Southern Medical Journal最新文献

{"title":"Assessment of Outcomes of Rehabilitation Program for Socially At-Risk Patients.","authors":"Alexis Mulvaney, Jennifer Cline, Nicole Coleman, Sima A Desai, Elizabeth Hartzog, Jennifer Marrero, Katie Sewell, Kyle W Cunningham","doi":"10.14423/SMJ.0000000000001969","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001969","url":null,"abstract":"<p><strong>Objectives: </strong>Safety-net hospitals are crucial in providing health care regardless of patients' financial means; however, individuals with social risk factors often face challenges in accessing postacute rehabilitation services, leading to functional decline and extended hospital stays. The Bridge to Home program was developed to address these disparities by providing intensive rehabilitation within an acute care setting for patients who lacked access to traditional postacute services.</p><p><strong>Methods: </strong>This retrospective observational cohort study examined patients enrolled in the Bridge to Home program at a Level I trauma center from April 2019 to December 2022. Participants included adults with significant diagnoses requiring intensive therapy. Data on demographics, Activity Measure for Post-Acute Care scores, and equipment issued were collected from hospital records and analyzed to assess discharge dispositions, length of stay, and functional outcomes.</p><p><strong>Results: </strong>Of 175 patients, 72% were male, and 78% were underfunded or self-pay; 76% were successfully discharged home. Participants showed significant improvement in functional mobility, with 64% of participants scoring >42.9 points, indicating an increase likelihood for discharge home. More than $100,000 in equipment was provided to facilitate safe discharges.</p><p><strong>Conclusions: </strong>The Bridge to Home program successfully delivered intensive rehabilitation services to underserved populations, resulting in improved functional outcomes and high discharge home rates. Key factors contributing to success included consistent therapy intensity, targeted resources, and multidisciplinary collaboration. This study highlights the feasibility of implementing a multidisciplinary rehabilitation program within acute care settings, improving access and outcomes for socioeconomically disadvantaged patients. Similar programs could be established in other trauma centers to enhance rehabilitation access for patients with significant injuries.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 5","pages":"263-268"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821158","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":"Insurance Type Affects Access to Care for Young Football Athletes with Hip Labrum Tears.","authors":"Nathaniel Buchanan, Jackson Byrd, Clay A Rahaman, Mathew Hargreaves, Maxwell L Harrell, Dev Dayal, Elizabeth Powell, Gerald McGwin, Thomas B Evely, Eugene W Brabston, Amit M Momaya, Aaron J Casp","doi":"10.14423/SMJ.0000000000001964","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001964","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with Medicaid compared with private insurance have increased difficulty gaining access to orthopedic care. How insurance status affects access to care for young athletes (football; from here, all \"young athletes\" are football players) with hip labrum tears has yet to be assessed. The purpose of this study was to determine whether there is a difference in insurance acceptance rates for Medicaid versus Blue Cross Blue Shield (BCBS) for young athletes with a hip labral tear.</p><p><strong>Methods: </strong>Fifty orthopedic clinics across 10 states were contacted using a standardized script. Each clinic was called twice: once as a young athlete with BCBS and once with a young athlete with Medicaid, requesting an appointment for a hip labral tear. The primary outcome was appointment success. Secondary outcomes included barriers to scheduling and wait times. Statistical analysis was performed using chi-squared and Mann-Whitney <i>U</i> tests.</p><p><strong>Results: </strong>All clinics accepted BCBS insurance, whereas only 16 (32%) accepted Medicaid (<i>P</i><0.0001). Young athletes with BCBS successfully scheduled an appointment 100% of the time compared with only 24% for young athletes with Medicaid (<i>P</i><0.0001). Of the 34 clinics that did not accept Medicaid, 22 (65%) cited not accepting the insurance, and 11 (32%) required a referral. Among clinics that accepted both insurance types, there was no significant difference in median wait time (13 vs 14 days, <i>P</i>=0.44).</p><p><strong>Conclusions: </strong>For young athletes with hip labrum tears, it is more difficult to schedule appointments with Medicaid insurance compared with BCBS insurance. The main barrier to care with Medicaid for young athletes is requiring a primary care physician referral.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 5","pages":"269-273"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821200","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":"Interprofessional Workshop: An Impactful Approach to Introducing Interprofessional Education to Health Professions Students.","authors":"Nana A Garba, Rachel D Clarke, Catherine Coccia, Jamal Bracken, Lisa Roberts, Elizabeth Olafson, Maria De Los Santos, Lourdes Martin, Ana Rodriguez, Lynette F Alonso-Capote, Onelia Lage, Alejandra Ponce, Valeria Raventos, Jean Mead","doi":"10.14423/SMJ.0000000000001953","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001953","url":null,"abstract":"<p><strong>Objective: </strong>Incorporating interprofessional education (IPE) into healthcare education programs is essential for preparing future healthcare professionals to meet the demands of modern healthcare environments. This study evaluated whether a condensed IPE session can produce significant changes in student knowledge and attitudes toward interprofessional collaboration.</p><p><strong>Methods: </strong>The session comprised a pre-workshop session describing the training requirements and professional role of members of an interprofessional team, and an interactive IPE remote workshop on Zoom. An adapted version of the Interprofessional Attitudes Scale was used to assess changes in students' knowledge and attitudes after participation in an IPE program. The Wilcoxon signed rank test was used to assess the changes in responses from pretest to posttest.</p><p><strong>Results: </strong>There were 458 participants from eight disciplines who completed both the pre- and post-test included in the analysis. In general, there were significant improvements in knowledge and attitudes about interprofessional teammates and collaboration after participation in the IPE session (<i>P</i> <0.001).</p><p><strong>Conclusions: </strong>This study demonstrates that a well-designed IPE session can significantly enhance students' understanding of interprofessional roles and improve their attitudes toward teamwork and collaboration.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"185-190"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718106","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":"Impact of Medical School-Mandated Step 2 Deadlines on Student Well‑Being and Match Outcomes: A Medical Student's Perspective.","authors":"James R Burmeister","doi":"10.14423/SMJ.0000000000001948","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001948","url":null,"abstract":"<p><p>Because the US Medical Licensing Examination Step 1 (Step 1) has transitioned to pass/fail scoring, US Medical Licensing Examination Step 2 has emerged as a primary standardized metric in residency selection. In response, many medical schools have implemented hard deadlines for Step 2 completion before Electronic Residency Application Service (ERAS) submission. Although intended to streamline the application process and ensure timely examination completion, such mandates may unintentionally heighten student stress, jeopardize academic performance, and impair Match outcomes. This perspective offers a medical student's insight into the psychological and professional consequences of Step 2 deadlines and suggests policy recommendations to better align institutional goals with student wellness and success.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"195-196"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718082","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":"A Call for Revising Handicapped Parking Permits Categories to Include Extreme Weather Conditions.","authors":"Meghana Dumpa, Aseret Medina Vargas, Suzanne Minor","doi":"10.14423/SMJ.0000000000001937","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001937","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"207"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718090","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":"Reimagining Medical Educator Development: A Mixed-Methods Evaluation of KinetiC3, A Longitudinal, Character-Integrated Teaching Academy.","authors":"Kristina Kaljo, Austin Tubbs, Alexandra M Harrington, Vivian Dondlinger, Devarati Syam, Amy H Farkas","doi":"10.14423/SMJ.0000000000001958","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001958","url":null,"abstract":"<p><strong>Objectives: </strong>Medical educators often navigate professional isolation, identity dissonance, and limited institutional support, despite strong motivation for growth. KinetiC3 is a year-long cohort-based educator enrichment program that integrates character education with pedagogical development, informed by theories of transformative learning, self-determination, and social identity.</p><p><strong>Methods: </strong>We conducted a mixed-methods evaluation of 173 participants from 2018 to 2024. Quantitative data were drawn from retrospective review of demographic and professional milestones. Semistructured group interviews (n=16) explored participants' experiences and perceptions of program impact.</p><p><strong>Results: </strong>Quantitative career mapping revealed professional advancement, including promotion and entry into educator leadership roles. Thematic analysis of interview data identified five themes: role evolution through transformative educator identity development; recognition and application of character strengths reinforcing professional values and purpose; advancement into formal and informal leadership roles; cohort-based, cross-disciplinary collaboration supporting peer mentorship and sustained engagement; and benefit of longitudinal character-integrated enrichment in fostering professional fulfillment.</p><p><strong>Conclusions: </strong>This study captures the need to reimagine educator development beyond traditional skill-based programs. KinetiC3's longitudinal, values-driven model supports motivation, confidence, and a strengthened sense of belonging within the educational community. Institutions aiming to retain and empower educators should invest in structured, character-integrated development programs.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"179-184"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718177","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":"Travel Costs and Health Disparities: The Impact of Rurality and Social Vulnerability on Hand Therapy Access in Alabama.","authors":"Luke Anderson, Emily Hecox, Shelley Edwards, Marc E Walker","doi":"10.14423/SMJ.0000000000001952","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001952","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative hand therapy is important for recovery and enhanced functional outcomes following hand surgery. Access to this essential care is limited in Alabama, however, particularly for vulnerable populations in rural areas where public transportation is scarce. These challenges are further amplified for patients who are unable to drive due to their injuries. This study aimed to quantify disparities and barriers to certified hand therapy access in Alabama.</p><p><strong>Methods: </strong>Certified hand therapists in Alabama were identified through the Hand Therapy Certification Commission directory. Practice addresses were geocoded and paired with county center coordinates to calculate travel distances from each county center to the nearest certified hand therapist. These distances were then converted into one-way travel costs using Internal Revenue Service standard mileage rates. Counties were categorized by rurality using Rural-Urban Continuum Codes (RUCC) and assessed for social vulnerability using the Social Vulnerability Index (SVI), which considers socioeconomic, housing, and transportation factors. Statistical analyses, including <i>t</i> tests, χ² tests, and multivariate regression, were used to evaluate patterns and predictors of travel costs.</p><p><strong>Results: </strong>Alabama counties had a mean SVI of 0.67 ± 0.195-significantly higher than the national mean of 0.50 (<i>P</i><0.0001). More than 80% of Alabama counties rank in the most vulnerable 50% of US counties, with Shelby County being the only county in the least vulnerable quartile (SVI 0.116). In addition, 36 counties (53.7%) are classified as rural (RUCC 4-9). Both SVI and RUCC independently correlated with increased travel costs. Multivariate regression modeling revealed that each unit increase in RUCC was associated with a $3.43 increase in travel costs (<i>P</i><0.0001), and each 10% increase in SVI corresponded to a $1.64 increase in travel costs (<i>P</i>=0.006). These factors explained 56.4% of the variability in travel costs. Heatmaps visually highlighted higher travel costs in rural, socially vulnerable areas.</p><p><strong>Conclusions: </strong>Rural and socially vulnerable populations in Alabama face significant travel barriers to accessing certified hand therapy. The combined impact of geographic isolation and social vulnerability underscores the need for targeted interventions to ensure equitable access to postoperative care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"208-213"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718206","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":"Obesity, Body Fat Distribution, and Blood Pressure in Hispanic and Non-Hispanic Whites in a National Survey.","authors":"Deba Ede-Imafidon, Justyna Sienkaniec, Fady Tawfik, Richard F Gillum","doi":"10.14423/SMJ.0000000000001951","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001951","url":null,"abstract":"<p><strong>Objectives: </strong>Recent data from the National Health and Nutrition Examination Survey (NHANES) indicated that despite a higher prevalence of obesity in Hispanic women than non-Hispanic White women, their hypertension prevalence did not differ. Obesity and large upper arm (UA) circumference can affect the accuracy of BP readings. Anthropometric data were used to test the hypothesis that UA circumference was related to systolic blood pressure (BP), indicating possible inaccuracy of readings in either group.</p><p><strong>Methods: </strong>The data analysis was conducted using the NHANES 2017-March 2020 pre-coronavirus disease 2019 pandemic cycle. After excluding individuals under age 20 years, non-Hispanic Black participants, and others, the final analytic sample included (4092) non-Hispanic and Hispanic White adult females. Trained technicians measured height, weight, waist circumference, UA length and circumference, and three oscillometric systolic BP readings using four cuff sizes. Analyses accounted for the complex sampling design and weighting of the NHANES.</p><p><strong>Results: </strong>Compared with non-Hispanic White women, Hispanic women had lesser median height and UA length but a greater body mass index and UA circumference. Among women assigned to large cuffs, there were more Hispanics (21%), but among those assigned to extra-large cuffs, there were fewer Hispanics (10%) compared with White women. This was consistent with a more central distribution of body fat in Hispanic women. In regression analyses controlling for age, height, and weight, UA circumference was significantly associated with Hispanic ethnicity but was not associated with BP in Hispanics or Whites. Similar trends were seen in men.</p><p><strong>Conclusions: </strong>Despite having a higher body mass index, fewer Hispanics than non-Hispanic White women and men required extra-large BP cuffs. There was no evidence that bias in BP readings explained the lack of excess prevalence of hypertension in Hispanic women or men.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"157-160"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718053","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":"Personal Philosophies of Practice: Purposeful Guides for Patient Engagement.","authors":"William Ventres","doi":"10.14423/SMJ.0000000000001949","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001949","url":null,"abstract":"<p><p>At a time when many physicians feel frustrated and burned out, the author invites them to create their own personal philosophies of practice, statements that clarify the purposeful meanings they choose to instill in their work beyond the exigencies of their daily endeavors. Three tasks frame the process of creating a personal philosophy of practice: thinking about what purpose individual physicians attribute to the work of medicine; considering what core concepts steer their professional activities such that they, their patients, and the health of the public at large all benefit; and documenting their own personal philosophy of practice, with an eye toward the future. The author includes three example personal philosophies of practice to help guide readers' creative efforts.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"203-206"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718190","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":"Incidence and Impact of Atrial Fibrillation after Open Thoracotomy and VATS Pulmonary Lobectomy: A Single-Center Experience.","authors":"Amie Woolard, Daniel Davenport, Sibu Saha","doi":"10.14423/SMJ.0000000000001957","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001957","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to measure the incidence and impact of atrial fibrillation (AF) after open thoracotomy versus video-assisted thoracoscopic surgery (VATS) lobectomy at an academic medical center.</p><p><strong>Methods: </strong>With institutional review board approval, 899 patients who underwent a pulmonary lobectomy from January 2005 to December 2021 were included in this study. Postoperative AF (POAF) was defined by electrocardiography. Patients with a preoperative diagnosis of AF were excluded. Univariate analyses were conducted to identify risk factors and outcomes of POAF. Multivariate analyses were conducted to identify independent predictors and associated complications of POAF.</p><p><strong>Results: </strong>The overall incidence of AF was 9.2%. This incidence after open thoracotomy (13.0%) and VATS procedures (6.5%) was significantly different (<i>P</i>=0.001). An independent risk factor for POAF was age (odds ratio [OR] 1.05, <i>P</i><0.001). POAF significantly increased the average number of other complications (<i>P</i><0.001). Multivariate analysis revealed that postoperative acute respiratory distress syndrome (OR 3.94, <i>P</i>≤0.001) and atelectasis (OR 3.89, <i>P</i>=0.004) were independently associated with POAF. POAF did not affect in-hospital mortality (<i>P</i>=0.341). Patients with POAF had a significantly longer average hospital length of stay compared with those without (8.80 vs 5.84, <i>P</i><0.001). The same is true for the first (3.52 vs 2.54, <i>P</i>=0.014) and the total length of stay in the intensive care unit (4.68 vs 3.10, <i>P</i>=0.009). POAF significantly increased the rate of postoperative mechanical ventilation (<i>P</i>=0.004), reintubation (<i>P</i><0.001), and return to the operating room (<i>P</i>=0.003).</p><p><strong>Conclusions: </strong>The incidence of POAF in patients who underwent an open lobectomy was significantly higher than those who underwent a VATS lobectomy. An independent risk factor for developing POAF was age. In the end, POAF greatly increased a patient's rate of postoperative complications, length of hospital and intensive care unit stay, and postoperative procedures.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"173-178"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718033","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}