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Introduction: Social insecurity, a form of deprivation of social amenities, if present among patients presenting in a rural emergency department (ED) can be a source of medical burden and poor health outcomes. Although knowledge and understanding of the insecurity profile of such patients is necessary for targeted care that improves their health outcomes, the concept has not been comprehensively quantified. In this study we explored, characterized, and quantified the social insecurity profile of ED patients at a rural teaching hospital in southeastern North Carolina with a large Native American population. Methods: A paper survey questionnaire was administered by trained research assistants between May–June 2018 to patients who presented to the ED and consented to participate in this cross-sectional, single-center study. The survey was anonymous with no identifying information collected on the respondents. A general demographic section and questions derived from the literature capturing sub-constructs of social insecurity—communication access, access to transportation, housing insecurity and home environment, food insecurity, and exposure to violence–were captured in the survey. We assessed the factors included in the index of social insecurity based on a rank ordering using the magnitude of their coefficient of variation and the Cronbach’s alpha reliability index of the constituent items. Results: Overall, we collected 312 surveys from the approximately 445 administered and included them in the analysis, representing a response rate of about 70%. The average age of the 312 respondents was 45.1 (±17.7) years with a range of 18.0–96.0. More females (54.2%) than males participated in the survey. Native Americans (34.3%), Blacks (33.7%), and Whites (27.6%) comprised the three major racial/ethnicity groups of the sample, which are representative of the study area’s population distribution. Social insecurity was observed among this population regarding all the subdomains and an overall measure (P

Introduction: Emergency department (ED) visits for mental health and substance use disorders have been on the rise, with substance use disorders frequently coexisting with mental health disorders. This study evaluated substances commonly used/abused by patients presenting to the ED of a rural, regional medical center with subsequent admission for mental health treatment in Robeson County, North Carolina. Methods: This retrospective, single-center study was approved by the Southeastern Health Institutional Review Board. We reviewed medical records of psychiatric patients presenting to the ED with ultimate admission to the inpatient psychiatric unit between January 1, 2016, and June 30, 2016. Frequencies of controlled substances testing positive on urine drug and alcohol screenings in admitted patients were obtained and analyzed. We also made ethnic and gender comparisons. Results: A total of 477 patients met inclusion criteria. The percentage of patients testing positive were as follows: tetrahydrocannabinol (THC) (40%); cocaine (28.7%); alcohol (15.1%); benzodiazepines (13%); opiates (9.6%); amphetamines (2.9%); barbiturates (2.3%); and methadone (0.8%). A relatively higher proportion of patients tested positive for THC than any other substance ( p≤.0002). We found statistically significant differences for gender ( p=.0004) and ethnicity ( p

Abstract This Critical Synthesis Package contains: (1) a Critical Analysis of the psychometric properties and application to health sciences education for the University of California Los Angeles Geriatric Knowledge Test for Primary Care Residents (UCLA GKTPCR), and (2) a copy of the UCLA GKTPCR instrument and scoring key developed by David B. Reuben, MD, Ming Lee, PhD, Michelle Eslami, MD, and Daniel Osterweil, MD. The UCLA GKTPCR was designed to provide a reliable and valid tool to measure the geriatric content knowledge of primary care residents. This instrument is composed of 23 multiple-choice responses to both questions and incomplete statements. Only one answer to the multiple choices is deemed best and correct. While few studies were found that provided further validity evidence, the few that used the measure reported that the content, known-groups, and concurrent validity evidence were appropriate. Reported validity was average but consistent with similar instruments. The UCLA GKTPCR is easy to modify and has been used quite extensively across the health sciences field (e.g., nursing) and medical education in various contexts, often together with tools measuring geriatric attitude. It has been used in international contexts as well. The UCLA GKTPCR promises to gauge the geriatric knowledge across the entire continuum of medical education and even for instances involving continuing education of practicing physicians.