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1.
J Interprof Care ; 37(5): 836-840, 2023 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36598137

RESUMO

Interprofessional education (IPE) allows students in health professional programs to practice providing collaborative patient care before graduating. Understanding the perceptions and experiences of health care professionals' IPE received prior to entering the workforce is key for improving IPE programs. This study investigated participants' post-licensure interprofessional collaboration (IPC) experiences, how IPE helped prepare them for IPC post-licensure, their perceptions of the IPE they received as students, and their suggestions for improving IPE. This qualitative descriptive study included 20 healthcare workers from seven professions who graduated from two of three co-located post-secondary educational institutions. Data were collected using semi-structured interviews, which were audiotaped and transcribed verbatim. Inductive thematic analysis revealed five themes and six sub-themes: (a) Quality of care; (b) Role clarification; (c) Interpersonal skills (sub-themes: communication and self-confidence); (d) Co-location; and (e) Need for IPE improvements (sub-themes: additional IPE exposures, shadowing experiences, mandatory IPE, and informal peer learning). These findings appear to reinforce the perception that pre-licensure IPE may support the development of skills for IPC among practicing health professionals.


Assuntos
Educação Interprofissional , Estudantes de Ciências da Saúde , Humanos , Relações Interprofissionais , Aprendizagem Baseada em Problemas , Currículo
2.
N Engl J Med ; 360(23): 2426-37, 2009 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-19494218

RESUMO

BACKGROUND: Autoinflammatory diseases manifest inflammation without evidence of infection, high-titer autoantibodies, or autoreactive T cells. We report a disorder caused by mutations of IL1RN, which encodes the interleukin-1-receptor antagonist, with prominent involvement of skin and bone. METHODS: We studied nine children from six families who had neonatal onset of sterile multifocal osteomyelitis, periostitis, and pustulosis. Response to empirical treatment with the recombinant interleukin-1-receptor antagonist anakinra in the first patient prompted us to test for the presence of mutations and changes in proteins and their function in interleukin-1-pathway genes including IL1RN. RESULTS: We identified homozygous mutations of IL1RN in nine affected children, from one family from Newfoundland, Canada, three families from The Netherlands, and one consanguineous family from Lebanon. A nonconsanguineous patient from Puerto Rico was homozygous for a genomic deletion that includes IL1RN and five other interleukin-1-family members. At least three of the mutations are founder mutations; heterozygous carriers were asymptomatic, with no cytokine abnormalities in vitro. The IL1RN mutations resulted in a truncated protein that is not secreted, thereby rendering cells hyperresponsive to interleukin-1beta stimulation. Patients treated with anakinra responded rapidly. CONCLUSIONS: We propose the term deficiency of the interleukin-1-receptor antagonist, or DIRA, to denote this autosomal recessive autoinflammatory disease caused by mutations affecting IL1RN. The absence of interleukin-1-receptor antagonist allows unopposed action of interleukin-1, resulting in life-threatening systemic inflammation with skin and bone involvement. (ClinicalTrials.gov number, NCT00059748.)


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças Autoimunes/genética , Inflamação/imunologia , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Receptores de Interleucina-1/antagonistas & inibidores , Doenças Autoimunes/tratamento farmacológico , Sequência de Bases , Criança , Feminino , Genes Recessivos , Homozigoto , Humanos , Lactente , Recém-Nascido , Inflamação/tratamento farmacológico , Inflamação/genética , Proteína Antagonista do Receptor de Interleucina 1/deficiência , Proteína Antagonista do Receptor de Interleucina 1/genética , Interleucina-1/genética , Interleucina-1/fisiologia , Interleucina-1beta/antagonistas & inibidores , Masculino , Mutação , Linhagem , RNA Mensageiro/metabolismo
3.
Healthcare (Basel) ; 10(8)2022 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-36011196

RESUMO

Interprofessional education (IPE) activities are utilized in health education programs to develop interprofessional collaboration (IPC) competencies. All first-year healthcare students at three postsecondary learning institutions attend a mandatory introductory IPE event annually. During the 2020/2021 academic year, the event was moved from a face-to-face activity to a virtual format due to the COVID-19 pandemic restrictions. This study examined whether the virtual IPE activity was effective in supporting the development of interprofessional competencies for first-year healthcare students. Two hundred and six students attended a synchronous didactic presentation on IPE competencies and discussed a simulated case in interprofessional groups of eight students and two faculty facilitators. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used to measure the students' opinions on interprofessional competencies. Paired t-tests were used to compare the pre- and post-scores. One hundred and nine (52.9% response rate) students completed the survey. Surveys from 99 students with matched pre- and post-scores were included in the study. The ICCAS competencies showed improvements (p < 0.05) in all of the students' self-reported IPE competencies following the activity compared to before the training. Our findings indicate that the virtual IPE activity is effective in facilitating the development of IPC for first-year healthcare students.

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