RESUMO
The destruction in Puerto Rico following Hurricane Maria brought an increased demand for health care services while severely limiting the health care system's ability to provide patient care. Immediately following the hurricane, countless patients found themselves in a situation without their medications for both acute and chronic conditions. Many of these patients turned first to community pharmacies for access to their medications. In this letter, we describe the response of pharmacists to the needs of their communities following the natural disaster, Hurricane Maria, and summarize some lessons learned from the experience that may be useful in future disaster planning.
Assuntos
Tempestades Ciclônicas , Planejamento em Desastres , Farmacêuticos , Acessibilidade aos Serviços de Saúde , Humanos , Assistência ao Paciente , Farmácias , Papel Profissional , Porto RicoRESUMO
OBJECTIVE: To evaluate the potential impact of a concussion management education program on community-practicing pediatricians. STUDY DESIGN: We prospectively surveyed 210 pediatricians before and 18 months after participation in an evidence-based, concussion education program. Pediatricians were part of a network of 38 clinically integrated practices in metro-Atlanta. Participation was mandatory for at least 1 pediatrician in each practice. We assessed pediatricians' self-reported concussion knowledge, use of guidelines, and comfort level, as well as self-reported referral patterns for computed tomography (CT) and/or emergency department (ED) evaluation of children who sustained concussion. RESULTS: Based on responses from 120 pediatricians participating in the 2 surveys and intervention (response rate, 57.1%), the program had significant positive effects from pre- to postintervention on knowledge of concussions (-0.26 to 0.56 on -3 to +1 scale; P < .001), guideline use (0.73-.06 on 0-6 scale; P < .01), and comfort level in managing concussions (3.76-4.16 on 1-5 scale; P < .01). Posteducation, pediatricians were significantly less likely to self-report referral for CT (1.64-1.07; P < .001) and CT/ED (4.73-3.97; P < .01), but not ED referral alone (3.07-3.09; P = ns). CONCLUSIONS: Adoption of a multifaceted, evidence-based, education program translated into a positive modification of self-reported practice behavior for youth concussion case management. Given the surging demand for community-based youth concussion care, this program can serve as a model for improving the quality of pediatric concussion management.
Assuntos
Concussão Encefálica/terapia , Pediatria/educação , Melhoria de Qualidade , Adulto , Idoso , Criança , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Prospectivos , AutorrelatoRESUMO
Objetivo: la adolescencia es una etapa crucial en la vida de las personas, caracterizada por profundos cambios que marcan el paso de la niñez a la vida adulta. La detección proactiva de factores de riesgo y la intervención temprana son fundamentales para prevenir conductas riesgosas. El objetivo planteado fue describir la prevalencia del riesgo biopsicosocial y la percepción de la funcionalidad familiar de las personas adolescentes. Métodos: la población del estudio estuvo constituida por 124 adolescentes de sexto grado. Se incluyó tanto hombres como mujeres, mayores de 10 años, con el consentimiento informado de sus padres. Se les aplicó los cuestionarios Tamizaje de Riesgo del Programa de Atención Integral de la Adolescencia (PAIA) y APGAR Familiar. Resultados: los factores de riesgo con mayor prevalencia fueron: ausencia de confidente (36,3 por ciento), sensación de depresión (23,4 por ciento), participación en peleas (12,1 por ciento)e ideas de muerte (8,1 por ciento). La prevalencia de buena función familiar fue el 68,6 por ciento, disfunción leve del 27,4 por ciento y disfunción severa del 4 por ciento. La percepción de buena funcionalidad familiar por parte de los adolescentes estuvo relacionada con bajo riesgo biopsicosocial (p=0,011), mayor comunicación con los padres (p=0,000), ausencia de sensación de depresión (p=0.002), ausencia de ideas de muerte (p=0,00041) y ausencia de intentos suicidas (p=0,003). Conclusiones: los mayores problemas encontrados en los adolescentes fueron: ausencia de un confidente, sensación de depresión, participación en peleas e ideas de muerte. La familia funcional se mostró como un factor protector contra síntomas depresivos, ideas de muerte e intentos suicidas...