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Preventing the adverse health impacts of wildfire smoke involves helping people understand if they are at risk, and the actions they can take to limit exposure. Cooperation between land managers, public health officials, and the health care system could alert the public to take actions that reduce wildfire smoke-related health risks.Natural disasters have occurred more frequently in Eastern North Carolina in recent years. Evidence supports that repeated exposure to natural disasters may have lasting mental health impacts among vulnerable populations. Greater access to mental health services may aid in ensuring equitable access to needed care and promote resilience.Increasingly hotter temperatures threaten the environment and pose serious risks to human health. From contending with damaged crops and loss of work due to extreme weather to working in life-threateningly hot and humid temperatures, agricultural farmworkers are on the front lines of this harsh reality.This commentary is adapted from the North Carolina Climate Science Report, led by the North Carolina Institute for Climate Studies, drawing from climate science expertise across the state and peer-reviewed research to reach conclusions about the impact of climate change and associated extreme weather on our state.Over the past century, anthropogenic activities have resulted in high levels of greenhouse gases in our environment, creating a warming effect on the Earth. As a result, global temperatures have risen, shifting climatic zones, influencing weather patterns, and intensifying storms. These changes include heavy precipitation, drought, wildfires, hurricanes, heat waves, and coastal flooding. The impacts from this climatic activity continue to contribute negatively to our environment while influencing human health.In this special issue of the North Carolina Medical Journal, authors from universities, governmental agencies, and not-for-profit organizations address how the global impacts of climate change are affecting the health of communities across our beautiful state. This issue offers our readers research and real-life stories that underscore the need for keeping the issue of climate change at the forefront of public health for North Carolina. The information provided in these articles gives policymakers and health care providers a deeper understanding of the public health implications and challenges of climate change while highlighting the health risks to our most susceptible populations.Because there are no direct clinical symptoms or signs, the effects of climate change are difficult to assess at the individual level. However, an abundance of peer-reviewed climate health research studies provides overwhelming scientific evidence that climate change is impacting population health with generalizable results. Mitigation and adaptability strategies are necessary for reducing carbon emissions and building climate-resilient communities. Policymakers and health care providers are in key positions for educating others, helping protect our planet, improving health outcomes, and moving North Carolina toward more sustainable solutions.BACKGROUND Mailed at-home stool testing offers a promising strategy for overcoming barriers to colorectal cancer (CRC) screening in vulnerable populations. This paper evaluates the facilitators and barriers of successful implementation of a mailed fecal testing program among Medicaid populations within a health department setting.METHOD Interviews were conducted with key informants involved in intervention start-up and implementation tasks. The Consolidated Framework for Implementation Research (CFIR) was used to design the interview guide and structure the analysis. Axial coding was used to connect the themes to each other under the major categories of facilitators and barriers.RESULTS Overall, the process evaluation suggests that with strong partnerships, effective champions, and existing infrastructure, a large county health department can successfully implement a mailed fecal testing program targeted at Medicaid beneficiaries. [https://www.selleckchem.com/products/hada-hydrochloride.html Selleckchem HADA chemical] The identified facilitators and challenges to implementation provide important information for similar emerging programs.LIMITATIONS The sample size of this evaluation is small. Additionally, we are unable to discern whether participating stakeholders' responses represent the feelings of non-interviewed staff, program implementers, or participants. We were not able to collect data on patient perspectives of the intervention. The nursing staff and interns were not able to be included in the process evaluation. Lastly, the information taken from this process evaluation may not be applicable to organizations and systems with different attributes.CONCLUSION The process evaluation suggests strong partnerships, effective champions, and elegant program designs were key contributors to successful implementation of a CRC screening program targeted at Medicaid beneficiaries in a large county health department.BACKGROUND Women are less likely than men to be physically active and more likely to reduce their physical activity as they age. The objective of this research was to understand barriers that might prevent North Carolina women from being physically active after retirement as well as aspects of retirement that might facilitate a more physically active lifestyle to inform intervention strategies applicable to retired women.METHOD Semi-structured interviews were conducted with 15 recently retired women living in North Carolina. Interviews were recorded and transcribed. Content analysis was used to identify themes related to barriers and facilitators of physical activity after retirement.RESULTS Six themes were identified. One theme was the development of leisure-time physical activity habits over the lifespan. Five other themes described how physical activity after retirement was influenced by prior occupational physical activity, concurrent life transitions (e.g., becoming a caregiver), health, social support, and the community environment.LIMITATIONS Women in this study were active participants in community organizations, which might make their experiences unique from those of women who are not engaged with their communities. However, similarities in themes in this and other qualitative studies corroborate the broader transferability of findings.CONCLUSION Interventions to promote physical activity among retired North Carolina women should consider emphasizing health benefits of physical activity and improving walking environments and access to physical activity facilities. Local residents should be involved in intervention design to address unique barriers among women who retire from physically demanding jobs or become caregivers.