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PubMed1999

Secondary school tobacco policy and prevention curricula in South Carolina.

The primary purpose of this study was to describe tobacco control policy in secondary schools in South Carolina, and sanctions imposed on students for violation of these policies; and to explore potential associations between policies and sanctions. A secondary purpose was to explore the use of tobacco education curricula in the state. This study employed a cross-sectional design in which two surveys were mailed to all secondary schools in South Carolina (n = 437): the School Principal Questionnaire (SPQ) and the Lead Health Education Teacher Questionnaire (LHETQ). The SPQ elicited information about tobacco control policies and the sanctions imposed on violators of such policies. The LHETQ was sent to lead health education teachers to elicit information about use of packaged curricula addressing tobacco use and prevention. Over 95% of respondents reported having school policies that prohibited use of tobacco inside buildings, and explicitly prohibited the use of cigarettes for students anywhere on school grounds. Sanctions imposed for violation of tobacco policy were severe. For a second offense, nearly 68% of students were suspended out-of-school or expelled, and for a third offense, almost 28% of students were expelled. There is some evidence to suggest that more stringent policies were associated with more severe sanctions. Cessation from tobacco programs were rarely used as a sanction, and in fact, tobacco education curricula were rarely used by health education teachers. In South Carolina secondary schools, tobacco policies are prevalent. Student violators of such policies are punished by means that potentially detract from their educational experience (e.g., out-of-school suspension, expulsion). It is recommended that school administrators and school health education teachers implement tobacco cessation programs as part of appropriate sanctions for violations of school tobacco use policy.

Adolescent↗
PubMed1987

Agricultural life-style: a mortality study among male farmers in South Carolina, 1983-1984.

After reviewing the death certificates of 2,820 South Carolina agricultural workers (including farmers, farm workers, and others in the agricultural industry) aged 35 to 84 during 1983-1984, we calculated proportional mortality ratios (PMRs). Among both white and nonwhite farmers in South Carolina, the PMR was significantly higher for cerebrovascular disease (whites, PMR = 1.20, P less than .05; nonwhites, PMR = 1.43, P less than .001) and lower for all malignant neoplasms (whites, PMR = 0.86, P less than .05; nonwhites, PMR = 0.78, P less than .001). In addition, external causes of death were elevated, attaining statistical significance for white farmers (PMR = 1.51, P less than .001). Significantly lower PMRs for all malignant neoplasms are attributed to fewer deaths from cancers related to smoking (buccal cavity and pharynx, esophagus, lung, and bladder) and colon and rectal cancers among both white and nonwhite farmers. White farmers did not show significantly elevated PMRs for cancers of the lymphatic and hematopoietic systems found in other studies in the Midwest. These data suggest that agricultural life-style can be improved for the prevention of strokes and for external causes of death.

Adult↗
PubMed1990

Prevalence of Raynaud phenomenon in the adult population of South Carolina.

A prevalence estimate for Raynaud phenomenon among adult residents of South Carolina was based on data obtained from respondents in a statewide health survey, followed by face-to-face interviews and clinical screening for Raynaud phenomenon, using a screening procedure developed by the authors. The survey obtained 5246 personal interviews from a probability sample of over 3000 households, and 494 survey subjects participated in the clinical screening. The prevalence estimates and their standard errors were computed using survey case weights, design-based estimation, and logistic modelling techniques. The prevalence of Raynaud phenomenon among adult residents of South Carolina was determined to be 3.5%, with a standard error of 0.6%. Prevalence was higher for females (4.3%, SE = 0.7%) than for males (2.7%, SE = 0.6%). These figures are much lower than most estimates in the existing literature on Raynaud phenomenon.

Adult↗
PubMed1998

Risk factors for congenital syphilis in infants of women with syphilis in South Carolina.

OBJECTIVES: This study examined risk factors for congenital syphilis in South Carolina. METHODS: Case infants with presumptive and confirmed congenital syphilis were compared with control infants born to women with reactive serologies during pregnancy, allowing investigation of risk factors for congenital rather than acquired transmission of syphilis. Data were collected from congenital syphilis report forms and birth certificates for 186 case infants and 487 controls born from 1991 to 1993. Odds ratios were calculated for maternal risk factors. RESULTS: Significant statistical trends were found for timing of first prenatal visit and number of visits. Other significant factors included rural residence (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.4, 2.9) and previous pregnancy loss (OR = 0.3, 95% CI = 0.2, 0.6). CONCLUSIONS: Prevention of congenital syphilis may be less effective among pregnant women with syphilis in South Carolina who have fewer prenatal care visits. Health care providers need further education on maternal/child syphilis management and techniques for motivating and educating patients.

Abortion, Spontaneous↗
PubMed2005

Oral cancer knowledge and experience: a survey of South Carolina medical students in 2002.

BACKGROUND: Compared to the U.S. states and District of Columbia, the adult population in South Carolina ranks in the high five in oral cavity and pharynx cancer mortality rate and top ten for incidence rate. Previous studies revealed a lack of knowledge related to the diagnosis of oral cancer among health professionals in the USA. This study assessed the oral cancer knowledge and experience of medical students in an academic setting. METHODS: This IRB approved cross-sectional survey used a self-administered pilot-tested questionnaire and the census of the Medical University of South Carolina medical students. Data were summarized by frequencies and chi-square comparisons of pre-clinical (first and second year) and clinical (third and fourth year) students. RESULTS: The overall response rate was 79% (450/571 students), range 61-91% by year. Significant (p < 0.001) differences were found between pre-clinical and clinical students for knowledge of risk factors, signs and symptoms of oral cancer, and tobacco cessation techniques; with clinical students more knowledgeable but at less than 78% accuracy. All students were in high agreement of the role and responsibility of physicians in tobacco cessation, and in medical history taking. Four students had seen or been instructed on how to perform an oral biopsy. Most (75%) of fourth year students felt adequately trained to palpate neck lymph nodes. However, less than 7% of all students perceived they were adequately trained to examine patients for oral cancers. CONCLUSIONS: Results suggest that these students may not receive adequate exposure to oral cancer prevention and detection knowledge and practices. Additional training to increase knowledge of risk factors and cessation counseling, and knowledge of signs and symptoms and examination skills may improve oral cancer prevention and detection. The implication is that additional education for the medical students in prevention and detection may lead to improvements in South Carolina oral cavity and pharyngeal cancer incidence and mortality rates.

Adult↗
PubMed1992

Epidemiology of Rocky Mountain spotted fever in South Carolina, 1985-1990.

By analyzing three different sources of data including DHEC reported cases, hospital discharge data, and death certificates, our study reveals that RMSF is endemic in South Carolina particularly in the Piedmont area and that underreporting of RMSF in South Carolina is likely. The incidence and case fatality rates of RMSF derived from hospital discharge data are higher than these rates derived from cases reported to DHEC. Physicians should be aware of the endemicity of RMSF in South Carolina and should include it in the differential diagnosis of any case of fever of unknown origin especially during the spring and summer seasons regardless of the history of a tick bite.

Adolescent↗
PubMed1985

Low country fevers: cultural adaptations to malaria in antebellum South Carolina.

The historical investigation of malaria in South Carolina offers a valuable opportunity for the medical anthropologist interested in the interrelationship between cultural practices and disease. Malaria was introduced to the New World by European settlers and African slaves, and the development of tidewater rice cultivation helped create and expand the conditions necessary for its spread. Once established, malaria became the region's most serious endemic disease, persisting until well into the twentieth century and cultural responses to it profoundly influenced antebellum southern society.

Cultural Characteristics↗
PubMed1994

Dietary behaviors of South Carolina adolescents.

Data from studies conducted on South Carolina adolescents indicate caloric intake to be less than recommended, intakes of calcium, iron and fiber are also less than recommended. Protein intake and cholesterol intake appears to higher than recommended. When distribution of energy intake is assessed excessive amounts of fat are consumed while reduced intakes of carbohydrates are observed. General dietary practices indicate inadequate intakes of fruits, cooked vegetables, and salads, while excessive intakes of hamburgers, fried foods, and pastries are observed. These findings indicate S. C. adolescents are consuming a diet that increases risk for diet related diseases that may occur in adulthood.

Adolescent↗
PubMed1995

Acute lower respiratory tract illness in illicit drug users--South Carolina, 1995.

On July 31, 1995, the South Carolina Department of Health and Environmental Control was notified of a cluster of five patients with acute, severe lower respiratory illnesses among previously healthy residents of a small rural community in Berkeley County (1990 population: 128,776). All five patients were users of illicit drugs. This report summarizes the preliminary findings of an investigation initiated to describe the clinical features and epidemiology of this syndrome and to determine an etiology. Based on information about the five cases obtained from interviews with the patients and reviews of records, a case was defined as an unexplained acute, severe respiratory illness in a previously healthy person aged < 65 years characterized by shortness of breath and/or pleuritic pain with onset of symptoms during July 15-31. One additional case was identified by contacting local physicians, intensive-care units, and pulmonary and infectious disease specialists. No cases of similar acute respiratory illness were noted in household contacts of patients.

Acute Disease↗
PubMed2001

Racial/ethnic health disparities in South Carolina and the role of rural locality and educational attainment.

BACKGROUND: The prevalence of selected health indicators were compared among the Catawba Indians, African Americans, and whites in South Carolina, considering the possible role of rural locality and education. METHODS: Catawba members were respondents of a 1998 survey (N = 808). Other South Carolina residents were respondents of the 1995-1997 Behavioral Risk Factor Survey (4,150 whites and 1,413 African Americans). Prevalence of cardiovascular disease, diabetes, hypertension, overweight, poor health, smoking, physical inactivity, and poor diet were compared among the racial/ethnic groups. Logistic regression analyses were conducted within strata of urban/rural locality and education to determine whether these factors were associated with the adverse health indicators. RESULTS: Both Catawba and African Americans had higher prevalence of diabetes, hypertension, overweight, poor health, physical inactivity, and poor diet than whites. In addition, prevalence of diabetes, poor health, smoking, and poor diet were higher among the Catawba than among African Americans. Restricting the analyses to comparisons within urban/rural locality had little effect, whereas restricting the analyses to comparisons by education level eliminated many of the disparities among those with low education. CONCLUSIONS: Prevalence of chronic disease and adverse health behavior are higher among the Catawba than among other residents of South Carolina, especially compared with white residents.

Adult↗
PubMed1978

The parasite fauna of the American alligator (Alligator mississippiensis) in South Carolina.

Twelve American alligators (Alligator mississippiensis) were obtained from three different areas of South Carolina. One species of pentastome (Sebekia oxycephala), two species of nematodes (Dujardinascaris waltoni and Multicaecum tenuicolle), four species of trematodes (Polycotyle ornata, Acanthostomum coronarium, Archaeodiplostomum acetabulatum and Pseudocrocodilicola americaniense) and one species of hemogregarine (Haemogregarina crocodilnorum) were recovered. Polycotyle ornata was observed only in alligators from Par Pond while P. americaniense was found in Par Pond and coastal hosts, A. acetabulatum from Kiawah Island and coastal alligators, and A. coronarium only at Kiawah Island. These patterns suggest disjunct distributions for the trematode species in South Carolina alligators. The other parasites were found in alligators from all three locations. The only parasite observed to initiate damage or lesions in the alligator was the pentastome.

Alligators and Crocodiles↗
PubMed1990

Recent trends in neonatal mortality in South Carolina.

This study examines some of the primary factors responsible for the decline in South Carolina's neonatal mortality rate during the 1980s. Essentially all of the observed decline between 1980-82 and 1984-86 could be attributed to improved birthweight-specific survival rather than improvements in the infant birthweight distribution. Improved survival of 500-1,499 g infants accounted for 64% of the decline in white neonatal mortality and 70% of the decline among blacks. Also, during this period, the percentage of 500-1,499 g infants delivered at Level III hospitals increased significantly for both race groups. Comparisons with other southeastern states suggest that further reductions in South Carolina's neonatal mortality rate are possible through continued efforts aimed at improving birthweight-specific survival. Existing state-supported programs such as regional perinatal referral networks and the High Risk Channeling Project will continue to play an important role in maintaining the decline in the state's neonatal mortality rate.

Black or African American↗
PubMed2003

Application of capture-recapture methodology to estimate the prevalence of dementia in South Carolina.

PURPOSE: The purpose of this study was to estimate the prevalence of dementia in individuals 65 years of age and older in the state of South Carolina using capture-recapture methodology. METHODS: We linked data from the Department of Mental Health admissions, inpatient admissions, and emergency room visits. Separate log-linear models were used to obtain estimates of the underascertainment-corrected prevalence of dementia in twelve age-gender-race subgroups, which were summed to estimate the prevalence of dementia in the total population. RESULTS: We found an overall prevalence of dementia of 14% in South Carolina for persons 65 years of age and older using capture-recapture methodology. This estimate of persons with dementia is 25% higher than the identified cases of dementia in the South Carolina Alzheimer's Disease Registry (10.5%). CONCLUSIONS: Although capture-recapture methods are prone to limitations, they can be used to more accurately estimate the prevalence of dementia in a geographic area.

Aged↗
PubMed2006

Missed opportunities for earlier diagnosis of HIV infection--South Carolina, 1997-2005.

In September 2006, CDC published revised recommendations for human immunodeficiency virus (HIV) testing in health-care settings to 1) increase early detection of HIV infection by expanding HIV screening of patients and 2) improve access to HIV care and prevention services (e.g., by conducting screening in locations such as emergency departments and urgent-care facilities, where persons who do not otherwise access HIV testing seek health-care services). HIV screening is now recommended for patients aged 13-64 years in all health-care settings after patients are notified that testing will be performed unless they decline (opt-out screening). This represents a substantial change from earlier recommendations to 1) offer HIV testing routinely to all patients only in health-care settings with high HIV prevalence and 2) conduct targeted screening on the basis of risk behaviors for patients in low-prevalence settings. This report examines HIV and acquired immunodeficiency syndrome (AIDS) case reporting in South Carolina before the 2006 recommendations were published. During 2001-2005, a total of 4,315 cases of HIV infection were reported in South Carolina. Of these, 41% were in persons (referred to as late testers) in whom AIDS was diagnosed within 1 year of their initial HIV diagnosis. Of these late testers, 73% made a total of 7,988 visits to a South Carolina health-care facility during 1997-2005 before their first reported positive HIV test. The diagnoses reported for 79% of these visits were not likely to prompt HIV testing under a risk-based testing strategy. These findings suggest that routine, opt-out HIV screening of all patients in health-care settings, rather than risk-based HIV testing, might result in substantially earlier HIV diagnoses in South Carolina.

AIDS Serodiagnosis↗
PubMed2003

Enslaved Africans and doctors in South Carolina.

This interpretation of the relationship between enslavement and American medicine in 19th century South Carolina reveals the intimacy that existed between Africans enslaved in that state and the doctors who practiced and taught there. Enslaved Africans were resourceful and reliable medical figures in the slave community. Their knowledge of medical botany permeated the slave quarters and plantation hospitals and was appropriated into southern medical knowledge. The trajectories of the careers of three South Carolina physicians are tied to their practice around and on the enslaved. The beginnings of gynecological surgery are linked to 1840s experimentation on enslaved African women performed by one of them.

Black or African American↗
PubMed2004

Ozone measurements in South Carolina using passive samplers.

Passive samplers with two different collection substrates were used to obtain an average ozone concentration for 1 month during the summer of 2002 for each South Carolina county. One sampler contained a filter coated with indigo carmine, whose color fades when exposed to ozone. The fading was measured by reflectance spectroscopy. The other sampler contained filters that were coated with nitrite, which is oxidized to nitrate when exposed to ozone. The nitrate was measured by ion chromatography. Calibration curves were developed for the two methods by comparing color fading from indigo carmine and nitrate ion concentration from the nitrite filter with ambient ozone concentration measured by a co-located reference continuous UV ozone analyzer. These curves were used to calculate integrated ozone concentrations for samplers distributed across South Carolina. Using the indigo carmine method, the average ozone concentrations ranged from 21 to 64 ppb (average = 46 +/- 7.9 ppb, n = 58) across the 46 counties in the state during one summer month of 2002. Concentrations for the same time period from the nitrite-coated filters ranged from 23 to 62 ppb (average = 41 +/- 8.1 ppb, n = 58). Also for the same time period, the 23 continuous UV photometric ozone monitors operated by the South Carolina Department of Health and Environmental Control at sites within 10 miles of some of the passive monitors showed ozone concentrations ranging from 28 to 50 ppb (average = 39 +/- 6.3 ppb, n = 22).

Air Pollutants↗
PubMed2001

Support for school-based reproductive health services among South Carolina voters.

In 1997 a statewide random digit-dialed telephone survey of 534 South Carolina registered voters was conducted to determine level of support for school-based reproductive health services. Results indicated most voters supported services in secondary schools that would provide students with information and counseling about contraceptive methods and refer students to community-based agencies for abstinence education and counseling. Voters were less supportive of reproductive health services that would diagnose or treat sexually transmitted diseases, test for pregnancy, refer students to community-based agencies for contraceptives, or make contraceptives available to students at school. Significant associations in support for school-based reproductive health services were reported based on income, personal beliefs, intentions, and outcome expectations regarding sexuality education and contraceptive availability. These data reinforce the need for school-aged youth in South Carolina to have access to reproductive health services within their communities, outside of the school setting.

Adolescent↗
PubMed2004

Lifestyle and prostate cancer among older African-American and Caucasian men in South Carolina.

OBJECTIVE: We investigated the association between lifestyle and prostate cancer risk among Caucasian and African-American men, separately. METHODS: This population-based case-control study of prostate cancer among men aged 65-79 years was conducted between 2000 and 2002 in South Carolina. Telephone interviews were completed with 416 incident prostate cancer cases ascertained through the South Carolina Central Cancer Registry, and 429 controls identified through the Health Care Financing Administration Medicare beneficiary file (with respective response rates of 71% and 64%). RESULTS: Caucasian men working in production, transportation, and material moving had increased prostate cancer risk (odds ratio [OR] = 2.04, 95% confidence interval [CI] 1.17-3.54), while African-American men in the military had reduced prostate cancer risk (OR = 0.19, 95% CI 0.05-0.76). Having five or more prostate specific antigen (PSA) tests within the past five years was associated with prostate cancer among Caucasian men; however, African-American men with prostate cancer tended to have fewer PSA tests. Increasing lycopene consumption was associated with a reduced risk of prostate cancer among Caucasian men (p = 0.03), but not among African-American men. CONCLUSIONS: In this population-based case-control study conducted in South Carolina we did not find marked differences in lifestyle factors associated with prostate cancer by race.

Black or African American↗