115 research outputs found

    Acute Care Surgery Patterns in the Current Era: Results of a Qualitative Study

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    Introduction: Since Acute Care Surgery (ACS) was first conceptualized as a specialty a decade ago, ACS teams have been widely adopted. Little is known about the structure and function of these teams. Methods: We conducted 18 open-ended interviews with ACS leaders (1 interview/center representing geographic [New England, Northeast, Mid-Atlantic, South, West, Midwest] and practice [Public/Charity, Community, University] variations). Two independent reviewers analyzed transcribed interviews using an inductive approach to determine major themes in practice variation (NVivo qualitative analysis software). Results: All respondents described ACS as a specialty treating time sensitive surgical disease including trauma, emergency general surgery (EGS), and surgical critical care (SCC). 11/18 combined trauma and EGS into a single clinical team; 6/18 included elective general surgery. Emergency orthopedics, neurosurgery, and triage for all surgical services were rare (1/18 each). 11/18 had blocked OR time. All had a core group of trauma and SCC surgeons; 8/18 shared EGS due to volume, manpower, or competition for EGS call. Many (12/18) had formal morning signout rounds; few (2/18) had prospective EGS data registries. Streamlined access to EGS, evidence-based EGS protocols, and improved communication were considered strengths of ACS. ACS was described as the last great surgical service reinvigorated to provide timely, cost-effective EGS by experts in resuscitation and critical care and to attract young, talented, eager surgeons to trauma and SCC; however, there was concern that it might become the waste basket for everything that happens at inconvenient times. Conclusion: Despite rapid adoption of ACS, its implementation varies widely. Standardization of scope of practice, continuity of care, and registry development may improve EGS outcomes and allow the specialty to thrive

    RAHI-SATHI Indo-U.S. Collaboration: The Evolution of a Trainee-Led Twinning Model in Global Health Into a Multidisciplinary Collaborative Program

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    BACKGROUND: In recent years there has been a surge in the number of global health programs operated by academic institutions. However, most of the existing programs describe partnerships that are primarily faculty-driven and supported by extramural funding. PROGRAM DESCRIPTION: Research and Advocacy for Health in India (RAHI, or pathfinder in Hindi) and Support and Action Towards Health-Equity in India (SATHI, or partnership in Hindi) are 2 interconnected, collaborative efforts between the University of Massachusetts Medical School (UMMS) and Charutar Arogya Mandal (CAM), a medical college and a tertiary care center in rural western India. The RAHI-SATHI program is the culmination of a series of student/trainee-led research and capacity strengthening initiatives that received institutional support in the form of faculty mentorship and seed funding. RAHI-SATHI\u27s trainee-led twinning approach overcomes traditional barriers faced by global health programs. Trainees help mitigate geographical barriers by acting as a bridge between members from different institutions, garner cultural insight through their ability to immerse themselves in a community, and overcome expertise limitations through pre-planned structured mentorship from faculty of both institutions. Trainees play a central role in cultivating trust among the team members and, in the process, they acquire personal leadership skills that may benefit them in their future careers. CONCLUSION: This paradigm of trainee-led twinning partnership promotes sustainability in an uncertain funding climate and provides a roadmap for conducting foundational work that is essential for the development of a broad, university-wide global health program

    The Policy and Practice of Music Education in England, 2010-2020

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    Since the introduction of the National Plan for Music Education there have been significant changes in music education within England. Whilst some celebrate figures that report increased access and engagement, many teachers and others continue to have legitimate concerns regarding the quality of the music education on offer in schools and Music Education Hubs. There are concerns that the provision of music education is incoherent and patchy across the country. Many would argue that the opportunity to access high‐quality music education has become a ‘postcode lottery’. There is a sense that the fragmentation of music education as a result of curriculum reforms and the diversity of approaches taken by Music Education Hubs and other bodies has significantly enhanced this incoherence. This article seeks to review the policy and practice of music education in England over the last 10 years. It draws on recent research from various sources and maintains a particular focus on government policy and the consequences of this for the field as a whole. It reflects on how things could be improved in the future. It argues for a clearer focus on a practitioner‐led approach to research and advocacy, in particular one led by the notion of ‘policy as practice’ rather than continuing with the current approach and its intrinsic failings

    Ranges of 40 keV ions in polycrystalline tungsten and gold

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    NRC publication: Ye
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