Neoplastic lesions of the head and neck are primarily squamous cell carcinomas of the aerodigestive tract mucosa. Approximately 43,000 new cases of head and neck cancer (8.5% of all malignancies) are diagnosed in the United States each year. Tumors, with a male predominance at age 50 to 60 years, generally occur on the surface of the mucosal lining of the oral cavity, oropharynx, nasopharynx, larynx, maxillary sinus, salivary glands, and the thyroid gland. Tobacco, alcohol, and the combination of tobacco and alcohol are the principle causative agents of head and neck neoplasms. The use of these carcinogenic agents often has a negative impact on lifestyle, and it is not unusual for significant nutritional deficiencies to exist in this population before diagnosis of head and neck cancer. Definitive and adjuvant cancer treatment modalities are rigorous, and sequelae associated with the therapy often further impair nutritional status and increase morbidity. Auspicious nutrition assessment and management before the initiation of therapy can have a significant impact on the course of treatment and the patient's quality of life.
Team training and interprofessional training have recently emerged as critical new simulations that enhance performance by coordinating communication, leadership, professional, and, to a certain extent, technical skills. In describing these new training tools, the term choreography has been loosely used, but no critical appraisal of the role of the science of choreography has been applied to a surgical procedure. By analogy, the surgical team, including anesthetists, surgeons, nurses, and technicians, constitutes a complete ensemble, whose physical actions and interactions constitute the "performance of surgery." There are very specific "elements" (tools) that are basic to choreography, such as space, timing, rhythm, energy, cues, transitions, and especially rehearsal. This review explores whether such a metaphor is appropriate and the possibility of applying the science of choreography to the surgical team in the operating theater.
Studies of health care providers' attitudes have revealed that many have misconceptions and fears about AIDS and possess negative attitudes about caring for people with the disease. Merely transmitting the basic facts about AIDS is insufficient to prepare health care workers to deal with AIDS patients. This article discusses the need for continuing education for health care professionals and educators and offers a model for the development of educational programs. The model is being developed in the School of Allied Health Professions, State University of New York at Stony Brook. Principles of "andragogy"--involvement of both the learner and the educator in identifying students' needs, planning learning experiences, and ongoing evaluation of the learning process--are discussed.
The purpose of this study was to determine the process/model of how dietitians develop into leaders, based on descriptions provided by the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) leaders. The qualitative methodology of grounded theory included semistructured audio-recorded telephone interviews of 25 nationally elected or appointed leaders of the Academy in the United States. Open coding identified the themes: born/made, mentoring, horizontal development, personal growth, "getting hooked," and "from fear to freedom." Axial and selective coding collapsed the themes into the central phenomenon: mentoring as the segue to leadership in dietetics. The model illustrates the hypothesized sequential unfolding of the leadership development process among dietitians.
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