MedChat

Addressing Provider Wellness and Resilience  For information about AMA PRA Category 2 credit™, visit the American Medical Association education hub and view page 10 and 11 of this document. Target Audience  This activity is targeted toward internal medicine, family medicine and all specialties.  Statement of Need  A 2015 Mayo Clinic study found that more than half of U.S. doctors experience at least one symptom of burnout, and dissatisfaction has significantly worsened in recent years. Physician stress and burnout can impact the quality of patient care as well as a physicians' own health and well-being. It is important for physicians to recognize the symptoms of burnout and to identify strategies/habits to promote resilience and work-life balance.  Objectives  At the conclusion of this offering, the participant will be able to:  Discuss the contributing factors and symptoms of burnout.  Describe strategies / resources to address clinician burnout and resilience.  Moderator  James Jennings, M.D.  Executive Medical Director, Adult Primary Care Director, Provider Wellbeing Norton Healthcare  Speaker  Paul F. DeChant, M.D., MBA, FAAFP  Deputy Chief Health Officer IBM Watson Health    Date of Original Release | November 2019  All information referenced in this podcast was correct at the time of initial publication. Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org  Resources for Additional Study  Paul DeChant, Diane W. Shannon, Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, CreateSpace Indepdent Publishing Platform, 2016, http://www.pauldechantmd.com/preventing-physician-burnout/  Bob Chapman and Raj Sisodia, Everybody Matters: The Extraordinary Power of Caring for Your People Like Family, Penguin Random House LLC, 2015, https://www.everybodymattersbook.com/  Brenda K. Wiederhold, et. al., Intervention for Physician Burnout: A Systematic Review, De Gruyter, Open Med. 2018; 13: 253-263  Hilary McClaffety, M.D., FAAO, et. al. Physician Health and Wellness, American Academy of Pediatrics, Volume 134, Number 4, October 2014, pp. 830-835  Mark Linzer, M.D., et. al., 10 Bold Steps to Prevent Burnout in General Internal Medicine, J Gen Intern Med 29(1):18–20, DOI: 10.1007/s11606-013-2597-8  C. P. West, et. al., Physician Burnout: Contributors, Consequences and Solutions, Journal of Internal Medicine,  Journal of Internal Medicine, 2018, 283; 516–529    Podcast editing and production:  www.unmuteaudio.com

Psychedelics - Potential for Therapeutic Use For information about AMA PRA Category 2 credit™, visit the American Medical Association education hub and view page 10 and 11 of this document. Target Audience            This activity is targeted toward Primary care specialties and psychiatrists. Statement of Need Promising research is being conducted on psychedelics for the treatment of psychiatric disorders.  Providers should be aware of emerging treatments. This podcast will address the research base and clinical use of psychedelics in the United States. Providers will be informed on the potential for use in practice in the future. Objectives At the conclusion of this offering, the participant will be able to: Review the history of psychedelics. Discuss the chemical and pharmacological properties of psychedelics. Describe the clinical use of psychedelics in the United States, including clinical trials.   Moderator John J. Wernert, M.D., MHA, DLFAPA Executive Medical Norton Behavioral Medicine   Speaker Christopher D. Bojrab, M.D., DFAPA President Indiana Health Group Carmel, Indiana   For information related to nursing credits, contact Sally Sturgeon DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org   Date of Original Release | September 2020 All information referenced in this podcast was correct at the time of initial publication. Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study  Chi, Tingying and Gold Jessica A., A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses, Journal of the Neurological Sciences, Volume 411, 15, April 2020.  https://www.sciencedirect.com/science/article/pii/S0022510X20300514?via%3Dihub  Krediet, Erwin, et.al., Reviewing the Potential of Psychedelics for the Treatment of PTSD, International Journal of Neuropsychopharmacology, March 20, 2020. https://academic.oup.com/ijnp/article/23/6/385/5805249 Romeo, Bruno, et. al, Efficacy of psychedelic treatments on depressive syndromes: A meta-analysis, Journal of Psychopharmacology, May 25, 2020.  https://journals.sagepub.com/doi/10.1177/0269881120919957    Podcast editing and production:  www.unmuteaudio.com

Treating Challenging Personalities in Primary Care For information about AMA PRA Category 2 credit™, visit the American Medical Association education hub and view page 10 and 11 of this document. Target Audience            This activity is targeted towards all physician specialties.   Statement of Need In the United States, approximately 9% of adult patients have a personality disorder.  In the primary care setting approximately 18% of patients that are treated have some type of personality disorder.  Primary care practitioners do not consistently recognize or manage personality disorders when treating patients for medical related illnesses. Clinicians should be aware of patient characteristics and symptoms that are related to personality disorders and effectively address and manage when providing primary care.   Objectives At the conclusion of this offering, the participant will be able to: Discuss basic personality traits. Define different personality disorders. List the risk factors for personality disorders. Explain the distinct diagnostic criteria of personality disorders. Discuss effective management strategies and treatment of patients with personality disorders. Moderator Joseph M. Flynn, D.O, MPH, FACP Chief Administrative Officer Norton Medical Group Physician-in-Chief Norton Cancer Institute Speaker John J. Wernert, M.D., MHA, DLFAPA Executive Medical Director, Behavioral Health Services Norton Medical Group   Date of Original Release | April 2020 All information referenced in this podcast was correct at the time of initial publication. Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study  The State Of Mental Health In America https://www.mhanational.org/issues/state-mental-health-america CDC Mental Health Website https://www.cdc.gov/mentalhealth/index.htm Dos and Don'ts in Treatments of Patients With Narcissistic Personality Disorder https://www.ncbi.nlm.nih.gov/pubmed/32186986   Podcast editing and production:  www.unmuteaudio.com

The Hidden Dangers of Vaping and the Pediatric Patient   For information about AMA PRA Category 2 credit™, visit the American Medical Association education hub and view page 10 and 11 of this document.   Target Audience               This activity is targeted towards all physician specialties.   Statement of Need Introduced in 2007, vaping has been promoted as a safe alternative to smoking. Research shows in 2017 vaping was the most common use of any tobacco-like product in adolescents,  with an estimated 1.3 million new adolescents using electronic cigarettes in 2018. In December of 2018, the US Surgeon General declared electronic cigarettes (EC) as an epidemic among youth. Evidence has linked vaping to an increase in acute lung injuries referred to as vaping-related acute lung injury (VpALI) and addiction in the adolescent/young adult population.   Objectives   At the conclusion of this offering, the participant will be able to: Define vaping-related acute lung injury (VpALI). Describe the contributing factors of vaping to acute lung injury. Discuss the symptoms, diagnostic guidelines and treatment protocols for VpALI. Implement an inclusive social history in determining patients utilizing electronic cigarettes / vaping and associated risks.   Moderator Mark J. McDonald, MD, CPE, FAAP Medical Director, Norton Children’s Hospital & Norton Children’s Medical Center Professor, Department of Pediatrics Division of Pediatric Critical Care University of Louisville School of Medicine   Speaker Scott G. Bickel, M.D. Assistant professor Division of pediatric pulmonology Department of pediatrics University of Louisville School of Medicine     Date of Original Release | March 2020 All information referenced in this podcast was correct at the time of initial publication.   Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study     Abeles, M.D., Michael, et.al., “Vaping-associated lung injury caused by inhalation of cannabis oil”, Pediatric Pulmonology, 2019; 1-3.   Al-Hamdani, Mohammed, et. al., “Vaping among youth and young adults: a “red alert” state”, Journal of Public Health Policy, October 2019.   Blagev, Denitza, P., Harris, Dixie, et. al., “Clinical presentation, treatment, and short-term outcomes of lung injury associated with e-cigarettes or vaping: a prospective observational cohort study”, The Lancet, Vol 394, December 7, 2019, pages 2073 – 2083.   Bozier, Jack, et. al., “How harmless are E-cigarettes? Effects in the pulmonary system”, Current Opinion Pulmonary Medicine, 2020, 26:97-102.   Fonesca Fuentes, Xavier, et. al., “VpALI-Vaping-related Acute Lunch Injury: A New Killer Around the Block”, Mayo Clinic Proceedings, December 2019; 94)12): 2534-2545.   Gray, Naudia, Halstead, Mary, et. al., “Analysis of Toxic Materials in Liquid From Electronic Cigarettes”. International Journal of Environmental Research and Public Health, 2019, 16, 4450.     Podcast editing and production:  www.unmuteaudio.com

Vaccine Hesitancy: Scope and Solutions  Evaluation and Credit: https://www.surveymonkey.com/r/MedChat10   Target Audience             This activity is targeted towards internal medicine, family medicine, pediatrics, and urgent care.   Statement of Need In January 2019, the World Health Organization included ‘vaccine hesitancy’ as one of the top 10 threats to global health.  Providers should be aware of current philosophies towards vaccine hesitancy, be current on the AAP vaccination schedule, and be knowledgeable in techniques to talk with families that are vaccine hesitant. Objectives At the conclusion of this offering, the participant will be able to: Define vaccine hesitancy. Describe factors that influence a family's tendency to be vaccine hesitant. Discuss effective strategies to address vaccine hesitancy with parents. Understand the scientific data about the safety and efficacy of vaccines and risks of non-vaccination. Moderator Mark J. McDonald, MD, CPE, FAAP Medical Director, Norton Children’s Hospital & Norton Children’s Medical Center Professor, Department of Pediatrics Division of Pediatric Critical Care University of Louisville School of Medicine Speaker Gary S. Marshall, MD Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases University of Louisville School of Medicine Speaker Disclosure The speaker has the following conflicts of interest to disclose:  Advisory Board, Consultant, Grant Recipient, Honoraria and Research – GSK, Merck, Pfizer, Sanofi, and Seqirus.   Moderator and Planner Disclosures  The moderator and planners for this activity have no potential or actual conflicts of interest to disclose. Commercial Support  This activity has not received commercial support.   Physician Credits   American Medical Association   Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.     Date of Original Release | December 2019 Course Termination Date | January, 2022; Updated to December 2025 Content review: This podcast was reviewed Dcember 2021 by Gary S. Marshall, M.D. It was determined that the information is still relevant and appropriate. Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study   Vaccine Hesitancy, History, and Human Nature: The 2018 Stanley A. Plotkin Lecture https://academic.oup.com/jpids/article-abstract/8/1/1/5099088?redirectedFrom=fulltext   The Vaccine Handbook: A Practical Guide for Clinicians, 8E "The Purple Book" https://pcibooks.com/books/view/49   Vaccine Hesitancy: Where We Are and Where We Are Going https://www.ncbi.nlm.nih.gov/pubmed/28774498   Vaccine Hesitancy in Pediatric Primary Care Practices https://www.ncbi.nlm.nih.gov/pubmed/29947574   Vaccine Hesitancy: Causes, Consequences, and a Call to Action https://www.ncbi.nlm.nih.gov/pubmed/26337116  

Podcast: Epilepsy for the Primary Care Provider  For information about AMA PRA Category 2 credit™, visit the American Medical Association education hub and view page 10 and 11 of this document.   Target Audience This activity is targeted toward internal medicine, family medicine and primary care specialties that provide primary care to patients with seizures and/or epilepsy. Statement of NeedAccording to the CDC approximately 40 - 50k of adults in Kentucky have epilepsy (2015 data). Prior to a diagnosis of epilepsy, a primary care practitioner may be the first provider to see a patient suspected of having had a seizure. Additionally, they may be responsible for initial diagnosis and treatment as well as referral to a specialist.  Objectives At the conclusion of this offering, the participant will be able to:  Discuss differential diagnosis of seizures.  Describe epilepsy syndromes and seizure classifications.  Discuss common treatments for epilepsy as well as required monitoring by the primary care provider.  Understand the relationship of epilepsy with co-existing disorders.    Moderator  Stephen Wright, M.D. Medical Director Norton Medical Group  Speakers  Ambica Tumkur, M.D. Neurologist Norton Neurology Services  Rebekah Woods, D.O. Neurologist Norton Neurology Services    Date of Original Release |September 2019  All information referenced in this podcast was correct at the time of initial publication.   Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org    Resources for Additional Study  Bates, M.D., Kimberly, “Epilepsy, Current Evidence-Based Paradigms for Diagnosis and Treatment”, Primary Care Clinic Office Practice, 42 (2015) 217 – 232.  Bosak, Magdalena, et. al. Implementation of the new ILAE classification of epilepsies into clinical practice – A cohort study”, Epilepsy & Behavior, 96 (2019) 28 – 32.  Bruun, Emmi, et. al. “Co-morbidity and clinically significant interactions between antiepileptic drugs and other drugs in elderly patients with newly diagnosed epilepsy”, Epilepsy & Behavior 73 (2017) 71 – 76.  Pack, Allison, M.D., MPH, “Epilepsy Overview and Revised Classification of Seizures and Epilepsies”, Continuum (Minneap Minn) 2019; 25 (2. EPILEPSY): 306-321.  Schachter, M.D., Steven C., “Comorbidities and complications of epilepsy in adults”, UpToDate, 2019.  Schachter, M.D., Steven C., “Evaluation and management of the first seizure in adults”, UpToDate, 2019.  St. Louis, M.D., MS, FAAN Erik K., and Cascino, M.D., FAAN, Gregory. “Diagnosis of Epilepsy and Related Episodic Disorders”, Continuum (Minneap Minn), 2016; 22(1): 15 – 37.  Yoo, M.D., Ji Yeoun, and Panov, M.D., Fedor, “Identification and Treatment of Drug-Resistant Epilepsy”, Continuum (Minneap Minn), 2019:25 (2, EPILEPSY): 362 – 380.  Podcast Editing and Production:  www.unmuteaudio.com  

Podcast: Medically Assisted Treatment for Opioid Use Disorder Part Two Evaluation and Credit: https://www.surveymonkey.com/r/MedChat5B Target Audience This activity is targeted toward internal medicine, family medicine and other specialties that treat patients with chronic pain. Statement of Need In 2017, overdose fatalities in Kentucky rose by 11% and Jefferson County had the most overdose deaths. It is critical for physicians and providers to be aware of the prevalence of illegal drugs and understand this culture - as legal prescribing guidelines / availability continues to be more restrictive and addicted patients may seek their "high" from illegal sources. Objectives At the conclusion of this offering, the participant will be able to: Discuss the effectiveness of medically assisted treatment (MAT) for opioid addictions. Describe the mechanisms of antagonist therapy. Understand the treatment guidelines for medically assisted therapy. Moderator James Jennings, M.D. Executive Medical Director, Adult Primary Care Director, Provider Wellbeing Norton Healthcare Speaker Jonathan W. Weeks, M.D. Maternal-Fetal Medicine Norton Children’s Maternal-Fetal Medicine Moderator, Speaker and Planner Disclosures The moderator, speaker and planners for this activity have no potential or actual conflicts of interest to disclose.   Commercial Support This activity is supported in part with a grant from Cardinal Health.   Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Medically Assisted Treatment for Opioid Use Disorder - Part Two for.50 HB1 credit hours. ID# 0519-H.50-NHC6b. Date of Original Release | August 2019 Course Termination Date | August 31, 2021 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org State Resources Listing of treatment centers / resources – FindHelpNowKY Kentucky State Police assistance in finding a treatment center – Angel Initiative Resources for Additional Study Hendrée E. Jones, Ph.D., et. al., “Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure”, New England Journal of Medicine 363: 24, pages 2320-2331 Quentin Johnson, “Case Study: County-Level Responses to the Opioid Crisis in Northern Kentucky”, The Journal of Law, Medicine & Ethics, 46 (2018): 382-386 Marc Galanter, “Combining medically assisted treatment and Twelve-Step programming: a perspective and Review”, The American Journal of Drug and Alcohol Abuse 2018, Vol. 44, No. 2, pages 151–159 Hefei Wen, PhD, et. al., “Impact of Medicaid Expansion on Medicaid-covered Utilization of Buprenorphine for Opioid Use Disorder Treatment”, Medical Care , Volume 55, Number 4, April 2017, pages 336-341 Harlan Matusow, M.A., et. al., “Medication assisted treatment in US drug courts: Results from a nationwide survey of availability, barriers and attitudes”, Journal of Substance Abuse Treatment 44 (2013) 473–480

Medically Assisted Treatment for Opioid Use Disorder Part One Evaluation and Credit: https://www.surveymonkey.com/r/MedChat5A Target Audience This activity is targeted toward internal medicine, family medicine and other specialties that treat patients with chronic pain. Statement of Need In 2017, overdose fatalities in Kentucky rose by 11% and Jefferson County had the most overdose deaths. It is critical for physicians and providers to be aware of the prevalence of illegal drugs and understand this culture - as legal prescribing guidelines / availability continues to be more restrictive and addicted patients may seek their "high" from illegal sources. Objectives At the conclusion of this offering, the participant will be able to: Define medically assisted therapy (MAT) for opioid addiction. Identify the FDA-approved medications for opioid use disorder. Understand the indications, benefits and limitations of MAT; including the pregnant patient. Discuss the psychological effects of opiate withdrawal. Moderator James Jennings, M.D. Executive Medical Director, Adult Primary Care Director, Provider Wellbeing Norton Healthcare Speaker Jonathan W. Weeks, M.D. Maternal-Fetal Medicine Norton Children’s Maternal-Fetal Medicine Moderator, Speaker and Planner Disclosures The moderator, speaker and planners for this activity have no potential or actual conflicts of interest to disclose.   Commercial Support This activity is supported in part with a grant from Cardinal Health.   Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Medically Assisted Treatment for Opioid Use Disorder - Part One for.50 HB1 credit hours. ID# 0519-H.50-NHC6b. Date of Original Release | August 2019 Course Termination Date | August 31, 2021 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org State Resources Listing of treatment centers / resources – FindHelpNowKY Kentucky State Police assistance in finding a treatment center – Angel Initiative Resources for Additional Study Hendrée E. Jones, Ph.D., et. al., “Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure”, New England Journal of Medicine 363: 24, pages 2320-2331. Quentin Johnson, “Case Study: County-Level Responses to the Opioid Crisis in Northern Kentucky”, The Journal of Law, Medicine & Ethics, 46 (2018): 382-386. Marc Galanter, “Combining medically assisted treatment and Twelve-Step programming: a perspective and Review”, The American Journal of Drug and Alcohol Abuse 2018, Vol. 44, No. 2, pages 151–159. Hefei Wen, PhD, et. al., “Impact of Medicaid Expansion on Medicaid-covered Utilization of Buprenorphine for Opioid Use Disorder Treatment”, Medical Care , Volume 55, Number 4, April 2017, pages 336-341. Harlan Matusow, M.A., et. al., “Medication assisted treatment in US drug courts: Results from a nationwide survey of availability, barriers and attitudes”, Journal of Substance Abuse Treatment 44 (2013) 473–480.

Podcast:  Addressing Opioid Use During Pregnancy   Evaluation and Credit: https://www.surveymonkey.com/r/MedChat4   Target Audience             This activity is targeted toward internal medicine, family medicine, pediatrics, obstetrics & gynecology, and other specialties that treat female patients of child-bearing years.   Statement of Need Kentucky's rate of infants born with NAS has increased significantly in the last decade and it has been noted that Kentucky's rate is higher than the national average. Providers should be current on the practice guidelines available to prevent NAS and minimize the effects when possible.   Objectives At the conclusion of this offering, the participant will be able to: Describe guidelines / requirements for identifying substance abuse in pregnant patients. Discuss the effects of opioids on maternal fetal health. Provide an overview of treatment options available. Define neonatal abstinence syndrome.  Understand the effects of NAS on the newborn. Moderator James Jennings, M.D. Executive Medical Director, Adult Primary Care Director, Provider Wellbeing Norton Healthcare   Speaker Jonathan W. Weeks, M.D. Maternal-Fetal Medicine Norton Children’s Maternal-Fetal Medicine     Moderator, Speaker and Planner Disclosures  The moderator, speaker and planners for this activity have no potential or actual conflicts of interest to disclose.   Commercial Support  This activity is supported in part with a grant from Cardinal Health.     Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation Norton Healthcare designates this enduring material for a maximum of .50AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Addressing Opioid Use During Pregnancyfor .50 HB1 credit hours. ID# 0519-H.50-NHC7b.   Date of Original Release |July 2019 Course Termination Date | July 31, 2021 Contact Information |Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   State Resources Listing of treatment centers / resources – FindHelpNowKY Kentucky State Police assistance in finding a treatment center – Angel Initiative    Resources for Additional Study    Bell, Jennifer, M.D., et. al., “Detoxification from opiate drugs during pregnancy,” American Journal of Obstetrics & Gynecology, September 2016,   Hodgins, Fran E., et. al. “Coordinating Outpatient Care for Pregnant and Postpartum Women with Opioid Use Disorder: Implications from the COACHH Program,” Maternal and Child Health Journal, (2019), 23:585 – 591.   Jansson, Lauren, M., M.D., et. al., “Neonatal Abstinence Syndrome,” Pediatric Clinics of North America, 66 (2019), pages 353 – 367.   Jones, Hendree E., PhD, et. al, “Analgesia, Opioids and Other Drug Use During Pregnancy and Neonatal Abstinence Syndrome,” Clinics in Perinatology, 46(2019), 349-366.   Klaman, Stacey, L., MPH, et. al., “Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of their Infants and Children: Literature Review to Support National Guidance,” Addict Medicine, Volume 11, Number 3, May/June 2017, pages 178 – 190.   Tran, Tran, H., et. al., “Methadone, Buphrenorphine, and Naltrexone for  the Treatment  of Opioid Use Disorder in Pregnant Women,”  Pharmacotherapy, 2017:37(7), pages 824 – 839.   Zedler, Barbara, K., et. al., “Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta-analysis fo safety in the mother, fetus and child,” Addiction, 111, pages 2115 – 2128.

Podcast: Streetwise:  Drugs in Kentucky   Evaluation and Credit: https://www.surveymonkey.com/r/MedChat3 Target Audience       This activity is targeted toward primary care, all specialties that provide pain management (acute/chronic), and specialties that prescribe opioids. Statement of Need In 2017, overdose fatalities in Kentucky rose by 11% and Jefferson County had the most overdose deaths. It is critical for physicians and providers to be aware of the prevalence of illegal drugs and understand this culture - as legal prescribing guidelines / availability continues to be more restrictive and addicted patients may seek their "high" from illegal sources.   Objectives  At the conclusion of this offering, the participant will be able to: Understand what an addict attributes the cause of their addiction to. Describe the scope of the drug problem in Kentucky. Moderator James Jennings, M.D. Executive Medical Director, Adult Primary Care Director, Provider Wellbeing Norton Healthcare   Speaker Trooper, Robert Purdy Kentucky State Police Public Affairs Officer at the Richmond KSP Post   Moderator, Speaker and Planner Disclosures The moderator, speaker and planners for this activity have no potential or actual conflicts of interest to disclose. Commercial Support This activity is supported in part with a grant from Cardinal Health.     Physician Credits   American Medical Association   Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation Norton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Opioids in Spine Surgery for .50 HB1 credit hours. ID# 0519-H.50-NHC5b.   Date of Original Release | June 2019 Course Termination Date | June 30, 2021 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study Baum, PharmD, Regan A., et.al., “Suspected Synthetic Cannabinomimetic Intoxication: Case Series and Review”, Journal of Phamacy Practice, 2018, Vol. 31(2), pages 238 – 243.   Pope, Sandra K., et. al., “Characteristics of Rural Crack and Powder Cocaine Users: Gender and Other Correlates”, American Journal Drug Alcohol Abuse, 2011 November; 37(6); pages 491 – 496.   Shannon, Lisa M., et. al., “Examining Gender Differences in Substance Use and Age of Use Among Rural, Appalachia Drug Users in Kentucky”, American Journal Drug Alcohol Abuse, 2011, March; 37(2); pages 98 – 104.   Slavova, Ph.D., Svetla, et. al., “Drug Overdose Surveillance Using Hospital Discharge Data”, Public Health Reports, September – October 2014, Volume 129, pages 437 – 445.   Stephens, Dustin B., et. al., “Healthcare Contact and Treatment Update Following Hepatitis C Virus Screening and Counseling Among Rural Appalachia People Who Use Drugs:, International Journal of Drug Policy, 46 (2017), pages 86 – 94.   Victor, Grant A., et. al., “Opioid Analgesics and Heron: Examining Drug Misuse Trends Among a Sample of Drug Treatment Clients in Kentucky”, Internal Journal of Drug Policy, 46 (2017), pages 1 – 6.   Webster, J. Matthew, et. al., “Drug Use and Criminal Activity Among Rural Probationers with DUI Histories”, International Journal of Offender Therapy and Comparative Criminology, Volume 53, Number 6, December 2009, pages 717 – 730.   Young, MPH, April M., et. al., “Transition from First Illicit Drug Use to First Injection Drug Use Among Rural Appalachian Drug Users: A Cross-sectional Comparison and Retrospective Survival Analysis”, Addiction, 2012 March; 107(3), pages 587 – 596.

Podcast: Management of Chronic Pain with Complementary and Integrative Medicine   Evaluation and Credit: https://www.surveymonkey.com/r/MedChat2   Target Audience This activity is targeted toward the specialties of internal medicine, family medicine and other specialties that treat patients with chronic pain. Statement of Need One of the most common reasons that patients see their physician is for chronic pain (>3 months). Physicians traditionally treat chronic pain with analgesics; which with long term use can have many complications, side effects as well as the potential for opioid addition. Providers should be aware of current complimentary and integrative medicine (CIM) research and treatment recommendations for the treatment of pain. Objectives At the conclusion of this offering, the participant will be able to: Understand recent research data for the management of chronic pain with complementary and integrative medicine (CIM). List complementary and integrative medicine options for the treatment of chronic pain as an alternative to prescribing analgesics ((NSAIDs) or opioids). Describe the clinical indications of CIM modalities for the treatment of chronic pain. Moderator James Jennings, M.D. Executive Medical Director Adult Primary Care & Provider Well-being   Speaker Rachel J. Busse, M.D. Norton Community Medical Associates – Highlands Director, Integrative Medicine – Norton Women’s and Children’s Hospital   Moderator, Speaker and Planner Disclosures The moderator, speaker and planners for this activity have no potential or actual conflicts of interest to disclose. Commercial Support This activity is supported in part with a grant from Cardinal Health.   Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation Norton Healthcare designates this other activity (podcast) for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Opioids in Spine Surgery for .50 HB1 credit hours. ID# 0419-H.50-NHC4b   Date of Original Release | May 2019 Course Termination Date | May 31, 2021 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Resources for Additional Study Arnold, M.D., Michael J. and Dhaliwal, DO, MPT, Sukhmani, “Cochrane for Clinicians, Putting Evidence in Practice, Complementary and Integrative Treatments for Pain Management in Labor”, American Academy of Family Physicians, Volume 99, Number 3, February 1, 2019, pages 154 – 156. Chao, DrPH, MPA, Maria Teresa, “Patient-Reported Outcomes of an Integrative Pain Management Program Implemented in a Primary Care Safety Net Clinic: a Quasi-experimental Study“, Journal of General Internal Medicine, 19 February 2019. Chen, M.D., Lucy, and Michalsen, M.D., Andreas, “Clinical Review: Management of chronic pain using complementary and integrative medicine”, The BMJ, April 24, 2017. Herman, ND, PhD, Patricia M, et. al., “Cost-effectiveness of Mindfulness-based Stress Reduction Versus Cognitive Behavioral Therapy or Usual Care Among Adults With Chronic Low Back Pain”, Spine, Oct 15:42(20): 1511-1520. University of Wisconsin Integrative Medicine, “Non-Pharmaceutical Therapy for Osteoarthritis”, https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/module_osteoarthritis_clinician.pdf.     Course number: 128904

Podcast: Opioids in Spine Surgery Evaluation and Credit: https://www.surveymonkey.com/r/OpioidsSpineMedChat Target Audience This activity is targeted toward the specialties of internal medicine, family medicine, neuro/spine, general surgery and other surgery specialties and anesthesia. Statement of Need In response to the increased opioid addiction crisis, physicians are looking for effective alternatives to treat patient pain following surgery. Treatment protocols for post-surgical pain control for spine patients continues to evolve as new research becomes available regarding the effectiveness of nonopioid pain control. Physicians may not be aware of these new alternative protocols. The goal with new protocols is to either reduce or completely eliminate the opioid prescribing following surgery therefore decreasing the risk of patient abuse and addiction. Objectives This program will discuss research being conducted that will highlight effective alternatives to opioids for the management of post-surgical pain, as well as patient characteristics that can lead to opioid use. At the conclusion of this offering, the participant will be able to: Discuss research protocols employed to minimize the prescribing of opioids post-spine surgery; Standard Escalation Pain Protocol (SEPP) and Multi-modal Pain Control (MMPC). List patient characteristics that contribute to opioid use. Describe the patient benefits of non-opioid pain control post-surgery. Implement pain control protocols that minimize or eliminate the use of opioids following surgery. Moderator James Jennings, M.D. Executive Medical Director Adult Primary Care & Provider Well-being   Faculty Jeffrey Gum, M.D. Spine Surgeon Leatherman Spine Center   Faculty Disclosure The speaker for this activity has a relevant relationship with Pacira Pharmaceuticals (honorarium). Other relevant relationships are specific to spine surgery and are not related to the topic of pain management. These include: Consultant (Medtronic, Acuity, K2M, NuVasive and Mazor), Advisory Board (K2M and Medtronic), Honoraria (Baxter), Research (Integra, Intellirod Spine, Inc. Pfizer and NuVasive), Speaker’s Bureau (Depuy and Stryker).  (Stock with Cingulate Therapeutics, related to ADHD medications).   Moderator and Planner Disclosures The moderator or planners for this activity have no potential or actual conflicts of interest to disclose. Commercial Support This activity is supported in part with a grant from Cardinal Health. Physician Credits American Medical Association   Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation Norton Healthcare designates this other activity (podcast) for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   HB1 / Prescribing Controlled Substances The Kentucky Board of Medical Licensure has approved the podcast Opioids in Spine Surgery for .50 HB1 credit hours. ID# 0319-H.50-NHC1b   Date of Original Release | April 2019 Course Termination Date | April 30, 2020 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org References Hill, M.D. Maureen V., et.al, “Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures,” Annuals of Surgery, Vol. 265, Number 4, April 2017, pages 709 – 714. Hill, M.D., Maureen V., et. al., “An Educational Intervention Decreases Opioid Prescribing After General Surgical Operations,” Annuals of Surgery, Vol. 267, Number 3, March 2018, pages 468 – 472. Nayoung, Kim, BS, Matzon, M.D., Jonas, etc. al., “A Prospective Evaluation of Opioid Utilization After Upper-Extremity Surgical Procedures: Identifying Consumption Patterns and Determining Prescribing Guidelines,” The Journal of Bone and Joint Surgery, 98(20); e89, Oct. 2016. Edwards, David A., M.D., PhD, etc.al, “American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy,” Anesthesia & Analgesia, March 14, 2019.   Course number: 128078

Episode 65: Guidelines for Safe Prescribing of Controlled Substances Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat65   Target AudienceThis activity is targeted toward primary care and geriatric healthcare providers and advanced providers. Statement of Need This activity will discuss the steps to safe prescribing of opioids for providers. In that chronic pain is commonly treated in the primary care office and back pain is one of top ten reasons patients visit health care providers, providers should be aware of how to safely prescribe controlled substances if selected as the treatment for these patients. Objectives At the conclusion of this offering, the participant will be able to: Describe the risks and benefits of prescribing and tapering controlled substances. Identify the key components of safe prescribing of controlled substances. ModeratorGregory E. Cooper, M.D., Ph.D. Chief of Adult Neurology Medical Director, Memory Center Norton Neuroscience Institute Norton Healthcare Louisville, Kentucky SpeakerKelly C. Cooper, M.D., MPH, FASAM Addiction Specialist Norton Behavioral Health Louisville, Kentucky Moderator, Speaker and Planner Disclosures  The planners, moderators and speakers of this activity do not have any relevant financial relationships to disclose.  Commercial Support  There was no commercial support for this activity.  Physician Credits Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing CreditsNorton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for 0.75 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org. HB1 / Prescribing Controlled SubstancesThe Kentucky Board of Medical Licensure has approved the podcast Guidelines for Safe Prescribing of Controlled Substances for .75 HB1 credit hours. ID# 0723-H.75-NHC2i Resources for Additional Study: The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System    https://pubmed.ncbi.nlm.nih.gov/31068400/ CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022 https://pubmed.ncbi.nlm.nih.gov/36327391/   Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.   Date of Original Release | March 2024; Information is current as of the time of recording. Course Termination Date | March 2027 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare’s podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute Resource Center, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Hear from stroke survivors and medical specialists about being stronger after stroke. Listen on the Norton Healthcare Channel on Apple Podcasts or on your favorite podcast platform.   Podcast editing and production:  www.unmuteaudio.com  

Management of Insomnia   Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat64   Target Audience             This activity is targeted toward primary care and geriatric healthcare providers and advanced providers.   Statement of Need  The program is a podcast discussion that will address the diagnosis and treatment of insomnia in adults. Insomnia is a common problem seen in the primary care setting and this podcast will address common issues/questions of providers helping them to improve patient care as related to insomnia.   Objectives  At the conclusion of this offering, the participant will be able to:  1.     Define acute and chronic insomnia. 2.     Discuss the diagnostic criteria for insomnia.        3.     Identify strategies for the management of insomnia.   Moderator Gregory E. Cooper, M.D., Ph.D. Chief of Adult Neurology Medical Director, Memory Center Norton Neuroscience Institute Norton Healthcare Louisville, Kentucky   Speaker Kevin K. Trice, M.D., MBA Sleep Medicine Physician Norton Pulmonary Specialists Louisville, Kentucky   Moderator, Speaker and Planner Disclosures   The planners and moderators of this activity do not have any relevant financial relationships to disclose. Kevin Trice, M.D. has relationships with Jazz Pharma, Harmony Biosciences, Axsome Therapeutics, Avadel and Idorsia as a consultant. These relationships have been mitigated.    Commercial Support   There was no commercial support for this activity.    Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation  Norton Healthcare designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for 0.75 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources for Additional Study: Insomnia https://pubmed.ncbi.nlm.nih.gov/36115372/   Waking up to the importance of sleep https://pubmed.ncbi.nlm.nih.gov/36115369/     Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release | March 2024; Information is current as of the time of recording.  Course Termination Date | March 2027 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org     Also listen to Norton Healthcare’s podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute Resource Center, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Hear from stroke survivors and medical specialists about being stronger after stroke. Listen on the Norton Healthcare Channel on Apple Podcasts or on your favorite podcast platform.     Podcast editing and production:  www.unmuteaudio.com  

Female Patterned Heart Disease   Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat63   Target Audience             This activity is targeted toward primary care providers and advanced providers.   Statement of Need  This podcast will discuss female-patterned heart disease. Cardiovascular disease continues to be one of the leading causes of mortality for women. Research indicates that there continues to be disparities in the diagnosis and treatment of cardiovascular disease for women, resulting in greater mortality rate. (American Journal of Preventive Cardiology). The goal of this program is to highlight risks, symptoms and diagnostic characteristics specific to female patients with the goal of earlier intervention and improved patient outcomes.   Objectives At the conclusion of this offering, the participant will be able to: Define female-patterned heart disease and presenting symptoms unique to females. Discuss the latest diagnostic guidelines for female-patterned heart disease. Describe female specific risk factors of cardiovascular disease.    Moderator Mona Lisa Tailor, M.D. Internal Medicine Norton Community Medical Associates - Barrett Louisville, Kentucky   Speaker Li Zhou, M.D., Ph.D. Medical Director Norton Heart and Vascular Institute Norton Healthcare Louisville, Kentucky   Moderator, Speaker and Planner Disclosures   The planners, moderator and speaker of this activity do not have any relevant financial relationships to disclose.    Commercial Support   There was no commercial support for this activity.    Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.     Designation  Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for .75 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources Cardiovascular disease in women https://pubmed.ncbi.nlm.nih.gov/17569469/   Beyond equality, women require extra care in cardiovascular imaging https://pubmed.ncbi.nlm.nih.gov/35962143/     Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release | Feb 2024; Information is current as of the time of recording.  Course Termination Date | Feb 2027 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org     Also listen to Norton Healthcare’s podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute Resource Center, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Hear from stroke survivors and medical specialists about being stronger after stroke. Listen on the Norton Healthcare Channel on Apple Podcasts or on your favorite podcast platform.     Podcast editing and production:  www.unmuteaudio.com

Human Trafficking: A Survivor’s Story Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat62 Target Audience             This activity is targeted toward primary care providers, advanced providers and healthcare clinicians.  Statement of Need  According to the American Public Health Association, the health system plays an important role in identifying and treating victims of human trafficking. Estimates show that approximately 80 percent of human trafficking victims are women, and health care providers are often the first professionals to have contact with trafficked women and girls. One study found that close to 50 percent of trafficked individuals saw a health care professional during their exploitation. Clinicians need to be aware of red flags that their patient could be a victim of human trafficking, best practices for screening and assessing patients for trafficking, and their response as a health care professional, and resources for assisting the victims. Providers should know how to screen patients for human trafficking; and what to do if there are indicators of a potential victim of human trafficking.   Objectives  At the conclusion of this offering, the participant will be able to:  Identify red flags of human trafficking and opportunities for victim identification that can be missed by the healthcare provider. Highlight communication strategies for identifying potential human trafficking victims from the perspective of a victim. Discuss the significance and impact of compassion to the patient in the delivery of health care.   Moderator Naomi Warnick, M.D., J.D. Pediatric Emergency Medicine Fellow UofL School of Medicine Department of Pediatrics Louisville, Kentucky Pediatric Hospitalist Norton Children’s Hospital Louisville Kentucky Guest Kathleen:  Human Traffic Survivor    Commercial Support   There was no commercial support for this activity.  Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation  Norton Healthcare designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. For more information about continuing medical education credits, please send an email to cme@nortonhealthcare.org.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for 1.0 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Social Workers   The National Association of Social Workers, Kentucky Chapter (NASW-KY), is an approved provider for social work credits through the Kentucky Board of Social Work. This activity will provide 1.0 hours of required continuing education units. NASWKY#090123 For more information about social worker credits, contact the Norton Healthcare Center for Medical, Provider & Nursing Education at (502) 446-5955 or cme@nortonhealthcare.org.   Other attendees   Confirmed attendance hours will be recorded for all other attendees. Hours of confirmed attendance will be equivalent to the number of hours of one’s attested attendance. For additional information related to confirmed attendance, contact the Norton Healthcare Center for Medical, Provider & Nursing Education at (502) 466-5955 or cme@nortonhealthcare.org.   Resources  National Human Trafficking Hotline      1-888-373-7888 or text 233733 Polaris Project – https://polarisproject.org HEAL Trafficking – Healtrafficking.org  Mental Health Lifeline - 988   Human Trafficking: Empowering Healthcare Providers and Community Partners as Advocates for Victims https://pubmed.ncbi.nlm.nih.gov/34569887/ Human Trafficking in the Emergency Department: Improving Our Response to a Vulnerable Population https://pubmed.ncbi.nlm.nih.gov/32421500/   Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.   Date of Original Release |Jan. 2024; Information is current as of the time of recording.  Course Termination Date | Jan 2026 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare’s podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute Resource Center, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Hear from stroke survivors and medical specialists about being stronger after stroke. Listen on the Norton Healthcare Channel on Apple Podcasts or on your favorite podcast platform.     Podcast editing and production:  www.unmuteaudio.com

Part One: Hidden Victims: A Guide for Healthcare Providers in Identifying Human Trafficking Victims Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat61 Target Audience             This activity is targeted toward primary care providers, advanced providers and healthcare clinicians.  Statement of Need  According to the American Public Health Association, the health system plays an important role in identifying and treating victims of human trafficking. Estimates show that approximately 80 percent of human trafficking victims are women, and health care providers are often the first professionals to have contact with trafficked women and girls. One study found that close to 50 percent of trafficked individuals saw a health care professional during their exploitation. Clinicians need to be aware of red flags that their patient could be a victim of human trafficking, best practices for screening and assessing patients for trafficking, and their response as a health care professional, and resources for assisting the victims. Providers should know how to screen patients for human trafficking; and what to do if there are indicators of a potential victim of human trafficking. Objectives  At the conclusion of this offering, the participant will be able to:  Discuss the scope of human trafficking locally and nationally. Identify the red flags of human trafficking and screening questions to ask, so that a potential victim can be identified when they are accessing the healthcare system. Review the reporting and documentation guidelines for when a patient is suspected of being a victim of human trafficking. Discuss appropriate communication strategies, including trauma-informed communication, to best facilitate trust between provider and patient.  Moderator Kim Boland, M.D., FAAP Professor and Chair of Pediatrics Billy F. Andrew’s Endowed Chair UofL School of Medicine Department of Pediatrics Chief of Staff Norton Children’s Hospital Louisville, Kentucky Speakers Olivia Mittel, M.D., M.S. Professor and Associate Dean for Student Affairs UofL School of Medicine Louisville, Kentucky Pediatric Hospitalist Norton Children’s Hospital Louisville Kentucky Naomi Warnick, M.D., J.D. Pediatric Emergency Medicine Fellow UofL School of Medicine Department of Pediatrics Louisville, Kentucky Moderator, Speaker and Planner Disclosures   The planners, moderator and speaker of this activity do not have any relevant financial relationships to disclose.  Commercial Support   There was no commercial support for this activity.  Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation  Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. For more information about continuing medical education credits, please send an email to cme@nortonhealthcare.org.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for .75 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org. Social Workers  The National Association of Social Workers, Kentucky Chapter (NASW-KY), is an approved provider for social work credits through the Kentucky Board of Social Work. This activity will provide .75 hours of required continuing education units. NASWKY#090123 For more information about social worker credits, contact the Norton Healthcare Center for Medical, Provider & Nursing Education at (502) 446-5955 or cme@nortonhealthcare.org. Other attendees   Confirmed attendance hours will be recorded for all other attendees. Hours of confirmed attendance will be equivalent to the number of hours of one’s attested attendance. For additional information related to confirmed attendance, contact the Norton Healthcare Center for Medical, Provider & Nursing Education at (502) 466-5955 or cme@nortonhealthcare.org.   Resources   National Human Trafficking Hotline      1-888-373-7888 or text 233733 Polaris Project – https://polarisproject.org HEAL Trafficking – Healtrafficking.org  Mental Health Lifeline – 988 Human Trafficking: Empowering Healthcare Providers and Community Partners as Advocates for Victims https://pubmed.ncbi.nlm.nih.gov/34569887/ Human Trafficking in the Emergency Department: Improving Our Response to a Vulnerable Population https://pubmed.ncbi.nlm.nih.gov/32421500/   Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.   Date of Original Release |Jan. 2024; Information is current as of the time of recording.  Course Termination Date | Jan 2026 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare’s podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute Resource Center, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Hear from stroke survivors and medical specialists about being stronger after stroke. Listen on the Norton Healthcare Channel on Apple Podcasts or on your favorite podcast platform.     Podcast editing and production:  www.unmuteaudio.com

Podcast: Updates in Hyperthyroidism    Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat60   Target Audience             This activity is targeted toward primary care providers and advanced providers.   Statement of Need  This podcast will discuss the diagnosis and management of hyperthyroidism in pediatric and adult patients. In that the clinical presentation of hyperthyroidism symptoms varies among adult and pediatric patients, it is important for providers to be aware of the latest diagnostic guidelines and latest updates in the treatment of hyperthyroidism.   Objectives  At the conclusion of this offering, the participant will be able to:  Define hyperthyroidism and causes of hyperthyroidism. Discuss symptoms and the latest diagnostic guidelines for hyperthyroidism in the adult and pediatric patient. Review the clinical components of a thyroid storm. Describe the management options for hyperthyroidism.   Moderator Mona Lisa Tailor, M.D. Internal Medicine Norton Community Medical Associates - Barrett Louisville, Kentucky   Speaker Lisal J. Folsom, M.D., M.S. Adult and Pediatric Endocrinologist Norton Community Healthcare Associates - Endocrinology Norton Children’s Endocrinology Louisville, Kentucky   Moderator, Speaker and Planner Disclosures   The planners, moderator and speaker of this activity do not have any relevant financial relationships to disclose.    Commercial Support   There was no commercial support for this activity.    Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation  Norton Healthcare designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for .5 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources Burch-Wartofsky Point Scale (BWPS) https://www.mdcalc.com/calc/3816/burch-wartofsky-point-scale-bwps-thyrotoxicosis   Clinical Review and Update on the Management of Thyroid Storm https://pubmed.ncbi.nlm.nih.gov/36118802/     Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release |Dec 2023; Information is current as of the time of recording.  Course Termination Date | Dec 2026 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org    

Bipolar Disease: Diagnosis and Management   Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat59   Target Audience             This activity is targeted toward primary care providers and advanced providers.   Statement of Need  This podcast will discuss the diagnosis and management of bipolar disorders with a focus for the primary care setting. Patients with these disorders are often seen in the primary care setting, although diagnosis can be challenging in that the prevalence is low. Objectives  At the conclusion of this offering, the participant will be able to:  Define bipolar disorder, including characteristics and prevalence. Describe the distinction between Bipolar Type 1 and Type 2. Discuss combordities that exist with Bipolar Disorder. Review management strategies for patients diagnosed with Bipolar Disorder.   Moderator Jim Frazier, M.D. Pediatrician Chief Medical Officer Norton Healthcare Louisville, Kentucky   Speaker John J. Wernert, M.D., MHA, DLFAP Executive Medical Director Norton Behavioral Medicine Norton Healthcare Louisville, Kentucky     Moderator, Speaker and Planner Disclosures   The planners, moderator and speaker of this activity do not have any relevant financial relationships to disclose.    Commercial Support   There was no commercial support for this activity.      Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation  Norton Healthcare designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for .5 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources for Additional Study Screening for Bipolar I Disorder and the Rapid Mood Screener: Results of a Nationwide Health Care Provider Survey https://pubmed.ncbi.nlm.nih.gov/37115145/   Is it depression or is it bipolar depression? https://pubmed.ncbi.nlm.nih.gov/33017361/     Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release |Nov 2023; Information is current as of the time of recording.  Course Termination Date | Nov 2025 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org    

Podcast: Screen Use and Mental Health   Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat58   Target Audience             This activity is targeted toward primary care and geriatric healthcare providers and advanced providers.   Statement of Need  This program will review the negative impact of digital technology (screen use) on brain health and cognitive brain development. Recent research indicates that children in the US spend more than 4 - 6 hours a day watching/using screens, and teens up to 9 hours; adults approx. 10.5 hours per day. This podcast will discuss the negative impacts of screen use for adolescents as well as characteristics and management of screen addiction..   Objectives  At the conclusion of this offering, the participant will be able to:  Distinguish between passive and interactive screen use. Identify the current diagnostics and clinical presentations for screen addicted patients. Discuss the emotional and physiological underpinning of interactive screen use compulsivity. Review the overview treatment methodology and clinical interventions for screen addiction.   Moderator Erin Frazier, M.D. Pediatrician Norton Children’s Medical Group – Broadway Norton Healthcare Louisville Kentucky   Speakers Michael Eiden, LCSW, LCADC, CSAT   Eiden Integrative Counseling Louisville, Kentucky   Moderator, Speaker and Planner Disclosures   The planners, moderator and speaker of this activity do not have any relevant financial relationships to disclose.    Commercial Support   There was no commercial support for this activity.    Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.     Designation  Norton Healthcare designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This continuing professional development activity has been approved for 1.0 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Social Workers The National Association of Social Workers, Kentucky Chapter (NASW-KY), is an approved provider for social work credits through the Kentucky Board of Social Work. This activity will provide 1.0 hours of required continuing education units. NASWKY#090123 For more information about social worker credits, contact the Norton Healthcare Center for Medical, Provider & Nursing Education at (502) 446-5955 or cme@nortonhealthcare.org.   Resources for Providers Healthy Children.org from the American Academy of Pediatrics American Academy of Pediatrics Screen Time Guidelines   Resources for Additional Study Screen Time and Children Screen Time and Children (aacap.org)   Dunckley V. L. (2015). Reset your child's brain: a four-week plan to end meltdowns raise grades and boost social skills by reversing the effects of electronic screen-time. New World Library.   Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women’s and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release |Oct 2023; Information is current as of the time of recording.  Course Termination Date | Oct 2025 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org