Horizon Behavioral Health

Abstract Adolescent substance use is typically addressed from the perspectives of school personnel (e.g., teachers, school counselors, social workers, and resource officers) who interact daily with students in school settings. Consequences of adolescent substance use in the schools may include suspension or expulsion and possible legal involvement. However, many adolescents do not have access to evidence-based treatment to address drug and alcohol use. Services are often not available or fragmented, resulting in poor compliance with treatment and inadequate treatment outcomes for youth. Cross-sector collaboration among schools, community behavioral health agencies, and juvenile court service units offers an opportunity to improve access to care and efficiency in delivering care to adolescents with drug and alcohol problems. Illuminated through a single case study, embedded substance use treatment in schools through partnerships with the court service unit and community behavioral health providers can increase access to care. Counselors and social workers play a key role in advocating for joint efforts to increase service access and improve treatment outcomes. Advocacy efforts may include participation and leadership in community coalitions, training and consultation in evidence-based practices, and seamless communication across all organizations that serve youth with substance use disorders.

ABSTRACT The benefits and challenges of cross-sector collaboration are well outlined in the literature on community network development. Two sectors, schools and community behavioral health agencies, often work with the same youth inasmuch as students with behavioral difficulties in schools may also receive services from behavioral health providers. The purpose of this article is to present a case study on the implementation of a screening, triage, and referral process developed by a Central Virginia school system and community service board as part of a collaborative network which may provide generalized lessons that other organizations consider when addressing behavioral problems in schools.

ABSTRACT Behavioral healthcare agencies experienced monumental changes to their operations as a result of the COVID-19 pandemic. These changes were in response to mitigation strategies to prevent the spread of the virus. These changes led many community behavioral healthcare agencies to shift their operations. Behavioral health agencies shifted from face-to-face counseling to telemental health (TMH) and counselors began telework and telesupervision. This article will present a case study on the modifications a community behavioral health center in Central Virginia made in response to COVID-19, which may provide generalized lessons to other behavioral health agencies.

Chilaiditi sign, a condition first described by Greek radiologist Demetrius Chilaiditi in 1910, is the radiological appearance of colonic interposition between the liver and the diaphragm. The incidence in chest/abdominal x-rays and CT scans is 0.025 – 0.28%. When there are symptoms, such as abdominal pain, nausea, constipation or respiratory distress, the condition is called Chilaiditi's syndrome. One of the key factors in the development of this anomaly is anatomic variation in the suspensory ligaments of the intestines. Other important etiological factors include aerophagia, constipation, liver cirrhosis and chronic lung disease with increased intrathoracic pressure. Below we discuss a case of Chilaiditi's syndrome in an elderly female, who presented with shortness of breath, constipation and abdominal distention. The diagnosis of Chilaiditi's syndrome was made by chest x-ray and CT scan.

BackgroundBurns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients.Methods/DesignThis is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ≥95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress symptomatology, speed of wound healing, and parent perception of how easy the dressing change is for their child.DiscussionStudy results will elucidate whether the disease process can be changed by using medical hypnosis with children to decrease pain, anxiety, and stress in the context of acute burn wounds.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12615000419561

This analysis documents the multinode evaluation of several lossof-coolant accidents for B&W's 2772-MWt non-vent-valve, nozzle supported nuclear power plants with prepressurized fuel pins.The basic computer code is discussed, including modifications that have been incorporated to make it more applicable to the system analyzed.Also, basic assumptions and areas of uncertainty and conservatism are discussed.The multinode model was used to perform a core cooling analysis for a spectrum of break sizes in the cold and hot legs of the reactor coolant system.Curves showing hot spot fuel cladding temperature versus time after an assumed break are included for a spectrum of hot and cold leg break sizes.-Ill -