Evaluation of an academic service partnership using a strategic alliance framework.

PubMed

Murray, Teri A; James, Dorothy C

2012-01-01

Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model. Copyright © 2012 Elsevier Inc. All rights reserved.

Emergence of the bipolar cultural complex in Walt Whitman.

PubMed

Herrmann, Steven B

2007-09-01

My main hypothesis in this paper(1) is that America's seminal poet, Walt Whitman, was trapped--like so many of his contemporaries--in 'cultural complexes' (Singer & Kimbles 2004) that he internalized, but that he found a way to transcend the splits inherent in these 'bipolar' (Perry 1970) organizations through his art. One way he accomplished this was through his aesthetic method of 'holding the opposites' between two poles of a slavery is wrong/white supremacy is justified cultural complex. In my paper, I provide evidence for some of the contradictions inherent in Whitman's character by examining the political splits of his times and explore how various Self symbols he produced through his poetry, particularly the figures he called 'Black Lucifer' and the Deus Quadriune--a quaternity symbol--facilitated his personal and cultural transformation. Finally, I demonstrate the relevance of my hypothesis to contemporary racism during the pre-Civil Rights period in the South through a clinical example, and I show how the Jungian method of 'holding the opposites' can be effectively practised in the transference/countertransference field of psychotherapy in general.

Group selection and the development of the biological species concept

PubMed Central

Mallet, James

2010-01-01

The development of what became known as the biological species concept began with a paper by Theodosius Dobzhansky in 1935, and was amplified by a mutualistic interaction between Dobzhansky, Alfred Emerson and Ernst Mayr after the second world war. By the 1950s and early 1960s, these authors had developed an influential concept of species as coadapted genetic complexes at equilibrium. At this time many features of species were seen as group advantages maintained by selection to avoid breakdown of beneficial coadaptation and the ‘gene pool’. Speciation thus seemed difficult. It seemed to require, more so than today, an external deus ex machina, such as allopatry or the founder effect, rather than ordinary within-species processes of natural selection, sexual selection, drift and gene flow. In the mid-1960s, the distinctions between group and individual selection were clarified. Dobzhansky and Mayr both understood the implications, but their views on species changed little. These group selectionist ideas now seem peculiar, and are becoming distinctly less popular today. Few vestiges of group selectionism and species-level adaptationism remain in recent reviews of speciation. One wonders how many of our own cherished views on evolution will seem as odd to future biologists. PMID:20439286

[Euclid and Pythagorus in the 21st century. A proposal on various harmonious craniofacial and occlusal constants].

PubMed

Blocquel, H

2001-01-01

The aim of this work was to study the architectural relationships between different squeletal and dental pieces participating in the mastication, and to prove their fixity. We have at our disposition a collection of teleradiographies taken from profile on the same subject, over the course of several years; 3000 of them have been selected. With the help of tracings, where are drawn 36 degrees angles; or 72 degrees and 108 degrees; we systematize our locations. Together with our ten experimenters, we have noticed the existence of a parallelism between the graphic representations of the Bouvet occlusal plane, the sphenoïdal planum (sphenoïdale bone) and the course of the second trigeminal branch (trigeminus nerve) in its infra-orbital section. The angle of those different marks with the superior clivus (quadrilateral strip of the sphenoïd) (dorsum sellae) still measures 72 degrees. It is equal to 108 degrees with the graphic representation of the third antero-inferior pterygoïd process. (pterygoïdeus process). The angle between the superior clivus and the pterygoïd process still measures 36 degrees. These works are new contributions to the orthodontic, occlusodontic or prosthetic conceptions.

Deus ex machina or e-slave? Public perception of healthcare robotics in the German print media.

PubMed

Laryionava, Katsiaryna; Gross, Dominik

2012-07-01

The news media plays a central role in providing information regarding new medical technologies and exerts an influence on their social perception, understanding, and assessments. This study, therefore, analyzes how healthcare robotics are portrayed in the German print news media. It examines whether the risks and opportunities of new medical technologies are presented in a balanced manner and investigates whether or not print media coverage of these technologies is affected by science-fiction discourse, in which robots appear mostly as a threat to humans. Ten years of German print media coverage (2000-2010) have been studied by means of systematic, standardized content analysis. Reporting focuses predominantly on beneficial advancements in medical practice and the advantages of robotics for patients, medical staff, and society. The results show that the dominant relationship between robots and humans that is transmitted in print media in medical contexts is positive, with robots mostly portrayed as assistants, colleagues, or even friends. Only a small number of articles report ethical questions and risks. In contrast to science-fiction discourse, the German print media provides a positive picture of robotics to the lay public.

[On freedom of scientific research].

PubMed

Folkers, G

2013-07-01

Debates about science and, more specifically, about scientific research quickly bring up the question about its freedom. Science is readily blamed for technological disasters or criticized for nursing fantasies of omnipotence and commercial gain. This prompts the call for a restriction of its freedom. At the same time, society's demands on science are enormous, to the effect that science and technology have acquired the status of a deus-ex-machina: they are expected to furnish short-term, affordable, and convenient solutions to a wide range of problems, including issues of health, transportation, food and, more generally, a comfortable life. What kind of freedom is required to meet these expectations? Who is in a position to grant it? What does freedom for science mean and how is it linked to responsibility? The paper examines the current situation of freedom in scientific research and of its restrictions, many of which are mentally or economically conditioned. It calls for the involvement of an informed, self-confident bourgeoisie in research decisions and for the educational measures this necessitates. Finally, it demands a greater appreciation of education (rather than training) as the basis of social trust, and the recognition of continuous education as a productive investment of time and a crucial element in the employment of social goods.

An evaluation of clinical laboratory services in sub-Saharan Africa. Ex africa semper aliquid novi?

PubMed

Gray, I P; Carter, J Y

1997-11-06

Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries 'first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.

Medicus Deus: a review of factors affecting hospital library services to patients between 1790–1950

PubMed Central

Perryman, Carol

2006-01-01

Question: What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Data Sources: Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. Study Selection: The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. Data Extraction: An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Main Results: Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. Conclusion: This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved. PMID:16888658

Medicus Deus: a review of factors affecting hospital library services to patients between 1790-1950.

PubMed

Perryman, Carol

2006-07-01

What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved.

Moral philosophy in bioethics. Etsi ethos non daretur?

PubMed

Pessina, Adriano

2013-01-01

In this paper I intend to put forward some criticism of the purely procedural model of bioethics, which, in fact, leads to delegating to biopolitics and biolaw the finding of a purely pragmatic solution to the issues for which bioethics was "invented" over forty years ago. This delegating takes place after the transition from the thesis, dear to modernity, whereby in ethics reasoning should avoid any discussion regarding its foundation or ultimate justification (Etsi Deus non daretur) to the contemporary affirmation of a substantial ethical agnosticism, which, in the name of the incommensurability of morals, should construct procedures as if no sole substantial moral were possible (Etsi ethos non daretur) and act as a guarantor of ethical pluralism. These theses will be discussed and an attempt will be made to demonstrate why it is necessary to establish a link between true and good, and how this is possible only by referring to ontology. The conclusion points to the need to propose bioethics explicitly in terms of content that satisfies the presumed axiological neutrality of procedural bioethics, which however, turns out to be theoretically weak and practically unable to protect the ethical pluralism for which it would like to be the guarantor. The conclusion is that only by referring to ontology can bioethics, which is a fully fledged form of moral philosophy, act as a guarantor of pluralism within the truth and oppose the authoritarian tendencies concealed under the liberal guise of ethical agnosticism.

Diet and exercise in uterine cancer survivors (DEUS pilot) - piloting a healthy eating and physical activity program: study protocol for a randomized controlled trial.

PubMed

Koutoukidis, Dimitrios A; Beeken, Rebecca J; Manchanda, Ranjit; Burnell, Matthew; Knobf, M Tish; Lanceley, Anne

2016-03-10

Endometrial cancer survivors comprise a high-risk group for obesity-related comorbidities. Healthy eating and physical activity can lead to better health and well-being, but this population may experience difficulties adopting healthy lifestyle practices. Personalised behaviour change programmes that are feasible, acceptable and cost-effective are needed. The aim of this trial is to pilot a manualised programme about healthy eating and physical activity. This is a phase II, individually randomized, parallel, controlled, two-site, pilot clinical trial. Adult endometrial cancer survivors (n = 64) who have been diagnosed with endometrial cancer within the previous 3 years and are not on active treatment will be invited to participate. Participants will be assigned in a 1:1 ratio through minimisation to either an 8-week, group-based, behaviour-change programme with weekly 90-min sessions about healthy eating and physical activity or usual care. The intervention will focus on self-monitoring, goal setting and self-rewards. Follow-up assessments will be conducted at 8 and 24 weeks from the baseline assessment. Primary feasibility outcomes will include rates of recruitment, adherence, and retention. The study results will inform the development of a definitive randomised controlled trial to test if the programme can improve the health and quality of life of this population. It will also provide guidance on costing the intervention and the health care resource use in this population. ClinicalTrials.gov identifier: NCT02433080, 20 April 2015.

[Back to units for nursing students' education? The Dedicated Education Units (DEU)].

PubMed

Randon, Giulia; Bortolami, Elena; Grosso, Silvia

2017-01-01

. Back to units for nursing students' education? The Dedicated Education Units (DEU). The reorganization and rationalization of resources and cost containment in health care put a strain on the sustainability of practical training of student nurses. The Dedicated Education Units (DEU), where ward staff, in collaboration with university teachers, receive large numbers of students, integrating the caring and teaching missions, are a possible answer. To describe the main characteristics of DEUs. A literature search was conducted in Pubmed with the following key-words Dedicated Education Unit, Education Unit and Nursing Education, up to January 30, 2017. Several models of DEU were identified with differences in contexts, professional roles involved, type of organizations (number of students, length of practical training). The students perceive a welcoming climate that promotes learning and allows time and space for reflection; they develop a professional group identity and learn to recognize and implement the presponsibilities related to the professional role. The students express satisfaction for the relationship with professionals involved in their education due to the clear definition of roles and responsibilities, of their learning needs and feel supported in the connections of theory and practice. The DEU, receiving large number of students optimize the use of resources. The DEU represent one of the possible models of organization of the practical training, able to ensure a high quality learning environment. The practical implications of its implementation in the italian context on skills acquisition and sustainability need a thorough assessment.

Resilience of Adapting Networks: Results from a Stylized Infrastructure Model.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beyeler, Walter E.; Vugrin, Eric D.; Forden, Geoffrey Ethan

2015-01-01

Adaptation is believed to be a source of resilience in systems. It has been difficult to measure the contribution of adaptation to resilience, unlike other resilience mechanisms such as restoration and recovery. One difficulty comes from treating adaptation as a deus ex machina that is interjected after a disruption. This provides no basis for bounding possible adaptive responses. We can bracket the possible effects of adaptation when we recognize that it occurs continuously, and is in part responsible for the current system’s properties. In this way the dynamics of the system’s pre-disruption structure provides information about post-disruption adaptive reaction. Seenmore » as an ongoing process, adaptation has been argued to produce “robust-yet-fragile” systems. Such systems perform well under historical stresses but become committed to specific features of those stresses in a way that makes them vulnerable to system-level collapse when those features change. In effect adaptation lessens the cost of disruptions within a certain historical range, at the expense of increased cost from disruptions outside that range. Historical adaptive responses leave a signature in the structure of the system. Studies of ecological networks have suggested structural metrics that pick out systemic resilience in the underlying ecosystems. If these metrics are generally reliable indicators of resilience they provide another strategy for gaging adaptive resilience. To progress in understanding how the process of adaptation and the property of resilience interrelate in infrastructure systems, we pose some specific questions: Does adaptation confer resilience?; Does it confer resilience to novel shocks as well, or does it tune the system to fragility?; Can structural features predict resilience to novel shocks?; Are there policies or constraints on the adaptive process that improve resilience?.« less

Spatial distribution and socioeconomic context of tuberculosis in Rio de Janeiro, Brazil

PubMed Central

Pereira, Alessandra Gonçalves Lisbôa; Medronho, Roberto de Andrade; Escosteguy, Claudia Caminha; Valencia, Luis Iván Ortiz; Magalhães, Mônica de Avelar Figueiredo Mafra

2015-01-01

OBJECTIVE To analyze the spatial distribution of risk for tuberculosis and its socioeconomic determinants in the city of Rio de Janeiro, Brazil. METHODS An ecological study on the association between the mean incidence rate of tuberculosis from 2004 to 2006 and socioeconomic indicators of the Censo Demográfico (Demographic Census) of 2000. The unit of analysis was the home district registered in the Sistema de Informação de Agravos de Notificação (Notifiable Diseases Information System) of Rio de Janeiro, Southeastern Brazil. The rates were standardized by sex and age group, and smoothed by the empirical Bayes method. Spatial autocorrelation was evaluated by Moran’s I. Multiple linear regression models were studied and the appropriateness of incorporating the spatial component in modeling was evaluated. RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west. The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom. CONCLUSIONS The spatial analysis identified areas of risk of tuberculosis incidence in the neighborhoods of the city of Rio de Janeiro and also found spatial dependence for the incidence of tuberculosis and some socioeconomic variables. However, the inclusion of the space component in the final model was not required during the modeling process. PMID:26270014

Spatial distribution and socioeconomic context of tuberculosis in Rio de Janeiro, Brazil.

PubMed

Pereira, Alessandra Gonçalves Lisbôa; Medronho, Roberto de Andrade; Escosteguy, Claudia Caminha; Valencia, Luis Iván Ortiz; Magalhães, Mônica de Avelar Figueiredo Mafra

2015-01-01

OBJECTIVE To analyze the spatial distribution of risk for tuberculosis and its socioeconomic determinants in the city of Rio de Janeiro, Brazil. METHODS An ecological study on the association between the mean incidence rate of tuberculosis from 2004 to 2006 and socioeconomic indicators of the Censo Demográfico (Demographic Census) of 2000. The unit of analysis was the home district registered in the Sistema de Informação de Agravos de Notificação (Notifiable Diseases Information System) of Rio de Janeiro, Southeastern Brazil. The rates were standardized by sex and age group, and smoothed by the empirical Bayes method. Spatial autocorrelation was evaluated by Moran's I. Multiple linear regression models were studied and the appropriateness of incorporating the spatial component in modeling was evaluated. RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west. The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom. CONCLUSIONS The spatial analysis identified areas of risk of tuberculosis incidence in the neighborhoods of the city of Rio de Janeiro and also found spatial dependence for the incidence of tuberculosis and some socioeconomic variables. However, the inclusion of the space component in the final model was not required during the modeling process.

Religiosity and spirituality as resilience strategies among long-living older adults in their daily lives.

PubMed

Reis, Luana Araújo Dos; Menezes, Tânia Maria de Oliva

2017-01-01

to investigate religiosity and spirituality as a resilience strategy for the long-living older adults in their daily lives. Qualitative research of phenomenological approach based on Martin Heidegger thoughts. Interviews were conducted with 14 older adults registered at a family health unit in the city of Jequié, BA, Brazil. The data were analyzed in the light of Being and Time. The results revealed that God occupies a central position in their lives, and the reading of the bible, praying the rosary and prayers are resilience strategies used for coping with unfavorable situations, recovery and/or maintenance of health, personal and family protection, and, above all, the experience of a satisfactory aging. Religiosity and spirituality were presented as an important resilience strategy in the existence of older adults, showing that through them it is possible to achieve well-being and cope with health and social problems. Desvelar a religiosidade e espiritualidade nas estratégias de resiliência do idoso longevo no cotidiano. Pesquisa qualitativa de abordagem fenomenológica fundamentada no pensamento de Martin Heidegger. Foram realizadas entrevistas com 14 pessoas idosas longevas cadastradas em uma unidade de saúde da família no município de Jequié, BA, Brasil. Os dados foram analisados à luz de Ser e Tempo. Desvelaram que Deus ocupa uma posição central em suas vidas, e a leitura da bíblia, a reza do terço e a oração são estratégias de resiliência utilizadas para o enfretamento de situações desfavoráveis, a recuperação e/ou manutenção da saúde, a proteção pessoal e familiar e, sobretudo, a vivência de uma velhice satisfatória. A religiosidade e espiritualidade foram desveladas como importante estratégia de resiliência no existir da pessoa idosa longeva, sinalizando que, por meio dela, é possível alcançar o bem-estar e enfrentar problemas de saúde e sociais.

Recruitment, adherence, and retention of endometrial cancer survivors in a behavioural lifestyle programme: the Diet and Exercise in Uterine Cancer Survivors (DEUS) parallel randomised pilot trial.

PubMed

Koutoukidis, Dimitrios A; Beeken, Rebecca J; Manchanda, Ranjit; Michalopoulou, Moscho; Burnell, Matthew; Knobf, M Tish; Lanceley, Anne

2017-10-08

Healthy eating and physical activity may help endometrial cancer survivors (ECS) improve their quality of life. However, most ECS do not meet the relevant guidelines. This pilot trial aimed to test the study feasibility procedures for a definitive trial of a behavioural lifestyle programme. This 24-week parallel two-arm randomised pilot trial took place in two hospitals in London, UK (April 2015-June 2016). Sixty disease-free ECS within 3 years of diagnosis. Participants were randomised using minimisation to receive the intervention or care as usual. The 'Shape-Up following cancer treatment' programme used self-monitoring, goal-setting, self-incentives, problem-solving and group social support for 12 hours over 8 weeks to help survivors improve their eating and physical activity. The main outcome measures were recruitment, adherence, and retention rates. Further outcomes included barriers to participation and feedback on programme satisfaction. Of the 296 potentially eligible ECS, 20% (n=60) were randomly allocated to the active intervention (n=29) or control group (n=31). Three participants in each arm were deemed ineligible after randomisation and excluded from analysis. Twenty participants (77%; 95% CI 61% to 93%) adhered to the intervention and provided generally favourable feedback. At 24 weeks, 25/26 (96%; 95% CI 89% to 100%) intervention and 24/28 (86%; 95% CI 73% to 99%) control participants completed their assessment. No intervention-related adverse events were reported. Among eligible survivors who declined study participation (n=83), inconvenience (78%; 95% CI 69% to 87%) was the most common barrier. The trial was feasible to deliver based on the a priori feasibility criteria. Enhancing recruitment and adherence in a definitive trial will require designs that promote convenience and consider ECS-reported barriers. NCT02433080; Pre-results. University College London, St. Bartholomew's Hospital Nurses League, and NIHR University College London Hospitals Biomedical Research Centre. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cross-cultural adaptation of the EMIC Stigma Scale for people with leprosy in Brazil.

PubMed

Morgado, Fabiane Frota da Rocha; Silveira, Erika Maria Kopp Xavier da; Sales, Anna Maria; Nascimento, Lilian Pinheiro Rodrigues do; Sarno, Euzenir Nunes; Nery, José Augusto da Costa; Oliveira, Aldair J; Illarramendi, Ximena

2017-09-04

Describe the process of cross-cultural adaptation of the "Explanatory Model Interview Catalog - Stigma Scale" for people affected by leprosy in Brazil. After being authorized by the author of the scale to use it in the national context, we initiated the five steps process of cross-cultural adaptation: (1) translation, (2) synthesis meeting, (3) back-translation, (4) committee of experts and (5) pre-test. The internal consistency of the scale was evaluated using Cronbach's alpha coefficient. The 15 items of the scale's original version were translated into Brazilian Portuguese. The adapted scale showed evidence of a good understanding of its content, attested both by experts and members of the target population. Its internal consistency was 0.64. The adapted instrument shows satisfactory internal consistency. It may be useful in future studies that intend to provide broad situational analysis that supports solid public health programs with a focus on effective stigma reduction. In a later study, the construct's validity, criterion, and reproducibility will be evaluated. Descrever o processo de adaptação transcultural da "Explanatory Model Interview Catalogue - Stigma Scale" para pessoas afetadas por hanseníase no Brasil. Após a autorização do autor da escala para seu uso no contexto nacional, deu-se início aos cinco passos do processo de adaptação transcultural: (1) tradução, (2) reunião de síntese, (3) retrotradução, (4) comitê de peritos e (5) pré-teste. A consistência interna da escala foi avaliada utilizando o coeficiente alfa de Cronbach. Os 15 itens da versão original da escala foram traduzidos para a língua portuguesa do Brasil. A escala adaptada apresentou evidência de boa compreensão de seu conteúdo, atestada tanto por peritos como por membros da população alvo. Sua consistência interna foi de 0,64. O instrumento adaptado apresenta consistência interna satisfatória. Pode ser útil em estudos futuros que intencionem viabilizar ampla análise situacional que sustente programas sólidos de saúde pública com enfoque na efetiva redução de estigma. Em estudo ulterior será avaliada a validade de constructo, critério e reprodutibilidade.

Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students' Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study.

PubMed

Braga, Mariana Minatel; Lenzi, Tathiane Larissa; Ferreira, Fernanda Rosche; Mendes, Fausto Medeiros; Raggio, Daniela Prócida; Imparato, José Carlos; Bonecker, Marcelo; Magalhães, Ana Carolina; Wang, Linda; Rios, Daniela; Pessan, Juliano Pelim; Duque, Cristiane; Rebelo, Maria Augusta Bessa; Alves Filho, Ary Oliveira; Lima, Marina De Deus Moura; Moura, Marcoeli Silva; De Carli, Alessandro Diogo; Sanabe, Mariane Emi; Cenci, Maximiliano Sergio; Oliveira, Elenara Ferreira; Correa, Marcos Britto; Rocha, Rachel Oliveira; Zenkner, Julio Eduardo; Murisí, Pedroza Uribe; Martignon, Stefania; Lara, Juan Sebastian; Aquino, Fatima Gabriela; Carrillo, Alfredo; Chu, Chun Hung; Deery, Chris; Ricketts, David; Melo, Paulo; Antunes, José Leopoldo Ferreira; Ekstrand, Kim Rud

2017-08-16

Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students' performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students' skills in the detection of caries lesions and clinical decision-making. ©Mariana Minatel Braga, Tathiane Larissa Lenzi, Fernanda Rosche Ferreira, Fausto Medeiros Mendes, Daniela Prócida Raggio, José Carlos Imparato, Marcelo Bonecker, Ana Carolina Magalhães, Linda Wang, Daniela Rios, Juliano Pelim Pessan, Cristiane Duque, Maria Augusta Bessa Rebelo, Ary Oliveira Alves Filho, Marina De Deus Moura Lima, Marcoeli Silva Moura, Alessandro Diogo De Carli, Mariane Emi Sanabe, Maximiliano Sergio Cenci, Elenara Ferreira Oliveira, Marcos Britto Correa, Rachel Oliveira Rocha, Julio Eduardo Zenkner, Pedroza Uribe Murisí, Stefania Martignon, Juan Sebastian Lara, Fatima Gabriela Aquino, Alfredo Carrillo, Chun Hung Chu, Chris Deery, David Ricketts, Paulo Melo, José Leopoldo Ferreira Antunes, Kim Rud Ekstrand, IuSTC Group. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.08.2017.

Translation and cultural adaptation of the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) to evaluate quality of life in women with cervical intraepithelial neoplasia.

PubMed

Fregnani, Cristiane Menezes Sirna; Fregnani, José Humberto Tavares Guerreiro; Paiva, Carlos Eduardo; Barroso, Eliane Marçon; Camargos, Mayara Goulart de; Tsunoda, Audrey Tieko; Longatto-Filho, Adhemar; Paiva, Bianca Sakamoto Ribeiro

2017-01-01

To translate and perform the cultural adaptation of the tool Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) to the Portuguese language. A descriptive cross-sectional study, with translation and cultural adaptation of the assessment tool performed according to international guidelines and the Functional Assessment of Chronic Illness Therapy (FACIT) protocol group. It involved eight experts, six from Brazil, one from Portugal and one from the United States. After translation and back-translation of the tool, the semantic analysis process was carried out. We randomly included 20 women aged between 18 and 70 years with altered cervical cytology exam, seen at the Department of Prevention and Gynecologic Oncology - Hospital de Câncer de Barretos. The sample consisted of women with low education level. In the first pre-test, ten women participated and half of them considered the questions CD1, CD2 and CD3 as difficult, because they did not understand the meaning of the term "pelvic area". The question CD5, "I worry about spreading the infection", was also considered difficult to understand by five women. After the reconsideration of the expert committee and FACIT group, the second pre-test was performed. At this stage, we concluded that the previously raised understanding problems had been solved. The translated version of FACIT-CD in universal Portuguese language is equivalent to the original version in English and was easily understood by patients with cervical intraepithelial neoplasia. Traduzir e adaptar o instrumento Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD), para a língua portuguesa. Estudo descritivo, transversal, com metodologia de tradução e adaptação cultural de instrumento de avaliação, realizado por meio de diretrizes internacionais e seguindo o protocolo do grupo Functional Assessment of Chronic Illness Therapy (FACIT). Envolveu oito especialistas, sendo seis nativos do Brasil, um de Portugal e um dos Estados Unidos. Ao término do processo de tradução e retrotradução, deu-se início ao processo de análise semântica. Foram incluídas aleatoriamente 20 mulheres entre 18 e 70 anos com exame de citologia cervical alterado, atendidas no Departamento de Prevenção e Ginecologia Oncológica do Hospital de Câncer de Barretos. A amostra foi composta por mulheres com baixa escolaridade. No primeiro pré-teste participaram dez mulheres, sendo que a metade considerou as questões CD1, CD2 e CD3 difíceis por não compreenderem o significado do termo "região pélvica". A questão CD5, "Estou preocupada em disseminar a infecção", também foi considerada de difícil entendimento por cinco mulheres. Após as reconsiderações do comitê de especialistas e do grupo FACIT, foi realizado o segundo pré-teste. Nesta fase, pode-se concluir que os problemas de entendimento anteriores foram resolvidos. A versão traduzida do FACIT-CD é equivalente à versão original em inglês e em língua portuguesa universal, sendo facilmente compreendida pelas pacientes com neoplasia intraepitelial cervical.