Southern Medical Journal最新文献

{"title":"Autism Spectrum Disorder in Child and Adolescent Inpatient Psychiatric Settings: Presentation, Clinical Strategies, and Application of the Double Empathy Problem.","authors":"Arielle M Morris, Rachel G Kasdin, Salonee Shah, Isabela Hill, Kevin H Bao, William Singletary, Timothy Rice","doi":"10.14423/SMJ.0000000000001857","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001857","url":null,"abstract":"<p><p>Children and adolescents with autism spectrum disorder (ASD) have presentations and clinical needs in the inpatient psychiatric (IP) setting that are distinct from those of their neurotypical peers. This narrative review describes the clinical presentations and IP environmental management strategies for youth with ASD. Evidence suggests that traditional IP care teams often are poorly equipped to address the multifaceted specific needs of this population. The benefits for a multifaceted approach in youth IP units with an increased focus on family collaboration, youth communication, and various psychosocial modalities are described, as are specialized IP units for patients with ASD. We suggest that an established framework called the double empathy problem can be used to better understand the complexities of interpersonal interactions and psychosocial environments within IP units. Future research may integrate the double empathy problem into understandings of caring for youth with ASD in IP contexts to optimize pharmacological interventions and enhance therapeutic milieus.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"528-532"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting a Housing Support Navigator Program at a Safety Net Hospital.","authors":"Kain Kim, Bhavin B Adhyaru","doi":"10.14423/SMJ.0000000000001858","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001858","url":null,"abstract":"<p><strong>Objectives: </strong>Homelessness is associated with poor health outcomes and increased healthcare utilization. The existing roles of social workers and case managers often are inadequate in addressing the complexity of patients' housing-specific needs. Our intervention aimed to pilot a novel housing support navigator (HSN) role within the existing electronic medical record workflow at one large safety-net hospital.</p><p><strong>Methods: </strong>This innovation encompassed 877 adult patients with defined housing needs at Grady Health System (GHS), a large academic safety-net hospital in Atlanta, Georgia. All social workers and community health workers at GHS were surveyed to quantify the demand for housing resources, prioritize housing needs, and elucidate current barriers to housing placement. These results informed the creation of a new HSN role that could use the regional Homeless Management Information System to evaluate the housing needs of referred patients and connect them to community resources. All referrals to the HSN were tracked over the period 2021- 2022. A point-in-time count was subsequently conducted at GHS to capture patient needs and characterize the extent of sheltered and unsheltered patients experiencing homelessness. Program evaluation included descriptive data from each HSN referral documenting demographic data and discharge location.</p><p><strong>Results: </strong>Nearly half of the patients referred to the HSN were connected with a housing resource such as a nonprofit organization, shelter, or rooming house. Key challenges in piloting the HSN program included management of timely referrals during brief inpatient stays and securing buy-in from stakeholders.</p><p><strong>Conclusions: </strong>This early innovation report hopes to inform other institutions aiming to incorporate a housing navigator role into their care for unhoused patients. Future studies will assess for the impact of HSN utilization on long-term patient outcomes and healthcare utilization.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"547-551"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Effective Work-Life Integration for Women in Academic Medicine: An Innovative Initiative for Physicians and Scientists with Caregiving Responsibilities.","authors":"Krasimira Mikhova, Katherine Clifton, Namrata Patel, Janice Hanson, Emily L Podany, Lisa Gong, Aditi Ramakrishnan, Rakhee K Bhayani","doi":"10.14423/SMJ.0000000000001856","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001856","url":null,"abstract":"<p><strong>Objectives: </strong>Integrating the professional responsibilities of academic medicine with the demands of caregiving is a challenge that often weighs disproportionately on women. Supporting women caregivers in academia has been shown to benefit their professional development and prevent burnout. An initiative to support women faculty and trainees with caregiving responsibilities was created within the Department of Medicine (DOM) at Washington University School of Medicine in St. Louis called DOM Moms & Caregivers.</p><p><strong>Methods: </strong>A needs assessment was completed by 111 women within the DOM, facilitating the formation of DOM Moms & Caregivers. Three events were held in the first year of the group, including informational and community-building events. Feedback on programming was collected in the form of surveys or interviews after each event and at the end of the academic year. Interviews were recorded, transcribed, and coded to identify themes.</p><p><strong>Results: </strong>Thirty-six unique individuals engaged in the events, ranging from trainees to faculty, encompassing women caring for infants to aging parents, and with varied abilities and levels of family support. The unifying themes in feedback included the desire for more social engagement and space for community building through shared stories and experiences. Participants requested variations of programming format and time, such as creating space to connect in small groups within larger events.</p><p><strong>Conclusions: </strong>DOM Moms & Caregivers will continue to evolve to support the diverse needs of the women within the department. Recent initiatives have included continuing to host informational events and creating a directory to connect trainee and faculty caregivers for advice and support.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"566-569"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Puberty Education Program for Girls and Their Caregivers in Arkansas.","authors":"Sally B Clark, Kathryn C Stambough, Laura L Hollenbach, Nirvana Manning, Everett F Magann, Cari A Bogulski","doi":"10.14423/SMJ.0000000000001863","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001863","url":null,"abstract":"<p><strong>Objective: </strong>In the United States, few elementary schools offer puberty education, leaving teaching girls about puberty-related body changes and hygiene practices to other sources. When school-based puberty education programs are taught, they often are inconsistently implemented and occur too late to help prepare girls before menarche. Rigorous evaluation of puberty education programs is lacking, but it is needed to improve these programs. To address this need, our team conducted a series of puberty education training workshops designed for and marketed to girls ages 8 to 13 years old and their caregivers. Our goal was to evaluate the implementation of this program for the purposes of quality improvement.</p><p><strong>Methods: </strong>We used a mixed-methods approach using pre- and postevent surveys in four in-person puberty education training sessions to assess the program's effectiveness in improving knowledge, comfort, and preparedness for puberty among adolescent females. We also deductively analyzed open responses provided by program participants and extracted themes and subthemes.</p><p><strong>Results: </strong>Our results indicated that increases in participants' understanding of puberty and female anatomy, as well as increases in participants' puberty preparedness, comfort with discussing puberty with caregivers, and comfort with puberty-related hygiene practices. We also identified several themes in the open responses, including positive workshop experience, learning/understanding, and communication, as well as training format feedback and discomfort and negative view of training content.</p><p><strong>Conclusions: </strong>Overall, our mixed-methods results provide support for this implementation of a puberty education program. Future puberty education sessions will incorporate findings such as discomfort and disgust, particularly from the younger girls, as part of continuous quality improvement efforts for puberty education training sessions.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"522-527"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Innovation Curriculum in Internal Medicine Residency Training.","authors":"Kamal Shair, Emily Wolf, Himesh Zaver, Aman Bali, Benjamin McCormick, Justin Call, Jaimie Grega, Turner Gibson, J Colt Cowdell, Abdallah El Sabbagh, Mary Hedges","doi":"10.14423/SMJ.0000000000001860","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001860","url":null,"abstract":"<p><strong>Objective: </strong>Innovation in medicine places the needs of our patients first by developing new solutions to healthcare challenges; however, formal education in innovation has not been previously established in Internal Medicine (IM) residency training programs. A novel innovation curriculum was implemented in the IM residency training program at an academic medical institution in the southeastern United States during the academic year 2022-2023.</p><p><strong>Methods: </strong>The innovation curriculum was divided into three phases: Inspire, Acquire, Apply. The Inspire phase included presentations by innovators sharing their journey. The Acquire phase included presentations to help take an idea to implementation, including artificial intelligence (AI), three-dimensional (3D) printing, patents, and entrepreneurship. The Apply phase supported residents in implementing their own innovative project or idea, including preparation for local think tanks and engagement with institutional resources. Interactive presentations were scheduled during noon conference, which all residents were scheduled to regularly attend. A precurriculum survey was obtained before implementation to assess residents' baseline knowledge and experience in medical innovation, and a postcurriculum survey was obtained at the end of 1 academic year to assess resident perspective and knowledge after one cycle of the curriculum experience.</p><p><strong>Results: </strong>At baseline, the majority of residents had never received formal education in innovation or entrepreneurship in medicine or patent filing. Few reported formal education on AI, 3D printing, virtual reality hardware/software, or medical application development. All respondents believed that innovation is important to clinical practice, and the majority believed that knowledge in innovation and entrepreneurship is important to being a well-rounded physician.</p><p><strong>Conclusions: </strong>IM residents identified innovation as an important aspect of clinical training, yet they had limited exposure to and confidence in their knowledge and application of innovation and entrepreneurship in medicine. A curriculum dedicated to teaching innovation during IM training is important and can address this unmet need. Based on resident survey feedback, this curriculum has been adjusted to increase teaching in AI as well as expand the individual mentorship model for residents interested in taking their innovative idea to implementation.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"561-565"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak Investigation of <i>Mycobacterium abscessus</i> Infections.","authors":"Katie Gravagna, Lauren DiBiase, Lisa Teal, Sharon Thompson, Cynthia Culbreth, Tara Sotak, Jessica Wiley, Greg Griffin, David J Weber, Emily Sickbert-Bennett","doi":"10.14423/SMJ.0000000000001864","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001864","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"542-546"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preexposure Prophylaxis Provided in the Emergency Department: Clinician Perspectives.","authors":"Sarah M Guess, Ava Roth, Mirinda Ann Gormley, Prerana Roth, Jessica Hobbs, Alain H Litwin, Moonseong Heo, Phillip Moschella","doi":"10.14423/SMJ.0000000000001861","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001861","url":null,"abstract":"<p><strong>Objectives: </strong>The southern United States is facing a burden of human immunodeficiency virus (HIV) diagnoses, with 52% of new diagnoses made in the region. The emergency department (ED) is an important access point for patient care, especially given nationwide shortages in primary care appointments. The objective of our study was to assess ED (ED) clinician knowledge regarding preexposure prophylaxis (PrEP), the perceived barriers to initiation of PrEP, and clinician willingness to initiate it in the ED.</p><p><strong>Methods: </strong>An institutional review board-approved survey was distributed using an internal e-mail listserv to all ED physicians and advanced practice clinicians within a southern academic level I trauma center ED. The survey was available throughout August 2023. Descriptive statistics described survey responses.</p><p><strong>Results: </strong>Fifty-six Emergency Medicine clinicians participated, for a response rate of 25.0%. Nearly one-fourth of clinicians reported not prescribing PrEP because they believed they lacked knowledge of or familiarity with the medication. Whereas 52 believed that PrEP could be integrated in the ED, 54 mentioned a potential barrier to implementation. The most common barrier to integrating PrEP into the ED was lack of information/training; additional barriers included time and staff constraints. More than half expressed a lack of confidence (58.9%) assessing PrEP eligibility. When asked how likely they would be to discuss linkage to PrEP, 52.8% answered confident or very confident and 52.8% were not confident or slightly not confident.</p><p><strong>Conclusions: </strong>Despite recognition of the utility of prescribing PrEP in the ED, clinicians identified multiple barriers to providing this essential component of health care. Findings indicate, however, that Emergency Medicine clinicians would be willing to prescribe PrEP with appropriate education and connection to care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"556-560"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Use Disorder and Pharmacological Treatment in Southwestern North Carolina: NC SID Database 2000-2020.","authors":"Beth Harmer, Brook Alemu, Aaron Brown, Hind A Beydoun","doi":"10.14423/SMJ.0000000000001862","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001862","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of the study were to provide a descriptive assessment of patient and hospital characteristics among individuals with an opioid use disorder (OUD) diagnosis in North Carolina and the seven western North Carolina counties and to identify rates of selected psychiatric/physical health outcomes associated with OUD and treatment gaps in medications for opioid use disorder (MOUD).</p><p><strong>Methods: </strong>Using the State Inpatient Database (SID), analyses were conducted to identify OUD and MOUD-related discharges between 2000 and 2020. Descriptive statistics and rates of OUD per 1000 discharges were calculated. Statistical significance for rates of OUD and non-OUD cases was determined using 95% confidence intervals. Variables indicating OUD diagnosis, MOUD participation, and comorbidities were identified.</p><p><strong>Results: </strong>The seven selected counties in North Carolina had a total of 396,183 hospitalizations between 2000 and 2020. Apart from Macon County, the overall county-level prevalence rates of OUD were consistently higher than that of the state. Compared with North Carolina, the median hospital length of stay and hospital charges for OUD patients in the seven counties were consistently higher than those for non-OUD discharges. Significant MOUD treatment gaps were observed in the seven counties.</p><p><strong>Conclusions: </strong>The impact of the opioid epidemic is still pervasive in North Carolina, particularly in the seven western countries. The high rates of OUD and comorbid conditions in tandem with treatment shortages pose serious public health threats in these rural communities. Policies, funding, and programmatic efforts should prioritize the expansion of MOUD and other treatment efforts, including crisis services, harm reduction services, and recovery programs. Public health needs assessment that involves both patients and stakeholders should be carried out to deliver targeted health services and deploy necessary resources in this medically underserved region.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"533-541"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Provider and Public Health Challenges: Decreasing \"Us\" versus \"Them\".","authors":"Gail Price-Wise, Ella Caroline Duffy, Katerina Benson, Yanna Willett, John Dunn, Charles H Hennekens, Panagiota Kitsantas, Maria Carmenza Mejia","doi":"10.14423/SMJ.0000000000001854","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001854","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"576-577"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Awareness and Care: Addressing Military Sexual Trauma among Women Veterans.","authors":"Joyce A Akwe, Daniel P Hunt","doi":"10.14423/SMJ.0000000000001855","DOIUrl":"10.14423/SMJ.0000000000001855","url":null,"abstract":"<p><p>Military sexual trauma (MST) significantly impacts the health and well-being of women veterans in the US military, where women constitute 16.3% of active-duty service members. Despite policy advancements, MST remains prevalent, with profound implications for mental and physical health. MST encompasses sexual assault and harassment, affecting 38% of women and 4% of men in the military. It is linked to higher rates of posttraumatic stress disorder, depression, substance use disorders, and physical health issues such as cardiovascular disease and chronic pain. In addition, MST survivors face social functional impairments, including difficulties in family relationships, occupational performance, and educational achievements. The military environment, characterized by close living quarters and hierarchical power dynamics, exacerbates the risk and consequences of MST. Survivors often experience institutional betrayal and fear of retaliation, hindering reporting and access to support. Effective interventions must address these unique challenges, emphasizing trauma-informed care, social support, and systemic changes to promote gender equity and accountability. Leveraging technology, such as mobile applications and online interventions, can enhance access to care and support for MST survivors. Comprehensive prevention and intervention strategies, coupled with policy reforms and cultural shifts within the military, are crucial for mitigating the impacts of MST and supporting the recovery and well-being of women veterans. The objective of this narrative review is to examine the health impacts and systemic challenges of MST among women veterans, advocating for trauma-informed care and policy reform.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 8","pages":"517-521"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}