the better off you are,” Chapman says.

Chapman adds that health authorities also need to use language appropriate to their target audience. “For example, don’t refer to something as a ‘gastrointestinal illness,’” he says, “instead, tell them ‘this could make you puke’ or ‘dude, wash your hands.’ The idea is to craft compelling messages that create discussion in that audience. Make them talk about it.”

Chapman also says that health officials should take advantage of social media, such as text messaging and Facebook, to raise awareness. “If your audience consists of students,” he explains, “you should use media that students use.

“Campuses need to expect outbreaks will happen and plan accordingly. Have the response tools in hand.”

The study, “University Students’ Hand Hygiene Practice During a Gastrointestinal Outbreak in Residence: What They Say They Do and What They Actually Do,” was co-authored by Chapman, Dr. Douglas Powell of Kansas State University and Brae Surgeoner, a former graduate student at the University of Guelph. The study was published in the September issue of the Journal of Environmental Health.

-shipman-

Note to Editors: The study abstract follows.

“University Students’ Hand Hygiene Practice During a Gastrointestinal Outbreak in Residence: What They Say They Do and What They Actually Do”

Authors: Brae V. Surgeoner, University of Guelph; Benjamin J. Chapman, North Carolina State University; Douglas A. Powell, Kansas State University

Published: September 2009, Journal of Environmental Health

Abstract: Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to postoutbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

“The health and safety of students, faculty, staff and visitors at NC State is a top priority for the university,” says David Rainer, associate vice chancellor of environmental health and public safety. “We are closely monitoring cases of H1N1 on campus, and working with public health officials to comply with state and county regulations and best practices.”

Given that H1N1 is now regarded as the prevalent flu strain, NC State will not provide campuswide notification of isolated outbreaks and will only notify those immediately affected. In the case of broader outbreaks, the university will issue campuswide alerts.

Campus administrators are working with Wake County Emergency Medical Services to prepare for administering the flu vaccine, once it becomes available.

“Since H1N1 vaccine will not be available until mid October or later, daily prevention efforts by everyone will be key to maintaining a healthy campus,” says Dr. Mary Bengtson, medical director of NC State Student Health Services. “Flu is spread by a sick person – by a kiss, sharing drinks, cough or sneeze – or by a ‘sick’ thing – contaminated by a sick person’s cough, sneeze or touch. The best prevention efforts are to avoid sick people and clean hands frequently after touching things. Those who are ill should contact their medical provider if symptoms are more than mild, stay home, cover cough or sneeze, and clean hands frequently. When we have more information about H1N1 vaccine opportunities, we will make that announcement quickly to the campus community. In the meantime, we encourage students, faculty and staff to regularly check the Student Health Services site for updated information.”

Information relating to H1N1, tips on staying healthy during flu season, procedures for reporting H1N1 cases, flu shot updates, and other relevant information can be found on NC State’s Student Health Services Web site, http://www.ncsu.edu/student_health/index.html. Throughout the fall, NC State will also communicate H1N1-related updates to the campus community through a variety of channels such as the NC State Web site, Talley Student Center message boards and home football game announcements, among others.

In the event of a broader outbreak or emergency situation, visit http://www.ncsu.edu/emergency-information/index.php for updated information.

-barnhill-