Application of multidisciplinary teams online teaching in the teaching of urology residents based on network platform / 中华医学教育探索杂志

Introducing the multidisciplinary cooperation model into the clinical teaching of residents has gradually been paid attention to, and the relevant multi-disciplinary teaching teams participate in and formulate teaching plan. The Department of Urology of the Peking University Third Hospital carries out multidisciplinary cooperative teaching of residents based on network platform to improve residents' autonomous learning ability and teaching effect. This model has certain advantages in mobilizing students' subjective initiative and cultivating learning interest. It is of great significance for the training of urology residents.

A brief analysis of the American Cancer Society′s Clinical Practice Guideline—Head and Neck Cancer Survivorship Care Guideline / 中国实用护理杂志

With the construction and development of head and neck tumor, diagnosis and treatment technology and survival rate of patients have been improved in different degrees. Nurses play an important role as managers and practitioners in the treatment and rehabilitation of patients with head and neck tumors, and it is very important to evaluate and manage the treatment and prognosis of head and neck tumor patients scientifically. In this context, the American Cancer Society launched the Head and Neck Cancer Survivorship Care Guideline in 2017 and was endorsed by the American Society for Clinical Oncology. This paper mainly discusses the forming process of the guidelines, the main points of the consensus of experts, the guiding role of the guidelines in clinical work and the obstacles and limitations of the guidelines.

Manejo interdisciplinario de pacientes quemados. Pilar fundamental para la reducción de secuelas funcionales / Multidisciplinary management of burned patients: Fundamental pillar for reduction of functional sequelae

Las secuelas de quemaduras representan una patología muy frecuente en nuestro medio y su impacto en la calidad de vida de los pacientes que las padecen es muy importante. El objetivo del trabajo fue demostrar la eficacia del manejo interdisciplinario en pacientes con quemaduras AB y B de zonas funcionales para reducir las secuelas. Se realizó un estudio retrospectivo que incluyó 53 pacientes tratados en nuestro servicio, detectando 15 pacientes secuelados; en el 90% de los casos la causa fue el incumplimiento de la terapia indicada luego del alta y el 10% la cicatrización patológica rebelde al tratamiento. Los pacientes con secuelas funcionales por abandono del tratamiento kinesiológico indicado fueron: cinco con retracción en la región cervical anterior, cuatro con retracción en la articulación del codo y cuatro con retracción axilar. Se detectaron dos pacientes que a pesar del tratamiento instaurado sufrieron cicatrices retráctiles, uno de ellos en cuello y el otro paciente en axila.

Sequels of burns represent a very frequent pathology in our environment and its impact on the quality of life of patients suffering from them is very important. The objective of the study was to demonstrate the effectiveness of the interdisciplinary management in patients with burns AB and B of functional areas to reduce the consequences. This is a retrospective study that included 53 patients treated in our service. Fifteen patients with sequelae were detected. In 90% of the cases the cause was a failure in following the prescriptions ordered in hospital discharge, and in10% it was due to rebel to treatment scarring. The patients with functional sequelae due to the absence of the indicated kinesiological treatment were: five with retraction in the anterior cervical region, four with retraction in the elbow joint and four with axillary retraction. Two patients were detected that in spite of the established treatment they suffered retractile scars, one of them in neck and the other patient in armpit.

Psicólogo intensivista: reflexões sobre a inserção profissional no âmbito hospitalar, formação e prática profissional / El psicólogo intensivista: reflexiones acerca de la inserción en el ámbito hospitalario, formación y práctica profesional / Intensive care psychologist: reflections about professional insertion, professional qualification and practice at the hospital

Esta pesquisa buscou analisar o perfil do psicólogo hospitalar atuante em Unidades de Terapia Intensiva em hospitais públicos e privados de Porto Alegre, conhecer sua formação, as principais intervenções psicológicas utilizadas no atendimento ao paciente e seus familiares, as possibilidades de intervenção com a equipe assistencial atuante em terapia intensiva e identificar possíveis carências na formação do psicólogo que sejam consideradas essenciais pelas participantes para atuação neste campo. Os dados foram coletados através de um questionário sociodemográfico e uma entrevista semi dirigida. Foram entrevistadas sete psicólogas intensivistas de dois hospitais de Porto Alegre-RS, atuantes em unidades de atenção a pacientes adultos, pediátrica e neonatal. As informações obtidas nas entrevistas foram submetidas à análise de conteúdo, e dela emergiram categorias temáticas para posterior interpretação dos resultados. Foi percebida uma carência nos cursos de Psicologia de conteúdos que capacitem os alunos para as especificidades da atuação em saúde e sua inserção em equipes multiprofissionais. A pesquisa também evidenciou a necessidade de adaptação das técnicas já utilizadas na clínica, tanto no que diz respeito à avaliação psicológica quanto nos atendimentos a pacientes, familiares e intervenções em grupo. Evidencia-se a carência de estudos sobre Psicologia Intensivista, destacando a necessidade de mais pesquisas nesta área.

Resumen La investigación buscó cono cer las especificidades de la práctica del psicólogo intensivista, analizando aspectos de su rutina profesional, dificultades y potencialidades, principales intervenciones con familiares y equipos de salud, además de investigar sobre su formación profesional y como esta repercute sus acciones en la actualidad. Los datos fueron recogidos a través de cuestionario sociodemográfico y entrevista semidirigida. Fueron entrevistadas siete psicólogas intensivistas, de dos hospitales de la ciudad de Porto Alegre-RS, actuantes en unidades de atención a pacientes adultos, pediátrica y neonatal. Las informaciones obtenidas en las entrevistas fueron sometidas a un análisis de contenido y emergieron categorías temáticas para la posterior interpretación de los resultados. Fue percibida una carencia en los cursos de Psicología de contenidos que capaciten los alumnos para las especificidades de la actuación en salud y su inserción en equipos multiprofesionales en el actual contexto brasilero. Además de esto, la investigación evidenció la necesidad de adaptación de las técnicas ya utilizadas en la clínica, tanto en lo que se refiere a la evaluación psicológica como en la atención a pacientes, familiares e intervenciones en grupo. Evidenciase la carencia de estudios sobre Psicología Intensivista, destacando la necesidad de un mayor número de investigaciones en el área.

Abstract This research aimed to investigate the specifities of the work of intensive care psychologists, analyzing aspects of their professional routines, difficulties and potential, major interventions with patients, families and healthcare teams, and also investigate their training and how it affects the professional actions that have been explored nowadays. The data was collected through a sociodemographic questionnaire and a semistructured interview. Seven intensive care psychologists were interviewed, active in two hospitals in Porto Alegre-RS, both in care units to adult patients, and in areas such as pediatric and neonatal. Information obtained from the interviews was subjected to content analysis from which emerged some topics for the subsequent interpretation of the results. From this analysis, a shortage in Psychology courses that enables students to the specifics of performance in healthcare and its role in multi-professional teams in the current Brazilian context was perceived. In addition, the survey also highlighted the need to adapt the techniques that these pofessionals already used in clinical care, both in terms of psychological assessment as in the care to patients and family and group interventions. The lack of studies on Intensive Psychology was overt, highlighting the need for more research in this area.

Processos formativos em álcool e outras drogas para trabalhadores da rede pública do município de São Paulo: a experiência do CRR-DIMESAD-UNIFESP / Training courses on addiction issues to workers from the public sector of São Paulo city: the experience of CRR-DIMESAD-UNIFESP / Procesos de formación en alcohol y otras drogas para trabajadores de la red pública del municipio de São Paulo: la experiencia del CRR-DIMESAD-UNIFESP

Este artigo descreve a experiência de implementação e avaliação de cursos de capacitação sobre a temática do álcool e outras drogas para profissionais da rede pública do município de São Paulo, organizados pelo CRR-DIMESAD-UNIFESP, apoiados por edital da Secretaria Nacional de Políticas sobre Drogas. A partir de metodologia mista de pesquisa, envolvendo abordagem qualitativa e quantitativa, são descritos os desafios metodológicos enfrentados na primeira edição dos cursos e a trajetória de mudanças que culminou na reestruturação dos cursos em módulos temáticos, a partir da avaliação dos processos formativos vigentes em 2014 e do diálogo com as secretarias parceiras, acerca das demandas dos profissionais. A reestruturação, em curso desde meados de 2016, pautou-se ainda nos pressupostos ético-políticos do paradigma da Educação Permanente, enfatizando o processo ensino-aprendizagem em sua dimensão emancipatória e política.

This article describes the implementation and evaluation of training courses on addiction issues to workers from the public sector in São Paulo city. It was conducted by the Regional Reference Center of the Federal University of São Paulo. The restructuring process of the courses, since their first edition, held in 2014, as well as their methodological challenges and the series of changes that led to their restructuring into thematic modules are described.. This changing process was based on the evaluation of the existing training courses in 2014 and on the dialogue, related to the worker's demands, with different public departments. The evaluation research conducted was based on qualitative and quantitative approach. Such restructuring, ongoing since mid-2016, was also marked by ethical and political assumptions of the Brazilian Permanent Education paradigm, emphasizing the teaching-learning process in its emancipatory and political dimension.

Esteartículodescribe la experiencia de implementación y evaluación de cursos de capacitación sobre la temática de alcohol y otras drogas para profesionales de la red pública del municipio de São Paulo, organizados por el Centro Regional de Referencia de la Universidad Federal de São Paulo. A partir de la metodología de investigación mixta, con enfoque cualitativo y cuantitativo, describiremos el trayecto de la reestructuración de los cursos, partiendo de la primera edición (2014) y planteada por la convocatoria de la Secretaria Nacional de Políticas sobre Drogas. Serán descritos los desafíos metodológicos enfrentados en la primera edición de los cursos y la trayectoria de los cambios que culminó en la reestructuración de los cursos en módulos temáticos, a partir de la evaluación de los procesos formativos vigentes en 2014 y del diálogo con las secretarías que trabajan en conjunto. Tal reestructuración se pautó en los supuestos ético-políticos del programa de Educación Permanente, enfatizando el proceso de enseñanza-aprendizaje en su dimensión emancipadora y política.

Management framework paradigms for disorders of sex development

Until 2005, questions regarding medical treatment and diagnostic information on Disorders of Sex Development (DSD) were not systematically discussed with both the patients and their families; however, the way these patients are currently treated have been changing with time. Interventional changes in the clinical-psychotherapeutic-surgical areas of DSD determine not only different medical recommendations but also help to place the patient and the family into the decisional process of therapy. We must consider two paradigmatic periods that have influenced and transformed the clinical management framework of patients with DSD: a) The "Money era" (1955), which emphasized the role of the gonads as the diagnostic criterion, having the environment as determinant of the sex identity; and b) The Chicago Consensus (2005) phase, in which the role of genetics and molecular biology was critical for an early identification, as well as in building a proper sex identity, emphasizing ethical questions and the "stigma culture". In addition, recent data have focused on the importance of interdisciplinarity and statements on questions concerning Human Rights as key factors in treatment decision making. Despite each of these management models being able to determine specific directions and recommendations regarding the clinical handling of these patients, we verify that a composite of these several models is the clinical routine nowadays. In the present paper, we discuss these several paradigms, and pinpoint clinical differences and their unfolding regarding management of DSD patients and their families.

Development experiences of integrated healthcare in England:A case in Oxfordshire / 中国卫生政策研究

An integration of British healthcare and social services has been underway in recent years, and a typical methodology has been formed in the process of regional explorations . Using qualitative research methods of on-site observation and in-depth interviews, the paper studies the Care Programme Approach ( CPA) system of mental health and emergency multidisciplinary teams of Oxfordshire, a typical case of the integrated healthcare system re-forms in the British healthcare system. England’s integrated healthcare reforms have placed primary care and commu-nity health services at the center of the healthcare system and have included social services within the system. The ex-periences of multidisciplinary teams, integrated care pathways, personalized care planning and patient involvement and independence from the reforms are worthy subjects of study for China’s own healthcare delivery system reforms.

Evaluación de un protocolo para valorar situaciones de desprotección infantil: la opinión de los técnicos / Evaluation of a protocol to assess situations where a child is in need of protection from the child protection workers' point of view

El objetivo de este trabajo es conocer la valoración que los técnicos municipales hacen de un protocolo cuyo objetivo es unificar, en los diferentes municipios de la isla de Tenerife, el procedimiento de valoración de los casos de desprotección infantil. 126 técnicos respondieron a un cuestionario en el que se les pedía su opinión sobre tres aspectos diferentes: el contenido del protocolo, los efectos de su aplicación y los recursos que facilitan su implementación. Los resultados indican que los profesionales valoran positivamente el contenido y los efectos del protocolo, sobre todo los referentes a las condiciones en las que realizan su labor, la unificación de criterios y la coordinación horizontal. Los recursos más valorados en la implementación del protocolo son el acompañamiento de técnicos especializados durante el proceso de implementación, la existencia de espacios de encuentro y una buena dinámica de trabajo en equipo. Se encontraron algunas diferencias en la valoración, en función del perfil profesional. Se concluye que es adecuada la creación de este tipo de instrumentos, a través de procesos participativos, y que su implementación se ve mediatizada por algunas variables ajenas al instrumento.

The aim of this study is to find out council child protection officers' assessment of a protocol that unifies the different evaluation procedures in district councils on the island of Tenerife in cases where a child is in need of protection. 126 child protection officers answered an ad hoc questionnaire in which their opinions on three aspects were requested: the content of the protocol, the effects of its application and the resources to facilitate its implementation. Results indicate that professionals value positively the content and effects of the protocol, above all in regard to the conditions in which they carry out their work, the unification of criteria and horizontal co-ordination. The resources most valued in the implementation of the protocol are: being accompanied by specialists during the implementation processes; the existence of opportunities for meetings and a good teamwork dynamic. There were some differences in the assessment of the professional's profile. In conclusion, the creation of this type of instrument through participative processes and its implementation when influenced by some variables not directly connected to the instrument is considered appropriate.