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At least 19 recordsLinked to original sources

An evaluation of EMS educational programs in North Carolina. North Carolina Community College System Emergency Medical Science Curriculum Improvement Project Advisory and Steering Committees.

OBJECTIVES: To determine whether EMS educational programs in North Carolina adequately prepare paramedics, and whether there is additional value to an associate of applied science (AAS) degree education in EMS when compared with traditional certificate training programs. METHODS: Surveys were developed and distributed to EMS administrators, AAS paramedics, and certificate paramedics. The administrators were asked to rate the performance of both AAS and certificate paramedics in the areas of preemployment evaluation, patient-care skills, and non-patient-care duties. The paramedics were asked to rate their preparation for specific responsibilities within those three categories. All of the participants were asked to describe the requirements for employment within their EMS systems, and any preferences given to AAS paramedics. RESULTS: The administrators rated both AAS and certificate paramedics as good or excellent in all three categories. The paramedics also rated their preparation for patient care as good or excellent. The certificate paramedics rated their preparation for eight non-patient-care duties significantly lower than did the AAS paramedics. The eight areas were: 1) verbal communication, 2) reading ability, 3) leadership, 4) conflict resolution, 5) computer skills, 6) teaching skills, 7) personal health/hygiene, and 8) Occupational Safety and Health Administration (OSHA) compliance. Fewer than half of the EMS administrators reported preferences in hiring (46.2%) or promotion (39.6%) for AAS paramedics, but at least half (50.0% and 54.2%) of the AAS paramedics worked in systems offering such preferences. CONCLUSIONS: While administrators and paramedics believe the current EMS educational programs in North Carolina adequately prepare students to function as paramedics, there are identifiable areas that require additional emphasis. There appears to be additional value to an AAS education when compared with traditional certificate EMS educational programs.

Administrative Personnel↗

Making a difference in infant survival: evidence-based actions to reduce tobacco exposure during pregnancy and infancy in North Carolina.

North Carolina faces major challenges in dealing with smoking and its consequences during pregnancy and infancy. Evidence-based strategies exist to help pregnant and parenting smokers to quit, to discourage young people from becoming smokers and to reduce exposure of infants to SHS. North Carolina is making progress in implementing these strategies, but more infant lives could be saved each year if the state adopted a more comprehensive approach to addressing tobacco use by improving cessation services for pregnant and parenting smokers, reimbursing clinicians for providing cessation services, increasing state excise taxes on tobacco products, establishing statewide help or quitline services and adopting tobacco-free school policies. These proven strategies can make a difference.

Evidence-Based Medicine↗

The TEAM (Total Exposure Assessment Methodology) Study: personal exposures to toxic substances in air, drinking water, and breath of 400 residents of New Jersey, North Carolina, and North Dakota.

EPA's TEAM Study has measured exposures to 20 volatile organic compounds in personal air, outdoor air, drinking water, and breath of approximately 400 residents of New Jersey, North Carolina, and North Dakota. All residents were selected by a probability sampling scheme to represent 128,000 inhabitants of Elizabeth and Bayonne, New Jersey, 131,000 residents of Greensboro, North Carolina, and 7000 residents of Devils Lake, North Dakota. Participants carried a personal monitor to collect two 12-hr air samples and gave a breath sample at the end of the day. Two consecutive 12-hr outdoor air samples were also collected on identical Tenax cartridges in the backyards of some of the participants. About 5000 samples were collected, of which 1500 were quality control samples. Ten compounds were often present in personal air and breath samples at all locations. Personal exposures were consistently higher than outdoor concentrations for these chemicals and were sometimes 10 times the outdoor concentrations. Indoor sources appeared to be responsible for much of the difference. Breath concentrations also often exceeded outdoor concentrations and correlated more strongly with personal exposures than with outdoor concentrations. Some activities (smoking, visiting dry cleaners or service stations) and occupations (chemical, paint, and plastics plants) were associated with significantly elevated exposures and breath levels for certain toxic chemicals. Homes with smokers had significantly increased benzene and styrene levels in indoor air. Residence near major point sources did not affect exposure.

Air Pollutants, Occupational↗

New patterns of community care: coordinated services for dually diagnosed adults in North Carolina.

North Carolina has developed coordinated care systems for people dually diagnosed with both a mental retardation and a different major mental illness. In response to a class action lawsuit, the state has become a leader in treatment of this form of dual diagnosis. Systems of care for this "Thomas S class" operate in each of 41 area programs for mental health, developmental disabilities, and substance abuse. Networks of care among leaders in mental health and developmental disability promote the coordination of health, housing, social, and vocational services. A survey of 100 area program leaders finds extensive cooperation and a variety of services provided and contracted for, both within and beyond each area program, particularly among developmental disability specialists. Cooperation among leaders is associated with service variety and inter-organizational linkages. The extent of relationships among provider organizations is associated with better access to care. Best practice includes a single portal of entry and inter-agency councils.

Community Mental Health Services↗

Hazardous waste. A North Carolina dilemma.

North Carolina, along with the rest of the nation, faces a number of dilemmas regarding management of hazardous waste: 1. North Carolina businesses and industries generate a lot of hazardous waste, but the state lacks the capacity to manage it. For many, it has been acceptable to ship the waste to other states for treatment, storage, and disposal. Some of the receiving states have indicated that they are no longer willing to serve as the "dumping ground" for North Carolina. 2. North Carolina, along with the EPA, has identified a number of hazardous waste sites now listed on the NPL. However, the state was excluded from its regional agreement with Alabama, South Carolina, Kentucky, and Tennessee in January 1991, meaning that Superfund monies may be withdrawn and that cleanup won't be completed at these sites. 3. Every year the country produces at least 260 million tons of hazardous waste--more than one ton for every man, woman, and child. Those opposed to constructing hazardous waste treatment facilities charge that businesses and industries should reduce their hazardous waste to zero or near zero, and they charge that the state is not doing enough to encourage waste reduction. North Carolina's hazardous waste regulations already require programs to minimize the amounts of waste generated by industries, but for most industrial processes, it is impossible to reduce the generation of waste to zero. However, industries must continue to reduce their waste through source reduction and recycling. Hazardous waste and toxic materials do pose a risk to human health and the environment unless properly managed.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental Health↗

North Carolina Institute of Medicine Task Force on the North Carolina Nursing Workforce (2004).

North Carolina is indeed fortunate to have avoided many of the extreme shortages of nurses reported in other states. Yet, there are important developments on the horizon that have the potential to cause such shortages. Taking action today to expand the production of new nurses, enhance their education, augment school-to-work transitions, and improve the nursing workplace environment can help reduce the likelihood of a future nursing workforce crisis. Some steps will require new financial commitments either from public or private sources. Others will require a renewed commitment on the part of employers, educators, regulators and the nursing community. However, these steps are necessary if we are to recruit and retain well-prepared and motivated nurses who are needed to meet our healthcare needs now and in the future. Nursing, especially nursing at the bedside in hospitals and in long-term care, requires increasingly sophisticated technical skills and continues to demand intellectual, physical and emotional energy beyond what would be required in many other professions and occupations. It is hoped that the recommendations offered here will help focus the efforts of legislators, educators, employers, the nursing community, trade associations, foundations and the public at large to ensure an adequate supply of well-trained nursing personnel for the future.

Adult↗