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Spotted fever rickettsiosis in solid organ transplant recipients is rarely described, and all reports document disease acquired months to years after the transplant, after recognized tick bites or exposures to [...]

The evolution of SARS-CoV-2 during the COVID-19 pandemic has raised interest in evolving disease manifestation and associated severity since early reports of its emergence in December 2019 (1). As SARS-CoV-2 [...]

Introduction Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services. Methods A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014-2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data. Results Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service-less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015. Discussion Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels., Author(s): Rhonda Stephens [sup.1] , Rocio Quinonez [sup.2] , Kim Boggess [sup.3] , Jane A. Weintraub [sup.4] Author Affiliations: (1) grid.410399.6, 0000 0004 0457 6816, Regional Public Health Dentist, Oral [...]

Infections with Salmonella spp., a leading cause of hospitalizations and death among persons with foodborne illness in the United States, are most often associated with contaminated poultry or eggs (1,2). [...]

BACKGROUND: Polybrominated diphenyl ethers (PBDEs) are persistent, bioaccumulative, and endocrine-disrupting chemicals. OBJECNVES: We used handwipes to estimate exposure to PBDEs in house dust among toddlers and examined sex, age, breast-feeding, [...]

Objectives. We identified factors associated with testing HIV positive in a prison system performing voluntary HIV testing on inmates and estimated the number of undetected HIV cases to evaluate the efficacy of risk-factor-based HIV testing. Methods. We used logistic regression to estimate associations between HIV serostatus and HIV risk behaviors, mental health, coinfection status, and sociodemographic characteristics for prisoners entering the North Carolina Department of Correction from January 2004 through May 2006. We estimated the number of undetected HIV cases on the basis of age-, gender-, and race-specific HIV prevalences among prisoners and in the state. Results. Nearly 3.4% (718/21 419) of tested prisoners were HIV positive. The strongest risk factors for infection among men were having sex with men (odds ratio [OR]=8.0), Black race (OR=6.2), other non-White race (OR=7.4), and being aged 35 to 44 years (OR = 4.1). The strongest risk factor among women was Black race (OR=3.8). Among HIV-positive prisoners, 65% were coinfected with HCV. We estimated that between 24% (223) and 61% (1101) of HIV cases remained undetected. Conclusions, The associations between HIV serostatus and a variety of factors highlight the potential limitations of risk-factor-based HIV testing in prisons, as do the high number of potential undetected HIV cases. doi: 10.2105/AJPH.2007.133389)

The implementation and the advantages of a statewide system for coronary reperfusion for the treatment of ST-segment elevation myocardial infarction (STEMI) are studied. The program is found to be very effective, as it helps in providing quality care to the patients.

North Carolina health statistics are often tabulated by race as a means of measuring health disparities. Many of North Carolina's racial minority groups have worse outcomes than the majority white […]

The prevalence of type 2 diabetes is increasing in the United States, particularly among minority individuals. Primary prevention programs for diabetes must be designed to address the beliefs of the populations they target. Little research has investigated the beliefs of those who do not have diabetes. This analysis uses in-depth interviews collected from Latino immigrants, not diagnosed with diabetes, living in a rural US community. Structured by the explanatory models [EM] of Illness framework, this analysis delineates the EMs of diabetes in this community. A significant number of the participants had little knowledge and few beliefs about diabetes. The EMs of those with knowledge of diabetes were varied, but several beliefs were widely held: (a) diabetes is a serious disease that is based on heredity or is inherent in all persons, (b) diabetes can result from several factors, including strong emotions and lifestyle characteristics (an unhealthy diet, not taking care of oneself), (c) beliefs about strong emotion and the importance of blood are related to diabetes causes, symptoms and treatment, and (d) a major and undesirable outcome of diabetes is weight loss. These results provide information for the design of health programs for the prevention of type 2 diabetes. Keywords: Diabetes: Minority health; Latinos/Hispanic; Explanatory models; Health beliefs; USA

A semipermanent exhibition on health and healing experiences in North Carolina is discussed. The exhibition, which opened in April 1998, features sections on natural, domestic and institutional settings related to health and healing.

Objectives. This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina. Methods. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care. Results. Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people. Conclusions. In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage. (Am J Public Health. 1995;85:1384-1390), Costs appear to pose more of a barrier to obtaining health care for elderly rural North Carolina residents than distance to care. Four thousand residents aged 65 and older residing in one of five North Carolina counties responded to a survey. All but one county was rural. No resident lived more than 90 minutes drive from a major medical center. Rural residents were more likely to be black, low income, and to have Medicaid coverage rather than Medicare or private insurance compared with residents of the urban county. Twenty-five percent of rural residents versus 14% of urban residents reported putting off health care because of cost, despite the fact that only 5% of rural and 3.5% of urban residents lacked Medicare coverage. Ten percent of rural residents versus 6% of urban residents reported putting off care because of transportation problems.

The study examines the continuum of care services for the elderly in rural areas of North Carolina, US, to ascertain whether the traditional view that care is better in urban areas is correct. Data from the North Carolina Division of Aging was used, including fiscal and state finance for 1988-89. The study looked at the different types of services offered in institutions, at home and in the community and examined expenditure/resource information in relation to demographic aspects, such income and race. The main conclusion was that rural community provision is highly variable.

EPIDEMIOLOGISTS HAVE LONG ESPOUSED the idea of health agencies studying community health problems. As noted by Schuman in 1963, " . . . health agencies on the firing-line should be […]

Objectives. The public health significance of intestinal parasitism among migrant farmworkers has been poorly defined. We report a three-part study in which we attempted to provide population-based estimates and identify risk factors for infection. Methods. Parasite prevalence and incidence were estimated from two cross-sectional studies and a longitudinal study. We used questionnaires and clinical measurements such as hematocrits to examine risk factors and health effects. Results. In the 1987 convenience sample (n = 265), parasite prevalence ranged from 28% among the US born to 86% among the Central American born, with no significant difference between the prevalence of pathogens among US-born (14%) and Mexican-born (24%) subjects (P = .12, [chi.sup.2] test). High prevalences were also found in the 1988 random sample. An annual incidence of 9.5% (n = 74) was demonstrated in 1988. Symptoms such as abdominal pain were associated with infection, and lower hematocrits were associated with hookworm infection (P = .02, t test). Conclusions. Infection with intestinal parasites appears to be an occupational hazard of farmwork, necessitating improved working and living conditions and greater clinical awareness. (Am J Public Health. 1992;82:1258-1262)

LOW BIRTH WEIGHT is a serious problem in the United States, especially in the southeastern region. Much of the reduction in neonatal mortality in the last 15 years has been […]

A Model Program for PRoviding Health Services for Migrant Farmworker Mothers and Children AN ESTIMATED 3 MILLION MIGRANT AND SEASONAL farmworkers and their dependents spend each winter planting and harvesting […]

All locatable subjects (n = 94) for whom tuberculosis prevalence had been determined in an earlier study were tested with purified protein derivative (PPD) and control antigens, sputum sampling, and chest x-rays. Of the 46 who had been tuberculin negative (confirmed with control antigens) 3 years earlier, 2 had developed active tuberculosis in the interim and 14 (30%) were tuberculin positive. All had been engaged continuously in migrant farmwork. Lack of access to health care, an institutional feature of migrant farmwork, was significantly associ ated with primary infection. (Am J Public Health. 1994;84:1836-1838), Tuberculosis may be more common among migrant farm workers and among African-Americans than among the general populace, especially in North Carolina. In 1991, researchers tested 46 migrant workers who had tested negative for tuberculosis in 1988. Of the 46, there were two new active cases of tuberculosis and 12 other positive skin tests. Twenty-two percent of the workers said they had had no health care in the three years between the two tests. Sixty-one percent said their employers had denied access to health care required by law. The agricultural lobby in North Carolina has blocked workers' compensation coverage in the state and opposed the 1984 state law that prohibited peonage and slavery. Federal agencies such as the Centers for Disease Control and Prevention consistently underestimate rates of tuberculosis among farm workers and among African-Americans.

Children in families eligible to receive Aid to Families with Dependent Children (AFDC) were found to have substantially higher mortality rates than non-AFDC children. The disparity seems to be greater for Whites than for non-Whites. These results suggest the presence of social class differentials in access to and use of health care and related services and facilities, in exposure to environmental risks, and in knowledge of injury control measures. (Am J Public Health. 1992;1131-1133)

* Context.--Hereditary benign intraepithelial dyskeratosis (HBID) is a rare autosomal dominant disorder characterized by elevated epibulbar and oral plaques and hyperemic conjunctival blood vessels. The condition is predominantly seen in Native Americans belonging to the Haliwa-Saponi tribe located in northeastern North Carolina. Objective.--To determine whether HBID can be diagnosed using cytologic preparations of the conjunctiva, and whether the cytologic findings correlated with the genetic linkage involving a duplication in chromosome 4 (4q35). Design.--Cytologic preparations from conjunctival brushings in patients afflicted with HBID and from unaffected blood relatives with normal conjunctivas were compared in a masked fashion. Cytologic observations were correlated with molecular genetic analyses. Results.--Papanicolaou-stained preparations from the conjunctiva showed the typical cytologic features of HBID, including rounded squamous epithelial cells with dense homogenous orange cytoplasm and hyperchromatic, pyknotic, or crenated nuclei. All cases with the diagnostic cytologic findings of HBID had a duplication in chromosome 4 (4q35). Conclusion.--HBID is an entity with distinct clinical, histopathologic, and genetic features. The results of this study indicate the diagnosis can also be supported in an appropriate clinical setting when adequate epibulbar cytology preparations are obtained and the characteristic genetic attributes are present. (Arch Pathol Lab Med. 2008;132:1325-1328), Hereditary benign intraepithelial dyskeratosis (HBID) (Mendelial Inheritance of Man [MIM] identification 127600) is a rare autosomal dominant disorder characterized by elevated epithelial plaques located on the ocular and oral mucous [...]

Watch out for tuna burgers. In North Carolina, over a period of 8 months in 1998-99 (JAMA 2001;285:1327-30) 22 people developed symptoms of histamine poisoning soon after eating tuna (as [...]

This multi-method, qualitative study addresses the question: How do mass media images and messages about love, sex and relationships interact with what teens learn about sexuality at home, in school, and from their friends? Using the Adolescents' Media Practice Model introduced by Steele & Brown (1995) as a starting point, this study seeks to extend our understanding of the media's role in shaping adolescents' values, attitudes, and beliefs about sex by factoring in some of the contexts that intersect with media practice. Data generated through focus groups, media journals, room tours, and in-depth interviews with middle school and high school teens suggest that ethnicity, gender, class status, and developmental stage influence media practices in important ways. Identity--teens' sense of themselves and others--affects the media they like best, how they interact with that media, and how they apply media matter in their everyday lives., Publication of North Carolina's first statewide survey of adolescent sexual behavior revealed that a majority of Tar Heel teens were engaging in sex while in high school, and many were [...]

We report a case of rickettsialpox from North Carolina confirmed by serologic testing. To our knowledge, this case is the first to be reported from this region of the United [...]