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PubMed1999

The modifiable factors contributing to leading causes of death in South Carolina.

In 1996, there were 34,035 deaths in South Carolina. Almost 70 percent of these deaths were due to chronic diseases. There are known ways to prevent chronic diseases from developing or at least delay their developmental process, thereby lengthening years of life. The purpose of this paper is to report modifiable risk factors for mortality related to leading causes of death. The top ten causes of death in South Carolina were obtained from the South Carolina Department of Health and Environmental Control. Estimates of the number of deaths due to certain modifiable risk factors were made using results of a study published by McGinnis and Foege. The percentage of deaths due to each cause was adapted to South Carolina death certificate data from the national estimates. Results indicate that small modifications in individual lifestyles could prevent or delay nearly 50 percent of deaths in South Carolina annually. Tobacco use, diet and physical activity, and misuse of alcohol contribute to the largest number of deaths. Other modifiable behaviors contributing to the 50 percent mortality are microbial agents, toxic agents, firearms, sexual behavior, motor vehicle accidents, and illicit use of drugs. The implication in these findings is that these risk factors for mortality are mainly modifiable. There are many causes of death that may be delayed due to these modifiable risk factors. By looking at preventable causes of death, rather than focusing on traditional causes of death, it becomes clear that prevention strategies are critically important.

Cause of Death↗
PubMedDate not supplied

Traumatic occupational fatalities in South Carolina, 1989-90.

Death certificates for South Carolina for 1989 and 1990 were examined to identify deaths resulting from injury incurred in the workplace. There were 277 deaths in that category in the 2-year period, an average yearly rate for traumatic occupational fatalities of 8.84 per 100,000 workers. The groups of industries with the highest fatality rates were transportation-communication-utilities, construction, and agriculture-fishing-forestry. The leading causes of death were injuries from motor vehicle crash, homicide, and falls. The traumatic occupational fatality rate for men was about 13 times greater than that for women; however, a much higher proportion of women died from homicide on the job. The findings in general reflect trends reported in other studies. The death rates for workers in South Carolina for 1989-90, however, were higher than national averages for 1980-88. National data for 1989-90 were not available for comparison. The data suggest that more effective injury prevention efforts need to be applied to such causes of on-the-job injury as motor vehicle crash, homicide, and falls. Those three categories accounted for more than 56 percent of all traumatic occupational fatalities in South Carolina in 1989 and 1990. Motor vehicle crash prevention efforts particularly are needed in the transportation-communication-utilities industries. The findings show that particular efforts need to be directed to the retail trade category for prevention of homicide and to the construction industry for prevention of falls.

Accidents, Occupational↗
PubMedDate not supplied

The Management Academy for Public Health: the South Carolina experience.

In the late 1990s, the South Carolina Department of Health and Environmental Control (SCDHEC) was faced with the challenges of a workforce that was not prepared in public health; the impending loss of significant agency expertise, leadership, and institutional knowledge through retirement; the lack of available and accessible training; and continuing state budget cuts. Preparedness for bioterrorism and other public health emergencies was also of concern, a need made more urgent after 2001. To respond to current and emerging public health challenges, the SCDHEC had to have a workforce with the knowledge and skills necessary for the delivery of essential public health services. To address these challenges, the department partnered with the University of North Carolina in the pilot of the Management Academy for Public Health. The Management Academy is now integrated into the South Carolina workforce development strategy, and 199 staff members and 22 community partners have graduated from the program. Along with increased knowledge, skills, and abilities of individual staff and increased organizational and community capacity, a significant result of South Carolina's experience with the Management Academy for Public Health is the development of a training program for emergency preparedness modeled on the Management Academy. This highly successful program illustrates the replicability of the Management Academy model.

Humans↗
PubMed1992

Willingness to use corporal punishment among school administrators in South Carolina.

Administrators of 221 South Carolina public elementary and middle schools were surveyed regarding behaviors appropriate for corporal punishment. Analysis indicated that aggressive acts by students, both mild and severe, were rated appropriate for corporal punishment, and these were not typically seen as appropriate for a psychologist's intervention. Rather, psychologists were seen as useful for character problems such as lying, cheating, and tantrums.

Child↗
PubMed1991

Mosquitoes, leeches and medicine in Charleston, South Carolina (1670-1861).

Charleston, South Carolina, USA has a rich history extending over 300 years. The plantations of the Carolina Low Country produced rice, indigo and cotton. Mosquitoes, which abounded in the wetlands, transmitted diseases such as Yellow Fever and epidemics occurred almost every year. African slaves, however, had a natural immunity to the disease and, together with the climate and the nature of the work, this shaped the economic and social system of the area. Physicians offered all sorts of cures to deal with the medical problems of the area and apothecaries also sold many nostrums including leeches. Newspaper advertisements reveal that these bloodsuckers were extensively used for many decades.

Animals↗
PubMed1993

A multidisciplinary public-academic liaison to improve public mental health services in South Carolina.

The state of South Carolina is in the process of transforming its core services for people with severe and persistent mental illnesses to a community-based model. This paper describes the planning and on-going implementation of an alliance of academic programs, mental health advocates, and service providers forged by the state department of mental health in 1990. Goals of the consortium are to develop graduates who possess the needed knowledge, skills, and attitudes to work in the public sector; to undertake collaborative research to improve services in that sector; and to maintain the effectiveness and satisfaction of current workers in the public system. The authors describe activities of the consortium to achieve these goals and give examples of enhanced academic involvement in the public mental health system as a result of the consortium's activities.

Community Mental Health Services↗
PubMed1989

Trends in public knowledge and attitudes about AIDS, South Carolina, 1987-1988.

The South Carolina Department of Health and Environmental Control AIDS Program assessed the state population's knowledge and attitudes about AIDS and HIV transmission in 1987 and 1988. Each year approximately 1,800 adults were selected by a random 3-stage cluster design and asked seventeen questions by telephone about AIDS and HIV. Questions addressed attitudes, general knowledge, HIV transmission by casual contact, HIV transmission by sex and IV drug contact, and HIV transmission by blood donation and transfusion. Over 90 percent of respondents were knowledgeable about HIV transmission by high risk behaviors addressed in the questionnaire. Respondents were less knowledgeable about HIV transmission by casual contact (12 to 41 percent gave incorrect answers), HIV testing (45 to 48 percent gave incorrect answers), and transmission by blood donation (43 to 52 percent gave incorrect answers). In general, a higher percentage of correct responses were given in 1988 than in 1987. In regard to responses measured by this survey, we conclude that: (1) there is a high level of knowledge in the state about transmission by high risk behaviors, (2) there are still many misconceptions about casual transmission, HIV testing, and blood donation, and (3) there was improvement in knowledge about AIDS and HIV from 1987 to 1988.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Adolescent sexual activity and pregnancy in South Carolina: trends, risks, and practice implications.

Using South Carolina vital record data, we examined current trends in teenage pregnancy and the related pregnancy outcome risks for the period 1977 to 1984. A review of the eight-year trends in the pregnancy outcomes of teenaged mothers (less than 18 years old) indicated a significant decline (P less than .05) in the percentage of total South Carolina live infants born to teenaged mothers. While a significant increase in the teenage abortion ratio was detected, the proportion of total South Carolina pregnancies (estimated by the summation of live births, fetal deaths, and induced abortions) among teenagers significantly decreased. Compared to mothers 18 to 34 years old, teenaged mothers were nearly twice as likely to deliver prematurely, while one half as likely to receive adequate prenatal care. Their offspring were at increased risk of low birth weight and had increased fetal and infant death rates. Thirty percent of pregnancies in teenaged mothers were terminated by induced abortion, and 22% of the teenage pregnancies were to mothers aged 15 or younger, emphasizing the importance of not delaying discussions with teens of the issues of adolescent sexuality and contraception.

Abortion, Induced↗
PubMed1999

Patient characteristics associated with hospitalizations for ambulatory care sensitive conditions in South Carolina.

BACKGROUND: Data for this study came from South Carolina 1995 Hospital Inpatient Encounter Data Base. The population figures were 1995 South Carolina population estimates. METHODS: We examined patient sociodemographic characteristics and costs associated with adult and pediatric ambulatory care sensitive condition (ACSC) hospitalization in South Carolina. Bivariate statistical comparisons were done to test the differences between ACSC and non-ACSC groups in specific sociodemographic characteristics. Logistic regression determined the relative significance of individual characteristics to hospitalizations for ACSC. Cost/charge ratios were used to estimate costs associated with ACSC hospitalizations. RESULTS: Nonwhites, low-income individuals, and those residing in more rural areas had significantly more ACSC hospitalizations than their respective counterparts (i.e., whites, high-income individuals, and those residing in metropolitan statistical areas). Individuals without a primary care physician were more likely to be hospitalized with ACSC. Ambulatory care sensitive condition hospitalization charges were 12% of total hospital charges for adults and 20% for children. The average cost per ACSC hospitalization was $3,929 for adults and $1,818 for children. CONCLUSION: Providers can rapidly assess needs and barriers faced by vulnerable population groups by using regularly collected hospital discharge data at the national, state, and community level.

Adolescent↗
PubMed1998

The physician assistant in South Carolina.

This article provides an overview of the physician assistant profession in general and in South Carolina. Information on the educational program at the Medical University of South Carolina and the results of a study of the satisfaction and contribution of the physician assistant as perceived by a sample of South Carolina supervising physicians is included. The study demonstrates that the physician assistant makes an important contribution to health care in South Carolina.

Health Care Surveys↗
PubMed1997

Ticks, Lyme disease spirochetes, trypanosomes, and antibody to encephalitis viruses in wild birds from coastal Georgia and South Carolina.

Ticks and blood samples were collected from wild birds mist-netted on St. Catherine's Island, Georgia, and at the Wedge Plantation in coastal South Carolina in 1994 and 1995. Immature stages of 5 species of ixodid ticks were recovered from 10 of 148 (7%) birds belonging to 6 species in Georgia, whereas 6 ixodid species were recovered from 45 of 259 (17%) birds representing 10 avian species in South Carolina. Borrelia burgdorferi sensu lato was isolated from 27 of 120 (23%) screened ticks (Ixodes scapularis and Ixodes minor) recovered from South Carolina birds, but from none of 16 screened ticks removed from Georgia birds. This spirochete was also isolated from 1 of 97 (1%) birds in South Carolina. In 1995, neither eastern equine encephalitis (EEE) virus nor St. Louis encephalitis (SLE) virus was isolated from any of 218 bird sera screened, but serum neutralizing antibodies were found to EEE virus in 4 of 121 (3%) sera and to SLE virus in 2 of 121 (2%) sera from South Carolina. No antibody to either virus was detected in 51 avian sera screened from Georgia. Trypanosomes (probably Trypanosoma avium) were isolated from 1 of 51 (2%) birds from Georgia and from 13 of 97 (13%) birds from South Carolina. Our data suggest that some wild birds may be reservoir hosts for the Lyme disease spirochete and for encephalitis viruses in coastal Georgia and South Carolina and that migrating birds can disperse immature ticks infected with B. burgdorferi.

Animals↗
PubMed1998

The medical workforce in South Carolina: its current status and a look to the future.

Available data suggest that South Carolina does not have the same degree of problems with its medical workforce as is present in many other areas of the country. While there may be too many specialists and not enough primary care physicians and while maldistribution is also a problem in some areas of the state; it appears that the total number of physicians and the size and focus of the medical education system in South Carolina are about what they should be. Furthermore, the graduate medical education system in South Carolina is currently changing on its own to emphasize more primary care and less specialist training. With careful monitoring, coordination of effort, and specific initiatives to address specialty, maldistribution and curricular issues, the state's medical education programs can take action to build on their current strengths and assure a medical workforce of sufficient size, type, and skill to meet the future needs of the citizens of South Carolina.

Education, Medical↗
PubMed2001

Arbovirus surveillance in South Carolina, 1996-98.

Arboviruses isolated and identified from mosquitoes in South Carolina (USA) are described, including new state records for eastern equine encephalitis virus (EEE), St. Louis encephalitis virus (SLE), Flanders virus, Tensaw virus (TEN), and a variant of Jamestown Canyon virus (JC). Mosquitoes were collected at 52 locations in 30 of 46 South Carolina counties beginning in June 1996, and ending in October 1998, and tested for arboviruses. Of 1,329 mosquito pools tested by virus isolation (85,806 mosquitoes representing 34 mosquito species or complexes), 15 pools were positive. Virus isolations included EEE from 1 pool each of Anopheles crucians complex and Culex erraticus; a variant of JC from 1 pool of An. crucians complex; a California serogroup virus from 1 pool of Aedes atlanticus/tormentor; TEN from 5 pools of An. crucians complex and 1 pool each of Culex salinarius and Psorophora ciliata; Flanders virus from 1 pool of Culiseta melanura; and Potosi virus from 1 pool each of Aedes vexans, Coquillettidia perturbans, and Psorophora columbiae. Of 300 mosquito pools tested by antigen-capture assay for EEE and SLE (14,303 mosquitoes representing 16 mosquito species or complexes), 21 were positive for EEE and I was positive for SLE. Positive EEE mosquito pools by antigen-capture assay included An. crucians complex (14 pools), Anopheles punctipennis (1 pool), Anopheles quadrimaculatus (1 pool), Cq. perturbans (4 pools), and Cs. melanura (1 pool). One pool of Cx. salinarius was positive for SLE by antigen-capture assay. Arbovirus-positive mosquito pools were identified from 12 South Carolina counties, all located in the Atlantic Coastal Plain, and from 4 of 8 Carolina bays surveyed.

Aedes↗
PubMed2006

Characterization of Fe(III)-reducing enrichment cultures and isolation of Fe(III)-reducing bacteria from the Savannah River site, South Carolina.

The Savannah River site, South Carolina (SRS), has been subjected to heavy metal and radionuclide contamination. Dissimilatory Fe(III)-reducing bacteria, by reducing insoluble Fe(III) to soluble Fe(II), may enhance contaminant mobility through subsurface environments. In order to investigate populations of the indigenous iron-reducing microbes from the SRS, duplicate enrichment cultures were initiated using a 10% inoculum of 7 sediment/soil samples, and serial dilutions were made into Wolfe's minimal salts media amended with 50 mM Fe(III) floc, 10 mM acetate and 0.01% yeast extract. Terminal restriction fragment length polymorphism (T-RFLP) analysis was used to generate fingerprints of the cultures and track changes in the microbial communities through the dilutions. Cluster analysis determined the relatedness of individual fingerprints. Initial enrichment cultures exhibited complex fingerprints consisting of many individual T-RF peaks, and demonstrated low similarity between sites. After four serial dilutions the fingerprints were less complex and clustered at higher similarities. Several individual T-RF peaks became dominant in a majority of the fingerprints. Cloning and sequence analysis revealed the presence of microbes closely related to Clostridium and Bacillus species and to known iron reducers such as Geobacter species and Pantoea agglomerans. Several Fe(III)-reducing isolates related to Aeromonas, Bacillus and Clostridium species were obtained.

Aeromonas↗
PubMed1999

Ticks of South Carolina (Acari: Ixodoidea).

County and host records are reported for 19 species of ticks from South Carolina: Amblyomma americanum, Amblyomma maculatum, Amblyomma tuberculatum, Aponomma latum, Boophilus annulatus, Boophilus microplus, Dermacentor albipictus, Dermacentor variablis, Haemaphysalis leporispalustris, Ixodes affinis, Ixodes brunneus, Ixodes cookei, Ixodes marxi, Ixodes minor, Ixodes scapularis, Ixodes texanus, Ixodes woodi, Rhipicephalus sanguineus, and Ornithodoros capensis. Ixodes woodi is recorded from South Carolina for the first time. Boophilus annulatus and Boophilus microplus probably no longer exist in South Carolina, and Aponomma latum is an exotic species that is not established in South Carolina. Brief notes follow each species.

Animals↗
PubMed2004

Physical activity trends in South Carolina, 1994-2000.

OBJECTIVES: During the 1990s, physical activity recommendations and surveillance methods were developed in an attempt to increase and monitor, respectively, regular physical activity prevalence rates. For this article, Behavioral Risk Factor Surveillance System data were analyzed to determine whether regular physical activity proportions in South Carolina adults changed from 1994 to 2000. The physical activity prevalence rates for South Carolina were compared with national rates and Healthy People 2000 goals to measure progress. The rate of physical activity counseling by physicians and other health professionals was also analyzed from 1998 to 1999. METHODS: Total subjects included 10,495 adults ages 18 years and older from South Carolina and 545,445 from the remainder of the United States. Using random-digit dialing procedures in 1994, 1996, 1998 and 2000, the two most frequent types of leisure-time physical activity performed in the past month were identified. For activities listed, the frequency (days/wk) and duration (minutes/d) were obtained. Linear regressions were performed on regular physical activity and inactivity for the total population and by gender, race, age, and body mass index (BMI). Data pertaining to whether or not a physician or other health professional had provided physical activity counseling were also obtained for 1998 and 1999. RESULTS: From 1994 to 2000, the proportion of South Carolina adults participating in regular leisure time physical activity significantly increased (10.8%). Interestingly, the prevalence of regular physical activity in the rest of the nation remained unchanged during this time. Although significant increases were observed in nearly all subgroups, physical activity prevalence rates for South Carolina adults lagged behind national levels and did not meet Healthy People 2000 goals. Physical activity counseling by physicians and other health professionals increased from 1998 (24.1%) to 1999 (30.4%). CONCLUSIONS: While it is not known what factors influenced regular physical activity from 1994 to 2000, they seem to have been equally effective in South Carolina adults of both genders, both races, regular and overweight status, and nearly all age groups. Despite these positive trends, additional efforts are needed to develop and implement effective community and primary care physical activity interventions that facilitate improvements among the nearly two-thirds of South Carolina adults who do not participate in sufficient physical activity to reap significant health benefits.

Adult↗
PubMed2001

Ancestral proportions and admixture dynamics in geographically defined African Americans living in South Carolina.

We analyzed admixture in samples of six different African-American populations from South Carolina: Gullah-speaking Sea Islanders in coastal South Carolina, residents of four counties in the "Low Country" (Berkeley, Charleston, Colleton, and Dorchester), and persons living in the city of Columbia, located in central South Carolina. We used a battery of highly informative autosomal, mtDNA, and Y-chromosome markers. Two of the autosomal markers (FY and AT3) are linked and lie 22 cM apart on chromosome 1. The results of this study indicate, in accordance with previous historical, cultural, and anthropological evidence, a very low level of European admixture in the Gullah Sea Islanders (m = 3.5 +/- 0.9%). The proportion of European admixture is higher in the Low Country (m ranging between 9. 9 +/- 1.8% and 14.0 +/- 1.9%), and is highest in Columbia (m = 17.7 +/- 3.1%). A sex-biased European gene flow and a small Native American contribution to the African-American gene pool are also evident in these data. We studied the pattern of pairwise allelic associations between the FY locus and the nine other autosomal markers in our samples. In the combined sample from the Low Country (N = 548), a high level of linkage disequilibrium was observed between the linked markers, FY and AT3. Additionally, significant associations were also detected between FY and 4 of the 8 unlinked markers, suggesting the existence of significant genetic structure in this population. A continuous gene flow model of admixture could explain the observed pattern of genetic structure. A test conditioning on the overall admixture of each individual showed association of ancestry between the two linked markers (FY and AT3), but not between any of the unlinked markers, as theory predicts. Thus, even in the presence of genetic structure due to continuous gene flow or some other factor, it is possible to differentiate associations due to linkage from spurious associations due to genetic structure.

Africa↗