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1.
Br J Hosp Med (Lond) ; 82(10): 1-7, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34726938

RESUMO

Clinical academia aims to bridge the gap between clinicians and scientists, by combining academic activity with clinical practice. The term 'clinical academics' generally refers to clinicians who have protected time within their job plans for undertaking academic activities. Engagement with academic activity by trainees is not only essential to fulfil necessary curriculum competencies, but also allows them to explore areas of interest outside of clinical practice and develop advanced academic skills. This article provides an overview of different routes into academic neurosurgery, and discusses the advantages and difficulties in pursuing this career path. It also covers the differences between postgraduate research degrees and explores the different job plan models available at consultant level. Academic neurosurgery is a rewarding career and opportunities should be made available to those who wish to explore it further. Developing academic careers may have a positive impact on wider workforce planning strategies and improve the delivery of high-quality evidence-based neurosurgical care.


Assuntos
Neurocirurgia , Médicos , Escolha da Profissão , Consultores , Currículo , Humanos , Recursos Humanos
2.
Middle East Afr J Ophthalmol ; 28(2): 93-97, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759666

RESUMO

PURPOSE: This study aims to identify the use of limbal versus fornix incisions among strabismus surgeons in Saudi Arabia and the preferred approach to teaching trainees with the shortest learning curve. METHODS: Two designed questionnaires were sent to local strabismus surgeons and ophthalmology trainees. RESULTS: A total of 127 participants responded to our survey: fifty-nine consultants (53% Saudi nationals and 43% expat ophthalmologists) and 68 trainees. The limbal approach was the preferred approach for all settings, including the primary pediatric procedure (30, 55.9%), pediatric reoperation (40, 64.7%), adult primary procedure (32, 55.9%), and reoperation (40, 70%). The reason was attributed to better exposure. As for fornix incision, the most commonly cited reason was less pain and discomfort. For the adjustable suture technique, 29 (49.2%) did not use adjustable sutures, and 22 (37.3%) prefer the limbal approach. When we compared Saudi versus non-Saudi surgeons, 26 (83.87%) Saudi surgeons were trained to perform the limbal method, whereas 16 (57.14%) non-Saudi surgeons were trained to perform the fornix approach. Of the trainees, 35 (51%) were trained on the limbal approach. When asked about the learning curve for different methods, 41 (60.3%) noted a faster learning curve with the limbal approach. CONCLUSION: Despite the many advantages of the fornix incision, it remains uncommon in our region. Each technique of strabismus surgery has its advantages and disadvantages. Programs should teach all methods to trainees. One should add all styles to his armamentarium and choose the appropriate one for each patient.


Assuntos
Oftalmologia , Estrabismo , Adulto , Criança , Consultores , Humanos , Músculos Oculomotores , Arábia Saudita/epidemiologia , Estrabismo/cirurgia
4.
Br J Nurs ; 30(19): 1132-1139, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34723662

RESUMO

BACKGROUND: There is an increasing body of evidence that identifies psychological stressors associated with working in emergency medicine. Peer Assessment After Clinical Exposure (PACE) is a structured programme designed to support staff following traumatic or chronic work-related stressful exposure. The first author of this study created the PACE programme and implemented it in one emergency department (ED). AIM: A service evaluation designed to explore the thoughts and experiences of the staff who accessed the PACE support service. METHOD: Participants were selected by a non-probability convenience strategy to represent the ED staff population. The study cohort ranged from junior staff nurse level to emergency consultant. Data were collected using a semi-structured interview and examined by the method of interpretative phenomenological analysis. FINDINGS: This study confirmed the findings of previous research that current pressures within the ED include crowding, time pressure and working within an uncontrollable environment. Eight participants identified an absence of previous emotional support resulting in dissociation and avoidance behaviours following traumatic exposure. Overall, the PACE service was well received by the majority of staff (11/12). There was a positive association with the one-to-one element and the educational component helped to reduce the stigma associated with stress reactions after work-related exposure. CONCLUSION: PACE received a positive response from staff. This service presently does not exist elsewhere in the NHS so further research will be needed to evaluate its long-term impact and effectiveness on a wider scale.


Assuntos
Serviços Médicos de Emergência , Consultores , Serviço Hospitalar de Emergência , Humanos , Grupo Associado , Estresse Psicológico
5.
Trials ; 22(1): 834, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819117

RESUMO

BACKGROUND: The benefits of mother's own milk (MOM) for preterm infants have been widely recognized. Many studies have shown that the rate of breastfeeding of premature infants remains very low. Although many studies use measures to promote breastfeeding, few high-quality cluster randomized controlled studies have evaluated the effectiveness of these measures. WeChat is an instant messaging software for smart terminals, and WeChat mini-programs have been widely used to promote health and self-management in China. Based on this background, we designed a randomized controlled study based on WeChat mini-programs to promote MOM feeding of premature infants in the neonatal intensive care unit (NICU). METHODS/DESIGN: This study will evaluate the effectiveness of WeChat mini-programs to increase the consumption of MOM feeding in twelve NICUs in Jiangsu Province, namely, six "intervention" NICUs and six "control" NICUs. The study process is as follows: (1) design and preparation, (2) NICU recruitment and training, (3) interpretation and analysis of baseline data, (4) quality control implementation process, and (5) data analysis feedback and publication of study reports. The primary outcome is the proportion of MOM feeding of premature infants during NICU hospitalization. The secondary outcomes are as follows: (1) time to initiation of MOM feeding (hours) and proportion of first-time MOM feeding (%), (2) duration of parenteral nutrition (days), (3) time to total gastrointestinal feeding (days), (4) hospitalization time and hospitalization cost, and (5) incidence of complications (necrotizing enterocolitis, bronchopulmonary dysplasia, feeding intolerance, late-onset sepsis, retinopathy of prematurity). DISCUSSION: This study is the first cluster randomized controlled trial on the intervention of using a WeChat mini-program-based lactation consultant for premature infants in the NICU in China. We hope this study can improve the consumption of MOM by NICU premature infants during hospitalization through the intervention of WeChat mini-programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04383379. Registered on May 5, 2020.


Assuntos
Consultores , Unidades de Terapia Intensiva Neonatal , Aleitamento Materno , Feminino , Promoção da Saúde , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Lactação , Leite Humano , Mães , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Acta Vet Scand ; 63(1): 44, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34801074

RESUMO

BACKGROUND: Structural changes in dairy farming increase farm complexity, thereby inducing a need to combine herd health management, technological solutions, legislation, and human relations among farmers, farm workers, and advisors. This complex situation may require 'transdisciplinary advisory service', i.e., a highly integrated network of both non-academic and different academic disciplines. While working in these networks, advisors need to offer specialized knowledge from their own field, interact in a dynamic relationship between different types of professions and facilitate complex processes. The objectives of this study were: (1) to identify and describe different advisor and farmer styles based on their reasons to engage in transdisciplinary advisory services at farm-level, (2) to identify any possible conflicting perspectives between advisors and farmers' demand, and (3) to discuss these styles and conflicts in the context and future of advisory services for dairy herd health and production management. RESULTS: Using Q methodology, we explored the purpose of transdisciplinary advisory service on dairy farms. The results were derived from correlations between 40 statements for 25 advisors and 33 statements for nine farmers. We identified three similar styles among advisors and farmers, characterized as: (1) the teamwork and knowledge-focused style, (2) the production and economy-focused style, and (3) the economy and strategy-focused style. These styles included reflections on financial aspects, production, knowledge-exchange and the teamwork process itself. In addition, different emphasis on animal welfare, farm strategy and follow-up procedures between the styles became evident. CONCLUSIONS: This Q-study suggests three comparable styles between advisors and farmers. The main differences between the styles related to the teamwork process and purpose, follow-up process, financial aspects, farm strategy, and operational production objectives. Therefore, styles and expectations should be explored and discussed to create a mutual understanding within a farmer-advisor(s)-team, and to clarify the farmer's needs and demands, and how the advisors can best meet these expectations. This study illustrates the importance of exploring different advisor and farmer styles to get a mutual understanding of the purpose of the transdisciplinary collaboration.


Assuntos
Indústria de Laticínios , Médicos Veterinários , Animais , Consultores , Dinamarca , Fazendas , Humanos
8.
Br J Nurs ; 30(20): 1213, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34761977

RESUMO

John Fowler, Educational Consultant, explores ways to enhance teamwork.


Assuntos
Consultores , Recursos Humanos de Enfermagem , Humanos
9.
Br Dent J ; 231(8): 458-462, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34686808

RESUMO

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning the prescribing and administering of dental emergency drugs in dental practice are discussed, with answers supplemented by relevant information from clinicians. These include the drugs that need to be stocked in the emergency drugs kit in dental practice, their formats and storage, and the restrictions on which members of the dental team can administer the drugs.


Assuntos
Odontólogos , Preparações Farmacêuticas , Consultores , Emergências , Humanos , Reino Unido
10.
Afr J Prim Health Care Fam Med ; 13(1): e1-e4, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34636618

RESUMO

The South African family physician (FP) is an expert generalist who has a number of roles to strengthen the district health system. A research study on FPs in district hospitals has previously demonstrated an impact; however, more evidence on impact in primary health care (PHC) is needed. By serving as a consultant for the PHC team, the FP may improve access to care, capacitate team members, enhance comprehensiveness of care, and improve coordination and continuity of care. This report narrates the story of how one of the FPs at a rural district hospital recorded his experience of being a consultant to the PHC team and was able to self-audit the experience. A self-designed audit tool analysed 1000 patient consultations with the FP and enabled a reflection on the coronavirus disease 2019 (COVID-19)-related changes to the consultant role. There was a clear need for FPs to consult patients with complex multi-morbidity and multifaceted psychosocial aspects to their illness, in consultation with their team members. Patients were referred to them by medical officers, other specialists, family medicine registrars, allied healthcare professionals and nurse practitioners. The FP's ability to strengthen the PHC service outside the district hospital may be enhanced by creating more FP posts at a subdistrict level to support high-quality, team-based primary care in line with the PHC policy directions.


Assuntos
COVID-19 , Médicos de Família , Baías , Consultores , Humanos , Atenção Primária à Saúde , SARS-CoV-2
12.
Br J Nurs ; 30(18): 1100, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34645351

RESUMO

John Fowler, Educational Consultant, explores how to survive your nursing career.


Assuntos
Recursos Humanos de Enfermagem , Consultores , Humanos
13.
Br Dent J ; 231(7): 393-397, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34625687

RESUMO

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning the prescribing, administering or dispensing of medicines in dental practice are discussed with answers supplemented by relevant information from clinicians. These include: different classes of medicines, unlicensed medicines, prescriptions, Patient Group Directions, Patient Specific Directions and dispensing of medicines - if appropriate.


Assuntos
Consultores , Odontólogos , Humanos , Reino Unido
15.
Rev Esc Enferm USP ; 55: e20200329, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34516600

RESUMO

OBJECTIVE: To develop and validate a prototype mobile application on breastfeeding for health professionals. METHOD: Methodological study. To build this prototype, information obtained from interviews with six health professionals who were certified as international breastfeeding consultants was employed. For validating the prototype, screenshots were sent to each professional participating in the first phase, as well as an adapted instrument to assess appearance, content, and language. RESULTS: Most assessments were "great" or "good". The participating professionals have also made important considerations for content enhancement, mainly for the clinical content. CONCLUSION: The prototype was positively assessed by the professionals, fulfilling the proposed objective. This study is highly important for breastfeeding care professional practice, since it presents a tool which improves quality of care by contributing to the best evidence-based practice.


Assuntos
Aleitamento Materno , Pessoal de Saúde , Consultores , Feminino , Humanos , Idioma
16.
Br J Nurs ; 30(16): 988, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34514820

RESUMO

John Fowler, Educational Consultant, explores the skills required to successfully manage a team.


Assuntos
Consultores , Humanos
17.
BMC Cancer ; 21(1): 1014, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507552

RESUMO

BACKGROUND: Adjuvant immunotherapy is revolutionising care for patients with resected stage III and IV melanoma. However, immunotherapy may be associated with toxicity, making treatment decisions complicated. This study aimed to identify factors physicians and nurses considered regarding adjuvant immunotherapy for melanoma. METHODS: In-depth interviews were conducted with physicians (medical oncologists, surgeons and dermatologists) and nurses managing patients with resected stage III melanoma at three Australian tertiary melanoma centres between July 2019 and March 2020. Factors considered regarding adjuvant immunotherapy were explored. Recruitment continued until data saturation and thematic analysis was undertaken. RESULTS: Twenty-five physicians and nurses, aged 28-68 years, 60% females, including eleven (44%) medical oncologists, eight (32%) surgeons, five (20%) nurses, and one (4%) dermatologist were interviewed. Over half the sample managed five or more new resected stage III patients per month who could be eligible for adjuvant immunotherapy. Three themes about adjuvant immunotherapy recommendations emerged: [1] clinical and patient factors, [2] treatment information provision, and [3] individual physician/nurse factors. Melanoma sub-stage and an individual patient's therapy risk/benefit profile were primary considerations. Secondary factors included uncertainty about adjuvant immunotherapy's effectiveness and their views about treatment burden patients might consider acceptable. CONCLUSIONS: Patients' disease sub-stage and their treatment risk versus benefit drove the melanoma health care professionals' adjuvant immunotherapy endorsement. Findings clarify clinician preferences and values, aiding clinical communication with patients and facilitating clinical decision-making about management options for resected stage III melanoma.


Assuntos
Imunoterapia , Melanoma/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Adulto , Fatores Etários , Atitude do Pessoal de Saúde , Austrália , Institutos de Câncer , Tomada de Decisão Clínica , Consultores , Dermatologistas , Feminino , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Oncologistas , Medição de Risco , Cirurgiões
18.
Multimedia | Recursos Multimídia | ID: multimedia-9190

RESUMO

No Museu Sandino, na Nicarágua, tendo atrás a reprodução de uma foto do líder nicaragüense, Augusto César Sandino, entre 1979 e 1980.


Assuntos
Fotografia , Consultores , Organização Pan-Americana da Saúde , Sistemas de Saúde , Nicarágua
19.
ANZ J Surg ; 91(7-8): 1328-1329, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34402177
20.
Bull Hist Med ; 95(2): 227-255, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34393137

RESUMO

Since the creation of the National Health Service in 1948, different groups of experts have competed to inform the development of British health policy. This article analyzes the long-term rise of one of these groups-management consultants. The scale and regularity of their engagement has increased considerably over time, strikingly in recent years, and the functions fulfilled by consultants have become ever more diverse. At important moments they were often seen by policymakers-particularly when there was understood to be a lack of internal expertise-as possessors and imparters of important knowledge. Firms and individuals worked consciously to integrate themselves into emerging health policy networks. But there has often been relatively little consideration of their real suitability for work in the health field. Many debates around the use of external consultants today-accountability, value for money, dependency-were foreshadowed during earlier periods, with implications for current policymakers.


Assuntos
Consultores , Medicina Estatal , Política de Saúde , Humanos , Casamento
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