ABSTRACT
Many different malignancies occur in children, but overall, cancer in childhood is rare. Survival rates have improved appreciably and are higher compared with most adult tumour types. Treatment schedules evolve as a result of clinical trials and are typically complex and multi-modality, with radiotherapy an integral component of many. Risk stratification in paediatric oncology is increasingly refined, resulting in a more personalized use of radiation. Every available modality of radiation delivery: simple and advanced photon techniques, proton beam therapy, molecular radiotherapy, and brachytherapy, have their place in the treatment of children's cancers. Radiotherapy is rarely the sole treatment. As local therapy, it is often given before or after surgery, so the involvement of the surgeon is critically important, particularly when brachytherapy is used. Systemic treatment is the standard of care for most paediatric tumour types, concomitant administration of chemotherapy is typical, and immunotherapy has an increasing role. Delivery of radiotherapy is not done by clinical or radiation oncologists alone; play specialists and anaesthetists are required, together with mould room staff, to ensure compliance and immobilization. The support of clinical radiologists is needed to ensure the correct interpretation of imaging for target volume delineation. Physicists and dosimetrists ensure the optimal dose distribution, minimizing exposure of organs at risk. Paediatric oncology doctors, nurses, and a range of allied health professionals are needed for the holistic wrap-around care of the child and family. Radiographers are essential at every step of the way. With increasing complexity comes a need for greater centralization of services.
Subject(s)
Brachytherapy , Neoplasms , Radiation Oncology , Adult , Humans , Child , Medical Oncology , United KingdomABSTRACT
Abstract The contribution of community health agents (CHAs) is strategic for overcoming the biomedical health model. However, weaknesses in defining the specific roles of this profession impose contradictions and impediments to this work, making it difficult to construct the professional world of CHAs. Thus, this study aimed to analyze the tasks performed by the CHAs to reveal the objects, values, and tools, used by these workers to help consolidate their professional world. This study is a qualitative research study guided by the principles of activity ergonomics that include documentary analysis, systematic observations, and interviews. The results showed that due to the myriad of activities performed by the CHAs, the professional world of these workers is not fully delineated. However, it is believed that the results, analysis, and discussion of the data verified in this research, can support the consolidation of the professional world of the CHAs.
Resumo A contribuição do trabalho dos ACS tem sido apontada como estratégica para superação do modelo biomédico de produção de saúde. No entanto, fragilidades na delimitação dessa profissão impõem contradições e impedimentos a esse trabalho, dificultando a construção do mundo profissional dos ACS. Este artigo tem como objetivo analisar as tarefas realizadas pelos ACS no intuito de revelar objeto, valores e ferramentas usadas por esses trabalhadores que ajudem na consolidação do seu mundo profissional. Trata-se de pesquisa qualitativa norteada pelos princípios da Ergonomia da Atividade, que contou com análise documental, observações sistemáticas e entrevistas. Os resultados demonstraram que em virtude de distintas e inúmeras atividades executadas pelos ACS, o mundo profissional desses trabalhadores não está plenamente delineado. Contudo, acredita-se que o resultado, análise e discussão dos dados apurados nesta pesquisa são capazes de apontar elementos que servem para apoiar a consolidação do mundo profissional dos ACS.
Subject(s)
Work , Community Health Workers , Public HealthABSTRACT
Purpose This paper investigates the prospects and difficulties of multi-professional teamwork in human services from a professional identity perspective. The purpose of this paper is to explore the mutual interplay between professional identity formation and team activities. Design/methodology/approach This is a process study of two cases of multi-professional teamwork in family care. Data were collected through in-depth interviews with team members and managers. The analysis follows a stepwise approach alternating between the individual and team levels. Findings In showing the mutual interplay between teamwork processes and individual identity formation, the study contributes knowledge on professional identity formation of mature professionals; in particular showing how unique individual identification processes have different consequences for multi-professional team activities. Further, alternative shapes of interplay between individual identity formation and team-level processes are identified. Research limitations/implications Despite the fact that the sample is small and that collaboration intensity was relatively low, the paper succeeds in conceptualising the links between professional identity formation and multi-professional teamwork. Practical implications In managing multi-professional teams, team composition and the team's early developments seem determining for whether the team will reach its collaborative intentions. Originality/value This paper is original in its exploration of the ongoing interplay between individual identity formation and multi-professional team endeavours. Further, the paper contributes knowledge on mature professionals' identity formation, particularly concerning individual variation within and between professional groups.
Subject(s)
Cooperative Behavior , Interprofessional Relations , Social Work , Female , Humans , Interviews as Topic , Male , Qualitative ResearchABSTRACT
AIM: To evaluate the impact of multi-professional teamwork (MPTW) and leadership training interventions on patient outcomes in acute hospital settings. BACKGROUND: Although investigations of teamwork and leadership training in acute hospital settings indicate that such programs can optimize patient outcomes, evidence-based recommendations on the content, duration and frequency of training programs associated with clinical evidence are still absent. DESIGN: Quantitative systematic review. DATA SOURCES: A search was conducted for relevant papers published during the period from 2000-February 2014. REVIEW METHODS: Twelve studies met the inclusion criteria and were appraised for quality and a risk-of-bias assessment was conducted. The review used a structured approach for literature search, data evaluation, analysis and presentation. A narrative summary was used to report results. RESULTS: Two MPTW and leadership interventions in stroke units have the greatest impact on patient outcomes in acute hospital settings. The interventions' impact on patient outcomes, explored in the ten remaining studies, is associated with great uncertainty due to several alternative explanations of the findings. CONCLUSION: Research designs that test such interventions must be improved before recommendations on the ultimate program can be made. This can be achieved by strengthening the design, methodology and descriptions of interventions and the use of more consistent patient outcomes. Building a safety culture adjacent to implementing teamwork and leadership training interventions is essential for improving patient outcomes.
