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Sample records for biopsychosocial multidisciplinary intervention

  1. 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

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

    Directory of Open Access Journals (Sweden)

    de Kort Nelleke

    2011-08-01

    Full Text Available Abstract Background Low back pain (LBP, with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP. Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days, Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP and 12 months (evaluate the outcomes at long term. Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration ISRCTN: ISRCTN58719694

  3. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis

    OpenAIRE

    Kamper, Steven J.; Apeldoorn, A T; Chiarotto, A; Smeets, R.J.E.M.; Ostelo, R.W.J.G.; J. Guzman; van Tulder, M. W

    2015-01-01

    Objective To assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain. Design Systematic review and random effects meta-analysis of randomised controlled trials. Data sources Electronic searches of Cochrane Back Review Group Trials Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. Study selecti...

  4. 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

    OpenAIRE

    Roura-Olivan Mercè; Martín-Peñacoba Raquel; Pie-Oncins Magda; González-Moneo Maria J; Núñez-Juárez Esther; Montiel-Morillo Elena; Moix Jenny; Berenguera Anna; Balagué-Corbella Montserrat; Fernández-San-Martin Isabel; Rodriguez-Blanco Teresa; Núñez-Juárez Montse; Pujol-Ribera Enriqueta

    2010-01-01

    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...

  5. British pain clinic practitioners' recognition and use of the bio-psychosocial pain management model for patients when physical interventions are ineffective or inappropriate: results of a qualitative study

    Directory of Open Access Journals (Sweden)

    Rahman Anisur

    2010-03-01

    Full Text Available Abstract Background To explore how chronic musculoskeletal pain is managed in multidisciplinary pain clinics for patients for whom physical interventions are inappropriate or ineffective. Methods A qualitative study was undertaken using semi-structured interviews with twenty five members of the pain management team drawn from seven pain clinics and one pain management unit located across the UK. Results All clinics reported using a multidisciplinary bio-psychosocial model. However the chronic pain management strategy actually focussed on psychological approaches in preference to physical approaches. These approaches were utilised by all practitioners irrespective of their discipline. Consideration of social elements such as access to social support networks to support patients in managing their chronic pain was conspicuously absent from the approaches used. Conclusion Pain clinic practitioners readily embraced cognitive/behavioural based management strategies but relatively little consideration to the impact social factors played in managing chronic pain was reported. Consequently multidisciplinary pain clinics espousing a bio-psychosocial model of pain management may not be achieving their maximum potential.

  6. Employment discrimination against cancer survivors: multidisciplinary interventions.

    Science.gov (United States)

    Hoffman, B

    1989-01-01

    Approximately 25% of the five million cancer survivors in the United States encounter barriers to employment solely because of their cancer histories. This discrimination is primarily rooted in erroneous stereotypes about cancer. Because cancer-based employment discrimination has legal, social, emotional, and economic impact on survivors, interventions must encompass legal and psychosocial resources. While state and federal laws prohibit certain actions that deprive survivors of job opportunities and health insurance, legal and psychosocial resources must be developed and made available to cancer survivors to help them overcome barriers to equal employment opportunities. PMID:10293296

  7. Adding work-focus to multidisciplinary interventions in specialist care

    OpenAIRE

    Marchand, Gunn Hege

    2015-01-01

    This thesis examines the effect of a work-focused intervention in specialist care for sick-listed patients with neck or low back pain on return to work (RTW), pain and disability. Neck and back pain is the leading cause of years lived with disability. A high proportion of patients with a chronic course of pain and disability are referred to specialist care. In the search for an effective treatment for pain-related work disability, multidisciplinary rehabilitation programs that ...

  8. Multidisciplinary interventions in the management of atopic dermatitis.

    Science.gov (United States)

    LeBovidge, Jennifer S; Elverson, Wendy; Timmons, Karol G; Hawryluk, Elena B; Rea, Corinna; Lee, Margaret; Schneider, Lynda C

    2016-08-01

    Atopic dermatitis (AD) is the most common pediatric skin disease. AD has a significant effect on patient and family quality of life caused by intense pruritus, sleep disruption, dietary and nutritional concerns, and psychological stress associated with the disease and its management. Multidisciplinary approaches to AD care have been developed in appreciation of the complex interplay among biological, psychological, behavioral, and dietary factors that affect disease control and the wide range of knowledge, skills, and support that patients and families require to effectively manage and cope with this condition. Common components of multidisciplinary treatment approaches include medical evaluation and management by an AD specialist, education and nursing care, psychological and behavioral support, and nutritional assessment and guidance. Models of care include both clinical programs and structured educational groups provided as adjuncts to standard clinical care. Available evidence suggests beneficial effects of multidisciplinary interventions in improving disease severity and quality of life, particularly for patients with moderate-to-severe disease. Additional research is needed to identify the best candidates for the various multidisciplinary approaches and evaluate the cost-effectiveness of these programs. PMID:27497275

  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...... 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...... 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 to...

  10. 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. PMID:24965802

  11. 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

  12. Effect of nutritional intervention on weight multidisciplinary ambulatory patients

    OpenAIRE

    María Luisa Fallas

    2012-01-01

    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 a...

  13. Hospital without dyspnea: rationale and design of a multidisciplinary intervention.

    Science.gov (United States)

    Vicent, Lourdes; Olarte, Juan Manuel Nuñez; Puente-Maestu, Luis; Artajona, Esther; Fernández-Avilés, Francisco; Martínez-Sellés, Manuel

    2016-07-01

    Dyspnea is a common and disabling symptom of respiratory and heart diseases, which is growing in incidence. During hospital admission, breathlessness is under-diagnosed and under-treated, although there are treatments available for controlling the symptom. We have developed a tailored implementation strategy directed to medical staff to promote the application of these pharmacological and non-pharmacological tools in dealing with dyspnea. The primary aim is to decrease the rate of patients that do not receive an adequate relief of dyspnea. This is a four-stage quasi-experimental study. The intervention consists in two teaching talks that will be taught in Cardiology and Respiratory Medicine Departments. The contents will be prepared by Palliative Care specialists, based on available tools for management of dyspnea and patients' needs. A cross-sectional study of dyspnea in hospitalized patients will be performed before and after the intervention to ascertain an improvement in dyspnea intensity due to changes in medical practices. The last phase consists in the creation of consensus protocols for dyspnea management based in our experience. The results of this study are expected to be of great value and may change clinical practice in the near future and promote a changing for the better of dyspnea care. PMID:27605944

  14. Multidisciplinary approach to identification and remedial intervention for adverse late effects of cancer therapy

    International Nuclear Information System (INIS)

    Because of advances in surgical technique, radiation therapy, and combined chemotherapy regimens, there has been a dramatic improvement in the survival of children with pediatric malignancies. All treatment modalities are associated with adverse effects that may be manifested months to years after therapy. This article has provided an overview of the physiologic and psychologic adverse effects of antineoplastic therapy and described the multidisciplinary approach used by one institution to identify and initiate appropriate remedial intervention. Nurses can learn to assist in the identification of adverse late effects, provide support to the family, and facilitate appropriate intervention

  15. A Multidisciplinary Intervention Utilizing Virtual Communication Tools to Reduce Health Disparities: A Pilot Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    John F. Emerson

    2015-12-01

    Full Text Available Advances in technology are likely to provide new approaches to address healthcare disparities for high-risk populations. This study explores the feasibility of a new approach to health disparities research using a multidisciplinary intervention and advanced communication technology to improve patient access to care and chronic disease management. A high-risk cohort of uninsured, poorly-controlled diabetic patients was identified then randomized pre-consent with stratification by geographic region to receive either the intervention or usual care. Prior to enrollment, participants were screened for readiness to make a behavioral change. The primary outcome was the feasibility of protocol implementation, and secondary outcomes included the use of patient-centered medical home (PCMH services and markers of chronic disease control. The intervention included a standardized needs assessment, individualized care plan, intensive management by a multidisciplinary team, including health coach-facilitated virtual visits, and the use of a cloud-based glucose monitoring system. One-hundred twenty-seven high-risk, potentially eligible participants were randomized. Sixty-one met eligibility criteria after an in-depth review. Due to limited resources and time for the pilot, we only attempted to contact 36 participants. Of these, we successfully reached 20 (32% by phone and conducted a readiness to change screen. Ten participants screened in as ready to change and were enrolled, while the remaining 10 were not ready to change. Eight enrolled participants completed the final three-month follow-up. Intervention feasibility was demonstrated through successful implementation of 13 out of 14 health coach-facilitated virtual visits, and 100% of participants indicated that they would recommend the intervention to a friend. Protocol feasibility was demonstrated as eight of 10 participants completed the entire study protocol. At the end of the three-month intervention

  16. The biopsychosocial model and hypothyroidism

    OpenAIRE

    Bonello Rod; Brown Benjamin T; Pollard Henry

    2005-01-01

    Abstract This paper comments on the role and emergence of the biopsychosocial model in modern medical literature and health care settings. The evolution of the biopsychosocial model and its close association with modern pain theory is also examined. This paper seeks to discuss the place of this model with respect to the management of hypothyroidism. This discussion represents a forerunner to a randomised control trial that will seek to investigate the effect of a biopsychosocial-based treatme...

  17. 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…

  18. Biopsychosocial Formulation: Recognizing Educational Shortcomings

    Science.gov (United States)

    McClain, Tina; O'Sullivan, Patricia S.; Clardy, James A.

    2004-01-01

    Objective: Since Engel introduced the biopsychosocial model, it has been extensively examined. The authors expect psychiatrists to formulate cases using the biopsychosocial model. However, resident psychiatrists' ability to generate formulations using this model has received little attention. Methods: The authors evaluated resident biopsychosocial…

  19. A Biopsychosocial Theory of Infertility.

    Science.gov (United States)

    Gerrity, Deborah A.

    2001-01-01

    Briefly reviews the literature on infertility and its emotional, physical, existential, and relational effects on individuals, couples, and families. Life crisis and biopsychosocial theories are discussed as they apply to persons struggling with infertility issues. In addition, stage models derived from a biopsychosocial perspective are presented.…

  20. Effects of a One Year Intensive Multidisciplinary Rehabilitation Program for Patients with Huntington’s Disease: a Prospective Intervention Study

    OpenAIRE

    Piira, Anu; van Walsem, Marleen R.; Mikalsen, Geir; Nilsen, Kjell Haavik; Knutsen, Synnove; Frich, Jan C.

    2013-01-01

    Objective: To assess the effects of an intensive, multidisciplinary rehabilitation program for patients with early to mid-stage Huntington’s disease. Design: A prospective intervention study. Setting: Two Norwegian inpatient rehabilitation centers. Subjects: 37 patients, with early- to midstage Huntington’s disease Interventions: A one year rehabilitation program, consisting of three admissions of three weeks each, and a five-day evaluation stay approximately 3 months after the last rehabilit...

  1. [Burning mouth syndrome - a joint biopsychosocial approach].

    Science.gov (United States)

    Arpone, Francesca; Combremont, Florian; Weber, Kerstin; Scolozzi, Paolo

    2016-02-10

    Burning mouth syndrome (BMS) is a medical condition that is often refractory to conventional diagnostic and therapeutic methods. Patients suffering from BMS can benefit from a biopsychosocial approach in a joint, medical-psychological consultation model. Such a consultation exists at Geneva University Hospitals, involving the collaboration of the maxillo-facial and oral surgery division and the division of liaison psychiatry and crisis intervention, in order to take into account the multiple factors involved in BMS onset and persistence. This article will describe BMS clinical presentation, and present an integrate approach to treat these patients. PMID:27039444

  2. 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.

  3. Practice of biopsychosocial medicine in Portugal: perspectives of professionals involved.

    Science.gov (United States)

    Pereira, M Graça; Fachada, Alfonso Alonso; Smith, Thomas Edward

    2009-05-01

    Although, recently, the biopsychosocial approach has been emphasized in the practice of family medicine, how psychologists and physicians interact in collaborative family health care practice is still emerging in Portugal. This article describes a qualitative study that focused on the understanding of psychologists and family physicians' perceptions of their role and the collaborative approach in health care. A questionnaire gathered information regarding collaboration, referral, training and the practice of biopsychosocial medicine. A content analysis on respondents' discourse was performed. Results show that both physicians and psychologists agree on the importance of the biopsychosocial model and interdisciplinary collaboration. However, they also mentioned several difficulties that have to do with the lack of psychologists working full time in health care centers, lack of communication and different expectancies regarding each other roles in health care delivery. Both physicians and psychologists acknowledge the lack of academic training and consider the need for multidisciplinary teams in their training and practice to improve collaboration and integrative care. Implications for future research and for the practice of biopsychosocial medicine are addressed. PMID:19476234

  4. An Alternative: The Biopsychosocial Model

    Science.gov (United States)

    Mosey, Anne Cronin

    1974-01-01

    This paper suggests a biopsychosocial model as an alternative to the use of medical or health models for occupational therapists. The model moves away from the illness-health continuum to an emphasis upon information, abilities, and values necessary for productive community living. (Author/JA)

  5. 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

  6. Multidisciplinary Care.

    Science.gov (United States)

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

    Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients. PMID:27535399

  7. Biopsychosocial implications of heroin addiction

    OpenAIRE

    Cheng, Lai-fung, Gordon; 鄭禮鋒

    2014-01-01

    Heroin abuse is devastating to both the individual abusers and society. Owing to its ability to elicit rapid feelings of euphoria and transcendent relaxation, coupled with adverse withdrawal effects, it is one of the most addictive illicit drugs of abuse. The severe and persistent socio-economic detriment caused by heroin abuse signifies an urgent need for understanding how this substance affects abusers. Currently, scientific research into the biopsychosocial functioning of heroin abusers is...

  8. The individualized rehabilitation interventions for dysphagia: a multidisciplinary case control study of acute stroke patients

    OpenAIRE

    Zheng, Lixue; Li, Yi; Liu, Ying

    2014-01-01

    Objective: To examine the effects of the individualized rehabilitation programs on the recovery of swallowing during acute stroke. Methods: A total of 88 stroke patients with dysphagia (within 2 weeks of acute stroke) were enrolled and classified into the experimental and control groups (n=44). The control group was treated with conventional rehabilitation program, while a multidisciplinary rehabilitation team was established to offer physical, social and psychological support to dysphagic pa...

  9. 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

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

    Science.gov (United States)

    Zingg, Walter; Cartier, Vanessa; Inan, Cigdem; Touveneau, Sylvie; Theriault, Michel; Gayet-Ageron, Angèle; Clergue, François; Pittet, Didier; Walder, Bernhard

    2014-01-01

    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. PMID:24714418

  11. 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…

  12. Biopsychosocial functioning and pain self-efficacy in chronic low back pain patients

    OpenAIRE

    Alex L. Koenig, MS; Amy E. Kupper, MS; Jay R. Skidmore, PhD; Karly M. Murphy, BA

    2015-01-01

    The aim of this study was to examine the relationship between biopsychosocial functioning and pain severity and to evaluate whether pain self-efficacy (PSE) mediates this relationship. This study used archival data from a multidisciplinary pain management program. Participants were 99 individuals (69% female) with chronic low back pain who completed measures of biological, psychological, and social functioning; pain severity; and PSE at admission. They ranged in age from 18 to 72 yr (mean = 4...

  13. 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. PMID:27018558

  14. Understanding ADHD from a Biopsychosocial-Cultural Framework: A Case Study

    Science.gov (United States)

    Pham, Andy V.

    2015-01-01

    The biopsychosocial-cultural framework is a systemic and multifaceted approach to assessment and intervention that takes into account biological, psychological, and socio-cultural factors that influence human functioning and service delivery. Although originally developed to assess physical health and medical illness, this contemporary model can…

  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. Early risk assessment of long-term sick leave among patients in primary health care : risk factors, assessment tools, multidisciplinary intervention, and patients’ views on sick leave conclusion

    OpenAIRE

    von Celsing, Anna-Sophia

    2016-01-01

    Background. Long-term sick leave is one of the main risk factors for permanent exit out of the labour market. The longer the duration of sickness absence, the less likely sick leave conclusion. Objectives and Methods. The aims were to analyse possible determinants of sick leave conclusion and their relative impacts, to analyse the properties of two models for the assessment of sick leave conclusion, to study the impact of a multidisciplinary vocational intervention for sick leave conclusion i...

  17. Impact of Nurse-Led, Multidisciplinary Home-Based Intervention on Event-Free Survival Across the Spectrum of Chronic Heart Disease

    OpenAIRE

    Stewart, Simon; Wiley, Joshua F.; Ball, Jocasta; Chan, Yih-Kai; Ahamed, Yasmin; Thompson, David R; Carrington, Melinda J.

    2016-01-01

    Background— We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Methods and Results— Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failu...

  18. 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

  19. Toward a Biopsychosocial Model of Domestic Violence.

    Science.gov (United States)

    McKenry, Patrick C.; And Others

    1995-01-01

    Interviewed and physically assessed 102 married men in an attempt to develop a biopsychosocial model of male domestic violence. Used Tobit analysis to identify significant predictors. Analyzed separately, each domain was significantly related to male domestic violence. When considered together, only the biological and social domains yielded…

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

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    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.

  1. Effectiveness and cost-effectiveness of a multidisciplinary intervention programme to prevent new falls and functional decline among elderly persons at risk: design of a replicated randomised controlled trial [ISRCTN64716113

    OpenAIRE

    Crebolder Harry FJM; Evers Silvia MAA; Diederiks Joseph PM; van Haastregt Jolanda CM; Hendriks Marike RC; van Eijk Jacques ThM

    2005-01-01

    Abstract Background Falls are common among community-dwelling elderly people and can have a considerable impact on quality of life and healthcare costs. People who have sustained a fall are at greater risk of falling again. We replicated a British randomised controlled trial which demonstrated the effectiveness of a multidisciplinary intervention programme to prevent falls. The objective is to describe the design of a replication study evaluating a multidisciplinary intervention programme on ...

  2. Limitations of the biopsychosocial model in psychiatry

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    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

  3. New concept for backache: biopsychosocial pain syndrome

    OpenAIRE

    Kikuchi, Shinichi

    2008-01-01

    Recently a new concept for explaining backache, “biopsychosocial pain syndrome,” has been suggested. Psychosocial factors play an important role in the development and persistence of backache from an early stage. Diagnosis and treatment of backache should be based on the new concept. A good relationship between doctors and patients influences treatment outcome and patient satisfaction. Treatment should be decided by patients themselves, after being informed of the natural history of the disea...

  4. The Biopsychosocial Model of Treatment the Patients with Inflammatory Chronic Bowel Disease

    OpenAIRE

    Rakovec-Felser, Zlatka

    2011-01-01

    We present the organised psychological group interventions for persons with inflammatory bowel disease (ulcerose colitis, Morbus Crohn). The actual bio-psychosocial model of health and illness is used to explain the situation of chronically ill patient as stressful life position and their ways of coping with such, health-related problems. Considering that numerous psychological factors can lead to insufficient illness adaptation and (non) adherence to treatment – and all those – t...

  5. Change in attitudes and performance of critical care teams after a multi-disciplinary simulation-based intervention

    OpenAIRE

    Jennifer Weller; Robert Frengley; Jane Torrie; Webster, Craig S.; Susan Tomlinson; Kaylene Henderson

    2012-01-01

    Objectives: To conduct an in-depth exploration of the self-reported long-term change in attitudes and performance after a full-day multidisciplinary simulation-based course focussed on team management of emergency events in the Critical Care Unit. To address the current lack of knowledge of factors which can lead to improved teamwork performance and their measurement through identification of measurable markers of behaviour and attitude change. Methods: A purposive sample of course participan...

  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. 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

    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...

  8. 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. PMID:19913665

  9. Physiotherapy and low back pain - part ii: outcomes research utilising the biopsychosocial model: biological outcomes

    Directory of Open Access Journals (Sweden)

    L. D. Bardin

    2002-02-01

    Full Text Available Low back pain (LBP is an acknowledged major health problem that is associated with high recurrence rates and increased chronic incapacity. It is one of the most common and costly conditions treated  by physiotherapists and therefore the physiotherapy profession has a responsibility to provide evidence of effectiveness of interventions for LBP.The quality and rigour of published research on LBP has been found lacking and has predominately utilised a biomedical model of health that focuses on disease and system pathology rather than on illness. Outcomes research has the potential to advance the quest for evidence of effective management of LBP. Patients with CLBP and disability face complex biopsychosocial problems, hence a multifactorial model of illness is particularly pertinent and is addressed by the outcomes research model. Outcome measures that are valid, reliable and responsive are necessary to determine effective interventions for LBP. Biological, psychological and social variables shape the experience and outcome of an episode of LBP and outcome measures reflecting all three aspects of the biopsychosocial model are important to the study of LBP. Outcome measures reflecting the biological component of the biopsychosocial model are discussed in part II: measures of pain and aspects of movement dysfunction.

  10. 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…

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

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    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

  12. What is the evidence to support home environmental adaptation in Parkinson's disease? A call for multidisciplinary interventions.

    Science.gov (United States)

    Bhidayasiri, Roongroj; Jitkritsadakul, Onanong; Boonrod, Nonglak; Sringean, Jirada; Calne, Susan M; Hattori, Nobutaka; Hayashi, Akito

    2015-10-01

    "Home" is where one has a sense of belonging and feels secure, but it can also be a risky place for people with Parkinson's disease (PD). PD patients need assistance making adjustments to their physical environment to maintain appropriate care and provide a safe environment. This relationship is called the "person-environmental fit" (P-E fit). While most PD patients remain in their own homes, little is known about the specific challenges that PD patients and their caregivers encounter in the routine activities of daily living. The aim of our study was to identify the existing evidence on the issue of housing environmental adaptation in PD by performing a systematic review with a proposal of development strategies to integrate a multidisciplinary team into a home environmental research. MEDLINE, and life science journals were searched by querying appropriate key words, but revealed very few publications in this area. However, early evidence suggested that PD patients do not enjoy an adequate P-E fit in their own homes and face more functional limitations compared to matched controls. We concluded that we need to develop research-based evaluation strategies that can provide us with a theoretical and conceptual basis as well as tools for analysis of the P-E fit for PD patients and caregivers. We recommend that individual members of the multidisciplinary team including patients, caregivers, physicians, rehabilitation specialists, and social workers use a team approach to identify the key indicators and solutions for the development of PD-specific solutions for improving the P-E fit. PMID:26365779

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

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    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.

  14. The value of early intervention and a multidisciplinary approach in the management of necrotizing fasciitis of the neck and anterior mediastinum of odontogenic origin.

    Science.gov (United States)

    Muhammad, Joseph Kamal; Almadani, Hana; Al Hashemi, Bader A; Liaqat, Muneezeh

    2015-05-01

    Necrotizing fasciitis (NF) is a serious clinical condition, which, if diagnosed late, invariably leads to a fatal outcome. A high index of suspicion of the presenting clinical signs and symptoms, supported by knowledge of the clinicopathologic processes that underlie its aggressive nature, should prompt early surgical intervention. Ultimately, the success of treatment requires a robust clinical pathway in which all members of the health care team are aligned by their skill sets and competencies to manage NF. This report describes the management of a case of a young man with aggressive NF of odontogenic origin affecting the neck and anterior mediastinum. A multidisciplinary approach brought about early recognition of the disease and surgical intervention, the use of frozen section biopsies to determine the extent of fascial spread, and aggressive debridement of the affected tissue. Teamwork, critical thinking, and situational awareness ensured that the patient received optimum care in a timely manner. The psychological, clinical, radiologic, pathologic, and microbiological aspects of the patient's care are presented with a literature review. PMID:25795188

  15. Change in attitudes and performance of critical care teams after a multi-disciplinary simulation-based intervention

    Directory of Open Access Journals (Sweden)

    Jennifer Weller

    2012-07-01

    Full Text Available Objectives: To conduct an in-depth exploration of the self-reported long-term change in attitudes and performance after a full-day multidisciplinary simulation-based course focussed on team management of emergency events in the Critical Care Unit. To address the current lack of knowledge of factors which can lead to improved teamwork performance and their measurement through identification of measurable markers of behaviour and attitude change. Methods: A purposive sample of course participants underwent semi-structured interviews one to five months after course completion. Responses were coded using grounded theory to identify instances of learning, changes in attitudes or clinical performance, and measurable behavioural and attitudinal markers for such change. Interviews continued until data saturation was achieved. Results: Twenty nine participants (15 doctors and 14 nurses were interviewed. Doctors became more confident in delegating and including nurses in decision making, and nurses became more confident and aware of the need for effective communication. Doctors reported that their ability to assign team roles improved over the day and that they made more frequent use of closed-loop communication. Both professional groups reported improvement in communication in the clinical setting after participation, including better vocalising of thoughts and use of colleagues' names. Attitudes to communication also improved and persisted in the clinical setting. Conclusions: Addressing gaps in current medical education knowledge, self-reported improvements in behaviour and attitudes translated to clinical performance after a simulation course. Measurable behavioural and attitudinal markers were identified that may assist with the development of evidence-based measurement tools in future team training work.

  16. Biopsychosocial functioning and pain self-efficacy in chronic low back pain patients

    Directory of Open Access Journals (Sweden)

    Alex L. Koenig, MS

    2015-01-01

    Full Text Available The aim of this study was to examine the relationship between biopsychosocial functioning and pain severity and to evaluate whether pain self-efficacy (PSE mediates this relationship. This study used archival data from a multidisciplinary pain management program. Participants were 99 individuals (69% female with chronic low back pain who completed measures of biological, psychological, and social functioning; pain severity; and PSE at admission. They ranged in age from 18 to 72 yr (mean = 42.6, standard deviation = 12.1. Structural equation modeling and bootstrapping techniques were used to test the significance of the mediated model. As we predicted, lower biological functioning (beta = −0.011; 95% confidence interval [CI] = −0.019 to −0.004, p = 0.002 and social functioning (beta = −0.009; 95% CI = −0.016 to −0.003, p = 0.007 were found to significantly predict higher pain severity, and lower social functioning was found to significantly predict lower PSE (beta = 0.196; 95% CI = −0.130 to 0.273, p = 0.002. PSE did not mediate the relationship between biopsychosocial functioning and pain severity, and psychological functioning did not significantly predict pain severity or PSE. These findings suggest that social functioning is an important factor in predicting outcomes and has a number of treatment implications.

  17. 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

  18. 多学科护理干预对脑卒中恢复期患者生存质量的影响%Effect of multidisciplinary intervention on the quality of life in convalescent patients after stroke

    Institute of Scientific and Technical Information of China (English)

    吴时新; 裘灵洁; 孙洁

    2011-01-01

    目的 探讨多学科护理干预对脑卒中恢复期患者生存质量的影响.方法 对118例脑卒中恢复期患者给予常规内科治疗和多学科护理干预,实施系统化生理、心理、社会、环境的整体护理干预.结果 干预前脑卒中恢复期患者生存质量较低,总均分仅为(51.97±18.95)分,通过多学科护理干预,患者的生存质量提高到(57.26±20.88)分,差异具有统计学意义(P<0.01).结论 脑卒中恢复期患者实施多学科护理干预,可以提高患者生存质量.%Objective To evduate the effect of multidisciplinary intervention on the quality of life in convalescent patients after atroke. Methods A total of 118 stroke survivor were enrolled. General medical treatment and multidisciplinary intervention were affered, including systematic physical, psychological, social, and environmental interventions. Results The quality of life of the involved patients was lower,and the mean score was (51.97 ± 18.95). After the multi-disciplinary intervention,the mean score (57.26 ±20.88) was significantly increased (P<0.01). Conclusion Multidisciplinary intervention can improve the quality of life of convalescent patients after stroke.

  19. Sustainability of return to work in sick-listed employees with low-back pain. Two-year follow-up in a randomized clinical trial comparing multidisciplinary and brief intervention

    Directory of Open Access Journals (Sweden)

    Jensen Chris

    2012-08-01

    Full Text Available Abstract Background Sick-listed employees with low back pain had similar return to work (RTW rates at one-year follow-up in a randomized trial comparing two interventions, but the effects were modified by specific workplace related factors. The present study addressed the sustainability of the intervention effects by performing a two-year follow-up and by using different outcome measures. Methods A total of 351 employees sick-listed for 3–16 weeks due to LBP were recruited from their general practitioners and were randomly allocated to a hospital-based brief or multidisciplinary intervention. Outcome measures were based on sick leave registered in a national database of social and health-related benefits. RTW rates, RTW status, sick leave weeks and sick leave relapse were studied. Results During the two-year follow-up 80.0% and 77.3% had RTW for at least four weeks continuously, and the percentages with RTW at the 104th week were 61.1% and 58.0% in the brief and multidisciplinary intervention groups, respectively. At the 104th week 16.6% and 18.8% were on sick leave in the two groups, respectively, and about 12% were employed in modified jobs or participated in job training. The number of weeks on sick leave in the first year was significantly lower in the brief intervention group (median 14 weeks than in the multidisciplinary intervention group (median 20 weeks, but during the second year the number of weeks on sick leave were not significantly different between intervention groups. Subgroups characterised by specific work related factors modified the effect of the intervention groups on RTW rates (p = 0.017. No difference in sick leave relapse was found between the intervention groups. Conclusion The effects of the brief and multidisciplinary interventions at the two-year follow-up were in general similar to the effects at one-year follow-up. Trial Registration Current Controlled Trials ISRCTN18609003

  20. Impact of Nurse-Led, Multidisciplinary Home-Based Intervention on Event-Free Survival Across the Spectrum of Chronic Heart Disease

    Science.gov (United States)

    Wiley, Joshua F.; Ball, Jocasta; Chan, Yih-Kai; Ahamed, Yasmin; Thompson, David R.; Carrington, Melinda J.

    2016-01-01

    Background— We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Methods and Results— Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failure, as well, were recruited. Overall, 612 and 614 patients, respectively, were allocated to a home visit 7 to 14 days postdischarge by a cardiac nurse with follow-up and multidisciplinary support according to clinical need or standard management. The primary outcome of days-alive and out-of-hospital was examined on an intention-to-treat basis. During 1371 days (interquartile range, 1112–1605) of follow-up, 218 patients died and 17 917 days of hospital stay were recorded. In comparison with standard management, HBI patients achieved significantly prolonged event-free survival (90.1% [95% confidence interval, 88.2–92.0] versus 87.2% [95% confidence interval, 85.1–89.3] days-alive and out-of-hospital; P=0.020). This reflected less all-cause mortality (adjusted hazard ratio, 0.67; 95% confidence interval, 0.50–0.88; P=0.005) and unplanned hospital stay (median, 0.22 [interquartile range, 0–1.3] versus 0.36 [0–2.1] days/100 days follow-up; P=0.011). Analyses of the differential impact of HBI on all-cause mortality showed significant interactions (characterized by U-shaped relationships) with age (P=0.005) and comorbidity (P=0.041); HBI was most effective for those aged 60 to 82 years (59%–65% of individual trial cohorts) and with a Charlson Comorbidity Index Score of 5 to 8 (36%–61%). Conclusions— These data provide further support for the application of postdischarge HBI across the full spectrum of patients being hospitalized for chronic forms of heart

  1. 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…

  2. 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.

  3. [Psychosocial rehabilitation at the dawn of the 21st century: III: Interdisciplinary evaluation method and bio-psycho-social schedule].

    Science.gov (United States)

    Grasset, François; Pomini, Valentino; Favrod, Jérôme; Orita, Alina; Veillon, Henri; Cucchia, Anne-Therèse

    2004-04-01

    During the past 20 years, therapeutic and rehabilitative modalities in the field of psychosocial rehabilitation have been diversified in becoming more specific. We have the possibility to offer individualized rehabilitation programs as well as in the general field of socio-professional goals as in the clinical field according to the patients' needs and personal assets. The content of these programs associates various forms of specialized medical and paramedical services. The indications are established trough a careful assessment. The rehabilitation unit of the University Department of Psychiatry in Lausanne has developed a multidisciplinary assessment method based on the bio-psychosocial integrative model and the vulnerability-stress model in integrating the level of experience of Wood for the analysis of the psychosocial functioning. This results in a structured assessment program, which leads to a multidisciplinary comprehensive assessment (difficulties versus adaptative resources). PMID:15209050

  4. Examining body dissatisfaction in young men within a biopsychosocial framework.

    Science.gov (United States)

    Bardone-Cone, Anna M; Cass, Kamila M; Ford, Jennifer A

    2008-06-01

    This study examined biopsychosocial factors related to body dissatisfaction in young men within multivariate and moderator contexts. A female sample was included as a gender comparison. Male (n=111) and female (n=236) undergraduates filled out self-report questionnaires assessing body mass index (BMI), media influence, a history of weight-related teasing, and socially prescribed perfectionism, along with various indices of body dissatisfaction. Perceived pressure from the media was consistently related to body dissatisfaction in men whereas multiple biopsychosocial variables accounted for body dissatisfaction in women. Socially prescribed perfectionism and a history of weight teasing each moderated the relationship between BMI and male body dissatisfaction, identifying men low in body dissatisfaction. Findings indicate that applying a biopsychosocial framework to the study of body dissatisfaction in men is useful and suggest the need for including other factors, such as male peers and sports involvement, in understanding contributors to male body image. PMID:18463012

  5. Multidisciplinary Inpatient Palliative Care Intervention

    Science.gov (United States)

    2006-05-12

    Cerebrovascular Accident; Cancer; Coronary Arteriosclerosis; Heart Failure, Congestive; Diabetes Mellitus; Acquired Immunodeficiency Syndrome; Failure to Thrive; Pulmonary Disease, Chronic Obstructive; Dementia; Kidney Failure, Chronic; Pneumonia; Liver Failure; Renal Failure; Respiratory Failure; Stroke

  6. Effectiveness and cost-effectiveness of a multidisciplinary intervention programme to prevent new falls and functional decline among elderly persons at risk: design of a replicated randomised controlled trial [ISRCTN64716113

    Directory of Open Access Journals (Sweden)

    Crebolder Harry FJM

    2005-01-01

    Full Text Available Abstract Background Falls are common among community-dwelling elderly people and can have a considerable impact on quality of life and healthcare costs. People who have sustained a fall are at greater risk of falling again. We replicated a British randomised controlled trial which demonstrated the effectiveness of a multidisciplinary intervention programme to prevent falls. The objective is to describe the design of a replication study evaluating a multidisciplinary intervention programme on recurrent falls and functional decline among elderly persons at risk. The study consists of an effect evaluation, an economic evaluation and a process evaluation. Methods/design The programme is aimed at community-dwelling elderly people aged 65 years or over who have visited an accident and emergency department (A&E department or a general practitioners' cooperative (GP cooperative because of a fall. The design involves a two-group randomised controlled trial. Participants are followed for twelve months after baseline. The intervention programme consists of a detailed medical and occupational therapy assessment with referral to relevant services if indicated. People in the control group receive usual care. The main outcome measures of the effect evaluation are number of falls and daily functioning. The economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention programme.

  7. The rise and fall of the biopsychosocial model.

    Science.gov (United States)

    Ghaemi, S Nassir

    2009-07-01

    The biopsychosocial model is the conceptual status quo of contemporary psychiatry. Although it has played an important role in combatting psychiatric dogmatism, it has devolved into mere eclecticism. Other non-reductionistic approaches to medicine and psychiatry such as William Osler's medical humanism or Karl Jaspers' method-based psychiatry should be reconsidered. PMID:19567886

  8. Realizing Engel's biopsychosocial vision: resilience, compassion, and quality of care.

    Science.gov (United States)

    Epstein, Ronald M

    2014-01-01

    George Engel's biopsychosocial vision was simultaneously scientific and humanistic. He passionately presented an approach to clinical care to correct the progressive distancing of clinical care and research from the lived experience of the patient. Yet, while science provides ever greater evidence for the linkages between subjectively-reported experience and health outcomes, trainees and practicing clinicians struggle to realize a biopsychosocial vision in a pragmatic way. These challenges are magnified by the mandate for greater patient autonomy and participation in care, increased access to information, and overlaps and omissions as multiple professionals try to address the whole person. Importantly, trainees and clinicians get stuck implementing the biopsychosocial model partly because they have not developed the capacity for resilience, self-awareness, and self-monitoring. These capacities must accompany efforts to help clinicians engage more deeply with their patients; otherwise, they risk emotional distress, empathic failure, premature closure, and withdrawal from effective connections with patients. This article will explore ways in which Engel's biopsychosocial vision can be realized through building the capacities of clinicians to become more self-aware and resilient, and engage in compassionate action. PMID:25084850

  9. 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

  10. [A MULTIDISCIPLINARY BIOPSYCHOSOCIAL INTEGRATED APPROACH IN ORGANIZATION OF REHABILITATIVE ACTIVITY IN NURSING HOMES (RSA)].

    Science.gov (United States)

    Panella, Lorenzo; Piccioni, Davide; Borcescu, Lidia; Isella, Celeste; Callegari, Camilla

    2015-01-01

    Objectives, social role and organization of Italian nursing homes (RSA) are characterized by a pronounced regional differentiation that causes situations which are difficult to compare about expected outcomes. The definition of a functional outcome is particularly difficult in institutionalized patients and this is due to the failure of a conclusive moment of the rehabilitative treatment. Furthermore we often take care of patients who have already been admitted to intensive and/or extensive rehabilitation units time after time, without further functional profit margin. The inconstant presence of professional figures of rehabilitation in nursing homes' staff makes difficult the drafting of an adequate rehabilitative project, especially for the multiple needs of frail old people. Starting with these assumptions, authors hypothesize and adopt a model of sanitary organization to consent a correct allocation of available resources, according to the patient's needs. They stratified all nursing home patients, using the Multidimensional Prognostic Index (MPI) and "Scheda di osservazione intermedia assistenza" (SOSIA), and measured the residual function. They concluded that a multidimensional evaluation of patients allows to identify wellness (of the sick person and of caregivers) as the main objective; nursing home organization could be think as a "complex supportive prosthesis for old people", made by the interaction among structure, operators and activities. PMID:26934811

  11. 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. PMID:27324267

  12. 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 and...... 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...

  13. 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. PMID:26756850

  14. Biopsychosocial Characteristics of Children Who Later Murder: A Prospective Study

    OpenAIRE

    Lewis, Dorothy Otnow; Moy, Ernest; Jackson, Lori D.; Aaronson, Robert; Restifo, Nicholas; Serra, Susan; Simos, Alexander

    1985-01-01

    The authors document the childhood neuropsychiatric and family characteristics of nine male subjects who were clinically evaluated as adolescents and were later arrested for murder. Those subjects are compared with 24 incarcerated delinquents who did not go on to commit violent offenses. The future murderers displayed a constellation of biopsychosocial characteristics that included psychotic symptoms, major neurological impairment, a psychotic first-degree relative, violent acts during childh...

  15. 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.

  16. Bridging a clinical gap in psychogenic nonepileptic seizures: Mental health provider preferences of biopsychosocial assessment approaches.

    Science.gov (United States)

    Jimenez, Xavier F; Bautista, Jocelyn F; Tilahun, Bikat S; Fan, Youran; Ford, Paul J; Tesar, George E

    2016-03-01

    Management of psychogenic nonepileptic seizures (PNES) is complex, requiring multidisciplinary care. A standardized assessment and formulation approach to PNES is lacking, yet use of a comprehensive model may alleviate problems such as mental health aftercare noncompliance. Although a biopsychosocial (BPS) approach to PNES balancing predisposing, precipitating, and perpetuating (PPP) variables has been described and has been recently tested in pilot form, it is unclear how this assessment style is perceived among community mental health practitioners such as psychotherapists (including psychologists, counselors, and social workers). We predicted preference of a comprehensive "BPS/PPP" assessment style by those most involved in PNES care (i.e., community psychotherapists). One hundred and forty-three community-based social workers and counselors completed a survey featuring a fictional PNES case followed by assessment style options ("Multiaxial," "Narrative," and "BPS/PPP"). Respondents clearly preferred the robust BPS/PPP approach over less-comprehensive multiaxial and narrative assessments (p<0.0001). Reasons for choosing the BPS/PPP by respondents include ease of organization, clear therapeutic goals, and comprehensive nature. This assessment of acceptability of a BPS/PPP approach to PNES assessment among community mental health practitioners may provide a patient-centered mechanism to enhance referrals from the neurological to mental health setting. Implications and future directions are explored. PMID:26878459

  17. 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...

  18. Perception of the transition from the biomedical model to the biopsychosocial model in internal users from the CESFAM Pinares, Chiguayante

    Directory of Open Access Journals (Sweden)

    Arlette Hernández Castro

    2012-01-01

    Full Text Available Introduction: The World Health Organization (WHO has defined the word “health” not only as the absence of an illness, but as a perspective that goes beyond the physical or biological wellfare of a person, involving a mental and social prosperity of an individual. Because of all these aspects, the health specialist or the so called Internal User has the need to adapt himself/herself to a new way of intervention in the Familiar Health Center, that it used to be called “health center” or “doctor’s office”. Objective: Determine the perception that the intern user has about the biomedical transition to the biopsychosocial one. Materials and methods: using quantitative methodology with a phenomenological approach. The instrument used was an interview that was applied to 23 users, specialists, related to the Family Health Center Pinares, located in Chiguayante, in February 2009. Results and discussion: The information does not demonstrate the rejection to the new Model of Familiar Health. Nevertheless, you can observe deficient or fragmented knowledge that was brought together with not so many resources; making difficult the implementation of the biopsychosocial model.

  19. 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.

  20. Back pain and backpacks in children: biomedical or biopsychosocial model?

    Science.gov (United States)

    Reneman, M F; Poels, B J J; Geertzen, J H B; Dijkstra, P U

    2006-10-30

    Public press, professional organisations and journals have been sending alarming messages about the rising prevalence of back pain in school age children. Carrying backpacks has been suggested as one of the key factors contributing to back pain in children. The basic assumption based on the biomedical model is that the maturing spine cannot handle the mechanical load of the backpack sufficiently. A review of the evidence in the professional literature, however, revealed very limited evidence to support this assumption. On the contrary, the literature does suggest that psychological and social factors may be of greater importance to explain back pain in children. We conclude this clinical commentary postulating that the public, children and their parents are better served with a more modest and balanced perspective of the professionals, and propose that back pain in children (as it is in adults) should be viewed from a biopsychosocial model. PMID:17023376

  1. 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. PMID:26732974

  2. A biopsychosocial model of fatigue and depression following stroke.

    Science.gov (United States)

    Ormstad, Heidi; Eilertsen, Grethe

    2015-12-01

    Poststroke fatigue (PSF) and poststroke depression (PSD) are both common and difficult sequelae following acute ischemic stroke (AIS). Two main perspectives to explain these sequelae are the biomedical perspective and the psychosocial perspective. Research has shown that PSF and PSD are undoubtedly associated with each other, although each can occur in the absence of the other. However, the nature of the relationship is unclear. For example, do stroke patients become fatigued because of being depressed, or do they become depressed because they are fatigued? Alternatively, is there a bidirectional relationship between these two sequelae, with each influencing the other? We propose a biopsychosocial model of PSF and PSD that supports the AIS-induced immune response and kynurenine pathway activation being related to fatigue but not (directly) to depression. We hypothesize that the risk of developing depression may be reduced if the experience of fatigue is acknowledged, and then addressed accordingly. PMID:26459975

  3. [Multidisciplinary approach to postpartum depression].

    Science.gov (United States)

    Arranz Lara, Lilia Cristina; Aguirre Rivera, Wilfrido; Ruiz Ornelas, Jaime; Gaviño Ambriz, Salvador; Cervantes Chávez, José Francisco; Carsi Bocanegra, Eduardo; Camacho Díaz, Margarita; Ochoa Madrigal, Martha Georgina

    2008-06-01

    Postpartum depression is a multifactorial condition suffered by 15% of women after delivery. We report a clinical case of a 32 years old female admitted at Postpartum depression clinic of gyneco-obstetric coordination at Centro Médico Nacional 20 de Noviembre, ISSTE, Mexico City. Patient was evaluated by psychiatric and psychological service personnel and diagnosed as with postpartum depression. She was admitted with her child during two weeks to be studied and treated. Several evaluation tests were applied and specific interventions by multidisciplinary team were designed. PMID:18800591

  4. 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.

  5. An investigation of multidisciplinary complex health care interventions - steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Skovgaard Lasse

    2012-04-01

    Full Text Available Abstract Background The Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model. Discussion The collaborative work towards an integrative treatment model for people with MS, involved six steps: 1 Working with an initial model 2 Unfolding the different treatment philosophies 3 Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme 4 Phrasing the common assumptions for an integrative MS program theory 5 Developing the integrative MS program theory 6 Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment. Summary An integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level.

  6. 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

    OpenAIRE

    Martha Kent; Rivers, Crystal T.; Glenda Wrenn

    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...

  7. 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…

  8. 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

  9. Like Alligators Bobbing for Poodles? A Critical Discussion of Education, ADHD and the Biopsychosocial Perspective

    Science.gov (United States)

    Cooper, Paul

    2008-01-01

    ADHD (Attention Deficit/Hyperactivity Disorder) continues to be a controversial issue among some educationalists. This paper argues that negativity towards the ADHD concept shown by some antagonists is based on outdated thinking and a lack of understanding of the diagnosis and the biopsychosocial paradigm through which it can be usefully…

  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. 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

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

    OpenAIRE

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

    2014-01-01

    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, a...

  13. Mental Health and Native Americans: Responding to the Challenge of the Biopsychosocial Model.

    Science.gov (United States)

    Marburg, Galen Sanford

    1983-01-01

    A rural, hospital-based, community mental health program at Keams Canyon Indian Hospital (Arizona) utilizes an array of remedial, developmental, and preventive strategies to respond to the unique biopsychosocial needs of the Navajo and Hopi populations. Outpatient, outreach, and aftercare programs, and development of treatment and consulting…

  14. Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective

    Science.gov (United States)

    Gatchel, Robert J.

    2004-01-01

    An exciting period in mental and physical health research is beginning, resulting from a paradigm shift from an outdated biomedical reductionism approach to a more comprehensive biopsychosocial model, which emphasizes the unique interactions among biological, psychological, and social factors required to better understand health and illness. This…

  15. 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…

  16. A Biopsychosocial Model of the Development of Chronic Conduct Problems in Adolescence.

    Science.gov (United States)

    Dodge, Kenneth A.; Pettit, Gregory S.

    2003-01-01

    A biopsychosocial model of the development of adolescent chronic conduct problems is presented and supported through a review of empirical findings. The model posits that biological dispositions and sociocultural contexts place certain children at risk in early life but that life experiences with parents, peers, and social institutions increment…

  17. 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…

  18. Building multidisciplinary business teams

    International Nuclear Information System (INIS)

    This paper is a description of an approach to managing Exploration and Production assets through the operation of multidisciplinary business teams. The business team approach can assist in improved asset performance in terms of efficiency, motivation and business results, compared with more traditional matrix style hierarchies. Within this paper certain critical success factors for the long term success of multidiscipline teams are outlined, together with some of the risk of business team operation

  19. 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....

  20. Understanding pandemic influenza behaviour: An exploratory biopsychosocial study.

    Science.gov (United States)

    Flowers, Paul; Davis, Mark; Lohm, Davina; Waller, Emily; Stephenson, Niamh

    2016-05-01

    Pandemic influenza represents an ongoing public health threat. Understanding the associated behavioural domain is vital for future intervention development. Cross-sectional qualitative research employing purposive sampling employed a combination of one-to-one semi-structured interviews (n = 57) and focus groups (n = 59). Data were analysed using (1) inductive thematic analysis and (2) theoretical thematic analysis focusing upon resonance with psychosocial and sociocultural constructs. Two broad themes highlighted an important duality regarding the determinants of pandemic behaviour: (1) psychosocial determinants (e.g. agency, cognitions and identity) and (2) sociocultural determinants (e.g. social context and capacity). These findings suggest this duality should shape future intervention development. PMID:24957318

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

    DEFF Research Database (Denmark)

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

    30 MTBI cases and assess non-surgical interventions using clinically-relevant outcomes such as self-rated recovery. Data extraction: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed...

  2. Psychiatric mental health nursing in a biopsychosocial era.

    Science.gov (United States)

    Abbondanza, D M; Puskar, K R; Wilkinson, B; Welch, C; Rudert, S; Gallippi, B

    1994-01-01

    Clients in long-term facilities carry a wide array of psychiatric diagnoses, often with equally diverse medical problems. This "back ward" population requires a specialized area of psychiatric mental health nursing practice. The need for comprehensive assessment and adequate interventions, and the various frustrations of nursing staff, are discussed using a case example. PMID:7862514

  3. A Crisis Intervention Service: Comparison of Younger and Older Adult Clients.

    Science.gov (United States)

    Winogrond, Iris R.; Mirassou, Marlene M.

    1983-01-01

    Compares adult and elderly clients of a Crisis Intervention Service in an urban metropolitan area, which included a telephone counseling/referral service and a mobile intervention team for home assessments. Findings indicated the importance of using a biopsychosocial model, particularly in the assessment of elderly persons. (JAC)

  4. 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. PMID:26640009

  5. GRC RBCC Concept Multidisciplinary Analysis

    Science.gov (United States)

    Suresh, Ambady

    2001-01-01

    This report outlines the GRC RBCC Concept for Multidisciplinary Analysis. The multidisciplinary coupling procedure is presented, along with technique validations and axisymmetric multidisciplinary inlet and structural results. The NPSS (Numerical Propulsion System Simulation) test bed developments and code parallelization are also presented. These include milestones and accomplishments, a discussion of running R4 fan application on the PII cluster as compared to other platforms, and the National Combustor Code speedup.

  6. 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.

  7. The Importance of Multi-level Theoretical Integration in Biopsychosocial Research

    Directory of Open Access Journals (Sweden)

    Daniel J. Kruger

    2007-12-01

    Full Text Available There is a growing interest in the unification of health research in a biopsychosocial framework. However, increasing specialization and advancement in instrumentation makes it more difficult to bridge understanding across areas. It would be very useful to ground biopsychosocial research in the most powerful explanatory framework in the life sciences, evolution by natural and sexual selection. This would require and explanation of the functional significance of the phenomena related to the area of study, in addition to descriptions of the mechanism. The application of an integrative evolutionary framework will be illustrated with the example of sex differences in human mortality rates, which are related to endocrine, psychological, and socio-environmental factors. The integrative evolutionary model will be contrasted with a theoretical model that acknowledges physiological and social influences, but artificially separates them.

  8. Synthesis of Scientific Disciplines in Pursuit of Health: the Interactive Biopsychosocial Model

    OpenAIRE

    Lindau, Stacy Tessler; Laumann, Edward O.; Levinson, Wendy; Waite, Linda J.

    2003-01-01

    Twenty-five years ago, George Engel proposed a challenge to the biomedical model and its limited view of disease as biologically rooted. Building on Engel’s work, we present the Interactive Biopsychosocial Model (IBM). The IBM argues for a reorientation in biomedicine where research, education, and clinical practice: (1) address health in addition to illness; (2) aim to decipher interrelated biophysical, psychocognitive, and social processes in health and disease, rather than seek a single ro...

  9. Toward a Biopsychosocial Understanding of the Patient–Physician Relationship: An Emerging Dialogue

    OpenAIRE

    Adler, Herbert M

    2007-01-01

    Complexity theory has been used to view the patient–physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other’s behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other’s psychobiology. This mutual influence may be subjective...

  10. Toward a biopsychosocial understanding of the patient-physician relationship: an emerging dialogue.

    Science.gov (United States)

    Adler, Herbert M

    2007-02-01

    Complexity theory has been used to view the patient-physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other's behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other's psychobiology. This mutual influence may be subjectively experienced as empathy, and may be skillfully employed by the clinician to directly improve the patient's psychobiology. PMID:17357001

  11. BIOPSYCHOSOCIAL DETERMINANTS OF HYPOACTIVE SEXUAL DESIRE IN WOMEN: A NARRATIVE REVIEW

    OpenAIRE

    Malary, Mina; Khani, Soghra; Pourasghar, Mehdi; Moosazadeh, Mahmood; Hamzehgardeshi, Zeinab

    2015-01-01

    Background: As a mental response to sexual stimuli, sexual desire determines human sexual behavior and represents the cognitive capacity of sexual stimulation, so that avoiding sexual activity has a very negative effect on the discharge of intimacy and joy in couple’s relationship and threatens the stability relationship, which can finally end in sexual dissatisfaction and divorce; it may even affect the reproduction. This study, reviews the literature on biopsychosocial determinants of hypoa...

  12. A biopsychosocial model of resilience for multiple sclerosis.

    Science.gov (United States)

    Black, Rebecca; Dorstyn, Diana

    2015-11-01

    The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis. PMID:24323335

  13. Multidisciplinary mental health teams.

    Science.gov (United States)

    Slade, M; Rosen, A; Shankar, R

    1995-01-01

    This study surveyed current practice amongst 91 Indian and Australian staff working within multidisciplinary mental health teams, looking at leadership skills, conflict resolution and therapeutic abilities. Length of training was associated with management skills, though these skill were more developed by psychiatric nurses and occupational therapists working in community settings. Hospital settings involved less consensual decision-making than community teams. Psychiatric nurses spent most time in clinical work, and occupational therapists were rated as less skilled in the therapeutic activities assessed than any other profession. Psychiatrists and clinical psychologists undertook most research. The activities assessed in this study could be undertaken by a team comprising psychiatrists, psychiatric nurses and social workers, with clinical psychologists employed where possible, especially for research or service evaluation. PMID:8847199

  14. 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

  15. Psychopathological aspects of kidney transplantation: Efficacy of a multidisciplinary team.

    Science.gov (United States)

    De Pasquale, Concetta; Veroux, Massimiliano; Indelicato, Luisa; Sinagra, Nunzia; Giaquinta, Alessia; Fornaro, Michele; Veroux, Pierfrancesco; Pistorio, Maria L

    2014-12-24

    Renal transplantation is a well established treatment for end-stage renal disease, allowing most patients to return to a satisfactory quality of life. Studies have identified many problems that may affect adaptation to the transplanted condition and post-operative compliance. The psychological implications of transplantation have important consequences even on strictly physical aspects. Organ transplantation is very challenging for the patient and acts as an intense stressor stimulus to which the patient reacts with neurotransmitter and endocrine-metabolic changes. Transplantation can result in a psychosomatic crisis that requires the patient to mobilize all bio-psycho-social resources during the process of adaptation to the new foreign organ which may result in an alteration in self-representation and identity, with possible psychopathologic repercussions. These reactions are feasible in mental disorders, e.g., post-traumatic stress disorder, adjustment disorder, and psychosomatic disorders. In organ transplantation, the fruitful collaboration between professionals with diverse scientific expertise, calls for both a guarantee for mental health and greater effectiveness in challenging treatments for a viable association between patients, family members and doctors. Integrated and multidisciplinary care should include uniform criteria and procedures for standard assessments, for patient autonomy, adherence to therapy, new coping strategies and the adoption of more appropriate lifestyles. PMID:25540735

  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. PMID:26239672

  17. 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

  18. Challenging cases in thyroid cancer: a multidisciplinary approach

    International Nuclear Information System (INIS)

    Recurrent thyroid cancer can present many complex management problems. Unfortunately, recurrent thyroid cancer is often refractory to radioiodine therapy. The proper use of external beam irradiation and surgical interventions can provide regional control of localized recurrences. Because of the complex nature of these patients, a multidisciplinary team approach to management which includes specialists in thyroid medicine and surgery, head and neck radiotherapy, and nuclear medicine often is required to provide individualized, optimal multimodality treatment recommendations. In this article we review a multidisciplinary team approach to a patient with widespread, radioiodine-refractory bone metastases from follicular thyroid cancer and to a patient with unresectable central neck recurrence of papillary thyroid cancer. (orig.)

  19. 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

  20. 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...

  1. 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. PMID:27013288

  2. 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. PMID:26484619

  3. Biopsychosocial care and the physiotherapy encounter: physiotherapists’ accounts of back pain consultations

    Directory of Open Access Journals (Sweden)

    Sanders Tom

    2013-02-01

    Full Text Available Abstract Background The physiotherapy profession has undergone a paradigmatic shift in recent years, where a ‘biopsychosocial’ model of care has acquired popularity in response to mounting research evidence indicating better patient outcomes when used alongside traditional physiotherapy. However, research has not examined how this new dimension to traditional physical therapy is implemented within the therapeutic consultation. Methods The study aimed to investigate physiotherapists’ reported approaches to back pain care in the context of increasing pressure to address patients’ psychosocial concerns. A secondary analysis of semi-structured qualitative interviews with 12 UK physiotherapists was conducted. Respondents were sampled from a national survey, to include a broad mix of physiotherapists. Data were analysed thematically, adopting the constant comparative methodology. Results The combination of traditional physical therapy with a broader biopsychosocial approach presented significant challenges. Physiotherapists responded by attempting to navigate patients’ biopsychosocial problems through use of various strategies, such as setting boundaries around their clinical role and addressing lay health beliefs of patients through the provision of reassurance and lifestyle advice. Conclusions As psychosocial issues, alongside biomechanical factors, command a prominent place within the back pain consultation, physiotherapists may benefit from further specific training and mentoring support in identifying specific strategies for combining the best of traditional physiotherapy approaches with greater focus on patients’ beliefs, fears and social context.

  4. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... 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......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...

  5. 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

  6. 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.

  7. The Complexity Signature: Developing a Tool to Communicate Biopsychosocial Severity of Disease for Children with Chronic Neurological Complexity.

    Science.gov (United States)

    Krieg, Sandro M; Sonanini, Sebastian; Sollmann, Nico; Focke, Axel; Gerstl, Lucia; Heinen, Florian

    2016-08-01

    Aim For children with medical complexity, interdisciplinary treatment approaches are required to address the various aspects defined within the biopsychosocial model. Methods The present study identifies dimensions of the biopsychosocial model to generate a standardized visualized severity score for chronic neurological diseases in children. We demonstrate the score's applicability and usefulness in clinical practice among clinicians with and without pediatric board certification with the aid of illustrative patient cases. The results are compared by Spearman correlation coefficient. Results Nine dimensions were identified as the basis for the development of the score, which consists of five grades of severity for each of the selected neuropediatric subsections. All board-certified pediatricians would recommend the application of the severity score in clinical routine. Furthermore, a good correlation was revealed between direct and indirect (severity score) assessment. Interpretation The severity score developed in this study takes into account biopsychosocial aspects of chronic diseases while being comprehensible and easily applicable in clinical routine-a biopsychosocial signature serving as an excellent, striking communication basis within the interdisciplinary team. However, upcoming studies including more patient cases are needed for further refinement. PMID:27228000

  8. Effect of guideline based computerised decision support on decision making of multidisciplinary teams: cluster randomised trial in cardiac rehabilitation

    OpenAIRE

    Goud, R.; de Keizer, N F; ter Riet, G; Wyatt, J C; Hasman, A.; Hellemans, I.M.; Peek, N.

    2009-01-01

    OBJECTIVE: To determine the extent to which computerised decision support can improve concordance of multidisciplinary teams with therapeutic decisions recommended by guidelines. DESIGN: Multicentre cluster randomised trial. PARTICIPANTS: Multidisciplinary cardiac rehabilitation teams in Dutch centres and their cardiac rehabilitation patients. INTERVENTIONS: Teams received an electronic patient record system with or without additional guideline based decision support. MAIN OUTCOME MEASURES: C...

  9. The Multidisciplinary Management of Osteosarcoma

    OpenAIRE

    Federman, Noah; Bernthal, Nicholas; Eilber, Fritz C.; Tap, William D.

    2009-01-01

    Patients with suspected or confirmed osteosarcoma should be evaluated and treated at a comprehensive cancer center within a multidisciplinary sarcoma program that includes pediatric, medical and radiation oncologists, orthopedic and surgical oncologists, musculoskeletal pathologists, and radiologists. Successful treatment involves proper diagnosis, neoadjuvant and adjuvant multi-agent chemotherapy, and aggressive surgery with an emphasis toward limb-preserving procedures. Treatment of osteosa...

  10. The robust nature of the biopsychosocial model challenge and threat: a reply to Wright and Kirby.

    Science.gov (United States)

    Blascovich, Jim; Mendes, Wendy Berry; Tomaka, Joe; Salomon, Kristen; Seery, Mark

    2003-01-01

    This article responds to Wright and Kirby's (this issue) critique of our biopsychosocial (BPS) analysis of challenge and threat motivation. We counter their arguments by reviewing the current state of our theory as well as supporting data, then turn to their specific criticisms. We believe that Wright and Kirby failed to accurately represent the corpus of our work, including both our theoretical model and its supporting data. They critiqued our model from a contextual, rational-economic perspective that ignores the complexity and subjectivity of person-person and person-environmental interactions as well as nonconscious influences. Finally, they provided criticisms regarding possible underspecificity of antecedent components of our model that do not so much indicate theoretical flaws as provide important and interesting questions for future research. We conclude by affirming that our BPS model of challenge and threat is an evolving, generative theory directed toward understanding the complexity of personality and social psychological factors underlying challenge and threat states. PMID:12788689

  11. Associations between biopsychosocial factors and chronic upper limb pain among slaughterhouse workers

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus D; Brandt, Mikkel;

    2016-01-01

    leg (p < 0.01), and reported impaired work ability index score and general health along with higher work disability and fear avoidance compared with controls (all p < 0.0001). No differences were observed between the groups in regard to age, BMI, physical activity level, job position and duration of...... slaughterhouse work (all p > 0.4). CONCLUSIONS: Chronic upper limb pain was paralleled by reduced neuromuscular function of the shoulder and hand along with impaired work ability, work disability and general health. Future studies on chronic pain management at the workplace should carefully consider the......BACKGROUND: Knowledge of factors associated with chronic pain is necessary for preventive strategies. The present study investigates biopsychosocial differences, with specific focus on rate of force development (RFD) and work ability, between workers with and without chronic upper limb pain...

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

    DEFF Research Database (Denmark)

    Lomholt, Johanne Jeppesen

    as a chronic pain diagnosis, and the pain is caused by the inflammations in the joint. The amount of pain experienced by a child with JIA may be modulated by psychological, social, and biological factors. The general purpose of the present thesis is twofold. First, the purpose is to investigate biopsychosocial...... associations between pain threshold and age, current pain experience, disease duration, or disease activity. Children with JIA had a substantially lower pain threshold even in areas usually unaffected by arthritis. Our findings suggest that JIA alters the pain perception and causes decreased pain threshold......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...

  13. 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.

  14. 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

  15. The Impact of Psychological Interventions on the Quality of Life of Diabetes Mellitus Patient

    OpenAIRE

    Oieru Dana Sonia; Popa Amorin Remus; Vlad Ionuţ

    2014-01-01

    Background and aims: The theory regarding the psychological factors as etiologic agents that trigger the somatic diseases has gained more and more ground in the past few years, successfully repeating that the human being is a bio-psycho-social entity. In order to render the psychological interventions more efficient in the management of the psychosomatic diseases, this research aims to detect and modify, even treat throught psychological interventions those configurations of the early maladap...

  16. Computational differentiation and multidisciplinary design

    Energy Technology Data Exchange (ETDEWEB)

    Bischof, C. [Argonne National Lab., IL (United States); Griewank, A. [Institute of Scientific Computing, Technical Univ. of Dresden, Dresden (Germany)

    1993-12-31

    Multidisciplinary Design Optimization (MDO) by means of formal sensitivity analysis requires that each single-discipline analysis code supply not only the output functions for the (usually constrained) optimization process and other discipline analysis inputs, but also the derivatives of all of these output functions with respect to its input variables. Computational differentiation techniques and automatic differentiation tools enable MDO by providing accurate and efficient derivatives of computer programs with little human effort. We discuss the principles behind automatic differentiation and give a brief overview of automatic differentiation tools and how they can be employed judiciously, for example, for sparse Jacobians and to exploit parallelism. We show how, and under what circumstances, automatic differentiation applied to iterative solvers delivers the mathematically desired derivatives. We then show how derivatives that can now be feasibly obtained by computational differentiation techniques can lead to improved solution schemes for nonlinear coupled systems and multidisciplinary design optimization.

  17. 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

  18. Multidisciplinary strategies in the management of early chronic kidney disease.

    Science.gov (United States)

    Martínez-Ramírez, Héctor R; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Hernández-Herrera, Aurora; Cueto-Manzano, Alfonso M

    2013-11-01

    Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. PMID:24215785

  19. Multidisciplinary Optimization of Aerocapture Maneuvers

    OpenAIRE

    Armellin, Roberto; Lavagna, Michèle

    2008-01-01

    A multidisciplinary-multiobjective optimization of aerocapture maneuvers is presented. The proposed approach allows a detailed analysis of the coupling among vehicle's shape, trajectory control, and thermal protection system design. A set of simplified models are developed to address this analysis and a multiobjective particle swarm optimizer is adopted to obtain the set of Pareto optimal solutions. In order to deal with an unconstrained multiobjective optimization, a two-point boundary value...

  20. Integral multidisciplinary rehabilitation treatment planning

    OpenAIRE

    Braaksma, A.; Kortbeek, Nikky; Post, Gerhard; Nollet, Frans

    2012-01-01

    This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure to plan the entire treatment plan at once, often occurs. This situation jeopardizes both the quality of care and the logistical performance. The multidisciplinary nature of the rehabilitation proce...

  1. 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

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

    OpenAIRE

    Cindy Crawford; Dawn B. Wallerstedt; Raheleh Khorsan; Shawn S. Clausen; 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...

  4. Health and nursing problems of elderly patients related to bio-psycho-social need deficiencies and functional assessment

    OpenAIRE

    Muszalik, Marta; Dijkstra, Ate; Kedziora-Kornatowska, Kornelia; Zielinska-Wieczkowska, Halina

    2012-01-01

    Elderly population is characterized by larger need for social welfare and medical treatment than other age groups. Along with aging, there is a number of emerging health, nursing, caring, psychological and social problems. Complexity of these problems results from overlapping and advancing involutional changes, multi-illness, decreased functional efficiency and other factors. The aim of the study was the assessment of health problems in geriatric patients as well as bio-psycho-social need def...

  5. 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). PMID:27043924

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

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. Adherence monitoring with chronic opioid therapy for persistent pain: a biopsychosocial-spiritual approach to mitigate risk.

    Science.gov (United States)

    Matteliano, Deborah; St Marie, Barbara J; Oliver, June; Coggins, Candace

    2014-03-01

    Opioids represent a mainstay in the pharmacologic management of persistent pain. Although these drugs are intended to support improved comfort and function, the inherent risk of abuse or addiction must be considered in the delivery of care. The experience of living with persistent pain often includes depression, fear, loss, and anxiety, leading to feelings of hopelessness, helplessness, and spiritual crisis. Collectively, these factors represent an increased risk for all patients, particularly those with a history of substance abuse or addiction. This companion article to the American Society for Pain Management Nursing "Position Statement on Pain Management in Patients with Substance Use Disorders" (2012) focuses on the intersection of persistent pain, substance use disorder (SUD), and chronic opioid therapy and the clinical implications of monitoring adherence with safe use of opioids for those with persistent pain. This paper presents an approach to the comprehensive assessment of persons with persistent pain when receiving opioid therapy by presenting an expansion of the biopsychosocial model to include spiritual factors associated with pain and SUD, thus formulating a biopsychosocial-spiritual approach to mitigate risk. Key principles are provided for adherence monitoring using the biopsychosocial-spiritual assessment model developed by the authors as a means of promoting sensitive and respectful care. PMID:24602442

  9. 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.

  10. EMSO: European Multidisciplinary Seafloor Observatory

    Science.gov (United States)

    Favali, Paolo; Partnership, Emso

    2010-05-01

    EEMSO, an ESFRI Research Infrastructure, 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. EMSO will reply also to the need expressed in the frame of GMES (Global Monitoring for Environment and Security) to develop a marine segment integrated in the in situ and satellite global monitoring system. The EMSO infrastructure will extend the coverage to the sea of the monitoring, integrating the land-based networks with multidisciplinary seafloor measurements. With this aim the two European research infrastructures EPOS (European Plate Observing System) and EMSO can operate in coordination in order to increase the mutual benefits. EMSO is presently at the stage of Preparatory Phase, funded in the EC FP7. The EMSO status, the perspectives and relations with other existing or incoming sensor networks and data infrastructures are outlined.

  11. Orbital rhabdomyosarcoma: multidisciplinary treatment experience

    International Nuclear Information System (INIS)

    Orbital rhabdomyosarcoma (RMS) accounts for 10% of childhood RMS and has a relatively good prognosis of up to 85% 5-year survival. Improved survival has led to increased interest in late effects of treatment. The objective of this study was to review the results of treating orbital RMS with multidisciplinary treatment at Women's and Children's Hospital and Royal Adelaide Hospital with emphasis on late effects of treatment. A retrospective review was carried out of all patients with orbital RMS treated with multidisciplinary treatment including radiation therapy and chemotherapy in the two institutions between 1982 and 2002. A total of five patients (age range 5.5-12 years) satisfied the eligibility requirements. Late effects were significant and included facial bone hypoplasia, cataract formation and growth hormone deficiency. Overall survival was 80% (4/5) with mean follow up of 8 years (range 3-13 years). Given the high cure rates achieved, future treatments must aim to maintain the good results but to reduce the high incidence of late effects of treatment. Standardised rating of late toxicity, long-term follow-up clinics, and implementation of modern radiation techniques (3-D conformal radiotherapy, intensity modulated radiotherapy, proton therapy) for patients with orbital RMS are important to improving outcome. Copyright (2006) Blackwell Science Pty Ltd

  12. 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.

  13. 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...

  14. The Case for Multidisciplinary Computer Science

    OpenAIRE

    Burge, Jamika

    2015-01-01

    Multidisciplinary computer science approaches problem solving from a range of disciplines. Arguably, some of today’s most salient areas of technical research – social computing, data analytics (“big data”), and cyber security – are multidisciplinary in nature. Moreover, multidisciplinary computing has the unique quality of empowering technology users in ways that did not exist just ten years ago (think Google Glass and quantified self applications). In this talk, I share a series of research ...

  15. 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...

  16. 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

    , multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges.The aim of this study is therefore to investigate the effect of an individually tailored...... mindfulness practice and learning de-catastrophizing pain management strategies through cognitive training.The primary outcome at 10-week follow-up is the between-group difference in intensity of perceived musculoskeletal pain during the last week (average value of back, neck, shoulder, elbow and hand...

  17. Mindfulness, functioning and catastrophizing after multidisciplinary pain management for chronic low back pain.

    Science.gov (United States)

    Cassidy, Emma Louise; Atherton, Rachel Jane; Robertson, Noelle; Walsh, David Andrew; Gillett, Raphael

    2012-03-01

    We examined mindfulness in people with chronic low back pain who were attending a multidisciplinary pain management programme. Participants completed questionnaires at baseline (n=116) and after a 3-month cognitive-behaviourally informed multidisciplinary intervention (n=87). Self-reported mindfulness was measured before and after the intervention, and relationships were explored between mindfulness, disability, affect and pain catastrophizing. Mindfulness increased following participation in the intervention, and greater mindfulness was predictive of lower levels of disability, anxiety, depression and catastrophizing, even when pain severity was controlled. Mediator analyses suggested that the relationship between mindfulness and disability was mediated by catastrophizing. It is possible that cognitive-behavioural interventions and processes can affect both catastrophizing and mindfulness. PMID:22240149

  18. 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.

  19. 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

  20. Exploring the bio-psychosocial effects of renal replacement therapy amongst patients in a state hospital in South Africa

    Directory of Open Access Journals (Sweden)

    Bharita Harilall

    2011-02-01

    Full Text Available This article described a qualitative study that investigated the bio-psychosocial effects of renal replacement therapy on patients in a state hospital in South Africa. The study aimed to investigate the level of debility experienced by patients undergoing haemodialysis (HDand continuous ambulatory peritoneal dialysis (CAPD and to explore how this debility affects their bio-psychosocial functioning. Respondents comprised a small sample of HD and CAPD patients. Using an interview schedule as the research tool allowed rich data to be uncovered. Content analysis and reducing data into themes facilitated data analysis. Although the study was not quantitative and thus did not allow for comparative analysis,themes regarding the levels of stress emerged amongst participants. The HD group voiced greater concerns regarding the degree of debility and psychosocial distress than the CAPD group. Governmental support for holistic kidney disease treatment and careful teaming of key role players to reduce the severity and far-reaching bio-psychosocial effects of HD and CAPD treatment are recommended.

    Opsomming

    Hierdie artikel beskryf ‘n kwalitatiewe studie wat die bio-psigososiale effekte van niervervangingsterapie op pasiënte in ‘n staatshospitaal in Suid-Afrika ondersoek het. Die studie is gemotiveer deur die mate van debiliteit van pasiënte wat hemodialise (HD en kontinue ambulatoriese peritoneale dialise (KAPD ondergaan en wat oënskynlik verder strek as bloot die fisieke aspekte van die siekte en die behandeling daarvan. Respondente het bestaan uit ‘n klein groep HD- en KAPD-pasiënte. Deur ‘n onderhoudskedule as die navorsingsinstrument te gebruik, is ryk data onthul. Inhoudanalise en die redusering van data tot temas het die data-analise gefasiliteer. Alhoewel die studie nie kwantitatief was nie en vergelykende analise dus nie moontlik was nie, het temas van spanning onder die respondente voorgekom. Dit was duidelik uit

  1. Improved work ability and return to work following vocational multidisciplinary rehabilitation of subjects on long-term sick leave

    OpenAIRE

    Braathen, Tore; Veiersted, Kaj Bo; Heggenes, Jan

    2007-01-01

    Objective: To evaluate a vocational multidisciplinary rehabilitation programme for patients on long-term sick leave with respect to their work ability and return to work. Methods: A multidisciplinary rehabilitation programme was administered to an intervention group of 183 patients on long-term sick leave (mean 12.2 months). Effects of the treatment were compared with a control group (n = 96) recruited from the national sickness insurance record of patients on sick lea...

  2. Multidisciplinary response for a radiological accident developed in Argentina

    International Nuclear Information System (INIS)

    In January 2009 during an oil well logging task in Rincon de los Sauces, Province of Neuquen, Argentina, and, as a result of the temporary loss of control of a 137Cs sealed source of 92,5 GBq (2,5 Ci), two workers were allegedly exposed to ionizing radiation. The Health Emergency Coordination System in Neuquen activated the Radiological Emergency Intervention System of the Nuclear Regulatory Authority (NRA). An initial assessment of the accident scenario and the involved persons was performed. Two workers were were transfer to Buenos Aires for a biodosimetry evaluation. In Buenos Aires, the Burn Hospital performed the first diagnostic and therapeutic approach of the radioinduced skin injuries. The NRA estimated the biological absorbed doses and the studies of telethermography. The Italian Hospital was in charge of the studies using ultrasonography and Eco- Doppler. As a result of the multidisciplinary evaluation performed, one of the workers was diagnosed with superficial radioinduced dermatitis. The mentioned intervention highlighted the importance of multidisciplinary and multiparametric work for the evaluation of a radiological accident, as well as for the diagnosis and early treatment of the exposed persons. (authors)

  3. Necrotizing Pancreatitis: A Review of Multidisciplinary Management

    Directory of Open Access Journals (Sweden)

    Anthony Sabo

    2015-05-01

    Full Text Available 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

  4. The relevance of the philosophical 'mind-body problem' for the status of psychosomatic medicine: a conceptual analysis of the biopsychosocial model.

    Science.gov (United States)

    Van Oudenhove, Lukas; Cuypers, Stefaan

    2014-05-01

    Psychosomatic medicine, with its prevailing biopsychosocial model, aims to integrate human and exact sciences with their divergent conceptual models. Therefore, its own conceptual foundations, which often remain implicit and unknown, may be critically relevant. We defend the thesis that choosing between different metaphysical views on the 'mind-body problem' may have important implications for the conceptual foundations of psychosomatic medicine, and therefore potentially also for its methods, scientific status and relationship with the scientific disciplines it aims to integrate: biomedical sciences (including neuroscience), psychology and social sciences. To make this point, we introduce three key positions in the philosophical 'mind-body' debate (emergentism, reductionism, and supervenience physicalism) and investigate their consequences for the conceptual basis of the biopsychosocial model in general and its 'psycho-biological' part ('mental causation') in particular. Despite the clinical merits of the biopsychosocial model, we submit that it is conceptually underdeveloped or even flawed, which may hamper its use as a proper scientific model. PMID:24443097

  5. A prospective biopsychosocial study of the persistent post-concussion symptoms following mild traumatic brain injury.

    Science.gov (United States)

    Wäljas, Minna; Iverson, Grant L; Lange, Rael T; Hakulinen, Ullamari; Dastidar, Prasun; Huhtala, Heini; Liimatainen, Suvi; Hartikainen, Kaisa; Öhman, Juha

    2015-04-15

    This study examined multiple biopsychosocial factors relating to post-concussion symptom (PCS) reporting in patients with mild traumatic brain injuries (mTBI), including structural (computed tomography and magnetic resonance imaging [MRI]) and microstructural neuroimaging (diffusion tensor imaging [DTI]). Patients with mTBIs completed several questionnaires and cognitive testing at approximately one month (n=126) and one year (n=103) post-injury. At approximately three weeks post-injury, DTI was undertaken using a Siemens 3T scanner in a subgroup (n=71). Measures of fractional anisotropy were calculated for 16 regions of interest (ROIs) and measures of apparent diffusion coefficient were calculated for 10 ROIs. Patients were compared with healthy control subjects. Using International Classification of Diseases, Tenth Revision (ICD-10) PCS criteria and mild or greater symptom reporting, 59% of the mTBI sample met criteria at one month and 38% met criteria at one year. However, 31% of the healthy control sample also met criteria for the syndrome-illustrating a high false-positive rate. Significant predictors of ICD-10 PCS at one month were pre-injury mental health problems and the presence of extra-cranial bodily injuries. Being symptomatic at one month was a significant predictor of being symptomatic at one year, and depression was significantly related to PCS at both one month and one year. Intracranial abnormalities visible on MRI were present in 12.1% of this sample, and multifocal areas of unusual white matter as measured by DTI were present in 50.7% (compared with 12.4% of controls). Structural MRI abnormalities and microstructural white matter findings were not significantly associated with greater post-concussion symptom reporting. The personal experience and reporting of post-concussion symptoms is likely individualized, representing the cumulative effect of multiple variables, such as genetics, mental health history, current life stress, medical problems

  6. An architecture for integration of multidisciplinary models

    DEFF Research Database (Denmark)

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

    2014-01-01

    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, in...

  7. Emerging multidisciplinary research across database management systems

    OpenAIRE

    Nica, Anisoara; Suchanek, Fabian; Varde, Aparna

    2010-01-01

    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...

  8. Pediatric pain management: the multidisciplinary approach

    OpenAIRE

    Odell, Shannon

    2013-01-01

    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 r...

  9. Pediatric pain management: the multidisciplinary approach

    OpenAIRE

    Odell S; Logan DE

    2013-01-01

    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 rehab...

  10. Advances in Multidisciplinary Treatment of Rectal Cancer

    OpenAIRE

    Zhao, Changlin; Hongqin SUN; Yang, Yang

    2009-01-01

    To summarize the advances in the multidisciplinary treatment of rectal cancer and to analyze the existing problems and development prospects. The full text database retrieval system of MEDLINE and the periodicals of CHKD were searched. The words “rectal cancer, diagnosis, surgery, chemotherapy, radiotherapy, targeted therapy, analysis” were used as key words for retrieval of literature concerning the values and clinical significance of rectal cancer multidisciplinary treatment from January, 2...

  11. 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

  12. 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

  13. Dialectic approach to multidisciplinary practice in requirements engineering

    OpenAIRE

    Denley, I. S.

    1999-01-01

    This thesis develops an approach that supports multidisciplinary practice in requirements engineering. It is argued that multidisciplinary requirements engineering practice is ineffective, and some specific problems for multidisciplinary practice are identified. It is also suggested that the incommensurability of conflicting paradigms is an underlying cause of the problems in multidisciplinary practice, and a number of criteria for support to overcome such problems are proposed...

  14. An Evaluation of an Hypothesized Paradigm: The Relationship between Childhood Abuse and Substance Use Mediated by Biopsychosocial Factors among Priority Populations.

    Science.gov (United States)

    Simons, Loretta N.

    This study evaluated an hypothesized model of biopsychosocial factors that mediate the relationship between childhood abuse and substance abuse. A questionnaire packet consisting of self-report measures was administered to 160 drug dependent participants with and without co-occurring psychological disorders in residential, partial, and outpatient…

  15. A Model for Diagnostics in Neurological Rehabilitation: An Answer to the Biopsychosocial Disease Consequence Model in Rehabilitation of Talo et al.

    Science.gov (United States)

    Faby, S.

    1998-01-01

    Discusses the bio-psycho-social disease consequence model in rehabilitation and the model's development in the Finnish "Work Hardening Program for Chronic Pain." The theoretical background of the model is explained and the possibility of applying the model to other fields of rehabilitation is explored. (Author/CR)

  16. 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

  17. Menkes disease: what a multidisciplinary approach can do.

    Science.gov (United States)

    Ojha, Rahul; Prasad, Asuri N

    2016-01-01

    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. PMID:27574440

  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. 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.

  20. Multidisciplinary management of hepatocellular carcinoma: a model for therapy

    Directory of Open Access Journals (Sweden)

    Cohen GS

    2013-05-01

    Full Text Available Gary S Cohen1, Martin Black2 1Liver Tumor Program, Temple University Hospital, 2Liver Transplantation, Temple University School of Medicine, Philadelphia, PA, USA Abstract: A multidisciplinary model is a useful approach in the management of hepatocellular carcinoma (HCC to coordinate, individualize, and optimize care. The HCC Multidisciplinary Team (MDT at Temple University Hospital was established in 2008 and comprises hepatologists, interventional radiologists, transplant surgeons, oncologists, residents, midlevel providers, and support staff. Patients may be enrolled by referral from (1 oncologists at Temple, (2 the hepatitis screening clinic recently established at Temple and staffed by hepatology residents, or (3 community practices. MDT conferences are held weekly, during which cases are discussed (based on medical history, interpretation of images, and laboratory analyses and treatment plans are formulated. The Temple treatment algorithm follows current standards of care, guided by tumor volume and morphology, but the novel multidisciplinary interaction challenges members to tailor therapy to achieve the best possible outcomes. Patients with a solitary lesion ≤2 cm may receive no treatment until eligible for transplantation or locoregional therapy or resection, with imaging every 3 to 6 months to monitor tumor progression. In patients with tumors > 2 cm and ≤5 cm, microwave ablation therapy is used if lesions are discrete and accessible. Conventional transarterial chemoembolization (TACE or drug-eluting bead TACE (DEB-TACE or yttrium-90 microspheres are utilized in multifocal disease. Patients with lesions > 5 cm are candidates for TACE for downstaging the tumor. Sorafenib is typically reserved for unresectable lesions between 2 cm and 5 cm. Frequently, we administer sorafenib continuously and in combination with DEB-TACE. In our experience, sorafenib does not produce effects on the tumor vasculature or blood flow that would impair

  1. 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

  2. Evidences in multidisciplinary management of rectal cancer

    International Nuclear Information System (INIS)

    In the last 10 years, a number of important European randomized published studies investigated the optimal management of rectal cancer. In order to define an evidence-based approach of the clinical practice based, an international consensus conference was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO) and European Society of Therapeutic Radiation Oncology (ESTRO). The aim of this article is to present highlights of multidisciplinary rectal cancer management and to compare the conclusions of the international conference on 'Multidisciplinary Rectal Cancer Treatment: looking for an European Consensus' (EURECA-CC2) with the new National Comprehensive Cancer Network (NCCN) guidelines. (authors)

  3. 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.

  4. The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease: an exploratory study

    OpenAIRE

    Cruickshank, Travis M.; Thompson, Jennifer A.; Domínguez D, Juan F.; Reyes, Alvaro P; Bynevelt, Mike; Georgiou-Karistianis, Nellie; Roger A Barker; Ziman, Mel R

    2015-01-01

    Background There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This explorator...

  5. 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.

  6. 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.

  7. Professional skills in international multidisciplinary teams

    OpenAIRE

    Ponsa Asensio, Pere; Román Jiménez, José Antonio; Arnó Macià, Elisabet; Pérez Soriano, Jaume

    2015-01-01

    The international engineering education programs must guarantee that a graduate possesses the attributes to work effectively within a global environment. It is therefore necessary to establish the competencies required for this effective working within an international context. The International Design Project Semester (IDPS) program integrates technical knowledge and professional engineering skills from a point of view of multidisciplinary and international teams. The preliminary...

  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. International Multidisciplinary Artificial Gravity (IMAG) Project

    Science.gov (United States)

    Laurini, Kathy

    2007-01-01

    This viewgraph presentation reviews the efforts of the International Multidisciplinary Artificial Gravity Project. Specifically it reviews the NASA Exploration Planning Status, NASA Exploration Roadmap, Status of Planning for the Moon, Mars Planning, Reference health maintenance scenario, and The Human Research Program.

  10. An experiment in multidisciplinary digital design

    NARCIS (Netherlands)

    Tuncer, B.; De Ruiter, P.; Mulders, S.

    2008-01-01

    The design and realization of complex buildings requires multidisciplinary design collaboration from early on in the design process. The intensive use of digital design environments in this process demands new knowledge and skills from the involved players including integrating and managing digital

  11. 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…

  12. 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

  13. Do number of days with low back pain and patterns of episodes of pain have similar outcomes in a biopsychosocial prediction model?

    DEFF Research Database (Denmark)

    Lemeunier, N; Leboeuf-Yde, C; Gagey, O; Wedderkopp, N; Kjaer, P

    2016-01-01

    PURPOSES: We used two different methods to classify low back pain (LBP) in the general population (1) to assess the overlapping of individuals within the different subgroups in those two classifications, (2) to explore if the associations between LBP and some selected bio-psychosocial factors are...... classified into two different ways: (1) In relation to the number of days with LBP in the preceding year (0, 1-30, and >30), (2) In relation to the frequency and duration of episodes of LBP (more or less never pain, episodic, and more or less constant pain). Some bio-psychosocial factors, collected with a...... questionnaire at baseline 9 years earlier, were entered into regression models to investigate their associations with the subgroups of the two classifications of LBP and the results compared. RESULTS: The percentage of agreement between categories of the two classification systems was above 68 % (Kappa 0...

  14. 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

  15. 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.

  16. Convergence Estimates for Multidisciplinary Analysis and Optimization

    Science.gov (United States)

    Arian, Eyal

    1997-01-01

    A quantitative analysis of coupling between systems of equations is introduced. This analysis is then applied to problems in multidisciplinary analysis, sensitivity, and optimization. For the sensitivity and optimization problems both multidisciplinary and single discipline feasibility schemes are considered. In all these cases a "convergence factor" is estimated in terms of the Jacobians and Hessians of the system, thus it can also be approximated by existing disciplinary analysis and optimization codes. The convergence factor is identified with the measure for the "coupling" between the disciplines in the system. Applications to algorithm development are discussed. Demonstration of the convergence estimates and numerical results are given for a system composed of two non-linear algebraic equations, and for a system composed of two PDEs modeling aeroelasticity.

  17. The Multidisciplinary Economics of Money Laundering

    OpenAIRE

    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 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 ...

  18. Multidisciplinary Design Optimization of Automotive Structures

    OpenAIRE

    Domeij Bäckryd, Rebecka

    2013-01-01

    Multidisciplinary design optimization (MDO) can be used as an effective tool to improve the design of automotive structures. Large-scale MDO problems typically involve several groups who must work concurrently and autonomously for reasons of efficiency. When performing MDO, a large number of designs need to be rated. Detailed simulation models used to assess automotive design proposals are often computationally expensive to evaluate. A useful MDO process must distribute work to the groups inv...

  19. A MULTIDISCIPLINARY APPROACH TO INTERCULTURAL COMMUNICATION

    OpenAIRE

    Stăncuţa Ramona DIMA-LAZA

    2012-01-01

    The present paper sets forth some ways of handling cultural complexity by approaching a multidisciplinary vision in order to explore cross-cultural communication and its framework. The main focus is on the conceptualization of intercultural competence and the way it occurs in applied linguistics, psychology or management studies. Intercultural communication has often been defined as an interaction between members belonging to various social groups, setting forth the similarities and differenc...

  20. Multidisciplinary teamwork in US primary health care.

    Science.gov (United States)

    Solheim, Karen; McElmurry, Beverly J; Kim, Mi Ja

    2007-08-01

    Primary health care (PHC) is a systems perspective for examining the provision of essential health care for all. A multidisciplinary collaborative approach to health care delivery is associated with effective delivery and care providers' enrichment. Yet data regarding multidisciplinary practice within PHC are limited. The purpose of this exploratory qualitative descriptive study was to better understand team-based PHC practice in the US. Aims included (a) describing nursing faculty involvement in PHC, (b) analyzing ways that multidisciplinary work was enacted, and (c) recommending strategies for multidisciplinary PHC practice. After institutional review board (IRB) protocol approval, data collection occurred by: (a) surveying faculty/staff in a Midwestern nursing college (N=94) about their PHC practice, and (b) interviewing a purposive sample of nursing faculty/staff identified with PHC (n=10) and their health professional collaborators (n=10). Survey results (28% return rate) were summarized, interview notes were transcribed, and a systematic process of content analysis applied. Study findings show team practice is valued because health issues are complex, requiring different types of expertise; and because teams foster comprehensive care and improved resource use. Mission, membership attributes, and leadership influence teamwork. Though PHC is not a common term, nurses and their collaborators readily associated their practice with a PHC ethos. PHC practice requires understanding community complexity and engaging with community, family, and individual viewpoints. Though supports exist for PHC in the US, participants identified discord between their view of population needs and the health care system. The following interpretations arise from this study: PHC does not explicitly frame health care activity in the US, though some practitioners are committed to its ethics; and, teamwork within PHC is associated with better health care and rewarding professional

  1. Multidisciplinary Treatment of Head and Neck Cancer

    OpenAIRE

    Varkey, Prashanth; Liu, Yi-Tien; Tan, Ngian Chye

    2010-01-01

    Head and neck cancer remains a significant cause of morbidity worldwide. Multimodality treatment is often the only way to achieve improved function, quality of life, and survival, calling for a multidisciplinary team approach, particularly in view of the rapid advances being made in various fields. The roles of the head and neck surgeon and reconstructive surgeon are discussed, together with the input afforded by specialists in areas such as diagnostic imaging, radiation therapy, medical onco...

  2. An experiment in multidisciplinary digital design

    OpenAIRE

    Tuncer, B.; de Ruiter, P; Van Mulders, S.

    2008-01-01

    The design and realization of complex buildings requires multidisciplinary design collaboration from early on in the design process. The intensive use of digital design environments in this process demands new knowledge and skills from the involved players including integrating and managing digital design data, developing custom design tools, and utilizing visualization and rapid prototyping techniques. In order to prepare our students for these evolving practices we have developed a multidis...

  3. [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. PMID:20619056

  4. 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

  5. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe;

    2016-01-01

    ) setting as the unit of randomization. Before starting the study, a train-the-trainer course was performed to educate the nutrition coordinators. In addition to the nutrition coordinator, the participants assigned to the intervention group strategy received multidisciplinary nutrition support. Focus was on...... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home......Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters...

  6. 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

  7. 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

  8. 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

  9. Using CamiTK for rapid prototyping of interactive Computer Assisted Medical Intervention applications.

    OpenAIRE

    Promayon, Emmanuel; Fouard, Celine; Bailet, Mathieu; Deram, Aurelien; Fiard, Gaelle; Hungr, Nikolai,; Luboz, Vincent; Payan, Yohan; Sarrazin, Johan; Saubat, Nicolas; Selmi, Sonia Yuki; Voros, Sandrine; Cinquin, Philippe; Troccaz, Jocelyne

    2013-01-01

    International audience Computer Assisted Medical Intervention (CAMI hereafter) is a complex multi-disciplinary field. CAMI research requires the collaboration of experts in several fields as diverse as medicine, computer science, mathematics, instrumentation, signal processing, mechanics, modeling, automatics, optics, etc.

  10. Multidisciplinary design optimization using multiobjective formulation techniques

    Science.gov (United States)

    Chattopadhyay, Aditi; Pagaldipti, Narayanan S.

    1995-01-01

    This report addresses the development of a multidisciplinary optimization procedure using an efficient semi-analytical sensitivity analysis technique and multilevel decomposition for the design of aerospace vehicles. A semi-analytical sensitivity analysis procedure is developed for calculating computational grid sensitivities and aerodynamic design sensitivities. Accuracy and efficiency of the sensitivity analysis procedure is established through comparison of the results with those obtained using a finite difference technique. The developed sensitivity analysis technique are then used within a multidisciplinary optimization procedure for designing aerospace vehicles. The optimization problem, with the integration of aerodynamics and structures, is decomposed into two levels. Optimization is performed for improved aerodynamic performance at the first level and improved structural performance at the second level. Aerodynamic analysis is performed by solving the three-dimensional parabolized Navier Stokes equations. A nonlinear programming technique and an approximate analysis procedure are used for optimization. The proceduredeveloped is applied to design the wing of a high speed aircraft. Results obtained show significant improvements in the aircraft aerodynamic and structural performance when compared to a reference or baseline configuration. The use of the semi-analytical sensitivity technique provides significant computational savings.

  11. 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.

  12. 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.

  13. 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.

  14. Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology.

    Science.gov (United States)

    Ho, Allen L; Erickson-Direnzo, Elizabeth; Pendharkar, Arjun V; Sung, Chih-Kwang; Halpern, Casey H

    2015-06-01

    Tremulous voice is a characteristic feature of a multitude of movement disorders, but when it occurs in individuals diagnosed with essential tremor, it is referred to as essential vocal tremor (EVT). For individuals with EVT, their tremulous voice is associated with significant social embarrassment and in severe cases may result in the discontinuation of employment and hobbies. Management of EVT is extremely difficult, and current behavioral and medical interventions for vocal tremor result in suboptimal outcomes. Deep brain stimulation (DBS) has been proposed as a potential therapeutic avenue for EVT, but few studies can be identified that have systematically examined improvements in EVT following DBS. The authors describe a case of awake bilateral DBS targeting the ventral intermediate nucleus for a patient suffering from severe voice and arm tremor. They also present their comprehensive, multidisciplinary methodology for definitive treatment of EVT via DBS. To the authors' knowledge, this is the first time comprehensive intraoperative voice evaluation has been used to guide microelectrode/stimulator placement, as well as the first time that standard pre- and post-DBS assessments have been conducted, demonstrating the efficacy of this tailored DBS approach. PMID:26030706

  15. 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...

  16. 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...

  17. Mind-Body Interventions to Reduce Risk for Health Disparities Related to Stress and Strength Among African American Women: The Potential of Mindfulness-Based Stress Reduction, Loving-Kindness, and the NTU Therapeutic Framework

    OpenAIRE

    Woods-Giscombé, Cheryl L.; Black, Angela R.

    2010-01-01

    In the current article, the authors examine the potential role of mind-body interventions for preventing or reducing health disparities in a specific group—African American women. The authors first discuss how health disparities affect this group, including empirical evidence regarding the influence of biopsychosocial processes (e.g., psychological stress and social context) on disparate health outcomes. They also detail how African American women's unique stress experiences as a result of di...

  18. 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; Fenger-Grøn, Morten; Moran, Brendan; Laurberg, Søren

    2011-01-01

    . 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 of...... consecutively performed pelvic MRI scans against which the evaluations from the participating centres were compared. Settings: Five imaging centres in West Denmark performing pelvic MRI in rectal cancer, from March 1, to December 31, 2007. Patients: One hundred and eighty patients with newly diagnosed rectal...... 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...

  19. 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 is...... package, e.g. power module, DFR approach meets trade-offs in electrical, thermal and mechanical design of the device. Today, virtual prototyping of power electronic circuits using advanced simulation tools is becoming attractive due to cost/time saving in building potential designs. With simulations, the...... for expensive computation facilities in DFR approach. Therefore, in this thesis focus is placed on the generation of accurate, simple and generic models to study and assess thermal and electrical behavior of power electronic circuits (especially power modules). In this thesis, different power...

  20. 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.

  1. GeoEnvironmental Education Through Multidisciplinary Research

    Science.gov (United States)

    Padilla, I. Y.; Hwang, S.

    2007-12-01

    The growing need to understand environmental and geological processes, their impacts, and solutions in a dynamic world requires a diverse, multidiscipline, and multicultural approach in science and engineering. In the last few years, faculty at the University of Puerto Rico, Mayagüez have engaged in education and training activities aimed at developing a critical mass of students that can address a wide range of geoenvironmental problems through multidisciplinary research. Students of diverse age, gender, culture, and academic disciplines addressing different research questions work together in a common space. Hierarchy assignments use senior students as primary mentors, but foster work at parallel levels that require sharing and developing knowledge and research resources. The activities have resulted in a significant increase in the number of diverse students in science and engineering areas related to the environment.

  2. 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.

  3. Pemphigus vulgaris: a multidisciplinary approach to management.

    Science.gov (United States)

    Vinall, Christopher; Stevens, Lucy; McArdle, Paul

    2013-01-01

    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. PMID:24343801

  4. Challenge: A Multidisciplinary Degree Program in Bioinformatics

    Directory of Open Access Journals (Sweden)

    Mudasser Fraz Wyne

    2006-06-01

    Full Text Available Bioinformatics is a new field that is poorly served by any of the traditional science programs in Biology, Computer science or Biochemistry. Known to be a rapidly evolving discipline, Bioinformatics has emerged from experimental molecular biology and biochemistry as well as from the artificial intelligence, database, pattern recognition, and algorithms disciplines of computer science. While institutions are responding to this increased demand by establishing graduate programs in bioinformatics, entrance barriers for these programs are high, largely due to the significant prerequisite knowledge which is required, both in the fields of biochemistry and computer science. Although many schools currently have or are proposing graduate programs in bioinformatics, few are actually developing new undergraduate programs. In this paper I explore the blend of a multidisciplinary approach, discuss the response of academia and highlight challenges faced by this emerging field.

  5. 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.

  6. Multidisciplinary Modelling Tools for Power Electronic Circuits

    DEFF Research Database (Denmark)

    Bahman, Amir Sajjad

    to this process is to quickly generate compact and simple models describing the electrical and thermal performance of a potential design. Even though, numerical tools based on Finite Element Analysis (FEA) are powerful in studying the physical behavior of power devices, they are time consuming and demand...... is the thermal management of power devices, efficient cooling system design will be aimed in the following. Due to better performance of direct liquid cooling systems compared to forced air cooling systems, they will be utilized to cool down the power module. A design tool is presented with a user friendly......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...

  7. Teamwork: a multidisciplinary pediatric-liaison service.

    Science.gov (United States)

    Froese, A P; Kamin, L E; Levine, C A

    Psychiatrists, psychologists and social workers are often consulted about the same hospitalized patient. Since each may differ in their training, orientation and experience, the opinions expressed by them to the consultee may differ. The authors have described a multidisciplinary liaison team operating within a pediatric teaching hospital. The consultants work as a team in close collaboration with each other and with the psychiatric nurse clinician and an occupational therapist. The team approach has specific advantages. It allows for a concise and unified approach to the emotional and social needs of the patients. It presents a forum for informal consultations and interdisciplinary meetings. In addition, teaching opportunities are many as each discipline learns from the other. PMID:1052083

  8. 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.

  9. 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

  10. A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

    OpenAIRE

    Procter, S.; Brooks, F; Wilson, Patricia M; Crouchman, C.; Kendall, S.

    2015-01-01

    Aim: To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice. Background: The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This pap...

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

    OpenAIRE

    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) consisted of four components (practical training; education, social interaction, counselling and training of problem-solving skills; individual and group goal setting; home-based exercise programme)....

  12. 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

  13. 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…

  14. 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

  15. Maintenance operation by divers on a swimming-pool type reactor (Osiris, CEN Saclay). Technical and medical prevention: an example of multidisciplinary ergonomic step

    International Nuclear Information System (INIS)

    Maintenance works in a swimming-pool reactor was performed by a team of divers. A multidisciplinary ergonomic study had previously defined the working procedure. The ergonomic approach is analysed. The divers' working techniques are described. After work, medical tests showed that previsions were verified and proved the methods as safe. This technique by divers' interventions should open new possibilities in nuclear industry

  16. 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

  17. 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

  18. Enhancing Transparency in Multidisciplinary Expert Communication

    International Nuclear Information System (INIS)

    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 enhancing mutual

  19. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol

    OpenAIRE

    Jay, Kenneth; Petersen, Mikkel Brandt; Sundstrup, Emil; schraefel, m.c.; Jakobsen, Markus D.; Sjøgaard, Gisela; Andersen, Lars L.

    2014-01-01

    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 control and may result in extended periods of time spent in static positions. In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physio...

  20. 78 FR 65675 - Proposed Collection; 60-Day Comment Request; Multidisciplinary Treatment Planning (MTP) Within...

    Science.gov (United States)

    2013-11-01

    ...; Multidisciplinary Treatment Planning (MTP) Within the National Cancer Institute (NCI) Community Cancer Centers... Collection: Multidisciplinary Treatment Planning (MTP) within the NCI Community Cancer Centers Program (NCI... Program (NCCCP) hospitals define, structure, and implement multidisciplinary treatment planning...

  1. Psychopharmacological Treatment and Psychological Interventions in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Emanuele Sinagra

    2012-01-01

    Full Text Available Irritable bowel syndrome (IBS accounts for 25% of gastroenterology output practice, making it one of the most common disorders in this practice. Psychological and social factors may affect the development of this chronic disorder. Furthermore, psychiatric symptoms and psychiatric diseases are highly prevalent in this condition, but the approach to treating these is not always straightforward. As emphasized in the biopsychosocial model of IBS, with regard to the modulatory role of stress-related brain-gut interactions and association of the disease with psychological factors and emotional state, it proves useful to encourage psychopharmacological treatments and psychosocial therapies, both aiming at reducing stress perception. The aim of this paper is to analyze the effectiveness of psychopharmacological treatment and psychological interventions on irritable bowel syndrome.

  2. Joint hypermobility syndrome: problems that require psychological intervention.

    Science.gov (United States)

    Baeza-Velasco, C; Gély-Nargeot, M C; Bulbena Vilarrasa, A; Bravo, J F

    2011-09-01

    Joint hypermobility syndrome (JHS), also known as Ehlers-Danlos III, is an inherited disorder of connective tissue, characterised by an exceptional increase in the joint's mobility and the presence of musculoskeletal and other symptoms. It is a benign syndrome if compared with the other types of Ehlers-Danlos, but it can become disabling particularly because it is a significant source of pain and distress. The purpose of this work is to describe some common problems in JHS that render psychological intervention in their overall management relevant. Chronic pain, associated psychopathological factors such as anxiety, depression and somatosensory amplification, and problems arising from a lack of recognition and knowledge of the syndrome, are frequent among those affected, having a negative impact on their quality of life. We emphasise the relevance of addressing JHS from a biopsychosocial approach. PMID:21373784

  3. 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.

  4. 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.

  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. A Collaborative, Multidisciplinary Environment for Coastal Science

    Science.gov (United States)

    Graves, S. J.; Harper, S.; Maskey, M.; Twilley, R.; McAnally, B.

    2011-12-01

    The Northern Gulf Coastal Hazards Collaboratory (NG-CHC); a collaborative environment for the coastal hazards research community in Louisiana, Mississippi, and Alabama; is being developed to advance the science and engineering of coastal hazards across the tri-state region and address problems of major national importance, including engineering design, coastal system response, and risk management of coastal hazards. NG-CHC aims to accelerate the research process by providing cyberinfrastructure for simulating coastal hazards in a multidisciplinary environment, enhancing the linkages between modeling and observations and allowing researchers to find and share data and information. In addition to serving as a community portal, the extensible environment allows researchers to organize, discover, share and reuse information about data, models, tools and other resources; manage project activities; discuss results with collaborators; view publications, presentations and other documents; and track the history of project activities. The environment also provides an education and outreach area for increasing public knowledge and understanding, with project information, educational tools, and learning modules. Since communication is at the heart of science, these technologies provide researchers with easy mechanisms to share ideas, data, and findings. By enabling the close interaction among scientists and enhancing productivity with tools and services, the collaboration environment frees the researcher from the complexities of sharing and using information, allowing him to concentrate on science. This cyberinfrastructure can be applied in many domains to stimulate knowledge discovery and breakthroughs in a range of fields.

  7. Multidisciplinary Optimization for Aerospace Using Genetic Optimization

    Science.gov (United States)

    Pak, Chan-gi; Hahn, Edward E.; Herrera, Claudia Y.

    2007-01-01

    In support of the ARMD guidelines NASA's Dryden Flight Research Center is developing a multidisciplinary design and optimization tool This tool will leverage existing tools and practices, and allow the easy integration and adoption of new state-of-the-art software. Optimization has made its way into many mainstream applications. For example NASTRAN(TradeMark) has its solution sequence 200 for Design Optimization, and MATLAB(TradeMark) has an Optimization Tool box. Other packages, such as ZAERO(TradeMark) aeroelastic panel code and the CFL3D(TradeMark) Navier-Stokes solver have no built in optimizer. The goal of the tool development is to generate a central executive capable of using disparate software packages ina cross platform network environment so as to quickly perform optimization and design tasks in a cohesive streamlined manner. A provided figure (Figure 1) shows a typical set of tools and their relation to the central executive. Optimization can take place within each individual too, or in a loop between the executive and the tool, or both.

  8. Multidisciplinary modeling and GIS for landscape management

    Energy Technology Data Exchange (ETDEWEB)

    Flamm, R.O.; Turner, M.G.

    1993-12-31

    Ecological dynamics in human-influenced landscapes are strongly affected by the socioeconomic factors that influence land-use decisions. Incorporating these factors into a spatially-explicit landscape-change model requires the integration of multidisciplinary data. We developed a model that simulates the effects of land use on landscape structure in the Little Tennessee River Basin in western North Carolina. This model uses a variety of data, including interpreted remotely-sensed imagery, census and ownership maps, topography, and results from econometric models. Data are integrated by using a geographic information system and translated into a common format, maps. Simulations generate new maps of land cover representing the amount of land-cover change that occurs. With spatially-explicit projections of landscape change, issues such as biodiversity conservation, the importance of specific landscape elements to conservation goals, and long-term landscape integrity can be addressed. In order for management to use the model to address these issues, a computer-based landscape-management decision aid is being developed. This tool integrates the models, associated data bases, and a geographic information system to facilitate the evaluation of land-use decisions and management plans. This system will estimate landscape-level consequences of alternative actions and will serve to focus coordination among different land-owners and land-use interests in managing the regional landscape.

  9. 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.

  10. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT

    OpenAIRE

    Luker, Julie A; Craig, Louise E; Bennett, Leanne; Ellery, Fiona; Langhorne, Peter; Wu, Olivia; Bernhardt, Julie

    2016-01-01

    Background The implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a large Phas...

  11. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT

    OpenAIRE

    Luker, Julie A; Craig, Louise E; Bennett, Leanne; Ellery, Fiona; Langhorne, Peter; Wu, Olivia; Bernhardt, Julie

    2016-01-01

    Background The implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a lar...

  12. A case study on collaboration within multidisciplinary teamwork

    DEFF Research Database (Denmark)

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

    2010-01-01

    . 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 the course is to provide training in transprofessionalism 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...

  13. 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.

  14. 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.

  15. Venous interventions in children.

    Science.gov (United States)

    Kukreja, Kamlesh; Vaidya, Sandeep

    2011-03-01

    Advanced medical treatment options have improved pediatric survival but often require invasive vascular procedures or venous access. These procedures increase the risk for thromboembolism in children, and there has been a corresponding increase in the reported incidence of deep venous thrombosis and postthrombotic syndrome in the pediatric population. Percutaneous venous interventions using catheter-directed therapy (CDT), like mechanical thrombectomy and infusion thrombolysis, have been used much less frequently in children, even though they have shown good results in adults. A multidisciplinary team including pediatric hematology, interventional radiology, and intensive care unit is suggested for management of venous thrombosis in children. Indications and contraindications for CDT in children are similar to adults. Mechanical thrombectomy and infusion thrombolysis are some of the more commonly performed treatments. CDT in children requires adapting to patient size and locally available equipment. Ultrasound guidance for access, "cork" technique, appropriate dosing of tissue plasminogen activator for infusion/pharmacomechanical thrombolysis, and simultaneous administration of heparin, plasminogen (fresh frozen plasma), and deficient coagulation factors are some of the important variations of CDT technique in children. Postprocedure monitoring is very important for successful thrombolysis. Retrievable inferior vena cava filters are increasingly being used in children as well, for prophylaxis against pulmonary embolism (PE) if there is a significant risk of PE with/without contraindications to anticoagulation. PMID:21335289

  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. 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

  18. 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

  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

    International Nuclear Information System (INIS)

    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

  1. Establishing a multidisciplinary academic cosmetic center.

    Science.gov (United States)

    Rao, Venkat K; Schmid, Daniel B; Hanson, Summer E; Bentz, Michael L

    2011-12-01

    The demand for cosmetic services has risen rapidly in recent years, but has slowed down with the current economic downturn. Managed care organizations and Medicare have been steadily reducing their reimbursements for physician services. The payment for reconstructive surgical procedures has been decreasing and is likely to worsen with healthcare reform, and many plastic surgery residency programs are facing fiscal challenges. An adequate volume of patients needing cosmetic services is necessary to recruit and train the best candidates to the residency programs. Self-pay patients will help ensure the fiscal viability of plastic surgery residency programs. Attracting patients to an academic healthcare center will become more difficult in a recession without the appropriate facilities, programs, and pricing strategies. Setting up a modern cosmetic services program at an academic center has some unique challenges, including funding, academic politics, and turf. The authors opened a free-standing academic multidisciplinary center at their medical school 3 years ago. The center is an off-site, 13,000-sq ft facility that includes faculty from plastic surgery, ear, nose, and throat, dermatology, and vascular surgery. In this article, the authors discuss the process of developing and executing a plan for starting an aesthetic services center in an academic setting. The financing of the center and factors in pricing services are discussed. The authors show the impact of the center on their cosmetic surgery patient volumes, resident education, and finances. They expect that their experience will be helpful to other plastic surgery programs at academic medical centers. PMID:22094775

  2. Multidisciplinary design optimization: An emerging new engineering discipline

    Science.gov (United States)

    Sobieszczanski-Sobieski, Jaroslaw

    1993-01-01

    This paper defines the Multidisciplinary Design Optimization (MDO) as a new field of research endeavor and as an aid in the design of engineering systems. It examines the MDO conceptual components in relation to each other and defines their functions.

  3. A Multidisciplinary Model for Undergraduate Education in Rehabilitation

    Science.gov (United States)

    Steger, Joseph M.

    1974-01-01

    An undergraduate program oriented to developing multidisciplinary team competence in members of a variety of rehabilitation specialities is presented as an illustration of how such a model can be implemented. (Author)

  4. Multidisciplinary, Interdisciplinary, and Transdisciplinary Collaboration: Implications for Vocational Psychology

    Science.gov (United States)

    Collin, Audrey

    2009-01-01

    The literature on interdisciplinarity identifies several forms of collaboration: multidisciplinary, transdisciplinary, and interdisciplinary (as bridge building or integration). To assist vocational psychology translate its interdisciplinary discourse into action, this paper uses that literature to identify the benefits, challenges and conditions…

  5. Supporting Multidisciplinary Science wtihin NASA's Discipline Data Systems

    Science.gov (United States)

    Preheim, L. E.

    1993-01-01

    Many current and future NASA and non-NASA missions are focusing on multidisciplinary science. The current paradigm for data identification and effective use by the NASA science community is based on the CODMAC model proposed in 1986.

  6. Multidisciplinary Learning, Another way of Teaching Maths in Engineering

    OpenAIRE

    Vázquez Gallo, María Jesús; Cantón Pire, Alicia; Pérez Gómez, Sonsoles

    2011-01-01

    Multidisciplinary training is widely appreciated in industry and business, and nevertheless usually is not addressed in the early stages of most undergraduate programs. We outline here a multidisciplinary course for undergraduates studying engineering in which mathematics would be the common language, the transverse tool. The goal is motivating students to learn more mathematics and as a result, improve the quality of engineering education. The course would be structured around projects...

  7. Multidisciplinary Therapy of Upper and Lower Jaws Defects

    OpenAIRE

    Bartonova, M.; Dostalova, T.; Racek, J.

    2002-01-01

    The aim of this study was to evaluate the possibility of multidisciplinary therapy of injury and other defects of the upper and lower jaws. The imperfections originate primary (cleft, oligodontia) or secondary (cysts, accidents, tumors, inflammation etc.).The incidence in the Czech Republic is criminal in 28 %, sports in 12 %, and home accidents in 9 %. The cleft genetic register includes at the present time more than 4500 families from Bohemia. The multidisciplinary therapy involves the f...

  8. Research on Multidisciplinary Optimization Design of Bridge Crane

    OpenAIRE

    Tong Yifei; Ye Wei; Yang Zhen; Li Dongbo; Li Xiangdong

    2013-01-01

    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 c...

  9. Incorporation of university graduated nurses into the multidisciplinary team.

    OpenAIRE

    Minařík, Martin

    2009-01-01

    My bachelor thesis {\\clqq}Integration of university-educated nurses into multidisciplinary teams``deals with integration of nurses into working teams where such cooperation takes place. The theoretical part of the thesis refers to the history of nursing, the today´s conditions for this profession, roles played by nurses and relations they have to cope with. The thesis outlines the concepts of team, medical multidisciplinary team and advantages of multidisciplinarity. It also points to potenti...

  10. Multi-disciplinary design optimisation via dashboard portals

    OpenAIRE

    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 will enable the user to understand the communication between the various disciplines involved, as well as being able to explain others parties why certain choices are made and how the design would...

  11. Multidisciplinary and multifaceted outpatient management of patients with osteoarthritis: protocol for a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Kvien Tore

    2010-11-01

    Full Text Available Abstract Background Osteoarthritis (OA is a prevalent joint disorder with a need for efficient and evidence-based management strategies. Objectives The primary purpose of this study is to compare the effects of a multidisciplinary outpatient clinic, including a brief group-based educational programme, with a traditional individual outpatient clinic for patients with hip, knee, hand or generalized OA. A secondary purpose is to investigate the effects of a telephone follow-up call. Methods This is a pragmatic randomised single-blind controlled study with a total of 400 patients with hip, knee, hand or generalized OA between 40 and 80 years referred to an outpatient rheumatology hospital clinic. The randomisation is stratified according to the diagnostic subgroups. The experimental group is exposed to a multidisciplinary and multifaceted intervention, including a 3.5 hour group-based patient education programme about OA in addition to individual consultations with members of a multidisciplinary team. The control intervention is based on regular care with an individual outpatient consultation with a rheumatologist (treatment as usual. Primary outcomes are patient satisfaction measured at 4 months and cost-effectiveness measured at 12 months. Secondary outcomes are pain and global disease activity measured on a numeric rating scales (NRS, generic and disease specific functioning and disability using Short Form-36 (SF-36 health survey, the Western Ontario and McMaster Universities Osteoarthritis Index 3 (WOMAC, the Australian/Canadian Osteoarthritis Hand Index (AUSCAN, and a patient-generated measure of disability (Patient-Specific Functional scale, PSFS. Global perceived effect of change in health status during the study period is also reported. At 4-month follow-up, patients in both groups will be randomly allocated to a 10-minute telephone call or no follow-up ("treatment as usual". After additional 8 months (12-month follow-up the four groups will

  12. 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…

  13. Life Skills Literacy: An Intervention Model to Alleviate Family Poverty

    Science.gov (United States)

    Johnson, Lee N.; Carswell, Andrew T.; Palmer, Lance; Sweaney, Annie L.; Mullis, Rebecca M.; Leonas, Karen K.; Moss, Joan Koonce; Mauldin, Teresa

    2005-01-01

    Life Skills Literacy (LSL) is a multidisciplinary intervention model that helps families living with limited resources (including poverty) achieve sustainable well-being. This model, based on ecological theory and a readiness for change framework, prepares people to learn from the program and teaches necessary life skills. The LSL project…

  14. The PreCardio-study protocol – a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme

    Directory of Open Access Journals (Sweden)

    Jacobs Nele

    2007-09-01

    Full Text Available Abstract Background Cardiovascular diseases (CVD are the leading cause of death and the third cause of disability in Europe. Prevention programmes should include interventions aimed at a reduction of medical risk factors (hypertension, hypercholesterol, hyperglycemia, overweight and obesity as well as behavioural risk factors (sedentary lifestyle, high fat intake and low fruit and vegetable intake, smoking. The aim of this study is to investigate the effects of a multifaceted, multidisciplinary electronic prevention programme on cardiovascular risk factors. Methods/Design In a randomized controlled trial, one group will receive a maximal intervention (= intervention group. The intervention group will be compared to the control group receiving a minimal intervention. An inclusion of 350 patients in total, with a follow-up of 3 years is foreseen. The inclusion criteria are age between 25–65 and insured by the Onderlinge Ziekenkas, insuring for guaranteed income in case of illness for self-employed. The maximal intervention group receives several prevention consultations by their general practitioner (GP using a new type of cardiovascular risk calculator with personalised feedback on behavioural risk factors. These patients receive a follow-up with intensive support of health behaviour change via different methods, i.e. a tailored website and personal advice of a multidisciplinary team (psychologist, physiotherapist and dietician. The aim of this strategy is to reduce cardiovascular risk factors according to the guidelines. The primary outcome measures will be cardiovascular risk factors. The secondary outcome measures are cardiovascular events, quality of life, costs and incremental cost effectiveness ratios. The control group receives prevention consultations using a new type of cardiovascular risk calculator and general feedback. Discussion This trial incorporates interventions by GPs and other health professionals aiming at a reduction of

  15. The unintended consequences of sex education: an ethnography of a development intervention in Latin America

    NARCIS (Netherlands)

    E. Nelson; A. Edmonds; M. Ballesteros; D. Encalada Soto; O. Rodriguez

    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. Physical Rehabilitation Interventions in Nonambulatory People with Multiple Sclerosis: A Systematic Review

    Science.gov (United States)

    Toomey, Elaine; Coote, Susan B.

    2012-01-01

    There is an expanding body of research on exercise intervention for multidisciplinary rehabilitation of people with multiple sclerosis (PwMS). Most of this research focuses on people with mild/moderate MS who are ambulatory. As the costs of care increases with increasing disability, it is important to evaluate the evidence for interventions in…

  17. Multi-Disciplinary Design Optimization Using WAVE

    Science.gov (United States)

    Irwin, Keith

    2000-01-01

    develop an associative control structure (framework) in the UG WAVE environment enabling multi-disciplinary design of turbine propulsion systems. The capabilities of WAVE were evaluated to assess its use as a rapid optimization and productivity tool. This project also identified future WAVE product enhancements that will make the tool still more beneficial for product development.

  18. Multidisciplinary design optimization using genetic algorithms

    Science.gov (United States)

    Unal, Resit

    1994-12-01

    Multidisciplinary design optimization (MDO) is an important step in the conceptual design and evaluation of launch vehicles since it can have a significant impact on performance and life cycle cost. The objective is to search the system design space to determine values of design variables that optimize the performance characteristic subject to system constraints. Gradient-based optimization routines have been used extensively for aerospace design optimization. However, one limitation of gradient based optimizers is their need for gradient information. Therefore, design problems which include discrete variables can not be studied. Such problems are common in launch vehicle design. For example, the number of engines and material choices must be integer values or assume only a few discrete values. In this study, genetic algorithms are investigated as an approach to MDO problems involving discrete variables and discontinuous domains. Optimization by genetic algorithms (GA) uses a search procedure which is fundamentally different from those gradient based methods. Genetic algorithms seek to find good solutions in an efficient and timely manner rather than finding the best solution. GA are designed to mimic evolutionary selection. A population of candidate designs is evaluated at each iteration, and each individual's probability of reproduction (existence in the next generation) depends on its fitness value (related to the value of the objective function). Progress toward the optimum is achieved by the crossover and mutation operations. GA is attractive since it uses only objective function values in the search process, so gradient calculations are avoided. Hence, GA are able to deal with discrete variables. Studies report success in the use of GA for aircraft design optimization studies, trajectory analysis, space structure design and control systems design. In these studies reliable convergence was achieved, but the number of function evaluations was large compared

  19. Multidisciplinary design optimization using genetic algorithms

    Science.gov (United States)

    Unal, Resit

    1994-01-01

    Multidisciplinary design optimization (MDO) is an important step in the conceptual design and evaluation of launch vehicles since it can have a significant impact on performance and life cycle cost. The objective is to search the system design space to determine values of design variables that optimize the performance characteristic subject to system constraints. Gradient-based optimization routines have been used extensively for aerospace design optimization. However, one limitation of gradient based optimizers is their need for gradient information. Therefore, design problems which include discrete variables can not be studied. Such problems are common in launch vehicle design. For example, the number of engines and material choices must be integer values or assume only a few discrete values. In this study, genetic algorithms are investigated as an approach to MDO problems involving discrete variables and discontinuous domains. Optimization by genetic algorithms (GA) uses a search procedure which is fundamentally different from those gradient based methods. Genetic algorithms seek to find good solutions in an efficient and timely manner rather than finding the best solution. GA are designed to mimic evolutionary selection. A population of candidate designs is evaluated at each iteration, and each individual's probability of reproduction (existence in the next generation) depends on its fitness value (related to the value of the objective function). Progress toward the optimum is achieved by the crossover and mutation operations. GA is attractive since it uses only objective function values in the search process, so gradient calculations are avoided. Hence, GA are able to deal with discrete variables. Studies report success in the use of GA for aircraft design optimization studies, trajectory analysis, space structure design and control systems design. In these studies reliable convergence was achieved, but the number of function evaluations was large compared

  20. Eating Disorders and the Family: Liberating families from conflicts over food

    OpenAIRE

    Burstein, Sam; Sananes, Renee

    1991-01-01

    Eating disorders are complex, often chronic, biopsychosocial disorders characterized by a pursuit for control which, in interaction with familial factors, results in disturbed patterns of relating to food and its meaning. Overt and covert resistance to intervention at the family level can reflect family dynamics but can be mitigated by engaging families of adolescents with eating disorders, by using multidisciplinary teams, and by hospitalization.

  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. Lost in persuasion A multidisciplinary approach for developing usable, effective, and reproducible persuasive technology for health promotion

    Directory of Open Access Journals (Sweden)

    Olivier Blanson Henkemans

    2015-08-01

    Full Text Available Despite its acknowledged benefits for health promotion, the full potential of persuasive technology is not (yet reached in regard to usability, effectiveness, and reproducibility. It often lacks an effective combination of technical features and behavior change strategies. This paper presents a multidisciplinary approach, addressing both aspects. It builds on the frameworks of situated Cognitive Engineering and Intervention Mapping. The approach generates building blocks from theory originating from different relevant disciplines; it specifies change objectives and requirements, described in the context of use, for intervention (strategy and interaction (technology; it evaluates process, effect and impact, whereby claims on interaction and intervention are validated. To cope with language barriers between developers from different disciplines, the approach is presented as a guideline, illustrated with a case study. This approach is expected to contribute to a sound design rationale, a broad reach and ongoing use of the technology, and larger results in regard to health promotion.

  3. The Society for Gastrointestinal Intervention. Are We, as an Organization of Disparate Disciplines, Cooperative or Competitive?

    OpenAIRE

    Kozarek, Richard A.

    2010-01-01

    This is the Fourth Annual Meeting of the Society for Gastrointestinal Intervention, a multi-disciplinary group of practitioners committed to a minimally invasive approach to both the diagnosis and treatment of digestive disorders. The key concepts are minimally invasive and multi-disciplinary which can be construed as practicing in parallel with occasional lines of procedural and clinical interaction or inter-disciplinary in which patients are acutely cared for by a team, with treatments tail...

  4. Evolution of Multidisciplinary Translational Teams (MTTs): Insights for Accelerating Translational Innovations.

    Science.gov (United States)

    Wooten, Kevin C; Calhoun, William J; Bhavnani, Suresh; Rose, Robert M; Ameredes, Bill; Brasier, Allan R

    2015-10-01

    There is growing consensus about the factors critical for development and productivity of multidisciplinary teams, but few studies have evaluated their longitudinal changes. We present a longitudinal study of 10 multidisciplinary translational teams (MTTs), based on team process and outcome measures, evaluated before and after 3 years of CTSA collaboration. Using a mixed methods approach, an expert panel of five judges (familiar with the progress of the teams) independently rated team performance based on four process and four outcome measures, and achieved a rating consensus. Although all teams made progress in translational domains, other process and outcome measures were highly variable. The trajectory profiles identified four categories of team performance. Objective bibliometric analysis of CTSA-supported MTTs with positive growth in process scores showed that these teams tended to have enhanced scientific outcomes and published in new scientific domains, indicating the conduct of innovative science. Case exemplars revealed that MTTs that experienced growth in both process and outcome evaluative criteria also experienced greater innovation, defined as publications in different areas of science. Of the eight evaluative criteria, leadership-related behaviors were the most resistant to the interventions introduced. Well-managed MTTs demonstrate objective productivity and facilitate innovation. PMID:25801998

  5. 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. PMID:26010046

  6. 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

  7. An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System

    Directory of Open Access Journals (Sweden)

    Amelia Brunani

    2015-05-01

    Full Text Available Introduction/Objective: 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. Methods: 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. Results: 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. Conclusions: 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.

  8. Can collaboration within multidisciplinary teamwork be explained using Belbin?

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2013-01-01

    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......Traditional collaboration between the architects and engineers, who always have been partners in a building process, is described as difficult. The reason for the malfunction of the collaboration might be lack of insight into other professions, but also the composition of the teams. The present...... case study is performed within a project-oriented course offered for students within the civil engineering - and architectural engineering programme. The task of the course is to plan a high-rise office building in multidisciplinary student teams. The course was held by a multidisciplinary team of...

  9. 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...

  10. '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.

  11. A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital

    DEFF Research Database (Denmark)

    Andersen, Stig Ejdrup; Knudsen, Inge Jenny Dahl

    2013-01-01

    BACKGROUND: 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). METHODS: 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. RESULTS: Though overall antimicrobial consumption remained unaffected...

  12. Efficient Multidisciplinary Analysis Procedure Using Multi-Level Parallelization Approach

    Science.gov (United States)

    Byun, Chansup; Hatay, Ferhat; Farhangnia, Mehrdad; Guruswamy, Guru; VanDalsem, William R. (Technical Monitor)

    1997-01-01

    Multidisciplinary applications are suitable for parallel computing environment by adopting the domain decomposition method. Immediately, a multidisciplinary application can be parallelized by solving each discipline separately. In order to perform coupled multidisciplinary analysis, coupling of each discipline can be accomplished by exchanging boundary data at the interfaces. This is regarded as discipline-level parallelization. Next level could be a "coarse-grain" parallelization of each discipline, which mainly depends on the physical geometry and nature of each discipline. For example, it is almost impossible for structured-grid based computational fluid dynamics codes to do flow analysis of an aircraft by using a single grid because of the complexity of its configuration. Thus, multi-block grid is commonly used to describe the details of complex geometry. Similarly, in structural analysis, the structure is frequently subdivided into substructures. Thus, the computation of each subdomain can be easily parallelized since each subdomain is solved separately independent of other domains. The parallelization is accomplished by solving each subdomain separately on a separate processor and exchanging the boundary conditions at domain interfaces periodically. However, the physical decomposition of the domain introduces explicit boundary conditions at the domain interfaces. This is not desirable for critical areas such as those containing shock waves or flow separations. Thus, a "fine-grain" parallelization is introduced to overcome this problem. The "fine-grain" parallelization is one that solves exactly the same system of equations of a subdomain by using more than one processors without introducing any explicit boundary conditions. An efficient multidisciplinary analysis procedure can be accomplished by successfully combining the above multi-level parallelism. A multidisciplinary analysis code, ENSAERO developed at NASA Ames Research Center is used in this study to

  13. Effects of multidisciplinary Internet-based program on management of heart failure

    Directory of Open Access Journals (Sweden)

    Machiko R Tomita

    2008-12-01

    Full Text Available Machiko R Tomita1, Bin-Min Tsai2, Nadine M Fisher1, Neeraj A Kumar1, Greg Wilding3, Kathy Stanton1, Bruce J Naughton41Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA; 2Department of Occupational Therapy, I-Shou University, Taiwan; 3Department of Biostatistics, University at Buffalo, Buffalo, New York, USA; 4Department of Medicine, University at Buffalo, Buffalo, New York, USAObjectives: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF.Methods: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results: The treatment group had a high (85% adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001, amount of exercise (p = 0.001, and quality of life (p = 0.001, and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001, blood pressure (systolic, p = 0.002; diastolic, p < 0.001, frequency of emergency room visit, and length of hospital stay (both p = 0.001.Conclusions: An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.Keywords: e-health, self-management, Internet, heart failure, older adults, exercise

  14. 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. PMID:25152539

  15. Multidisciplinary analysis and synthesis - Needs and opportunities. [for aerospace design

    Science.gov (United States)

    Tolson, R. H.; Sobieszczanski-Sobieski, J.

    1985-01-01

    A comprehensive evaluation is conducted of structural analysis and synthesis opportunities which emerge through a multidisciplinary design program approach that simultaneously and interactively encompasses, in its determination of a given aircraft design, aerodynamics, structure, structural dynamics, materials, controls, and propulsion. In this way, it becomes possible to rapidly exploit technological advances in order to yield synergistic effects among configurational subsystems. The aircraft type presently considered as recipients of this treatment are commercial transports, high performance military aircraft, rotorcraft, and large space antennas, giving attention to common features among the multidisciplinary design tasks represented.

  16. The result of implementation of multidisciplinary teams in rectal cancer

    DEFF Research Database (Denmark)

    Wille-Jørgensen, Peer; Sparre, Peter; Glenthøj, Anders; Holck, Susanne; Petersen, Lone Nørgaard; Harling, Henrik; Højen, Helle Stub; Bülow, Steffen

    2013-01-01

    Aim:  In 2003 colorectal multidisciplinary teams (MDT) were established in all major Danish hospitals treating colorectal cancer. The aim was to improve the prognosis by a multidisciplinary evaluation and decision about surgical and oncological treatment, based on medical history, clinical...... examination, imaging, histology, and comorbidity.The present study evaluated the effect of the introduction of colorectal MDT on 1.8.2004 in two Danish hospitals. Method:  A retrospective cohort study was conducted comparing the outcome during the last three years before introduction of the MDT with the first...

  17. The unintended consequences of sex education: an ethnography of a development intervention in Latin America

    OpenAIRE

    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-to-teen communication. This paper analyzes the project's efforts to foster such communication and how social actors variously interpreted, responded to, and repurposed the intervention's language...

  18. Defining the Content of an Online Sexual Health Intervention: The MenSS Website

    OpenAIRE

    Webster, R; Gerressu, M; Michie, S; Estcourt, C.; Anderson, J.; Ang, C S; Murray, E; Rait, G.; Stephenson, J; Bailey, J. V.

    2015-01-01

    BACKGROUND: Health promotion and risk reduction are essential components of sexual health care. However, it can be difficult to prioritize these within busy clinical services. Digital interventions may provide a new method for supporting these. OBJECTIVE: The MenSS (Men's Safer Sex) website is an interactive digital intervention developed by a multidisciplinary team, which aims to improve condom use in men who have sex with women (MSW). This paper describes the content of this intervention, a...

  19. The journey from opposition to recovery from eating disorders: multidisciplinary model integrating narrative counseling and motivational interviewing in traditional approaches

    OpenAIRE

    Golan, Moria

    2013-01-01

    Background In the world of today’s of ever-briefer therapies and interventions, people often seem more interested in outcome than process. This paper focuses on the processes used by a multidisciplinary team in the journey from opposition to change to recovery from eating disorders. The approach outlined is most relevant to those with severe and enduring illness. Methods This paper describes a five-phase journey from eating-disorder disability and back to health as it occurs for patients in a...

  20. 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

  1. Interventional procedures for liver tumors: an overview

    International Nuclear Information System (INIS)

    Full text: Liver tumor interventions has a long story starts from the early '70s. The last 15 years show a significant speeding up by increasing the treatment numbers and by uprising of several promising technical solution on the endovascular and the ablative field as well. The interventional radiologist can hardly navigate their own practice by lacking the clear evidences about these new toys. On the other hand our potential target lesions have tremendous variability, by type, by biological behavior and treatment-sensitivity. As a third aspect, the economical and financial limits are more and more important for the communities. The multidisciplinary approach, the combination of different therapeutical options, using them in a well organised, pre-shaped and personalised fashion, seems to be the goal,which can lead us and our patients to the highest effectiveness. The lecture will overview the short history, the present and the possible future of liver tumor interventions from this point of view

  2. Chess robot system : a multi-disciplinary experience in automation

    OpenAIRE

    Gonçalves, José; Lima, José; Leitão, Paulo

    2005-01-01

    This paper describes a chess robot system that allows remote users to play chess, using a six axes anthropomorphic robot to move chess pieces in the chessboard on getting commands from the player and from the application chess engine. This experience allowed applying the concept of 'learning by doing', involving the integration of multi-disciplinary skills and teams.

  3. Philosophizing about Teacher Dissatisfaction: A Multidisciplinary Hermeneutic Approach

    Science.gov (United States)

    Santoro, Doris A.

    2015-01-01

    In this methodological reflection, I describe the multidisciplinary hermeneutic process of philosophizing about teacher dissatisfaction. I discuss how philosophy serves as a starting point for interpretive work based on interviews with former teachers and readings of qualitative and quantitative research on teacher attrition and dissatisfaction.…

  4. Multidisciplinary design optimization - An emerging new engineering discipline

    Science.gov (United States)

    Sobieszczanski-Sobieski, Jaroslaw

    1993-01-01

    A definition of the multidisciplinary design optimization (MDO) is introduced, and functionality and relationship of the MDO conceptual components are examined. The latter include design-oriented analysis, approximation concepts, mathematical system modeling, design space search, an optimization procedure, and a humane interface.

  5. Comment 2: Nurturing multidisciplinary research on the global commons

    International Nuclear Information System (INIS)

    Both an improved understanding of the causes and consequences of global warming as well as the exploration of responses to global warming require the integration of knowledge from a wide variety of disciplines in the natural sciences, social sciences, and humanities. There are a variety of examples of successful multidisciplinary enterprises that have conducted research over an extended period of time

  6. 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…

  7. 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…

  8. 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

  9. 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.

  10. 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

  11. 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

  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. 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

  14. 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

  15. Systems design and engineering : facilitating multidisciplinary development projects

    NARCIS (Netherlands)

    Bonnema, G. Maarten; Veenvliet, Karel Th.; Broenink, Jan 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 st

  16. Ten years of multidisciplinary mental health guidelines in the Netherlands

    NARCIS (Netherlands)

    Franx, G.C.; Niesink, P.; Swinkels, J.; Burgers, J.S.; Wensing, M.J.P.; Grol, R.P.T.M.

    2011-01-01

    Abstract From 1999 until 2009 the National Steering Group for Multidisciplinary Guideline Development in Mental Health led a national guideline programme in the Netherlands. Ten service user and carer groups and 30 professional organizations were involved. Within the programme 13 practice guidelines

  17. Ten years of multidisciplinary mental health guidelines in the Netherlands

    NARCIS (Netherlands)

    G. Franx; P. Niesink; J. Swinkels; J. Burgers; M. Wensing; R. Grol

    2011-01-01

    From 1999 until 2009 the National Steering Group for Multidisciplinary Guideline Development in Mental Health led a national guideline programme in the Netherlands. Ten service user and carer groups and 30 professional organizations were involved. Within the programme 13 practice guidelines and a ra

  18. Expanding the Field: Revisiting Environmental Education Principles through Multidisciplinary Frameworks

    Science.gov (United States)

    Cole, Anna Gahl

    2007-01-01

    In response to calls for discourse that builds on the substantive structure of environmental education in efforts to further the scope of the field, this article reexamines key principles of environmental education through the multidisciplinary lenses of critical pedagogy, the environmental justice movement, and more recent definitions of…

  19. 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. [...

  20. Geometric requirements for multidisciplinary analysis of aerospace-vehicle design

    Science.gov (United States)

    Smith, Robert E.; Kerr, Patirca A.

    1992-01-01

    The geometric requirements for creating surfaces and grids for multidisciplinary analysis and optimization of aerospace-vehicle designs are described. Geometric surface representations are outlined and compared. Directions for future designs are proposed. High-speed civil transport aircraft configurations are targeted to demonstrate the processes.

  1. Hierarchial parallel computer architecture defined by computational multidisciplinary mechanics

    Science.gov (United States)

    Padovan, Joe; Gute, Doug; Johnson, Keith

    1989-01-01

    The goal is to develop an architecture for parallel processors enabling optimal handling of multi-disciplinary computation of fluid-solid simulations employing finite element and difference schemes. The goals, philosphical and modeling directions, static and dynamic poly trees, example problems, interpolative reduction, the impact on solvers are shown in viewgraph form.

  2. Implementing Multidisciplinary and Multi-Zonal Applications Using MPI

    Science.gov (United States)

    Fineberg, Samuel A.

    1995-01-01

    Multidisciplinary and multi-zonal applications are an important class of applications in the area of Computational Aerosciences. In these codes, two or more distinct parallel programs or copies of a single program are utilized to model a single problem. To support such applications, it is common to use a programming model where a program is divided into several single program multiple data stream (SPMD) applications, each of which solves the equations for a single physical discipline or grid zone. These SPMD applications are then bound together to form a single multidisciplinary or multi-zonal program in which the constituent parts communicate via point-to-point message passing routines. Unfortunately, simple message passing models, like Intel's NX library, only allow point-to-point and global communication within a single system-defined partition. This makes implementation of these applications quite difficult, if not impossible. In this report it is shown that the new Message Passing Interface (MPI) standard is a viable portable library for implementing the message passing portion of multidisciplinary applications. Further, with the extension of a portable loader, fully portable multidisciplinary application programs can be developed. Finally, the performance of MPI is compared to that of some native message passing libraries. This comparison shows that MPI can be implemented to deliver performance commensurate with native message libraries.

  3. Multidisciplinary Design Optimization and Analysis of Hydrazine Monopropellant Propulsion System

    OpenAIRE

    Amirhossein Adami; Mahdi Mortazavi; Mehran Nosratollahi; Mohammadreza Taheri; Jalal Sajadi

    2015-01-01

    Monopropellant propulsion systems are widely used especially for low cost attitude control or orbit correction (orbit maintenance). To optimize the total propulsion system, subsystems should be optimized. Chemical decomposition, aerothermodynamics, and structure disciplines demand different optimum condition such as tank pressure, catalyst bed length and diameter, catalyst bed pressure, and nozzle geometry. Subsystem conflicts can be solved by multidisciplinary design optimization (MDO) techn...

  4. A Multidisciplinary Approach to Literacy through Picture Books and Drama

    Science.gov (United States)

    Burke, Anne; Peterson, Shelley Stagg

    2007-01-01

    Anne Burke and Shelley Stagg Peterson argue that "picture books offer a medium for teaching visual and critical literacy across the curriculum." To support this idea, they describe a multidisciplinary unit on World War II that pushes high school students to utilize visual and print literacies to analyze, comprehend, and relate to public events and…

  5. Implementation of the ‘BeweegKuur’ in practice: utilization of care of a lifestyle intervention in the Netherlands.

    NARCIS (Netherlands)

    Barte, J.C.M.; Hendriks, M.R.C.; Rutten, G.; Veenhof, C.; Bemelmans, W.J.E.

    2014-01-01

    This study investigates the delivered care in a multidisciplinary lifestyle intervention by dieticians and physiotherapists compared to the protocol of this intervention. Participants with a body mass index (BMI) between 25 and 40 kgm22 were divided over three different programs depending on their B

  6. Implementation of the 'BeweegKuur' in practice: Utilization of care of a lifestyle intervention in the Netherlands

    NARCIS (Netherlands)

    Barte, J.C.M.; Hendriks, M.R.C.; Rutten, G.M.; Veenhof, C.; Bemelmans, W.J.E.

    2014-01-01

    This study investigates the delivered care in a multidisciplinary lifestyle intervention by dieticians and physiotherapists compared to the protocol of this intervention. Participants with a body mass index (BMI) between 25 and 40 kg m− 2 were divided over three different programs depending on their

  7. 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...

  8. Interventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Fukatsu, Hiroshi [Nagoya Univ. (Japan). School of Medicine

    2002-01-01

    MR guided interventional procedures have become useful clinical tools recently. In this article the authors discuss the usefulness and problems of MR-guided needle biopsy and MR-guided laser induced thermotherapy (LITT) for clinical cases. MR enabled optimal plane monitoring with desired image contrast during the procedure without X-ray irradiation for puncture and tissue sampling. Also only MR could non-invasively provide interstitial temperature information during laser ablation. Bone and soft tissue lesions are likely to be candidates for MR interventions because they are free from any physiological motions, and radiologists should compare MR-guidance with CT- or US guidance for individual cases in order to achieve a less invasive diagnosis or treatment. (author)

  9. Empiricist Interventions

    DEFF Research Database (Denmark)

    Munk, Anders Kristian; Abrahamsson, Sebastian

    2012-01-01

    Recent papers by prominent scholars in science and technology studies (notably JohnLaw and Bruno Latour) have crystallized a fundamental disagreement about the scope and purpose of intervention in actor-network theory or what we here choose to bracket as empirical philosophy. While the precept of...... crafting of an adequate account). A key point here is to challenge the impermeability of such a division and show how the strategic dispute, if to be taken seriously, invariably spills over to swamp the level of tactics. To illustrate this point, we draw upon materials from our recent doctoral research...... projects and to facilitate the discussion we make two deliberate caricatures: Firstly, we operate with a simplifi ed history of actor-network theory in which a strategy of epistemological critique has been replaced by two contending agendas for ontological intervention. Secondly, we address these two...

  10. Fetal cardiac interventions: clinical and experimental research.

    Science.gov (United States)

    Yuan, Shi-Min; Humuruola, Gulimila

    2016-01-01

    Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block. The therapeutic options are advocated as prenatal aortic valvuloplasty, pulmonary valvuloplasty, creation of interatrial communication and fetal cardiac pacing. Experimental research on fetal cardiac intervention involves technical modifications of catheter-based cardiac clinical interventions and open fetal cardiac bypass that cannot be applied in human fetuses for the time being. Clinical fetal cardiac interventions are plausible for midgestation fetuses with the above-mentioned congenital heart defects. The technical success, biventricular outcome and fetal survival are continuously being improved in the conditions of the sophisticated multidisciplinary team, equipment, techniques and postnatal care. Experimental research is laying the foundations and may open new fields for catheter-based clinical techniques. In the present article, the clinical therapeutic options and experimental fetal cardiac interventions are described. PMID:27279868

  11. Corticobasal degeneration: clinical characteristics and multidisciplinary therapeutic approach in 26 patients.

    Science.gov (United States)

    Shehata, Hatem S; Shalaby, Nevin M; Esmail, Eman H; Fahmy, Ebtesam

    2015-09-01

    Corticobasal syndrome (CBS) is a sporadic tauopathy that manifests by a various combination of motor and cognitive deficits, which makes its diagnosis challenging. Treatment of CBS is symptomatic and based on evidence from other similar disorders due to the lack of studies on CBS. The aim of the study was to investigate low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool in CBS. Twenty-six patients with clinically evident CBS according to Cambridge criteria were followed for 12-18 months while receiving low-frequency rTMS combined with pharmacological, rehabilitation treatment and botulinum toxin injection. The majority of patients are manifested with akinetic-rigid syndrome and cognitive dysfunction. There was improvement of the UPDRS and quality of life after 3 months of therapeutic interventions (P < 0.001 and <0.05, respectively). No significant deterioration in cognitive functions was detected over the study period. There was a significant reduction of caregiver burden after 3 months of interventions (P < 0.01); this improvement was maintained up to 18 months. Cognitive dysfunction is a frequent manifestation of CBS. CBS patients can benefit from multidisciplinary therapeutic approach employing low-frequency rTMS. PMID:25917399

  12. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

    International Nuclear Information System (INIS)

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures

  13. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology (United States); Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)

    2016-03-15

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures.

  14. Multidisciplinary Environments: A History of Engineering Framework Development

    Science.gov (United States)

    Padula, Sharon L.; Gillian, Ronnie E.

    2006-01-01

    This paper traces the history of engineering frameworks and their use by Multidisciplinary Design Optimization (MDO) practitioners. The approach is to reference papers that have been presented at one of the ten previous Multidisciplinary Analysis and Optimization (MA&O) conferences. By limiting the search to MA&O papers, the authors can (1) identify the key ideas that led to general purpose MDO frameworks and (2) uncover roadblocks that delayed the development of these ideas. The authors make no attempt to assign credit for revolutionary ideas or to assign blame for missed opportunities. Rather, the goal is to trace the various threads of computer architecture and software framework research and to observe how these threads contributed to the commercial framework products available today.

  15. SEMPATH Ontology: modeling multidisciplinary treatment schemes utilizing semantics.

    Science.gov (United States)

    Alexandrou, Dimitrios Al; Pardalis, Konstantinos V; Bouras, Thanassis D; Karakitsos, Petros; Mentzas, Gregoris N

    2012-03-01

    A dramatic increase of demand for provided treatment quality has occurred during last decades. The main challenge to be confronted, so as to increase treatment quality, is the personalization of treatment, since each patient constitutes a unique case. Healthcare provision encloses a complex environment since healthcare provision organizations are highly multidisciplinary. In this paper, we present the conceptualization of the domain of clinical pathways (CP). The SEMPATH (SEMantic PATHways) Oontology comprises three main parts: 1) the CP part; 2) the business and finance part; and 3) the quality assurance part. Our implementation achieves the conceptualization of the multidisciplinary domain of healthcare provision, in order to be further utilized for the implementation of a Semantic Web Rules (SWRL rules) repository. Finally, SEMPATH Ontology is utilized for the definition of a set of SWRL rules for the human papillomavirus) disease and its treatment scheme. PMID:21768052

  16. Can collaboration within multidisciplinary teamwork be explained using Belbin?

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2013-01-01

    case study is performed within a project-oriented course offered for students within the civil engineering - and architectural engineering programme. The task of the course is to plan a high-rise office building in multidisciplinary student teams. The course was held by a multidisciplinary team of...... by the end of the course, which is the base of this study. The goal of the present work is to study the effect of the completeness of the teams according to Belbin on collaboration. It is measured how collaboration was perceived in general and for the different Belbin roles. Furthermore, the......Traditional collaboration between the architects and engineers, who always have been partners in a building process, is described as difficult. The reason for the malfunction of the collaboration might be lack of insight into other professions, but also the composition of the teams. The present...

  17. 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...

  18. MULTIDISCIPLINARY TEACHING – MSc COURSE ON TEAMWORK AND OPARATION

    DEFF Research Database (Denmark)

    Karlshøj, Jan; Dederichs, Anne

    2011-01-01

    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....

  19. Supporting multidisciplinary science within NASA's discipline data systems

    Science.gov (United States)

    Preheim, Larry E.

    1993-01-01

    Many current and future NASA and non-NASA missions are focusing on multidisciplinary science. The current paradigm for data identification and effective use by the NASA science community is based on the CODMAC model proposed in 1986. As multidisciplinary investigations become more prevalent, many existing systems and the newly developing systems will have to augment the current data identification and access strategies and tools and form alliances with other data systems to provide the broad range of data required. This paper describes the current paradigm, surveys and characterizes, within that paradigm, efforts to develop new access methods and data analysis and visualization tools, identifies additional areas of research not adequately addressed and recommends a further plan of action.

  20. 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...

  1. 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. PMID:26621971

  2. 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.

  3. Multidisciplinary Teaching-Changing Collaboration During Building Design

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2011-01-01

    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....../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 to be found within on specific profession. 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....

  4. 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.

  5. A Multidisciplinary Approach to Creating the Entrepreneurial Mindset Amongst Graduates

    OpenAIRE

    Hamouda, Angela; Ledwith, Colman

    2016-01-01

    The aim of this paper is to investigate how one third level college in Ireland has responded to economic change with the development of a multi-disciplinary entrepreneurship programme and to explore its impact on the development of entrepreneurial mind-sets amongst its current students and graduates. The findings are based on results of surveys from twenty graduates from the programme who have come from a cross section of engineering and science disciplines. Findings of this study indicate th...

  6. Multidisciplinary approach to converting power chair into motorized prone cart

    OpenAIRE

    Steven W. Brose, DO; Eisha Wali, BS

    2015-01-01

    Pressure ulcers remain a major source of morbidity and mortality in veterans with neurologic impairment. Management of pressure ulcers typically involves pressure relief over skin regions containing wounds, but this can lead to loss of mobility and independence when the wounds are located in regions that receive pressure from sitting. An innovative, low-cost, multidisciplinary effort was undertaken to maximize quality of life in a veteran with a thoracic-4 level complete spinal cord injury an...

  7. Towards a theoretical foundation for a multidisciplinary economics

    OpenAIRE

    Keizer, P.

    2007-01-01

    This article analyses the primary motives that set people in motion, namely the economic, the social and the psychic motive. By integrating the three basic analyses, we formulate an integrated paradigm and analysis that can flinction as a theoretical basis for a multidisciplinary economics. Orthodox economics analyses the force that results from the confrontation between humans and their natural environment. In such a situation humans are driven to maximise the utilities they derive from cons...

  8. Occupational Therapy in Multidisciplinary Residency in Family and Community Health

    OpenAIRE

    Luzianne Feijó Alexandre Paiva; Fernanda dos Reis Souza; Kátia Costa Savioli; Josefa Lilian Vieira

    2013-01-01

    In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, ...

  9. 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 cancer management ...

  10. Benefits of multidisciplinary teamwork in the management of breast cancer

    OpenAIRE

    Taylor, Cath

    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...

  11. A Multidisciplinary Engineering Summer School in an Industrial Setting

    DEFF Research Database (Denmark)

    Larsen, Peter Gorm; Fernandes, Joao M.; Habel, Jacek;

    2009-01-01

    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......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...

  12. Multi-level and multidisciplinary optimisation of microelectromechanical systems

    OpenAIRE

    Farnsworth, Michael

    2012-01-01

    A comparative investigation into the role multi-level and multidisciplinary design optimisation can play in the automated design synthesis of microelectromechanical systems (MEMS) is presented. Microelectromechanical systems are a field grown out of the integrated circuit industry, with the goal of developing smart micro devices which can interact with the environment in some form. They promise to revolutionise our present day lifestyles as much as the integrated circuit has do...

  13. Thoracic oncology multidisciplinary teams: Between the promises and challenges

    OpenAIRE

    Jazieh Abdul-Rahman; Al Hadab Abdulrahman; Howington John

    2008-01-01

    The thoracic oncology multidisciplinary teams are playing an increasing role in the management of thoracic malignancies. These teams have a great potential to improve the patient care and the health care system, however, they are faced by many challenges. To realize the full potential of these teams, a better understanding of their functions, roles, benefits and challenges from all involved including teams members and leadership is crucial.

  14. Thoracic oncology multidisciplinary teams: Between the promises and challenges

    Directory of Open Access Journals (Sweden)

    Jazieh Abdul-Rahman

    2008-01-01

    Full Text Available The thoracic oncology multidisciplinary teams are playing an increasing role in the management of thoracic malignancies. These teams have a great potential to improve the patient care and the health care system, however, they are faced by many challenges. To realize the full potential of these teams, a better understanding of their functions, roles, benefits and challenges from all involved including teams members and leadership is crucial.

  15. A Multidisciplinary Artificial Intelligence Model of an Affective Robot

    OpenAIRE

    Hooman Aghaebrahimi Samani; Elham Saadatian

    2012-01-01

    A multidisciplinary approach to a novel artificial intelligence system for an affective robot is presented in this paper. The general objective of the system is to develop a robotic system which strives to achieve a high level of emotional bond between humans and robot by exploring human love. Such a relationship is a contingent process of attraction, affection and attachment from humans towards robots, and the belief of the vice versa from robots to humans. The advanced artificial intelli...

  16. A new relation for multidisciplinary knowledge organization systems: dependence

    OpenAIRE

    Gnoli, Claudio; Bosch, Mela; Mazzocchi, Fulvio

    2007-01-01

    Most existing knowledge organization systems (KOS) are based on disciplines. However, as research is increasingly multidisciplinary, scholars need tools allowing them to explore relations between phenomena throughout the whole spectrum of knowledge. We focus on the dependence relationship, holding between one phenomenon and those at lower integrative levels on which it depends for its existence, like alpinism on mountains, and mountains on rocks. This relationship was first described by D.J. ...

  17. Freight Distribution Systems with Cross Docking: A Multidisciplinary Analysis

    OpenAIRE

    Gonzalez-Feliu, Jesus

    2012-01-01

    Freight transport assures a vital link between suppliers and customers and it represents a major source of employment. Multi-echelon distribution is one of the most common strategies in this field. This paper presents the main concepts of multi-echelon distribution with cross-docking through a multidisciplinary analysis that includes an optimization study and an interview-based analysis. The optimization analysis uses both a geographic approach based on the concept of accessibility and a scen...

  18. Freight distribution systems with cross-docking: a multidisciplinary analysis

    OpenAIRE

    Gonzalez-Feliu, Jesus

    2012-01-01

    Freight transport constitutes one of the main activities that influences economy and society, as it assures a vital link between suppliers and customers and it represents a major source of employment. Multi-echelon distribution is one of the most common strategies adopted by the transport companies in an aim of cost reduction. This paper presents the main concepts of multi-echelon distribution with cross-docks through a multidisciplinary analysis that includes an optimisation study (using bot...

  19. Marketing management within the multinational corporation: a multidisciplinary approach

    OpenAIRE

    VERCAUTEREN, Anne; MATTHYSSENS, Paul; Vanhaverbeke, Wim

    2003-01-01

    This paper presents a multi-disciplinary framework for the study of marketing management within the multinational corporation (MNC). Research domains of MNC management, the role of knowledge within the firm and international marketing is combined. We identify overlaps between the different domains and we clarify how these intersecting areas produce synergetic effects for further investigation of marketing management within the MNC. More specifically, we see potential in the knowledge related...

  20. A multidisciplinary approach to the study of the fluminense vegetation

    OpenAIRE

    KELECOM ALPHONSE; REIS GEISA L.; FEVEREIRO PAULO C.A.; SILVA JANIE G.; SANTOS MARCELO G.; MELLO NETO CÍCERO B.; GONZALEZ MARCELO S.; GOUVEA RITA C.S.; ALMEIDA GILBERTO S.S.

    2002-01-01

    The fluminense vegetation, more specifically the flora from the Jurubatiba restinga has been investigated by a multidisciplinary team of botanists, chemist, radiobiologist, insect physiologists and geneticist. Vouchers of 564 specimens have been collected, identified, organized in an herbarium, and a database is being build up containing, in addition to classical botanical data, chemical data and information on the potential economic use either for landscape gardening, alternative foods or as...

  1. Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly

    Directory of Open Access Journals (Sweden)

    Jaul E

    2014-05-01

    Full Text Available Efraim Jaul Skilled Geriatric Nursing Department, Herzog Memorial Hospital, Affiliated to the Hebrew University Hadassah Medical School, Jerusalem, Israel Abstract: The occurrence of pressure ulcers (PUs is common and poses serious problems for the frail elderly, with implications for functional disability and reduced quality of life. PUs are preventable in a majority of cases. The increase in PU occurrence, however, appears regardless of higher awareness in prevention and improvement through utilization of pressure relieving devices. Multiple changes in the elderly body systems occur over time including aging, multiple chronic conditions, and functional impairment, potentially culminating in the final pathways of geriatric syndrome, unless awareness to the development of PUs is reversible and prevented. The assumption is that the development of PUs is based on multifactorial causes (extrinsic and intrinsic factors; thus, the optimal management for elderly patients requires a comprehensive approach in all medical settings (community, hospital, and at the long term care [LTC] level. Comprehensiveness signifies looking beyond the wounds, assisting the patient through both local (wound and systemic (medical condition treatment, using a strategy of prevention and supporting quality of life. Within the multidisciplinary involvement team approach, each professional discipline contributes its own task in coordination with other disciplines to address PU prevention, assessment, and treatment. The entire medical staff and the multidisciplinary team work together and communicate frequently in order to prevent, halt at an early stage, and provide healing in a timely fashion. Limiting the formation of PUs is facilitated through early identification, treating contributing causes, eliminating all unnecessary medications, instituting supportive interventions which include the family. Understanding the relationship between the formation of PUs and the

  2. Multidisciplinary Team Contributions Within a Dedicated Outpatient Palliative Radiotherapy Clinic: A Prospective Descriptive Study

    International Nuclear Information System (INIS)

    Purpose: Patients with bone metastases may experience pain, fatigue, and decreased mobility. Multiple medications for analgesia are often required, each with attendant side effects. Although palliative-intent radiotherapy (RT) is effective in decreasing pain, additional supportive care interventions may be overlooked. Our objective was to describe the feasibility of multidisciplinary assessment of patients with symptomatic bone metastases attending a dedicated outpatient palliative RT clinic. Methods and Materials: Consecutive patients referred for RT for painful bone metastases were screened for symptoms and needs relevant to their medications, nutritional intake, activities of daily living, and psychosocial and spiritual concerns from January 1 to December 31, 2007. Consultations by appropriate team members and resulting recommendations were collected prospectively. Patients who received RT were contacted by telephone 4 weeks later to assess symptom outcomes. Results: A total of 106 clinic visits by 82 individual patients occurred. As determined by screening form responses, the clinical Pharmacist, Occupational Therapist, Registered Dietician and Social Worker were consulted to provide assessments and recommendations within the time constraints presented by 1-day palliative RT delivery. In addition to pain relief, significant improvements in tiredness, depression, anxiety, drowsiness and overall well-being were reported at 4 weeks. Conclusions: Systematic screening of this population revealed previously unmet needs, addressed in the form of custom verbal and written recommendations. Multidisciplinary assessment is associated with a high number of recommendations and decreased symptom distress. Our findings lend strong support to the routine assessment by multiple supportive care professionals for patients with advanced cancer being considered for palliative RT.

  3. [Present status and future of multi-disciplinary treatment for colorectal cancer].

    Science.gov (United States)

    Cai, Guoxiang; Dai, Weixing; Cai, Sanjun

    2016-06-25

    Multi-disciplinary treatment (MDT) is an effective pattern to implement the standardized and individualized treatment for cancer. Under the pattern of MDT which integrates the surgery, chemotherapy, radiotherapy, interventional therapy, targeted therapy and immune therapy, there has been a landmark progress in the diagnosis and treatment of colorectal cancer. Curative resection followed by adjuvant chemotherapy has been established as a standard treatment for stage III( colon cancer, but it is still controversial about whether patients with stage II( colon cancer should receive adjuvant chemotherapy and which regimen is preferred. Decision making regarding the use of adjuvant therapy for stage II( patients should not only depend upon the clinicopathological features but also individualized discussion between patients and physicians about the biological behavior of the disease, evidence supporting the efficacy, and possible toxicity. Radical operation following neoadjuvant chemoradiotherapy is currently the standard modality for locally advanced rectal cancer, but the strategy of 'Wait and See' is proposed by some researchers for those achieving complete response after chemoradiotherapy, although there is no sufficient supportive data yet. Patients with metastatic colorectal cancer should undergo an upfront evaluation and discussion by a multidisciplinary team before the initial treatment. Achieving a negative surgical margin with adequate remanent liver reserve is the criteria for determining the resectability of liver metastasis. Both adjuvant and neoadjuvant chemotherapy are two alternatives for initially resectable liver metastasis. Concomitant with the progress of medicine, the MDT is moving toward a precise treatment system oriented by genes and being able to predict the prognosis, efficacy and side effects exactly. PMID:27353092

  4. Long-term weight loss maintenance for obesity: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Montesi L

    2016-02-01

    Full Text Available Luca Montesi,1 Marwan El Ghoch,2 Lucia Brodosi,1 Simona Calugi,2 Giulio Marchesini,1 Riccardo Dalle Grave2 1Unit of Metabolic Diseases, S Orsola-Malpighi Hospital, “Alma Mater Studiorum” University, Bologna, Italy; 2Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy Abstract: The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight, a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help, and a few to personality traits (eg, low novelty seeking and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner” as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. Keywords: obesity, lifestyle modification, cognitive behavior therapy, multidisciplinary treatment

  5. A multidisciplinary approach to therapeutic risk management of the suicidal patient

    Directory of Open Access Journals (Sweden)

    Grant CL

    2015-06-01

    Full Text Available Cynthia L Grant,1,2 Jaimie L Lusk3 1Arapahoe/Douglas Mental Health Network, Englewood, CO, 2School of Education and Human Development, University of Colorado Denver, Denver, CO, 3Mental Health Service, VA Portland Health Care System, Portland, OR, USA Abstract: As health care trends toward a system of care approach, providers from various disciplines strive to collaborate to provide optimal care for their patients. While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicidality, standardized clinical guidelines for such an approach do not yet exist. In this article, the authors propose the adoption of the therapeutic risk management of the suicidal patient (TRMSP to improve suicide risk assessment and management within multidisciplinary systems of care. The TRMSP, which has been fully articulated in previous articles, involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. Augmenting clinical risk assessments with reliable and valid structured instruments serves several functions, including ensuring important aspects of suicide are addressed, establishing a baseline for suicidal thoughts and behaviors, facilitating interprofessional communication, and mitigating risk. Similarly, a two-dimensional risk stratification qualifying suicide risk in terms of both severity and temporality can enhance communication across providers and settings and improve understanding of acute crises in the context of chronic risk. Finally, safety planning interventions allow providers and patients to collaboratively create a personally meaningful plan for managing a suicidal crisis that can be continually modified across time with multiple providers in different care settings. In a busy care environment, the TRMSP can provide concrete guidance on conducting clinically and

  6. Quality of education at multidisciplinary case conferences in psychiatry.

    LENUS (Irish Health Repository)

    Naughton, Marie

    2012-02-01

    PURPOSE: A large Dublin-based teaching hospital facilitates a weekly Psychiatric Case Presentation meeting, which is relatively unique in medicine and even in psychiatry, in that there is a large variety of attendees from various multidisciplinary groups: consultant psychiatrists, psychiatric trainees, nurses, psychologists and psychoanalytic psychotherapists, occupational therapists, social workers and pastoral care staff. The aim of this audit is to assess the quality of education for members of different disciplines at these meetings, and to highlight the differing learning needs of the attendees. DESIGN\\/METHODOLOGY\\/APPROACH: Group-structured assessments and Likert scale questionnaires were used to identify what attendees thought were educational and what needed to be improved. FINDINGS: Overall, the case conference is educationally worthwhile but there were several areas of dissatisfaction. Some felt that the case conference was overly medical in its orientation and that there was excessive medical jargon. The seating arrangements were not conducive to group discussion. Consultants and psychiatric trainees felt that the quality of the clinical presentations could be improved. Presentation skills teaching classes and topic-based classes would be useful inclusions. Feedback to the multidisciplinary group on the patients\\' progress and feedback to the patient is important. Changes were implemented in areas of dissatisfaction, and these changes evaluated. ORIGINALITY\\/VALUE: The educational qualities of multidisciplinary Case Conferences need to be constantly evaluated to ensure that the learning needs of the different disciplines who attend are being met.

  7. Multidisciplinary treatment of Wilms' tumour. 13 years' experience

    International Nuclear Information System (INIS)

    The authors describe the results obtained by them personally in their multidisciplinary treatment of Wilms' tumour. In the National Paediatric Institute, Mexico City, 116 cases of Wilms' tumour in children were studied between January 1971 and December 1983. Of these, only 57 were evaluated as only they had completed their multidisciplinary treatment and had been followed up for over two years. Wilms' tumour is the solid abdominal tumour most frequently found in Mexican children. It is the fifth most frequent malign tumour after leukaemia, tumours of the central nervous system, Hodgkin's disease and non-Hodgkin's lymphomas, and retinoblastoma. The multidisciplinary treatment included: radical surgery; radiotherapy (site and dosage by group and by age of the child) and chemotherapy (drugs according to the group and histology of the tumour). In 82% of cases, the tumours occurred before the age of five, predominantly in girls. The average growth time was three months. Where tumour histology was favourable, 78% survived; 45% survived when the histology was adverse. For the various groups, survival was 100% in group I, 83.5% in group II, and 71.5% in group III and 25% in group IV. The survival of all groups was 67% and the actuarial survival was 83%. (author)

  8. 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.

  9. Quality assurance in clinical trials : a multi-disciplinary approach

    International Nuclear Information System (INIS)

    Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  10. Multidisciplinary management of type 2 diabetes in children and adolescents.

    Science.gov (United States)

    Bowen, Michael E; Rothman, Russell L

    2010-01-01

    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. PMID:21197360

  11. 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

  12. Bio-psycho-social model of treatment and rehabilitation of addicts during the conduction of safety measure of obligatory psychiatric treatment in prison hospital Zagreb

    OpenAIRE

    Sušić, Esta; Ničea Gruber, Ema; Guberina Korotaj, Blaženka

    2014-01-01

    Addicts are a specific category of offenders or prisoners. Although some of them are primarily criminalized, the largest number of sentences for drug abuse crimes seem just as direct or indirect consequences of these disorders. Therefore, the application of a special program is needed for the treatment of addicts, lead by multi-disciplinary team of experts and focused on the prevention of future addiction behavior, and therefore criminal relapse. Authors are presenting the bio-psycho-so...

  13. The Learning Curve for a Fetal Cardiac Intervention Team

    OpenAIRE

    Stephen P. Emery; Jacqueline Kreutzer; McCaffrey, Frances M.; Sherman, Fredrick S.; Simhan, Hyagriv N.; Keller, Bradley B.

    2010-01-01

    Objectives. Multiple technical difficulties are encountered when a multidisciplinary team of subspecialists begins a minimally-invasive fetal cardiac interventional program. We describe the learning curve. Study Design. Ten pregnant sheep underwent ultrasound-guided balloon valvuloplasty of the aortic valve. Team members and their roles remained constant through the trial. The time between needle insertion and entrance of the left ventricle at the aortic root was recorded. F-test was used to ...

  14. Pacing: A Concept Analysis of a Chronic Pain Intervention

    OpenAIRE

    Jamieson-Lega, Kathryn; Berry, Robyn; Brown, Cary A.

    2013-01-01

    BACKGROUND: The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers’ ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain manag...

  15. Multidisciplinary approach to the diagnosis and management of patients with peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Walker CM

    2015-07-01

    Full Text Available Craig M Walker,1,2 Frank T Bunch,3 Nick G Cavros,4 Eric J Dippel5 1Cardiovascular Institute of the South, Tulane University School of Medicine, New Orleans, LA, 2Louisiana State University School of Medicine, New Orleans, LA, 3Cardiology Associates, Mobile, AL, 4Cardiovascular Institute of the South, Lafayette General Medical Center, Lafayette, LA, 5Cardiovascular Medicine, PC Genesis Heart Institute, Davenport, IA, USA Abstract: Peripheral arterial disease (PAD is frequently diagnosed after permanent damage has occurred, resulting in a high rate of morbidity, amputation, and loss of life. Early and ongoing diagnosis and treatment is required for this progressive disease. Lifestyle modifications can prevent or delay disease progression and improve symptoms. Limb-sparing endovascular interventions can restore circulation based on appropriate diagnostic testing to pinpoint vascular targets, and intervention must occur as early as possible to ensure optimal clinical outcomes. An algorithm for the diagnosis and management of PAD was developed to enable a collaborative approach between the family practice and primary care physician or internist and various specialists that may include a diabetologist, endocrinologist, smoking cessation expert, hypertension and lipid specialist, endovascular interventionalist, vascular surgeon, orthopedist, neurologist, nurse practitioner, podiatrist, wound healing expert, and/or others. A multidisciplinary team working together has the greatest chance of providing optimal care for the patient with PAD and ensuring ongoing surveillance of the patient’s overall health, ultimately resulting in better quality of life and increased longevity for patients with PAD. Keywords: peripheral arterial disease, diagnosis, endovascular intervention

  16. The EuroGEOSS Brokering Framework for Multidisciplinary Interoperability

    Science.gov (United States)

    Santoro, M.; Nativi, S.; Craglia, M.; Boldrini, E.; Vaccari, L.; Papeschi, F.; Bigagli, L.

    2011-12-01

    The Global Earth Observation System of Systems (GEOSS), envisioned by the group of eight most industrialized countries (G-8) in 2003, provides the indispensable framework to integrate the Earth observation efforts at a global level. The European Commission also contributes to the implementation of the GEOSS through research projects funded from its Framework Programme for Research & Development. The EuroGEOSS (A European Approach to GEOSS) project was launched on May 2009 for a three-year period with the aim of supporting existing Earth Observing systems and applications interoperability and use within the GEOSS and INSPIRE frameworks. EuroGEOSS developed a multidisciplinary interoperability infrastructure for the three strategic areas of Drought, Forestry and Biodiversity; this operating capacity is currently being extended to other scientific domains (i.e. Climate Change, Water, Ocean, Weather, etc.) Central to the multidisciplinary infrastructure is the "EuroGEOSS Brokering Framework", which is based on a Brokered SOA (Service Oriented Architecture) Approach. This approach extends the typical SOA archetype introducing "expert" components: the Brokers. The Brokers provide the mediation and distribution functionalities needed to interconnect the distributed and heterogeneous resources characterizing a System of Systems (SoS) environment. Such a solution addresses significant shortcomings characterizing the present SOA implementations for global frameworks, such as multiple protocols and data models interoperability. Currently, the EuroGEOSS multidisciplinary infrastructure is composed of the following brokering components: 1. The Discovery Broker: providing harmonized discovery functionalities by mediating and distributing user queries against tens of heterogeneous services. 2. The Semantic Discovery Augmentation Component: enhancing the capabilities of the discovery broker with semantic query-expansion. 3. The Data Access Broker: enabling users to seamlessly

  17. The CONECSI trial: results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury.

    Science.gov (United States)

    Heutink, Matagne; Post, Marcel W M; Bongers-Janssen, Helma M H; Dijkstra, Catja A; Snoek, Govert J; Spijkerman, Dorien C M; Lindeman, Eline

    2012-01-01

    Many people with spinal cord injury (SCI) rate chronic neuropathic pain as one of the most difficult problems to manage. The aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain) trial was to evaluate a multidisciplinary cognitive behavioral treatment program for persons with chronic neuropathic pain after SCI. The intervention consisted of educational, cognitive, and behavioral elements. A total of 61 people were randomized to either the intervention group or the waiting list control group in 4 Dutch rehabilitation centers. Primary outcomes were pain intensity and pain-related disability (Chronic Pain Grade questionnaire), and secondary outcomes were mood (Hospital Anxiety and Depression Scale), participation in activities (Utrecht Activities List), and life satisfaction (Life Satisfaction Questionnaire). Measurements were performed at baseline, and at 3, and 6 months follow-up. The primary statistical technique was random coefficient analysis. The analyses showed significant changes over time on both primary (t1-t2), and 2 out of 4 secondary outcomes (both t1-t2 and t1-t3). Significant intervention effects (Time*Group interactions) were found for anxiety and participation in activities, but not for the primary outcomes. Subsequent paired t tests showed significant changes in the intervention group that were not seen in the control group: decrease of pain intensity, pain-related disability, anxiety, and increase of participation in activities. This study implies that a multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic SCI pain. PMID:22100355

  18. Bioenergy options. Multidisciplinary participatory method for assessing bioenergy options for rural villages in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Kauzeni, A.S.; Masao, H.P.; Sawe, E.N.; Shechambo, F.C. [Dar Es Salaam Univ. (Tanzania). Inst. of Resource Assessment; Ellegaard, A. [Stockholm Environment Inst. (Sweden)

    1998-12-31

    In Tanzania, like in many other developing countries in Southern and Eastern Africa, bioenergy planning has received relatively little attention, compared to planning for `modern` energy sources, although it accounts for about 90% of the country`s energy supply. As a result there is less understanding of the complexity and diversity of bioenergy systems. There is a lack of reliable data and information on bio-resources, their consumption and interaction with social, economic, institutional and environmental factors. This is largely due to lack of adequately developed and easily understood methods of data and information development, analysis and methods of evaluating available bioenergy options. In order to address the above constraints a project was initiated where the general objective was to develop and test a multi-disciplinary research method for identifying bioenergy options that can contribute to satisfying the energy needs of the rural household, agricultural and small scale industrial sectors, promote growth and facilitate sustainable development. The decision on the development and testing of a multidisciplinary research method was based on the fact that in Tanzania several bioenergy programmes have been introduced e.g. tree planting, improved cookstoves, biogas, improved charcoal making kilns etc. for various purposes including combating deforestation; promoting economic growth, substitution of imported petroleum fuels, health improvement, and raising standards of living. However efforts made in introducing these programmes or interventions have met with limited success. This situation prevails because developed bioenergy technologies are not being adopted in adequate numbers by the target groups. There are some indications from the study that some of the real barriers to effective bioenergy interventions or adoption of bioenergy technologies lie at the policy level and not at the project level. After the development and testing of the methodology

  19. The development of an intervention to manage pain in people with late-stage osteoarthritis

    Directory of Open Access Journals (Sweden)

    Tina Kruger-Jakins

    2016-02-01

    Full Text Available Background: Osteoarthritis (OA is one of the most common musculoskeletal conditions worldwide, affecting the functional abilities of millions of people. Arthroplasty is recommended as a successful treatment option for late-stage OA. However, in South Africa there are extensive waiting lists for OA-related arthroplasty in government hospitals. This has negative consequences for patients having to cope for long periods of time with chronic pain and its impact. Alternative treatment methods in the form of physiotherapy-led exercise and education programmes focusing on pain, disability, self-efficacy, physical function and health-related quality of life have had good impact in populations elsewhere.Objectives: To develop an exercise and education intervention based on the current literature and by doing a field survey in a South African population.Results: A combined educational approach, with a strong focus on the physical aspects of exercise in particular, was adopted for the intervention in order to improve function and manage the disability associated with OA.Conclusion: This paper reports on the process and development of an intervention for use in South Africans with late-stage OA awaiting arthroplasty.Keywords: Hip/knee osteoarthritis, arthroplasty, joint replacement, bio-psychosocial intervention, waiting list, physiotherapy, exercise, education, chronic pain

  20. Dose to patients and professionals in cardiology interventional: Progress of multicenter group Doccaci

    International Nuclear Information System (INIS)

    The multidisciplinary group and multicenter DOCCACI (dosimetry and quality assurance in interventional cardiology), sponsored by the section of haemodynamics of the Spanish society of Cardiology, is intended to propose reference levels to doses received by patients in interventional cardiology procedures such as recommended by the International Commission on radiological protection It also investigates the doses received by professionals, in particular dose in Crystallyne whose recommended limit dose has been reduced recently from 150 to 20 mSv/year. (Author)

  1. Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review

    OpenAIRE

    Mauri, G; Mattiuz, C; Sconfienza, L.M.; V. Pedicini; D. Poretti; F. Melchiorre; Rossi, U.; F.R. Lutman; M. Montorsi

    2014-01-01

    Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres. A multidisciplinary approach is essential in the management of these events and interventional radiology plays a crucial role in the treatment of patients developing post-surgical complications. This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications a...

  2. A new standard for multidisciplinary health and safety technicians

    International Nuclear Information System (INIS)

    Over the last two decades, a significant trend in health and safety has been toward greater specialization. However, compartmentalization of health and safety disciplines often leads to an inequity in resources, especially when appropriations overemphasize one risk to the detriment of others. For example, overemphasis on radiological safety can create an imbalance in overall worker protection. A multidisciplinary technical can help restore the balance and provide for a healthier and safer work environment. The key advantages of a multidisciplinary health and safety technician include: Broad coverage of the work area by one technician, More diverse use of the technician pool, Better coverage for off-shift or nonstandard hours, Balance of risks because all hazards are considered, Integrated emergency response, Ownership, Less time of identify the correct person with the requisite skills. We have developed a new standard that establishes the training and related qualifications for a multidisciplinary health and safety technician. The areas of training and qualification that are addressed include elements of industrial hygiene, industrial safety, fire protection, electrical safety, construction safety, and radiation safety. The initial core training program ensures that individuals are trained to the performance of requirements of the job. Initial training is in five areas: Fundamentals, Hazard recognition, Hazard assessment, Hazards controls, Hazards minimization. Core training is followed by formal qualification on specific tasks, including ventilation surveys, air monitoring, noise assessments, radiological monitoring, area inspections, work-area setups, and work coverage. The new standard addresses not only training topics and requirements, but also guidance to ensure that performance objectives are met. The standard applies to technicians, supervisors, technologists, and six specialty areas, including academic institutions and decontamination and decommissioning

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

    Directory of Open Access Journals (Sweden)

    Kathy K Li

    2008-11-01

    Full Text Available Kathy K Li, Emily Sinclair, Joan Pope, Macey Farhadian, Kristin Harris, Julie Napolskikh, Albert Yee, Lawrence Librach, Lesia Wynnychuk, Cyril Danjoux, Edward Chow. On behalf of the Bone Metastases Team.Bone Metastases Site Group, Toronto-Sunnybrook Regional Cancer Centre, University of Toronto, Toronto, ON, CanadaAbstract: 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.Keywords: bone metastases, multidisciplinary approach, experience

  4. Case Study: Caregiver Perception of Pediatric Multidisciplinary Feeding Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Thomas F. Fisher PhD, OT, FAOTA

    2014-01-01

    Full Text Available This study explores the perception of satisfaction of caregivers who attended a feeding clinic at a large pediatric hospital in the midwest. The clinic is designed for a multidisciplinary team to meet with the child and the caregiver. Thirty-five participants were involved in the study. Results indicated that most participants were satisfied with the clinic experience. However, there were areas of care not covered by the members of the feeding team, which indicates a need. It is suggested that this need could be filled by occupational therapists.

  5. [Curative treatment for esophageal cancer: results of a multidisciplinary consensus].

    Science.gov (United States)

    Allemann, Pierre; Mantziari, Styliani; Wagner, Dorothea; Digklia, Antonia; Ozsahin, Esat; De Bari, Berardino; Dorta, Gian; Godat, Sébastien; Montserrat, Fraga; Sempoux, Christine; Brunel, Christophe; Demartines, Nicolas; Schäfer, Markus

    2016-06-15

    The management of patients with resectable cancer of the esophagus or gastroesophageal junction is currently not standardized. A multi- disciplinary regional consensus has been developed and is presented in this article. The standard workup includes an upper endoscopy, ultrasonography and a CT-scan. For locally advanced tumors, surgery should be associated with either preoperative radiochemotherapy orperioperative chemotherapy after discussion in multidisciplinary tumor board. Before the operation, smoking and alcohol cessation is imperative and nutritional status should be optimized. Nowadays, surgery is well standardized and generally performed minimally invasive accesses. After surgery, clinical and oncological follow-up is necessary. PMID:27487620

  6. Multidisciplinary teaching – Engineering course in advanced building design

    DEFF Research Database (Denmark)

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

    2011-01-01

    students could experience that collaboration can be improved. The traditional role distribution can be broken and generally a flat team structure, where decisions are made in consensus, can be induced. The transprofessionalism during the course was appreciated but it was also described as a challenge. It......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 the...

  7. Acute Intermittent Porphyria Associated with Respiratory Failure: A Multidisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Mayra Gonçalves Menegueti

    2011-01-01

    Full Text Available Despite being challenging, delivery of effective nursing care to patients with acute intermittent porphyria is a matter of utmost importance. In this paper, the diversity of symptoms and the difficult diagnosis of this condition are emphasized, and details concerning the treatment of this disorder in the intensive care unit are presented. We believe that acute intermittent porphyria should be borne in mind during performance of differential diagnosis of neurological, psychiatric, and gastroenterological disorders on patients whose routine investigation tests are normal, especially when precipitating factors exist. Intensive care measures and a multidisciplinary team approach are essential.

  8. Acute intermittent porphyria associated with respiratory failure: a multidisciplinary approach.

    Science.gov (United States)

    Menegueti, Mayra Gonçalves; Gil Cezar, Alkmim-Teixeira; Casarini, Karin Aparecida; Muniz Cordeiro, Kátia Simone; Basile-Filho, Anibal; Martins-Filho, Olindo Assis; Auxiliadora-Martins, Maria

    2011-01-01

    Despite being challenging, delivery of effective nursing care to patients with acute intermittent porphyria is a matter of utmost importance. In this paper, the diversity of symptoms and the difficult diagnosis of this condition are emphasized, and details concerning the treatment of this disorder in the intensive care unit are presented. We believe that acute intermittent porphyria should be borne in mind during performance of differential diagnosis of neurological, psychiatric, and gastroenterological disorders on patients whose routine investigation tests are normal, especially when precipitating factors exist. Intensive care measures and a multidisciplinary team approach are essential. PMID:21687623

  9. Placenta paraaortic with bladder invasion: A plea for multidisciplinary approach

    International Nuclear Information System (INIS)

    Placenta previa percreta with the urinary bladder invasion is a rare but potentially lethal condition. It has an increasing clinical significance due to its association with previous cesarean sections and uterine curettage. Herein, we report on a patient with placenta percreta and bladder invasion, who presented with hematuria and in whom delivery was delayed to almost full term highlighting the potential catastrophic results and the need for a multidisciplinary approach with the need to involve surgeons who are familiar with vascular and urologic surgery. We also present an elegant MRI of placenta percreta invading the urinary bladder, which shows that MRI is potentially an excellent diagnostic diagnostic modality in this difficult condition. (author)

  10. Integrated Care and the Evolution of the Multidisciplinary Team.

    Science.gov (United States)

    Dobbins, Mary Iftner; Thomas, Sheila A; Melton, Stacy L Stokes; Lee, Stacy

    2016-06-01

    The primary care medical home continues to adapt by applying new research to population health approaches to care. With the discovery that life experiences trigger a chain of biologic events linked to chronic illnesses, the role of patient-centered multidisciplinary care teams becomes of paramount importance. Subsequently, mental health professionals are being incorporated into the primary care setting, using their skills in nontraditional models to customize care for each patient. This "integration" of primary care and unique mental health services engenders opportunity for enhanced clinical care, professional workforce development and support, more effective population health initiatives, and informed health care policy. PMID:27262000

  11. Acute Intermittent Porphyria Associated with Respiratory Failure: A Multidisciplinary Approach

    Science.gov (United States)

    Menegueti, Mayra Gonçalves; Gil Cezar, Alkmim-Teixeira; Casarini, Karin Aparecida; Muniz Cordeiro, Kátia Simone; Basile-Filho, Anibal; Martins-Filho, Olindo Assis; Auxiliadora-Martins, Maria

    2011-01-01

    Despite being challenging, delivery of effective nursing care to patients with acute intermittent porphyria is a matter of utmost importance. In this paper, the diversity of symptoms and the difficult diagnosis of this condition are emphasized, and details concerning the treatment of this disorder in the intensive care unit are presented. We believe that acute intermittent porphyria should be borne in mind during performance of differential diagnosis of neurological, psychiatric, and gastroenterological disorders on patients whose routine investigation tests are normal, especially when precipitating factors exist. Intensive care measures and a multidisciplinary team approach are essential. PMID:21687623

  12. Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    Boot Cécile RL

    2009-12-01

    Full Text Available Abstract Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality

  13. A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

    Directory of Open Access Journals (Sweden)

    Procter S

    2015-04-01

    Full Text Available Susan Procter,1 Fiona Brooks,2 Patricia Wilson,3 Carolyn Crouchman,1 Sally Kendall21Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK; 2Centre for Research in Primary and Community Care (CRIPACC, University of Hertfordshire, Hatfield, UK; 3Centre for Health Services Studies, University of Kent, Canterbury, UKAim: To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice.Background: The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This paper identifies the potential of school nursing to provide the vision and multiagency leadership required to coordinate multidisciplinary collaboration.Method: A mixed-method single-case study design using Yin's approach, including focus groups, interviews, and analysis of policy documents and public health reports.Results: A model that explains the integrated population approach to managing school-age asthma is described; the role of the lead school nurse coordinator was seen as critical to the development and sustainability of the model.Conclusion: School nurses can provide strategic multidisciplinary leadership to address pressing public health issues. Health service managers and commissioners need to understand how to support clinicians working across multiagency boundaries and to identify how to develop leadership skills for collaborative interprofessional practice so that the capacity for nursing and other health care professionals to address public health issues does not rely on individual motivation. In England, this will be of particular importance to the commissioning of public health services by local authorities from

  14. Guideline for interventional recanalizat ion of lower extremity artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwn [Dept. of Radiology, Keimyung University College of Medicine, Daegu (Korea, Republic of); Bae, Jae Ik [Mint Radiologic Clinic, Seongnam (Korea, Republic of); Jeon, Yong Sun [Dept. of Radiology, Inha University College of Medicine, Incheon (Korea, Republic of); Kim, Chang Won [Dept. of Radiology, Pusan National University College of Medicine, Busan (Korea, Republic of); Jae, Hwan Jun [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Kwang Bo [Dept. of Radiology, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Jo, Young Kwon [Dept. of Radiology, Eulji University College of Medicine, Seoul (Korea, Republic of); Kim, Man Deuk [Dept. of Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Peripheral arterial occlusive disease caused by atheroscleorsis can be presented with intermittent claudication or critical limb ischemia. The proper diagnosis and management is warranted to reduce symptoms and salvage the limbs. With the introduction of new technique and dedicated materials, endovascular recanalization has been widely performed for treatment of peripheral arterial occlusive disease because it is lesser invasive than surgery. However, there have been different opinions regarding the appropriate indications and procedure methods for interventional recanalization among operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute for public health care.

  15. [Liver intervention].

    Science.gov (United States)

    Oi, H

    2000-12-01

    Interventional radiology is now widely performed for the treatment of liver tumors, because surgery is sometimes limited by poor liver function. Transcatheter arterial chemoembolization(TACE) is an effective therapy for hepatocellular carcinoma. Lipiodol TACE shows a strong antitumor effect because of the overflow of excess iodized oil into the portal veins, and segmental TACE is recommended to avoid deteriorating liver function. Selective CT arteriography is performed in order to decide on the treatment area, and TACE under CT guidance leads to effective results in terms of dense accumulation of the chemotherapeutic drug in the individual tumors that are affected by the ischemic state and anticancer drugs. Percutaneous microwave or radiofrequency coagulation therapy is adequate for a few of the hypovascular tumors. Excessive coagulation through the needle tract is indispensable in these therapies, and precisely designed puncture is necessary to minimize damage to the liver parenchyma. Selective chemotherapy to the tumor-bearing organ is the first step in a number of liver tumors. Continuous intra-arterial infusion chemotherapy is performed for multiple liver metastases. The reservoir implantation technique is percutaneously achieved via the left subclavian artery under ultrasound guidance, without the exposure of an artery in the incision method, which can induce thrombus formation. PMID:11197832

  16. Integrated Multidisciplinary Constrained Optimization of Offshore Support Structures

    International Nuclear Information System (INIS)

    In the current offshore wind turbine support structure design method, the tower and foundation, which form the support structure are designed separately by the turbine and foundation designer. This method yields a suboptimal design and it results in a heavy, overdesigned and expensive support structure. This paper presents an integrated multidisciplinary approach to design the tower and foundation simultaneously. Aerodynamics, hydrodynamics, structure and soil mechanics are the modeled disciplines to capture the full dynamic behavior of the foundation and tower under different environmental conditions. The objective function to be minimized is the mass of the support structure. The model includes various design constraints: local and global buckling, modal frequencies, and fatigue damage along different stations of the structure. To show the usefulness of the method, an existing SWT-3.6-107 offshore wind turbine where its tower and foundation are designed separately is used as a case study. The result of the integrated multidisciplinary design optimization shows 12.1% reduction in the mass of the support structure, while satisfying all the design constraints

  17. [Psychic changes in systemic lupus erythematosus: a multidisciplinary prospective study].

    Science.gov (United States)

    Miguel Filho, E C; Pereira, R M; Busatto Filho, G; Shavitt, R G; Hirsch, R; de Sá, L C; de Arruda, P C

    1990-01-01

    Despite the high prevalence of psychic symptoms in lupus patients, there are few systematic studies in this area. Through a multidisciplinary approach, the authors developed a prospective study to characterize and correlate psychopathological aspects with clinical and laboratory data concerning neural manifestations of the disease. Out of 23 patients studied, 12 showed psychic alterations, which were interpreted as primary manifestations of the disease. All of them presented organic mental syndromes (DSM-III-R) in which cognitive symptoms were the most prominent, followed by affective, catatonic and hallucinatory features. The neurologic findings (seizure, migraine and muscular atrophy), as well as the ophthalmologic alterations (hemorrhage and soft exudates) were frequent and concomitant with the psychic features. The laboratory findings were: LE cells 50%; anti-Sm: 16%; anti-U1 RNP: 50%; anti-Ro/SS-A: 50%; anti-nDNA: 58%; decreased CH50 or fractions (C3, C4): 67%; anti-P: 18%; antigangliosides IgG: 67%; antigangliosides IgM: 78%. The cerebrospinal fluid analysis showed: increased cellularity: 18%; elevated protein: 36%; antigangliosides IgG: 67%; antigangliosides IgM: 33%; immunocomplexes: 36%. In spite of the absence of an adequate control group and of the small number of patients, the multidisciplinary approach leads to a better characterization of the nervous system involvement in this disease. PMID:1965671

  18. Multifidelity, multidisciplinary optimization of turbomachines with shock interaction

    Science.gov (United States)

    Joly, Michael Marie

    Research on high-speed air-breathing propulsion aims at developing aircraft with antipodal range and space access. Before reaching high speed at high altitude, the flight vehicle needs to accelerate from takeoff to scramjet takeover. Air turbo rocket engines combine turbojet and rocket engine cycles to provide the necessary thrust in the so-called low-speed regime. Challenges related to turbomachinery components are multidisciplinary, since both the high compression ratio compressor and the powering high-pressure turbine operate in the transonic regime in compact environments with strong shock interactions. Besides, lightweight is vital to avoid hindering the scramjet operation. Recent progress in evolutionary computing provides aerospace engineers with robust and efficient optimization algorithms to address concurrent objectives. The present work investigates Multidisciplinary Design Optimization (MDO) of innovative transonic turbomachinery components. Inter-stage aerodynamic shock interaction in turbomachines are known to generate high-cycle fatigue on the rotor blades compromising their structural integrity. A soft-computing strategy is proposed to mitigate the vane downstream distortion, and shown to successfully attenuate the unsteady forcing on the rotor of a high-pressure turbine. Counter-rotation offers promising prospects to reduce the weight of the machine, with fewer stages and increased load per row. An integrated approach based on increasing level of fidelity and aero-structural coupling is then presented and allows achieving a highly loaded compact counter-rotating compressor.

  19. Occupational Therapy in Multidisciplinary Residency in Family and Community Health

    Directory of Open Access Journals (Sweden)

    Luzianne Feijó Alexandre Paiva

    2013-12-01

    Full Text Available In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, is faced with the challenge to build a new field of knowledge. Objective: To analyze the inclusion of occupational therapy in the Family Health Strategy within the scope of Multidisciplinary Residency. Methodology: This is a descriptive study of qualitative approach, which was based on the experience of four occupational therapy resident students, performed through the documental analysis of field diaries, scientific papers, and case studies produced between 2009 and 2011. Results: The occupational therapists as well as the other NASF professionals operated the logic of Matrix Support to the Family Health teams, sharing their knowledge and assisting in resolving complex cases of the families, groups, and communities served. In this context, we found people with different relationships with their doings and a reduced repertoire of activities. The occupational therapists invested in the creation or consolidation of groups in the Family Health Centers and in the territory, which also stood as living and socializing spaces, focusing on prevention and health promotion.

  20. Multidisciplinary management--an opportunity for service integration.

    Science.gov (United States)

    Cameron, M

    1997-01-01

    The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble. PMID:10175172

  1. [Tourette syndrome: from a neurological clinic to a multidisciplinary approach].

    Science.gov (United States)

    Benarroch, Fortu; Warman, Orly; Gross-Tsur, Varda

    2006-04-01

    Tourette Syndrome (TS) is a chronic, familial disorder, characterized by involuntary motor and phonic tics that wax and wane in severity. TS is frequently accompanied by behavioral, emotional and cognitive problems that are often more incapacitating than the tic disorder itself. After a review of the disorder, in which the multidisciplinary aspects are emphasized, the article describes the clinical features of 60 children with TS, 49 boys and 11 girls, aged 13 +/- 3.6 years (mean SD), treated in the Neuropediatric Unit at Shaare Zedek Medical Center. The children described had both motor and vocal tics, but also had ADHD (n = 44), obsessive-compulsive disorder (n = 32), learning disabilities (with 12 children learning in special education frameworks) and behavioral disorders (n = 36). The clinical profile of this group of children with TS is similar to that reported on referred patients regardless of cultural background. Since children with TS manifest multiple comorbidities, optimal therapy mandates the cooperation of a multidisciplinary team including a pediatric neurologist, a child psychiatrist, a psychologist and a family therapist. Working in concert, these specialists can implement a multimodal approach, addressing the neurological and psychiatric aspects of TS as well as enhancing the child's coping skills with the disorder itself and its consequences. PMID:16642633

  2. Nursing role in the multidisciplinary management of motor neurone disease.

    Science.gov (United States)

    Skelton, Jane

    Motor neurone disease (MND) is a debilitating and progressive neurological disorder in which degeneration of the motor neurones results in muscle weakness and wasting. Recent high-profile media coverage about assisted suicide and euthanasia has increased awareness of MND and yet still relatively little is known or understood about it, even among the healthcare profession. This article looks at the key areas in management of patients with MND, including the role of the nurse and the importance of a well-coordinated multidisciplinary team. Ways to deal with communication problems, respiratory dysfunction, feeding and nutrition, and legal and ethical issues are examined. Good management of patients with MND involves a hospital and community-based multidisciplinary team. The essence of care is good symptomatic management of respiratory failure and nutritional problems that result from difficulties in swallowing and increasing dependency. Palliative care should be introduced before the terminal stages after careful discussion with the patient and carers. Most patients with MND die from pulmonary infections or respiratory failure, but contrary to popular belief, death by choking attacks is rare and the final stages of MND are usually peaceful and dignified. PMID:15750484

  3. A relational conceptual framework for multidisciplinary health research centre infrastructure

    Directory of Open Access Journals (Sweden)

    Johnson Joy L

    2010-10-01

    Full Text Available Abstract Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds. Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts. The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning. A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation.

  4. A relational conceptual framework for multidisciplinary health research centre infrastructure.

    Science.gov (United States)

    Coen, Stephanie E; Bottorff, Joan L; Johnson, Joy L; Ratner, Pamela A

    2010-01-01

    Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds.Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts.The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning.A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation. PMID:20925953

  5. Multidisciplinary Aerodynamic-Structural Shape Optimization Using Deformation (MASSOUD)

    Science.gov (United States)

    Samareh, Jamshid A.

    2000-01-01

    This paper presents a multidisciplinary shape parameterization approach. The approach consists of two basic concepts: (1) parameterizing the shape perturbations rather than the geometry itself and (2) performing the shape deformation by means of the soft object animation algorithms used in computer graphics. Because the formulation presented in this paper is independent of grid topology, we can treat computational fluid dynamics and finite element grids in the same manner. The proposed approach is simple, compact, and efficient. Also, the analytical sensitivity derivatives are easily computed for use in a gradient-based optimization. This algorithm is suitable for low-fidelity (e.g., linear aerodynamics and equivalent laminate plate structures) and high-fidelity (e.g., nonlinear computational fluid dynamics and detailed finite element modeling) analysis tools. This paper contains the implementation details of parameterizing for planform, twist, dihedral, thickness, camber, and free-form surface. Results are presented for a multidisciplinary application consisting of nonlinear computational fluid dynamics, detailed computational structural mechanics, and a simple performance module.

  6. Eco-Anthropic Compatibility - a Multidisciplinary Model in Urban Ecology

    Directory of Open Access Journals (Sweden)

    MARIANO L. BIANCA

    2010-01-01

    Full Text Available In this paper I propose a multidisciplinary model of urban development which goes beyond the notion of ecological sustainability, by building on the concept of eco-anthropic compatibility. First of all I will sketch the historical development of human aggregations and I will underline the difference between ancient and modern aggregations. On the basis of this analysis, I will take into consideration the notion of sustainability and its possible application to present conurbations. I will underline several limits of the notion of sustainable development and I will propose a multidisciplinary model grounded on a broader and new notion: the eco-anthropic compatibility. Using this notion, which includes the idea of sustainability, it is possible to handle, within the model, the human factors and human living conditions inside an urban aggregation. Finally, I will state that the actual urban model is decaying and therefore, sooner or later, we will have to face the end of urban civilization; for this reason we can start imagining new future ways for human aggregations on the planet based on the notion of eco-anthropic compatibility.

  7. Multidisciplinary Design Optimization and Analysis of Hydrazine Monopropellant Propulsion System

    Directory of Open Access Journals (Sweden)

    Amirhossein Adami

    2015-01-01

    Full Text Available Monopropellant propulsion systems are widely used especially for low cost attitude control or orbit correction (orbit maintenance. To optimize the total propulsion system, subsystems should be optimized. Chemical decomposition, aerothermodynamics, and structure disciplines demand different optimum condition such as tank pressure, catalyst bed length and diameter, catalyst bed pressure, and nozzle geometry. Subsystem conflicts can be solved by multidisciplinary design optimization (MDO technique with simultaneous optimization of all subsystems with respect to any criteria and limitations. In this paper, monopropellant propulsion system design algorithm is presented and the results of the proposed algorithm are validated. Then, multidisciplinary design optimization of hydrazine propulsion system is proposed. The goal of optimization can be selected as minimizing the total mass (including propellant, minimizing the propellant mass (maximizing the Isp, or minimizing the dry mass. Minimum total mass, minimum propellant mass, and minimum dry mass are derived using MDO technique. It is shown that minimum total mass, minimum dry mass, and minimum propellant mass take place in different conditions. The optimum parameters include bed-loading, inlet pressure, mass flow, nozzle geometry, catalyst bed length and diameter, propellant tank mass, specific impulse (Isp, and feeding mass which are derived using genetic algorithm (GA.

  8. Multidisciplinary Multiobjective Optimal Design for Turbomachinery Using Evolutionary Algorithm

    Science.gov (United States)

    2005-01-01

    This report summarizes Dr. Lian s efforts toward developing a robust and efficient tool for multidisciplinary and multi-objective optimal design for turbomachinery using evolutionary algorithms. This work consisted of two stages. The first stage (from July 2003 to June 2004) Dr. Lian focused on building essential capabilities required for the project. More specifically, Dr. Lian worked on two subjects: an enhanced genetic algorithm (GA) and an integrated optimization system with a GA and a surrogate model. The second stage (from July 2004 to February 2005) Dr. Lian formulated aerodynamic optimization and structural optimization into a multi-objective optimization problem and performed multidisciplinary and multi-objective optimizations on a transonic compressor blade based on the proposed model. Dr. Lian s numerical results showed that the proposed approach can effectively reduce the blade weight and increase the stage pressure ratio in an efficient manner. In addition, the new design was structurally safer than the original design. Five conference papers and three journal papers were published on this topic by Dr. Lian.

  9. COPD Multidisciplinary Team Meetings in the United Kingdom: Health Care Professionals' Perceptions of Aims and Structure.

    Science.gov (United States)

    Kruis, Annemarije L; Soljak, Michael; Chavannes, Niels H; Elkin, Sarah L

    2016-10-01

    Over the last 10 years, community and hospital-based multidisciplinary teams (MDTs) have been set up for the management of patients with chronic obstructive pulmonary disease (COPD) in the UK. Meetings of the MDTs have become a regular occurrence, mostly on healthcare professionals' own initiatives. There are no standardized methods to conduct an MDT meeting, and although cancer MDT meetings are widely implemented, the value and purpose of COPD MDT meetings are less clear. Therefore, the aim of this study was to conduct a cross-sectional descriptive online survey to explore COPD MDT members' perceptions of the purpose and usefulness of MDT meetings, and to identify suggestions or requirements to improve the meetings. In total, we received 68 responses from 10 MDTs; six teams (n = 36 members) were located in London and four (n = 32 members) outside. Analysis of the replies by two independent researchers found that MDT meetings aim to optimise management and improve pathways for respiratory patients by improving communication between providers across settings and disciplines. Education of the MDT members also occurs with the aim of safer practice. Discussed patients are characterised by (multiple) co-morbidities, frequent exacerbations and admissions, social and mental health problems, unclear diagnosis and suboptimal responses to interventions. Members reported participating in a COPD MDT as very useful (74%) or useful (20%). Meetings could be improved by ensuring attendance through requirement in job plans, by clear documentation and sharing of derived plans with a wider audience including general practitioners and patients. PMID:26263193

  10. From management to leadership: a shift towards understanding the organizational complexity of multidisciplinary collaboration

    DEFF Research Database (Denmark)

    Villumsen, Anne Marie Anker; Kristensen, Ole Steen

    2015-01-01

    to explore managerial roles and perspectives during an organizational process of developing multidisciplinary collaboration. Eighteen management meetings, held during a two-year period, are analysed. The analysis reveals that the management gradually grasps the complexity of multidisciplinary...... collaboration; negotiations on the concept are ongoing while their point of view changes from distant to involved. The management takes leadership towards multidisciplinary collaboration through a series of legitimacy-related negotiations, illustrating the organizational and managerial contexts of...

  11. Multidisciplinary teamwork as a crucial competence in modern engineering education programs

    OpenAIRE

    D'hulster, F.; Detand, J.; De Couvreur, L.B.J.; Dewulf, K.R.

    2009-01-01

    The current process of designing and developing new industrial products has become more differentiated and complex. This has resulted in the need for multidisciplinary teams from the initial product development stage. Because engineers are mainly educated in designing typical technical product related aspects, the need for multidisciplinary competences arises. Simulation of real-life industrial innovation cases using multidisciplinary teams must be integrated in engineering education programs...

  12. Web-based interventions for caregivers of cancer patients: A review of literatures

    Directory of Open Access Journals (Sweden)

    Winnie PY Tang

    2014-01-01

    Full Text Available Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to "paediatric", "parent", "caregiver", "cancer", "web-based", and "psycho education". Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

  13. Web-based interventions for caregivers of cancer patients: A review of literatures

    Directory of Open Access Journals (Sweden)

    Winnie PY Tang

    2014-06-01

    Full Text Available Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to "paediatric", "parent", "caregiver", "cancer", "web-based", and "psycho education". Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

  14. Extension of an Object Oriented Multidisciplinary Analysis Optimization (MDAO) Environment Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Multidisciplinary design, analysis, and optimization (MDAO) tools today possess limited disciplines with little fidelity modeling capability. These tools are...

  15. Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2013-10-01

    According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.

  16. Successful management of Barth syndrome: a systematic review highlighting the importance of a flexible and multidisciplinary approach.

    Science.gov (United States)

    Reynolds, Stacey

    2015-01-01

    This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended that a comprehensive care team should include individuals with Barth syndrome, their family members and caregivers, as well as medical, rehabilitative, nutritional, psychological, and educational professionals. The evidence for specific treatments, therapies, and techniques for individuals with Barth syndrome is currently lacking in both quality and quantity. PMID:26251611

  17. Variations in clinical decision-making between cardiologists and cardiac surgeons; a case for management by multidisciplinary teams?

    Directory of Open Access Journals (Sweden)

    Walker A

    2006-03-01

    Full Text Available Abstract Objective To assess variations in decisions to revascularise patients with coronary heart disease between general cardiologists, interventional cardiologists and cardiac surgeons Design Six cases of coronary heart disease were presented at an open meeting in a standard format including clinical details which might influence the decision to revascularise. Clinicians (n = 53 were then asked to vote using an anonymous electronic system for one of 5 treatment options: medical, surgical (CABG, percutaneous coronary intervention (PCI or initially medical proceeding to revascularisation if symptoms dictated. Each case was then discussed in an open forum following which clinicians were asked to revote. Differences in treatment preference were compared by chi squared test and agreement between groups and between voting rounds compared using Kappa. Results Surgeons were more likely to choose surgery as a form of treatment (p = 0.034 while interventional cardiologists were more likely to choose PCI (p = 0.056. There were no significant differences between non-interventional and interventional cardiologists (p = 0.13 in their choice of treatment. There was poor agreement between all clinicians in the first round of voting (Kappa 0.26 but this improved to a moderate level of agreement after open discussion for the second vote (Kappa 0.44. The level of agreement among surgeons (0.15 was less than that for cardiologists (0.34 in Round 1, but was similar in Round 2 (0.45 and 0.45 respectively Conclusion In this case series, there was poor agreement between cardiac clinical specialists in the choice of treatment offered to patients. Open discussion appeared to improve agreement. These results would support the need for decisions to revascularise to be made by a multidisciplinary panel.

  18. Aortoiliac interventions

    International Nuclear Information System (INIS)

    Full text: Atheromatosis is a systemic disease that involves various vascular beds. The most known risk factors are smoking, diabetes mellitus, dyslipedemia, hypertension, advanced age, black gender and male sex. Occlusive aortoiliac disease is due to atheromatosis in the vast majority of cases and is a common distribution of that pathology. Historically aortoiliac occlusions were treated with surgery. Nowadays, the endovascular minimally invasive techniques have revolutionized the treatment of such lesions. The success rate is extremely high with a technical success of 96%. Long term (5 years) patency of the diseased vessel can be as high as 71%. These results combined to the advent of new materials and techniques have set the new standards for treating aortoiliac occlusive disease. The first TASC recommendations (TASC I) were recently revised (TASC II) and the new guidelines (TASC III) will be shortly published. On the other hand endovascular techniques are not always successful. Technical failure (inability to cross the lesion) is estimated to be approximately 5% in single short iliac occlusions and can rise up to 15- 20% in complex long or multiple occlusive lesions. Possible, although not very frequent, complications are dissection, rupture and distal embolization. In the case of total occlusions we can use different materials and techniques. For example in an acute or subacute total occlusion chemical (urokinase or rtPA), mechanical or aspiration thrombolysis can be implemented. These minimally invasive techniques are of the outmost importance if we consider that the majority of the patients are old with a high rate of cardiac and other co-morbidities and therefore cannot go into surgery. That is the reason why the risk of morbidity and mortality following open surgical intervention remains high (5 - 20%). In chronic lesions we can use rentry catheters, glidewires, laser or thrombolysis/thrombectomy (if the clot is not very 'old'). Nevertheless, it should

  19. Biopsychosocial correlates of work motivation

    OpenAIRE

    Liesienė, Justina; Endriulaitienė, Auksė

    2008-01-01

    Background, purpose. Work motivation is a potential predictor of employee turnover, job satisfaction, commitment, job performance and psychological wellbeing. Researchers argue that motivated employees work more effectively. The purpose of the current study was to identify biological (gender, age and health), psychological (personality traits) and social (marital status, children, work sector and position) factors related to employees’ work motivation. It was also predicted that subjectively ...

  20. Challenges in multidisciplinary cancer care among general surgeons in Canada

    Directory of Open Access Journals (Sweden)

    McLeod Robin S

    2008-12-01

    Full Text Available Abstract Background While many factors can influence the way that cancer care is delivered, including the way that evidence is packaged and disseminated, little research has evaluated how health care professionals who manage cancer patients seek and use this information to identify whether and how this could be supported. Through interviews we identified that general surgeons experience challenges in coordinating care for complex cancer patients whose management is not easily addressed by guidelines, and conducted a population-based survey of general surgeon information needs and information seeking practices to extend these findings. Methods General surgeons with privileges at acute care hospitals in Ontario, Canada were mailed a questionnaire to solicit information needs (task, importance, information seeking (source, frequency of and reasons for use, key challenges and suggested solutions. Non-responders received up to three reminder packages. Significant differences among sub-groups (age, setting were examined statistically (Kruskal Wallis, Mann Whitney, Chi Square. Standard qualitative methods were used to thematically analyze open-ended responses. Results The response rate was 44.2% (170/385 representing all 14 health regions. System resource constraints (60.4%, comorbidities (56.4% and physiologic factors (51.8% were top-ranked issues creating information needs. Local surgical colleagues (84.6%, other local colleagues (82.2% and the Internet (81.1% were top-ranked sources of information, primarily due to familiarity and speed of access. No resources were considered to be highly applicable to patient care. Challenges were related to limitations in diagnostics and staging, operative resources, and systems to support multidisciplinary care, together accounting for 76.0% of all reported issues. Findings did not differ significantly by surgeon age or setting of care. Conclusion General surgeons appear to use a wide range of information

  1. Process factors explaining the ineffectiveness of a multidisciplinary fall prevention programme: A process evaluation

    Directory of Open Access Journals (Sweden)

    van Rossum Erik

    2008-09-01

    Full Text Available Abstract Background Falls are a major health threat to older community-living people, and initiatives to prevent falls should be a public health priority. We evaluated a Dutch version of a successful British fall prevention programme. Results of this Dutch study showed no effects on falls or daily functioning. In parallel to the effect evaluation, we carried out a detailed process evaluation to assess the feasibility of our multidisciplinary fall prevention programme. The present study reports on the results of this process evaluation. Methods Our fall prevention programme comprised a medical and occupational-therapy assessment, resulting in recommendations and/or referrals to other services if indicated. We used self-administered questionnaires, structured telephone interviews, structured recording forms, structured face-to-face interviews and a plenary group discussion to collect data from participants allocated to the intervention group (n = 166 and from all practitioners who performed the assessments (n = 8. The following outcomes were assessed: the extent to which the multidisciplinary fall prevention programme was performed according to protocol, the nature of the recommendations and referrals provided to the participants, participants' self-reported compliance and participants' and practitioners' opinions about the programme. Results Both participants and practitioners judged the programme to be feasible. The programme was largely performed according to protocol. The number of referrals and recommendations ensuing from the medical assessment was relatively small. Participants' self-reported compliance as regards contacting their GP to be informed of the recommendations and/or referrals was low to moderate. However, self-reported compliance with such referrals and recommendations was reasonable to good. A large majority of participants reported they had benefited from the programme. Conclusion The results of the present study show that the

  2. Historical earthquakes in Mexico. Past efforts andnew multidisciplinary achievements

    Directory of Open Access Journals (Sweden)

    V. García Acosta

    2004-06-01

    Full Text Available The 1985 Mexican earthquakes demonstrated that knowledge concerning their history was still scarce and precarious.In fact those earthquakes acted as triggers, because it was then when a new field of research began to develop: disaster historical research. An initial task was to retrieve the history of earthquakes in Mexico in order throughout to produce an exhaustive inventory. The main result was a paradigmatic catalogue, published some years ago as the book Los sismos en la historia de México (Earthquakes in Mexican History. It contains information about every event along 450 years of Mexican seismological history. This paper will focus on the background of this seismological compilation and its characteristics, addressing mainly methodological items concerning sources, qualitative and/or quantitative data, the importance of joint and multidisciplinary efforts, and the research they have inspired on historical earthquakes investigation in Mexico.

  3. Epidermolysis Bullosa - Why Does a Multidisciplinary Team Approach Matter?

    Directory of Open Access Journals (Sweden)

    Minhee Kim

    2016-06-01

    Full Text Available Epidermolysis bullosa (EB is a rare inherited group of mechanobullous genodermatoses. It is known to be one of the most devastating chronic conditions due to its frequent and detrimental cutaneous and extracutaneous complications. Current treatment is aimed at optimizing the quality-of-life and effectively managing the EB associated complications. In order to provide the best possible care, clinicians need to recognize and appreciate that different subtypes of EB carry different associated co-morbidities. The complexity of medical care in these patients warrants a regular review by a multidisciplinary team experienced in EB. Optimal collaboration and coordination between professionals in the delivery of integrated care is essential for the provision of high-quality care in patients with EB.

  4. 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...... 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 and they....... 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 the course is to provide training in transprofessionalism and...

  5. Multidisciplinary Management of Mastocytosis: Nordic Expert Group Consensus.

    Science.gov (United States)

    Broesby-Olsen, Sigurd; Dybedal, Ingunn; Gülen, Theo; Kristensen, Thomas K; Møller, Michael B; Ackermann, Leena; Sääf, Maria; Karlsson, Maria A; Agertoft, Lone; Brixen, Kim; Hermann, Pernille; Stylianou, Eva; Mortz, Charlotte G; Torfing, Trine; Havelund, Troels; Sander, Birgitta; Bergström, Anna; Bendix, Marie; Garvey, Lene H; Bjerrum, Ole Weis; Valent, Peter; Bindslev-Jensen, Carsten; Nilsson, Gunnar; Vestergaard, Hanne; Hägglund, Hans

    2016-06-15

    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 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 an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis. PMID:26694951

  6. Multidisciplinary treatment for advanced and recurrent breast cancer including brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Ohno, Tatsuya (Tochigi Cancer Center, Utsunomiya (Japan). Hospital); Takizawa, Yoshikazu; Ikeda, Hiroshi; Egawa, Sunao; Ogino, Takashi

    1994-06-01

    Between 1986 and 1992, 10 patients (12 lesions) of advanced breast cancer were treated with multidisciplinary treatment including brachytherapy. The lesions treated included 5 primary breast tumors, 3 metastatic lesions in the contra lateral breast, 2 recurrences after external beam irradiation, 1 metastasis to the axillary lymph node and 1 metastasis to the upper arm skin. The interstitial irradiation techniques used were [sup 192]Ir low dose-rate irradiation for 5 lesions and high dose-rate for 7 lesions (including 3 with mould irradiation). External hyperthermia as performed for 6 lesions and interstitial hyperthermia were performed for 4 lesions. The local response was CR for 3 lesions, PRa for 8 lesions, PRb for 1 lesion with the local response rate being 100%. Excellent local control could be achieved by combination external and interstitial irradiation, indicating that radiotherapy is definitely useful for the treatment of advanced breast cancer. (author).

  7. Astronomy and development: a multidisciplinary project in the Mexican countryside

    Science.gov (United States)

    Bravo Alfaro, Hector; Caretta, César; Brito, Elcia M. S.

    2015-08-01

    We outline a long term project focused on children and young students living in rural places of the Mexican State of Guanajuato. This multidisciplinary project includes astronomers, environment engineers, biologists and sociologists of Universidad de Guanajuato. One part of the activities are done in situ, at the villages, and other is currently proposed to be held at the Public Astronomical Observatory of Universidad de Guanajuato. Organizing the trips and the activities for scholar groups at the observatory (where telescopes, computers and microscopes are available) would fit very well within several of the IAU-OAD strategies. We expect that, attending the FM20 of the IAU and presenting our results there will help us to develop regionalcollaborations and showing the many opportunities for new possible volunteers.

  8. Repression predicts outcome following multidisciplinary treatment of chronic pain.

    Science.gov (United States)

    Burns, J W

    2000-01-01

    This study examined whether repression predicts outcome following multidisciplinary treatment for chronic pain and whether links between anxiety and outcome are obscured by repressors. Ninety-three chronic pain patients completed a 4-week pain program. Lifting capacity, walking endurance, depression, pain severity, and activity were measured at pre- and posttreatment. Low-anxious, repressor, high-anxious, and defensive/high-anxious groups were formed from median splits of Anxiety Content (ACS) and Lie scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Significant ACS x Lie interactions were found for lifting capacity, depression, and pain severity changes. Planned comparisons showed that both repressors and high-anxious patients performed poorly on lifting capacity; repressors alone recovered poorly on depression and pain severity. Results imply that repression may interfere with the process and outcome of pain programs. PMID:10711590

  9. 2nd International Multidisciplinary Microscopy and Microanalysis Congress

    CERN Document Server

    Oral, Ahmet; Ozer, Mehmet

    2015-01-01

    The 2nd International Multidisciplinary Microscopy and Microanalysis Congress & Exhibition (InterM 2014) was held on 16–19 October 2014 in Oludeniz, Fethiye/ Mugla, Turkey. The aim of the congress was to gather scientists from various branches and discuss the latest improvements in the field of microscopy. The focus of the congress has been widened in an "interdisciplinary" manner, so as to allow all scientists working on several related subjects to participate and present their work. These proceedings include 33 peer-reviewed technical papers, submitted by leading academic and research institutions from over 17 countries and representing some of the most cutting-edge research available. The papers were presented at the congress in the following sessions: ·         Applications of Microscopy in the Physical Sciences ·         Applications of Microscopy in the Biological Sciences.

  10. Need for multidisciplinary research towards a second green revolution.

    Science.gov (United States)

    Wollenweber, Bernd; Porter, John R; Lübberstedt, Thomas

    2005-06-01

    Despite recent achievements in conventional plant breeding and genomics, the rate of increase of crop yields is declining and thus there is a need for a second green revolution. Advances within single disciplines, alone, cannot solve the challenges of increasing yield. As scientific disciplines have become increasingly diversified, a more complete understanding of the mechanisms by which genetic and environmental variation modify grain yield and composition is needed, so that specific quantitative and quality targets can be identified. To achieve this aim, the expertise of plant genomics, physiology and agronomy, as well as recently developed plant modelling techniques, must be combined. There has been recent progress in these individual disciplines, but multidisciplinary approaches must be implemented to tackle drought stress and salinity as major constraints to achieving sufficient grain yield in the future. PMID:15860432

  11. A multidisciplinary approach to the study of the fluminense vegetation

    Directory of Open Access Journals (Sweden)

    KELECOM ALPHONSE

    2002-01-01

    Full Text Available The fluminense vegetation, more specifically the flora from the Jurubatiba restinga has been investigated by a multidisciplinary team of botanists, chemist, radiobiologist, insect physiologists and geneticist. Vouchers of 564 specimens have been collected, identified, organized in an herbarium, and a database is being build up containing, in addition to classical botanical data, chemical data and information on the potential economic use either for landscape gardening, alternative foods or as medicinal plants. Phytochemical studies of the Guttiferae, Clusia hilariana, yielded oleanolic acid and nemorosone. Their biological activities against the haematophagous insect Rhodnius prolixus vector of Chagas disease have been investigated. Finally, it has been observed that aquatic plants possessed high levels of the natural radionuclide polonium-210, which seems to be originated mainly from soil rather than from atmospheric supply.

  12. A Matrix-Free Algorithm for Multidisciplinary Design Optimization

    Science.gov (United States)

    Lambe, Andrew Borean

    Multidisciplinary design optimization (MDO) is an approach to engineering design that exploits the coupling between components or knowledge disciplines in a complex system to improve the final product. In aircraft design, MDO methods can be used to simultaneously design the outer shape of the aircraft and the internal structure, taking into account the complex interaction between the aerodynamic forces and the structural flexibility. Efficient strategies are needed to solve such design optimization problems and guarantee convergence to an optimal design. This work begins with a comprehensive review of MDO problem formulations and solution algorithms. First, a fundamental MDO problem formulation is defined from which other formulations may be obtained through simple transformations. Using these fundamental problem formulations, decomposition methods from the literature are reviewed and classified. All MDO methods are presented in a unified mathematical notation to facilitate greater understanding. In addition, a novel set of diagrams, called extended design structure matrices, are used to simultaneously visualize both data communication and process flow between the many software components of each method. For aerostructural design optimization, modern decomposition-based MDO methods cannot efficiently handle the tight coupling between the aerodynamic and structural states. This fact motivates the exploration of methods that can reduce the computational cost. A particular structure in the direct and adjoint methods for gradient computation. motivates the idea of a matrix-free optimization method. A simple matrix-free optimizer is developed based on the augmented Lagrangian algorithm. This new matrix-free optimizer is tested on two structural optimization problems and one aerostructural optimization problem. The results indicate that the matrix-free optimizer is able to efficiently solve structural and multidisciplinary design problems with thousands of variables and

  13. Predictive factors for the outcome of multidisciplinary treatments in chronic low back pain at the first multidisciplinary pain center of Japan

    OpenAIRE

    Hayashi, Kazuhiro; Arai, Young-Chang P.; Ikemoto, Tatsunori; Nishihara, Makoto; Suzuki, Shigeyuki; Hirakawa, Tomoe; Matsuo, Shingo; Kobayashi, Mami; Haruta, Midori; Kawabata, Yuka; Togo, Hiroki; Noguchi, Taiji; Hase, Toshiyuki; Hatano, Genki; Ushida, Takahiro

    2015-01-01

    [Purpose] Multidisciplinary treatments are recommended for treatment of chronic low back pain. The aim of this study was to show the associations among multidisciplinary treatment outcomes, pretreatment psychological factors, self-reported pain levels, and history of pain in chronic low back pain patients. [Subjects and Methods] A total of 221 chronic low back pain patients were chosen for the study. The pretreatment scores for the 10-cm Visual Analogue Scale, Hospital Anxiety and Depression ...

  14. Effects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study

    OpenAIRE

    Jiao, Fang Fang; Fung, Colman Siu Cheung; Wong, Carlos King Ho; Wan, Yuk Fai; Dai, Daisy; Kwok, Ruby; Lam, Cindy Lo Kuen

    2014-01-01

    Background To assess whether the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) led to improvements in biomedical outcomes, observed cardiovascular events and predicted cardiovascular risks after 12-month intervention in the primary care setting. Methods A random sample of 1,248 people with diabetes enrolled to RAMP-DM for at least 12 months was selected and 1,248 people with diabetes under the usual primary care were matched by age, sex...

  15. Improved performance in activities of daily living and mobility after a multidisciplinary postoperative rehabilitation in older people with femoral neck fracture : a randomized controlled trial with 1-year follow-up.

    OpenAIRE

    Stenvall, Michael; Olofsson, Birgitta; Nyberg, Lars; Lundström, Maria; Gustafson, Yngve

    2007-01-01

    OBJECTIVE: To investigate the short- and long-term effects of a multidisciplinary postoperative rehabilitation programme in patients with femoral neck fracture. DESIGN AND SUBJECTS: A randomized controlled trial in patients (n = 199) with femoral neck fracture, aged >or= 70 years. METHODS: The primary outcomes were: living conditions, walking ability and activities of daily living performance on discharge, 4 and 12 months postoperatively. The intervention consisted of staff education, indi...

  16. Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis.

    Science.gov (United States)

    van Vilsteren, M; Boot, C R L; Voskuyl, A E; Steenbeek, R; van Schaardenburg, D; Anema, J R

    2016-09-01

    Purpose To perform a process evaluation of the implementation of a workplace integrated care intervention for workers with rheumatoid arthritis to maintain and improve work productivity. The intervention consisted of integrated care and a participatory workplace intervention with the aim to make adaptations at the workplace. Methods The implementation of the workplace integrated care intervention was evaluated with the framework of Linnan and Steckler. We used the concepts recruitment, reach, dose delivered, dose received, fidelity and satisfaction with the intervention. Data collection occurred through patient questionnaires and medical records. Results Participants were recruited by sending a letter including a reply card from their own rheumatologist. In total, we invited 1973 patients to participate. We received 1184 reply cards, and of these, 150 patients eventually participated in the study. Integrated care was delivered according to protocol for 46.7 %, while the participatory workplace intervention was delivered for 80.6 %. Dose received was nearly 70 %, which means that participants implemented 70 % of the workplace adaptations proposed during the participatory workplace intervention. The fidelity score for both integrated care and the participatory workplace intervention was sufficient, although communication between members of the multidisciplinary team was limited. Participants were generally satisfied with the intervention. Conclusions This process evaluation shows that our intervention was not entirely implemented as intended. The integrated care was not delivered to enough participants, but for the intervention components that were delivered, the fidelity was good. Communication between members of the multidisciplinary team was limited. However, the participatory workplace intervention was implemented successfully, and participants indicated that they were satisfied with the intervention. PMID:26811171

  17. Developing an adherence support intervention for patients on antiretroviral therapy in the context of the recent IDU-driven HIV/AIDS epidemic in Estonia

    OpenAIRE

    Laisaar, Kaja-Triin; Uusküla, Anneli; Sharma, Anjali; DeHovitz, Jack A.; Amico, K. Rivet

    2013-01-01

    There is limited data on and experience with interventions for antiretroviral therapy (ART) adherence support for patients on ART in Eastern Europe. We sought to identify a feasible adherence support intervention for delivery amongst HIV-positive adults receiving care in Estonia, where the HIV/AIDS epidemic has been mainly concentrated among injection drug users. Our application of intervention mapping strategies used existing literature, formative research and multidisciplinary team input to...

  18. MRI and interventions

    Institute of Scientific and Technical Information of China (English)

    Roberto Blanco Sequeiros

    2002-01-01

    @@ Interventional radiology was started not long after the discovery of X - rays. Interventions started as image guided biopsies and angiographies early this century, later emerged computed tomography (CT) and ultrasound-guided interventions in the 1970s and ultimately the magnetic resonance imaging(MRI) guided interventions at the 1980s.

  19. RFID-Based Multidisciplinary Educational Platform to Improve the Engineering and Technology Curriculums

    Science.gov (United States)

    Yelamarthi, Kumar

    2012-01-01

    Multidisciplinary projects involving electrical engineering (EE), mechanical engineering (ME), and computer engineering (CE) students are both exciting and difficult to conceptualize. Answering this challenge, this paper presents a multidisciplinary educational platform on radio frequency identification-based assistive devices. The combination of…

  20. Predictors of outcome of the treatment programme in a multidisciplinary headache centre

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Zeeberg, Peter; Dehlendorff, Christian;

    2010-01-01

    Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. The objective was to characterise patients and treatment results in a tertiary headache centre.......Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. The objective was to characterise patients and treatment results in a tertiary headache centre....

  1. TOWARD MORE EFFECTIVE INVOLVEMENT OF AGRICULTURAL ECONOMISTS IN MULTIDISCIPLINARY RESEARCH AND EXTENSION PROGRAMS

    OpenAIRE

    Dobbs, Thomas L.

    1987-01-01

    Multidisciplinary research and extension involving agricultural economics and sister agricultural disciplines entail several tensions arising out of differences in perspective and methodology. Recognition of these differences is essential to the achievement of effective and productive working relationships in farming systems and other multidisciplinary research and extension endeavors. Problems and means of addressing differences are covered in this article.

  2. Multidisciplinary teamwork in the treatment and rehabilitation of the head and neck cancer patient.

    Science.gov (United States)

    King, G E; Lemon, J C; Martin, J W

    1992-06-01

    The advantages of multidisciplinary treatment planning of head and neck cancer patients is described. Planning rehabilitation concurrently with curing the malignancy results in the most effective application of treatment modalities coordinated with rehabilitative care. Concentrated multidisciplinary treatment reduces post treatment morbidity by shortening recovery and rehabilitation time. PMID:1631776

  3. Multidisciplinary Optimization of a Transport Aircraft Wing using Particle Swarm Optimization

    Science.gov (United States)

    Sobieszczanski-Sobieski, Jaroslaw; Venter, Gerhard

    2002-01-01

    The purpose of this paper is to demonstrate the application of particle swarm optimization to a realistic multidisciplinary optimization test problem. The paper's new contributions to multidisciplinary optimization is the application of a new algorithm for dealing with the unique challenges associated with multidisciplinary optimization problems, and recommendations as to the utility of the algorithm in future multidisciplinary optimization applications. The selected example is a bi-level optimization problem that demonstrates severe numerical noise and has a combination of continuous and truly discrete design variables. The use of traditional gradient-based optimization algorithms is thus not practical. The numerical results presented indicate that the particle swarm optimization algorithm is able to reliably find the optimum design for the problem presented here. The algorithm is capable of dealing with the unique challenges posed by multidisciplinary optimization as well as the numerical noise and truly discrete variables present in the current example problem.

  4. Radiological intervention in postoperative complications following liver transplantation

    International Nuclear Information System (INIS)

    Purpose: Postoperative complications contribute significantly to the morbidity and mortality of liver transplant patients. The management of these complications requires a multidisciplinary approach in which interventional radiology plays an integral role. Indications, techniques, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent radiological interventions, including angioplasty (n=20), embolization (n=2), percutaneous drainage (n=11), and biliary interventions (n=19). Results: Nine out of ten arterial stenoses located at the anastomoses (n=8), within the liver (n=1) and in the coeliac trunk (n=1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n=5) provided long-term success only in combination with stent implantation. Portal vein stenoses and chronic thrombosis were treated by balloon dilatation and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante- or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is poor. Conclusion: Interventional radiological procedures are very useful in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, and thus, surgical interventions may be avoided in selected cases. (orig.)

  5. GEOWOW: a drought scenario for multidisciplinary data access and use

    Science.gov (United States)

    Santoro, Mattia; Sorichetta, Alessandro; Roglia, Elena; Craglia, Massimo; Nativi, Stefano

    2013-04-01

    Recent enhancements of the GEOSS Common Infrastructure (GCI; http://www.earthobservations.org/gci_gci.shtml), and in particular the introduction of a middleware in the GCI that brokers across heterogeneous information systems, have increased significantly the number of information resources discoverable worldwide. Now the challenge moves to the next level of ensuring access and use of the resources discovered, which have many different and domain-specific data models, communication protocols, encoding formats, etc. The GEOWOW Project - GEOSS interoperability for Weather, Ocean and Water, http://www.geowow.eu - developed a set of multidisciplinary use scenarios to advance the present GCI. This work describes the "Easy discovery and use of GEOSS resources for addressing multidisciplinary challenges related to drought scenarios" showcase demonstrated at the last GEO Plenary in Foz de Iguazu (Brazil). The scientific objectives of this showcase include: prevention and mitigation of water scarcity and drought situations, assessment of the population and geographical area potentially affected, evaluation of the possible distribution of mortality and economic loss risk, and support in building greater capacity to cope with drought. The need to address these challenges calls for producing scientifically robust and consistent information about the extent of land affected by drought and degradation. Similarly, in this context it is important: (i) to address uncertainties about the way in which various biological, physical, social, and economic factors interact each other and influence the occurrence of drought events, and (ii) to develop and test adequate indices and/or combination of them for monitoring and forecasting drought in different geographic locations and at various spatial scales (Brown et al., 2002). The scientific objectives above can be met with an increased interoperability across the multidisciplinary domains relevant to this drought scenario. In particular

  6. [Unhealthy homes: possible interventions and their efficacy].

    Science.gov (United States)

    Charpin, Denis; Ercoli, Jennifer; Griol, Sabine; Mouche, Jean-Marie; Maurel, Gilles; Felipo, Rachel; Dumon, Henri; Max, Garans; Charpin-Kadouch, Carmel

    2007-11-01

    Numerous health risks have been identified in dwellings and are a public health priority. Homes most often accumulate several different risks. Intervention programs must take this reality into account. Identification of a source of chemical pollution in the home makes it possible to correct indoor air quality quickly and inexpensively and provides immediate health benefits. Extermination of mites requires implementation of a group of complementary techniques in all contaminated areas, with help, when possible, from an indoor environment counselor. A team of multidisciplinary indoor habitat and health advisors must assess the health risks of the home. This inexpensive strategy reduces risks, although its effectiveness still requires confirmation. When the building has structural defects or abnormalities, more complex methods of renovation, or even moving, are necessary. There again, a complete assessment of their benefits to occupants' health is necessary. PMID:17433612

  7. Diabetes and Low-Health Literacy: A Preliminary Outcome Report of a Mediated Intervention to Enhance Patient-Physician Communication

    Science.gov (United States)

    Shue, Carolyn K.; O'Hara, Laura L. S.; Marini, David; McKenzie, Jim; Schreiner, Melanie

    2010-01-01

    Patients with diabetes who experience low-health literacy often struggle in their roles as health consumers. A multi-disciplinary group of educators and researchers collaborated to develop a video intervention to help these patients better understand their disease and communicate more effectively with their physician. We describe the assessment…

  8. Expectations and requests regarding team training interventions to promote interdisciplinary collaboration in medical rehabilitation – A qualitative study

    OpenAIRE

    Müller, C.(Dr. Remeis-Sternwarte and ECAP, Universität Erlangen-Nürnberg, Sternwartstr. 7, 96049 , Bamberg, Germany); Plewnia, A.; S. Becker; Rundel, M.; L. Zimmermann; Körner, M.

    2015-01-01

    Background Interdisciplinary teamwork and team interventions are highly valued in the rehabilitation sector because they can improve outcomes of care for persons with complex health problems. However, little is known about expectations and requests regarding team interventions, especially in medical rehabilitation. This study aimed to explore how clinical managers and health professionals within multidisciplinary rehabilitation teams describe their expectations and requests regarding team-tra...

  9. Body composition changes during interventions to treat overweight and obesity in children and adolescents: a descriptive review

    OpenAIRE

    Pilar de Miguel-Etayo; Moreno, Luis A; Iris Iglesia; Silvia Bel-Serrat; Theodora Mouratidou; Garagorri, Jesús M.

    2013-01-01

    Nutrition, physical activity and behavior-modifying techniques are widely applied components of interventions treating obesity. Our aim was to review available information on the short and long term effects of intervention treatment on body fat composition of overweight and obese children and adolescents and, to obtain a further understanding on how different body composition techniques detect longitudinal changes. In total, thirteen papers were included; seven included a multidisciplinary in...

  10. Pan-Britain, mixed-methods study of multidisciplinary teams teaching parents to manage children's long-term kidney conditions at home: Study protocol

    Directory of Open Access Journals (Sweden)

    Swallow Veronica M

    2012-02-01

    Full Text Available Abstract Background Care of children and young people (children with long-term kidney conditions is usually managed by multidisciplinary teams. Published guidance recommends that whenever possible children with long-term conditions remain at home, meaning parents may be responsible for performing the majority of clinical care-giving. Multidisciplinary team members, therefore, spend considerable time promoting parents' learning about care-delivery and monitoring care-giving. However, this parent-educative aspect of clinicians' role is rarely articulated in the literature so little evidence exists to inform professionals' parent-teaching interventions. Methods/Design This ongoing study addresses this issue using a combination of quantitative and qualitative methods involving the twelve children's kidney units in England, Scotland and Wales. Phase I involves a survey of multidisciplinary team members' parent-teaching interventions using: i A telephone-administered questionnaire to determine: the numbers of professionals from different disciplines in each team, the information/skills individual professionals relay to parents and the teaching strategies/interventions they use. Data will be managed using SPSS to produce descriptive statistics ii Digitally-recorded, qualitative group or individual interviews with multidisciplinary team members to explore their accounts of the parent-teaching component of their role. Interviews will be transcribed anonymously and analysed using Framework Technique. Sampling criteria will be derived from analysis to identify one/two unit(s for subsequent in-depth study Phase II involves six prospective, ethnographic case-studies of professional-parent interactions during parent-teaching encounters. Parents of six children with a long-term kidney condition will be purposively sampled according to their child's age, diagnosis, ethnicity and the clinical care-giving required; snowball sampling will identify the

  11. Interventions for treating obesity in children.

    Science.gov (United States)

    De Miguel-Etayo, Pilar; Bueno, Gloria; Garagorri, Jesús M; Moreno, Luis A

    2013-01-01

    Childhood obesity remains an important public health concern and prevention programmes should be the priority in order to decrease the prevalence of obesity. The aim of this review is to summarize the most effective types of intervention for treating obesity in children and adolescents. A number of identified strategies used to treat childhood obesity range from lifestyle approaches, pharmacotherapy to surgical intervention. Dietary treatment of obese children and adolescents should aim to ensure adequate growth and development by reducing excessive fat mass accumulation, avoiding loss of lean body mass, improving well-being and self-esteem, and preventing cyclical weight regain. Management protocols involve behaviour modifications, family support, and lifestyle changes which are difficult to put into practice and may require multidisciplinary professional teams. The cornerstone of weight loss programmes is to achieve a negative energy balance. There is evidence that dietary interventions are more effective in achieving weight loss when combined with other strategies, such as increasing physical activity levels and/or psychological interventions to promote behavioural changes. Psychological interventions have been employed in an effort to achieve long-term maintenance of behavioural change. Childhood obesity treatments should involve a combination of lifestyle changes including strategies to reduce energy intake, increase physical activity, reduce sedentary activities, facilitate family involvement and change behaviours associated with eating and physical activity. However, drug therapy in obese children must not be used as isolated treatment but as complementary to the traditional treatments of diet, physical activity and lifestyle changes. Besides, surgical procedures have been used to treat severe morbid obesity in children and adolescents when more conservative treatments have proven to be inadequate. PMID:24029793

  12. Benefits of multidisciplinary teamwork in the management of breast cancer

    Directory of Open Access Journals (Sweden)

    Taylor C

    2013-08-01

    Full Text Available 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 cancer management has in part evolved due to the increasing complexity of diagnostic and treatment decision-making. An MDT approach aims to bring together the range of specialists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled trial evidence of their effectiveness. Clinical consensus is generally favorable on the benefits of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment from a specialist center, and evidence continues to accrue from comparative studies of clinical benefits of an MDT approach, including improved survival. Patients’ views of the MDT model of decision-making (and in particular its impact on involvement in decisions about their care have been under-researched. Barriers to effective teamwork and poor decision-making include excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been associated with improved patient experience and quality of life. This paper examines the evidence for the benefits of MDT-work, in particular for breast cancer. Evidence is considered within a context of growing cancer incidence at a time of increased financial restraint, and it may now be important to

  13. Isolated inhalational injury: Clinical course and outcomes in a multidisciplinary intensive care unit

    Directory of Open Access Journals (Sweden)

    Jose Chacko

    2012-01-01

    Full Text Available Background and Aims: Although smoke inhalation is well known to cause acute lung injury, there are few reports in literature that study the evolution, clinical course and outcomes of isolated inhalational lung injury in a modern intensive care setting. A major fire disaster provided us the opportunity to study victims of isolated inhalational injury admitted to our Multidisciplinary Intensive Care Unit (MICU. Materials and Methods: We studied the clinical course, ICU and hospital outcomes of 13 victims of a fire disaster who required mechanical ventilation for isolated inhalational lung injury. All patients were followed up at regular intervals, and their functional status was assessed at 8 months after hospital discharge. Results: The Lung Injury Scores (LIS worsened to reach a nadir on Day 3 of injury. There was a significant correlation between the LIS on Day 3 and duration of mechanical ventilation (r = 0.8; P = 0.003, ICU (r = 0.8; P = 0.002 and hospital (r = 0.6; P = 0.02 days. Late-onset airway complications were encountered in four patients. Three of them required long-term artificial airways - two with a tracheostomy while the third patient required surgical insertion of a "T" tube. Persistent problems with phonation occurred in two patients. At 8 months postdischarge, all patients were independent with activities of daily living; all were back to work, except for two who continued to need artificial airways. Conclusions: Inhalational lung injury progresses over the first few days and is worst after 72 h. Late-onset airway complications may manifest after several weeks and require repeated intervention.

  14. Intraoperative radiotherapy in the multidisciplinary treatment of pediatric tumors

    International Nuclear Information System (INIS)

    From September 1984 to July 1987, 33 children received intraoperative radiotherapy as part of a multidisciplinary tumor treatment. Their age ranged from 2 to 17 years. Tumors types: Ewing's sarcoma (n=11), osteosarcoma (n=8), soft tissue sarcomas (n=5), Wilms' tumor (n=3), neuroblastoma (n=3), malignant pheochromocytoma (n=1), Hodgkin's disease (n=1), and optic nerve glioma (n=1). In 25 patients the disease was localized while 8 had distant metastases. Intraoperative radiotherapy was used in 26 previously untreated patients as part of a radical treatment program and in 7 cases as an effort to rescue local failures (5 in previously irradiated areas). The intraoperative radiation field included the surgically exposed tumor or tumor bed, and the single doses ranged from 10 to 20 Gy, with 6-20 MeV electrons. Patients with osteosarcoma and recurrent tumor in a previously irradiated area did not receive postoperative external beam radiotherapy. With a median follow-up time of 10 months (1 to 31+months) 24 out of 33 patients are alive without local recurrence and 9 have died from tumor (5 with local disease progression). Intraoperative radiotherapy seems to be a feasible treatment which might promote local control in pediatric tumors. (orig.)

  15. Multidisciplinary Treatment of a Fenestration-type Defect.

    Science.gov (United States)

    Travassos, Rafael; Soares, Bruno; Bhandi, Shilpa H; Silva, Monica Barros da; Bandéca, Matheus Coelho; Mouchrek, José Carlos Elias; Silva, Vanessa Camila da; Benatti, Bruno Braga

    2015-04-01

    The case report aimed at treating a fenestration-type defect with multidisciplinary conventional and advanced surgical techniques. Fenestrations are isolated areas in which the exposed root surface is covered only by the periosteum and gingiva, but the remaining cortical bone remains intact. Root coverage is indicated in cases of root hypersensitivity, treatment of shallow caries lesions, cervical abrasions, and esthetic and cosmetic needs. In this case report, after proper hygiene instruction and dental biofilm control, a fenestration-type defect was treated using guided tissue regeneration (anorganic bovine matrix and resorbable membrane) and a connective tissue grafts, associated to an endodontic apicoectomy. After reevaluation, the remaining gingival recession was treated with a second gingival connective tissue graft covered with q double papillae type in order to reconstruct the periodontal tissues of the involved tooth. In this clinical case, the interaction between the different areas of dentistry has made it possible to correct a fenestration-type defect, following procedures based on scientific evidence, restoring periodontal health, esthetics, self-esteem, and meeting the patient's expectations regarding her initial complaint. This case report shows the important role of interdisciplinary approach to treating a patient with a complex periodontal defect that required different types of knowledge and abilities to achieve the best results based on the current status of dentistry possibilities. PMID:26067739

  16. [Idiopatic pulmonary fibrosis - news in multidisciplinary diagnostic and therapeutic approaches].

    Science.gov (United States)

    Vašáková, Martina; Matěj, Radoslav

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF) is a primary fibrosing pulmonary process. Due to the ineffectiveness of current therapeutic strategies and unfavorable prognosis, IPF is the most serious example of idiopathic interstitial lung diseases (ILD). Etiology and pathogenesis of this disorder have not been fully clarified yet; but it is anticipated, that the fibroproliferation is caused by the imbalance of reparative and immunologic processes in the genetically predisposed patients. Radiologically and histopathologically, IPF is characterized by specific pattern called usual interstitial pneumonia (UIP), however, this pattern is not fully typical in all cases, and, moreover, it could be seen in other ILD´s, e.g. chronic hypersensitivity pneumonitis, asbestosis, autoimmune connective tissue diseases and many others as well. The final diagnosis of IPF is a consensual result of multidisciplinary team composed of pulmologist, pathologist and radiologist. IPF was an incurable disease with prognosis worse than cancer till the year 2011, when antifibrotic drugs decelerating a progression of this disease have been introduced. Earlier and correct diagnosis of IPF is the most important issue for the patients because they could be effectively treated and thus, prolonging their survival as much as possible. PMID:27223586

  17. Multidisciplinary approach to converting power chair into motorized prone cart.

    Science.gov (United States)

    Brose, Steven W; Wali, Eisha

    2014-01-01

    Pressure ulcers remain a major source of morbidity and mortality in veterans with neurologic impairment. Management of pressure ulcers typically involves pressure relief over skin regions containing wounds, but this can lead to loss of mobility and independence when the wounds are located in regions that receive pressure from sitting. An innovative, low-cost, multidisciplinary effort was undertaken to maximize quality of life in a veteran with a thoracic-4 level complete spinal cord injury and a stage 4 ischial wound. The person's power wheelchair was converted into a motorized prone cart, allowing navigation of the Department of Veterans Affairs spinal cord injury hospital ward and improved socialization while relieving pressure on the wound. Physical and occupational therapy assisted with the reconfiguration of the power chair and verified safe transfers into the chair and driving of the device. Psychology verified positive psychosocial benefit, while nursing and physician services verified an absence of unwanted pain or skin injury resulting from use of the device. Further investigation of ways to apply this technique is warranted to improve the quality of life of persons with pressure ulcers. PMID:25786192

  18. Multidisciplinary approach to converting power chair into motorized prone cart

    Directory of Open Access Journals (Sweden)

    Steven W. Brose, DO

    2015-02-01

    Full Text Available Pressure ulcers remain a major source of morbidity and mortality in veterans with neurologic impairment. Management of pressure ulcers typically involves pressure relief over skin regions containing wounds, but this can lead to loss of mobility and independence when the wounds are located in regions that receive pressure from sitting. An innovative, low-cost, multidisciplinary effort was undertaken to maximize quality of life in a veteran with a thoracic-4 level complete spinal cord injury and a stage 4 ischial wound. The person's power wheelchair was converted into a motorized prone cart, allowing navigation of the Department of Veterans Affairs spinal cord injury hospital ward and improving socialization while relieving pressure on the wound. Physical and occupational therapy assisted with the reconfiguration of the power chair and verified safe transfers into the chair and driving of the device. Psychology verified positive psychosocial benefit, while nursing and physician services verified an absence of unwanted pain or skin injury resulting from use of the device. Further investigation of ways to apply this technique is warranted to improve the quality of life of persons with pressure ulcers.

  19. a Multidisciplinary Analytical Framework for Studying Active Mobility Patterns

    Science.gov (United States)

    Orellana, D.; Hermida, C.; Osorio, P.

    2016-06-01

    Intermediate cities are urged to change and adapt their mobility systems from a high energy-demanding motorized model to a sustainable low-motorized model. In order to accomplish such a model, city administrations need to better understand active mobility patterns and their links to socio-demographic and cultural aspects of the population. During the last decade, researchers have demonstrated the potential of geo-location technologies and mobile devices to gather massive amounts of data for mobility studies. However, the analysis and interpretation of this data has been carried out by specialized research groups with relatively narrow approaches from different disciplines. Consequently, broader questions remain less explored, mainly those relating to spatial behaviour of individuals and populations with their geographic environment and the motivations and perceptions shaping such behaviour. Understanding sustainable mobility and exploring new research paths require an interdisciplinary approach given the complex nature of mobility systems and their social, economic and environmental impacts. Here, we introduce the elements for a multidisciplinary analytical framework for studying active mobility patterns comprised of three components: a) Methodological, b) Behavioural, and c) Perceptual. We demonstrate the applicability of the framework by analysing mobility patterns of cyclists and pedestrians in an intermediate city integrating a range of techniques, including: GPS tracking, spatial analysis, auto-ethnography, and perceptual mapping. The results demonstrated the existence of non-evident spatial behaviours and how perceptual features affect mobility. This knowledge is useful for developing policies and practices for sustainable mobility planning.

  20. Needle localization breast biopsy: a model for multidisciplinary quality assurance.

    Science.gov (United States)

    Howe, J R; Monsees, B; Destouet, J; Seib, J; Dehner, L P; Kraybill, W G

    1995-04-01

    As part of the quality assurance role of the Cancer Committee at Barnes Hospital, an institutional audit of Needle Localization Breast Biopsy (NLBB) was performed. Mammographic, operative, and surgical pathology reports from 370 consecutive patients at our institution undergoing both mammography and needle localization biopsy over a 34-month interval were reviewed. Carcinoma was diagnosed pathologically in 103 patients (28%), and 27% of these proved to be noninvasive. Sixteen patients were found to have histologic or clinical involvement of the axillary nodes; no patients with Tis lesions were found to have axillary nodal involvement. Of the patients, 73% were found to have either Stage 0 or Stage I disease, and 61% with an established malignancy had mastectomy (67% of patients with invasive carcinoma, 44% of those with carcinoma-in-situ), whereas 39% had some form of conservation therapy (33% of patients with invasive lesions, 56% of those with carcinoma-in-situ). Our results have been compared with other published studies, and important clinical indicators for evaluating the results of individual centers performing NLBB are discussed. It is concluded that NLBB is a safe and effective method of biopsying nonpalpable breast lesions, which allows for the identification of early stage breast carcinomas. In the present environment of concerns about the quality of care and costs, it is the responsibility of each center performing NLBB periodically to evaluate their results with this multidisciplinary procedure and to bring about change in those areas found to be deficient. PMID:7723366

  1. Systematic Review of Multidisciplinary Chronic Pain Treatment Facilities.

    Science.gov (United States)

    Fashler, Samantha R; Cooper, Lynn K; Oosenbrug, Eric D; Burns, Lindsay C; Razavi, Shima; Goldberg, Lauren; Katz, Joel

    2016-01-01

    This study reviewed the published literature evaluating multidisciplinary chronic pain treatment facilities to provide an overview of their availability, caseload, wait times, and facility characteristics. A systematic literature review was conducted using PRISMA guidelines following a search of MEDLINE, PsycINFO, and CINAHL databases. Inclusion criteria stipulated that studies be original research, survey more than one pain treatment facility directly, and describe a range of available treatments. Fourteen articles satisfied inclusion criteria. Results showed little consistency in the research design used to describe pain treatment facilities. Availability of pain treatment facilities was scarce and the reported caseloads and wait times were generally high. A wide range of medical, physical, and psychological pain treatments were available. Most studies reported findings on the percentage of practitioners in different health care professions employed. Future studies should consider using more comprehensive search strategies to survey facilities, improving clarity on what is considered to be a pain treatment facility, and reporting on a consistent set of variables to provide a clear summary of the status of pain treatment facilities. This review highlights important information for policymakers on the scope, demand, and accessibility of pain treatment facilities. PMID:27445618

  2. Teaching multidisciplinary environmental science in a wetland setting

    Science.gov (United States)

    Panno, S.V.; Hackley, Keith C.; Nuzzo, V.A.

    1998-01-01

    High-school students from across the country came to the Illinois State Geological Survey (ISGS) to assist in field research for two weeks in July, 1994, as part of The Johns Hopkins University Center for Talented Youth Summer Experience Program. During the research project at the ISGS, students were exposed to a multidisciplinary scientific investigation where geology, hydrogeology, ground-water chemistry, and plant biology could be directly observed and used to study the potentially destructive effects of nearby road and house construction on a fen-wetland complex. Experienced researchers provided classroom and field instruction to the students prior to leading the field investigations. Following field work, the students returned to the ISGS laboratories where they assisted with the chemical analysis of ground-water samples and compiled and interpreted their data. The students wrote up their results in standard scientific report format and gave oral presentations covering various aspects of the project to an audience of ISGS scientists and guests. The results of their work, which showed changes in the wetland's plant biodiversity resulting from urban development within the watershed, will provide data needed for the preservation of biodiversity in these and other wetlands.

  3. Multidisciplinary approaches to understanding collective cell migration in developmental biology.

    Science.gov (United States)

    Schumacher, Linus J; Kulesa, Paul M; McLennan, Rebecca; Baker, Ruth E; Maini, Philip K

    2016-06-01

    Mathematical models are becoming increasingly integrated with experimental efforts in the study of biological systems. Collective cell migration in developmental biology is a particularly fruitful application area for the development of theoretical models to predict the behaviour of complex multicellular systems with many interacting parts. In this context, mathematical models provide a tool to assess the consistency of experimental observations with testable mechanistic hypotheses. In this review, we showcase examples from recent years of multidisciplinary investigations of neural crest cell migration. The neural crest model system has been used to study how collective migration of cell populations is shaped by cell-cell interactions, cell-environmental interactions and heterogeneity between cells. The wide range of emergent behaviours exhibited by neural crest cells in different embryonal locations and in different organisms helps us chart out the spectrum of collective cell migration. At the same time, this diversity in migratory characteristics highlights the need to reconcile or unify the array of currently hypothesized mechanisms through the next generation of experimental data and generalized theoretical descriptions. PMID:27278647

  4. Managing chronic pain with nonopioid analgesics: a multidisciplinary consult.

    Science.gov (United States)

    Clauw, Daniel; McCarberg, Bill H

    2012-05-01

    As detailed in this online CME activity (www.cmeaccess.com/AJM/ChronicPain04), determining pain mechanism is an important aspect guiding treatment selection for chronic musculoskeletal pain states. Although broad classifications provide a framework, any combination of mechanisms may be present in a chronic pain patient, and there is growing evidence that pain states generally considered nociceptive may also involve elements of augmented central nervous system pain processing. Nonopioid analgesics, including serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and alpha-2-delta ligand anticonvulsants, are the treatments of choice for fibromyalgia and other central neuropathic pain states. Additionally, studies have now shown that certain SNRIs can be effective in treating "classic" nociceptive pain states, such as osteoarthritis, and also are effective for low back pain. In addition to considering biological mechanisms, chronic pain management also involves recognizing and evaluating the contribution of psychological and sociocultural factors that can influence pain chronicity and patient prognosis. A multimodal/multidisciplinary approach incorporating pharmacologic and nonpharmacologic therapy into a program that includes more than 1 discipline is important to improve outcomes in patients with chronic pain. PMID:22482859

  5. Development of a Multidisciplinary, Multicampus Subspecialty Practice in Endocrine Cancers

    Science.gov (United States)

    Bible, Keith C.; Smallridge, Robert C.; Morris, John C.; Molina, Julian R.; Suman, Vera J.; Copland, John A.; Rubin, Joseph; Menefee, Michael E.; Sideras, Kostandinos; Maples, William J.; McIver, Bryan; Fatourechi, Vahab; Hay, Ian; Foote, Robert L.; Garces, Yolanda I.; Kasperbauer, Jan L.; Thompson, Geoffrey B.; Grant, Clive S.; Richards, Melanie L.; Sebo, Thomas; Lloyd, Ricardo; Eberhardt, Norman L.; Reddi, Honey V.; Casler, John D.; Karlin, Nina J.; Westphal, Sydney A.; Richardson, Ronald L.; Buckner, Jan C.; Erlichman, Charles

    2012-01-01

    Purpose: Relative to more abundant neoplasms, endocrine cancers have been historically neglected, yet their incidence is increasing. We therefore sought to build interest in endocrine cancers, improve physician experience, and develop innovative approaches to treating patients with these neoplasms. Methods: Between 2005 and 2010, we developed a multidisciplinary Endocrine Malignancies Disease Oriented Group involving all three Mayo Clinic campuses (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ). In response to higher demand at the Rochester campus, we sought to develop a Subspecialty Tumor Group and an Endocrine Malignancies Tumor Clinic within the Division of Medical Oncology. Results: The intended groups were successfully formed. We experienced difficulty in integration of the Mayo Scottsdale campus resulting from local uncertainty as to whether patient volumes would be sufficient to sustain the effort at that campus and difficulty in developing enthusiasm among clinicians otherwise engaged in a busy clinical practice. But these obstacles were ultimately overcome. In addition, with respect to the newly formed medical oncology subspecialty endocrine malignancies group, appointment volumes quadrupled within the first year and increased seven times within two years. The number of active therapeutic endocrine malignancies clinical trials also increased from one in 2005 to five in 2009, with all three Mayo campuses participating. Conclusion: The development of subspecialty tumor groups for uncommon malignancies represents an effective approach to building experience, increasing patient volumes and referrals, and fostering development of increased therapeutic options and clinical trials for patients afflicted with otherwise historically neglected cancers. PMID:22942830

  6. Multidisciplinary neoadjuvant management for potentially curable pancreatic cancer

    International Nuclear Information System (INIS)

    Pancreatic adenocarcinoma remains the fourth leading cause of cancer mortality in the U.S. Despite advances in surgical technique, radiotherapy technologies, and chemotherapeutics, the 5-year survival rate remains approximately 20% for the 15% of patients who are eligible for surgical resection. The majority of this group suffers metastatic recurrence. However, despite advances in therapies for patients with advanced pancreatic cancer, only surgery has consistently proven to improve long-term survival. Various combinations of chemotherapy, biologic-targeted therapy, and radiotherapy have been evaluated in different settings to improve outcomes. In this context, a neoadjuvant (preoperative) treatment strategy offers numerous potential benefits: (1) ensuring delivery of early, systemic therapy, (2) improving selection of patients for surgical therapy with truly localized disease, (3) potential downstaging of the neoplasm facilitating a negative margin resection in patients with locally advanced disease, and (4) providing a superior clinical trial mechanism capable of rapid assessment of the efficacy of novel therapeutics. This article reviews the recent trends in the management of pancreatic adenocarcinoma, with a particular emphasis on a multidisciplinary neoadjuvant approach to treatment

  7. A Multidisciplinary Optimization Platform Applied to Steel Constructions

    Science.gov (United States)

    Benanane, Abdelkader; Caperaa, Serge; Said Bekkouche, M.; Kerdal, Djamel

    The design of the complex objects such as the buildings was always organized in levels of design since the preliminary phases to the final phases. If the approach by levels allows the designers to practise a precise and progressive definition to objects, it does not allow leading nevertheless to an optimal design of the projects. Consequently, we propose in this study, an original modelling allowing representing effectively all the process of the multidisciplinary design by the exchange of textual files (technical data and knowledge) between the different disciplines of the civil engineering (geotechnical studies, reinforced concrete and structural studies). We use for the loops of optimization the Monte-Carlo method because of its great robustness since it is based on the use of random numbers and the statistical tools, because it also puts up with any form of a function objective and allows to hold account easily constraints of optimization. The studies of test cases carried out on simple structures emphasize very significant and very promising variations as well as the dimensioning that the global cost.

  8. Multidisciplinary effort in treating children with hepatoblastoma in China.

    Science.gov (United States)

    Yuan, Xiao-Jun; Wang, Huan-Min; Jiang, Hui; Tang, Meng-Jie; Li, Zhang-Lin; Zou, Xiang; Fang, Yong-Jun; Pan, Ci; Tou, Jin-Fa; Zhang, Ke-Ren; Liu, Xiang; Li, Wei-Song; Li, Yang; Lu, Jun; Wu, Ye-Ming

    2016-05-28

    The purpose of this study is to report the first nationwide protocol (Wuhan Protocol) developed by Chinese Children's Cancer Group and the results of multidisciplinary effort in treating hepatoblastoma. In this study, we reported the final analysis, which includes 153 hepatoblastoma patients in 13 hospitals from January 2006 to December 2013. The 6-year overall survival and event-free survival rates were 83.3 ± 3.1% and 71.0 ± 3.7%, respectively, in this cohort. The univariate analysis revealed that female (P = 0.027), under 5 years of age (P = 0.039), complete surgical resection (P = 0.000), no metastases (P = 0.000), and delayed surgery following neoadjuvant chemotherapy (P = 0.000) had better prognosis. In multivariate analysis, male, 5 years of age or above, stage PRETEXT III or IV, and incomplete surgical resection were among the some adverse factors contributing to poor prognosis. The preliminary results from this study showed that patients who underwent treatment following Wuhan Protocol had similar OS and EFS rates compared to those in developed countries. However, the protocol remains to be further optimized in standardizing surgical resection (including liver transplantation), refining risk stratification and risk-based chemotherapy. PMID:26945966

  9. NCC: A Multidisciplinary Design/Analysis Tool for Combustion Systems

    Science.gov (United States)

    Liu, Nan-Suey; Quealy, Angela

    1999-01-01

    A multi-disciplinary design/analysis tool for combustion systems is critical for optimizing the low-emission, high-performance combustor design process. Based on discussions between NASA Lewis Research Center and the jet engine companies, an industry-government team was formed in early 1995 to develop the National Combustion Code (NCC), which is an integrated system of computer codes for the design and analysis of combustion systems. NCC has advanced features that address the need to meet designer's requirements such as "assured accuracy", "fast turnaround", and "acceptable cost". The NCC development team is comprised of Allison Engine Company (Allison), CFD Research Corporation (CFDRC), GE Aircraft Engines (GEAE), NASA Lewis Research Center (LeRC), and Pratt & Whitney (P&W). This development team operates under the guidance of the NCC steering committee. The "unstructured mesh" capability and "parallel computing" are fundamental features of NCC from its inception. The NCC system is composed of a set of "elements" which includes grid generator, main flow solver, turbulence module, turbulence and chemistry interaction module, chemistry module, spray module, radiation heat transfer module, data visualization module, and a post-processor for evaluating engine performance parameters. Each element may have contributions from several team members. Such a multi-source multi-element system needs to be integrated in a way that facilitates inter-module data communication, flexibility in module selection, and ease of integration.

  10. Multidisciplinary care in severe pediatric electrical oral burn.

    Science.gov (United States)

    Pontini, A; Reho, F; Giatsidis, G; Bacci, C; Azzena, B; Tiengo, C

    2015-05-01

    Oral burns in pediatric patient are commonly due to electrical injuries, representing an important reconstructive issue even for functional than esthetic reason. Different classification, surgical management and even oral device were described to allow the best long-term result. In most case a multidisciplinary approach is necessary to achieve a satisfactory outcome. A severe case of pediatric oral burn with germinative teeth damage is presented, describing a multispecialist team approach that guarantee a satisfactory outcome by reconstructive surgery, careful progressive evaluation of dental and soft tissue healing and speech recovery. The use of acellular dermal substitute template within traditional reconstructive surgery had provided a good functional and esthetic result joint to valid preservation of germinative dental element as shown at long-term X-ray evaluation. Intensive rehabilitation speech program has also avoided phonetic impairment in an important speech develop period. It was so evident that the necessity of a multispecialist care in such difficult injury to achieve the best long-term result. PMID:25716757

  11. Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Kei Nakajima

    2012-01-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD and non-alcoholic steatohepatitis (NASH are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome should target not only the cardiometabolic abnormalities, but also the associated liver disorders. In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1 inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. However, the efficacy, safety, and tolerability of long-term treatment (potentially for many years with these drugs have not been fully established. Furthermore, clinical trials have not comprehensively examined the efficacy of lipid-lowering drugs (i.e., statins, fibrates, and NPC1L1 inhibitors for the treatment of NAFLD. Although clinical evidence for RAS blockers and incretin-based agents (GLP-1 analogs and dipeptidyl peptidase-4 inhibitors is also lacking, these agents are promising in terms of their insulin-sensitizing and anti-inflammatory effects without causing weight gain.

  12. A multidisciplinary approach for rehabilitation following ocular trauma

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar

    2014-11-01

    Full Text Available Ocular trauma is a very common incidence that occurs in up to 67% of patients with maxillofacial trauma. It results in life-long agony of not being like others with two eyes, which can see and admire the nature's beauty. This article reports on a case of a 23-year-old male patient with phthisis bulbi, resulting from ocular trauma. The patient was rehabilitated aesthetically by fabrication of custom-made ocular prosthesis for his traumatically injured right eye. The patient was pleased with the aesthetic outcome, comfort, and mobility offered by the custom ocular prosthesis. There were no complications with regard to health of underlying residual ocular tissues and there was no need of relining of the prosthesis at 6 month recall appointment. Rehabilitation of patients with ocular trauma requires a multidisciplinary approach involving ophthalmologist, psychologist, and skilled maxillofacial prosthodontist. Custom-made ocular prosthesis fitted over the phthisical globe seems to be a highly positive, logical, noninvasive, and beneficial approach to increase mobility to the prosthesis, improve the cosmetic appearance and psychological well-being of the patient.

  13. Effectiveness of Occupation- and Activity-Based Interventions to Improve Everyday Activities and Social Participation for People With Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Powell, Janet M; Rich, Timothy J; Wise, Elizabeth K

    2016-01-01

    This systematic review presents research on the effectiveness of occupation- and activity-based interventions to improve everyday activities and areas of occupation and social participation for people with traumatic brain injury (TBI). Nineteen studies identified through a comprehensive database search were reviewed and synthesized into five themes: (1) multidisciplinary and interdisciplinary treatment approaches, (2) community-based rehabilitation programs, (3) treatment approaches using client-centered goals and relevant contexts, (4) social skills training and peer mentoring interventions, and (5) community mobility interventions. Evidence supports the use of multidisciplinary and interdisciplinary approaches across a variety of settings, with no single treatment approach or setting clearly superior to another. The specific contributions of occupational therapy practitioners and the nature of occupational therapy interventions have not been well studied, making it difficult to determine the extent to which occupation- and activity-based interventions provided by occupational therapy practitioners improve occupational performance and social participation after TBI. PMID:27089288

  14. Multidisciplinary Design, Analysis, and Optimization Tool Development Using a Genetic Algorithm

    Science.gov (United States)

    Pak, Chan-gi; Li, Wesley

    2009-01-01

    Multidisciplinary design, analysis, and optimization using a genetic algorithm is being developed at the National Aeronautics and Space Administration Dryden Flight Research Center (Edwards, California) to automate analysis and design process by leveraging existing tools to enable true multidisciplinary optimization in the preliminary design stage of subsonic, transonic, supersonic, and hypersonic aircraft. This is a promising technology, but faces many challenges in large-scale, real-world application. This report describes current approaches, recent results, and challenges for multidisciplinary design, analysis, and optimization as demonstrated by experience with the Ikhana fire pod design.!

  15. Society of Interventional Radiology

    Science.gov (United States)

    ... how interventional radiology research improves patients’ lives at Society of Interventional Radiology’s 2017 Annual Scientific Meeting; read ... comments to CMS on two MACRA coding issues; society is engaged with CMS as they develop codes ...

  16. Vascular Complications of Pancreatitis: Role of Interventional Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Barge, Jaideep U.; Lopera, Jorge E. [University of Texas Health Science Center, San Antonio (United States)

    2012-02-15

    Major vascular complications related to pancreatitis can cause life-threatening hemorrhage and have to be dealt with as an emergency, utilizing a multidisciplinary approach of angiography, endoscopy or surgery. These may occur secondary to direct vascular injuries, which result in the formation of splanchnic pseudoaneurysms, gastrointestinal etiologies such as peptic ulcer disease and gastroesophageal varices, and post-operative bleeding related to pancreatic surgery. In this review article, we discuss the pathophysiologic mechanisms, diagnostic modalities, and treatment of pancreatic vascular complications, with a focus on the role of minimally-invasive interventional therapies such as angioembolization, endovascular stenting, and ultrasound-guided percutaneous thrombin injection in their management.

  17. An educational intervention to improve hospital tumor conferences.

    Science.gov (United States)

    Nyquist, J G; Radecki, S E; Gates, J D; Abrahamson, S

    1995-01-01

    Hospital tumor conferences exist to improve patient care through the application of a multidisciplinary approach to cancer management decisions and to provide continuing medical education for physicians and other health professionals who participate in cancer care. Based on educational needs identified by means of direct observation of conference sessions, this study implemented an experimental intervention designed to increase the educational benefits associated with participation in these conferences. Participating hospitals were randomly assigned either to a study group that received an "educational case" intervention (emphasizing progressive disclosure of cases, an active leadership style, and use of educational principles such as stating objectives at the beginning of sessions) or to a control group receiving no intervention. Each of the nine experimental and nine control group hospitals had multiple tumor sessions and case presentations with sessions observed and coded before and after intervention. Results showed significant differences in the specific educational procedures emphasized in the educational case intervention, such as use of the progressive disclosure method of presentation, and quality of session leadership. No difference, however, was found in other factors such as participation rates by major categories of specialists. The study has thus shown that educational interventions of this type can have a significant impact on the clinical and educational effectiveness of ongoing hospital conferences. PMID:7669537

  18. Paediatric Interventional Uroradiology

    International Nuclear Information System (INIS)

    Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

  19. Multidisciplinary approach of ectodermal dysplasia with implant retained fixed prosthesis

    OpenAIRE

    Vishnu Priya; Srivatsa,; Ramachandraprabakar,; Kamala Kannan; Dwaragesh

    2013-01-01

    Ectodermal dysplasia represents a group of rare inherited conditions in which two or more ectodermally derived anatomical structures fail to develop. Early dental intervention can improve patient′s appearance, thereby minimizing associated emotional and psychological problems in these patients. Treatment requires a teamwork by medical personnel along with dental professionals of various specialties. Here, a rare case of a young female patient is presented with prosthetic management with impla...

  20. Multidisciplinary approach of ectodermal dysplasia with implant retained fixed prosthesis

    Directory of Open Access Journals (Sweden)

    Vishnu Priya

    2013-01-01

    Full Text Available Ectodermal dysplasia represents a group of rare inherited conditions in which two or more ectodermally derived anatomical structures fail to develop. Early dental intervention can improve patient′s appearance, thereby minimizing associated emotional and psychological problems in these patients. Treatment requires a teamwork by medical personnel along with dental professionals of various specialties. Here, a rare case of a young female patient is presented with prosthetic management with implant supported fixed partial denture.

  1. Changing Climates @ Colorado State: 100 (Multidisciplinary) Views of Climate Change

    Science.gov (United States)

    Campbell, S.; Calderazzo, J.; Changing Climates, Cmmap Education; Diversity Team

    2011-12-01

    We would like to talk about a multidisciplinary education and outreach program we co-direct at Colorado State University, with support from an NSF-funded STC, CMMAP, the Center for Multiscale Modeling of Atmospheric Processes. We are working to raise public literacy about climate change by providing information that is high quality, up to date, thoroughly multidisciplinary, and easy for non-specialists to understand. Our primary audiences are college-level students, their teachers, and the general public. Our motto is Climate Change is Everybody's Business. To encourage and help our faculty infuse climate-change content into their courses, we have organized some 115 talks given by as many different speakers-speakers drawn from 28 academic departments, all 8 colleges at CSU, and numerous other entities from campus, the community, and farther afield. We began with a faculty-teaching-faculty series and then broadened our attentions to the whole campus and surrounding community. Some talks have been for narrowly focused audiences such as extension agents who work on energy, but most are for more eclectic groups of students, staff, faculty, and citizens. We count heads at most events, and our current total is roughly 6,000. We have created a website (http://changingclimates.colostate.edu) that includes videotapes of many of these talks, short videos we have created, and annotated sources that we judge to be accurate, interesting, clearly written, and aimed at non-specialists, including books, articles and essays, websites, and a few items specifically for college teachers (such as syllabi). Pages of the website focus on such topics as how the climate works / how it changes; what's happening / what might happen; natural ecosystems; agriculture; impacts on people; responses from ethics, art, literature; communication; daily life; policy; energy; and-pulling all the pieces together-the big picture. We have begun working on a new series of very short videos that can be

  2. 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

    OpenAIRE

    María Lorena Weinreich; Carmen Gloria Hidalgo

    2004-01-01

    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 seguimie...

  3. Draix multidisciplinary observatory for water and sediment processes

    Science.gov (United States)

    Le Bouteiller, C.; Mathys, N.; Liébault, F.; Klotz, S.

    2013-12-01

    Over the last decades, much progress has been done in the modeling and conceptualizing of surface processes. Testing theories and models requires field data, and possibly long-term time series. Here we present a 30-year old field observatory dedicated to water and sediment fluxes in the French Alps. Draix observatory is located in a badland area of the French Alps (shale lithology), and includes several subcatchments which differ in size (0.001 to 1 km2) and vegetation coverage (bare soil or forest). Climate is mountainous and Mediterranean, characterized with summer storm-induced floods and winter frost. Data collected includes climatic data (rainfall, temperature) and water and sediment fluxes (discharge at the outlet of each subcatchment, suspended load and bedload fluxes). High frequency monitoring (minute/hour) is used to capture flood dynamics. Some soil hydraulic and geophysical properties, lidar scans and vegetation maps are also available. The combination of an erodible badland morphology and tough climatic conditions induces very high erosion rates and sediment yield (up to 70 tons/ha/yr). Observed erosion processes include landslides, small-scale debris flows, gully formation, weathering on the slopes and in the riverbeds, hyperconcentrated flows and in-transport sediment abrasion. The sediment response is highly non-linear with a strong seasonal pattern of storage and scour in the bed. Current research on Draix observatory is multidisciplinary and involves hydraulic engineers, hydrologists, geomorphologists, soil scientists and restoration ecologists. Fast rates of geomorphic changes, well-constrained sediment budgets and long data series are some of the advantages of this site for the study of earth surface processes. Our data is available for the community and we welcome everyone who is interested in collaborating on it.

  4. Multidisciplinary life cycle metrics and tools for green buildings.

    Science.gov (United States)

    Helgeson, Jennifer F; Lippiatt, Barbara C

    2009-07-01

    Building sector stakeholders need compelling metrics, tools, data, and case studies to support major investments in sustainable technologies. Proponents of green building widely claim that buildings integrating sustainable technologies are cost effective, but often these claims are based on incomplete, anecdotal evidence that is difficult to reproduce and defend. The claims suffer from 2 main weaknesses: 1) buildings on which claims are based are not necessarily "green" in a science-based, life cycle assessment (LCA) sense and 2) measures of cost effectiveness often are not based on standard methods for measuring economic worth. Yet, the building industry demands compelling metrics to justify sustainable building designs. The problem is hard to solve because, until now, neither methods nor robust data supporting defensible business cases were available. The US National Institute of Standards and Technology (NIST) Building and Fire Research Laboratory is beginning to address these needs by developing metrics and tools for assessing the life cycle economic and environmental performance of buildings. Economic performance is measured with the use of standard life cycle costing methods. Environmental performance is measured by LCA methods that assess the "carbon footprint" of buildings, as well as 11 other sustainability metrics, including fossil fuel depletion, smog formation, water use, habitat alteration, indoor air quality, and effects on human health. Carbon efficiency ratios and other eco-efficiency metrics are established to yield science-based measures of the relative worth, or "business cases," for green buildings. Here, the approach is illustrated through a realistic building case study focused on different heating, ventilation, air conditioning technology energy efficiency. Additionally, the evolution of the Building for Environmental and Economic Sustainability multidisciplinary team and future plans in this area are described. PMID:20050028

  5. SUSTAINABLE DEVELOPMENT MULTIDISCIPLINARY COMMITTEE OF SAN MIGUEL ALMAYA

    Directory of Open Access Journals (Sweden)

    Carolina Mejía-Madero

    2013-04-01

    Full Text Available In this article it is analyzed the role of the “Sustainable Development Multidisciplinary Committee of San Miguel Almaya” created in this community with an otomi background in the State of Mexico, with the purpose to continue with the touristic acts supported in 2006 by the Federal and State Secretaries of Tourism. All with the aim to get benefit from its potential, centered on a lagoon and an extinct volcano. The Committee was created in 2010 because an Eco Tourist Park wanted to be constructed; Even though two stages of the eco tourist park were constructed, it was not concluded; in order to give it continuity, the local authorities decided to negotiate resources. The purpose of the present document is to analyze through the Public Policy Networks the role its members played at the moment of taking decisions to determine if they created the necessary conditions to promote the tourist and the sustainability of the community. The study was based on the methodology of Cruz (2008 and Zabaleta (2006 which identifies the objectives, interests, resources, capabilities, limitations and attributions, between the elements that have an influence on establishing links; in this case, among the actors of the network formed inside the committee. The information was obtained from an empiric and documental investigation that included reunions with the local authorities. One of the most important results is that, the decisions taken within the committee and the exclusion of some of the actors stopped the sustainable development due to a lack of negotiation between its members and differences in their objectives and interests, resulting in a lack of compromise and cooperation to solve the normative, economic, ecologic and cultural problems of the community that could put into risk the touristic potential of the zone.

  6. Physics Education in a Multidisciplinary Materials Research Environment

    Science.gov (United States)

    Doyle, W. D.

    1997-03-01

    The MINT Center, an NSF Materials Research Science and Engineering Center, is a multidisciplinary research program focusing on materials information storage. It involves 17 faculty, 10 post-doctoral fellows and 25 graduate students from six academic programs including Physics, Chemistry, Materials Science, Metallurgical and Materials Engineering, Electric al Engineering and Chemical Engineering, whose research is supported by university, federal and industrial funds. The research facilities (15,000 ft^2) which include faculty and student offices are located in one building and are maintained by the university and the Center at no cost to participating faculty. The academic requirements for the students are determined by the individual departments along relatively rigid, traditional grounds although several materials and device courses are offered for students from all departments. Within the Center, participants work in teams assigning responsibilities and sharing results at regularly scheduled meetings. Bi-weekly research seminars for all participants provide excellent opportunities for students to improve their communication skills and to receive critical input from a large, diverse audience. Strong collaboration with industrial partners in the storage industry supported by workshops, research reviews, internships, industrial visitors and participation in industry consortia give students a broader criteria for self-evaluation, higher motivation and excellent career opportunities. Physics students, because of their rigorous basic training, are an important element in a strong materials sciences program, but they often are deficient in the behavior and characterization of real materials. The curriculum for physics students should be broadened to prepare them fully for a rewarding career in this emerging discipline.

  7. A review of analgesic and emotive breathing: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2016-02-01

    Full Text Available Bruno Bordoni,1–3 Fabiola Marelli,2,3 Giovannni Bordoni,2,31Department of Cardiology, Santa Maria Nascente IRCCS, Milan, Don Carlo Gnocchi Foundation, Milan, Italy; 2Department of Osteopathy, Centre de recherche d’emploi du Sud-Ouest (CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy; 3Department of Osteopathy, Centre de recherche d’emploi du Sud-Ouest (CRESO, Osteopathic Centre for Research and Studies, Castellanza, Varese, Italy Abstract: The diaphragm is the primary muscle involved in breathing and other non-primarily respiratory functions such as the maintenance of correct posture and lumbar and sacroiliac movement. It intervenes to facilitate cleaning of the upper airways through coughing, facilitates the evacuation of the intestines, and promotes the redistribution of the body’s blood. The diaphragm also has the ability to affect the perception of pain and the emotional state of the patient, functions that are the subject of this article. The aim of this article is to gather for the first time, within a single text, information on the nonrespiratory functions of the diaphragm muscle and its analgesic and emotional response functions. It also aims to highlight and reflect on the fact that when the diaphragm is treated manually, a daily occurrence for manual operators, it is not just an area of musculature that is treated but the entire body, including the psyche. This reflection allows for a multidisciplinary approach to the diaphragm and the collaboration of various medical and nonmedical practitioners, with the ultimate goal of regaining or improving the patient’s physical and mental well-being. Keywords: diaphragm, fascia, osteopathic, pain, motions, manual therapy

  8. Inception of a national multidisciplinary registry for stereotactic radiosurgery.

    Science.gov (United States)

    Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

    2016-01-01

    Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway. PMID

  9. Integrated Multidisciplinary Fault Observation in Marmara Through MARSite

    Science.gov (United States)

    Meral Ozel, N.; Necmioglu, O.; Ozel, A. O.; Ergintav, S.; Tan, O.; Geli, L. B.; Favali, P.; Guralp, C. M.; Douglas, J.; Mathieu, P. P.; Gurbuz, C.; Erdik, M. O.

    2014-12-01

    MARSite Project, initiated in November 2012 under the EC/FP-7 framework, aims to coordinate research groups ranging from seismology to gas geochemistry in a comprehensive monitoring activity developed both in the Marmara Region based on collection of multidisciplinary data to be shared, interpreted and merged in consistent theoretical and practical models suitable for the implementation of good practices to move the necessary information to the end users in charge of seismic risk management of the region. In addition, processes involved in earthquake generation and the physics of short-term seismic transients, 4D deformations to understand earthquake cycle processes, fluid activity monitoring and seismicity under the sea floor using existing autonomous instrumentation, early warning and development of real-time shake and loss information, real- and quasi-real-time earthquake and tsunami hazard monitoring and earthquake-induced landslide hazard topics are also covered within MARSite. This presentation would provide a report on the progress achieved during the half-life of the project. In this respect, the main data server for the integration of real time network data has been finalized. Daily evaluation of online spring water and soil radon gas data in relation to seismic activity is in place, together with the continuous GPS data processing. A significant combination of postseismic (viscoelastic) deformation and afterslip was detected in the western segment of the 1999 Izmit rupture plane based on InSAR modeling. The optimum borehole depths have been identified based on seismic reflection studies and GURALP Systems is continuing its work on the manufacturing the borehole system. Seismic risk study for IGDAS Natural Gas Network including pipelines and its components has been carried out with several earthquake scenarios in Marmara Sea and an automatic shut-off algorithm has been developed for the automatic shut-off of the gas flow at the IGDAS district regulators

  10. Numerical Algorithms for Steady and Unsteady Multi-Disciplinary Simulation of Flight Vehicles Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Industry is driven by the cost of man-power and time to market, and is still awaiting a versatile and reliable multi-disciplinary analysis code. The proposed JFLO...

  11. A solution of multidisciplinary collaborative simulation for complex engineering systems in a distributed heterogeneous environment

    Institute of Scientific and Technical Information of China (English)

    ZHANG HeMing

    2009-01-01

    This paper presents an integrated approach to multidisciplinary collaborative simulation for complex engineering systems. The formulized paradigm of mulUdisciplinary collaborative simulation for com-plex engineering systems is principally analyzed. An IEEE HLA and web services based framework is proposed to provide a heterogeneous, distributed and collaborative running environment where multi-disciplinary modeling, running management and post-processing of collaborative simulation are under-taken. The mechanism of multidisciplinary collaborative modeling, disciplinary model transformation, and time-synchronized simulation advancement are studied in detail. A prototype with the functions of multidisciplinary modeling, running management and post-processing for collaborative simulations is developed, and a typical complex engineering system is chosen as a case study to demonstrate the effectiveness of this new approach towards collaborative simulation.

  12. Are members of multidisciplinary teams in breast cancer aware of each other's informational roles?

    OpenAIRE

    Jenkins, V; Fallowfield, L.; Poole, K

    2001-01-01

    Aim—To conduct a commissioned survey of multidisciplinary breast team members' expectations of their own and each other's roles in providing different kinds of information to women with breast cancer.

  13. Numerical Algorithms for Steady and Unsteady Multi-Disciplinary Simulation of Flight Vehicles Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A new multidisciplinary software environment ('MUSE') will be developed for the simulation of flight vehicles, drawing on the results of recent research on very...

  14. Rule-Based Multidisciplinary Tool for Unsteady Reacting Real-Fluid Flows Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Loci-STREAM is a CFD-based, multidisciplinary, high-fidelity design and analysis tool resulting from Phase I work whose objectives were: (a) to demonstrate the...

  15. Computer science and educational software design a resource for multidisciplinary work in technology enhanced learning

    CERN Document Server

    Tchounikine, Pierre

    2011-01-01

    Rather than offer a general methodology, this book proposes a framework and means for actively taking into account the relationships between pedagogical settings and software, and for working together in a multidisciplinary way to develop educational software.

  16. [Multidisciplinary outpatient clinics for back pain patients--a new treatment program].

    Science.gov (United States)

    Skouen, Jan Sture; Laerum, Even; Jensen, Thor Øivind

    2003-10-23

    Chronic low back pain (LBP) represents a major health problem, especially in Western Europe and North America. The aim of this study is to give an account of why a multidisciplinary treatment program in an outpatient spine clinic is the best treatment for many sub-acute and chronic LBP patients on long-term sick leave. We present an overview of documented treatment effects from multidisciplinary treatment programmes, an outline of the treatment in an outpatient spine clinic, and an account of why multidisciplinary programs are beneficial. The treatment of this patient group is also shown to be cost-effective when one differentiates between light and extensive multidisciplinary programmes. A future challenge rests in the fact that even after optimal treatment, approximately 20 % of patients still do not return to work. PMID:14600719

  17. The marketing of high-tech innovation: research and teaching as a multidisciplinary communication task

    OpenAIRE

    Hasenauer, Rainer; Fi8lo, Peter; Störi, Herbert

    2013-01-01

    Economically successful high-tech innovation is one of the driving forces for global welfare. Like innovation half-life, break-even time to market or technology acceptance, effective multidisciplinary communication between engineering and marketing is a critical success factor. This paper aims to show the requirements of multidisciplinary communication in B2B marketing of high-tech innovation and methodical approaches in research and academic education: 1. Requirements in high-tech innovat...

  18. TRANSFORMING TRADITIONAL UNIVERSITY STRUCTURES FOR THE KNOWLEDGE ECONOMY THROUGH MULTIDISCIPLINARY INSTITUTES

    OpenAIRE

    S. MOSEY; Wright, M.(SUPA – School of Physics and Astronomy, University of Glasgow, Glasgow, United Kingdom); B. CLARYSSE

    2012-01-01

    Within the UK, considerable policy support has been provided to create multi-disciplinary institutes to encourage academics to develop new knowledge to address industry and societal problems. We consider four large traditional UK universities that have gained significant funding for such activities. We examine the changes in institutional structures necessary to enable universities to transform from single discipline based schools to multi-disciplinary institutes. New incentives for working a...

  19. Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs

    OpenAIRE

    Hammarström, Anne; Haukenes, Inger; Fjellman Wiklund, Anncristine; Lehti, Arja; Wiklund, Maria; Evengard, Birgitta; Stålnacke, Britt-Marie

    2014-01-01

    Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team ...

  20. Cost of Illness for Patients with Arthritis Receiving Multidisciplinary Rehabilitation Care

    OpenAIRE

    Till Uhlig; Eline Aas; Margreth Grotle; Kåre Birger Hagen

    2011-01-01

    Purpose. To describe healthcare consumption and costs prior to, during, and after multidisciplinary rehabilitation due to arthritis. Methods. 306 patients (age 18–75 years) with arthritis scheduled for multidisciplinary rehabilitation care in 9 rehabilitation centres and 4 rheumatology hospital departments were included and followed for 6 months. Costs were estimated in Euros (€) for the total sample and five clinical subgroups. Results. Healthcare costs ranged from €3,033 to €91,336 and were...