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PubMed1990

Tobacco prevention in North Carolina public schools.

The purpose of this study is to report on the extent of, and organization for, tobacco prevention education in North Carolina Public Schools. Moreover, issues for the diffusion of tobacco prevention curricula are discussed. A questionnaire examining tobacco education practices and curriculum within school districts was mailed to health education representatives in each of the North Carolina public school districts. One-hundred twenty-five usable questionnaires were returned for analysis (125/140 = 89.3%). Of the school districts responding to the survey, 101 (80.8%) reported having adopted a system-wide curriculum which includes tobacco-related instruction. Additionally, a large percentage of the school districts with an adopted curriculum were using commercially published materials (85.2%). Large tobacco producing counties in North Carolina were not significantly different than other counties in the adoption or public acceptance of school programs with a tobacco prevention component. However, school systems with an adopted, general tobacco use policy for the district were more likely to have adopted a district-wide tobacco education curriculum. Individual schools were also involved with multiple tobacco prevention curriculum and learning programs. In the sixth, seventh, and eighth grades, the sample reported using a total of twelve different programs. Many of these learning programs lacked necessary elements of effective programs. Key diffusion issues included the impact of multi-tobacco curricula use to the introduction of new and effective material, as well as the association between district-wide tobacco use policies and the adoption of curriculum.

Adolescent↗
PubMed1999

Hepatitis B maternal screening, infant vaccination, and infant prophylaxis practices in North Carolina.

OBJECTIVES: To determine if the Advisory Committee on Immunization Practices hepatitis B screening, vaccination, and prophylaxis recommendations were being followed in North Carolina, and to establish a baseline hepatitis B seroprevalence rate. DESIGN: A survey of mother and infant birthing facility medical records. SETTING: Four birthing facilities selected from each of the 7 districts in North Carolina (a total of 28 facilities). PARTICIPANTS: A probability proportional to size survey design was used to select 4763 mother-infant record pairs. All records came from the 1996 birth cohort. MAIN OUTCOME MEASURES: Maternal hepatitis B screening status, infant vaccination status, infants prophylaxis status, hepatitis B seroprevalence rate, demographic and clinical predictors for maternal infection, failure to receive prenatal care or for whom status was unknown, failure to screen, and failure to vaccinate. RESULTS: Ninety-two percent of pregnant women were screened for hepatitis B surface antigen. Eighty-six percent of infants received dose 1 of the hepatitis B vaccine. Four of the 9 infants with mothers who were hepatitis B surface antigen-positive did not receive both vaccine and hepatitis B immune globulin. The hepatitis B seroprevalence rate was 0.2%. Mothers who were not screened for infection were 3.4 times more likely to have infants who were not vaccinated. White mothers were twice as likely not to have their child vaccinated as mothers of other races. CONCLUSIONS: Not all infants with hepatitis B-infected mothers were receiving vaccine and hepatitis B immune globulin as recommended. Seroprevalence of hepatitis B infection may be lower in North Carolina than in other states. Hepatitis B laboratory test results should be included in every mother's medical record.

Birthing Centers↗
PubMed1996

Racial differences in stage at diagnosis of screenable oral cancers in North Carolina.

OBJECTIVE: This study examined differences between blacks and whites in stage at diagnosis of screenable oral cancers. METHODS: Data for 1,137 North Carolina residents with first primary tumors of the oral cavity (excluding the lip and salivary glands) or oropharynx diagnosed from 1990-92 were obtained from the North Carolina Central Cancer Registry. The outcome variable was stage at diagnosis dichotomized as localized and advanced. The explanatory variables were race, sex, age, year diagnosed, tumor site, and county-level socioeconomic and health care resource factors. Bivariate, stratified, and multiple regression analyses were conducted. RESULTS: In the regression analysis, the odds of advanced stage was 2.1 (95% CI = 1.5, 2.9) times greater for blacks than whites. Other multivariable effects were sex [males compared to females: OR = 1.5 (95% CI = 1.2, 2.0)] and tumor site (oropharynx compared to palate: OR = 4.2 (95% CI = 2.5, 7.0)]. CONCLUSION: Among black and white residents of North Carolina diagnosed with cancer of the oral cavity or oropharynx, blacks had a greater odds of diagnosis at advanced stage.

Age Factors↗
PubMed2004

Graduated driver licensing restrictions: awareness, compliance, and enforcement in North Carolina.

PROBLEM: This study examined the extent to which critical restrictions in North Carolina's graduated driver licensing (GDL) system are known, adhered to, and enforced. METHOD: Teenagers and their parents were recruited as they applied for either an intermediate or full license at 1 of 23 licensing offices. Telephone interviews were conducted with 900 teenagers and their parents. RESULTS: Awareness of North Carolina's night and passenger restrictions was very high among both parents and teenagers. Ten percent of teenagers reported violating the night restriction without their parents' knowledge, and 15% had done so with their parents' approval. Only 4% of parents reported allowing their teenagers to drive with more than one teenage passenger, but 19% of teenagers reported that they were allowed to do this. Violations of the passenger restriction without parental knowledge were more common than violations of the night restriction (22% vs. 10%, respectively). Among teenagers who violated restrictions without their parents' knowledge, most reported doing so only once or a few times. Teenagers expressed little concern about detection, although a majority reported driving more carefully to avoid police notice. Neither parents nor teenagers knew much about police enforcement of GDL restrictions. To obtain a sense of the views of law enforcement officers, informal interviews were conducted with 20 officers from five diverse communities and the state highway patrol. These officers were highly supportive of GDL but unfamiliar with many of the specific provisions. Moreover, enforcement of GDL restrictions did not appear to be a high priority. IMPACT ON INDUSTRY: There is a need to increase the belief among teens (and parents) that police are enforcing GDL restrictions in their community; law enforcement participation in well-publicized traffic safety enforcement efforts would likely produce this result.

Adolescent↗
PubMed2005

Assessment of local health department smoking policies--North Carolina, July-August 2003.

Secondhand smoke is a cause of disease in healthy nonsmokers, and an increasing number of states have adopted laws prohibiting smoking in private-sector worksites, restaurants, and bars. However, certain state governments have provisions in their state smoking restrictions that preempt more stringent local laws. North Carolina has such a preemptive state smoking law, passed in 1993, which mandates that 20% of the space within state-controlled buildings be designated as smoking areas. Exemptions from the law included local health departments (LHDs), providing an opportunity for public health practitioners to enact more stringent policies. To assess smoking policy gains from this exemption, a research team from the University of North Carolina at Chapel Hill (UNC) surveyed LHD directors. Results of the survey indicated uncertainty regarding the state law, with 37% of LHD directors believing they were prohibited from enacting a 100% tobacco-free policy on LHD grounds and 20% not knowing whether they were prohibited. The North Carolina Association of Local Health Directors used these findings to work with legislators in the North Carolina General Assembly to amend the state smoking law in 2005, specifying that the exemption applies to both LHD buildings and grounds.

Government Agencies↗
PubMed1991

Elevated intraoperative blood carboxyhemoglobin levels in surgical patients--Georgia, Illinois, and North Carolina.

In October 1990, three hospitals, one each in Georgia, Illinois, and North Carolina, reported 26 episodes of elevated blood carboxyhemoglobin (COHb) levels (normal: less than 3% in a nonsmoker, less than 10% in a smoker) during surgery in patients with no known carbon monoxide (CO) exposure. All three hospitals are large, medical-school-affiliated, training institutions. Hospital A (Georgia) reported 15 episodes from January 1987 through September 1989; hospital B (North Carolina), eight episodes from January through October 1990; and hospital C (Illinois), three episodes from January through September 1990. All of the episodes were detected during routine blood gas analyses that included COHb measurements (co-oximetry). In eight episodes, peak COHb levels were greater than 20%. Usually, when an elevated COHb level was detected intraoperatively, 100% oxygen was administered, an alternate gas source was instituted, and COHb levels returned to normal. No deaths or serious complications were reported.

Anesthesia, Inhalation↗
PubMed1995

Blood lead levels in North Carolina painters.

1. Blood lead levels were examined in 127 housepainters in North Carolina between April and September, 1993. Each participant filled out a questionnaire and gave a blood sample. The questionnaire covered the individual's work history, concentrating on paint-removal activities and personal protection, and also covered potential nonoccupational sources of lead exposure. Blood samples were analysed for lead content using atomic absorption spectroscopy. 2. The geometric mean blood lead level was 0.33 mumol L-1 (6.8 micrograms dL-1). No blood lead samples were found to exceed the occupational standard of 1.93 mumol L-1 (40 micrograms dL-1). The three highest samples had levels between 0.97 and 1.45 mumol L-1 (20 and 30 micrograms dL-1); this represented 2.4% of the study sample. 3. No statistical association was found between blood lead levels in these painters and their painting activities, including using dust masks for personal protection. 4. Current painting practices in this group of North Carolina painters do not appear to elevate blood lead levels above the occupational standard.

Adolescent↗
PubMed1998

Outbreak of primary and secondary syphilis--Guilford County, North Carolina, 1996-1997.

In 1996 and 1997, 153 cases of primary and secondary (P&S) syphilis were reported each year in Guilford County, North Carolina, a 147% increase from the 62 cases reported in 1994 (Figure 1). The incidence of P&S syphilis in Guilford County during 1996-1997 was 40.5 cases per 100,000 persons, substantially higher than the national health objective for 2000 of four cases per 100,000 (objective 19.3). In comparison, the number of P&S syphilis cases in North Carolina declined 57% from 1994 to 1997 (Figure 1), to a rate of 10.9 per 100,000 in 1997. This report summarizes the results of an investigation conducted by the Guilford County Health Department (GCHD), the North Carolina Division of Epidemiology, and CDC, which suggest this ongoing outbreak has been associated with missed opportunities for syphilis screening and treatment in high-risk settings, increased exchange of sex for money or drugs, and substantial rates of coinfection with syphilis and human immunodeficiency virus (HIV) among those tested.

Adult↗
PubMed1975

Dietary survey of low-income, rural families in Iowa and North Carolina. II. Family distribution of dietary adequacy.

Distribution patterns of Iowa and North Carolina families for dietary adequacy at various income levels were compared according to: (a) two family dietary standards, based on the 1968 Recommended Dietary Allowance and the Ten-State Nutrition Survey dietary standards, and (b) two income standards, family income and per capita income. A 24-hr. recall method was used to collect the dietary data. Nutrients studied included: protein, calcium, iron, vitamin A, ascorbic acid, thiamin, and riboflavin. Clear differences emerged in family distribution patterns by the two dietary standards and by the two income standards. Comparison of family distribution patterns for dietary intake by the two standards showed that percentages of families with poor nutrient intakes were lower by Ten-State evaluation than for the recommended allowance evaluation, except for protein and iron. For example, the percentage of families with poor calcium intakes, by Ten-State criteria, was approximately half that measured by the recommended allowances. While, according to the latter, calcium was the most limiting nutrient in many family diets, vitamin A was most limiting by Ten-State evaluation. The proportions of families with poor ascorbic acid, thiamin, and riboflavin intakes were also lower by Ten-State standards. While the iron adequacy remained approximately the same by both dietary standards, the percentage of families with poor protein intakes was higher by the Ten-State criteria. A higher percentage of families at each income level had fair and good diets by Ten-State comparison. Family distribution patterns for intakes of individual nutrients at various family income levels demonstrated a positive relationship between nutritional intake and income. Proportions of families with poor nutrient intakes according to per capita income tended to increase with the income level. For both income standards, the percentages of families with good and fair diets in the total family sample gradually increased with income. Percentages of Iowa families with fair and good diets at various income levels were, in general, higher than those of North Carolina families. The lowest and the highest percentages of families with poor diets of two population groups were higher for per capita income distribution than for family income distribution.

Adolescent↗
PubMedDate not supplied

Race and colorectal cancer screening: a population-based study in North Carolina.

OBJECTIVE: National and state data document racial differences in colorectal cancer (CRC) mortality and incidence. Screening for CRC reduces cancer incidence and deaths. Racial differences in colorectal cancer screening behavior may contribute to the racial disparity in incidence and mortality. The purpose of this study was to determine if colorectal cancer screening rates are different between blacks and whites while controlling for potential confounders. STUDY DESIGN: Cross-sectional survey. DATA SOURCE(S)/STUDY SETTING: We used data from the North Carolina Colon Cancer Study, a population-based case-control study conducted in 33 counties of North Carolina. We analyzed data from 598 control subjects who were eligible for colorectal cancer screening. METHODS: Trained nurses conducted face-to-face interviews from October 1996 through October 2000. RESULTS: Overall, 50% of the respondents were compliant with CRC screening guidelines. In the multivariable logistic regression model having a regular doctor and participation in a general medical exam were significantly associated with current screening status with odds ratios (OR) (95% confidence interval (CI)) of 3.8 (1.7-8.3) and 3.7 (2.1-6.7), respectively. Older age was a significant predictor of current screening status with an OR (95% CI) of 2.9 (1.7-4.8) for those 60-69 compared to respondents 50-59 and OR 3.2 (1.9-5.5) for those 70 and older compared to respondents 50-59. After adjusting for age, having a regular doctor and participation in general medical exams, race was not significantly associated with current CRC screening status, with an OR of 1.1 (95% CI 0.7-1.6). CONCLUSION: CRC screening rates in North Carolina were low. Race was not a significant determinant of screening behavior and therefore does not explain the racial disparity in incidence or survival. Older age, having a regular doctor and participating in general medical exams were significant predictors of CRC screening. RELEVANCE: This study reinforces the fact that screening rates in North Carolina are low despite the strong evidence that colorectal cancer screening reduces cancer deaths.

Aged↗
PubMedDate not supplied

Babesia gibsoni infections in dogs from North Carolina.

The recognition of canine babesiosis in North Carolina caused by Babesia gibsoni documents the expansion of the previously reported endemic area of this disease. Clinical signs ranged from severe hemolytic anemia and thrombocytopenia to subclinical infections. No infected dogs had traveled to endemic areas. Antibabesial treatment failed to eradicate the organism from infected dogs.

Animals↗
PubMedDate not supplied

Highlights from a socioeconomic survey of radiologic technologists in North Carolina.

A survey of radiologic technologists in North Carolina shows that, in general, technologists fare better economically when working in hospitals than in radiologists' offices. It is not surprising to note that salaries increase with an increase in job responsibilities and for those who participate in continuing education. At the time of the survey in early 1975, only 35 per cent of those responding were involved in some form of continuing education program. Further studies are needed to better define some of the implications noted in the survey.

Age Factors↗
PubMed1992

The introduction of human immunodeficiency virus into the North Carolina pediatric population.

The authors reviewed the means by which human immunodeficiency virus (HIV) seropositivity was acquired for the 134 seropositive children seen at Duke University Medical Center prior to September 1990. Perinatal transmission occurred in 111 (83%) and blood product transmission in 15 (11%). Of the 108 mothers (there were three sets of siblings) responsible for perinatal transmission, 44 (41%) had acquired their infection while residing in North Carolina. Intravenous (IV) drug use by the mother or her sexual partner was the significant risk factor for maternal infection in 91 (84%) of the total cases and in 38 (86%) of the 44 women infected in North Carolina. The proportion of women who acquired their HIV infection from a sexual partner who was an IV drug user was significantly greater for mothers who were resident in North Carolina when infected compared with mothers infected elsewhere (P less than .001). On the basis of admission to drug treatment programs during the 1990 fiscal year, cocaine is the predominant IV drug used in North Carolina. Admissions to cocaine abuse programs occurred throughout the state, and mothers who acquired HIV infection from IV drug use were more likely to live in counties with a higher frequency of cocaine abuse treatment.

Child↗
PubMed1995

Eighteen-month incidence of tooth loss among older adults in North Carolina.

This study investigated tooth loss in North Carolina adults 65 years of age or older. A random sample of 335 Blacks and 284 Whites participated in dental examinations and interviews at baseline and again after 18 months. Blacks were more likely than Whites to lose at least one tooth (36% vs 19%), and they lost more teeth on average (1.0 vs 0.4). Several oral disease conditions and symptoms were related to tooth loss, but many other hypothesized factors were not. Risk models were inconclusive in the identification of factors related to risk of tooth loss.

Aged↗
PubMed1988

Prevalence of alcohol and drug use among North Carolina public school students.

During spring 1987, North Carolina conducted a drug prevalence survey on a randomly selected, stratified cluster sample of 10,259 seventh-12th grade students enrolled in public schools. The survey assisted in development of new drug prevention programs funded by the Drug-Free Schools Act of 1986. Results indicated alcohol, tobacco, and marijuana were the most commonly used drugs; males and whites were more frequent users than females and blacks; and almost 20% of 11th and 12th grade students reported coming to school drunk in the year preceding the survey. Extensive use of wine coolers and smokeless tobacco was noted. The need is discussed for other states to conduct similar surveys to establish a data base from which better programming decisions can be made.

Adolescent↗
PubMedDate not supplied

A comparison of mental health center operated detoxification programs in North Carolina.

The mental health center program in North Carolina provides detoxification services for substance abusers in community-based detoxification programs. Some of these programs are licensed as "social setting" and other as "medical nonhospital." Evaluation of one medical program and comparison with social setting programs revealed that the cost per bed in the social setting is 58% less, and that the cost for physicians and drugs constitute 17% of the medical detoxification program. However, because of the efficiency of the medical program, the costs per patient treated are comparable. Sixty-nine percent of the patients receive librium in the first 24 h after admission and 26% in the second 24 h in doses of 109 mg and 59 mg, respectively, and 62% required medication other than librium. As judged by the staff, 68% of the patients treated successfully completed the program. Follow-up of patients 30 days after discharge revealed that approximately 50% were in recovery.

Adult↗
PubMed1997

An ancestral core haplotype defines the critical region harbouring the North Carolina macular dystrophy gene (MCDR1).

Autosomal dominant North Carolina macular dystrophy (NCMD) or central areolar pigment epithelial dystrophy (CAPED) is an allelic disorder that maps to an approximately 7.2 cM interval between DNA markers at D6S424 and D6S1671 on 6q14-q16.2. The further refinement of the disease locus has been hindered by the lack of additional recombination events involving the critical region. In this study, we have identified three multigeneration families of German descent who express the NCMD phenotype. Genotyping was carried out with a series of markers spanning approximately 53 cM around the NCMD locus, MCDR1. Genetic linkage between the markers and the disease phenotype in each of the families could be shown. Disease associated haplotypes were constructed and provide evidence for an ancestral founder for the German NCMD families. This haplotype analysis suggests that a 4.0 cM interval flanked by markers at D6S249 and D6S475 harbours the gene causing NCMD, facilitating further positional cloning approaches.

Chromosomes, Human, Pair 6↗
PubMedDate not supplied

Quality of life measures and gender comparisons in North Carolina Cardiac Rehabilitation Programs.

BACKGROUND: Quality of life (QOL) is an important health-related outcome measure in patients with cardiovascular disease. The North Carolina Cardiopulmonary Rehabilitation Association (NCCRA) is a coalition of 72 state-certified, multidisciplinary cardiac rehabilitation (CR) programs. In 1997, the NCCRA Executive Board and Research Committee agreed to collect ongoing data to assess QOL changes following CR participation using the Ferrans & Powers QOL Index Cardiac Version III. The purpose of this study was to determine if changes were present in QOL scores after 12 weeks of CR in men and women from multiple outpatient centers. METHODS: Data were analyzed from 420 patients from 19 Phase II early outpatient CR programs who completed the QOL index survey within the first week of program entry and upon discharge. The four QOL index domains measured were health/function, psychological/spiritual status, socioeconomic status, and family interaction. Overall QOL was tabulated as the aggregate score from the four domains. Each domain, as well as overall QOL, was compared pre- and post-CR participation with a repeated measures analysis of variance. RESULTS: Across programs, statistically significant improvements in QOL indices were observed following 12 weeks of CR in each of the four domains and on the overall score in all patients. Men reported greater CR entry and discharge scores than women on the health/function, family interaction, and overall scores. Women showed a greater positive change in scores than men on the socioeconomic, family interaction, and overall scores. CONCLUSIONS: Patients who participated in Phase II multidisciplinary North Carolina CR programs and completed the protocol improved QOL parameters. While men had higher physical function and overall QOL scores both pre- and post-CR, women showed greater improvements in overall scores, as well as in family and socioeconomic parameters. These findings suggest that North Carolina CR patients experience a positive change in QOL following short-term participation in CR. Further study with a larger number of patients benchmarked with programs from other regions with comparisons to patients who do not participate in formalized CR programs is indicated from this investigation.

Adult↗