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PubMed2000

Depression among victims of south Mississippi's methyl parathion disaster.

Human-induced disasters have long been considered responsible for a wide array of physiological, psychological, and economic distress. This study examined depressive symptoms among victims of south Mississippi's methyl parathion disaster. Results indicated that irrespective of the level of methyl parathion contamination in respondents' dwellings, more than half the victims interviewed reported depressive symptoms at levels suggesting probable clinical depression. Those at greatest risk of depressive symptoms were people who had been exposed to the neurotoxin for the longest period of time, among whom there was an overrepresentation of women and African Americans. Despite high statistical levels of depression, few victims used mental health services. Implications for social work's response to human-induced disasters are provided.

Adult↗
PubMed1992

Ecological studies of adult Ixodes scapularis in central Mississippi: questing activity in relation to time of year, vegetation type, and meteorologic conditions.

Adult Ixodes scapularis Say were collected weekly during two fall-winter-spring seasons from 1989 to 1991 to assess their temporal and spatial distribution as well as the effects of several meteorologic parameters on questing activity. Collections were made in three 0.4-ha sites in central Mississippi by flagging vegetation with a white flannel cloth. Adult I. scapularis were collected from 25 October through 11 April during the 1989-1990 season and 24 October-1 April in the 1990-1991 season. Peak I. scapularis questing activity occurred on 5 February and 4 February during the two seasons, respectively. Ticks were collected most often at approximately 20 degrees C but seven were collected on a day when the temperature was 6.9 degrees C. Ticks were clustered within the study sites and not evenly distributed. Most I. scapularis were collected from Ligustrum sinense and Chasmanthium sessiliflorum at a height of 31-40 cm. Statistical analyses of the meteorologic factors that affect questing activity are presented and discussed.

Animals↗
PubMed2005

Vancomycin-tolerance among clinical isolates of Streptococcus pneumoniae in Mississippi during 1999-2001.

BACKGROUND: In recent years, infection with Streptococcus pneumoniae has been a serious worldwide health concern. Antimicrobial-resistant S pneumoniae is increasing in incidence worldwide, posing a potentially serious threat. Resistance to beta-lactams, macrolides, and trimethoprim-sulfamethoxazole represents a major problem in the treatment of pneumococcal infections METHODS: Our laboratory conducted a survey of local resistance patterns in S pneumoniae. Clinical isolates from two separate respiratory seasons were collected from representative geographic areas in Mississippi (totaling 28 hospitals) and were tested for antimicrobial resistance to penicillin, amoxicillin, ceftriaxone, cefuroxime, azithromycin, clindamycin, tetracycline, trimethoprim-sulfamethoxazole, levofloxacin, gatifloxacin, moxifloxacin, and vancomycin using reference methods. Vancomycin-tolerant strains of S pneumoniae were initially identified as those in which the vancomycin MIC was 0.5 microg/mL. Strain tolerance was confirmed by time kill studies RESULTS: For the 1999-2000 respiratory season, 318 isolates were available for testing; for 2001-2002, 166 isolates were available. Of the 484 total isolates tested, two isolates were identified as having increased tolerance to vancomycin. A greater than 2 log10 difference in viability between the tolerant isolates and the nontolerant isolates of S pneumoniae was observed in time kill studies CONCLUSIONS: Two vancomycin-tolerant isolates of S pneumoniae were identified and characterized. Antibiotic tolerance is defined as the ability of bacteria to survive but not proliferate in the presence of an antibacterial agent. Tolerance to vancomycin is particularly significant when the incidence of penicillin tolerance or resistance is high. In addition, tolerance to vancomycin is not detected by routine in vitro susceptibility testing.

Anti-Bacterial Agents↗
PubMed1989

Patients' and physicians' assessments of patients' health in rural Mississippi.

A two-week health-appraisal survey of the patients of a rural Mississippi medical clinic during the month of January 1988 revealed that the larger percentage of the patients assessed their individual health status in about the same way that it was assessed by the clinic's staff physicians. The highest dissimilarity between physicians' and patients' assessments of patients' health occurred for the black patients in general and for the black men specifically. Findings of this study indicate a need for increased efforts in health education for rural communities, more research on how rural people assess their own health, and greater knowledge of rural people's health belief models.

Adolescent↗
PubMed1984

Child abuse in Jackson, Mississippi.

During an 18-month period, 148 children examined in the emergency room at the University of Mississippi Medical Center were suspected of having been the victims of child abuse. Physical abuse was suspected in 42.5%, sexual abuse in 38.5%, and neglect in 24.0%. The high prevalence of sexual abuse, particularly rape, and the severity of the various injuries associated with physical abuse indicate the need for primary prevention.

Adolescent↗
PubMed1995

Vibrio vulnificus wound infections from the Mississippi Gulf coastal waters: June to August 1993.

Vibrio vulnificus, part of the normal marine flora of the Gulf of Mexico, is being increasingly recognized as an important human pathogen. V vulnificus contamination of superficial wounds can cause a severe, rapidly progressive, necrotizing cellulitis with bullous skin lesions that may require surgical debridement and is occasionally fatal. We summarize information about six cases of V vulnificus wound infection reported to the Mississippi State Department of Health from June to August 1993. Five of the six patients required hospitalization for intravenous antibiotic treatment and, in two cases, surgery. Two patients died from septicemia, despite aggressive antibiotic treatment; both had preexisting medical conditions that could have contributed to immune compromise and fulminant infection. This report underscores the virulence of this organism and the need for awareness by both the clinician and diagnostic laboratory personnel when dealing with superficial wounds occupationally or recreationally exposed to seawater.

Adult↗
PubMed1995

Analysis of 11 cases of delusions of parasitosis reported to the Mississippi Department of Health.

Delusions of parasitosis (DOP) is a psychiatric disorder in which people have an unshakable false belief that they are infested with arthropod parasites. To rid themselves of the "bugs" patients with DOP may become desperate and quit their jobs, burn furniture, abandon homes, and use pesticides dangerously and repeatedly. Data from 11 cases of DOP, reported to the Mississippi Department of Health between 1989 and 1993, are presented in an attempt to identify common factors among the cases. Seven of the 11 patients (64%) were elderly white women. Five patients complained of "mites," 3 of "insects," and 3 of "bugs"; and all characteristically offered "proof" of their infestation such as bits of debris or skin scrapings wrapped in paper or in tiny jars. Only one complained of itching. Six patients reported extensive use of pesticides. These results elucidate the clinical presentation of DOP cases, thus aiding in diagnosis of the disorder.

Adult↗
PubMed2004

Body weight status, dietary habits, and physical activity levels of middle school-aged children in rural Mississippi.

OBJECTIVES: Obesity and cardiovascular diseases are more prevalent in the Southeast as compared with other geographic regions of the United States. However, few investigations have addressed health disparities among children in rural Southeastern areas. The purpose of this investigation was to determine the risk of overweight and obesity in middle school-aged children residing in a racially diverse rural community, and to characterize their dietary and physical activity habits. METHODS: Two hundred and five middle school children from Scott County, Mississippi were enrolled in this investigation. Measurements included height, weight, body mass index, dietary intake using a 24-hour recall, and physical activity level using pedometers. RESULTS: Of the 205 children studied, 54% were "overweight" or "at risk for overweight" according to a body mass index-for-age sex-specific percentile. Intake of saturated fat and sodium exceeded recommended levels, whereas intake of calcium, fruits, and vegetables was inadequate. One third of the sample consumed 12 fluid ounces or more of soda on the day of the recall. Physical activity level was below that previously reported for children in this age range, and knowledge of the importance of diet and physical activity in the prevention of cardiovascular disease was poor, particularly among African-American children. CONCLUSIONS: The children in our sample are at increased risk for overweight and obesity. Factors that may be targeted for intervention include a reduction in dietary intake of fat, saturated fat, sodium, and soft drinks, and an increased intake of fruits and vegetables. Physical activity should be encouraged. Many of these factors could be improved through changes within the school environment.

Adolescent↗
PubMed2001

Opportunities to improve prevention and services for HIV-infected women in nonurban Alabama and Mississippi.

OBJECTIVE: The intent of this study was to identify opportunities for improving the effectiveness of HIV prevention before nonurban (rural and small-city resident) Southern women are infected and the medical and social services offered to them after they are infected. METHODS: At several HIV clinics in nonurban Alabama and Mississippi, women with HIV infection (who reside in small cities and towns outside of Birmingham) were identified and interviewed about the period during which they probably acquired HIV and about their needs and the services provided after they were found to be infected with HIV. RESULTS: Before they were infected, these 211 young (mean age, 33 years), mainly African-American (67%) women often reported being seen at HIV testing sites (37%) and, among drug users, at drug treatment facilities (30%), where they presumably received counseling to prevent becoming infected. Once infected, many (21%) said they were not directed to HIV treatment sites, half (50%) were sexually active in the month before they were interviewed, many (13%) sought treatment of sexually transmitted diseases in the 12 months before the interview, and many (36%) reported unmet needs for HIV treatment related to having no insurance or Medicaid. CONCLUSIONS: Prevention and treatment of HIV for nonurban Southern women are not fully effective. Given the continued sexual activity of these women, more focus on preventing transmission from persons who are already infected is warranted.

Adult↗
PubMed2003

Personal breast-feeding behaviors of female physicians in Mississippi.

BACKGROUND: In this study, we examined the personal breast-feeding behaviors of female physicians in Mississippi. METHOD: Two hundred fifteen of 350 female physicians responded to a survey inquiring of their personal breast-feeding behaviors. RESULTS: One hundred fifty-five mothers (74%) reported having biologic children, and 146 (94.2%) breast-fed at least 1 child. Approximately 21% of the responding mothers breast-fed their first-born children for at least 6 months. There was a positive relationship between the duration of breast-feeding of older children and the breast-feeding duration for younger children. The major reasons for weaning were return to work, diminishing milk supply, and lack of time to pump breast milk. CONCLUSION: The breast-feeding initiation rates among female physicians surpassed those of women in the general population, yet duration rates were comparable. Their own breast-feeding success might enhance the potential of female physicians as advocates and sources of credible information regarding breast-feeding; however, physicians need to be better educated regarding the management of breast-feeding.

Adult↗
PubMed2005

Obesity and the African-American adolescent in mississippi: an overview.

Obesity is one of the most common conditions seen in medical practice, and is one of the most difficult to treat. This condition is often perceived as a cosmetic problem, but it is associated with a number of chronic medical conditions including, but not limited to, heart disease, hypertension, and dyslipidemia. Youth obesity has increased at an alarming rate in the United States and in other developed countries around the world. Given the high prevalence of obesity among adults in the United States, it is not surprising that pediatric obesity is also on the rise. The current trends in obesity among African-American adolescents in the state of Mississippi remain alarming and disheartening. Since obesity starts in early childhood and extends into the adolescent years and possibly into adulthood, behavior modification is the key to preventing the onset of obesity in all population groups.

Adolescent↗
PubMed2005

Effectiveness of a school-based intervention to increase health knowledge of cardiovascular disease risk factors among rural Mississippi middle school children.

BACKGROUND: Few school-based interventions have been evaluated to assess health awareness among children in rural southern areas. The purpose of this controlled investigation was to increase health awareness among middle school-aged children residing in a racially diverse rural community in Mississippi. METHODS: This investigation assessed health knowledge before and after a 16-week school-based intervention in 205 fifth-grade students. Height, weight, BMI, body composition, waist circumference, dietary intake, blood lipids and lipoprotein concentrations, blood glucose concentrations, and resting blood pressure were measured to enhance student awareness of cardiovascular disease risk factors. Values in the intervention school were compared with those obtained simultaneously in a control school within the same community. RESULTS: The school-based intervention was effective in increasing health knowledge in the intervention as compared with the control school. Secondarily, it was effective in improving certain dietary behaviors. Utilizing health care professionals in the classroom to teach students appropriate lifestyles and actually measuring cardiovascular risk factors to increase awareness among students was effective in increasing overall health knowledge. CONCLUSIONS: Health knowledge of rural adolescents can be increased through partnerships with schools and multidisciplinary teams of health care professionals. Ongoing efforts to reduce childhood obesity and cardiovascular disease risk factors are urgently needed, and information obtained during this investigation may be used in planning school-based interventions in other diverse, rural communities.

Body Weights and Measures↗
PubMed2006

Black/white differential use of health services by young children in a rural Mississippi community.

BACKGROUND AND OBJECTIVES: Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community. METHODS: Data were prospectively collected for 396 children attending a private practice to determine if race was associated with the use of health services in this community. RESULTS: White children made more sick contacts than black children (P < 0.001). Black children (36%) were more likely to be treated in the emergency room than white children (24%; P = 0.013). There was no black-white difference in the hospitalization rates, although white children were more likely to undergo ear-nose-throat (ENT) surgery for pressure equalizing tube (PET) placement, and/or tonsillectomy and adenoidectomy (T and A; P < 0.001). Even after controlling for various confounders, the frequency of all physician sick contacts was twice as high for white children than for black children (RR = 2.17; 95% C.I. = 1.32-3.58). CONCLUSION: Overall, black children used disproportionately fewer health services than their white counterparts, but used significantly higher emergency room services. Private insurance coverage was the single most significant variable that accounted for the black-white differential use of the emergency room.

Adult↗
PubMed2005

The politics of racial disparities: desegregating the hospitals in Jackson, Mississippi.

As health care policymakers and providers focus on eliminating the persistent racial disparities in treatment, it is useful to explore how resistance to hospital desegregation was overcome. Jackson, Mississippi, provides an instructive case study of how largely concealed deliberations achieved the necessary concessions in a still rigidly segregated community. The Veterans Administration hospital, the medical school hospital, and the private nonprofit facilities were successively desegregated, owing mainly to the threatened loss of federal dollars. Many of the changes, however, were cosmetic. In contrast to the powerful financial incentives offered to hospitals to desegregate and ensure equal access in the early years of the Medicare program, current trends in federal reimbursement encourage segregation and disparities in treatment.

Hospitals↗
PubMed1984

Prevalence of cerebral palsy in the biracial population of Copiah County, Mississippi.

As part of a door-to-door survey of major neurological disorders, the prevalence of cerebral palsy was ascertained in the institutionalized and non-institutionalized biracial population of Copiah County, Mississippi. The over-all prevalence ratio was 212 per 100,000 inhabitants. For whites, as for blacks, males had a higher prevalence ratio than females. For both sexes, blacks had a higher prevalence ratio, but the race difference was not striking. Prevalence ratios declined with age. Other findings are presented on clinical features and degree of disability.

Adolescent↗
PubMed1994

Mississippi public health nurses and midwives: a partnership that worked.

At the turn of the century maternal and infant mortality rates were high in this southern state. Untrained midwives conducted many of the deliveries. Initial support for locating and training midwives by public health nurses was provided by the American Red Cross and the United States Public Health Services. Later, funding from a philanthropic organization (Rockefeller International Foundation) provided a mechanism that brought Mississippi public health nurses and midwives to a partnership that endured for over a half a century, and contributed to better maternal-infant health care outcomes for that state.

Black or African American↗
PubMed2003

Physician knowledge of the diagnosis and management of Rocky Mountain spotted fever: Mississippi, 2002.

Rocky Mountain spotted fever (RMSF), a tick-borne illness that has its highest incidence in the south central and southeastern United States, is often a diagnostic challenge, as patients frequently present with nonspecific symptoms during the early stages of illness. RMSF has a high case fatality rate among untreated individuals, and the median time from onset of symptoms to death is only eight days, making early recognition and treatment of RMSF crucial. In two Mississippi public health districts, 148 primary care physicians were randomly selected and mailed surveys regarding RMSF diagnosis, treatment, and prevention. Eighty-four of the 148 (57%) physicians responded. Responses from different specialties and different health districts were compared using chi square statistics. Almost all (99%) physicians correctly identified doxycycline as the antibiotic agent of choice for treating adults and adolescents. However, only 21% of family practice physicians, and 25% of emergency medicine physicians correctly identified the antibiotic of choice for treating children with RMSF. Twenty-three percent of physicians responded that waiting for the development of a rash before prescribing antibiotics is an appropriate treatment strategy. The current standard of care-doxycycline as the agent of choice among children 8 years of age or younger with suspected RMSF-has not been effectively communicated to all physicians caring for children. Also, many physicians are not familiar with the rationale underlying initiation of antibiotic therapy prior to the development of rash in patients with suspected RMSF. Continuing education efforts should focus on antibiotic selection in pediatric patients and initiation of therapy prior to the onset of rash in appropriate patients.

Animals↗
PubMed2006

Oral health status of mississippi delta 3- to 5-year-olds in child care: an exploratory study of dental health status and risk factors for dental disease and treatment needs.

OBJECTIVES: For poor and minority young children, disparities exist in dental health and treatment. In rural impoverished areas, institutions that reach young children and potentially offer access to care are limited. In the current Mississippi Delta study, child care centers were examined as potential venues for oral health intervention and research, and potential risk factors for dental caries and treatment urgency in high-risk preschool children were explored. METHODS: Child care centers were selected and attending children recruited. Data on oral health practices were collected from surveys of center directors and parents/caregivers. Children were examined for caries and treatment urgency at centers by dentists. Bivariate and multivariate analyses with a 0. 05 alpha were used to examine data. RESULTS: A total of 346 preschool children at 15 participating centers were examined: 46% were female, 68% minority. Minority children and those with public insurance were more than twice as likely to have caries and urgent treatment needs as non-minorities or those with private insurance. The odds of children having caries were half as great if parents reported using floss and nearly twice as great if the parent had experienced a dental abscess. For every soft drink the parent consumed daily, the odds of dental caries for children increased by 44%. CONCLUSIONS: Conducting oral health exams and research in child care venues was possible, yet presented challenges. The combined use of two parental variables, reported soft drink consumption and abscess history, appears promising for caries prediction. Implementation of oral health programs and research in child care venues merits further exploration.

Carbonated Beverages↗