Prioritizing Oral Health: Oral Health IS Health!

How did we let the mouth get separated from the rest of the body? And more importantly, how do we put oral health back into overall health? This issue of the NCMJ highlights recent efforts to develop strategies to create an accessible, sustainable, and equitable care delivery system in North Carolina.

Community Oral Health Initiative: Driving value-based transformation in North Carolina.

CareQuest Institute for Oral Health's mission is to improve the oral health of all. One way to achieve this is through programmatic initiatives, which train dental clinics to provide equitable, integrated and accessible care for their communities. The Community Oral Health Transformation (COrHT) Initiative, allowed CareQuest Institute to collaborate with the North Carolina Oral Health Collaboration (NCOHC) and Blue Cross Blue Shield (BCBS) of North Carolina Foundation to implement and support the initiative in North Carolina.

The complexity of biological disturbance agents, fuels heterogeneity, and fire in coniferous forests of the western United States.

Forest biological disturbance agents (BDAs) are insects, pathogens, and parasitic plants that affect tree decline, mortality, and forest ecosystems processes. BDAs are commonly thought to increase the likelihood and severity of fire by converting live standing trees to more flammable, dead and downed fuel. However, recent research indicates that BDAs do not necessarily increase, and can reduce, the likelihood or severity of fire.

An Ecological Perspective on Living with Fire in Ponderosa Pine Forests of Oregon and Washington: Resistance, Gone but not Forgotten.

Wildland fires (WLF) have become more frequent, larger, and severe with greater impacts to society and ecosystems and dramatic increases in firefighting costs. Forests throughout the range of ponderosa pine in Oregon and Washington are jeopardized by the interaction of anomalously dense forest structure, a warming and drying climate, and an expanding human population. These forests evolved with frequent interacting disturbances including low-severity surface fires, droughts, and biological disturbance agents (BDAs).

Regional patterns of increasing Swiss needle cast impacts on Douglas-fir growth with warming temperatures.

The fungal pathogen, , causing Swiss needle cast (SNC) occurs wherever Douglas-fir is found but disease damage is believed to be limited in the U.S. Pacific Northwest (PNW) to the Coast Range of Oregon and Washington (Hansen et al.

Interactions of predominant insects and diseases with climate change in Douglas-fir forests of western Oregon and Washington, U.S.A.

Forest disturbance regimes are beginning to show evidence of climate-mediated changes, such as increasing severity of droughts and insect outbreaks. We review the major insects and pathogens affecting the disturbance regime for coastal Douglas-fir forests in western Oregon and Washington State, USA, and ask how future climate changes may influence their role in disturbance ecology. Although the physiological constraints of light, temperature, and moisture largely control tree growth, episodic and chronic disturbances interacting with biological factors have substantial impacts on the structure and functioning of forest ecosystems in this region.

The promise of data-driven care.

The growing adoption of electronic medical records and advances in health information technology are fueling an explosion of new health data. Expectations are high that new data resources will guide the transformation of the health care industry and positively influence population health. There have been challenges and opportunities at every turn, and progress has been slow, but mounting evidence suggests that better use of data is moving health care in the right direction.

All-hazards preparedness in an era of bioterrorism funding.

Objectives: All-hazards preparedness was evaluated in North Carolina's 85 local health departments (LHDs).

Methods: In regional meetings, data were collected from LHD teams from North Carolina's LHDs using an instrument constructed from Centers for Disease Control and Prevention's preparedness indicators and from the Local Public Health Preparedness and Response Capacity Inventory.

Results And Conclusions: Levels of preparedness differ widely by disaster types.

Evaluation of public health response to hurricanes finds North Carolina better prepared for public health emergencies.

Reviews of state public health preparedness improvements have been primarily limited to measuring funds expenditures and achievement of cooperative agreement benchmarks. Such reviews fail to assess states' actual capacity for meeting the challenges they may face during an emergency, as evidenced by activities undertaken during the various phases of a disaster. This article examines North Carolina's public health preparedness and response performance during two hurricanes, Hurricane Floyd in 1999 and Hurricane Isabel in 2003, as well as capacity building activities in the intervening years.

Development and implementation of a public health workforce training needs assessment survey in North Carolina.

Assessing the training needs of local public health workers is an important step toward providing appropriate training programs in emergency preparedness and core public health competencies. The North Carolina Public Health Workforce Training Needs Assessment survey was implemented through the collaboration of several organizations, including the North Carolina Center for Public Health Preparedness at the North Carolina Institute for Public Health, the outreach and service unit of the University of North Carolina School of Public Health, the Office of Public Health Preparedness and Response in the North Carolina Division of Public Health Epidemiology Section, and local health departments across the state.

Evaluation of metric precision for a riparian forest survey.

This article evaluates the performance of a protocol to monitor riparian forests in western Oregon, United States based on the quality of the data obtained from a field survey. Precision is the criteria used to determine the quality of 19 field and 6 derived metrics. The derived metrics were calculated from the field data.

First case of bioterrorism-related inhalational anthrax, Florida, 2001: North Carolina investigation.

The index case of inhalational anthrax in October 2001 was in a man who lived and worked in Florida. However, during the 3 days before illness onset, the patient had traveled through North Carolina, raising the possibility that exposure to Bacillus anthracis spores could have occurred there. The rapid response in North Carolina included surveillance among hospital intensive-care units, microbiology laboratories, medical examiners, and veterinarians, and site investigations at locations visited by the index patient to identify the naturally occurring or bioterrorism-related source of his exposure.