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Sample records for establish multidisciplinary childhood

  1. The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

    Science.gov (United States)

    Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

    2017-07-18

    Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as

  2. 75 FR 7197 - Establishing a Task Force on Childhood Obesity

    Science.gov (United States)

    2010-02-18

    ... of February 9, 2010 Establishing a Task Force on Childhood Obesity Memorandum for the Heads of Executive Departments and Agencies Across our country, childhood obesity has reached epidemic rates and, as... is committed to redoubling our efforts to solve the problem of childhood obesity within a generation...

  3. Establishment of Multidisciplinary Methodology in the Modern Industrial Enterprise Management

    Directory of Open Access Journals (Sweden)

    Dergacheva Elena

    2016-01-01

    Full Text Available The concept of an enterprise as a socio-technical system meets a wide socio-economic approach in the management of the economic complex. In accordance with this approach, a company as a product of the society develops on the basis of socio-economic patterns, supported by scientific and technical solutions. And the surrounding nature evolves on the basis of natural biological laws that does not imply interwoven links of these processes. From the field of view of researchers and managers due to the activities of the company, the deep transformation of interconnected society and nature escapes through the use of advanced productive forces, the expansion of the artificial world as a whole. Social systems recreate the technical infrastructure of an enterprise and in the wider build artificial environment - the technosphere. It helps to accelerate the innovative development of the enterprise, and also leads to the interrelated transformations in a society, a person and nature. Therefore it is necessary to expand the narrow content of the broad multidisciplinary system approach with its interpretation, to include integrative technogenic socio-natural processes into the consideration of enterprise systems. This will allow preventing negative trends and in the future - coming over to the sustainable socio-natural development.

  4. TU-E-211-01: Establishing Multidisciplinary Collaboration as a Medical Physicist.

    Science.gov (United States)

    Xing, L; Fraass, B; Ford, E; Chang, S

    2012-06-01

    Many medical physicists are scientists at heart and their career fulfillment includes a balance of clinical service and research development. Multidisciplinary collaboration is a great way for the medical physicists to advance science and technology of our fields and the fields of our collaborators. Cross-pollination among scientists of different fields has been the key for some of the most significant breakthroughs in science and medicine and produced some of the most rewarding experiences for the individuals involved. However, medical physicists face unique challenges in establishing multidisciplinary collaboration because our time and resources for research are often quite limited compared to basic scientists. Yet we medical physicists are uniquely positioned and have a tremendous opportunity to create/contribute to multidisciplinary research: our fields are already multidisciplinary in nature and hospital environment is problem rich. How do we establish and carry out research collaboration with scientists of other fields? How to balance research with your higher priority clinical service? How do you find the right multidisciplinary collaboration in your own environment? We will discuss the challenges, provide real exemplary solutions to the above questions, and offer advise to medical physicists who are interested in starting or improving their multidisciplinary collaboration. There are different kinds of multidisciplinary collaborations a medical physicist can create and participate at different involvement levels. Multidisciplinary collaboration is not for every medical physicist but for those who seek and devote time to it, the experience can be truly rewarding and the impact can be enormous. 1. Learn the types of multidisciplinary collaboration medical physicists can created/participated 2. Learn the approaches and strategies to develop collaborations with scientists and professional of other fields3. Understand the challenges and different approaches to

  5. Causes and patterns of referral to a tertiary, multidisciplinary program for the treatment of childhood obesity.

    Science.gov (United States)

    Yaeger-Yarom, Gili; Nemet, Dan; Eliakim, Alon

    2011-01-01

    Despite the childhood obesity epidemic, few obese children receive therapy and relatively few weight management multidisciplinary programs exist. The objective of this study was to examine the patterns and causes for obese children referrals to a tertiary multidisciplinary childhood obesity treatment program. A total of 227 children (10.6 +/- 2.6 years; 108 boys, 119 girls) were evaluated at the beginning of the programs for personal and familial demographic and anthropometric details, the referring agent to the program, and the main reasons for participation and for the child's desire to lose weight. The majority of participants had an obese family member (83%), in particular an obese parent (62%). The majority of patients were self-referred (86.8%), mainly by their mothers (74%). Only a small fraction were referred by healthcare providers (15.4%). The desire to improve appearance (44.5%), social/psychological issues (39.2%) and the will to improve fitness (29.5%) were the main reasons for joining the program. Understanding the motives for participation and referral patterns can improve recruitment and participation of obese children in weight reduction intervention programs.

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

    NARCIS (Netherlands)

    Vos, Rimke Cathelijne

    2011-01-01

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

  7. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  8. Fifteen Challenges in Establishing a Multidisciplinary Research Program on eHealth Research in a University Setting: A Case Study.

    Science.gov (United States)

    Grönqvist, Helena; Olsson, Erik Martin Gustaf; Johansson, Birgitta; Held, Claes; Sjöström, Jonas; Lindahl Norberg, Annika; Hovén, Emma; Sanderman, Robbert; van Achterberg, Theo; von Essen, Louise

    2017-05-23

    U-CARE is a multidisciplinary eHealth research program that involves the disciplines of caring science, clinical psychology, health economics, information systems, and medical science. It was set up from scratch in a university setting in 2010, funded by a governmental initiative. While establishing the research program, many challenges were faced. Systematic documentation of experiences from establishing new research environments is scarce. The aim of this paper was to describe the challenges of establishing a publicly funded multidisciplinary eHealth research environment. Researchers involved in developing the research program U-CARE identified challenges in the formal documentation and by reflecting on their experience of developing the program. The authors discussed the content and organization of challenges into themes until consensus was reached. The authors identified 15 major challenges, some general to establishing a new research environment and some specific for multidisciplinary eHealth programs. The challenges were organized into 6 themes: Organization, Communication, Implementation, Legislation, Software development, and Multidisciplinarity. Several challenges were faced during the development of the program and several accomplishments were made. By sharing our experience, we hope to help other research groups embarking on a similar journey to be prepared for some of the challenges they are likely to face on their way. ©Helena Grönqvist, Erik Martin Gustaf Olsson, Birgitta Johansson, Claes Held, Jonas Sjöström, Annika Lindahl Norberg, Emma Hovén, Robbert Sanderman, Theo van Achterberg, Louise von Essen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.05.2017.

  9. The risk of childhood leukaemia near nuclear establishments

    International Nuclear Information System (INIS)

    Stather, J.W.; Clarke, R.H.; Duncan, K.P.

    1988-01-01

    Childhood leukaemia has been reported to be increased in communities living near a number of nuclear sites in the United Kingdom. The National Radiological Protection Board has, over the last three and a half years, published the results of a series of studies giving radiation doses and risks calculated for some of these populations. The studies have all indicated that it is most unlikely that radiation doses arising from releases of radioactive materials into the environment could have contributed to any increase in the leukaemia incidence in local communities. In the absence of any other obvious causative agent, however, there remains some concern that the radiation doses and risks of leukaemia have been underestimated. This report, therefore, summarises the methods used in the analyses by the Board, examines possible sources of uncertainty in the calculations, and considers the extent to which more information is required. (author)

  10. The risk of childhood leukaemia near nuclear establishments

    International Nuclear Information System (INIS)

    Fry, F.A.

    1997-01-01

    The author concentrates on an epidemiological investigation on the increased incidence of leukaemia in young people of age 0∼24 years old in the years of 1963∼1992 in Seascale, a Village near the BNFL reprocessing plant at Sellafield on the north-west coast of England. A comparison of this incidence is made with that revealed in regions of other similar nuclear establishments. It has been concluded that the increased incidence of leukaemia in young people in Seascale can not be imputed to any single factor, but interaction between different factor cannot be ruled out

  11. Multidisciplinary team working in an adult male prison establishment in the UK.

    Science.gov (United States)

    Heidari, E; Dickinson, C; Newton, T

    2014-08-01

    The first two articles in this series exploring the oral and dental health of male prisoners in the UK demonstrated how the general and oral health of prisoners is compromised compared to those of a similar age who are not prisoners. In caring for the oral health needs of this group the high demand for emergency dental services often precludes the delivery of preventive and routine care. Comprehensive oral care for this population requires a level of training to gain the skills and knowledge to manage prisoners' complex medical, dental and social needs and the heightened dental anxiety that prisoners exhibit. The type of training that might be required for prison dentistry will be discussed in the final article. This article will describe a number of cases selected to demonstrate the complex problems presented by male prisoners in Her Majesty's Prison (HMP), Brixton. This article will also discuss the establishment of a primary care inter-professional relationship network (IRN) developed within a prison setting involving a dentist and other healthcare professionals. After informal discussions between the dentist and other prison healthcare professionals, it became apparent that vulnerable patients were not accessing dental services. These patients also cancel/fail to attend their dental appointments more frequently. In order to improve access and provision of dental care for this group of prisoners, an IRN was developed between the dentist, diabetic nurse, forensic psychology team, communicable disease lead, general medical practitioner (GMP), prison officers and healthcare manager within HMP Brixton. The nature of the IRN is presented along with reviews with relevant patient cases. The IRN allowed information sharing between professionals and an open care culture. The network was valued by prisoners. Prison populations show higher rates of general and oral disease, therefore an IRN can help to identify vulnerable groups and allow healthcare providers to give

  12. Living with childhood obesity: the experience of children enrolled in a multidisciplinary monitoring program

    Directory of Open Access Journals (Sweden)

    Silvia Veridiana Zamparoni Victorino

    2015-02-01

    Full Text Available This study aimed to understand the perceptions of obesity from the perspective of obese children enrolled in a multidisciplinary monitoring program. Descriptive exploratory study of qualitative nature. Data collection occurred in December 2013, along with eight children accompanied by a child and adolescent obesity group in a municipality in northwestern Paraná, Brazil, through semi-structured interviews. Data were submitted to content analysis, from which four categories emerged: “Obesity in children’s perspective”; “Being an obese child”; “Eating and the practice of physical exercise in the routine of obese children”; and “Living with obesity: social and family implications for children.” It was verified the negative impact of obesity on children’s lives, justifying the importance of multidisciplinary follow-up through group activities, seeking a comprehensive care. Nursing is accountable for planning activities of health promotion and control of this disease, in order to improve the quality of life.

  13. Overcoming obstacles to establish a multidisciplinary team approach to hepatobiliary diseases: a working model in a Caribbean setting.

    Science.gov (United States)

    Cawich, Shamir O; Johnson, Peter B; Shah, Sundeep; Roberts, Patrick; Arthurs, Milton; Murphy, Trevor; Bonadie, Kimon O; Crandon, Ivor W; Harding, Hyacinth E; Abu Hilal, Mohammed; Pearce, Neil W

    2014-01-01

    By providing a structured forum to exchange information and ideas, multidisciplinary team meetings improve working relationships, expedite investigations, promote evidence-based treatment, and ultimately improve clinical outcomes. This discursive paper reports the introduction of a multidisciplinary team approach to manage hepatobiliary diseases in Jamaica, focusing on the challenges encountered and the methods used to overcome these obstacles. Despite multiple challenges in resource-limited environments, a multidisciplinary team approach can be incorporated into clinical practice in developing nations. Policy makers should make it a priority to support clinical, operational, and governance aspects of the multidisciplinary teams.

  14. The effect of family-based multidisciplinary cognitive behavioral treatment on health-related quality of life in childhood obesity

    NARCIS (Netherlands)

    Vos, R.C.; Huisman, S.D.; Houdijk, E.C.A.M.; Pijl, H.; Wit, J.M.

    2012-01-01

    Purpose To evaluate the effect of multidisciplinary treatment on obesity and health-related quality of life (HRQOL). Methods Obese children were randomized to a multidisciplinary lifestyle treatment, including medical, nutritional, physical, and psychological counseling during 3 months, (n = 40,

  15. Issues and Strategies for Establishing Work-Integrated Learning for Multidisciplinary Teams: A Focus on Degrees in Sustainability

    Science.gov (United States)

    Wilson, Robyn Fay

    2015-01-01

    This study was conducted to identify challenges and potential strategies to streamline work-integrated learning placements for multidisciplinary teams of students undertaking degrees in sustainability. Face-to-face interviews using a semi-structured questionnaire were conducted with 15 academics and senior university staff, from four universities…

  16. Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

    Science.gov (United States)

    Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

    2017-01-01

    This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

  17. [Evaluation of the management of soft tissue sarcomas in Franche-Comté since the establishment of a multidisciplinary meeting at University Hospital. About 47 cases].

    Science.gov (United States)

    Haddad, J; Kalbacher, E; Piccard, M; Aubry, S; Chaigneau, L; Pauchot, J

    2017-02-01

    A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. [Technical statement by the Spanish Paediatric Association in relation to gender diversity in childhood and adolescence: Ethical and legal view from a multidisciplinary perspective].

    Science.gov (United States)

    Riaño Galán, Isolina; Del Río Pastoriza, Inés; Chueca Guindulain, María; Gabaldón Fraile, Sabel; de Montalvo Jááskeläinem, Federico

    2018-03-19

    An ethical and legal view of gender diversity in childhood and adolescence is presented from the perspective of the best interest of the child and the principle of protection against vulnerability. The identification of gender diversity in childhood and adolescence is a process that requires support, coordination and a multidisciplinary team that improves care and helps to obtain evidence that is lacking today. Secure, equitable and comprehensive access to care and health care should be guaranteed when required. It is necessary to promote a changing of social outlook, capable of overcoming the stereotypes that lead to discrimination and increase suffering. Respect for gender diversity in childhood and adolescence is a fundamental Human Right. The recognition of a positive value in diversity is an ethical imperative. All of this, without forgetting that we are talking about minors often in contexts of vulnerability, and currently very uncertain, so prudence is the main rule that should guide decision-making. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  19. A methodology to establish a database to study gene environment interactions for childhood asthma

    Directory of Open Access Journals (Sweden)

    McCormick Jonathan

    2010-12-01

    Full Text Available Abstract Background Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES - Paediatric Asthma Gene Environment Study. Methods Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR, skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database. Results To date 1045 children have been invited to participate and data collected in 501 (48%. The mean age (SD of participants is 8.6 (3.9 years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD FEV1 97% (15 and median (IQR BDR is 5% (2, 9. There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024. Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part. Conclusions It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.

  20. 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…

  1. A Cooperative Plan to Establish an Early Childhood Center for the Invention, Demonstration, and Evaluation of Innovative Practices in Early Childhood Education. Final Report.

    Science.gov (United States)

    Irondequoit Central School District 3, Rochester, NY.

    In 1968 an upstate New York School district, acting on behalf of nine school districts, planned and established an Early Childhood Center. This evaluative report of a 2-year demonstration preschool, modeled on the British Infant School, describes the open classroom arrangement and its effect on the center's children, teachers, and student…

  2. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement.

    Science.gov (United States)

    Stewart, Simon; Riegel, Barbara; Boyd, Cynthia; Ahamed, Yasmin; Thompson, David R; Burrell, Louise M; Carrington, Melinda J; Coats, Andrew; Granger, Bradi B; Hides, Julie; Weintraub, William S; Moser, Debra K; Dickson, Victoria Vaughan; McDermott, Cressida J; Keates, Ashley K; Rich, Michael W

    2016-06-01

    Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. “A rising tide lifts all boats”: establishing a multidisciplinary genomic tumor board for breast cancer patients with advanced disease

    Directory of Open Access Journals (Sweden)

    Michelle L. McGowan

    2016-11-01

    Full Text Available Abstract Background Research suggests that multidisciplinary genomic tumor boards (MGTB can inform cancer patient care, though little is known about factors influencing how MGTBs interpret genomic test results, make recommendations, and perceive the utility of this approach. This study’s objective was to observe, describe, and assess the establishment of the Breast Multidisciplinary Genomic Tumor Board, the first MGTB focused on interpreting genomic test results for breast cancer patients with advanced disease. Methods We conducted a qualitative case study involving participant observation at monthly MGTB meetings from October 2013 through November 2014 and interviews with 12 MGTB members. We analyzed social dynamics and interactions within the MGTB regarding interpretation of genomic findings and participants’ views on effectiveness of the MGTB in using genomics to inform patient care. Results Twenty-two physicians, physician-scientists, basic scientists, bioethicists, and allied care professionals comprised the MGTB. The MGTB reviewed FoundationOne™ results for 40 metastatic breast cancer patients. Based on findings, the board mostly recommended referring patients to clinical trials (34 and medical genetics (15, and Food and Drug Administration-approved (FDA breast cancer therapies (13. Though multidisciplinary, recommendations were driven by medical oncologists. Interviewees described providing more precise care recommendations and professional development as advantages and the limited actionability of genomic test results as a challenge for the MGTB. Conclusions Findings suggest both feasibility and desirability of pooling professional expertise in genomically-guided breast cancer care and challenges to institutionalizing a Breast MGTB, specifically in promoting interdisciplinary contributions and managing limited actionability of genomic test results for patients with advanced disease.

  4. Childhood Obesity Task Forces Established by State Legislatures, 2001-2010

    Science.gov (United States)

    Kim, Sonia A.; Sherry, Bettylou; Blanck, Heidi M.

    2013-01-01

    Introduction States and communities are considering policy and environmental strategies, including enacting legislation, to reduce and prevent childhood obesity. One legislative approach has been to create task forces to understand key issues and develop a course of action. The goal of this study was to describe state-level, childhood obesity task forces in the United States created by legislation from 2001 through 2010. Methods We used the Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity database to identify state-level childhood obesity task forces created through legislation from 2001 through 2010. Results We identified 21 states that had enacted legislation creating childhood obesity task forces of which 6 had created more than one task force. Most task forces were charged with both gathering and reviewing information and making recommendations for obesity-prevention actions in the state. Most legislation required that task forces include representation from the state legislature, state agencies, community organizations, and community members. Conclusion Evaluation of the effectiveness of obesity-prevention task forces and the primary components that contribute to their success may help to determine the advantages of the use of such strategies in obesity prevention. PMID:23987250

  5. Establishment of a schizophrenic animal model through chronic administration of MK-801 in infancy and social isolation in childhood.

    Science.gov (United States)

    Liu, Weiqing; Wang, Xiuyan; Hong, Wenjuan; Wang, Dong; Chen, Xiaogang

    2017-02-01

    Although an increasing amount of evidence supports a "two-hit" hypothesis for the neurodevelopmental model of schizophrenia, there has been no development in animal models to test this hypothesis. An animal model was established by chronic administration of 0.1, 0.3, and 0.5mg/kg MK-801 in P7-P21 rats followed by four weeks of social isolation in childhood and then five days of social housing. Animal behaviors were measured by the open field (OF) test, the novel object recognition (NOR) test, the prepulse inhibition (PPI) test, and the elevated plus maze (EPM) test. We found a significant decrease in the NOR index in adolescent rats compared to saline control rats when administering 0.5mg/kg of MK-801 (P=0.02). We found that social isolation had no significant effect on NOR index, though social isolation significantly increased the total distance traveled and significantly decreased the resting time in adolescent rats in the OF test (Psocial isolation had no significant effect on the percent of PPI and startle amplitudes in adolescent rats. Social isolation significantly reduced the open arm entries in adolescent rats in the EPM test (P=0.023), but it did not reduce the ratio to enter the open arms and the stay time in open arm. Administration of MK-801 showed no significant effect on the indexes of entering the open arms in the EPM test on adolescent rats. MK-801 intervention in infancy is associated with the damage of long-term visual memory, whereas social isolation in childhood is associated with the increased spontaneous activity and anxiety levels. Administration of MK-801 in infancy and social isolation in childhood are two independent factors on the neurodevelopmental defects. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors

    Science.gov (United States)

    Gianfrancesco, Milena A.; Acuna, Brigid; Shen, Ling; Briggs, Farren B.S.; Quach, Hong; Bellesis, Kalliope H.; Bernstein, Allan; Hedstrom, Anna K.; Kockum, Ingrid; Alfredsson, Lars; Olsson, Tomas; Schaefer, Catherine; Barcellos, Lisa F.

    2014-01-01

    Objective To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors. Methods Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1,235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied. Results In analyses stratified by gender, being overweight at age 10 and 20 were associated with MS in females (prisk of MS for females with a BMI ≥ 30 kg/m2 was observed (OR = 2.15, 95% CI 1.18, 3.92). Significant associations between BMI in 20’s and MS in males were not observed. Multivariate modeling demonstrated that significant associations between BMI or body size with MS in females persisted after adjusting for history of infectious mononucleosis and genetic risk factors, including HLA-DRB1*15:01 and established non-HLA risk alleles. Interpretation Results show that childhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20’s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors. PMID:25263833

  7. Multidisciplinary treatment

    International Nuclear Information System (INIS)

    Hayabuchi, Naofumi; Jingu, Kenichi; Matsuura, Keiichi

    1985-01-01

    Multidisciplinary treatment for malignant lymphoma is reported in terms of indication, current status, and outcome of this approach to Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NLH). HD is considered to be most successfully managed with multidisciplinary treatment. Success of treatment of HD in European countries and the US, which has resulted from accurate staging of HD and developments in radiotherapy and chemotherapy, is reviewed in the literature. Problems in the treatment of HD in Japan are presented. A treatment policy for NHL is discussed according to the original site, i.e. lymph nodes, Waldeyer's ring or other sites of tumor involvement. (Namekawa, K.)

  8. Childhood leukaemia in the West Berkshire and Basingstoke and North Hampshire District Health Authorities in relation to nuclear establishments in the vicinity

    International Nuclear Information System (INIS)

    Roman, Eve; Beral, Valerie; Carpenter, Lucy; Watson, Ann; Barton, Carol; Ryder, Hilary; Aston, D.L.

    1987-01-01

    These data indicate that in the two district health authorities studied there was an excess incidence of childhood leukaemia during 1972-85 in the vicinity of the nuclear establishments. In the West Berkshire and Basingstoke and North Hampshire District Health Authorities an average of 60 000 children aged 0-14 lived within a 10 km radius of a nuclear establishment each year. The normal expectation of leukaemia in these children was two cases a year, whereas the recorded incidence was three cases per year, representing one extra case of leukaemia each year among these 60 000 children. (author)

  9. Multidisciplinary Approaches to Allergies

    NARCIS (Netherlands)

    Gao Zhongshan,; Shen, Hua-Hao; Zheng, M.; Frewer, L.J.; Gilissen, L.J.W.J.

    2012-01-01

    Allergy is an immunological disease caused by multiple factors and characterized by variability, specificity and complexity. "Multidisciplinary Approaches to Allergies" covers diverse aspects ranging from basic molecular mechanisms to societal issues within the framework of multidisciplinary

  10. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors.

    Science.gov (United States)

    Gianfrancesco, Milena A; Acuna, Brigid; Shen, Ling; Briggs, Farren B S; Quach, Hong; Bellesis, Kalliope H; Bernstein, Allan; Hedstrom, Anna K; Kockum, Ingrid; Alfredsson, Lars; Olsson, Tomas; Schaefer, Catherine; Barcellos, Lisa F

    2014-01-01

    To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors. Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied. In analyses stratified by gender, being overweight at ages 10 and 20 were associated with MS in females (pchildhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  11. Multidisciplinary intervention for childhood feeding difficulties.

    Science.gov (United States)

    Marshall, Jeanne; Hill, Rebecca J; Ware, Robert S; Ziviani, Jenny; Dodrill, Pamela

    2015-05-01

    The aim of the study was to determine whether operant conditioning (OC) or systematic desensitization (SysD) intervention resulted in more improvements in dietary variety/intake, and more reductions in difficult mealtime behaviors. Children 2 to 6 years with autism spectrum disorder or with a nonmedically complex history were recruited. Feeding difficulties were confirmed based on clinical assessment. Participants were randomized to receive 10 OC or SysD sessions (parents could opt for intervention once per week, or intensively within a week). Immersive parent education was delivered across both arms. A 3-month review was provided to measure outcomes postintervention. In total, 68 participants (87%) completed the study. There were no significant differences in outcome measures between the OC and SysD intervention groups from baseline to 3-month review. When the data were combined across both groups, however, significant improvements in primary outcome measures were observed (P education, these 2 intervention approaches are effective. Further research is required in exploring these interventions across other subgroups, and examining outcomes for longer periods.

  12. Multidisciplinary Computational Research

    National Research Council Canada - National Science Library

    Visbal, Miguel R

    2006-01-01

    The purpose of this work is to develop advanced multidisciplinary numerical simulation capabilities for aerospace vehicles with emphasis on highly accurate, massively parallel computational methods...

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

  14. [Anorexia nervosa: a multidisciplinary approach].

    Science.gov (United States)

    Bastidas, A; Cantó, T; Font, E

    2000-06-01

    The childhood-adolescent psychiatrics field has, for various years, been confronted by a very significant increase in cases of nervous anorexia, a serious eating disorder characterized by a noticeable loss of weight. At the bottom of this situation lie complex biological, psychological and social-cultural problems, which demand an interdisciplinary approach to solve them. This article presents the predisposing factors, the initial factors, the factors which maintain this disorder...; what behaviors are considered to be normal; what the physical and psychological manifestations are; as well as what the medical evaluation carried out is ... to finalize with an explanation of the different functions to be performed by each member of a multidisciplinary team.

  15. [Childhood obesity].

    Science.gov (United States)

    Chueca, M; Azcona, C; Oyárzabal, M

    2002-01-01

    Obesity during childhood and adolescence is an increasingly frequent cause for medical consultation. The increase in the prevalence of this disease, which has been considered as an epidemic by the World Health Organisation, is worrying. Obesity is a complex disease, whose aetiology still remains to be clarified due to the numerous factors involved: environmental, genetic, life style and behavioural, neuroendocrinological and metabolic. The persistence of childhood obesity until adulthood significantly increases the risk of suffering from diabetes mellitus, cardiovascular disease, hypertension, cholecystitis and cholelithiasis. Treatment of obesity is complicated and few patients regularly attend follow up examinations. A multidisciplinary team is required to carry out a suitable treatment, composed of paediatricians, dieticians, nurses, psychologists and psychiatrists. Successful treatment of obesity resides in reducing the calorie intake in relation to energy expenditure, and at the time providing instruction in appropriate eating habits and life styles that in the long term will promote the maintenance of the ideal weight.

  16. Nonpharmacologic Treatments for Childhood Constipation : Systematic Review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine.

  17. Nonpharmacologic treatments for childhood constipation: systematic review

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. We

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

    DEFF Research Database (Denmark)

    Wille-Jørgensen, Peer; Sparre, Peter; Glenthøj, Anders

    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...

  19. Multidisciplinary Special Education Efforts: A Transactional-Ecological Approach.

    Science.gov (United States)

    Buktenica, Norman A.

    The rationale and philosophy for multidisciplinary activities by school psychologists and educators are presented with an emphasis on the acquisition of information on the social context of children's behavior and needs. Multidisciplinary training teams (MDTT) established over an eight-year period in elementary schools in Nashville, Kentucky, are…

  20. Integrating Multidisciplinary Engineering Knowledge

    Science.gov (United States)

    Wolff, Karin; Luckett, Kathy

    2013-01-01

    In order to design two distinct engineering qualification levels for an existing University of Technology programme, empirical evidence based on the current diploma is necessary to illuminate the nature of and the relationship between the "contextual" and "conceptual" elements underpinning a multidisciplinary engineering…

  1. Multidisciplinary care of craniosynostosis

    Directory of Open Access Journals (Sweden)

    Buchanan EP

    2017-07-01

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

  2. Multidisciplinary team functioning.

    Science.gov (United States)

    Kovitz, K E; Dougan, P; Riese, R; Brummitt, J R

    1984-01-01

    This paper advocates the need to move beyond interdisciplinary team composition as a minimum criterion for multidisciplinary functioning in child abuse treatment. Recent developments within the field reflect the practice of shared professional responsibility for detection, case management and treatment. Adherence to this particular model for intervention requires cooperative service planning and implementation as task related functions. Implicitly, this model also carries the potential to incorporate the supportive functioning essential to effective group process. However, explicit attention to the dynamics and process of small groups has been neglected in prescriptive accounts of multidisciplinary child abuse team organization. The present paper therefore focuses upon the maintenance and enhancement aspects of multidisciplinary group functioning. First, the development and philosophy of service for the Alberta Children's Hospital Child Abuse Program are reviewed. Second, composition of the team, it's mandate for service, and the population it serves are briefly described. Third, the conceptual framework within which the program functions is outlined. Strategies for effective group functioning are presented and the difficulties encountered with this model are highlighted. Finally, recommendations are offered for planning and implementing a multidisciplinary child abuse team and for maintaining its effective group functioning.

  3. Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics

    DEFF Research Database (Denmark)

    Adeltoft, Teresa Ajslev; Andersen, C S; Gamborg, M

    2011-01-01

    Objective: To investigate whether delivery mode (vaginal versus by caesarean section), maternal pre-pregnancy body mass index (BMI) and early exposure to antibiotics (..., with information on maternal pre-pregnancy BMI, delivery mode and antibiotic administration in infancy, were assessed. Logistic regression analyses were performed with childhood height and weight at the 7-year follow-up as outcome measures. Results: Delivery mode was not significantly associated with childhood.......54, 95% CI: 0.30–0.98). The same tendency was observed among children of obese mothers (OR: 0.85, 95% CI: 0.41–1.76). Conclusion: The present cohort study revealed that a combination of early exposures, including delivery mode, maternal pre-pregnancy BMI and antibiotics in infancy, influences the risk...

  4. Building multidisciplinary business teams

    International Nuclear Information System (INIS)

    Dyson, C.J.; Winte, N.C.

    1991-01-01

    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

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

  6. 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....

  7. Building multidisciplinary business teams

    International Nuclear Information System (INIS)

    Dyson, C.J.; Winter, N.C.

    1992-01-01

    This paper describes an approach to managing oil and gas industry E and P assets through the operation of multidisciplinary business teams (MBT's). This approach can result in improved asset performance in terms of efficiency, motivation, and business results compared with more traditional matrix-style hierarchies. This paper also outlines certain critical success factors for the long-term success of MBT's and discusses some of the risks of MBT operation

  8. 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

  9. Initial Multidisciplinary Design and Analysis Framework

    Science.gov (United States)

    Ozoroski, L. P.; Geiselhart, K. A.; Padula, S. L.; Li, W.; Olson, E. D.; Campbell, R. L.; Shields, E. W.; Berton, J. J.; Gray, J. S.; Jones, S. M.; hide

    2010-01-01

    Within the Supersonics (SUP) Project of the Fundamental Aeronautics Program (FAP), an initial multidisciplinary design & analysis framework has been developed. A set of low- and intermediate-fidelity discipline design and analysis codes were integrated within a multidisciplinary design and analysis framework and demonstrated on two challenging test cases. The first test case demonstrates an initial capability to design for low boom and performance. The second test case demonstrates rapid assessment of a well-characterized design. The current system has been shown to greatly increase the design and analysis speed and capability, and many future areas for development were identified. This work has established a state-of-the-art capability for immediate use by supersonic concept designers and systems analysts at NASA, while also providing a strong base to build upon for future releases as more multifidelity capabilities are developed and integrated.

  10. Multidisciplinary System Reliability Analysis

    Science.gov (United States)

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

    2001-01-01

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

  11. Breakfast: a multidisciplinary approach.

    Science.gov (United States)

    Affinita, Antonio; Catalani, Loredana; Cecchetto, Giovanna; De Lorenzo, Gianfranco; Dilillo, Dario; Donegani, Giorgio; Fransos, Lucia; Lucidi, Fabio; Mameli, Chiara; Manna, Elisa; Marconi, Paolo; Mele, Giuseppe; Minestroni, Laura; Montanari, Massimo; Morcellini, Mario; Rovera, Giuseppe; Rotilio, Giuseppe; Sachet, Marco; Zuccotti, Gian Vincenzo

    2013-07-10

    The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being.

  12. 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.

  13. Multidisciplinary accident investigation : volume 2

    Science.gov (United States)

    1976-05-01

    The Task II final report for 1974 of the Multidisciplinary Accident Investigation : Team of the Maryland Medical-Legal Foundation, Inc. is presented. This report describes some preliminary findings emanating from a series of comprehensive, multivaria...

  14. Multidisciplinary accident investigation : volume 1

    Science.gov (United States)

    1976-09-01

    The final report of the Multidisciplinary Accident Investigation Team of the Maryland Medical-Legal Foundation, Inc. is presented. The report describes the methodology, results, discussions, conclusions and recommendations pertaining to the investiga...

  15. Asthma phenotypes in childhood.

    Science.gov (United States)

    Reddy, Monica B; Covar, Ronina A

    2016-04-01

    This review describes the literature over the past 18 months that evaluated childhood asthma phenotypes, highlighting the key aspects of these studies, and comparing these studies to previous ones in this area. Recent studies on asthma phenotypes have identified new phenotypes on the basis of statistical analyses (using cluster analysis and latent class analysis methodology) and have evaluated the outcomes and associated risk factors of previously established early childhood asthma phenotypes that are based on asthma onset and patterns of wheezing illness. There have also been investigations focusing on immunologic, physiologic, and genetic correlates of various phenotypes, as well as identification of subphenotypes of severe childhood asthma. Childhood asthma remains a heterogeneous condition, and investigations into these various presentations, risk factors, and outcomes are important since they can offer therapeutic and prognostic relevance. Further investigation into the immunopathology and genetic basis underlying childhood phenotypes is important so therapy can be tailored accordingly.

  16. 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

  17. Vertigo in childhood: a clinical experience.

    Science.gov (United States)

    Erbek, Seyra H; Erbek, Selim S; Yilmaz, Ismail; Topal, Ozgul; Ozgirgin, Nuri; Ozluoglu, Levent N; Alehan, Fusun

    2006-09-01

    Vertigo in childhood is a complaint consisting of a wide spectrum of diagnoses. The aim of this study was to evaluate pediatric patients with vertigo with normal eardrum and middle ear findings and discuss the differential diagnoses. Patient records of 50 children under 18 years of age with vertigo as the chief complaint, examined at the Baskent University, Research and Application Centers at Konya and Adana otorhinolaryngology clinics between May 2003 and October 2005 were retrospectively reviewed. The questionnaires, laboratory tests including blood samples, audiological and vestibular tests, and final diagnoses were analyzed. Patients with perforated eardrums, otitis media with effusion, and acute upper respiratory tract infections were not included in the study. The study group consisted of 50 patients (33 females, 66%; 17 males, 34%), between 4 and 17 years of age (mean age, 11.5+/-3.9 years). Severe sensorineural hearing loss was present in one patient unilaterally (2%) and one patient bilaterally (2%). Bilateral low-frequency sensorineural hearing loss was present in one patient (2%). Electronystagmography revealed central vestibular abnormalities in three patients (6%). Canal paresis was established in six patients (12%). The Dix-Hallpike test was positive in six patients (12%). The most frequent cause of vertigo was migraine, occurring in 34% of patients (n=17). Other less-frequent etiologies of vertigo were benign paroxysmal vertigo (n=6; 12%), benign paroxysmal positional vertigo (n=6; 12%), psychogenic vertigo (n=5; 10%), epilepsy (n=3; 6%), metabolic disorders (n=3; 6%), vestibular neuritis (n=2; 4%), Meniere's disease (n=1; 2%), perilymphatic fistula (n=1; 2%), amblyopia (n=1; 2%), and unclassifiable (n=5; 10%). Migraine was found to be the most frequent presenting diagnosis in childhood vertigo, although several peripheral vestibular disorders also were diagnosed. Evaluation of vertigo in childhood should begin with a thorough neuro

  18. Sensitivity Analysis of Multidisciplinary Rotorcraft Simulations

    Science.gov (United States)

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

    2017-01-01

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

  19. Communication in multidisciplinary systems architecting

    NARCIS (Netherlands)

    Bonnema, Gerrit Maarten

    2014-01-01

    Systems architecting is multidisciplinary by nature. It is interesting to note that the methods and tools that are developed and presented in literature are mostly based on one or a very limited number of formalisms. This means that an often large part of the stakeholders involved in the

  20. Multidisciplinary Efforts Driving Translational Theranostics

    Science.gov (United States)

    Hu, Tony Y.

    2014-01-01

    This themed issue summarizes significant efforts aimed at using “biological language” to discern between “friends” and “foes” in the context of theranostics for true clinical application. It is expected that the success of theranostics depends on multidisciplinary efforts, combined to expedite our understanding of host responses to “customized” theranostic agents and formulating individualized therapies. PMID:25285169

  1. Childhood Stress

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Childhood Stress KidsHealth / For Parents / Childhood Stress What's in this ... and feel stress to some degree. Sources of Stress Stress is a function of the demands placed ...

  2. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  3. Childhood Obesity

    OpenAIRE

    Trandafir, Laura Mihaela; Ioniuc, Ileana; Miron, Ingrith

    2017-01-01

    Childhood obesity has important consequences for health and wellbeing both during childhood and also in later adult life. The rising prevalence of childhood obesity poses a major public health challenge in both developed and developing countries by increasing the burden of chronic non-communicable diseases. Despite the urgent need for effective preventative strategies, there remains disagreement over its definition due to a lack of evidence on the optimal cut-offs linking childhood BMI to dis...

  4. [Endocrine consequences in young adult survivors of childhood cancer treatment].

    Science.gov (United States)

    Leroy, C; Cortet-Rudelli, C; Desailloud, R

    2015-10-01

    Endocrine complications (particularly gonadal, hypothalamic-pituitary and metabolic) of childhood cancer treatments are common in young adults. Gonadal damage may be the result of chemotherapy or radiotherapy. Fertility preservation must be systematically proposed before initiation of gonadotoxic treatment if only the child is eligible. Hypothalamic-pituitary deficiency is common after brain or total-body irradiation, the somatotropic axis is the most sensitive to irradiation. Pituitary deficiency screening must be repeated since this endocrine consequence can occur many years after treatment. Hormone replacement must be prudent particularly in case of treatment with growth hormone or steroids. Metabolic syndrome, diabetes and cardiovascular damage resulting from cancer treatments contribute to the increase of morbidity and mortality in this population and should be screened routinely even if the patient is asymptomatic. The multidisciplinary management of these adults must be organized and the role of the endocrinologist is now well established. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. 34 CFR 303.17 - Multidisciplinary.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Multidisciplinary. 303.17 Section 303.17 Education... DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.17 Multidisciplinary. As used in this part, multidisciplinary means the involvement of two or more disciplines or professions in the...

  6. Recommending Research Profiles for Multidisciplinary Academic Collaboration

    Science.gov (United States)

    Gunawardena, Sidath Deepal

    2013-01-01

    This research investigates how data on multidisciplinary collaborative experiences can be used to solve a novel problem: recommending research profiles of potential collaborators to academic researchers seeking to engage in multidisciplinary research collaboration. As the current domain theories of multidisciplinary collaboration are insufficient…

  7. Multidisciplinary teamwork and communication training.

    Science.gov (United States)

    Deering, Shad; Johnston, Lindsay C; Colacchio, Kathryn

    2011-04-01

    Every delivery is a multidisciplinary event, involving nursing, obstetricians, anesthesiologists, and pediatricians. Patients are often in labor across multiple provider shifts, necessitating numerous handoffs between teams. Each handoff provides an opportunity for errors. Although a traditional approach to improving patient outcomes has been to address individual knowledge and skills, it is now recognized that a significant number of complications result from team, rather than individual, failures. In 2004, a Sentinel Alert issued by the Joint Commission revealed that most cases of perinatal death and injury are caused by problems with an organization's culture and communication failures. It was recommended that hospitals implement teamwork training programs in an effort to improve outcomes. Instituting a multidisciplinary teamwork training program that uses simulation offers a risk-free environment to practice skills, including communication, role clarification, and mutual support. This experience should improve patient safety and outcomes, as well as enhance employee morale. Published by Elsevier Inc.

  8. 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.

  9. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

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

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...

  10. 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

  11. 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.

  12. Knowledge Exchange and Discovery in the Age of Social Media: The Journey From Inception to Establishment of a Parent-Led Web-Based Research Advisory Community for Childhood Disability.

    Science.gov (United States)

    Russell, Dianne J; Sprung, Jennifer; McCauley, Dayle; Kraus de Camargo, Olaf; Buchanan, Francine; Gulko, Roman; Martens, Rachel; Gorter, Jan Willem

    2016-11-11

    Efforts to involve parents and families in all aspects of research, from initiating the question through to dissemination and knowledge exchange, are increasing. While social media as a method for health communication has shown numerous benefits, including increasing accessibility, interactions with others, and access to health care information, little work has been published on the use of social media to enhance research partnerships. Our objective was to describe the development and evaluation of a Web-based research advisory community, hosted on Facebook and connecting a diverse group of parents of special needs children with researchers at CanChild Centre for Childhood Disability Research. The goal of this community is to work together and exchange knowledge in order to improve research and the lives of children and their families. The Web-based Parents Participating in Research (PPR) advisory community was a secret Facebook group launched in June 2014 and run by 2 parent moderators who worked in consultation with CanChild. We evaluated its success using Facebook statistics of engagement and activity (eg, number of posts, number of comments) between June 2014 and April 2015, and a Web-based survey of members. The PPR community had 96 participants (2 parent moderators, 13 researchers, and 81 family members) as of April 1, 2015. Over 9 months, 432 original posts were made: 155 (35.9%) by moderators, 197 (45.6%) by parents, and 80 (18.5%) by researchers. Posts had a median of 3 likes (range 0-24) and 4 comments (range 0-113). Members, rather than moderators, generated 64% (277/432) of posts. The survey had a 51% response rate (49/96 members), with 40 (82%) being parent members and 9 (18%) being researchers. The initial purpose of the group was to be an advisory to CanChild, and 76% (28/37) of parents and all the researchers (9/9) identified having an impact on childhood disability research as their reason for participating. A total of 58% (23/40) of parents and 56

  13. Childhood leukaemia risks: from unexplained findings near nuclear installations to recommendations for future research

    International Nuclear Information System (INIS)

    Laurier, D; Jacob, S; Grosche, B; Dehos, A; Hornhardt, S; Ziegelberger, G

    2014-01-01

    Recent findings related to childhood leukaemia incidence near nuclear installations have raised questions which can be answered neither by current knowledge on radiation risk nor by other established risk factors. In 2012, a workshop was organised on this topic with two objectives: (a) review of results and discussion of methodological limitations of studies near nuclear installations; (b) identification of directions for future research into the causes and pathogenesis of childhood leukaemia. The workshop gathered 42 participants from different disciplines, extending widely outside of the radiation protection field. Regarding the proximity of nuclear installations, the need for continuous surveillance of childhood leukaemia incidence was highlighted, including a better characterisation of the local population. The creation of collaborative working groups was recommended for consistency in methodologies and the possibility of combining data for future analyses. Regarding the causes of childhood leukaemia, major fields of research were discussed (environmental risk factors, genetics, infections, immunity, stem cells, experimental research). The need for multidisciplinary collaboration in developing research activities was underlined, including the prevalence of potential predisposition markers and investigating further the infectious aetiology hypothesis. Animal studies and genetic/epigenetic approaches appear of great interest. Routes for future research were pointed out. (review)

  14. 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).

  15. 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

  16. 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...... from the game’s core mechanics....

  17. Hypohidrotic ectodermal dysplasia: a multidisciplinary approach.

    Science.gov (United States)

    Bildik, Tezan; Ozbaran, Burcu; Kose, Sezen; Koturoglu, Guldane; Gokce, Bulent; Gunaydin, Asli; Altintas, Inci

    2012-01-01

    Hypohidrotic ectodermal dysplasia (HED; Christ-Siemens-Touraine syndrome) is a genetic disorder characterized by sparse hair, oligodontia with peg-shaped teeth, reduced sweating, and defects in a number of other ectodermal organs. A partial or complete absence of eccrine glands can lead to recurrent severe overheating that may cause seizures and neurological deficits. This clinical report presents a 14-year-old male patient with hypohidrotic ectodermal dysplasia, including the clinical and radiographic findings, and multidisciplinary treatment. The Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was administered to patient along with mother to assess for any psychiatric disorders. The screening and rating scales completed by mother and two teachers to evaluate the severity of attention deficit hyperactivity disorder (ADHD) symptoms, and other behavioral problems. Patient's academic performance, adaptive functioning, and problem behavior was evaluated using. The Teacher Report Form. Mental capacity was assessed with the Wechsler Intelligence Scale for Children (WISC-R). Illness Perception Questionnaire Revised was used to systematically assess illness representation attributes and emotional representations of illness. On the psychiatric diagnosis assessment using K-SADS-PL sub-threshold attention deficits and anxiety symptoms were determined. In this case we established a multidisciplinary approach in his treatment with pediatric, dermatological, and dental examinations, beside his psychiatric evaluation. The prosthetic rehabilitation included restoring upper teeth with copings and fabrication of upper and lower complete dentures. Metal framework was not incorporated in the partial denture design allowing modifications as the oral and maxillofacial development continued. Removable complete or partial dentures without metal framework is a treatment of choice until the completion of facial growth at

  18. Multidisciplinary collaboration in primary care: through the eyes of patients.

    Science.gov (United States)

    Cheong, Lynn H; Armour, Carol L; Bosnic-Anticevich, Sinthia Z

    2013-01-01

    Managing chronic illness is highly complex and the pathways to access health care for the patient are unpredictable and often unknown. While multidisciplinary care (MDC) arrangements are promoted in the Australian primary health care system, there is a paucity of research on multidisciplinary collaboration from patients' perspectives. This exploratory study is the first to gain an understanding of the experiences, perceptions, attitudes and potential role of people with chronic illness (asthma) on the delivery of MDC in the Australian primary health care setting. In-depth semi-structured interviews were conducted with asthma patients from Sydney, Australia. Qualitative analysis of data indicates that patients are significant players in MDC and their perceptions of their chronic condition, perceived roles of health care professionals, and expectations of health care delivery, influence their participation and attitudes towards multidisciplinary services. Our research shows the challenges presented by patients in the delivery and establishment of multidisciplinary health care teams, and highlights the need to consider patients' perspectives in the development of MDC models in primary care.

  19. Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic.

    Science.gov (United States)

    Light, Tyler; Rassi, Edward El; Maggiore, Ronald J; Holland, John; Reed, Julie; Suriano, Kathleen; Stooksbury, Marcelle; Tobin, Nora; Gross, Neil; Clayburgh, Daniel

    2017-06-01

    Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC). A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic. Fifty-two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5-year disease-specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease-specific survival. Implementation of a multidisciplinary clinic improved care coordination and disease-specific survival in patients with oropharyngeal SCC. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1106-1112, 2017. © 2017 Wiley Periodicals, Inc.

  20. 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...

  1. INDIAN CHILDHOOD AND OTHER CHILDHOODS

    Directory of Open Access Journals (Sweden)

    Alceu Zoia

    2010-12-01

    Full Text Available This article aims to show how children of the Indian community Terena, from North Mato Grosso, live, how they are educated, and what are the conceptions of childhood among the members of this community. Taking childhood in various contexts, we seek to analyze how this education process has been carried out.

  2. Vocational rehabilitation: a multidisciplinary intervention.

    Science.gov (United States)

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

    2007-09-15

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

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

    Science.gov (United States)

    Hilhorst-Hofstee, Yvonne

    2013-01-01

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

  4. [Multidisciplinary treatment of orofacial pain].

    Science.gov (United States)

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

    2016-11-01

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

  5. Multidisciplinary approach to carotid stenting.

    Science.gov (United States)

    Mak, C S; Chambers, B R; Clark, D J; Molan, M; Brooks, M; Roberts, N; Fell, G; Roberts, A K; New, G; Donnan, G A

    2011-11-01

    Stroke neurologists, vascular surgeons, interventional neuroradiologists and interventional cardiologists have embraced carotid angioplasty and stenting (CAS) because of potential advantages over carotid endarterectomy (CEA). At Austin Health, a multidisciplinary neuro-interventional group was formed to standardise indications and facilitate training. The aims of this study were to describe our organisational model and to determine whether 30-day complications and early outcomes were similar to those of major trials. A clinical protocol was developed to ensure optimal management. CAS was performed on patients with high medical risk for CEA, with technically difficult anatomy for CEA, or who were randomised to CAS in a trial. From October 2003 to May 2008, 47 patients (34 male, mean age 71.5) underwent CAS of 50 carotid arteries. Forty-three cases had ipsilateral carotid territory symptoms within the previous 12 months. The main indications for CAS were high risk for CEA (n= 17) and randomised to CAS (n= 21). Interventionists were proctored in 27 cases. The procedural success rate was 94% with two cases abandoned because of anatomical problems and one because of on-table angina. Hypotension requiring vasopressor therapy occurred in 12 cases (24%). The duration of follow up was one to 44 months (mean 6.8 months). The 30-day rate of peri-procedural stroke or death was 6% and the one-year rate of peri-procedural stroke or death or subsequent ipsilateral stroke was 10.6%. Restenosis occurred in 13% (all asymptomatic). A multidisciplinary approach is a useful strategy for initiating and sustaining a CAS programme. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  6. PARAMETER COORDINATION AND ROBUST OPTIMIZATION FOR MULTIDISCIPLINARY DESIGN

    Institute of Scientific and Technical Information of China (English)

    HU Jie; PENG Yinghong; XIONG Guangleng

    2006-01-01

    A new parameter coordination and robust optimization approach for multidisciplinary design is presented. Firstly, the constraints network model is established to support engineering change, coordination and optimization. In this model, interval boxes are adopted to describe the uncertainty of design parameters quantitatively to enhance the design robustness. Secondly, the parameter coordination method is presented to solve the constraints network model, monitor the potential conflicts due to engineering changes, and obtain the consistency solution space corresponding to the given product specifications. Finally, the robust parameter optimization model is established, and genetic arithmetic is used to obtain the robust optimization parameter. An example of bogie design is analyzed to show the scheme to be effective.

  7. Childhood Cancer Statistics

    Science.gov (United States)

    ... Watchdog Ratings Feedback Contact Select Page Childhood Cancer Statistics Home > Cancer Resources > Childhood Cancer Statistics Childhood Cancer Statistics – Graphs and Infographics Number of Diagnoses Incidence Rates ...

  8. Childhood Leukemia

    Science.gov (United States)

    ... acute types. Symptoms include Infections Fever Loss of appetite Tiredness Easy bruising or bleeding Swollen lymph nodes Night sweats Shortness of breath Pain in the bones or joints Risk factors for childhood leukemia include having a brother ...

  9. 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.

  10. Multidisciplinary Management of Laryngeal Carcinoma

    International Nuclear Information System (INIS)

    Mendenhall, William M.; Mancuso, Anthony A.; Hinerman, Russell W.; Malyapa, Robert S.; Werning, John W.; Amdur, Robert J.; Villaret, Douglas B.

    2007-01-01

    The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor

  11. EMSO: European multidisciplinary seafloor observatory

    Science.gov (United States)

    Favali, Paolo; Beranzoli, Laura

    2009-04-01

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

  12. Establishment of heart teams in Portugal.

    Science.gov (United States)

    Sousa Uva, M; Leite Moreira, A; Gavina, C; Pereira, H; Lopes, M G

    2014-01-01

    Whenever several therapeutic options exist, multidisciplinary decision-making is beneficial for the patient and for society at large. The main obstacles to the establishment of heart teams in Portugal are organizational and logistical. Implementing a heart team approach entails definition of the situations requiring multidisciplinary discussion, creation of clear lines of communication, written protocols and obtaining patient informed consent. The European Society of Cardiology guidelines define the clinical scenarios where intervention of the heart team is recommended. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  13. [Principles of multidisciplinary management of Duchenne muscular dystrophy].

    Science.gov (United States)

    Chabrol, B; Mayer, M

    2015-12-01

    Given the gradual progression observed in Duchenne muscular dystrophy, organization of care in multidisciplinary consultations is essential for optimal management of the different aspects of the disease. Drawing up a care plan is always preceded by a specific consultation for the announcement of the diagnosis with both the parents and the child. Explaining to the child the origin of his problems with simple words, telling him that why he experienced a particular symptom has been understood, is a fundamental step. The child needs to receive the information at different times of the disease following the rhythms of the disease stages, with an appropriate lead time. With the progress achieved in managing this disease, more than 90% of these children now live into adulthood. The switch from pediatric consultations to adult consultations, marking the transition from childhood management at adulthood, is a major challenge in the organization of care. Although today death occurs most often in adulthood, some children die in childhood. For the majority of teams who care for children, whatever the initial pathology may be, the notion of care continuity and accompaniment from the announcement of the disease to the terminal phase is essential. Increasing numbers of therapeutic trials have been developed over the past few years aiming to investigate children with DMD. However, they must not neglect the overall management of these patients and provide the best accompaniment possible. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Whey protein stories - An experiment in writing a multidisciplinary biography.

    Science.gov (United States)

    Jensen, Tenna; Bechshoeft, Rasmus L; Giacalone, Davide; Otto, Marie Haulund; Castro-Mejía, Josue; Bin Ahmad, Hajar Fauzan; Reitelseder, Søren; Jespersen, Astrid Pernille

    2016-12-01

    This is an experimental, dual-purpose article about whey protein and how to conduct interdisciplinary analyses and writings. On the one hand, this article is a multidisciplinary commodity biography, which consists of five descriptions of whey protein written by the five different research groups involved in the interdisciplinary research project CALM(Counteracting Age-related loss of Skeletal Muscle Mass). On the other hand, it is a meta-analysis, which aims to uncover and highlight examples of how the five descriptions contribute to each other with insights into the contextualisation of knowledge, contrasts between the descriptions and the new dimensions they bring to established fields of interest. The meta-analysis also contains a discussion of interdisciplinary study objects and the usefulness of the multidisciplinary commodity biography as a format for interdisciplinary publications. The article contributes to the field of food studies with a multidisciplinary biography of whey protein - including its sensory qualities and challenges, insights into its cultural history, its nutritional value and effects on the human body and an analysis of how it is perceived by people who consume it. The biography thereby expands upon existing understandings of whey protein while discussing the usefulness of employing the commodity biography format in interdisciplinary writing. Moreover, the article contributes to the field of interdisciplinary research by providing a practical example of a joint publication and reflections upon the existence, interaction and possibilities of monodisciplinary knowledge structures within interdisciplinary studies and publications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. ELIMAIA: A Laser-Driven Ion Accelerator for Multidisciplinary Applications

    Directory of Open Access Journals (Sweden)

    Daniele Margarone

    2018-04-01

    Full Text Available The main direction proposed by the community of experts in the field of laser-driven ion acceleration is to improve particle beam features (maximum energy, charge, emittance, divergence, monochromaticity, shot-to-shot stability in order to demonstrate reliable and compact approaches to be used for multidisciplinary applications, thus, in principle, reducing the overall cost of a laser-based facility compared to a conventional accelerator one and, at the same time, demonstrating innovative and more effective sample irradiation geometries. The mission of the laser-driven ion target area at ELI-Beamlines (Extreme Light Infrastructure in Dolní Břežany, Czech Republic, called ELI Multidisciplinary Applications of laser-Ion Acceleration (ELIMAIA , is to provide stable, fully characterized and tuneable beams of particles accelerated by Petawatt-class lasers and to offer them to the user community for multidisciplinary applications. The ELIMAIA beamline has been designed and developed at the Institute of Physics of the Academy of Science of the Czech Republic (IoP-ASCR in Prague and at the National Laboratories of Southern Italy of the National Institute for Nuclear Physics (LNS-INFN in Catania (Italy. An international scientific network particularly interested in future applications of laser driven ions for hadrontherapy, ELI MEDical applications (ELIMED, has been established around the implementation of the ELIMAIA experimental system. The basic technology used for ELIMAIA research and development, along with envisioned parameters of such user beamline will be described and discussed.

  16. Integrated Multidisciplinary Optimization Objects, Phase I

    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...

  17. Childhood obesity.

    Science.gov (United States)

    Sabin, M A; Shield, J P H

    2008-01-01

    The prevalence of childhood obesity continues to increase worldwide. Its presence is associated with significant adverse effects on health including an increased propensity to type II diabetes, cardiovascular, respiratory, and liver disease. In the vast majority of children, obesity is lifestyle-related, yet there is a dearth of evidence on how to best develop effective prevention and treatment strategies. This review outlines the importance of childhood and adolescent growth on long-term health, the definitions used to define obesity in children (along with up-to-date prevalence data), causes and consequences, and aspects of prevention and management.

  18. Space Weather in the Machine Learning Era: A Multidisciplinary Approach

    Science.gov (United States)

    Camporeale, E.; Wing, S.; Johnson, J.; Jackman, C. M.; McGranaghan, R.

    2018-01-01

    The workshop entitled Space Weather: A Multidisciplinary Approach took place at the Lorentz Center, University of Leiden, Netherlands, on 25-29 September 2017. The aim of this workshop was to bring together members of the Space Weather, Mathematics, Statistics, and Computer Science communities to address the use of advanced techniques such as Machine Learning, Information Theory, and Deep Learning, to better understand the Sun-Earth system and to improve space weather forecasting. Although individual efforts have been made toward this goal, the community consensus is that establishing interdisciplinary collaborations is the most promising strategy for fully utilizing the potential of these advanced techniques in solving Space Weather-related problems.

  19. [Global brain metastases management strategy: a multidisciplinary-based approach].

    Science.gov (United States)

    Métellus, P; Tallet, A; Dhermain, F; Reyns, N; Carpentier, A; Spano, J-P; Azria, D; Noël, G; Barlési, F; Taillibert, S; Le Rhun, É

    2015-02-01

    Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. Copyright © 2015. Published by Elsevier SAS.

  20. EMSO: European Multidisciplinary Seafloor Observatory

    Science.gov (United States)

    Favali, P.; Partnership, Emso

    2009-04-01

    EMSO, a Research Infrastructure listed within ESFRI (European Strategy Forum on Research Infrastructures) Roadmap), 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 development relays upon the synergy between the scientific community and the industry to improve the European competitiveness with respect to countries like USA/Canada, NEPTUNE, VENUS and MARS projects, Taiwan, MACHO project, and Japan, DONET project. In Europe the development of an underwater network is based on previous EU-funded projects since early '90, and presently supported by EU initiatives. The EMSO infrastructure will constitute the extension to the sea of the land-based networks. Examples of data recorded by seafloor observatories will be presented. EMSO is presently at the stage of Preparatory Phase (PP), funded in the EC FP7 Capacities Programme. The project has started in April 2008 and will last 4 years with the participation of 12 Institutions representing 12 countries. EMSO potential will be significantly increased also with the interaction with other Research Infrastructures addressed to Earth Science. 2. IFREMER-Institut Français de Recherche pour l'exploitation de la mer (France, ref. Roland Person); KDM-Konsortium Deutsche Meeresforschung e.V. (Germany, ref. Christoph Waldmann); IMI-Irish Marine Institute (Ireland, ref. Michael Gillooly); UTM-CSIC-Unidad de

  1. 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

  2. Dietary Patterns in Childhood

    DEFF Research Database (Denmark)

    Andersen, Louise Beltoft Borup

    A healthy diet is essential for healthy growth and development during childhood and may prevent obesity, diabetes, and cardiovascular diseases throughout life. Traditionally, diet has been investigated as single nutrients. However, people do not eat one single nutrient and they do not even eat one...... single food. People consume meals and these meals vary during a day, over a year and during a life time. To comprehend some of this complexity it could be advantageous to investigate dietary patterns representing the whole diet as patterns might be better markers of growth and health than single...... childhood. These associations might contribute to the identification of families, who would benefit from guidance to help them establish healthy dietary patterns for their infants. Finding tracking for some infants and changes in adherence to dietary patterns for others as well as the association between...

  3. Childhood Obesity

    Science.gov (United States)

    Yuca, Sevil Ari, Ed.

    2012-01-01

    This book aims to provide readers with a general as well as an advanced overview of the key trends in childhood obesity. Obesity is an illness that occurs due to a combination of genetic, environmental, psychosocial, metabolic and hormonal factors. The prevalence of obesity has shown a great rise both in adults and children in the last 30 years.…

  4. Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

    Science.gov (United States)

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

    2018-06-01

    To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

  5. Childhood vitiligo

    Directory of Open Access Journals (Sweden)

    Aparna Palit

    2012-01-01

    Full Text Available Childhood vitiligo is often encountered in dermatological practice. When present in infancy or early childhood, various nevoid and hereditary disorders are to be differentiated. In many cases, familial aggregation of the disease is seen and other autoimmune disorders may be associated. Segmental presentation is more common, and limited body surface area involvement is usual in this age group. Children with vitiligo often suffer from anxiety and depression because of their unusual appearance. Management of vitiligo in children is difficult as therapeutic options are restricted when compared to that in adult patients. Selection of treatment should be careful in these patients with the aim to achieve best results with minimal side effects as well as relieving patients′ and parents′ anxiety.

  6. The effect of family-based multidisciplinary cognitive behavioral treatment in children with obesity: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kruyff Carolien C

    2011-05-01

    Full Text Available Abstract Background The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity. The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. Study design/Methods In this randomized clinical trial newly presented children with obesity (8-17 years old are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Discussion Because of the increasing prevalence of

  7. The effect of family-based multidisciplinary cognitive behavioral treatment in children with obesity: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Vos, Rimke C; Wit, Jan M; Pijl, Hanno; Kruyff, Carolien C; Houdijk, Euphemia C A M

    2011-05-06

    The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity.The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. In this randomized clinical trial newly presented children with obesity (8-17 years old) are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Because of the increasing prevalence of childhood obesity and the impact on the individual as well as on society

  8. Multi-disciplinary facilities at the centre for nuclear sciences, U.W.I

    International Nuclear Information System (INIS)

    Lalor, G.C.; Robotham, H.

    1994-01-01

    The Centre for Nuclear Sciences was established in 1984 with the mandate to introduce Caribbean scientists to the application of nuclear technology in multi-disciplinary studies, and to carry out research in areas of national and regional importance. It describes the present facilities and the major programmes being carried out at the Centre. (author) 9 refs

  9. Scripting for Construction of a Transactive Memory System in Multidisciplinary CSCL Environments

    Science.gov (United States)

    Noroozi, Omid; Biemans, Harm J. A.; Weinberger, Armin; Mulder, Martin; Chizari, Mohammad

    2013-01-01

    Establishing a Transactive Memory System (TMS) is essential for groups of learners, when they are multidisciplinary and collaborate online. Environments for Computer-Supported Collaborative Learning (CSCL) could be designed to facilitate the TMS. This study investigates how various aspects of a TMS (i.e., specialization, coordination, and trust)…

  10. Scripting for construction of a transactive memory system in multidisciplinary CSCL environments

    NARCIS (Netherlands)

    Noroozi, O.; Biemans, H.J.A.; Weinberger, A.; Mulder, M.; Chizari, M.

    2013-01-01

    Establishing a Transactive Memory System (TMS) is essential for groups of learners, when they are multidisciplinary and collaborate online. Environments for Computer-Supported Collaborative Learning (CSCL) could be designed to facilitate the TMS. This study investigates how various aspects of a TMS

  11. Early Childhood Development and E-Learning in Africa: The Early Childhood Development Virtual University Programme

    Science.gov (United States)

    Pence, Alan

    2007-01-01

    This article explores the development and evaluation of the graduate-level Early Childhood Development Virtual University (ECDVU) programme in Sub-Saharan Africa from 2001 through to 2004. It outlines the history of the ECDVU and the establishing of a Sub-Saharan programme for future leaders in the early childhood field guided by the key principle…

  12. Evidences in multidisciplinary management of rectal cancer

    International Nuclear Information System (INIS)

    De Bari, B.; Bosset, J.F.; Gerard, J.P.; Maingon, P.; Valentini, V.

    2012-01-01

    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)

  13. Childhood Obesity Facts

    Science.gov (United States)

    ... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Facts Recommend on Facebook Tweet Share Compartir On ... Children (WIC) Program, 2000-2014 Prevalence of Childhood Obesity in the United States Childhood obesity is a ...

  14. Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

    Science.gov (United States)

    Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Kwass, Jo-Ann; Land, Thomas

    2017-01-01

    Introduction Childhood obesity is a multifaceted disease that requires sustainable, multidimensional approaches that support change at the individual, community, and systems levels. The Massachusetts Childhood Obesity Research Demonstration project addressed this need by using clinical and public health evidence-based methods to prevent childhood obesity. To date, little information is known about successes and lessons learned from implementing such large-scale interventions. To address this gap, we examined perspectives of community stakeholders from various sectors on successes achieved and lessons learned during the implementation process. Methods We conducted 39 semistructured interviews with key stakeholders from 6 community sectors in 2 low-income communities from November 2013 through April 2014, during project implementation. Interviews were audio-recorded, transcribed, and analyzed by using the constant comparative method. Data were analyzed by using QSR NVivo 10. Results Successes included increased parental involvement in children’s health and education, increased connections within participating organizations and within the broader community, changes in organizational policies and environments to better support healthy living, and improvements in health behaviors in children, parents, and stakeholders. Lessons learned included the importance of obtaining administrative and leadership support, involving key stakeholders early in the program planning process, creating buffers that allow for unexpected changes, and establishing opportunities for regular communication within and across sectors. Conclusion Study findings indicate that multidisciplinary approaches support health behavior change and provide insight into key issues to consider in developing and implementing such approaches in low-income communities. PMID:28125400

  15. Can Childhood Factors Predict Workplace Deviance?

    Science.gov (United States)

    Piquero, Nicole Leeper; Moffitt, Terrie E

    2014-07-01

    Compared to the more common focus on street crime, empirical research on workplace deviance has been hampered by highly select samples, cross-sectional research designs, and limited inclusion of relevant predictor variables that bear on important theoretical debates. A key debate concerns the extent to which childhood conduct-problem trajectories influence crime over the life-course, including adults' workplace crime, whether childhood low self-control is a more important determinant than trajectories, and/or whether each or both of these childhood factors relate to later criminal activity. This paper provides evidence on this debate by examining two types of workplace deviance: production and property deviance separately for males and females. We use data from the Dunedin Multidisciplinary Health and Development Study, a birth cohort followed into adulthood, to examine how childhood factors (conduct-problem trajectories and low self-control) and then adult job characteristics predict workplace deviance at age 32. Analyses revealed that none of the childhood factors matter for predicting female deviance in the workplace but that conduct-problem trajectories did account for male workplace deviance.

  16. Multi-Disciplinary Design Optimization Using WAVE

    Science.gov (United States)

    Irwin, Keith

    2000-01-01

    The current preliminary design tools lack the product performance, quality and cost prediction fidelity required to design Six Sigma products. They are also frequently incompatible with the tools used in detailed design, leading to a great deal of rework and lost or discarded data in the transition from preliminary to detailed design. Thus, enhanced preliminary design tools are needed in order to produce adequate financial returns to the business. To achieve this goal, GEAE has focused on building the preliminary design system around the same geometric 3D solid model that will be used in detailed design. With this approach, the preliminary designer will no longer convert a flowpath sketch into an engine cross section but rather, automatically create 3D solid geometry for structural integrity, life, weight, cost, complexity, producibility, and maintainability assessments. Likewise, both the preliminary design and the detailed design can benefit from the use of the same preliminary part sizing routines. The design analysis tools will also be integrated with the 3D solid model to eliminate manual transfer of data between programs. GEAE has aggressively pursued the computerized control of engineering knowledge for many years. Through its study and validation of 3D CAD programs and processes, GEAE concluded that total system control was not feasible at that time. Prior CAD tools focused exclusively on detail part geometry and Knowledge Based Engineering systems concentrated on rules input and data output. A system was needed to bridge the gap between the two to capture the total system. With the introduction of WAVE Engineering from UGS, the possibilities of an engineering system control device began to formulate. GEAE decided to investigate the new WAVE functionality to accomplish this task. NASA joined GEAE in funding this validation project through Task Order No. 1. With the validation project complete, the second phase under Task Order No. 2 was established to

  17. Childhood Overweight and Obesity

    Science.gov (United States)

    ... and Nutrition Healthy Food Choices Childhood Overweight and Obesity: Helping Your Child Achieve a Healthy Weight Childhood Overweight and Obesity: Helping Your Child Achieve a Healthy Weight Share ...

  18. A new standard for multidisciplinary health and safety technicians

    Energy Technology Data Exchange (ETDEWEB)

    Trinoskey, P.A.; Fry, L.A. [Lawrence Livermore National Laboratory, Univ. of California, CA (United States); Egbert, W.F. [Lawrence Livermore National Laboratory, Allied Signal Technical Corporation (United States)

    2000-05-01

    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

  19. Promoting Implementation of Multi-Disciplinary Sustained Ocean Observations

    Science.gov (United States)

    Pearlman, Jay; Bourassa, Mark; Hill, Katherine; Miloslavich, Patricia; Simmons, Samantha; Sloyan, Bernadette; Telszewski, Maciej

    2017-04-01

    Since the OceanObs'09 Conference, the ocean observing community has been improving coordination and collaboration amongst physical, biogeochemical and biology/ecosystem communities. Societal and scientific requirements for sustained observations are being captured in Essential Ocean Variables (EOVs), many of which are also Essential Climate Variables (ECVs) as defined by the Global Climate Observing System reporting to the UNFCCC. Significant progress has been made through the introduction of the Framework for Ocean Observing in 2012 and the creation and refinement of the disciplinary EOVs, based on expert evaluation of feasibility and impact. With advances in observing technology, and the definition of EOVs, clear opportunities exist to improve the coordinated planning and implementation of observing activities measuring EOVs across the three disciplines of physical, biogeochemical and biology/ecosystem oceanography. In early 2017, a workshop examined priority steps forward with the objectives: • To build on the established societal and scientific requirements expressed in EOVs, identify the key applications and phenomena that will benefit from co-located multi-disciplinary sustained observations • To identify near-term innovation priorities for observing platforms and sensors to enable multi-disciplinary observations, and • To identify programmatic and professional connections between existing and emerging observing networks that will increase multi-disciplinary observations. To support these objectives and to provide a mechanism for looking at convergence across the oceans disciplines, three preselected demonstration themes were defined and discussed: • Changes in plankton communities (including ocean color), • Oxygen minimum zones, • Open ocean/shelf interactions (including boundary currents) These themes were chosen because they represent global and challenging problems that are best addressed through collaboration of physical, biogeochemical and

  20. A new standard for multidisciplinary health and safety technicians

    International Nuclear Information System (INIS)

    Trinoskey, P.A.; Fry, L.A.; Egbert, W.F.

    2000-01-01

    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

  1. 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

  2. Improving Student Achievement in a Multidisciplinary Context

    Science.gov (United States)

    Chapman, Amanda; Bloxham, Sue

    2004-01-01

    This article analyses interim findings of an ongoing action research project into the use of assessment criteria and grade descriptors in the assessment process. The project is multidisciplinary and covers areas as diverse as Sports Sociology, Economics, Youth and Community Studies, and Education. The idea is to equip first-year students with the…

  3. Sustaining impactful multidisciplinary contributions over five decades

    Directory of Open Access Journals (Sweden)

    Kulbhushan Balooni

    2017-06-01

    By tracing the trajectory of Singh's vast and varied experience, attitude and approach to research, and scholarly output in international publications that have advanced knowledge and found applications from management to biological and social sciences, this interview offer pathways to research scholars for sustained multidisciplinary and impactful research in their careers.

  4. Stronger Disciplinary Identities in Multidisciplinary Research Schools

    Science.gov (United States)

    Geschwind, Lars; Melin, Göran

    2016-01-01

    In this study, two multidisciplinary Social Sciences and Humanities research schools in Sweden have been investigated regarding disciplinary identity-making. This study investigates the meetings between different disciplines around a common thematic area of study for Ph.D. students. The Ph.D. students navigate through a complex social and…

  5. Multidisciplinary Teams: The Next Step in Science.

    Directory of Open Access Journals (Sweden)

    Aldo Leal-Egaña.

    2006-07-01

    Full Text Available One of the current characteristics in science, is the high complexity and technical character that becomes over the last years. This has induced the development of a specific type of professionals, highly specialized in the disciplines that they are involved in, which has produced a communicational breach between the scientists involved on different branches of the science. One of the strategies intended to cross this breach, is the generation of multidisciplinary research strategies, in which professionals of every field of the science can take part, being a kind of scientific and human bridge between the different research teams where they are involved in. This new style to do investigation has made possible the generation of new branches in science, such as for example Biotechnology. In this field -Tissue Engineering- becomes to be a very interesting example of the potential to work in multidisciplinary teams. The reason for this is mainly to avoid technical mistakes, which could cause the death of some patients and which can only be solved by developing research under a multidisciplinary strategy. Nevertheless, and in spite of the success working with multidisciplinary teams, this kind of strategy is rarely used in Latin-American, where the reasons seems to be centered in some aspects personal and cultural. This work shows an example of the new style to develop complex research, which could suggest a new way of working in Latin-American, granted that there is the will to enhance current scientific level.

  6. 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.

  7. Multidisciplinary training of cancer specialists in Europe

    DEFF Research Database (Denmark)

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

    2017-01-01

    The best care for patients with cancer is most likely to be achieved when decisions about diagnosis, staging and treatment are made at multidisciplinary and multiprofessional meetings, preferably when all the professional expertise relevant to the patient's condition is gathered together. Questio......The best care for patients with cancer is most likely to be achieved when decisions about diagnosis, staging and treatment are made at multidisciplinary and multiprofessional meetings, preferably when all the professional expertise relevant to the patient's condition is gathered together....... Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice. Data were lacking for Surgery because...... surgeons training in cancer surgery) is recommended. This is likely to improve the value of multidisciplinary meetings and may result in improved patient care. The Expert Group on Cancer Control of the European Commission has endorsed this recommendation....

  8. Multidisciplinary Analysis of a Hypersonic Engine

    Science.gov (United States)

    Suresh, Ambady; Stewart, Mark

    2003-01-01

    The objective is to develop high fidelity tools that can influence ISTAR design In particular, tools for coupling Fluid-Thermal-Structural simulations RBCC/TBCC designers carefully balance aerodynamic, thermal, weight, & structural considerations; consistent multidisciplinary solutions reveal details (at modest cost) At Scram mode design point, simulations give details of inlet & combustor performance, thermal loads, structural deflections.

  9. Multidisciplinary approaches to climate change questions

    Science.gov (United States)

    Middleton, Beth A.; LePage, Ben A.

    2011-01-01

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

  10. Multidisciplinary workshops: learning to work together.

    Science.gov (United States)

    Fatchett, Anita; Taylor, Dawn

    2013-03-01

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

  11. The Multidisciplinary Economics of Money Laundering

    NARCIS (Netherlands)

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

    2012-01-01

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

  12. Selective Mutism in Elementary School: Multidisciplinary Interventions.

    Science.gov (United States)

    Giddan, Jane J.; And Others

    1997-01-01

    Presents the symptoms of selective mutism and historical background for treatment. It provides a case study which illustrates successful multidisciplinary treatment outcomes for a child who was selectively mute. Issues relevant to speech-language pathologists working with elementary school children are discussed and treatment guidelines provided.…

  13. Placenta accreta and anesthesia: A multidisciplinary approach

    OpenAIRE

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

    2016-01-01

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

  14. 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.

  15. Towards multidisciplinary support tools for innovation tasks

    NARCIS (Netherlands)

    Wits, Wessel Willems; Bakker, H.M.; Chechurin, L.S.

    2012-01-01

    This paper highlights the imperative need for innovation and characterizes a promising support tool to stimulate this process. The importance of innovation for both a global economy and specifically for engineering education is discussed. Additionally, the urgency for multidisciplinary skills for

  16. Childhood psoriasis

    Directory of Open Access Journals (Sweden)

    Dogra Sunil

    2010-01-01

    Full Text Available Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexural involvement is common and guttate type is the characteristic presentation. Whether onset in childhood predicts a more severe form of psoriasis is a matter of controversy, it may cause significant morbidity particularly if it keeps relapsing. Most children have mild form of psoriasis which can be generally treated effectively with topical agents such as emollients, coal tar, corticosteroids, dithranol, calcipotriol etc. according to age and the sites affected. Narrow band UVB is the preferred form of phototherapy in children for moderate to severe disease or in patients not responding to topical therapy alone. Systemic therapies are reserved for more severe and extensive cases that cannot be controlled with topical treatment and/or phototherapy such as severe plaque type, unstable forms like erythrodermic and generalized pustular psoriasis and psoriatic arthritis. There are no controlled trials of systemic therapies in this age group, most experience being with retinoids and methotrexate with favorable results. Cyclosporine can be used as a short-term intermittent crisis management drug. There is an early promising experience with the use of biologics (etanercept and infliximab in childhood psoriasis. Systemic treatments as well as phototherapy have limited use in children due to cumulative dose effects of drugs, low acceptance, and risk of gonadal toxicity. More evidence-based data is needed about the effectiveness and long-term safety of topical

  17. Childhood rhabdomyosarcoma.

    Science.gov (United States)

    Córdoba Rovira, S M; Inarejos Clemente, E J

    Rhabdomyosarcoma is the most common soft-tissue sarcoma in children; it can appear in any part of the body. Its biological behavior varies widely, and despite the absence of specific clinical or radiological characteristics, rhabdomyosarcoma should be taken into account in the differential diagnosis of solid tumors in children. This review focuses primarily on the imaging findings and anatomical distribution of the histological subtypes of childhood rhabdomyosarcoma and secondarily on the differential findings in histological studies. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. MULTIDISCIPLINARY RESEARCH ON SHOREA JAVANICA

    Directory of Open Access Journals (Sweden)

    E.F. TORQUEBIAU*

    1987-01-01

    establishment of a permanent tree plantation, constitutes an efficient agroforestry system which is extensively described by Michon 1984, 1985; Michon et al 1984; and Torquebiau 1984. The resin of Shorea javanica is traditionally used for torches, caulking boats, batik coloring, etc., and is now exported to industrial countries where there is market for uses such as food additives, cosmetics, paints, varnishes a

  19. Childhood Leukemia and Primary Prevention

    Science.gov (United States)

    Whitehead, Todd P.; Metayer, Catherine; Wiemels, Joseph L.; Singer, Amanda W.; Miller, Mark D.

    2016-01-01

    Leukemia is the most common pediatric cancer, affecting 3,800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia – usually before age five – and the presence at birth of “pre-leukemic” genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature – in the United States and internationally – that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the pre-conception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors – including pooled analyses from around the world and systematic reviews – is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children’s health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgement until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co

  20. Childhood immunization

    Science.gov (United States)

    Romain, Sandra; Schillaci, Michael A.

    2009-01-01

    ABSTRACT OBJECTIVE To examine childhood immunization levels relative to the number of family physicians, pediatricians, and public health nurses in Ontario. DESIGN Retrospective comparative analysis of publicly available data on immunization coverage levels and the relative number of family physicians, pediatricians, and public health nurses. SETTING Ontario. PARTICIPANTS Seven-year-old children, family physicians, pediatricians, and public health nurses in Ontario. MAIN OUTCOME MEASURES The association between immunization coverage levels and the relative number of family physicians, pediatricians, and public health nurses. RESULTS We found correlations between immunization coverage levels and the relative number (ie, per 1000 Ontario residents) of family physicians (ρ = 0.60) and pediatricians (ρ = 0.70) and a lower correlation with the relative number of public health nurses (ρ = 0.40), although none of these correlations was significant. A comparison of temporal trends illustrated that variation in the relative number of family physicians and pediatricians in Ontario was associated with similar variation in immunization coverage levels. CONCLUSION Increasing the number of family physicians and pediatricians might help to boost access to immunizations and perhaps other components of cost-saving childhood preventive care. PMID:19910599

  1. Framework for Multidisciplinary Analysis, Design, and Optimization with High-Fidelity Analysis Tools

    Science.gov (United States)

    Orr, Stanley A.; Narducci, Robert P.

    2009-01-01

    A plan is presented for the development of a high fidelity multidisciplinary optimization process for rotorcraft. The plan formulates individual disciplinary design problems, identifies practical high-fidelity tools and processes that can be incorporated in an automated optimization environment, and establishes statements of the multidisciplinary design problem including objectives, constraints, design variables, and cross-disciplinary dependencies. Five key disciplinary areas are selected in the development plan. These are rotor aerodynamics, rotor structures and dynamics, fuselage aerodynamics, fuselage structures, and propulsion / drive system. Flying qualities and noise are included as ancillary areas. Consistency across engineering disciplines is maintained with a central geometry engine that supports all multidisciplinary analysis. The multidisciplinary optimization process targets the preliminary design cycle where gross elements of the helicopter have been defined. These might include number of rotors and rotor configuration (tandem, coaxial, etc.). It is at this stage that sufficient configuration information is defined to perform high-fidelity analysis. At the same time there is enough design freedom to influence a design. The rotorcraft multidisciplinary optimization tool is built and substantiated throughout its development cycle in a staged approach by incorporating disciplines sequentially.

  2. [Multidisciplinary management of gastroplasty candidates: example of Avicenne Hospital].

    Science.gov (United States)

    Bihan, Hélène; Choleau, Carine; Catheline, Jean-Marc; Reach, Gérard; Fournier, Jean-Luc; Garnier, Nathalie; Robert, Françoise; Poulhès, Christiane; Sidotmane, Fatma; Bénichou, Joseph; Cohen, Régis

    2008-03-01

    The decision to perform gastroplasty must be made by a multidisciplinary team. This organization ensures compliance with good practice guidelines. Multidisciplinary management after surgery is also essential but patients' adhesion to follow-up is relatively poor.

  3. Recent advances in multidisciplinary critical care.

    Science.gov (United States)

    Blot, Stijn; Afonso, Elsa; Labeau, Sonia

    2015-01-01

    The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters. ©2015 American Association of Critical-Care Nurses.

  4. Rhabdomyosarcoma treatment and outcome at a multidisciplinary pediatric cancer center in Lebanon.

    Science.gov (United States)

    Salman, Maysaa; Tamim, Hani; Medlej, Fouad; El-Ariss, Tarek; Saad, Fatima; Boulos, Fouad; Eid, Toufic; Muwakkit, Samar; Khoury, Nabil; Abboud, Miguel; Saab, Raya

    2012-05-01

    Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Outcome of patients treated on standard protocols, in a multidisciplinary cancer center setting outside of clinical trials, is not well reported. We reviewed characteristics and outcome of 23 pediatric patients treated at a single, multidisciplinary cancer center in Lebanon, between April 2002 and December 2010. Median follow-up was 41 months. The most commonly affected primary site was the head and neck (48%, n = 11). Nineteen tumors (82.6%) were of embryonal histology. Tumor size was ≥5 cm in eight (34.8%) patients. Sixteen patients (69.6%) had localized disease, and one (4.4%) had metastatic disease. Fifteen (65.2%) had Group III tumors. All patients received chemotherapy, for a duration ranging 21-51 weeks. Upfront surgical resection was performed in 10 patients (43.5%). Eighteen patients (78.3%) received radiation therapy. The 5-year overall and disease-free survival rates were 83% and 64%, respectively. Relapse correlated with absence of surgery. Treatment of childhood RMS in a multidisciplinary cancer center in Lebanon results in similar survival to that in developed countries when similar protocols are applied. There was a higher incidence of local relapse, but those were salvageable with further therapy and surgical local control.

  5. 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 ...

  6. Multidisciplinary Mentoring Programs to Enhance Junior Faculty Research Grant Success.

    Science.gov (United States)

    Freel, Stephanie A; Smith, Paige C; Burns, Ebony N; Downer, Joanna B; Brown, Ann J; Dewhirst, Mark W

    2017-10-01

    Junior faculty face challenges in establishing independent research careers. Declining funding combined with a shift to multidisciplinary, collaborative science necessitates new mentorship models and enhanced institutional support. Two multidisciplinary mentorship programs to promote grant success for junior faculty were established at the Duke University School of Medicine beginning in 2011. These four-month programs-the Path to Independence Program (PtIP) for National Institutes of Health (NIH) R applicants and the K Club for NIH K applicants-use multiple senior faculty mentors and professional grant-writing staff to provide a 20-hour joint curriculum comprising a series of lectures, hands-on workshops, career development counseling, peer groups, and an internal study section. In March 2016, the authors analyzed the success rate for all NIH grants submitted by participants since program enrollment. In a 2015 postprogram survey, participants rated their feelings of support and competency across six skill factors. From October 2011 to March 2016, the programs engaged 265 senior faculty mentors, 145 PtIP participants, and 138 K Club participants. Success rates for NIH grant applications were 28% (61 awards/220 decisions) for PtIP participants-an increase over the 2010 Duke University junior faculty baseline of 11%-and 64% (38/59) for K Club participants. Respondents reported significantly increased feelings of support and self-ratings for each competency post program. The authors plan to expand the breadth of both the mentorship pool and faculty served. Broad implementation of similar programs elsewhere could bolster success, satisfaction, and retention of junior faculty investigators.

  7. Childhood roots of financial literacy

    OpenAIRE

    Grohmann, Antonia; Kouwenberg, Roy; Menkhoff, Lukas

    2015-01-01

    Financial literacy predicts informed financial decisions, but what explains financial literacy? We use the concept of financial socialization and aim to represent three major agents of financial socialization: family, school and work. Thus we compile twelve relevant childhood characteristics in a new survey study and examine their relation to financial literacy, while controlling for established socio-demographic characteristics. We find in a mediation analysis that both family and school pos...

  8. Childhood cancer, Dounreay

    International Nuclear Information System (INIS)

    Kynoch, G.A.B.; Stewart, J.A.

    1994-01-01

    Details of the findings of the Committee of the Medical Aspects of Radiation in the Environment (COMARE) on the incidence of childhood cancer in the Dounreay area in the United Kingdom are given in a written response to a parliamentary question. In the period 1985-91, four cases of leukaemia and non-Hodgkin's lymphoma were observed in the 1 to 24 age group living within 25 km of the Dounreay Nuclear Establishment, compared to 1.4 expected cases. In the light of these results, which reinforce previous findings, the Committee concluded that the raised incidence of childhood leukemia in the area is a real phenomenon and is less likely to have risen by chance. COMARE also concluded that further epidemiological research in the area to try to determine causal mechanics was not a practicable way forward at present because of the small number of cases involved. This advice has been accepted by the UK Government, but further nationally based studies are being carried out. (UK)

  9. Establishing an Inpatient Gym for Recipients of Stem Cell Transplantation: A Multidisciplinary Collaborative.

    Science.gov (United States)

    Blackburn, Roxann; Presson, Kimberly; Laufman, Robin; Tomczak, Nancy; Brassil, Kelly J

    2016-02-01

    Evidence suggests that exercise can have a profound impact on physiologic and quality-of-life outcomes for patients undergoing hematopoietic stem cell transplantation (HSCT). Despite this, implementation of a gym on inpatient HSCT units may be limited because of space, infrastructure, and budget. This article presents the design, implementation, and evaluation of the gym and highlights its use for individual and group patient activities. An interprofessional team at a National Cancer Institute-designated comprehensive cancer center collaborated to design and implement gym space on an inpatient HSCT unit servicing as many as 86 beds. Informal feedback from patients, as well as metrics on use of the space, indicates that the gym is well received and frequently used. Limitations include the absence of a designated physical therapy technician to supervise individual activity, which may limit patient access when a staff member is unavailable. The cost associated with the implementation of such space may be offset by benefits to patients, including enhanced conditioning, quality of life, and time to discharge, as evidenced in the literature.

  10. 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

  11. Multidisciplinary Techniques and Novel Aircraft Control Systems

    Science.gov (United States)

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

    2000-01-01

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

  12. American Vacuum Society: A multidisciplinary organization

    International Nuclear Information System (INIS)

    Beavis, L.C.

    1979-01-01

    This presentation is based upon that which was to be given by the Society President at the 25th National Symposium of the American Vacuum Society, 29 November 1978, in San Francisco, California. The talk to the Society by its President was an innovation of the 1979 Program Committee. The intention is that such a presentation be given each year at the awards acceptance plenary session along with those of the Welch and, when appropriate, Gaede--Langmuir awards. To be discussed are the recent highlights of Society activity, the direction the Society is taking, and an example of the multidisciplinary activities of Society members

  13. The “Pearls” of Multidisciplinary Team: Conquering the Uncommon Rosette Rash

    Directory of Open Access Journals (Sweden)

    Nitin Verma

    2016-01-01

    Full Text Available Linear IgA disease of childhood (LAD also known as chronic bullous disease of childhood is an autoimmune disease with IgA deposition at the basement membrane zone leading to a vesiculobullous rash. It has a clinical appearance which frequently is described as resembling “strings of pearls” or rosette-like. Diagnosis is usually clinical but sometimes biopsy is required. Dapsone is widely considered to be the first line therapy in the treatment of LAD. A 5-year-old girl presented with 4-day history of a widespread painful rash and pyrexia. The rash transformed into painful blisters. A recent contact with chickenpox was present. She remained apyrexial but hemodynamically stable and was treated as chickenpox patient with secondary infection. Due to persistent symptoms after repeated attendance she was reviewed by Dermatology team and diagnosed with linear IgA disease also known as chronic bullous disease of childhood. This was based on the presence of blistering rash with rosette appearance and string of pearl lesions. The clinical features of LAD can be difficult to distinguish from more common skin infections. Benefiting from the experience of other multidisciplinary teams can sometimes be a game changer and can lead to the correct diagnosis and treatment.

  14. Childhood Brain Tumors

    Science.gov (United States)

    Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood ... still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches and ...

  15. Childhood Obesity Causes & Consequences

    Science.gov (United States)

    ... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Causes & Consequences Recommend on Facebook Tweet Share Compartir ... determine how a community is designed. Consequences of Obesity More Immediate Health Risks Obesity during childhood can ...

  16. Childhood Obesity: Common Misconceptions

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Childhood Obesity: Common Misconceptions Page Content Article Body Everyone, it ... for less than 1% of the cases of childhood obesity. Yes, hypothyroidism (a deficit in thyroid secretion) and ...

  17. Hydrothermal alteration, fumarolic deposits and fluids from Lastarria Volcanic Complex: A multidisciplinary study

    OpenAIRE

    Aguilera, Felipe; Layana, Susana; Rodríguez-Díaz, Augusto; González, Cristóbal; Cortés, Julio; Inostroza, Manuel

    2016-01-01

    A multidisciplinary study that includes processing of Landsat ETM+ satellite images, chemistry of gas condensed, mineralogy and chemistry of fumarolic deposits, and fluid inclusion data from native sulphur deposits, has been carried out in the Lastarria Volcanic Complex (LVC) with the objective to determine the distribution and characteristics of hydrothermal alteration zones and to establish the relations between gas chemistry and fumarolic deposits. Satellite image processing shows the pres...

  18. Aesthetic Discourses in Early Childhood Settings: Dewey, Steiner, and Vygotsky

    Science.gov (United States)

    Lim, Booyeun

    2004-01-01

    Early childhood, when young children are already capable of undergoing aesthetic experience, must be the starting point for aesthetic education. Despite increasing attention to the significant values of the arts in early childhood classrooms, no theoretical framework to support aesthetic education has been established. This article introduces the…

  19. 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.

  20. ASTROS: A multidisciplinary automated structural design tool

    Science.gov (United States)

    Neill, D. J.

    1989-01-01

    ASTROS (Automated Structural Optimization System) is a finite-element-based multidisciplinary structural optimization procedure developed under Air Force sponsorship to perform automated preliminary structural design. The design task is the determination of the structural sizes that provide an optimal structure while satisfying numerous constraints from many disciplines. In addition to its automated design features, ASTROS provides a general transient and frequency response capability, as well as a special feature to perform a transient analysis of a vehicle subjected to a nuclear blast. The motivation for the development of a single multidisciplinary design tool is that such a tool can provide improved structural designs in less time than is currently needed. The role of such a tool is even more apparent as modern materials come into widespread use. Balancing conflicting requirements for the structure's strength and stiffness while exploiting the benefits of material anisotropy is perhaps an impossible task without assistance from an automated design tool. Finally, the use of a single tool can bring the design task into better focus among design team members, thereby improving their insight into the overall task.

  1. Developing a Collaborative Multidisciplinary Online Design Course

    Directory of Open Access Journals (Sweden)

    Diane M. Bender, Ph.D.

    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.

  2. Information Management for a Large Multidisciplinary Project

    Science.gov (United States)

    Jones, Kennie H.; Randall, Donald P.; Cronin, Catherine K.

    1992-01-01

    In 1989, NASA's Langley Research Center (LaRC) initiated the High-Speed Airframe Integration Research (HiSAIR) Program to develop and demonstrate an integrated environment for high-speed aircraft design using advanced multidisciplinary analysis and optimization procedures. The major goals of this program were to evolve the interactions among disciplines and promote sharing of information, to provide a timely exchange of information among aeronautical disciplines, and to increase the awareness of the effects each discipline has upon other disciplines. LaRC historically has emphasized the advancement of analysis techniques. HiSAIR was founded to synthesize these advanced methods into a multidisciplinary design process emphasizing information feedback among disciplines and optimization. Crucial to the development of such an environment are the definition of the required data exchanges and the methodology for both recording the information and providing the exchanges in a timely manner. These requirements demand extensive use of data management techniques, graphic visualization, and interactive computing. HiSAIR represents the first attempt at LaRC to promote interdisciplinary information exchange on a large scale using advanced data management methodologies combined with state-of-the-art, scientific visualization techniques on graphics workstations in a distributed computing environment. The subject of this paper is the development of the data management system for HiSAIR.

  3. Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

    NARCIS (Netherlands)

    Hauri, D.; Spycher, B.; Huss, A.; Zimmermann, F.; Grotzer, M.; von der Weid, N.; Weber, D.; Spoerri, A.; Kuehni, C.E.; Röösli, M.

    2013-01-01

    Background: In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results.Objective: We investigated the association between domestic radon exposure and childhood

  4. What Are the Long-Term Economic Costs of Psychological Problems during Childhood? Fact Sheet

    Science.gov (United States)

    Steinberg, Paul

    2010-01-01

    Recent research has established evidence of a strong link between poor physical health during childhood (and even in utero) and health and economic outcomes much later in adulthood. But much less is known about the long-term economic consequences of psychological conditions experienced during childhood, although childhood psychological…

  5. Unity in Diversity: Electronic Patient Record Use in Multidisciplinary Practice

    OpenAIRE

    Oborn, Eivor; Barrett, Michael; Davidson, Elizabeth

    2011-01-01

    In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this persp...

  6. Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations

    DEFF Research Database (Denmark)

    Nielsen, Tenna Ruest Haarmark; Fonvig, Cilius Esmann; Dahl, Maria

    2018-01-01

    Objective The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during......, and 80% improved their lipid concentrations. Conclusion Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition...... childhood obesity treatment. Methods 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6±21.7), and median BMI SDS 2.8 (range 1.3±5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0...

  7. Translating childhood tuberculosis case management research into operational policies.

    Science.gov (United States)

    Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

    2011-08-01

    The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

  8. Multidisciplinary care of obese children and adolescents for one year reduces ectopic fat content in liver and skeletal muscle.

    Science.gov (United States)

    Fonvig, Cilius Esmann; Chabanova, Elizaveta; Ohrt, Johanne Dam; Nielsen, Louise Aas; Pedersen, Oluf; Hansen, Torben; Thomsen, Henrik S; Holm, Jens-Christian

    2015-12-30

    Ectopic fat deposition in liver and skeletal muscle tissue is related to cardiovascular disease risk and is a common metabolic complication in obese children. We evaluated the hypotheses of ectopic fat in these organs could be diminished following 1 year of multidisciplinary care specialized in childhood obesity, and whether this reduction would associate with changes in other markers of metabolic function. This observational longitudinal study evaluated 40 overweight children and adolescents enrolled in a multidisciplinary treatment protocol at the Children's Obesity Clinic, Holbæk, Denmark. The participants were assessed by anthropometry, fasting blood samples (HbA1c, glucose, insulin, lipids, and biochemical variables of liver function), and liver and muscle fat content assessed by magnetic resonance spectroscopy at enrollment and following an average of 12.2 months of care. Univariate linear regression models adjusted for age, sex, treatment duration, baseline degree of obesity, and pubertal developmental stage were used for investigating possible associations. The standard deviation score (SDS) of baseline median body mass index (BMI) was 2.80 (range: 1.49-3.85) and the median age was 14 years (10-17). At the end of the observational period, the 40 children and adolescents (21 girls) significantly decreased their BMI SDS, liver fat, muscle fat, and visceral adipose tissue volume. The prevalence of hepatic steatosis changed from 28 to 20 % (p = 0.26) and the prevalence of muscular steatosis decreased from 75 to 45 % (p = 0.007). Changes in liver and muscle fat were independent of changes in BMI SDS, baseline degree of obesity, duration of treatment, age, sex, and pubertal developmental stage. A 1-year multidisciplinary intervention program in the setting of a childhood obesity outpatient clinic confers a biologically important reduction in liver and muscle fat; metabolic improvements that are independent of the magnitude of concurrent weight loss

  9. Changes in physical health among participants in a multidisciplinary health programme for long-term unemployed persons

    NARCIS (Netherlands)

    C.A. Schutgens (Christine); M. Schuring (Merel); T. Voorham (Toon); A. Burdorf (Alex)

    2009-01-01

    textabstractBackground. The relationship between poor health and unemployment is well established. Health promotion among unemployed persons may improve their health. The aims of this study were to investigate characteristics of non-participants and drop-outs in a multidisciplinary health promotion

  10. Residential exposures to pesticides and childhood leukaemia

    International Nuclear Information System (INIS)

    Metayer, C.; Buffler, P. A.

    2008-01-01

    Like many chemicals, carcinogenicity of pesticides is poorly characterised in humans, especially in children, so that the present knowledge about childhood leukaemia risk derives primarily from epidemiological studies. Overall, case-control studies published in the last decade have reported positive associations with home use of insecticides, mostly before the child's birth, while findings for herbicides are mixed. Previous studies relied solely on self-reports, therefore lacking information on active ingredients and effects of potential recall bias. Few series to date have examined the influence of children's genetic susceptibility related to transport and metabolism of pesticides. To overcome these limitations, investigators of the Northern California Childhood Leukaemia Study (NCCLS) have undertaken, in collaboration with a multidisciplinary team, a comprehensive assessment of residential pesticide exposure, including: (1) quality control of self-reports; (2) home pesticide inventory and linkage to the Environmental Protection Agency to obtain data on active ingredients; (3) collection and laboratory analyses of ∼600 home dust samples for over 60 pesticides and (4) geographic information studies using California environmental databases to assess exposure to agricultural pesticides. The NCCLS is also conducting large-scale geno-typing to evaluate the role of genes in xenobiotic pathways relevant to the transport and metabolism of pesticides. A better quantification of children's exposures to pesticides at home is critical to the evaluation of childhood leukaemia risk, especially for future gene-environment interaction studies. (authors)

  11. Robust Parameter Coordination for Multidisciplinary Design

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

  12. Multi-disciplinary collaboration in radiopharmaceutical chemistry

    International Nuclear Information System (INIS)

    Nozaki, Tadashi

    1989-01-01

    Various possibilities often exist in each step of radiopharmaceutical preparation, and multi-disciplinary knowledge and collaboration are necessary for improved choice of the preparation conditions. In the radionuclide production step, proton bombardment of a separated nuclide target usually exceeds other bombardments of natural targets. Isotope separation by laser-chemical method is expected to soon offer several enriched nuclides useful as the target in enough amount and moderate price. The design and preparation of radiopharmaceuticals will be directly influenced by further progress of enzymology and immunology. Nondestructive, continuous observation of chemical changes in vivo is a longing of radiochemists, and may be realized gradually through elaborate examination of chemical effects in Mossbauer absorption, γ-γ angular correlation, EC X-ray properties, and positron annihilation. Present knowledge and techniques in radiopharmaceutical chemistry, on the other hand, can be utilized effectively in other fields of life sciences

  13. Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.

    Science.gov (United States)

    Tesher, Melissa S

    2015-06-01

    A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the biologic, psychologic, and social factors contributing to the perpetuation of chronic pain. The author reviews the diagnostic criteria, pathophysiology, and treatment of juvenile fibromyalgia. Medications, particularly antidepressants and anticonvulsants, can be useful adjuncts to therapy. However, multimodal pain management including intensive physical therapy, exercise, counseling, and sleep hygiene is most effective in treating fibromyalgia. Copyright 2015, SLACK Incorporated.

  14. Multidisciplinary treatment approach in Treacher Collins syndrome.

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  16. 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.

  17. 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.

  18. The genetics of childhood obesity and interaction with dietary macronutrients.

    Science.gov (United States)

    Garver, William S; Newman, Sara B; Gonzales-Pacheco, Diana M; Castillo, Joseph J; Jelinek, David; Heidenreich, Randall A; Orlando, Robert A

    2013-05-01

    The genes contributing to childhood obesity are categorized into three different types based on distinct genetic and phenotypic characteristics. These types of childhood obesity are represented by rare monogenic forms of syndromic or non-syndromic childhood obesity, and common polygenic childhood obesity. In some cases, genetic susceptibility to these forms of childhood obesity may result from different variations of the same gene. Although the prevalence for rare monogenic forms of childhood obesity has not increased in recent times, the prevalence of common childhood obesity has increased in the United States and developing countries throughout the world during the past few decades. A number of recent genome-wide association studies and mouse model studies have established the identification of susceptibility genes contributing to common childhood obesity. Accumulating evidence suggests that this type of childhood obesity represents a complex metabolic disease resulting from an interaction with environmental factors, including dietary macronutrients. The objective of this article is to provide a review on the origins, mechanisms, and health consequences of obesity susceptibility genes and interaction with dietary macronutrients that predispose to childhood obesity. It is proposed that increased knowledge of these obesity susceptibility genes and interaction with dietary macronutrients will provide valuable insight for individual, family, and community preventative lifestyle intervention, and eventually targeted nutritional and medicinal therapies.

  19. A mixed-methods evaluation of a multidisciplinary point of care ultrasound program.

    Science.gov (United States)

    Smith, Andrew; Parsons, Michael; Renouf, Tia; Boyd, Sarah; Rogers, Peter

    2018-04-24

    Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents' discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program. Analysis was conducted using a mixed-methods, sequential exploratory approach. Initially, a focus group of seven first year residents was conducted to generate themes that were used to guide development of a survey administered to residents over a two-year period. Thirty residents responded to the survey (response rate 63.8%) with 53.3% meeting the training requirements for focused assessment using sonography in trauma, 43.3% for pleural effusion, 40.0% for aortic aneurysms, and 40.0% for cardiac scans. Early pregnancy assessment was the skill of least interest with 46.6% not interested. Over half the residents (53.6%) agreed or strongly agreed that a multidisciplinary program met their needs while 21.4% disagreed. The focus group found the multidisciplinary approach adequate. A single PoCUS curriculum has been shown to meet the needs and expectations of a majority of residents from multiple disciplines. It can enhance collaboration and bridge gaps between increasingly compartmentalized practices of medicine.

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

    Science.gov (United States)

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

    2014-01-01

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

  1. A blueprint for multidisciplinary fast track gastrointestinal oncology care

    NARCIS (Netherlands)

    Basta, Y.L.

    2017-01-01

    In this thesis, we have evaluated the implementation of two key concepts of the Gastro Intestinal oncology Center Amsterdam (GIOCA): multidisciplinary teams (MDT) and the fast delivery of care in fast track clinics (FTC). The first part of this thesis investigates the value of multidisciplinary

  2. The multidisciplinary approach to the management toxic epidermal ...

    African Journals Online (AJOL)

    Complete haematological and biochemical tests were carried out and management was symptomatic. This report shows the multidisciplinary approach to the management and highlights the role of the dental surgeon in the management. It concludes that multidisciplinary approach to healthcare provision will be of benefit to ...

  3. Use of Multi-Disciplinary Projects To Develop Competence.

    Science.gov (United States)

    Trotman-Dickenson, Danusia

    1992-01-01

    Undergraduate technology and business students at the Polytechnic of Wales (United Kingdom) participated in multi-disciplinary team projects to experience real life business challenges and develop competences that employers expect in professionals. Lists characteristics of successful multi-disciplinary projects, discusses cost and industry…

  4. Stochastic integer programming for multi-disciplinary outpatient clinic planning

    NARCIS (Netherlands)

    Leeftink, A. G.; Vliegen, I. M.H.; Hans, E. W.

    2017-01-01

    Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multi-disciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are

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

    Science.gov (United States)

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

    2015-01-01

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

  6. Cognition in Childhood Dystonia : A systematic review

    NARCIS (Netherlands)

    Coenen, Maraike A; Eggink, Hendriekje; Tijssen, M.A.; Spikman, Jacoba

    Background and aim: Cognitive impairments have been established as part of the non-motor phenomenology of adult dystonia. In childhood dystonia, the extent of cognitive impairments is less clear. This systematic review aims at presenting an overview over the existing literature to elucidate the

  7. Crowdsourcing Novel Childhood Predictors of Adult Obesity

    NARCIS (Netherlands)

    Bevelander, K.E.; Kaipainen, K.; Swain, R.; Dohle, S.; Bongard, J.C.; Hines, P.D.H.; Wansink, B.

    2014-01-01

    Effective and simple screening tools are needed to detect behaviors that are established early in life and have a significant influence on weight gain later in life. Crowdsourcing could be a novel and potentially useful tool to assess childhood predictors of adult obesity. This exploratory study

  8. Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model

    Directory of Open Access Journals (Sweden)

    Jacqueline Loonen

    2018-01-01

    Full Text Available Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the “Personalized Cancer Survivorship Care Model”, that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

  9. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; Meije, Carin; Myin-Germeys, Inez; van Os, Jim; Wiersma, Durk

    2015-01-01

    Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of

  10. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W

    2015-01-01

    BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect

  11. Rethinking childhood adversity in chronic fatigue syndrome.

    Science.gov (United States)

    Clark, James E; Davidson, Sean L; Maclachlan, Laura; Newton, Julia L; Watson, Stuart

    2018-01-01

    Background: Previous studies have consistently shown increased rates of childhood adversity in chronic fatigue syndrome (CFS). However, such aetiopathogenic studies of CFS are potentially confounded by co-morbidity and misdiagnosis particularly with depression. Purpose: We examined the relationship between rates of childhood adversity using two complimentary approaches (1) a sample of CFS patients who had no lifetime history of depression and (2) a modelling approach. Methods: Childhood trauma questionnaire (CTQ) administered to a sample of 52 participants with chronic fatigue syndrome and 19 controls who did not meet criteria for a psychiatric disorder (confirmed using the Structured Clinical Interview for DSM-IV). Subsequently, Mediation Analysis (Baye's Rules) was used to establish the risk childhood adversity poses for CFS with and without depression. Results: In a cohort of CFS patients with depression comprehensively excluded, CTQ scores were markedly lower than in all previous studies and, in contrast to these previous studies, not increased compared with healthy controls. Post-hoc analysis showed that CTQ scores correlated with the number of depressive symptoms during the lifetime worst period of low mood. The probability of developing CFS given a history of childhood trauma is 4%, a two-fold increased risk compared to the general population. However, much of this risk is mediated by the concomitant development of major depression. Conclusions: The data suggests that previous studies showing a relationship between childhood adversity and CFS may be attributable to the confounding effects of co-morbid or misdiagnosed depressive disorder. Abbreviations: CFS: Chronic fatigue syndrome; CTQ: Childhood trauma questionnaire; MDD: Major depressive disorder; CA: Childhood adversity; P : Probability.

  12. Developing criteria to establish Trusted Digital Repositories

    Science.gov (United States)

    Faundeen, John L.

    2017-01-01

    This paper details the drivers, methods, and outcomes of the U.S. Geological Survey’s quest to establish criteria by which to judge its own digital preservation resources as Trusted Digital Repositories. Drivers included recent U.S. legislation focused on data and asset management conducted by federal agencies spending $100M USD or more annually on research activities. The methods entailed seeking existing evaluation criteria from national and international organizations such as International Standards Organization (ISO), U.S. Library of Congress, and Data Seal of Approval upon which to model USGS repository evaluations. Certification, complexity, cost, and usability of existing evaluation models were key considerations. The selected evaluation method was derived to allow the repository evaluation process to be transparent, understandable, and defensible; factors that are critical for judging competing, internal units. Implementing the chosen evaluation criteria involved establishing a cross-agency, multi-disciplinary team that interfaced across the organization. 

  13. 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.

  14. The exploration-exploitation dilemma: a multidisciplinary framework.

    Directory of Open Access Journals (Sweden)

    Oded Berger-Tal

    Full Text Available The trade-off between the need to obtain new knowledge and the need to use that knowledge to improve performance is one of the most basic trade-offs in nature, and optimal performance usually requires some balance between exploratory and exploitative behaviors. Researchers in many disciplines have been searching for the optimal solution to this dilemma. Here we present a novel model in which the exploration strategy itself is dynamic and varies with time in order to optimize a definite goal, such as the acquisition of energy, money, or prestige. Our model produced four very distinct phases: Knowledge establishment, Knowledge accumulation, Knowledge maintenance, and Knowledge exploitation, giving rise to a multidisciplinary framework that applies equally to humans, animals, and organizations. The framework can be used to explain a multitude of phenomena in various disciplines, such as the movement of animals in novel landscapes, the most efficient resource allocation for a start-up company, or the effects of old age on knowledge acquisition in humans.

  15. Therapeutical Approach of Osteoporosis — a Multidisciplinary Issue

    Directory of Open Access Journals (Sweden)

    Camelia Gliga

    2013-08-01

    Full Text Available Osteoporosis is the most frequent systemic disease of the bone, that affects elderly, mainly women in menopause. It can be defined by lowering of bone mass and microarchitectural deterioration of the bone tissue, resulting in an increased bone fragility. Main complications of osteoporosis are fractures of the vertebrae, hips and forearm. In view of its large variety of causes and manifestations, diagnostic and therapeutical approach in osteoporosis represents a multidisciplinary issue. The accurate diagnosis of osteoporosis is based on a method that measures the bone mineral density, expressed by the T-score, using dual energy X-ray absorptiometry, so called DXA. Lately, in practice in order for establishing the risk of osteoporosis and osteoporotic fracture the FRAX tool is increasingly used (The Fracture Risk Assessment. Treatment of osteoporosis is complex involving non-pharmacological and pharmacological measures. Non-pharmacological methods include preventive measures like exercise, external hip protectors, increase of dietary intake of calcium, vitamin D and proteins, especially in elderly, over 65 years. Pharmacological measures are represented by different types of drugs, including biphosphonates, bone formation stimulatory drugs, agents with new mechanisms of action, hormone replacement therapy and they will be indicated only after a detailed clinical and paraclinical examination of the patient. Regardless of the chosen pharmacological measure, periodical follow-up of efficacy, side-effects and complications of antiosteoporotic treatment, by clinical examination and laboratory investigations targeting bone remodelling, is strongly indicated.

  16. [Multidisciplinary team building in enhanced recovery after surgery].

    Science.gov (United States)

    Jia, W D

    2018-01-01

    There has been 10 years to explore the road in line with China's actual enhanced recovery after surgery(ERAS) since Academician Li Jieshou introduced the view of ERAS into China. ERAS has been widely carried out in the field of surgery, and gradually formed with Chinese characteristics of ERAS clinical pathway.The clinical implementation of ERAS relies on the effective integration of a series of perioperative methods, and any single technique or method can't completely reduce the perioperative physiological and psychological traumatic stress of the patient, so as to achieve the patient's rapid rehabilitation patient-centered multidisciplinary team(MDT)collaboration is an inevitable trend in ERAS development. On the basis of drawing lessons from foreign experience, the establishment of ERAS-MDT model in line with China's national conditions is a new subject that needs to be studied at present. The construction of ERAS-MDT might promote the development of new ERAS services, new technologies, and ultimately promote the improvement of surgical treatment, and bring the greatest clinical benefit to the society and patients.

  17. Take a Multidisciplinary, Team-based Approach on Elder Abuse.

    Science.gov (United States)

    2016-07-01

    While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem. Providing great care to a victim of elder abuse requires time and setting up a circumstance whereby one can actually communicate with the patient reliably and alone. While most states require providers to report suspected cases of elder abuse to Adult Protective Services, there is little evidence this requirement has incentivized more reports in the same way a similar requirement has prompted providers to report cases of suspected child abuse. Investigators advise ED leaders to train and empower every member of their team to identify potential signs of elder abuse.

  18. 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

    2014-01-01

    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

  19. Enhancing Transparency in Multidisciplinary Expert Communication

    International Nuclear Information System (INIS)

    Hukki, Kristiina; Pulkkinen, Urho

    2003-01-01

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

  20. Stages of Childhood Hodgkin Lymphoma

    Science.gov (United States)

    ... Version Key Points Childhood Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. There are two types of childhood Hodgkin lymphoma. Epstein-Barr virus infection increases the risk of childhood Hodgkin ...

  1. Childhood obesity case statement.

    Science.gov (United States)

    Esposito, Paul W; Caskey, Paul; Heaton, Lisa E; Otsuka, Norman

    2013-04-01

    The goal of this publication is to raise awareness of the impact of childhood obesity on the musculoskeletal health of children and its potential long-term implications. Relevant articles dealing with musculoskeletal disorders either caused by or worsened by childhood obesity were reviewed through a Pub Med search. Efforts to recognize and combat the childhood obesity epidemic were also identified through Internet search engines. This case statement was then reviewed by the members of the pediatric specialty group of the US Bone and Joint Initiative, which represents an extensive number of organizations dealing with musculoskeletal health. Multiple musculoskeletal disorders are clearly caused by or worsened by childhood obesity. The review of the literature clearly demonstrates the increased frequency and severity of many childhood musculoskeletal disorders. Concerns about the long-term implications of these childhood onset disorders such as pain and degenerative changes into adulthood are clearly recognized by all the member organizations of the US Bone and Joint Initiative. It is imperative to recognize the long-term implications of musculoskeletal disorders caused by or worsened by childhood obesity. It is also important to recognize that the ability to exercise comfortably is a key factor to developing a healthy lifestyle and maintaining a healthy body weight. Efforts to develop reasonable and acceptable programs to increase physical activity by all facets of society should be supported. Further research into the long-term implications of childhood musculoskeletal disorders related to childhood obesity is necessary. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Detailed debris flow hazard assessment in Andorra: A multidisciplinary approach

    Science.gov (United States)

    Hürlimann, Marcel; Copons, Ramon; Altimir, Joan

    2006-08-01

    In many mountainous areas, the rapid development of urbanisation and the limited space in the valley floors have created a need to construct buildings in zones potentially exposed to debris flow hazard. In these zones, a detailed and coherent hazard assessment is necessary to provide an adequate urban planning. This article presents a multidisciplinary procedure to evaluate the debris flow hazard at a local scale. Our four-step approach was successfully applied to five torrent catchments in the Principality of Andorra, located in the Pyrenees. The first step consisted of a comprehensive geomorphologic and geologic analysis providing an inventory map of the past debris flows, a magnitude-frequency relationship, and a geomorphologic-geologic map. These data were necessary to determine the potential initiation zones and volumes of future debris flows for each catchment. A susceptibility map and different scenarios were the principal outcome of the first step, as well as essential input data for the second step, the runout analysis. A one-dimensional numerical code was applied to analyse the scenarios previously defined. First, the critical channel sections in the fan area were evaluated, then the maximum runout of the debris flows on the fan was studied, and finally simplified intensity maps for each defined scenario were established. The third step of our hazard assessment was the hazard zonation and the compilation of all the results from the two previous steps in a final hazard map. The base of this hazard map was the hazard matrix, which combined the intensity of the debris flow with its probability of occurrence and determined a certain hazard degree. The fourth step referred to the hazard mitigation and included some recommendations for hazard reduction. In Andorra, this four-step approach is actually being applied to assess the debris flow hazard. The final hazard maps, at 1 : 2000 scale, provide an obligatory tool for local land use planning. Experience

  3. Design Environment for Multifidelity and Multidisciplinary Components

    Science.gov (United States)

    Platt, Michael

    2014-01-01

    One of the greatest challenges when developing propulsion systems is predicting the interacting effects between the fluid loads, thermal loads, and structural deflection. The interactions between technical disciplines often are not fully analyzed, and the analysis in one discipline often uses a simplified representation of other disciplines as an input or boundary condition. For example, the fluid forces in an engine generate static and dynamic rotor deflection, but the forces themselves are dependent on the rotor position and its orbit. It is important to consider the interaction between the physical phenomena where the outcome of each analysis is heavily dependent on the inputs (e.g., changes in flow due to deflection, changes in deflection due to fluid forces). A rigid design process also lacks the flexibility to employ multiple levels of fidelity in the analysis of each of the components. This project developed and validated an innovative design environment that has the flexibility to simultaneously analyze multiple disciplines and multiple components with multiple levels of model fidelity. Using NASA's open-source multidisciplinary design analysis and optimization (OpenMDAO) framework, this multifaceted system will provide substantially superior capabilities to current design tools.

  4. "Redefining smile-a multidisciplinary approach".

    Science.gov (United States)

    Manne, Prakash; Zakkula, Srujana; Atla, Jyothi; Muvva, Suresh Babu; Sampath, Anche

    2013-07-01

    This article presents a case report of a 20 year old female who was very much dissatisfied with her facial appearance and smile.On examination, it was found that there was a Angles class II division 1 malocclusion and a generalised spacing in the anterior teeth, with a retained, deciduous, left maxillary canine and a malposed 15. On radiographic examination, an impacted 18, 23 was noticed. As the part of the treatment plan, the retained deciduous canine and the impacted permanent canine were extracted and an orthodontic correction of the malocclusion was accomplished. The missing canine was planned to be replaced with a fixed partial denture.The short clinical crown height of the abutment teeth was increased by crown lengthening procedures and the pontic space was contoured to receive a ovate pontic by using diode lasers. The missing tooth was restored by using an all ceramic three unit zirconia bridge. This multi-disciplinary approach improved the smile of the patient and it ultimately enhanced her aesthetics and self confidence.

  5. Multidisciplinary management of intrahepatic cholangiocarcinoma: Current approaches.

    Science.gov (United States)

    Guro, Hanisah; Kim, Jin Won; Choi, YoungRok; Cho, Jai Young; Yoon, Yoo-Seok; Han, Ho-Seong

    2017-06-01

    Intrahepatic cholangiocarcinoma (ICC) is a common primary hepatic tumor. However, its outcomes are usually worse than those of hepatocellular carcinoma owing to its non-specific presentation and detection at an advanced stage. The most widely used serum marker, carbohydrate antigen 19-9, is non-specific. Furthermore, imaging studies rarely identify any pathognomonic features. Surgery is the only treatment option that offers a chance of long-term survival. However, the resectability rate is low owing to the high frequencies of intrahepatic metastases, peritoneal carcinomatosis, or extrahepatic metastases. Surgical treatment should be tailored according to the macroscopic classification of ICC (e.g. mass-forming, periductal infiltrating, and intraductal growth types) because it reflects the tumor's dissemination pattern. Although lymph node metastasis is a negative prognostic factor, the importance and extent of lymph node dissection is still controversial. To improve patient survival, liver transplantation is considered in some patients with unresectable ICC, especially in those with an insufficient remnant liver volume. Minimally invasive procedures, including laparoscopic and robotic liver resection, have been tested and achieved comparable outcomes to conventional surgery in preliminary studies. No randomized trials have confirmed the efficacy of adjuvant chemotherapy in ICC, and several trials have evaluated molecular-targeted agents as monotherapy or in combination with cytotoxic chemotherapy. Multidisciplinary approaches are necessary to improve the outcomes of ICC. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Instruction of Multidisciplinary Content in Introductory Courses

    Science.gov (United States)

    Shaibani, Saami J.

    2017-01-01

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

  7. Multi-Disciplinary System Reliability Analysis

    Science.gov (United States)

    Mahadevan, Sankaran; Han, Song

    1997-01-01

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

  8. Desensitization to rituximab in a multidisciplinary setting.

    Science.gov (United States)

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

    2015-10-01

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

  9. The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment

    DEFF Research Database (Denmark)

    Kloppenborg, Julie T; Gamborg, Michael; Fonvig, Cilius E

    2017-01-01

    and adolescents from the Children's Obesity Clinic, Holbaek, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C-peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow......OBJECTIVE: To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment. METHODS: The present study is a longitudinal observational study, including children...... mass index (BMI) z-score 2.94 (range 1.34-5.54) were included. The mean BMI z-score reduction was 0.31 (±0.46) after 13 months (range 6-18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C...

  10. Multi-disciplinary decision making in general practice.

    Science.gov (United States)

    Kirby, Ann; Murphy, Aileen; Bradley, Colin

    2018-04-09

    Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

  11. 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 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...

  12. 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

  13. Malignent diseases in childhood

    International Nuclear Information System (INIS)

    Havers, W.

    1980-01-01

    As malignant diseases in childhood are rare, and only a small group of radiotherapists have been able to gain experience in this field, this chapter treats the particularities of childhood from this aspect. The side effects of radiotherapy are particularly important here for the growing and developing organism of the child. The most frequently occuring malignant diseases are treated individually. (MG) [de

  14. Pregnancy and Cardiomyopathy After Anthracyclines in Childhood

    Directory of Open Access Journals (Sweden)

    Kara Annette Thompson

    2018-03-01

    Full Text Available With advances in cancer therapy, there has been a remarkable increase in survival in children diagnosed with malignancies. Many of these children are treated with anthracyclines which are well known to cause cardiotoxicity. As more childhood cancer survivors reach childbearing age, many will choose to become pregnant. At this time, the factors associated with development of cardiomyopathy after anthracycline treatment are not clearly identified. It is possible that cardiac stress could predispose to cardiac deterioration in a patient with reduced functional reserve from prior anthracycline exposure. Pregnancy is one form of cardiovascular stress. The cardiac outcomes of pregnancy in childhood cancer survivors must be considered. In view of limited data, guidelines for pregnancy planning, management, and monitoring after cardiotoxic cancer therapy have not been established. This review summarizes the limited data available on the topic of pregnancy after anthracyclines in childhood.

  15. Space-time interactions in childhood cancers

    International Nuclear Information System (INIS)

    Morris, V.

    1990-01-01

    During the last twenty five years, there have been sporadic published reports of cases of childhood leukaemia occurring in clusters. Renewed interest in the topic, following suggests that clusters may occur in the vicinity of nuclear establishments, has prompted this report of an investigation into 418 childhood cancer cases which occurred in the Midlands between 1953 and 1960. There was evidence among some age groups and diagnoses of an unexpectedly high number of close pairs of onsets, and some indication of similar patterns among births of children who later developed cancer. Measles appeared to occur more often in the 2-3 years before the onset of leukaemia in children who were later involved in close pairs than in their matched controls. It is concluded that common infectious diseases of childhood may play a minor role in the development of some cancers. Epidemics of these diseases may then be reflected on a greatly reduced scale in the subsequent distribution of cancer cases. (author)

  16. Multidisciplinary cognitive content of nanoscience and nanotechnology

    International Nuclear Information System (INIS)

    Milojević, Staša

    2012-01-01

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

  17. Merkel cell carcinoma: An algorithm for multidisciplinary management and decision-making.

    Science.gov (United States)

    Prieto, Isabel; Pérez de la Fuente, Teresa; Medina, Susana; Castelo, Beatriz; Sobrino, Beatriz; Fortes, Jose R; Esteban, David; Cassinello, Fernando; Jover, Raquel; Rodríguez, Nuria

    2016-02-01

    Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. Therapeutic approach is often unclear, and considerable controversy exists regarding MCC pathogenesis and optimal management. Due to its rising incidence and poor prognosis, it is imperative to establish the optimal therapy for both the tumor and the lymph node basin, and for treatment to include sentinel node biopsy. Sentinel node biopsy is currently the most consistent predictor of survival for MCC patients, although there are conflicting views and a lack of awareness regarding node management. Tumor and node management involve different specialists, and their respective decisions and interventions are interrelated. No effective systemic treatment has been made available to date, and therefore patients continue to experience distant failure, often without local failure. This review aims to improve multidisciplinary decision-making by presenting scientific evidence of the contributions of each team member implicated in MCC management. Following this review of previously published research, the authors conclude that multidisciplinary team management is beneficial for care, and propose a multidisciplinary decision algorithm for managing this tumor. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Complex multidisciplinary systems decomposition for aerospace vehicle conceptual design and technology acquisition

    Science.gov (United States)

    Omoragbon, Amen

    Although, the Aerospace and Defense (A&D) industry is a significant contributor to the United States' economy, national prestige and national security, it experiences significant cost and schedule overruns. This problem is related to the differences between technology acquisition assessments and aerospace vehicle conceptual design. Acquisition assessments evaluate broad sets of alternatives with mostly qualitative techniques, while conceptual design tools evaluate narrow set of alternatives with multidisciplinary tools. In order for these two fields to communicate effectively, a common platform for both concerns is desired. This research is an original contribution to a three-part solution to this problem. It discusses the decomposition step of an innovation technology and sizing tool generation framework. It identifies complex multidisciplinary system definitions as a bridge between acquisition and conceptual design. It establishes complex multidisciplinary building blocks that can be used to build synthesis systems as well as technology portfolios. It also describes a Graphical User Interface Designed to aid in decomposition process. Finally, it demonstrates an application of the methodology to a relevant acquisition and conceptual design problem posed by the US Air Force.

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

    Science.gov (United States)

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

    2017-06-01

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

  20. Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood

    DEFF Research Database (Denmark)

    Rasmussen, Line Jee Hartmann; Moffitt, Terrie E; Eugen-Olsen, Jesper

    2018-01-01

    BACKGROUND: Childhood risk factors are associated with elevated inflammatory biomarkers in adulthood, but it is unknown whether these risk factors are associated with increased adult levels of the chronic inflammation marker soluble urokinase plasminogen activator receptor (suPAR). We aimed to test...... the hypothesis that childhood exposure to risk factors for adult disease is associated with elevated suPAR in adulthood and to compare suPAR with the oft-reported inflammatory biomarker C-reactive protein (CRP). METHODS: Prospective study of a population-representative 1972-1973 birth cohort; the Dunedin...... Multidisciplinary Health and Development Study observed participants to age 38 years. Main childhood predictors were poor health, socioeconomic disadvantage, adverse childhood experiences (ACEs), low IQ, and poor self-control. Main adult outcomes were adulthood inflammation measured as suPAR and high...

  1. Charting Multidisciplinary Team External Dynamics Using a Systems Thinking Approach

    Science.gov (United States)

    Barthelemy, Jean-Francois; Waszak, Martin R.; Jones, Kenneth M.; Silcox, Richard J.; Silva, Walter A.; Nowaczyk, Ronald H.

    1998-01-01

    Using the formalism provided by the Systems Thinking approach, the dynamics present when operating multidisciplinary teams are examined in the context of the NASA Langley Research and Technology Group, an R&D organization organized along functional lines. The paper focuses on external dynamics and examines how an organization creates and nurtures the teams and how it disseminates and retains the lessons and expertise created by the multidisciplinary activities. Key variables are selected and the causal relationships between the variables are identified. Five "stories" are told, each of which touches on a different aspect of the dynamics. The Systems Thinking Approach provides recommendations as to interventions that will facilitate the introduction of multidisciplinary teams and that therefore will increase the likelihood of performing successful multidisciplinary developments. These interventions can be carried out either by individual researchers, line management or program management.

  2. [The multidisciplinary practice guideline 'The responsible use of biologicals'].

    NARCIS (Netherlands)

    Bijlsma, J.W.J.; Hagemeijer, J.W.; Bijl, M. van der; Jansen, T.L.Th.A.; Laar, M.A. van der; Landewe, R.B.; Nurmohamed, M.T.

    2011-01-01

    - A multidisciplinary working group has developed a practice guideline containing various recommendations on the responsible and efficient use of biologicals.- These biologicals include both soluble immune-receptor proteins and monoclonal antibodies that are aimed at immune mediators, receptors or

  3. The Assessment of Hyperactivity in Preschool Populations: A Multidisciplinary Perspective.

    Science.gov (United States)

    Rosenberg, Michael S.; And Others

    1989-01-01

    The variety of methods available for the assessment of hyperactivity in preschool populations is reviewed. Specific procedures for assessment are presented from a multidisciplinary perspective, integrating biophysical, behavioral, cognitive, and ecological models. (Author/JDD)

  4. Multidisciplinary Training to Undergraduate Students in the Faculty ...

    African Journals Online (AJOL)

    Multidisciplinary Training to Undergraduate Students in the Faculty of Health ... other disciplines in order to achieve an effective and cohesive working relationship. ... theoretical knowledge regarding blood pressure measurement and exercise, ...

  5. Multidisciplinary Design Optimization for High Reliability and Robustness

    National Research Council Canada - National Science Library

    Grandhi, Ramana

    2005-01-01

    .... Over the last 3 years Wright State University has been applying analysis tools to predict the behavior of critical disciplines to produce highly robust torpedo designs using robust multi-disciplinary...

  6. Transforming Multidisciplinary Customer Requirements to Product Design Specifications

    Science.gov (United States)

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

    2017-09-01

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

  7. High Fidelity Multidisciplinary Tool Development for Helicopter Quieting

    National Research Council Canada - National Science Library

    Chen, Chung-Lung; Chen, Ya-Chi; Chen, Bing; Jain, Rohit; Lund, Tom; Zhao, Hongwu; Wang, Z.-J; Sun, Yuzhi; Saberi, Hossein; Shih, T.-H

    2007-01-01

    .... The problem is indeed multidisciplinary. Current helicopter blade designers use computational models, which depend heavily on experimental data and cannot be used to predict any novel design, which is a significant departure from existing designs...

  8. Use of research reactors in multidisciplinary education at Cornell University

    International Nuclear Information System (INIS)

    Clark, D.D.

    1992-01-01

    Multidisciplinary aspects of nuclear science and technology form a large part of the research and teaching activities of the Nuclear Science and Engineering (NS and E) Program at Cornell, and the two reactors housed in Ward Laboratory - a 500-kW TRIGA and a 100-W critical facility [zero-power reactor (ZPR)]- play a central role in those activities. Several primarily educational and multidisciplinary features of the NS and E program are described in this paper

  9. Establishment Registration & Device Listing

    Data.gov (United States)

    U.S. Department of Health & Human Services — This searchable database contains establishments (engaged in the manufacture, preparation, propagation, compounding, assembly, or processing of medical devices...

  10. The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study.

    Science.gov (United States)

    Cunningham, Jennifer M; Blake, Catherine; Power, Camillus K; O'Keeffe, Declan; Kelly, Valerie; Horan, Sheila; Spencer, Orla; Fullen, Brona M

    2011-01-10

    using actigraphy (Actiwatch 7). These measures will be repeated after the four week multidisciplinary cognitive behavioural therapy pain management programme, and at a two month follow-up. The waiting list control group will be assessed at baseline, and two months later. Analysis for the primary outcome will include between group differences of subjective and objective sleep parameters from baseline to follow-up using Independent T-tests or Mann-Whitney U tests. The secondary outcomes establishing relationships between the sleep variables and physical and psychological outcome measures will be established using multiple linear regression models. This pilot study will evaluate the impact of a multidisciplinary CBT-PMP on both subjective and objective measures of sleep in patients with chronic pain and provide guidance for a larger clinical trial. Current controlled trial ISRCTN: ISRCTN74913595.

  11. [Social participation after childhood craniopharyngioma].

    Science.gov (United States)

    Olivari-Philiponnet, C; Roumenoff, F; Schneider, M; Chantran, C; Picot, M; Berlier, P; Mottolese, C; Bernard, J-C; Vuillerot, C

    2016-12-01

    % neurocognitive impairment. In the entire group of patients, 57% were able to attend a normal school (of which 38% needed a personal helper), 43% had to enter a specialized school. In patients in a specialized school, the LIFE-H results were significantly lower in the nutrition, communication, housing, and recreation dimensions. Girls also had significantly better results in many dimensions than boys. Heavy comorbidity goes with childhood craniopharyngioma and affects patients' participation in life activities, which is not very low but multidimensional (more than three affected dimensions). This participation is mainly affected in social dimensions, whereas in cerebral palsy, where the LIFE-H has been tested several times, the daily activities dimensions are more affected. Patients with childhood craniopharyngioma are affected in their participation in daily activities, mainly in the social dimensions. This could be improved with systematic diagnosis of these participation impairments, with the goal of adapted multidisciplinary management. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Multidisciplinary Care Models for Patients With Psoriatic Arthritis.

    Science.gov (United States)

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

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

  13. Head and neck multidisciplinary team meetings: Effect on patient management.

    Science.gov (United States)

    Brunner, Markus; Gore, Sinclair M; Read, Rebecca L; Alexander, Ashlin; Mehta, Ankur; Elliot, Michael; Milross, Chris; Boyer, Michael; Clark, Jonathan R

    2015-07-01

    The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management. We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management. One hundred seventy-two patients were discussed in 39 meetings. In 52 patients (30%), changes in management were documented of which 20 (67%) were major. Changes were statistically more likely when the referring physician was a medical or radiation oncologist, when the initial treatment plan did not include surgery, and when the histology was neither mucosal squamous cell cancer nor a skin malignancy. Compliance to the multidisciplinary team meeting treatment recommendation was 84% for all patients and 70% for patients with changes in their treatment recommendation. Head and neck multidisciplinary team meetings changed management in almost a third of the cases. © 2014 Wiley Periodicals, Inc.

  14. Training multidisciplinary biomedical informatics students: three years of experience.

    Science.gov (United States)

    van Mulligen, Erik M; Cases, Montserrat; Hettne, Kristina; Molero, Eva; Weeber, Marc; Robertson, Kevin A; Oliva, Baldomero; de la Calle, Guillermo; Maojo, Victor

    2008-01-01

    The European INFOBIOMED Network of Excellence recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. A carefully developed 3-year training program for biomedical informatics students addressed these educational aspects through the following four activities: (1) an internet course database containing an overview of all Medical Informatics and BioInformatics courses, (2) a BioMedical Informatics Summer School, (3) a mobility program based on a 'brokerage service' which published demands and offers, including funding for research exchange projects, and (4) training challenges aimed at the development of multi-disciplinary skills. This paper focuses on experiences gained in the development of novel educational activities addressing work in multidisciplinary teams. The training challenges described here were evaluated by asking participants to fill out forms with Likert scale based questions. For the mobility program a needs assessment was carried out. The mobility program supported 20 exchanges which fostered new BMI research, resulted in a number of peer-reviewed publications and demonstrated the feasibility of this multidisciplinary BMI approach within the European Union. Students unanimously indicated that the training challenge experience had contributed to their understanding and appreciation of multidisciplinary teamwork. The training activities undertaken in INFOBIOMED have contributed to a multi-disciplinary BMI approach. It is our hope that this work might provide an impetus for training efforts in Europe, and yield a new generation of biomedical informaticians.

  15. Multidisciplinary chronic pain management in a rural Canadian setting.

    Science.gov (United States)

    Burnham, Robert; Day, Jeremiah; Dudley, Wallace

    2010-01-01

    Chronic pain is prevalent, complex and most effectively treated by a multidisciplinary team, particularly if psychosocial issues are dominant. The limited access to and high costs of such services are often prohibitive for the rural patient. We describe the development and 18-month outcomes of a small multidisciplinary chronic pain management program run out of a physician's office in rural Alberta. The multidisciplinary team consisted of a family physician, physiatrist, psychologist, physical therapist, kinesiologist, nurse and dietician. The allied health professionals were involved on a part-time basis. The team triaged referral information and patients underwent either a spine or medical care assessment. Based on the findings of the assessment, the team managed the care of patients using 1 of 4 methods: consultation only, interventional spine care, supervised medication management or full multidisciplinary management. We prospectively and serially recorded self-reported measures of pain and disability for the supervised medication management and full multidisciplinary components of the program. Patients achieved clinically and statistically significant improvements in pain and disability. Successful multidisciplinary chronic pain management services can be provided in a rural setting.

  16. New ideas in asthma and allergy research: creating a multidisciplinary graduate school

    Science.gov (United States)

    Björkstén, Bengt; Graninger, Göran; Ekman, Gunilla Jacobsson

    2003-01-01

    The spring term of 2001 saw the start of a new, unique graduate research training program at the Centre for Allergy Research at the Karolinska Institutet in Stockholm, Sweden. The program was created to bridge the gaps between basic, clinical, social, and behavioral sciences and to establish a global approach to the study of asthma and allergy. A reflection, two years on, discusses the strategies that are key to this model’s success and the challenges in introducing a multidisciplinary research program. PMID:12975463

  17. Benefits and limitations of a multidisciplinary approach to individualized management of Cornelia de Lange syndrome and related diagnoses.

    Science.gov (United States)

    January, Kathleen; Conway, Laura J; Deardorff, Matthew; Harrington, Ann; Krantz, Ian D; Loomes, Kathleen; Pipan, Mary; Noon, Sarah E

    2016-06-01

    Given the clinical complexities of Cornelia de Lange Syndrome (CdLS), the Center for CdLS and Related Diagnoses at The Children's Hospital of Philadelphia (CHOP) and The Multidisciplinary Clinic for Adolescents and Adults at Greater Baltimore Medical Center (GBMC) were established to develop a comprehensive approach to clinical management and research issues relevant to CdLS. Little work has been done to evaluate the general utility of a multispecialty approach to patient care. Previous research demonstrates several advantages and disadvantages of multispecialty care. This research aims to better understand the benefits and limitations of a multidisciplinary clinic setting for individuals with CdLS and related diagnoses. Parents of children with CdLS and related diagnoses who have visited a multidisciplinary clinic (N = 52) and who have not visited a multidisciplinary clinic (N = 69) were surveyed to investigate their attitudes. About 90.0% of multispecialty clinic attendees indicated a preference for multidisciplinary care. However, some respondents cited a need for additional clinic services including more opportunity to meet with other specialists (N = 20), such as behavioral health, and increased information about research studies (N = 15). Travel distance and expenses often prevented families' multidisciplinary clinic attendance (N = 41 and N = 35, respectively). Despite identified limitations, these findings contribute to the evidence demonstrating the utility of a multispecialty approach to patient care. This approach ultimately has the potential to not just improve healthcare for individuals with CdLS but for those with medically complex diagnoses in general. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. 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.

  19. Minimising food waste: a call for multidisciplinary research.

    Science.gov (United States)

    Alamar, Maria Del Carmen; Falagán, Natalia; Aktas, Emel; Terry, Leon A

    2018-01-01

    Food losses and waste have always been a significant global problem for mankind, and one which has become increasingly recognised as such by policy makers, food producers, processors, retailers, and consumers. It is, however, an emotive subject whereby the extent, accuracy and resolution of available data on postharvest loss and waste are questionable, such that key performance indicators on waste can be misinformed. The nature and extent of food waste differ among developed economies, economies in transition and developing countries. While most emphasis has been put on increasing future crop production, far less resource has been and is still channelled towards enabling both established and innovative food preservation technologies to reduce food waste while maintaining safety and quality. Reducing food loss and waste is a more tractable problem than increasing production in the short to medium term, as its solution is not directly limited, for instance, by available land and water resources. Here we argue the need for a paradigm shift of current funding strategies and research programmes that will encourage the development, implementation and translation of collective biological, engineering and management solutions to better preserve and utilise food. Such multidisciplinary thinking across global supply chains is an essential element in the pursuit of achieving sustainable food and nutritional security. The implementation of allied technological and management solutions is reliant on there being sufficient skilled human capital and resources. There is currently a lack of robust postharvest research networks outside of the developed world, and insufficient global funding mechanisms that can support such interdisciplinary collaborations. There is, thus, a collective need for schemes that encourage inter-supply chain research, knowledge exchange and capacity building to reduce food losses and waste. © 2017 Society of Chemical Industry. © 2017 Society of Chemical

  20. Extrapyramidal disorders in childhood

    International Nuclear Information System (INIS)

    Angelini, L.; Nardocci, N.; Balottin, U.; Lanzi, G.

    1987-01-01

    Movement disorders have become significantly interesting as a subject in the Neurosciences. The majority of the data, however, relate to the more specific problems of extrapyramidal disorders in adults. As a disease in childhood it still remains poorly systemized. This book is a collection of certain studies with reference to the most recent advances regarding the morphofunctional organization of the basal ganglia in relation to development. Moreover, the book attempts to systemize the extrapyramidal diseases typical of childhood or at the onset in childhood, focusing on diagnostic and therapeutic criteria. refs.; figs.; tabs

  1. Prevention of childhood injuries

    African Journals Online (AJOL)

    road traffic crashes, drowning, burns, poisoning or falls), has become a major ... hugely on childhood health in terms of disability and, depending on their cause ... SA, children continue to be threatened by injuries of various kinds, although this ...

  2. Adrenarche and middle childhood.

    Science.gov (United States)

    Campbell, Benjamin C

    2011-09-01

    Middle childhood, the period from 6 to 12 years of age, is defined socially by increasing autonomy and emotional regulation, somatically by the development of anatomical structures for subsistence, and endocrinologically by adrenarche, the adrenal production of dehydroepiandrosterone (DHEA). Here I suggest that DHEA plays a key role in the coordinated development of the brain and body beginning with middle childhood, via energetic allocation. I argue that with adrenarche, increasing levels of circulating DHEA act to down-regulate the release of glucose into circulation and hence limit the supply of glucose which is needed by the brain for synaptogenesis. Furthermore, I suggest the antioxidant properties of DHEA may be important in maintaining synaptic plasticity throughout middle childhood within slow-developing areas of the cortex, including the insula, thamalus, and anterior cingulate cortex. In addition, DHEA may play a role in the development of body odor as a reliable social signal of behavioral changes associated with middle childhood.

  3. Childhood Traumatic Grief

    Science.gov (United States)

    ... and Practices Treatments That Work Screening and Assessment Psychological First Aid and SPR Core Curriculum on Childhood Trauma Trauma- ... Measure Reviews All Measure Reviews Usage and Glossary Psychological First Aid and SPR About PFA About SPR NCTSN Resources ...

  4. Reducing Childhood Obesity

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Reducing Childhood Obesity Past Issues / Summer 2007 Table of Contents For ... Ga. were the first three We Can! cities. Obesity Research: A New Approach The percentage of children ...

  5. Childhood vitiligo: Treatment paradigms

    Directory of Open Access Journals (Sweden)

    Amrinder Jit Kanwar

    2012-01-01

    Full Text Available Childhood vitiligo differs from the adults by showing a higher incidence in females, segmental vitiligo being more common and less frequent association with other systemic autoimmune and endocrine disorders.Childhood vitiligo is often associated with a marked psychosocial and long lasting effect on the self-esteem of the affected children and their parents, hence an adequate treatment is very essential. Treatment of vitiligo is indeed a tough challenge for the dermatologists′ more so in the background of childhood vitiligo. Although multiple therapeutic modalities are available in the therapeutic armamentarium, not all can be used in children. This brief report updates regarding various therapies available in the treatment of childhood vitiligo.

  6. Instant Childhood Immunization Schedule

    Science.gov (United States)

    ... Recommendations Why Immunize? Vaccines: The Basics Instant Childhood Immunization Schedule Recommend on Facebook Tweet Share Compartir Get ... date. See Disclaimer for additional details. Based on Immunization Schedule for Children 0 through 6 Years of ...

  7. Childhood Autism In Africa

    Science.gov (United States)

    Lotter, Victor

    1978-01-01

    Mentally handicapped children were screened in 5 countries in Africa in order to explore the usefulness of Western criteria for the recognition of childhood autism in children from developing countries. (CM)

  8. Childhood trauma and resilience in psoriatic patients: A preliminary report.

    Science.gov (United States)

    Crosta, Maria Luigia; De Simone, Clara; Di Pietro, Salvatore; Acanfora, Mariateresa; Caldarola, Giacomo; Moccia, Lorenzo; Callea, Antonino; Panaccione, Isabella; Peris, Ketty; Rinaldi, Lucio; Janiri, Luigi; Di Nicola, Marco

    2018-03-01

    Psoriasis is a chronic inflammatory skin disease with a complex etiology, involving the immune system, genetic factors, and external/internal triggers, with psychosomatic aspects. The aim of the study was to investigate childhood trauma and resilience in a psoriatic sample compared with healthy controls. Correlations between childhood trauma, resilience, quality of life, clinical data and psoriatic features were also evaluated. Seventy-seven psoriatic patients and seventy-six homogeneous healthy controls were enrolled. We used the Psoriasis Area and Severity Index (PASI) to assess the severity of psoriasis and the Skindex-29 to measure health-related quality of life. The psychometric battery included the Childhood Trauma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-Risc) to assess trauma exposure and resilience, respectively. Psoriatic patients showed a significant prevalence of childhood trauma and a lower resilience level compared to healthy controls. Associations between traumatic experiences, low resilience and reduced quality of life in psoriatic subjects were also observed. A multidisciplinary approach is helpful to investigate clinical aspects, trigger factors and psychophysiological stress response in psoriatic subjects. Improving resilience with an early psychological intervention focused on self-motivation and strengthening of self-efficacy could facilitate the management of psoriasis. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Establishing software quality assurance

    International Nuclear Information System (INIS)

    Malsbury, J.

    1983-01-01

    This paper is concerned with four questions about establishing software QA: What is software QA. Why have software QA. What is the role of software QA. What is necessary to ensure the success of software QA

  10. Blood Establishment Registration Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — This application provides information for active, inactive, and pre-registered firms. Query options are by FEI, Applicant Name, Establishment Name, Other Names,...

  11. Establishment of prairies

    International Nuclear Information System (INIS)

    Lotero Cadavid, J.

    2001-01-01

    Are analyzed the establishment of prairies, such as the selection of the species, the factors of the environment, the impact in the establishment and forage production and its relation to the soil, the precipitation, the temperature, the light and the biotic factors. It is indicated that the selection of the species to settle down, is directly related with the climate and the soil and they group to be tolerant to drought, tolerant to flood soils, tolerant to humid soils, tolerant to soils very acids, moderately acids and saline. It is noticed that a bad establishment of the grasses can be due to the bad quality of the seed, a temperature and unfavorable humidity can cause low germination; equally seeds planted very deeply in heavy soils with excess of humidity. Considerations are made about the establishment and growth of the prairies in connection with the germination, cultures, sowing density and sowing on time, as well as for the soil preparation, the sowing in terrestrial mechanic and non mechanic and the use of cultivations forms of low cost and fertilization systems; equally the establishment of leguminous in mixture with gramineous, the renovation of prairies and the establishment of pastures

  12. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  13. Initiation of a multidisciplinary summer studentship in palliative and supportive care in oncology

    Directory of Open Access Journals (Sweden)

    Fairchild A

    2012-09-01

    Full Text Available Alysa Fairchild,1 Sharon Watanabe,1 Carole Chambers,2 Janice Yurick,3 Lisa Lem,4 Patty Tachynski51Faculty of Medicine and Dentistry, University of Alberta, Edmonton, 2Department of Pharmacy, Alberta Health Services, 3Department of Rehabilitation Medicine, Cross Cancer Institute, Edmonton, 4Department of Respiratory Therapy, Cross Cancer Institute, Edmonton, 5Department of Clinical Nutrition, Cross Cancer Institute, Edmonton, Alberta, CanadaPurpose: The optimal setting for interprofessional education (IPE for prelicensure health care trainees is unclear, especially in a field as complex and emotionally challenging as oncology. In this article, the authors describe the initiation of the Cross Cancer Institute Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology, a 6-week, multidisciplinary team-based clinical placement in supportive care, designed to incorporate features of best practice cooperative learning.Methods: A steering committee established goals, structure, eligibility criteria, application process, funding, and a consensus approach to instruction and evaluation for the IPE program. Studentship components included mandatory and flexible clinical time, an exploratory investigation, discussion groups, and a presentation. Two senior students per iteration were selected from clinical nutrition, medicine, nursing, occupational therapy, pharmacy, physiotherapy, respiratory therapy, social work, and speech–language pathology applicants. These students completed questionnaires investigating their views of their own and others' professions at baseline, at the end of the rotation, and 6 months after the studentship.Results: Eight students from medicine, clinical nutrition, occupational therapy, physiotherapy, and speech–language pathology have participated to date. At the elective's end, students have described a more positive view of multidisciplinary team practice, with each participating discipline perceived as

  14. Multidisciplinary and biodanza intervention for the management of fibromyalgia.

    Science.gov (United States)

    Carbonell-Baeza, Ana; Ruiz, Jonatan R; Aparicio, Virginia A; Martins-Pereira, Clelia M; Gatto-Cardia, M Claudia; Martinez, Jose M; Ortega, Francisco B; Delgado-Fernandez, Manuel

    2012-01-01

    To evaluate and compare the effectiveness of a 16-week multidisciplinary (exercise plus psychological therapy) and biodanza intervention in women with fibromyalgia. Thirty-eight women with fibromyalgia were distributed to a 16-week multidisciplinary (3-times/week) intervention (n=21) or Biodanza (1-time/week) intervention (n=17). We assessed tender point, body composition, physical fitness and psychological outcomes (Fibromyalgia Impact Questionnaire, the Short-Form Health Survey 36 questionnaire (SF-36), the Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory (VPMI), Rosenberg Self-Esteem Scale and General Self-Efficacy Scale). We observed a significant group*time interaction effect for the scales of SF-36 physical role (P=0.038) and social functioning (P=0.030) and for the passive coping scale in VPMI (P=0.043). Post hoc analysis revealed a significant improvement on social functioning (P=0.030) in the multidisciplinary group whereas it did not change in the Biodanza group. Post hoc analysis revealed a reduction in the use of passive coping (positive) (P less than 0.001) in the multidisciplinary group. There was no significant interaction or time effect in body composition and physical fitness. 16 weeks of multidisciplinary intervention induced greater benefits than a Biodanza intervention for social functioning and the use of passive coping strategies in women with fibromyalgia.

  15. [Optimal use of peritoneal dialysis with multi-disciplinary management].

    Science.gov (United States)

    Elios Russo, Gaspare; Martinez, A; Mazzaferro, S; Nunzi, A; Testorio, M; Rocca, A R; Lai, S; Morgia, A; Borzacca, B; Gnerre Musto, T

    2013-01-01

    Considering the increasing incidence of chronic kidney disease and the increased use of peritoneal dialysis, we wanted to assess whether the multidisciplinary management of patients in peritoneal dialysis might produce improvement in the quality of patients' lives when compared to management by a routine team of operators. Our study observed 40 patients on peritoneal dialysis in our Department between 2010 and 2012. They were randomly assigned to either group A, the routine team which consisted of a nephrologist and a nurse, or group B, a multidisciplinary team comprising several medical specialists, a nurse, a psychologist and a social worker. Two tests, KDQOL-SF and MMPI-2, were administered to both groups. In group B, the number of days of hospitalization and day hospital were more than 88% lower when compared to group A. The multidisciplinary team achieved better results with the KDQOL-SF test with regards to both emotional and objective dimensions. The Pearson coefficient between the results of the two questionnaires shows how multidisciplinary management can positively influence the perceived well-being of the patient and his or her adherence to treatment. In a multidisciplinary team, each operator, in addition to his or her specific role, also contributes to the achievement of the overall objective, namely of ensuring an optimal quality of life to the patient on peritoneal dialysis thereby allowing these patients to continue their professional and social lives.

  16. Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood.

    Science.gov (United States)

    Rasmussen, Line Jee Hartmann; Moffitt, Terrie E; Eugen-Olsen, Jesper; Belsky, Daniel W; Danese, Andrea; Harrington, HonaLee; Houts, Renate M; Poulton, Richie; Sugden, Karen; Williams, Benjamin; Caspi, Avshalom

    2018-05-09

    Childhood risk factors are associated with elevated inflammatory biomarkers in adulthood, but it is unknown whether these risk factors are associated with increased adult levels of the chronic inflammation marker soluble urokinase plasminogen activator receptor (suPAR). We aimed to test the hypothesis that childhood exposure to risk factors for adult disease is associated with elevated suPAR in adulthood and to compare suPAR with the oft-reported inflammatory biomarker C-reactive protein (CRP). Prospective study of a population-representative 1972-1973 birth cohort; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years. Main childhood predictors were poor health, socioeconomic disadvantage, adverse childhood experiences (ACEs), low IQ, and poor self-control. Main adult outcomes were adulthood inflammation measured as suPAR and high-sensitivity CRP (hsCRP). Participants with available plasma samples at age 38 were included (N = 837, 50.5% male). suPAR (mean 2.40 ng/ml; SD 0.91) was positively correlated with hsCRP (r 0.15, p childhood risks were aggregated into a Cumulative Childhood Risk index, and controlling for sex, BMI, and smoking, Cumulative Childhood Risk was associated with higher suPAR (b 0.10; SE 0.03; p = .002). Cumulative Childhood Risk predicted elevated suPAR, after controlling for hsCRP (b 0.18; SE 0.03; p childhood risk factors was associated with higher suPAR levels, independent of CRP. suPAR is a useful addition to studies connecting childhood risk to adult inflammatory burden. © 2018 Association for Child and Adolescent Mental Health.

  17. Multidisciplinary design optimization of the diesel particulate filter in the composite regeneration process

    International Nuclear Information System (INIS)

    Zhang, Bin; E, Jiaqiang; Gong, Jinke; Yuan, Wenhua; Zuo, Wei; Li, Yu; Fu, Jun

    2016-01-01

    Highlights: • The multidisciplinary design optimization (MDO) for the DPF is presented. • MDO model and multi-objective functions of the DPF are established. • The optimal design parameters are obtained and DPF’s performances are improved. • The optimized results are verified by experiments. • The composite regeneration process of the optimized DPF allows a higher energy saving. - Abstract: In our previous works, the diesel particulate filter (DPF) using a new composite regeneration mode by coupling microwave and ceria-manganese base catalysts is verified as an effective way to reduce the particulate matter emission of the diesel engine. In order to improve the overall performance of this DPF, its multidisciplinary design optimization (MDO) model is established based on objective functions such as pressure drop, regeneration performance, microwave energy consumption, and thermal shock resistance. Then, the DPF is optimized by using MDO method based on adaptive mutative scale chaos optimization algorithm. The optimization results show that with the help of MDO, DPF’s pressure drop is decreased by 14.5%, regeneration efficiency is increased by 17.3%, microwave energy consumption is decreased by 17.6%, and thermal deformation is decreased by 25.3%. The optimization results are also verified by experiments, and the experimental results indicate that the optimized DPF has larger filtration efficiency, better emission performance and regeneration performance, smaller pressure drop, lower wall temperature and temperature gradient, and lower microwave energy consumption.

  18. Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results

    Science.gov (United States)

    Smeltzer, Matthew P.; Rugless, Fedoria E.; Jackson, Bianca M.; Berryman, Courtney L.; Faris, Nicholas R.; Ray, Meredith A.; Meadows, Meghan; Patel, Anita A.; Roark, Kristina S.; Kedia, Satish K.; DeBon, Margaret M.; Crossley, Fayre J.; Oliver, Georgia; McHugh, Laura M.; Hastings, Willeen; Osborne, Orion; Osborne, Jackie; Ill, Toni; Ill, Mark; Jones, Wynett; Lee, Hyo K.; Signore, Raymond S.; Fox, Roy C.; Li, Jingshan; Robbins, Edward T.; Ward, Kenneth D.; Klesges, Lisa M.

    2018-01-01

    Background Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary vs. serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic. Methods We used a mixed-methods approach to conduct a patient-centered, combined implementation and effectiveness study of a multidisciplinary model of lung cancer care. We established a co-located multidisciplinary clinic to study the implementation of this care-delivery model. We identified and engaged key stakeholders from the onset, used their input to develop the program structure, processes, performance benchmarks, and study endpoints (outcome-related process measures, patient- and caregiver-reported outcomes, survival). In this report, we describe the study design, process of implementation, comparative populations, and how they contrast with patients within the local and regional healthcare system. Trial Registration: ClinicalTrials.gov Identifier: NCT02123797. Results Implementation: the multidisciplinary clinic obtained an overall treatment concordance rate of 90% (target >85%). Satisfaction scores were high, with >95% of patients and caregivers rating themselves as being “very satisfied” with all aspects of care from the multidisciplinary team (patient/caregiver response rate >90%). The Reach of the multidisciplinary clinic included a higher proportion of minority patients, more women, and younger patients than the regional population. Comparative effectiveness: The comparative effectiveness trial conducted in the last phase of the study met the planned enrollment per statistical design, with 178 patients in the multidisciplinary arm and 348 in the serial care arm. The multidisciplinary cohort had older age and a higher percentage of racial

  19. MULTIDISCIPLINARY TEACHING – MSc COURSE ON TEAMWORK AND OPARATION

    DEFF Research Database (Denmark)

    Karlshøj, Jan; Dederichs, Anne

    2011-01-01

    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....... during the design phase; as well as a need of new work methods within the process. This calls for employees who are experienced in collaborating in interdisciplinary teams. To fulfill this demand a multidisciplinary course in “Advanced building design” has been developed at the Technical University...... of Denmark. The goal of the course is to provide training in teamwork at the final stage of the engineering education. The course has been carried out twice. It was held by a multidisciplinary team of professors in periods 2008/09, 2009/10 and 20010/2011. Teams of students were subject of a questionnaire...

  20. 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...

  1. Multi-disciplinary coupling for integrated design of propulsion systems

    Science.gov (United States)

    Chamis, C. C.; Singhal, S. N.

    1993-01-01

    Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions for determining the true response of propulsion systems. Results are presented for propulsion system responses including multi-discipline coupling effects via (1) coupled multi-discipline tailoring, (2) an integrated system of multidisciplinary simulators, (3) coupled material-behavior/fabrication-process tailoring, (4) sensitivities using a probabilistic simulator, and (5) coupled materials/structures/fracture/probabilistic behavior simulator. The results show that the best designs can be determined if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated interactive multi-discipline numerical propulsion system simulator.

  2. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

    Science.gov (United States)

    Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

    2015-08-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.

  3. Diagnosis of bone metastasis from thyroid carcinoma: a multidisciplinary approach

    International Nuclear Information System (INIS)

    Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E; Ewertsen, Caroline

    2015-01-01

    Sarcomas are rare tumors originating from soft tissue or bone. Diagnosis and treatment of sarcomas should be performed at specialized sarcoma centers, where patients are evaluated at a multidisciplinary tumor conference. We present a case where sarcoma was suspected from magnetic resonance imaging (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re-evaluation of previous pathology and a thorough patient history enabled a final diagnosis

  4. Multidisciplinary patient education in groups increases knowledge on Osteoporosis

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nissen, Nis

    2008-01-01

    of osteoporosis may be increased by a group-based multidisciplinary education programme. Methods: Three hundred patients, aged 45-81 years, recently diagnosed with osteoporosis and started on specific treatment, were randomized to either the ‘‘school'' or ‘‘control'' group. Teaching was performed by nurses...... level, the higher the gain in knowledge during the course (Rho520.25, pv0.01). Conclusions: A group-based multidisciplinary education programme significantly increases patients' knowledge of the disease.....

  5. MULTIDISCIPLINARY APPROACH TO SUPPORTING TREATMENT COMPLIANCE IN TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    T. V. Sherstneva

    2017-01-01

    Full Text Available The article presents the algorithm for working with tuberculosis patients in TB hospital, providing implementation of multidisciplinary patient-centered activities for early diagnostics of psychiatric and social disorders, therapy and rehabilitation of concurrent psychiatric disorders and addictions. Multidisciplinary approach to activities within TB unit is aimed at improvement of treatment compliance of tuberculosis patients. The training programme has been developed in order to improve competency of medical personnel on the issue of treatment interruption prevention and motivating patients to undergo the continuous treatment.

  6. Effectiveness of an intensive multidisciplinary headache treatment program.

    Science.gov (United States)

    Gunreben-Stempfle, Birgit; Griessinger, Norbert; Lang, Eberhard; Muehlhans, Barbara; Sittl, Reinhard; Ulrich, Kathrin

    2009-07-01

    To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P tension-type headache days (P tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    and evaluating a multiple-choice question(MCQ) test for use in a multi-disciplinary training program inobstetric-anesthesia emergencies. Methods: A multi-disciplinary working committee with 12members representing six professional healthcare groups andanother 28 participants were involved. Recurrent revisions......, 40 out of originally50 items were included in the final MCQ test. The MCQ test wasable to distinguish between levels of competence, and good con-struct validity was indicated by a significant difference in the meanscore between consultants and first-year trainees, as well as betweenfirst...

  8. Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

    Science.gov (United States)

    Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

    2018-01-01

    Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

  9. Establishing a University Foundation.

    Science.gov (United States)

    Lemish, Donald L.

    A handbook on how to establish a university foundation is presented. It presupposes that a foundation will be used as the umbrella organization for receiving all private gifts, restricted and unrestricted, for the benefit of a public college or university; and hence it chiefly addresses readers from public colleges and universities. Information is…

  10. Childhood, consumption and education: connections and dialogues

    Directory of Open Access Journals (Sweden)

    Marcelize Niviadonski Brites Albertini

    2016-04-01

    Full Text Available The growing process of industrialization and commercialization has embroiled the consumerist logic in different social groups including even children, since the discovery of its potential consumer awakened commercial interests in various segments. From this context, this paper supported on a theoretical study in which bibliographic and documentary analysis would establish connections between the triad: childhood, consumption and education, by seeking to reflect and talk about this relationship in today's contemporary society. At first we intend to know the evolution of the concept of childhood over time, their cultural historical context, as well as to understand this concept today. Later we will present considerations about the dilemmas of contemporary childhood and observations about the influence of consumer culture, and further on we will seek opportunities in education paths for understanding and reflecting upon the analysis of consumerist logic. Perspectives brought to light by this study suggest that thinking and rethinking childhood in the consumer culture must become axis of the major themes in school’s education process, because education can provide mediation to foster an analytical and reflective look forward to the consumerist logic, stimulating, thus, significant changes in children's behavior as consumers.

  11. Pregnancy and Electroconvulsive Therapy: A Multidisciplinary Approach.

    Science.gov (United States)

    Ray-Griffith, Shona L; Coker, Jessica L; Rabie, Nader; Eads, Lou Ann; Golden, Kimberly J; Stowe, Zachary N

    2016-06-01

    To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine these data with a literature review to refine the treatment guidelines for ECT during pregnancy. A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women's mental health program. A total of 8 pregnant women treated with ECT were identified from January 2012 to August 2014. Information was extracted from the medical records of a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range, 1-7). All women were diagnosed as having a mood disorder (either unipolar or bipolar), and 5 of the 8 women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications after the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania after ECT. Obstetrical complications included 2 women with preterm delivery-one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The 5 women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in 6 of the 8 women. Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.

  12. Witnessing versus Experiencing Direct Violence in Childhood as Correlates of Adulthood PTSD

    Science.gov (United States)

    Kulkarni, Madhur R.; Graham-Bermann, Sandra; Rauch, Sheila A. M.; Seng, Julia

    2011-01-01

    Research has established that childhood violence exposure plays a considerable role in the development of deleterious outcomes in childhood and adulthood. However, important gaps remain in understanding the complex relationships between early violence exposure, adulthood trauma exposure, and posttraumatic stress disorder (PTSD). This study…

  13. Poverty and Behavior Problems during Early Childhood: The Mediating Role of Maternal Depression Symptoms and Parenting

    Science.gov (United States)

    Mazza, Julia Rachel; Pingault, Jean-Baptiste; Booij, Linda; Boivin, Michel; Tremblay, Richard; Lambert, Jean; Zunzunegui, Maria Victoria; Côté, Sylvana

    2017-01-01

    Poverty is a well-established risk factor for behavior problems, yet our understanding of putative family mediators during early childhood (i.e., before age 5 years) is limited. The present study investigated whether the association between poverty and behavior problems during early childhood is mediated simultaneously by perceived parenting,…

  14. Parental neglect during childhood and increased risk of obesity in young adulthood

    DEFF Research Database (Denmark)

    Lissau, I; Sørensen, T I

    1994-01-01

    The association of various features of family life with obesity in childhood is well established, but less is known about the effect of these influences on the risk of later obesity. In this prospective, population-based study, we examined the influence of parental care in childhood on the risk o...

  15. The Influence of Simulations on Family Engagement--Prospective Early Childhood Educators' Perceptions

    Science.gov (United States)

    Paz-Albo Prieto, Jesús

    2018-01-01

    Nurturing experiences in preparation for prospective early childhood educators' work with families during their training are critical for establishing empowering relationships. This article details a qualitative case study of 77 prospective early childhood educators engaged with the Parent, Family and Community Engagement Simulation. An electronic…

  16. Atomic Weapons Establishment Bill

    International Nuclear Information System (INIS)

    Clark, Alan; Dalyell, Tam; Haynes, Frank

    1990-01-01

    The Bill debated concerns the government's proposal for the future organisations of the atomic weapons establishment in the United Kingdom. The proposals arise from a full review carried out in 1989 and include points raised by the Select Committee on the Trident programme. Studies of productivity, pay and conditions, information systems and long term manufacturing strategy have been started to enable recommendations of the reorganisation of the establishments to be made. The details of the Bill were debated for just over two hours. The debate is reported verbatim. The main issues were over the principle of contractorisation, possible staff redundancies, conditions of employment, safety and security. The proposal that the Bill be read a second time was carried. (UK)

  17. Atopic endotype in childhood

    DEFF Research Database (Denmark)

    Schoos, Ann-Marie Malby; Chawes, Bo Lund Krogsgaard; Rasmussen, Morten Arendt

    2016-01-01

    against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly...... with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P ...%), eczema (26%), asthma (14%), or healthy status (24%). Conclusion: We found very little interdependency between asthma, eczema, and allergic sensitization through childhood. The associations between those entities were strongly dependent on age, type of allergens, and method of testing for sensitization...

  18. Hodgkin's disease in childhood

    International Nuclear Information System (INIS)

    Misol Perez, A.; Dabezies Antia, A.

    1994-01-01

    Actually, the majority of the children that suffer from Hodgkin illness can have long period of survive. The cures are related with the continuous achievements in biology molecular; techniques of different state, radiotherapy, chemotherapy, imagenology, proceedings and to the multidisciplinary handling. This article summarizes those aspects related with the illness and its treatment, taking in count the biggest impact of the secondary effects on children and adolescents that are in growth and active development. (Au) [es

  19. Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study

    Directory of Open Access Journals (Sweden)

    Vincent Busch

    2013-04-01

    Full Text Available Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs involve multidisciplinary teams. Here doctors, nurses, midwives, maternity help professionals and educationists are integrated into multidisciplinary teams in neighbourhood-based centres. To date there has been little research on the implementation of service delivery in these centres.Study Design: A SWOT analysis was performed by use of triangulation data; this took place by integrating all relevant published documents on the origin and organization of the PCCs and the results from interviews with PCC experts and with PCC professionals (N=91. Structured interviews were performed with PCC-professionals (health care professionals (N=67 and PCC managers N=12 and PCC-experts (N=12 in Amsterdam and qualitatively analysed thematically. The interview themes were based on a pre-set list of codes, derived from a prior documentation study and a focus group with PCC experts. Results: Perceived advantages of PCCs were more continuity of care, shorter communication lines, low-threshold contact between professionals and promising future perspectives. Perceived challenges included the absence of uniform multidisciplinary guidelines, delays in communication with hospitals and midwives, inappropriate accommodation for effective professional integration, differing expectations regarding the PCC-manager role among PCC-partners and the danger of professionals' needs dominating clients' needs.Conclusions: Professionals perceive PCCs as a promising development in the integration of services. Remaining challenges involved improvements at the managerial and organizational level. Quantitative research into the improvements in quality of care and child health is recommended.

  20. Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study

    Directory of Open Access Journals (Sweden)

    Vincent Busch

    2013-04-01

    Full Text Available Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs involve multidisciplinary teams. Here doctors, nurses, midwives, maternity help professionals and educationists are integrated into multidisciplinary teams in neighbourhood-based centres. To date there has been little research on the implementation of service delivery in these centres. Study Design: A SWOT analysis was performed by use of triangulation data; this took place by integrating all relevant published documents on the origin and organization of the PCCs and the results from interviews with PCC experts and with PCC professionals (N=91. Structured interviews were performed with PCC-professionals (health care professionals (N=67 and PCC managers N=12 and PCC-experts (N=12 in Amsterdam and qualitatively analysed thematically. The interview themes were based on a pre-set list of codes, derived from a prior documentation study and a focus group with PCC experts.  Results: Perceived advantages of PCCs were more continuity of care, shorter communication lines, low-threshold contact between professionals and promising future perspectives. Perceived challenges included the absence of uniform multidisciplinary guidelines, delays in communication with hospitals and midwives, inappropriate accommodation for effective professional integration, differing expectations regarding the PCC-manager role among PCC-partners and the danger of professionals' needs dominating clients' needs. Conclusions: Professionals perceive PCCs as a promising development in the integration of services. Remaining challenges involved improvements at the managerial and organizational level. Quantitative research into the improvements in quality of care and child health is recommended.

  1. 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

  2. The multi-disciplinary role of 'pion factories'

    International Nuclear Information System (INIS)

    Davies, J.D.; Batty, C.J.; Green, K.

    1977-01-01

    The multi-disciplinary role of intermediate energy proton accelerators in pure and applied nuclear physics is discussed with particular reference to the experimental programmes at LAMPF (Los Alamos Meson Physics Facility) and SIN (Swiss Institute for Nuclear Research, Zurich). (author)

  3. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

    Science.gov (United States)

    Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K

    2015-01-01

    Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

  4. 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.…

  5. Aeroelastic multidisciplinary design optimization of a swept wind turbine blade

    DEFF Research Database (Denmark)

    Pavese, Christian; Tibaldi, Carlo; Zahle, Frederik

    2017-01-01

    Mitigating loads on a wind turbine rotor can reduce the cost of energy. Sweeping blades produces a structural coupling between flapwise bending and torsion, which can be used for load alleviation purposes. A multidisciplinary design optimization (MDO) problem is formulated including the blade sweep...

  6. Creating innovative and powerful learners : a multidisciplinary framework

    NARCIS (Netherlands)

    Post, Tim; Post, Tim; Walma van der Molen, Julie Henriëtte

    2015-01-01

    Ongoing efforts to explicate the 21st-century skill set in terms of relevant knowledge, skills and attitudes have not yet resulted into the development of (a) a conceptual framework that provides clear, operationalized descriptions of the qualities of mind that – based on a multidisciplinary

  7. 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.

    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

  8. 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. [...

  9. Benefits, barriers and opinions on multidisciplinary team meetings

    DEFF Research Database (Denmark)

    Rosell, Linn; Alexandersson, Nathalie; Hagberg, Oskar

    2018-01-01

    BACKGROUND: Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants' views on the meeting func...

  10. Hypoxaemia on arrival in a multidisciplinary intensive care unit | de ...

    African Journals Online (AJOL)

    It is, however, potentially preventable. Objective. To determine the incidence of hypoxaemia on arrival in a tertiary multidisciplinary intensive care unit (ICU) and to identify risk factors for this complication. Method. A retrospective observational study was conducted at King Edward VIII Hospital, Durban, South Africa, from May ...

  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. Systems design and engineering : facilitating multidisciplinary development projects

    NARCIS (Netherlands)

    Bonnema, Gerrit Maarten; Veenvliet, Karel; Broenink, Johannes F.

    2016-01-01

    As its name implies, the aim of Systems Design and Engineering: Facilitating Multidisciplinary Development Projects is to help systems engineers develop the skills and thought processes needed to successfully develop and implement engineered systems. Such expertise typically does not come through

  13. System Design and Engineering, lubricating multidisciplinary development projects

    NARCIS (Netherlands)

    Bonnema, Gerrit Maarten; Veenvliet, Karel; Broenink, Johannes F.

    This text book introduces systems engineering for designing systems in multidisciplinary projects. First an overview of the systems engineering process is given. Several systems thinking tracks are presented, to think about the system in a number of ways, its context, its user, its functionality,

  14. How to Reform the EU Budget? A Multidisciplinary Approach

    NARCIS (Netherlands)

    Figueira, F.

    The European Commission is currently drafting a proposal for a review of the EU budget, which could lead to its most significant reform to date. This paper proposes a method for restructuring the EU budget, based on a multidisciplinary approach. The insights of public sector economics, fiscal

  15. Strategies for multi-disciplinary science innovation education

    NARCIS (Netherlands)

    Proveniers, A.; Westra, J.; Chova, L.G.; Belenguer, D.M.; Torres, I.C.

    2010-01-01

    Almost by definition, innovative, sustainable economics, technologies, derived services and products have to be developed in a multi-disciplinary way: all kinds of bits and parts from less sustainable methods, technologies, services and products have to be reshuffled in new innovative, sustainable

  16. Development of a Multidisciplinary Middle School Mathematics Infusion Model

    Science.gov (United States)

    Russo, Maria; Hecht, Deborah; Burghardt, M. David; Hacker, Michael; Saxman, Laura

    2011-01-01

    The National Science Foundation (NSF) funded project "Mathematics, Science, and Technology Partnership" (MSTP) developed a multidisciplinary instructional model for connecting mathematics to science, technology and engineering content areas at the middle school level. Specifically, the model infused mathematics into middle school curriculum…

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

    African Journals Online (AJOL)

    Background: Multidisciplinary Team meetings (MDTs) in cancer management emphasize collaborative decision making and treatment planning among core members of the specialties relevant to an index case, who come together to share their knowledge and make recommendations for an 'all-inclusive' patient ...

  18. Multidisciplinary Design and Optimization Framework for Aircraft Box Structures

    NARCIS (Netherlands)

    Van Dijk, R.E.C.; Zhao, X.; Wang, H.; Van Dalen, F.

    2012-01-01

    Competitive aircraft box structures are a perfect compromise between weight and price. The conceptual design process of these structures is a typical Multidisciplinary Design and Optimization effort, normally conducted by human engineers. The iterative nature of MDO turns development into a long and

  19. 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. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

  20. 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…

  1. A Multidisciplinary Process Curriculum in Environmental Education, Grade 2.

    Science.gov (United States)

    Edmonds School District 15, Lynnwood, WA.

    This second grade curriculum guide is based on a multidisciplinary approach to environmental education. The guide includes activities, guidelines for field trip planning, and a resource section. The guide deals with the subjects of plants, soil, and litter. Each subject section includes activities based on the physical characteristics, man's use,…

  2. 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.P.

    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

  3. Multidisciplinary projects at the Eindhoven/Maastricht BME program

    NARCIS (Netherlands)

    Sauren, A.A.H.J.; Lammerts, I.M.M.; Clark, J.W.

    2002-01-01

    Integration and application of technical and (bio)medical knowledge in the complex area of biomedical engineering is a matter of teamwork. In our educational BME program special attention is focussed on this issue, by means of multidisciplinary projects (MDP's) for 3rd and 4th year students. The

  4. Agronomy—A Multidisciplinary and Open Access Journal

    OpenAIRE

    Peter Langridge

    2011-01-01

    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. [...

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

    Directory of Open Access Journals (Sweden)

    Michael E Bowen

    2010-07-01

    Full Text Available Michael E Bowen1,2, Russell L Rothman2,31Veterans Affairs Quality Scholars Fellowship Program, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA; 2Division of General Internal Medicine and Public Health, Department of Medicine, 3Vanderbilt Eskind Diabetes Center, Vanderbilt University School of Medicine, Nashville, TN, USAAbstract: Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is increasing at a significant rate. Similar to adults, youth with type 2 diabetes are at increased risk for developing hypertension, lipid abnormalities, renal disease, and other diabetes-related complications. However, children and adolescents with type 2 diabetes also face many unique management challenges that are different from adults with type 2 diabetes or children with type 1 diabetes. To deliver safe, effective, high-quality, cost-effective health care to adolescents with type 2 diabetes, reorganization and redesign of health care systems are needed. Multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their skills within an organized diabetes treatment team, may increase efficiency and effectiveness and may improve outcomes in children with type 2 diabetes. This review article provides a brief review of type 2 diabetes in children and adolescents, provides an overview of multidisciplinary health care teams, and discusses the role of multidisciplinary health care management in youth with type 2 diabetes.Keywords: adolescent, type 2 diabetes, multidisciplinary

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

    International Nuclear Information System (INIS)

    Feeny, D.

    1992-01-01

    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

  7. A Multidisciplinary Approach to Pancreas Cancer in 2016: A Review.

    Science.gov (United States)

    Fogel, Evan L; Shahda, Safi; Sandrasegaran, Kumar; DeWitt, John; Easler, Jeffrey J; Agarwal, David M; Eagleson, Mackenzie; Zyromski, Nicholas J; House, Michael G; Ellsworth, Susannah; El Hajj, Ihab; O'Neil, Bert H; Nakeeb, Attila; Sherman, Stuart

    2017-04-01

    In this article, we review our multidisciplinary approach for patients with pancreatic cancer. Specifically, we review the epidemiology, diagnosis and staging, biliary drainage techniques, selection of patients for surgery, chemotherapy, radiation therapy, and discuss other palliative interventions. The areas of active research investigation and where our knowledge is limited are emphasized.

  8. Multidisciplinary Rural Studies in the Land Grant University Context.

    Science.gov (United States)

    Brown, David L; Ranney, Christine

    1991-01-01

    Proposes a multidisciplinary graduate program in rural studies within the land grant university context. Requires a universitywide Rural Studies Center to coordinate efforts across the various colleges. Students could earn dual-title master's and Ph.D. degrees in rural studies and applied economics, sociology, geography, public administration,…

  9. The development of a design behaviour questionnaire for multidisciplinary teams

    NARCIS (Netherlands)

    Peeters, M.A.G.; Tuijl, van H.F.J.M.; Reymen, I.M.M.J.; Rutte, C.G.

    2007-01-01

    The relationship between design behaviours and successful design task completion is studied for multidisciplinary design teams. In this research, no observational methods such as audio–visual recordings or ethnographic fieldwork were used, as often the case in design research, but a questionnaire

  10. Teaching about Dying and Death in a Multidisciplinary Student Group.

    Science.gov (United States)

    Barton, David; And Others

    1979-01-01

    Discusses dimensions which emerged in a multidisciplinary class of medical, nursing, social work, and theology students about dying and death. Group process was the most important aspect. Students evaluated their roles and transactions in caring for the dying. The recognition of solidarity of purpose, shared feeling, and mutual support emerged.…

  11. Multidisciplinary conservative management in classical Volkmann's contracture: A case report

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Eisma, W.H.

    1996-01-01

    This clinical note describes the case of a nine-year-old girl with classical Volkmann's contracture of the left forearm. The report demonstrates the results and follow-up of conservative orthotic management used as a mode of treatment by a multidisciplinary team. When using an orthosis it is

  12. Discovering the Culture of Childhood

    Science.gov (United States)

    Plank, Emily

    2016-01-01

    We often filter our interactions with children through the lens of adulthood. View the culture of childhood through a whole new lens. Identify age-based bias and expand your outlook on and understanding of early childhood as a culture. Examine various elements of childhood culture: language, the power of believing, artistic expressions, and social…

  13. Severe childhood malnutrition

    DEFF Research Database (Denmark)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

    2017-01-01

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use...... the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...

  14. Lowering Entry Barriers for Multidisciplinary Cyber(e)-Infrastructures

    Science.gov (United States)

    Nativi, S.

    2012-04-01

    Multidisciplinarity is more and more important to study the Earth System and address Global Changes. To achieve that, multidisciplinary cyber(e)-infrastructures are an important instrument. In the last years, several European, US and international initiatives have been started to carry out multidisciplinary infrastructures, including: the Spatial Information in the European Community (INSPIRE), the Global Monitoring for Environment and Security (GMES), the Data Observation Network for Earth (DataOne), and the Global Earth Observation System of Systems (GEOSS). The majority of these initiatives are developing service-based digital infrastructures asking scientific Communities (i.e. disciplinary Users and data Producers) to implement a set of standards for information interoperability. For scientific Communities, this has represented an entry barrier which has proved to be high, in several cases. In fact, both data Producers and Users do not seem to be willing to invest precious resources to become expert on interoperability solutions -on the contrary, they are focused on developing disciplinary and thematic capacities. Therefore, an important research topic is lowering entry barriers for joining multidisciplinary cyber(e)-Infrastructures. This presentation will introduce a new approach to achieve multidisciplinary interoperability underpinning multidisciplinary infrastructures and lowering the present entry barriers for both Users and data Producers. This is called the Brokering approach: it extends the service-based paradigm by introducing a new a Brokering layer or cloud which is in charge of managing all the interoperability complexity (e.g. data discovery, access, and use) thus easing Users' and Producers' burden. This approach was successfully experimented in the framework of several European FP7 Projects and in GEOSS.

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

    Science.gov (United States)

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

    2015-10-01

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

  16. Secular Religious Establishment

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2013-01-01

    Secularism as a political doctrine claims that religion and politics should be separated. The compatibility question is whether secularism can accept some forms of religious establishment in the form of institutional linkages between state and organised religion. I argue that the answer...... to the compatibility question is not obvious and requires a systematic analysis of secularism. Based on a distinction between a general concept and specific conceptions of secularism I offer a general structure for conceptions of secularism that incorporates both a) basic values, e.g. political equality and freedom...

  17. Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

    Science.gov (United States)

    McGregor, Alison H

    2016-01-01

    Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

  18. [Childhood obesity prevention from a community view].

    Science.gov (United States)

    Ariza, Carles; Ortega-Rodríguez, Eduard; Sánchez-Martínez, Francesca; Valmayor, Sara; Juárez, Olga; Pasarín, M Isabel

    2015-04-01

    The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  19. Suicide in childhood: a literatura review.

    Science.gov (United States)

    Sousa, Girliani Silva de; Santos, Marília Suzi Pereira Dos; Silva, Amanda Tabosa Pereira da; Perrelli, Jaqueline Galdino Albuquerque; Sougey, Everton Botelho

    2017-09-01

    This is an integrated review of specific literature on the main factors associated to suicidal behavior in children under 14 years. Data were retrieved from PubMed and PsycInfo databases for the 1980-2016 period, with the following descriptors: "risk of suicide"; "children"; "suicide"; "childhood". Twenty-nine papers complied with the eligibility criteria of the review and were thus selected and analyzed. Results pointed to an association of suicide with neurobiological, school-related, social and mental factors, among which the role of impulsivity stands out. In addition, results found show that most of suicidal behavior-vulnerable factors are preventable insofar as they are identified and the child receives psychological and medical treatment. We conclude that family conflicts, school-related problems, bullying, impulsivity and depression are associated with childhood suicide. In addition, the scarce national research on suicide can contribute to the invisibility of this theme when establishing health promotion and treatment programs.

  20. Paleoclimatic variations in Maknassy Basin (central Tunisia) during the Holocene period using multidisciplinary approaches

    International Nuclear Information System (INIS)

    Zouari, K.; Chkir, N.; Ouda, B.

    2002-01-01

    The signature of humid climatic episodes in the Holocene paleoclimatic history of Tunisia are evident in outcroppings along riverbanks almost all over the Tunisian drainage network. Previous multidisciplinary studies have already identified some sites where these remnants can contribute valuable information for reconstruction of paleoenvironmental and paleoclimatic variations in the presently hyper-arid zone of the Northern Sahara. Sedimentary deposits outcropping on Wadi Leben and Wadi Ben Sellam banks, in the Maknassy Basin (Central Tunisia), have been sampled. Multidisciplinary studies, including prehistory, sedimentology, mineralogy, ecology and radiochronology have been conducted to improve palaeoenvironmental interpretations and to determine a precise chronological history of humid episodes during the Holocene in Tunisia. This paper deals with the interpretation of results obtained from the Maknassy Basin in comparison with some other Tunisian sites in order to highlight Holocene humid episodes. Establishment of a precise chronological framework is prerequisite to exploring potential relationships between the occurrence of humid phases and recharge of aquifers located in this area. (author)

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach

    Directory of Open Access Journals (Sweden)

    Susie A. Nogueira

    Full Text Available OBJECTIVES: To determine the HIV vertical transmission rate (VTR and associated risk factors by use of zidovudine and infant care education in Brazil. METHODS: Since 1995, a prospective cohort of HIV infected pregnant women has been followed at the Federal University of Rio de Janeiro. A multidisciplinary team was established to implement the best available strategy to prevent maternal-infant HIV transmission. Patients with AIDS or low CD4 and high viral load received anti-retroviral drugs in addition to zidovudine. Children were considered infected if they had 2 positive PCR-RNA tests between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula instead of breast feeding was provided. RESULTS: Between 1995 and August, 2000, HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2%. Intra-partum zidovudine treatment was completed in 134/145 (92.6% of patients; 88.1% had rupture of membranes 4 hours were associated with increased HIV transmission. CONCLUSION: HIV vertical transmission in Brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. A high level of compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.

  3. Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach

    Directory of Open Access Journals (Sweden)

    Nogueira Susie A.

    2001-01-01

    Full Text Available OBJECTIVES: To determine the HIV vertical transmission rate (VTR and associated risk factors by use of zidovudine and infant care education in Brazil. METHODS: Since 1995, a prospective cohort of HIV infected pregnant women has been followed at the Federal University of Rio de Janeiro. A multidisciplinary team was established to implement the best available strategy to prevent maternal-infant HIV transmission. Patients with AIDS or low CD4 and high viral load received anti-retroviral drugs in addition to zidovudine. Children were considered infected if they had 2 positive PCR-RNA tests between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula instead of breast feeding was provided. RESULTS: Between 1995 and August, 2000, HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2%. Intra-partum zidovudine treatment was completed in 134/145 (92.6% of patients; 88.1% had rupture of membranes 4 hours were associated with increased HIV transmission. CONCLUSION: HIV vertical transmission in Brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. A high level of compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.

  4. Decision making in a multidisciplinary cancer team: does team discussion result in better quality decisions?

    Science.gov (United States)

    Kee, Frank; Owen, Tracy; Leathem, Ruth

    2004-01-01

    To establish whether treatment recommendations made by clinicians concur with the best outcomes predicted from their prognostic estimates and whether team discussion improves the quality or outcome of their decision making, the authors studied real-time decision making by a lung cancer team. Clinicians completed pre- and postdiscussion questionnaires for 50 newly diagnosed patients. For each patient/doctor pairing, a decision model determined the expected patient outcomes from the clinician's prognostic estimates. The difference between the expected utility of the recommended treatment and the maximum utility derived from the clinician's predictions of the outcomes (the net utility loss) following all potential treatment modalities was calculated as an indicator of quality of the decision. The proportion of treatment decisions changed by the multidisciplinary team discussion was also calculated. Insofar as the change in net utility loss brought about by multidisciplinary team discussion was not significantly different from zero, team discussion did not improve the quality of decision making overall. However, given the modest power of the study, these findings must be interpreted with caution. In only 23 of 87 instances (26%) in which an individual specialist's initial treatment preference differed from the final group judgment did the specialist finally concur with the group treatment choice after discussion. This study does not support the theory that team discussion improves decision making by closing a knowledge gap.

  5. Childhood temperament predictors of adolescent physical activity

    Directory of Open Access Journals (Sweden)

    James A Janssen

    2017-01-01

    Full Text Available Abstract Background Physical inactivity is a leading cause of mortality worldwide. Many patterns of physical activity involvement are established early in life. To date, the role of easily identifiable early-life individual predictors of PA, such as childhood temperament, remains relatively unexplored. Here, we tested whether childhood temperamental activity level, high intensity pleasure, low intensity pleasure, and surgency predicted engagement in physical activity (PA patterns 11 years later in adolescence. Methods Data came from a longitudinal community study (N = 206 participants, 53% females, 70% Caucasian. Parents reported their children’s temperamental characteristics using the Child Behavior Questionnaire (CBQ when children were 4 & 5 years old. Approximately 11 years later, adolescents completed self-reports of PA using the Godin Leisure Time Exercise Questionnaire and the Youth Risk Behavior Survey. Ordered logistic regression, ordinary least squares linear regression, and Zero-inflated Poisson regression models were used to predict adolescent PA from childhood temperament. Race, socioeconomic status, and adolescent body mass index were used as covariates. Results Males with greater childhood temperamental activity level engaged in greater adolescent PA volume (B = .42, SE = .13 and a 1 SD difference in childhood temperamental activity level predicted 29.7% more strenuous adolescent PA per week. Males’ high intensity pleasure predicted higher adolescent PA volume (B = .28, SE = .12. Males’ surgency positively predicted more frequent PA activity (B = .47, SE = .23, OR = 1.61, 95% CI: 1.02, 2.54 and PA volume (B = .31, SE = .12. No predictions from females’ childhood temperament to later PA engagement were identified. Conclusions Childhood temperament may influence the formation of later PA habits, particularly in males. Boys with high temperamental activity level, high intensity

  6. Childhood Acute Lymphoblastic Leukemia

    DEFF Research Database (Denmark)

    Pui, Ching-Hon; Yang, Jun J; Hunger, Stephen P

    2015-01-01

    PURPOSE: To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia (ALL) in children and adolescents. METHODS: A review of English literature on childhood ALL focusing on collaborative studies was performed. The resulting article...

  7. Childhood Obesity: An Overview

    Science.gov (United States)

    Reilly, John J.

    2007-01-01

    This article reviews recent research evidence, largely from systematic reviews, on a number of aspects of childhood obesity: its definition and prevalence; consequences; causes and prevention. The basis of the body mass index (BMI) as a means of defining obesity in children and adolescents is discussed: a high BMI for age constitutes obesity. In…

  8. Diet quality in childhood

    NARCIS (Netherlands)

    Velde, van der Laura A.; Nguyen, Anh N.; Schoufour, Josje D.; Geelen, Anouk; Jaddoe, Vincent W.V.; Franco, Oscar H.; Voortman, Trudy

    2018-01-01

    Purpose: We aimed to evaluate diet quality of 8-year-old children in the Netherlands, to identify sociodemographic and lifestyle correlates of child diet quality, and to examine tracking of diet quality from early to mid-childhood. Methods: For 4733 children participating in a population-based

  9. The Teening of Childhood.

    Science.gov (United States)

    Hymowitz, Kay S.

    2000-01-01

    The market and advertising media aimed at children has skyrocketed in recent years. Many new products targeting 8-12-year-olds appeal to their sense of teen fashion, image consciousness, and independence from adults. Describes the development of this market aimed at early adolescents and how it is changing childhood as Americans have known it. (SM)

  10. Narrative Processes across Childhood

    Science.gov (United States)

    Mulvaney, Matthew Keefe

    2011-01-01

    According to the narrative perspective on personality development, personality is constructed largely by interpreting and representing experience in story format (scripts) over the course of the lifespan. The focus of this paper is to describe briefly the narrative perspective on personality development during childhood and adolescence, to discuss…

  11. Conscientiousness: Origins in Childhood?

    Science.gov (United States)

    Eisenberg, Nancy; Duckworth, Angela L.; Spinrad, Tracy L.; Valiente, Carlos

    2014-01-01

    In this review, we evaluate developmental and personality research with the aim of determining whether the personality trait of conscientiousness can be identified in children and adolescents. After concluding that conscientiousness does emerge in childhood, we discuss the developmental origins of conscientiousness with a specific focus on…

  12. Early childhood aggression

    NARCIS (Netherlands)

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results

  13. Childhood environment and obesity

    Science.gov (United States)

    US children are at risk for developing childhood obesity. Currently, 23% of children ages 2–5 are overweight or obese, i.e., at or above the 85th percentile. This prevalence becomes even higher as children age, with 34% of children ages 6–11 being overweight or obese. Ethnic minority children are at...

  14. Stress and childhood epilepsy

    NARCIS (Netherlands)

    Campen, J.S. van

    2015-01-01

    Epilepsy is one of the most common chronic diseases in childhood, characterized by the enduring predisposition to generate epileptic seizures. Children with epilepsy and their parents often report seizures precipitated by stress. In order to increase our understanding of the pathophysiological

  15. Childhood in Victorian Literature

    NARCIS (Netherlands)

    Moore, B.

    2017-01-01

    As the Victorian period began, literary depictions of childhood were influenced from two main directions. On the one hand, there was the figure of the idealized Romantic child, typically conceived as naturally innocent and close to God, most famously in Wordsworth’s poem “Ode: Intimations of

  16. Childhood microbial keratitis

    Directory of Open Access Journals (Sweden)

    Abdullah G Al Otaibi

    2012-01-01

    Conclusion: Children with suspected microbial keratitis require comprehensive evaluation and management. Early recognition, identifying the predisposing factors and etiological microbial organisms, and instituting appropriate treatment measures have a crucial role in outcome. Ocular trauma was the leading cause of childhood microbial keratitis in our study.

  17. Early Childhood Trauma

    Science.gov (United States)

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  18. Predictors of outcome of multidisciplinary treatment in chronic widespread pain: an observational study

    NARCIS (Netherlands)

    de Rooij, A.; van der Leeden, M.; Roorda, L.D.; Steultjens, M.P.M.; Dekker, J.

    2013-01-01

    Background: The effectiveness of multidisciplinary treatment in chronic widespread pain (CWP) is limited. The considerable heterogeneity among patients is a likely explanation. Knowledge on predictors of the outcome of multidisciplinary treatment can help to optimize treatment effectiveness. The

  19. Fostering multidisciplinary learning through computer-supported collaboration script: The role of a transactive memory script

    NARCIS (Netherlands)

    Noroozi, O.; Weinberger, A.; Biemans, H.J.A.; Teasley, S.D.; Mulder, M.

    2012-01-01

    For solving many of today's complex problems, professionals need to collaborate in multidisciplinary teams. Facilitation of knowledge awareness and coordination among group members, that is through a Transactive Memory System (TMS), is vital in multidisciplinary collaborative settings. Online

  20. Multi-Fidelity Multi-Strategy and Multi-Disciplinary Design Optimization Environment, Phase I

    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...

  1. Whole of Systems Trial of Prevention Strategies for Childhood Obesity: WHO STOPS Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Steven Allender

    2016-11-01

    Full Text Available Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1 strengthen community action for childhood obesity prevention, and (2 measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1 to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y, grade four (9–10 y and grade six (11–12 y students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools. An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.

  2. Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood.

    Science.gov (United States)

    Lee, Sang-Il

    2010-04-01

    Childhood asthma is a major concern because it leads to more hospital visits and a heavy economic burden. Proper management and prevention strategies for childhood asthma must be based on correct evaluation of prevalence and risk factors for its development. In Korea, nationwide studies were conducted in 1995 and 2000 on students from 68 elementary schools (age, 6-12 years) and junior high schools (age, 12-15 years) by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We used the Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) written and video questionnaires at the same schools during the same period (October-November). The prevalence of asthma in junior high school children seemed to increase over 5 years. However, in elementary school children, the prevalence of asthma symptoms decreased, although the prevalence of 'diagnosis of asthma, ever' and 'treatment of asthma, last 12 months' increased. In addition, it was found that various factors, such as obesity, passive smoking, dietary habits, raising pets at home, and fever/antibiotic use during infancy were associated with childhood asthma. When prevalence of asthma in Korea was compared with that in different regions, the prevalence changes in the 6-7 years age group did not seem to be consistent between regions, whereas similar trends were observed among children aged 13-14 years. To conduct another epidemiological study to evaluate the time trend over time, a third nationwide survey is planned in 2010, and we anticipate ISAAC Phase 3 will explore recent changes in the prevalence of childhood asthma and assess its risk factors in Korean children. On the basis of accurate data on the current status of childhood asthma in 2010, we will be able to establish proper management strategies.

  3. Making Childhood Asthma Management Education Happen in the Community: Translating Health Behavioral Research into Local Program.

    Science.gov (United States)

    Krutzch, Christine B.; And Others

    1987-01-01

    A technology transfer project for getting initial community adoption of childhood asthma management programs is described. The evolution of the project, including development of programs, packaging considerations, establishment of partnerships, implementation, and evaluation are discussed. (Author/CH)

  4. Establishing a national research center on day care

    DEFF Research Database (Denmark)

    Ellegaard, Tomas

    The paper presents and discusses the current formation of a national research center on ECEC. The center is currently being established. It is partly funded by the Danish union of early childhood and youth educators. It is based on cooperation between a number of Danish universities and this nati...... current new public management policies. However there is also more conflicting issues that emerge in this enterprise – especially on interests, practice relevance and knowledge paradigms....

  5. The readiness of schools in Zimbabwe for the implementation of early childhood education

    Directory of Open Access Journals (Sweden)

    Ezron Mangwaya

    2016-02-01

    Full Text Available This qualitative study focuses on primary schools' state of readiness for the introduction of early childhood education. Adopting a multiple case study design, the article explores, through semi-structured interviews and documentation, school heads, teachers-in-charge and classroom teachers' perceptions of their respective schools' state of readiness for the installation and implementation of early childhood education. The study established that, while classroom teachers were adequately qualified to implement early childhood education, teachers-in-charge were not. Secondly, school heads received limited induction for the introduction and implementation of early childhood education. Additionally, inadequate teaching-learning resources and lack of on-going teacher support contributed to schools' lack of readiness for the introduction of early childhood education. The study recommends interventions that curriculum planners and implementers can utilise in order to create conditions that enable primary schools to be ready for introducing and implementing early childhood education.

  6. Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

    Directory of Open Access Journals (Sweden)

    Mi Ja Kim, PhD, RN, FAAN

    2008-03-01

    Conclusion: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.

  7. Establishing Substantial Equivalence: Transcriptomics

    Science.gov (United States)

    Baudo, María Marcela; Powers, Stephen J.; Mitchell, Rowan A. C.; Shewry, Peter R.

    Regulatory authorities in Western Europe require transgenic crops to be substantially equivalent to conventionally bred forms if they are to be approved for commercial production. One way to establish substantial equivalence is to compare the transcript profiles of developing grain and other tissues of transgenic and conventionally bred lines, in order to identify any unintended effects of the transformation process. We present detailed protocols for transcriptomic comparisons of developing wheat grain and leaf material, and illustrate their use by reference to our own studies of lines transformed to express additional gluten protein genes controlled by their own endosperm-specific promoters. The results show that the transgenes present in these lines (which included those encoding marker genes) did not have any significant unpredicted effects on the expression of endogenous genes and that the transgenic plants were therefore substantially equivalent to the corresponding parental lines.

  8. Establishing Political Deliberation Systems

    DEFF Research Database (Denmark)

    Rose, Jeremy; Sæbø, Øystein

    2008-01-01

    The extension and transformation of political participation is dependent on widespread deliberation supported by information and communication technologies.  The most commonly found examples of these eParticipation systems are political discussion forums.  Though much of the discussion...... of these technologies is conducted in the eGovernment and (particularly) the eDemocracy literature, political discussion forums present a distinct set of design and management challenges which relate directly to IS concerns. In this article we analyze problems in establishing political deliberation systems under five...... headings: stakeholder engagement, web platform design, web platform management, political process re-shaping and evaluation and improvement. We review the existing literature and present a longitudinal case study of a political discussion forum: the Norwegian DemokratiTorget (Democracy Square).  We define...

  9. Causality re-established.

    Science.gov (United States)

    D'Ariano, Giacomo Mauro

    2018-07-13

    Causality has never gained the status of a 'law' or 'principle' in physics. Some recent literature has even popularized the false idea that causality is a notion that should be banned from theory. Such misconception relies on an alleged universality of the reversibility of the laws of physics, based either on the determinism of classical theory, or on the multiverse interpretation of quantum theory, in both cases motivated by mere interpretational requirements for realism of the theory. Here, I will show that a properly defined unambiguous notion of causality is a theorem of quantum theory, which is also a falsifiable proposition of the theory. Such a notion of causality appeared in the literature within the framework of operational probabilistic theories. It is a genuinely theoretical notion, corresponding to establishing a definite partial order among events, in the same way as we do by using the future causal cone on Minkowski space. The notion of causality is logically completely independent of the misidentified concept of 'determinism', and, being a consequence of quantum theory, is ubiquitous in physics. In addition, as classical theory can be regarded as a restriction of quantum theory, causality holds also in the classical case, although the determinism of the theory trivializes it. I then conclude by arguing that causality naturally establishes an arrow of time. This implies that the scenario of the 'block Universe' and the connected 'past hypothesis' are incompatible with causality, and thus with quantum theory: they are both doomed to remain mere interpretations and, as such, are not falsifiable, similar to the hypothesis of 'super-determinism'.This article is part of a discussion meeting issue 'Foundations of quantum mechanics and their impact on contemporary society'. © 2018 The Author(s).

  10. Using an Undergraduate Materials Research Project to Foster Multidisciplinary Teaming Skills

    Science.gov (United States)

    Newell, James A.; Cleary, Doug D.

    2004-01-01

    This paper describes the use of undergraduate materials multidisciplinary research projects as a means of addressing the growing industrial demand for graduates experienced in working in multidisciplinary teams. It includes a detailed description of a project in which a multidisciplinary team of chemical engineering and civil engineering students…

  11. Challenges of Trainees in a Multidisciplinary Research Program: Nano-Biotechnology

    Science.gov (United States)

    Kriegel, Christina; Koehne, Jessica; Tinkle, Sally; Maynard, Andrew D.; Hill, Rodney A.

    2011-01-01

    The breadth of knowledge required for the multidisciplinary field of nanotechnology challenges and extends traditional concepts of multidisciplinary graduate education. There is a paucity of information, both general reporting and peer-reviewed studies, on the challenges for graduate students working in this multidisciplinary paradigm, from the…

  12. 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

    measures. Sleep will be measured for seven days using actigraphy (Actiwatch 7. These measures will be repeated after the four week multidisciplinary cognitive behavioural therapy pain management programme, and at a two month follow-up. The waiting list control group will be assessed at baseline, and two months later. Analysis for the primary outcome will include between group differences of subjective and objective sleep parameters from baseline to follow-up using Independent T-tests or Mann-Whitney U tests. The secondary outcomes establishing relationships between the sleep variables and physical and psychological outcome measures will be established using multiple linear regression models. Discussion This pilot study will evaluate the impact of a multidisciplinary CBT-PMP on both subjective and objective measures of sleep in patients with chronic pain and provide guidance for a larger clinical trial. Trial Registration Current controlled trial ISRCTN: ISRCTN74913595

  13. 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.

  14. A social-cognitive framework of multidisciplinary team innovation.

    Science.gov (United States)

    Paletz, Susannah B F; Schunn, Christian D

    2010-01-01

    The psychology of science typically lacks integration between cognitive and social variables. We present a new framework of team innovation in multidisciplinary science and engineering groups that ties factors from both literatures together. We focus on the effects of a particularly challenging social factor, knowledge diversity, which has a history of mixed effects on creativity, most likely because those effects are mediated and moderated by cognitive and additional social variables. In addition, we highlight the distinction between team innovative processes that are primarily divergent versus convergent; we propose that the social and cognitive implications are different for each, providing a possible explanation for knowledge diversity's mixed results on team outcomes. Social variables mapped out include formal roles, communication norms, sufficient participation and information sharing, and task conflict; cognitive variables include analogy, information search, and evaluation. This framework provides a roadmap for research that aims to harness the power of multidisciplinary teams. Copyright © 2009 Cognitive Science Society, Inc.

  15. 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...

  16. A Multidisciplinary Engineering Summer School in an Industrial Setting

    DEFF Research Database (Denmark)

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

    2009-01-01

    Most university-level engineering studies produce technically skilled engineers. However, typically students face several difficulties when working in multidisciplinary teams when they initiate their industrial careers. In a globalised world, it becomes increasingly important that engineers...... are capable of collaborating across disciplinary boundaries and exhibit soft competencies, like communication, interpersonal and social skills, time planning, creativity, initiative, and reflection. To prepare a group of engineering and industrial design students to acquire those capabilities......, an international summer school that combined industrial design with different kinds of engineering disciplines was organised on the site of Bang & Olufsen (B&O) in Denmark. This multidisciplinary engineering summer school was attended by students from six European university-level teaching institutions...

  17. Improving innovation and multidisciplinary competences among bachelor of engineering students

    DEFF Research Database (Denmark)

    Løje, Hanne; Andersson, Pernille Hammar; Grex, Sara

    2017-01-01

    within Engineering Education. Furthermore, there is also a demand for the graduates to be able to work multidisciplinary and to be able to use generic skills in their work. In this paper, the research question is how to enhance innovation and multidisciplinary competences of engineering students......From society and industry, there are increasing requirements for skilled and well-educated engineers who can develop new solutions through innovation and this have pushed universities to meet these requirements by having an increasing focus on developing innovation and entrepreneurship programmes......? This is a central question in order to educate engineers that can create sustainable solutions for the environment, for products and to secure future workplaces. In this paper, a new mandatory course for Bachelor of Engineering students at the Technical University of Denmark (DTU) "Innovation Pilot...

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

    Science.gov (United States)

    Marr, Caroline; Seasman, Alison; Bishop, Nick

    2017-01-01

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

  19. Whey protein stories - an experiment in writing a multidisciplinary biography

    DEFF Research Database (Denmark)

    Jensen, Tenna; Bechschøft, Rasmus L.; Giacalone, Davide

    2016-01-01

    This is an experimental, dual-purpose article about whey protein and how to conduct interdisciplinary analyses and writings. On the one hand, this article is a multidisciplinary commodity biography, which consists of five descriptions of whey protein written by the five different research groups...... contributes to the field of food studies with a multidisciplinary biography of whey protein - including its sensory qualities and challenges, insights into its cultural history, its nutritional value and effects on the human body and an analysis of how it is perceived by people who consume it. The biography...... thereby expands upon existing understandings of whey protein while discussing the usefulness of employing the commodity biography format in interdisciplinary writing. Moreover, the article contributes to the field of interdisciplinary research by providing a practical example of a joint publication...

  20. A case study on collaboration within multidisciplinary teamwork

    DEFF Research Database (Denmark)

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

    2010-01-01

    Collaboration within the building process has always been difficult. Additionally the new demands on functionality such as energy and cost efficiency change the roles within the teams of engineers and architects, engaged in building design and generate a need of new work methods within the process...... and teamwork at the final stage of the engineering education. The course was held by a multidisciplinary team of teachers for 9 multidisciplinary teams of students. The team of teachers and the student teams had similar working conditions. These teams were subject of investigation on collaboration...... and transprofessionalism. 32 students and 7 teachers answered a questionnaire leading to the following findings. Collaboration was improving during the course. Other than in traditional building teams we could see that the students placed the role as a designer only in a few cases were perceived the team leader...

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

    Science.gov (United States)

    Larson, Heidi; Leask, Julie; Aggett, Sian; Sevdalis, Nick; Thomson, Angus

    2013-01-01

    There is increasingly broad global recognition of the need to better understand determinants of vaccine acceptance. Fifteen social science, communication, health, and medical professionals (the “Motors of Trust in Vaccination” (MOTIV) think tank) explored factors relating to vaccination decision-making as a step to building a multidisciplinary research agenda. One hundred and forty seven factors impacting decisions made by consumers, professionals, and policy makers on vaccine acceptance, delay, or refusal were identified and grouped into three major categories: cognition and decision-making; groups and social norms; and communication and engagement. These factors should help frame a multidisciplinary research agenda to build an evidence base on the determinants of vaccine acceptance to inform the development of interventions and vaccination policies. PMID:26344114

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

    Directory of Open Access Journals (Sweden)

    Nick Sevdalis

    2013-07-01

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

  3. Toward a Sustained, Multi-disciplinary Socioeconomic Community

    Science.gov (United States)

    Pearlman, J.; Pearlman, F.

    2014-12-01

    Over the last several years the availability of geospatial data has evolved from a scarce and expensive resource, primarily provided by governmental organizations to an abundant resource, often sourced at no or minimum charge by a much broader community including citizen scientists. In an upcoming workshop (October 28/29, 2014), the consequences of the changing technology, data, and policy landscape will be examined thus evaluating the emerging new data-driven paradigms, and advancing the state-of-the-art methodologies to measure the resulting socioeconomic impacts. Providers and users of geospatial data span a broad range of multi-disciplinary areas include policy makers and analysts, financial analysts, economists, geospatial practitioners and other experts from government, academia and the private sector. This presentation will focus on the emerging plan for a sustained, multi-disciplinary community to identify and pursue exemplary use cases for further research and applications. Considerations will include the necessary outreach enablers for such a project.

  4. Anxiety and depression levels among multidisciplinary health residents

    Directory of Open Access Journals (Sweden)

    Daniela Salvagni Rotta

    2016-01-01

    Full Text Available Objective: to assess symptoms of anxiety and depression of professionals of Multidisciplinary Health Residence Programs. Methods: this is a cross-sectional study, performed with fifty professionals, using three instruments: one for socioeconomic and demographic data, and the Beck’s Anxiety and Depression Scale. Results: predominance of females (92.0%, average age 26 years old, single (88.0%, family income from two to five salaries (56.0% satisfied with the work (82.0% and thought about quitting the program (56.0% showed anxiety (50.0% and depression (28.0%. Conclusion: there was an association between anxiety and depression in multidisciplinary residents, which points to the need for rethinking strategies for identifying these symptoms and control of stress factors for the promotion of mental health.

  5. An Educational Program of Mechatronics for Multidisciplinary Knowledge Acquisition

    Science.gov (United States)

    Watanuki, Keiichi; Kojima, Kazuyuki

    Recently, as the technologies surrounding mechanical engineering have improved remarkably, the expectations for students who graduate from departments of mechanical engineering have increased. For example, in order to develop a mechatronics system, a student needs to integrate a wide variety of technologies, such as mechanical engineering, electrical and electronics engineering, and information technology. Therefore, from the perspective of educators, the current education system, which stresses expertizing each technology, should be replaced by an education system that stresses integrating multidisciplinary knowledge. In this paper, a trial education program for students of the department of mechanical engineering in our university, in which students are required to integrate multidisciplinary knowledge in order to develop a biologically-based robot, is described. Finally, the efficacy of the program is analyzed.

  6. ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia

    Directory of Open Access Journals (Sweden)

    Jayesh M. Bhatt

    2015-12-01

    Full Text Available Ataxia telangiectasia (A-T is a rare, progressive, multisystem disease that has a large number of complex and diverse manifestations which vary with age. Patients with A-T die prematurely with the leading causes of death being respiratory diseases and cancer. Respiratory manifestations include immune dysfunction leading to recurrent upper and lower respiratory infections; aspiration resulting from dysfunctional swallowing due to neurodegenerative deficits; inefficient cough; and interstitial lung disease/pulmonary fibrosis. Malnutrition is a significant comorbidity. The increased radiosensitivity and increased risk of cancer should be borne in mind when requesting radiological investigations. Aggressive proactive monitoring and treatment of these various aspects of lung disease under multidisciplinary expertise in the experience of national multidisciplinary clinics internationally forms the basis of this statement on the management of lung disease in A-T. Neurological management is outwith the scope of this document.

  7. Assessing and evaluating multidisciplinary translational teams: a mixed methods approach.

    Science.gov (United States)

    Wooten, Kevin C; Rose, Robert M; Ostir, Glenn V; Calhoun, William J; Ameredes, Bill T; Brasier, Allan R

    2014-03-01

    A case report illustrates how multidisciplinary translational teams can be assessed using outcome, process, and developmental types of evaluation using a mixed-methods approach. Types of evaluation appropriate for teams are considered in relation to relevant research questions and assessment methods. Logic models are applied to scientific projects and team development to inform choices between methods within a mixed-methods design. Use of an expert panel is reviewed, culminating in consensus ratings of 11 multidisciplinary teams and a final evaluation within a team-type taxonomy. Based on team maturation and scientific progress, teams were designated as (a) early in development, (b) traditional, (c) process focused, or (d) exemplary. Lessons learned from data reduction, use of mixed methods, and use of expert panels are explored.

  8. TRANSAUTOPHAGY: European network for multidisciplinary research and translation of autophagy knowledge

    Science.gov (United States)

    Casas, Caty; Codogno, Patrice; Pinti, Marcello; Batoko, Henri; Morán, María; Proikas-Cezanne, Tassula; Reggiori, Fulvio; Sirko, Agnieszka; Soengas, María S; Velasco, Guillermo; Lafont, Frank; Lane, Jon; Faure, Mathias; Cossarizza, Andrea

    2016-01-01

    abstract A collaborative consortium, named “TRANSAUTOPHAGY,” has been created among European research groups, comprising more than 150 scientists from 21 countries studying diverse branches of basic and translational autophagy. The consortium was approved in the framework of the Horizon 2020 Program in November 2015 as a COST Action of the European Union (COST means: CO-operation in Science and Technology), and will be sponsored for 4 years. TRANSAUTOPHAGY will form an interdisciplinary platform for basic and translational researchers, enterprises and stakeholders of diverse disciplines (including nanotechnology, bioinformatics, physics, chemistry, biology and various medical disciplines). TRANSAUTOPHAGY will establish 5 different thematic working groups, formulated to cooperate in research projects, share ideas, and results through workshops, meetings and short term exchanges of personnel (among other initiatives). TRANSAUTOPHAGY aims to generate breakthrough multidisciplinary knowledge about autophagy regulation, and to boost translation of this knowledge into biomedical and biotechnological applications. PMID:27046256

  9. TRANSAUTOPHAGY: European network for multidisciplinary research and translation of autophagy knowledge.

    Science.gov (United States)

    Casas, Caty; Codogno, Patrice; Pinti, Marcello; Batoko, Henri; Morán, María; Proikas-Cezanne, Tassula; Reggiori, Fulvio; Sirko, Agnieszka; Soengas, María S; Velasco, Guillermo; Lafont, Frank; Lane, Jon; Faure, Mathias; Cossarizza, Andrea

    2016-01-01

    A collaborative consortium, named "TRANSAUTOPHAGY," has been created among European research groups, comprising more than 150 scientists from 21 countries studying diverse branches of basic and translational autophagy. The consortium was approved in the framework of the Horizon 2020 Program in November 2015 as a COST Action of the European Union (COST means: CO-operation in Science and Technology), and will be sponsored for 4 years. TRANSAUTOPHAGY will form an interdisciplinary platform for basic and translational researchers, enterprises and stakeholders of diverse disciplines (including nanotechnology, bioinformatics, physics, chemistry, biology and various medical disciplines). TRANSAUTOPHAGY will establish 5 different thematic working groups, formulated to cooperate in research projects, share ideas, and results through workshops, meetings and short term exchanges of personnel (among other initiatives). TRANSAUTOPHAGY aims to generate breakthrough multidisciplinary knowledge about autophagy regulation, and to boost translation of this knowledge into biomedical and biotechnological applications.

  10. Permanent health education based on research with professionals of a multidisciplinary residency program: case study

    Directory of Open Access Journals (Sweden)

    Cristiane Trivisiol da Silva

    Full Text Available This research aims to identify the perception of professional members of a multi-professional residency program on Permanent Health Education. It is a case study research using a qualitative approach, with sixteen members of a multi-professional residency program. The data were collected from January to May 2012, through semi-structured interviews, document analysis and systematic observation, and analyzed according to Thematic Content Analysis. Two categories were identified: Permanent Health Education establishing collective spaces of reflection of practices and Permanent Health Education that promotes integration between disciplines. The members of the multiprofessional residency team were found to be aware that permanent education permeates their training and enables reflection on their clinical practices and multidisciplinary action as producers of health actions.

  11. Application of analytical target cascading method in multidisciplinary design optimization of ship conceptual design

    Directory of Open Access Journals (Sweden)

    WANG Jian

    2017-10-01

    Full Text Available [Objectives] Ship conceptual design requires the coordination of many different disciplines for comprehensive optimization, which presents a complicated system design problem affecting several fields of technology. However, the development of overall ship design is relatively slow compared with other subjects. [Methods] The decomposition and coordination strategy of ship design is presented, and the analytical target cascading (ATC method is applied to the multidisciplinary design optimization of the conceptual design phase of ships on this basis. A tank ship example covering the 5 disciplines of buoyancy and stability, rapidity, maneuverability, capacity and economy is established to illustrate the analysis process in the present study. [Results] The results demonstrate the stability, convergence and validity of the ATC method in dealing with the complex coupling effect occurring in ship conceptual design.[Conclusions] The proposed method provides an effective basis for optimization of ship conceptual design.

  12. Assessment of the pattern of childhood malignant diseases seen at ...

    African Journals Online (AJOL)

    Methods: In a bid to accurately document Cancers at the University of Benin Teaching Hospital, a cancer registry was established in the unit as all cases are usually managed in the unit. All cases of childhood admissions for malignant diseases were documented in the cancer registry. This data was recalled and a reviewed ...

  13. Early Childhood Services in AEAs: A Blueprint for the Future.

    Science.gov (United States)

    Iowa State Department of Education, 2004

    2004-01-01

    The purpose of this document is to facilitate discussion among decision makers at the Iowa Department of Education (DE), Area Education Agencies (AEAs) and local communities (including school districts) to establish early childhood priorities, and define the AEA role in the statewide efforts to build a strong early care, health, and education…

  14. Implementation of Attachment Theory into Early Childhood Settings

    Science.gov (United States)

    Shirvanian, Natalia; Michael, Tony

    2017-01-01

    Because numerous studies show that early child-adult attachment significantly affects a child's socio-emotional and cognitive development, we propose that establishing attachment-based child care can contribute to a healthy and happy childhood. This proposition is part of a new theoretical and experimental field and, thus, research is limited.…

  15. Prevention of Childhood Blindness through the Integration with ...

    African Journals Online (AJOL)

    Objective: The prevention of childhood blindness through the provision of preventive services at the community level, specialized surgical services in ophthalmic units and the provision of devices to correct low and services to children with established visual loss. Materials and methods: A series of free surgical cataract eye ...

  16. 3rd International Multidisciplinary Microscopy and Microanalysis Congress

    CERN Document Server

    Oral, Zehra

    2017-01-01

    The 3rd International Multidisciplinary Microscopy Congress (InterM2015), held from 19 to 23 October 2015, focused on the latest developments concerning applications of microscopy in the biological, physical and chemical sciences at all dimensional scales, advances in instrumentation, techniques in and educational materials on microscopy. These proceedings gather 17 peer-reviewed technical papers submitted by leading academic and research institutions from nine countries and representing some of the most cutting-edge research available.

  17. Managing the pediatric patient with celiac disease: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Isaac DM

    2016-10-01

    Full Text Available Daniela Migliarese Isaac,1 Jessica Wu,2 Diana R Mager,3,4 Justine M Turner1 1Department of Pediatric Gastroenterology and Nutrition, Faculty of Medicine and Dentistry, University of Alberta; 2Alberta Health Services–Child Health Nutrition Services, Stollery Children’s Hospital; 3Department of Agriculture, Food and Nutritional Science; 4Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Abstract: Celiac disease (CD is an autoimmune reaction to gluten, leading to intestinal inflammation, villous atrophy, and malabsorption. It is the most common autoimmune gastrointestinal disorder, with an increasing prevalence. A life-long gluten-free diet (GFD is an effective treatment to alleviate symptoms, normalize autoantibodies, and heal the intestinal mucosa in patients with CD. Poorly controlled CD poses a significant concern for ongoing malabsorption, growth restriction, and the long-term concern of intestinal lymphoma. Achieving GFD compliance and long-term disease control poses a challenge, with adolescents at particular risk for high rates of noncompliance. Attention has turned toward innovative management strategies to improve adherence and achieve better disease control. One such strategy is the development of multidisciplinary clinic approach, and CD is a complex life-long disease state that would benefit from a multifaceted team approach as recognized by multiple national and international bodies, including the National Institutes of Health. Utilizing the combined efforts of the pediatric gastroenterologist, registered dietitian, registered nurse, and primary care provider (general practitioner or general pediatrician in a CD multidisciplinary clinic model will be of benefit for patients and families in optimizing diagnosis, provision of GFD teaching, and long-term adherence to a GFD. This paper discusses the benefits and proposed structure for multidisciplinary care in improving management of CD. Keywords: celiac disease

  18. Recent Advances in Multidisciplinary Analysis and Optimization, part 3

    Science.gov (United States)

    Barthelemy, Jean-Francois M. (Editor)

    1989-01-01

    This three-part document contains a collection of technical papers presented at the Second NASA/Air Force Symposium on Recent Advances in Multidisciplinary Analysis and Optimization, held September 28-30, 1988 in Hampton, Virginia. The topics covered include: aircraft design, aeroelastic tailoring, control of aeroelastic structures, dynamics and control of flexible structures, structural design, design of large engineering systems, application of artificial intelligence, shape optimization, software development and implementation, and sensitivity analysis.

  19. Increasing Access to Modern Multidisciplinary Breast Cancer Care

    Science.gov (United States)

    2002-02-01

    direct interventions to increase the utilization of proven treatments, and evaluations of the cost-effectiveness of new technologies . The component...contemporary United States society. In: Arnott M, editor. Gastronomy : Anthropology of Food Habits. Paris: Mouton Publishers; 1976. 4. Glanz K...Gradishar, M.D. A. INTRODUCTION The purpose of this project was to explore the use of teleconferencing technology to provide multidisciplinary

  20. Unbounding entrepreneurial intents of university students: a multidisciplinary perspective

    OpenAIRE

    Aurora A.C. Teixeira; Rosa Portela Forte

    2009-01-01

    Entrepreneurial activities are seen as key drivers of innovation, job creation, and economic growth. Recent efforts are being pursued by several entities, including governments to promote entrepreneurial skills amongst the youngest. However, to design effective programs, policy makers have to uncover the determinants of entrepreneurship. To avoid that such efforts would be fruitless we argue that a multidisciplinary account of entrepreneurial intents among students is mandatory, circumventing...

  1. Multidisciplinary Management of Pediatric Sports-Related Concussion.

    Science.gov (United States)

    Ellis, Michael J; Ritchie, Lesley J; McDonald, Patrick J; Cordingley, Dean; Reimer, Karen; Nijjar, Satnam; Koltek, Mark; Hosain, Shahid; Johnston, Janine; Mansouri, Behzad; Sawyer, Scott; Silver, Norm; Girardin, Richard; Larkins, Shannon; Vis, Sara; Selci, Erin; Davidson, Michael; Gregoire, Scott; Sam, Angela; Black, Brian; Bunge, Martin; Essig, Marco; MacDonald, Peter; Leiter, Jeff; Russell, Kelly

    2017-01-01

    To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

  2. Evaluation of a multidisciplinary burn care journal club: Lessons learned.

    Science.gov (United States)

    Carta, T; Gawaziuk, J P; Cristall, N; Forbes, L; Logsetty, S

    2018-05-01

    Journal clubs allow discussion of the quality and findings of recent publications. However, journal clubs have not historically been multidisciplinary. Burn care is recognized as a true collaborative care model, including regular multidisciplinary rounds. Since 2011 we have offered a multidisciplinary burn journal club at our institution. We present an evaluation of the factors that have made the sessions successful to facilitate others to commence their own club. At the end of each journal club session participants anonymously completed a structured evaluation. Five-point scales were used to evaluate understanding, meeting objectives, presentation and appropriateness of information. Qualitative questions were asked to identify beneficial factors, suggestions for improvements, ideas for future sessions and feedback for the facilitator. Attendance grew from six to a maximum of 19. Members included physicians, nurses, dieticians, physiotherapists, occupational therapists, social workers, basic scientists and students. Presentations were undertaken by all of these disciplines. Ratings improved steadily over time. Understanding increased from a score of 4.5 to 4.8; meeting objectives from 4 to 4.9; satisfaction with method of presentation from 4.3 to 4.9 and with level of information from 3 to 4.9. Over time, the journal club has evolved to better meet the needs of our team. Successful multidisciplinary journal club implementation requires identification of champions and ongoing evaluation. The success of the journal club has been possible through the engagement of the entire burn team. Champions within each discipline, facilitated discussion and evaluation tools have helped nurture a nonthreatening team based learning environment. Copyright © 2017. Published by Elsevier Ltd.

  3. Strengthening Multidisciplinary Research on Climate and Environmental Change

    Science.gov (United States)

    Beer, Tom; Li, Jianping; Alverson, Keith

    2014-08-01

    The difficulty with multidisciplinary research is finding common ground for scientists, whose approach to a particular scientific problem can differ radically. For example, there is agreement between the geophysical community and the food science and technology community that food security is an important issue. However, the climate change community sees possible solutions coming from more detailed studies on the links between climate change and agriculture, whereas the food science community sees possible solutions emerging from studies of food logistics and supply chains.

  4. Skin Microbiota Workshop: Multidisciplinary Perspectives, Challenges and Opportunities

    Science.gov (United States)

    2014-12-08

    SECURITY CLASSIFICATION OF: This report details the outcome of the 1st Skin Microbiota Workshop, Boulder, CO, held on October 15th-16th 2012. The...Sep-2014 Approved for Public Release; Distribution Unlimited Final Report: Skin Microbiota Workshop: Multidisciplinary Perspectives, Challenges and...Number of Papers published in peer-reviewed journals: Number of Papers published in non peer-reviewed journals: Final Report: Skin Microbiota Workshop

  5. A Multidisciplinary Engineering Summer School in an Industrial Setting

    DEFF Research Database (Denmark)

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

    2009-01-01

    are capable of collaborating across disciplinary boundaries and exhibit soft competencies, like communication, interpersonal and social skills, time planning, creativity, initiative, and reflection. To prepare a group of engineering and industrial design students to acquire those capabilities......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...

  6. Risoe Research Establishment, Denmark

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1973-07-01

    On the poetic Roskilde Fjord, 40 kilometers from Copenhagen, and near Roskilde, capital of Denmark in the 12th century, stands the Risoe Research Establishment of the Danish Atomic Energy Commission. ere 700 men and women are engaged in searching for ways in which atomic energy can be used to make the world a better and healthier place. The work at Risoe comprises fundamental research, reactor technology and other technological studies, agricultural research and health and safety studies. Nuclear power stations are scheduled to be operative in Denmark some time between 1975 and 1980, and the planning of these stations and development of the many processes this will involve has become a major task at Risoe. Special conditions have to be fulfilled in selecting the site of an atomic research station, and the barren Risoe peninsula had them all: safety, because the site was free from buildings to permit continuous control; closeness to the scientific institutions of the capital, Copenhagen; social amenities in Roskilde; finally, access to an a adequate water supply. his special series of photos covering some aspects of the work and safety conditions at Risoe was commissioned by WHO. (author)

  7. Risoe Research Establishment, Denmark

    International Nuclear Information System (INIS)

    1973-01-01

    On the poetic Roskilde Fjord, 40 kilometers from Copenhagen, and near Roskilde, capital of Denmark in the 12th century, stands the Risoe Research Establishment of the Danish Atomic Energy Commission. ere 700 men and women are engaged in searching for ways in which atomic energy can be used to make the world a better and healthier place. The work at Risoe comprises fundamental research, reactor technology and other technological studies, agricultural research and health and safety studies. Nuclear power stations are scheduled to be operative in Denmark some time between 1975 and 1980, and the planning of these stations and development of the many processes this will involve has become a major task at Risoe. Special conditions have to be fulfilled in selecting the site of an atomic research station, and the barren Risoe peninsula had them all: safety, because the site was free from buildings to permit continuous control; closeness to the scientific institutions of the capital, Copenhagen; social amenities in Roskilde; finally, access to an a adequate water supply. his special series of photos covering some aspects of the work and safety conditions at Risoe was commissioned by WHO. (author)

  8. Multidisciplinary in-hospital teams improve patient outcomes: A review.

    Science.gov (United States)

    Epstein, Nancy E

    2014-01-01

    The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses' aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient "staff" satisfaction. Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers' performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.

  9. Uncertainty quantification using evidence theory in multidisciplinary design optimization

    International Nuclear Information System (INIS)

    Agarwal, Harish; Renaud, John E.; Preston, Evan L.; Padmanabhan, Dhanesh

    2004-01-01

    Advances in computational performance have led to the development of large-scale simulation tools for design. Systems generated using such simulation tools can fail in service if the uncertainty of the simulation tool's performance predictions is not accounted for. In this research an investigation of how uncertainty can be quantified in multidisciplinary systems analysis subject to epistemic uncertainty associated with the disciplinary design tools and input parameters is undertaken. Evidence theory is used to quantify uncertainty in terms of the uncertain measures of belief and plausibility. To illustrate the methodology, multidisciplinary analysis problems are introduced as an extension to the epistemic uncertainty challenge problems identified by Sandia National Laboratories. After uncertainty has been characterized mathematically the designer seeks the optimum design under uncertainty. The measures of uncertainty provided by evidence theory are discontinuous functions. Such non-smooth functions cannot be used in traditional gradient-based optimizers because the sensitivities of the uncertain measures are not properly defined. In this research surrogate models are used to represent the uncertain measures as continuous functions. A sequential approximate optimization approach is used to drive the optimization process. The methodology is illustrated in application to multidisciplinary example problems

  10. MELODI: The 'Multidisciplinary European Low-Dose Initiative'

    International Nuclear Information System (INIS)

    Belli, M.; Salomaa, S.; Ottolenghi, A.

    2011-01-01

    The importance of research to reduce uncertainties in risk assessment of low and protracted exposures is now recognised globally. In Europe a new initiative, called 'Multidisciplinary European Low Dose Initiative' (MELODI), has been proposed by a 'European High Level and Expert Group on low-dose risk research' (www.hleg.de), aimed at integrating national and EC (Euratom) efforts. Five national organisations: BfS (DE), CEA (FR), IRSN (FR), ISS (IT) and STUK (FI), with the support of the EC, have initiated the creation of MELODI by signing a letter of intent. In the forthcoming years, MELODI will integrate in a step-by-step approach EU institutions with significant programmes in the field and will be open to other scientific organisations and stakeholders. A key role of MELODI is to develop and maintain over time a strategic research agenda (SRA) and a road map of scientific priorities within a multidisciplinary approach, and to transfer the results for the radiation protection system. Under the coordination of STUK a network has been proposed in the 2009 Euratom Programme, called DoReMi (Low-Dose Research towards Multidisciplinary Integration), which can help the integration process within the MELODI platform. DoReMi and the First MELODI Open Workshop, organised by BfS in September 2009, are now important inputs for the European SRA. (authors)

  11. Multidisciplinary Optimization Branch Experience Using iSIGHT Software

    Science.gov (United States)

    Padula, S. L.; Korte, J. J.; Dunn, H. J.; Salas, A. O.

    1999-01-01

    The Multidisciplinary Optimization (MDO) Branch at NASA Langley is investigating frameworks for supporting multidisciplinary analysis and optimization research. A framework provides software and system services to integrate computational tasks and allows the researcher to concentrate more on the application and less on the programming details. A framework also provides a common working environment and a full range of optimization tools, and so increases the productivity of multidisciplinary research teams. Finally, a framework enables staff members to develop applications for use by disciplinary experts in other organizations. This year, the MDO Branch has gained experience with the iSIGHT framework. This paper describes experiences with four aerospace applications, including: (1) reusable launch vehicle sizing, (2) aerospike nozzle design, (3) low-noise rotorcraft trajectories, and (4) acoustic liner design. Brief overviews of each problem are provided, including the number and type of disciplinary codes and computation time estimates. In addition, the optimization methods, objective functions, design variables, and constraints are described for each problem. For each case, discussions on the advantages and disadvantages of using the iSIGHT framework are provided as well as notes on the ease of use of various advanced features and suggestions for areas of improvement.

  12. Multidisciplinary studies of wildlife trade in primates: Challenges and priorities.

    Science.gov (United States)

    Blair, Mary E; Le, Minh D; Sterling, Eleanor J

    2017-11-01

    Wildlife trade is increasingly recognized as an unsustainable threat to primate populations and informing its management is a growing focus and application of primatological research. However, management policies based on ecological research alone cannot address complex socioeconomic or cultural contexts as drivers of wildlife trade. Multidisciplinary research is required to understand trade complexity and identify sustainable management strategies. Here, we define multidisciplinary research as research that combines more than one academic discipline, and highlight how the articles in this issue combine methods and approaches to fill key gaps and offer a more comprehensive understanding of underlying drivers of wildlife trade including consumer demand, enforcement patterns, source population status, and accessibility of targeted species. These articles also focus on how these drivers interact at different scales, how trade patterns relate to ethics, and the potential effectiveness of different policy interventions in reducing wildlife trade. We propose priorities for future research on primate trade including expanding from multidisciplinary to interdisciplinary research questions and approaches co-created by research teams that integrate across different disciplines such as cultural anthropology, ecology, economics, and public policy. We also discuss challenges that limit the integration of information across disciplines to meet these priorities. © 2017 Wiley Periodicals, Inc.

  13. 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.

  14. 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.

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

    International Nuclear Information System (INIS)

    Cornes, D.

    2001-01-01

    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

  16. Pressure ulcer prevention: the role of the multidisciplinary team.

    Science.gov (United States)

    Samuriwo, Ray

    Pressure ulcer prevention has long been a priority for health professionals; however, poor pressure-ulcer-related practices like poor documentation continue to be identified. Research has shown that the attitude and behaviour of some nurses towards pressure ulcer prevention are not conducive to the best possible patient outcomes.This article reviews the findings of a Straussian grounded theory study, which sought to ascertain the value that is placed on pressure ulcer prevention by nurses, but also revealed the role that other health professionals in the multidisciplinary team play in the maintenance of skin integrity. The findings of this study which are presented in this paper highlight a number of important issues. Firstly, nurses are expected to know how to prevent and manage pressure ulcers, but in reality they are very reliant on the advice and support of other health professionals to maintain their patients' skin integrity. In addition,the level of support that nurses get from other health professionals in the multidisciplinary varies tremendously. Therefore, nurses in clinical practice need to be proactive in seeking input from other health professionals, as there are many members of the multidisciplinary team who are able to give them the advice and support that they need in prevention and management.

  17. Childhood angular kyphosis: a plea for involvement of the pediatric neurosurgeon.

    Science.gov (United States)

    Cornips, E; Koudijs, S; Vles, J; van Rhijn, L

    2017-06-01

    Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners. Angular kyphosis is a cosmetic problem but above all a serious threat to the spinal cord and as such to the child's ambulatory, sphincter, and genito-urinary functions. Spinal cord stretch over the internal kyphosis may cause pain and/or neurological deficit, often accompanied by myelomalacia or even segmental cord atrophy. Spinal cord function may be additionally affected by associated disorders such as syringomyelia or tethered cord, an orthopedic surgeon may be less familiar with. The decision when and how to proceed surgically should be made by a multidisciplinary team, including a pediatric neurosurgeon who actively participates in the operation and helps to safely achieve adequate spinal cord decompression and stabilization. Childhood angular kyphosis is a complex, heterogeneous disorder that should be managed by a multidisciplinary team in specialized pediatric spine centers. While every case is truly unique, the spinal cord is always at risk, especially during decompression, stabilization, and eventual correction of deformity. Pediatric neurosurgeons have an important role to play in preoperative work-up, actual operation, and follow-up.

  18. Multidisciplinary studies on ancient sandstone quarries of Western Sardinia (Italy).

    Science.gov (United States)

    Grillo, Silvana Maria; Del Vais, Carla; Naitza, Stefano

    2013-04-01

    The ancient coastal quarries of Mediterranean are increasingly considered geosites of multidisciplinary relevance. They are sites of historical-archaeological interest that show ancient techniques of stone extraction; they are significant for cultural heritage conservation and restoration, as sources of the stones used in ancient buildings and monuments; they are sites of geological relevance, as often retain important stratigraphic sections; they are also useful markers of secular changes in the sea level. A multisciplinary study is in progress on the ancient quarries of the Sinis region (western Sardinia island), integrating archaeological, geological, minero-petrographical data. In Sardinia, coastal quarries have been established from Punic and Roman times. Many of them exploited Quaternary sediments along the southern and western coasts of the island. They consist of middle-late Pleistocene marine conglomerates and carbonate sandstones, and of coastal (aeolian) carbonate sandstones. Sandstone blocks of different sizes have been widely used in ancient cities for buildings, defensive works, harbours, etc. Three main areas of stone extraction (San Giovanni di Sinis, Punta Maimoni, Is Arutas) have been so far recognized in the Sinis. GIS-supported mapping and documentation of the sites includes their geology and stratigraphy, the extension and layout of the quarries, and an evaluation of volumes of extracted rocks. Documented archaeological evidences include ancient extraction fronts, spoil heaps, working areas, working traces in the old fronts, transport routes of blocks, and traces of loading facilities. The study is aimed at reconstructing the relationships of the quarries with the urban areas of Sinis, as the ancient Punic-Roman city of Tharros. Consequently, a minero-petrographical characterization (optical microscopy, XRD) is performed on sandstones sampled in each quarry, and in historical buildings in Tharros and other centres of the region (Cabras

  19. Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study

    NARCIS (Netherlands)

    Sigurdson, Alice J.; Ronckers, Cécile M.; Mertens, Ann C.; Stovall, Marilyn; Smith, Susan A.; Liu, Yan; Berkow, Roger L.; Hammond, Sue; Neglia, Joseph P.; Meadows, Anna T.; Sklar, Charles A.; Robison, Leslie L.; Inskip, Peter D.

    2005-01-01

    Survivors of malignant disease in childhood who have had radiotherapy to the head, neck, or upper thorax have an increased risk of subsequent primary thyroid cancer, but the magnitude of risk over the therapeutic dose range has not been well established. We aimed to quantify the long-term risk of

  20. Genetics of Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Jianhua Zhao

    2011-01-01

    Full Text Available Obesity is a major health problem and an immense economic burden on the health care systems both in the United States and the rest of the world. The prevalence of obesity in children and adults in the United States has increased dramatically over the past decade. Besides environmental factors, genetic factors are known to play an important role in the pathogenesis of obesity. Genome-wide association studies (GWAS have revealed strongly associated genomic variants associated with most common disorders; indeed there is general consensus on these findings from generally positive replication outcomes by independent groups. To date, there have been only a few GWAS-related reports for childhood obesity specifically, with studies primarily uncovering loci in the adult setting instead. It is clear that a number of loci previously reported from GWAS analyses of adult BMI and/or obesity also play a role in childhood obesity.

  1. Early Childhood Caries

    Directory of Open Access Journals (Sweden)

    Yumiko Kawashita

    2011-01-01

    Full Text Available Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries.

  2. Danish Childhood Cancer Registry

    DEFF Research Database (Denmark)

    Schrøder, Henrik; Rechnitzer, Catherine; Wehner, Peder Skov

    2016-01-01

    AIM OF DATABASE: The overall aim is to monitor the quality of childhood cancer care in Denmark; to register late effects of treatment; to analyze complications of permanent central venous catheters (CVCs); to study blood stream infections in children with cancer; and to study acute toxicity of high......-dose methotrexate infusions in children with leukemia. STUDY POPULATION: All children below 15 years of age at diagnosis living in Denmark diagnosed after January 1, 1985 according to the International Classification of Diseases 10, including diagnoses DC00-DD48. MAIN VARIABLES: Cancer type, extent of disease......, and outcome of antimicrobial chemotherapy. DESCRIPTIVE DATA: Since 1985, 4,944 children below 15 years of age have been registered in the database. There has been no significant change in the incidence of childhood cancer in Denmark since 1985. The 5-year survival has increased significantly since 1985...

  3. Cultivating childhood obesity

    OpenAIRE

    Greene-Martin, DeCleasha

    2013-01-01

    In recent years the levels of obesity in the United States has risen greatly especially amongst children. Doctors, psychologists, and other scientists have been studying the growing problem for years. Implications for childhood obesity not only have enormous physical consequences but emotional repercussions which can affect the child’s academic and social development. A number of factors have been identified as having an effect on these children; family life reveals the grocery store habits o...

  4. SATISFACTION OF PATIENTS WITH ARTHROSIS FROM MULTIDISCIPLINARY COOPERATION

    Directory of Open Access Journals (Sweden)

    Gergana Nenova

    2016-10-01

    Full Text Available INTRODUCTION: The research of patient satisfaction with arthrosis from multidisciplinary cooperation is related to clarifying the position and the role of the physiotherapist in public health and in the development of integrated care. AIM OF THE STUDY: To investigate the satisfaction of patients with arthrosis from multidisciplinary cooperation. MATERIAL AND METHODS: In this research study participated 30 patients of the Department of Orthopedics and Traumatology of University Hospital "St. Marina" EAD - Varna for the period 2012-2016 of which 13 were men and 17 women. A feedback from these patients was sought based on the 5-point Likert scale regarding their satisfaction after the completion of the work of the multidisciplinary task team that provides integrated care at home. The questionnaire includes 12 questions, grouped in the following areas: awareness, attitude / communication, time, physical activity, professionalism and benefit / effectiveness. The data were compared with the results from a study of the satisfaction of a control group of 30 patients who were treated in the same ward, but chose to continue their rehabilitation with NHIF. RESULTS: The respondents from the test group are highly satisfied in the "awareness" area (respectively 4.80 and 4.90. They say that they have more freedom in daily activities after the procedure conducted by physiotherapist (4.93 and would seek the same physiotherapist if they need rehabilitation in the future. Patients appreciate the quality behavior/approach and communication skills displayed by the physiotherapist during the rehabilitation process (5.00, which enables them to better understand their illness (4.93. The respondents from the test group felt much better after each procedure performed by the physiotherapist (5.00 and would recommend him/her to other patients who have the same need (5.00. The satisfaction from the work of the physiotherapist is appreciated by patients extremely high, but

  5. The Radiographer's multidisciplinary team role in theatre scenarios

    International Nuclear Information System (INIS)

    Williams, H.; Widdowfield, M.; Cosson, P.

    2015-01-01

    Background: Radiographers work in multidisciplinary teams (MDTs) to image intra-operatively using ionising radiation. The radiographer is responsible according to IR(ME)ER (2000) and IRR(99) regulations for advocating patient and theatre personnel safety. A comprehensive literature search revealed limited studies analysing the radiographer's experiences of utilising power to influence MDTs. Therefore the aim of the study was to explore the power relationships within different MDT scenarios. Method: A qualitative approach was adopted consisting of interviews exploring radiographers' experiences as 1) established Cardiology team members and 2) transient members of Orthopaedic teams. French and Raven's power bases were used as an a priori framework. Ethical approval was obtained prior to commencement. Sampling was purposive, following gatekeeper permission, and subsequent participation was voluntary. Thematic content analysis was undertaken following data collection. Findings and discussion: Perpetration of Legitimate Power was more frequently attempted in transient teams. However, there were more successful descriptions in established teams. Expert Power was reciprocated successfully in established teams but was context dependent in transient teams. Referent power was well used by participants, although the transient nature of teams did affect this. Job satisfaction was expressed by both groups, although evidence presented was more comprehensive in established teams. Conclusion: The social bases of power at play within two MDTs have been examined. It is unclear to what extent the team specialism has a role in the differences identified. Radiographers working in established teams may have greater job satisfaction and perpetrate power bases more effectively than radiographers serving in transient teams. - Highlights: • This is a qualitative study using a phenomenological approach. • The social bases of power are adopted as an a priori theoretical

  6. Self-construals and earliest childhood memories

    DEFF Research Database (Denmark)

    Antalikova, Radka; Hansen, Tia G. B.; de la Mata Benitez, Manuel

    Studies on self-construals and earliest childhood memories have shown significant differences across culture (Wang, 2001, 2006). However, these studies are often carried out in countries such as USA and China, considered to be prototypical representatives of individualistic and collectivistic...... be developing an extreme tendency towards an individualistic profile as they were born into a just established democratic regime? And, would the young Danes display more collectivistic values, as their strong sense for community could suggest? Data from 80 Slovak and 80 Danish adolescents are under analysis....

  7. Chile Successfully Halts Rise in Childhood Obesity

    International Nuclear Information System (INIS)

    Gorisek, Aleksandra Sasa

    2014-01-01

    The increasing prevalence of childhood obesity in Latin America has become a cause for concern. The IAEA has worked closely with the Institute of Nutrition and Food Technology (INTA) at the University of Chile since 1997 to address the problem of malnutrition in the country. In Santiago, the Laboratory of Energy Metabolism and Stable Isotopes was established in 1998 with the help of the IAEA to provide an isotope ratio mass spectrometer and training in the use of stable isotope techniques to assess body composition, infant feeding practices and total daily energy expenditure

  8. Stress and Obesity in Childhood

    OpenAIRE

    Koch, Felix-Sebastian

    2009-01-01

    Childhood obesity is a serious health problem and prevalence increases dramatically around the world, including Sweden. The aim of the current thesis was to examine parents’ and children’s stress in relation to childhood obesity. Parenting stress, social support, parental worries, and serious life events, as well as children’s temperament, self-esteem, body dissatisfaction, saliva cortisol, weight and height were measured to estimate stress and the relation between stress and childhood obesit...

  9. Psychiatric Aspects of Childhood Epilepsy

    OpenAIRE

    Raman Deep PATTANAYAK; Rajesh SAGAR

    2012-01-01

    How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2):9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequen...

  10. Childhood cataract: home to hospital.

    OpenAIRE

    Muhit, MA

    2004-01-01

    Globally, there are 190,000 children who are blind from cataract.1 Cataract in children may be present at birth (congenital cataract) or may appear anytime during the first few years of life (developmental cataract). Childhood cataract is the most common treatable cause of childhood blindness, being responsible for 10-30% of all childhood blindness. A recent national study in Bangladesh showed that 1 in every 3 blind children is unnecessarily blind from congenital/developmental cataract.

  11. Personalizing the Approach to Childhood Asthma

    Science.gov (United States)

    ... to Childhood Asthma Share | Personalizing the approach to childhood asthma Published Online: March 24, 2104 Clinicians treating asthmatic ... classifying 1,041 asthmatics who participated in the Childhood Asthma Management Program (CAMP) clinical trial that assessed long- ...

  12. Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations.

    Science.gov (United States)

    Nielsen, Tenna Ruest Haarmark; Fonvig, Cilius Esmann; Dahl, Maria; Mollerup, Pernille Maria; Lausten-Thomsen, Ulrik; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

    2018-01-01

    The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during childhood obesity treatment. 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6-21.7), and median BMI SDS 2.8 (range 1.3-5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0.4-7.4). Height and weight, body composition measured by dual-energy X-ray absorptiometry, and fasting plasma lipid concentrations were assessed at baseline and at follow-up. Lipid concentrations (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, and triglycerides (TG)) were available in 469 individuals (264 girls). Linear regressions were performed to investigate the associations between BMI SDS, body composition indices, and lipid concentrations. At baseline, BMI SDS was negatively associated with concentrations of HDL (p = 6.7*10-4) and positively with TG (p = 9.7*10-6). Reductions in BMI SDS were associated with reductions in total body fat percentage (pobesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition and lipid concentrations may improve.

  13. A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

    Science.gov (United States)

    Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

    2016-01-01

    Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

  14. Late endocrine effects of cancer and cancer therapies in survivors of childhood malignancies.

    Science.gov (United States)

    Marques, Pedro; Van Huellen, Hans; Fitzpatrick, Ailbhe; Druce, Maralyn

    2016-03-01

    The development of several cancer treatment modalities including surgery, radiotherapy and chemotherapy has improved the survival rates of childhood cancers over recent decades, leading to an increase in the population of childhood cancer survivors. Detailed epidemiological studies have demonstrated that childhood cancer survivors frequently develop medical complications months or years after cancer treatment. Endocrine complications are common in survivors, particularly those exposed to radiotherapy, total body irradiation and alkylating agents, and may involve dysfunction of the hypothalamic-pituitary axes, gonads, thyroid gland, bone and body composition as well as metabolic abnormalities. Early identification and proper management of these disorders can significantly improve the quality of life and reduce the morbidity and potentially mortality in this population. Multidisciplinary teams, expert physicians and the development of healthcare structures are key elements for improving the screening, surveillance, cost effectiveness and overall management of endocrine late effects of cancer therapies in childhood cancer survivors. The aim of the present review was to discuss the most important and common late endocrine effects of childhood cancer treatment.

  15. Preventing childhood obesity in Latin America: an agenda for regional research and strategic partnerships.

    Science.gov (United States)

    Caballero, B; Vorkoper, S; Anand, N; Rivera, J A

    2017-07-01

    The increasing prevalence of childhood obesity in Latin America poses a major public health challenge to the region. In response, many countries are implementing obesity prevention programmes aimed at modifying known risk factors. However, the limited scientific evidence inhibits the development and implementation of novel, effective interventions across the region. To address these gaps, the NIH Fogarty International Center convened a workshop of researchers, policymakers, programme implementers and public health advocates who are actively engaged in the region to prevent childhood obesity. Major aims of the meeting were to define the current status of childhood obesity, identify the scientific gaps in our understanding of the epidemic, point out the barriers and opportunities for research and outline a plan for capacity building in the region in the area of childhood obesity. This series of articles reflects the key outcome of the meeting and offers an analysis of the knowledge translation needed for evidence-based policy initiatives, a review of the research agenda and an evaluation of research capacity in the region. The goal of the papers is to inform the development of multidisciplinary and multisector research collaborations, which are essential to the implementation of successful childhood obesity prevention strategies in the region. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  16. Do family meals affect childhood overweight or obesity?: nationwide survey 2008-2012.

    Science.gov (United States)

    Lee, H J; Lee, S Y; Park, E C

    2016-06-01

    The prevalence of childhood obesity is increasing worldwide and this trend is no exception for South Korea. A multidisciplinary approach is needed for the prevention and management of childhood obesity. To do so, among many other strategies, managing the family unit can be a very effective strategy. The purpose of this study was to identify the relationship between frequency of family meals and overweight/obesity in elementary students and to suggest the management and prevention strategies of childhood obesity. Data from a total of 2904 elementary students were analyzed from the 2008-2012 Korea National Health and Nutrition Examination Survey. Multiple logistic regression analysis was used to examine the association between overweight/obesity and family meals. Of the total 2904 elementary students, 573 (19.4%) were overweight or obese. The odds ratio of overweight or obese students who had family dinner only was 1.21 (95% CI: 0.89-1.64), that of those who had family breakfast only was 3.20 (95% CI: 1.70-6.02), and that of those who had neither family breakfast nor family dinner was 4.17 (95% CI: 1.98-8.78) compared with those who had both family breakfast and family dinner. The frequency of family meals was strongly an inverse association with childhood overweight or obesity. Therefore, we suggest that the intervention of childhood obesity should include family meals. © 2015 World Obesity.

  17. Childhood and contemporaneous correlates of adolescent leisure time physical inactivity: a longitudinal study.

    Science.gov (United States)

    Richards, Rosalina; Poulton, Richie; Reeder, Anthony I; Williams, Sheila

    2009-03-01

    Although concurrent influences on adolescent physical activity are well documented, longitudinal studies offer additional insights about early life antecedents of participation. The aim of this study was to examine associations between childhood and contemporaneous factors and patterns of physical activity participation during adolescence. Physical activity participation at ages 15 and 18 was assessed among members of the Dunedin Multidisciplinary Health and Development Study cohort using the interview-based Minnesota Leisure Time Physical Activity Questionnaire. Logistic regression was used to examine associations between childhood factors (socioeconomic status, family "active-recreation" orientation, home activities, motor ability, intelligence, and psychiatric disorder), contemporaneous factors (parental health, body mass index, predicted VO(2 max), general health, television viewing, smoking, and alcohol use) and "persistent inactivity," "declining participation," or "persistent activity" during adolescence. In multivariate models, persistent inactivity during adolescence was associated with lower childhood family active-recreation orientation, and poorer cardiorespiratory fitness and general health during adolescence. Declining participation was more likely among those who reported fewer activities at home during childhood. Persistent activity was associated with better cardiorespiratory fitness and watching less television during adolescence. This study found that childhood and contemporaneous factors were associated with persistent inactivity, persistent activity and declining participation during adolescence. The findings highlight several factors from the family and home environment of potential importance in early intervention programs to support adolescent participation in physical activity.

  18. Thyroid Adenomas After Solid Cancer in Childhood

    Energy Technology Data Exchange (ETDEWEB)

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Thomas-Teinturier, Cecile [Radiation Epidemiology Group, INSERM, Villejuif (France); Hopital Bicetre, Bicetre (France); Oberlin, Odile [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Veres, Cristina [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Pacquement, Helene [Institut Curie, Paris (France); Jackson, Angela [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Munzer, Martine; N' Guyen, Tan Dat [Institut Jean Godinot, Reims (France); Bondiau, Pierre-Yves [Centre Antoine Lacassagne, Nice (France); Berchery, Delphine; Laprie, Anne [Centre Claudius Regaud, Toulouse (France); Bridier, Andre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Schlumberger, Martin [Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Rubino, Carole; Diallo, Ibrahima [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Vathaire, Florent de, E-mail: florent.devathaire@igr.fr [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France)

    2012-10-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  19. Thyroid Adenomas After Solid Cancer in Childhood

    International Nuclear Information System (INIS)

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth; Thomas-Teinturier, Cécile; Oberlin, Odile; Veres, Cristina; Pacquement, Hélène; Jackson, Angela; Munzer, Martine; N'Guyen, Tan Dat; Bondiau, Pierre-Yves; Berchery, Delphine; Laprie, Anne; Bridier, André; Lefkopoulos, Dimitri; Schlumberger, Martin; Rubino, Carole; Diallo, Ibrahima; Vathaire, Florent de

    2012-01-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  20. Identification of early childhood caries in primary care settings.

    Science.gov (United States)

    Nicolae, Alexandra; Levin, Leo; Wong, Peter D; Dave, Malini G; Taras, Jillian; Mistry, Chetna; Ford-Jones, Elizabeth L; Wong, Michele; Schroth, Robert J

    2018-04-01

    Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations. Young children visit primary care providers at regular intervals from an early age. These encounters provide an ideal opportunity for primary care providers to educate clients about their children's oral health and its importance for general health. We designed an office-based oral health screening guide to help primary care providers identify ECC, a dental referral form to facilitate dental care access and an oral health education resource to raise parental awareness. These resources were reviewed and trialled with a small number of primary care providers.

  1. Scientific spirit in early childhood

    Directory of Open Access Journals (Sweden)

    Isabel Samacá Bohórquez

    2016-01-01

    Full Text Available Play and fun are key elements in the pedagogical work with five-year school children, since the teacher is required to carry out a hermeneutical and phenomenological exercise coming from the interaction among the different languages used by children to communicate their thoughts, emotions and ideas. In order to reflect about the scientific spirit in early childhood, it is necessary firstly to think about how its logic develops and operates and about the need to recognize in the sociocultural environment the possibilities to stimulate talents or the limitations demarcating their development, secondly, teaching practice must be thought in order to establish dialogue forums with students to know their needs and interests and guide their searches. To meet other is possible for children to the extent that the dialogical principle of knowledge interaction is recognized and the discovery of tensions and meeting points around the educational praxis, as an approach to infant’s rationality and his/her ways of learning, towards the social construction of boy and girl gender identity in our society.

  2. Functional neuroimaging and childhood autism

    Energy Technology Data Exchange (ETDEWEB)

    Boddaert, Nathalie [Service de Radiologie Pediatrique, Necker-Enfants Malades Hospital, Paris (France); Service Hospitalier Frederic Joliot, DRM, DSV, CEA, Orsay (France); Zilbovicius, Monica [Service Hospitalier Frederic Joliot, DRM, DSV, CEA, Orsay (France); INSERM, Tours [France

    2002-01-01

    Childhood autism is now widely viewed as being of developmental neurobiological origin. Yet, localised structural and functional brain correlates of autism have to be established. Structural brain-imaging studies performed in autistic patients have reported abnormalities such as increased total brain volume and cerebellar abnormalities. However, none of these abnormalities fully account for the full range of autistic symptoms. Functional brain imaging, such as positron emission tomography (PET), single photon emission computed tomography (SPECT) and functional MRI (fMRI) have added a new perspective to the study of normal and pathological brain functions. In autism, functional studies have been performed at rest or during activation. However, first-generation functional imaging devices were not sensitive enough to detect any consistent dysfunction. Recently, with improved technology, two independent groups have reported bilateral hypoperfusion of the temporal lobes in autistic children. In addition, activation studies, using perceptive and cognitive paradigms, have shown an abnormal pattern of cortical activation in autistic patients. These results suggest that different connections between particular cortical regions could exist in autism. The purpose of this review is to present the main results of rest and activation studies performed in autism. (orig.)

  3. [Localized scleroderma (morphea) in childhood].

    Science.gov (United States)

    Weibel, L

    2012-02-01

    Localized scleroderma or morphea is a sclerosing connective tissue disease of the skin, which may affect underlying tissues such as subcutis, muscle and bone. Many patients show extracutaneous symptoms and antinuclear antibodies, however, secondary transformation into systemic sclerosis does not occur. Localized scleroderma usually begins in childhood with a wide variation in its clinical spectrum. The linear variant is the most common subtype in children, associated with a progressive course and increased risk of complications. The disease may progress over years and result in severe functional and cosmetic disability. The etiology of localized scleroderma remains unknown. A genetic background is suspected, while triggers such as trauma, vaccinations and infections may lead to secondary immunologic phenomena. Localized scleroderma often remains unrecognized for a long time, resulting in substantial delay in treatment. The combination of systemic corticosteroids and methotrexate has been established as first-line therapy for progressive (usually linear) disease, whereas phototherapy (UVA-1 or UVB-narrow band) is suitable for adolescents with superficial circumscribed subtypes.

  4. [Care continuity for patients with Prader-Willi syndrome during transition from childhood to adulthood].

    Science.gov (United States)

    Saitoh, Shinji

    2010-01-01

    Prader-Willi syndrome(PWS) is a complex multisystem genetic disorder, of which characteristic phenotypes include neonatal hypotonia, hyperphagia resulting in obesity, mental retardation, hypogonadism, and behavioral and psychiatric problems. The diagnosis can be obtained as early as during neonatal period thanks to development of genetic testing. Clinical features of PWS will change depending on age, although core phenotypes of hyperphagia, obesity and psychiatric issues stay for lifetime. Therefore, integrated multidisciplinary approach starting from neonatal period is mandatory to ensure optimal management to improve lifelong quality of life. For successful transition from childhood to adulthood, multidisciplinary team need to share clinical information, and should keep the same policy about food, environment and psychiatric issues.

  5. Puberty is an important developmental period for the establishment of adipose tissue mass and metabolic homeostasis.

    Science.gov (United States)

    Holtrup, Brandon; Church, Christopher D; Berry, Ryan; Colman, Laura; Jeffery, Elise; Bober, Jeremy; Rodeheffer, Matthew S

    2017-07-03

    Over the past 2 decades, the incidence of childhood obesity has risen dramatically. This recent rise in childhood obesity is particularly concerning as adults who were obese during childhood develop type II diabetes that is intractable to current forms of treatment compared with individuals who develop obesity in adulthood. While the mechanisms responsible for the exacerbated diabetic phenotype associated with childhood obesity is not clear, it is well known that childhood is an important time period for the establishment of normal white adipose tissue in humans. This association suggests that exposure to obesogenic stimuli during adipose development may have detrimental effects on adipose function and metabolic homeostasis. In this study, we identify the period of development associated with puberty, postnatal days 18-34, as critical for the establishment of normal adipose mass in mice. Exposure of mice to high fat diet only during this time period results in metabolic dysfunction, increased leptin expression, and increased adipocyte size in adulthood in the absence of sustained increased fat mass or body weight. These findings indicate that exposure to obesogenic stimuli during critical developmental periods have prolonged effects on adipose tissue function that may contribute to the exacerbated metabolic dysfunctions associated with childhood obesity.

  6. Multidisciplinary Approach to Esophageal Achalasia: A Single Center Experience.

    Science.gov (United States)

    Schlottmann, Francisco; Andolfi, Ciro; Kavitt, Robert T; Konda, Vani J A; Patti, Marco G

    2017-04-01

    The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed. A total of 147 patients with achalasia underwent LHM and partial fundoplication. Sixty-two patients (42%) had been treated preoperatively with PD and/or botulinum toxin (BT). The preoperative Eckardt score (ES) was 6.4 ± 2. At a median follow-up of 22 months, 128 patients (87%) did well and required no further treatment (ES 0.1). The remaining 19 patients (13%) had recurrence of symptoms and required further treatment: 12 were treated with PD and improved (ES 0.7); 4 were treated with PD and BT and improved (ES 1.3); 3 failed PD. These 3 patients had been treated with multiple sessions of PD and BT before the myotomy. Overall, 144 patients (98%) did well with laparoscopic (87%) or laparoscopic and endoscopic treatment (11%). The results of this study show that (a) LHM is an effective treatment modality, (b) PD improved symptoms in the majority of patients with recurrent dysphagia after myotomy and (c) multiple preoperative endoscopic treatments seem to affect outcomes of LHM. Patients with achalasia should be treated in a quaternary care center by a multidisciplinary team.

  7. 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

  8. Multidisciplinary Analysis and Optimal Design: As Easy as it Sounds?

    Science.gov (United States)

    Moore, Greg; Chainyk, Mike; Schiermeier, John

    2004-01-01

    The viewgraph presentation examines optimal design for precision, large aperture structures. Discussion focuses on aspects of design optimization, code architecture and current capabilities, and planned activities and collaborative area suggestions. The discussion of design optimization examines design sensitivity analysis; practical considerations; and new analytical environments including finite element-based capability for high-fidelity multidisciplinary analysis, design sensitivity, and optimization. The discussion of code architecture and current capabilities includes basic thermal and structural elements, nonlinear heat transfer solutions and process, and optical modes generation.

  9. EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum.

    Science.gov (United States)

    van de Velde, Cornelis J H; Boelens, Petra G; Borras, Josep M; Coebergh, Jan-Willem; Cervantes, Andres; Blomqvist, Lennart; Beets-Tan, Regina G H; van den Broek, Colette B M; Brown, Gina; Van Cutsem, Eric; Espin, Eloy; Haustermans, Karin; Glimelius, Bengt; Iversen, Lene H; van Krieken, J Han; Marijnen, Corrie A M; Henning, Geoffrey; Gore-Booth, Jola; Meldolesi, Elisa; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm; Schmoll, Hans J; Smith, Jason J; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Wiggers, Theo; Gambacorta, Maria A; Aristei, Cynthia; Valentini, Vincenzo

    2014-01-01

    Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Consensus was achieved using the Delphi method. For the Delphi process, multidisciplinary experts were invited to comment and vote three web-based online voting rounds and to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. This manuscript covers all sentences of the consensus document with the result of the voting. The consensus document represents sections on diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where

  10. 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.

  11. Multidisciplinary Teaching-Changing Collaboration During Building Design

    DEFF Research Database (Denmark)

    Dederichs, Anne; Karlshøj, Jan

    2011-01-01

    Traditionally the design phase was carried out by one single person – the master builder. Industrialization and technical development led to a split of the role of the design master into two: the architect and the engineer. Today, demands on functionality such as energy and cost efficiency led...... 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....

  12. Multidisciplinary treatment of a fractured maxillary central incisor

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Neela

    2017-01-01

    Full Text Available Subgingivally fractured incisors are still a challenge to treat. Restoration of severely damaged teeth requires careful attention and comprehensive preplanned treatment. Here, a patient who had traumatic injury to the upper left central incisor which led to an oblique fracture involving enamel, dental and extending into the root below the gingival margin was saved from extraction by accelerated forced eruption of a root portion, allowing placement of crown, and eliminating the need for a fixed partial denture. A tooth otherwise would have gone for extraction routinely was thus saved and restored through a multidisciplinary approach by a combined orthodontic, periodontal and endodontic treatment.

  13. Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic.

    Science.gov (United States)

    Merguerian, Paul A; Grady, Richard; Waldhausen, John; Libby, Arlene; Murphy, Whitney; Melzer, Lilah; Avansino, Jeffrey

    2015-08-01

    Value in healthcare is measured in terms of patient outcomes achieved per dollar expended. Outcomes and cost must be measured at the patient level to optimize value. Multidisciplinary clinics have been shown to be effective in providing coordinated and comprehensive care with improved outcomes, yet tend to have higher cost than typical clinics. We sought to lower individual patient cost and optimize value in a pediatric multidisciplinary reconstructive pelvic medicine (RPM) clinic. The RPM clinic is a multidisciplinary clinic that takes care of patients with anomalies of the pelvic organs. The specialties involved include Urology, General Surgery, Gynecology, and Gastroenterology/Motility. From May 2012 to November 2014 we performed time-driven activity-based costing (TDABC) analysis by measuring provider time for each step in the patient flow. Using observed time and the estimated hourly cost of each of the providers we calculated the final cost at the individual patient level, targeting clinic preparation. We utilized Toyota Kata methodology to enhance operational efficiency in an effort to optimize value. Variables measured included cost, time to perform a task, number of patients seen in clinic, percent value-added time (VAT) to patients (face to face time) and family experience scores (FES). At the beginning of the study period, clinic costs were $619 per patient. We reduced conference time from 6 min/patient to 1 min per patient, physician preparation time from 8 min to 6 min and increased Medical Assistant (MA) preparation time from 9.5 min to 20 min, achieving a cost reduction of 41% to $366 per patient. Continued improvements further reduced the MA preparation time to 14 min and the MD preparation time to 5 min with a further cost reduction to $194 (69%) (Figure). During this study period, we increased the number of appointments per clinic. We demonstrated sustained improvement in FES with regards to the families overall experience with their providers

  14. Multidisciplinary teaching – Engineering course in advanced building design

    DEFF Research Database (Denmark)

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

    2011-01-01

    Collaboration within the building process is difficult. This calls for employees who are experienced in collaborating in interdisciplinary teams. To fulfil this demand a multidisciplinary course in “Advanced building design” has been developed at the Technical University of Denmark. The goal....... The 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...

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

    International Nuclear Information System (INIS)

    Shawish, Fahmy M. I.; Hammad, Fayez T.; Kazim, Essa M.

    2007-01-01

    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)

  16. Combined dyslipidemia in childhood.

    Science.gov (United States)

    Kavey, Rae-Ellen W

    2015-01-01

    Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  17. An Investigation of the Security of Caregiver Attachment during Middle Childhood in Children with High-Functioning Autistic Disorder

    Science.gov (United States)

    Chandler, Felicity; Dissanayake, Cheryl

    2014-01-01

    Previous research has investigated caregiver attachment relationships in children with autism during early childhood, with few differences found from matched control groups. However, little is known of this relationship during middle childhood (ages 8-12 years). In this study, the aim was to establish whether there are differences in the security…

  18. Developing an Active Play Resource for a Range of Australian Early Childhood Settings: Formative Findings and Recommendations

    Science.gov (United States)

    Riethmuller, Annaleise; McKeen, Kim; Okely, Anthony D.; Bell, Colin; de Silva Sanigorski, Andrea

    2009-01-01

    Physical activity habits are established in early childhood. Increasing a child's fundamental movement skill confidence and competence may result in a trajectory of increased physical activity and a lower risk of becoming overweight. The evidence upon which the promotion of physical activity in early childhood settings is based is tenuous. This…

  19. 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

  20. Therapeutic drug monitoring in epilepsy clinic: a multi-disciplinary approach

    Directory of Open Access Journals (Sweden)

    Sunee Lertsinudom

    2014-12-01

    Full Text Available Epilepsy is a common public health problem and needs multi-disciplinary treatment. Therapeutic drug monitoring (TDM is one of step of the multi-disciplinary treatment in epilepsy at Epilepsy clinic, Khon Kaen University (Thailand. The TDM service has been established since 2008. Here, we aimed to study the roles of TDM order and epilepsy control. This is a prospective descriptive study in which data collection was done from January 1 to December 31, 2010, the period when pharmacists took part in assessing the appropriateness in measurement and interpretation of TDM in order to provide suggestions for physicians. The 112 patients under study had an average age of 38.21±15.36 years; 254 samples were collected for therapeutic drug monitoring; phenytoin was submitted mostly for drug monitoring at 46.46%; 44.49% of sub-missions for drug level monitoring were made owing to a suspected sub-therapeutic level. Associations were found between reasons of sending samples for drug level monitoring and the measured drug levels, i.e., 66.67% of drug levels found was so low that they were undetectable in sample for patients’ compliance investigation and 38.94% of the drug levels were found to be sub-therapeutic as for the case where submission of samples was done because of suspected sub-therapeutic level, 40% of the cases were found to be in toxicity range in the cases with suspected over-therapeutic levels and monitoring levels, 58.25% were found to be within the therapeutic range. Pharmacists used the interpreted results in patients’ care by recommending physicians to monitor therapeutic drug closely, to adjust the dosage of drugs, and to recommend checking patients’ compliance in their use of drugs at 56.5, 38.9, and 4.3%, respectively. Physicians’ responses were found to be absolute follow, partial follow and not follow at 77.95, 11.03, and 7.48%, respectively. In conclusion, associations were found between reasons of TDM order and measured drug

  1. Early Childhood Workforce Index, 2016

    Science.gov (United States)

    Whitebook, Marcy; McLean, Caitlin; Austin, Lea J. E.

    2016-01-01

    The State of the Early Childhood Workforce (SECW) Initiative is a groundbreaking multi-year project to shine a steady spotlight on the nation's early childhood workforce. The SECW Initiative is designed to challenge entrenched ideas and policies that maintain an inequitable and inadequate status quo for early educators and for the children and…

  2. Early Childhood Education in Taiwan.

    Science.gov (United States)

    Barclay, Lisa K.

    1989-01-01

    Describes early childhood education in Taiwan, focusing on living patterns and child care arrangements, the position of the individual within the family and community, and the application of cultural norms to early childhood education. Compares the behavior of Chinese preschool children to that of American preschool children. (RJC)

  3. Early Childhood Inclusion in Spain

    Science.gov (United States)

    Giné, Climent; Balcells-Balcells, Anna; Cañadas, Margarita; Paniagua, Gema

    2016-01-01

    This article describes early childhood inclusion in educational settings in Spain. First, we address the legislative framework of preschool education in Spain and offer a brief analysis of some relevant issues, including the current situation of early childhood education and inclusion at this stage. Second, current policies and practices relating…

  4. Childhood cancer: Early warning signs

    African Journals Online (AJOL)

    World-wide there are more than 200 000 new cases of childhood cancer per year and more than 70% of these occur in the developing world. In the First World more than 70% of these children will become long-term survivors. For some childhood cancers 5-year survival rates approach 95% . In England only 0.5% of all ...

  5. Childhood disintegrative disorder

    DEFF Research Database (Denmark)

    Mouridsen, Svend Erik

    2003-01-01

    In 1908 a Viennese remedial educator Theodor Heller described six children under the name of dementia infantilis who had insidiously developed a severe mental regression between the 3rd and 4th years of life after normal mental development. Neuropathological and other medical conditions...... are sometimes associated with this disorder, but contrary to earlier belief this is not typical. Interest in childhood disintegrative disorder has increased markedly in recent years and in this review attention is given to more recently published cases based on ICD-9, ICD-10 and DSM-IV diagnostic systems...

  6. Subclinical hypothyroidism in childhood.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-02-01

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) in association with a normal total or free thyroxine (T4) or triiodothyronine (T3). It is frequently encountered in both neonatology and general paediatric practice; however, its clinical significance is widely debated. Currently there is no broad consensus on the investigation and treatment of these patients; specifically who to treat and what cut-off level of TSH should be used. This paper reviews the available evidence regarding investigation, treatments and outcomes reported for childhood SH.

  7. Radiation therapy in the management of childhood cancer

    International Nuclear Information System (INIS)

    Kun, L.E.

    1987-01-01

    Over the past two decades, multimodality treatment regimens have produced significant improvement in survival rates for most types of childhood cancer. The role of radiation therapy has been critically evaluated in prospective clinical trials that established the importance of irradiation in assuring local and regional control of disease central to ultimate survival. Indications for cranial and craniospinal irradiation in acute lymphoblastic leukemia are reviewed, as is difficult technical factors important for successful management. The role of radiation therapy in neuroblastoma and Wilms tumor is reviewed in the context of tumor biology and increasing data from multi-institutional trials. Interactions of irradiation with surgery and chemotherapy are stressed in childhood rhabdomyosarcoma and Ewing sarcoma. Current results in the more common central nervous tumors of childhood are presented, including the central role of radiation therapy in medulloblastoma, astrocytoma, and craniopharyngioma. Concerns regarding late effects of radiation therapy are balanced with the importance of achieving disease control

  8. Drug Establishments Current Registration Site

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Drug Establishments Current Registration Site (DECRS) is a database of current information submitted by drug firms to register establishments (facilities) which...

  9. Childhood trauma and compulsive buying.

    Science.gov (United States)

    Sansone, Randy A; Chang, Joy; Jewell, Bryan; Rock, Rachel

    2013-02-01

    Childhood trauma has been empirically associated with various types of self-regulatory difficulties in adulthood. However, according to the extant literature, no study has examined relationships between various types of childhood trauma and compulsive buying behavior in adulthood. Using a self-report survey methodology in a cross-sectional consecutive sample of 370 obstetrics/gynecology patients, we examined five types of childhood trauma before the age of 12 years (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to compulsive buying as assessed by the Compulsive Buying Scale (CBS). All forms of trauma demonstrated statistically significant correlations with the CBS. Using a linear regression analysis, both witnessing violence and emotional abuse significantly contributed to CBS scores. Further analyses indicated that race did not moderate the relationship between childhood trauma and compulsive buying. Findings indicate that various forms of childhood trauma are correlated with compulsive buying behavior, particularly witnessing violence and emotional abuse.

  10. The potential role for a pharmacist in a multidisciplinary general practitioner super clinic.

    Science.gov (United States)

    Bajorek, Beata; LeMay, Kate; Gunn, Kate; Armour, Carol

    2015-01-01

    The Australian government's General Practitioner (GP) super clinics programme aims to provide well-integrated, multidisciplinary, patient-centred care for people with chronic disease. However, there is no research into the current role of pharmacists in this setting. To explore the perspectives of GP super clinic staff on current and potential (future) pharmacist-led services provided in this setting. Individual interviews (facilitated using a semi-structured interview guide and thematically analysed) were conducted with purposively sampled staff of a GP super clinic in a semirural location in the state of New South Wales, until theme saturation. Participating staff included (n=9): three GPs, one pharmacist, one nurse, one business manager, and three reception staff. Three themes emerged conveying perspectives on: working relationships between staff; a pharmacist's current role; and potential future roles for a pharmacist. All clinic staff actively engaged the pharmacist in their "team approach". Currently established roles for home medicines reviews (HMRs) and drug information were well supported, but needed to be expanded, for example, with formalised case conferences between GPs, pharmacists, and other staff. New roles needed be explored in auditing medication use, optimising medication records, specialised drug information, dispensing, and prescribing. Although GPs had differing views about opportunities for pharmacists' prescribing in this setting, they saw several benefits to this service, such as reducing the time pressure on GPs to enable more effective consultations. Results suggest a pharmacist's services can potentially be better used within the multidisciplinary super clinic model of care to address current gaps within the semi-rural practice setting. Any future role for the pharmacist could be addressed as part of a formalised, strategic approach to creating an integrated healthcare team, with attention to funding and government legislation.

  11. Impact of a specialized multidisciplinary tracheostomy team on tracheostomy care in critically ill patients

    Science.gov (United States)

    de Mestral, Charles; Iqbal, Sameena; Fong, Nancy; LeBlanc, Joanne; Fata, Paola; Razek, Tarek; Khwaja, Kosar

    2011-01-01

    Background A multidisciplinary tracheostomy team was created in 2005 to follow critically ill patients who had undergone a tracheostomy until their discharge from hospital. Composed of a surgeon, surgical resident, respiratory therapist, speech-language pathologist and clinical nurse specialist, this team has been meeting twice a week for rounds involving patients who transitioned from the intensive care unit (ICU) to the medical and surgical wards. Our objective was to assess the impact of this multidisciplinary team on downsizing and decannulation times, on the incidence of speaking valve placement and on the incidence of tracheostomy-related complications on the ward. Methods This study was conducted at a tertiary care, level-1 trauma centre and teaching hospital and involved all patients who had received a tracheostomy during admission to the ICU from Jan. 1 to Dec. 31, 2004 (preservice group), and from Jan. 1 to Dec. 31, 2006 (postservice group). We compared the outcomes of patients who required tracheostomies in a 12-month period after the team was created with those of patients from a similar time frame before the establishment of the team. Results There were 32 patients in the preservice group and 54 patients in the post-service group. Under the new tracheostomy service, there was a decrease in incidence of tube blockage (5.5% v. 25.0%, p = 0.016) and calls for respiratory distress (16.7% v. 37.5%, p = 0.039) on the wards. A significantly larger proportion of patients also received speaking valves (67.4% v. 19.4%, p tracheostomy team was associated with fewer tracheostomy-related complications and an increase in the use of a speaking valve. PMID:21443833

  12. Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, K.; Czajka, A.; Komarek, E.; Hohenberg, G.; Poetter, R. [Medical University of Vienna (Austria). Dept. of Radiation Oncology; Ponocny-Seliger, E. [Sigmund Freud Private University, Vienna (Austria). Dept. of Psychology; Doerr, W. [Medical University of Vienna (Austria). Dept. of Radiation Oncology; Medical University of Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology

    2013-07-15

    Background: In order to identify cancer patients with psychosocial needs during radiotherapy, a routine screening questionnaire is widely recommended in the literature. Several tools focusing mainly on psychological issues have been developed during the past decade. However, problems with their implementation into clinical routine have been repeatedly reported, due to a lack of practicability for clinicians and nurses. This study reports the compilation of a multidisciplinary screening questionnaire and an analysis of the effectiveness of its implementation into clinical routine at the Department of Radiotherapy, Medical University of Vienna. Materials and methods: The screening questionnaire is based on a compilation of several subscales from established and validated assessment tools. It focuses on comprehensive information with high a clinical relevance for all professions. In a pilot study, patients' acceptance was assessed qualitatively. Analysis of missing screening data in consecutively admitted patients reflects the effectiveness of implementation and representativity of the data. A validation analysis of the psychological subscales was performed using external criteria and its internal consistency was tested with Cronbachs' {alpha}. Results: Qualitative patient acceptance of the screening questionnaire is good. The overall response rate in the screening procedure was 75 %. Missing patient screening data sets arose randomly - mainly due to organizational problems - and did not result in systematic errors. The psychological subscales identify highly distressed patients with a sensitivity of 89 and 78 %, and an internal consistency of 0.843 and 0.617. Conclusion: The multidisciplinary screening questionnaire compiled in this study has a high patient acceptance, provides reliable and representative data and identifies highly distressed patients with excellent sensitivity. Although requiring additional personnel resources, it can be implemented

  13. 5-year review of a unique multidisciplinary nonmelanoma skin cancer clinic.

    Science.gov (United States)

    Culleton, Shaelyn; Breen, Dale; Assaad, Dalal; Zhang, Liying; Balogh, Judith; Tsao, May; Kamra, Juhu; Czarnota, Greg; Antonyshyn, Oleh; Fialkov, Jeffery; Barnes, Elizabeth

    2011-01-01

    A multidisciplinary nonmelanoma skin cancer (NMSC) clinic is held weekly at our center, where all new patients are jointly assessed by dermatology/dermatopathology, radiation oncology, and plastic surgery. A new patient database was established in 2004. The purpose of this study was to provide a preliminary report on the patients seen in the NMSC clinic and the treatment recommendations rendered. The new patient database was reviewed from January 2004 to December 2008, and patient demographics, tumor characteristics, and treatment recommendations were extracted. Cochran-Mantel-Harnszel (CMH) testing and chi-square analysis were used to detect any associations or relationships between variables within the database. A p value of less than .05 was considered significant. During the 5-year study period, 2,146 new patients were seen in the NMSC clinic. The majority of patients presented with basal cell carcinoma (64%) or squamous cell carcinoma (22%), with a median tumor size of 1 to 2 cm (range 0 to > 9 cm). Tumors were located in the head and neck region (80%), extremities (14%), and torso (6%). Previous treatment included biopsy only (62%), surgery (20%), electrodesiccation and curettage (11%), topical imiquimod (3%), and radiotherapy (1%). Treatment recommendations included surgery (55%) (with either simple excision [31%] or excision with margin control under frozen-section guidance [24%]), radiotherapy (19%), topical imiquimod (10%), observation (7%), and electrodesiccation and curettage (4%). The NMSC clinic at our center sees a high volume of patients who benefit from the multidisciplinary assessment provided. Treatment recommendations were based on patient and disease characteristics as well as patient preference.

  14. Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

    International Nuclear Information System (INIS)

    Kirchheiner, K.; Czajka, A.; Komarek, E.; Hohenberg, G.; Poetter, R.; Ponocny-Seliger, E.; Doerr, W.; Medical University of Vienna

    2013-01-01

    Background: In order to identify cancer patients with psychosocial needs during radiotherapy, a routine screening questionnaire is widely recommended in the literature. Several tools focusing mainly on psychological issues have been developed during the past decade. However, problems with their implementation into clinical routine have been repeatedly reported, due to a lack of practicability for clinicians and nurses. This study reports the compilation of a multidisciplinary screening questionnaire and an analysis of the effectiveness of its implementation into clinical routine at the Department of Radiotherapy, Medical University of Vienna. Materials and methods: The screening questionnaire is based on a compilation of several subscales from established and validated assessment tools. It focuses on comprehensive information with high a clinical relevance for all professions. In a pilot study, patients' acceptance was assessed qualitatively. Analysis of missing screening data in consecutively admitted patients reflects the effectiveness of implementation and representativity of the data. A validation analysis of the psychological subscales was performed using external criteria and its internal consistency was tested with Cronbachs' α. Results: Qualitative patient acceptance of the screening questionnaire is good. The overall response rate in the screening procedure was 75 %. Missing patient screening data sets arose randomly - mainly due to organizational problems - and did not result in systematic errors. The psychological subscales identify highly distressed patients with a sensitivity of 89 and 78 %, and an internal consistency of 0.843 and 0.617. Conclusion: The multidisciplinary screening questionnaire compiled in this study has a high patient acceptance, provides reliable and representative data and identifies highly distressed patients with excellent sensitivity. Although requiring additional personnel resources, it can be implemented successfully in

  15. No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity

    DEFF Research Database (Denmark)

    Trier, C; Fonvig, Cilius Esmann; Bøjsøe, C

    2016-01-01

    . There were no associations between the baseline intake of sweetened beverages, candy, snacks, and/or fast food and BMI SDS at baseline or the change in BMI SDS during treatment. CONCLUSIONS: The intake of sweetened beverages, candy, snacks or fast food when entering a childhood obesity treatment program......BACKGROUND: Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity. OBJECTIVE: The aim of the present study was to assess whether the intake of sweetened beverages, candy, snacks or fast food at baseline in a multidisciplinary childhood obesity...... treatment program was associated with the baseline degree of obesity or the treatment effect. METHODS: This prospective study included 1349 overweight and obese children (body mass index standard deviation scores (BMI SDS) ≥ 1.64) enrolled in treatment at The Children's Obesity Clinic, Copenhagen University...

  16. The risk of childhood leukaemia from low-level radiation exposure

    International Nuclear Information System (INIS)

    Wakeford, R.; Binks, K.; Slovak, A.J.M.

    1992-01-01

    Exposure to ionizing radiation is an established cause of leukemia in childhood ( -5 excess childhood leukemia cases per mSv for fetal exposure, around 1.5 x 10 -5 excess childhood leukemia cases per mSv for irradiation in early infancy, this latter risk coefficient reducing with advancing age at exposure . The closeness of the risk coefficients for exposure just before and after birth (derived from different sources of information) is reassuring. It is these coefficients that are used in assessing the risk of childhood leukemia due to, say, the operation of a nuclear facility, and such assessments have demonstrated that the risk due to normal operations will produce a very small number of extra cases, a 'signal' that will not be detectable above the unavoidable 'noise' of statistical fluctuations in background incidence rates . However, reports of childhood leukemia 'clusters' near certain nuclear installations in Britain have led to the accuracy of these assessments being challenged. (author)

  17. Recurrent Childhood Animal Cruelty and Its Link to Recurrent Adult Interpersonal Violence.

    Science.gov (United States)

    Trentham, Caleb E; Hensley, Christopher; Policastro, Christina

    2018-06-01

    In the early 1960s, researchers began to examine the potential link between childhood animal cruelty and future interpersonal violence. Findings since then have been inconsistent in establishing a relationship between the two. This may be due to researchers failing to measure the recurrency of childhood animal abuse and the recurrency of later violent acts committed in adulthood. The current study, using data from 257 inmates at a medium-security prison in a Southern state, is a replication of research conducted by Tallichet and Hensley, and Hensley, Tallichet, and Dutkiewicz, which examined this recurrency issue. The only statistically significant predictor of recurrent adult interpersonal violence in this study was recurrent childhood animal cruelty. Inmates who engaged in recurrent childhood animal cruelty were more likely to commit recurrent adult interpersonal violence. Respondents' race, education, and childhood residence were not significant predictors of the outcome variable.

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

    Science.gov (United States)

    O'Kelly, Julian; Koffman, Jonathan

    2007-04-01

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

  19. Multidisciplinary perspective of hepatocellular carcinoma: A Pacific Northwest experience

    Science.gov (United States)

    Yeh, Matthew M; Yeung, Raymond S; Apisarnthanarax, Smith; Bhattacharya, Renuka; Cuevas, Carlos; Harris, William P; Hon, Tony Lim Kiat; Padia, Siddharth A; Park, James O; Riggle, Kevin M; Daoud, Sayed S

    2015-01-01

    Hepatocellular carcinoma (HCC) is the most rapidly increasing type of cancer in the United States. HCC is a highly malignant cancer, accounting for at least 14000 deaths in the United States annually, and it ranks third as a cause of cancer mortality in men. One major difficulty is that most patients with HCC are diagnosed when the disease is already at an advanced stage, and the cancer cannot be surgically removed. Furthermore, because almost all patients have cirrhosis, neither chemotherapy nor major resections are well tolerated. Clearly there is need of a multidisciplinary approach for the management of HCC. For example, there is a need for better understanding of the fundamental etiologic mechanisms that are involved in hepatocarcinogenesis, which could lead to the development of successful preventive and therapeutic modalities. It is also essential to define the cellular and molecular bases for malignant transformation of hepatocytes. Such knowledge would: (1) greatly facilitate the identification of patients at risk; (2) prompt efforts to decrease risk factors; and (3) improve surveillance and early diagnosis through diagnostic imaging modalities. Possible benefits extend also to the clinical management of this disease. Because there are many factors involved in pathogenesis of HCC, this paper reviews a multidisciplinary perspective of recent advances in basic and clinical understanding of HCC that include: molecular hepatocarcinogenesis, non-invasive diagnostics modalities, diagnostic pathology, surgical modality, transplantation, local therapy and oncological/target therapeutics. PMID:26085907

  20. The INGECAD multidisciplinary integrated computer aided engineering system

    International Nuclear Information System (INIS)

    Kisielewicz, L.T.

    1989-01-01

    The purpose of this paper is to define the key criteria of an integrated CAE system, and to discuss the solution developed by Ingevision to match these criteria. An information flow model of process plant engineering is presented as a background to the key criteria of CAE systems. This model includes multidisciplinary interfaces and project changes up to the as-built stage. The key quality criteria of CAE systems correspond to managerial issues, such as project control, to technical issues, consistency and quality assurance, and to economical issues, such as cost optimization. The INGECAD system answers these criteria with a tripod nucleus underlying a set of specialized applications. The nucleus includes a Data Base Management System, basic Graphical Tools, and a Decision Support System. The paper overviews the different modules of the INGECAD system emphasizing the general architecture and the basic tools. Specific examples are developed in functional design, cost optimized items selection, and semi-automated routing of piping system. These examples are not intended to illustrate exhaustively the capabilities of the INGECAD system, but rather to highlight some of the advantages the multidisciplinary integration of the system provides to the users. (orig./HP)

  1. High-Fidelity Multidisciplinary Design Optimization of Aircraft Configurations

    Science.gov (United States)

    Martins, Joaquim R. R. A.; Kenway, Gaetan K. W.; Burdette, David; Jonsson, Eirikur; Kennedy, Graeme J.

    2017-01-01

    To evaluate new airframe technologies we need design tools based on high-fidelity models that consider multidisciplinary interactions early in the design process. The overarching goal of this NRA is to develop tools that enable high-fidelity multidisciplinary design optimization of aircraft configurations, and to apply these tools to the design of high aspect ratio flexible wings. We develop a geometry engine that is capable of quickly generating conventional and unconventional aircraft configurations including the internal structure. This geometry engine features adjoint derivative computation for efficient gradient-based optimization. We also added overset capability to a computational fluid dynamics solver, complete with an adjoint implementation and semiautomatic mesh generation. We also developed an approach to constraining buffet and started the development of an approach for constraining utter. On the applications side, we developed a new common high-fidelity model for aeroelastic studies of high aspect ratio wings. We performed optimal design trade-o s between fuel burn and aircraft weight for metal, conventional composite, and carbon nanotube composite wings. We also assessed a continuous morphing trailing edge technology applied to high aspect ratio wings. This research resulted in the publication of 26 manuscripts so far, and the developed methodologies were used in two other NRAs. 1

  2. A Multidisciplinary Approach to Mixer-Ejector Analysis and Design

    Science.gov (United States)

    Hendricks, Eric, S.; Seidel, Jonathan, A.

    2012-01-01

    The design of an engine for a civil supersonic aircraft presents a difficult multidisciplinary problem to propulsion system engineers. There are numerous competing requirements for the engine, such as to be efficient during cruise while yet quiet enough at takeoff to meet airport noise regulations. The use of mixer-ejector nozzles presents one possible solution to this challenge. However, designing a mixer-ejector which will successfully address both of these concerns is a difficult proposition. Presented in this paper is an integrated multidisciplinary approach to the analysis and design of these systems. A process that uses several low-fidelity tools to evaluate both the performance and acoustics of mixer-ejectors nozzles is described. This process is further expanded to include system-level modeling of engines and aircraft to determine the effects on mission performance and noise near airports. The overall process is developed in the OpenMDAO framework currently being developed by NASA. From the developed process, sample results are given for a notional mixer-ejector design, thereby demonstrating the capabilities of the method.

  3. 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.

  4. 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 central variable studied by cognitive psychologists-analogy-and examines its relationship to a central variable examined by social psychologists-conflict. In an observational, field study, over 11h of audio-video data from conversations of the Mars Exploration Rover scientists were coded for different types of analogy and micro-conflicts that reveal the character of underlying psychological mechanisms. Two different types of time-lagged logistic models applied to these data revealed asymmetric patterns of associations between analogy and conflict. Within-domain analogies, but not within-discipline or outside-discipline analogies, preceded science and work process conflicts, suggesting that in multidisciplinary teams, representational gaps in very close domains will be more likely to spark conflict. But analogies also occurred in reaction to conflict: Process and negative conflicts, but not task conflicts, preceded within-discipline analogies, but not to within-domain or outside-discipline analogies. This study demonstrates ways in which cognition can be bidirectionally tied to social processes and discourse. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Integrated Multidisciplinary Constrained Optimization of Offshore Support Structures

    International Nuclear Information System (INIS)

    Haghi, Rad; Molenaar, David P; Ashuri, Turaj; Van der Valk, Paul L C

    2014-01-01

    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

  6. Multidisciplinary response for a radiological accident developed in Argentina

    International Nuclear Information System (INIS)

    Di Giorgio, Marina; Tadic, Matilde; Vazquez, Marina; Cateriano, Miguel; Jordan, Osvaldo; Rojas, Carlos A.; Portas, M.; Coppola, A.; De Lellis, M. del C.; Dovasio, F.

    2010-01-01

    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 137 Cs 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) [es

  7. 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.

  8. Multidisciplinary Shape Optimization of a Composite Blended Wing Body Aircraft

    Science.gov (United States)

    Boozer, Charles Maxwell

    A multidisciplinary shape optimization tool coupling aerodynamics, structure, and performance was developed for battery powered aircraft. Utilizing high-fidelity computational fluid dynamics analysis tools and a structural wing weight tool, coupled based on the multidisciplinary feasible optimization architecture; aircraft geometry is modified in the optimization of the aircraft's range or endurance. The developed tool is applied to three geometries: a hybrid blended wing body, delta wing UAS, the ONERA M6 wing, and a modified ONERA M6 wing. First, the optimization problem is presented with the objective function, constraints, and design vector. Next, the tool's architecture and the analysis tools that are utilized are described. Finally, various optimizations are described and their results analyzed for all test subjects. Results show that less computationally expensive inviscid optimizations yield positive performance improvements using planform, airfoil, and three-dimensional degrees of freedom. From the results obtained through a series of optimizations, it is concluded that the newly developed tool is both effective at improving performance and serves as a platform ready to receive additional performance modules, further improving its computational design support potential.

  9. 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.

  10. Teachers’ Shared Expertise at a Multidisciplinary University of Applied Sciences

    Directory of Open Access Journals (Sweden)

    Arto O. Salonen

    2015-07-01

    Full Text Available Shared expertise, team teaching, and cooperation among lecturers from different fields have become more and more important in promoting learning and achieving more innovative learning outcomes in multidisciplinary universities. To increase and improve sharing expertise between teachers from different faculties and disciplines, we wanted, on one hand, to identify skills and competences that teachers have in common and, on the other hand, to find areas in which they identify that they need complementation. As a framework for this research, we applied Lee Shulman’s (1986 seven categories of teachers’ knowledge base including the theory of pedagogical content knowledge (PCK. The data were collected by group discussions. The teachers (N = 22 represented all seven faculties of Helsinki Metropolia University of Applied Sciences (UAS, that is, Business School, Civil Engineering and Building Services, Culture and Creative Industries, Health Care and Nursing, School of Information and Communication Technology (ICT, Industrial Engineering, and Welfare and Human Functioning. The data were analyzed using theory-based content analysis. According to our data, the mutual core competence of a teacher is the capacity to interact effectively. It is a basis for shared expertise. Interaction skills are necessary in collaborative construction of knowledge as students, teachers of different fields, and their partners inside and outside the organization co-operate. Multidisciplinary co-operation among colleagues also helps to maintain subject matter knowledge, as it supports peer learning and encourages everyone to move out of their comfort zones.

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

    Directory of Open Access Journals (Sweden)

    Marr C

    2017-04-01

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

  12. Challenges and successes of a multidisciplinary pediatric obesity treatment program.

    Science.gov (United States)

    Walsh, Stephanie M; Palmer, Wendy; Welsh, Jean A; Vos, Miriam B

    2014-12-01

    Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs. The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse. Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated 6 months, but longer follow-up and assessment of comorbidities are needed. © 2014 American Society for Parenteral and Enteral Nutrition.

  13. Implementation of a multidisciplinary guideline improves preterm infant admission temperatures.

    Science.gov (United States)

    Harer, M W; Vergales, B; Cady, T; Early, A; Chisholm, C; Swanson, J R

    2017-11-01

    Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team. Clinical practice changes in the guideline included: increasing operating room temperatures, obtaining a 10-min axillary temperature, using an exothermic mattress for all infants <35 weeks, and using a polyethylene wrap for infants <32 weeks. The baseline rate of hypothermia (<36.5 °CC) was 63%. Three PDSA cycles data were completed on 168 consecutive preterm births. The post-implementation rate of hypothermia (<36.5 °C) was reduced to 30% (P<0.001). The incidence of moderate hypothermia (< 36 °C) was reduced from a baseline of 29% to a rate of 9% (P<0.001). Use of a multidisciplinary guideline to increase preterm NICU admission temperatures resulted in a decrease in hypothermic infants.

  14. Effectiveness of a Multidisciplinary Rehabilitation Program Following Shoulder Injury

    Directory of Open Access Journals (Sweden)

    Andrea Bean

    2017-07-01

    Full Text Available Background: Shoulder injuries in working age adults result in a major cost to the health care system. The purpose of this study was to examine the effectiveness of a new multidisciplinary rehabilitation program and to explore factors that affected a successful return to work (RTW in injured workers with shoulder problems who received this program. Methods: This was a prospective longitudinal study. The patient-oriented outcome measures were the Numeric Pain Rating Scale (NPRS and the Disabilities of the Arm, Shoulder, and Hand (DASH. Range of motion (ROM in flexion, abduction, and external rotation and strength in lifting and push/pull were documented. All outcomes were measured before and at the completion of the program. Results: Data of 68 patients were used for analysis. All outcomes showed a statistically significant improvement over time. Conclusions: Multidisciplinary rehabilitation programs help to improve pain, disability, ROM, strength, and facilitate RTW. Higher stress and a fast-paced work environment increased the risk of not progressing in work status.

  15. [Consensus statement for accreditation of multidisciplinary thyroid cancer units].

    Science.gov (United States)

    Díez, Juan José; Galofré, Juan Carlos; Oleaga, Amelia; Grande, Enrique; Mitjavila, Mercedes; Moreno, Pablo

    2016-03-01

    Thyroid cancer is the leading endocrine system tumor. Great advances have recently been made in understanding of the origin of these tumors and the molecular biology that makes them grow and proliferate, which have been associated to improvements in diagnostic procedures and increased availability of effective local and systemic treatments. All of the above makes thyroid cancer a paradigm of how different specialties should work together to achieve the greatest benefit for the patients. Coordination of all the procedures and patient flows should continue throughout diagnosis, treatment, and follow-up, and is essential for further optimization of resources and time. This manuscript was prepared at the request of the Working Group on Thyroid Cancer of the Spanish Society of Endocrinology and Nutrition, and is aimed to provide a consensus document on the definition, composition, requirements, structure, and operation of a multidisciplinary team for the comprehensive care of patients with thyroid cancer. For this purpose, we have included contributions by several professionals from different specialties with experience in thyroid cancer treatment at centers where multidisciplinary teams have been working for years, with the aim of developing a practical consensus applicable in clinical practice. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. Challenges and Experiences of Building Multidisciplinary Datasets across Cultures

    Science.gov (United States)

    Jamiyansharav, K.; Laituri, M.; Fernandez-Gimenez, M.; Fassnacht, S. R.; Venable, N. B. H.; Allegretti, A. M.; Reid, R.; Baival, B.; Jamsranjav, C.; Ulambayar, T.; Linn, S.; Angerer, J.

    2017-12-01

    Efficient data sharing and management are key challenges to multidisciplinary scientific research. These challenges are further complicated by adding a multicultural component. We address the construction of a complex database for social-ecological analysis in Mongolia. Funded by the National Science Foundation (NSF) Dynamics of Coupled Natural and Human (CNH) Systems, the Mongolian Rangelands and Resilience (MOR2) project focuses on the vulnerability of Mongolian pastoral systems to climate change and adaptive capacity. The MOR2 study spans over three years of fieldwork in 36 paired districts (Soum) from 18 provinces (Aimag) of Mongolia that covers steppe, mountain forest steppe, desert steppe and eastern steppe ecological zones. Our project team is composed of hydrologists, social scientists, geographers, and ecologists. The MOR2 database includes multiple ecological, social, meteorological, geospatial and hydrological datasets, as well as archives of original data and survey in multiple formats. Managing this complex database requires significant organizational skills, attention to detail and ability to communicate within collective team members from diverse disciplines and across multiple institutions in the US and Mongolia. We describe the database's rich content, organization, structure and complexity. We discuss lessons learned, best practices and recommendations for complex database management, sharing, and archiving in creating a cross-cultural and multi-disciplinary database.

  17. Continued multidisciplinary project-based learning - implementation in health informatics.

    Science.gov (United States)

    Wessel, C; Spreckelsen, C

    2009-01-01

    Problem- and project-based learning are approved methods to train students, graduates and post-graduates in scientific and other professional skills. The students are trained on realistic scenarios in a broader context. For students specializing in health informatics we introduced continued multidisciplinary project-based learning (CM-PBL) at a department of medical informatics. The training approach addresses both students of medicine and students of computer science. The students are full members of an ongoing research project and develop a project-related application or module, or explore or evaluate a sub-project. Two teachers guide and review the students' work. The training on scientific work follows a workflow with defined milestones. The team acts as peer group. By participating in the research team's work the students are trained on professional skills. A research project on a web-based information system on hospitals built the scenario for the realistic context. The research team consisted of up to 14 active members at a time, who were scientists and students of computer science and medicine. The well communicated educational approach and team policy fostered the participation of the students. Formative assessment and evaluation showed a considerable improvement of the students' skills and a high participant satisfaction. Alternative education approaches such as project-based learning empower students to acquire scientific knowledge and professional skills, especially the ability of life-long learning, multidisciplinary team work and social responsibility.

  18. 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.

  19. 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.

  20. Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

    Directory of Open Access Journals (Sweden)

    Sadaksharam Jayachandran

    2017-10-01

    Full Text Available Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients.

  1. Severe childhood malnutrition.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  2. Acute hemiplegia in childhood

    International Nuclear Information System (INIS)

    Okuno, Takehiko; Takao, Tatsuo; Itoh, Masatoshi; Konishi, Yukuo; Nakano, Shozo

    1983-01-01

    The results of CT in 100 patients with acute hemiplegia in childhood are reported here. The etiology was various: 2 patients had infratentorial brain tumors, 56 had cerebral vascular diseases, 3 had head injuries, 16 had intracranial infectious diseases, one had postinfectious encephalomyelitis, one had multiple sclerosis, 2 had epilepsy, and the diagnosis of 19 were unknown. Eleven patients had a normal CT and a good prognosis. As for the type of onset, there were patients of type 1 with fever and 42 with convulsions and unconsciousness; those of type 2 with convulsions and unconsciousness were 12, and those of type 3 without fever and convulsions were 46. This classification is assumed to be useful, as the type of onset is characteristic of the etiology. Six patients were diagnosed correctly by repeated examinations, although the first CT did not reveal any remarkable findings. Capsular infarction, occlusion of the posterior cerebral artery in acute hemiplegia in childhood, abnormal findings of the internal capsule, thalamus, and midbrain in a patient with postinfectious encephalomyelitis, and a diffuse low density in the CT of the unilateral hemisphere in the patients with acute encephalopathy and acute hemiplegia of an obscure origin have been found after the introduction of computerized tomography. (author)

  3. Precisely Tracking Childhood Death.

    Science.gov (United States)

    Farag, Tamer H; Koplan, Jeffrey P; Breiman, Robert F; Madhi, Shabir A; Heaton, Penny M; Mundel, Trevor; Ordi, Jaume; Bassat, Quique; Menendez, Clara; Dowell, Scott F

    2017-07-01

    Little is known about the specific causes of neonatal and under-five childhood death in high-mortality geographic regions due to a lack of primary data and dependence on inaccurate tools, such as verbal autopsy. To meet the ambitious new Sustainable Development Goal 3.2 to eliminate preventable child mortality in every country, better approaches are needed to precisely determine specific causes of death so that prevention and treatment interventions can be strengthened and focused. Minimally invasive tissue sampling (MITS) is a technique that uses needle-based postmortem sampling, followed by advanced histopathology and microbiology to definitely determine cause of death. The Bill & Melinda Gates Foundation is supporting a new surveillance system called the Child Health and Mortality Prevention Surveillance network, which will determine cause of death using MITS in combination with other information, and yield cause-specific population-based mortality rates, eventually in up to 12-15 sites in sub-Saharan Africa and south Asia. However, the Gates Foundation funding alone is not enough. We call on governments, other funders, and international stakeholders to expand the use of pathology-based cause of death determination to provide the information needed to end preventable childhood mortality.

  4. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

    Science.gov (United States)

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-12-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

  5. Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.

    Science.gov (United States)

    Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L

    2013-08-01

    To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.

  6. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  7. 10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center.

    Science.gov (United States)

    Chen, Jenny T; Nayar, Harry S; Rao, Venkat K

    2017-09-01

    In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

  8. Social aspects of the implementation of multidisciplinary approach in palliative and hospice care

    Directory of Open Access Journals (Sweden)

    V. V. Proskura

    2017-06-01

    The results of our empirical research have shown that the palliative care services in the city of Lviv include the functions of social workers, though no social worker positions exists in the service providing working groups. Instead, the functions of the social worker in this area are handled either by other team members (e.g. a chief doctor or other medical personnel, psychologist, priest, etc., or professionals who do not belong to the service team (mostly psychologist. In some cases most part of the functions of the social worker are not delivered at all. The main social worker’s functions while implementing the social component of the palliative care may include the conduction of self-help groups for the terminally ill and their relatives, management of a client’s case, drawing up an individual work plan with the client and his/her family, basic legal counseling, provision of the supervision for members of the multidisciplinary team, establishment of contacts with other specialists, conduction of measures to prevent burnout, development of educational and leisure programs for children of different ages with different illnesses, training for teachers how to work with terminally ill children, development of leisure programs for the elderly (taking into account their age and physical condition, training for practitioners to provide these services, research and development of new programs in order to improve social services in the palliative care, establishment of networks with other social organizations, search for partners, grants, and training of clergy to work in palliative care.

  9. Multidisciplinary design optimization of the belt drive system considering both structure and vibration characteristics based on improved genetic algorithm

    Science.gov (United States)

    Yuan, Yongliang; Song, Xueguan; Sun, Wei; Wang, Xiaobang

    2018-05-01

    The dynamic performance of a belt drive system is composed of many factors, such as the efficiency, the vibration, and the optimal parameters. The conventional design only considers the basic performance of the belt drive system, while ignoring its overall performance. To address all these challenges, the study on vibration characteristics and optimization strategies could be a feasible way. This paper proposes a new optimization strategy and takes a belt drive design optimization as a case study based on the multidisciplinary design optimization (MDO). The MDO of the belt drive system is established and the corresponding sub-systems are analyzed. The multidisciplinary optimization is performed by using an improved genetic algorithm. Based on the optimal results obtained from the MDO, the three-dimension (3D) model of the belt drive system is established for dynamics simulation by virtual prototyping. From the comparison of the results with respect to different velocities and loads, the MDO method can effectively reduce the transverse vibration amplitude. The law of the vibration displacement, the vibration frequency, and the influence of velocities on the transverse vibrations has been obtained. Results show that the MDO method is of great help to obtain the optimal structural parameters. Furthermore, the kinematics principle of the belt drive has been obtained. The belt drive design case indicates that the proposed method in this paper can also be used to solve other engineering optimization problems efficiently.

  10. A multidisciplinary overview of intoxicating snuff rituals in the western hemisphere.

    Science.gov (United States)

    de Smet, P A

    1985-03-01

    Part one of the paper discusses ethnobotanical, chemical and general pharmacological aspects of intoxicating snuff rituals in the western hemisphere. Four categories of ritual snuff ingredients arise from this multidisciplinary approach: It is well established that the plant contains one or more psychoactive principles and the Indian use of the plant as a ritual snuff ingredient is confirmed or quite probable: Anadenanthera, Erythroxylum, Nicotiana, Virola; It is well established that the plant contains one or more psychoactive principles, but the Indian use of the plant as a ritual snuff ingredient is not well recorded or even unlikely: Banisteriopsis, Cannabis, Datura, Ilex guayusa; The Indian use of the plant as a ritual snuff ingredient is confirmed or quite probable, but it is not well established that the plant contains one or more psychoactive principles: Justicia pectoralis, Pagamea macrophylla, Tanaecium nocturnum; The Indian use of the plant as a ritual snuff ingredient is not well recorded, and it is not well established that the plant contains one or more psychoactive principles: Acorus calamus, Capsicum, Macquira sclerophylla, Piper interitum. Part two of the paper discusses the nasal pharmacokinetics and efficacy of possible ritual snuff constituents. The literature yields convincing clinical evidence that atropine, cocaine, nicotine and scopolamine are effective following nasal application, but experimental confirmation of the efficacy of nasal tryptamine alkaloids is still awaited. In self-experiments, 6.4 mg/kg of caffeine produced substantial plasma levels via the nasal route, but 0.5 mg/kg of harmine did not produce measurable plasma levels, when taken as a nasal powder. Without additional experiments, it is difficult to give a definite explanation for this negative result.

  11. How to Learn Multidisciplinary Design: Biomedical Engineering in Cross Cultural Seminar

    OpenAIRE

    Shigehiro Hashimoto

    2016-01-01

    The way to learn multidisciplinary design has been discussed. "Biomedical engineering" is exemplified for multidisciplinary field. "Biomedical Engineering" makes the 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 work, students are divided into the small cross cultural groups. Each group finds a problem, methods to solve the problem...

  12. A framework for developing finite element codes for multi-disciplinary applications.

    OpenAIRE

    Dadvand, Pooyan

    2007-01-01

    The world of computing simulation has experienced great progresses in recent years and requires more exigent multidisciplinary challenges to satisfy the new upcoming demands. Increasing the importance of solving multi-disciplinary problems makes developers put more attention to these problems and deal with difficulties involved in developing software in this area. Conventional finite element codes have several difficulties in dealing with multi-disciplinary problems. Many of these codes are d...

  13. Follow-up of permanent hearing impairment in childhood.

    Science.gov (United States)

    Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

    2016-02-01

    Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  14. Practical Multi-Disciplinary Analysis Tools for Combustion Devices, Phase I

    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...

  15. Practical Multi-Disciplinary Analysis Tools for Combustion Devices, Phase II

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

    Science.gov (United States)

    2013-11-01

    ..., Division of Cancer Control & Population Sciences, National Cancer Institute, 9609 Medical Center Drive...), which initiates a coordinated approach to multidisciplinary care. The web-based, organizational survey...

  17. Outcomes of Childhood Asthma and Wheezy Bronchitis. A 50-Year Cohort Study.

    Science.gov (United States)

    Tagiyeva, Nara; Devereux, Graham; Fielding, Shona; Turner, Stephen; Douglas, Graham

    2016-01-01

    Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD. To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade. A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used. FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73-10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12-2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline. Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.

  18. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    Full Text Available Sexual abuse is defined as use of child or adolescent by the adults for satisfying of sexual urges and needs with forcing, threatening or tricking. Sexual abuse can be in the form of sexual abuse without touch, sexual touch, interfemoral intercourse, sexual penetration, and sexual exploitation. The prevalence of sexual abuse is reported as 10-40%. It is seen in female four times more than in males. Abusers are frequently male, only 5-15% of them are female. The abuse by females is usually towards male child. Thirty-fifty percent of abuse cases among child and adolescent are outside the family including strangers or familiar person. Some features of abusers are introvert personality, pedophilic and antisocial personality. Most of the abusers have a history of sexual abuse or aggression during childhood. Sexual intercourse between two people who are not allowed to marry by law is called as incest. Family pattern of incest is defined globally as disorganized and dysfunctional. The most commonly reported familial pattern is rigid and patriarchal family pattern with a harsh father using force quite frequently. The clinical features and impacts of the sexual abuse on the child varies according to the relation between abusers and the child, form of abuse, duration of abuse, presence of physical assault, developmental phase, child age and psychological development before the abuse. Sexual abuse history may result in psychiatric disorders including anxiety, depression, substance dependence, suicide act, borderline personality disorder, posttraumatic stress disorder. Abuse negatively affects interpersonal relationships and self esteem of abused individuals. Several studies reported close association between risky sexual behaviors in adulthood and a history of of sexual abuse during childhood. Four traumatic dynamics including traumatic sexuality with abuse, feeling of betrayal, weakness, and stigmatization exist in childhood abuse. Trauma can cause

  19. [Childhood periodic syndromes].

    Science.gov (United States)

    Cuvellier, J-C; Lépine, A

    2010-01-01

    This review focuses on the so-called "periodic syndromes of childhood that are precursors to migraine", as included in the Second Edition of the International Classification of Headache Disorders. Three periodic syndromes of childhood are included in the Second Edition of the International Classification of Headache Disorders: abdominal migraine, cyclic vomiting syndrome and benign paroxysmal vertigo, and a fourth, benign paroxysmal torticollis is presented in the Appendix. The key clinical features of this group of disorders are the episodic pattern and intervals of complete health. Episodes of benign paroxysmal torticollis begin between 2 and 8 months of age. Attacks are characterized by an abnormal inclination and/or rotation of the head to one side, due to cervical dystonia. They usually resolve by 5 years. Benign paroxysmal vertigo presents as sudden attacks of vertigo, accompanied by inability to stand without support, and lasting seconds to minutes. Age at onset is between 2 and 4 years, and the symptoms disappear by the age of 5. Cyclic vomiting syndrome is characterized in young infants and children by repeated stereotyped episodes of pernicious vomiting, at times to the point of dehydration, and impacting quality of life. Mean age of onset is 5 years. Abdominal migraine remains a controversial issue and presents in childhood with repeated stereotyped episodes of unexplained abdominal pain, nausea and vomiting occurring in the absence of headache. Mean age of onset is 7 years. Both cyclic vomiting syndrome and abdominal migraine are noted for the absence of pathognomonic clinical features but also for the large number of other conditions to be considered in their differential diagnoses. Diagnostic criteria, such as those of the Second Edition of the International Classification of Headache Disorders and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, have made diagnostic approach and management easier. Their diagnosis

  20. Establishment of peak bone mass.

    Science.gov (United States)

    Mora, Stefano; Gilsanz, Vicente

    2003-03-01

    Among the main areas of progress in osteoporosis research during the last decade or so are the general recognition that this condition, which is the cause of so much pain in the elderly population, has its antecedents in childhood and the identification of the structural basis accounting for much of the differences in bone strength among humans. Nevertheless, current understanding of the bone mineral accrual process is far from complete. The search for genes that regulate bone mass acquisition is ongoing, and current results are not sufficient to identify subjects at risk. However, there is solid evidence that BMD measurements can be helpful for the selection of subjects that presumably would benefit from preventive interventions. The questions regarding the type of preventive interventions, their magnitude, and duration remain unanswered. Carefully designed controlled trials are needed. Nevertheless, previous experience indicates that weight-bearing activity and possibly calcium supplements are beneficial if they are begun during childhood and preferably before the onset of puberty. Modification of unhealthy lifestyles and increments in exercise or calcium assumption are logical interventions that should be implemented to improve bone mass gains in all children and adolescents who are at risk of failing to achieve an optimal peak bone mass.