Developing an Adolescent and Young Adult Oncology Program in a Medium-Sized Canadian Centre: Lessons Learned.

The Adolescent and Young Adult (AYA) Program at CancerCare Manitoba (CCMB) has experienced tremendous growth since its inception. This report provides an overview of how the AYA program at CCMB was established and the crucial factors that led to its early accomplishments and continued expansion. These factors included actions and decisions made at the individual and organizational level that helped lay a strong foundation for the program's sustained success. We hope that some of these lessons learned can be adapted and implemented by other oncology agencies to improve the care outcomes and experiences of AYAs living with cancer.

The Virginia Applied Behavior Analysis Consortium: Preparing Behavior Analysts Using a Collaborative Model.

The development and the evolution of the Virginia Applied Behavior Analysis Consortium, a collaborative project between four institutions of higher education in the state of Virginia, are described. The main goal of the program is to address the shortage of certified behavior analysts by preparing special education teachers and autism specialists to implement effective behavior-analytic interventions in natural environments. In this article, we briefly discuss the history and the purpose of the program, its components, the evolution of the program, the advantages and outcomes of a collaborative model, and future directions for improvement.

Programa API (Apoyo Psiquiatría Infantil): Programa piloto de colaboración en Salud Mental Infanto-Juvenil en el Servicio de Salud Valparaíso-San Antonio: 12 meses de funcionamiento / Program API (Support Child Psychiatry): Mental Health adolescent collaboration pilot program in the San Antonio-Valparaíso Health Service: 12 months of operating

El Programa API (Apoyo Psiquiatría Infantil), es un sistema colaborativo multimodal (telefónico y presencial), entre nivel primario (7 Consultorios) y secundario (Hospital Salvador, Valparaíso) de salud. Se presentan los resultados del estudio descriptivo prospectivo del Programa API durante 12 meses de funcionamiento, obtenidos desde los registros de consultoría telefónica y presencial. En un periodo de 12 meses se recibieron 105 llamadas telefónicas. De estas, 87% fueron hechas por psicólogos/as. Se indicó atención conjunta en 59% y derivación a nivel secundario en 16% de los llamados. Los psicólogos de los equipos de salud mental participantes, coinciden en ser quienes dirigen y recurren más a este sistema. Se resuelven la mayoría de las dudas, a través de sugerencia de hipótesis diagnósticas y de manejo. Se concluye que los profesionales de los CESFAM les interesa el apoyo del programa, facilitando el trabajo con niños y adolescentes con problemas de salud mental.

The API PROGRAM (Child Psychiatry Support) is a multimodal collaborative program (giving phonecall support and face-to-face collaboration), between 7 primary healthcare centers (PHC) and secondary level healthcare centers (Hospital del Salvador, Valparaiso. The objective of this study is to describe the API Program after 12 months of implementation. This is a descriptive and prospective study with follow up calls and face to face collaboration. After 12 months, 105 phone calls were received. Of these , 87% were made by psychologists. Joint consultation in PHC was suggested in 59% of calls and referral to secondary level was indicated in 16% of the incoming calls. Psychologists belonging to mental health teams were the professionals with the highest disposition to use the program. Most doubts are solved by telephone, through the suggestion of diagnostic hypotheses and management. PHC professionals seem very interested in the support provided by the API Program, facilitating their work with children and adolescents with mental health problems.

Sustaining nursing programs in the face of budget cuts and faculty shortages.

When asked what their major problems are, many nursing deans would state that they are very concerned about budget cuts and faculty shortages. Yet, there is little, if anything in the literature describing how administrators are dealing with these problems. This article describes three strategies that we employed to address these issues. The first strategy, our home hospital program, involves qualified hospital staff serving as clinical instructors. The second strategy, a collaborative on-line doctor of nursing practice program, reduces the number of courses our faculty must teach, while ensuring adequate numbers of students. Lastly, differential fees is a strategy whereby students enrolled in high-cost educational programs (e.g., nursing) pay greater fees but reap supportive benefits that increase their success in the program. These strategies have allowed us to enhance our educational programs despite budget cuts and faculty shortages.

Sustainable knowledge transfer in pediatric cardiac surgery: a team approach to shared learning.

The study assesses the impact of a program using a model of knowledge transfer on the long-term development of a pediatric cardiac service in Lithuania. A team from the United Kingdom evaluated Lithuanian pediatric cardiac services and provided support in areas targeted for improvement. The total number of infant operations performed in Lithuania from 1990 to 2008, together with in-hospital mortality rates, was broken down into 3 time periods and analyzed to estimate the efficacy of the program: (1) 1990-1998, before the program; (2) 1999-2002, during the program; (3) 2003-2008, following the end of the program. Lithuanian results in children older than 1 year were comparable with other European centers. However, only 315 infant and neonatal cardiac procedures were performed between 1990 and 1998, and there was an in-hospital mortality of 34.2%. Between 1999 and 2002, the UK team performed 23 highly complex demonstration procedures (in-hospital mortality, 13%). During the same period the Lithuanian team performed 305 additional operations in neonates and infants, and in-hospital mortality decreased to 18.7%. From 2003 to 2008 results continued to improve-559 infant operations were performed, with in-hospital mortality of 11.3% (P < .0001). Knowledge transfer has led to substantial and sustainable long-term improvement in the results of infant cardiac surgery in Lithuania. Demonstrating techniques and care on a limited number of more complex cases is an efficient way of transferring knowledge and skills to the developing pediatric cardiac centers.