Experience Report Research Articles

Bridging research and practice in a learning health system: Developing and refining an embedded scholars program through insights from scholars and clinical mentors

AbstractIntroductionA learning health system (LHS) necessitates collaboration to produce translational health research. This experience report examines the integration of Clemson University scholars into clinical departments of Prisma Health–Upstate in South Carolina, highlighting their experiences working alongside clinician mentors to inform and facilitate research translation. Particularly, this study aims to explore the interpersonal and structural factors influencing the success of an embedded scholar program, focusing on enablers and barriers to collaboration, knowledge integration, and mentorship within the LHS.MethodsNine embedded scholar and 12 mentor semi‐structured interviews were conducted. This qualitative study initially used an inductive technique to analyze responses thematically. After thematic saturation was achieved, deductive analysis was utilized to further organize enablers and barriers across the following five categories: (1) Scholar Integration, (2) Scholar Autonomy, (3) Mentor Support, (4) Programmatic Outcomes, and (5) Institutional Dynamics.ResultsWe found 10 major program‐related enablers and barriers to successfully embedding scholars. These were clinical environment adaptation, mentor interaction, research management, balance of independence, role clarity, resource provision, research application and quality, scholar development, organizational support, and policy and procedure alignment. Findings reveal that effective mentorship, organizational alignment, and resource availability are critical enablers of program success, while misaligned expectations, limited institutional support, and insufficient scholar integration into clinical environments are barriers.ConclusionEvaluating specific components of embedded scholar programs can uncover best practices and innovation opportunities in the LHS. These provide a great opportunity to enhance the mentorship mechanisms between clinical mentors and embedded researchers. As research on embedded scholars in a LHS progresses, fostering structured mentoring relationships may serve as an impetus to bridge the gap between research and clinical practice. Further study is needed to operationalize these relationships effectively.

IMPLEMENTAÇÃO DE UMA UNIDADE DE TERAPIA INTENSIVA(UTI) DURANTE A PANDEMIA DA CORONAVÍRUS EM UMA UNIDADE PÚBLICA DE SAÚDE: UM RELATO DE EXPERIÊNCIA

Objective: To describe the experience of a nurse in the implementation of an intensive care unit during the Coronavívus pandemic and the strategies used in the organization of the unit and the nursing team in the face of the difficulties imposed by the scenario experienced. Methodology: This is an experience report of nurses involved in the creation of a unit focused on the treatment of critically ill patients affected by COVID-19, at the height of the Coronavirus pandemic in Brazil. The study took place in two stages: in the first stage, a literature review was carried out and in the second stage, the description of the organization of the service, training of flows and established routines. Results: The physical space, routines in the service for intensive care of patients with COVID-19 were organized, and the nursing team was managed in terms of training, dimensioning, and emotional support for professionals. The difficulties and challenges encountered in terms of human, material and structural resources were described. Conclusions: Progress was made in the organization of care and training of professionals, as well as efficiency in the adequacy of the service in the face of constant changes. The obstacles experienced in coping with COVID-19 required a critical look from nurses, skills and competencies to establish new strategies to minimize losses in established processes and the spread of the new coronavirus.

Sustainability in Higher Education: Experience report on achieving Sustainable Development Goals.

Describe the activities aimed at achieving the Sustainable Development Goals (SDGs), implemented by a polytechnic higher education institution, in the northern region of Portugal. This is an experience report from a Higher Education Institution, which characterizes the contribution to the SDGs, within the scope of teaching, research, campus and leadership. In total, 1247 activities were mapped, with a preponderance in the "people" dimension (685 activities), with SDG 3 being the most prominent. Scientific articles contribute significantly to the SDGs, with a notable discrepancy between automatic (Scopus) and manual classifications, indicating a tendency to underestimate the impact of nursing studies. The results demonstrate the significant contribution of this institution to the SDGs, with a special focus on health and education. This contribution reflects the mission of the institution, which involves training competent and socially conscious health professionals, but simultaneously the need for greater awareness and training of the teaching staff.

Covid19 Pandemic: Impact on Quality of Life of Children with Cerebral Palsy. A Brief Report of Parental Experiences, Challenges & Suggestions

Covid19 Pandemic: Impact on Quality of Life of Children with Cerebral Palsy. A Brief Report of Parental Experiences, Challenges & Suggestions

Child Maltreatment and Medical Traumatic Stress—A Double-Edged Sword

Background/Objectives: Medical procedures can be a traumatic event for both children and their parents. Children who have experienced maltreatment or early traumatic experiences are at a higher risk for various emotional, behavioral, and health issues, including declining mental health. This may include experiencing heightened distress following medical procedures. The goal of this paper is to investigate the risk of distress symptoms following medical procedures for children with a history of child maltreatment vs. controls. Methods: A prospective study of 219 parents and children hospitalized in a pediatric surgical ward was conducted, with participants divided into study and control groups based on their reports of early traumatic experiences. Questionnaires measuring psychological distress were administered before the medical procedure and 3–5 months after discharge. Results: Children from the study group displayed significantly more distress symptoms before and after the procedure, with a substantial post-procedure increase. Parents of children who endured prior trauma and child maltreatment also exhibited elevated pre-procedure distress. Prior trauma and child maltreatment independently contributed to heightened medical distress. Post-procedure child distress was influenced by the early traumatic events and also by family support, socioeconomic status, and parental procedure-related post-traumatic stress symptoms. Conclusions: Children with a history of child maltreatment and trauma show an increased chance of psychological distress following medical procedures. Medical teams should be aware of this heightened risk and provide appropriate support.

Students' Reports of Challenges, Experiences, and Perceptions of Equity, Diversity, and Inclusion at Veterinary Colleges in Canada and the United States.

Equity, diversity, and inclusion (EDI) in veterinary medicine affects veterinarians, students, clients, and the regional availability of veterinary services. Veterinary students from 5 colleges in Canada and 5 colleges in the United States were surveyed about their challenges, experiences, and perceptions related to EDI, resulting in 456 responses (10.4%). A greater proportion of participants reported personal, financial, mental health, and physical health challenges during veterinary college compared to the proportion reporting these challenges before starting veterinary college. Statistically, participants who did not identify as White (odds ratio [OR]: 2.2, confidence interval [CI]: 1.1-4.3), who reported having a disability (OR: 5.0, CI: 2.1-12.1), and who identified as part of the LGBTQ2S+ community (OR: 8.5, CI: 3.8-19.2 ) were more likely to agree or strongly agree that discrimination occurs at veterinary colleges. Fewer participants reported experiencing discrimination in veterinary colleges (20.6%) compared to veterinary workplaces (36.8%). In the workplace, more participants reported the expectation of facing bias from clients than from managers or peers. The expectation of facing bias from clients was associated with the female gender (OR: 2.7, CI: 1.3-5.6), not identifying as White (OR: 7.4, CI: 2.5-21.3), and identifying as part of the LGBTQ2S+ community (OR: 2.7, CI: 1.3-5.4). More participants expected to practice in the same type of region as where they grew up rather than a different type of region. Thus, training future veterinarians from areas with region-based lack of access to veterinary services may be more effective than simply training more veterinarians. College EDI initiatives should include input from all participants and especially those who are most likely to experience discrimination, facilitating meaningful training and support.

Oral Health Practices in Home Care: A Report on Bonding and Care

Introduction: Home Care (HC) is a form of healthcare that provides patients with a comprehensive range of services. The guidelines of Brazil's National Oral Health Policy highlight HC as a key approach for expanding access to services and fostering a connection with the population. Methodology: This study presents an experience report from the Oral Health Team within the Family Health Strategy (FHS). The intervention period was from March to July 2023 in the city of Itatiba, SP. Results: A total of 25 patients received home care consultations, with an average age of 65 years. Eleven patients used full dentures, five had carious lesions, eight presented dental calculus, and one patient had an ulcerated lesion on the alveolar ridge. Interventions included oral hygiene guidance, restorative treatment, periodontal treatment, and referrals to secondary care for complementary exams. Conclusion: The study concluded that most procedures performed were denture guidance, atraumatic restorative treatment, and scaling and root planing. Additionally, the importance of oral cancer screening was highlighted, with one case identified in a patient. Moreover, the need for sensitivity and compassion in home care was emphasized, recognizing the conditions of both the patient and their family.

REFLEXÕES SOBRE PRÁTICAS PEDAGÓGICAS PARA CRIANÇAS COM TEA NA FORMAÇÃO CONTINUADA DE PROFESSORES DA EDUCAÇÃO INFANTIL

Continuing and in-service training are extremely important for professionals who are part of the educational process for young children to be able to express and share experiences and anxieties about the reality in which they live and work, especially when it comes to the inclusion of the Special Education Target Public (PAEE). Thus, the aim of this study was to portray a proposal for continuing training for teachers at Municipal Early Childhood Education Centers (CMEIs) with a focus on assisting children with Autism Spectrum Disorder (ASD). To this end, a qualitative experience report was carried out from a cultural-historical perspective, in which the following participants took part 7 CMEIs and 41 professionals, including teachers, directors, and supervisors, in a city in the interior of Paraná state. Three online training sessions were held, each lasting 1 hour and 30 minutes, in November 2022. The importance of adopting flexible strategies that consider the uniqueness of each child, as well as the relevance of effective communication and diverse resources, was highlighted. The training emphasized the need for ongoing education and cooperation among professionals, families, and institutions to ensure an inclusive and equitable educational environment, with a special focus on the identification of ASD signs, early intervention, and referral.

EDUCADORAS DA INFÂNCIA E O DESENVOLVIMENTO DA LINGUAGEM MATEMÁTICA NO TERRITÓRIO DAS CRIANÇAS DE ZERO A TRÊS ANOS

We analyzed written narratives (reports of experiences) from educators of babies and very young children (zero to three years old). The objective of the work, the result of the research we developed, lies in understanding the dynamics of pedagogical work with mathematical language based on the analysis of narratives from a collaborative group. To this end, with a qualitative approach, we focus our efforts on describing and analyzing the written reflection of teachers' reports when experiencing contexts of mathematical exploration. The theoretical framework discusses aspects of child care, post-LDB, conceptualizes the Early Childhood Education curriculum, as well as presenting the expected and possible mathematical notions when working in this area of knowledge, intentionally, in the space-time of the daycare center. The results indicate that: 1) mathematical language can and should be worked with babies and very young children in routine situations; 2) the narratives demonstrate the possibility of self-reflection regarding the proposed pedagogical experience; and 3) performance indicators were identified, in pedagogical practice, of how to explore senses of magnitudes and measurements, resolution of unconventional problems and spatial issues. Thus, the contribution of this article implies recognition of the need for teaching professionalization of educators who work directly in the field of Brazilian Early Childhood Education, with emphasis on processes in which care and education are integrated as binomials in the area.

SENSIBILIZAÇÃO PARA IMUNIZAÇÃO DE PROFISSIONAIS DE ENFERMAGEM DA PEDIATRIA COM FOCO NA VACINA DE DIFTERIA, TÉTANO E COQUELUCHE ACELULAR : UM RELATO DE EXPERIÊNCIA

To describe awareness of immunization among pediatric nursing professionals with a focus on the diphtheria, tetanus and acellular pertussis vaccine. Methodology: This is a descriptive study of the experience report type. The actions described were approved by the Human Research Ethics Committee under opinion no. 6,234,026. Results and discussion: From the analysis of the cards, it was identified that several had vaccination delays, especially for the COVID-19, Influenza and Tdap vaccines. Servers were encouraged to look for the reference vaccination rooms for their home or the one that is most convenient. Additionally, three days of extramural vaccinations were provided within the Labor Day commemorative activities within the hospital premises. Eight pediatric nursing professionals sought the service on the days offered and were immunized against Tdap. Conclusion: The immunization of employees in the pediatric service should contribute to avoiding risk situations, allowing early interventions in occupational health and collective health issues. Achieving this objective requires the dissemination of information, the mobilization of society and effective environmental communication

Challenges of Operationalizing a Mobile Computerized Tomography Unit: Experience Report from the ProPulmão Project

Challenges of Operationalizing a Mobile Computerized Tomography Unit: Experience Report from the ProPulmão Project

Development and refinement of patient care recommendations in brachytherapy for locally advanced cervical cancer using nominal group technique workshops

PurposePatient experiences of brachytherapy for locally advanced cervical cancer (LACC) are widely variable, with reports of difficult and traumatic experiences and aspects of care requiring improvement. The aim of this study was to develop patient care recommendations and consult with key stakeholders to review, refine and prioritise recommendations.MethodsPhase 1: Patient care recommendations were developed from qualitative exploratory study data. Phase 2: Service users and providers with recent experience of brachytherapy for LACC were recruited to online nominal group technique (NGT) workshops. Four NGT stages were followed: (1) initial voting and silent generation; (2) round robin; (3) clarification; and (4) prioritisation. Voting data were summed across the workshops, deriving inter-group scores. Qualitative data were analysed through content analysis.ResultsPhase 1: Fifty-one patient care recommendations were developed. Phase 2: Thirteen participants took part in three online NGT workshops, with a combination of service users and providers. Initial recommendations were voted on; four new recommendations were added; minor changes were made and second voting was undertaken. Recommendations were positively received with 25 recommendations scoring maximum points from all participants. An importance score above 90% was given to 46 recommendations. The remaining recommendations received scores between 74 and 90%.ConclusionsNGT workshops facilitated collaboration between key stakeholders, discussing, refining and prioritising patient care recommendations, leading to verification of achievable and relevant recommendations. These provide a foundation for future development of guidelines and subsequent implementation into clinical practice, aiming to improve consistency of care and patient experiences of brachytherapy for LACC.

VIVÊNCIA DAS ESTUDANTES DE ODONTOLOGIA DA FACULDADE DO AMAZONAS – IAES NO PROJETO DE EXTENSÃO REFERENTE ÀS PRÁTICAS MULTIDISCIPLINARES EM ODONTOLOGIA HOSPITALAR – UM RELATO DE EXPERIÊNCIA

Introduction: The role of the university is to train critical, reflective and ethical professionals. In this context, as an educational strategy, aligning theoretical teaching with practice, this experience took place at the Hospital and Emergency Room 28 de Agosto. The study was carried out by undergraduate students of the Dentistry course, in their sixth semester, with the practice taking place on two days a week, monthly, with a total duration of eight hours. The activities included lectures to patients, such as oral hygiene care and intraoral examinations, under the supervision of Prof. MSc. Guilherme Ferreira. Hospital Dentistry is a consolidated specialty in the care of hospitalized patients, encompassing a multidisciplinary approach and dental interventions. The care structure at the hospital was organized, ensuring safety and comfort for patients. In the Intensive Care Unit, there was one intubated patient, receiving continuous monitoring, and the other patients demonstrated good health. This experience report aims to share the experience acquired in the practice of Hospital Dentistry, highlighting the multidisciplinary work, the application of the relevant legislation and the challenges faced. Methodology: Descriptive in nature, providing an insight into the dental practices applied in the hospital environment – ​​description of the care provided, the clinical conditions of the patients, the multidisciplinary approaches and the difficulties faced by the professionals. Results and Discussion: Dental care provided to patients with various clinical conditions was observed, allowing an immersion in hospital dentistry. There was an opportunity to learn about hospital protocols and how they align with the hospital's standards and procedures, in relation to infection control and patient safety. The experience highlighted the complexity of dental care and highlighted the importance of multidisciplinary collaboration. Conclusion: The experience was an essential act for future professional practice, providing theoretical and practical learning, the opportunity to observe in a real clinical environment, to verify the complexity of hospital dental care and to adapt to the challenges of the environment.

EDUCAÇÃO EM SAÚDE PARA CONTROLE DA HIPERTENSÃO EM IDOSOS: EXPERIÊNCIA DOS ACADÊMICOS DE MEDICINA NA CASA DE IDOSOS SÃO PIO, CODÓ-MA.

This experience report aims to demonstrate the integration of medical students with the local elderly population, focusing on health education about systemic arterial hypertension (SAH). In this sense, the initiative aimed to promote awareness and prevention of the disease. There was interaction between students and the elderly, blood pressure measurement and discussion circles with the purpose of clarifying doubts about the disease and its consequences for the individual’s health and establishing na academic-community bond.

A novel method for quantitative analysis of subjective experience reports: application to psychedelic visual experiences.

Psychedelic compounds such as LSD, psilocybin, mescaline, and DMT can dramatically alter visual perception. However, the extent to which visual effects of psychedelics consistently vary for different substances is an open question. The visual effects of a given psychedelic compound can range widely both across and within individuals, so datasets with large numbers of participants and descriptions of qualitative effects are required to adequately address this question with the necessary sensitivity. Here we present an observational study with narrative self-report texts, leveraging the massive scale of the Erowid experience report dataset. We analyzed reports associated with 103 different psychoactive substances, with a median of 217 reports per substance. Thirty of these substances are standardly characterized as psychedelics, while 73 substances served as comparison substances. To quantitatively analyze these semantic data, we associated each sentence in the self-report dataset with a vector representation using an embedding model from OpenAI, and then we trained a classifier to identify which sentences described visual effects, based on the sentences' embedding vectors. We observed that the proportion of sentences describing visual effects varies significantly and consistently across substances, even within the group of psychedelics. We then analyzed the distributions of psychedelics' visual effect sentences across different categories of effects (for example, movement, color, or pattern), again finding significant and consistent variation. Overall, our findings indicate reliable variation across psychedelic substances' propensities to affect vision and in their qualitative effects on visual perception.

Learning sites for health systems research: Reflections on five programs in Africa, Asia, and Central America

AbstractIntroductionLearning sites have supported intervention development and testing in health care, but studies reflecting on lessons relating to their deployment for health policy and system research (HPSR) in low‐ and middle‐income settings are limited.MethodsThis experience report draws from learning over three continents and five research and community engagement programs—the oldest starting in 2010—to reflect on the challenges and benefits of doing embedded HPSR in learning sites, and how those have been managed. Its objective is to generate better understanding of their potential and constraints. The report draws from team members' experiential insights and program publications.ResultsChallenges relating to initial engagement in the sites included building and maintaining trust, managing partner expectations, and negotiating priority topics and stakeholders. Once the embedded research was underway, sustaining engagement, and managing power dynamics within the group, supporting all participants in developing new skills and managing rapidly changing settings were important. Finally, the complexity of reflecting on action and assessing impact are outlined, along with potential approaches to managing all of these challenges and the variety of gains that have been noted across the programs.ConclusionsWe highlight the potential of learning sites to develop relationships, capacities, and local innovations which can strengthen health systems in the long term and some lessons in relation to how to do that, including the importance of stable, long‐term funding as well as developing and recognizing facilitation skills among researchers. Supporting spaces for learning is particularly important when health systems face resource constraints and everyday or acute stressors and shocks.

Singular Therapeutic Plan: Strategies For The Well-Being Of The Elderly In Primary Care

Background: Elderly health faces challenges due to increased life expectancy and the prevalence of chronic diseases. In this scenario, the Singular Therapeutic Project (PTS) emerges as an innovative strategy, initially developed in mental health, but now applied in geriatrics. The PTS promotes a personalized care plan, created in collaboration with the elderly person, their family and an interdisciplinary team, focusing on the needs This approach not only improves adherence to treatment, but also promotes autonomy and protagonism, essential for quality of life in old age. Aim: This experience report aims to describe the practical learning experience of medical students in the implementation of a STP for an elderly patient in primary health care, highlighting the impact on medical care and education. Experience Report: During the second semester of 2024, medical students had the opportunity to experience the practice of the Singular Therapeutic Project (PTS) in a real context, through home visits in the territory of Primary Health Care at the Basic Health Unit (UBS) Riozinho in the municipality of Bragança-PA. During the home visit to the patient's home, several instruments were applied for a more complete evaluation of both the elderly woman and her caregiver, her husband, 83 years old. Among these tools, the Adult Stress Symptom Inventory (LIPP) and the Zarit Caregiver Burden Interview (ZBI) scale were used to assess caregiver stress and burden. Conclusion: The participation of medical students in the construction of the Singular Therapeutic Plan (PTS) in primary health care is an essential training experience that significantly enriches the training of future professionals.

HPR126 Health Economics Centers and Support in SUS Management: A Report of Successful Experiences

HPR126 Health Economics Centers and Support in SUS Management: A Report of Successful Experiences

Relato de experiências: a produção do GEDHA/CEAF-MPPA/CNPq e o Observatório de Direitos Humanos (Projeto Expresso DH)

The article presents a report of experiences based on the production of the Studies and Research Group on Development and Human Rights in the Amazon (GEDHA/CEAF-MPPA/CNPq), linked to the Center for Studies and Functional Improvement (CEAF), of the Ministry Public of the State of Pará (MPPA). For this purpose, it chose as its starting point the GEDHA productions in the implementation of the Human Rights Observatory of the “Expresso DH” Project, caried out within the MPPA. It is organized as follows: i) it treats GEDHA as a technology and a social innovation within the MPPA; ii) characterizes some of the dimensions of the Expresso DH Project. Finally, in item iii), it outlines a reflection on the production of knowledge within the MP.

EDUCAÇÃO EM SAÚDE NO CICLO GRAVÍDICO-PUERPERAL: UM RELATO DE EXPERIÊNCIA EM ATENÇÃO PRIMÁRIA À SAÚDE

Introduction: The processes of pregnancy, childbirth, and the postpartum period are critical and complex, marked by significant biological, psychological, and social changes in a woman’s life. These transformations demand prioritized care by public health, especially within Primary Health Care (PHC). Objective: To describe the experience of a Family and Community Medicine resident in designing and conducting a short course aimed at pregnant women, postpartum women, and caregivers, covering topics related to the pregnancy-puerperal cycle. Materials and Methods: This is an experience report about the development of a short course with three sessions covering breastfeeding, newborn care, and postpartum care. Results: The short course included 17 participants: 15 pregnant women, 1 postpartum woman, and 1 mother of a pregnant woman. A welcoming environment was provided, with an expanded perspective that integrated various PHC professionals to encourage the sharing of experiences. Discussion: The course addressed breastfeeding, highlighting its importance and providing detailed information to prevent early weaning and to increase maternal confidence. Regarding newborn care, safe practices were emphasized to prevent complications, such as Sudden Infant Death Syndrome, along with general care for the newborn. Lastly, postpartum care focused on the physical and emotional health of the mother, addressing essential topics such as nutrition, physical activity, and mental health for maternal well-being. Conclusion: Educational activities proved essential for empowering pregnant and postpartum women, though family participation needs to be encouraged. Proposals for monthly meeting cycles could enhance health education during pregnancy and the postpartum period.