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PubMed2001

Outbreak of listeriosis associated with homemade Mexican-style cheese--North Carolina, October 2000-January 2001.

On November 13, 2000, health-care providers at a hospital in Winston-Salem, North Carolina, contacted the local health department about three cases of listeriosis within a 2-week period in recent Mexican immigrants. The North Carolina General Communicable Disease Control Branch, in collaboration with the Forsyth County Health Department, the North Carolina Departments of Agriculture and Consumer Services (NCDA&CS) and Environment and Natural Resources, the Food and Drug Administration (FDA), and CDC investigated this outbreak of Listeria monocytogenes infections. This report summarizes the results of the investigation, which implicated noncommercial, homemade, Mexican-style fresh soft cheese produced from contaminated raw milk sold by a local dairy farm as the causative agent. Culturally appropriate education efforts are important to reduce the risk for L. monocytogenes transmission through Mexican-style fresh soft cheese.

Adult↗
PubMedDate not supplied

A survey of private pediatric dental practices in North Carolina.

PURPOSE: In response to concerns about current and future demands for specialized pediatric dental care in North Carolina, a survey of private pediatric dental practices was conducted. METHODS: Data were collected on the demographics and other practice variables. Information was also collected on the ages, caries activity, Medicaid status, estimated treatment needs, fluoridation status, and location of residence (urban/rural) of all new patients seen in each practice during three designated, consecutive days in November 1996. RESULTS: The survey response rate was 76%. The data indicated that most pediatric dentists in North Carolina are quite busy. A total of 519 new patients were seen during the three-day survey period. The mean age was 4.7 years and 22% had advanced caries. Forty seven percent were caries free. Most of the disease was found in the primary dentitions of young children. CONCLUSIONS: The findings indicate that the specialized pediatric dental care system in North Carolina is operating close to its capacity and is overtaxed in many areas of the state.

Adolescent↗
PubMed2006

Medical coverage of high school athletics in North Carolina.

BACKGROUND: A significant percentage of high school students participate in athletics, and of those participating, at least one third will experience a sport-related injury. Despite the high risk of injury, there are few guidelines on what type of medical coverage should be provided for high school athletics. Although vague recommendations are present, it is not known to what extent high schools comply with these guidelines. The primary objective of this cross-sectional study was to assess the quality and extent of medical coverage at high school athletic events in North Carolina. METHODS: A questionnaire, mailed to all athletic directors at public and private North Carolina high school members of the North Carolina High School Athletic Association, was used to assess medical coverage. RESULTS: Only 56% of the schools had coverage by either nationally or state certified athletic trainers. Although 71% of schools had physician coverage at some athletic events, less than 10% of physician coverage included monitoring of athletic practices. Only 27% of the schools surveyed felt that their existing medical coverage of athletic events could be considered adequate. CONCLUSIONS: These preliminary findings suggest that medical coverage of high school athletics in North Carolina, as in other states, is lacking and inconsistent.

Adolescent↗
PubMed1991

Programming, budgeting, and control in the North Carolina "Willie M." program: a case of public sector accountability.

In eight years of program operation, the State of North Carolina has spent upwards of $200 million on its Willie M. program. In doing so, the state has developed a model program of services for severely emotionally disturbed children. This paper describes the program legacy wrought by the Willie M. class action suit against the State of North Carolina. The response of the state is reported in terms of the programming, budgeting, and control challenges generated by North Carolina's voluntary settlement of the suit.

Budgets↗
PubMed1993

Adolescent health services in North Carolina's local health departments.

The purpose of this study was to assess availability of clinical health services and special adolescent health programs for those aged 10-19 years administered by local health departments in North Carolina, and to evaluate factors that were associated with the existence of specialized adolescent programs, comprehensive services, and school services. We used self-report surveys mailed to 100 county health directors. All counties responded. One in five (21%) North Carolina youth received one or more health department service in 1990. Thirty-four health departments have programs or services specifically designed for adolescents; 7 health departments provide comprehensive services. The majority of health departments (85%) provide services in public schools, most often health education or counseling. Counties with more adolescents and with higher per capita income were more likely to have adolescent programs and more likely to provide comprehensive clinics. Health departments with school services served proportionally twice as many of their county's adolescents as those without school services. We concluded that few local health departments in North Carolina provide comprehensive health services to their youth. Community-wide participation and state support are needed to improve public sector access to comprehensive health care for adolescents in North Carolina and in other states with decentralized, county-controlled public health systems.

Adolescent↗
PubMedDate not supplied

Characteristics of drowning deaths in North Carolina.

A retrospective study of 1,052 unintentional drowning deaths in North Carolina during the period from 1980 through 1984 was carried out, with emphasis on the victims' activity and alcohol consumption, and the settings of the accidents. The data suggest that many drownings are preventable, and reinforce the etiologic importance of ethanol consumption in such deaths. The overall drowning rate for North Carolina residents during the period covered by the study was 3.2 per 100,000 persons. Nonwhite males had the highest rate, 8.8 per 100,000 population. The next highest rate was for white males, 4.7 per 100,000. Swimming and wading, involved in 41 percent of the drowning deaths, was the most frequently associated activity. Fishing was involved in 15 percent of the deaths, and motor vehicle accidents with 8 percent. Most occurred in freshwater settings, notably lakes and ponds, 39 percent, and rivers and creeks, 29 percent. Of the 752 victims 15 years and older tested for blood ethanol, 53 percent had positive tests and 38 percent had blood alcohol concentrations of 100 milligrams per deciliter or greater. Significant percentages of victims 15 years and older with blood alcohol concentrations greater than 100 milligrams per deciliter were found in all settings and activity groups.

Accidents, Traffic↗
PubMedDate not supplied

Public health news frames in North Carolina newspaper coverage of the 100% Tobacco-Free Schools campaign? Sometimes.

OBJECTIVE: News organizations are an important and influential part of the social environment. They identify certain issues by the extent and nature of their coverage. To help explain what public health policy messages may have influenced school policy decisions, this content analysis provides an examination of newspaper coverage of North Carolinas 100% tobacco-free schools campaign. DATA COLLECTION METHODS: Researchers searched LexisNexis for articles published in North Carolina newspapers between January 1, 2001 and December 31, 2004 that included variations of "North Carolina tobacco-free schools." Researchers then conducted a descriptive analysis of 138 stories from nine North Carolina newspapers (approximately 4% of all the states newspapers) and used page placement and story type to examine the level of importance placed on the issue. Finally, frames for and against tobacco-free school policies were tracked, along with the presence of key messages presented by 100% TFS advocates. PRINCIPAL FINDINGS: The volume of news coverage changed throughout the study period, with peaks and valleys closely associated with external "trigger" events. In addition, a majority of the newspaper articles did not include key public health messages. CONCLUSIONS: The results suggest an opportunity for public health experts and officials to work more effectively with local journalists to increase the use (and impact) of public health messages in news coverage of tobacco policies affecting youth.

Child↗
PubMedDate not supplied

Skin problems related to the occupation of commercial fishing in North Carolina.

OBJECTIVE: Commercial fishing is one of the most dangerous professions with many of the occupational health problems related to the skin. This study elucidates the types of occupational skin disorders that occur in commercial fishermen in North Carolina. STUDY DESIGN/SETTINGS: Booths were set up offering free skin cancer screenings at various seafood festivals, a "blessing of the fleet" event and commercial fishing shows, which were located throughout eastern North Carolina from 2002-2004. When commercial fishermen were screened, they were asked about significant skin problems that they had experienced and were related to their occupation. They were specifically asked about their history of (1) cancerous and precancerous skin lesions, (2) eczemas, (3) superficial fungal infections, (4) bacterial infections of the skin, (5) traumatic injuries related to the skin, (6) bites and stings, (7) shocks from fish, and (8) skin problems related to environmental extremes. RESULTS: Eighty-one North Carolina watermen were screened: seven of the fishermen (9%) had at least one basal cell carcinoma, five (6%) had at least one squamous cell carcinoma, and no melanomas were detected. Many occupationally related skin disorders were noted on the historical survey, and some of the more dangerous of these included traumatic injuries related to fishing equipment, cutaneous cancers, fish bites, infections, stingray injuries, and man-of-war stings. LIMITATIONS: The sample population was comprised of volunteers, which limits generalizability, and some diagnoses were established retrospectively. CONCLUSIONS: There are a wide variety of skin disorders among commercial fishermen in North Carolina and healthcare professionals should be aware of these when working with watermen.

Adult↗
PubMed2000

Evaluating Floyd's effect on health in eastern North Carolina.

Since the now-famous storm of September 1999, the name "Floyd" has taken on new associations for many people in eastern North Carolina: devastation and environmental catastrophe. On 12 November 1999, representatives from state and federal agencies and local universities met on the NIEHS campus in Research Triangle Park, North Carolina, to discuss the environmental health implications of the floods following Hurricane Floyd. In addition to determining the potential long-term human health and ecological problems, participants hoped to develop strategies, collaborations, and partnerships to be used in the restoration of eastern North Carolina.

Disasters↗
PubMed2001

Evaluation of the effects of North Carolina's 0.08% BAC law.

This study was conducted to determine whether the lowered BAC limit for drivers in North Carolina resulted in fewer alcohol-related motor vehicle crashes. We used time-series analysis to examine several indicators of alcohol involvement in both injury and fatal crashes between 1991 and 1996. Data from NC crash files as well as the Fatality Analysis Reporting System (FARS) are used. We also examined several indicators used in previous research on lower BAC limits using a before-after design to compare North Carolina with 37 states that did not change their BAC limit for 24 months before and after the BAC limit was lowered. When controlling for the pre-existing downward trend in drinking driver crashes, along with other pertinent factors such as amount of travel and number of weekends per month, there was no evidence of either a significant shift or a change in the downward trend of alcohol-related crashes associated with the lowered BAC limit. In conclusion, although the lower BAC limit was actively enforced and a substantial proportion of drinkers were aware of the new BAC limit, the drinking-driving population in North Carolina, at the time the lower limit took effect in October 1993, was simply unresponsive to this change.

Accidents, Traffic↗
PubMed2006

Knowledge, attitudes, and use of emergency contraception among rural western North Carolina women.

BACKGROUND: To determine the knowledge, attitudes and self-reported usage of emergency contraception (EC) in rural western North Carolina women. METHODS: Using a cross-sectional survey, with a convenience sample, participants self-administered the survey in waiting rooms of eight medical clinics in three counties in western North Carolina. Participants included 401 English-speaking women of childbearing age (18-44 years old) presenting for routine medical care during a three-month period in 2004. RESULTS: Of the 70.5% who responded, almost all (97%) were sexually active and most (92%) perceived an unintended pregnancy to be a problem. A majority of the participants (72%) were aware of EC, but only 7.5% of women reported usage in the last year. More than 80% of the surveyed women were uncertain if EC was the same as the abortion pill, RU-486. While only 16% of respondents indicated they had discussed EC with a doctor or another health professional, most women (89%) reported that doctors or other health professionals would be their first choice for accurate information about EC pills. CONCLUSIONS: Among western North Carolina women of childbearing age, EC is rarely used, perhaps because of confusion about its mechanism of action. Furthermore, EC is infrequently discussed with doctors. Since women indicate that health care providers would be their preferred choice for accurate information about EC, improved patient education by physicians about EC would be a first step in increasing knowledge among patients.

Adolescent↗
PubMed2003

Changes in summer temperature and heat-related mortality since 1971 in North Carolina, South Finland, and Southeast England.

Three climatically diverse regions were studied to determine the impact of temperature change on heat-related mortality from 1971 to 1997. Median regressions showed that May-August temperatures in North Carolina rose by 1.0 degrees C (95% CL 0.0-2.0 degrees C) from 23.5 degrees C (74.3 degrees F), were unchanged in South Finland at 13.5 degrees C (56.3 degrees F), and rose in Southeast England 2.1 degrees C (0.3-4.0 degrees C) from 14.9 degrees C (58.8 degrees F). After determining for each region the daily temperature (as a 3 degrees C band) at which the mortality was the lowest, annual heat-related mortality was obtained as excess mortality per million at temperatures above this. Annual heat-related mortality per million (among the population at risk, aged 55+) fell in North Carolina by 212 (59-365) from 228 (140-317) to only 16 (not significant, NS); fell in South Finland by 282 (66-500) from 382 (257-507) to 99 (NS); and fell in Southeast England by 2.4 (NS) from 111 (41-180) to 108 (41-176). The falls in North Carolina and South Finland remained significant after allowances were made for changes in age, sex, and baseline mortality. Increased air conditioning probably explains the virtual disappearance of heat-related mortality in the hottest region, North Carolina, despite warmer summers. Other lifestyle changes associated with increasing prosperity probably explain the favorable trends in the cooler regions.

Aged↗
PubMedDate not supplied

Trends in up-to-date status in colorectal cancer screening, North Carolina, 1998-2002.

BACKGROUND: Rates of colorectal cancer (CRC) screening are rising nationwide. Our purpose was to determine the proportion of North Carolina adults who were up-to-date with CRC screening in 1998-2002 and analyze trends by socio-demographic subgroups. METHODS: We examined data from the North Carolina Behavioral Risk Factor Surveillance System. For 1998, 1999, 2001, and 2002, we determined the proportion of respondents 50 years old and older who were up-to-date, defined as a home fecal occult blood test (FOBT) in the past 12 months and/or a sigmoidoscopy or colonoscopy in the past five years. We examined trends in up-to-date status in all respondents and in selected socio-demographic subgroups. We also examined the characteristics of respondents who were up-to-date in 2001-2002. RESULTS: From 1998-2002, the percentage of respondents 50 years old or older who were up-to-date with CRC screening increased from 46.1% to 54.0% (test for trend, p < 0.0001). The proportion who were up-to-date increased among those 50-74 years old, those with a high school or college education, and those with incomes less than dollar 25,000. Proportions that were up-to-date did not significantly increase among African Americans and respondents with less than a high school education. In 2001-2002, we found low percentages that were up-to-date among adults 50-54 years old Hispanics, and the uninsured CONCLUSIONS: The proportion of North Carolina adults who are up-to-date with CRC screening is increasing but not across all socio-demographic groups. These results indicate that there are subgroups that need to be reached with screening programs. Efforts to educate the public and providers about CRC screening should continue.

Aged↗
PubMed2000

Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives.

OBJECTIVE: To determine the prevalence and types of complementary and alternative medicine therapies used by certified nurse-midwives in North Carolina. METHODS: Surveys were sent to all 120 licensed certified nurse-midwives in North Carolina requesting information concerning their recommendations for use of complementary and alternative medicine for their pregnant or postpartum patients. RESULTS: Eighty-two responses were received (68.3%). Seventy-seven (93.9%) reported recommending complementary and alternative medicine to their pregnant patients in the past year. Forty-seven (57.3%) reported recommending complementary and alternative medicine to more than 10% of patients. The percentage of nurse-midwives who recommended each type of complementary and alternative medicine was as follows: herbal therapy (73.2%), massage therapy (67.1%), chiropractic (57.3%), acupressure (52.4%), mind-body interventions (48.8%), aromatherapy (32.9%), homeopathy (30.5%), spiritual healing (23.2%), acupuncture (19.5%), and bioelectric or magnetic applications (14.6%). The 60 respondents who reported prescribing herbal therapies gave them for the following indications: nausea and vomiting, labor stimulation, perineal discomfort, lactation disorders, postpartum depression, preterm labor, postpartum hemorrhage, labor analgesia, and malpresentation. CONCLUSION: Complementary and alternative medicine, especially herbal therapy, is commonly prescribed to pregnant women by nurse-midwives in North Carolina.

Adult↗
PubMed1998

Community exposure to toluene diisocyanate from a polyurethane foam manufacturing plant--North Carolina, 1997.

In August 1996, residents of a community in Randolph County, North Carolina, contacted the Agency for Toxic Substances and Disease Registry (ATSDR) because of health concerns about possible exposure to chemical emissions from a polyurethane manufacturing plant. ATSDR and the North Carolina Department of Environment, Health, and Natural Resources (NCDEHNR) conducted ambient air monitoring to characterize air contamination near the plant. ATSDR and Randolph County health officials also conducted biologic monitoring to determine whether residents were being exposed to toluene diisocyanate (TDI) emitted from the plant. This report summarizes the results of these investigations, which indicate that residents were being exposed to TDI in ambient air surrounding the plant.

Air Pollutants↗
PubMedDate not supplied

Support for tobacco control policies among youth in North Carolina.

BACKGROUND: The objective of this research was to examine attitudes toward tobacco control policies among middle and high school students in North Carolina. Specifically, we report data on knowledge of the harmfulness of secondhand smoke and support for restaurant and school-based smoking restrictions. METHODS: The statewide North Carolina Youth Tobacco Survey was administered to a representative sample of 3,073 middle school and 3,261 high school students in the fall of 2003. The overall response rate for the middle and high school samples was 77.0% and 77.4%, respectively. Support for tobacco policies was analyzed by smoking status and by knowledge of the harmfulness of secondhand smoke RESULTS: The vast majority of respondents in the middle school (87.6%) and high school (91.6%) reported that secondhand smoke was "definitely" or probably" harmful. However, less than half of middle school (48.6%) and high school (40.2%) students responded that smoking should be banned in restaurants. Even among the select group of students who had never smoked and who believed secondhand smoke was harmful, support for such a ban was less than 60% at both school levels. CONCLUSIONS: Youth in North Carolina are aware of the health risks of secondhand smoke, but are not convinced of the need to restrict smoking in restaurants. These results point to the need for more youth-focused advocacy and education around smoking restrictions, both to reduce youth exposure to secondhand smoke and to solidify voter support for such protections once they reach adulthood.

Adolescent↗
PubMed1991

Characteristics of neonatal intensive care unit patients in North Carolina: a cross-sectional survey.

A shortage of neonatal intensive care facilities has been encountered in some areas of the country including North Carolina. To examine possible solutions to this health care delivery problem, a cross-sectional survey of all the neonatal intensive care units in North Carolina was performed to examine characteristics of patients occupying the beds in these facilities. It was found that a substantial amount of chronic care is now occurring in neonatal intensive care beds, with 38% of occupants of neonatal intensive care beds being 31 days of age or older and 3% being mechanically ventilated at 91 days of age or older. In addition, according to criteria established for this study, a substantial number of "convalescent" patients (32%) were occupying beds in neonatal intensive care units. It is concluded that an increase in both intermediate/convalescent care beds and establishment of chronic care facilities in North Carolina, rather than an increase in intensive care beds in these units, would alleviate the shortage of neonatal intensive care facilities. Further, the characteristics of the population occupying neonatal intensive care unit beds should be considered by health planners in addition to occupancy rate, when new facilities are being established.

Bed Occupancy↗