WorldWideScience

Sample records for biopsychosocial multidisciplinary intervention

  1. [Biopsychosocial approach in a multidisciplinary intervention: a report of a case of a newborn with mentally disabled parents].

    Science.gov (United States)

    Berlanga-Fernández, Sofía; González-López, Noelia; Cujó-López, Eva; López-Parada, Ana María

    2012-01-01

    A case report is presented of a newborn who was seen by the paediatric nurse a Primary Care clinic, and whose parents had mental disabilities. They had been followed up for years by the social services in their area, due to difficulties and limitations in their personal, social and employment development. They were also living in unhealthy conditions, so in order to address the problem, a multidisciplinary team of professionals from different areas was formed. We prepared a standardised care plan based on the model of the basic needs of Virginia Henderson. Using taxonomies of the North American Nursing Diagnosis Association (NANDA), Nursing Outcomes Classification's (NOC) and Nursing Interventions Classification (NIC) "knowledge poor" and "parental impairment" diagnoses were made. The nursing and social work goals were to make an assessment, support and use comprehensive biopsychosocial family monitoring to enable the child to grow and develop in the best possible conditions, to monitor child protection and try to improve the living conditions of the home. The child and parents were initially monitored weekly and then monthly. The assessment showed an improvement in care: "background: infant care," "risk control: drug abuse" "child care: psychological security" and "execution of the role of parents." The joint and coordinated work of the various services involved was focused towards achieving the goals set, in order to give biopsychosocial care to the baby and family.

  2. Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-speficic sub-acute low back pain in the working population: cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Roura-Olivan Mercè

    2010-01-01

    Full Text Available Abstract Background Non-specific low back pain is a common cause for consultation with the general practitioner, generating increased health and social costs. This study will analyse the effectiveness of a multidisciplinary intervention to reduce disability, severity of pain, anxiety and depression, to improve quality of life and to reduce the incidence of chronic low back pain in the working population with non-specific low back pain, compared to usual clinical care. Methods/Design A Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and its surrounding areas. The centres are randomly allocated to the multidisciplinary intervention or to usual clinical care. Patients between 18 and 65 years old (n = 932; 466 per arm and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, in addition to a biopsychosocial multidisciplinary intervention consisting of group educational sessions lasting a total of 10 hours. The main outcome is change in the score in the Roland Morris disability questionnaire at three months after onset of pain. Other outcomes are severity of pain, quality of life, duration of current non-specific low back pain episode, work sick leave and duration, Fear Avoidance Beliefs and Goldberg Questionnaires. Outcomes will be assessed at baseline, 3, 6 and 12 months. Analysis will be by intention to treat. The intervention effect will be assessed through the standard error of measurement and the effect-size. Responsiveness of each scale will be evaluated by standardised response mean and receiver-operating characteristic method. Recovery according to the patient will be used as an external criterion. A multilevel regression will be performed on repeated measures. The time until the current episode of low back pain takes to subside will be analysed by Cox

  3. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain.

    Science.gov (United States)

    Kamper, Steven J; Apeldoorn, Andreas T; Chiarotto, Alessandro; Smeets, Rob J E M; Ostelo, Raymond W J G; Guzman, Jaime; van Tulder, Maurits W

    2014-09-02

    Low back pain (LBP) is responsible for considerable personal suffering worldwide. Those with persistent disabling symptoms also contribute to substantial costs to society via healthcare expenditure and reduced work productivity. While there are many treatment options, none are universally endorsed. The idea that chronic LBP is a condition best understood with reference to an interaction of physical, psychological and social influences, the 'biopsychosocial model', has received increasing acceptance. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR) programs that target factors from the different domains, administered by healthcare professionals from different backgrounds. To review the evidence on the effectiveness of MBR for patients with chronic LBP. The focus was on comparisons with usual care and with physical treatments measuring outcomes of pain, disability and work status, particularly in the long term. We searched the CENTRAL, MEDLINE, EMBASE, PsycINFO and CINAHL databases in January and March 2014 together with carrying out handsearches of the reference lists of included and related studies, forward citation tracking of included studies and screening of studies excluded in the previous version of this review. All studies identified in the searches were screened independently by two review authors; disagreements regarding inclusion were resolved by consensus. The inclusion criteria were published randomised controlled trials (RCTs) that included adults with non-specific LBP of longer than 12 weeks duration; the index intervention targeted at least two of physical, psychological and social or work-related factors; and the index intervention was delivered by clinicians from at least two different professional backgrounds. Two review authors extracted and checked information to describe the included studies, assessed risk of bias and performed the analyses. We used the Cochrane risk of bias tool to describe the

  4. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain.

    Science.gov (United States)

    Marin, Teresa J; Van Eerd, Dwayne; Irvin, Emma; Couban, Rachel; Koes, Bart W; Malmivaara, Antti; van Tulder, Maurits W; Kamper, Steven J

    2017-06-28

    Low back pain (LBP) is associated with enormous personal and societal burdens, especially when it reaches the chronic stage of the disorder (pain for a duration of more than three months). Indeed, individuals who reach the chronic stage tend to show a more persistent course, and they account for the majority of social and economic costs. As a result, there is increasing emphasis on the importance of intervening at the early stages of LBP.According to the biopsychosocial model, LBP is a condition best understood with reference to an interaction of physical, psychological, and social influences. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR) programs that target factors from the different domains, administered by healthcare professionals from different backgrounds.This review is an update of a Cochrane Review on MBR for subacute LBP, which was published in 2003. It is part of a series of reviews on MBR for musculoskeletal pain published by the Cochrane Back and Neck Group and the Cochrane Musculoskeletal Group. To examine the effectiveness of MBR for subacute LBP (pain for a duration of six to 12 weeks) among adults, with a focus on pain, back-specific disability, and work status. We searched for relevant trials in any language by a computer-aided search of CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and two trials registers. Our search is current to 13 July 2016. We included randomised controlled trials (RCTs) of adults with subacute LBP. We included studies that investigated a MBR program compared to any type of control intervention. We defined MBR as an intervention that included a physical component (e.g. pharmacological, physical therapy) in combination with either a psychological, social, or occupational component (or any combination of these). We also required involvement of healthcare professionals from at least two different clinical backgrounds with appropriate training to deliver the component for which they were

  5. Recurrent abdominal pain, medical intervention, and biofeedback: what happened to the biopsychosocial model?

    Science.gov (United States)

    Masters, Kevin S

    2006-06-01

    Recurrent abdominal pain (RAP) is a significant and common problem among pediatric populations. Based on results from randomized controlled trials there are no established efficacious treatments for this disorder. Biofeedback (BFB) and other psychological treatments offer logically appealing alternatives or adjuncts to medical interventions and there is some evidence to support their use. This paper presents a typical case of RAP that exemplifies how the lack of integration of the biopsychosocial model may result in less than optimal treatment. Specifically, it demonstrates that the patient was exposed to potentially risky treatments that lack evidence to support their use and were not beneficial. Although there was evidence of psychological involvement early in the treatment, this was only attended to following numerous medical trials and exploratory surgery over three years. The patient was finally referred for BFB and during a course of seven sessions over five months that variously included heart rate variability and skin temperature feedback along with extensive home practice of paced breathing and hand warming the patient achieved significant symptom reduction and improved coping abilities. This case vividly illustrates the need for multidisciplinary collaboration and full implementation and integration of the biopsychosocial model of health and illness.

  6. Vocational rehabilitation: a multidisciplinary intervention.

    Science.gov (United States)

    Gobelet, C; Luthi, F; Al-Khodairy, A T; Chamberlain, M A

    2007-09-15

    Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine.

  7. Multidisciplinary meetings as an effective clinical intervention.

    Science.gov (United States)

    MacCallam, Jackie; Higgins, Lisa

    2014-06-01

    When used well, multidisciplinary meetings can function in the same way as other clinical interventions to improve communication, efficiency and outcomes. They help break down barriers, manage difficult emotions, and benefit service users and staff. But it is imperative that they are well prepared, well attended, and that the purpose and agenda are agreed. It is also vital to have an efficient chair and that meetings take place in an environment where feelings can be shared openly and respected. Services should recognise and address relevant training and support requirements.

  8. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians

    DEFF Research Database (Denmark)

    Jay, Kenneth; Petersen, Mikkel Brandt; Sundstrup, Emil

    2014-01-01

    biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. METHODS/DESIGN: In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants...... by questionnaire (modified visual analogue scale 0-10). DISCUSSION: This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT02047669.......BACKGROUND: Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor...

  9. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Andersen, Kenneth Jay; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    pain using individually tailored physical and cognitive elements. STUDY DESIGN: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA...... region separately showed significant pain reductions of the neck, shoulders, upper back and lower back, as well as a tendency for hand pain. Within the PCMT group, general linear models adjusted for age, baseline pain, and stress levels showed significant associations for the change in pain...... with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with the change in stress as outcome. LIMITATIONS: Limitations of behavioral interventions include the inability...

  10. Rethinking research on psychosocial interventions in biopsychosocial oncology: an essay written in honor of the scholarly contributions of Bernard H. Fox.

    Science.gov (United States)

    Temoshok, Lydia R

    2004-07-01

    In his best known contribution to the field of psychooncology, the late Dr Bernard H. Fox applied his breadth of scholarship in biopsychosocial cancer epidemiology to address the question of whether and to what extent stress and other psychosocial factors may contribute to cancer risk. Less well known but equally important to the field is his incisive critique of the 1989 study by Spiegel et al. on survival time of patients with metastatic breast cancer following a psychosocial intervention. This essay represents an attempt to take Fox's line of thought to the next logical level of rethinking research on psychosocial interventions in biopsychosocial oncology. Following an analysis of the inadequacy of randomized clinical trials (RCT) to evaluate the causal effects of psychosocial interventions on cancer outcomes and distinguish these from mere prediction, an integrated RCT design is suggested to take into account the psychogenicity of a given intervention, potential mediating mechanisms, and individual differences that could help illuminate hypothesized causal processes linking an experimental intervention and cancer outcomes. Copyright 2004 John Wiley & Sons, Ltd.

  11. Effect of nutritional intervention on weight multidisciplinary ambulatory patients

    Directory of Open Access Journals (Sweden)

    María Luisa Fallas

    2012-10-01

    Full Text Available This retrospective descriptive study is based on statistical data generated in the outpatient nutritional support of Dr. RA Calderon Guardia Hospital. Educate the patient and their family. Further, the nutritional plans and nutritional supplementation given by the multidisciplinary group shows a weight gain of 74% of the study group. The sample population was 156 patients who presented during calendar 2011. The population consisted of 100 patients who had at least 2 evaluations in 2011. The analysis evaluated the impact of nutritional interventions on body weight of those treated. At each patient examination, weight was measured in kilograms (kg, height in meters, body mass index as (kg/m2, and changes in weight in kilograms. The spreadsheet designed and used for data and graphs was Word 2003 and Excel 2003. The doctor and a nurse specialist trained in nutritional support, the team was complete the sample. Variables were: Age, Sex, Patient Diagnosis Regarding the outcome of patients treated in the outpatient, nutritional support found that 74 patients gained weight which represents 74% of the sample group, 4 patients (4% were able to maintain weight, and 22 patients (22% continued to lose weight. A multidisciplinary approach to nutritional support allows most of patients by their pathology or malnutrition to submit increased risk of suffering, can improve or maintain their nutritional status

  12. A systematic evaluation of a multidisciplinary social work-lawyer elder mistreatment intervention model.

    Science.gov (United States)

    Rizzo, Victoria M; Burnes, David; Chalfy, Amy

    2015-01-01

    This study introduces a conceptually based, systematic evaluation process employing multivariate techniques to evaluate a multidisciplinary social work-lawyer intervention model (JASA-LEAP). Logistic regression analyses were used with a random sample of case records (n = 250) from three intervention sites. Client retention, program fidelity, and exposure to multidisciplinary services were significantly related to reduction in mistreatment risk at case closure. Female gender, married status, and living with perpetrator significantly predicted unfavorable outcomes. This study extends the elder mistreatment program evaluation literature beyond descriptive/bivariate evaluation strategies. Findings suggest that a multidisciplinary social work-lawyer elder mistreatment intervention model is a successful approach.

  13. Effectiveness of a biopsychosocial e-learning intervention on the clinical judgements of medical students and GP trainees regarding future risk of disability in patients with chronic lower back pain: study protocol for a randomised controlled trial

    Science.gov (United States)

    Dwyer, Christopher P; MacNeela, Pádraig; Reynolds, Bronagh; Hamm, Robert M; Main, Christopher J; O'Connor, Laura L; Conneely, Sinéad; Taheny, Darragh; Slattery, Brian W; O'Neill, Ciaran; NicGabhainn, Saoirse; Murphy, Andrew W; Kropmans, Thomas; McGuire, Brian E

    2016-01-01

    Introduction Chronic lower back pain (CLBP) is a major healthcare problem with wide ranging effects. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions that identify biopsychosocial barriers to recovery have been observed to lead to successfully reduced pain-related work absences and increased return to work for individuals with CLBP. Modern conceptualisations of pain adopt a biopsychosocial approach, such as the flags approach. Biopsychosocial perspectives have been applied to judgements about future adjustment, recovery from pain and risk of long-term disability; and provide a helpful model for understanding the importance of contextual interactions between psychosocial and biological variables in the experience of pain. Medical students and general practitioner (GP) trainees are important groups to target with education about biopsychosocial conceptualisations of pain and related clinical implications. Aim The current study will compare the effects of an e-learning intervention that focuses on a biopsychosocial model of pain, on the clinical judgements of medical students and trainees. Methods and analysis Medical student and GP trainee participants will be randomised to 1 of 2 study conditions: (1) a 20 min e-learning intervention focused on the fundamentals of the flags approach to clinical judgement-making regarding risk of future pain-related disability; compared with a (2) wait-list control group on judgement accuracy and weighting (ie, primary outcomes); flags approach knowledge, attitudes and beliefs towards pain, judgement speed and empathy (ie, secondary outcomes). Participants will be assessed at preintervention and postintervention. Ethics and dissemination The study will be performed in agreement with the Declaration of Helsinki and is approved by the National University of Ireland Galway Research Ethics Committee. The results of the trial will be published according to the

  14. Multidisciplinary rehabilitation for subacute low back pain : graded activity or workplace intervention or both? : a randomized controlled trial

    NARCIS (Netherlands)

    Anema, J.R.; Steenstra, I.A.; Bongers, P.M.; Vet, H.C.W. de; Knol, D.L.; Loisel, P.

    2007-01-01

    To assess the effectiveness of workplace intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods: Participants

  15. Effect of Individually Tailored Biopsychosocial Workplace Interventions on Chronic Musculoskeletal Pain and Stress Among Laboratory Technicians: Randomized Controlled Trial.

    Science.gov (United States)

    Jay, Kenneth; Brandt, Mikkel; Hansen, Klaus; Sundstrup, Emil; Jakobsen, Markus D; Schraefel, M C; Sjogaard, Gisela; Andersen, Lars L

    2015-01-01

    Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal pain using individually tailored physical and cognitive elements. This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA09)--Laboratory technicians" was registered at ClinicalTrials.gov prior to participant enrolment. The study was conducted at the head division of a large private pharmaceutical company's research and development department in Denmark. The study duration was March 2014 (baseline) to July 2014 (follow-up). Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioral therapy/education. Participants of the REF group were encouraged to follow ongoing company health initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0-10) in average of the regions: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively, as outcome measures. A significant (P change in pain with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with

  16. Children with developmental problems and disorders : selected aspects of motor and multidisciplinary assessment and intervention

    OpenAIRE

    2006-01-01

    The general aim of this thesis was to apply a multidisciplinary approach to selected clinical aspects of children with developmental problems and disorders, in order to contribute to the development of assessment and intervention strategies. Motor coordination difficulties were particularly focused. The following aspects were investigated in the separate studies: - Behaviour, cognitive, linguistic and motor skills were assessed in 6-year old children considered at risk with regard to...

  17. Game playbooks: tools to guide multidisciplinary teams in developing videogame-based behavior change interventions.

    Science.gov (United States)

    Duncan, Lindsay R; Hieftje, Kimberly D; Culyba, Sabrina; Fiellin, Lynn E

    2014-03-01

    As mobile technologies and videogaming platforms are becoming increasingly prevalent in the realm of health and healthcare, so are the opportunities to use these resources to conduct behavioral interventions. The creation and empirical testing of game style interventions, however, is challenged by the requisite collaboration of multidisciplinary teams, including researchers and game developers who have different cultures, terminologies, and standards of evidence. Thus, traditional intervention development tools such as logic models and intervention manuals may need to be augmented by creating what we have termed "Game Playbooks" which are intervention guidebooks that are created by, understood by, and acceptable to all members of the multidisciplinary game development team. The purpose of this paper is to describe the importance and content of a Game Playbook created to aide in the development of a videogame intervention designed specifically for health behavior change in young teens as well as the process for creating such a tool. We draw on the experience of our research and game design team to describe the critical components of the Game Playbook and the necessity of creating such a tool.

  18. A Multidisciplinary Workplace Intervention for Chronic Low Back Pain among Nursing Assistants in Iran.

    Science.gov (United States)

    Shojaei, Sarallah; Tavafian, Sedigheh Sadat; Jamshidi, Ahmad Reza; Wagner, Joan

    2017-06-01

    Interventional research with a 6-month follow-up period. We aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory. WRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP. We included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data. The comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (pnurse aides, making them suitable for implementation in programs to improve WRLBP among nursing assistants working in hospitals.

  19. Functional Anatomy in Low Back Rehabilitation: Balance in the Biopsychosocial Model

    NARCIS (Netherlands)

    J-P. van Wingerden (Jean-Paul)

    2009-01-01

    textabstractThe work presented in this thesis examines whether a more prominent role of functional anatomy within multidisciplinary treatment of non-specific chronic low back pain (NCLBP) will increase its therapeutic effect. The multidisciplinary treatment of NCLBP is based on the biopsychosocial (

  20. Functional Anatomy in Low Back Rehabilitation: Balance in the Biopsychosocial Model

    NARCIS (Netherlands)

    J-P. van Wingerden (Jean-Paul)

    2009-01-01

    textabstractThe work presented in this thesis examines whether a more prominent role of functional anatomy within multidisciplinary treatment of non-specific chronic low back pain (NCLBP) will increase its therapeutic effect. The multidisciplinary treatment of NCLBP is based on the biopsychosocial

  1. Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.

    Science.gov (United States)

    Blegen, M A; Sehgal, N L; Alldredge, B K; Gearhart, S; Auerbach, A A; Wachter, R M

    2010-08-01

    The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before-after design. Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists. While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units.

  2. Interventional oncology in multidisciplinary cancer treatment in the 21(st) century.

    Science.gov (United States)

    Adam, Andreas; Kenny, Lizbeth M

    2015-02-01

    Interventional oncology is an evolving branch of interventional radiology, which relies on rapidly evolving, highly sophisticated treatment tools and precise imaging guidance to target and destroy malignant tumours. The development of this field has important potential benefits for patients and the health-care system, but as a new discipline, interventional oncology has not yet fully established its place in the wider field of oncology; its application does not have a comprehensive evidence base, or a clinical or quality-assurance framework within which to operate. In this regard, radiation oncology, a cornerstone of modern cancer care, has a lot of important information to offer to interventional oncologists. A strong collaboration between radiation oncology and interventional oncology, both of which aim to cure or control tumours or to relieve symptoms with as little collateral damage to normal tissue as possible, will have substantial advantages for both disciplines. A close relationship with radiation oncology will help facilitate the development of a robust quality-assurance framework and accumulation of evidence to support the integration of interventional oncology into multidisciplinary care. Furthermore, collaboration between interventional oncology and radiation oncology fields will have great benefits to practitioners, people affected by cancer, and to the wider field of oncology.

  3. Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

    Science.gov (United States)

    Bathrellou, Eirini; Yannakoulia, Mary; Papanikolaou, Katerina; Pehlivanidis, Artemios; Pervanidou, Panagiota; Kanaka-Gantenbein, Christina; Tsiantis, John; Chrousos, George P.; Sidossis, Labros S.

    2010-01-01

    Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical…

  4. Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

    Science.gov (United States)

    Bathrellou, Eirini; Yannakoulia, Mary; Papanikolaou, Katerina; Pehlivanidis, Artemios; Pervanidou, Panagiota; Kanaka-Gantenbein, Christina; Tsiantis, John; Chrousos, George P.; Sidossis, Labros S.

    2010-01-01

    Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical…

  5. Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

    Directory of Open Access Journals (Sweden)

    Torisson G

    2013-09-01

    Full Text Available Gustav Torisson,1 Lennart Minthon,1 Lars Stavenow,2 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 2Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann–Whitney U test, P = 0.02. For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009. Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002 and decreased from 75 to 58 in the intervention group (P = 0.25. From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann–Whitney test, P = 0.054. Conclusion: A multidisciplinary approach

  6. Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

    Science.gov (United States)

    Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

    2016-08-05

    We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, pteamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

  7. Experiences by patients and health professionals of a multidisciplinary intervention for long-term orofacial pain

    Directory of Open Access Journals (Sweden)

    Nilsson H

    2013-09-01

    Full Text Available Håkan Nilsson,1 Mats Samuelsson,2 Susanne Ekdahl,3 Yvonne Halling,4 Anders Öster,4 Kent-Inge Perseius2,3 1Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, and Unit of Stomatognathic Physiology, Specialist Dental Centre, Kalmar County Hospital, Kalmar, 2Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, 3Nyckeln Competence Center for Pedagogics in Healthcare, Kalmar County Hospital, Kalmar, 4Unit of Stomatognathic Physiology, Specialist Dental Centre, Kalmar County Hospital, Kalmar, Sweden Abstract: The aim of the present study was to describe patients’ and health professionals’ experiences of a multidisciplinary stress-focused clinical evaluation with prolonged engagement as an intervention for patients with long-term orofacial pain. Data in the patient part of this study were collected by free-text questionnaires using open-ended questions. Data were collected by group interview in the part of the study concerning health professionals. All data were analyzed according to qualitative content analysis. Data from patients revealed three categories for the intervention, ie, “helpful for most and crucial for some”, “being listened to, respected and validated”, and “gives important coping strategies”. The results showed that a vast majority of patients described themselves as having been helped by the intervention. Some patients reported that meeting with the orofacial pain consultant team was crucial to the future course of their lives. Most patients described still having residual pain and symptoms, and only a few described their pain as being fully remitted. However, because of the intervention, the patients reported being able to adopt more constructive coping strategies. They also described their perception of the pain as being different, in that it was not so frightening once they had been given a model with which to understand it. Data from the health

  8. A multidisciplinary intervention programme has positive effects on quality of life in overweight and obese preschool children

    NARCIS (Netherlands)

    Bocca, Gianni; Kuitert, M.W.B.; Sauer, P.J.J.; Stolk, R.P.; Flapper, B.C.; Corpeleijn, E.

    AIM: Up to 18.1% of Dutch children aged three to five are overweight and up to 3.3% are obese, with higher levels in girls. This study assessed the effect of a multidisciplinary intervention programme on health-related quality of life (HRQoL) in this patient group. METHODS: We randomised 75 children

  9. A multidisciplinary intervention programme has positive effects on quality of life in overweight and obese preschool children

    NARCIS (Netherlands)

    Bocca, Gianni; Kuitert, M.W.B.; Sauer, P.J.J.; Stolk, R.P.; Flapper, B.C.; Corpeleijn, E.

    2014-01-01

    AIM: Up to 18.1% of Dutch children aged three to five are overweight and up to 3.3% are obese, with higher levels in girls. This study assessed the effect of a multidisciplinary intervention programme on health-related quality of life (HRQoL) in this patient group. METHODS: We randomised 75 children

  10. Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia

    Directory of Open Access Journals (Sweden)

    Glenda Dias Santos

    2015-12-01

    Full Text Available Abstract Background Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer’s disease (AD and cognitive impairment without dementia (CIND. Methods Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54 or control (n = 16 groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13 or with CIND (n = 14 who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021 and quality of life (p = 0.003, along with a reduction in depressive symptoms (p < 0.001. As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005 and depressive symptoms (p = 0.011. No such benefits were found among patients with moderate AD.Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention.

  11. Intervención de Salud en Familias de Alto Riesgo Biopsicosocial: Seguimiento a Largo Plazo del Funcionamiento Familiar Health Intervention in High Biopsychosocial Risk Families: Long Term Follow-up of Family Functioning

    Directory of Open Access Journals (Sweden)

    María Lorena Weinreich

    2004-05-01

    Full Text Available Este estudio forma parte de otro mayor que tuvo como objetivo evaluar el impacto a largo plazo de un programa de salud integral familiar, de un centro de salud de la comuna de La Florida en Santiago. Se informan los hallazgos de la evaluación de seguimiento del funcionamiento familiar de las familias en condiciones de riesgo biopsicosocial que participaron en el programa. Se utilizó un diseño cuasiexperimental prospectivo de mediciones repetidas: pre intervención, post intervención y seguimiento. Se administró el test "Cómo es su familia", a 31 madres de las familias intervenidas, evidenciándose una mejoría significativa en factores importantes del funcionamiento familiar, como la comunicación y el estilo familiar de resolución de problemas, lo que es relevante, al ser un factor de protección de las condiciones de salud de los individuos.This study is part of a larger research whose purpose was to evaluate the long term impact of a family integral health program, of a Center of Health of the sector of "La Florida" in Santiago. The main findings concerning the evaluation of the follow-up of the family functioning of the families in conditions of biopsychosocial risk taking part in the program are informed. A prospective quasi-experimental design of repeated measurements was used: pre intervention, post intervention and follow-up. The test "What is your family like" was administered to 31 mothers of the treated families. A significant improvement was noted in important factors of the family functioning, such as the communication and the family's problem resolution style, which is relevant as it is a protection factor of the health conditions of the individuals.

  12. Effectiveness of pharmacovigilance: multifaceted educational intervention related to the knowledge, skills and attitudes of multidisciplinary hospital staff

    Directory of Open Access Journals (Sweden)

    Fabiana Rossi Varallo

    Full Text Available OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil. The intervention involved four activities: 1 an interactive lecture, 2 a practical class, 3 a pre-post questionnaire administered to professionals on a multidisciplinary team, and 4 educational material. The intervention’s impact on the professionals’ knowledge and skills was assessed using the World Health Organization’s definitions. The intervention’s effect on the professionals’ attitudes was analysed by the prevalence of adverse drug event reports (adverse drug reactions, medication errors, therapeutic failure and drug quality deviations and the relevance (seriousness and expectancy of the events. RESULTS: One hundred seventy-three professionals were enrolled. A 70-fold increase in the number of adverse drug event reports was observed during the 12 months post-intervention. The intervention improved the professionals’ form-completion skills (p<0.0001 and their knowledge of pharmacovigilance (p<0.0001. The intervention also contributed to detecting serious drug-induced events. The nursing staff reported medication errors, and pharmacists and physiotherapists recognized serious adverse drug reactions. Physicians communicated suspicions of therapeutic failure. CONCLUSIONS: A multidisciplinary approach to drug-safety assessments contributes to identifying new, relevant drug-related problems and improving the rate of adverse drug event reporting. This strategy may therefore be applied to improve risk communication in

  13. Pilot study of a 10-week multidisciplinary Tai Chi intervention in sedentary obese women.

    NARCIS (Netherlands)

    Dechamps, A.A.; Gatta, B.; Bourdel-Marchasson, I.; Tabarin, A.; Roger, P.

    2009-01-01

    OBJECTIVE: Alternative approaches to weight control and physical activity are increasingly needed. Numerous factors influence weight management, including the choice of physical exercise. No study has previously examined the therapeutic effect of a multidisciplinary weight management program incorpo

  14. Multidisciplinary lifestyle intervention in the obese: its impact on patients' perception of the disease, food and physical exercise.

    Science.gov (United States)

    Piana, N; Battistini, D; Urbani, L; Romani, G; Fatone, C; Pazzagli, C; Laghezza, L; Mazzeschi, C; De Feo, P

    2013-04-01

    To be successful, lifestyle intervention in obesity must take into account patients' views. The aim of the present study, conducted using a narrative-autobiographical approach, was to report on the perception of disease, food and physical exercise in a group of 80 obese patients during a structured multidisciplinary lifestyle intervention. Patients underwent lifestyle intervention, of three months' duration, structured in the following steps: 1) an initial medical examination; 2) an interview by a psychologist; 3) an assessment by a dietician, 4) a physical examination by a specialist in sports medicine; 5) an individualized program consisting of 24 sessions (two per week) of structured indoor exercise 6) eight sessions of group therapeutic education; 7) Nordic walking activity combined with walking excursions during weekends. All the narrative autobiographic texts obtained during the lifestyle intervention were submitted for content analysis; data were analysed according to the ''grounded theory'' method. According to patients' descriptions at the end of the intervention, lifestyle intervention resulted in enhanced self-efficacy and a reduction in their dependency on food and people; their fear of change was also diminished because, by undergoing intervention, they had experienced change. The findings made in the present qualitative analysis suggest that whenever multidisciplinary lifestyle intervention is planned for patients with obesity, it is of the utmost importance to tailor the approach while taking the following key aspects into account: motivation, barriers and/or facilitators in lifestyle change, patients' perceptions of obesity and relationship with food, diet and exercise. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain

    DEFF Research Database (Denmark)

    Pedersen, Pernille; Nielsen, Claus Vinther; Jensen, Ole Kudsk

    2017-01-01

    AIMS: To evaluate differences in employment status, during a five-year follow-up period in patients on sick leave due to low back pain who had participated in a trial comparing a brief and a multidisciplinary intervention. METHODS: From 2004 to 2008, 535 patients were referred to the Spine Centre...... at the Regional Hospital in Silkeborg if they had been on sick leave for 3-16 weeks due to low back pain. All patients underwent a clinical examination by a rehabilitation physician and a physiotherapist, and were randomised to either the brief intervention or the multidisciplinary intervention. The outcome...... patients were randomised to the brief intervention and 233 patients to the multidisciplinary intervention. No statistically significant differences in the mean weeks spent within the different employment statuses were found between the two intervention groups. After five years of follow-up, participants...

  16. Republished paper: Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.

    Science.gov (United States)

    Blegen, M A; Sehgal, N L; Alldredge, B K; Gearhart, S; Auerbach, A A; Wachter, R M

    2010-12-01

    The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before-after design. Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists. While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units.

  17. Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain

    DEFF Research Database (Denmark)

    Fisker, Annette; Langberg, Henning; Petersen, Tom

    2013-01-01

    Musculoskeletal disorders account for one third of the long-term absenteeism in Denmark and the number of individuals sick listed for more than four weeks is increasing. Compared to other diagnoses, patients with musculoskeletal diseases, including low back pain, are less likely to return to work...... after a period of sick leave. It seems that a multidisciplinary intervention, including cooperation between the health sector, the social sector and in the work place, has a positive effect on days off work due to musculoskeletal disorders and particularly low back pain. It is a challenge to coordinate...... this type of intervention, and the implementation of a return-to-work (RTW)-coordinator is suggested as an effective strategy in this process. The purpose of this paper is to describe the study protocol and present a new type of intervention, where the physiotherapist both has the role as RTW...

  18. Using a biopsychosocial perspective in the treatment of fibromyalgia patients.

    Science.gov (United States)

    Turk, Dennis C; Adams, Leah M

    2016-05-01

    Fibromyalgia (FM) is a complex illness that manifests in different ways across individuals. Given that there are currently no known cures for FM, like treatment for other chronic diseases, interventions focus on learning strategies to alleviate symptom severity, to cope with and manage residual symptoms of the illness and to maximize health-related quality of life despite symptoms. In this article, we highlight the need for providers to adopt a biopsychosocial perspective for understanding and addressing patients with FM, noting that biological, psychosocial and behavioral factors function interdependently to affect a person's experience and adaptation. A cognitive-behavioral approach, which incorporates a biopsychosocial perspective, is detailed, along with specific treatment considerations for helping patients with FM manage their symptoms.

  19. Improving decision making in multidisciplinary tumor boards: prospective longitudinal evaluation of a multicomponent intervention for 1,421 patients.

    Science.gov (United States)

    Lamb, Benjamin W; Green, James S A; Benn, Jonathan; Brown, Katrina F; Vincent, Charles A; Sevdalis, Nick

    2013-09-01

    Due to its complexity, cancer care is increasingly being delivered by multidisciplinary tumor boards (MTBs). Few studies have investigated how best to organize and run MTBs to optimize clinical decision making. We developed and evaluated a multicomponent intervention designed to improve the MTB's ability to reach treatment decisions. We conducted a prospective longitudinal study during 16 months that evaluated MTB decision making for urological cancer patients at a university hospital in London, UK. After a baseline period, MTB improvement interventions (eg, MTBs checklist, MTB team training, and written guidance) were delivered sequentially. Outcomes measures were the MTB's ability to reach a decision, the quality of information presentation, and the quality of teamwork (as assessed by trained assessors using a previously validated observational assessment tool). The efficacy of the intervention was evaluated using multivariate analyses. There were 1,421 patients studied between December 2009 and April 2, 2011. All outcomes improved considerably between baseline and intervention implementation: the MTB's ability to reach a decision rose from 82.2% to 92.7%, quality of information presentation rose from 29.6% to 38.3%, and quality of teamwork rose from 37.8% to 43.0%. The MTB's ability to reach a treatment decision was related to the quality of available information (r = 0.298; p < 0.05) and quality of teamwork within the MTB (r = 0.348; p < 0.05). The most common barriers to reaching clinical decisions were inadequate radiologic information (n = 77), inadequate pathologic information (n = 51), and inappropriate patient referrals (n = 21). Multidisciplinary tumor board-delivered treatment is becoming the standard for cancer care worldwide. Our intervention is efficacious and applicable to MTBs and can improve decision making and expedite cancer care. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Game playbooks: tools to guide multidisciplinary teams in developing videogame-based behavior change interventions

    National Research Council Canada - National Science Library

    Duncan, Lindsay R; Hieftje, Kimberly D; Culyba, Sabrina; Fiellin, Lynn E

    2014-01-01

    ... have different cultures, terminologies, and standards of evidence. Thus, traditional intervention development tools such as logic models and intervention manuals may need to be augmented by creating what we have termed “Game Playbooks...

  1. The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents - a longitudinal pilot intervention study

    OpenAIRE

    Bock, Dirk E; Robinson, Tracy; Seabrook, Jamie A; Rombeek, Meghan; Norozi, Kambiz; Filler, Guido; Rauch, Ralf; Clarson, Cheril L

    2014-01-01

    Background Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese ...

  2. Mutual interactions between depression/quality of life and adherence to a multidisciplinary lifestyle intervention in obesity.

    Science.gov (United States)

    Mazzeschi, Claudia; Pazzagli, Chiara; Buratta, Lidia; Reboldi, Gian Paolo; Battistini, Dalila; Piana, Natalia; Pippi, Roberto; Fatone, Cristina; De Feo, Pierpaolo

    2012-12-01

    There is scarce knowledge of the interaction between depression/health-related quality of life (HRQOL) and lifestyle intervention in obesity. The aim of the study was to establish whether baseline mood status or HRQOL affects attendance to educational or exercise sessions and whether attendance to these two components of the intervention affects mood and/or HRQOL in obesity. A total of 282 overweight/obese subjects (body mass index, 33.4 ± 5.9 kg/m(2); 103 males, 179 females; age, 53.8 ± 13.0 yr, mean ± sd) were consecutively enrolled in a multidisciplinary lifestyle intervention program. During the intensive phase of the intervention (3 months) patients were invited to attend eight educational sessions and 26 exercise group sessions. Poor adherence to exercise sessions is predicted by baseline depressive mood (P =0.006) and by low levels of HRQOL (domains of Vitality, Physical Role Functioning, Social Functioning, Mental Composite, Physical Composite Scores) (P obesity.

  3. Process evaluation of an integrated, multidisciplinary intervention programme for hand eczema.

    NARCIS (Netherlands)

    Gils, R.F. van; Groenewoud, K.; Boot, C.R.L.; Rustemeyer, T.; Mechelen, W. van; Valk, P.G.M. van der; Anema, J.R.

    2012-01-01

    BACKGROUND. Over the last decade, few randomized controlled trials of high methodological quality have been carried out to evaluate the effectiveness of interventions for patients with hand eczema. Little to no attention has been paid to the feasibility of these interventions. This process evaluatio

  4. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Directory of Open Access Journals (Sweden)

    Walter Zingg

    Full Text Available Central line-associated bloodstream infection (CLABSI is the major complication of central venous catheters (CVC. The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001 after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22. Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI.

  5. Subgroup analyses on return to work in sick-listed employees with low back pain in a randomised trial comparing brief and multidisciplinary intervention

    Directory of Open Access Journals (Sweden)

    Petersen Karin D

    2011-05-01

    Full Text Available Abstract Background Multidisciplinary intervention is recommended for rehabilitation of employees sick-listed for 4-12 weeks due to low back pain (LBP. However, comparison of a brief and a multidisciplinary intervention in a randomised comparative trial of sick-listed employees showed similar return to work (RTW rates in the two groups. The aim of the present study was to identify subgroups, primarily defined by work-related baseline factors that would benefit more from the multidisciplinary intervention than from the brief intervention. Methods A total of 351 employees sick-listed for 3-16 weeks due to LBP were recruited from their general practitioners. They received a brief or a multidisciplinary intervention. Both interventions comprised clinical examination and advice by a rehabilitation doctor and a physiotherapist. The multidisciplinary intervention also comprised assignment of a case manager, who made a rehabilitation plan in collaboration with the patient and a multidisciplinary team. Using data from a national database, we defined RTW as no sickness compensation benefit disbursement for four consecutive weeks within the first year after the intervention. At the first interview in the clinic, it was ensured that sick leave was primarily due to low back problems.Questionnaires were used to obtain data on health, disability, demographic and workplace-related factors. Cox hazard regression analyses were used with RTW as outcome measure and hazard rate ratios (HRR = HRmultidisciplinary/HRbrief were adjusted for demographic and health-related variables. An interaction term consisting of a baseline variable*intervention group was added to the multivariable regression model to analyse whether the effects of the interventions were moderated by the baseline factor. Subsequently, a new study was performed that included 120 patients who followed the same protocol. This group was analyzed in the same way to verify the findings from the original

  6. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions.

    Science.gov (United States)

    Aarås, A; Horgen, G; Bjørset, H H; Ro, O; Thoresen, M

    1998-10-01

    The study has a parallel group design with two intervention groups (T and S) and one control group (C) of VDU operators. Three serial interventions were carried out in the T and S groups, first a new lighting system, then new workplaces and last an optometric examination and corrections if needed. The new lighting gave significantly increased illuminance levels, increased luminances of the room surfaces and better luminance distribution. The two intervention groups reported significant improvement of the lighting conditions, as well as of the visual conditions and significantly reduced visual discomfort and glare. Significant reduction of headache was found in one of the intervention groups. Optometric corrections reduced the visual discomfort in both the intervention groups. When looking at those given new corrections, a significant reduction was found in the T group and a clear tendency was also found in the S group. The C group reported no improvements for any of these health outcomes. The workplace intervention gave the operator the possibility to support the whole forearm and hand on the table top. Before the intervention there were no significant differences between the three groups regarding shoulder pain and static trapezius electromyographic (EMG) load. Two years after the intervention, a significant reduction of shoulder pain was reported in the T and S groups in parallel with a significant reduction in static trapezius load, while no such reduction was found in the C group. At the same time, both static trapezius load and shoulder pain were significantly lower in the T and S groups compared with the C group. Pain in the forearm and hand showed no significant changes in any of the groups during the study period. However, there seem to be a relationship between pain in the forearm and hand and the time the operator used the mouse. The C group reported significantly higher intensity of pain and used the mouse significantly more than the S group.

  7. Programa de intervención multidisciplinaria para cuidadores de pacientes en atención domiciliaria Multidisciplinary intervention program for caregivers of patients in a home care program

    Directory of Open Access Journals (Sweden)

    Laura Guerrero Caballero

    2008-10-01

    Full Text Available Objetivos: Mejorar la calidad de vida, la ansiedad y la depresión de los cuidadores de pacientes en atención domiciliaria. Métodos: Ensayo clínico aleatorizado; 79 cuidadores principales (39 grupo control y 40 grupo intervención de pacientes en atención domiciliaria de un centro de salud entre 2000 y 2001. La calidad de vida, la ansiedad y la depresión se midieron mediante los cuestionarios COOP/WONCA y la escala de Goldberg, respectivamente, al inicio y al final del estudio. Las intervenciones consistieron en 2 visitas médicas para realizar la anamnesis biopsicosocial del cuidador y una visita de enfermería sobre educación sanitaria. Se enviaron dos cartas adaptadas a cada cuidador y se realizaron dos llamadas telefónicas de apoyo. Resultados: Se observó una mejora significativa del grupo intervención respecto al grupo control en relación con WONCA-sentimientos (p = 0,03, WONCA-actividades sociales (p = 0,05 y WONCA-calidad de vida (p = 0,02. Conclusiones: Una intervención multidisciplinaria y adaptada a la consulta habitual podría reducir el deterioro de la calidad de vida de los cuidadores.Objectives: To improve quality of life, anxiety and depression in caregivers of patients in home care. Methods: We performed a randomized clinical trial in 79 main caregivers (39 control group and 40 intervention group of patients in the home care program of a primary care health center between 2000 and 2001. Quality of life, anxiety and depression were measured by the COOP/WONCA and Goldberg questionnaires, respectively, at the beginning and at the end of the study. Interventions consisted of two medical visits to take a bio-psychosocial history of the caregiver and a nurse visit for health education. Two letters, adapted to each carer's needs, were sent and two telephone calls were made. vlife (p = 0.02. Conclusions: A short multidisciplinary intervention program adapted to routine consultations could prevent deterioration in caregivers

  8. Prostatic abscess in a patient with chronic granulomatous disease: a multi-disciplinary intervention.

    Science.gov (United States)

    Martini, Alberto; Katafigiotis, Ioannis; Kalantzi, Sofia; Anastasiou, Ioannis; Adamakis, Ioannis; Toskas, Aggelos; Constantinides, Constantinos A

    2017-02-08

    Chronic granulomatous disease (CGD) is a rare pathology that increases patients' susceptibility to infections, given the inability to generate oxygen radicals to fight microorganisms.In the context of CGD, primary prostatic involvement has been described only once in the past, in a pediatric patient. We report the case of a 35-year old patient with CGD presenting with persistent fever. After hospital admission, blood and urine were sent for culture and antibiotic therapy was initiated. Patient´s conditions continued to deteriorate and an aggressive antibiotic therapy was administered to treat the septic scenario. Urine culture grew a multidrug-resistant Escherichia Coli. After patient's condition improved, a CT scan was performed. The depiction showed multiple abscesses within the prostate. A rectal approach was excluded given patient's underlying disease. A TURP was performed and prostatic pathology resolved. Patient was discharged on postoperative day 14. At 6-month follow-up he hasn't experienced major infections.To the best of our knowledge, this is the first case of septic shock originating from a prostatic abscess in an adult patient with CGD. Aggressive medical therapy along with TURP resulted curative in our case. A multi-disciplinary approach was mandatory.

  9. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial.

    Science.gov (United States)

    Lin, Jin-Xiang; Chen, Xiang-Wei; Chen, Zhan-Hong; Huang, Xiu-Yan; Yang, Jin-Jie; Xing, Yan-Fang; Yin, Liang-Hong; Li, Xing; Wu, Xiang-Yuan

    2017-06-01

    Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients. This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points. There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P nutrition intervention (P nutrition intervention (P > .05). A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.

  10. Impact of a Behavioral-Based Intervention on Inspiratory Muscle Training Prescription by a Multidisciplinary Team

    Science.gov (United States)

    Simms, Alanna M.; Li, Linda C.; Geddes, E. Lynne; Brooks, Dina; Hoens, Alison M.; Reid, W. Darlene

    2012-01-01

    Introduction: Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR). Methods: Six hospital PR programs were randomly assigned to a…

  11. Biopsychosocial model in Depression revisited.

    Science.gov (United States)

    Garcia-Toro, Mauro; Aguirre, Iratxe

    2007-01-01

    There are two fundamental etiological perspectives about mental disorders; biomedical and psychosocial. The biopsychosocial model has claimed to integrate these two perspectives in a scientific way, signalling their interconnection and interdependence. To that end, it used a systemic conceptual framework, taking advantage of the possibilities which it offers to establish general principles for diverse systems, independently of their physical, biological or sociological nature. In recent years, drawing on the theory of systems, theories have been developing of the dynamic non-linear systems, applicable to networks of a large quantity of densely interconnected elements (also called complex systems), like the mind or the brain. We believe that this revised systemic conceptual framework can bring integrative ideas to apply to Depression, such as the "binding dysfunction" concept we use in this article. According to this, vulnerability or predisposition to Depression would be associated with the imbalance between activating and inhibiting interactions (between some cognitions and emotions at a mental level, and between certain neuronal groups at a cerebral level). Precipitating factors would imply the increase of the activation level over this pattern of cognitions and emotions, or over those neuronal systems. When stress goes beyond the vulnerability threshold an excessive positive feedback between cognitions and emotions would appear (and between groups of neurons) with insufficient inhibitory control to mitigate it, which would imply a mental/cerebral dissociation in dominions of different level of activation. As a consequence, the generation and dissolution of patterns of cerebral and mental activation will no longer have the dynamism and flexibility that permits an optimal interaction with the environment ("binding dysfunction"). Therefore, our hypothesis is that the person with Depression will suffer at a cerebral level a functional dissociation in neural

  12. Automatic day-2 intervention by a multidisciplinary Antimicrobial Stewardship-Team leads to multiple positive effects

    Directory of Open Access Journals (Sweden)

    Jan-Willem H Dik

    2015-06-01

    Full Text Available Background: Antimicrobial resistance rates are increasing. This is, among others, caused by incorrect or inappropriate use of antimicrobials. To target this, a multidisciplinary Antimicrobial Stewardship-Team (A-Team was implemented at the University Medical Center Groningen on a urology ward. Goal of this study is to evaluate the clinical effects of the case-audits done by this team, looking at length of stay (LOS and antimicrobial use.Methods: Automatic e-mail alerts were sent after 48 hours of consecutive antimicrobial use triggering the case-audits, consisting of an A-Team member visiting the ward, discussing the patient’s therapy with the bed-side physician and together deciding on further treatment based on available diagnostics and guidelines. Clinical effects of the audits were evaluated through an Interrupted Time Series analysis and a retrospective historic cohort. Results: A significant systemic reduction of antimicrobial consumption for all patients on the ward, both with and without case-audits was observed. Furthermore, LOS for patients with case-audits who were admitted primarily due to infections decreased to 6.20 days (95% CI: 5.59-6.81 compared to the historic cohort (7.57 days; 95% CI: 6.92-8.21 (p=0.012. Antimicrobial consumption decreased for these patients from 8.17 DDD/patient (95% CI: 7.10-9.24 to 5.93 DDD/patient (95% CI: 5.02-6.83 (p=0.008. For patients with severe underlying diseases (e.g. cancer these outcome measures remained unchanged.Conclusions: The evaluation showed a considerable positive impact. Antibiotic use of the whole ward was reduced, transcending the intervened patients. Furthermore, LOS and mean antimicrobial consumption for a subgroup was reduced, thereby improving patient care and potentially lowering resistance rates.

  13. Does exercise intensity affect blood pressure and heart rate in obese adolescents? A 6-month multidisciplinary randomized intervention study.

    Science.gov (United States)

    Farah, B Q; Ritti-Dias, R M; Balagopal, P B; Hill, J O; Prado, W L

    2014-04-01

    Aerobic exercise improves cardiovascular health in general, but whether the impact varies with exercise intensity is not clear. The aim of the current study was to compare the effects of a high-intensity aerobic exercise training (HIT) vs. a low-intensity aerobic exercise training (LIT) on blood pressure (BP), heart rate (HR) and heart rate variability (HRV) in obese adolescents. Forty-three (13-18 years) Tanner stage (III-IV) matched obese adolescents were studied in a randomized trial of either HIT (corresponding to the ventilatory threshold I; n = 20) or LIT (corresponding to 20% below the ventilatory threshold I; n = 23) programme for a period of 6 months. All participants also received a multidisciplinary therapy that included nutritional, psychological and clinical counselling. Both HIT and LIT sessions were isocaloric, with energy expenditure set at 350 kcal. BP, HR and HRV were measured along with markers of body adiposity and insulin resistance before and after the respective interventions. The participants in both groups had similar physical and clinical characteristics. After the 6-month intervention, systolic, diastolic and mean BP decreased (P exercise training set at a high intensity compared with the low intensity appears to have additional benefits on abdominal obesity and cardiovascular health in that it enhances the parasympathetic and autonomic modulation of the heart in obese adolescents. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

  14. Exploration of the Mechanisms of Change in Constructs From Self-Determination Theory and Quality of Life During a Multidisciplinary Family-Based Intervention for Overweight Adolescents.

    Science.gov (United States)

    Fenner, Ashley A; Howie, Erin K; Straker, Leon M; Hagger, Martin S

    2016-02-01

    The current study explored whether a multidisciplinary family-based intervention underpinned by self-determination theory could enhance perceptions of parent need support, autonomous motivation, and quality of life in overweight and obese adolescents. Using a staggered-entry waitlist-period control design, adolescents (n = 56) were assessed at baseline and preintervention (within-participant control), immediately following intervention, and at 3, 6, and 12 month follow-ups. Parents were trained in need-supportive behaviors within the broader context of an 8-week multidisciplinary intervention attended jointly with adolescents. Following intervention, significant improvements were demonstrated in adolescent perceptions of parent need support, autonomous motivation, and quality of life, and changes were maintained at the 1-year follow-up. Mediation analyses revealed changes in perceptions of parent need support predicted changes in quality of life indirectly via changes in autonomous motivation. Findings suggest overweight and obese adolescents are likely to benefit from multidisciplinary family-based interventions that aim to train parents in need-supportive behaviors.

  15. Telomere length as a biomarker for adiposity changes after a multidisciplinary intervention in overweight/obese adolescents: the EVASYON study.

    Directory of Open Access Journals (Sweden)

    Sonia García-Calzón

    Full Text Available CONTEXT: Telomeres are biomarkers of biological aging. Shorter telomeres have been associated with increased adiposity in adults. However, this relationship remains unclear in children and adolescents. OBJECTIVE: To evaluate the association between telomere length (TL and adiposity markers in overweight/obese adolescents after an intensive program. We hypothesize that greater TL at baseline would predict a better response to a weight loss treatment. DESIGN SETTING PATIENTS AND INTERVENTION: The EVASYON is a multidisciplinary treatment program for adolescents with overweight and obesity that is aimed at applying the intervention to all possibly involved areas of the individual, such as dietary habits, physical activity and cognitive and psychological profiles. Seventy-four participants (36 males, 38 females, 12-16 yr were enrolled in the intervention program: 2 months of an energy-restricted diet and a follow-up period (6 months. MAIN OUTCOME: TL was measured by quantitative real-time polymerase chain reaction at baseline and after 2 months; meanwhile, anthropometric variables were also assessed after 6 months of follow-up. RESULTS: TL lengthened in participants during the intensive period (+1.9±1.0, p<0.001 being greater in overweight/obese adolescents with the shortest telomeres at baseline (r = -0.962, p<0.001. Multivariable linear regression analysis showed that higher baseline TL significantly predicted a higher decrease in body weight (B = -1.53, p = 0.005; B = -2.25, p = 0.047 and in standard deviation score for body mass index (BMI-SDS (B = -0.22, p = 0.010; B = -0.47, p = 0.005 after the intensive and extensive period treatment respectively, in boys. CONCLUSION: Our study shows that a weight loss intervention is accompanied by a significant increase in TL in overweight/obese adolescents. Moreover, we suggest that initial longer TL could be a potential predictor for a better weight loss response.

  16. A biopsychosocial model of metaphor therapy with holistic cultures.

    Science.gov (United States)

    Dwairy, M

    1997-11-01

    For centuries western cultures have adopted a dualistic perspective toward people's health. The "self" has emerged as an independent entity from others as well from the body. Human distress has been psychologized and depression and anxiety have been attributed to intrapsychic structures and processes. Nevertheless, many nonwestern cultures still adopt holistic perspectives. Within these cultures, distress is manifested through physical rather than psychological complains. Therefore, psychological approaches, based on the independence of the self, may not be fitting for these societies. Instead, based on the assumption that nonwestern cultures are holistic and less psychologized and their problems are social rather than intrapsychic, a biopsychosocial approach is suggested. In addition, nonwesterners have a different concept of reality. For instance, within some communities fantasies and delusions are appreciated, constitute part of a normal life, and are considered to be the "real reality." Furthermore, complains are often described in metaphoric language. Accordingly, a biopsychosocial model of metaphoric therapy is proposed in which therapists would incorporate their clients' metaphoric imaginative culture. Metaphoric intervention also allow for changes in the biological, psychological, and sociocultural reality of the client.

  17. Influence of cataract surgery in biopsychosocial adaptation in the elderly

    Directory of Open Access Journals (Sweden)

    Leonor Rosario Diaz Alfonso

    2010-11-01

    Full Text Available Background: The twenty-first century is characterized by a progressive aging in the population, with the subsequent demand of medical care it implies due to the polimorbility rates typical of this stage of life. Objective: to prove the positive influence of cataract surgery in biopsychosocial adaptation of elderlies. Methods: a descriptive study conducted from January to June 2008 in the General University Hospital "Dr. Aldereguía Gustavo Lima’’ in Cienfuegos. The 60 elder patients who underwent surgery cataract in that period were included. Geriatric evaluation was used as assessment instrument. It was applied before and 3 months after cataract surgery and included the Yesavage Geriatric Depression Rating Scale to measure emotional function and the Katz index for functional evaluation. The variables used are part of the preoperative geriatric assessment. Among them we can find biomedical, social, functional and psychological aspects as well as-risk benefit and anesthetic risks analysis. Results: the largest amount of patients was between 70 and 74 years old, predominantly males and white skinned. Most frequent personal pathological records were arthropathies, diabetes mellitus and hypertension. A significant relationship between initial visual acuity levels and depression rates was found; as well as limitations in performing basic daily life activities. Conclusions: with surgical intervention an improved visual acuity was achieved and a number of functional capacities were reestablished to allow a better biopsychosocial adaptation in elderlies.

  18. [Obesity and work: proposal for a multidisciplinary intervention model for prevention and its application in an engineering plant].

    Science.gov (United States)

    Vigna, Luisella; Agnelli, Gianna Maria; Tirelli, Amedea Silvia; Belluigi, Valentina; Aquilina, Tatiana; Riboldi, L

    2011-01-01

    the multidisciplinary intervention, which was conducted in collaboration with the occupational physician, two major initiatives were taken: one in the canteen with the aim of improving the nutritional content and type of meals offered to suit the dietary needs of overweight or obese workers, and the other consisted of an agreement with local gyms so as to motivate workers to exercise more. A prerequisitefor this type of initiative is the willingness and understanding of the management to recognize the health of the worker as a priority value.

  19. Limitations of the biopsychosocial model in psychiatry

    Directory of Open Access Journals (Sweden)

    Benning TB

    2015-05-01

    Full Text Available Tony B Benning Maple Ridge Mental Health Centre, Maple Ridge, BC, Canada Abstract: A commitment to an integrative, non-reductionist clinical and theoretical perspective in medicine that honors the importance of all relevant domains of knowledge, not just “the biological,” is clearly evident in Engel’s original writings on the biopsychosocial model. And though this model’s influence on modern psychiatry (in clinical as well as educational settings has been significant, a growing body of recent literature is critical of it - charging it with lacking philosophical coherence, insensitivity to patients’ subjective experience, being unfaithful to the general systems theory that Engel claimed it be rooted in, and engendering an undisciplined eclecticism that provides no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social. Keywords: critique of biopsychosocial psychiatry, integrative psychiatry, George Engel

  20. What can the treatment of Parkinson's disease learn from dementia care; applying a bio-psycho-social approach to Parkinson's disease.

    Science.gov (United States)

    Gibson, Grant

    2017-07-07

    Within contemporary medical practice, Parkinson's disease (PD) is treated using a biomedical, neurological approach, which although bringing numerous benefits can struggle to engage with how people with PD experience the disease. A bio-psycho-social approach has not yet been established in PD; however, bio-psycho-social approaches adopted within dementia care practice could bring significant benefit to PD care. This paper summarises existing bio-psycho-social models of dementia care and explores how these models could also usefully be applied to care for PD. Specifically, this paper adapts the bio-psycho-social model for dementia developed by Spector and Orrell (), to suggest a bio-psycho-social model, which could be used to inform routine care in PD. Drawing on the biopsychosocial model of Dementia put forward by Spector and Orrell (), this paper explores the application of a bio-psycho-social model of PD. This model conceptualises PD as a trajectory, in which several interrelated fixed and tractable factors influence both PD's symptomology and the various biological and psychosocial challenges individuals will face as their disease progresses. Using an individual case study, this paper then illustrates how such a model can assist clinicians in identifying suitable interventions for people living with PD. This model concludes by discussing how a bio-psycho-social model could be used as a tool in PD's routine care. The model also encourages the development of a theoretical and practical framework for the future development of the role of the PD specialist nurse within routine practice. A biopsychosocial approach to Parkinson's Disease provides an opportunity to move towards a holistic model of care practice which addresses a wider range of factors affecting people living with PD. The paper puts forward a framework through which PD care practice can move towards a biopsychosocial perspective. PD specialist nurses are particularly well placed to adopt such a model

  1. Effects of a Two-Year Intensive Multidisciplinary Rehabilitation Program for Patients with Huntington's Disease: a Prospective Intervention Study.

    Science.gov (United States)

    Piira, Anu; van Walsem, Marleen R; Mikalsen, Geir; Øie, Lars; Frich, Jan C; Knutsen, Synnove

    2014-11-25

    To assess effects of a two year intensive, multidisciplinary rehabilitation program for patients with early- to mid-stage Huntington's disease. A prospective intervention study. One inpatient rehabilitation center in Norway. 10 patients, with early- to mid-stage Huntington's disease. A two year rehabilitation program, consisting of six admissions of three weeks each, and two evaluation stays approximately three months after the third and sixth rehabilitation admission. The program focused on physical exercise, social activities, and group/teaching sessions. Standard measures for motor function, including gait and balance, cognitive function, including MMSE and UHDRS cognitive assessment, anxiety and depression, activities of daily living (ADL), health related quality of life (QoL) and Body Mass Index (BMI). Six out of ten patients completed the full program. Slight, but non-significant, decline was observed for gait and balance from baseline to the evaluation stay after two years. Non-significant improvements were observed in physical QoL, anxiety and depression, and BMI. ADL-function remained stable with no significant decline. None of the cognitive measures showed a significant decline. An analysis of individual cases revealed that four out of the six participants who completed the program sustained or improved their motor function, while motor function declined in two participants. All the six patients who completed the program reported improved or stable QoL throughout the study period. Our findings suggest that participation in an intensive rehabilitation program is well tolerated among motivated patients with early to mid-stage HD. The findings should be interpreted with caution due to the small sample size in this study.

  2. Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: Development of priority concerns and potential health, nutrition and education interventions

    Directory of Open Access Journals (Sweden)

    Gyorkos Theresa W

    2007-07-01

    Full Text Available Abstract Background Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus. Methods Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits. Results The top ten priority problems in Belen were identified as: 1 infant malnutrition; 2 adolescent pregnancy; 3 diarrhoea; 4 anaemia; 5 parasites; 6 lack of basic sanitation; 7 low level of education; 8 sexually transmitted diseases; 9 domestic violence; and 10 delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues. Conclusion The two workshops provided valuable insight into the main health and health-related problems facing the community of

  3. Engel's biopsychosocial model is still relevant today.

    Science.gov (United States)

    Adler, Rolf H

    2009-12-01

    In 1977, Engel published the seminal paper, "The Need for a New Medical Model: A Challenge for Biomedicine" [Science 196 (1977) 129-136]. He featured a biopsychosocial (BPS) model based on systems theory and on the hierarchical organization of organisms. In this essay, the model is extended by the introduction of semiotics and constructivism. Semiotics provides the language which allows to describe the relationships between the individual and his environment. Constructivism explains how an organism perceives his environment. The impact of the BPS model on research, medical education, and application in the practice of medicine is discussed.

  4. A multidisciplinary lifestyle intervention for childhood obesity : effects on body composition, exercise tolerance, quality of life and gut hormones

    NARCIS (Netherlands)

    Vos, Rimke Cathelijne

    2011-01-01

    The general aim of the studies described in this thesis is the effect evaluation of a family-based multidisciplinary cognitive behavioral treatment on several domains related to childhood obesity compared to standard care. The main findings from these studies are a modest long-term reduction of both

  5. A multidisciplinary lifestyle intervention for childhood obesity : effects on body composition, exercise tolerance, quality of life and gut hormones

    NARCIS (Netherlands)

    Vos, Rimke Cathelijne

    2011-01-01

    The general aim of the studies described in this thesis is the effect evaluation of a family-based multidisciplinary cognitive behavioral treatment on several domains related to childhood obesity compared to standard care. The main findings from these studies are a modest long-term reduction of both

  6. Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate?

    DEFF Research Database (Denmark)

    Pincus, Tamar; Kent, Peter; Bronfort, Gert

    2013-01-01

    An integrated review of current knowledge about the biopsychosocial model of back pain for understanding etiology, prognosis, and interventions, as presented at the plenary sessions of the XII International Forum on LBP Research in Primary Care (Denmark; October 17-19, 2012)....

  7. Racism as a Stressor for African Americans: A Biopsychosocial Model.

    Science.gov (United States)

    Clark, Rodney; Anderson, Norman B.; Clark, Vernessa R.; Williams, David R.

    1999-01-01

    Outlines a biopsychosocial model for perceived racism as a guide for future research, reviewing how racism has been conceptualized in scientific literature, examining research on the existence of intergroup and intragroup racism, presenting a contextual model for systematic studies of the biopsychosocial effects of perceived racism in African…

  8. The background biopsychosocial status of teachers with voice problems.

    NARCIS (Netherlands)

    Houdt, I. van; Thomas, G.; Wellens, W.A.; Vertommen, H.; Jong, F.I.C.R.S. de

    2008-01-01

    OBJECTIVE: The aim of the study was to explore the background biopsychosocial status of teachers with a relative voice handicap. The study also intended to investigate this biopsychosocial status in relation to behavior of not always reporting voice complaints. METHODS: This research was a cross-sec

  9. BPS-ICF model, a tool to measure biopsychosocial functioning and disability within ICF concepts: theory and practice updated.

    Science.gov (United States)

    Talo, Seija A; Rytökoski, Ulla M

    2016-03-01

    The transformation of International Classification of Impairments, Disabilities and Handicaps into International Classification of Functioning, Disability and Health (ICF) meant a lot for those needing to communicate in terms of functioning concept in their daily work. With ICF's commonly understood language, the decades' uncertainty on what concepts and terms describe functioning and disabilities seemed to be dispelled. Instead, operationalizing ICF to measure the level of functioning along with the new nomenclature has not been as unambiguous. Transforming linguistic terms into quantified functioning seems to need another type of theorizing. Irrespective of challenging tasks, numerous projects were formulated during the past decades to apply ICF for measurement purposes. This article updates one of them, the so-called biopsychosocial-ICF model, which uses all ICF categories but classifies them into more components than ICF for measurement purposes. The model suggests that both disabilities and functional resources should be described by collecting and organizing functional measurement data in a multidisciplinary, biopsychosocial data matrice.

  10. Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Bianca L Share

    Full Text Available Young women are under-represented in cardiovascular disease research, with obesity and cardiometabolic risk factor interventions generally targeting older adults. Furthermore, appropriate study designs for young women remain uncertain. This study aimed to assess the impact of a 12 week multi-disciplinary lifestyle intervention on cardiometabolic risk factors in premenopausal women with abdominal obesity.Women aged 18-30 y with abdominal obesity [waist circumference (WC ≥ 80 cm] were randomised to a 12 week lifestyle intervention (n = 26 of physical activity, nutrition education and cognitive behavioural therapy, or a wait-list control group (n = 17. Both groups completed anthropometric, biochemical, nutrition and fitness testing, at pre (0 weeks and post (12 weeks, with intervention participants completed follow-up testing at 24 weeks.Results from a linear mixed model showed no between-group differences, other than increased physical activity in the intervention group, at post. In the intervention group alone, positive within-group changes were observed in WC, waist-hip-ratio (WHR, waist-height-ratio (WHtR, resting heart rate, blood pressure, predicted VO2max, and total energy intake. Most changes were maintained at 24 weeks post-intervention. Similar within-group improvements were observed in control participants in WC, WHR, WHtR, and systolic blood pressure but no changes were detected in physical activity and nutrition.Cardiometabolic risk factors were decreased as a result of a lifestyle intervention in young women with abdominal obesity. It is difficult to describe observations in the control group without greater understanding of the behaviour of wait-list participants.Australian New Zealand Clinical Trials Registry ACTRN12612001017819.

  11. Chronic fatigue syndrome: Harvey and Wessely's (biopsychosocial model versus a bio(psychosocial model based on inflammatory and oxidative and nitrosative stress pathways

    Directory of Open Access Journals (Sweden)

    Twisk Frank NM

    2010-06-01

    Full Text Available Abstract Background In a recently published paper, Harvey and Wessely put forward a 'biopsychosocial' explanatory model for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS, which is proposed to be applicable to (chronic fatigue even when apparent medical causes are present. Methods Here, we review the model proposed by Harvey and Wessely, which is the rationale for behaviourally oriented interventions, such as cognitive behaviour therapy (CBT and graded exercise therapy (GET, and compare this model with a biological model, in which inflammatory, immune, oxidative and nitrosative (IO&NS pathways are key elements. Discussion Although human and animal studies have established that the pathophysiology of ME/CFS includes IO&NS pathways, these abnormalities are not included in the model proposed by Harvey and Wessely. Activation of IO&NS pathways is known to induce fatigue and somatic (F&S symptoms and can be induced or maintained by viral and bacterial infections, physical and psychosocial stressors, or organic disorders such as (autoimmune disorders. Studies have shown that ME/CFS and major depression are both clinical manifestations of shared IO&NS pathways, and that both disorders can be discriminated by specific symptoms and unshared or differentiating pathways. Interventions with CBT/GET are potentially harmful for many patients with ME/CFS, since the underlying pathophysiological abnormalities may be intensified by physical stressors. Conclusions In contrast to Harvey and Wessely's (biopsychosocial model for ME/CFS a bio(psychosocial model based upon IO&NS abnormalities is likely more appropriate to this complex disorder. In clinical practice, we suggest physicians should also explore the IO&NS pathophysiology by applying laboratory tests that examine the pathways involved.

  12. A multidisciplinary intervention to reduce infections of ESBL- and AmpC-producing, gram-negative bacteria at a University Hospital.

    Directory of Open Access Journals (Sweden)

    Jenny Dahl Knudsen

    Full Text Available In response to a considerable increase in the infections caused by ESBL/AmpC-producing Klebsiella pneumonia in 2008, a multidisciplinary intervention, with a main focus on antimicrobial stewardship, was carried out at one university hospital. Four other hospitals were used as controls. Stringent guidelines for antimicrobial treatment and prophylaxis were disseminated throughout the intervention hospital; cephalosporins were restricted for prophylaxis use only, fluoroquinolones for empiric use in septic shock only, and carbapenems were selected for penicillin-allergic patients, infections due to ESBL/AmpC-producing and other resistant bacteria, in addition to their use in severe sepsis/septic shock. Piperacillin-tazobactam ± gentamicin was recommended for empiric treatments of most febrile conditions. The intervention also included education and guidance on infection control, as well as various other surveillances. Two year follow-up data on the incidence rates of patients with selected bacterial infections, outcomes, and antibiotic consumption were assessed, employing before-and-after analysis and segmented regression analysis of interrupted time series, using the other hospitals as controls. The intervention led to a sustained change in antimicrobial consumption, and the incidence of patients infected with ESBL-producing K. pneumoniae decreased significantly (p<0.001. The incidences of other hospital-associated infections also declined (p's<0.02, but piperacillin-tazobactam-resistant Pseudomonas aeruginosa and Enterococcus faecium infections increased (p's<0.033. In wards with high antimicrobial consumption, the patient gut carrier rate of ESBL-producing bacteria significantly decreased (p = 0.023. The unadjusted, all-cause 30-day mortality rates of K. pneumoniae and E. coli were unchanged over the four-year period, with similar results in all five hospitals. Although not statistically significant, the 30-day mortality rate of patients

  13. TECNOB: study design of a randomized controlled trial of a multidisciplinary telecare intervention for obese patients with type-2 diabetes

    National Research Council Canada - National Science Library

    Castelnuovo, Gianluca; Manzoni, Gian Mauro; Cuzziol, Paola; Cesa, Gian Luca; Tuzzi, Cristina; Villa, Valentina; Liuzzi, Antonio; Petroni, Maria Letizia; Molinari, Enrico

    2010-01-01

    ... (TEChnology for OBesity) is a comprehensive two-phase stepped down program enhanced by telemedicine for the long-term treatment of obese people with type 2 diabetes seeking intervention for weight loss...

  14. Effects of a stepwise multidisciplinary intervention for challenging behavior in advanced dementia: a cluster randomized controlled trial.

    NARCIS (Netherlands)

    Pieper, M.J.C.; Francke, A.L.; Steen, J.T. van der; Scherder, E.J.A.; Twisk, J.W.R.; Kovach, C.R.; Achterberg, W.P.

    2016-01-01

    Objectives: To assess whether implementation of a stepwise multicomponent intervention (STA OP!) is effective in reducing challenging behavior and depression in nursing home residents with advanced dementia. Design: Cluster randomized controlled trial. Setting: Twenty-one clusters (single

  15. Effects of a Stepwise Multidisciplinary Intervention for Challenging Behavior in Advanced Dementia: A Cluster Randomized Controlled Trial

    NARCIS (Netherlands)

    Pieper, M.J.; Francke, A.L.; Steen, J.T. van der; Scherder, E.J.; Twisk, J.W.; Kovach, C.R.; Achterberg, W.P.

    2016-01-01

    OBJECTIVES: To assess whether implementation of a stepwise multicomponent intervention (STA OP!) is effective in reducing challenging behavior and depression in nursing home residents with advanced dementia. DESIGN: Cluster randomized controlled trial. SETTING: Twenty-one clusters (single

  16. Effects of a multidisciplinary educational rehabilitative intervention in breast cancer survivors: the role of body image on quality of life outcomes.

    Science.gov (United States)

    Morone, Giovanni; Iosa, Marco; Fusco, Augusto; Scappaticci, Antonella; Alcuri, Maria Rosaria; Saraceni, Vincenzo Maria; Paolucci, Stefano; Paolucci, Teresa

    2014-01-01

    In breast cancer survivors, own body image may change due to physical and psychological reasons, worsening women's living. The aim of the study was to investigate whether body image may affect the functional and quality of life outcomes after a multidisciplinary and educational rehabilitative intervention in sixty women with primary nonmetastatic breast cancer who have undergone conservative surgery. To assess the quality of life was administered The European Organization for Research and Treatment of Cancer Study Group on Quality of Life core questionnaire, while to investigate the psychological features and self-image were administered the following scales: the Body Image Scale, the Hamilton Rating Scale for Depression, and the State-Trait Anxiety Inventory. To assess the recovery of the function of the shoulder were administered: the Disabilities of the Arm, Shoulder, and Hand Questionnaire and the Constant-Murley Score. Data were collected at the baseline, at the end of the intervention, and at 3-month follow-up. We found a general improvement in the outcomes related to quality of life, and physical and psychological features after treatment (P image in respect of those with an altered self-perception of their own body was found (P = 0.01). In conclusion, the body image may influence the efficacy of a rehabilitative intervention, especially in the short term of follow-up.

  17. Biopsychosocial functioning of women after mastectomy.

    Science.gov (United States)

    Skrzypulec, Violetta; Tobor, Ewa; Drosdzol, Agnieszka; Nowosielski, Krzysztof

    2009-02-01

    The aim of this work was to identify the problems of women after total mastectomy and partial mastectomy with regard to various factors and intensity of discomfort which affect the quality of life. The loss of the attribute of femininity, maternity and sexuality, as the mammary gland is perceived by patients, is a highly traumatic experience, frequently resulting in re-evaluation of life and functioning to date. The survey encompassed 494 women after operational treatment of breast cancer with varying time since the procedure. The research group consisted of women after radical mastectomy, and the control group consisted of patients after partial mastectomy. The intensity of post-traumatic stress was an important factor affecting the level of depression and anxiety. This correlation appeared to be statistically highly significant in the group of women after total mastectomy. Life satisfaction, the level of depression and anxiety in women after such an operation were dependent on the intensity of post-traumatic stress and they caused inferior biopsychosocial functioning. Women after mastectomy require professional long-term support; this need should result in the enhancement of services provided in relevant women's support groups. When evaluating holistically the life of women after mastectomy, all spheres of everyday functioning should be taken into account: physical, cognitive, emotional and social.

  18. Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain: a multicentre, quasi-experimental study.

    Directory of Open Access Journals (Sweden)

    Jana Semrau

    Full Text Available Improvement of the long-term effectiveness of multidisciplinary ortho-paedic rehabilitation (MOR in the management of chronic non-specific low back pain (CLBP remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named "PASTOR" to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR.A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group, were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group. It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome using the Hannover Functional Ability Questionnaire (FFbH-R and vari-ous secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions.In total 536 participants were consecutively assigned to PASTOR (n=266 or MOR (n=270. At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78 using complete data and 3.56 (95% CI 0.45 to 6.67 using available da-ta, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001 and d=0.10 (p=0.025 in favour of PASTOR. Further improvements in secondary out-comes were also observed in favour of PASTOR.The interprofessional and interdisciplinary, biopsychosocial rehabilita-tion program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults

  19. Biopsychosocial model of chronic recurrent pain

    Directory of Open Access Journals (Sweden)

    Zlatka Rakovec-Felser

    2009-07-01

    Full Text Available Pain is not merely a symptom of disease but a complex independent phenomenon where psychological factors are always present (Sternberg, 1973. Especially by chronic, recurrent pain it's more constructive to think of chronic pain as a syndrome that evolves over time, involving a complex interaction of physiological/organic, psychological, and behavioural processes. Study of chronic recurrent functional pain covers tension form of headache. 50 suffering persons were accidentally chosen among those who had been seeking medical help over more than year ago. We tested their pain intensity and duration, extent of subjective experience of accommodation efforts, temperament characteristics, coping strategies, personal traits, the role of pain in intra- and interpersonal communication. At the end we compared this group with control group (without any manifest physical disorders and with analyse of variance (MANOVA. The typical person who suffers and expects medical help is mostly a woman, married, has elementary or secondary education, is about 40. Pain, seems to appear in the phase of stress-induced psychophysical fatigue, by persons with lower constitutional resistance to different influences, greater irritability and number of physiologic correlates of emotional tensions. Because of their ineffective style of coping, it seems they quickly exhausted their adaptation potential too. Through their higher level of social–field dependence, reactions of other persons (doctor, spouse could be important factors of reinforcement and social learning processes. In managing of chronic pain, especially such as tension headache is, it's very important to involve bio-psychosocial model of pain and integrative model of treatment. Intra- and inter-subjective psychological functions of pain must be recognised as soon as possible.

  20. Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

    Science.gov (United States)

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

    Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

  1. TECNOB: study design of a randomized controlled trial of a multidisciplinary telecare intervention for obese patients with type-2 diabetes

    Directory of Open Access Journals (Sweden)

    Tuzzi Cristina

    2010-04-01

    Full Text Available Abstract Background Obesity is one of the most important medical and public health problems of our time: it increases the risk of many health complications such as hypertension, coronary heart disease and type 2 diabetes, needs long-lasting treatment for effective results and involves high public and private costs. Therefore, it is imperative that enduring and low-cost clinical programs for obesity and related co-morbidities are developed and evaluated. Methods/Design TECNOB (TEChnology for OBesity is a comprehensive two-phase stepped down program enhanced by telemedicine for the long-term treatment of obese people with type 2 diabetes seeking intervention for weight loss. Its core features are the hospital-based intensive treatment (1-month, that consists of diet therapy, physical training and psychological counseling, and the continuity of care at home using new information and communication technologies (ICT such as internet and mobile phones. The effectiveness of the TECNOB program compared with usual care (hospital-based treatment only will be evaluated in a randomized controlled trial (RCT with a 12-month follow-up. The primary outcome is weight in kilograms. Secondary outcome measures are energy expenditure measured using an electronic armband, glycated hemoglobin, binge eating, self-efficacy in eating and weight control, body satisfaction, healthy habit formation, disordered eating-related behaviors and cognitions, psychopathological symptoms and weight-related quality of life. Furthermore, the study will explore what behavioral and psychological variables are predictive of treatment success among those we have considered. Discussion The TECNOB study aims to inform the evidence-based knowledge of how telemedicine may enhance the effectiveness of clinical interventions for weight loss and related type-2 diabetes, and which type of obese patients may benefit the most from such interventions. Broadly, the study aims also to have a effect on

  2. Psychological interventions for headache in children and adolescents.

    Science.gov (United States)

    Sieberg, Christine B; Huguet, Anna; von Baeyer, Carl L; Seshia, Shashi

    2012-01-01

    Headache in children and adolescents represents a number of complex and multifaceted pain syndromes that can benefit from psychological intervention. There is good evidence for the efficacy of cognitive behavioral therapy, relaxation training, and biofeedback. The choice of intervention is influenced by patients' age, sex, family and cultural background, as well as the nature of stressors and comorbid psychiatric symptoms. Management must always be family-centered. Psychological treatments are essential elements of the multidisciplinary, biopsychosocial management of primary headache disorders, particularly for those with frequent or chronic headache, a high level of headache-related disability, medication overuse, or comorbid psychiatric symptoms. Future studies of efficacy and effectiveness of psychological treatment should use the International Headache Society's definition and classification of headache disorders, and stratify results by headache type, associated conditions, and treatment modality.

  3. Effects of multidisciplinary teamwork on lead times and patient flow in the emergency department: a longitudinal interventional cohort study.

    Science.gov (United States)

    Muntlin Athlin, Asa; von Thiele Schwarz, Ulrica; Farrohknia, Nasim

    2013-11-01

    Long waiting times for emergency care are claimed to be caused by overcrowded emergency departments and non-effective working routines. Teamwork has been suggested as a promising solution to these issues. The aim of the present study was to investigate the effects of teamwork in a Swedish emergency department on lead times and patient flow. The study was set in an emergency department of a university hospital where teamwork, a multi-professional team responsible for the whole care process for a group of patients, was introduced. The study has a longitudinal non-randomized intervention study design. Data were collected for five two-week periods during a period of 1.5 years. The first part of the data collection used an ABAB design whereby standard procedure (A) was altered weekly with teamwork (B). Then, three follow-ups were conducted. At last follow-up, teamwork was permanently implemented. The outcome measures were: number of patients handled within teamwork time, time to physician, total visit time and number of patients handled within the 4-hour target. A total of 1,838 patient visits were studied. The effect on lead times was only evident at the last follow-up. Findings showed that the number of patients handled within teamwork time was almost equal between the different study periods. At the last follow-up, the median time to physician was significantly decreased by 11 minutes (p = 0.0005) compared to the control phase and the total visit time was significantly shorter at last follow-up compared to control phase (p = Teamwork seems to contribute to the quality improvement of emergency care in terms of small but significant decreases in lead times. However, although efficient work processes such as teamwork are necessary to ensure safe patient care, it is likely not sufficient for bringing about larger decreases in lead times or for meeting the 4-hour target in the emergency department.

  4. Children with problematic severe asthma: A biopsychosocial perspective

    NARCIS (Netherlands)

    Verkleij, M.

    2016-01-01

    This thesis focuses on problematic severe asthma in children and its treatment from a biopsychosocial perspective. Asthma is a chronic inflammatory disease of the airways. In children with problematic severe asthma, asthma is not under control despite optimal medical treatment. Asthma control is the

  5. Comorbidity of depression and diabetes : an application of biopsychosocial model

    NARCIS (Netherlands)

    Habtewold, Tesfa; Islam, Atiqul; Radie, Yosef Tsige; Tegegne, Balewgizie

    2016-01-01

    Background: Type 2 diabetes (T2D) is one of the most psychologically demanding chronic medical illness in adult. Comorbidity between diabetes and depression is quite common, but most studies were based on developed country sample. Limited data exists to document biopsychosocial predictors of

  6. Comorbidity of depression and diabetes : an application of biopsychosocial model

    NARCIS (Netherlands)

    Habtewold, Tesfa; Islam, Atiqul; Radie, Yosef Tsige; Tegegne, Balewgizie

    2016-01-01

    Background: Type 2 diabetes (T2D) is one of the most psychologically demanding chronic medical illness in adult. Comorbidity between diabetes and depression is quite common, but most studies were based on developed country sample. Limited data exists to document biopsychosocial predictors of depress

  7. Children with problematic severe asthma: A biopsychosocial perspective

    NARCIS (Netherlands)

    Verkleij, M.

    2016-01-01

    This thesis focuses on problematic severe asthma in children and its treatment from a biopsychosocial perspective. Asthma is a chronic inflammatory disease of the airways. In children with problematic severe asthma, asthma is not under control despite optimal medical treatment. Asthma control is the

  8. Risk Factors Accompanied with Nephropathy in Patients with Type II Diabetes; Test of the Biopsychosocial Model

    Directory of Open Access Journals (Sweden)

    I. Rahimian Boogar

    2012-07-01

    Full Text Available Introduction & Objective: The study of biopsychosocial factors influencing nephropathy as a most serious complication of type II diabetes is important. This study aimed to investigate risk factors accompanied with nephropathy in patients with type II diabetes based on the biopsychosocial model. Materials & Methods: In a cross-sectional descriptive study, 295 patients with type II diabetes were selected by convenience sampling in Tehran Shariati hospital outpatient clinics. The data were collected by demographical information questionnaire along with disease characteristics and depression anxiety stress scales (dass, quality of life scale (who- qol- bref, diabetes self-management scale (dsms, and diabetes knowledge scale (dks, then analyzed by chi-square, independent t-test and logistic regression with pasw software. Results: Hypertension (OR=3.841 & P0.05.Conclusion: It is important to pay attention to hypertension, glycated hemoglobin, body mass index, diabetes self-management, depression, quality of life, and diabetes knowledge for therapeutic intervention programming and diabetes complications control protocols for diabetic patients.(Sci J Hamadan Univ Med Sci 2012;19(2:44-53

  9. Improving guideline concordance in multidisciplinary teams: preliminary results of a cluster-randomized trial evaluating the effect of a web-based audit and feedback intervention with outreach visits.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; Gude, Wouter T; van der Veer, Sabine N; Kemps, Hareld M C; Jaspers, Monique M W; de Keizer, Nicolette F; Peek, Niels

    2015-01-01

    Despite their widespread use, audit and feedback (A&F) interventions show variable effectiveness on improving professional performance. Based on known facilitators of successful A&F interventions, we developed a web-based A&F intervention with indicator-based performance feedback, benchmark information, action planning and outreach visits. The goal of the intervention was to engage with multidisciplinary teams to overcome barriers to guideline concordance and to improve overall team performance in the field of cardiac rehabilitation (CR). To assess its effectiveness we conducted a cluster-randomized trial in 18 CR clinics (14,847 patients) already working with computerized decision support (CDS). Our preliminary results showed no increase in concordance with guideline recommendations regarding prescription of CR therapies. Future analyses will investigate whether our intervention did improve team performance on other quality indicators.

  10. Improving guideline concordance in multidisciplinary teams: preliminary results of a cluster-randomized trial evaluating the effect of a web-based audit and feedback intervention with outreach visits

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M.; Gude, Wouter T.; van der Veer, Sabine N.; Kemps, Hareld M.C.; Jaspers, Monique M.W.; de Keizer, Nicolette F.; Peek, Niels

    2015-01-01

    Despite their widespread use, audit and feedback (A&F) interventions show variable effectiveness on improving professional performance. Based on known facilitators of successful A&F interventions, we developed a web-based A&F intervention with indicator-based performance feedback, benchmark information, action planning and outreach visits. The goal of the intervention was to engage with multidisciplinary teams to overcome barriers to guideline concordance and to improve overall team performance in the field of cardiac rehabilitation (CR). To assess its effectiveness we conducted a cluster-randomized trial in 18 CR clinics (14,847 patients) already working with computerized decision support (CDS). Our preliminary results showed no increase in concordance with guideline recommendations regarding prescription of CR therapies. Future analyses will investigate whether our intervention did improve team performance on other quality indicators. PMID:26958310

  11. Depression after traumatic brain injury: a biopsychosocial cultural perspective.

    Science.gov (United States)

    Roy, Durga; Jayaram, Geetha; Vassila, Alex; Keach, Shari; Rao, Vani

    2015-02-01

    There are several challenges in diagnosing and treating mental illness amongst South Asians. Often times, formulating a patient's case presentation cannot adequately be accomplished strictly using a biopsychosocial model. The cultural components play an imperative role in explaining certain psychiatric symptoms and can guide treatment. With the growing population of immigrants coming to the United States, many of which require treatment for mental illness, it is essential that clinicians be cognizant in incorporating cultural perspectives when treating such patients. The authors describe the case of a 24-year old South Asian male who suffered an exacerbation of a depressive syndrome after a traumatic brain injury. Using a biopsychosocial cultural approach, this case highlights how South Asian cultural values can contribute to and incite psychiatric symptoms while simultaneously providing protective drivers for treatment outcomes.

  12. Effectiveness of Multidisciplinary Group-Based Intervention versus Individual Physiotherapy for Improving Chronic Low Back Pain in Nursing Staff: A Clinical Trial with 3- and 6-Month Follow-Up Visits from Tehran, Iran.

    Science.gov (United States)

    Ghadyani, Leila; Tavafian, Sedigheh Sadat; Kazemnejad, Anoshirvan; Wagner, Joan

    2017-06-01

    Clinical trial. To evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran. Although low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities. Overall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16. There were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (ppreventive behaviors in the intervention group were improved after 3 and 6 months (p<0.001). Finally, in the intervention group, pain severity and disability were decreased significantly. This study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.

  13. A Biopsychosocial Model Based on Negative Feedback and Control

    Directory of Open Access Journals (Sweden)

    Timothy Andrew Carey

    2014-02-01

    Full Text Available Although the biopsychosocial model has been a popular topic of discussion for over four decades it has not had the traction in fields of research that might be expected of such an intuitively appealing idea. One reason for this might be the absence of an identified mechanism or a functional architecture that is authentically biopsychosocial. What is needed is a robust mechanism that is equally important to biochemical processes as it is to psychological and social processes. Negative feedback may be the mechanism that is required. Negative feedback has been implicated in the regulation of neurotransmitters as well as important psychological and social processes such as emotional regulation and the relationship between a psychotherapist and a client. Moreover, negative feedback is purported to also govern the activity of all other organisms as well as humans. Perceptual Control Theory (PCT describes the way in which negative feedback establishes control at increasing levels of perceptual complexity. Thus, PCT may be the first biopsychosocial model to be articulated in functional terms. In this paper we outline the working model of PCT and explain how PCT provides an embodied hierarchical neural architecture that utilises negative feedback to control physiological, psychological, and social variables. PCT has major implications for both research and practice and, importantly, provides a guide by which fields of research that are currently separated may be integrated to bring about substantial progress in understanding the way in which the brain alters, and is altered by, its behavioural and environmental context.

  14. Biopsychosocial and spiritual aspects of Parkinson disease: an integrative review.

    Science.gov (United States)

    Hermanns, Melinda; Deal, Belinda; Haas, Barbara

    2012-08-01

    The purpose of this study is to systematically examine the scientific literature and report the biopsychosocial and spiritual aspects of persons with Parkinson disease and their adaptation to the disease, to discuss methodological challenges associated with researching this phenomenon, and to propose future research. Synthesis of the literature will reveal the state of the science on the holistic approach to care in persons with Parkinson disease. An exhaustive review of the English language peer-reviewed literature published from January 1961 to July 2011 was conducted utilizing Academic Search Premier, MEDLINE, CINAHL, Psych Articles, Psych Info, PubMed, Wiley InterScience, the Cochrane Center Register for Control Trials, Health and Psychosocial Instruments, and SpringerLink databases. Ninety studies were reviewed. Although numerous medical studies focusing on pharmacological agents for Parkinson disease are reported, there are gaps in the literature on the biopsychosocial, spiritual, and holistic approaches in Parkinson disease care. More research is needed to examine the biopsychosocial and spiritual aspects of persons with Parkinson disease.

  15. Family therapy for adolescents with functional somatic symptoms: A systemic narrative approach on a biopsychosocial foundation

    DEFF Research Database (Denmark)

    Dehlholm-Lambertsen, Birgitte; Hulgaard, Ditte Roth

    FSS are common in children and adolescents, resulting in significant morbidity and health expenses. In daily clinical practice there is limited consensus regarding the treatment. To understand FSS, a biopsychosocial framework is generally accepted. This includes, biological, psychological...... by the fact that “family therapy” is based on a broad definition, which encompasses a wide range of interventions with theoretical and technical eclictism dominating the field. Research in adults shows that psychological treatment is effective for FSS. According to children and adolescents there is a growing...... evidence on the effect of psychological treatment. At the department of Child and Adolescent Psychiatry, University Hospital of Southern Denmark, a team of experienced therapists has developed an approach for the treatment of adolescents with FSS. This approach includes a formalized and well...

  16. A biopsychosocial model for the management of patients with sickle-cell disease transitioning to adult medical care.

    Science.gov (United States)

    Crosby, Lori E; Quinn, Charles T; Kalinyak, Karen A

    2015-04-01

    The lifespan of patients with sickle-cell disease (SCD) continues to increase, and most affected individuals in high-resource countries now live into adulthood. This necessitates a successful transition from pediatric to adult health care. Care for transitioning patients with SCD often falls to primary care providers who may not be fully aware of the many challenges and issues faced by patients and the current management strategies for SCD. In this review, we aim to close the knowledge gap between primary care providers and specialists who treat transitioning patients with SCD. We describe the challenges and issues encountered by these patients, and we propose a biopsychosocial multidisciplinary approach to the management of the identified issues. Examples of this approach, such as transition-focused integrated care models and quality improvement collaboratives, with the potential to improve health outcomes in adulthood are also described.

  17. Changes in plasma levels of ghrelin, leptin, and other hormonal and metabolic parameters following standardized breakfast, lunch, and physical exercise before and after a multidisciplinary weight-reduction intervention in obese adolescents.

    Science.gov (United States)

    Rigamonti, A E; Agosti, F; De Col, A; Marazzi, N; Lafortuna, C L; Cella, S G; Muller, E E; Sartorio, A

    2010-10-01

    To investigate in severely obese adolescents the effects of a 3-week multidisciplinary weight-reduction intervention involving moderate energy restriction, individualised physical activity and behavior therapy on the response of some hormonal and metabolic parameters to meals and exercise. Clinical longitudinal study on inpatients in a specialised institution. A total of 20 obese adolescents (10 boys and 10 girls) aged 12-17 yr [body mass index (BMI): 37.7±6.1 kg/m2; fat mass (FM): 44.8±13.2 kg]. The changes in plasma concentration of leptin, ghrelin, GH, IGF-I, insulin, glucose, and non-esterified fatty acids (NEFA) in response to standardised meals and exercise bouts were measured before and after the weight-reduction intervention. At the same times, body composition was assessed by bioelectrical impedance as well as appetite sensations using a visual analog scale. At the end of the intervention, the adolescents had lost body weight and FM (expressed both in kg and %) (pexercise, after the 3-week intervention, plasma leptin concentration decreased significantly (pghrelin, GH, and IGF-I) and metabolic parameters (glucose and NEFA) did not change. Interestingly, appetite was not affected by the intervention. This 3-week multidisciplinary intervention in obese adolescents induced a significant body weight loss with beneficial changes in body composition. However, despite there being no change in metabolic parameters and ghrelin in response to meals and exercise after the intervention, plasma concentrations of leptin were decreased. The failure of ghrelin levels to increase by this approach might explain the good control of appetite observed at the end of the study.

  18. How to Improve Adolescent Stress Responses: Insights From Integrating Implicit Theories of Personality and Biopsychosocial Models.

    Science.gov (United States)

    Yeager, David S; Lee, Hae Yeon; Jamieson, Jeremy P

    2016-08-01

    This research integrated implicit theories of personality and the biopsychosocial model of challenge and threat, hypothesizing that adolescents would be more likely to conclude that they can meet the demands of an evaluative social situation when they were taught that people have the potential to change their socially relevant traits. In Study 1 (N = 60), high school students were assigned to an incremental-theory-of-personality or a control condition and then given a social-stress task. Relative to control participants, incremental-theory participants exhibited improved stress appraisals, more adaptive neuroendocrine and cardiovascular responses, and better performance outcomes. In Study 2 (N = 205), we used a daily-diary intervention to test high school students' stress reactivity outside the laboratory. Threat appraisals (Days 5-9 after intervention) and neuroendocrine responses (Days 8 and 9 after intervention only) were unrelated to the intensity of daily stressors when adolescents received the incremental-theory intervention. Students who received the intervention also had better grades over freshman year than those who did not. These findings offer new avenues for improving theories of adolescent stress and coping.

  19. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, A.-M.; Nielsen, C.V.; Rasmussen, J.O.

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... people with hip fracture, homeless people with mental illness, adults with multiple sclerosis, stroke, aquired brain injury, chronic arthropathy, chronic pain, low back pain, and fibromyalgia. Whereas evidence was not found for adults with amyetrophic lateral schlerosis, and neck and shoulder pain....... Conclusion: Although these studies included heterogeneous patient groups the overall conclusion was that multidisciplinary rehabilitation team care effectively improves rehabilitation intervention. However, further research in this area is needed. © 2012 The Authors....

  20. Locking-In Effects Due to Early Interventions? An Evaluation of a Multidisciplinary Screening Programs for Avoiding Long-Term Sickness

    Science.gov (United States)

    Johansson, Per; Lindahl, Erica

    2012-01-01

    Objective: In this article, we estimate the effect of a multidisciplinary collaboration program on the length of sickness absence. The intention with the program was to avoid long-term sickness absence by providing an early and holistic evaluation of the sick-listed individuals' conditions. The target group was individuals who were at risk of…

  1. A novel bio-psycho-social approach for rehabilitation of traumatized victims of torture and war in the post-conflict context: a pilot randomized controlled trial in Kosovo.

    Science.gov (United States)

    Wang, Shr-Jie; Bytyçi, Ardiana; Izeti, Selvi; Kallaba, Melita; Rushiti, Feride; Montgomery, Edith; Modvig, Jens

    2016-01-01

    Some evidence showed that multidisciplinary rehabilitation in Western countries is effective for treating war-related trauma, but it remains unclear whether this approach is applicable to civilians living in resource-poor countries affected by war. In 2012-14, Danish Institute against Torture (DIGNITY) conducted a randomized controlled trial (RCT), in partnership with Kosova Rehabilitation Centre for Torture Victims (KRCT), to examine the effects of multidisciplinary intervention among victims of torture and war in Kosovo. A single-center, randomized, parallel-arm, single-masked, waiting-list controlled trial was implemented in northern Kosovo. Thirty-four participants meeting the recruiting criteria were randomized to either intervention group, which received integrated treatments plus a once-daily multivitamin, or the waiting list group, which received multivitamin alone. The integrated treatments consisted of 10 weekly individual 60-min sessions of cognitive behavioral therapy (CBT), based on an adapted prolonged exposure therapy manual, an individual 20-min breathing exercise with an emWave biofeedback device, and 90-min group physiotherapy. The waiting list group also received the same treatment after the intervention group had completed their sessions. Outcome assessments were conducted at 3, 6 and 9 months after baseline assessment. Outcomes measures consisted of 4 subtypes: mental, emotional, physical health, functioning and social outcomes, i.e. PTSD, depression, anxiety, chronic pain, anger and hatred expression, body mass index, handgrip strength, standing balance, income, employment rate and disability score. Over 1/3 of PTSD cases were successfully treated. Inconsistent patterns with mental health and chronic pain outcomes were observed while there was a definite impact of intervention on functioning and social outcomes, i.e. the employment rate, which increased nearly 15 %, and the monthly wage, which rose 45-137 %. There was also a noticeable

  2. Barriers and Challenges in Seeking Psychiatric Intervention in a General Hospital, by the Collaborative Child Response Unit, (A Multidisciplinary Team Approach to Handling Child Abuse) A Qualitative Analysis.

    Science.gov (United States)

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Mital, Anukant; Rao, Chandrika; Chandra, Girish

    2017-01-01

    Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services.

  3. Satisfacción Usuaria: Un Indicador de Calidad del Modelo de Salud Familiar, Evaluada en un Programa de Atención de Familias en Riesgo Biopsicosocial, en la Atención Primaria User Satisfaction: A Quality Indicator of the Family Health Model, Evaluated in an Intervention Program with Families in Biopsychosocial Risk, in Primary Care Health

    Directory of Open Access Journals (Sweden)

    Carolina Oliva

    2004-11-01

    Full Text Available Este artículo presenta los resultados de una investigación que evaluó la satisfacción usuaria de los consultantes a un programa experimental de Salud Familiar1 (PRODEFA II2 dirigido a familias en riesgo biopsicosocial. Se realizó un análisis comparativo de satisfacción usuaria entre los consultantes del PRODEFA II (GE y los usuarios de programas tradicionales (GC, del mismo Centro de Salud de Atención Primaria (AP. La satisfacción usuaria se evaluó con una encuesta3 que consideró diversas variables organizadas según las dimensiones de estructura, proceso y resultado de la atención. Los análisis estadísticos señalan que los usuarios del PRODEFA II evalúan significativamente mejor la atención recibida que los usuarios de programas tradicionales, tanto en términos globales como en los indicadores específicos. Se concluye que este programa, basado en un modelo biopsicosocial de atención, genera mayor satisfacción en los usuarios que los programas tradicionales basados en un modelo exclusivamente biomédico.The present article presents the main results of a study that evaluates user's satisfaction of the consultants of an experimental program of Family Health, in primary care health, aimed at families in biopsychosocial risk (PRODEFA II. Through a quantitative analysis a comparison of user satisfaction was made between PRODEFA II users and those attending traditional programs, at the same health center. The groups were compared according to the dimensions of structure, process and results in health care. It was found that users of PRODEFA II evaluated the received attention better than users of traditional programs. The final conclusion is that PRODEFA II, based on a biopsychosocial model of attention, generates more user satisfaction than the tradicional programs based on a biomedical model.

  4. Effect of multidisciplinary team intensive intervention on metabolic indexes of diabetes high-risk group%多学科团队强化干预对糖尿病高危人群代谢指标的影响

    Institute of Scientific and Technical Information of China (English)

    吕召霞; 贾荣娟; 李惠云; 林治萍; 姜庥每

    2013-01-01

    目的 观察多学科团队强化干预对糖尿病高危人群代谢指标的影响.方法 选择健康体检且自愿参与本研究的糖尿病高危者88例,按随机数字表法分为干预组和对照组.干预组在常规健康教育的基础上,由多学科团队给予强化知识培训、强化进行自我监测、强化信息反馈、加强追踪随访.干预1年后,比较两组研究对象在血糖、血脂、血压、体重、脂肪、肌肉、蛋白、骨总量等方面的变化.结果 干预1年后,两组研究对象除HDL差异无统计学意义外,干预组其他指标如体重、BMI、脂肪含量、血压、空腹血糖、糖化血红蛋白、血脂总胆固醇、甘油三酯、低密度脂蛋白均低于对照组(P<0.05);干预组TC、TG、血糖、BMI、血压达标率较对照组高(P<0.05).结论 多学科团队强化干预对糖尿病高危人群代谢指标有显著的影响,能帮助干预对象建立健康的生活模式,从而减少糖尿病的风险因素.%Objective To observe the effect of the multidisciplinary team intensive intervention on metabolic indexes of diabetes high-risk group.Methods 88 diabetic patients at high risk for health examination and voluntarily participated in the study,were randomly divided into intervention group and control group.The two groups all took routine health education,intervention group was given by a multidisciplinary team strengthened knowledge training,self-monitoring,information feedback and follow-up.1 year after the intervention,we compared two groups in glucose,lipid,blood pressure,body weight,fat,muscle,bone,protein and total variation.Results After 1 year of intervention,except for HDL without statistical significance,other indicators such as body weight,BMI,fat,blood pressure,fasting blood glucose,glycosylated hemoglobin,blood total cholesterol,triglyceride and low density lipoprotein in intervention group were lower than those of the control group (P<0.05); in intervention group

  5. Barriers and challenges in seeking psychiatric intervention in a General Hospital, by the collaborative child response unit, (A multidisciplinary team approach to handling child abuse A qualitative analysis

    Directory of Open Access Journals (Sweden)

    Vyjayanthi Kanugodu Srinivasa Subramaniyan

    2017-01-01

    Full Text Available Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services. Methodology: Members of the team were recruited from different disciplines and trained by experts. A mission statement, protocol to assess the victims and provide treatment was formulated as an algorithm. The barriers to psychiatric treatment among the stakeholders were analyzed using framework method of qualitative analysis. Results (After 20 months the unit received 27 referrals in 20 months, 24 females, and 3 males. Age of the victims was between 8 months and 17 years. Two cases found to be physically abused. Penetrative sexual abuse was found in 23 cases, pregnant victims were 4. Most referrals were by police, trafficking found in 6 cases. Discussion: It was possible to provide multidisciplinary care to the victims and families. Recurrent themes of barriers to psychiatric treatment were stigma, victim blaming; focus on termination of pregnancy, minimization of abuse in males by stakeholders. Conclusion is collaboration needs more effort to integrate psychiatric services but can minimize the reduplication of services.

  6. Barriers and Challenges in Seeking Psychiatric Intervention in a General Hospital, by the Collaborative Child Response Unit, (A Multidisciplinary Team Approach to Handling Child Abuse) A Qualitative Analysis

    Science.gov (United States)

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Mital, Anukant; Rao, Chandrika; Chandra, Girish

    2017-01-01

    Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services. Methodology: Members of the team were recruited from different disciplines and trained by experts. A mission statement, protocol to assess the victims and provide treatment was formulated as an algorithm. The barriers to psychiatric treatment among the stakeholders were analyzed using framework method of qualitative analysis. Results (After 20 months) the unit received 27 referrals in 20 months, 24 females, and 3 males. Age of the victims was between 8 months and 17 years. Two cases found to be physically abused. Penetrative sexual abuse was found in 23 cases, pregnant victims were 4. Most referrals were by police, trafficking found in 6 cases. Discussion: It was possible to provide multidisciplinary care to the victims and families. Recurrent themes of barriers to psychiatric treatment were stigma, victim blaming; focus on termination of pregnancy, minimization of abuse in males by stakeholders. Conclusion is collaboration needs more effort to integrate psychiatric services but can minimize the reduplication of services.

  7. Serious gaming during multidisciplinary rehabilitation for patients with complex chronic pain or fatigue complaints: study protocol for a controlled trial and process evaluation.

    Science.gov (United States)

    Vugts, Miel A P; Joosen, Margot C W; Mert, Agali; Zedlitz, Aglaia; Vrijhoef, Hubertus J M

    2017-06-08

    Many individuals suffer from chronic pain or functional somatic syndromes and face boundaries for diminishing functional limitations by means of biopsychosocial interventions. Serious gaming could complement multidisciplinary interventions through enjoyment and independent accessibility. A study protocol is presented for studying whether, how, for which patients and under what circumstances, serious gaming improves patient health outcomes during regular multidisciplinary rehabilitation. A mixed-methods design is described that prioritises a two-armed naturalistic quasi-experiment. An experimental group is composed of patients who follow serious gaming during an outpatient multidisciplinary programme at two sites of a Dutch rehabilitation centre. Control group patients follow the same programme without serious gaming in two similar sites. Multivariate mixed-modelling analysis is planned for assessing how much variance in 250 patient records of routinely monitored pain intensity, pain coping and cognition, fatigue and psychopathology outcomes is attributable to serious gaming. Embedded qualitative methods include unobtrusive collection and analyses of stakeholder focus group interviews, participant feedback and semistructured patient interviews. Process analyses are carried out by a systematic approach of mixing qualitative and quantitative methods at various stages of the research. The Ethics Committee of the Tilburg School of Social and Behavioural Sciences approved the research after reviewing the protocol for the protection of patients' interests in conformity to the letter and rationale of the applicable laws and research practice (EC 2016.25t). Findings will be presented in research articles and international scientific conferences. A prospective research protocol for the naturalistic quasi-experimental outcome evaluation was entered in the Dutch trial register (registration number: NTR6020; Pre-results). © Article author(s) (or their employer(s) unless

  8. Biopsychosocial obstetrics and gynaecology - a perspective from Australia.

    Science.gov (United States)

    Rowe, Heather

    2016-01-01

    Prior to and throughout the twentieth century, biomedical understandings of health predominated. Australian obstetrician and gynaecologist, Professor Derek Llewellyn-Jones responded to frustrations with the limitations of this narrow approach from both within and beyond the medical profession. His pioneering research, education and writings re-conceptualised the discipline as encompassing the social and psychological contexts and profoundly influenced women's own understanding of their health and the practice of obstetrics and gynaecology. The biopsychosocial model has replaced biological determinism and is now pervasive in education and clinical practice in many parts of the world. Widespread acceptance of the model has until now been associated with under-recognition of the importance of biology. Recent findings from epigenetics and neuroscience are enabling integration of body, mind and society and enhanced understanding and practice of psychosomatic obstetrics and gynaecology.

  9. Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students.

    Science.gov (United States)

    Gan, Wan Ying; Mohd Nasir, Mohd Taib; Zalilah, Mohd Shariff; Hazizi, Abu Saad

    2012-12-01

    The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.

  10. A multidisciplinary intervention to reduce infections of ESBL- and AmpC-producing, gram-negative bacteria at a University Hospital

    DEFF Research Database (Denmark)

    Knudsen, Inge Jenny Dahl; Andersen, Stig Ejdrup

    2014-01-01

    guidelines for antimicrobial treatment and prophylaxis were disseminated throughout the intervention hospital; cephalosporins were restricted for prophylaxis use only, fluoroquinolones for empiric use in septic shock only, and carbapenems were selected for penicillin-allergic patients, infections due to ESBL...

  11. MULTIDISCIPLINARY ROBUST OPTIMIZATION DESIGN

    Institute of Scientific and Technical Information of China (English)

    Chen Jianjiang; Xiao Renbin; Zhong Yifang; Dou Gang

    2005-01-01

    Because uncertainty factors inevitably exist under multidisciplinary design environment, a hierarchical multidisciplinary robust optimization design based on response surface is proposed. The method constructs optimization model of subsystem level and system level to coordinate the coupling among subsystems, and also the response surface based on the artificial neural network is introduced to provide information for system level optimization tool to maintain the independence of subsystems,i.e. to realize multidisciplinary parallel design. The application case of electrical packaging demonstrates that reasonable robust optimum solution can be yielded and it is a potential and efficient multidisciplinary robust optimization approach.

  12. Multidisciplinary care in haemoglobinopathies

    Directory of Open Access Journals (Sweden)

    Adriana Ceci

    2014-12-01

    Full Text Available While most complications are related to haemoglobinopathies and their treatment, it is also possible to observe substantial differences in comorbidities’ onset and seriousness which depend also to the different HPs genotypes. These differences should be carefully considered when health authorities set up and manage adequate care systems and treatments plans. We describe services organisation in Italy including the availability of multispecialty care and tools, in the HPs units participating to the HTA-THAL Multiregional Registry, with the aim to derive the impact of the services and multispecialty care availability on the management of the disease and on the patients wellbeing. The high dispersion and heterogeneity of services demonstrated, exposes the Italian system to a high risk of: a inappropriate use of economical and medical resources, b limited access to multidisciplinary care of some patients with apparent inequality among different centres, and c low patients satisfaction with the services provided. The identification of a ‘standard for HPs services’ is necessary not only at national but also at interventional level in order to implement collaborative research and the identification and networking of reference’ centres worldwide. Following the big efforts provided in the last years here there is a new challenging mission for the TIF.

  13. From Vitality to Vital Exhaustion and Other States of "Tense Tiredness": A New Biopsychosocial Risk Domain.

    Science.gov (United States)

    Rozanski, Alan; Cohen, Randy

    2017-04-01

    Fatigue is a common prodromal symptom for various medical conditions, including acute myocardial infarction. Fatigue is also the core component of vital exhaustion, which consists of a specific triad: excessive fatigue, increased irritability, and feelings of demoralization. In this issue of Psychosomatic Medicine, Frestad and Prescott present a meta-analysis of 16 studies, involving 53,337 participants, which found vital exhaustion to be associated with an increased risk of incident coronary heart disease (CHD) and recurrent cardiac events among individuals with established CHD. After discussing methodological limitations of the studies included in this meta-analysis, we describe these findings in terms of a larger genre of risk that is biopsychosocial in origin and tied to two types of tiredness: "calm tiredness" and "tense tiredness." The former is regenerative, while the latter enhances disease risk. We propose that besides vital exhaustion, other symptoms of negative affect may combine with tiredness to produce increased clinical risk, such as the presence of depressed mood, an inability to relax or recover after work, and symptoms of burnout. We further propose that vital exhaustion can be considered as part of a larger paradigm, ranging from a positive state of vitality to a negative state of exhaustion of vitality. We conclude this editorial by emphasizing the importance of improving vitality and the need to clarify biobehavioral mechanisms that play a role in the association between vital exhaustion and adverse CHD outcomes. New interventions are needed that target reducing exhaustion and improving vitality for individuals at high risk of CHD.

  14. Building a Biopsychosocial Conceptual Framework to Explore Pressure Ulcer Pain for Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Junglyun Kim

    2016-01-01

    Full Text Available Although pressure ulcers are a prevalent condition, pain associated with pressure ulcers is not fully understood. Indeed, previous studies do not shed light on the association between pressure ulcer stages and the experience of pain. Especially, pain characteristics of suspected deep tissue injury, which is a new category that was recently added by the National Pressure Ulcer Advisory Panel, are yet unknown. This is concerning because the incidence of pressure ulcers in hospitalized patients has increased exponentially over the last two decades, and health care providers are struggling to ensure providing adequate care. Thus, in order to facilitate the development of effective interventions, this paper presents a conceptual framework to explore pressure ulcer pain in hospitalized patients. The concepts were derived from a biopsychosocial model of pain, and the relationships among each concept were identified through a literature review. Major propositions are presented based on the proposed conceptual framework, which integrates previous research on pressure ulcer pain, to ultimately improve understanding of pain in hospitalized patients with pressure ulcers.

  15. Building a Biopsychosocial Conceptual Framework to Explore Pressure Ulcer Pain for Hospitalized Patients.

    Science.gov (United States)

    Kim, Junglyun; Ahn, Hyochol; Lyon, Debra E; Stechmiller, Joyce

    2016-01-08

    Although pressure ulcers are a prevalent condition, pain associated with pressure ulcers is not fully understood. Indeed, previous studies do not shed light on the association between pressure ulcer stages and the experience of pain. Especially, pain characteristics of suspected deep tissue injury, which is a new category that was recently added by the National Pressure Ulcer Advisory Panel, are yet unknown. This is concerning because the incidence of pressure ulcers in hospitalized patients has increased exponentially over the last two decades, and health care providers are struggling to ensure providing adequate care. Thus, in order to facilitate the development of effective interventions, this paper presents a conceptual framework to explore pressure ulcer pain in hospitalized patients. The concepts were derived from a biopsychosocial model of pain, and the relationships among each concept were identified through a literature review. Major propositions are presented based on the proposed conceptual framework, which integrates previous research on pressure ulcer pain, to ultimately improve understanding of pain in hospitalized patients with pressure ulcers.

  16. An Integrative Bio-Psycho-Social Theory of Anorexia Nervosa.

    Science.gov (United States)

    Munro, Calum; Randell, Louise; Lawrie, Stephen M

    2017-01-01

    The need for novel approaches to understanding and treating anorexia nervosa (AN) is well recognized. The aim of this paper is to describe an integrative bio-psycho-social theory of maintaining factors in AN. We took a triangulation approach to develop a clinically relevant theory with face validity and internal consistency. We developed theoretical ideas from our clinical practice and reviewed theoretical ideas within the eating disorders and wider bio-psycho-social literature. The synthesis of these ideas and concepts into a clinically meaningful framework is described here. We suggest eight key factors central to understanding the maintenance and treatment resistance of anorexia nervosa: genetic or experiential predisposing factors; dysfunctional feelings processing and regulation systems; excessive vulnerable feelings; 'feared self' beliefs; starvation as a maladaptive physiological feelings regulation mechanism; maladaptive psychological coping modes; maladaptive social behaviour; and unmet physical and psychological core needs. Each of these factors serves to maintain the disorder. The concept of universal physical and psychological core needs can provide an underpinning integrative framework for working with this distinctly physical and psychological disorder. This framework could be used within any treatment model. We suggest that treatments which help address the profound lack of trust, emotional security and self-acceptance in this patient group will in turn address unmet needs and improve well-being. Copyright © 2016 John Wiley & Sons, Ltd. The concept of unmet physical and psychological needs can be used as an underlying integrative framework for understanding and working with this patient group, alongside any treatment model. A functional understanding of the neuro-biological, physiological and psychological mechanisms involved in anorexia nervosa can help patients reduce self-criticism and shame. Fears about being or becoming fat, greedy, needy

  17. [Multidisciplinary therapy of Tourette syndrome].

    Science.gov (United States)

    Bábel, B Tamás; Németh, Attila; Gádoros, Júlia; Bihari, Katalin

    2003-02-01

    The marked fluctuation in symptoms with a spectrum of behavioral problems contribute to misdiagnosis of Tourette syndrome. The authors review the recent progress in diagnosis and management with an emphasis on multidisciplinary approach. Possible associations with various genes have been found in etiology of Tourette syndrome. Development of the disease comes of dopaminerg neurotransmission disorder resulting in cortico-striato-thalamic system dysfunction. Tics are brief movements or sounds that occur intermittently and unpredictably mimicking fragments of normal behavior. Diagnostic criteria are based on the motor and vocal phenomena and their dynamics. The key concept in management are the tic severity scaling correlating with quality of life measurements. Therapeutic interventions indicated at severe alteration in patient's quality of life. Treatment plan combines various drug protocols, psychotherapy and behavioral therapy which should be optimalized for most disabling symptom. Social isolation and self injurious behavior complicates the treatment resistant, severe cases. In these subgroup of patient, an adequate selection of stereotactic intervention could provide an effective control of tic severity or behavioral disorder. Tourette syndrome, as a typical neuropsychiatric disorder, is a striking example for improved efficacy of multidisciplinary approach.

  18. Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education.

    Science.gov (United States)

    Wijma, Amarins J; van Wilgen, C Paul; Meeus, Mira; Nijs, Jo

    2016-07-01

    Pain neuroscience education (PNE) is increasingly used as part of a physical therapy treatment in patients with chronic pain. A thorough clinical biopsychosocial assessment is recommended prior to PNE to allow proper explanation of the neurophysiology of pain and the biopsychosocial interactions in an interactive and patient-centered manner. However, without clear guidelines, clinicians are left wondering how a biopsychosocial assessment should be administered. Therefore, we provided a practical guide, based on scientific research and clinical experience, for the biopsychosocial assessment of patients with chronic pain in physiotherapy practice. The purpose of this article is to describe the use of the Pain - Somatic factors - Cognitive factors - Emotional factors - Behavioral factors - Social factors - Motivation - model (PSCEBSM-model) during the intake, as well as a pain analysis sheet. This model attempts to clearly establish what the dominant pain mechanism is (predominant nociceptive, neuropathic, or non-neuropathic central sensitization pain), as well as to assess the provoking and perpetuating biopsychosocial factors in patients with chronic pain. Using this approach allows the clinician to specifically classify patients and tailor the plan of care, including PNE, to individual patients.

  19. Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions.

    Science.gov (United States)

    Mallow, Jennifer A; Theeke, Laurie A; Theeke, Elliott; Mallow, Brian K

    2016-01-01

    Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams' preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N = 8) and nonprescribing healthcare team members (n = 21) completed the focus groups and survey. The majority were practicing for more than 20 years (44.8%) in an outpatient clinic (62%) for 20-40 hours per week (37.9%). Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users.

  20. Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Jennifer A. Mallow

    2016-01-01

    Full Text Available Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams’ preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N=8 and nonprescribing healthcare team members (n=21 completed the focus groups and survey. The majority were practicing for more than 20 years (44.8% in an outpatient clinic (62% for 20–40 hours per week (37.9%. Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users.

  1. Reduction and sustainability of cesarean section surgical site infection: An evidence-based, innovative, and multidisciplinary quality improvement intervention bundle program.

    Science.gov (United States)

    Hsu, Chaur-Dong; Cohn, Inna; Caban, Rebeca

    2016-11-01

    We found cesarean section (C-section) surgical site infection (SSI) at our institution was significantly higher than the national benchmark. A retrospective cohort study was conducted under 4 phases from January 2008-December 2014. The hospital infection control (IC) policies and a presurgical checklist were bundled and implemented. The study was conducted with 3,334 cesarean deliveries: phase A (January 1, 2008-January 31,2010): 1,250 patients without intervention (baseline SSI rate), phase B (February 1, 2010-July 31, 2011): 682 patients were intervened with IC policies, phase C (August 1, 2011-December 31, 2012): 591 patients with an SSI reduction bundle, and phase D (January 1, 2013-December 31, 2014): 811 patients were monitored for C-section SSI sustainability. Patients not following strict protocols because of emergency C-section deliveries were excluded. The χ(2) test, Fisher exact test, and standard Z test were used for statistical analyses. C-section SSI rates were 6.2% (77/1,250) in phase A, 3.7% (25/682) in phase B, 1.7% (10/591) in phase C, and 0.1% (1/811) in phase D, respectively. By implementing the IC policies and bundle, the C-section SSI rate was reduced 40.3% (phase B vs phase A), 72.6% (phase C vs phase A), and 98.4% (phase D vs phase A). All statistics were significantly different. We conclude that implementing a C-section SSI reduction bundle was associated with reduced C-section SSI rate down toward zero. A future prospectively randomized controlled trial is warranted. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Biopsychosocial Characteristics, Using a New Functional Measure of Balance, of an Elderly Population with CLBP

    Directory of Open Access Journals (Sweden)

    Ryan Hulla

    2016-08-01

    Full Text Available This study examined the biopsychosocial characteristics of chronic low back pain (CLBP in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older. A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH-developed Patient-Reported Outcome Measurement Information System (PROMIS was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24; and the other without (NCLBP, n = 24. Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly.

  3. The influence of a biopsychosocial-based treatment approach to primary overt hypothyroidism: a protocol for a pilot study

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2010-11-01

    Full Text Available Abstract Background Hypothyroidism is a prevalent endocrine condition. Individuals with this disease are commonly managed through supplementation with synthetic thyroid hormone, with the aim of alleviating symptoms and restoring normal thyroid stimulating hormone levels. Generally this management strategy is effective and well tolerated. However, there is research to suggest that a significant proportion of hypothyroid sufferers are being inadequately managed. Furthermore, hypothyroid patients are more likely to have a decreased sense of well-being and more commonly experience constitutional and neuropsychiatric complaints, even with pharmacological intervention. The current management of hypothyroidism follows a biomedical model. Little consideration has been given to a biopsychosocial approach to this condition. Within the chiropractic profession there is growing support for the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET for this population. Methods/Design A placebo-controlled, single-blinded, randomised clinical pilot-trial has been designed to assess the influence of Neuro-Emotional Technique on a population with primary overt hypothyroidism. A sample of 102 adults (≥18 years who meet the inclusion criteria will be randomised to either a treatment group or a placebo group. Each group will receive ten treatments (NET or placebo over a six week period, and will be monitored for six months. The primary outcome will involve the measurement of depression using the Depression, Anxiety and Stress Scale (DASS. The secondary outcome measures to be used are; serum thyroid stimulating hormone, serum free-thyroxine, serum free-triiodothyronine, serum thyroid peroxidase auto-antibodies, serum thyroglobulin auto-antibodies as well as the measurement of functional health and well-being using the Short-Form-36 Version 2. The emotional states of anxiety and stress will be measured using the DASS. Self-measurement of

  4. Multidisciplinary care of craniosynostosis

    Directory of Open Access Journals (Sweden)

    Buchanan EP

    2017-07-01

    Full Text Available Edward P Buchanan,1 Yunfeng Xue,1 Amy S Xue,1 Asaf Olshinka,1 Sandi Lam2 1Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, 2Michael E. DeBakey Department of Surgery, Division of Neurosurgery, Baylor College of Medicine, Houston, TX, USA Abstract: The management of craniosynostosis, especially in the setting of craniofacial syndromes, is ideally done in a multidisciplinary clinic with a team focused toward comprehensive care. Craniosynostosis is a congenital disorder of the cranium, caused by the premature fusion of one or more cranial sutures. This fusion results in abnormal cranial growth due to the inability of the involved sutures to accommodate the growing brain. Skull growth occurs only at the patent sutures, resulting in an abnormal head shape. If cranial growth is severely restricted, as seen in multisuture craniosynostosis, elevation in intracranial pressure can occur. Whereas most patients treated in a multidisciplinary craniofacial clinic have non-syndromic or isolated craniosynostosis, the most challenging patients are those with syndromic craniosynostosis. The purpose of this article was to discuss the multidisciplinary team care required to treat both syndromic and non-syndromic craniosynostosis. Keywords: multidisciplinary team care, syndromic craniosynostosis, nonsyndromic craniosynostosis

  5. Parasympathetic Regulation and Parental Socialization of Emotion: Biopsychosocial Processes of Adjustment in Preschoolers

    Science.gov (United States)

    Hastings, Paul D.; De, Ishani

    2008-01-01

    Variations in parents' emotion socialization have been linked to children's social competence (SC) and behavior problems, but parental influences do not act independently of children's characteristics. A biopsychosocial model was tested, in which children's parasympathetic regulation of cardiac function and paternal and maternal socialization of…

  6. Neuroplasticity, Psychosocial Genomics, and the Biopsychosocial Paradigm in the 21st Century

    Science.gov (United States)

    Garland, Eric L.; Howard, Matthew Owen

    2009-01-01

    The biopsychosocial perspective is a foundation of social work theory and practice. Recent research on neuroplasticity and psychosocial genomics lends compelling support to this perspective by elucidating mechanisms through which psychosocial forces shape neurobiology. Investigations of neuroplasticity demonstrate that the adult brain can continue…

  7. The Nature of Workplace Bullying Experienced by Teachers and the Biopsychosocial Health Effects

    Science.gov (United States)

    De Vos, J.; Kirsten, G. J. C.

    2015-01-01

    This article reports on the nature of workplace bullying experienced by teachers in South African schools and the biopsychosocial health effects that may arise from such victimisation. Voluntary victimised teachers who wanted to share their experiences were sampled using a lifestyle magazine and online articles. Twenty-seven teachers participated…

  8. Blooming Sexuality : A Biopsychosocial Perspective on Adolescent Romantic and Sexual Development

    NARCIS (Netherlands)

    Baams, L.

    2015-01-01

    The aim of this dissertation was to examine adolescent romantic and sexual development, in a biopsychosocial model, in which physical, psychological, and social contextual factors are considered. The findings of this dissertation show the importance of individual factors such as pubertal status and

  9. Blooming Sexuality : A Biopsychosocial Perspective on Adolescent Romantic and Sexual Development

    NARCIS (Netherlands)

    Baams, L.

    2015-01-01

    The aim of this dissertation was to examine adolescent romantic and sexual development, in a biopsychosocial model, in which physical, psychological, and social contextual factors are considered. The findings of this dissertation show the importance of individual factors such as pubertal status and

  10. Biopsychosocial impact of the voice in relation to the psychological features in female student teachers.

    NARCIS (Netherlands)

    Meulenbroek, L.F.P.; Thomas, G.; Kooijman, P.G.C.; Jong, F.I.C.R.S. de

    2010-01-01

    OBJECTIVE: The aim of the study was to assess biopsychosocial impact of the voice in relation to the psychological features in female student teachers. METHODS: This research was a cross-sectional study in 755 student teachers using general questionnaires, the Voice Handicap Inventory (VHI), Type D

  11. Intervention Strategies with the Homeless Population

    Science.gov (United States)

    Dykeman, Bruce F.

    2011-01-01

    A literature review describing psychological and sociological factors of homelessness. Methods of estimating the frequency of homelessness are described, along with recent point-in-time and period-of-time estimates. Models of service delivery are reviewed. A biopsychosocial model of intervention is proposed that describes stages of intervention…

  12. Multidisciplinary management of complex care.

    Science.gov (United States)

    Schofield, Deborah; Fuller, Jeffrey; Wagner, Scott; Friis, Leanne; Tyrell, Bill

    2009-02-01

    Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.

  13. Multidisciplinary Management of Mastocytosis

    DEFF Research Database (Denmark)

    Broesby-Olsen, Sigurd; Dybedal, Ingunn; Gülen, Theo

    2016-01-01

    Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been consid...... an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis....

  14. Is current brain injury rehabilitation enhancing the biopsychosocial model?

    DEFF Research Database (Denmark)

    Glintborg, Chalotte; Hansen, Tia G. B.; Thomsen, Ane Søndergaard

    2014-01-01

    original, peer-reviewed research published in English and other languages. References were also identified from the bibliographies of eligible articles. Study selection: Controlled trials and cohort and case-control studies were selected according to pre-defined criteria. Studies had to have a minimum......, only two of seven studies related to non-surgical interventions were found to have a low risk of bias. One studied the effect of a scheduled telephone intervention offering counselling and education on outcome and found a significantly better outcome for symptoms (6.6 differences in adjusted mean...

  15. Stress, cancer and immunity. New developments in biopsychosocial and psychoneuroimmunologic research.

    Science.gov (United States)

    Baltrusch, H J; Stangel, W; Titze, I

    1991-08-01

    Research in biobehavioral oncology has been focused on stress as one dispositional factor in the multifactorial origin and in the clinical progression of malignant disease. New insights into the transduction of environmental influences to the immune system and to other body systems by the brain and neurotransmitters have increased the salience of this approach. Behavioral medicine in the area of cardiovascular disease has been successful due to the introduction of a "Type A" or coronary prone behavior pattern in large epidemiologic studies. This pattern is marked by both psychologic and physiologic hyperresponsiveness. Type A persons appear to be hostile, easily angered, competitive and hard-driving. More recently, behavioral oncologists have similarly attempted at conceptualizing a "Type C" or biopsychosocial cancer risk pattern, as they have noted the denial and suppression of emotions, in particular anger. Other features of this pattern are "pathological niceness", avoidance of conflicts, exaggerated social desirability, harmonizing behavior, over-compliance, over-patience, as well as high rationality and a rigid control of emotional expression ("anti-emotionality"). This pattern, usually concealed behind a facade of pleasantness, appears to be effective as long as environmental and psychological homeostasis is maintained, but collapses in the course of time under the impact of accumulated strains and stressors, especially those evoking feelings of depression and reactions of helplessness and hopelessness. As a prominent feature of this particular coping style, excessive denial, avoidance, suppression and repression of emotions and own basic needs appears to weaken the organism's natural resistance to carcinogenic influences. This may mean that the excessive use of denial and suppression/repression has important psychophysiologic effects linked to tumor biology and host-defense. Recent studies reveal that psychosocial stressors which are met by inadequate and

  16. Witchcraft and Biopsychosocial Causes of Mental Illness: Attitudes and Beliefs About Mental Illness Among Health Professionals in Five Countries.

    Science.gov (United States)

    Stefanovics, Elina A; He, Hongbo; Cavalcanti, Maria; Neto, Helio; Ofori-Atta, Angelo; Leddy, Meaghan; Ighodaro, Adesuwa; Rosenheck, Robert

    2016-03-01

    This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.

  17. The ideal of biopsychosocial chronic care: How to make it real? A qualitative study among Dutch stakeholders

    Directory of Open Access Journals (Sweden)

    van Dijk-de Vries Anneke

    2012-03-01

    Full Text Available Abstract Background Chronically ill patients often experience psychosocial problems in everyday life. A biopsychosocial approach is considered to be essential in chronic care. In Dutch primary health care the current biomedically oriented clinical practice may conflict with the biopsychosocial approach. This study is aimed to explore the views of Dutch stakeholders on achieving a biopsychosocial approach to the care of patients with chronic diseases. Methods In a qualitative explorative study design, we held semi-structured interviews with stakeholders, face-to-face or by telephone. Data were analysed using content analysis. Thirty representatives of Dutch patients with chronic illnesses, primary care professionals, policy makers, health inspectorate, health insurers, educational institutes and researchers were interviewed. Results Stakeholders were aware that a systematic biopsychosocial care approach is lacking in current practice. Opportunities for effective change are multidimensional. Achieving a biopsychosocial approach to care relates to active patient participation, the training of professionals, high-quality guidelines, protocols and tools, integrated primary care, research and financial issues. Conclusions Although the principles and importance of the biopsychosocial model have been recognized, the provision of care that starts from the medical, emotional or social needs of individual patients does not fit in easily with the current Dutch health care system. All parties involved need to make a commitment to realize the ideal of biopsychosocial chronic care. Together they need to equip health professionals with skills to understand patients' multifaceted needs and to reward integrated biopsychosocial care. Patients need to be empowered to be active partners in their own care.

  18. The impact of a civic service program on biopsychosocial outcomes of post 9/11 U.S. military veterans.

    Science.gov (United States)

    Matthieu, Monica M; Lawrence, Karen A; Robertson-Blackmore, Emma

    2017-02-01

    Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report measures before and after the program. Statistically significant differences were detected in overall health rating, level of emotional difficulty, PTSD and depression symptoms, purpose in life, self-efficacy, social isolation, and the perceived availability of social support at program completion. Screening positive for probable PTSD predicted improved perceived self-efficacy while probable depression predicted a decrease in loneliness, an increase in purpose in life, and an increase in perceived social support, at program completion. Volunteering was associated with significant improvements in health, mental health and social outcomes in returning veterans.

  19. Biopsychosocial Correlates of Binge Eating Disorder in Caucasian and African American Women with Obesity in Primary Care Settings.

    Science.gov (United States)

    Udo, Tomoko; White, Marney A; Lydecker, Janet L; Barnes, Rachel D; Genao, Inginia; Garcia, Rina; Masheb, Robin M; Grilo, Carlos M

    2016-05-01

    This study examined racial differences in eating-disorder psychopathology, eating/weight-related histories, and biopsychosocial correlates in women (n = 53 Caucasian and n = 56 African American) with comorbid binge eating disorder (BED) and obesity seeking treatment in primary care settings. Caucasians reported significantly earlier onset of binge eating, dieting, and overweight, and greater number of times dieting than African American. The rate of metabolic syndrome did not differ by race. Caucasians had significantly elevated triglycerides whereas African Americans showed poorer glycaemic control (higher glycated haemoglobin A1c [HbA1c]), and significantly higher diastolic blood pressure. There were no significant racial differences in features of eating disorders, depressive symptoms, or mental and physical health functioning. The clinical presentation of eating-disorder psychopathology and associated psychosocial functioning differed little by race among obese women with BED seeking treatment in primary care settings. Clinicians should assess for and institute appropriate interventions for comorbid BED and obesity in both African American and Caucasian patients.

  20. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Andersen, Kenneth Jay; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    2014 (follow-up). METHODS: Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain......, as outcome measures. RESULTS: A significant (P difference at follow-up of -1.0 (95%CI: -1.4 to -0.6). No significant effect on stress was observed (treatment by time P = 0.16). Exploratory analyses for each body...... pain using individually tailored physical and cognitive elements. STUDY DESIGN: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA...

  1. Halitosis: the multidisciplinary approach.

    Science.gov (United States)

    Bollen, Curd M L; Beikler, Thomas

    2012-06-01

    Halitosis, bad breath or oral malodour are all synonyms for the same pathology. Halitosis has a large social and economic impact. For the majority of patients suffering from bad breath, it causes embarrassment and affects their social communication and life. Moreover,halitosis can be indicative of underlying diseases. Only a limited number of scientific publications were presented in this field until 1995. Ever since, a large amount of research is published, often with lack of evidence. In general, intraoral conditions, like insufficient dental hygiene, periodontitis or tongue coating are considered to be the most important cause (85%) for halitosis. Therefore, dentists and periodontologists are the first-line professionals to be confronted with this problem. They should be well aware of the origin, the detection and especially of the treatment of this pathology. In addition, ear-nose-throat-associated (10%) or gastrointestinal/endocrinological (5%) disorders may contribute to the problem. In the case of halitophobia, psychiatrical or psychological problems may be present. Bad breath needs a multidisciplinary team approach: dentists, periodontologists, specialists in family medicine, ear-nose-throat surgeons, internal medicine and psychiatry need to be updated in this field, which still is surrounded by a large taboo.Multidisciplinary bad breath clinics offer the best environment to examine and treat this pathology that affects around 25% of the whole population. This article describes the origin, detection and treatment of halitosis, regarded from the different etiological origins.

  2. 多学科团队合作干预模式在儿童重症监护病房压疮护理中的应用分析%Analysis of Multidisciplinary Teamwork Intervention Model in Pressure Sores in Pediatric Intensive Care Unit

    Institute of Scientific and Technical Information of China (English)

    杨雪梅; 王若谷; 沈艳玲

    2016-01-01

    Objective To investigate the clinical effects of multidisciplinary teamwork interventionmodel which applied to pressure sores in PICU. Methods The children with pressure sores were randomly divided into a intervention group and a normal group,with 21 patients in each. Besides basic treatment as the conventional group,the intervention group received remedy lay within multidisciplinary teamwork intervention model,we compared the clinical effect of pressure ulcers in 2 groups. Results The healing rate of pressure sores in the intervention group was significantly higher than that in the normal group,in addition,the use of multi disciplinary team cooperative intervention model can also improve the compliance of children and their families onhealth care. Conclusion With multi disciplinary team cooperative intervention model of standardized management of pressure ulcers have a significant effect.%目的:探讨多学科团队合作干预模式在 PICU 压疮护理中的临床效果。方法将压疮患儿随机分为干预组和常规组,每组各21例,干预组在常规组基础上应用多学科合作团队干预模式实施干预治疗,比较2组压疮治疗护理的临床效果。结果干预组压疮愈合率高于常规护理组,而且运用多学科团队合作干预模式还可提高患儿及家属对医护的依从性。结论采用多学科合作的干预模式对压疮进行规范化管理效果明显。

  3. International Multidisciplinary Microscopy Congress

    CERN Document Server

    Oral, Ahmet; Ozer, Mehmet; InterM; INTERM2013

    2014-01-01

    The International Multidisciplinary Microscopy Congress (INTERM2013) was organized on October 10-13, 2013. The aim of the congress was to bring together scientists from various branches to discuss the latest advances in the field of microscopy. The contents of the congress have been broadened to a more "interdisciplinary" scope, so as to allow all scientists working on related subjects to participate and present their work. These proceedings include 39 peer-reviewed technical papers, submitted by leading academic and research institutions from over 12 countries and representing some of the most cutting-edge research available. The 39 papers are grouped into the following sections: - Applications of Microscopy in the Physical Sciences - Applications of Microscopy in the Biological Sciences

  4. Multidisciplinary Management of Mastocytosis

    DEFF Research Database (Denmark)

    Broesby-Olsen, Sigurd; Dybedal, Ingunn; Gülen, Theo

    2016-01-01

    Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been consid...... an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis....... considered rare; however, it is probably underdiagnosed with potential severe implications. Diagnosis can be challenging and symptoms may be complex and involve multiple organ-systems. In general it is advised that patients should be referred to centres with experience in the disease offering...

  5. [The victim as object of the medico-legal intervention].

    Science.gov (United States)

    Magalhães, Teresa

    2005-01-01

    We present a reflection about the victim as the object of the medico-legal intervention, that opens perspectives not only to the evidence research (as a techno-scientific contribute to support Justice in what concerns bio-psycho-social questions), but also to the support of victims which, in a last analysis, is no more than another aspect of this the social contribution of this science to ensure the best interest of the victim. This reflection aims to contribute to a better knowledge of the victim in his/her various perspectives. Accordingly, during the exposition, we refer some contributes of Victimology towards the understanding of the victims' behaviour's. Afterwards, we focus on the problems related to the aetiologies (with a particular reference to trauma), levels and consequences (physical, psychological and socio-economical) of victimization, as well as the methodologies of victims approach, medico-legal evaluation and reparation. Considering victims as being not only those who suffer directly the consequences of the victimizing phenomena, but also those that suffer from it indirectly and even secondarily, we shall approach the topic regarding both perspectives. We highlight the importance of understanding the victim as a person, not just understanding him/her confined to the organic aspect (as it used to be until recently in certain fields of medico-legal intervention, and as it still happens due to some legal obligations, for instance in the Labour Law), but considering the person in a global way (body, capacities, life situations and subjectivity). In conclusion, we highlight the importance of this topic to the medico-legal mission, while taking part in various multidisciplinary interventions and being involved in strategies and measures which purpose is to prevent violence, promote safety, avoid secondary victimization and revictimization as well as guarantee the victims' protection and reintegration, in a work attitude that should happen, even more and

  6. A multidisciplinary approach to short bowel syndrome.

    Science.gov (United States)

    Denegri, Andrea; Paparo, Francesco; Denegri, Roberto; Revelli, Matteo; Frascio, Marco; Rollandi, Gian Andrea; Fornaro, Rosario

    2014-01-01

    Short bowel syndrome is a complex clinical picture, characterized by signs and symptoms of malabsorption and subsequent malnutrition, which often occurs after extensive bowel resections. Short bowel syndrome's treatment must begin together with the planning of the first surgery, especially for disease that may need multiple interventions. Patients with short bowel should be individually managed because they all are different in diagnosis, length of the remaining bowel and in psychosocial characteristics. For all these reasons, a multidisciplinary approach between the various specialists is therefore needed.

  7. Multidisciplinary team interaction: summary and Action Plan.

    Science.gov (United States)

    Brink, B; Bugslag, R; González Del Castillo, B; Hastings, P; Kipor, G V; Lee, S W; Lo, C B; Poles, L; Robinson, P; Ronquillo, E L; Staña, J; Sydor, J; Thani, H

    2001-01-01

    Multidisciplinary team interaction has become a commonplace phrase in the discussion of disaster response. Theme 6 explored multidisciplinary team interactions and attempted to identify some of the key issues and possible solutions to the seemingly intractable problems inherent in this endeavour. Details of the methods used are provided in the introductory paper. The Cochairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. The Cochairs then presided over a workshop that resulted in the generation of a set of Action Plans that then were reported to the collective group of all delegates. Main points developed during the presentations and discussion included: (1) promotion of multidisciplinary collaboration, (2) standardization, (3) the Incident Command System, (4) professionalism, (5) regional disparities, and (6) psychosocial impact. Action plans recommended: (1) a standardized template for Needs Assessment be developed, implemented, and applied using collaboration with international organizations, focusing on needs and criteria appropriate to each type of event, and (2) team needs assessments be recognized for local responses and for determination of when international assistance may be required, for planning a command system, and for evaluating the psychosocial impact. There is a clear need for the development of standardized methods for the assessment of needs, development and implementation of a command structure, and for appreciation of regional differences and the psychosocial impact of all interventions.

  8. Irritable bowel syndrome: Personality and health behaviours: A biopsychosocial approach

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    1999-01-01

    Full Text Available The goal of this study was to indicate the complex nature of functional gastrointestinal disorders by studying the interaction between Irritable Bowel Syndrome and person personality aspects and health behaviour. An ex post facto design was used to compare two groups of women, the one group with iBS (N = 60 and the other without (N = 60 in terms of the above mentioned variables. The NEO-Personality lnventory (Revised was used to compare the groups on five broad aspects of personality i.e. Neuroticism, Extraversion, Openness for Experience, Agreeableness and Conscientiousness. The Health Behaviour Checklist was used to measure health behaviours as indicated by the foilowing factors: Wellness Maintenance and Enhancement, Accident Control, Traffic Risk Taking and Substance Risk Taking. The results indicate that statistically significant differences do indeed exist between the groups in terms of certain personality aspects (neuroticism, extraversion, openness for experience and certain health aspects (especially wellness maintenance and enhancement and traffic risk taking. It seems then as if IBS sufferers share certain personality characteristics which influence their behaviour related to the maintenance and enhancement of their health. Finally, we recommend a holistic approach to treatment and therapeutic interventions.

    Opsomming
    Die studie het ten doel gehad om die komplekse aard van die Funksionele Maagderm Versteurings aan te dui deur die interaksie tussen Prikkelbare Dermsindroom en persoonlikheidsaspekte en gesondheidsgedrag ("health behavioui' te bestudeer. Daar is gebruik gemaak van 'n ex post facto ontwerp om twee groepe vrouens, die een groep met PDS (N = 60 en die ander daarsonder (N = 60, ten opsigte van die veranderlikes te vergelyk. Die NEO - Personality lnventory (Revised is gebruik om die groepe te vergelyk ten opsigte van vyf brei persoonlikheidsaspekte naamlik, Neurotisme, Ekstraversie, Oopheid vir Ervaring, Welgevalligheid

  9. Presurgical biopsychosocial variables predict medical, compensation, and aggregate costs of lumbar discectomy in Utah workers' compensation patients.

    Science.gov (United States)

    DeBerard, M Scott; Wheeler, Anthony J; Gundy, Jessica M; Stein, David M; Colledge, Alan L

    2011-05-01

    Elective lumbar discectomy among injured workers is a prevalent spine surgery that often requires a lengthy rehabilitation. It is important to determine presurgical biopsychosocial predictors of compensation and medical costs in such patients. To determine if presurgical biopsychosocial variables are predictive of compensation and medical costs in a cohort of Utah patients who have undergone open or microlumbar discectomy that are receiving workers' compensation. A retrospective cohort study consisting of a review of presurgical medical records and accrued medical and compensation costs. A consecutive sample of 266 compensated workers from Utah who had undergone either open discectomy or microlumbar discectomy from 1994 to 2000. All patients were at least 2 years postsurgery at the time of follow-up. Total accrued medical, compensation, and aggregate costs. A retrospective review of presurgical biopsychosocial variables and total accrued medical, compensation, and aggregate costs. Presurgical variables were statistically significantly correlated with medical and compensation costs. Multiple linear regression models accounted for 31% of variation in compensation costs, 32% in medical costs, and 43% in total aggregate costs. Presurgical biopsychosocial variables are important predictors of compensated lumbar discectomy costs. Medical cost control programs might benefit from identifying biopsychosocial variables related to increased costs. Published by Elsevier Inc.

  10. 多学科团队工作模式下老年肺部感染并发多器官功能不全综合征的预防干预研究%Multidisciplinary team work mode-guided intervention to prevent elderly multiple organ dysfunction syndrome caused by pulmonary infection

    Institute of Scientific and Technical Information of China (English)

    谭清武; 范艳平; 李志颖; 唐静怡; 李庆华

    2015-01-01

    目的:探讨多学科团队工作模式下老年肺部感染并发老年多器官功能不全综合征(MODSE)的预防干预,为早期预防老年肺部感染并发MODSE奠定基础。方法选取解放军白求恩国际和平医院干部病房2010年10月至2014年3月住院并筛查出住院期间肺部感染并发MODSE的高危病例57例,采用多学科协作的团队工作方式,建立MODSE多学科团队预防干预模式,应用多学科团队预防干预模式对其中23例老年肺部感染并发MODSE高危病例进行干预,并与34例实施常规干预的老年肺部感染并发MODSE高危病例进行比较。结果在多学科干预组(MIG)23例老年肺部感染并发MODSE的高危病例中,有2例并发MODSE,MODSE发病率为8.70%;常规干预组(CIG)34例老年肺部感染并发MODSE的高危病例中,有11例并发MODSE,MODSE发病率为32.35%。MIG组老年肺部感染并发MODSE高危病例的MODSE发病率低于CIG组(χ2=4.361,P=0.037)。结论多学科团队预防干预模式能充分利用医院各学科的技术优势,使MODSE高危病例得到最佳干预治疗,从而达到早期保护各器官功能、减少MODSE的发生。%Objective To explore the intervention to prevent multiple organ dysfunction syndrome in the elderly (MODSE) caused by pulmonary infection under the guide of multidisciplinary team work mode and find a basis for early prevention of the syndrome. Methods The multidisciplinary team prevention model was established to prevent MODSE caused by pulmonary infection. A total of 57 patients (over 65 years old) of high risk for MODSE due to pulmonary infection admitted in our ward from October 2010 to March 2014 were recruited in this study. Twenty-three of them underwent the intervention based on the multidisciplinary team prevention model, and assigned as multidisciplinary intervention group (MIG). Another 34 cases were treated by conventional intervention to prevent MODSE, and

  11. Multidisciplinary System Reliability Analysis

    Science.gov (United States)

    Mahadevan, Sankaran; Han, Song; Chamis, Christos C. (Technical Monitor)

    2001-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code, developed under the leadership of NASA Glenn Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multidisciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  12. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...

  13. Multidisciplinary management for esophageal and gastric cancer

    Directory of Open Access Journals (Sweden)

    Boniface MM

    2016-04-01

    Full Text Available Megan M Boniface,1 Sachin B Wani,2 Tracey E Schefter,3 Phillip J Koo,4 Cheryl Meguid,1 Stephen Leong,5 Jeffrey B Kaplan,6 Lisa J Wingrove,7 Martin D McCarter1 1Section of Surgical Oncology, Division of GI, Tumor and Endocrine Surgery, Department of Surgery, 2Division of Gastroenterology and Hepatology, Department of Therapeutic and Interventional Endoscopy, 3Department of Radiation Oncology, 4Division of Radiology-Nuclear Medicine, Department of Radiology, 5Division of Medical Oncology, 6Department of Pathology, University of Colorado Denver, 7Department of Food and Nutrition Services, University of Colorado Hospital Cancer Center, Aurora, CO, USA Abstract: The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical, and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. Keywords: tumor board, upper gastrointestinal malignancies, patient centered

  14. The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment.

    Science.gov (United States)

    Pergolizzi, Joseph; Ahlbeck, Karsten; Aldington, Dominic; Alon, Eli; Coluzzi, Flaminia; Dahan, Albert; Huygen, Frank; Kocot-Kępska, Magdalena; Mangas, Ana Cristina; Mavrocordatos, Philippe; Morlion, Bart; Müller-Schwefe, Gerhard; Nicolaou, Andrew; Pérez Hernández, Concepción; Sichère, Patrick; Schäfer, Michael; Varrassi, Giustino

    2013-09-01

    Chronic pain is currently under-diagnosed and under-treated, partly because doctors' training in pain management is often inadequate. This situation looks certain to become worse with the rapidly increasing elderly population unless there is a wider adoption of best pain management practice. This paper reviews current knowledge of the development of chronic pain and the multidisciplinary team approach to pain therapy. The individual topics covered include nociceptive and neuropathic pain, peripheral sensitization, central sensitization, the definition and diagnosis of chronic pain, the biopsychosocial model of pain and the multidisciplinary approach to pain management. This last section includes an example of the implementation of a multidisciplinary approach in Belgium and describes the various benefits it offers; for example, the early multidimensional diagnosis of chronic pain and rapid initiation of evidence-based therapy based on an individual treatment plan. The patient also receives continuity of care, while pain relief is accompanied by improvements in physical functioning, quality of life and emotional stress. Other benefits include decreases in catastrophizing, self-reported patient disability, and depression. Improved training in pain management is clearly needed, starting with the undergraduate medical curriculum, and this review is intended to encourage further study by those who manage patients with chronic pain.

  15. The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment

    Science.gov (United States)

    Ahlbeck, Karsten; Aldington, Dominic; Alon, Eli; Coluzzi, Flaminia; Dahan, Albert; Huygen, Frank; Kocot-Kępska, Magdalena; Mangas, Ana Cristina; Mavrocordatos, Philippe; Morlion, Bart; Müller-Schwefe, Gerhard; Nicolaou, Andrew; Pérez Hernández, Concepción; Sichère, Patrick; Schäfer, Michael; Varrassi, Giustino

    2013-01-01

    Chronic pain is currently under-diagnosed and under-treated, partly because doctors’ training in pain management is often inadequate. This situation looks certain to become worse with the rapidly increasing elderly population unless there is a wider adoption of best pain management practice. This paper reviews current knowledge of the development of chronic pain and the multidisciplinary team approach to pain therapy. The individual topics covered include nociceptive and neuropathic pain, peripheral sensitization, central sensitization, the definition and diagnosis of chronic pain, the biopsychosocial model of pain and the multidisciplinary approach to pain management. This last section includes an example of the implementation of a multidisciplinary approach in Belgium and describes the various benefits it offers; for example, the early multidimensional diagnosis of chronic pain and rapid initiation of evidence-based therapy based on an individual treatment plan. The patient also receives continuity of care, while pain relief is accompanied by improvements in physical functioning, quality of life and emotional stress. Other benefits include decreases in catastrophizing, self-reported patient disability, and depression. Improved training in pain management is clearly needed, starting with the undergraduate medical curriculum, and this review is intended to encourage further study by those who manage patients with chronic pain. PMID:23786498

  16. [Low back pain during pregnancy. Multidisciplinary approach].

    Science.gov (United States)

    Gallo-Padilla, D; Gallo-Padilla, C; Gallo-Vallejo, F J; Gallo-Vallejo, J L

    2016-09-01

    After explaining that low back pain is considered the most common pregnancy complication, its pathogenesis, risk factors and the clinical characteristics of the very painful symptoms of this condition are described. As for its approach, it is stressed that it must be multidisciplinary, introducing very important preventive measures, including proper postural hygiene. For its treatment, the methods may be based on non-surgical or pharmacological interventions of a conservative non-invasive nature. Thus, physiotherapy, osteopathic manipulation, multimodal intervention (exercise and education), exercises performed in water environment, acupuncture, etc., have proven to be effective. Finally, it is emphasised that given the significant impact on their quality of life, different health professionals must be proactive and treat the lumbar disease in pregnant women. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Integrated Multidisciplinary Optimization Objects Project

    Data.gov (United States)

    National Aeronautics and Space Administration — M4 Engineering proposes to implement physics-based, multidisciplinary analysis and optimization objects that will be integrated into a Python, open-source framework...

  18. A biopsychosocial approach to women's sexual function and dysfunction at midlife: A narrative review.

    Science.gov (United States)

    Thomas, Holly N; Thurston, Rebecca C

    2016-05-01

    A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.

  19. Quantifying biopsychosocial aspects in everyday contexts: an integrative methodological approach from the behavioral sciences

    Science.gov (United States)

    Portell, Mariona; Anguera, M Teresa; Hernández-Mendo, Antonio; Jonsson, Gudberg K

    2015-01-01

    Contextual factors are crucial for evaluative research in psychology, as they provide insights into what works, for whom, in what circumstances, in what respects, and why. Studying behavior in context, however, poses numerous methodological challenges. Although a comprehensive framework for classifying methods seeking to quantify biopsychosocial aspects in everyday contexts was recently proposed, this framework does not contemplate contributions from observational methodology. The aim of this paper is to justify and propose a more general framework that includes observational methodology approaches. Our analysis is rooted in two general concepts: ecological validity and methodological complementarity. We performed a narrative review of the literature on research methods and techniques for studying daily life and describe their shared properties and requirements (collection of data in real time, on repeated occasions, and in natural settings) and classification criteria (eg, variables of interest and level of participant involvement in the data collection process). We provide several examples that illustrate why, despite their higher costs, studies of behavior and experience in everyday contexts offer insights that complement findings provided by other methodological approaches. We urge that observational methodology be included in classifications of research methods and techniques for studying everyday behavior and advocate a renewed commitment to prioritizing ecological validity in behavioral research seeking to quantify biopsychosocial aspects. PMID:26089708

  20. The biopsychosocial model and its potential for a new theory of homeopathy.

    Science.gov (United States)

    Schmidt, Josef M

    2012-04-01

    Since the nineteenth century the theory of conventional medicine has been developed in close alignment with the mechanistic paradigm of natural sciences. Only in the twentieth century occasional attempts were made to (re)introduce the 'subject' into medical theory, as by Thure von Uexküll (1908-2004) who elaborated the so-called biopsychosocial model of the human being, trying to understand the patient as a unit of organic, mental, and social dimensions of life. Although widely neglected by conventional medicine, it is one of the most coherent, significant, and up-to-date models of medicine at present. Being torn between strict adherence to Hahnemann's original conceptualization and alienation caused by contemporary scientific criticism, homeopathy today still lacks a generally accepted, consistent, and definitive theory which would explain in scientific terms its strength, peculiarity, and principles without relapsing into biomedical reductionism. The biopsychosocial model of the human being implies great potential for a new theory of homeopathy, as may be demonstrated with some typical examples.

  1. Maternal and pediatric health and disease: integrating biopsychosocial models and epigenetics.

    Science.gov (United States)

    Rubin, Lewis P

    2016-01-01

    The concepts of allostasis (stability through adaptation) and accumulated life stress (McEwen's allostatic load) aim to understand childhood and adult outcomes. Chronic malnutrition, changes in social condition, and adverse early-life experiences may program phenotypes and contribute to long-lasting disease risk. However, integration of life course approaches, social and economic contexts, and comparison among different biopsychosocial models has not generally been explored. This review critically examines the literature and evaluates recent insights into how environmental stress can alter lifelong hypothalamic-pituitary-adrenal axis and immune system responsiveness and induce metabolic and neurodevelopmental maladaptation. Models of biopsychosocial stress overlap but may consider different conditions. Concepts include allostasis, which incorporates hormonal responses to predictable environmental changes, and Geronimus's "weathering," which aims to explain how socially structured, repeated stress can accumulate and increase disease vulnerability. Weathering emphasizes roles of internalized/interpersonal racism in outcomes disparities. For Mexican immigrants and Mexican Americans, the "acculturation" framework has proven especially useful to explore disparities, including preterm birth and neuropsychiatric risks in childhood. Complexities of stress assessments and recent research into epigenetic mechanisms mediating effects of physical, nutritional, psychological, and social stress are reviewed.

  2. Comparison of biopsychosocial functioning of women of different nationalities in the perimenopausal period

    Directory of Open Access Journals (Sweden)

    Marta Makara-Studzińska

    2014-12-01

    Full Text Available Introduction : The perimenopausal age is a time of many changes in women’s health. Changes in women’s health affect all spheres of life, because health is not merely the absence of disease or infirmity but full psychological, physical and social well-being. Presentation and comparison of the biopsychosocial functioning of women of different races and nationalities in perimenopause, identification of the most common menopause symptoms occurring among women and their needs. Material and methods : Work supported with research examples. Using the PubMed database, the medical literature was searched for works that contain the key words menopause and race or ethnicity published between 1996 and 2013 and available in English. Literature in Polish is a supplementary issue. Results : Various demographic processes taking place in the countries of Africa, North and South America, Asia and Europe are the basis for observing the situation in perimenopausal women in these countries. Caucasian women living in North America and Europe most often experience the negative symptoms of menopause, hindering daily functioning, and women living in urbanized countries in Asia best assess their health condition, both psychosocial and physical. Conclusions : Biopsychosocial functioning of women varies among countries. Developing countries should be given the necessary support and financial information to ensure the health and quality of life in perimenopausal women. In most countries of the world there has been observed the need to promote women’s health, particularly research aimed at prevention, increasing physical activity and attention to nutrition.

  3. Association between waking-state oral parafunctional behaviors and bio-psychosocial characteristics

    Science.gov (United States)

    Khawaja, Shehryar N.; Nickel, Jeffrey C.; Iwasaki, Laura R.; Crow, Heidi C.; Gonzalez, Yoly

    2015-01-01

    Background The term “oral parafunctional behaviors” encompasses behaviors that are different from those required for, or associated with, physiological functional needs such as mastication, communication, swallowing, or breathing. Previous reports have associated waking-state oral parafunctional behaviors with biopsychosocial characteristics, such as, female gender, presence of psychological symptoms, intensity of pain, and pain-related Temporomandibular Disorders (TMD) diagnosis. However, the findings have been inconsistent, possibly due to methodological limitations and differences. Objectives In the present investigation, we aim to determine if any association is present between waking-state oral parafunctional behaviors and biopsychosocial characteristics. Methods All participants were investigated using a set of standardized and validated self-reporting questionnaires and diagnostic criteria for temporomandibular disorders (DC/TMD) examination protocol for clinical characterization. Results and Conclusion Univariate analysis found that self-reported waking-state oral parafunctional behaviors were statistically significantly associated with presence of anxiety, depression, and physical symptoms, pain intensity, and TMD diagnosis. However, forward model multiple linear regression analysis indicated that only self-reported presence of physical and depression symptoms could explain statistically significant portions of the variance in self-reported waking-state oral parafunctional behaviors. PMID:25891146

  4. Objective Assessment of Physical Activity during Physical Exercise Sessions in a Multidisciplinary Intervention for the Treatment of Childhood Obesity/Valoració objectiva de l'activitat física en sessions d'exercici físic d'un programa multidisciplinari per al tractament de l'obesitat infantil

    National Research Council Canada - National Science Library

    Assumpta Ensenyat; Ignasi Palacios; Noemi Serra-Paya; Ivan Castro-Viñuales

    2016-01-01

    .... The aim of this study was to analyse the level of movement and estimate energy expenditure during the supervised physical exercise sessions of an intervention for the treatment of childhood obesity. Method...

  5. 护士主导全科团队服务对高龄独居老人心理干预的效果评价%Effects of a nurse-led multidisciplinary team intervention program for elderly aged over 80 and Hying alone at home

    Institute of Scientific and Technical Information of China (English)

    荀雪琴; 易景娜; 刘清; 曹缨; 汪友斌; 乐嘉宜

    2011-01-01

    目的 评价以社区护士为主导的全科团队服务对社区高龄独居老人抑郁、孤独等心理状况的影响.方法 将81例80岁以上的高龄独居老人随机分为干预组41例和对照组40例,干预组接受为期3个月、每月3次、每次30min,由社区护士为主导的高龄独居老人全科团队家访服务.对照组实施常规的社区卫生服务.两组在干预前后分别进行抑郁、孤独等观察指标评价.结果 干预前两组高龄老人抑郁、孤独显著低于我国常模水平(p<0.05),两组间差异无统计学意义.干预后干预组抑郁、孤独得分均低于干预前水平和对照组同期水平(P<0.01),对照组前后变化不明显(P=0.858和0.785).结论 以社区护士为主导的全科团队家访服务可明显改善高龄独居老人的抑郁、孤独等不良心理状况.%Objective To evaluate the effect of a nurse-led multidisciplinary team intervention program on the psychological state such as depression and loneliness in community-dwelling elderly aged over 80 who lived alone. Methods Eighty-one elderly people aged over 80 who lived alone were randomly divided into two groups. The 41 elderly in the intervention group received a nurse-led multidisciplinary team home visit program, for three months and were visited three times a month. The 40 elderly in the control group received usual community health care. All the elderly were investigated with Geriatric Depression Scale(GDS) and UCLA Loneliness Scale before and after the intervention. Results Before the intervention,the scores of depression and loneliness were both higher than the norms (P0.05). After the intervention,the scores of depression and loneliness were significantly decreased in the intervention group, and were significanlty lower than the control group (P0.05). Conclusion The nurse-led multidisciplinary team intervention program can relieve the depression and loneliness of elderly aged over 80 who lived alone in community.

  6. Significance and Costs of Complex Biopsychosocial Health Care Needs in Elderly People : Results of a Population-Based Study

    NARCIS (Netherlands)

    Wild, Beate; Heider, Dirk; Maatouk, Imad; Slaets, Joris; Koenig, Hans-Helmut; Niehoff, Dorothea; Saum, Kai-Uwe; Brenner, Hermann; Soellner, Wolfgang; Herzog, Wolfgang

    2014-01-01

    Objective: To improve health care for the elderly, a consideration of biopsychosocial health care needs may be of particular importance-especially because of the prevalence of multiple conditions, mental disorders, and social challenges facing elderly people. The aim of the study was to investigate

  7. After the Biomedical Technology Revolution: Where to Now for a Bio-Psycho-Social Approach to Social Work?

    Science.gov (United States)

    Healy, Karen

    2016-07-01

    In the late twentieth century, the bio-psycho-social framework emerged as a powerful influence on the conceptualisation and delivery of health and rehabilitation services including social work services in these fields. The bio-psycho-social framework is built on a systems view of health and well-being ( Garland and Howard, 2009). The systems perspective encourages medical and allied health professions, including social work, to recognise and to respond to the multiple systems impacting on individual health and well-being ( Engel, 2003). This paper analyses how advances in biomedical technology, particularly in the fields of neuroscience and human genomics, are challenging the bio-psycho-social approach to practice. The paper examines the pressures on the social work profession to embrace biomedical science and points to the problems in doing so. The conclusion points to some tentative ways forward for social workers to engage critically with biomedical advances and to strengthen the bio-psycho-social framework in the interests of holistic and ethical approaches to social work practice.

  8. Toward a Unified Theory of Depression among Urban African American Youth: Integrating Socioecologic, Cognitive, Family Stress, and Biopsychosocial Perspectives.

    Science.gov (United States)

    Hammack, Phillip L.

    2003-01-01

    Reviews theories of depression relevant to research on African American adolescents (socioecologic, cognitive, family stress, and biopsychosocial), asserting that all four emphasize the role of oppression in urban black youth's development and that an integrated theory would assume this underlying construct as its core focus. Presents a…

  9. Multidisciplinary care in pediatric oncology

    Directory of Open Access Journals (Sweden)

    Cantrell MA

    2011-05-01

    Full Text Available Mary Ann Cantrell1, Kathy Ruble21College of Nursing, Villanova University, Villanova, PA, USA; 2Department of Pediatric Oncology, Johns Hopkins University, School of Medicine, Baltimore, MD, USAAbstract: This paper describes the significant advances in the treatment of childhood cancer and supportive care that have occurred over the last several decades and details how these advances have led to improved survival and quality of life (QOL for children with cancer through a multidisciplinary approach to care. Advances in the basic sciences, general medicine, cooperative research protocols, and policy guidelines have influenced and guided the multidisciplinary approach in pediatric oncology care across the spectrum from diagnosis through long-term survival. Two case studies are provided to highlight the nature and scope of multidisciplinary care in pediatric oncology care.Keywords: childhood cancer, chemotherapy, leukemia

  10. Effect of team intervention model of multidisciplinary cooperation on postoperative self - care ability of patients with laryngeal cancer%多学科合作团队干预模式对喉癌患者术后自我护理能力的影响

    Institute of Scientific and Technical Information of China (English)

    高莲英; 李娜

    2015-01-01

    目的:探讨多学科合作团队干预模式对喉癌患者术后自我护理能力的影响。方法:将84例喉癌喉部分切除术患者随机分为观察组和对照组各42例,两组患者住院期间均给予呼吸内科常规护理,对照组出院后定期进行门诊随访,随访过程中对患者进行健康宣教;观察组在对照组基础上应用多学科合作团队干预模式实施干预。干预前后应用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、自我护理能力测定量表(ESCA)、WHO 生存质量测定量表(WHO QOL - BREF)对两组患者负性情绪、自我护理能力及生存质量进行评价。结果:观察组干预后 HAMA、HAMD 评分显著高于对照组(P <0.05),观察组干预后健康知识水平、自护责任感、自我护理技能、自我概念评分均显著高于对照组(P <0.05),观察组出院时生理、心理、社会、环境维度评分均显著高于对照组(P <0.05)。结论:多学科合作团队干预模式能有效提高喉癌患者自我护理能力,改善患者负性情绪及生存质量。%Objective:To explore the effect of team intervention model of multidisciplinary cooperation on postoperative self - care ability of patients with laryngeal cancer. Methods:84 laryngeal cancer patients who underwent partial resection were randomly divided into the ob-servation group and the control group(42 cases in each group). The patients in both groups were given routine nursing care of respiratory department of internal medicine during hospitalization. The patients in the control group were given regular outpatient follow - up after dis-charge;the team intervention model of multidisciplinary cooperation was implemented in the observation group. HAMA,HAMD,ESCA and WHO QOL - BREF were used to evaluate the negative emotion,self - care ability and quality of life of the patients in the two groups before and after the intervention. Results

  11. Palliative medicine update: a multidisciplinary approach.

    Science.gov (United States)

    Vissers, Kris C P; van den Brand, Maria W M; Jacobs, Jose; Groot, Marieke; Veldhoven, Carel; Verhagen, Constans; Hasselaar, Jeroen; Engels, Yvonne

    2013-09-01

    Palliative medicine is a young specialty that is officially recognized in relatively few countries. The World Health Organization published an adapted definition in 2002, describing palliative care as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. When the accent is shifting from curative to palliative, the goal of management is the maintenance or improvement of the patient's quality of life. The different dimensions of palliative care and the multitude of types of care to be provided require a multidisciplinary, well-functioning team, effective communication and a clear task division between primary and hospital care. Considering the complexity of care for incurable patients, a multidisciplinary approach is a prerequisite to balance curative and palliative intervention options. Optimal functioning of a team requires excellent training, communication and a description of the tasks and responsibilities of each team member. More and more advanced care planning is introduced in palliative care, focusing on an early identification of patients in a palliative trajectory and on the prevention of annoying symptoms, hoping that this approach results in an improved quality of life for the individual patient, less useless technical investigations and a better end-of-life care on the place the patient and his family desires.

  12. The Role of Traditional Chinese Medicine in the Management of Chronic Pain: A Biopsychosocial Approach

    Directory of Open Access Journals (Sweden)

    John Burns

    2015-11-01

    Full Text Available The National Institute of Medicine revealed that chronic pain affects more than 100 million adults in the United States, citing chronic pain as the leading reason patients seek medical care. Pain is also an extremely costly problem, with $635 billion per year spent nationally, more than cancer, heart disease and diabetes combined. The biomedical model of chronic pain management has largely revolved around the use of narcotic analgesics for pain control. Unfortunately, this corresponds to a growth in the rate of abuse, misuse and overdose of these drugs. Additionally, there is an inherent failure rate to the myriad procedures used to control pain, such as spinal epidural injections and insertion of indwelling narcotic delivery systems, largely because these procedures fail to comprehensively address the multiple facets of pain generation. With its roots in the biopsychosocial model of pain management, traditional Chinese medicine may be a useful systematic or adjunct approach in the management of chronic pain.

  13. Quantifying biopsychosocial aspects in everyday contexts: an integrative methodological approach from the behavioral sciences

    Directory of Open Access Journals (Sweden)

    Portell M

    2015-06-01

    Full Text Available Mariona Portell,1 M Teresa Anguera,2 Antonio Hernández-Mendo,3 Gudberg K Jonsson4 1Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; 2Department of Methodology of Behavioral Sciences, University of Barcelona, Barcelona, Spain; 3Department Social Psychology, Social Anthropology, Social Work and Social Services, University of Málaga, Málaga, Spain; 4Human Behavior Laboratory, University of Iceland, Reykjavík, Iceland Abstract: Contextual factors are crucial for evaluative research in psychology, as they provide insights into what works, for whom, in what circumstances, in what respects, and why. Studying behavior in context, however, poses numerous methodological challenges. Although a comprehensive framework for classifying methods seeking to quantify biopsychosocial aspects in everyday contexts was recently proposed, this framework does not contemplate contributions from observational methodology. The aim of this paper is to justify and propose a more general framework that includes observational methodology approaches. Our analysis is rooted in two general concepts: ecological validity and methodological complementarity. We performed a narrative review of the literature on research methods and techniques for studying daily life and describe their shared properties and requirements (collection of data in real time, on repeated occasions, and in natural settings and classification criteria (eg, variables of interest and level of participant involvement in the data collection process. We provide several examples that illustrate why, despite their higher costs, studies of behavior and experience in everyday contexts offer insights that complement findings provided by other methodological approaches. We urge that observational methodology be included in classifications of research methods and techniques for studying everyday behavior and advocate a renewed

  14. Children and youth's biopsychosocial wellbeing in the context of energy resource activities.

    Science.gov (United States)

    Cox, Robin S; Irwin, Pamela; Scannell, Leila; Ungar, Michael; Bennett, Trevor Dixon

    2017-10-01

    Children and youth emerge as key populations that are impacted by energy resource activities, in part because of their developmental vulnerabilities, as well as the compounding effects of energy systems on their families, communities, and physical environments. While there is a larger literature focused on fossil fuel emissions and children, the impacts of many aspects of energy systems on children and youth remain under examined and scattered throughout the health, social science, and environmental science literatures. This systematic interdisciplinary review examines the biological, psychosocial, and economic impacts of energy systems identified through social science research - specifically focused on household and industrial extraction and emissions - on children and youth functioning. A critical interpretive search of interdisciplinary and international social sciences literature was conducted using an adaptive protocol focusing on the biopsychosocial and economic impacts of energy systems on children and youth. The initial results were complemented with a purposeful search to extend the breadth and depth of the final collection of articles. Although relatively few studies have specifically focused on children and youth in this context, the majority of this research uncovers a range of negative health impacts that are directly and indirectly related to the development and ongoing operations of natural resource production, particularly oil and gas, coal, and nuclear energy. Psychosocial and cultural effects, however, remain largely unexamined and provide a rich avenue for further research. This synthesis identifies an array of adverse biopsychosocial health outcomes on children and youth of energy resource extraction and emissions, and identifies gaps that will drive future research in this area. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Multidisciplinary management of chronic heart failure: principles and future trends.

    Science.gov (United States)

    Davidson, Patricia M; Newton, Phillip J; Tankumpuan, Thitipong; Paull, G; Dennison-Himmelfarb, Cheryl

    2015-10-01

    Globally, the management of chronic heart failure (CHF) challenges health systems. The high burden of disease and the costs associated with hospitalization adversely affect individuals, families, and society. Improved quality, access, efficiency, and equity of CHF care can be achieved by using multidisciplinary care approaches if there is adherence and fidelity to the program's elements. The goal of this article was to summarize evidence and make recommendations for advancing practice, education, research, and policy in the multidisciplinary management of patients with CHF. Essential elements of multidisciplinary management of CHF were identified from meta-analyses and clinical practice guidelines. The study factors were discussed from the perspective of the health care system, providers, patients, and their caregivers. Identified gaps in evidence were used to identify areas for future focus in CHF multidisciplinary management. Although there is high-level evidence (including several meta-analyses) for the efficacy of management programs for CHF, less evidence exists to determine the benefit attributable to individual program components or to identify the specific content of effective components and the manner of their delivery. Health care system, provider, and patient factors influence health care models and the effective management of CHF and require focus and attention. Extrapolating trial findings to clinical practice settings is limited by the heterogeneity of study populations and the implementation of models of intervention beyond academic health centers, where practice environments differ considerably. Ensuring that individual programs are both developed and assessed that consider these factors is integral to ensuring adherence and fidelity with the core dimensions of disease management necessary to optimize patient and organizational outcomes. Recognizing the complexity of the multidisciplinary CHF interventions will be important in advancing the design

  16. Multidisciplinary development of Belerofont Observatory.

    Science.gov (United States)

    Babović, V.

    1997-08-01

    Belerofont Astronomical Observatory in Kragujevac, inaugurated on the occasion of the appearance of Halley's comet on February 26, 1986, develops astronomical activities among pupils, university youth and people interested in cosmic phenomena. In preparing a course of astronomy and astrophysics in the physics study curriculum, the society tends toward a multidisciplinary way of work.

  17. Anorectal malformations : A multidisciplinary approach

    NARCIS (Netherlands)

    D. van den Hondel (Desiree)

    2015-01-01

    markdownabstractAbstract The research described in this thesis was performed with the aim to evaluate and improve multidisciplinary treatment of anorectal malformation patients. An overview of current literature on treatment of anorectal malformations is given in the Preface section, which also inc

  18. Goal-Directed Resilience in Training (GRIT: A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia in Evocative Contexts of PTSD, Obesity, and Chronic Pain

    Directory of Open Access Journals (Sweden)

    Martha Kent

    2015-06-01

    Full Text Available This paper presents a biopsychosocial model of self-regulation, executive functions, and personal growth that we have applied to Goal-Directed Resilience in Training (GRIT interventions for posttraumatic stress disorder (PTSD, obesity, and chronic pain. Implications of the training for the prevention of maladaptation, including psychological distress and health declines, and for promoting healthy development are addressed. Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention. We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual’s values and common humanity with others created a context-independent domain that could compensate for the effects of adversity. The efficacy of the resilience skills intervention for promoting positive emotion, enhancing neurocognitive capacities, and reducing symptoms was investigated in a randomized controlled trial with a veteran population diagnosed with PTSD. The intervention had low attrition (8% and demonstrated improvement on symptom and wellbeing outcomes, indicating that the intervention may be efficacious for PTSD and that it taps into those mechanisms which the intervention was designed to address. Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.

  19. Goal-Directed Resilience in Training (GRIT): A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia) in Evocative Contexts of PTSD, Obesity, and Chronic Pain

    Science.gov (United States)

    Kent, Martha; Rivers, Crystal T.; Wrenn, Glenda

    2015-01-01

    This paper presents a biopsychosocial model of self-regulation, executive functions, and personal growth that we have applied to Goal-Directed Resilience in Training (GRIT) interventions for posttraumatic stress disorder (PTSD), obesity, and chronic pain. Implications of the training for the prevention of maladaptation, including psychological distress and health declines, and for promoting healthy development are addressed. Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention. We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual’s values and common humanity with others created a context-independent domain that could compensate for the effects of adversity. The efficacy of the resilience skills intervention for promoting positive emotion, enhancing neurocognitive capacities, and reducing symptoms was investigated in a randomized controlled trial with a veteran population diagnosed with PTSD. The intervention had low attrition (8%) and demonstrated improvement on symptom and wellbeing outcomes, indicating that the intervention may be efficacious for PTSD and that it taps into those mechanisms which the intervention was designed to address. Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain. PMID:26039013

  20. Mathematical modeling with multidisciplinary applications

    CERN Document Server

    Yang, Xin-She

    2013-01-01

    Features mathematical modeling techniques and real-world processes with applications in diverse fields Mathematical Modeling with Multidisciplinary Applications details the interdisciplinary nature of mathematical modeling and numerical algorithms. The book combines a variety of applications from diverse fields to illustrate how the methods can be used to model physical processes, design new products, find solutions to challenging problems, and increase competitiveness in international markets. Written by leading scholars and international experts in the field, the

  1. BIOPSYCHOSOCIAL CHARACTERISTICS OF ADOLESCENT MOTHERS ASSISTED AT A SCHOOL HOSPITAL IN A CITY OF MINAS GERAIS, BRAZIL

    Directory of Open Access Journals (Sweden)

    Daniela Tavares Gontijo

    2010-10-01

    Full Text Available The adolescence is a human development time characterized by biopsychosocial changes, influenced by personal life experiences. In this context pregnancy along adolescence has been regarded as a relevant social issue due to the high prevalence in this age group. This study aims to describe biopsychosocial characteristics of adolescent mothers in a school hospital (SH of a public university in Minas Gerais, Brazil. This is a cross-sectional descriptive study with 40 adolescent mothers in this hospital. Data were collected through a form and analyzed using descriptive statistics. The data in this study were similar to findings in studies conducted in other urban centers especially as regards the participants’ average age and the precarious economic condition of their families and school performance. The data analysis has highlighted the need to Características de mães adolescentes understand teenage pregnancy as an experience with different factors as biological, psychological, economic and social development. teenage pregnancy, adolescent, reproduction

  2. Biopsychosocial characteristics of adolescent mothers assisted at a school hospital in a City of Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Daniela Tavares Gontijo

    2010-01-01

    Full Text Available The adolescence is a human development time characterized by biopsychosocial changes, influenced by personal life experiences. In this context pregnancy along adolescence has been regarded as a relevant social issue due to the high prevalence in this age group. This study aims to describe biopsychosocial characteristics of adolescent mothers in a school hospital (SH of a public university in Minas Gerais, Brazil. This is a cross-sectional descriptive study with 40 adolescent mothers in this hospital. Data were collected through a form and analyzed using descriptive statistics. The data in this study were similar to findings in studies conducted in other urban centers especially as regards the participants’ average age and the precarious economic condition of their families and school performance. The data analysis has highlighted the need to understand teenage pregnancy as an experience with different factors as biological, psychological, economic and social development.

  3. [The bio-psycho-social tridimensional constructivism of Socolas' School in the perspective of contemporary psychiatry (author's transl)].

    Science.gov (United States)

    Branzei, P P; Nathanson, I N

    1981-01-01

    The authors present the characteristics of the bio-psycho-social concept, developed by the School of Iasi, with pertinence and consequence on and after 1960. This one affirms its originality through its constructivistic psychiatric theory based on the tridimensional concept. The authors review several concepts of "constructivism" and analyze its implications in psychology, psychoanalysis, sociology, ethnology etc. This critical review shows once more the originality and specificity of the approach of the School of Socola. The bio-psycho-social concept is conceived as a dynamic and unitary concept and is applyed through a close link between psychiatric services and society and through an intense interdisciplinary activity aimed at the knowledge of the whole man.

  4. [Bio-psycho-social history--is it still up to date in the time of media communication?].

    Science.gov (United States)

    Buddeberg, C

    2006-07-01

    Specialization in medicine changes the kind of communication between doctor and patient. The direct personal communication is quite often complemented by the indirect communication via interactive media. A clinical investigation still demands a broad bio-psycho-social anamnesis which should encompass the history of the illness, the patient, and his/her ailment. The bio-psycho-social anamnesis is subdivided into nine steps: Joining, "map", actual disease, former illnesses, family history, personal development, social anamnesis, overview of the functioning of the systems, finalization of the anamnesis. The different steps are explained, and adequate techniques of exploration are described. How to conduct a professional doctor-patient conversation and exploration can similarly be learnt as the techniques of a physical investigation. These communication skills should be continuously taught during the education of medical students as well as during the further training of physicians.

  5. A bio-psycho-social exercise program (RÜCKGEWINN for chronic low back pain in rehabilitation aftercare - Study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pfeifer Klaus

    2010-11-01

    Full Text Available Abstract Background There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours. Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent. Methods/Design This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN in comparison to the current usual aftercare (IRENA and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation. Discussion Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured

  6. Embarazo en la adolescencia: algunos factores biopsicosociales Pregnancy in adolescence: some biopsychosocial factors

    Directory of Open Access Journals (Sweden)

    Rosa María Alonso Uría

    2005-12-01

    Full Text Available Se realizó un estudio descriptivo, prospectivo, y con carácter comparativo entre 2 grupos poblacionales: grupo A, integrado por todas las madres adolescentes atendidas en el Hospital Docente Ginecoobstétrico de Guanabacoa en el período comprendido del 1ro. de enero al 31 de diciembre de 2001, y el grupo B representado por 506 madres (que es el doble de las madres adolescentes, con edad comprendida entre los 20 y los 35 años de edad, para identificar algunos factores biopsicosociales presentes en ambos grupos. Para la recolección de la información se aplicó una encuesta validada y preparada para el estudio, identificándose algunas variables biopsicosociales. Con la información obtenida, se realizó el procesamiento estadístico para variables cualitativas y cuantitativas. La incidencia de embarazo en la adolescencia fue de 13,2 %, predominó el embarazo en la adolescente tardía para un 52,9 %, el nivel de escolaridad fue bajo en el 86,2 %, y un 82,2 % eran de amas de casas. Es de destacar la importancia de la consulta de orientación a la embarazada adolescente para el correcto tratamiento de la gestación y de su descendencia, así como el papel de la educación sexual en la salud reproductiva.A descriptive prospective and comparative study was undertaken between 2 population groups to identify some biopsychosocial factors present in both groups: group A was composed of all the adolescent mothers that received attention at the Gynecoobstetric Teaching Hospital of Guanabacoa from January 1st to December 31st, 2001, and group B included 506 mothers aged 20-35 ( the double of the adolescent mothers. The information was collected by a survey validated and prepared for the study. Some biopsychosocial factors were identified. The statistical processing for qualitative and quantitative variables was carried out by using the information obtained. The incidence of pregnancy in adolescence was 13.2 %. It was observed a predominance of pregnancy

  7. Biopsychosocial approaches to a patient with vomiting of 10 years' duration – a case of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Kitamura Kana

    2009-01-01

    Full Text Available Abstract Background Vomiting is commonly encountered in clinical medicine. When organic gastrointestinal, metabolic, and brain diseases are ruled out, many cases are considered to be functional. We experienced an adult patient with epilepsy whose main symptom was vomiting. Biopsychosocial approaches were needed to control the symptoms. Case presentation A 26-year-old female with a 10-year history of persistent vomiting was found to have temporal lobe epilepsy (TLE. Throughout this time, during which the vomiting had become part of a vicious cycle, her epilepsy was poorly controlled by medication. Biopsychosocial approaches were employed successfully and the patient subsequently undertook training to become a home-helper, started a job, and was able to leave her parents' house and live independently. All of her symptoms resolved after she became self-sufficient. Discussion Vomiting without impaired consciousness is seldom considered to be a manifestation of epilepsy. Difficulty in recording an electroencephalogram (EEG because of the presence of persistent vomiting delayed the diagnosis. The improvement of symptoms was thought to have been due to the patient's emotional stabilization and physical improvement, which may have stabilized the limbic system. Conclusion When an illness persists for many years and conditioning and a vicious cycle occur secondarily, systematic biopsychosocial approaches are needed in addition to general treatment. Also, secondary symptoms make the diagnosis more difficult when efforts at treatment are ineffective.

  8. Effects of a multidisciplinary group rehabilitation programme on participation of the visually impaired elderly : a pilot study

    NARCIS (Netherlands)

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Post, Marcel W. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2012-01-01

    Purpose: To pilot test the newly developed multidisciplinary group rehabilitation programme Visually Impaired elderly Persons Participating (VIPP). Method: A single group pretest-posttest design pilot study included 29 visually impaired persons (>= 55 years). The intervention (20 weekly meetings) co

  9. The biopsychosocial model of stress in adolescence: self-awareness of performance versus stress reactivity.

    Science.gov (United States)

    Rith-Najarian, Leslie R; McLaughlin, Katie A; Sheridan, Margaret A; Nock, Matthew K

    2014-03-01

    Extensive research among adults supports the biopsychosocial (BPS) model of challenge and threat, which describes relationships among stress appraisals, physiological stress reactivity, and performance; however, no previous studies have examined these relationships in adolescents. Perceptions of stressors as well as physiological reactivity to stress increase during adolescence, highlighting the importance of understanding the relationships among stress appraisals, physiological reactivity, and performance during this developmental period. In this study, 79 adolescent participants reported on stress appraisals before and after a Trier Social Stress Test in which they performed a speech task. Physiological stress reactivity was defined by changes in cardiac output and total peripheral resistance from a baseline rest period to the speech task, and performance on the speech was coded using an objective rating system. We observed in adolescents only two relationships found in past adult research on the BPS model variables: (1) pre-task stress appraisal predicted post-task stress appraisal and (2) performance predicted post-task stress appraisal. Physiological reactivity during the speech was unrelated to pre- and post-task stress appraisals and to performance. We conclude that the lack of association between post-task stress appraisal and physiological stress reactivity suggests that adolescents might have low self-awareness of physiological emotional arousal. Our findings further suggest that adolescent stress appraisals are based largely on their performance during stressful situations. Developmental implications of this potential lack of awareness of one's physiological and emotional state during adolescence are discussed.

  10. Male coping with cancer-fertility issues: putting the 'social' into biopsychosocial approaches.

    Science.gov (United States)

    Crawshaw, Marilyn

    2013-09-01

    Biopsychosocial approaches in infertility and cancer services and research pay limited attention to 'social dimensions'. Additionally, existing cancer-related male infertility research is dominated by sperm banking studies even though fertility-related social concerns in the long term are reported to have an adverse effect on wellbeing. This paper considers whether social influences affected the fertility-related experiences of 28 men interviewed as part of a mixed-gender qualitative study of 'South Asian' and 'White' cancer survivors and their professional carers. Findings are reported under: managing stigma; sexuality and virility; ambiguity in fertile status; relationship to sperm; and meaning of fatherhood. Gender and other social influences were ambiguous, fluid and subtle--yet powerful. Combinations were neither standard nor static, indicating the dangers of practitioners stereotyping, and/or assuming homogeneity of, (in)fertile men and being unaware of their own socialized expectations. Social structures and attitudes towards valued male social roles as well as the men's psychological capacity and bodily state appear to affect experience. Men may more readily be engaged if practitioners proactively attend to the impact of social concerns, including employment and financial matters, on their perceived capacity to be fathers as a route into raising issues of sexuality and fertility.

  11. The nature of workplace bullying experienced by teachers and the biopsychosocial health effects

    Directory of Open Access Journals (Sweden)

    J. De Vos

    2015-08-01

    Full Text Available This article reports on the nature of workplace bullying experienced by teachers in South African schools and the bio-psychosocial health effects that may arise from such victimisation. Voluntary victimised teachers who wanted to share their experiences were sampled using a lifestyle magazine and online articles. Twenty-seven teachers participated in the study. Data was collected through telephonic semi-structured phenomenological interviews and personal documents. Interpretive Phenomenological Analysis (IPA was further used to analyse and interpret qualitative data. Findings indicated that bullying is mostly perpetrated by principals, who often use colleagues as accomplices, and that the bullying mostly tends to be psychological in nature. Participants reported experiencing various physical, psychological and social health problems after being victimised. It was further recognised that health problems do not occur in isolation, but if contextualised, may form part of a list of psychiatric conditions, such as depression, posttraumatic stress disorder, and in isolated cases, panic attacks. Victimised teachers' health may have a significant impact on the teaching-learning process, acting as a barrier to learning, which may consequently have a negative impact on the organisational culture and the South African emerging economy.

  12. Behaviour of some biopsychosocial factors in the elderly of 90 years old and more.

    Directory of Open Access Journals (Sweden)

    Damaris Rubido Gómez

    2011-09-01

    Full Text Available Aging is a universal process that seems to affect all human beings, which is understood as a succession of morphological, physiological and phychological modifications with an irreversible character. A descriptive investigation was done with the objective of identifying the behaviour of some biopsychosocial factors in elder people of 90 years old and more in the dispensaries 44,45,and 49 of the policlinic 2 “Arcelio Suérez Bernal from Jatibonico municipality from January 1st ,2007 to december 31 st ,2008.The sample was conformed by 23 long lived that fulfilled with the inclusion criteria. Different variables were used like:sex, age, autovalidism, food, toxic habits, assossiated deseases and principal plans and projects. Female sex prevailed (69,6%, the 90-94years old group, coffe as risk factor (56,5 %, hip break (39,1% and the autovalidism in the way (86,9%.It was found these elderly get old in a best way because they were physical and social active.

  13. Mind-body dualism and the biopsychosocial model of pain: what did Descartes really say?

    Science.gov (United States)

    Duncan, G

    2000-08-01

    In the last two decades there have been many critics of western biomedicine's poor integration of social and psychological factors in questions of human health. Such critiques frequently begin with a rejection of Descartes' mind-body dualism, viewing this as the decisive philosophical moment, radically separating the two realms in both theory and practice. It is argued here, however, that many such readings of Descartes have been selective and misleading. Contrary to the assumptions of many recent authors, Descartes' dualism does attempt to explain the union of psyche and soma - with more depth than is often appreciated. Pain plays a key role in Cartesian as well as contemporary thinking about the problem of dualism. Theories of the psychological origins of pain symptoms persisted throughout the history of modern medicine and were not necessarily discouraged by Cartesian mental philosophy. Moreover, the recently developed biopsychosocial model of pain may have more in common with Cartesian dualism than it purports to have. This article presents a rereading of Descartes' mental philosophy and his views on pain. The intention is not to defend his theories, but to re-evaluate them and to ask in what respect contemporary theories represent any significant advance in philosophical terms.

  14. Retrospective coping strategies during sexual identity formation and current biopsychosocial stress.

    Science.gov (United States)

    Juster, Robert-Paul; Ouellet, Émilie; Lefebvre-Louis, Jean-Philippe; Sindi, Shireen; Johnson, Philip Jai; Smith, Nathan Grant; Lupien, Sonia J

    2016-01-01

    Lesbian, gay men, and bisexual individuals (LGBs) often experience distress related to the recognition, self-acceptance, and disclosure of their sexual orientation. Retrospectively reported coping strategies enacted during sexual identity formation among LGBs were assessed in relation to current stress indices measured using environmental (frequency of perceived daily hassles), psychological (perceived distress), and biological (allostatic load [AL] levels representing physiological dysregulations) perspectives. Forty-six healthy LGBs between the ages of 18 and 45 (M = 23.91, SE = .80) participated. Questionnaires included the Ways of Coping Checklist adapted to disclosure milestones, Daily Hassles Inventory, and Perceived Stress Scale. AL was calculated using 21 biomarkers of neuroendocrine, immune, cardiovascular, and metabolic functioning. Avoidance coping during sexual identity formation was positively associated with frequency of daily hassles (β = .598, p < .001), perceived stress (β = .361, p = .015), and AL (β = .405, p = .006). By contrast, seeking social support was negatively associated with perceived stress (β = -.598, p = .048). Emotion-focused coping strategies during LGB sexual identity development are associated with current indices of biopsychosocial stress.

  15. The FBE development project: toward flexible electronic standards-based bio-psycho-social individual records.

    Science.gov (United States)

    Frattura, Lucilla; Simoncello, Andrea; Bassi, Giovanni; Soranzio, Andrea; Terreni, Stefano; Sbroiavacca, Fulvio

    2012-01-01

    Under the ARCHITRAVE programme aimed at redesigning the regional health and social information system, the alpha version of a new web application was developed using the International Classification of Functioning, Disability and Health (ICF) and other medical terminology systems as a basis for a flexible electronic standards-based bio-psycho-social record. The web application was developed in order to collect information according to a multiaxial assessment framework consistent with the model of functioning adopted by the ICF. The web application translates information collected in natural language into ICF and releases outputs at different stages of the assessment process useful in evaluating clinical and social outcomes, distinguishing between functioning and disability in the same functioning profile and planning reasonable adaptations to overcome disability. The alpha version works in Italian and was adapted to the Italian welfare system/services/policies, but an international version working in other languages/welfare systems can be designed. The first field trial is ongoing in the Friuli Venezia Giulia Region, implementing the regional Health and Social Action Plan 2010-2012.

  16. Biological psychological and social determinants of old age: Bio-psycho-social aspects of human aging

    Directory of Open Access Journals (Sweden)

    Małgorzata Dziechciaż

    2014-11-01

    Full Text Available Biological psychological and social determinants of old age: Bio-psycho-social aspects of human aging. The aging of humans is a physiological and dynamic process ongoing with time. In accordance with most gerontologists’ assertions it starts in the fourth decade of life and leads to death. The process of human aging is complex and individualized, occurs in the biological, psychological and social sphere. Biological aging is characterized by progressive age-changes in metabolism and physicochemical properties of cells, leading to impaired self-regulation, regeneration, and to structural changes and functional tissues and organs. It is a natural and irreversible process which can run as successful aging, typical or pathological. Biological changes that occur with age in the human body affect mood, attitude to the environment, physical condition and social activity, and designate the place of seniors in the family and society. Psychical ageing refers to human awareness and his adaptability to the ageing process. Among adaptation attitudes we can differentiate: constructive, dependence, hostile towards others and towards self attitudes. With progressed age, difficulties with adjustment to the new situation are increasing, adverse changes in the cognitive and intellectual sphere take place, perception process involutes, perceived sensations and information received is lowered, and thinking processes change. Social ageing is limited to the role of an old person is culturally conditioned and may change as customs change. Social ageing refers to how a human being perceives the ageing process and how society sees it.

  17. Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain.

    Science.gov (United States)

    Souza, Paula Patricia; Romão, Adriana Salata; Rosa-e-Silva, Julio Cesar; Reis, Francisco Candido dos; Nogueira, Antonio Alberto; Poli-Neto, Omero Benedicto

    2011-12-01

    Chronic pelvic pain (CPP) is a highly prevalent clinical condition and is recognized as a public health problem. Although the number of qualitative studies related to the topic is increasing, it is essential that this knowledge be presented in a synthesized manner, grounded in the context of the care provided to patients with CPP, in order to increase the clinical and research applicability of the findings. Little attention is given to CPP in undergraduate courses and in meetings for the continuing education of health professionals, the approach to CPP typically being based on the biomedical model. We believe that qualitative research can provide insights into CPP and form the basis for a biopsychosocial approach to the condition, which can in turn lead to better results, including resolution of the pain and greater patient/health professional satisfaction. Therefore, we conducted a metasynthesis of seven qualitative studies of CPP, the principal themes of which were as follows: (a) coping with CPP versus secondary gain; (b) the great importance of determining the cause of the pain; (c) expectations regarding the doctor-patient relationship; and (d) gender issues. We hope that the present study can aid in restoring the humanistic aspects of CPP treatment.

  18. How Multidisciplinary Are the Multidisciplinary Journals Science and Nature?

    Science.gov (United States)

    Solomon, Gregg E A; Carley, Stephen; Porter, Alan L

    2016-01-01

    Interest in cross-disciplinary research knowledge interchange runs high. Review processes at funding agencies, such as the U.S. National Science Foundation, consider plans to disseminate research across disciplinary bounds. Publication in the leading multidisciplinary journals, Nature and Science, may signify the epitome of successful interdisciplinary integration of research knowledge and cross-disciplinary dissemination of findings. But how interdisciplinary are they? The journals are multidisciplinary, but do the individual articles themselves draw upon multiple fields of knowledge and does their influence span disciplines? This research compares articles in three fields (Cell Biology, Physical Chemistry, and Cognitive Science) published in a leading disciplinary journal in each field to those published in Nature and Science. We find comparable degrees of interdisciplinary integration and only modest differences in cross-disciplinary diffusion. That said, though the rate of out-of-field diffusion might be comparable, the sheer reach of Nature and Science, indicated by their potent Journal Impact Factors, means that the diffusion of knowledge therein can far exceed that of leading disciplinary journals in some fields (such as Physical Chemistry and Cognitive Science in our samples).

  19. Measuring the impact of a burns school reintegration programme on the time taken to return to school: A multi-disciplinary team intervention for children returning to school after a significant burn injury.

    Science.gov (United States)

    Arshad, Sira N; Gaskell, Sarah L; Baker, Charlotte; Ellis, Nicola; Potts, Jennie; Coucill, Theresa; Ryan, Lynn; Smith, Jan; Nixon, Anna; Greaves, Kate; Monk, Rebecca; Shelmerdine, Teresa; Leach, Alison; Shah, Mamta

    2015-06-01

    Returning to school can be a major step for burn-injured children, their family, and staff and pupils at the receiving school. Previous literature has recognised the difficulties children may face after a significant injury and factors that may influence a successful reintegration. A regional paediatric burns service recognised that some patients were experiencing difficulties in returning to school. A baseline audit confirmed this and suggested factors that hindered or facilitated this process, initiating the development of a school reintegration programme (SRP). Since the programme's development in 2009, it has been audited annually. The aim of this paper was to evaluate the impact of the SRP by presenting data from the 2009 to 2011 audits. For the baseline audit, the burn care team gathered information from clinical records (age, gender, total body surface area burned (TBSA), skin grafting and length of stay) and telephone interviews with parents and teachers of the school returners. For the re-audits, the same information was gathered from clinical records and feedback questionnaires. Since its introduction, the mean length of time from discharge to return to school has dropped annually for those that opted into the programme, when compared to the baseline by 62.3% (53 days to 20 days). Thematic analysis highlights positive responses to the programme from all involved. Increased awareness and feeling supported were amongst the main themes to emerge. Returning to school after a significant burn injury can be challenging for all involved, but we hypothesise that outreach interventions in schools by burns services can have a positive impact on the time it takes children to successfully reintegrate. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  20. Late mental health changes in tortured refugees in multidisciplinary treatment

    DEFF Research Database (Denmark)

    Carlsson, Jessica Mariana; Olsen, Dorte Reff; Kastrup, Marianne

    2010-01-01

    The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted to the R......The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted....... Thus, no clinically significant improvement was observed, but there is a need for further studies, in particular randomized trials evaluating the efficacy of various health-related and social interventions among severely traumatized refugees....

  1. Managing the patient with osteogenesis imperfecta: a multidisciplinary approach

    Science.gov (United States)

    Marr, Caroline; Seasman, Alison; Bishop, Nick

    2017-01-01

    Osteogenesis imperfecta (OI) is a heterogeneous heritable connective tissue disorder characterized by low bone density. The type and severity of OI are variable. The primary manifestations are fractures, bone deformity, and bone pain, resulting in reduced mobility and function to complete everyday tasks. OI affects not only the physical but also the social and emotional well-being of children, young people, and their families. As such, medical, surgical, and allied health professionals’ assessments all play a role in the management of these children. The multidisciplinary approach to the treatment of children and young people living with OI seeks to provide well-coordinated, comprehensive assessments, and interventions that place the child and family at the very center of their care. The coordinated efforts of a multidisciplinary team can support children with OI to fulfill their potential, maximizing function, independence, and well-being. PMID:28435282

  2. A Multidisciplinary Research Agenda for Understanding Vaccine-Related Decisions

    Directory of Open Access Journals (Sweden)

    Nick Sevdalis

    2013-07-01

    Full Text Available There is increasingly broad global recognition of the need to better understand determinants of vaccine acceptance. Fifteen social science, communication, health, and medical professionals (the “Motors of Trust in Vaccination” (MOTIV think tank explored factors relating to vaccination decision-making as a step to building a multidisciplinary research agenda. One hundred and forty seven factors impacting decisions made by consumers, professionals, and policy makers on vaccine acceptance, delay, or refusal were identified and grouped into three major categories: cognition and decision-making; groups and social norms; and communication and engagement. These factors should help frame a multidisciplinary research agenda to build an evidence base on the determinants of vaccine acceptance to inform the development of interventions and vaccination policies.

  3. How Do You Learn Multidisciplinary Idea?

    OpenAIRE

    Shigehiro Hashimoto

    2015-01-01

    The way how to learn multidisciplinary ideas has been discussed. Biomedical engineering is exemplified for a multidisciplinary field. "Biomedical Engineering" makes a multidisciplinary research area, which includes biology, medicine, engineering and others. The cross-cultural student seminars on biomedical engineering have been exemplified as the case studies. In the group fieldwork, students were divided into small groups. Each group visited the university hospital to find research topics re...

  4. Oncoplastic multidisciplinary meetings: a necessity or luxury?

    Science.gov (United States)

    Rusby, Jennifer E; Gough, Jenny; Harris, Paul A; MacNeill, Fiona A

    2011-05-01

    Although there is scant evidence to support multidisciplinary meetings in any cancer specialty, they are now regarded as best practice. We believe the oncoplastic multidisciplinary meeting plays a similarly important role, consolidating oncoplastic multidisciplinary working and allowing transparent decision making, standardisation of care and recording of results. This may drive oncoplastic surgery to an evidence-based position from which oncoplastic excellence can be achieved.

  5. A Randomized Controlled Trial of a Multidisciplinary Telemedicine Intervention for Patients with Type-2 diabetes%糖尿病远程管理系统的应用及对代谢指标的改善作用

    Institute of Scientific and Technical Information of China (English)

    陶红; 李燕玲; 瞿彤; 李金平; 刘桂新; 吴尽; 刘素云; 尤文洁; 张爱琴; 程玉文; 林运; 吴燕焱; 佟秋红; 贺孟萍; 袁慧; 曾哲淳

    2011-01-01

    目的 探讨糖尿病远程网络管理对糖尿病患者代谢指标的改善作用.方法 将120例2型糖尿病患者随机分为网络管理组和常规门诊组,每组60例.两组均接受每周一次的糖尿病自我管理技能培训.网络管理组患者配备家用电脑,由疾病管理师通过Lifelink糖尿病远程管理系统进行糖尿病日常网络管理,制定个性化管理目标,实现家中检测数据的上传、各项检测实施的提醒、相关教育信息的转达以及实现与远程管理人员多功能互动.管理实施3个月后,比较管理前后糖、脂代谢等指标的变化.结果 两组年龄、糖尿病病程差异均无统计学意义,各项生化指标在基线时除尿酸外差异均无统计学意义.经过3个月的管理,网络管理组和常规门诊组的体重、腰围、体质指数(BMI)、尿酸及血脂成分(总胆固醇、三酰甘油、低密度脂蛋白胆固醇)均较基线时明显下降(P<0.05或P<0.01);两组间比较差异无统计学意义.两组糖化血红蛋白在3个月后亦均较基线时下降,并且网络组比常规组下降更为明显(P<0.05).两组的空腹血糖和尿白蛋白/尿肌酐均无明显变化.网络管理组低血糖事件(15.3%)较常规门诊组(31.0%)明显减少(P<0.05),并且网络管理组血糖变异系数低于常规门诊组(P<0.01).结论 短期远程网络管理模式较常规管理可显著改善2型糖尿病糖代谢指标.%Objective To investigate the effectiveness oi telemedicine intervention on metabolic iactors improvement in patients with diabetes. Methods 120 subjects with type-2 diabetes were enrolled in this 3-month study. They were randomly divided into the web-based group and usual care group, and all of them received diabetes self-management education once a week. For web -based patients, they uploaded home meter data and other pertinent data such as anti -hyperglcemic regimens, dietary diary, activity level, and medical history through

  6. Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

    Directory of Open Access Journals (Sweden)

    Şar V

    2017-05-01

    , DID may be seen as an exemplary disease model of the biopsychosocial paradigm in psychiatry. Keywords: dissociation, childhood trauma, neurobiology, family dysfunction, social factors, cultural factors, dissociative identity disorder

  7. Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

    Science.gov (United States)

    Şar, Vedat; Dorahy, Martin J; Krüger, Christa

    2017-01-01

    Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such, DID may be seen as an exemplary disease model of the biopsychosocial paradigm in psychiatry. PMID:28496375

  8. Aorta Balloon Occlusion in Trauma: Three Cases Demonstrating Multidisciplinary Approach Already on Patient’s Arrival to the Emergency Room

    Energy Technology Data Exchange (ETDEWEB)

    Hörer, Tal M., E-mail: tal.horer@orebroll.se [Örebro University, Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital (Sweden); Hebron, Dan [Hillel Yaffe Medical Center, Department of Radiology (Israel); Swaid, Forat [Bnai-Zion Medical Center, Department of General Surgery (Israel); Korin, Alexander [Hillel Yaffe Medical Center, Trauma Unit (Israel); Galili, Offer [Hillel Yaffe Medical Center, Department of Vascular Surgery (Israel); Alfici, Ricardo [Hillel Yaffe Medical Center, Surgical Division (Israel); Kessel, Boris [Hillel Yaffe Medical Center, Trauma Unit (Israel)

    2016-02-15

    PurposeTo describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care.MethodsWe briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management.ResultsThree severely injured multi-trauma patients were treated by ABO as a bridge to surgery and embolization. The procedures were performed by an interventional radiologist in the early stages of trauma management.ConclusionsThe interventional radiologist and the multidisciplinary team approach can be activated already on severe trauma patient arrival. ABO usage and other endovascular methods are becoming more widely spread, and can be used early in trauma management, without delay, thus justifying the early activation of this multidisciplinary approach.

  9. Recent advances in multidisciplinary management ofhepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Asmaa I Gomaa; Imam Waked

    2015-01-01

    The incidence of hepatocellular carcinoma (HCC)is increasing, and it is currently the second leadingcause of cancer-related death worldwide. Potentiallycurative treatment options for HCC include resection,transplantation, and percutaneous ablation, whereaspalliative treatments include trans-arterial chemoembolization(TACE), radioembolization, and systemictreatments. Due to the diversity of available treatmentoptions and patients' presentations, a multidisciplinary team should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved moleculartargeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC.

  10. Learning Multidisciplinary Collaboration with Games

    DEFF Research Database (Denmark)

    Henriksen, Thomas Duus

    2015-01-01

    This chapter describes the design of a game-based learning process for developing communication in public organisations. The game-design presented here emphasises those parts of public organisations that tend to employ multidisciplinary teams for solving wicked problems. As such teams employ...... members from different, professional backgrounds, the game Public Professional sought to develop new understandings among team members and across professions. The purpose of this game was to facilitate an understanding among team members and across professions, a game-based learning process named Public...... Professional was designed. Its purpose was to a) provide team members with a shared language for discussing work related problems in regard to communication. To facilitate an understanding on the collaboration across professions, and to provide a space for dialogue about professional cooperation, Public...

  11. [Multidisciplinary practice guideline 'Marfan syndrome'].

    Science.gov (United States)

    Hilhorst-Hofstee, Yvonne

    2013-01-01

    Marfan syndrome is a multi-system disorder of dominant inheritance in which the cardiovasculature, in particular the aorta, the eyes and the skeleton are affected. Diagnostic assessment and treatment of patients who are suspected of or have Marfan syndrome should preferably be done by multidisciplinary teams such as those found in specialised Marfan syndrome centres. The practice guideline is intended for all care givers involved with the recognition, diagnosis, consultations and the medicinal and surgical treatment of Marfan patients; it includes referral criteria and information on the referral process. A diagnosis of Marfan syndrome is based on international criteria in which aortic root dilatation and dissection, ectopia lentis, an affected first-degree family member and a pathogenic FBN1 mutation are the cardinal features. Alternative diagnoses are also included in the practice guideline. Recommendations are given for the monitoring and treatment of Marfan patients during pregnancy and delivery. Advice on lifestyle is mainly focussed on sports activities.

  12. [Multidisciplinary treatment of orofacial pain].

    Science.gov (United States)

    Geurts, J W; Haumann, J; van Kleef, M

    2016-11-01

    The diagnosis and treatment of orofacial pain can be complex. The differential diagnosis is very extensive. Therefore, multidisciplinary diagnosis and treatment are often indicated. The diagnosis of chronic pain also entails the investigation of psychological factors. This is because psychological problems can play a role in the chronification of pain, but they can also be a consequence of chronic pain. Patients with persistent orofacial complaints should be seen by a medical team consisting of an oral and maxillofacial surgeon, a neurologist, an anaesthesiologist/pain specialist, a dentist-gnathologist, an orofacial physical therapist, and a psychologist or psychiatrist specialising in orofacial pain. Treatment options should be discussed, taking into account literature concerning their effectiveness. The general conclusion is that much research remains to be done into the causes of, and treatments for, orofacial pain.

  13. Intragastric balloon and multidisciplinary team

    Directory of Open Access Journals (Sweden)

    R. A. Mazure

    Full Text Available Background: The intragastric balloon is widely used for weight reduction in obese patients, but results are variable. We describe our results enhancing the importance of a Multidisciplinary Team (MT taking part in the treatment. Methods: A retrospective review was done concerning a total of 119 balloons , placed in 116 patients, under endoscopic control and conscious sedation, from May 2001 until August 2006. 49 patients were prepared and recommended to be followed by a MT in a physical unit, at least every 15 days during 6 months. 67 were indicated and followed by other colleagues, without MT. Removal was performed 6 months later. Results: Concerning our 49 patients, mean age was 38, 1 years, 31 female and 18 males, with BMI ranged between 32 and 63, average of 42. The average decrease of weight excess was 31, 85% (-4, 45-80, 4%, and the BMI diminished 5,3 points (from 13,6 to gain of 0,9. The treatment failed in 34,6 % of our patients -including 4 patients lost of follow-up (8, 16%-, compared with 53, 8% of patients without structured MT for selection and follow-up. Physical exercise enhanced markedly the results with 45, 8% of excess of weight loss in women and 39, 7% in males, compared with 14, 6 and 15, 6% in patients who didn't follow the program. The weight loss was mostly fat mass, 89,9% in men and 75,6% in women.- The results maintenance was obtained in 40% of patients one year later. There were no major complications; one balloon had to be removed at 3 weeks because of intolerance, another at 5 months because of gastroesophageal reflux. Conclusions: BIB is an effective help to achieve a short term weight loss in obese patients; nevertheless, good and long lasting results will depend on the modification of life style obtained by a multidisciplinary approach.

  14. Sensitivity Analysis for Multidisciplinary Systems (SAMS)

    Science.gov (United States)

    2016-12-01

    AFRL-RQ-WP-TM-2017-0017 SENSITIVITY ANALYSIS FOR MULTIDISCIPLINARY SYSTEMS (SAMS) Richard D. Snyder Design & Analysis Branch Aerospace Vehicles...for public release. Distribution is unlimited. 1 AFRL-NASA Collaboration Provide economical, accurate sensitivities for multidisciplinary design and... Concept Refinement Technology Development System Development & Demonstration Production & Deployment Operation & Support • Knowledge is most limited

  15. How Do You Learn Multidisciplinary Idea?

    Directory of Open Access Journals (Sweden)

    Shigehiro Hashimoto

    2015-10-01

    Full Text Available The way how to learn multidisciplinary ideas has been discussed. Biomedical engineering is exemplified for a multidisciplinary field. "Biomedical Engineering" makes a multidisciplinary research area, which includes biology, medicine, engineering and others. The cross-cultural student seminars on biomedical engineering have been exemplified as the case studies. In the group fieldwork, students were divided into small groups. Each group visited the university hospital to find research topics related to biomedical engineering as the fieldwork by the cross cultural group. Students pointed out several topics related to the multidisciplinary field, which includes mechanics, informatics, and systemics. They have learned how to communicate with people, who has variety of cultural backgrounds. Through the training, students realized another way of thinking, which stands on another base of idea. The process is effective to master multidisciplinary ideas.

  16. Multidisciplinary research of geothermal modeling

    Science.gov (United States)

    -Ing. Ulvi Arslan, Univ., ., Dr. _., Prof.; Heiko Huber, Dipl.-Ing.

    2010-05-01

    KEYWORDS Geothermal sciences, geothermics, research, theory and application, numerical calculation, geothermal modeling, Technical University Darmstadt, Ministry of Economics and Technology (BMWi) INTRODUCTION In times of global warming renewable, green energies are getting more and more important. The development of application of geothermal energy as a part of renewable energies in Germany is a multidisciplinary process of fast growing research and improvements. Geothermal energy is the energy, which is stored below earth's surface. The word geothermal derives from the Greek words geo (earth) and thermos (heat), so geothermal is a synonym to earth heat. Geothermal energy is one of the auspicious renewable energies. In average the temperature increases 3°C every 100 m of depth, which is termed as geothermal gradient. Therefore 99 percent of our planet is hotter than 1.000°C, while 99 percent of that last percent is even hotter than 100°C. Already in a depth of about 1 kilometer temperatures of 35 - 40°C can be achieved. While other renewable energies arise less or more from the sun, geothermal energy sources its heat from the earth's interior, which is caused mostly by radioactive decay of persistent isotopes. This means a possibility of a base-loadable form of energy supply. Especially efficient is the use of deep geothermal energy of high-enthalpie reservoirs, which means a high energy potential in low depths. In Germany no high-enthalpie reservoirs are given. To use the given low-enthalpie potential and to generate geothermal power efficiently inventions and improvements need to be performed. An important part of geothermal progresses is performed by universities with multidisciplinary research of geothermal modeling. Especially in deep geothermal systems numerical calculations are essential for a correct dimensioning of the geothermal system. Therefore German universities and state aided organizations are developing numerical programs for a detailed use of

  17. The importance of a multidisciplinary approach to hepatocellular carcinoma

    Science.gov (United States)

    Siddique, Osama; Yoo, Eric R; Perumpail, Ryan B; Perumpail, Brandon J; Liu, Andy; Cholankeril, George; Ahmed, Aijaz

    2017-01-01

    Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners. In most cases, HCC is diagnosed by abdominal imaging studies, preferably with a triphasic computed tomography scan of the abdomen or magnetic resonance imaging of the abdomen. Histopathological diagnosis using a guided liver biopsy may be needed in noncirrhotic patients or when radiological diagnostic criteria are not fulfilled in the setting of cirrhosis. The Barcelona Clinic Liver Cancer staging system facilitates a standardized therapeutic strategy based on the tumor burden, extent of metastasis, severity of hepatic decompensation, comorbid medical illnesses, functional status of patient, HCC-related symptoms, and preference of the patient. Treatment options include curative surgery (hepatic resection and liver transplantation) and palliative measures (radiofrequency ablation, transarterial chemoembolization, and chemotherapy with sorafenib). The role of the multidisciplinary team is crucial in promptly reconfirming the diagnosis, staging the HCC, and formulating an individualized treatment plan. In potential liver transplant candidates, timely liver transplant evaluation and coordinating bridging/downsizing treatment modalities, such as radiofrequency ablation and transarterial chemoembolization, can be time-consuming. In summary, a multidisciplinary team approach provides a timely, individualized treatment plan, which can vary from curative surgery in patients with early-stage HCC to palliative

  18. Classifying Patients with Chronic Pelvic Pain into Levels of Biopsychosocial Dysfunction Using Latent Class Modeling of Patient Reported Outcome Measures

    Directory of Open Access Journals (Sweden)

    Bradford W. Fenton

    2015-01-01

    Full Text Available Chronic pelvic pain affects multiple aspects of a patient’s physical, social, and emotional functioning. Latent class analysis (LCA of Patient Reported Outcome Measures Information System (PROMIS domains has the potential to improve clinical insight into these patients’ pain. Based on the 11 PROMIS domains applied to n=613 patients referred for evaluation in a chronic pelvic pain specialty center, exploratory factor analysis (EFA was used to identify unidimensional superdomains. Latent profile analysis (LPA was performed to identify the number of homogeneous classes present and to further define the pain classification system. The EFA combined the 11 PROMIS domains into four unidimensional superdomains of biopsychosocial dysfunction: Pain, Negative Affect, Fatigue, and Social Function. Based on multiple fit criteria, a latent class model revealed four distinct classes of CPP: No dysfunction (3.2%; Low Dysfunction (17.8%; Moderate Dysfunction (53.2%; and High Dysfunction (25.8%. This study is the first description of a novel approach to the complex disease process such as chronic pelvic pain and was validated by demographic, medical, and psychosocial variables. In addition to an essentially normal class, three classes of increasing biopsychosocial dysfunction were identified. The LCA approach has the potential for application to other complex multifactorial disease processes.

  19. Interventions for Necrotizing Pancreatitis Summary of a Multidisciplinary Consensus Conference

    NARCIS (Netherlands)

    Freeman, Martin L.; Werner, Jens; van Santvoort, Hjalmar C.; Baron, Todd H.; Besselink, Marc G.; Windsor, John A.; Horvath, Karen D.; vanSonnenberg, Eric; Bollen, Thomas L.; Vege, Santhi Swaroop

    2012-01-01

    Pancreatic and peripancreatic necrosis may result in significant morbidity and mortality in patients with acute pancreatitis. Many recommendations have been made for management of necrotizing pancreatitis, but no published guidelines have incorporated the many recent developments in minimally invasi

  20. EMSO: European multidisciplinary seafloor observatory

    Energy Technology Data Exchange (ETDEWEB)

    Favali, Paolo [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Via di Vigna Murata 605, 00143 Roma (Italy); Universita degli Studi di Roma ' La Sapienza' , P.le Aldo Moro 5, 00185 Roma (Italy)], E-mail: emsopp@ingv.it; Beranzoli, Laura [Istituto Nazionale di Geofisica e Vulcanologia (INGV), Via di Vigna Murata 605, 00143 Roma (Italy)

    2009-04-11

    EMSO has been identified by the ESFRI Report 2006 as one of the Research Infrastructures that European members and associated states are asked to develop in the next decades. It will be based on a European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the aim of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes, providing long time series data for the different phenomenon scales which constitute the new frontier for study of Earth interior, deep-sea biology and chemistry, and ocean processes. The development of an underwater network is based on past EU projects and is supported by several EU initiatives, such as the on-going ESONET-NoE, aimed at strengthening the ocean observatories' scientific and technological community. The EMSO development relies on the synergy between the scientific community and industry to improve European competitiveness with respect to countries such as USA, Canada and Japan. Within the FP7 Programme launched in 2006, a call for Preparatory Phase (PP) was issued in order to support the foundation of the legal and organisational entity in charge of building up and managing the infrastructure, and coordinating the financial effort among the countries. The EMSO-PP project, coordinated by the Italian INGV with participation by 11 institutions from as many European countries, started in April 2008 and will last four years.

  1. Submarine Landslides: A Multidisciplinary Crossroad

    Science.gov (United States)

    Moscardelli, L. G.

    2014-12-01

    The study of submarine landslides has advanced considerably in the last decade. A multitude of geoscience disciplines, including marine, petroleum and planetary geology, as well as geohazard assessments, are concerned with the study of these units. Oftentimes, researchers working in these fields disseminate their findings within their own communities and a multidisciplinary approach seems to lack. This presentation showcases several case studies in which a broader approach has increased our understanding of submarine landslides in a variety of geologic settings. Three-dimensional seismic data from several continental margins (Trinidad, Brazil, Morocco, Canada, GOM), as well as data from outcrop localities are shown to explore geomorphological complexities associated with submarine landslides. Discussion associated with the characterization and classification of submarine landslides is also part of this work. Topics that will be cover include: 1) how data from conventional oil and gas exploration activities can be used to increase our understanding of the dynamic behavior of submarine landslides, 2) analogies between terrestrial submarine landslides and potential Martian counterparts, 3) impact of submarine landslides in margin construction, as well as their economic significance and 4) the importance of quantifying the morphology of submarine landslides in a systematic fashion.

  2. Necrotizing pancreatitis: a review of multidisciplinary management.

    Science.gov (United States)

    Sabo, Anthony; Goussous, Naeem; Sardana, Neeraj; Patel, Shirali; Cunningham, Steven C

    2015-03-20

    The objective of this review is to summarize the current state of the art of the management of necrotizing pancreatitis, and to clarify some confusing points regarding the terminology and diagnosis of necrotizing pancreatitis, as these points are essential for management decisions and communication between providers and within the literature. Acute pancreatitis varies widely in its clinical presentation. Despite the publication of the Atlanta guidelines, misuse of pancreatitis terminology continues in the literature and in clinical practice, especially regarding the local complications associated with severe acute pancreatitis. Necrotizing pancreatitis is a manifestation of severe acute pancreatitis associated with significant morbidity and mortality. Diagnosis is aided by pancreas-protocol computed tomography or magnetic resonance imaging, ideally 72 h after onset of symptoms to achieve the most accurate characterization of pancreatic necrosis. The extent of necrosis correlates well with the incidence of infected necrosis, organ failure, need for debridement, and morbidity and mortality. Having established the diagnosis of pancreatic necrosis, goals of appropriately aggressive resuscitation should be established and adhered to in a multidisciplinary approach, ideally at a high-volume pancreatic center. The role of antibiotics is determined by the presence of infected necrosis. Early enteral feeds improve outcomes compared with parenteral nutrition. Pancreatic necrosis is associated with a multitude of complications which can lead to long-term morbidity or mortality. Interventional therapy should be guided by available resources and the principle of a minimally invasive approach. When open debridement is necessary, it should be delayed at least 3-6 weeks to allow demarcation of necrotic from viable tissue.

  3. An architecture for integration of multidisciplinary models

    DEFF Research Database (Denmark)

    Belete, Getachew F.; Voinov, Alexey; Holst, Niels

    2014-01-01

    , Enterprise Application Integration, and Integration Design Patterns. We developed an architecture of a multidisciplinary model integration framework that brings these three aspects of integration together. Service-oriented-based platform independent architecture that enables to establish loosely coupled...

  4. Moebius sequence -a multidisciplinary clinical approach

    DEFF Research Database (Denmark)

    Pedersen, Line Kjeldgaard; Maimburg, Rikke Damkjær; Hertz, Jens Michael

    2017-01-01

    ) and vascular events in utero are reported. The purpose of present study was through a multidisciplinary clinical approach to examine children diagnosed with Moebius-like symptoms. Ten children underwent odontological, ophthalmological, obstetric, paediatric, orthopaedic, genetic, radiological...

  5. Establishing a framework for building multidisciplinary programs

    Directory of Open Access Journals (Sweden)

    Meguid C

    2015-12-01

    Full Text Available Cheryl Meguid,1 Carrie E Ryan,2 Barish H Edil,1 Richard D Schulick,1 Csaba Gajdos,1 Megan Boniface,1 Tracey E Schefter,3 W Thomas Purcell,4 Martin McCarter1 1Department of Surgery, Division of GI, Tumor, and Endocrine Surgery, Section of Surgical Oncology, University of Colorado Hospital, Aurora, CO, 2Morsani College of Medicine, University of South Florida, Tampa, FL, 3Department of Radiation Oncology, University of Colorado Denver, Denver, CO, 4Department of Medicine, Division of Medical Oncology, University of Colorado Hospital, Aurora, CO, USA Abstract: While most providers support the concept of a multidisciplinary approach to patient care, challenges exist to the implementation of successful multidisciplinary clinical programs. As patients become more knowledgeable about their disease through research on the Internet, they seek hospital programs that offer multidisciplinary care. At the University of Colorado Hospital, we utilize a formal multidisciplinary approach across a variety of clinical settings, which has been beneficial to patients, providers, and the hospital. We present a reproducible framework to be used as a guide to develop a successful multidisciplinary program. Keywords: multidisciplinary clinic, patient centered, tumor board

  6. Long-Term Study of Children With ROME III Functional Gastrointestinal Disorders Managed Symptomatically in a Biopsychosocial Model.

    Science.gov (United States)

    Madani, Shailender; Parikh, Suchi; Madani, Rohit S; Krasaelap, Amornluck

    2017-04-01

    Our study evaluated progression of and identified potential factors contributing to outcomes of ROME III defined-functional gastrointestinal disorders (FGIDs) in children treated symptomatically in a biopsychosocial model of care with a long-term follow-up. We performed a retrospective review of pediatric patients who were diagnosed with ROME III defined-FGIDs including functional abdominal pain, functional dyspepsia, irritable bowel syndrome and abdominal migraine. Patients were managed symptomatically in a biopsychosocial model of care from the time of initial diagnosis. Demographics, management, progression and response to treatment assessed as complete, partial, and no improvement were reviewed. Two hundred fifty-eight patients were included with mean age of 10.6 years, female 55.4%, mean number of encounters 3.3 visits, and mean follow-up was 18.7 months (range 2 - 59, SD 15.8). Diagnoses were functional abdominal pain 45%, irritable bowel syndrome 20.9%, multiple 13.2%, functional dyspepsia 12.8%, and abdominal migraine 8.1%. Investigations were performed in most patients: laboratory studies in 93.4% (non-contributory abnormal 23.6%), imaging studies in 45.3% (non-contributory abnormal 5%) and endoscopies in 43.0% (non-contributory abnormal 1.2%). Treatment included medication in 93.7%, and surgery in 1.9% (normal pathology). There were new functional gastrointestinal diagnosis in 11.6%, evolution of FGIDs, from one to another in 12.0%, and recurrence found in 35.7% of patients. There were 60.1% patients in the complete improvement group (CIG) and 39.1% in the partial/no improvement group (PIG/NIG). No statistical difference was found between CIG and PIG/NIG regarding demographics or evaluation. PIG/NIG had more encounters (mean 3.63 vs. 3.11; P = 0.03), had non-contributory lab abnormalities (34.4% vs. 20.0%; P = 0.01), needed more endoscopies (52.4% vs. 36.8%; P = 0.02), required more treatment changes (mean 1.41 vs. 0.81; P ROME III defined-FGIDs who

  7. EMSO: European Multidisciplinary Seafloor Observatory

    Science.gov (United States)

    Favali, Paolo

    2010-05-01

    EMSO, a Research Infrastructure listed within ESFRI (European Strategy Forum on Research Infrastructures) Roadmap (Report 2006, http://cordis.europa.eu/esfri/roadmap.htm), is the European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the scientific objective of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes through long time series appropriate to the scale of the phenomena, constituting the new frontier of studying Earth interior, deep-sea biology and chemistry and ocean processes. The development of an underwater network is based on previous EU-funded projects since early '90 and is being supported by several EU initiatives, as the on-going ESONET-NoE, coordinated by IFREMER (2007-2011, http://www.esonet-emso.org/esonet-noe/), and aims at gathering together the Research Community of the Ocean Observatories. In 2006 the FP7 Capacities Programme launched a call for Preparatory Phase (PP) projects, that will provide the support to create the legal and organisational entities in charge of managing the infrastructures, and coordinating the financial effort among the countries. Under this call the EMSO-PP project was approved in 2007 with the coordination of INGV and the participation of other 11 Institutions of 11 countries. The project has started in April 2008 and will last 4 years. The EMSO is a key-infrastructure both for Ocean Sciences and for Solid Earth Sciences. In this respect it will enhance and complement profitably the capabilities of other European research infrastructures such as EPOS, ERICON-Aurora Borealis, and SIOS. The perspective of the synergy among EMSO and other ESFRI Research Infrastructures will be outlined. EMSO Partners: IFREMER-Institut Français de Recherche pour l'exploitation de la mer (France, ref. Roland Person); KDM-Konsortium Deutsche Meeresforschung e.V. (Germany, ref. Christoph

  8. Multidisciplinary design using collaborative optimization

    Science.gov (United States)

    Sobieski, Ian Patrick

    Management of the modern aircraft design process is a substantial challenge. Formal iterative optimization is commonly used with disciplinary design tools to aid designers in the definition of optimal subsystems. However, the expense in executing high fidelity analysis, the decomposition of the design expertise into disciplines, and the size of the design space, often precludes the use of direct optimization in the overall design process. Collaborative optimization is a recently developed methodology that shows promise in enabling formal optimization of the overall design. The architecture preserves disciplinary design autonomy while providing a coordinating mechanism that leads to interdisciplinary agreement and improved designs. The basic formulation has been applied to a variety of sample design problems which demonstrate that the method successfully discovers correct optimal solutions. This work places collaborative optimization in the context of other multidisciplinary design optimization methods and characterizes problems for which the basic formulation is applicable. Artifacts of the problem formulation are discussed and methods for handling high bandwidth coupling, such as that found in aeroelasticity, are presented. The use of response surfaces for representing expensive analyses has become increasingly popular in design optimization. Response surfaces are smooth analytic functions that are inexpensive to evaluate and may be generated from data points obtained from the parallel execution of analyses. These properties motivate the introduction of response surfaces into collaborative optimization. Response surfaces have been previously used to model subproblem analyses and were generated just once. Here, approximate models are used to represent the subproblem optimization results, not the analysis, and are regenerated as the design is modified. The use of response surfaces in collaborative optimization requires an inexpensive method for generating the

  9. A systematic review of biopsychosocial training programs for the self-management of emotional stress: potential applications for the military.

    Science.gov (United States)

    Crawford, Cindy; Wallerstedt, Dawn B; Khorsan, Raheleh; Clausen, Shawn S; Jonas, Wayne B; Walter, Joan A G

    2013-01-01

    Combat-exposed troops and their family members are at risk for stress reactions and related disorders. Multimodal biopsychosocial training programs incorporating complementary and alternative self-management techniques have the potential to reduce stress-related symptoms and dysfunction. Such training can preempt or attenuate the posttraumatic stress response and may be effectively incorporated into the training cycle for deploying and redeploying troops and their families. A large systematic review was conducted to survey the literature on multimodal training programs for the self-management of emotional stress. This report is an overview of the randomized controlled trials (RCTs) identified in this systematic review. Select programs such as mindfulness-Based Stress Reduction, Cognitive Behavioral Stress Management, Autogenic Training, Relaxation Response Training, and other meditation and mind-body skills practices are highlighted, and the feasibility of their implementation within military settings is addressed.

  10. A Systematic Review of Biopsychosocial Training Programs for the Self-Management of Emotional Stress: Potential Applications for the Military

    Directory of Open Access Journals (Sweden)

    Cindy Crawford

    2013-01-01

    Full Text Available Combat-exposed troops and their family members are at risk for stress reactions and related disorders. Multimodal biopsychosocial training programs incorporating complementary and alternative self-management techniques have the potential to reduce stress-related symptoms and dysfunction. Such training can preempt or attenuate the posttraumatic stress response and may be effectively incorporated into the training cycle for deploying and redeploying troops and their families. A large systematic review was conducted to survey the literature on multimodal training programs for the self-management of emotional stress. This report is an overview of the randomized controlled trials (RCTs identified in this systematic review. Select programs such as mindfulness-Based Stress Reduction, Cognitive Behavioral Stress Management, Autogenic Training, Relaxation Response Training, and other meditation and mind-body skills practices are highlighted, and the feasibility of their implementation within military settings is addressed.

  11. Clinical features and multidisciplinary approaches to dementia care

    Directory of Open Access Journals (Sweden)

    Gr

    2011-05-01

    Full Text Available Jacob HG Grand¹, Sienna Caspar², Stuart WS MacDonald11Department of Psychology, University of Victoria, Victoria, BC, Canada; 2Interdisciplinary Graduate Studies, University of British Columbia, Vancouver, BC, CanadaAbstract: Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1 Alzheimer’s disease; 2 vascular dementias; 3 frontotemporal dementias; and 4 dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of

  12. Emerging multidisciplinary research across database management systems

    CERN Document Server

    Nica, Anisoara; Varde, Aparna

    2011-01-01

    The database community is exploring more and more multidisciplinary avenues: Data semantics overlaps with ontology management; reasoning tasks venture into the domain of artificial intelligence; and data stream management and information retrieval shake hands, e.g., when processing Web click-streams. These new research avenues become evident, for example, in the topics that doctoral students choose for their dissertations. This paper surveys the emerging multidisciplinary research by doctoral students in database systems and related areas. It is based on the PIKM 2010, which is the 3rd Ph.D. workshop at the International Conference on Information and Knowledge Management (CIKM). The topics addressed include ontology development, data streams, natural language processing, medical databases, green energy, cloud computing, and exploratory search. In addition to core ideas from the workshop, we list some open research questions in these multidisciplinary areas.

  13. Multidisciplinary perspectives of music therapy in adult palliative care.

    Science.gov (United States)

    O'Kelly, Julian; Koffman, Jonathan

    2007-04-01

    Music therapy aims to provide holistic support to individuals through the sensitive use of music by trained clinicians. A recent growth in music therapy posts in UK palliative care units has occurred despite a paucity of rigorous research. To explore the role of music therapy within multidisciplinary palliative care teams, and guide the future development of the discipline. In-depth qualitative interviews with 20 multidisciplinary colleagues of music therapists, based in five UK hospices. Analysis of interview material revealed a number of themes relevant to the study aims. Music therapy was valued by most interviewees; however there exists some lack of understanding of the role of the music therapist, particularly amongst nurses. Emotional, physical, social, environmental, creative and spiritual benefits of music therapy were described, with some benefits perceived as synergistic, arising from collaborations with other disciplines. Interviewees found experiencing or witnessing music therapy is effective in developing an understanding of the discipline. Music therapy is an appropriate therapeutic intervention for meeting the holistic needs of palliative care service users. More understanding and integration of music therapy could be encouraged with collaborative work, educational workshops, and the utilization of environmentally focused techniques. The study merits further research to explore and develop these findings.

  14. Managing the patient with osteogenesis imperfecta: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Marr C

    2017-04-01

    Full Text Available Caroline Marr,1,* Alison Seasman,1,* Nick Bishop2 1Metabolic Bone Disease Team, 2Academic Unit of Child Health, Department of Human Metabolism, University of Sheffield, Sheffield Children’s NHS Foundation Trust, Sheffield, UK *These authors contributed equally to this work Abstract: Osteogenesis imperfecta (OI is a heterogeneous heritable connective tissue disorder characterized by low bone density. The type and severity of OI are variable. The primary manifestations are fractures, bone deformity, and bone pain, resulting in reduced mobility and function to complete everyday tasks. OI affects not only the physical but also the social and emotional well-being of children, young people, and their families. As such, medical, surgical, and allied health professionals’ assessments all play a role in the management of these children. The multidisciplinary approach to the treatment of children and young people living with OI seeks to provide well-coordinated, comprehensive assessments, and interventions that place the child and family at the very center of their care. The coordinated efforts of a multidisciplinary team can support children with OI to fulfill their potential, maximizing function, independence, and well-being. Keywords: physical therapy, occupational therapy, bisphosphonates, nursing, psychology, pediatrics

  15. [Clinical characteristics and multidisciplinary management of chronic musculoskeletal pain].

    Science.gov (United States)

    Inoue, Shinsuke; Ushida, Takahiro; Inoue, Masayuki

    2012-11-01

    Musculoskeletal disorders are the most common causes of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. In industrialized countries, which have increasingly aging populations, chronic musculoskeletal pain has become a significant health care burden and major issue in the 1980s and 1990s. On January 13, 2000, The Bone and Joint Decade was formally launched at the headquarters of the World Health Organization in Geneva, Switzerland. This global campaign aimed to improve the quality of life for people who have musculoskeletal conditions. Complying with this trend, large-scale surveys have been conducted in Europe and the US in recent years to evaluate the effect of chronic pain on society, but in Japan, there has been a paucity of basic information on the status of chronic musculoskeletal pain. We organized a postal survey designed to quantify and describe the prevalence and distribution of chronic pain in the Japanese community. We found that chronic pain of moderate to severe intensity occurs in 17.2%. Chronic pain had a significant impact on the occupational and social relationships, and it seriously affected their psychological conditions and quality of life. Such disabling chronic pain is regarded as the result of interrelated physical, psychological, and social or occupational factors requiring multidisciplinary intervention. We introduce a multidisciplinary clinical approach and report on novel multimodal methodologies -- for patients with chronic musculoskeletal pain.

  16. Pediatric pain management: the multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Odell S

    2013-11-01

    Full Text Available Shannon Odell,1,2 Deirdre E Logan1,21Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 2Department of Psychiatry, Harvard Medical School, Boston, MA, USAAbstract: Chronic pain in children and adolescents is a growing problem and one that is increasingly being addressed with multidisciplinary treatment teams. This review summarizes different multidisciplinary clinics, focusing specifically on intensive pediatric pain rehabilitation centers. This review offers a summary of the challenges faced by these programs and areas for future study.Keywords: pediatric pain rehabilitation, pediatric chronic pain, interdisciplinary, pain associated disability

  17. A biopsychosocial investigation of pediatric chronic pain with special focus on juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Lomholt, Johanne Jeppesen

    Our understanding and management of pediatric chronic pain have advanced markedly over the last half century. Chronic pain is pain that persists for a usually more than three months and is highly prevalent in children and adolescents. Juvenile idiopathic arthritis (JIA) can be characterized...... increased quality of life, reductions in anxiety levels and pain catastrophizing, and improvements in adaptive pain cognitions; the latter were expressed as strengthened beliefs in the ability to control pain and self-efficacy. After controlling for disease activity, no differences between the intervention...... and waitlist condition were found in measures of pain and functional disability. The feasibility of the CBT program was supported by a low drop-out rate, and high levels of reported intervention credibility and satisfaction with the treatment. In study 4 differences in pain and health complaints was examined...

  18. Quality of life in Brazilian obese adolescents: effects of a long-term multidisciplinary lifestyle therapy

    Directory of Open Access Journals (Sweden)

    Tufik Sergio

    2009-07-01

    Full Text Available Abstract Background Obesity has adverse physical, social, and economic consequences that can negatively affect quality of life (QOL. Thus the aim of this study was to verify the effects of a long-term multidisciplinary lifestyle intervention on QOL, body image, anxiety, depression and binge eating in obese adolescents. Methods Sixty-six obese adolescents (41 girls and 25 boys; BMI: 35.62 ± 4.18 kg/m2 were recruited from the Multidisciplinary Obesity Intervention Program outpatient clinic, and were submitted to a multidisciplinary lifestyle therapy (short-term = 12 weeks and long-term = 24 weeks, composed of medical, dietary, exercise and psychological programs. Validated self-report questionnaires were used to assess symptoms of anxiety Trait/State (STAI; depression (BDI; binge eating (BES, body image dissatisfaction (BSQ and QOL (SF-36. Data were analyzed by means of scores; comparisons were made by ANOVA for repeated measures, and Tukey's test as post-hoc and Students T test. Results Long-term therapy decreased depression and binge eating symptoms, body image dissatisfaction, and improved QOL in girls, whereas, for boys, 24 weeks, were effective to reduce anxiety trait/state and symptoms of binge eating, and to improve means of dimensions of QOL (p Conclusion A long-term multidisciplinary lifestyle therapy is effective to control psychological aspects and to improve QOL in obese adolescents.

  19. Multidisciplinary Approach for Patients Hospitalized With Heart Failure.

    Science.gov (United States)

    Frankenstein, Lutz; Fröhlich, Hanna; Cleland, John G F

    2015-10-01

    Acute heart failure describes the rapid deterioration, over minutes, days or hours, of symptoms and signs of heart failure. Its management is an interdisciplinary challenge that requires the cooperation of various specialists. While emergency providers, (interventional) cardiologists, heart surgeons, and intensive care specialists collaborate in the initial stabilization of acute heart failure patients, the involvement of nurses, discharge managers, and general practitioners in the heart failure team may facilitate the transition from inpatient care to the outpatient setting and improve acute heart failure readmission rates. This review highlights the importance of a multidisciplinary approach to acute heart failure with particular focus on the chain-of-care delivered by the various services within the healthcare system. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Frailty Intervention Trial (FIT).

    Science.gov (United States)

    Fairhall, Nicola; Aggar, Christina; Kurrle, Susan E; Sherrington, Catherine; Lord, Stephen; Lockwood, Keri; Monaghan, Noeline; Cameron, Ian D

    2008-10-13

    Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagues used to define the frailty syndrome will be used in this study (i.e. weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity). Previous studies have shown that clinical outcomes for frail older people can be improved using multi-factorial interventions such as comprehensive geriatric assessment, and single interventions such as exercise programs or nutritional supplementation, but no interventions have been developed to specifically reverse the syndrome of frailty.We have developed a multidisciplinary intervention that specifically targets frailty as defined by Fried et al. We aim to establish the effects of this intervention on frailty, mobility, hospitalisation and institutionalisation in frail older people. A single centre randomised controlled trial comparing a multidisciplinary intervention with usual care. The intervention will target identified characteristics of frailty, functional limitations, nutritional status, falls risk, psychological issues and management of chronic health conditions. Two hundred and thirty people aged 70 and over who meet the Fried definition of frailty will be recruited from clients of the aged care service of a metropolitan hospital. Participants will be followed for a 12-month period. This research is an important step in the examination of specifically targeted frailty interventions. This project will assess whether an intervention specifically targeting frailty can be implemented, and whether it is effective when compared to usual care. If successful, the study will establish a new approach to the treatment of older people at risk of further

  1. Placenta accreta and anesthesia: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    R S Khokhar

    2016-01-01

    Full Text Available Placenta accreta (an abnormally adherent placenta is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  2. Augmented Reality for Multi-disciplinary Collaboration

    OpenAIRE

    WANG, XIANGYU; Rui

    2010-01-01

    This chapter presents a framework for multi-disciplinary collaboration. Tangible Augmented Reality has been raised as one of suitable systems for design collaboration. Furthermore, it emphasizes the advantages of Tangible Augmented Reality to illustrate the needs for integrating the Tangible User Interfaces and Augmented Reality Systems.

  3. Multidisciplinary approaches to climate change questions

    Science.gov (United States)

    Middleton, Beth A.; LePage, Ben A.

    2011-01-01

    Multidisciplinary approaches are required to address the complex environmental problems of our time. Solutions to climate change problems are good examples of situations requiring complex syntheses of ideas from a vast set of disciplines including science, engineering, social science, and the humanities. Unfortunately, most ecologists have narrow training, and are not equipped to bring their environmental skills to the table with interdisciplinary teams to help solve multidisciplinary problems. To address this problem, new graduate training programs and workshops sponsored by various organizations are providing opportunities for scientists and others to learn to work together in multidisciplinary teams. Two examples of training in multidisciplinary thinking include those organized by the Santa Fe Institute and Dahlem Workshops. In addition, many interdisciplinary programs have had successes in providing insight into climate change problems including the International Panel on Climate Change, the Joint North American Carbon Program, the National Academy of Science Research Grand Challenges Initiatives, and the National Academy of Science. These programs and initiatives have had some notable success in outlining some of the problems and solutions to climate change. Scientists who can offer their specialized expertise to interdisciplinary teams will be more successful in helping to solve the complex problems related to climate change.

  4. Multidisciplinary workshops: learning to work together.

    Science.gov (United States)

    Fatchett, Anita; Taylor, Dawn

    2013-03-01

    Health and social care professional practice needs to move with the times and to respond to the ever-changing combination of health needs, economic realities and health-policy imperatives. A clear understanding of the variety of forces at play and the ability to marshal these to good effect by working in partnership with multidisciplinary colleagues and children/families is a must, not least in this time of economic austerity and ever-rising health inequalities, when vulnerable children's lives and complex family relationships and behaviours so easily become increasingly strained and challenged. This sad reality calls out for relevant joined-up solutions by all participants--an agenda so often called into question by court judgement after court judgement. The multidisciplinary workshops to be discussed have developed and changed over the past decade and provide a safe but realistic learning environment for students from health and social care backgrounds to experience the difficulties and barriers to good multidisciplinary working, to better understand others' perspectives and activities and consider and develop new and better practical strategies for working with multidisciplinary professional colleagues, children and families. All of the workshops are underpinned by specific discipline-focused theoretical work.

  5. The Multidisciplinary Economics of Money Laundering

    NARCIS (Netherlands)

    Ferwerda, J.|info:eu-repo/dai/nl/314405526

    2012-01-01

    Money laundering has been studied for many years, but mainly by lawyers and criminologists. This dissertation presents a number of ways on how an economist – mainly in a multidisciplinary fashion – can contribute to this field of research. This dissertation answers four important questions about

  6. Thoughts about multidisciplinary, interdisciplinary, and transdisciplinary research.

    Science.gov (United States)

    Fawcett, Jacqueline

    2013-10-01

    This essay focuses on multidisciplinary, interdisciplinary, and transdisciplinary research. The definitions and objectives for these three types of multiple discipline research are given. Discussion centers on the gains and losses that may be experienced by individual nurses who engage in such research, as well as gains and losses for the discipline of nursing.

  7. Placenta accreta and anesthesia: A multidisciplinary approach.

    Science.gov (United States)

    Khokhar, R S; Baaj, J; Khan, M U; Dammas, F A; Rashid, N

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  8. The Multidisciplinary Economics of Money Laundering

    NARCIS (Netherlands)

    Ferwerda, J.

    2012-01-01

    Money laundering has been studied for many years, but mainly by lawyers and criminologists. This dissertation presents a number of ways on how an economist – mainly in a multidisciplinary fashion – can contribute to this field of research. This dissertation answers four important questions about mon

  9. Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service

    Directory of Open Access Journals (Sweden)

    Bath B

    2015-04-01

    assessment process as those with higher psychological distress (measured by the Fear Avoidance Beliefs Questionnaire and the Distress and Risk Assessment Measure were more likely to improve on certain outcomes. The use of an evaluation framework guided by a biopsychosocial model may help determine potential mechanisms of action for a physiotherapy-delivered triage program. Keywords: low back disorders, physiotherapy, biopsychosocial, outcome, predictors

  10. Early Support Development of Children with Disorders of the Biopsychosocial Functioning in Poland

    Directory of Open Access Journals (Sweden)

    Anna Czyż

    2017-05-01

    Full Text Available This article presents the results of a research study on the system of early child development support with developmental disabilities and their families in Poland. The analysis covered areas such as proximity and accessibility of services, infrastructural conditions, preparation of personnel, and occurrence of systemic barriers. The article provides a verification of the model of early intervention teams working in the field of diagnosis, design and implementation of impact, the responsibility for the course of therapeutic work and team development. In addition, the role of parents in therapy as well as the strengths and weaknesses of the system are discussed.

  11. Manual Physical Therapists’ Use of Biopsychosocial History Taking in the Management of Patients with Back or Neck Pain in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Rob A. B. Oostendorp

    2015-01-01

    Full Text Available Objective. To develop and evaluate process indicators relevant to biopsychosocial history taking in patients with chronic back and neck pain. Methods. The SCEBS method, covering the Somatic, Psychological (Cognition, Emotion, and Behavior, and Social dimensions of chronic pain, was used to evaluate biopsychosocial history taking by manual physical therapists (MPTs. In Phase I, process indicators were developed while in Phase II indicators were tested in practice. Results. Literature-based recommendations were transformed into 51 process indicators. Twenty MTPs contributed 108 patient audio recordings. History taking was excellent (98.3% for the Somatic dimension, very inadequate for Cognition (43.1% and Behavior (38.3%, weak (27.8% for Emotion, and low (18.2% for the Social dimension. MTPs estimated their coverage of the Somatic dimension as excellent (100%, as adequate for Cognition, Emotion, and Behavior (60.1%, and as very inadequate for the Social dimension (39.8%. Conclusion. MTPs perform screening for musculoskeletal pain mainly through the use of somatic dimension of (chronic pain. Psychological and social dimensions of chronic pain were inadequately covered by MPTs. Furthermore, a substantial discrepancy between actual and self-estimated use of biopsychosocial history taking was noted. We strongly recommend full implementation of the SCEBS method in educational programs in manual physical therapy.

  12. How Do We Understand Children’s Restlessness? A Critique of the Biopsychosocial Model and ADHD as the Dominating Perspective in Current Understanding and Treatment

    Directory of Open Access Journals (Sweden)

    Anna Helle-Valle

    2014-03-01

    Full Text Available How is children’s restlessness understood and handled by surrounding adults? Two approaches are outlined in this article: one is the biomedical and later the biopsychosocial model, the other is a tradition that can be traced back to Foucault’s concept of historical ontology. The biopsychosocial model and ADHD is currently the dominating perspective when it comes to describing, understanding and treating restlessness in children. In this tradition, a focus on pathology and biology places the root of the problem within the child and positions the surrounding adults as neutral observers and helpers. By contrast, historical ontology opens up to questions about the neutrality and validity of a biopsychosocial approach by pointing to our active role as subjects in creating ideas of truth about children, in judging their behaviour and in “helping” them. Rather than claiming that one approach is better than the other, it can be useful to regard the two traditions as providing different levels of analysis and be aware of the possibilities and limitations pertaining to these.

  13. Image-guided therapies in the treatment of hepatocellularcarcinoma: A multidisciplinary perspective

    Institute of Scientific and Technical Information of China (English)

    Jonathon Willatt; Kevin K Hannawa; Julie A Ruma; Timothy L Frankel; Dawn Owen; Pranab M Barman

    2015-01-01

    A multidisciplinary approach to the treatment ofpatients with unresectable hepatocellular carcinoma(HCC) has led to improvements in screening, detection,and treatments. Interventional techniques includethermal ablation, transarterial chemoembolization, andradioembolization whilst stereotactic body radiationtherapy also uses imaging to target the radiation. Bothsurvival rates and cure rates have improved markedlysince the introduction of these techniques. This reviewarticle describes the image guided techniques used forthe treatment of HCC.

  14. Image-guided therapies in the treatment of hepatocellular carcinoma: A multidisciplinary perspective.

    Science.gov (United States)

    Willatt, Jonathon; Hannawa, Kevin K; Ruma, Julie A; Frankel, Timothy L; Owen, Dawn; Barman, Pranab M

    2015-02-27

    A multidisciplinary approach to the treatment of patients with unresectable hepatocellular carcinoma (HCC) has led to improvements in screening, detection, and treatments. Interventional techniques include thermal ablation, transarterial chemoembolization, and radioembolization whilst stereotactic body radiation therapy also uses imaging to target the radiation. Both survival rates and cure rates have improved markedly since the introduction of these techniques. This review article describes the image guided techniques used for the treatment of HCC.

  15. Oral health considerations in anorexia and bulimia nervosa. 2. Multidisciplinary management and personalized dental care.

    Science.gov (United States)

    Bassiouny, Mohamed A; Tweddale, Elizabeth

    2017-01-01

    This article outlines a comprehensive, multidisciplinary strategy for treatment of patients with anorexia and bulimia nervosa. In this approach, primary medical intervention and emergency dental care are followed by the staging of treatment phases that integrate medical care, psychotherapy, nutritional counseling, and dental management, which may encompass various treatment options for repair of damaged dentition. Emphasis is placed on prevention of further tissue damage during all phases of management and following completion of the treatment course.

  16. Fifty Shades of African Lightness: A Bio-psychosocial Review of the Global Phenomenon of Skin Lightening Practices

    Science.gov (United States)

    Jacobs, Meagan; Levine, Susan; Abney, Kate

    2016-01-01

    Skin-lightening is an aesthetic practice of global concern. By adopting a biopsycho-social approach, we consider the interplay between the biological, psychological and social factors that underpin the circulation and consumption of skin lighteners in South Africa. This paper reflects on biological aspects of skin lightening, interpersonal relationships, individual beliefs and expectations about the maintenance of health and well being that informs cosmetic practices. The paper seeks to examine claims made by historians (Thomas) and political philosophers and activists (Biko) that colonialism and apartheid in South Africa historically reinforced the use of skin lightening products in the country. The paper also investigates the role of media in staking out the boundaries of beauty. We argue that men and women practice skin-lightening not only as a complex result of the internalization of global standards of beauty, but meshed with a national politics of race and colorism. Banning skin lightening products without understanding the biological effects but also the social forces that underlie their increased popularity will prove futile. Moreover, we must consider the immeasurable pleasures associated with lightening, and the feelings with achieving visibility in South Africa, a country that continues to wrestle with blackness. PMID:28299156

  17. Biopsychosocial functioning among cirrhotic patients in various stages of transplant process in comparison to liver transplant recipients

    Directory of Open Access Journals (Sweden)

    Agustín Martín-Rodríguez

    2014-01-01

    Full Text Available Background: Although assessment of pre and posttransplant quality of life is a current scientific target; it has not yet been carried out throughout the entire transplant process. Aims: 1 To analyze differences in mental health and quality of life at prewaiting list study, waiting list, and post transplant phases; 2 to analyze correlation between these quality of life and affective variables and Model for End Stage Liver Disease (MELD scores. Methods: Two liver patient groups were recruited: 51 cirrhotic patients, who were assessed at two different stages (at pre waiting list study and waiting list phases, and 51 cadaveric liver transplant recipients; groups were homogeneous in gender and age variables by matching. Anxiety depressive symptomatology and quality of life were assessed by HADS and SF-36 Health Survey, respectively. Results: Pre waiting list study patients self perceived their global health status much worse than transplant recipients. Waiting list patients displayed much higher anxiety, more role limitations due to physical problems, worse physical functioning, as well as perceiving their global health status much worse than transplant recipients. Statistically significant correlations were only found in waiting list patients between MELD-Anxiety and MELD-Social Functioning subscales. Conclusions: Waiting list patients displayed the worst biopsychosocial well being status; liver transplant recipients enjoyed the best status instead.

  18. Life Stress and Kindling in Bipolar Disorder: Review of the Evidence and Integration with Emerging Biopsychosocial Theories

    Science.gov (United States)

    Bender, Rachel E.; Alloy, Lauren B.

    2011-01-01

    Most life stress literature in bipolar disorder (BD) fails to account for the possibility of a changing relationship between psychosocial context and episode initiation across the course of the disorder. According to Post’s (1992) influential kindling hypothesis, major life stress is required to trigger initial onsets and recurrences of affective episodes, but successive episodes become progressively less tied to stressors and may eventually occur autonomously. Subsequent research on kindling has largely focused on unipolar depression (UD), and the model has been tested in imprecise and inconsistent ways. The aim of the present paper is to evaluate evidence for the kindling model as it applies to BD. We first outline the origins of the hypothesis, the evidence for the model in UD, and the issues needing further clarification. Next, we review the extant literature on the changing relationship between life stress and bipolar illness over time, and find that evidence from the methodologically strongest studies is inconsistent with the kindling hypothesis. We then integrate this existing body of research with two emerging biopsychosocial models of BD: the Behavioral Approach System dysregulation model, and the circadian and social rhythm theory. Finally, we present therapeutic implications and suggestions for future research. PMID:21334286

  19. Fifty Shades of African Lightness: A Bio-psychosocial Review of the Global Phenomenon of Skin Lightening Practices.

    Science.gov (United States)

    Jacobs, Meagan; Levine, Susan; Abney, Kate; Davids, Lester

    2016-12-31

    Skin-lightening is an aesthetic practice of global concern. By adopting a biopsycho-social approach, we consider the interplay between the biological, psychological and social factors that underpin the circulation and consumption of skin lighteners in South Africa. This paper reflects on biological aspects of skin lightening, interpersonal relationships, individual beliefs and expectations about the maintenance of health and well being that informs cosmetic practices. The paper seeks to examine claims made by historians (Thomas) and political philosophers and activists (Biko) that colonialism and apartheid in South Africa historically reinforced the use of skin lightening products in the country. The paper also investigates the role of media in staking out the boundaries of beauty. We argue that men and women practice skin-lightening not only as a complex result of the internalization of global standards of beauty, but meshed with a national politics of race and colorism. Banning skin lightening products without understanding the biological effects but also the social forces that underlie their increased popularity will prove futile. Moreover, we must consider the immeasurable pleasures associated with lightening, and the feelings with achieving visibility in South Africa, a country that continues to wrestle with blackness.

  20. Fifty shades of African lightness: a bio-psychosocial review of the global phenomenon of skin lightening practices

    Directory of Open Access Journals (Sweden)

    Meagan Jacobs

    2016-12-01

    Full Text Available Skin-lightening is an aesthetic practice of global concern. By adopting a biopsycho-social approach, we consider the interplay between the biological, psychological and social factors that underpin the circulation and consumption of skin lighteners in South Africa. This paper reflects on biological aspects of skin lightening, interpersonal relationships, individual beliefs and expectations about the maintenance of health and well being that informs cosmetic practices. The paper seeks to examine claims made by historians (Thomas and political philosophers and activists (Biko that colonialism and apartheid in South Africa historically reinforced the use of skin lightening products in the country. The paper also investigates the role of media in staking out the boundaries of beauty. We argue that men and women practice skinlightening not only as a complex result of the internalization of global standards of beauty, but meshed with a national politics of race and colorism. Banning skin lightening products without understanding the biological effects but also the social forces that underlie their increased popularity will prove futile. Moreover, we must consider the immeasurable pleasures associated with lightening, and the feelings with achieving visibility in South Africa, a country that continues to wrestle with blackness.

  1. A Multidisciplinary Health Care Team's Efforts to Improve Educational Attainment in Children with Sickle-Cell Anemia and Cerebral Infarcts

    Science.gov (United States)

    King, Allison; Herron, Sonya; McKinstry, Robert; Bacak, Stephen; Armstrong, Melissa; White, Desiree; DeBaun, Michael

    2006-01-01

    The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically…

  2. A Multidisciplinary Health Care Team's Efforts to Improve Educational Attainment in Children with Sickle-Cell Anemia and Cerebral Infarcts

    Science.gov (United States)

    King, Allison; Herron, Sonya; McKinstry, Robert; Bacak, Stephen; Armstrong, Melissa; White, Desiree; DeBaun, Michael

    2006-01-01

    The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically…

  3. A Multidisciplinary Approach to Educating Preschool Children with Optic Nerve Hypoplasia and Septo-Optic Nerve Dysplasia.

    Science.gov (United States)

    Bahar, Cheryl; Brody, Jill; McCann, Mary Ellen; Mendiola, Rosalinda; Slott, Gayle

    2003-01-01

    This article discusses the observations and experiences of a multidisciplinary team at the Blind Childrens Center in Los Angeles, which works specifically with children from birth to 5 years of age who have been diagnosed with optic nerve hypoplasia and may have septo-optic displasia. Strategies for educational interventions are explained.…

  4. Multidisciplinary therapy reduces risk factors for metabolic syndrome in obese adolescents.

    Science.gov (United States)

    Bianchini, Josiane Aparecida Alves; da Silva, Danilo Fernandes; Nardo, Claudia Christina Sanchez; Carolino, Idalina Diair Regla; Hernandes, Florencio; Nardo, Nelson

    2013-02-01

    This study aims to assess the effects of a 16-week multidisciplinary program of obesity treatment on the control of metabolic syndrome (MS) and dyslipidemia in obese adolescents. Eighty-six adolescents aged 10-18 years were allocated in either the intervention group (IG; n = 44) or control group (CG; n = 42). IG was submitted to a multidisciplinary intervention based on cognitive behavioral therapy that aimed to modify eating habits and exercise behavior. We analyzed, before and after the intervention period, anthropometric parameters, body composition, bone mineral density, cardiorespiratory fitness, blood pressure, glucose, insulin, and lipid profile of the subjects. MS was classified according to International Diabetes Federation (2007) and the presence of dyslipidemia according to Back et al. (Arq Bras Cardiol 85:4-36, 2005). In the beginning of the intervention, the median number (range) of risk factors for MS present was 2.0 (0.0-5.0) in the IG and 2.0 (0.0-4.0) in the CG. After the intervention, this parameter reduced significantly in the IG (1.0 (0.0-5.0); p = 0.004) while no change was observed in the CG (2.0 (0.0-4.0); p = 0.349). In addition, we observed improvements in body mass index, waist circumference, hip circumference, maximal oxygen uptake, absolute and relative body fat, systolic blood pressure, diastolic blood pressure, and total cholesterol in the IG which was not identified in the CG. Conclusio n: We suggest that a 16-week multidisciplinary intervention based on cognitive behavioral therapy was adequate to reduce risk factors for MS in obese adolescents.

  5. A multidisciplinary approach for improving outcomes.

    Science.gov (United States)

    Sierchio, Grace P

    2003-01-01

    The healthcare environment has been impacted tremendously by higher patient acuity, cost-cutting measures, an increase in litigation, and increased expectations by an educated generation of healthcare consumers. This has led to the need to continually measure, assess, and improve quality. These activities must consider not only patient clinical outcomes, but also customer service ratings and financial outcomes. Quality improvement requires a collaborative approach to succeed, and the need to build a cohesive and effective multidisciplinary team is critical for positive outcomes. Strategies to build a culture of teamwork include incorporating total quality management principles into every level of the organization, seeking participation from every discipline and level of the organization, and recognizing employees for their efforts. Infusion nurses have an excellent opportunity to contribute their expertise to any multidisciplinary team that impacts the outcomes of infusion patients. In addition, team-building and quality improvement may prove to be excellent career moves for infusion nurses looking to further specialize their practice.

  6. Multidisciplinary Optimization Methods for Aircraft Preliminary Design

    Science.gov (United States)

    Kroo, Ilan; Altus, Steve; Braun, Robert; Gage, Peter; Sobieski, Ian

    1994-01-01

    This paper describes a research program aimed at improved methods for multidisciplinary design and optimization of large-scale aeronautical systems. The research involves new approaches to system decomposition, interdisciplinary communication, and methods of exploiting coarse-grained parallelism for analysis and optimization. A new architecture, that involves a tight coupling between optimization and analysis, is intended to improve efficiency while simplifying the structure of multidisciplinary, computation-intensive design problems involving many analysis disciplines and perhaps hundreds of design variables. Work in two areas is described here: system decomposition using compatibility constraints to simplify the analysis structure and take advantage of coarse-grained parallelism; and collaborative optimization, a decomposition of the optimization process to permit parallel design and to simplify interdisciplinary communication requirements.

  7. The Multidisciplinary Economics of Money Laundering

    OpenAIRE

    J. Ferwerda

    2012-01-01

    Money laundering has been studied for many years, but mainly by lawyers and criminologists. This dissertation presents a number of ways on how an economist – mainly in a multidisciplinary fashion – can contribute to this field of research. This dissertation answers four important questions about money laundering: Why should we fight money laundering? How is money laundered? In which sectors is money laundered? And how can we fight money laundering? The literature mentions 25 effects of money ...

  8. An architecture for integration of multidisciplinary models

    DEFF Research Database (Denmark)

    Belete, Getachew F.; Voinov, Alexey; Holst, Niels

    2014-01-01

    , integration of models requires us to address technical, semantic, and dataset aspects of interoperability. So we need a genuine techniques that enable us to integrate various domain specific models for interdisciplinary study. In this research work, we investigated best practices of System Integration......Integrating multidisciplinary models requires linking models: that may operate at different temporal and spatial scales; developed using different methodologies, tools and techniques; different levels of complexity; calibrated for different ranges of inputs and outputs, etc. On the other hand...

  9. [Multidisciplinary oncology teams: beware of endless discussions].

    Science.gov (United States)

    Giard, Raimond W M

    2010-01-01

    The continual and increasing complexity of diagnostic and treatment options in oncology demands careful communication, coordination and decision making. Cancer care could be improved by multidisciplinary teamwork. Although this sort of teamwork has many advantages in theory, we know very little about its effectiveness in practice. We have to answer questions such as how teams can accomplish their task most effectively and how we must manage organizations in such a way that team-based working contributes optimally to organizational effectiveness.

  10. The Multidisciplinary Economics of Money Laundering

    OpenAIRE

    J. Ferwerda

    2012-01-01

    Money laundering has been studied for many years, but mainly by lawyers and criminologists. This dissertation presents a number of ways on how an economist – mainly in a multidisciplinary fashion – can contribute to this field of research. This dissertation answers four important questions about money laundering: Why should we fight money laundering? How is money laundered? In which sectors is money laundered? And how can we fight money laundering? The literature mentions 25 effects of money ...

  11. Multidisciplinary training of cancer specialists in Europe

    DEFF Research Database (Denmark)

    Benstead, Kim; Turhal, Nazim Serdar; O'Higgins, Niall

    2017-01-01

    The best care for patients with cancer is most likely to be achieved when decisions about diagnosis, staging and treatment are made at multidisciplinary and multiprofessional meetings, preferably when all the professional expertise relevant to the patient's condition is gathered together. Questio...... surgeons training in cancer surgery) is recommended. This is likely to improve the value of multidisciplinary meetings and may result in improved patient care. The Expert Group on Cancer Control of the European Commission has endorsed this recommendation........ Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice. Data were lacking for Surgery because...... Surgical Oncology is not recognised as a speciality in the EU and most specialist training in cancer surgery is organ based. A period of time in cross-disciplinary training in each of the other two disciplines for all trainees in Medical Oncology, Radiation Oncology and Surgical Oncology (including all...

  12. Prevalence of and biopsychosocial factors associated with low back pain in commercial airline pilots.

    Science.gov (United States)

    Prombumroong, Jaruchon; Janwantanakul, Prawit; Pensri, Praneet

    2011-09-01

    The aim of this study was to examine the 12-mo prevalence of low back pain (LBP) and to identify individual, flight-related, and psychosocial factors associated with the prevalence of LBP in commercial airline pilots. A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 708 Thai airline pilots visiting the Institute of Aviation Medicine, Royal Thai Air Force, for their regular medical examinations. A multivariable logistic regression model was used to assess the associations between the prevalence of LBP and statistically significant factors. A total of 684 subjects (97%) returned the questionnaires. The 12-mo prevalence of self-reported LBP among commercial airline pilots was 55.7%. An elevated risk of experiencing LBP was associated with occasionally to frequently encountering turbulence in the previous year, lifting luggage four or more times per duty period, perception of noise in the cockpit as being too loud, and perception of work hazards at intermediate to high levels, assessed by the JCQ Thai version. On the other hand, the factors that reduced the risk of experiencing LBP were performing vigorous exercise regularly and having 5-23 h rest breaks between flights. LBP is common among commercial airline pilots. Our findings suggest that LBP in commercial airline pilots is occupation-related. Interventions aimed at reducing the occurrence of LBP in commercial airline pilots should focus on work condition adjustment and mental stress reduction.

  13. Biopsychosocial determinants of physical and mental fatigue in patients with spondyloarthropathy.

    Science.gov (United States)

    Da Costa, Deborah; Zummer, Michel; Fitzcharles, Mary-Ann

    2011-04-01

    The objectives of this study are to characterize fatigue in patients with spondyloarthropathy (SpA) using a multidimensional assessment and to delineate contributors to dimensions of fatigue. Fatigue in 125 participants with SpA was assessed using the Multidimensional Fatigue Inventory (MFI-20). Participants completed standardized questionnaires assessing sleep quality, depressed mood, perceived stress, social support, leisure time physical activity, functional capacity, and disease activity. Hierarchical multiple regressions were computed to identify contributors to physical and mental fatigue. Patients scored high on all five MFI-20 fatigue dimensions, with general fatigue and physical fatigue having the highest scores. A hierarchical multiple regression showed that worse functional capacity, greater perceived stress, more depressed mood and less participation in leisure time physical activity contributed to higher physical fatigue scores. The results of the second model found depressed mood to be the strongest determinant of mental fatigue, followed by poorer sleep quality and younger age. These findings indicate that fatigue in SpA is a multidimensional experience, with physical and mental aspects likely having different etiologies. A number of variables potentially amenable to treatment were found to be associated with physical and mental fatigue. A multidimensional assessment of fatigue in SpA is needed to tailor and optimize interventions aimed at alleviating fatigue.

  14. [Interventional radiology: current problems and new directions].

    Science.gov (United States)

    Santos Martín, E; Crespo Vallejo, E

    2014-01-01

    In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork.

  15. Multi-disciplinary team meetings in stroke rehabilitation: an observation study and conceptual framework.

    Science.gov (United States)

    Tyson, S F; Burton, L; McGovern, A

    2014-12-01

    To explore how multi-disciplinary team meetings operate in stroke rehabilitation. Non-participant observation of multi-disciplinary team meetings and semi-structured interviews with attending staff. Twelve meetings were observed (at least one at each site) and 18 staff (one psychologist, one social worker; four nurses; four physiotherapists four occupational therapists, two speech and language therapists, one stroke co-ordinator and one stroke ward manager) were interviewed in eight in-patient stroke rehabilitation units. Multi-disciplinary team meetings in stroke rehabilitation were complex, demanding and highly varied. A model emerged which identified the main inputs to influence conduct of the meetings were personal contributions of the members and structure and format of the meetings. These were mediated by the team climate and leadership skills of the chair. The desired outputs; clinical decisions and the attributes of apparently effective meetings were identified by the staff. A notable difference between the meetings that staff considered effective and those that were not, was their structure and format. Successful meetings tended to feature a set agenda, structured documentation; formal use of measurement tools; pre-meeting preparation and skilled chairing. These features were often absent in meetings perceived to be ineffective. The main features of operation of multi-disciplinary team meetings have been identified which will enable assessment tools and interventions to improve effectiveness to be developed. © The Author(s) 2014.

  16. [Headache in children and adolescents. Epidemiology, biopsychosocial correlates, and psychological treatment approaches].

    Science.gov (United States)

    Kröner-Herwig, B

    2014-08-01

    An abundance of studies have consistently shown that headache is the most prevalent pain in children and adolescents. Weekly headache is experienced by more than 10 % and is distinctly more frequent in girls. The number of headache-affected youths with high disability is lower than expected (~ 4 %). Headache is associated with pain in other body sites, thus multiple pain is experienced more often than isolated headache. Various somatic symptoms and even chronic diseases are also correlated with headache. Headache in parents carries a high risk of also occurring in their children. Various other psychosocial factors such as dysfunctional psychological traits are closely linked with headache, the most prominent being internalizing symptoms. However, externalizing symptoms also correlate with headache. Pain catastrophizing, as well as somatosensory amplification and anxiety sensitivity, have been shown to characterize individuals with headache. Features of the social environment, such as life events, school, as well as family stressors and socioeconomic parameters, are among the risk factors. Psychological interventions such as biofeedback, relaxation, and cognitive-behavioral training have proved their efficacy in headache treatment according to several meta-analyses. The latter has also been conducted in group settings and more recently in self-management focused trainings using electronic media. They mainly aim at the prevention of further headache episodes. The goal of this training is the strengthening of self-efficacy beliefs and active coping strategies. It is proposed that these competencies could contribute to the successful long-term prevention of an adverse course of headache into adulthood.

  17. Menkes disease: what a multidisciplinary approach can do

    Directory of Open Access Journals (Sweden)

    Ojha R

    2016-08-01

    Full Text Available Rahul Ojha,1 Asuri N Prasad1–4 1Department of Pediatrics, 2Section of Pediatric Neurology, 3Division of Clinical Neurological Sciences, 4Child Health Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada Abstract: Disorders of copper homeostasis are currently recognized across the life span. Their recognition and links to human disease have spanned several decades, beginning with the recognition of a degenerative disorder in the offspring of sheep grazing in copper-deficient pastures, through to the description of infants suffering from a progressive neurodegenerative disorder characterized by epileptic seizures, developmental regression, failure to thrive, and an unusual hair quality (giving the condition its distinctive label of “kinky hair disease”. In this review, we trace the historical background and describe the biochemistry and physiology of copper metabolism and transport, inheritance patterns, molecular genetics, and genotype–phenotype correlations based on current understanding of the disorder. It is clear from the clinical presentations and variants that disorders of copper homeostasis include phenotypes ranging from mild occipital horn syndrome to intermediate and severe forms of classical Menkes disease. The symptoms involve multiple organ systems such as brain, lung, gastrointestinal tract, urinary tract, connective tissue, and skin. A multisystem disorder needs a multidisciplinary approach to care, as treatment interventions permit longer survival for some individuals. Animal models have been developed to help screen treatment options and provide a better understanding of these disorders in the laboratory. Finally, we propose a multidisciplinary approach to promote continued research (both basic and clinical to improve survival, quality of life, and care for these conditions. Keywords: Menkes disease, kinky hair, ceruloplasmin, neurodegenerative, copper

  18. Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

    Directory of Open Access Journals (Sweden)

    Gillespie BM

    2015-10-01

    Full Text Available Brigid M Gillespie,1 Evelyn Kang,1 Shelley Roberts,1 Frances Lin,1,2 Nicola Morley,3 Tracey Finigan,3 Allison Homer,3 Wendy Chaboyer1 1National Health and Medical Research Council Research Centre for Clinical Excellence in Nursing Interventions (NCREN and Centre for Healthcare Practice Innovation (HPI, Menzies Health Institute, 2School of Nursing and Midwifery, Griffith University, 3Surgical and Procedural Services, Gold Coast University Hospital, Gold Coast, QLD, Australia Purpose: To identify and describe the strategies and processes used by multidisciplinary teams of health care professionals to reduce surgical site infections (SSIs.Materials and methods: An integrative review of the research literature was undertaken. Searches were conducted in April 2015. Following review of the included studies, data were abstracted using summary tables and the methodological quality of each study assessed using the Standards for Quality Improvement Reporting Excellence guidelines by two reviewers. Discrepancies were dealt with through consensus. Inductive content analysis was used to identify and describe the strategies/processes used by multidisciplinary health care teams to prevent SSI.Results and discussion: In total, 13 studies met the inclusion criteria. Of these, 12 studies used quantitative methods, while a single study used qualitative interviews. The majority of the studies were conducted in North America. All quantitative studies evaluated multifaceted quality-improvement interventions aimed at preventing SSI in patients undergoing surgery. Across the 13 studies reviewed, the following multidisciplinary team-based approaches were enacted: using a bundled approach, sharing responsibility, and, adhering to best practice. The majority of studies described team collaborations that were circumscribed by role. None of the reviewed studies used strategies that included the input of allied health professionals or patient participation in SSI prevention

  19. Bio-psychosocial determinants of time lost from work following non life threatening acute orthopaedic trauma

    Directory of Open Access Journals (Sweden)

    Ozanne-Smith Joan

    2010-01-01

    Full Text Available Abstract Background To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Methods Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Results Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30] whereas "financial security" and "because they felt able to" did not achieve significance. Conclusions Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants

  20. The biopsychosocial characteristics proceding the pregnancy in the teenages from two level one medical centers in Popayán

    Directory of Open Access Journals (Sweden)

    Sandra Yamile Martínez

    2010-12-01

    Full Text Available Objetive: To identify biopsychosocial characteristics preceding the pregnancy in teenagers that went to see the doctor in two level one medical centers in Popayán. Method: Descriptive study, gathering and analysing qualitative and quantitative information. Results: 38 teenagers with an average age of 16.37 years at conception. 90% (34 were first-time mothers. 73% (28 were attending high school and 68% (26 were from a low socioeconomic background. 36.8% (14 were planning a future involving study and work. 46% (17 had dropped out from school. The young girls average age and of commencing sexual activities are 12.89 and 15.32 respectively. 71% 27 had a sexual partner and mentioned that the main reasons for getting pregnant were falling in love and loneliness. Dysfunctional families were a notable feature with 32% (12 coming from broken nuclear families. In order of frequency, social activities in their free time 22/38; 34.2% (13 spend time with their boyfriends. 55%( 21 did not use any contraceptive. 50% (19 heard negative comments against teenage motherhood before their pregnancy. 63% (24 did not plan to get pregnant. 71% 27 had their mother, cousins or a friend with a history of teenage pregnancy. Conclusions: In this population, pregnancy is perhaps a way to establish the sexual identity. It is probable that there is an influence of the repetitive generational pattern of pregnancy at an early age. Teenagers find it viable to adopt adult roles to establish their identity creating a false identity, in addition the limited support from their parents lead them to a marriage or pregnancy as a way to reaffirm their role.

  1. Sensitivity Analysis of Multidisciplinary Rotorcraft Simulations

    Science.gov (United States)

    Wang, Li; Diskin, Boris; Biedron, Robert T.; Nielsen, Eric J.; Bauchau, Olivier A.

    2017-01-01

    A multidisciplinary sensitivity analysis of rotorcraft simulations involving tightly coupled high-fidelity computational fluid dynamics and comprehensive analysis solvers is presented and evaluated. An unstructured sensitivity-enabled Navier-Stokes solver, FUN3D, and a nonlinear flexible multibody dynamics solver, DYMORE, are coupled to predict the aerodynamic loads and structural responses of helicopter rotor blades. A discretely-consistent adjoint-based sensitivity analysis available in FUN3D provides sensitivities arising from unsteady turbulent flows and unstructured dynamic overset meshes, while a complex-variable approach is used to compute DYMORE structural sensitivities with respect to aerodynamic loads. The multidisciplinary sensitivity analysis is conducted through integrating the sensitivity components from each discipline of the coupled system. Numerical results verify accuracy of the FUN3D/DYMORE system by conducting simulations for a benchmark rotorcraft test model and comparing solutions with established analyses and experimental data. Complex-variable implementation of sensitivity analysis of DYMORE and the coupled FUN3D/DYMORE system is verified by comparing with real-valued analysis and sensitivities. Correctness of adjoint formulations for FUN3D/DYMORE interfaces is verified by comparing adjoint-based and complex-variable sensitivities. Finally, sensitivities of the lift and drag functions obtained by complex-variable FUN3D/DYMORE simulations are compared with sensitivities computed by the multidisciplinary sensitivity analysis, which couples adjoint-based flow and grid sensitivities of FUN3D and FUN3D/DYMORE interfaces with complex-variable sensitivities of DYMORE structural responses.

  2. Multidisciplinary Graduate Education in Bioprocess Engineering

    Energy Technology Data Exchange (ETDEWEB)

    Mark A. Eiteman

    2006-04-18

    This report describes the accomplishments of the University of Georgia in establishing an academic program geared toward the emerging biobased products industry. By virtue of its strengths and structure, the University of Georgia is particularly well-suited for developing a program focused on plant- and microbial-based bioproducts, and it was in this general area that this program was developed. The program had several unique characteristics. First, we implemented a distinguished lecture series that brought outstanding scientists and engineers to our University to interact with students and share their vision of the biobased economy. Second, we offered industrially-oriented and multidisciplinary courses that provided students with a broad background on various facets of biobased business and technology. Third, we provided the students with opportunities to expand beyond the classroom by engaging in research lab rotations and industrial internships. Fourth, each student was engaged in a creative research project as led by a multidisciplinary faculty team. Throughout the implementation of these activities, we maintained a student-centered, mentoring approach to education. The most tangible outcome of this project was the graduation of two students who participated in a variety of scholarly activities, culminating in research toward the completion of a thesis and dissertation. Both research projects involved the use of microorganisms to produce industrial products from agricultural substrates via fermentation processes. The research advanced our understanding of microorganisms as used for industrial processes and products, as described in several articles published in scholarly journals and presentations made at scientific conferences (see information on pp. 14-15). Another outcome is one graduate course, Fermentation Engineering Laboratory, which is a unique experiential and multidisciplinary course. This course will be offered in the future as an elective to

  3. Climate Change: A Multidisciplinary Approach, Second Edition

    Science.gov (United States)

    Kirk-Davidoff, Daniel

    2008-07-01

    William Burroughs, who died in November 2007, was a wonderfully clear and evocative writer. Chapter 3 of his last work, Climate Change: A Multidisciplinary Approach, begins with the loveliest four-paragraph description of the general circulation of the Earth's atmosphere I have ever encountered. His writing also shines in his descriptions of the climate record of the past few thousand years, and in his introduction to the measurement of climate change. Unfortunately, the book is marred by inconsistencies in its treatment of climate dynamics, as well as by a number of idiosyncratic choices of emphasis that detract from the book's quality as a general introduction to the science of climate change.

  4. Multidisciplinary Techniques and Novel Aircraft Control Systems

    Science.gov (United States)

    Padula, Sharon L.; Rogers, James L.; Raney, David L.

    2000-01-01

    The Aircraft Morphing Program at NASA Langley Research Center explores opportunities to improve airframe designs with smart technologies. Two elements of this basic research program are multidisciplinary design optimization (MDO) and advanced flow control. This paper describes examples where MDO techniques such as sensitivity analysis, automatic differentiation, and genetic algorithms contribute to the design of novel control systems. In the test case, the design and use of distributed shape-change devices to provide low-rate maneuvering capability for a tailless aircraft is considered. The ability of MDO to add value to control system development is illustrated using results from several years of research funded by the Aircraft Morphing Program.

  5. Multidisciplinary design optimization in computational mechanics

    CERN Document Server

    Breitkopf, Piotr

    2013-01-01

    This book provides a comprehensive introduction to the mathematical and algorithmic methods for the Multidisciplinary Design Optimization (MDO) of complex mechanical systems such as aircraft or car engines. We have focused on the presentation of strategies efficiently and economically managing the different levels of complexity in coupled disciplines (e.g. structure, fluid, thermal, acoustics, etc.), ranging from Reduced Order Models (ROM) to full-scale Finite Element (FE) or Finite Volume (FV) simulations. Particular focus is given to the uncertainty quantification and its impact on the robus

  6. Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases

    Science.gov (United States)

    Ballou, Sarah; Keefer, Laurie

    2017-01-01

    Psychological interventions have been designed and implemented effectively in a wide range of medical conditions, including Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Diseases (IBD). The psychological treatments for IBS and IBD with the strongest evidence base include: cognitive behavioral therapy, hypnosis, and mindfulness-based therapies. The evidence for each of these therapies is reviewed here for both IBS and IBD. In general, there is a stronger and larger evidence base to support the use of psychological interventions in IBS compared with IBD. This is likely due to the high level of psychiatric comorbidity associated with IBS and the involvement of the stress-response in symptom presentation of IBS. Further research in psychosocial interventions for IBD is necessary. Finally, the importance of conceptualizing both IBS and IBD in a biopsychosocial model is discussed and several resources for accessing Clinical Health Psychology materials and referrals are provided. PMID:28102860

  7. A Multidisciplinary Approach to the Management of Atypical Osseous Epithelioid Hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    J. K. Ma

    2014-01-01

    Full Text Available Hemangioendothelioma is a rare vascular tumor of intermediate malignant potential. Though epithelioid hemangioendothelioma (EH is commonly found in soft tissues, it has been known to be present in skeletal tissues. The authors present a case of a 50-year-old woman diagnosed with EH of the iliac bone and acetabulum, who experienced pathological fracture at presentation. This report describes a multidisciplinary approach to the management that includes initial incisional biopsy, curettage, and bone grafting, followed by Intensity Modulated Radiation Therapy. The patient finally underwent hemipelvic resection with allograft reconstruction after recurrence. Histopathological study revealed osseous EH of low mitotic activity that stained positively for CD31, CD34, vimentin, and Factor VIII. Herein, the authors discuss the imaging characteristics, histopathological aspects, cytogenetic findings, and the radiobiological behavior of osseous EH. After an aggressive multidisciplinary intervention, the patient is able to achieve local control with no evidence of distal metastatic disease.

  8. A proposed multidisciplinary approach for identifying feeding abnormalities in children with cerebral palsy.

    Science.gov (United States)

    Santoro, Amelia; Lang, Maria Bianca Dasso; Moretti, Elena; Sellari-Franceschini, Stefano; Orazini, Laura; Cipriani, Paola; Cioni, Giovanni; Battini, Roberta

    2012-06-01

    Children with neurodevelopmental disabilities, such as cerebral palsy, frequently have associated oral motor dysfunction, which leads to feeding difficulties, risk of aspiration, prolonged feeding times, and malnutrition with its attendant physical compromise. The authors propose a comprehensive multidisciplinary assessment, including neurological and dysphagia examination and ear, nose, and throat examination, to evaluate clinical indicators and severity of feeding impairment in children affected by neurodevelopmental disorders. A representative sample of 40 children with cerebral palsy (spastic, dyskinetic, or mixed), intellectual disability, and feeding problems was included in the study. A specific multidisciplinary evaluation and standardized mealtime observation in patients with cerebral palsy appear feasible and appropriate to recognize proactive indicators of dysphagia and to establish personalized programs of gastric and rehabilitative interventions.

  9. Symptomatic pain and fibromyalgia treatment through multidisciplinary approach for primary care.

    Science.gov (United States)

    Gonzalez Gonzalez, Jaime; del Teso Rubio, Maria del Mar; Waliño Paniagua, Carmen Nelida; Criado-Alvarez, Juan Jose; Sanchez Holgado, Javier

    2015-01-01

    Fibromyalgia is a chronic disease of unknown etiology characterized by widespread muscle pain, with occupational, familial, social, physical and psychological performance involvement. The multidisciplinary approach to the disease leads to improvement in quality of life and symptomatology. To evaluate the improvement of activities of daily living (ADL) and quality of life following a multidisciplinary intervention (Health Primary Care and Occupational Therapy). Pretest-posttest study performed with a simple random sample of 21 patients with fibromyalgia (range 16-55 years). The measurement was performed with the Barthel scale (ADL), the scale of Lawton and Brody (IADL), the FIQ questionnaire, and no standardized surveys to assess the pre and post intervention situation. An intervention on motor skills (basic motor skills, pool exercise, outdoor exercise, restructuring, occupational performance and graded activity and intervention in ADL) was performed, combining pharmacological control of their symptoms and treatment. Fibromyalgia patients are not fully satisfied with their treatment; Primary Care receives a score of 6.89, and Hospital Care 5.79, improving the Barthel, Lawton and Brody and FIQ indexes, being statistically significant (p<.05). After the combined procedure the number of independent women in ADL and IADL increases. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  10. A crisis in chronic pain care: an ethical analysis. Part three: Toward an integrative, multi-disciplinary pain medicine built around the needs of the patient.

    Science.gov (United States)

    Giordano, James; Schatman, Michael E

    2008-01-01

    A number of variables have contributed to the current crisis in chronic pain care and are affected by, and affect, the philosophies and politics that influence the socio-economic climate of the American healthcare system. Thus, we posit that managing the crisis in chronic pain care in the United States is contingent upon the development of a multi-focal healthcare paradigm that more thoroughly enables and fortifies research, its translation (in education and practice), and the implementation of, and support for, both the curative and healing approaches in medicine in general, and pain care specifically. These steps necessitate re-examination, if not revision of the health care system and its economics. The ethical imperative to consider and prudently employ cutting-edge diagnostic and therapeutic technologies in pain medicine is obligatory. However, "supply side prudence" is of little value if "demand side accessibility" is lacking. Revisions to health insurance plans advocated by the in-coming administration seek to create uniformity in basic health care services based upon re-assessment of the clinical effectiveness (versus merely cost) of treatments, including those that are "high tech." These plans attempt to allow every patient a more complete ability to deliberatively work with physicians to access those services and resources that maximize health functioning and goals. But even given these revisions, authentic pain care must take into account the interactive contexts of the painient individual. The biopsychosocial model of chronic pain management may have significant practical and ethical worth in this regard. A system of pain treatment operating from a biopsychosocial perspective necessitates integrative multi-disciplinarity. We propose a tiered, multi-disciplinary paradigm based upon the differing needs of each specific patient. But establishing such a system does not guarantee access, and distribution of these services and resources requires economic

  11. Opus: A Coordination Language for Multidisciplinary Applications

    Directory of Open Access Journals (Sweden)

    Barbara Chapman

    1997-01-01

    Full Text Available Data parallel languages, such as High Performance Fortran, can be successfully applied to a wide range of numerical applications.However, many advanced scientific and engineering applications are multidisciplinary and heterogeneous in nature, and thus do not fit well into the data parallel paradigm. In this paper we present Opus, a language designed to fill this gap. The central concept of Opus is a mechanism called ShareD Abstractions (SDA. An SDA can be used as a computation server, i.e., a locus of computational activity, or as a data repository for sharing data between asynchronous tasks. SDAs can be internally data parallel, providing support for the integration of data and task parallelism as well as nested task parallelism. They can thus be used to express multidisciplinary applications in a natural and efficient way. In this paper we describe the features of the language through a series of examples and give an overview of the runtime support required to implement these concepts in parallel and distributed environments.

  12. [Ectopia cordis: multidisciplinary approach with successful result].

    Science.gov (United States)

    Serrano Gómez, Servando Germán; Bermlúez Sosa, Marco Tulio; Palma Hernández, Emigdio; del Castillo Salceda, Luis Fernando; Pinzón Muslera, Otto; Hernández Cortés, Bernardino; Méndez Machado, Gustavo

    2006-08-01

    Ectopia cordis is a pathology in which the heart is complete or partially outside of the thoracic cavity. It represents a challenge for the diagnosis and handling because of its high perinatal mortality. We present the first case of thoracic ectopia cordis with prenatal diagnostic (27th week), its multidisciplinary handling at Hospital de Ginecopediatria núm. 71 of the Centro Medico Nacional Adolfo Ruiz Cortines, IMSS, in Veracruz, Mexico. We communicate the case of a 24 year-old woman referred by her correspondent medical unit with the diagnosis of 23.6 weeks pregnancy with suspicion of heart malformation by ultrasound. The pregnancy was followed-up until the 38th week, when it was programmed a caesarean section. The newborn had ectopia cordis, which was treated at the moment of birth. In this article, we present pictures of the heart defect as well as its evolution. The up-to-date bibliography is revised about the medical profile and treatment. The handling of the ectopia cordis includes an appropriate prenatal diagnosis through echocardiograph, a multidisciplinary perinatal team, to program the caesarean operation, aseptic handling of the newborn, immediate correction of the wall defect with skin torn piece without trying to correct the costal grill, specific hemodynamic cares, to reprogramme a correction of associated defects.

  13. Photogrammetry Education for Multidisciplinary Geomatics in China

    Institute of Scientific and Technical Information of China (English)

    ZHU Qing

    2006-01-01

    After briefly reviews the history of photogrammetry education in China, the development of undergraduate and graduate program, and the corresponding curricula design are analyzed by use of the data from Wuhan University in which the photogrammetry is awarded as the state-level key discipline. The academic educational program of photogrammetry in universities has trained students to perform tasks in all fields of the photogrammetric profession. In recent years, the nature of photogrammetry is changing and multidisciplinary geomatics are developing very rapidly, the educational program of photogrammetry has also changed in new concepts and structures to adapt very new technologies and the extension of the field. Finally, the prospect of photogrammetry education for the requirements of multidisciplinary geomatics is proposed. The growing interest in fast and accurate 3D spatial data collection (such as city modeling and digital earth) results in the increasing need of photogrammetry as principal tool, photogrammetric courses are therefore requested to be up-to-date and to become one kind of the fundamental professional courses for university geomatics and remote sensing degree programs.

  14. Opus: A Coordination Language for Multidisciplinary Applications

    Science.gov (United States)

    Chapman, Barbara; Haines, Matthew; Mehrotra, Piyush; Zima, Hans; vanRosendale, John

    1997-01-01

    Data parallel languages, such as High Performance fortran, can be successfully applied to a wide range of numerical applications. However, many advanced scientific and engineering applications are multidisciplinary and heterogeneous in nature, and thus do not fit well into the data parallel paradigm. In this paper we present Opus, a language designed to fill this gap. The central concept of Opus is a mechanism called ShareD Abstractions (SDA). An SDA can be used as a computation server, i.e., a locus of computational activity, or as a data repository for sharing data between asynchronous tasks. SDAs can be internally data parallel, providing support for the integration of data and task parallelism as well as nested task parallelism. They can thus be used to express multidisciplinary applications in a natural and efficient way. In this paper we describe the features of the language through a series of examples and give an overview of the runtime support required to implement these concepts in parallel and distributed environments.

  15. Developing a Collaborative Multidisciplinary Online Design Course

    Directory of Open Access Journals (Sweden)

    Diane M. Bender

    2005-07-01

    Full Text Available Technology is transforming the practice of architecture and design from the conceptual stages right down to the actual construction. One would assume technology is being readily integrated into current design education. Unfortunately, this is not the case. The purpose of this study is to explore the integration of online education into the curriculum of architecture and design. The three primary obstacles to integrating technology with education in these disciplines are identified as: 1 the limited evidence of online education in the fields of architecture and design (Sagun, Demirkan, & Goktepe, 2001; 2 the reluctance of design educators to teach in an online environment (Bender & Good, 2003; and 3 the lack of multidisciplinary coursework currently available between architecture, design, and other related fields (IIDA Report, 1998. This paper will discuss online education in the context of traditional architecture and design studio instruction. A case study of the development of a collaborative, multidisciplinary online course offered between five major universities will be presented as a catalyst for change. The paper concludes with reflections on the pedagogical advantages and disadvantages of this new educational model and its implications for instructors involved in online education.

  16. Integrative health care model for climacteric stage women: design of the intervention

    Directory of Open Access Journals (Sweden)

    Pérez-Cuevas Ricardo

    2011-02-01

    Full Text Available Abstract Background Climacteric stage women experience significant biological, psychological and social changes. With demographic changes being observed in the growing number of climacteric stage women in Mexico, it is important to improve their knowledge about the climacteric stage and its potential associated problems, encourage their participation in screening programs, and promote the acquisition of healthy lifestyles. At Mexican health care institutions the predominant health care model for climacteric stage women has a biomedical perspective. Medical doctors provide mostly curative services and have limited support from other health professionals. This study aims to design an integrative health care model (IHCM: bio-psycho-social, multidisciplinary and women-centered applicable in primary care services aimed at climacteric stage women. Methods/Design We present the design, inclusion criteria and detailed description of an IHCM. The IHCM consists of collaborative and coordinated provision of services by a health team, which is involves a family doctor, nurse, psychologist, and the woman herself. The health team promotes the empowerment of women through individual and group counseling on the climacteric stage and health related self-care. The intervention lasts three months followed by a three-month follow-up period to evaluate the effectiveness of the model. The effectiveness of the model will be evaluated through the following aspects: health-related quality of life (HR-QoL, empowerment, self-efficacy and knowledge regarding the climacteric stage and health-related self-care activities, use of screening services, and improvement in lifestyles (regular leisure time physical activity and healthy diet. Discussion Participation in preventive activities should be encouraged among women in Mexico. Designing and evaluating the effectiveness of an integrative health care model for women at the climacteric stage, based on the empowerment approach

  17. Practical Multi-Disciplinary Analysis Tools for Combustion Devices Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The use of multidisciplinary analysis (MDA) techniques for combustion device environment prediction, including complex fluid mixing phenomena, is now becoming...

  18. Practical Multi-Disciplinary Analysis Tools for Combustion Devices Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The use of multidisciplinary analysis (MDA) techniques for complex fluid/structure interaction phenomena is increasing as proven numerical and visualization...

  19. Development of knowledge tests for multi-disciplinary emergency training

    DEFF Research Database (Denmark)

    Sorensen, J. L.; Thellesen, L.; Strandbygaard, J.

    2015-01-01

    Background: The literature is sparse on written test developmentin a post-graduate multi-disciplinary setting. Developing and evalu-ating knowledge tests for use in multi-disciplinary post-graduatetraining is challenging. The objective of this study was to describethe process of developing...... and evaluating a multiple-choice question(MCQ) test for use in a multi-disciplinary training program inobstetric-anesthesia emergencies. Methods: A multi-disciplinary working committee with 12members representing six professional healthcare groups andanother 28 participants were involved. Recurrent revisions...

  20. Frailty Intervention Trial (FIT

    Directory of Open Access Journals (Sweden)

    Lockwood Keri

    2008-10-01

    Full Text Available Abstract Background Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagues used to define the frailty syndrome will be used in this study (i.e. weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. Previous studies have shown that clinical outcomes for frail older people can be improved using multi-factorial interventions such as comprehensive geriatric assessment, and single interventions such as exercise programs or nutritional supplementation, but no interventions have been developed to specifically reverse the syndrome of frailty. We have developed a multidisciplinary intervention that specifically targets frailty as defined by Fried et al. We aim to establish the effects of this intervention on frailty, mobility, hospitalisation and institutionalisation in frail older people. Methods and Design A single centre randomised controlled trial comparing a multidisciplinary intervention with usual care. The intervention will target identified characteristics of frailty, functional limitations, nutritional status, falls risk, psychological issues and management of chronic health conditions. Two hundred and thirty people aged 70 and over who meet the Fried definition of frailty will be recruited from clients of the aged care service of a metropolitan hospital. Participants will be followed for a 12-month period. Discussion This research is an important step in the examination of specifically targeted frailty interventions. This project will assess whether an intervention specifically targeting frailty can be implemented, and whether it is effective when compared to usual care. If successful, the study will establish a

  1. Robin sequence: what the multidisciplinary approach can do

    Directory of Open Access Journals (Sweden)

    Cohen SM

    2017-03-01

    Full Text Available Stephanie M Cohen,1 S Travis Greathouse,2 Cyrus C Rabbani,3 Joseph O’Neil,4 Matthew A Kardatzke,5 Tasha E Hall,6 William E Bennett Jr,7 Ameet S Daftary,8 Bruce H Matt,3 Sunil S Tholpady1 1Division of Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, 2Reid Health, Richmond, 3Department of Otolaryngology – Head and Neck Surgery, 4Section of Developmental Pediatrics, 5Section of Neonatal-Perinatal Medicine, Department of Pediatrics, 6Department of Orthodontics, 7Section of Children’s Health Services Research, Section of Pediatric and Adolescent Comparative Effectiveness Research, 8Section of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Abstract: Robin sequence (RS is a commonly encountered triad of micrognathia, glossoptosis, and airway obstruction, with or without a cleft palate. The management of airway obstruction is of paramount importance, and multiple reviews and retrospective series outline the diagnosis and treatment of RS. This article focuses on the multidisciplinary nature of RS and the specialists’ contributions and thought processes regarding the management of the RS child from birth to skeletal maturity. This review demonstrates that the care of these children extends far beyond the acute airway obstruction and that thorough monitoring and appropriate intervention are required to help them achieve optimal outcomes. Keywords: cleft palate, micrognathia, mandibular distraction, retrognathia, laryngomalacia

  2. Survey, modeling, interpretation as multidisciplinary components of a Knowledge System

    Directory of Open Access Journals (Sweden)

    Carlo Bianchini

    2014-04-01

    Full Text Available Cultural Heritage represents a very difficult subject to be handled. Despite its cross-cutting and multi-level characters (scientific, social, economic, political, etc., nevertheless the topic can hardly be framed in a proper and comprehensive way. Any project addressing Cultural Heritage  (documentation, preservation, retrofitting, valorisation and so on actually tends to exalt a specific point of view and, therefore, to neglect potentially crucial contributions coming from different fields of expertise. Comprehensive solutions to this problem seem by now available thanks to ICT and the 3D Digitalization and Multimedia Technologies: nevertheless the more the platforms improve their multidisciplinary capabilities and interoperability, the more they need an intelligent design and an accurate control during the implementation phase. Built Cultural Heritage (as historic buildings, districts, sites, etc. perfectly represents the wide range of situations, which have to be tackled. Any intervention, in fact, from the design phase to its realization and validation, actually deals with several different interlaced layers that together depict a “complex system”. The construction of a Knowledge System represents a crucial step in correctly addressing the problem.

  3. A multidisciplinary youth violence-prevention initiative: impact on attitudes.

    Science.gov (United States)

    Chang, David C; Cornwell, Edward E; Sutton, Erica R H; Yonas, Michael A; Allen, Fred

    2005-11-01

    In a previous report, enhanced resource commitment at a Level I trauma center was associated with improved outcomes for most major categories of injured patients, except those with gunshot wounds, which disproportionately affected the young (ages 15 to 24 years). We hypothesized that a primary violence-prevention initiative geared toward changing attitudes about interpersonal conflict among at-risk youths can be effective. Between May 2002 and November 2003, 97 youths (mean age 12.6 years) were recruited from one of two Police Athletic League centers in the catchment area of our Level I trauma center. Participant attitudes about interpersonal conflicts were surveyed with six previously validated scales before and after a hospital tour with a video and slide presentation graphically depicting the results of gun violence. Mean differences in scores between pre- and postintervention surveys were assessed. Of the 97 participants, 48 (49.4%) completed the intervention program with both the pre- and postintervention tests, with a mean of 25.8 days between tests. There was a statistically significant reduction in the Beliefs Supporting Aggression scale (mean -0.38 U; 95% CI, -0.23 to -0.54; p toward reduced Likelihood of Violence (mean -0.17 U; 95% CI, 0.01 to -0.34; p = 0.06). A multidisciplinary violence-prevention outreach program can produce short-term improvement in beliefs supporting aggression among at-risk youth. Longterm impact of this attitude change needs to be examined in future studies.

  4. Swearing: A Biopsychosocial Perspective

    Directory of Open Access Journals (Sweden)

    Ad J.J.M. Vingerhoets

    2013-09-01

    Full Text Available Swearing, also known as cursing, can be best described as a form of linguistic activity utilizing taboo words to convey the expression of strong emotions. Although swearing and cursing are frequently occurring behaviors, the actual functions of swearing remain largely unknown. Since swearing typically includes taboo words, these words can be more powerful than non-swear words. Therefore, people who swear are often judged negatively, because the uttered swearwords can shock and disturb others, though the comments of others are strongly dependent on contextual factors. In this review, we provide an insight into the current state of the literature with respect to the interpersonal functions of swearing. In addition, we briefly discuss neurological, psychosocial and contextual factors that may contribute to person’s swearing behavior. Swearing is hypothesized to produce a catharsis-effect, which results in a relief of stress or pain. Swearing also influences the perceived credibility, intensity, and persuasiveness of the swearer. Additionally, swearing can have a variety of interpersonal consequences, including promoting group bonding and solidarity, inhibiting aggression, eliciting humor, and causing emotional pain to others. This paper further presents a hypothetical model of swearing that draws from basic emotion research in an attempt to provide a scaffolding for future research.

  5. Robust Parameter Coordination for Multidisciplinary Design

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This paper introduced a robust parameter coordination method to analyze parameter uncertainties so as to predict conflicts and coordinate parameters in multidisciplinary design. The proposed method is based on constraints network, which gives a formulated model to analyze the coupling effects between design variables and product specifications. In this model, interval boxes are adopted to describe the uncertainty of design parameters quantitatively to enhance the design robustness. To solve this constraint network model, a general consistent algorithm framework is designed and implemented with interval arithmetic and the genetic algorithm, which can deal with both algebraic and ordinary differential equations. With the help of this method, designers could infer the consistent solution space from the given specifications. A case study involving the design of a bogie dumping system demonstrates the usefulness of this approach.

  6. Multidisciplinary Modelling Tools for Power Electronic Circuits

    DEFF Research Database (Denmark)

    Bahman, Amir Sajjad

    This thesis presents multidisciplinary modelling techniques in a Design For Reliability (DFR) approach for power electronic circuits. With increasing penetration of renewable energy systems, the demand for reliable power conversion systems is becoming critical. Since a large part of electricity...... in reliability assessment of power modules, a three-dimensional lumped thermal network is proposed to be used for fast, accurate and detailed temperature estimation of power module in dynamic operation and different boundary conditions. Since an important issue in the reliability of power electronics...... are generic and valid to be used in circuit simulators or any programing software. These models are important building blocks for the reliable design process or performance assessment of power electronic circuits. The models can save time and cost in power electronics packaging and power converter to evaluate...

  7. Internationality of the Multidisciplinary Psychology Journals

    Directory of Open Access Journals (Sweden)

    GUALBERTO BUELA-CASAL

    2010-03-01

    Full Text Available International journals are considered more prestigious and with more quality than national ones, although the meaning of this had not been established until recently. Moreover, internationality has been used as a criterion to make important decisions, for example to assess the performance of scientists,universities, doctoral degree programs, and so on, without knowing the exact meaning of internationality. Thus, the current study uses the criteriaof internationality established by a survey on more than 16,000 scientists from all over the world to create an Internationality Index of multidisciplinary psychology journals published in Ibero-America and included in the Web of Science. Results show that the most international journal is Revista Latinoamericana de Psicología, followed by The Spanish Journal of Psychology,Psicothema and Universitas Psychologica. All the journals fulfill the criteria for internationality and the study provides very important results which will allow its increase.

  8. Pemphigus vulgaris: a multidisciplinary approach to management.

    Science.gov (United States)

    Vinall, Christopher; Stevens, Lucy; McArdle, Paul

    2013-12-16

    Pemphigus vulgaris (PV) is a rare but potentially life-threatening autoimmune disease affecting the mucosa and the skin. The disease is caused by circulating antibodies to desmosomes (important adhesion proteins linking cells together). Disruption of these intercellular connections results in a loss of cohesion between cells (acantholysis). The clinical result of this process is the development of multiple blisters that easily rupture, leaving behind painful sloughing eroded areas of mucosa and/or skin. We report a case of severe PV in a 56-year-old man presenting with widespread, painful, eroded mucocutaneous lesions. The severity of the disease demanded a range of medical and surgical specialties to successfully manage the problem. This paper highlights the importance of an early multidisciplinary team approach to improve the outcome of patients suffering with this disease.

  9. Gummy smile: A contemporary and multidisciplinary overview

    Directory of Open Access Journals (Sweden)

    Marcelo Tomás Oliveira

    2013-01-01

    Full Text Available The aim of this study was to elucidate the diagnosis, etiology, and therapeutic options for the treatment of gummy smile. The smile level is an imaginary line after the lower superior lip and used seems to be convex. The presence of 3 mm or grater continuous gingival band exposures to natural smile or speech performs the gummy smile. Original articles studying the diagnosis, etiology, and therapeutic alternatives for the treatment of gummy smile were searched in the Medline, Scopus, Science direct, and EBSCO host databases. Together with some example and diagnosis method was purposed. The authors conclude that the etiology is multifactorial and can be showed excessive vertical maxillary grow up, excessive labial contraction, shorter upper lip, gingival excess, and extrusion of the anterior teeth. The therapeutics alternative are often multidisciplinary, besides can be used orthognathic, plastic and periodontal surgery, and orthodontic.

  10. Multidisciplinary treatment approach in Treacher Collins syndrome.

    Science.gov (United States)

    Hylton, Joseph B; Leon-Salazar, Vladimir; Anderson, Gary C; De Felippe, Nanci L O

    2012-01-01

    Treacher Collins syndrome (TCS) is a common genetic disorder with high penetrance and phenotypic variability. First and second branchial arches are affected in TCS, resulting in craniofacial and intraoral anomalies such as: severe convex facial profile; mid-face hypoplasia; microtia; eyelid colobomas; mandibular retrognathism; cleft palate; dental hypoplasia; heterotopic teeth; maxillary transverse hypoplasia; anterior open bite; and Angle Class II molar relationship. A high incidence of caries is also a typical finding in TCS patients. Nonetheless, even simple dental restorative procedures can be challenging in this patient population due to other associated medical conditions, such as: congenital heart defects; decreased oropharyngeal airways; hearing loss; and anxiety toward treatment. These patients often require a multidisciplinary treatment approach, including: audiology; speech and language pathology; otorhinolaryngology; general dentistry; orthodontics; oral and maxillofacial surgery; and plastic and reconstructive surgeries to improve facial appearance. This paper's purpose was to present a current understanding of Treacher Collins syndrome etiology, phenotype, and current treatment approaches.

  11. Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.

    Science.gov (United States)

    Tesher, Melissa S

    2015-06-01

    A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the biologic, psychologic, and social factors contributing to the perpetuation of chronic pain. The author reviews the diagnostic criteria, pathophysiology, and treatment of juvenile fibromyalgia. Medications, particularly antidepressants and anticonvulsants, can be useful adjuncts to therapy. However, multimodal pain management including intensive physical therapy, exercise, counseling, and sleep hygiene is most effective in treating fibromyalgia.

  12. Turner syndrome case report: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Guilherme Thiesen

    2015-01-01

    Full Text Available Turner syndrome (TS was fi rst reported in the literature in 1938 by Laurel Thatcher Ulrich and Henry Turner. This chromosomal alteration only affects female individuals, who have monosomy of the X chromosome. Only one X chromosome is functional, while the other sexual chromosome is either absent or abnormal. The main oral characteristics are transverse defi ciency of the maxilla, mandibular retrognathism, anterior open bite, cleft palate, premature dental eruption, and alterations in the shape, size and thickness of teeth, with an increased number of roots on the fi rst and second premolars. The objective of this study was to describe the clinical case of a patient with TS undergoing orthodontic treatment, and to emphasize the importance of a multidisciplinary approach to patients with TS.

  13. Multidisciplinary systems engineering architecting the design process

    CERN Document Server

    Crowder, James A; Demijohn, Russell

    2016-01-01

    This book presents Systems Engineering from a modern, multidisciplinary engineering approach, providing the understanding that all aspects of systems design, systems, software, test, security, maintenance and the full life-cycle must be factored in to any large-scale system design; up front, not factored in later. It lays out a step-by-step approach to systems-of-systems architectural design, describing in detail the documentation flow throughout the systems engineering design process. It provides a straightforward look and the entire systems engineering process, providing realistic case studies, examples, and design problems that will enable students to gain a firm grasp on the fundamentals of modern systems engineering.  Included is a comprehensive design problem that weaves throughout the entire text book, concluding with a complete top-level systems architecture for a real-world design problem.

  14. A multidisciplinary conceptualization of conservation opportunity.

    Science.gov (United States)

    Moon, Katie; Adams, Vanessa M; Januchowski-Hartley, Stephanie R; Polyakov, Maksym; Mills, Morena; Biggs, Duan; Knight, Andrew T; Game, Edward T; Raymond, Christopher M

    2014-12-01

    An opportunity represents an advantageous combination of circumstances that allows goals to be achieved. We reviewed the nature of opportunity and how it manifests in different subsystems (e.g., biophysical, social, political, economic) as conceptualized in other bodies of literature, including behavior, adoption, entrepreneur, public policy, and resilience literature. We then developed a multidisciplinary conceptualization of conservation opportunity. We identified 3 types of conservation opportunity: potential, actors remove barriers to problem solving by identifying the capabilities within the system that can be manipulated to create support for conservation action; traction, actors identify windows of opportunity that arise from exogenous shocks, events, or changes that remove barriers to solving problems; and existing, everything is in place for conservation action (i.e., no barriers exist) and an actor takes advantage of the existing circumstances to solve problems. Different leverage points characterize each type of opportunity. Thus, unique stages of opportunity identification or creation and exploitation exist: characterizing the system and defining problems; identifying potential solutions; assessing the feasibility of solutions; identifying or creating opportunities; and taking advantage of opportunities. These stages can be undertaken independently or as part of a situational analysis and typically comprise the first stage, but they can also be conducted iteratively throughout a conservation planning process. Four types of entrepreneur can be identified (business, policy, social, and conservation), each possessing attributes that enable them to identify or create opportunities and take advantage of them. We examined how different types of conservation opportunity manifest in a social-ecological system (the Great Barrier Reef) and how they can be taken advantage of. Our multidisciplinary conceptualization of conservation opportunity strengthens and

  15. [Irritable Bowel Syndrome treatment: a multidisciplinary approach].

    Science.gov (United States)

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

    Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life.

  16. Evaluating Multidisciplinary Child Abuse and Neglect Teams: A Research Agenda

    Science.gov (United States)

    Lalayants, Marina; Epstein, Irwin

    2005-01-01

    A review of child welfare research literature reveals that although multidisciplinary teams are increasingly used to investigate and intervene in child abuse and neglect cases, the field does not know enough about their structural variations, implementation processes, or effectiveness. Moreover, although articles advocating multidisciplinary teams…

  17. Effects of a nurse practitioner on a multidisciplinary consultation team

    NARCIS (Netherlands)

    van der Sluis, Corry K.; Datema, Linetta; Saan, Ingrid; Stant, Dennis; Dijkstra, Pieter U.

    2009-01-01

    Effects of a nurse practitioner on a multidisciplinary consultation team. This paper is a report of a study to evaluate the impact on office hours capacity, patient satisfaction, quality of life and costs of including a nurse practitioner in a multidisciplinary consultation team for patients with ha

  18. A case study on collaboration within multidisciplinary teamwork

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan; Hertz, Kristian Dahl

    2010-01-01

    and teamwork at the final stage of the engineering education. The course was held by a multidisciplinary team of teachers for 9 multidisciplinary teams of students. The team of teachers and the student teams had similar working conditions. These teams were subject of investigation on collaboration...

  19. The Problems Facing Multidisciplinary Teams: As Perceived by Team Members.

    Science.gov (United States)

    Pfeiffer, Steven I.

    1981-01-01

    Investigated the problems team members perceive to exist on multidisciplinary teams. Results indicated the two major areas of concern for urban, multidisciplinary team members were: too constrictive a set of team roles and goals, and teams functioning under extensive pressure with minimal support. (Author)

  20. Multi-disciplinary design optimisation via dashboard portals

    NARCIS (Netherlands)

    Uijtenhaak, T.; Coenders, J.L.

    2012-01-01

    This paper will present the opportunities a dashboard-based system provides to gather information on alternatives and display this in such a way that it will help the user making decisions by making use of multi-disciplinary optimisation (MDO) technology. The multi-disciplinary set up of the program

  1. Using Sustainability Themes and Multidisciplinary Approaches to Enhance STEM Education

    Science.gov (United States)

    Rogers, Michael; Pfaff, Thomas; Hamilton, Jason; Erkan, Ali

    2015-01-01

    Purpose: The purpose of this paper is to report on the Multidisciplinary Sustainability Education Project (MSEP) as a framework using sustainability-themed education modules to introduce students to the need for multidisciplinary approaches to solving twenty-first-century problems while retaining traditional course strengths and content.…

  2. Multi-disciplinary design optimisation via dashboard portals

    NARCIS (Netherlands)

    Uijtenhaak, T.; Coenders, J.L.

    2012-01-01

    This paper will present the opportunities a dashboard-based system provides to gather information on alternatives and display this in such a way that it will help the user making decisions by making use of multi-disciplinary optimisation (MDO) technology. The multi-disciplinary set up of the program

  3. Multidisciplinary teaching – Engineering course in advanced building design

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan; Hertz, Kristian Dahl

    2011-01-01

    Collaboration within the building process is difficult. This calls for employees who are experienced in collaborating in interdisciplinary teams. To fulfil this demand a multidisciplinary course in “Advanced building design” has been developed at the Technical University of Denmark. The goal of t....... It is worthwhile to offer a multidisciplinary course and give engineering students experience in new collaboration methods....

  4. Multidisciplinary Teamwork in Autism: Can One Size Fit All?

    Science.gov (United States)

    Dillenburger, Karola; Röttgers, Hanns-Rüdiger; Dounavi, Katerina; Sparkman, Coleen; Keenan, Mickey; Thyer, Bruce; Nikopoulos, Christos

    2014-01-01

    Multidisciplinary practice has become an accepted approach in many education and social and health care fields. In fact, the right to a multidisciplinary assessment is enshrined in the United Nations Convention of the Rights for Persons with Disabilities (United Nations, 2007). In order to avert a "one size fits all" response to…

  5. Effects of a nurse practitioner on a multidisciplinary consultation team

    NARCIS (Netherlands)

    van der Sluis, Corry K.; Datema, Linetta; Saan, Ingrid; Stant, Dennis; Dijkstra, Pieter U.

    2009-01-01

    Effects of a nurse practitioner on a multidisciplinary consultation team. This paper is a report of a study to evaluate the impact on office hours capacity, patient satisfaction, quality of life and costs of including a nurse practitioner in a multidisciplinary consultation team for patients with ha

  6. Influence of cataract surgery in biopsychosocial adaptation in the elderly Influencia de la cirugía de catarata en la adaptación biopsicosocial del adulto mayor

    Directory of Open Access Journals (Sweden)

    Bárbara Suárez Rodríguez

    2010-11-01

    Full Text Available Background: The twenty-first century is characterized by a progressive aging in the population, with the subsequent demand of medical care it implies due to the polimorbility rates typical of this stage of life. Objective: to prove the positive influence of cataract surgery in biopsychosocial adaptation of elderlies. Methods: a descriptive study conducted from January to June 2008 in the General University Hospital "Dr. Aldereguía Gustavo Lima’’ in Cienfuegos. The 60 elder patients who underwent surgery cataract in that period were included. Geriatric evaluation was used as assessment instrument. It was applied before and 3 months after cataract surgery and included the Yesavage Geriatric Depression Rating Scale to measure emotional function and the Katz index for functional evaluation. The variables used are part of the preoperative geriatric assessment. Among them we can find biomedical, social, functional and psychological aspects as well as-risk benefit and anesthetic risks analysis. Results: the largest amount of patients was between 70 and 74 years old, predominantly males and white skinned. Most frequent personal pathological records were arthropathies, diabetes mellitus and hypertension. A significant relationship between initial visual acuity levels and depression rates was found; as well as limitations in performing basic daily life activities. Conclusions: with surgical intervention an improved visual acuity was achieved and a number of functional capacities were reestablished to allow a better biopsychosocial adaptation in elderlies.Fundamento: el siglo XXI se caracteriza por un aumento progresivo del envejecimiento poblacional, con la consecuente demanda de atención médica por la polimorbilidad que presenta esta etapa del ciclo vital. Objetivo: demostrar la influencia de la cirugía de catarata en la adaptaci

  7. A multidisciplinary weight-loss program: the importance of psychological group therapy

    Directory of Open Access Journals (Sweden)

    Gustavo Duarte Ferrari

    Full Text Available Abstract In addition to dietary factors and sedentary habits, there is a relationship between obesity and psychological variables, even without a clear distinction between cause, effect, and correlation. Despite this relationship, weight-loss programs are limited to a combination of nutrition and physical education, leaving psychological intervention out of the treatment plan. Self-esteem issues, depression, and anxiety are just some of the emotional conditions related to obesity. However, there is no information in the literature about the importance of psychological counseling in a multidisciplinary program for weight-loss in adults. In this context, the main objective of this study was to analyze the effect of cognitive-behavioral therapy in groups (CBTG combined with nutrition and physical education within a multidisciplinary approach to treat obesity. 46 individuals (7 men and 39 women were divided into two groups: control (GC and psychology (GP. Baseline and intervention measures were obtained prior to intervention and before the final meeting, including physical capacity tests and the administering the International Physical Activities Questionnaire (IPAQ. Both groups attended weekly lectures given by a nutritionist and two physical education professionals for 12 weeks. In addition, the GP participated in weekly sessions of CBTG for the same period. After the program, there were significant changes in body mass index, waist circumference, body fat percentage, and strength of the lower limbs in both groups. In addition to these changes, the GP also showed improvements in diastolic blood pressure and IPAQ scores, being the only one that increased its time of weekly physical activity. Thus, it was concluded that the psychological treatment might play an important role in a multidisciplinary weight-loss program.

  8. Multidisciplinary Portuguese recommendations on DXA request and indication to treat in the prevention of fragility fractures.

    Science.gov (United States)

    Marques, Andréa; Rodrigues, Ana M; Romeu, José Carlos; Ruano, Afonso; Barbosa, Ana Paula; Simões, Eugénia; Águas, Fernanda; Canhão, Helena; Alves, José Delgado; Lucas, Raquel; Branco, Jaime Cunha; Laíns, Jorge; Mascarenhas, Mário; Simões, Susete; Tavares, Viviana; Lourenço, Oscar; da Silva, José António Pereira

    2016-01-01

    To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions. 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal.

  9. Interventions to promote healthy eating habits

    DEFF Research Database (Denmark)

    Traill, W. B.; Shankar, B.; Branbila-Macias, J.

    2010-01-01

    and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality-adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology...... of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one-stop guide to methods and measures in interventions evaluation...

  10. A Correlation Analysis Model for Multidisciplinary Data in Disaster Research

    Directory of Open Access Journals (Sweden)

    Hongyue Zhang

    2015-05-01

    Full Text Available Data play an important role in disaster mitigation applications, and the integrated employment of multidisciplinary data promotes the development of disaster science. Therefore it is very useful to identify the multidisciplinary data usage in the research of disaster events. In order to discover the correlation between multidisciplinary data and disaster research, three earthquake events, the Tangshan earthquake, the Wenchuan earthquake, and the Haidi earthquake were selected as typical study cases for this paper. A knowledge model for literature data mining was applied to analyze the correlation between earthquake events and multidisciplinary data types. The results indicate that high-cited papers show different data usage trends when compared with whole-set papers and also that data usage for the three earthquake events varies. According to analysis results, the factors that influence multidisciplinary data usage include the characteristics of spatial and temporal elements as well as differing interests of the data users.

  11. An improved multidisciplinary feasible method using DACE approximation approach

    Institute of Scientific and Technical Information of China (English)

    Su Zijian; Xiao Renbin; Zhong Yifang

    2005-01-01

    Multidisciplinary feasible method (MDF) is conventional method to multidisciplinary optimization (MDO) and well-understood by users. It reduces the dimensions of the multidisciplinary optimization problem by using the design variables as independent optimization variables. However, at each iteration of the conventional optimization procedure,multidisciplinary analysis (MDA) is numerously performed that results in extreme expense and low optimization efficiency. The intrinsic weakness of MDF is due to the times that it loop fixed-point iterations in MDA, which drive us to improve MDF by building inexpensive approximations as surrogates for expensive MDA. An simple example is presented to demonstrate the usefulness of the improved MDF. Results show that a significant reduction in the number of multidisciplinary analysis required for optimization is obtained as compared with original MDF and the efficiency of optimization is increased.

  12. The Challenges of Multidisciplinary Education in Computer Science

    Institute of Scientific and Technical Information of China (English)

    Fred S. Roberts

    2011-01-01

    Some of the most important problems facing the United States and China,indeed facing our entire planet,require approaches that are fundamentally multidisciplinary in nature.Many of those require skills in computer science (CS),basic understanding of another discipline,and the ability to apply the skills in one discipline to the problems of another.Modern training in computer science needs to prepare students to work in other disciplines or to work on multidisciplinary problems.What do we do to prepare them for a multidisciplinary world when there are already too many things we want to teach them about computer science? This paper describes successful examples of multidisciplinary education at the interface between CS and the biological sciences,as well as other examples involving CS and security,CS and sustainability,and CS and the social and economic sciences.It then discusses general principles for multidisciplinary education of computer scientists.

  13. Mobilization of intensive care patients: a multidisciplinary practical guide for clinicians

    Directory of Open Access Journals (Sweden)

    Green M

    2016-05-01

    Full Text Available Margot Green1, Vince Marzano1, I Anne Leditschke2,3, Imogen Mitchell2,3, Bernie Bissett1,4,5 1Physiotherapy Department, Canberra Hospital, Canberra, ACT, Australia; 2Intensive Care Unit, Canberra Hospital, Canberra, ACT, Australia; 3School of Medicine, Australian National University, Canberra, ACT, Australia; 4Discipline of Physiotherapy, University of Canberra, Canberra, ACT, Australia; 5School of Medicine, University of Queensland, Brisbane, QLD, Australia Objectives: To describe our experience and the practical tools we have developed to facilitate early mobilization in the intensive care unit (ICU as a multidisciplinary team.Background: Despite the evidence supporting early mobilization for improving outcomes for ICU patients, recent international point-prevalence studies reveal that few patients are mobilized in the ICU. Existing guidelines rarely address the practical issues faced by multidisciplinary ICU teams attempting to translate evidence into practice. We present a comprehensive strategy for safe mobilization utilized in our ICU, incorporating the combined skills of medical, nursing, and physiotherapy staff to achieve safe outcomes and establish a culture which prioritizes this intervention.Methods: A raft of tools and strategies are described to facilitate mobilization in ICU by the multidisciplinary team. Patients without safe unsupported sitting balance and without ≥3/5 (Oxford scale strength in the lower limbs commence phase 1 mobilization, including training of sitting balance and use of the tilt table. Phase 2 mobilization involves supported or active weight-bearing, incorporating gait harnesses if necessary. The Plan B mnemonic guides safe multidisciplinary mobilization of invasively ventilated patients and emphasizes the importance of a clearly articulated plan in delivering this valuable treatment as a team.Discussion: These tools have been used over the past 5 years in a tertiary ICU with a very low incidence of

  14. Post Graduate Multidisciplinary Development Programme – Impact on the Interpretation of Pelvic MRI in Rectal Cancer Patients

    DEFF Research Database (Denmark)

    Pedersen, Bodil Ginnerup; Blomqvist, Lennart; Brown, Gina;

    2011-01-01

    Background: Pelvic magnetic resonance imaging in patients with rectal cancer is an accepted tool for the identification of patients with poor prognostic tumours who may benefit from neo-adjuvant therapy. In Denmark, the examination has been mandatory in the work-up on rectal cancer since 2002....... Objective: To assess the impact of a multidisciplinary team course for doctors in West Denmark on the technical quality, reporting and interpretation of pelvic MRI in rectal cancer. Design: Interventional, observational study. Two expert reviewers served as reference standard in the evaluation...... cancer were enrolled. Interventions: A multidisciplinary team course including on-site-visits. Main Outcome Measures: The MR-scans were evaluated concerning technical performance, reporting, interpretation and the ability to correctly allocate patients to chemo-irradiation based on imaging findings pre...

  15. Dissociative part-dependent biopsychosocial reactions to backward masked angry and neutral faces: An fMRI study of dissociative identity disorder☆

    Science.gov (United States)

    Schlumpf, Yolanda R.; Nijenhuis, Ellert R.S.; Chalavi, Sima; Weder, Ekaterina V.; Zimmermann, Eva; Luechinger, Roger; La Marca, Roberto; Reinders, A.A.T. Simone; Jäncke, Lutz

    2013-01-01

    Objective The Theory of Structural Dissociation of the Personality (TSDP) proposes that dissociative identity disorder (DID) patients are fixed in traumatic memories as “Emotional Parts” (EP), but mentally avoid these as “Apparently Normal Parts” of the personality (ANP). We tested the hypotheses that ANP and EP have different biopsychosocial reactions to subliminally presented angry and neutral faces, and that actors instructed and motivated to simulate ANP and EP react differently. Methods Women with DID and matched healthy female actors (CON) were as ANP and EP (DIDanp, DIDep, CONanp, CONep) consecutively exposed to masked neutral and angry faces. Their brain activation was monitored using functional magnetic resonance imaging. The black-and-white dotted masks preceding and following the faces each had a centered colored dot, but in a different color. Participants were instructed to immediately press a button after a perceived color change. State anxiety was assessed after each run using the STAI-S. Final statistical analyses were conducted on 11 DID patients and 15 controls for differences in neural activity, and 13 DID patients and 15 controls for differences in behavior and psychometric measures. Results Differences between ANP and EP in DID patients and between DID and CON in the two dissociative parts of the personality were generally larger for neutral than for angry faces. The longest reaction times (RTs) existed for DIDep when exposed to neutral faces. Compared to DIDanp, DIDep was associated with more activation of the parahippocampal gyrus. Following neutral faces and compared to CONep, DIDep had more activation in the brainstem, face-sensitive regions, and motor-related areas. DIDanp showed a decreased activity all over the brain in the neutral and angry face condition. There were neither significant within differences nor significant between group differences in state anxiety. CON was not able to simulate genuine ANP and EP biopsychosocially

  16. Clinical applicative characteristics of biopsychosocial medical mode%生物-心理-社会医学模式的临床应用特征

    Institute of Scientific and Technical Information of China (English)

    袁震

    2005-01-01

    目的:推进生物-心理-社会医学模式在国内医院的临床应用.方法:分析生物-心理-社会医学模式的临床应用特征以增进医务人员对现代医学模式科学内涵的全面理解,从而提高应用现代医学模式的自觉性.结果:医院必须确立"以患者为中心"的医疗服务模式,在临床实践中既了解疾病的产生过程,又注重患者的生理改变,更注重患者的生活特点及社会环境,形成"以患者为中心"的整体诊断治疗思维方式.结论:"以患者为中心"的医疗服务模式体现了生物-心理-社会医学模式的科学内涵,务必大力弘扬,以推进医学模式转变.%AIM: To promote the clinical application of biology-psychology-social medical mode in national hospitals.METHODS: To analyze the clinical applicative characteristics of biopsychosocial medical mode to enhance to complete understanding of the scientific intension of modern medical mode by medical professionals, and thereby to improve the consciousness in the application of modern medical mode.RESULTS: Hospitals must establish the patient-centered medical service mode, which not only understand the generative process of the disease, but also pay attentions to the physiological changes of the patients, and pay more attentions to the life character and social environment of the patients as well to form patient-centered integrative diagnostic therapeutic system.CONCLUSION: Patient-centered medial service mode represents the scientific intension of biopsychosocial medical mode, which should be greatly developed to advance the transition of medical mode.Yuan Z. Clinical applicative charocteristics of biopsychosocial medical mode.

  17. The right team at the right time - Multidisciplinary approach to multi-trauma patient with orthopedic injuries.

    Science.gov (United States)

    Bach, John A; Leskovan, John J; Scharschmidt, Thomas; Boulger, Creagh; Papadimos, Thomas J; Russell, Sarah; Bahner, David P; Stawicki, Stanislaw P A

    2017-01-01

    Integrated, multidisciplinary team approach to the multiply injured patient can help optimize care, minimize morbidity, and reduce mortality. It also provides a framework for accelerated postinjury rehabilitation course. The characteristics and potential benefits of this approach, including team dynamics and interactions, are discussed in this brief review. Emphasis is placed on synergies provided by specialty teams working together in the framework of care coordination, timing of surgical and nonsurgical interventions, and injury/physiologic considerations.

  18. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study

    OpenAIRE

    Lamb, Benjamin W; Jalil, Rozh T; Sevdalis, Nick; Vincent, Charles; Green, James S A

    2014-01-01

    Background The prevalence of multidisciplinary teams (MDT) for the delivery of cancer care is increasing globally. Evidence exists of benefits to patients and healthcare professionals. However, MDT working is time and resource intensive. This study aims to explore members’ views on existing practices of urology MDT working, and to identify potential interventions for improving the efficiency and productivity of the MDT meeting. Methods Members of urology MDTs across the UK were purposively re...

  19. The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

    Directory of Open Access Journals (Sweden)

    Ohde Sachiko

    2012-07-01

    Full Text Available Abstract Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1 the fall risk assessment tool, 2 an intervention protocol to prevent in-patient falls, 3 specific environmental safety interventions, 4 staff education, and 5 multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331 in 2004 versus 1.53 falls per 1000 patient days (263/172325 in 2010, representing a significant decrease (p = 0.039. In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368, increasing to 97.6% in 2010 (10564/10828. The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.

  20. Desensitization to rituximab in a multidisciplinary setting.

    Science.gov (United States)

    Amorós-Reboredo, Patrícia; Sánchez-López, Jaime; Bastida-Fernández, Carla; do Pazo-Oubiña, Fernando; Borràs-Maixenchs, Núria; Giné, Eva; Valero, Antonio; Creus-Baró, Natàlia

    2015-10-01

    The need to offer first-line therapy to the increasing number of patients who have suffered an hypersensitivity reaction has stimulated the use of rapid desensitization protocols. To present our experience working as a multidisciplinary team using a rituximab rapid desensitization scheme. Patient demographics, allergic reaction, skin tests to rituximab, number of desensitizations, reactions during the desensitization protocol and actions taken, number of administered and completed cycles, were retrospectively collected in patients who received at least one desensitization to rituximab. Number of desensitizations successfully managed. Between 2012 and June 2013 five patients received a total of 19 desensitizations to rituximab using a 12 step rapid desensitization protocol. All patients received the scheduled chemotherapeutic cycles as inpatients, with no delay in administration dates. Three patients presented a hypersensitivity reaction during the first desensitization and in one patient the event occurred again during the second treatment cycle. All reactions occurred in the last step, when the infusion rate reached the maximum speed. The developed protocol for rapid desensitization was successful in five patients receiving rituximab. Patients could receive the full intended dose.

  1. Multidisciplinary Russian biomedical research in space

    Science.gov (United States)

    Orlov, O. I.; Sychev, V. N.; Samarin, G. I.; Ilyin, E. A.; Belakovskiy, M. S.; Kussmaul, A. R.

    2014-08-01

    Research activities on a comprehensive multidisciplinary program are vital for enhancement of the system of crew's medical care, environmental health and hygiene in space missions. The primary goal of the program must be identification of patterns, intensity and dynamics of structural and functional shifts in organism induced by an aggregate of spaceflight factors including microgravity, isolation, artificial environment, space radiation, etc. Also, the program must pursue differential assessment of emerging deviations from the standpoint of adequacy to the spaceflight conditions and prospects of returning to Earth and guide the development of principles, methods and techniques necessary to maintain health and working capacity of humans during short- and long-duration missions and on return to Earth. Over 50 years, since 1963, the IBMP researchers apply systemic and innovational approaches to fundamental and exploratory studies in the fields of medical sciences, radiation biology, engineering science, biotechnology, etc. with participation of various biological specimens and human volunteers. Investigations aboard manned spacecrafts and biological satellites as well as in ground-based laboratories further enhancement of the medical care system for crews on orbital and remote space missions; they give insight into the fundamental problems of gravitational physiology and biology, psychophysiology, radiation biology, and contribute thereby to the development of knowledge, methods and technologies, as well as medical and scientific equipment.

  2. Instruction of Multidisciplinary Content in Introductory Courses

    Science.gov (United States)

    Shaibani, Saami J.

    2017-01-01

    There has been an ever-increasing emphasis on the integration of material in the areas of science, technology, engineering and mathematics during the past decade or so. However, there are two major requirements for accomplishing the effective delivery of such multidisciplinary content in the classroom: having high levels of expertise in all of the subjects; and, having the ability to combine the separate fields in a consistent manner without compromising academic purity. The research reported here involves a teacher with this skill set and it includes an example from kinematics, which is initially explored with standard treatment of concepts in mechanics and then developed with analysis employing algebra. As often happens, the non-trivial nature of the result in this case does not readily allow students to have a sense that the physics-based outcome is correct. This shortfall is remedied by adopting a complementary approach with geometry and calculus, which adds an independent perspective that reassures students by confirming the validity of the original answer. The enhanced quality of instruction achieved with the above methodology produces many benefits, including greater student understanding and more opportunities for active involvement by students in the learning process.

  3. Multi-Disciplinary System Reliability Analysis

    Science.gov (United States)

    Mahadevan, Sankaran; Han, Song

    1997-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code developed under the leadership of NASA Lewis Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multi-disciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  4. Multidisciplinary Management of Soft Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    Lukas M. Nystrom

    2013-01-01

    Full Text Available Soft tissue sarcoma is a rare malignancy, with approximately 11,000 cases per year encountered in the United States. It is primarily encountered in adults but can affect patients of any age. There are many histologic subtypes and the malignancy can be low or high grade. Appropriate staging work up includes a physical exam, advanced imaging, and a carefully planned biopsy. This information is then used to guide the discussion of definitive treatment of the tumor which typically involves surgical resection with a negative margin in addition to neoadjuvant or adjuvant external beam radiation. Advances in imaging and radiation therapy have made limb salvage surgery the standard of care, with local control rates greater than 90% in most modern series. Currently, the role of chemotherapy is not well defined and this treatment is typically reserved for patients with metastatic or recurrent disease and for certain histologic subtypes. The goal of this paper is to review the current state of the art in multidisciplinary management of soft tissue sarcoma.

  5. Multidisciplinary approach for patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Victoria M Villaflor; Marco E Allaix; Bruce Minsky; Fernando A Herbella; Marco G Patti

    2012-01-01

    Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.

  6. Social persuasion in rheumatology: a randomized trial of testimonials on television in the rheumatology clinic waiting room to increase attendance for multidisciplinary education.

    Science.gov (United States)

    Tingey, Paul; Khanafer, Mohamed; Singh, Kulraj; Thompson, Andy; Le Riche, Nicole; Barra, Lillian; Haig, Sara; Rohekar, Gina; Rohekar, Sherry; Nielson, Warren; Pope, Janet E

    2014-07-01

    Multidisciplinary self-management programs are important in inflammatory arthritis as adjunctive treatment. Patients often have excuses as to why they do not attend these programs. The purpose of this study was to determine whether an intervention of televised testimonials from rheumatologists and allied health professionals increases attendance at a multidisciplinary education day for rheumatology patients seen in a large university hospital clinic. This was an RCT of intervention: playing televised interviews in the waiting room where rheumatology patients were seen versus no TV. There was a total of 6 months (3 months with and 3 without the televised interview playing). All eligible patients who attended the rheumatology outpatient clinic were then tracked to determine whether they attended a subsequent education day over the next 10 months. The sample size was calculated to have a 15% increase in attendance at the education days. There was a 20% increase in attendees at the multidisciplinary education days for patients who saw the televised testimonials. Sixty-three patients who viewed the testimonials (2.17% of 2,908) attended the education day compared to 39 who did not receive the intervention (1.80% of 2,168); however, the increase was not statistically significant (p = 0.36). Attendance of eligible patients increased using televised testimonials; however, the increase was not significant as the rates of attendance were still very low in both groups. Many eligible patients did not attend the program. Other interventions are necessary to encourage attendance in a multidisciplinary program.

  7. Results of a Multidisciplinary Treatment Program in 3-Year-Old to 5-Year-Old Overweight or Obese Children A Randomized Controlled Clinical Trial

    NARCIS (Netherlands)

    Bocca, Gianni; Corpeleijn, Eva; Stolk, Ronald P.; Sauer, Pieter J. J.

    2012-01-01

    Objective: To assess the effects of a multidisciplinary intervention program for 3-year-old to 5-year-old overweight and obese children compared with a usual-care program. Design: Randomized controlled clinical trial conducted from October 2006 to March 2008. Setting: Groningen Expert Center for Kid

  8. Torpedo Overall Multidisciplinary Design Based on Collaborative Optimization

    Institute of Scientific and Technical Information of China (English)

    YU De-hai; SONG Bao-wei; LI Jia-wang; YANG Shi-xing; GAO Zhi-yong

    2008-01-01

    A torpedo multidisciplinary design optimization (MDO) based on the collaborative optimization is proposed. Through decomposition and coordination, some problems in torpedo design such as multidisciplinary coupling, large data volume and complex data relationships can be solved. Taking aim at some complex problems in the torpedo design, such as computation in multidisciplinary design, organization, modeling and information exchange, the collaborative optimization methods based on approximate technology are presented. An example to increase the torpedo range is also given. It demonstrates that the method can converge quickly, has higher reliability and smaller data throughput, and is a very effective MDO method.

  9. An Efficient Method for Reliability-based Multidisciplinary Design Optimization

    Institute of Scientific and Technical Information of China (English)

    Fan Hui; Li Weiji

    2008-01-01

    Design for modem engineering system is becoming multidisciplinary and incorporates practical uncertainties; therefore, it is necessary to synthesize reliability analysis and the multidiscipLinary design optimization (MDO) techniques for the design of complex engineering system. An advanced first order second moment method-based concurrent subspace optimization approach is proposed based on the comparison and analysis of the existing multidisciplinary optimization techniques and the reliability analysis methods. It is seen through a canard configuration optimization for a three-surface transport that the proposed method is computationally efficient and practical with the least modification to the current deterministic optimization process.

  10. Multidisciplinary approach to understand the pathogenesis of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Juan Shang; AS Pe(n)a

    2005-01-01

    Gastric carcinoma remains a common disease worldwide with a dismal prognosis. Therefore, it represents a very important health problem. It occurs with a high incidence in Asia and is one of the leading causes of cancer death in the world. Although the incidence and mortality of gastric carcinoma are decreasing in many countries,gastric cancer still represents the second most frequent malignancies in the world and the fourth in Europe. The 5-year survival rate of gastric carcinoma is low. The etiology and pathogenesis are not yet fully known. The study of gastric cancer is important in clinical medicine as well as in public health. Over the past 15 years,integrated research in molecular pathology has clarified the details of genetic and epigenetic abnormalities of cancer-related genes in the course of the development and progression of gastric cancer. Gastric cancer, as all cancers, is the end result of the interplay of many risk factors as well as protective factors. Although epidemiological evidence indicates that environmental factors play a major role in gastric carcinogenesis, the role of immunological, genetic, and immunogenetic factors are thought to contribute to the pathogenesis of gastric carcinoma. Among the environmental factors,diet and Helicobacter pylori are more amenable to intervention aimed at the prevention of gastric cancer.The aim of the present paper is to review and include the most recent published evidence to demonstrate that only a multidisciplinary approach will lead to the advancement of the pathogenesis and prevention of gastric cancer. On the immunogenetic research it is clear that evidence is accumulating to suggest that a genetic profile favoring the proinflammatory response increases the risk of gastric carcinoma.

  11. Six easy steps on how to create a lean sigma value stream map for a multidisciplinary clinical operation.

    Science.gov (United States)

    Lee, Emily; Grooms, Richard; Mamidala, Soumya; Nagy, Paul

    2014-12-01

    Value stream mapping (VSM) is a very useful technique to visualize and quantify the complex workflows often seen in clinical environments. VSM brings together multidisciplinary teams to identify parts of processes, collect data, and develop interventional ideas. An example involving pediatric MRI with general anesthesia VSM is outlined. As the process progresses, the map shows a large delay between the fax referral and the date of the scheduled and registered appointment. Ideas for improved efficiency and metrics were identified to measure improvement within a 6-month period, and an intervention package was developed for the department.

  12. A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team.

    Science.gov (United States)

    Carande, Elliott J; Bilton, Samuel J; Adwani, Satish

    2017-01-01

    Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1 gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS.

  13. A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team

    Science.gov (United States)

    Carande, Elliott J.; Adwani, Satish

    2017-01-01

    Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1 gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS. PMID:28168077

  14. A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team

    Directory of Open Access Journals (Sweden)

    Elliott J. Carande

    2017-01-01

    Full Text Available Neonatal Marfan syndrome (nMFS is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1 gene, exon 26, chromosome 15, which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS.

  15. Psychological management for head and neck cancer patients: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Humphris, G

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G).

  16. The MED-SUV Multidisciplinary Interoperability Infrastructure

    Science.gov (United States)

    Mazzetti, Paolo; D'Auria, Luca; Reitano, Danilo; Papeschi, Fabrizio; Roncella, Roberto; Puglisi, Giuseppe; Nativi, Stefano

    2016-04-01

    In accordance with the international Supersite initiative concept, the MED-SUV (MEDiterranean SUpersite Volcanoes) European project (http://med-suv.eu/) aims to enable long-term monitoring experiment in two relevant geologically active regions of Europe prone to natural hazards: Mt. Vesuvio/Campi Flegrei and Mt. Etna. This objective requires the integration of existing components, such as monitoring systems and data bases and novel sensors for the measurements of volcanic parameters. Moreover, MED-SUV is also a direct contribution to the Global Earth Observation System of Systems (GEOSS) as one the volcano Supersites recognized by the Group on Earth Observation (GEO). To achieve its goal, MED-SUV set up an advanced e-infrastructure allowing the discovery of and access to heterogeneous data for multidisciplinary applications, and the integration with external systems like GEOSS. The MED-SUV overall infrastructure is conceived as a three layer architecture with the lower layer (Data level) including the identified relevant data sources, the mid-tier (Supersite level) including components for mediation and harmonization , and the upper tier (Global level) composed of the systems that MED-SUV must serve, such as GEOSS and possibly other global/community systems. The Data level is mostly composed of existing data sources, such as space agencies satellite data archives, the UNAVCO system, the INGV-Rome data service. They share data according to different specifications for metadata, data and service interfaces, and cannot be changed. Thus, the only relevant MED-SUV activity at this level was the creation of a MED-SUV local repository based on Web Accessible Folder (WAF) technology, deployed in the INGV site in Catania, and hosting in-situ data and products collected and generated during the project. The Supersite level is at the core of the MED-SUV architecture, since it must mediate between the disparate data sources in the layer below, and provide a harmonized view to

  17. Enhancing Transparency in Multidisciplinary Expert Communication

    Energy Technology Data Exchange (ETDEWEB)

    Hukki, Kristiina; Pulkkinen, Urho [VTT Industrial Systems (Finland)

    2003-10-01

    Faced with problems of public acceptance most nuclear waste management organisations now acknowledge the importance of transparency in their pursuit of solutions for high-level nuclear waste disposal. To make progress the implementing organizations need the trust of other stakeholders in the decision-making process. For such trust these outside stakeholders need knowledge on the grounds for the judgments and decisions made in different scientific and technical disciplines. Transparency is, however, at least as important for the multidisciplinary expert communication itself. As a matter of fact, the transparency of the internal expert interaction processes is a prerequisite for the true transparency of the communication between the implementer and the external stakeholder groups. The introduced conceptual framework has been developed for the identification of the requirements of safety-informed communication in multidisciplinary expert work in nuclear waste management. The framework offers a common thinking model and common concepts which can be utilized in the development of the communication practices. The basis of the framework is on the possibility to understand the safety-critical significance of one's work. The transparency of communication is, for its part, based on making explicit the relevant knowledge necessary for gaining the understanding. This supplementary knowledge, which is related to the substance issues but is not scientific-technical by nature, enhances the experts' awareness of the context of their own contribution and of the background of the other experts' contributions. The common conceptualization and modelling of the knowledge-related dependencies between the tasks make it possible to realize the significance of the supplementary knowledge for transparent communication in actual situations. They also facilitate the recognition of the need for different types of supplementary knowledge in the interfaces between the tasks. By

  18. Implementing web-based ping-pong-type e-communication to enhance staff satisfaction, multidisciplinary cooperation, and clinical effectiveness

    Science.gov (United States)

    Yeh, Pei-Han; Hung, Shih-Kai; Lee, Moon-Sing; Chiou, Wen-Yen; Lai, Chun-Liang; Tsai, Wei-Ta; Hsieh, Hui-Ling; Shih, Yi-Ting; Chen, Liang-Cheng; Huang, Li-Wen; Lin, Yi-An; Lin, Po-Hao; Lin, Yung-Hsiang; Liu, Dai-Wei; Hsu, Feng-Chun; Tsai, Shiang-Jiun; Liu, Jia-Chi; Chung, En-Seu; Lin, Hon-Yi

    2016-01-01

    Abstract Background: Frequent multidisciplinary communication is essential in conducting daily radiotherapy (RT) practice. However, traditional oral or paper-based communication has limitations. E-communication has been suggested, but its effects are still not well demarcated in the field of radiation oncology. Objects: In our web-based integrated information platform, we constructed a ping-pong-type e-communication function to transfer specific notations among multidisciplinary RT staffs. The purpose was to test whether applying this e-communication can increase effectiveness of multidisciplinary cooperation when compared with oral or paper-based practice. Staff satisfaction and clinical benefits were also demonstrated. Design and setting: A real-world quality-improving study was conducted in a large center of radiation oncology. Participants and dataset used: Before and after applying multidisciplinary e-communication (from 2014 to 2015), clinical RT staffs were surveyed for their user experience and satisfaction (n = 23). For measuring clinical effectiveness, a secondary database of irradiated head and neck cancer patients was re-analyzed for comparing RT toxicities (n = 402). Interventions: Applying ping-pong-type multidisciplinary reflective e-communication was the main intervention. Outcome measures: For measuring staff satisfaction, eight domains were surveyed, such as timeliness, convenience, and completeness. For measuring clinical effectiveness of multidisciplinary cooperation, event rates of severe (i.e., grade 3–4) RT mucositis and dermatitis were recorded. Results: Overall, when compared with oral communication only, e-communication demonstrated multiple benefits, particularly on notation-review convenience (2.00 ± 1.76 vs 9.19 ± 0.81; P communication showed statistically significant benefits on all eight domains, especially on notation-review convenience (5.05 ± 2.11 vs 9.19 ± 0.81; P communication (8.76 ± 0

  19. Application of multidisciplinary analysis to gene expression.

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xuefel (University of New Mexico, Albuquerque, NM); Kang, Huining (University of New Mexico, Albuquerque, NM); Fields, Chris (New Mexico State University, Las Cruces, NM); Cowie, Jim R. (New Mexico State University, Las Cruces, NM); Davidson, George S.; Haaland, David Michael; Sibirtsev, Valeriy (New Mexico State University, Las Cruces, NM); Mosquera-Caro, Monica P. (University of New Mexico, Albuquerque, NM); Xu, Yuexian (University of New Mexico, Albuquerque, NM); Martin, Shawn Bryan; Helman, Paul (University of New Mexico, Albuquerque, NM); Andries, Erik (University of New Mexico, Albuquerque, NM); Ar, Kerem (University of New Mexico, Albuquerque, NM); Potter, Jeffrey (University of New Mexico, Albuquerque, NM); Willman, Cheryl L. (University of New Mexico, Albuquerque, NM); Murphy, Maurice H. (University of New Mexico, Albuquerque, NM)

    2004-01-01

    Molecular analysis of cancer, at the genomic level, could lead to individualized patient diagnostics and treatments. The developments to follow will signal a significant paradigm shift in the clinical management of human cancer. Despite our initial hopes, however, it seems that simple analysis of microarray data cannot elucidate clinically significant gene functions and mechanisms. Extracting biological information from microarray data requires a complicated path involving multidisciplinary teams of biomedical researchers, computer scientists, mathematicians, statisticians, and computational linguists. The integration of the diverse outputs of each team is the limiting factor in the progress to discover candidate genes and pathways associated with the molecular biology of cancer. Specifically, one must deal with sets of significant genes identified by each method and extract whatever useful information may be found by comparing these different gene lists. Here we present our experience with such comparisons, and share methods developed in the analysis of an infant leukemia cohort studied on Affymetrix HG-U95A arrays. In particular, spatial gene clustering, hyper-dimensional projections, and computational linguistics were used to compare different gene lists. In spatial gene clustering, different gene lists are grouped together and visualized on a three-dimensional expression map, where genes with similar expressions are co-located. In another approach, projections from gene expression space onto a sphere clarify how groups of genes can jointly have more predictive power than groups of individually selected genes. Finally, online literature is automatically rearranged to present information about genes common to multiple groups, or to contrast the differences between the lists. The combination of these methods has improved our understanding of infant leukemia. While the complicated reality of the biology dashed our initial, optimistic hopes for simple answers from

  20. Multidisciplinary cognitive content of nanoscience and nanotechnology

    Science.gov (United States)

    Milojević, Staša

    2012-01-01

    This article examines the cognitive evolution and disciplinary diversity of nanoscience/nanotechnology (nano research) as expressed through the terminology used in titles of nano journal articles. The analysis is based on the NanoBank bibliographic database of 287,106 nano articles published between 1981 and 2004. We perform multifaceted analyses of title words, focusing on 100 most frequent words or phrases (terms). Hierarchical clustering of title terms reveals three distinct time periods of cognitive development of nano research: formative (1981-1990), early (from 1991 to 1998), and current (after 1998). Early period is characterized by the introduction of thin film deposition techniques, while the current period is characterized by the increased focus on carbon nanotube and nanoparticle research. We introduce a method to identify disciplinary components of nanotechnology. It shows that the nano research is being carried out in a number of diverse parent disciplines. Currently, only 5% of articles are published in dedicated nano-only journals. We find that some 85% of nano research today is multidisciplinary. The case study of the diffusion of several nano-specific terms (e.g., "carbon nanotube") shows that concepts spread from the initially few disciplinary components to the majority of them in a time span of around a decade. Hierarchical clustering of disciplinary components reveals that the cognitive content of current nanoscience can be divided into nine clusters. Some clusters account for a large fraction of nano research and are identified with such parent disciplines as the condensed matter and applied physics, materials science, and analytical chemistry. Other clusters represent much smaller parts of nano research, but are as cognitively distinct. In the decreasing order of size, these fields are: polymer science, biotechnology, general chemistry, surface science, and pharmacology. Cognitive content of research published in nano-only journals is the

  1. Multidisciplinary cognitive content of nanoscience and nanotechnology

    Energy Technology Data Exchange (ETDEWEB)

    Milojevic, Stasa, E-mail: smilojev@indiana.edu [Indiana University, School of Library and Information Science (United States)

    2012-01-15

    This article examines the cognitive evolution and disciplinary diversity of nanoscience/nanotechnology (nano research) as expressed through the terminology used in titles of nano journal articles. The analysis is based on the NanoBank bibliographic database of 287,106 nano articles published between 1981 and 2004. We perform multifaceted analyses of title words, focusing on 100 most frequent words or phrases (terms). Hierarchical clustering of title terms reveals three distinct time periods of cognitive development of nano research: formative (1981-1990), early (from 1991 to 1998), and current (after 1998). Early period is characterized by the introduction of thin film deposition techniques, while the current period is characterized by the increased focus on carbon nanotube and nanoparticle research. We introduce a method to identify disciplinary components of nanotechnology. It shows that the nano research is being carried out in a number of diverse parent disciplines. Currently, only 5% of articles are published in dedicated nano-only journals. We find that some 85% of nano research today is multidisciplinary. The case study of the diffusion of several nano-specific terms (e.g., 'carbon nanotube') shows that concepts spread from the initially few disciplinary components to the majority of them in a time span of around a decade. Hierarchical clustering of disciplinary components reveals that the cognitive content of current nanoscience can be divided into nine clusters. Some clusters account for a large fraction of nano research and are identified with such parent disciplines as the condensed matter and applied physics, materials science, and analytical chemistry. Other clusters represent much smaller parts of nano research, but are as cognitively distinct. In the decreasing order of size, these fields are: polymer science, biotechnology, general chemistry, surface science, and pharmacology. Cognitive content of research published in nano-only journals

  2. Automation enhancements in multidisciplinary design optimization

    Science.gov (United States)

    Wujek, Brett Alan

    The process of designing complex systems has necessarily evolved into one which includes the contributions and interactions of multiple disciplines. To date, the Multidisciplinary Design Optimization (MDO) process has been addressed mainly from the standpoint of algorithm development, with the primary concerns being effective and efficient coordination of disciplinary activities, modification of conventional optimization methods, and the utility of approximation techniques toward this goal. The focus of this dissertation is on improving the efficiency of MDO algorithms through the automation of common procedures and the development of improved methods to carry out these procedures. In this research, automation enhancements are made to the MDO process in three different areas: execution, sensitivity analysis and utility, and design variable move-limit management. A framework is developed along with a graphical user interface called NDOPT to automate the setup and execution of MDO algorithms in a research environment. The technology of automatic differentiation (AD) is utilized within various modules of MDO algorithms for fast and accurate sensitivity calculation, allowing for the frequent use of updated sensitivity information. With the use of AD, efficiency improvements are observed in the convergence of system analyses and in certain optimization procedures since gradient-based methods, traditionally considered cost-prohibitive, can be employed at a more reasonable expense. Finally, a method is developed to automatically monitor and adjust design variable move-limits for the approximate optimization process commonly used in MDO algorithms. With its basis in the well established and probably convergent trust region approach, the Trust region Ratio Approximation method (TRAM) developed in this research accounts for approximation accuracy and the sensitivity of the model error to the design space in providing a flexible move-limit adjustment factor. Favorable results

  3. Multidisciplinary care and management selection in prostate cancer.

    Science.gov (United States)

    Aizer, Ayal A; Paly, Jonathan J; Efstathiou, Jason A

    2013-07-01

    The management of prostate cancer is complicated by the multitude of treatment options, the lack of proven superiority of one modality of management, and the presence of physician bias. Care at a multidisciplinary prostate cancer clinic offers patients the relative convenience of consultation with physicians of multiple specialties within the confines of a single visit and appears to serve as a venue in which patients can be counseled regarding the risks and benefits of available therapies in an open and interactive environment. Physician bias may be minimized in such an environment, and patient satisfaction rates are high. Available data suggest that low-risk patients who are seen at a multidisciplinary prostate cancer clinic appear to select active surveillance in greater proportion. However, relatively few studies have investigated the other added value that multidisciplinary clinics provide to the patient or health care system, and therefore, additional studies assessing the impact of multidisciplinary care in the management of patients with prostate cancer are needed.

  4. Improving Nurse-Physician Teamwork: A Multidisciplinary Collaboration.

    Science.gov (United States)

    Streeton, Abigail; Bisbey, Cindy; O'Neill, Carrie; Allen, Danielle; O'Hara, Sara; Weinhold, Megan; Miller, Jenna; Bursiek, April; Grubbs, Pamela

    2016-01-01

    Nurses surveyed on an inpatient gynecology surgical unit suggested communication and teamwork between nurses and physicians could be improved. To enhance teamwork, a multidisciplinary collaboration committee of nurses and physicians was created.

  5. Diagnostics of halitosis complaints by a multidisciplinary team

    NARCIS (Netherlands)

    Baat, Cees de; Mulder, J.; Broek, A.M. van den; Feenstra, L.

    2014-01-01

    AIM: The study objective was to collect diagnostic data, to explore correlations between diagnostic variables, to provide an accurate initial diagnosis, and to provide appropriate management in consecutive subjects consulting with a multidisciplinary halitosis team because of a halitosis complaint.

  6. Multidisciplinary team (MDT) approach to management of malignant ...

    African Journals Online (AJOL)

    Multidisciplinary team (MDT) approach to management of malignant diseases: A review. ... to care and ensuring that patients get the right treatment in optimum time. ... challenges facing the use of MDTs in the management of cancer in Nigeria ...

  7. Diagnostics of halitosis complaints by a multidisciplinary team

    NARCIS (Netherlands)

    Baat, Cees de; Mulder, J.; Broek, A.M. van den; Feenstra, L.

    2014-01-01

    AIM: The study objective was to collect diagnostic data, to explore correlations between diagnostic variables, to provide an accurate initial diagnosis, and to provide appropriate management in consecutive subjects consulting with a multidisciplinary halitosis team because of a halitosis complaint.

  8. Transforming Multidisciplinary Customer Requirements to Product Design Specifications

    Science.gov (United States)

    Ma, Xiao-Jie; Ding, Guo-Fu; Qin, Sheng-Feng; Li, Rong; Yan, Kai-Yin; Xiao, Shou-Ne; Yang, Guang-Wu

    2017-09-01

    With the increasing of complexity of complex mechatronic products, it is necessary to involve multidisciplinary design teams, thus, the traditional customer requirements modeling for a single discipline team becomes difficult to be applied in a multidisciplinary team and project since team members with various disciplinary backgrounds may have different interpretations of the customers' requirements. A new synthesized multidisciplinary customer requirements modeling method is provided for obtaining and describing the common understanding of customer requirements (CRs) and more importantly transferring them into a detailed and accurate product design specifications (PDS) to interact with different team members effectively. A case study of designing a high speed train verifies the rationality and feasibility of the proposed multidisciplinary requirement modeling method for complex mechatronic product development. This proposed research offersthe instruction to realize the customer-driven personalized customization of complex mechatronic product.

  9. A multidisciplinary approach for the management of hypodontia: case report

    Directory of Open Access Journals (Sweden)

    Accácio Lins do Valle

    2011-10-01

    Full Text Available Hypodontia is the congenital absence of one or more teeth and may affect permanent teeth. Several options are indicated to treat hypodontia, including the maintenance of primary teeth or space redistribution for restorative treatment with partial adhesive bridges, tooth transplantation, and implants. However, a multidisciplinary approach is the most important requirement for the ideal treatment of hypodontia. This paper describes a multidisciplinary treatment plan for congenitally missing permanent mandibular second premolars involving orthodontics, implantology and prosthodontic specialties.

  10. [Multidisciplinary treatment of lung cancer in 21st century].

    Science.gov (United States)

    Aikawa, Hirokazu; Sagawa, M; Usuda, K; Ueno, M; Tanaka, M; Machida, Y; Sakuma, T

    2008-01-01

    Lung cancer is the leading cause of cancer deaths in Japan. Recently, big progress in the treatment of lung cancer has been achieved, such as new anti-cancer drugs, molecular targeted therapy, stereotactic radiotherapy, etc. Multidisciplinary approach has been required to the therapy for lung cancer patients. In this paper, we introduce The 21st Century Multidisciplinary Center in Kanazawa Medical University, and the Hokuriku Training Program for Making Specialists in Cancer Treatment.

  11. A multidisciplinary primary care team consultation in a socio-economically deprived community: An exploratory randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gibney David

    2011-01-01

    Full Text Available Abstract Background Psychosocial problems in socioeconomically deprived communities are not always amenable to traditional medical approaches. Mothers living in these areas are a particularly vulnerable group. The objective of this study was to evaluate the effectiveness of a lengthened multi-disciplinary team consultation in primary care in reducing anxiety and depression in mothers. Methods This was a prospective randomised controlled trial of a multidisciplinary team consultation against normal care. 94 mothers were recruited from three general practices from an area of extreme socio-economic deprivation. Mothers randomised into the intervention group attended a multidisciplinary consultation with up to four case-specific health care professionals. Consultations addressed medical, psychological and social problems and lasted up to one hour. Conventional primary care continued to be available to the intervention families. Control group families received normal primary care services. The outcomes measured were anxiety and depression as using the Hospital Anxiety and Depression Scale (HADS, health status using SF36v2, and quality of life using the abbreviated Schedule for the Evaluation of Individual Quality of Life (SEIQoL-DW at baseline, 6 months and 12 months. Results Ordered logistic regression was used to analyse the data. There was no significant difference found between intervention and control groups after 6 months and 12 months in all of the measured outcomes. Conclusions The new lengthened multi-disciplinary team consultation did not have any impact on the mental health, general health, and quality of life of mothers after 6 and 12 months. Other methods of primary health care delivery in socio-economically deprived communities need to be evaluated.

  12. Multidisciplinary Care Models for Patients With Psoriatic Arthritis.

    Science.gov (United States)

    Queiro, Rubén; Coto, Pablo; Rodríguez, Jesús; Notario, Jaume; Navío Marco, Teresa; de la Cueva, Pablo; Pujol Busquets, Manel; García Font, Mercè; Joven, Beatriz; Rivera, Raquel; Alvarez Vega, Jose Luis; Chaves Álvarez, Antonio Javier; Sánchez Parera, Ricardo; Ruiz Carrascosa, Jose Carlos; Rodríguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea Arana, Ana; Hergueta, Mercedes; Luelmo, Jesús; Gratacós, Jordi

    To describe (structure, processes) of the multidisciplinary care models in psoriatic arthritis (PsA) in Spain, as well as barriers and facilitators of their implementation. A qualitative study was performed following structured interviews with 24 professionals (12 rheumatologists, 12 dermatologists who provide multidisciplinary care for patients with PsA). We collected data related to the hospital, department, population and multidisciplinary care model (type, physical and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision- making, research and education, clinical sessions, development and planning of the model, advantages and disadvantages of the model, barriers and facilitators in the implementation of the model. The models characteristics are described. We analyzed 12 multidisciplinary care models in PsA, with at least 1-2 years of experience, and 3 subtypes of models, face-to-face, parallel, and preferential circuit. All are adapted to the hospital and professionals characteristics. A proper implementation planning is essential. The involvement and empathy between professionals and an access and well-defined referral criteria are important facilitators in the implementation of a model. The management of agendas and data collection to measure the multidisciplinary care models health outcomes are the main barriers. There are different multidisciplinary care models in PsA that can improve patient outcomes, system efficiency and collaboration between specialists. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - A review of the experience from 1999 to 2005.

    Science.gov (United States)

    Li, Kathy K; Sinclair, Emily; Pope, Joan; Farhadian, Macey; Harris, Kristin; Napolskikh, Julie; Yee, Albert; Librach, Lawrence; Wynnychuk, Lesia; Danjoux, Cyril; Chow, Edward; Bone, On Behalf Of The; Team, Metastases

    2008-09-01

    Our objective in this study was to review the experience of a one-stop multidisciplinary bone metastases clinic (BMC) that offers a coordinated multidisciplinary approach to the care of cancer patients with bone metastases in a tertiary cancer centre. Patients with symptomatic bone metastases were referred to BMC and assessed by a team of specialists in various disciplines - interventional radiology, orthopedic surgery, palliative medicine, and radiation oncology. At initial consultation, patient demographics, reasons for referral, and case disposition were recorded. From January 1999 to February 2005, a total of 272 patients with bone metastases were referred to the BMC. The median age was 65 years (range 28-95) and median KPS score at consultation was 60 (range 30-90). The majority of patients came from home (74%), while others came from a nursing home or the hospital (9%). Almost a third (28%) of patients had 2 or more reasons of referral, yielding a total of 354 reasons. The most common reason for referral was bone pain (42%), bone metastases (21%), high risk for pathological fracture (12%), and pathological fracture (10%). Of the 272 patients who received consultation, 40% received palliative radiotherapy, 19% received interventional surgery, 7% were referred to other support services such as palliative care, physiotherapy, and 7% had further investigation or imaging. A multidisciplinary clinic is useful for co-coordinating the management of bone metastatic disease in symptomatic patients.

  14. Mindfulness Interventions.

    Science.gov (United States)

    Creswell, J David

    2017-01-03

    Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

  15. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  16. The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

    Science.gov (United States)

    Bach, John A.; Leskovan, John J.; Scharschmidt, Thomas; Boulger, Creagh; Papadimos, Thomas J.; Russell, Sarah; Bahner, David P.; Stawicki, Stanislaw P. A.

    2017-01-01

    Integrated, multidisciplinary team approach to the multiply injured patient can help optimize care, minimize morbidity, and reduce mortality. It also provides a framework for accelerated postinjury rehabilitation course. The characteristics and potential benefits of this approach, including team dynamics and interactions, are discussed in this brief review. Emphasis is placed on synergies provided by specialty teams working together in the framework of care coordination, timing of surgical and nonsurgical interventions, and injury/physiologic considerations. Republished with permission from: Bach JA, Leskovan JJ, Scharschmidt T, Boulger C, Papadimos TJ, Russell S, Bahner DP, Stawicki SPA. Multidisciplinary approach to multi-trauma patient with orthopedic injuries: the right team at the right time. OPUS 12 Scientist 2012;6(1):6-10.

  17. Quality of life after percutaneous coronary intervention: part 1.

    Science.gov (United States)

    Cassar, Stephen; R Baldacchino, Donia

    Quality of life (QOL) is a complex concept comprised of biopsychosocial, spiritual and environmental dimensions. However, the majority of research addresses only its physical function perspectives. This two-part series examines the holistic perspective of QOL of patients after percutaneous coronary intervention (PCI). Part 1 explains the research process of a cross-sectional descriptive study and its limitations. Data were collected by a mailed WHOQOL-BREF questionnaire in Maltese from a systematic sample of patients who had undergone PCI; the response rate was 64% (n=228; males n=169, females n=59, age 40-89 years). Part 1 also considers limitations, such as its cross-sectional design and retrospective data collection. The hierarchy of human needs theory (Maslow, 1999) guided the study. Part 2 gives the findings on the holistic view of QOL. Having social and family support, as a characteristic of Maltese culture appeared to contribute towards a better QOL.

  18. The BEST-CLI trial: a multidisciplinary effort to assess which therapy is best for patients with critical limb ischemia.

    Science.gov (United States)

    Farber, Alik; Rosenfield, Kenneth; Menard, Matthew

    2014-09-01

    Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease and is associated with a significant risk of limb loss. It is currently treated with limb revascularization by a variety of specialists. Although both open vascular bypass and endovascular therapy are offered to patients with infrainguinal peripheral arterial disease and CLI, significant disagreement exists as to which therapy works best in candidates for both types of intervention. Persistent clinical equipoise in combination with a paucity of comparative effectiveness data to guide treatment of CLI has led to a multidisciplinary effort to organize the Best Endovascular versus Best Surgical Therapy in patients with CLI (BEST-CLI) trial. The BEST-CLI trial is a pragmatic, multicenter, open label, randomized trial that compares best endovascular therapy with best open surgical treatment in patients eligible for both treatments. This trial is highly innovative in both its design and its collaborative nature. BEST-CLI aims to provide urgently needed clinical guidance for CLI management by using (1) a pragmatic design comparing the effectiveness of established techniques while allowing for the introduction of newer therapies as they become available; (2) a novel primary end point that includes limb amputation rates, repeat intervention, and mortality; (3) a multidisciplinary structure that fosters cooperation among interventional cardiologists, interventional radiologists, vascular surgeons, and vascular medicine specialists; and (4) novel techniques to evaluate the cost-effectiveness and quality-of-life outcomes of the 2 treatment strategies being tested. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. The effect of multidisciplinary team care on cancer management.

    Science.gov (United States)

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical oncologist. The report further suggested that a lead clinician with a well established interest in cancer care should be appointed to organise and coordinate the whole range of cancer services provided within the Cancer Unit. Many people have argued that the multidisciplinary team management of patients has resulted in better care and improved survival. However, there are barriers to the optimal effectiveness of the multidisciplinary team. This paper aims to review various studies on the effectiveness of the multidisciplinary team in the management of cancer patients and also discuss some of the barriers to the multidisciplinary team.

  20. A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital.

    Science.gov (United States)

    Andersen, Stig Ejdrup; Knudsen, Jenny Dahl

    2013-11-01

    Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). At a 510-bed Danish university hospital, a multidisciplinary change project inspired by Kotter's Eight Steps of Change was designed. In addition to revision of antimicrobial guidelines and restriction of selected antimicrobials, the complex, managed, multi-faceted intervention comprised training and education, enhanced isolation precautions, and a series of actions to improve the infection control measures and standardise procedures across the hospital. A prospective interrupted time series design was used to analyse data collected at hospital level from January 2008 through December 2011. Though overall antimicrobial consumption remained unaffected, the intervention led to intended, immediate and sustained reduction in the use of cefuroxime, and an increase in the use of ertapenem, piperacillin/tazobactam and β-lactamase sensitive penicillin. Moreover, a postintervention reduction in the rate of ESBL-KP in diagnostic samples and in the incidence of ESBL-KP infections was observed. The intervention may also have reduced the need for isolation precautions and may have shortened each isolation period. The results indicate that an immediate and sustained change in the antimicrobial consumption and a decreasing rate of ESBL-KP are achievable through the application of a managed, multi-faceted intervention that does not require ongoing antibiotic stewardship.

  1. The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

    Directory of Open Access Journals (Sweden)

    de Witte Luc P

    2006-03-01

    Full Text Available Abstract Background Demented nursing home patients are at high risk for falls. Falls and associated injuries can have a considerable influence on the autonomy and quality of life of patients. The prevention of falls among demented patients is therefore an important issue. In order to intervene in an efficient way in this group of patients, it is important to systematically evaluate the fall risk profile of each individual patient so that for each patient tailor-made preventive measures can be taken. Therefore, the objective of the present study is to develop a feasible and evidence based multidisciplinary fall risk evaluation tool to be used for tailoring preventive interventions to the needs of individual demented patients. Methods To develop this multidisciplinary fall risk evaluation tool we have chosen to combine scientific evidence on the one hand and experts' opinions on the other hand. Firstly, relevant risk factors for falling in elderly persons were gathered from the literature. Secondly, a group of Dutch experts in the field of falls and fall prevention in the elderly were consulted to judge the suitability of these risk factors for use in a multidisciplinary fall risk evaluation tool for demented nursing home patients. Thirdly, in order to generate a compact list of the most relevant risk factors for falling in demented elderly, all risk factors had to fulfill a set of criteria indicating their relevance for this specific target population. Lastly the final list of risk factors resulting from the above mentioned procedure was presented to the expert group. The members were also asked to give their opinion about the practical use of the tool. Results The multidisciplinary fall risk evaluation tool we developed includes the following items: previous falls, use of medication, locomotor functions, and (correct choice and use of assistive and protective devices. The tool is developed for the multidisciplinary teams of the nursing homes

  2. Qualitative and Quantitative Outcomes of a 1:1 Multidisciplinary Weight Management Clinic

    Directory of Open Access Journals (Sweden)

    Desley Turner

    2015-06-01

    Full Text Available Background: Obesity management in Wales includes the provision of a 1:1 Multidisciplinary Weight Management Clinic (MDWMC. Strategic management of obesity in Wales is guided by The All Wales Obesity Pathway and recommends MDWMCs for people with obesity who have one or more co-morbidities and who have tried several interventions without success, or who have complex emotional relationships with food. No known previous studies have included a qualitative evaluation of a MDWMC. Objectives: To conduct a service evaluation of a 1:1 Multi-disciplinary Weight Management Clinic to evaluate associated physiological benefits and qualitative data about the service. Methods: Semi-structured interviews were conducted with 180 patients attending the MDWMC at Aneurin Bevan Hospital, Ebbw Vale, Wales. Results: The MDWMC supports weight loss with 95% of patients reporting loss. For those for whom baseline data was available 73% lost at least 5% of initial body weight. Eighty-eight percent of patients prefer individual appointments and over 90% of patients who see each team member find consultations useful. Sixty-nine percent of patients report improved health mainly due to a decrease in obesity-related symptoms, and of patients taking obesity-related medication 48% report a reduction in dose of medication for asthma, 42% report a reduction in dose of antidepressants, and 36% report a reduction in dose for medication for diabetes. Of employed patients, 30% report a reduction of days taken off work due to sickness. Ninety-six percent of patients would recommend the clinic to others. Conclusions: A 1:1 Multi-disciplinary Weight Management Clinic provides value in reducing obesity and symptoms of obesity-related diseases. It also is a treatment choice favoured by patients.

  3. The Johns Hopkins Venous Thromboembolism Collaborative: Multidisciplinary team approach to achieve perfect prophylaxis.

    Science.gov (United States)

    Streiff, Michael B; Lau, Brandyn D; Hobson, Deborah B; Kraus, Peggy S; Shermock, Kenneth M; Shaffer, Dauryne L; Popoola, Victor O; Aboagye, Jonathan K; Farrow, Norma A; Horn, Paula J; Shihab, Hasan M; Pronovost, Peter J; Haut, Elliott R

    2016-12-01

    Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative. To achieve the goal of perfect prophylaxis for every patient, we developed evidence-based, specialty-specific computerized clinical decision support VTE prophylaxis order sets that assist providers in ordering risk-appropriate VTE prevention. We developed novel strategies to improve provider VTE prevention ordering practices including face-to-face performance reviews, pay for performance, and provider VTE scorecards. When we discovered that prescription of risk-appropriate VTE prophylaxis does not ensure its administration, our multidisciplinary research team conducted in-depth surveys of patients, nurses, and physicians to design a multidisciplinary patient-centered educational intervention to eliminate missed doses of pharmacologic VTE prophylaxis that has been funded by the Patient Centered Outcomes Research Institute. We expect that the studies currently underway will bring us closer to the goal of perfect VTE prevention care for every patient. Our learning journey to eliminate harm from VTE can be applied to other types of harm. Journal of Hospital Medicine 2016;11:S8-S14. © 2016 Society of Hospital Medicine.

  4. Sickle cell retinopathy: improving care with a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Menaa F

    2017-08-01

    Full Text Available Farid Menaa,1,2 Barkat Ali Khan,3 Bushra Uzair,4 Abder Menaa2 1Department of Pharmaceutical Sciences and Nanomedicine, California Innovations Corporation, San Diego, CA, USA; 2Departments of Clinical Medicine and Laser Therapy, Centre Médical des Guittières, Saint-Philbert-de-Grand-Lieu, Loire-Atlantique, France; 3Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, 4Department of Bioinformatics and Biotechnology, International Islamic University, Islamabad, Pakistan Abstract: Sickle cell retinopathy (SCR is the most representative ophthalmologic complication of sickle cell disease (SCD, a hemoglobinopathy affecting both adults and children. SCR presents a wide spectrum of manifestations and may even lead to irreversible vision loss if not properly diagnosed and treated at the earliest. Over the past decade, multidisciplinary research developments have focused upon systemic, genetic, and ocular risk factors of SCR, enabling the clinician to better diagnose and manage these patients. In addition, newer imaging and testing modalities, such as spectral domain-optical coherence tomography angiography, have resulted in the detection of subclinical retinopathy related to SCD. Innovative therapy includes intravitreal injection of an anti-vascular endothelial growth factor (eg, Lucentis® [ranibizumab] or Eylea® [aflibercept] which appears comparatively safe and efficient, and may be combined with laser photocoagulation (LPC for proliferative SCR. The effect of LPC alone does not significantly lead to the regression of advanced SCR, although it helps in avoiding hemorrhage and sight loss. This comprehensive article is based on 10-years retrospective (2007–2017 studies. It aims to present advances and recommendations in SCR theranostics while pointing out the requirement of combinatorial approaches for better management of SCR patients. To reach this goal, we identified and analyzed randomized original and

  5. Crisis resource management: evaluating outcomes of a multidisciplinary team.

    Science.gov (United States)

    Jankouskas, Tara; Bush, Mary Chasko; Murray, Bosseau; Rudy, Sally; Henry, Jody; Dyer, Anne Marie; Liu, Wenlei; Sinz, Elizabeth

    2007-01-01

    Crisis resource management (CRM) is a team-training program that teaches nontechnical skills such as: collaboration, communication, task management, teamwork, and leadership. The purpose of this study was to evaluate improvement in the nontechnical skills of a multidisciplinary team of pediatric residents, anesthesiology residents and pediatric nurses following participation in the CRM educational program. Self-efficacy theory guided the teaching method used in the CRM program. The Collaboration and Satisfaction about Care Decisions instrument and the Anesthetists' Nontechnical Skills System served as outcome measures. Seven multidisciplinary groups were studied with a total of 40 subjects. A significant increase was found in posttest scores for perceived collaboration and satisfaction with care and in numerical ratings of observed team skills following the CRM program. The results suggest multidisciplinary team participation in the CRM program increased perceived team collaboration, satisfaction with care, and observed teamwork skills.

  6. Design of efficient and safe neural stimulators a multidisciplinary approach

    CERN Document Server

    van Dongen, Marijn

    2016-01-01

    This book discusses the design of neural stimulator systems which are used for the treatment of a wide variety of brain disorders such as Parkinson’s, depression and tinnitus. Whereas many existing books treating neural stimulation focus on one particular design aspect, such as the electrical design of the stimulator, this book uses a multidisciplinary approach: by combining the fields of neuroscience, electrophysiology and electrical engineering a thorough understanding of the complete neural stimulation chain is created (from the stimulation IC down to the neural cell). This multidisciplinary approach enables readers to gain new insights into stimulator design, while context is provided by presenting innovative design examples. Provides a single-source, multidisciplinary reference to the field of neural stimulation, bridging an important knowledge gap among the fields of bioelectricity, neuroscience, neuroengineering and microelectronics;Uses a top-down approach to understanding the neural activation proc...

  7. Effective multidisciplinary working: the key to high-quality care.

    Science.gov (United States)

    Ndoro, Samuel

    This article explores multidisciplinary team working, inter-disciplinary, trans-disciplinary and effective collaborative practice in order to provide high-quality patient care. It discusses different views on collaboration, some of the issues around cross-discipline and multi-agency working and concerns around promoting 'high-quality' care. It also discusses the importance of evidence-based practice in multidisciplinary teams. Issues around good-quality care, clinical governance and the audit cycle in MDTs are addressed. The article highlights the importance of the 6Cs (care, compassion, competence, communication, courage and commitment) in MDTs if quality care is to be achieved. The article also explores advantages and limitations of multidisciplinary team working, trans-disciplinary working and inter-professional working in developing and delivering high-quality patient-centred care. Further research is needed on how clinical audits can help to improve how MDTs function in order improve the quality of service provided to clients.

  8. [Should cases of hepatocellular carcinoma be discussed by non-specialized multidisciplinary team meetings?].

    Science.gov (United States)

    Barbare, Jean-Claude; Franco, Dominique; André, Thierry; Bronowicki, Jean-Pierre; Merle, Philippe; Péron, Jean-Marie; Raoul, Jean-Luc; Seitz, Jean-François; Ychou, Marc

    2014-06-01

    The treatment of hepatocellular carcinoma (HCC) is difficult due to the underlying cirrhosis which has its own influence on therapeutic issues. An inquiry was performed in centres with specialized multidisciplinary team meetings dedicated to HCC (HCC-MTM) or in centres with non-specialized (digestive oncology or general oncology) multidisciplinary team meetings (NS-MTM). The number of cases of HCCs taken in charge yearly was significantly higher in HCC-MTM than in NS-MTM (p=0,0014). Interventional radiologists and transplant surgeons were more frequently implied in HCC-MTM than in NS-MTM (respectively p=0,009 and p=0,02). On site availability of every treatment of HCC was higher in RCP-MTM than in NS-MTM (p=0,015). There were no inclusion in clinical trials in 40.5 % of NS-MTM versus only 17.6 % of HCC-MTM (p=0,0086). In three clinical cases out of seven there were discrepancies between the therapeutic options of HCC-MTM and NS-MTM. In all three cases, the treatment offered to the patient by HCC-MTM was more consistent with clinical standards. These results prompt to perform more studies on the quality of management of patients with HCCs by MTMs.

  9. A Team Formation Framework for Managing Diversity in Multidisciplinary Engineering Project

    Directory of Open Access Journals (Sweden)

    Shawqi Mohammed Hossain

    2017-02-01

    Full Text Available Team formation is one of the essential elements in constructing effective teamwork of any team size that requires different skill sets. Diversity in team encourages students to challenge and compete with one another while searching for new ideas, which in turn can lead to a better team performance. In a well-functioning diverse teams, the students who performed poorly may gain benefit by observing how excellent students approach the assignments. They may also benefit by getting advice and assistance from the excellent students. Studies have shown that Malaysian university graduates lack of team skills. The purpose of this paper is to propose a framework for forming a diverse multidisciplinary team among engineering undergraduates based on selected criteria such as individual personality type, gender, and other relevant demographic information. The proposed framework can also be used to design an automated team-formation system based on the identified metrics. The purpose of the framework is to consolidate the existing team formation literature, and to develop and test interventions for maximizing individual member and team performance as a whole that makes an effective team. For this study, a multidisciplinary approach was used where first year engineering students from three different faculties, namely Faculty of Electrical Engineering (FKE, Faculty of Mechanical Engineering (FKM, and Faculty of Biosciences and Medical Engineering (FBME at Universiti Teknologi Malaysia (UTM worked on an innovation project using the Conceive, Design, Implement, and Operate (CDIO framework. Keirsey Temperament Sorter was used as an instrument to identify an individual's personality type.

  10. The Multidisciplinary Translational Team (MTT) Model for Training and Development of Translational Research Investigators.

    Science.gov (United States)

    Ameredes, Bill T; Hellmich, Mark R; Cestone, Christina M; Wooten, Kevin C; Ottenbacher, Kenneth J; Chonmaitree, Tasnee; Anderson, Karl E; Brasier, Allan R

    2015-10-01

    Multiinstitutional research collaborations now form the most rapid and productive project execution structures in the health sciences. Effective adoption of a multidisciplinary team research approach is widely accepted as one mechanism enabling rapid translation of new discoveries into interventions in human health. Although the impact of successful team-based approaches facilitating innovation has been well-documented, its utility for training a new generation of scientists has not been thoroughly investigated. We describe the characteristics of how multidisciplinary translational teams (MTTs) promote career development of translational research scholars through competency building, interprofessional integration, and team-based mentoring approaches. Exploratory longitudinal and outcome assessments from our experience show that MTT membership had a positive effect on the development of translational research competencies, as determined by a self-report survey of 32 scholars. We also observed that all trainees produced a large number of collaborative publications that appeared to be associated with their CTSA association and participation with MTTs. We conclude that the MTT model provides a unique training environment for translational and team-based learning activities, for investigators at early stages of career development.

  11. Formal and heuristic system decomposition methods in multidisciplinary synthesis. Ph.D. Thesis, 1991

    Science.gov (United States)

    Bloebaum, Christina L.

    1991-01-01

    The multidisciplinary interactions which exist in large scale engineering design problems provide a unique set of difficulties. These difficulties are associated primarily with unwieldy numbers of design variables and constraints, and with the interdependencies of the discipline analysis modules. Such obstacles require design techniques which account for the inherent disciplinary couplings in the analyses and optimizations. The objective of this work was to develop an efficient holistic design synthesis methodology that takes advantage of the synergistic nature of integrated design. A general decomposition approach for optimization of large engineering systems is presented. The method is particularly applicable for multidisciplinary design problems which are characterized by closely coupled interactions among discipline analyses. The advantage of subsystem modularity allows for implementation of specialized methods for analysis and optimization, computational efficiency, and the ability to incorporate human intervention and decision making in the form of an expert systems capability. The resulting approach is not a method applicable to only a specific situation, but rather, a methodology which can be used for a large class of engineering design problems in which the system is non-hierarchic in nature.

  12. Multidisciplinary Optimization of Airborne Radome Using Genetic Algorithm

    Science.gov (United States)

    Tang, Xinggang; Zhang, Weihong; Zhu, Jihong

    A multidisciplinary optimization scheme of airborne radome is proposed. The optimization procedure takes into account the structural and the electromagnetic responses simultaneously. The structural analysis is performed with the finite element method using Patran/Nastran, while the electromagnetic analysis is carried out using the Plane Wave Spectrum and Surface Integration technique. The genetic algorithm is employed for the multidisciplinary optimization process. The thicknesses of multilayer radome wall are optimized to maximize the overall transmission coefficient of the antenna-radome system under the constraint of the structural failure criteria. The proposed scheme and the optimization approach are successfully assessed with an illustrative numerical example.

  13. Thriving in multidisciplinary research: advice for new bioinformatics students.

    Science.gov (United States)

    Auerbach, Raymond K

    2012-09-01

    The sciences have seen a large increase in demand for students in bioinformatics and multidisciplinary fields in general. Many new educational programs have been created to satisfy this demand, but navigating these programs requires a non-traditional outlook and emphasizes working in teams of individuals with distinct yet complementary skill sets. Written from the perspective of a current bioinformatics student, this article seeks to offer advice to prospective and current students in bioinformatics regarding what to expect in their educational program, how multidisciplinary fields differ from more traditional paths, and decisions that they will face on the road to becoming successful, productive bioinformaticists.

  14. A new member of the multidisciplinary ALS team: the otolaryngologist.

    Science.gov (United States)

    Rubin, Adam D; Griffin, Garrett R; Hogikyan, Norman D; Feldman, Eva L

    2012-02-01

    The multidisciplinary approach to treatment of amyotrophic lateral sclerosis (ALS) has improved the overall care of patients suffering from this disease ( 1 , 2 ). This approach typically has included neurologists, physiatrists, occupational therapists, respiratory therapists and speech therapists. Dysphonia, dysarthria, and dysphagia are three of the most common bulbar manifestations of ALS, and are often the presenting symptoms in bulbar-onset patients. Despite this, otolaryngologists are often not included in ALS management until a tracheostomy is considered. The otolaryngologist can play an important role in early diagnosis and subsequent management of bulbar manifestations of ALS, and would be a valuable member of the multidisciplinary team.

  15. Building collaborative teams for multidisciplinary educational projects in optoelectronics

    Science.gov (United States)

    Jokerst, Nan Marie; Brooke, Martin A.; Laskar, Joy; Wills, D. Scott; Brown, April S.; Ingram, Mary Ann

    2000-06-01

    Multidisciplinary team-oriented research is an effective method for investigating systems spanning multiple knowledge areas. Building on cross-functional team strategies developed for highly competitive industries, experts from a variety of technical domains can be brought together in a team and focused toward a common set of goals. However, building and maintaining these teams is an art that combines technical, social, and management skills, and requires proactive, conscious attention to enable and achieve positive results. This paper explores some avenues toward effective multi-disciplinary team building, and explores the educational potential associated with team-oriented research.

  16. Integration of intradisciplinary quality assessment into a multidisciplinary approach.

    Science.gov (United States)

    Greer, A

    1992-01-01

    One challenge for the QA professional in healthcare today is initiating, coordinating, and facilitating QA programs that cross traditional departmental and discipline barriers and bring together multidisciplinary teams. When looking at healthcare from a customer's perspective, the QA professional must not isolate what nursing does for the patient, what the medical staff does for the patient, what pharmacy does for the patient, and so on. The imperative, instead, is to evaluate the healthcare as it truly is perceived and delivered-as a team effort. This article presents one method that uses the Joint Commission on Accreditation of Healthcare Organizations' 10-step model to create an effective multidisciplinary QA program.

  17. Balancing confidentiality and collaboration within multidisciplinary health care teams.

    Science.gov (United States)

    Van Liew, Julia R

    2012-12-01

    As multidisciplinary perspectives are increasingly integrated into the treatment of health problems, opportunities for clinical psychologists in medical settings are expanding. Although cross-discipline collaboration is at the core of multidisciplinary treatment models, psychologists must be particularly cautious about information sharing due to their profession's ethical standards regarding patient confidentiality. Psychologists' ethical obligations require them to achieve a delicate balance between contributing to the treatment team and protecting patient confidentiality. In the current review, relevant ethical standards and federal guidelines are applied to everyday practices of clinical psychologists in medical settings. Additionally, recommendations for individual psychologists, health care organizations, and graduate training programs are presented.

  18. Thriving in Multidisciplinary Research: Advice for New Bioinformatics Students

    Science.gov (United States)

    Auerbach, Raymond K.

    2012-01-01

    The sciences have seen a large increase in demand for students in bioinformatics and multidisciplinary fields in general. Many new educational programs have been created to satisfy this demand, but navigating these programs requires a non-traditional outlook and emphasizes working in teams of individuals with distinct yet complementary skill sets. Written from the perspective of a current bioinformatics student, this article seeks to offer advice to prospective and current students in bioinformatics regarding what to expect in their educational program, how multidisciplinary fields differ from more traditional paths, and decisions that they will face on the road to becoming successful, productive bioinformaticists. PMID:23012580

  19. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial.

    Science.gov (United States)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe; Damsbo-Svendsen, Signe; Kreinfeldt Skovgaard Møller, Tina; Boll Hansen, Eigil; Keiding, Hans

    2014-08-28

    Older adults in nursing home and home-care are a particularly high-risk population for weight loss or poor nutrition. One negative consequence of undernutrition is increased health care costs. Several potentially modifiable nutritional risk factors increase the likelihood of weight loss or poor nutrition. Hence a structured and multidisciplinary approach, focusing on the nutritional risk factors and involving e.g. dieticians, occupational therapists, and physiotherapist, may be necessary to achieve benefits. Up till now a few studies have been done evaluating the cost-effectiveness of nutritional support among undernourished older adults and none of these have used such a multidisciplinary approach. An 11 week cluster randomized trial to assess the cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care, identified by screening with the Eating validation Scheme. Before start of the study there will be performed a train-the-trainer intervention involving educated nutrition coordinators.In addition to the nutrition coordinator, the participants assigned to the intervention group strategy will receive multidisciplinary nutrition support. Focus will be on treatment of the potentially modifiable nutritional risk factors identified by screening, by involving physiotherapist, registered dietician, and occupational therapist, as relevant and independent of the municipality's ordinary assessment and referral system.The primary outcome parameter will be change in quality of life (by means of Euroquol-5D-3L). Secondary outcomes will be: physical performance (chair stand), nutritional status (weight, Body Mass Index and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (for participants from home-care), use of social services and mortality.An economic evaluation will be conducted to evaluate the cost-effectiveness of the multidisciplinary

  20. [The bio-psycho-social model and the International Classification of Functioning, Disability and Health : Examples of using the model, its parts and the items].

    Science.gov (United States)

    Wenzel, Tobias-Raphael; Morfeld, Matthias

    2016-09-01

    The International Classification of Functioning, Disability and Health (ICF) can be used in practice in a variety of ways. The aim of this work is to illustrate some of the most important ways of using the ICF and some aspects of their theoretical concepts. Database searches (PubMed, Rehadat, and Google Scholar) were conducted for studies concerning the use of the ICF in practice. For all aspects of the ICF, and many of the intended ways of using it, there are concrete developments and examples or indications for their implementation into practice in different contexts. In particular, the common language and the bio-psycho-social model is widely accepted and applied in practice. At the level of chapters, there are a few developments and examples of practical applications of the ICF. When using the ICF based on Items, however, diverse developments of different theoretical and methodological quality are available. The multitude of different adaptations of the ICF for practice illustrates the great effort to the implementation in practice. However, this also shows that no comprehensive solution to the satisfaction of concerned protagonists was found. Research is needed on the theoretical foundations of the ICF, capturing the current practice of using the ICF and in the creation of specific instructions for ways to use the ICF in practice.

  1. Positive impact of Tai Chi Chuan participation on biopsychosocial quality of life compared to exercise and sedentary controls: a cross-sectional survey.

    Science.gov (United States)

    Baxter, Alex; J P Francis, Andrew

    2013-05-24

    Tai Chi Chuan (TCC) is a traditional Chinese medicine practice and martial art with biopsychosocial aspects. This study aimed to examine the impact of participation in TCC on multiple domains of Quality of Life (QoL) and to assess the involvement of the psychological factors of self-efficacy, Locus of Control (LoC) and Hope in these effects. A total of 68 participants from the general community (13 males and 55 females) aged between 18 and 68 (M=43.55 years) and not currently suffering from a mental or physical illness took part in the study. It was found that TCC participants, as a group, scored significantly better than those in sedentary (book club) and active (gym exercise) control conditions on Psychological and Physical QoL, and that the Physical QoL benefits of TCC continue to accrue with years of practice. The three psychological factors were shown to variously mediate (self-efficacy) and moderate (internal LoC and Hope) this latter relationship. Whilst the results bear limitations (in particular small sample sizes), it is hoped that these findings will encourage further research into TCC, and consideration of TCC as part of the range of treatment options available in community-based mental and physical health management.

  2. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

    Science.gov (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia

    2015-01-01

    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  3. A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.

    LENUS (Irish Health Repository)

    Whitford, David L

    2007-01-01

    BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more

  4. Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

    DEFF Research Database (Denmark)

    Toft Tengberg, Line; Bay-Nielsen, M; Bisgaard, T;

    2017-01-01

    BACKGROUND: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery...... after initiation of the AHA protocol as standard care. The intervention cohort was compared with a predefined, consecutive historical cohort of patients from the same department. The protocol involved continuous staff education, consultant-led attention and care, early resuscitation and high......-dose antibiotics, surgery within 6 h, perioperative stroke volume-guided haemodynamic optimization, intermediate level of care for the first 24 h after surgery, standardized analgesic treatment, early postoperative ambulation and early enteral nutrition. The primary outcome was 30-day mortality. RESULTS: Six...

  5. Improving perioperative care for adolescent idiopathic scoliosis patients: the impact of a multidisciplinary care approach

    Science.gov (United States)

    Borden, Timothy C; Bellaire, Laura L; Fletcher, Nicholas D

    2016-01-01

    The complex nature of the surgical treatment of adolescent idiopathic scoliosis (AIS) requires a wide variety of health care providers. A well-coordinated, multidisciplinary team approach to the care of these patients is essential for providing high-quality care. This review offers an up-to-date overview of the numerous interventions and safety measures for improving outcomes after AIS surgery throughout the perioperative phases of care. Reducing the risk of potentially devastating and costly complications after AIS surgery is the responsibility of every single member of the health care team. Specifically, this review will focus on the perioperative measures for preventing surgical site infections, reducing the risk of neurologic injury, minimizing surgical blood loss, and preventing postoperative complications. Also, the review will highlight the postoperative protocols that emphasize early mobilization and accelerated discharge. PMID:27695340

  6. The role of a multidisciplinary team meeting in an antiretroviral treatment programme

    Directory of Open Access Journals (Sweden)

    C van deventer

    2009-08-01

    Full Text Available Abstract Introduction The multidisciplinary team at the wellness clinic, Potchefstroom hospital has been having regular meetings since the clinic was accredited as a treatment site for HAART. The meetings have concentrated on patients who have experienced problems on treatment. The aim was to understand and overcome barriers to adherence and any other patient related issues at the clinic. Method. Minutes of 2006 were audited in order to acquire an understanding of the difficulties faced by patients and to investigate outcomes of corrective interventions. Results 17% of the files could not be traced in order to obtain more information. 36% of patients had stabilized with improved or undetectable viral loads. Alcohol and work related matters played an important role in poor adherence. There were however many other factors identified

  7. The Phil Hearne course: an evaluation of a multidisciplinary mental health education programme for clinical practitioners.

    Science.gov (United States)

    Parsons, S; Barker, P

    2000-04-01

    A description and evaluation of the pilot of a 30-week multidisciplinary mental health education programme (The Phil Hearne Course) is presented. The course was based upon the expressed service needs of an NHS Trust and upon the needs of users consulted during the developmental phase of the project. The course was designed to provide core skills, relating to effective assessment, communication, intervention and networking. These skills were thought to be applicable to all mental health disciplines. The course was evaluated positively by students and staff and was found to be effective in improving practice by providing a range of core skills for mental health workers. It was also determined that students tended to over-estimate their skills in core areas, particularly care planning and record-keeping. It is intended to develop the course into a distance learning, skills-based package.

  8. 'Miracle baby': an outcome of multidisciplinary approach to neurotrauma in pregnancy.

    LENUS (Irish Health Repository)

    Neville, Grace

    2012-01-01

    Traumatic brain injury (TBI) warranting neurosurgical intervention in the pregnant population is a rarity. We describe a case of a 27-year-old woman who at 13 weeks of gestation presented with multiple traumas having been involved in a near fatal road traffic accident. Glasgow Coma Scale was 6\\/15. CT brain showed extensive haemorrhagic contusions, diffuse brain swelling and multiple skull and facial fractures. Decompressive craniectomy was performed to control her intracranial pressure during her management in the intensive care. A viable intrauterine pregnancy was confirmed and progressed as maternal stabilisation and rehabilitation continued. At 35+3 weeks a 2770 g male child was delivered via emergency caesarean section after spontaneous onset of labour. The child had no detectable abnormalities and is clinically well. Eight months post-TBI the patient continues to make gradual improvements but is left with severe cognitive impairment and currently undergoing rehabilitation. A multidisciplinary approach was adopted in the management of this patient.

  9. Sleep Disorders in Children: Collaboration for School-Based Intervention

    Science.gov (United States)

    Everhart, D. Erik

    2011-01-01

    The effects of sleep disturbance on children are wide ranging and include alterations in behavior, mood, cognition, and academic performance. Screening and intervention for pediatric sleep disorders within the schools are not widely implemented, and the concept of integrating school personnel into the multidisciplinary sleep team has yet to be…

  10. Activity-Based Intervention Practices in Special Education

    Science.gov (United States)

    Ozen, Arzu; Ergenekon, Yasemin

    2011-01-01

    Teaching practices in natural settings such as activity-based intervention (ABI) are suggested as alternatives to be used in effective early childhood education. As a multidisciplinary model, ABI consists of four components, which are choosing activities according to the child's interests; teaching generalizable goals embedded in routines and…

  11. Physiotherapists’ experiences of physiotherapy interventions in scientific physiotherapy publications focusing on interventions for children with cerebral palsy: a qualitative phenomenographic approach

    Science.gov (United States)

    2012-01-01

    Background Physiotherapy research concerning interventions for children with CP is often focused on collecting evidence of the superiority of particular therapeutic methods or treatment modalities. Articulating and documenting the use of theory, instrumentation and research design and the assumptions underlying physiotherapy research interventions are important. Physiotherapy interventions focusing on children with Cerebral Palsy should, according to the literature, be based on a functional and environmental perspective with task-specific functional activity, motor learning processes and Family-Centred Service i.e. to enhance motor ability and improve capacity so that the child can perform the tasks necessary to participate actively in everyday life. Thus, it is important to coordinate the norms and values of the physiotherapist with those of the family and child. The aim of this study was to describe how physiotherapists’ experiences physiotherapy interventions for children with CP in scientific physiotherapy publications written by physiotherapists. Methods A qualitative phenomenographic approach was used. Twenty- one scientific articles, found in PubMed, strategically chosen according to year of publication (2001–2009), modality, journals and country, were investigated. Results Three qualitatively different descriptive categories were identified: A: Making it possible a functional-based intervention based on the biopsychosocial health paradigm, and the role of the physiotherapist as collaborative, interacting with the child and family in goal setting, intervention planning and evaluation, B: Making it work an impairment-based intervention built on a mixed health paradigm (biomedical and biopsychosocial), and the role of the physiotherapist as a coach, leading the goal setting, intervention planning and evaluation and instructing family members to carry out physiotherapist directed orders, and; C: Making it normal an impairment-based intervention built on a

  12. Physiotherapists' experiences of physiotherapy interventions in scientific physiotherapy publications focusing on interventions for children with cerebral palsy: a qualitative phenomenographic approach.

    Science.gov (United States)

    Larsson, Ingalill; Miller, Michael; Liljedahl, Kerstin; Gard, Gunvor

    2012-07-02

    Physiotherapy research concerning interventions for children with CP is often focused on collecting evidence of the superiority of particular therapeutic methods or treatment modalities. Articulating and documenting the use of theory, instrumentation and research design and the assumptions underlying physiotherapy research interventions are important. Physiotherapy interventions focusing on children with Cerebral Palsy should, according to the literature, be based on a functional and environmental perspective with task-specific functional activity, motor learning processes and Family-Centred Service i.e. to enhance motor ability and improve capacity so that the child can perform the tasks necessary to participate actively in everyday life. Thus, it is important to coordinate the norms and values of the physiotherapist with those of the family and child. The aim of this study was to describe how physiotherapists' experiences physiotherapy interventions for children with CP in scientific physiotherapy publications written by physiotherapists. A qualitative phenomenographic approach was used. Twenty- one scientific articles, found in PubMed, strategically chosen according to year of publication (2001-2009), modality, journals and country, were investigated. Three qualitatively different descriptive categories were identified: A: Making it possible a functional-based intervention based on the biopsychosocial health paradigm, and the role of the physiotherapist as collaborative, interacting with the child and family in goal setting, intervention planning and evaluation, B: Making it work an impairment-based intervention built on a mixed health paradigm (biomedical and biopsychosocial), and the role of the physiotherapist as a coach, leading the goal setting, intervention planning and evaluation and instructing family members to carry out physiotherapist directed orders, and; C: Making it normal an impairment-based intervention built on a biomedical health paradigm, and

  13. Physiotherapists’ experiences of physiotherapy interventions in scientific physiotherapy publications focusing on interventions for children with cerebral palsy: a qualitative phenomenographic approach

    Directory of Open Access Journals (Sweden)

    Larsson Ingalill

    2012-07-01

    Full Text Available Abstract Background Physiotherapy research concerning interventions for children with CP is often focused on collecting evidence of the superiority of particular therapeutic methods or treatment modalities. Articulating and documenting the use of theory, instrumentation and research design and the assumptions underlying physiotherapy research interventions are important. Physiotherapy interventions focusing on children with Cerebral Palsy should, according to the literature, be based on a functional and environmental perspective with task-specific functional activity, motor learning processes and Family-Centred Service i.e. to enhance motor ability and improve capacity so that the child can perform the tasks necessary to participate actively in everyday life. Thus, it is important to coordinate the norms and values of the physiotherapist with those of the family and child. The aim of this study was to describe how physiotherapists’ experiences physiotherapy interventions for children with CP in scientific physiotherapy publications written by physiotherapists. Methods A qualitative phenomenographic approach was used. Twenty- one scientific articles, found in PubMed, strategically chosen according to year of publication (2001–2009, modality, journals and country, were investigated. Results Three qualitatively different descriptive categories were identified: A: Making it possible a functional-based intervention based on the biopsychosocial health paradigm, and the role of the physiotherapist as collaborative, interacting with the child and family in goal setting, intervention planning and evaluation, B: Making it work an impairment-based intervention built on a mixed health paradigm (biomedical and biopsychosocial, and the role of the physiotherapist as a coach, leading the goal setting, intervention planning and evaluation and instructing family members to carry out physiotherapist directed orders, and; C: Making it normal an impairment

  14. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age.

    Science.gov (United States)

    Turner-Stokes, Lynne; Pick, Anton; Nair, Ajoy; Disler, Peter B; Wade, Derick T

    2015-12-22

    Evidence from systematic reviews demonstrates that multi-disciplinary rehabilitation is effective in the stroke population, in which older adults predominate. However, the evidence base for the effectiveness of rehabilitation following acquired brain injury (ABI) in younger adults has not been established, perhaps because this scenario presents different methodological challenges in research. To assess the effects of multi-disciplinary rehabilitation following ABI in adults 16 to 65 years of age. We ran the most recent search on 14 September 2015. We searched the Cochrane Injuries Group Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (OvidSP), Web of Science (ISI WOS) databases, clinical trials registers, and we screened reference lists. Randomised controlled trials (RCTs) comparing multi-disciplinary rehabilitation versus routinely available local services or lower levels of intervention; or trials comparing an intervention in different settings, of different intensities or of different timing of onset. Controlled clinical trials were included, provided they met pre-defined methodological criteria. Three review authors independently selected trials and rated their methodological quality. A fourth review author would have arbitrated if consensus could not be reached by discussion, but in fact, this did not occur. As in previous versions of this review, we used the method described by Van Tulder 1997 to rate the quality of trials and to perform a 'best evidence' synthesis by attributing levels of evidence on the basis of methodological quality. Risk of bias assessments were performed in parallel using standard Cochrane methodology. However, the Van Tulder system provided a more discriminative evaluation of rehabilitation trials, so we have continued to use it for our primary synthesis of evidence. We subdivided trials in terms of

  15. A Multidisciplinary Engineering Summer School in an Industrial Setting

    Science.gov (United States)

    Larsen, Peter Gorm; Fernandes, Joao M.; Habel, Jacek; Lehrskov, Hanne; Vos, Richard J. C.; Wallington, Oliver; Zidek, Jan

    2009-01-01

    Most university-level engineering studies produce technically skilled engineers. However, typically students face several difficulties when working in multidisciplinary teams when they initiate their industrial careers. In a globalised world, it becomes increasingly important that engineers are capable of collaborating across disciplinary…

  16. A Multidisciplinary Process Curriculum in Environmental Education, Grade 2.

    Science.gov (United States)

    Edmonds School District 15, Lynnwood, WA.

    This second grade curriculum guide is based on a multidisciplinary approach to environmental education. The guide includes activities, guidelines for field trip planning, and a resource section. The guide deals with the subjects of plants, soil, and litter. Each subject section includes activities based on the physical characteristics, man's use,…

  17. Learning to evaluate multidisciplinary crisis-management team exercises

    NARCIS (Netherlands)

    Berlo, M.P.W. van; Dommele, R. van; Schneider, P.; Veerdonk, I. van de; Braakhekke, E.; Hendriks van de Weem, N.; Dijkman, E. van; Wartna, S.

    2007-01-01

    Training of multidisciplinary crisis management teams is becoming more common practice. Nevertheless, the value of these trainings and exercises is questionable. Scenarios are quite often realistic and challenging to the trainees: the team members are heavily engaged in doing their jobs in a multidi

  18. Can collaboration within multidisciplinary teamwork be explained using Belbin?

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2013-01-01

    of teachers for 13 multidisciplinary teams of students. Belbin’s theory on teamwork was introduced and the teams were formed according to the theory, in order to optimize the collaboration. Students were given a standard- and course specific questionnaire including the possibility for making individual notes...

  19. Autism and Multidisciplinary Teamwork through the SCERTS Model

    Science.gov (United States)

    Molteni, Paola; Guldberg, Karen; Logan, Nick

    2013-01-01

    This research investigates multidisciplinary teamwork in an English special school located in the West Midlands region of the UK. The research was carried out by Paola Molteni, a PhD student at Università Cattolica del Sacro Cuore, Milan, Karen Guldberg of the Autism Centre for Education and Research Director at the University of Birmingham School…

  20. The development of a design behaviour questionnaire for multidisciplinary teams

    NARCIS (Netherlands)

    Peeters, Miranda A.G.; Tuijl, van Harrie F.J.M.; Reymen, Isabelle M.M.J.; Rutte, Christel G.

    2007-01-01

    The relationship between design behaviours and successful design task completion is studied for multidisciplinary design teams. In this research, no observational methods such as audio–visual recordings or ethnographic fieldwork were used, as often the case in design research, but a questionnaire ta

  1. Multidisciplinary conservative management in classical Volkmann's contracture: A case report

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Eisma, W.H.

    1996-01-01

    This clinical note describes the case of a nine-year-old girl with classical Volkmann's contracture of the left forearm. The report demonstrates the results and follow-up of conservative orthotic management used as a mode of treatment by a multidisciplinary team. When using an orthosis it is

  2. Research on Multidisciplinary Optimization Design of Bridge Crane

    Directory of Open Access Journals (Sweden)

    Tong Yifei

    2013-01-01

    Full Text Available Bridge crane is one of the most widely used cranes in our country, which is indispensable equipment for material conveying in the modern production. In this paper, the framework of multidisciplinary optimization for bridge crane is proposed. The presented research on crane multidisciplinary design technology for energy saving includes three levels, respectively: metal structures level, transmission design level, and electrical system design level. The shape optimal mathematical model of the crane is established for shape optimization design of metal structure level as well as size optimal mathematical model and topology optimal mathematical model of crane for topology optimization design of metal structure level is established. Finally, system-level multidisciplinary energy-saving optimization design of bridge crane is further carried out with energy-saving transmission design results feedback to energy-saving optimization design of metal structure. The optimization results show that structural optimization design can reduce total mass of crane greatly by using the finite element analysis and multidisciplinary optimization technology premised on the design requirements of cranes such as stiffness and strength; thus, energy-saving design can be achieved.

  3. Decisions about Product Safety. A Multidisciplinary Teaching Unit.

    Science.gov (United States)

    Procter and Gamble Educational Services, Cincinnati, OH.

    A multidisciplinary educational unit featuring product safety decisions made by businesses and consumers is presented. teach critical thinking and decision making while supplementing the science, home economics, social studies, and economics curricula. The activities rely extensively, though not exclusively, on Procter & Gamble's experiences…

  4. An information driven strategy to support multidisciplinary design

    Science.gov (United States)

    Rangan, Ravi M.; Fulton, Robert E.

    1990-01-01

    The design of complex engineering systems such as aircraft, automobiles, and computers is primarily a cooperative multidisciplinary design process involving interactions between several design agents. The common thread underlying this multidisciplinary design activity is the information exchange between the various groups and disciplines. The integrating component in such environments is the common data and the dependencies that exist between such data. This may be contrasted to classical multidisciplinary analyses problems where there is coupling between distinct design parameters. For example, they may be expressed as mathematically coupled relationships between aerodynamic and structural interactions in aircraft structures, between thermal and structural interactions in nuclear plants, and between control considerations and structural interactions in flexible robots. These relationships provide analytical based frameworks leading to optimization problem formulations. However, in multidisciplinary design problems, information based interactions become more critical. Many times, the relationships between different design parameters are not amenable to analytical characterization. Under such circumstances, information based interactions will provide the best integration paradigm, i.e., there is a need to model the data entities and their dependencies between design parameters originating from different design agents. The modeling of such data interactions and dependencies forms the basis for integrating the various design agents.

  5. Multidisciplinary management of type 2 diabetes in children and adolescents

    Directory of Open Access Journals (Sweden)

    Michael E Bowen

    2010-07-01

    Full Text Available Michael E Bowen1,2, Russell L Rothman2,31Veterans Affairs Quality Scholars Fellowship Program, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA; 2Division of General Internal Medicine and Public Health, Department of Medicine, 3Vanderbilt Eskind Diabetes Center, Vanderbilt University School of Medicine, Nashville, TN, USAAbstract: Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is increasing at a significant rate. Similar to adults, youth with type 2 diabetes are at increased risk for developing hypertension, lipid abnormalities, renal disease, and other diabetes-related complications. However, children and adolescents with type 2 diabetes also face many unique management challenges that are different from adults with type 2 diabetes or children with type 1 diabetes. To deliver safe, effective, high-quality, cost-effective health care to adolescents with type 2 diabetes, reorganization and redesign of health care systems are needed. Multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their skills within an organized diabetes treatment team, may increase efficiency and effectiveness and may improve outcomes in children with type 2 diabetes. This review article provides a brief review of type 2 diabetes in children and adolescents, provides an overview of multidisciplinary health care teams, and discusses the role of multidisciplinary health care management in youth with type 2 diabetes.Keywords: adolescent, type 2 diabetes, multidisciplinary

  6. IMI - An information system for effective Multidisciplinary Incident Management

    NARCIS (Netherlands)

    Lee, M.D.E. van der; Vugt, M. van der

    2004-01-01

    The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of

  7. System Design and Engineering, lubricating multidisciplinary development projects

    NARCIS (Netherlands)

    Bonnema, Gerrit Maarten; Veenvliet, Karel; Broenink, Johannes F.

    This text book introduces systems engineering for designing systems in multidisciplinary projects. First an overview of the systems engineering process is given. Several systems thinking tracks are presented, to think about the system in a number of ways, its context, its user, its functionality,

  8. Training Multidisciplinary Biomedical Informatics Students: Three Years of Experience

    NARCIS (Netherlands)

    E.M. van Mulligen (Erik); M. Cases (Montserrat); K.M. Hettne (Kristina); E. Molero (Eva); M. Weeber (Marc); K.A. Robertson (Kevin); B. Oliva (Baldomero); G. de la Calle (Guillermo); V. Maojo (Victor)

    2008-01-01

    textabstractObjective: The European INFOBIOMED Network of Excellence1recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams.

  9. Can collaboration within multidisciplinary teamwork be explained using Belbin?

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2013-01-01

    of teachers for 13 multidisciplinary teams of students. Belbin’s theory on teamwork was introduced and the teams were formed according to the theory, in order to optimize the collaboration. Students were given a standard- and course specific questionnaire including the possibility for making individual notes...

  10. Systems design and engineering : facilitating multidisciplinary development projects

    NARCIS (Netherlands)

    Bonnema, Gerrit Maarten; Veenvliet, Karel; Broenink, Johannes F.

    2016-01-01

    As its name implies, the aim of Systems Design and Engineering: Facilitating Multidisciplinary Development Projects is to help systems engineers develop the skills and thought processes needed to successfully develop and implement engineered systems. Such expertise typically does not come through

  11. Cost and benefits of a multidisciplinary intensive diabetes education programme

    NARCIS (Netherlands)

    Keers, J.C.; Groen, H.; Sluiter, W.J.; Bouma, J.; Links, T.P.

    2005-01-01

    OBJECTIVES: To determine the cost and benefits of an intensive diabetes education programme for patients with prolonged self-management problems and to determine the inclusion criteria for optimal outcomes. METHODS: Sixty-one participants of a multidisciplinary intensive diabetes education programme

  12. Autism and Multidisciplinary Teamwork through the SCERTS Model

    Science.gov (United States)

    Molteni, Paola; Guldberg, Karen; Logan, Nick

    2013-01-01

    This research investigates multidisciplinary teamwork in an English special school located in the West Midlands region of the UK. The research was carried out by Paola Molteni, a PhD student at Università Cattolica del Sacro Cuore, Milan, Karen Guldberg of the Autism Centre for Education and Research Director at the University of Birmingham School…

  13. A Multidisciplinary Engineering Summer School in an Industrial Setting

    Science.gov (United States)

    Larsen, Peter Gorm; Fernandes, Joao M.; Habel, Jacek; Lehrskov, Hanne; Vos, Richard J. C.; Wallington, Oliver; Zidek, Jan

    2009-01-01

    Most university-level engineering studies produce technically skilled engineers. However, typically students face several difficulties when working in multidisciplinary teams when they initiate their industrial careers. In a globalised world, it becomes increasingly important that engineers are capable of collaborating across disciplinary…

  14. Agronomy—A Multidisciplinary and Open Access Journal

    Directory of Open Access Journals (Sweden)

    Peter Langridge

    2011-01-01

    Full Text Available Agronomy is a highly multidisciplinary area of science. It includes all aspects of science and technology related to the production and utilization of plants for food, feed, fuel, fiber and even land reclamation. In many respects, agronomy represents the integration of activities and disciplines ranging from genetics, chemistry and biotechnology to ecology, soil science and meteorology. [...

  15. Multidisciplinary teaching – Engineering course in advanced building design

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan; Hertz, Kristian Dahl

    2011-01-01

    Collaboration within the building process is difficult. This calls for employees who are experienced in collaborating in interdisciplinary teams. To fulfil this demand a multidisciplinary course in “Advanced building design” has been developed at the Technical University of Denmark. The goal...

  16. Ethnic Group Differences in the Outcomes of Multidisciplinary Pain Treatment

    Science.gov (United States)

    Merry, Brian; Campbell, Claudia M; Buenaver, Luis F.; McGuire, Lynanne; Haythornthwaite, Jennifer A.; Doleys, Daniel M.; Edwards, Robert R.

    2011-01-01

    Objectives The aim of this prospective investigation was to evaluate ethnic group differences in pain-related outcomes following multidisciplinary chronic pain treatment. A prospective pre- and post-treatment assessment design was employed to investigate the effects of ethnicity on changes in pain-related variables following completion of a multidisciplinary pain treatment program. Methods One hundred fifty five chronic pain patients participating in a multidisciplinary pain treatment program completed measures of pain and mood both prior to and following the four-week treatment. Primary outcome variables included pain severity, pain-related interference, and depressive symptoms. Results Baseline differences between African-Americans and Whites were observed for depressive symptoms, but not for pain severity or pain-related interference. Following multidisciplinary pain treatment, both White and African-American patients displayed post-treatment reductions in depressive symptoms and pain-related interference. However, White patients also reported reduced pain severity while African-Americans did not. Conclusions The treatment approach used in the present study appeared to be less effective in reducing self-reported pain severity in African-American versus White patients, though both groups benefited in terms of reduced depressive symptoms and pain-related interference. Moreover, the observation that improvements in functioning occurred without reductions in pain severity in African-American patients suggests that differences may exist in treatment processes as a function of ethnic group, and will consequently be an important area for future research. PMID:21731407

  17. Decisions about Product Safety. A Multidisciplinary Teaching Unit.

    Science.gov (United States)

    Procter and Gamble Educational Services, Cincinnati, OH.

    A multidisciplinary educational unit featuring product safety decisions made by businesses and consumers is presented. teach critical thinking and decision making while supplementing the science, home economics, social studies, and economics curricula. The activities rely extensively, though not exclusively, on Procter & Gamble's experiences in…

  18. IMI - An information system for effective Multidisciplinary Incident Management

    NARCIS (Netherlands)

    Lee, M.D.E. van der; Vugt, M. van der

    2004-01-01

    The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of

  19. Using Student Technical Conferences to Build Multidisciplinary Teamwork Skills

    Science.gov (United States)

    Silverstein, David L.

    2007-01-01

    An open-ended student conference project involving sophomore, junior, and senior chemical engineering students is described. The project is designed to address outcomes in each of the courses in which those students are enrolled, as well as broader "soft skills" including multidisciplinary teamwork, communications, lifelong learning, and…

  20. Training Multidisciplinary Biomedical Informatics Students: Three Years of Experience

    NARCIS (Netherlands)

    E.M. van Mulligen (Erik); M. Cases (Montserrat); K.M. Hettne (Kristina); E. Molero (Eva); M. Weeber (Marc); K.A. Robertson (Kevin); B. Oliva (Baldomero); G. de la Calle (Guillermo); V. Maojo (Victor)

    2008-01-01

    textabstractObjective: The European INFOBIOMED Network of Excellence1recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. Desig

  1. [Better multidisciplinary team meetings are linked to better care

    NARCIS (Netherlands)

    Drielen, E. van; Vries, A.W. de; Ottevanger, P.B.; Hermens, R.P.M.G.

    2012-01-01

    Discussing a patient in an oncology multidisciplinary team meeting (MTM) increases the value of the quality of the treatment chosen. MTMs are increasingly mentioned in guidelines and indicator sets. Based on literature review and observations, the Comprehensive Cancer Centre Netherlands (CCCNL), in

  2. The Interplay of Conflict and Analogy in Multidisciplinary Teams

    Science.gov (United States)

    Paletz, Susannah B. F.; Schunn, Christian D.; Kim, Kevin H.

    2013-01-01

    Creative teamwork in multidisciplinary teams is a topic of interest to cognitive psychologists on the one hand, and to both social and organizational psychologists on the other. However, the interconnections between cognitive and social layers have been rarely explored. Drawing on mental models and dissonance theories, the current study takes a…

  3. justification of a multidisciplinary approach to teaching language arts

    African Journals Online (AJOL)

    adeyemim

    teaching of a concept with the use of the multidisciplinary approaches with the attendant ... Environmental Science, Mathematics, History and so on. In this way, each subject ..... Finally, it is an area of knowledge that is open to more research to ...

  4. The multidisciplinary team in palliative care: A case reflection

    Directory of Open Access Journals (Sweden)

    Liza Bowen

    2014-01-01

    Full Text Available This essay is a reflection on the multidisciplinary team in palliative care, from the perspective of a final year MBBS student from the UK spending one month with an Indian pain and palliative care team at Institute Rotary Cancer Hospital (IRCH, AIIMS, New Delhi.

  5. Oncologic multidisciplinary team meetings: evaluation of quality criteria

    NARCIS (Netherlands)

    Ottevanger, N.; Hilbink, M.; Weenk, M.; Janssen, R.; Vrijmoeth, T.; Vries, A. de; Hermens, R.

    2013-01-01

    RATIONALE, AIMS AND OBJECTIVES: To develop a guideline with quality criteria for an optimal structure and functioning of a multidisciplinary team meeting (MTM), and to assess to what extent the Dutch MTMs complied with these criteria. METHOD: A literature search and expert opinions were used to deve

  6. Learning to evaluate multidisciplinary crisis-management team exercises

    NARCIS (Netherlands)

    Berlo, M.P.W. van; Dommele, R. van; Schneider, P.; Veerdonk, I. van de; Braakhekke, E.; Hendriks van de Weem, N.; Dijkman, E. van; Wartna, S.

    2007-01-01

    Training of multidisciplinary crisis management teams is becoming more common practice. Nevertheless, the value of these trainings and exercises is questionable. Scenarios are quite often realistic and challenging to the trainees: the team members are heavily engaged in doing their jobs in a

  7. Food-based Science Curriculum Increases 4(th) Graders Multidisciplinary Science Knowledge.

    Science.gov (United States)

    Hovland, Jana A; Carraway-Stage, Virginia G; Cela, Artenida; Collins, Caitlin; Díaz, Sebastián R; Collins, Angelo; Duffrin, Melani W

    2013-10-01

    Health professionals and policymakers are asking educators to place more emphasis on food and nutrition education. Integrating these topics into science curricula using hand-on, food-based activities may strengthen students' understanding of science concepts. The Food, Math, and Science Teaching Enhancement Resource (FoodMASTER) Initiative is a compilation of programs aimed at using food as a tool to teach mathematics and science. Previous studies have shown that students experiencing the FoodMASTER curriculum were very excited about the activities, became increasingly interested in the subject matter of food, and were able to conduct scientific observations. The purpose of this study was to: 1) assess 4(th) graders food-related multidisciplinary science knowledge, and 2) compare gains in food-related science knowledge after implementation of an integrated, food-based curriculum. During the 2009-2010 school year, FoodMASTER researchers implemented a hands-on, food-based intermediate curriculum in eighteen 4(th) grade classrooms in Ohio (n=9) and North Carolina (n=9). Sixteen classrooms in Ohio (n=8) and North Carolina (n=8), following their standard science curricula, served as comparison classrooms. Students completed a researcher-developed science knowledge exam, consisting of 13 multiple-choice questions administered pre- and post-test. Only subjects with pre- and post-test scores were entered into the sample (Intervention n=343; Control n=237). No significant differences were observed between groups at pre-test. At post-test, the intervention group scored (9.95±2.00) significantly higher (p=.000) than the control group (8.84±2.37) on a 13-point scale. These findings suggest the FoodMASTER intermediate curriculum is more effective than a standard science curriculum in increasing students' multidisciplinary science knowledge related to food.

  8. An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System.

    Science.gov (United States)

    Brunani, Amelia; Raggi, Alberto; Sirtori, Anna; Berselli, Maria Elisa; Villa, Valentina; Ceriani, Francesca; Corti, Stefania; Leonardi, Matilde; Capodaglio, Paolo

    2015-05-29

    In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese patients to standardize rehabilitation interventions. After training on the ICF and based on the relevant studies, ICF categories were identified in a formal consensus process by our multidisciplinary team. Thereafter, we defined an individual rehabilitation project based on a structured multi-disciplinary approach to obesity. the proposed IRPOb model identified the specific intervention areas (nutritional, physiotherapy, psychology, nursing), the short-term goals, the intervention modalities, the professionals involved and the assessment of the outcomes. Information was shared with the patient who signed informed consent. The model proposed provides the following advantages: (1) standardizes rehabilitative procedures; (2) facilitates the flow of congruent and updated information from the hospital to outpatient facilities, relatives, and care givers; (3) addresses organizational issues; (4) might serve as a benchmark for professionals who have limited specific expertise in rehabilitation of comorbid obese patients.

  9. A multidisciplinary antimicrobial stewardship programme safely decreases the duration of broad-spectrum antibiotic prescription in Singaporean adult renal patients.

    Science.gov (United States)

    Cai, Yiying; Shek, Pui Ying; Teo, Isabelle; Tang, Sarah S L; Lee, Winnie; Liew, Yi Xin; Chlebicki, Piotr; Kwa, Andrea L

    2016-01-01

    Patients with chronic kidney disease have increased risk of infections. Thus, physicians may favour prolonged broad-spectrum antibiotic use. Studies focused on antimicrobial stewardship programmes (ASPs) in renal patients are currently lacking. Here we describe the role of a multidisciplinary ASP and the impact of ASP interventions in renal patients. A multidisciplinary ASP was initiated at a tertiary hospital in Singapore. Patients prescribed broad-spectrum parenteral antibiotics were identified daily and were subjected to prospective review with immediate concurrent feedback. ASP data from January 2010 to December 2011 were analysed for all renal patients. Outcome measures included the duration and appropriateness of antibiotics, intervention acceptance rates, cost savings and safety outcomes. A total of 2084 antibiotic courses were reviewed, of which 24% were inappropriate, with meropenem most commonly prescribed inappropriately (31.0%). The commonest reasons for inappropriate use were wrong choice (51.0%) and wrong duration (21.4%). In total, 634 recommendations were made, with high acceptance rates (73.3%). Recommendations to discontinue antibiotics (33.4%) and to optimise doses (17.2%) comprised the bulk of ASP work. A mean reduction of -1.28 days of antibiotic use was observed among patients with interventions accepted versus those rejected (Pantibiotic use without compromising safety in renal patients. Continued effort is needed to produce a long-term impact on antibiotic prescription and resistance.

  10. The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study

    Directory of Open Access Journals (Sweden)

    Horan Sheila

    2011-01-01

    Full Text Available Abstract Background Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index and objective sleep quality (measured by Actigraphy in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Methods/Design Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI]. Those patients with a sleep disturbance (PSQI >5 will be assigned to either the intervention group (immediate treatment, or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia, and functional outcome

  11. Multidisciplinary Specialty Teams: A Self-Management Program for Patients With Advanced Cancer

    Science.gov (United States)

    Tocchi, Christine; McCorkle, Ruth; Knobf, M. Tish

    2015-01-01

    Self-management has been shown to be an effective intervention to enable and empower patients with chronic illness to manage their health. Taking Early Action to Manage Self (TEAMS) is such an intervention, providing education and support to patients with advanced solid tumors to develop self-management skills. We conducted a study and surveyed health-care providers about their perceptions of multidisciplinary teams on the outcomes of this TEAMS intervention as well as factors that may influence its adoption into practice. The majority of respondents reported that the TEAMS program was feasible to practice and well suited to their patient population. In this article, the full results of this survey are presented, along with the emerging themes of empowerment and improved communication between patients and providers. In addition, facilitators and barriers to its adoption are explored. Although providers supported the adoption of the TEAMS program, provider resources to implement and maintain it need to be addressed prior to its widespread adoption. PMID:27069734

  12. Multidisciplinary management of lung cancer: how to test its efficacy?

    Science.gov (United States)

    Leo, Francesco; Venissac, Nicolas; Poudenx, Michel; Otto, Josiane; Mouroux, Jérôme

    2007-01-01

    The multidisciplinary management of lung cancer has been universally accepted. In France, the multidisciplinary approach for cancer patients is established by law. However, the efficacy of this approach remains theoretical, given that no evaluation criteria have been made available and no previous reports have been published on the prospective follow-up of these patients. The Groupe d' Oncologie Thoracique Azuréen carried out a 1-year prospective study on patients discussed during its multidisciplinary weekly meetings, to analyze the concordance between the proposed and administered treatment, the delay of treatment, and the 1-year actuarial survival. Of the 344 patients discussed during the period considered, the therapeutic decision was chemotherapy in 183 patients, surgery in 93, radiochemotherapy in 42, radiotherapy in 14, and supportive care 12. Therapeutic discordance between the planned and the administered treatment was recorded in 15 cases (4.4%), mainly for patient's refusal (seven cases) or poor performance status (five cases). The median delay of treatment was 20 days, shorter for chemotherapy (16 days), and longer for radiotherapy (27 days). The overall 1-year survival rate was 51.4%: 80.4% for stage I, 50.3% for stage II, 37.5% for stage III, and 27.2% for stage IV. For patients for whom discordance of treatment was recorded, a lower survival rate was recorded, without reaching statistical significance (0.07). In conclusion, the efficacy of the Groupe d' Oncologie Thoracique Azuréen multidisciplinary management was confirmed, as we believe that a discordant rate of less than 5% and a delay of treatment of 4 weeks can be considered acceptable. Furthermore, a periodic survival evaluation of the population as a whole could provide additional useful information for multidisciplinary groups.

  13. The reablement team’s voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement

    Directory of Open Access Journals (Sweden)

    Hjelle KM

    2016-11-01

    Full Text Available Kari Margrete Hjelle,1,2 Olbjørg Skutle,2,3 Oddvar Førland,2,4 Herdis Alvsvåg4 1Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway; 2Centre for Care Research Western Norway, Bergen University College, Bergen, Norway; 3Department of Health and Social Educators, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway; 4VID Specialized University, Bergen, Norway Background: Reablement is an early and time-limited home-based rehabilitation intervention that emphasizes intensive, goal-oriented, and multidisciplinary assistance for people experiencing functional decline. Few empirical studies to date have examined the experiences of the integrated multidisciplinary teams involved in reablement. Accordingly, the aim of this study was to explore and describe how an integrated multidisciplinary team in Norway experienced participation in reablement.Methods: An integrated multidisciplinary team consisting of health care professionals with a bachelor’s degree (including a physiotherapist, a social educator, occupational therapists, and nurses and home-based care personnel without a bachelor’s degree (auxiliary nurses and nursing assistants participated in focus group discussions. Qualitative content analysis was used to analyze the resulting data.Results: Three main themes emerged from the participants’ experiences with participating in reablement, including “the older adult’s goals are crucial”, “a different way of thinking and acting – a shift in work culture”, and “a better framework for cooperation and application of professional expertise and judgment”. The integrated multidisciplinary team and the older adults collaborated and worked in the same direction to achieve the person’s valued goals. The team supported the older adults in performing activities themselves rather than completing tasks for them. To

  14. The unintended consequences of sex education: an ethnography of a development intervention in Latin America

    NARCIS (Netherlands)

    Nelson, E.; Edmonds, A.; Ballesteros, M.; Encalada Soto, D.; Rodriguez, O.

    2014-01-01

    This paper is an ethnography of a four-year, multi-disciplinary adolescent sexual and reproductive health intervention in Bolivia, Nicaragua and Ecuador. An important goal of the intervention--and of the larger global field of adolescent sexual and reproductive health--is to create more open

  15. The unintended consequences of sex education: an ethnography of a development intervention in Latin America

    NARCIS (Netherlands)

    Nelson, E.; Edmonds, A.; Ballesteros, M.; Encalada Soto, D.; Rodriguez, O.

    2014-01-01

    This paper is an ethnography of a four-year, multi-disciplinary adolescent sexual and reproductive health intervention in Bolivia, Nicaragua and Ecuador. An important goal of the intervention--and of the larger global field of adolescent sexual and reproductive health--is to create more open parent-

  16. Fostering multidisciplinary learning through computer-supported collaboration script: The role of a transactive memory script

    NARCIS (Netherlands)

    Noroozi, O.; Weinberger, A.; Biemans, H.J.A.; Teasley, S.D.; Mulder, M.

    2012-01-01

    For solving many of today's complex problems, professionals need to collaborate in multidisciplinary teams. Facilitation of knowledge awareness and coordination among group members, that is through a Transactive Memory System (TMS), is vital in multidisciplinary collaborative settings. Online platfo

  17. Fostering multidisciplinary learning through computer-supported collaboration script: The role of a transactive memory script

    NARCIS (Netherlands)

    Noroozi, O.; Weinberger, A.; Biemans, H.J.A.; Teasley, S.D.; Mulder, M.

    2012-01-01

    For solving many of today's complex problems, professionals need to collaborate in multidisciplinary teams. Facilitation of knowledge awareness and coordination among group members, that is through a Transactive Memory System (TMS), is vital in multidisciplinary collaborative settings. Online

  18. Multi-Fidelity Multi-Strategy and Multi-Disciplinary Design Optimization Environment Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Multidisciplinary design and optimization (MDO) tools developed to perform multi-disciplinary analysis based on low fidelity computation methods have been used in...

  19. Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

    Science.gov (United States)

    McGregor, Alison H

    2016-01-01

    Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

  20. Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

    Directory of Open Access Journals (Sweden)

    Mi Ja Kim, PhD, RN, FAAN

    2008-03-01

    Conclusion: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.

  1. Pain in patients with multiple sclerosis: a complex assessment including quantitative and qualitative measurements provides for a disease-related biopsychosocial pain model

    Directory of Open Access Journals (Sweden)

    Michalski D

    2011-08-01

    Full Text Available Dominik Michalski1,*, Stefanie Liebig1,*, Eva Thomae1,2, Andreas Hinz3, Florian Then Bergh1,21Department of Neurology, 2Translational Centre for Regenerative Medicine (TRM, 3Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany *These authors contributed equallyBackground: Pain of various causes is a common phenomenon in patients with Multiple Sclerosis (MS. A biopsychosocial perspective has proven a useful theoretical construct in other chronic pain conditions and was also started in MS. To support such an approach, we aimed to investigate pain in MS with special emphasis on separating quantitative and qualitative aspects, and its interrelation to behavioral and physical aspects.Materials and methods: Pain intensity (NRS and quality (SES were measured in 38 consecutive outpatients with MS (mean age, 42.0 ± 11.5 years, 82% women. Pain-related behavior (FSR, health care utilization, bodily complaints (GBB-24 and fatigue (WEIMuS were assessed by questionnaires, and MS-related neurological impairment by a standardized neurological examination (EDSS.Results: Mean pain intensity was 4.0 (range, 0–10 and mean EDSS 3.7 (range, 0–8 in the overall sample. Currently present pain was reported by 81.6% of all patients. Disease duration and EDSS did not differ between patients with and without pain and were not correlated to quality or intensity of pain. Patients with pain had significantly higher scores of musculoskeletal complaints, but equal scores of exhaustion, gastrointestinal and cardiovascular complaints. Pain intensity correlated only with physical aspects, whereas quality of pain was additionally associated with increased avoidance, resignation and cognitive fatigue.Conclusion: As in other conditions, pain in MS must be assessed in a multidimensional way. Further research should be devoted to adapt existing models to a MS-specific model of pain.Keywords: pain intensity, quality of pain, pain

  2. Biopsychosocial repercussions of work and income generation in the life of Northe-âstern Brazilian women - doi:10.5020/18061230.2007.p68

    Directory of Open Access Journals (Sweden)

    Cibelly Aliny Siqueira Lima Freitas

    2012-01-01

    Full Text Available In the discussions about health promotion, this is conceived as quality of life, in which social and economic policies should act directly on determinant factors of the health-illnesses process, such as feeding, education, sanitation, work, income, leisure and access to goods and services. In this perspective, the aim of this study was to investigate the expectations of a group of women, inhabitants of Cachoeiro Community, a deprived locality of Northeast Brazil, on the professionalization possibilities, and to know the biopsychosocial repercussions of work-income generation, after a professionalizing action. The study consisted in an action in research, with a qualitative approach, based on the Theoretical Referential of Madeleine Leininger, with six local women, by means of interviews and the accomplishment of a course on carnauba straw handicraft, between May, 2005 and June, 2006. This study resulted from the participation of the researchers in a University Extension project, which favored a bigger interaction with the women of that place. During sociability it was observed that they claimed for a work that contributed to the increase of the family income and breached with the financial dependence on their spouses. It is perceived in this study the cultural factor as strongly influencing the lives of these women, in which abusive relations of power, perceived since infancy, became obstacles in matters related to health, education and in the work and income generation. At the end, the women of the Community were able to seize upon a handicraft technique that contributes for their recognition as citizens, interacting with greater knowledge and attitude in the settlement where they live.

  3. Challenges of Trainees in a Multidisciplinary Research Program: Nano-Biotechnology

    Science.gov (United States)

    Kriegel, Christina; Koehne, Jessica; Tinkle, Sally; Maynard, Andrew D.; Hill, Rodney A.

    2011-01-01

    The breadth of knowledge required for the multidisciplinary field of nanotechnology challenges and extends traditional concepts of multidisciplinary graduate education. There is a paucity of information, both general reporting and peer-reviewed studies, on the challenges for graduate students working in this multidisciplinary paradigm, from the…

  4. Three-year follow-up of 3-year-old to 5-year-old children after participation in a multidisciplinary or a usual-care obesity treatment program

    NARCIS (Netherlands)

    Bocca, Gianni; Corpeleijn, Eva; van den Heuvel, Edwin R.; Stolk, Ronald P.; Sauer, Pieter J. J.

    2014-01-01

    Background & aims: Little is known on the long-term effects of obesity intervention programs in preschool-aged children. We compared the long-term effects of a multidisciplinary treatment program with a usual-care program in seventy-five 3- to 5-year-old overweight or obese children who had

  5. Three-year follow-up of 3-year-old to 5-year-old children after participation in a multidisciplinary or a usual-care obesity treatment program

    NARCIS (Netherlands)

    Bocca, Gianni; Corpeleijn, Eva; van den Heuvel, Edwin R.; Stolk, Ronald P.; Sauer, Pieter J. J.

    2014-01-01

    Background & aims: Little is known on the long-term effects of obesity intervention programs in preschool-aged children. We compared the long-term effects of a multidisciplinary treatment program with a usual-care program in seventy-five 3- to 5-year-old overweight or obese children who had particip

  6. ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia

    Directory of Open Access Journals (Sweden)

    Jayesh M. Bhatt

    2015-12-01

    Full Text Available Ataxia telangiectasia (A-T is a rare, progressive, multisystem disease that has a large number of complex and diverse manifestations which vary with age. Patients with A-T die prematurely with the leading causes of death being respiratory diseases and cancer. Respiratory manifestations include immune dysfunction leading to recurrent upper and lower respiratory infections; aspiration resulting from dysfunctional swallowing due to neurodegenerative deficits; inefficient cough; and interstitial lung disease/pulmonary fibrosis. Malnutrition is a significant comorbidity. The increased radiosensitivity and increased risk of cancer should be borne in mind when requesting radiological investigations. Aggressive proactive monitoring and treatment of these various aspects of lung disease under multidisciplinary expertise in the experience of national multidisciplinary clinics internationally forms the basis of this statement on the management of lung disease in A-T. Neurological management is outwith the scope of this document.

  7. ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia.

    Science.gov (United States)

    Bhatt, Jayesh M; Bush, Andrew; van Gerven, Marjo; Nissenkorn, Andreea; Renke, Michael; Yarlett, Lian; Taylor, Malcolm; Tonia, Thomy; Warris, Adilia; Zielen, Stefan; Zinna, Shairbanu; Merkus, Peter J F M

    2015-12-01

    Ataxia telangiectasia (A-T) is a rare, progressive, multisystem disease that has a large number of complex and diverse manifestations which vary with age. Patients with A-T die prematurely with the leading causes of death being respiratory diseases and cancer. Respiratory manifestations include immune dysfunction leading to recurrent upper and lower respiratory infections; aspiration resulting from dysfunctional swallowing due to neurodegenerative deficits; inefficient cough; and interstitial lung disease/pulmonary fibrosis. Malnutrition is a significant comorbidity. The increased radiosensitivity and increased risk of cancer should be borne in mind when requesting radiological investigations. Aggressive proactive monitoring and treatment of these various aspects of lung disease under multidisciplinary expertise in the experience of national multidisciplinary clinics internationally forms the basis of this statement on the management of lung disease in A-T. Neurological management is outwith the scope of this document. Copyright ©ERS 2015.

  8. A Web-Based Monitoring System for Multidisciplinary Design Projects

    Science.gov (United States)

    Rogers, James L.; Salas, Andrea O.; Weston, Robert P.

    1998-01-01

    In today's competitive environment, both industry and government agencies are under pressure to reduce the time and cost of multidisciplinary design projects. New tools have been introduced to assist in this process by facilitating the integration of and communication among diverse disciplinary codes. One such tool, a framework for multidisciplinary computational environments, is defined as a hardware and software architecture that enables integration, execution, and communication among diverse disciplinary processes. An examination of current frameworks reveals weaknesses in various areas, such as sequencing, displaying, monitoring, and controlling the design process. The objective of this research is to explore how Web technology, integrated with an existing framework, can improve these areas of weakness. This paper describes a Web-based system that optimizes and controls the execution sequence of design processes; and monitors the project status and results. The three-stage evolution of the system with increasingly complex problems demonstrates the feasibility of this approach.

  9. A Multidisciplinary Engineering Summer School in an Industrial Setting

    DEFF Research Database (Denmark)

    Larsen, Peter Gorm; Fernandes, Joao M.; Habel, Jacek

    2009-01-01

    Most university-level engineering studies produce technically skilled engineers. However, typically students face several difficulties when working in multidisciplinary teams when they initiate their industrial careers. In a globalised world, it becomes increasingly important that engineers...... are capable of collaborating across disciplinary boundaries and exhibit soft competencies, like communication, interpersonal and social skills, time planning, creativity, initiative, and reflection. To prepare a group of engineering and industrial design students to acquire those capabilities......, an international summer school that combined industrial design with different kinds of engineering disciplines was organised on the site of Bang & Olufsen (B&O) in Denmark. This multidisciplinary engineering summer school was attended by students from six European university-level teaching institutions...

  10. Whey protein stories - an experiment in writing a multidisciplinary biography

    DEFF Research Database (Denmark)

    Jensen, Tenna; Bechschøft, Rasmus L.; Giacalone, Davide

    2016-01-01

    contributes to the field of food studies with a multidisciplinary biography of whey protein - including its sensory qualities and challenges, insights into its cultural history, its nutritional value and effects on the human body and an analysis of how it is perceived by people who consume it. The biography......This is an experimental, dual-purpose article about whey protein and how to conduct interdisciplinary analyses and writings. On the one hand, this article is a multidisciplinary commodity biography, which consists of five descriptions of whey protein written by the five different research groups...... thereby expands upon existing understandings of whey protein while discussing the usefulness of employing the commodity biography format in interdisciplinary writing. Moreover, the article contributes to the field of interdisciplinary research by providing a practical example of a joint publication...

  11. Multidisciplinary Teaching-Changing Collaboration During Building Design

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2011-01-01

    to an increasing need of functioning collaboration in large teams during the design phase; as well as a need of new work methods within the process. This calls for employees who are experienced in collaborating in interdisciplinary teams. To fulfill this demand a multidisciplinary course in “Advanced building...... design” has been developed at the Technical University of Denmark. The goal of the course is to provide training in teamwork at the final stage of the engineering education. The course has been carried out twice. It was held by a multidisciplinary team of professors in periods 2008/09 and 2009....../10. The team of professors and the student teams had similar working conditions. These teams were subject of a questionnaire investigation on collaboration and team work. The study has the following findings. Collaboration can be learned and improves in time. It is shown that the team leader is not necessarily...

  12. Anxiety and depression levels among multidisciplinary health residents

    Directory of Open Access Journals (Sweden)

    Daniela Salvagni Rotta

    2016-01-01

    Full Text Available Objective: to assess symptoms of anxiety and depression of professionals of Multidisciplinary Health Residence Programs. Methods: this is a cross-sectional study, performed with fifty professionals, using three instruments: one for socioeconomic and demographic data, and the Beck’s Anxiety and Depression Scale. Results: predominance of females (92.0%, average age 26 years old, single (88.0%, family income from two to five salaries (56.0% satisfied with the work (82.0% and thought about quitting the program (56.0% showed anxiety (50.0% and depression (28.0%. Conclusion: there was an association between anxiety and depression in multidisciplinary residents, which points to the need for rethinking strategies for identifying these symptoms and control of stress factors for the promotion of mental health.

  13. A Concise Introduction to Mechanics of Rigid Bodies Multidisciplinary Engineering

    CERN Document Server

    Huang, L

    2012-01-01

    A Concise Introduction to Mechanics of Rigid Bodies: Multidisciplinary Engineering presents concise, key concepts of kinematics and dynamics of rigid bodies. This compact volume bridges the steep gap between  introductory texts on engineering mechanics, which focus on one and two dimensional motions of particles and rigid bodies, and advanced texts on multi-body dynamics in high dimension spaces  found in multidisciplinary areas like mechatronics, robotics and biomechanics. In the book, rigid body motions in the spaces with different dimensions are described in addition to studies in a uniform framework supported by vector and matrix operations. Rigorous mathematic tools and explanations are provided to clarify the most complex concepts. This book also: Provides practical examples from different engineering areas, offering a link between theoretical fundamentals and everyday applications Offers simplified mathematical equations to clearly present essential theories in robotics and mechanics Presents statics...

  14. An Educational Program of Mechatronics for Multidisciplinary Knowledge Acquisition

    Science.gov (United States)

    Watanuki, Keiichi; Kojima, Kazuyuki

    Recently, as the technologies surrounding mechanical engineering have improved remarkably, the expectations for students who graduate from departments of mechanical engineering have increased. For example, in order to develop a mechatronics system, a student needs to integrate a wide variety of technologies, such as mechanical engineering, electrical and electronics engineering, and information technology. Therefore, from the perspective of educators, the current education system, which stresses expertizing each technology, should be replaced by an education system that stresses integrating multidisciplinary knowledge. In this paper, a trial education program for students of the department of mechanical engineering in our university, in which students are required to integrate multidisciplinary knowledge in order to develop a biologically-based robot, is described. Finally, the efficacy of the program is analyzed.

  15. A case study on collaboration within multidisciplinary teamwork

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan; Hertz, Kristian Dahl

    2010-01-01

    Collaboration within the building process has always been difficult. Additionally the new demands on functionality such as energy and cost efficiency change the roles within the teams of engineers and architects, engaged in building design and generate a need of new work methods within the process...... and teamwork at the final stage of the engineering education. The course was held by a multidisciplinary team of teachers for 9 multidisciplinary teams of students. The team of teachers and the student teams had similar working conditions. These teams were subject of investigation on collaboration...... and transprofessionalism. 32 students and 7 teachers answered a questionnaire leading to the following findings. Collaboration was improving during the course. Other than in traditional building teams we could see that the students placed the role as a designer only in a few cases were perceived the team leader...

  16. MULTIDISCIPLINARY TEACHING – MSc COURSE ON TEAMWORK AND OPARATION

    DEFF Research Database (Denmark)

    Karlshøj, Jan; Dederichs, Anne

    2011-01-01

    of Denmark. The goal of the course is to provide training in teamwork at the final stage of the engineering education. The course has been carried out twice. It was held by a multidisciplinary team of professors in periods 2008/09, 2009/10 and 20010/2011. Teams of students were subject of a questionnaire...... investigation on collaboration and team work. The study has the following findings. The latest year there has been a special focus on team work and all members tested their role according to Belbin’s theory on teamwork. The work has the following findings: Collaboration was generally good. However the extra...... focus on teamwork did not lead to a improvement of the team work in contrary. The team-structure was generally flat and decisions were mostly made in consensus. It is worthwhile to offer a multidisciplinary course and give engineering students experience in collaboration methods....

  17. Multidisciplinary approach for the rehabilitation of dentoalveolar trauma.

    Science.gov (United States)

    Ustün, Yakup; Esen, Emin; Toroğlu, M Serdar; Akova, Tolga

    2004-10-01

    Satisfactory dental rehabilitation of dentoalveolar trauma requires intense effort and time. Usually multidisciplinary treatment planning and teamwork are necessary to deal with multitask problems associated with these cases. Dental implants have been successfully used for replacement of missing teeth, but in trauma cases insufficient alveolar bone hinders implantation. In this report we present the multidisciplinary approach for the treatment of a trauma case. Maxillary segmental alveolar osteotomy in conjunction with interpositional and onlay bone grafting was performed to prepare the site for placement of osseointegrated implants. Titanium microplate and screws were used to provide orthodontic anchorage for intrusion of the extruded mandibular incisors. The patient was rehabilitated by implant supported fixed partial denture 6 months after implant placement.

  18. Breaking Down the Siloes: Developing Effective Multidisciplinary HIV Research Teams.

    Science.gov (United States)

    Magnus, Manya; Castel, Amanda

    2016-09-01

    As the HIV epidemic passes its 35 years mark, the role of multidisciplinary approaches to HIV research has become increasingly important. Development of diverse, cross-cutting research teams has been found to be key to engaging and retaining participants in population-based studies; it is also a crucial component of designing studies capable of examining the sensitive and nuanced issues that surround HIV related risk and adherence behavior. Expanding our understanding of these issues is central to being able to overcome them and ultimately to the development of best practices for translation of research discovery into improvements in prevention and care. The objectives of this paper are to characterize the importance of multidisciplinary teams in HIV research where they are critical to gaining information that can have a positive impact on the epidemic and to propose specific methods for creating teams to conduct research with optimal public health impact.

  19. Multidisciplinary teams in consultation-liaison psychiatry: the Yale model.

    Science.gov (United States)

    Leigh, H

    1987-01-01

    The consultation-liaison service at Yale features integrated teams of psychiatrists, social workers, and clinical nurse specialists working together in both consultation and outpatient settings. The model is based on the tenets that (1) comprehensive evaluation of patients is essential for effective treatment; (2) role definition is necessary for specific disciplines, including the definition of overlapping and separate areas of expertise and practice. The multidisciplinary teams are coordinated by a psychiatric resident, who is supervised by an attending psychiatrist. The role of the resident is that of a diagnostician and coordinating physician. The social worker functions as an expert in family evaluation and treatment, and the nurse specialist functions as supportive therapist and liaison with the nursing staff. The structure of the division of consultation-liaison and ambulatory services at Yale is described and the advantages and disadvantages of the multidisciplinary team concept are discussed in comparison with other models of consultation-liaison psychiatry.

  20. Multidisciplinary design optimization of mechatronic vehicles with active suspensions

    Science.gov (United States)

    He, Yuping; McPhee, John

    2005-05-01

    A multidisciplinary optimization method is applied to the design of mechatronic vehicles with active suspensions. The method is implemented in a GA-A'GEM-MATLAB simulation environment in such a way that the linear mechanical vehicle model is designed in a multibody dynamics software package, i.e. A'GEM, the controllers and estimators are constructed using linear quadratic Gaussian (LQG) method, and Kalman filter algorithm in Matlab, then the combined mechanical and control model is optimized simultaneously using a genetic algorithm (GA). The design variables include passive parameters and control parameters. In the numerical optimizations, both random and deterministic road inputs and both perfect measurement of full state variables and estimated limited state variables are considered. Optimization results show that the active suspension systems based on the multidisciplinary optimization method have better overall performance than those derived using conventional design methods with the LQG algorithm.

  1. A social-cognitive framework of multidisciplinary team innovation.

    Science.gov (United States)

    Paletz, Susannah B F; Schunn, Christian D

    2010-01-01

    The psychology of science typically lacks integration between cognitive and social variables. We present a new framework of team innovation in multidisciplinary science and engineering groups that ties factors from both literatures together. We focus on the effects of a particularly challenging social factor, knowledge diversity, which has a history of mixed effects on creativity, most likely because those effects are mediated and moderated by cognitive and additional social variables. In addition, we highlight the distinction between team innovative processes that are primarily divergent versus convergent; we propose that the social and cognitive implications are different for each, providing a possible explanation for knowledge diversity's mixed results on team outcomes. Social variables mapped out include formal roles, communication norms, sufficient participation and information sharing, and task conflict; cognitive variables include analogy, information search, and evaluation. This framework provides a roadmap for research that aims to harness the power of multidisciplinary teams. Copyright © 2009 Cognitive Science Society, Inc.

  2. ICTR-PHE: scientists engage with multidisciplinary research

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    In 2016, the next edition of the unique conference that gathers scientists from a variety of fields will focus on many topics particularly dear to the heart of physicists, clinicians, biologists, and computer specialists. The call for abstracts is open until 16 October.   When detector physicists, radiochemists, nuclear-medicine physicians and other physicists, biologists, software developers, accelerator experts and oncologists think outside the box and get involved in multidisciplinary research, they create innovative healthcare. ICTR-PHE is a biennial event, co-organised by CERN, whose main aim is to foster multidisciplinary research by positioning itself at the crossing of physics, medicine and biology. At the ICTR-PHE conference, physicists, engineers, and computer scientists share their knowledge and technologies while doctors and biologists present their needs and vision for the medical tools of the future, thus triggering breakthrough ideas and technological developments in speci...

  3. A Multidisciplinary Design Optimization Model for AUV Synthetic Conceptual Design

    Institute of Scientific and Technical Information of China (English)

    BU Guang-zhi; ZHANG Yu-wen

    2006-01-01

    Autonomous undersea vehicle (AUV) is a typical complex engineering system. This paper studies the disciplines and coupled variables in AUV design with multidisciplinary design optimization (M DO) methods. The framework of AUV synthetic conceptual design is described first, and then a model with collaborative optimization is studied. At last,an example is given to verify the validity and efficiency of MDO in AUV synthetic conceptual design.

  4. Hepatic encephalopathy: what the multidisciplinary team can do

    Directory of Open Access Journals (Sweden)

    Liu A

    2017-03-01

    Full Text Available Andy Liu,1 Eric R Yoo,2 Osama Siddique,3 Ryan B Perumpail,4 George Cholankeril,5 Aijaz Ahmed4 1Department of Medicine, California Pacific Medical Center, San Francisco, CA, 2Department of Medicine, University of Illinois College of Medicine, Chicago, IL, 3Department of Medicine, Brown University, Providence, RI, 4Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, 5Division of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN, USA Abstract: Hepatic encephalopathy (HE is a complex disease requiring a multidisciplinary approach among specialists, primary care team, family, and caregivers. HE is currently a diagnosis of exclusion, requiring an extensive workup to exclude other possible etiologies, including mental status changes, metabolic, infectious, traumatic, and iatrogenic causes. The categorization of HE encompasses a continuum, varying from the clinically silent minimal HE (MHE, which is only detectable using psychometric tests, to overt HE, which is further divided into four grades of severity. While there has been an increased effort to create fast and reliable methods for the detection of MHE, screening is still underperformed due to the lack of standardization and efficient methods of diagnosis. The management of HE requires consultation from various disciplines, including hepatology, primary care physicians, neurology, psychiatry, dietician/nutritionist, social workers, and other medical and surgical subspecialties based on clinical presentation and clear communication among these disciplines to best manage patients with HE throughout their course. The first-line therapy for HE is lactulose with or without rifaximin. Following the initial episode of overt HE, secondary prophylaxis with lactulose and/or rifaximin is indicated with the goal to prevent recurrent episodes and improve quality of life. Recent studies have demonstrated the negative impact

  5. Managing the pediatric patient with celiac disease: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Isaac DM

    2016-10-01

    Full Text Available Daniela Migliarese Isaac,1 Jessica Wu,2 Diana R Mager,3,4 Justine M Turner1 1Department of Pediatric Gastroenterology and Nutrition, Faculty of Medicine and Dentistry, University of Alberta; 2Alberta Health Services–Child Health Nutrition Services, Stollery Children’s Hospital; 3Department of Agriculture, Food and Nutritional Science; 4Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Abstract: Celiac disease (CD is an autoimmune reaction to gluten, leading to intestinal inflammation, villous atrophy, and malabsorption. It is the most common autoimmune gastrointestinal disorder, with an increasing prevalence. A life-long gluten-free diet (GFD is an effective treatment to alleviate symptoms, normalize autoantibodies, and heal the intestinal mucosa in patients with CD. Poorly controlled CD poses a significant concern for ongoing malabsorption, growth restriction, and the long-term concern of intestinal lymphoma. Achieving GFD compliance and long-term disease control poses a challenge, with adolescents at particular risk for high rates of noncompliance. Attention has turned toward innovative management strategies to improve adherence and achieve better disease control. One such strategy is the development of multidisciplinary clinic approach, and CD is a complex life-long disease state that would benefit from a multifaceted team approach as recognized by multiple national and international bodies, including the National Institutes of Health. Utilizing the combined efforts of the pediatric gastroenterologist, registered dietitian, registered nurse, and primary care provider (general practitioner or general pediatrician in a CD multidisciplinary clinic model will be of benefit for patients and families in optimizing diagnosis, provision of GFD teaching, and long-term adherence to a GFD. This paper discusses the benefits and proposed structure for multidisciplinary care in improving management of CD. Keywords: celiac disease

  6. Advanced computational aeroelasticity and multidisciplinary application for composite curved wing

    OpenAIRE

    Kim, Dong-Hyun; Kim, Yu-Sung

    2008-01-01

    This article preferentially describes advanced computational aeroelasticity and its multidisciplinary applications based on the coupled CFD (Computational Fluid Dynamics) and CSD (Computational Structural Dynamics) method. A modal-based coupled nonlinear aeroelastic analysis system incorporated with unsteady Euler aerodynamics has been developed based on the high-speed parallel processing technique. It is clearly expected to give accurate and practical engineering data in the design fields of...

  7. Recent Advances in Multidisciplinary Analysis and Optimization, part 3

    Science.gov (United States)

    Barthelemy, Jean-Francois M. (Editor)

    1989-01-01

    This three-part document contains a collection of technical papers presented at the Second NASA/Air Force Symposium on Recent Advances in Multidisciplinary Analysis and Optimization, held September 28-30, 1988 in Hampton, Virginia. The topics covered include: aircraft design, aeroelastic tailoring, control of aeroelastic structures, dynamics and control of flexible structures, structural design, design of large engineering systems, application of artificial intelligence, shape optimization, software development and implementation, and sensitivity analysis.

  8. Benefits of multidisciplinary teamwork in the management of breast cancer

    OpenAIRE

    Taylor C.; Shewbridge A; Harris J; Green JS

    2013-01-01

    Cath Taylor,1 Amanda Shewbridge,2 Jenny Harris,1 James S Green3,4 1Florence Nightingale School of Nursing and Midwifery, King’s College London, London UK; 2Breast Cancer Services, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Urology, Barts Health NHS Trust, London, UK; 4Department of Health and Social Care, London South Bank University, London, UK Abstract: The widespread introduction of multidisciplinary team (MDT)-work for breast cance...

  9. Educating primary care providers about HIV disease: multidisciplinary interactive mechanisms.

    OpenAIRE

    Macher, A; Goosby, E; Barker, L; Volberding, P; Goldschmidt, R.; Balano, K B; Williams, A; Hoenig, L; Gould, B; Daniels, E.

    1994-01-01

    As HIV-related prophylactic and therapeutic research findings continue to evolve, the Health Resources and Services Administration (HRSA) of the Public Health Service has created multidisciplinary mechanisms to disseminate new treatment options and educate primary care providers at rural and urban sites throughout our nation's health care system. HRSA has implemented (a) the International State-of-the-Art HIV Clinical Conference Call Series, (b) the national network of AIDS Education and Trai...

  10. Importance of multidisciplinary approach in diagnosis of histoplasmosis*

    Science.gov (United States)

    de Oliveira, Patricia Botini; de Abreu, Marilda Aparecida Milanez Morgado; Mattos, Antônio Luiz de Arruda

    2016-01-01

    A patient with systemic involvement, initially treated as tuberculosis, is presented in this report. There were only two painful subcutaneous nodules, from which we arrived at the correct diagnosis of histoplasmosis. The patient was attended by several experts in the fields of infectious diseases, nephrology and internal medicine, but the diagnosis was only possible after dermatological examination and skin biopsy. This case values multidisciplinary interaction between dermatologists and other medical areas for diagnosis of cases with atypical manifestations. PMID:27438207

  11. 3rd International Multidisciplinary Microscopy and Microanalysis Congress

    CERN Document Server

    Oral, Zehra

    2017-01-01

    The 3rd International Multidisciplinary Microscopy Congress (InterM2015), held from 19 to 23 October 2015, focused on the latest developments concerning applications of microscopy in the biological, physical and chemical sciences at all dimensional scales, advances in instrumentation, techniques in and educational materials on microscopy. These proceedings gather 17 peer-reviewed technical papers submitted by leading academic and research institutions from nine countries and representing some of the most cutting-edge research available.

  12. The effect of multidisciplinary team care on cancer management

    OpenAIRE

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical o...

  13. Family meetings in palliative care: Multidisciplinary clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    O'Hanlon Brendan

    2008-08-01

    Full Text Available Abstract Background Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion. Methods The guidelines were developed via the following methods: (1 A literature review; (2 Conceptual framework; (3 Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia. Results The literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented. Conclusion Family meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined.

  14. The road we must take: multidisciplinary team science.

    Science.gov (United States)

    Disis, Mary L; Slattery, John T

    2010-03-10

    Translational research is acknowledged to be complex and to require a diverse skill set. Many organizations, particularly academic institutions, have invested in educational programs, facilities, and enhanced resources to encourage translational research. Critically needed, however, is an emphasis on creating and sustaining multidisciplinary research teams. It is through the power of many and a diverse approach to our health care problems that we will realize lasting solutions.

  15. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    von Kodolitsch Y

    2016-11-01

    Full Text Available Yskert von Kodolitsch,1 Meike Rybczynski,1 Marina Vogler,2 Thomas S Mir,3 Helke Schüler,1 Kerstin Kutsche,4 Georg Rosenberger,4 Christian Detter,5 Alexander M Bernhardt,5 Axel Larena-Avellaneda,6 Tilo Kölbel,6 E Sebastian Debus,6 Malte Schroeder,7,8 Stephan J Linke,9,10 Bettina Fuisting,9 Barbara Napp,1 Anna Lena Kammal,11 Klaus Püschel,11 Peter Bannas,12 Boris A Hoffmann,13 Nele Gessler,13 Eva Vahle-Hinz,14 Bärbel Kahl-Nieke,14 Götz Thomalla,15 Christina Weiler-Normann,16 Gunda Ohm,17 Stefan Neumann,18 Dieter Benninghoven,19 Stefan Blankenberg,1 Reed E Pyeritz20 1Clinic of Cardiology, University Heart Centre, 2Marfan Hilfe Deutschland e.V., Zentrumsehstärke, 3Clinic for Pediatric Cardiology, University Heart Centre, 4Institute of Human Genetics, 5Clinic of Cardiovascular Surgery, University Heart Centre, 6Clinic of Vascular Medicine, University Heart Centre, 7Department of Trauma, Hand, and Reconstructive Surgery, 8Department of Orthopedics, 9Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 10Smilow Center for Translational Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 11Department of Legal Medicine, 12Diagnostic and Interventional Radiology Department and Clinic, 13Clinic of Electrophysiology, University Heart Centre, 14Department of Orthodontics, Center for Dental and Oral Medicine, 15Clinic of Neurology, 16Martin Zeitz Center for Rare Diseases, 17Strategic Business Development, 18Business Unit Quality Management, University Medical Center Hamburg-Eppendorf, 19Mühlenberg-Clinic for Rehabilitation, Bad Malente-Gremsmühlen, 20Zentrumsehstärke, Hamburg, Germany Abstract: Marfan syndrome (MFS is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary

  16. Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

    Science.gov (United States)

    Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V

    2017-03-01

    Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing

  17. Dropout of a multidisciplinary treatment program for women with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Tatiana Rehder Gonçalves

    2010-03-01

    Full Text Available Objective: To evaluate the dropout of a multidisciplinary treatment program in fibromyalgia (FM. Methods: An observational study conducted during the period of April 2000 to December 2005, including 133 women with fibromyalgia, participating in a multidisciplinary treatment program. Those who had left the treatment for two weeks or more were classified as inactive and contacted by telephone to record the reasons for their noncompliance, which were divided into four groups: 1 Family; 2 Occupations; 3 Medical; 4 Other Reasons. Results: When collecting data, 92 (69.4% women were considered inactive. There was no significant difference between noncompliance before and after six months of treatment. Of the total number of inactive women, 54 (40.8% participants left for medical reasons, 30 (22.6% for other reasons, 26 (19.4% for family reasons and 23 (17.2% due to occupation. There was no statistical difference between the motives of dropout according to the length of stay in the program (p> 0.05. Conclusion: We conclude that the multidisciplinary program for women with fibromyalgia had high levels of noncompliance, half of them occurred in the first six months. Among the main reasons reported for dropout, the medical reasons were more frequent.

  18. Multidisciplinary approach to transvenous lead extraction: a single center's experience.

    Science.gov (United States)

    Maus, Timothy M; Shurter, Jesse; Nguyen, Liem; Birgersdotter-Green, Ulrika; Pretorius, Victor

    2015-04-01

    To evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. One university hospital. One hundred ninety-five patients scheduled for transvenous lead extraction. A multidisciplinary approach to transvenous lead extraction involving cardiac surgery, electrophysiology, perfusion, and cardiac anesthesiology. A case series of 351 lead extractions performed in 195 patients over a 42-month period. Indications, success rates, and complication rates were tracked and retrospectively evaluated and reported. Indications for lead extraction included 53.3% because of lead malfunction, 36.9% because of infection, with the remaining 9.7% from other categories such as venous stenosis. The lead extraction rate was 99.7%, with complete removal in 97.7%. The overall major complication rate was 3.08%. After an initial 1-year period of performing lead extractions, the overall major complication rate reduced to 1.23%. Transvenous lead extraction generally is a safe procedure, but not without complications. A multidisciplinary approach involving cardiac surgery, electrophysiology, and cardiac anesthesiology allows for successful management and the ability to rapidly manage major complications. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Whey protein stories - An experiment in writing a multidisciplinary biography.

    Science.gov (United States)

    Jensen, Tenna; Bechshoeft, Rasmus L; Giacalone, Davide; Otto, Marie Haulund; Castro-Mejía, Josue; Bin Ahmad, Hajar Fauzan; Reitelseder, Søren; Jespersen, Astrid Pernille

    2016-12-01

    This is an experimental, dual-purpose article about whey protein and how to conduct interdisciplinary analyses and writings. On the one hand, this article is a multidisciplinary commodity biography, which consists of five descriptions of whey protein written by the five different research groups involved in the interdisciplinary research project CALM(Counteracting Age-related loss of Skeletal Muscle Mass). On the other hand, it is a meta-analysis, which aims to uncover and highlight examples of how the five descriptions contribute to each other with insights into the contextualisation of knowledge, contrasts between the descriptions and the new dimensions they bring to established fields of interest. The meta-analysis also contains a discussion of interdisciplinary study objects and the usefulness of the multidisciplinary commodity biography as a format for interdisciplinary publications. The article contributes to the field of food studies with a multidisciplinary biography of whey protein - including its sensory qualities and challenges, insights into its cultural history, its nutritional value and effects on the human body and an analysis of how it is perceived by people who consume it. The biography thereby expands upon existing understandings of whey protein while discussing the usefulness of employing the commodity biography format in interdisciplinary writing. Moreover, the article contributes to the field of interdisciplinary research by providing a practical example of a joint publication and reflections upon the existence, interaction and possibilities of monodisciplinary knowledge structures within interdisciplinary studies and publications.

  20. Multidisciplinary in-hospital teams improve patient outcomes: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2014-01-01

    Full Text Available Background: The use of multidisciplinary in-hospital teams limits adverse events (AE, improves outcomes, and adds to patient and employee satisfaction. Methods: Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses′ aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others. Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality while improving patient and healthcare worker satisfaction. Results: Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs, hospital wards, intensive care units (ICUs, and most critically, operating rooms (ORs. Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS, and yielded greater patient "staff" satisfaction. Conclusion: Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers′ performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.