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Dentists in western NC brush up on skills in new pilot program to better care for underserved

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Dentists in western NC brush up on skills in new pilot program to better care for underserved


By Anne Blythe

Amanda Stroud has a ardour for public well being — an enthusiasm that’s so palpable lots of her friends in dentistry describe it as contagious.

Because the dental director at AppHealthCare, which serves Ashe, Alleghany and Watauga counties, Stroud is acquainted with the challenges of offering oral well being care to many within the western a part of the state.

Too usually, dentists on the federally certified well being middle she’s affiliated with wind up having to refer sufferers who want  knowledge tooth extractions, root canals or different sophisticated oral well being procedures to different practitioners.

Most of the sufferers are economically deprived and have transportation challenges or work schedules that make it tough to maintain such appointments. Generally they find yourself in emergency rooms with harmful infections as a result of they waited too lengthy to get care.

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With that in thoughts, Stroud started to pose inquiries to oral well being care suppliers throughout the state a number of years in the past about how she and her colleagues may keep away from having to make so many referrals, which offered yet one more entry impediment to well being care.

“I began what I name ‘water cooler conversations,’” Stroud stated throughout a latest telephone interview.

These conversations introduced a stream of concepts from a variety of people who resulted in a “mini residency” pilot program launched in late March by the North Carolina Oral Well being Collaborative and the Mountain Space Well being Training Heart, or MAHEC.

Attending to the nitty gritty

Zachary Brian, a dentist with a twin appointment on the UNC Chapel Hill Adams Faculty of Dentistry and the Gillings Faculty of World Public Well being, was one of many early movers and shakers behind the concept. He was director of the oral well being collaborative on the time.

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Steve Cline, interim vice chairman of the collaborative and a dentist with an in depth background in public well being, is enthusiastic concerning the partnership with MAHEC and the potential to increase the prototype statewide.

The purpose is to assist prepare “safety-net dentists,” those that take care of a inhabitants that usually lacks personal dental insurance coverage and is unable to pay out of pocket for oral well being providers.

Stroud and two different western North Carolina dentists from security internet amenities are within the first cohort to obtain hands-on scientific coaching with classroom instruction.

“She was one of many first to say, ‘Can’t we do extra?’ ” Cline recalled in a latest telephone interview. “We’re attempting to get these dentists snug with doing these procedures. We’re hoping if this works, we are able to do extra of those in different elements of the state.”

Lack of suppliers

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In 2020, information launched by the federal Well being Sources and Companies Administration, confirmed that 98 of North Carolina’s 100 counties have been designated Dental Well being Skilled Scarcity Areas. Counties are given such designations once they don’t have sufficient oral well being professionals to satisfy the wants of all the county.

A number of the county options that contribute to such a classification embody geographic, transportation and financial challenges, in keeping with the oral well being collaborative.

Though Orange and Stokes counties have been the one two that didn’t meet the definition, some counties akin to Mecklenburg and Wake have been designated scarcity areas even when elements of the county had sufficient dentists to satisfy wants of a swath of the inhabitants.

Additional complicating the image is how few dentists settle for Medicaid and underinsured sufferers. Even when they do, in keeping with public well being dentists, it’s usually a restricted quantity due to low Medicaid reimbursement formulation.

Between 35 p.c and 40 p.c of dentists in North Carolina take part in both Medicaid or the Kids’s Well being Insurance coverage Program, or CHIPS.

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That places stress on well being facilities such because the one the place Stroud and others work to are inclined to the customarily extra sophisticated wants of sufferers whose visits to a dentist usually are not routine. A number of the youngsters they see have by no means been to a dentist.

Although the dentists within the amenities have been by dental college at universities and been taught most of the procedures in class, in the event that they don’t do knowledge tooth extractions, root canals or different sophisticated procedures often of their day-to-day apply, they may lack the boldness to supply such care.

Amadeo Valdez, director of the MAHEC common dentistry residency program, stated such procedures might be intensive. The mini residency program is about greater than determining tips on how to give dentists in his facility the instruments to do extra.

“You get to know your limitations,” Valdez stated, including that members get to search out that out with the security internet of a extra specialised supplier by their facet.

Stroud, Blaire Mirmow, a dentist at Western North Carolina Group Well being Companies and Smile America Companions, and Mark Snelson, a dentist at Western North Carolina Group Well being Companies, confirmed a willingness to be taught through the first weekend of the four-weekend program.

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Whereas many dentists take Fridays off, the three have been on the MAHEC Biltmore Campus in Asheville.

“These guys have been as open as a sponge to get as a lot as they might.” Valdez stated.

A pebble’s ripple impact

The trouble to create a unbroken training program to assist dentists in federal and group well being facilities was gaining momentum a number of years in the past, then COVID-19 created havoc with many plans.

The creators weren’t idle through the pandemic, although.

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“It took a really very long time to work by all of the legalities,” Katherine Jowers, chair of MAHEC’s Division of Dentistry and Oral Well being and affiliate professor of the College of North Carolina Adams Faculty of Dentistry, stated in a telephone interview.

Though the pilot challenge just isn’t a college accredited program, it has been arrange and carried out to adapt with requirements of the American Dental Affiliation Persevering with Training Recognition Program.

The mini residency was designed, Jowers stated, as one through which the members may spend a lot of the week caring for the underserved individuals of their areas.

“Normally these docs are actively working towards, and even paying off loans, so going again for a residency isn’t within the playing cards,” Jowers stated in a information launch about this system. “Offering them with a ‘mini residency’ in a single space of apply, over just a few weekends, offers them a longitudinal studying alternative with each didactic and scientific experiences.”

On April 14 and 15, Jowers stated, the chosen dentists will apply suturing and tooth extraction on hog jaws.

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Even earlier than taking part in that class, Stroud stated she already is healthier knowledgeable. “I really feel extra empowered to maneuver ahead,” Stroud stated.

Stroud lives by the creed to “Do all the nice you’ll be able to, by all of the measures you’ll be able to, in all of the methods you’ll be able to, in all of the locations that you would be able to, to all of the individuals you’ll be able to.” The coaching periods, she hopes, will permit her and others to do much more good towards night out the entry disparities in high quality oral well being care.

“It’s like placing just a little pebble within the pond and watching the ripple impact,” Stroud stated.

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North Carolina

WATCH: Steamy and Stormy in North Carolina on Friday, Heat Advisory in the eastern Triad

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WATCH: Steamy and Stormy in North Carolina on Friday, Heat Advisory in the eastern Triad


Friday, August 2: High humidity remains Friday with highs reaching into the 90s and feels like temperatures expected near 100 degrees. A Heat Advisory for the heat index reaching between 105 to 107 degrees is in effect from 11 a.m. Friday until 8 p.m. in the easter Piedmont Triad. Spotty to scattered storms may also bring a severe threat for the afternoon. Storms that do become severe may bring damaging wind and hail.



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Body of 20-year-old North Carolina man recovered after 400-foot fall at Grand Canyon National Park

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Body of 20-year-old North Carolina man recovered after 400-foot fall at Grand Canyon National Park


GRAND CANYON NATIONAL PARK, Ariz. — The body of a North Carolina man who fell 400 feet (122 meters) near a scenic viewpoint on the South Rim of Grand Canyon National Park has been recovered, authorities said Thursday.

Park rangers said they received a report about a park visitor falling from the Pipe Creek Vista around 10:30 a.m. Wednesday. They said the body of Abel Joseph Mejia, 20, of Hickory, was later recovered about a quarter-mile from the overlook.

Park officials said Mejia accidentally fell when he was near the edge of the rim. The National Park Service and the Coconino County medical examiner’s office are investigating.

Authorities said park staff encourages visitors to stay on designated trails and walkways, keep a safe distance of at least 6 feet (1.8 meters) from the edge of the rim and stay behind railings and fences at overlooks.

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‘Very competitive’: Inside the Kamala Harris campaign’s plan to flip NC, defy history

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‘Very competitive’: Inside the Kamala Harris campaign’s plan to flip NC, defy history


Kamala Harris’ new presidential campaign views North Carolina not just as a potential bonus prize on the electoral map this fall, but the possible linchpin in her path to victory against her Republican rival, former President Donald Trump.

Democrats started spending money early on in a state they insisted they could win in the presidential contest. Now senior campaign advisers tell McClatchy that Harris’ replacement of President Joe Biden as the presumptive Democratic nominee has not only scrambled the race, but the map as well, raising the odds that Americans will be waiting Election Night on the results from North Carolina and Arizona — not just Pennsylvania and Wisconsin — to learn who has won the White House.

A senior campaign official said that North Carolina Gov. Roy Cooper’s decision on Monday night, publicly withdrawing himself from consideration to join the ticket as Harris’ vice president, had no impact on the calculus driving their strategy in the state.

That strategy, officials said, has been fueled instead by internal data focused on the kinds of new voters moving into the state, modeling the electorate and their propensity to vote, and examining special election and off-year election results — data that holds regardless of Cooper’s choice and that campaign officials believe is far more predictive than head-to-head polling conducted months in advance.

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Vice President Kamala Harris arrives for a rally during a campaign stop at Westover High School on Thursday, July 18, 2024 in Fayetteville, N.C.

Vice President Kamala Harris arrives for a rally during a campaign stop at Westover High School on Thursday, July 18, 2024 in Fayetteville, N.C.

And all of that data is telling Harris’ advisers that North Carolina’s fast-changing electorate will make for a “very competitive” race in November, the official added.

“I don’t really view it as a Blue Wall path, or a Southern path, or a Western path. I don’t think that’s how people should think about this. There are seven or-so states, all of which have been extremely close cycle after cycle,” Dan Kanninen, battleground state director for the Harris campaign, said in an interview.

“They’ve been effectively toss-ups,” Kanninen added. “So I think all seven of those are gonna be close. The difference is, we have built an infrastructure designed to win a close race. The Trump campaign has not.”

DATA DRIVING CONFIDENCE

The Biden campaign — now transformed into the Harris campaign — has made frequent stops in North Carolina. Harris will make her eighth visit of the year and her first as a presidential candidate to the state next week, and will bring her yet-to-be-announced running mate to Raleigh with her.

On paper, Harris faces an uphill battle in a state that has gone for a Democratic candidate for president only twice in the last 50 years: for Jimmy Carter in 1976, and Barack Obama in 2008.

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Since the last presidential election, North Carolina Republicans have grown their registration numbers by 156,000, while Democrats have shed 126,000 registrants, according to the North Carolina State Board of Elections – numbers that on their face appear to challenge Harris in her quest to exceed Biden’s 2020 performance, when he lost the state to Trump by 1.3% of the vote, or 74,000 votes, his narrowest loss that year.

That is just the continuation of a long trend that began in 2016, when Democrats held a voter advantage of nearly 645,000 over Republicans, said Matt Mercer, communications director for the North Carolina Republican Party.

“If you want to talk about the impact that Donald Trump has had in North Carolina,” Mercer said, “it’s Democrats shedding half a million voters to either Republicans or unaffiliated voters. That is a stark repudiation of a party that essentially controlled North Carolina for a century.”

But the Harris campaign told McClatchy and N&O their data indicates voter trends across the state are working in their favor, with 57% of newly registered voters in North Carolina since 2020 being millennial age or younger, 34% identifying as Black, Hispanic, Asian American or Pacific Islander, and 38.7% being registered as unaffiliated with either party — three cohorts that are increasingly breaking for Harris in their polling.

Campaign leadership is drilling down at the county level on which districts saw Nikki Haley — Trump’s strongest and most moderate challenger in the Republican primary — overperform her statewide total, with 25% or more of the GOP vote, including in New Hanover, typically seen as a state bellwether, and Union, an historically conservative area.

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Even still, Kanninen said registration numbers don’t necessarily predict “the electorate that will show up in the fall,” noting the campaign is planning an aggressive push to maximize the state’s one-stop voting system, where residents can turn up at a polling site both to register and vote at the same time.

“What I will tell you is that the on-the-ground enthusiasm that we see in North Carolina has been incredibly strong — maybe historic — in the past week, and we’ve had a campaign that’s been built to capitalize that, in a way the Trump campaign has simply been absent,” Kanninen said. He pointed to a gathering to train volunteers in Greenville days after Harris entered the race that drew nearly 100 people — a relatively sizable crowd in a small city that surprised the campaign.

While both Hillary Clinton, the 2016 Democratic nominee, and Biden both ultimately invested in North Carolina, neither did so until much later in the election cycle, Kanninen noted, placing those campaigns further behind in building the infrastructure he said would be needed to win. The Biden-Harris campaign has been investing in the state since February.

Building out early has allowed the campaign to reach out to a key voting bloc — rural Black voters — earlier than they would have otherwise, and also begin their effort to “cut the margins” of Trump’s support among moderate Republicans and “middle partisans” in rural counties, Kanninen said.

“We put into place infrastructure early — leadership teams on the ground in February and March, building robust teams throughout the spring, now to the point of having 150 staff in North Carolina that will get much, much bigger before the end of the summer,” Kanninen said. “We’re at scale, and building to a greater scale, so that when people start paying much closer attention after the convention and beyond, we’ll have the people, the resources, the volunteers to capitalize on that and drive it, which really matters in a close race.”

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ROBINSON ‘MADE POSSIBLE’ BY TRUMP

Confident that the data supports a potential victory, Harris’ campaign has settled on a clear strategy in the state: tying Trump to the Republican candidate for governor, Lt. Gov. Mark Robinson.

North Carolinians have a long history of “ticket-splitting,” choosing candidates of different parties down ballot. But Kanninen argued that Robinson was a creature of Trump’s making, indelibly tied to the former president.

“I don’t think it’s a one-off that Mark Robinson exists in a vacuum from Donald Trump. I think he is made possible by Donald Trump,” Kanninen said.

“Donald Trump endorsed him, and vice versa. He spoke at the convention,” Kanninen added. “And I think there’s no escaping the fact that the sort of politics you see from Robinson looks, feels and sounds just like Donald Trump. And I think that will be on the ballot.”

The Harris campaign believes that Robinson’s record — calling LGBTQ+ Americans “filth,” stating he would not compromise on abortion restrictions and quoting Hitler on social media — will prove toxic to moderate Republicans, Republican women and independents, recreating the coalition that challenged Trump and supported Haley in the GOP primary.

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“Those voters are really turned off by that sort of toxic MAGA rhetoric, and Mark Robinson is a direct throughline to Donald Trump. They see that as a sort of MAGA ticket, so to speak,” Kanninen said. “I think that is a winning playbook for people who are new to the state, but do not ascribe to those kinds of politics.”

Mercer said the state Republican Party is prepared for the attacks. “It’s a campaign, right? Both sides do their best to work to define their opponent,” he said.

But the Trump campaign does appear to be taking threats to its hold on North Carolina seriously, taking out a television ad buy in the state starting Thursday.

“I think you’re always looking at solidifying your position,” Mercer said of the ad buy, “and, despite having a strong position, you don’t want to get complacent, either. So it’s treating it with the appropriate levels of concern.”

Neither side is expressing exuberant confidence. Kanninen, for his part, acknowledged the race for the state would come down to the wire.

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“There’s some political gravity that I think is true in a place like North Carolina, or in some of the other core battlegrounds,” he added. “They’ve been really close races, they’re destined to be really close races.”

McClatchyDC reporter David Catanese contributed reporting.



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