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ABSTRACT Introduction: Systemic Mastocytosis comprises a group of neoplastic diseases characterized by clonal expansion and infiltration of mast cells into several organs. The diagnosis and treatment of this disease may be challenging for non-specialists. Objective: Make suggestions or recommendations in Systemic Mastocytosis based in a panel of Brazilian specialists. Method and results: An online expert panel with 18 multidisciplinary specialists was convened to propose recommendations on the diagnosis and treatment of Systemic Mastocytosis in Brazil. Recommendations were based on discussions of topics and multiple-choice questions and were graded using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Chart. Conclusion: Twenty-two recommendations or suggestions were proposed based on a literature review and graded according to the findings.
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Mastocytosis, Systemic/diagnosis , Mastocytosis, Systemic/therapy , Child , AdultABSTRACT
Despite consensus group methods such as Delphi technique commonly used in medical education, there is a lack of standardization in methodology definitions and reporting. Size of the panel is one of fundamental questions of the researcher in a Delphi study. The present study was conducted to determine adequacy of the panel size in the Delphi round.METHODSIn this study, to determine adequacy of the panel size, the data stability was investigated in Delphi round. The Delphi study was conducted to determine competencies of educational leaders in Iran's medical sciences universities. Original data was collected from 33 experts, who were selected purposefully. Computer-generated samples of 1000 and 2000 were used for resampling. Data analysis was performed using bootstrap technique.RESULTSResults of the bootstrap technique showed that, in each of the three data groups (original and resampling data), 10 common items were in priority of 1 to 10. Ethical, commitment, punctuality, full recognition of their duties, strategic thinking, believing in values and morals, self-confidence, team working, trusteeship, motivation, maintaining morale, and supporting the faculty and staff were selected as 10 common competencies.CONCLUSIONSStability results of three data types showed that, selected panel size was sufficient to conduct this research. In Delphi studies, regardless of emphasis on small or large panel size, a panel of appropriate size should be selected. Using statistical methods, adequacy of size of the study panel can also be ensured.
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Central serous chorioretinopathy (CSCR), one of the most common diseases in retina clinics, needs a special attention by retina specialists. Considering the challenges in diagnosis, classification, and management of this enigmatic disease and lack of level 1 evidence, there is a need for consensus with regard to establishing management protocols.
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Sistemas de monitoramento são essenciais para avaliação das ações previstas noPrograma de Segurança do Paciente e, principalmente, para a implantação dos protocolosconsiderados prioritários pela Organização Mundial de Saúde. Em todos estes protocolosexistem indicadores para avaliar a sua implantação. O objetivo do presente estudo foi avaliara adequação do sistema utilizado para o monitoramento da higienização das mãos dosprofissionais de saúde de um hospital de alta complexidade do estado do Rio de Janeiro epropor modificações para que possa ser realizado de forma uniforme e abrangente, no localdo estudo e em outros hospitais em todo o país. Inicialmente foi realizada uma validação deconstructo da ferramenta utilizada no hospital de estudo pela perspectiva dos avaliadorespertencentes ao núcleo de qualidade e segurança do paciente. Após esta etapa, foi realizadoum levantamento na literatura sobre a segurança do paciente, infecções relacionadas àassistência à saúde e instrumentos de monitoramento. Quanto às referências utilizadas, éimportante informar que se buscou fundamentar a pesquisa nas recomendações de instituiçõese autores nacionais e internacionais com reconhecida credibilidade na área da segurança dopaciente, como a Organização Mundial da Saúde (OMS), o Centers for Disease Control andPrevention (CDC) e a Joint Commission Internacional (JCI), entre outras instituições, e dogoverno brasileiro, através do Ministério da Saúde e da Agência Nacional de VigilânciaSanitária (ANVISA). Este estudo permitiu a criação de um novo instrumento demonitoramento, que foi submetido ao julgamento de especialistas, usando a técnica deconsenso Delphi. A conclusão do estudo remete o pressuposto da necessidade da utilização deinstrumentos adequados de monitoramento de implantação do protocolo de higienização dasmãos...
Monitoring systems are essential for Patient Safety Program evaluation actions and forWorld Health Organization priority protocols implementation. There are some indicators toevaluate implementation of these protocols. The objective of the present study was evaluatethe adequacy of the system used to monitor health professional hands hygiene of a highcomplexity hospital in the state of Rio de Janeiro. The study also propose modifications toperform the system in a uniform and comprehensive manner, not only in the study hospitalbut also in other hospitals throughout the country. We performed initially a constructvalidation of the tool used in the study hospital. We used a perspective of evaluators belongingto patient quality and safety services. After this step, we performed a literature review basedon patient safety, health care related infections and monitoring instruments. The base of theresearch was national and international institutions recommendations and authors withrecognized credibility in patient safety area - World Health Organization (WHO), Centers forDisease Control and Prevention (CDC), International Joint Commission (JCI), among otherinstitutions, and the Brazilian government, through the Health Ministry and the NationalAgency of Sanitary Surveillance (ANVISA). The study allowed the creation of a newmonitoring instrument submitted to the judgment of specialists (experts), using the Delphiconsensus technique. The conclusion of the study points the need to use adequate instrumentsto monitor the implantation of the hand hygiene protocol...