North Carolina Medical Journal最新文献

{"title":"Behavioral Health Trends Among Perinatal North Carolina Medicaid Beneficiaries.","authors":"Alexis French, Kelly A Jones, Naomi O Davis, Karen Burns, Tara Owens Shuler, Andi Davis, Gary Maslow, Mary Kimmel","doi":"10.18043/001c.123264","DOIUrl":"https://doi.org/10.18043/001c.123264","url":null,"abstract":"<p><p>Untreated behavioral health conditions among the perinatal population are associated with high mortality and morbidity. We examined trends of behavioral health conditions and treatment received by perinatal Medicaid beneficiaries and described the characteristics of providers treat-ing these beneficiaries from 2017 to 2022. Results indicated that 24.4% of beneficiaries had a behav-ioral health diagnosis, 13.8% received a psycho-tropic prescription, and 7.1% received a behavioral health service.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Misuse Among Pediatric Patients: Encounters in the Prehospital Field.","authors":"A Kyle Cecil, Julianne M Cyr, Hussein Ahmad, Angela Strain, Alexander B Requarth, Jane H Brice","doi":"10.18043/001c.121367","DOIUrl":"https://doi.org/10.18043/001c.121367","url":null,"abstract":"<p><strong>Background: </strong>Few data describing prehospital pediatric substance misuse exist. The objective of this study was to characterize substance misuse in North Carolina pediatric patients receiving emergency medical services (EMS) care.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of patients aged < 16 years transported by EMS for substance misuse. Data were obtained from a statewide repository including patients treated for confirmed or suspected misuse of marijuana, alcohol, benzodiazepines, opioids, stimulants, acetaminophen, antidepressants, or other drugs.</p><p><strong>Results: </strong>Of 45,855 EMS encounters, 448 patients misused drugs. Most patients were female (56.7%), White (50.9%), adolescent (73.8%), and resided in Central North Carolina (54.0%). A plurality of cases was rural (46.2%), followed by urban (27.9%) and regional city/suburban counties (25.7%). Calls most often originated in residential locations (68.5%). Drugs identified during EMS calls included alcohol (24.2%), marijuana (24.2%), benzodiazepines (8.8%), antidepressants (8.8%), stimulants (6.8%), opioids (5.9%), and other medications (17.6%). Motivations for drug use were recreational (58.4%), self-harm (24.6%), and accidental (17.0%).</p><p><strong>Limitations: </strong>Due to insufficient data documentation, one EMS system was removed from analysis. Additionally, misclassification of type of drug or intention of drug use is possible due to the use of free-text patient narratives.</p><p><strong>Conclusions: </strong>EMS responded to a vast variety of drug misuse among pediatric patients including prescription medications, alcohol, marijuana, and illicit drugs. Accidental ingestions occurred exclusively in infant/preschool ages and intent for recreation or self-harm primarily occurred in adolescents. By increasing awareness of the more common pediatric patient characteristics associated with the type and reason for drug use, EMS agencies can improve pediatric readiness among prehospital clinicians.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"North Carolina Treatment Courts: Therapeutic Jurisprudence as a Path Toward Recovery and Restoration.","authors":"Paul Newby","doi":"10.18043/001c.123271","DOIUrl":"https://doi.org/10.18043/001c.123271","url":null,"abstract":"<p><p>At a time when most of our headlines focus on overdoses and overdose-related deaths, recovery is possible. Treatment courts are providing a path toward recovery and healing.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Complex Relationship Between Social and Functional Needs in Frail Older Adults.","authors":"Elena Wright, Kathryn E Callahan, Haley Park, Corrinne Dunbar, Jennifer Gabbard, Kristin Lenoir, Jaime M Hughes, Renee Woodard, Deepak Palakshappa","doi":"10.18043/001c.121369","DOIUrl":"https://doi.org/10.18043/001c.121369","url":null,"abstract":"<p><strong>Background: </strong>There has been a growing interest in integrating social and function-focused care into health care settings. Little is known about what older adults perceive as the needs that impact their lives, and the resources to address patients' social and functional needs often exist outside of traditional health care settings.</p><p><strong>Methods: </strong>Our objective was to understand frail older adults' and community organizations' perspectives on what social and functional needs impact older adults' health, the support they receive, and how organizations and health systems could partner to address these needs. We conducted semi-structured interviews with patients and community-based organizations. Patients were aged 65 years or older, frail (electronic frailty index greater than 0.21), and at an increased geographic risk of unmet social needs (Area Deprivation Index greater than or equal to the 75th percentile). Staff were from organizations that provided social and/or functional resources to older adults. We used an inductive content analysis approach and the constant comparative method to analyze the data and identify themes.</p><p><strong>Results: </strong>We interviewed 23 patients and 28 staff from 22 distinct organizations. We found that social, financial, and functional needs were common and highly intertwined among older adults with frailty, but the support they received at home, from their health care providers, and from community organizations was highly varied.</p><p><strong>Limitations: </strong>Our sample was limited to participants from one county, so the results may not be generalizable to other areas. We only inter-viewed organizations and patients with frailty.</p><p><strong>Conclusions: </strong>Health systems and community organizations have distinct areas of expertise, and purposeful collaboration between them could be important in addressing the needs of frail older adults.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons From One Physician's Experience With Substance Use Recovery.","authors":"Stephen Loyd","doi":"10.18043/001c.123263","DOIUrl":"https://doi.org/10.18043/001c.123263","url":null,"abstract":"<p><p>I advocate for a \"no wrong door\" approach, which ensures that no matter where you enter the system-doctor, therapist, family-referral, self-report, jail, hospital, etc. -you get the treatment that gives you the best chance at long-term recovery, even if you don't have M.D. after your name.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role and Importance of Physician and Health Care Professional Programs.","authors":"Linda Bresnahan, Joseph P Jordan","doi":"10.18043/001c.123262","DOIUrl":"https://doi.org/10.18043/001c.123262","url":null,"abstract":"<p><p>Physician Health Programs (PHPs) have been support-ing and advocating for health professionals for nearly four decades. Initially developed by state medical societies in the 1980s, PHPs recognized the need for therapeutic alterna-tives to disciplinary measures for physicians facing health issues that could impair their ability to practice safely. Originally focused on substance use disorders, PHPs have since expanded their services to encompass mental health and other co-occurring conditions.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma is Still a Barrier to Substance Use Disorder Treatment in North Carolina.","authors":"Amy Ford","doi":"10.18043/001c.123258","DOIUrl":"https://doi.org/10.18043/001c.123258","url":null,"abstract":"<p><p>Almost 12 people in North Carolina die each day from a drug overdose. Primary care providers are ill-equipped to screen, diagnose, and treat substance use disorders. We must see the humanity in all patients and build a better understand-ing of the root causes of, and truly effective solutions for, addiction.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nation's Response to the Substance Use Crisis.","authors":"Rahul Gupta","doi":"10.18043/001c.123261","DOIUrl":"https://doi.org/10.18043/001c.123261","url":null,"abstract":"<p><p>Dr. Rahul Gupta, the first practicing physician to serve as Director of the White House Office of National Drug Control Policy, shares his perspective on the national response to the opioid crisis and how North Carolina is poised to take action to save lives from overdose.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Crucial Role of Academic Medical Centers in Preparing for the Future of Health AI","authors":"Michael J. Pencina, Mary E. Klotman","doi":"10.18043/001c.120563","DOIUrl":"https://doi.org/10.18043/001c.120563","url":null,"abstract":"","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Don’t Panic” – Stephen Aylward, PhD, on AI in Medical Imaging","authors":"Sean Sylvia","doi":"10.18043/001c.120566","DOIUrl":"https://doi.org/10.18043/001c.120566","url":null,"abstract":"","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}