Pública, Universidade de São Paulo; 2012. O Núcleo de Apoio à Saúde da Família (NASF) é constituído por uma equipe multiprofissional e atua de forma conjunta com as equipes da Estratégia Saúde da Família (ESF). Ambos configuram-se como um espaço favorável para o estudo da interação entre os profissionais, o grau de cooperação e a produção de cuidado. O objetivo deste trabalho foi identificar elementos facilitadores e barreiras para o trabalho compartilhado, no âmbito da ESF e NASF. Para tanto, foi realizada uma pesquisa qualitativa, que utilizou de entrevistas em profundidade como instrumento de coleta de dados. Participaram do estudo 15 profissionais da ESF/NASF do município de São Paulo. As entrevistas foram transcritas e analisadas segundo a técnica de análise do discurso. Os resultados evidenciaram três categorias: recursos de cooperação; modelo de cooperação interprofissional; e metas, carga horária e rotatividade. A cooperação interprofissional está relacionada aos sentidos e significados que os profissionais dão ao seu papel no trabalho compartilhado, à sua forma de atuação e às diretrizes de trabalho. A utilização dos recursos, a adequação ao modelo de cooperação e a forma como os profissionais lidam com as metas denotam a coexistência de diferentes modelos de produção do cuidado. Observou-se insuficiência de dispositivos organizacionais para apoiar o trabalho compartilhado na ESF. O estudo destaca a necessidade de se ampliar o conhecimento sobre os processos colaborativos na ESF, reconhecendo o seu potencial de contribuição no campo da gestão do trabalho e da reforma dos modelos de atenção / The Family Health Supporting Center (NASF) consists in multidisciplinary team which has principle to operate together with Family Health Strategy (ESF). Both of them are configured to a favorable space for the study of interaction between professionals, cooperation degrees and care. The aim of this study was to identify enablers and barriers of shared work in ESF/NASF. For this purpose a qualitative study was conducted. In-depth interviews were used for data collection. Fifteen São Paulo NASF/ESF professionals participated. The interviews were analyzed using discourse analysis technique. The results indicate the categories: collaboration resources, interprofessional collaboration model and goals, working hours, turnover. The interprofessional collaboration is related to the meanings that professionals give to their role in shared work, their way of acting and working guidelines. The use of resources, the cooperation model adequacy and how the professionals deal with the goals denote the coexistence of different models of care. There are insufficient organizational devices to support the shared work in the ESF. The study highlights the need to increase knowledge about the collaborative processes in the ESF, recognizing its potential contribution in the field of labor management and reform of health care models

O processo de aprendizagem escolar ocorre em um dinamismo evolutivo a partir do amadurecimento das áreas corticais superiores, o que permite a aquisição da leitura, escrita, interpretação, argumentação, cálculo e raciocínio lógico. Diversos fatores podem interferir negativamente nesse processo levando às dificuldades de aprendizagem. Essas interferências podem ser por fatores intrínsecos primários como as alterações neurobiológicas que ocorrem no Transtorno Específico de Aprendizagem e no Transtorno de Déficit de Atenção e Hiperatividade (TDAH), ou por fatores intrínsecos secundários como os problemas psicoemocionais e doenças crônicas, ou ainda por interferências extrínsecas como os ambientais desfavoráveis. Neste trabalho, foi descrito o processo de triagem interdisciplinar do Ambulatório de Distúrbio de Comportamento e Aprendizagem (ADCA) do Hospital das Clínicas da Faculdade de Medicina Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), para diagnóstico de dificuldade de aprendizagem em crianças de 6 a 10 anos procedentes de uma única escola do ensino fundamental. Devido à complexidade e interdisciplinaridade do tema abordado contou-se com profissionais da área da saúde (fonoaudiólogo, neuropediatra, neuropsicólogo, psiquiatra infantil e terapeuta ocupacional) e da educação (pedagogo) que participaram da aplicação de testes e discussão dos resultados para definição de diagnóstico. Foi realizada uma triagem baseada em análise estatística do rendimento escolar em 104 crianças, com seleção de 56 alunos (54%). No entanto, apenas 27 alunos (48%) dessa amostra concluíram as avaliações. Após a bateria de testes, todos os alunos selecionados que compareceram à avaliação, obtiveram ao menos um diagnóstico compatível com dificuldade de aprendizagem. Entre as causas mais frequentes das dificuldades de aprendizagem, encontrou-se os sintomas/transtornos de ansiedade, o TDAH e os transtornos específicos de aprendizagem, representados por 15 (55%), 13 (48%) e 6 (22%), respectivamente, dos alunos avaliados. Em alguns casos essas condições foram comórbidas. Conclui-se que a escolha por uma escola atendeu as expectativas de homogeneizar a população em estudo; a análise estatística de rendimento escolar pode ser considerado um método com boa sensibilidade; a baixa adesão às avaliações permite evidenciar o quão difícil é para os pais compreenderem a importância dessa investigação; a abordagem interdisciplinar foi uma avaliação criteriosa e conclusiva sobre os variados diagnósticos encontrados e por fim, os diagnósticos mais encontrados foram os sintomas/transtornos de ansiedade, seguido por TDAH e por Transtornos Específicos de Aprendizagem. / The process of school learning occurs in an evolutionary dynamism from the maturation of the upper cortical areas. They allow the acquisition of writing, reading, interpretation, argumentation, calculation and logical reasoning. Thus, many factors can interfer in this process negatively, generating learning disabilities. These interferences can be associated with; (1) primary intrinsic factors like the neurobiological alterations observed in the Attention Deficit Hyperactivity Disorder (ADHD) and Specific Learning Disorders (SLD); (2) secondary intrinsic factor like the psicoemotional problem or cronic diseases; (3) extrinsic interferences such as unfavorable ambient. This work described interdisciplinary evaluations to diagnose learning disabilities in children to 6 from 10 years. All the students are at the same school. It was chosen just one place to homogenize the population sample. The tests were applied in the Behavioral Disorder Learning Ambulatory (BDLA) in the Clinical Hospital of the School of Medicine of Ribeirão Preto - University of São Paulo. Due to the complexity and the interdisciplinary question, different types of health and educational professionals (speech therapist, neuropsychologist, neuropsychologist, child psychiatrist, occupational therapist and educacionalist) participated in this study. It was made a sorting of 104 children based on their school performance, which was selected 56 (54%). However, just 27 students (48%) finished the evaluation. After the tests, all students presented at least one diagnosis associated with learning disabilities. The most important causes found: 15 students (55%) with anxiety symptoms, 13 (48%) with ADHD and 6 (22%) with Specific Learning Disorders. In some situations, this conditions occurred simultaneously. In this way, it was concluded that: the statistical analysis showed a good sensibility; the lower accession in this research showed that the parents didn\'t know about the importance of this investigation; the interdisciplinary approach were carefully and conclusive evaluation of various diagnoses and the most frequence of them were: anxiety symptoms followed by ADHD and Specific Learning Disorders.

Restoring speech in persons who are tracheostomy and ventilator dependent, through the use of a Passy-Muir Speaking Valve (PMSV), requires specific training. Methods of training interprofessional team members to assess in-line PMSVs are unclear. This study used a pretest/ post-test design to compare effects of online training and online training plus simulation training on knowledge acquisition, skills performance, and comfort levels when working with persons who are tracheostomy and ventilator dependent. Twenty-six students studying either respiratory therapy (N=13) or speech-language pathology (N=13) were assigned to the control group or experimental group. Results revealed that online training proved beneficial for increasing tracheostomy and ventilator knowledge. Participants who underwent simulation training reported greater levels of comfort and demonstrated more efficient skills performance during simulation post-testing. Simulation training is efficacious to train interprofessional teams how to properly assess this population for use of in-line PMSVs.

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET) PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88%) were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%), improved relationships with providers in the community (75.9%), and professional development opportunities (69.0%) were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63%) and workflow disruptions (20%) as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas. Type: Original Research

Objectives: To assess and compare interprofessional and interpersonal communication self-efficacy beliefs of medical, nursing and pharmacy students before and after participation in a communication skills course. Method: Using self-efficacy as a theoretical framework, a 37-item survey instrument was developed based on Interprofessional Education Collaborative (IPEC) Core Competencies and course learning objectives. Medical, nursing, and pharmacy students voluntarily completed the survey instrument before and after the required course. Nonparametric tests were employed to examine matched pre- and post-assessments within colleges and to explore differences in self-efficacy beliefs across college. Results: A response rate of 87% (168/193) was achieved. Overall, nursing students entered the course with higher self-efficacy beliefs as compared to medical and pharmacy students. Pharmacy students indicated particularly low self-efficacy beliefs regarding their ability to communicate with other health professionals (p=0.009) and contribute to healthcare teams (p=0.002). Matched pre/post analyses indicated statically significant increases in student self-efficacy beliefs across all colleges. After the course, pharmacy students continued to perceive a relative lack of confidence in their ability to develop positive relationships with other health care providers as compared to medical and nursing students (p=0.02). Implications: Our findings suggest that completion of an interprofessional communications course was associated with a positive effect on self-efficacy beliefs aligned with IPEC competencies across all colleges. Pharmacy students, in particular, noted significant improvements in self-efficacy beliefs across multiple domains. Research is being conducted to examine relationships between validated observational assessments and student self-perceptions.

No description available.

No description available.

The current prevailing approach to managing offenders in the community involves community supervision professionals such as probation and parole officers partnering with other community professionals, such as psychologists, social workers, and other mental health providers to address offenders’ needs. Each type of professional draws from a unique field with goals, values, and theoretical orientations, which do not necessarily overlap. These relationships are rarely studied, and previous examinations are limited. The current study aims to address this deficit in the empirical literature. Drawing on data obtained from qualitative interviews, four aims were examined. First, using thematic analysis, interview data are analyzed open-endedly to identify major themes. Second, these partnerships are examined against the interprofessional competencies in the healthcare system. Third, the perceived impact of partnerships on offenders’ success in the community is discussed. Finally, differences in themes within community supervision professionals and mental health providers were quantitatively examined by comparing groups using a variety of demographic variables. Major themes identified by mental health providers include the appreciation for and challenges to collaboration, individual characteristics and roles, characteristics of collaboration, elements of interprofessional relationship, and the involvement of the courts. Community supervision professionals discussed issues pertaining to collaboration and services coordination, professional roles, when conflict occurs, and their lack of basic knowledge about other professionals. Themes identified in the initial thematic analysis resembled healthcare values and ethics competencies and roles and responsibilities competences; healthcare competencies regarding interprofessional communication and teamwork showed partial congruence with the current data’s themes. Perceived impact on offender outcomes was most evident in how collaboration helps each professional complement the others’ work. Few significant quantitative patterns within groups were evident. Overall, treatment providers and supervision professionals value interprofessional collaboration. Their priorities differ, which provides better opportunities to address clients’ needs but also creates the potential for conflict. Benefits to re-entry outcomes are the result of treatment providers addressing the needs of clients and supervision professionals addressing the motivation of clients. This research highlights the strengths of this type of interprofessional collaboration, and offers suggestions for improving the efficacy of collaborations.

Interprofessional education has the potential to prepare health career students to be practice-ready and enter the workforce with a collaborative mindset. Respiratory care educators must adequately prepare students to work in this capacity. This emphasis on a team approach to patient-centered care has the ability to impact and improve health outcomes. Throughout the last decade, sleep medicine has experienced fluctuations. Sustainability of sleep labs who only perform diagnostic testing may prove challenging. The role of interprofessional practice in sleep medicine would be to overcome traditional roles (silos) so that multiple skilled practitioners could help identify and treat complex patient conditions. A review of the literature demonstrated how various providers can serve as active members of interprofessional health care teams. The opportunity to expand services and partner with other providers to detect, educate, and treat sleep disordered breathing could help laboratories endure and even thrive in the current health care system.

Excerpt: The World Health Organization describes inter-professional education (IPE) as being when studentsfrom at least two professions learn about, from, and with each other to facilitate effective collaboration among health care providers and improve patient health outcomes.