O uso abusivo de drogas é um problema relevante em saúde pública, e causa uma série de prejuízos aos usuários, tanto físicos quanto psicológicos. No âmbito físico, alterações sistêmicas e bucais são notáveis. O consumo de drogas entre jovens e adultos, fenômeno conhecido como drogadição, tem-se estabelecido em faixas etárias cada vez mais precoces nas últimas décadas. O objetivo do presente estudo foi avaliar a condição bucal, nutrição e qualidade de vida de usuários de drogas ilícitas que se encontram em tratamento na Ala de Desintoxicação do Hospital Universitário do Oeste do Paraná. Para tanto foram utilizados questionários estruturados e realizados exames clínicos bucais para identificar as condições associadas ao uso de tais substâncias. Os resultados demonstraram que a maioria dos voluntários avaliados apresenta alterações bucais importantes, principalmente, cáries. Tem uma dieta predominantemente cariogênica e baixo fluxo salivar. Conclusão: Conclui-se que é importante que os drogaditos sejam acompanhados por um cirurgião-dentista porque a dependência afeta diretamente a cavidade bucal, reduzindo a autoestima e a recuperação do paciente.
Despite the known effectiveness, physical activity (PA) is not currently offered to older adult clients receiving Medicaid Home and Community Based Services (HCBS). To optimize PA implementation within Medicaid HCBS, understanding client preferences for PA programming is needed. Thus, the objective of this exploratory qualitative study was to identify the PA preferences of HCBS clients including mode, duration, implementation strategy, and frequency, as well as barriers and motivators to PA. We recruited participants from the Illinois’ Department on Aging Community Care Program. We conducted semi-structured interviews in participants’ homes which were audio recorded, transcribed, and analyzed using Dedoose (version 7.0.23). We derived semi-structured interview questions from the Health Belief, Social Cognitive, and Health Action Process Approach framework. We used a structured coding approach using conventional content analysis to derive codes from the text, then applied these codes to each interview and examined the frequency to determine themes. The most frequently referenced theme was barriers to PA, primarily co-morbidities. The primary motivator was social support by a peer or instructor. The preferred PA program components were walking 2-3 days per week with duration varying from 20 minutes to 2 hours. Clients also preferred individualized PA instruction versus a passive strategy such as pamphlets or videotapes. Our findings show that individual-level factors most significantly influence PA participation and should be addressed among Medicaid HCBS clients. We recommend Medicaid HCBS consider a personalized approach of PA implementation with their clients.
Background: Addressing operational inefficiencies in operating rooms (ORs) enhances patient access to care, reduces delays, and improves employee and patient satisfaction. The Comprehensive Unit-based Safety Program (CUSP) promotes patient safety through increased teamwork, empowerment of frontline staff, and utilization of science of safety principles. CUSP has demonstrated success in outpatient and inpatient settings to decrease complication rates and establish a culture of safety but has been used minimally in the perioperative setting. In this study, the CUSP methodology was utilized to improve perioperative efficiency in pediatric spine surgery, and preimplementation and postimplementation efficiency were compared, using the rate of first case on-time starts (FCOTS) as the primary metric. Methods: A CUSP quality improvement workgroup including nurses, technicians, surgeons, anesthesiologists, and administrators sought feedback on opportunities for improvement and tracked key performance metrics in the OR from 2015 to 2020. Key interventions developed in response to feedback included standardizing and streamlining room setup and adjusting staffing models for greater efficiency. Univariate analysis was conducted to compare time periods pre-CUSP and post-CUSP implementation. Results: First case on-time starts increased from 38% to a high of 81% after implementation. For more complex cases, the average patient in the room to anesthesia ready time improved by 31% with decreased variance over time, and average closure to patient out of room time improved by 45%. Improvements were sustained through Year 3, while CUSP remained a primary focus for the team. Conclusions: CUSP is effective in enhancing perioperative efficiency, demonstrating strong improvement in on-time starts over 5 years. The results indicate that process improvement in ORs requires consistent attention to sustain gains over time. Engaging frontline staff in quality improvement fosters collaboration and provides employee buy-in to promoting a culture of safety and improving value in patient care.
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