North Carolina Medical Journal最新文献

{"title":"The North Carolina Model for Opioid Settlement Funds.","authors":"Steven Mange","doi":"10.18043/001c.123268","DOIUrl":"10.18043/001c.123268","url":null,"abstract":"<p><p>North Carolina's effort to hold drug companies account-able for their role in creating and fueling the overdose epi-demic has generated $1.4 billion for the state over 18 years. Securing these funds has been a victory, but ensuring they are used to save lives is equally critical.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 5","pages":"336-339"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Conversation with ECU School of Dental Medicine Dean Greg Chadwick.","authors":"Crystal Adams, Steven Cline","doi":"10.18043/001c.125718","DOIUrl":"10.18043/001c.125718","url":null,"abstract":"","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 6","pages":"414-416"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How North Carolina's New Center on the Workforce for Health Can Contribute to Oral Health Improvements.","authors":"Andy MacCracken","doi":"10.18043/001c.125710","DOIUrl":"10.18043/001c.125710","url":null,"abstract":"<p><p>The recently created North Carolina Center on the Workforce for Health can help to ensure an adequate oral health workforce to appropriately meet the dental care needs of all our state's residents.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 6","pages":"401-403"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Local Public Health Governance in North Carolina Across Organizational and Governance Configurations.","authors":"Karl Johnson, Juan Yanguela Eguizabal, Dorothy Cilenti, John Wiesman, Todd Jensen, Kristen Hassmiller Lich","doi":"10.18043/001c.121368","DOIUrl":"10.18043/001c.121368","url":null,"abstract":"<p><strong>Background: </strong>Every county in North Carolina must include a board of health (BOH) with specific prescribed duties and powers. It is unclear how BOHs in North Carolina are currently exercising their governance ability. In 2012, the North Carolina General Assembly provided coun-ties with additional flexibility to select among different configurations for their local health department (LHD). The impact of this flexibility on the governance and service delivery of LHDs is yet to be explored.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with LHD directors and BOH members to assess the strengths and weaknesses of BOHs within different local public health configurations across North Carolina. We employed conventional content analysis to derive themes from the interview transcripts.</p><p><strong>Results: </strong>BOHs were largely described as an underutilized institution, with few BOHs noted to be active beyond satisfying their required legal duties. Strong BOHs were noted to fulfill three identities on behalf of the LHD: an advocate, a bridge, and an advisor. The majority of interviewees desired to work in a standalone county health department (as opposed to a consolidated human services agency) with an appointed (versus elected) board of health. This configuration was preferred because, according to participants, it is more likely to enable a structural focus on public health initiatives.</p><p><strong>Limitations: </strong>Our sample frame did not control for the length of time an interviewee had been in the office nor the professional background of each BOH member.</p><p><strong>Conclusions: </strong>Wide variations exist in the exercise of BOHs across the state, partially due to how different LHD configurations structurally focus resources and attention on public health.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 5","pages":"350-357"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Access to Health Care and Opioid Use Treatment: An Evaluation of a Medicaid Population.","authors":"Casey Tak, Bayla Ostrach, Melinda Ramage","doi":"10.18043/001c.125106","DOIUrl":"10.18043/001c.125106","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to examine postpartum health care utilization and identify gaps in care among a postpartum Medicaid population of patients diagnosed with opioid use disorder (OUD) during pregnancy.</p><p><strong>Methods: </strong>We queried North Carolina Medicaid medical and pharmacy claims to identify individuals with a live delivery and evidence of OUD during pregnancy from 2015 to 2019. We examined any evidence of postpartum health care utilization and evidence of medications for OUD (MOUD) during postpartum. We also determined the impact that 4 factors may have had on these outcomes: type of Medicaid coverage (Medicaid for Pregnant Women as compared to other types of Medicaid coverage), rurality, race, and the prenatal use of MOUD. Descriptive statistics, Kaplan-Meier curves with log-rank tests, and negative binomial regression were used.</p><p><strong>Results: </strong>Of the 6,186 individuals in the study, 84.5% were White, 29.6% lived in rural areas, and 35.0% had MPW coverage. Of the sample, 77.4% sought health care services during the postpartum period. In the multiple negative binomial regression model, individuals who were MPW beneficiaries, non-White, lived in rural areas, and had no evidence of prenatal MOUD all had significantly lower rates of postpartum health care utilization. Of the sample, 53.6% had evidence of MOUD utilization during the postpartum period. We found that patients with MPW continued MOUD at much lower rates compared to patients with other forms of Medicaid (86% versus 93% at 60 days; 57% versus 78% at 180 days, respectively).</p><p><strong>Limitations: </strong>Limitations to this analysis are inherent to administrative claims data, such as misclassification of outcomes and covariates, as well as loss to follow-up.</p><p><strong>Conclusions: </strong>Significant gaps in health care use remain across type of Medicaid coverage, race, geographic setting, and prenatal care access.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 6","pages":"462-470"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teledentistry as a Tool for Health Care Transformation.","authors":"Christine Kanan, Carolina McLeod, Rebekah Mathews","doi":"10.18043/001c.125137","DOIUrl":"10.18043/001c.125137","url":null,"abstract":"<p><p>Teledentistry is a valuable technology tool that supports dental professionals in improving access to oral health care. Technological infrastructure, workforce availability, staff readiness, reimbursement, and patient population served must all be considered when implementing teledentistry.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 6","pages":"396-400"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Local Health Departments in Addressing the Opioid Crisis and Deploying Opioid Settlement Funds.","authors":"Katie Varnadoe","doi":"10.18043/001c.123266","DOIUrl":"10.18043/001c.123266","url":null,"abstract":"<p><p>This article examines the evolving role of local health departments in North Carolina's opioid crisis response. Highlighting strategies like community mobilization, data prioritization, and regional partnerships, it illustrates the impact of opioid settlement funds in empowering local health departments to manage behavioral health systems and implement effective opioid abatement interventions.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 5","pages":"331-333"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing Oral Health: Oral Health IS Health!","authors":"J Steven Cline","doi":"10.18043/001c.125109","DOIUrl":"10.18043/001c.125109","url":null,"abstract":"<p><p>How did we let the mouth get separated from the rest of the body? And more importantly, how do we put oral health back into overall health? This issue of the NCMJ highlights recent efforts to develop strategies to create an accessible, sustainable, and equitable care delivery system in North Carolina.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 6","pages":"374-376"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating Recovery-Ready Communities.","authors":"Devin Lyall","doi":"10.18043/001c.123265","DOIUrl":"10.18043/001c.123265","url":null,"abstract":"<p><p>This article explores the transformative impact of peer support specialists in creating communities where recovery is not only possible but probable. It focuses on the innovative approach of Wilkes Recovery Revolution, Inc. in addressing substance use disorders and the critical integration of harm reduction services to enhance current recovery efforts.</p>","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":"85 5","pages":"329-330"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"85 5","pages":"343-349"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}