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

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

Multidisciplinary Optimization of a Transport Aircraft Wing using Particle Swarm Optimization

Science.gov (United States)

Sobieszczanski-Sobieski, Jaroslaw; Venter, Gerhard

2002-01-01

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

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...

Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.

Science.gov (United States)

Rice, Simon M; Simmons, Magenta B; Bailey, Alan P; Parker, Alexandra G; Hetrick, Sarah E; Davey, Christopher G; Phelan, Mark; Blaikie, Simon; Edwards, Jane

2014-01-01

There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.

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

Science.gov (United States)

Yelamarthi, Kumar

2012-01-01

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

The Use of Psychotropic Medication for People with Intellectual Disabilities and Behaviours That Challenge in the Context of a Community Multidisciplinary Team Approach

Science.gov (United States)

Niven, Abigail; Goodey, Rebecca; Webb, Alison; Shankar, Rohit

2018-01-01

Background: The use of psychotropic medication to manage challenging behaviours of people with intellectual disabilities is a contentious issue which NHS England has now focused on. This paper looks to evaluate this within the multidisciplinary context. Method: Records of clients (n = 106) open to a Community Intellectual Disabilities team for…

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.

A Case Study of a Co-Instructed Multidisciplinary Senior Capstone Project in Sustainability

Science.gov (United States)

Rhee, Jinny; Oyamot, Clifton; Parent, David; Speer, Leslie; Basu, Anuradha; Gerston, Larry

2014-01-01

As societal challenges involving sustainable development increase, the need to effectively integrate this inherently multidisciplinary topic into existing curricula becomes more pressing. Multidisciplinary, team-taught, project-based instruction has shown effectiveness in teaching teamwork, communication, and life-long learning skills, and…

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.

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.

Nanoscale control of energy and matter: challenges and opportunities for plasma science

International Nuclear Information System (INIS)

Ostrikov, Kostya

2013-01-01

Multidisciplinary challenges and opportunities in the ultimate ability to achieve nanoscale control of energy and matter are discussed using an example of the Plasma Nanoscience. This is an emerging multidisciplinary research field at the cutting edge of a large number of disciplines including but not limited to physics and chemistry of plasmas and gas discharges, materials science, surface science, nanoscience and nanotechnology, solid state physics, space physics and astrophysics, photonics, optics, plasmonics, spintronics, quantum information, physical chemistry, biomedical sciences and related engineering subjects. The origin, progress and future perspectives of this research field driven by the global scientific and societal challenges, is examined. The future potential of the Plasma Nanoscience to remain as a highly topical area in the global research and technological agenda in the Age of Fundamental-Level Control for a Sustainable Future is assessed using a framework of the five Grand Challenges for Basic Energy Sciences recently mapped by the US Department of Energy. It is concluded that the ongoing research is very relevant and is expected to substantially expand to competitively contribute to the solution of all of these Grand Challenges. The approach to control energy and matter at nano- and subnanoscales is based on identifying the prevailing carriers and transfer mechanisms of the energy and matter at the spatial and temporal scales that are most relevant to any particular nanofabrication process. Strong accent is made on the competitive edge of the plasma-based nanotechnology in applications related to the major socio-economic issues (energy, food, water, health and environment) that are crucial for a sustainable development of humankind. Several important emerging topics, opportunities and multidisciplinary synergies for the Plasma Nanoscience are highlighted. The main nanosafety issues are also discussed and the environment- and human health

Rootstock breeding in Prunus species: Ongoing efforts and new challenges

Directory of Open Access Journals (Sweden)

Felipe Gainza

2015-08-01

Full Text Available The current global agricultural challenges imply the need to generate new technologies and farming systems. In this context, rootstocks are an essential component in modern agriculture. Most currently used are those clonally propagated and there are several ongoing efforts to develop this type of plant material. Despite this tendency, lesser number of rootstock breeding programs exists in comparison to the large number of breeding programs for scion cultivars. In the case of rootstocks, traits evaluated in new selection lines are quite different: From the agronomic standpoint vigor is a key issue in order to establish high-density orchards. Other important agronomic traits include compatibility with a wide spectrum of cultivars from different species, good tolerance to root hypoxia, water use efficiency, aptitude to extract or exclude certain soil nutrients, and tolerance to soil or water salinity. Biotic stresses are also important: Resistance/tolerance to pests and diseases, such as nematodes, soil-borne fungi, crown gall, bacterial canker, and several virus, viroids, and phytoplasms. In this sense, the creation of new rootstocks at Centro de Estudios Avanzados en Fruticultura (CEAF offers an alternative to stone fruit crop, particularly in Chile, where just a few alternatives are commercially available, and there are site-specific problems. The implementation of molecular markers in order to give support to the phenotypic evaluation of plant breeding has great potential assisting the selection of new genotypes of rootstocks. Marker-Assisted Selection (MAS can shorten the time required to obtain new cultivars and can make the process more cost-effective than selection based exclusively on phenotype, but more basic research is needed to well understood the molecular and physiological mechanisms behind the studied trait.

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

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

Exploring Electrochromics: A Series of Eye-Catching Experiments to Introduce Students to Multidisciplinary Research

Science.gov (United States)

Small, Leo J.; Wolf, Steven; Spoerke, Erik D.

2014-01-01

Introducing students to a multidisciplinary research laboratory presents challenges in terms of learning specific technical skills and concepts but also with respect to integrating different technical elements to form a coherent picture of the research. Here we present a multidisciplinary series of experiments we have developed in the Electronic,…

Prostate cancer diagnostics: Clinical challenges and the ongoing need for disruptive and effective diagnostic tools.

Science.gov (United States)

Sharma, Shikha; Zapatero-Rodríguez, Julia; O'Kennedy, Richard

The increased incidence and the significant health burden associated with carcinoma of the prostate have led to substantial changes in its diagnosis over the past century. Despite technological advancements, the management of prostate cancer has become progressively more complex and controversial for both early and late-stage disease. The limitations and potential harms associated with the use of prostate-specific antigen (PSA) as a diagnostic marker have stimulated significant investigation of numerous novel biomarkers that demonstrate varying capacities to detect prostate cancer and can decrease unnecessary biopsies. However, only a few of these markers have been approved for specific clinical settings while the others have not been adequately validated for use. This review systematically and critically assesses ongoing issues and emerging challenges in the current state of prostate cancer diagnostic tools and the need for disruptive next generation tools based on analysis of combinations of these biomarkers to enhance predictive accuracy which will benefit clinical diagnostics and patient welfare. Copyright © 2016. Published by Elsevier Inc.

Making and Operating Molecular Machines: A Multidisciplinary Challenge.

Science.gov (United States)

Baroncini, Massimo; Casimiro, Lorenzo; de Vet, Christiaan; Groppi, Jessica; Silvi, Serena; Credi, Alberto

2018-02-01

Movement is one of the central attributes of life, and a key feature in many technological processes. While artificial motion is typically provided by macroscopic engines powered by internal combustion or electrical energy, movement in living organisms is produced by machines and motors of molecular size that typically exploit the energy of chemical fuels at ambient temperature to generate forces and ultimately execute functions. The progress in several areas of chemistry, together with an improved understanding of biomolecular machines, has led to the development of a large variety of wholly synthetic molecular machines. These systems have the potential to bring about radical innovations in several areas of technology and medicine. In this Minireview, we discuss, with the help of a few examples, the multidisciplinary aspects of research on artificial molecular machines and highlight its translational character.

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.;

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

Fascioliasis: An Ongoing Zoonotic Trematode Infection.

Science.gov (United States)

Nyindo, Mramba; Lukambagire, Abdul-Hamid

2015-01-01

Zoonotic trematode infections are an area of the neglected tropical diseases that have become of major interest to global and public health due to their associated morbidity. Human fascioliasis is a trematode zoonosis of interest in public health. It affects approximately 50 million people worldwide and over 180 million are at risk of infection in both developed and underdeveloped countries. The one health paradigm is an area that seeks to address the problem of zoonotic infections through a comprehensive and sustainable approach. This review attempts to address the major challenges in managing human and animal fascioliasis with valuable insights gained from the one health paradigm to global health and multidisciplinary integration.

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease.

Science.gov (United States)

Rizzello, Fernando; Olivieri, Ignazio; Armuzzi, Alessandro; Ayala, Fabio; Bettoli, Vincenzo; Bianchi, Luca; Cimino, Luca; Costanzo, Antonio; Cristaudo, Antonio; D'Angelo, Salvatore; Daperno, Marco; Fostini, Anna Chiara; Galeazzi, Mauro; Gilio, Michele; Gionchetti, Paolo; Gisondi, Paolo; Lubrano, Ennio; Marchesoni, Antonio; Offidani, Annamaria; Orlando, Ambrogio; Pugliese, Daniela; Salvarani, Carlo; Scarpa, Raffaele; Vecchi, Maurizio; Girolomoni, Giampiero

2018-04-01

Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis and uveitis. A Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements. Consensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important. The present Delphi consensus identified a set of

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.

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.

Fascioliasis: An Ongoing Zoonotic Trematode Infection

Science.gov (United States)

Nyindo, Mramba; Lukambagire, Abdul-Hamid

2015-01-01

Zoonotic trematode infections are an area of the neglected tropical diseases that have become of major interest to global and public health due to their associated morbidity. Human fascioliasis is a trematode zoonosis of interest in public health. It affects approximately 50 million people worldwide and over 180 million are at risk of infection in both developed and underdeveloped countries. The one health paradigm is an area that seeks to address the problem of zoonotic infections through a comprehensive and sustainable approach. This review attempts to address the major challenges in managing human and animal fascioliasis with valuable insights gained from the one health paradigm to global health and multidisciplinary integration. PMID:26417603

Integrated, Multidisciplinary and Technology-Enhanced Science Education: The Next Frontier

OpenAIRE

Dinov, Ivo D.

2008-01-01

Contemporary science education at all levels presents several critical pedagogical and social challenges to educators and learners alike. Among these challenges are the widening Intergenerational Information Technology (IIT) divide and the need for a comprehensive and balanced multidisciplinary training. In the past few years, it has become clear that one significant hurdle impedes the efforts to integrate information technology in the classroom – the Intergenerational IT divide. The IIT gap ...

Multidisciplinary Design Optimization Techniques: Implications and Opportunities for Fluid Dynamics Research

Science.gov (United States)

Zang, Thomas A.; Green, Lawrence L.

1999-01-01

A challenge for the fluid dynamics community is to adapt to and exploit the trend towards greater multidisciplinary focus in research and technology. The past decade has witnessed substantial growth in the research field of Multidisciplinary Design Optimization (MDO). MDO is a methodology for the design of complex engineering systems and subsystems that coherently exploits the synergism of mutually interacting phenomena. As evidenced by the papers, which appear in the biannual AIAA/USAF/NASA/ISSMO Symposia on Multidisciplinary Analysis and Optimization, the MDO technical community focuses on vehicle and system design issues. This paper provides an overview of the MDO technology field from a fluid dynamics perspective, giving emphasis to suggestions of specific applications of recent MDO technologies that can enhance fluid dynamics research itself across the spectrum, from basic flow physics to full configuration aerodynamics.

Environmental impact of ongoing sources of metal contamination on remediated sediments

Energy Technology Data Exchange (ETDEWEB)

Knox, Anna Sophia, E-mail: anna.knox@srn.doe.gov [Savannah River National Laboratory, Aiken, SC 29808 (United States); Paller, Michael H., E-mail: michael.paller@srnl.doe.gov [Savannah River National Laboratory, Aiken, SC 29808 (United States); Milliken, Charles E., E-mail: charles.milliken@srnl.doe.gov [Savannah River National Laboratory, Aiken, SC 29808 (United States); Redder, Todd M., E-mail: tredder@limno.com [LimnoTech, Ann Arbor, Minnesota 48108 (United States); Wolfe, John R., E-mail: jwolfe@limno.com [LimnoTech, Ann Arbor, Minnesota 48108 (United States); Seaman, John, E-mail: seaman@srel.uga.edu [Savannah River Ecology Laboratory, University of Georgia, Aiken, SC 29802 (United States)

2016-09-01

A challenge to all remedial approaches for contaminated sediments is the continued influx of contaminants from uncontrolled sources following remediation. We investigated the effects of ongoing contamination in mesocosms employing sediments remediated by different types of active and passive caps and in-situ treatment. Our hypothesis was that the sequestering agents used in active caps and in situ treatment will bind elements (arsenic, chromium, cadmium, cobalt, copper, nickel, lead, selenium, and zinc) from ongoing sources thereby reducing their bioavailability and protecting underlying remediated sediments from recontamination. Most element concentrations in surface water remained significantly lower in mesocosms with apatite and mixed amendment caps than in mesocosms with passive caps (sand), uncapped sediment, and spike solution throughout the 2520 h experiment. Element concentrations were significantly higher in Lumbriculus variegatus from untreated sediment than in Lumbriculus from most active caps. Pearson correlations between element concentrations in Lumbriculus and metal concentrations in the top 2.5 cm of sediment or cap measured by diffusive gradient in thin films (DGT) sediment probes were generally strong (as high as 0.98) and significant (p < 0.05) for almost all tested elements. Metal concentrations in both Lumbriculus and sediment/cap were lowest in apatite, mixed amendment, and activated carbon treatments. These findings show that some active caps can protect remediated sediments by reducing the bioavailable pool of metals/metalloids in ongoing sources of contamination. - Graphical abstract: Conventional methods of remediating contaminated sediments may be inadequate for the protection of benthic organisms when ongoing sources of contamination are present. However, sediment caps with chemically active sequestering agents have the ability to reduce the bioavailable pool of metals in ongoing sources of contamination (red dots), reduce toxicity to

Environmental impact of ongoing sources of metal contamination on remediated sediments

International Nuclear Information System (INIS)

Knox, Anna Sophia; Paller, Michael H.; Milliken, Charles E.; Redder, Todd M.; Wolfe, John R.; Seaman, John

2016-01-01

A challenge to all remedial approaches for contaminated sediments is the continued influx of contaminants from uncontrolled sources following remediation. We investigated the effects of ongoing contamination in mesocosms employing sediments remediated by different types of active and passive caps and in-situ treatment. Our hypothesis was that the sequestering agents used in active caps and in situ treatment will bind elements (arsenic, chromium, cadmium, cobalt, copper, nickel, lead, selenium, and zinc) from ongoing sources thereby reducing their bioavailability and protecting underlying remediated sediments from recontamination. Most element concentrations in surface water remained significantly lower in mesocosms with apatite and mixed amendment caps than in mesocosms with passive caps (sand), uncapped sediment, and spike solution throughout the 2520 h experiment. Element concentrations were significantly higher in Lumbriculus variegatus from untreated sediment than in Lumbriculus from most active caps. Pearson correlations between element concentrations in Lumbriculus and metal concentrations in the top 2.5 cm of sediment or cap measured by diffusive gradient in thin films (DGT) sediment probes were generally strong (as high as 0.98) and significant (p < 0.05) for almost all tested elements. Metal concentrations in both Lumbriculus and sediment/cap were lowest in apatite, mixed amendment, and activated carbon treatments. These findings show that some active caps can protect remediated sediments by reducing the bioavailable pool of metals/metalloids in ongoing sources of contamination. - Graphical abstract: Conventional methods of remediating contaminated sediments may be inadequate for the protection of benthic organisms when ongoing sources of contamination are present. However, sediment caps with chemically active sequestering agents have the ability to reduce the bioavailable pool of metals in ongoing sources of contamination (red dots), reduce toxicity to

Bio-Nanotechnology: Challenges for Trainees in a Multidisciplinary Research Program

Science.gov (United States)

Koehne, Jessica Erin

2009-01-01

The recent developments in the field of nanotechnology have provided scientists with a new set of nanoscale materials, tools and devices in which to investigate the biological science thus creating the mulitdisciplinary field of bio-nanotechnology. Bio-nanotechnology merges the biological sciences with other scientific disciplines ranging from chemistry to engineering. Todays students must have a working knowledge of a variety of scientific disciplines in order to be successful in this new field of study. This talk will provide insight into the issue of multidisciplinary education from the perspective of a graduate student working in the field of bio-nanotechnology. From the classes we take to the research we perform, how does the modern graduate student attain the training required to succeed in this field?

Gaucher disease: Progress and ongoing challenges.

Science.gov (United States)

Mistry, Pramod K; Lopez, Grisel; Schiffmann, Raphael; Barton, Norman W; Weinreb, Neal J; Sidransky, Ellen

Over the past decades, tremendous progress has been made in the field of Gaucher disease, the inherited deficiency of the lysosomal enzyme glucocerebrosidase. Many of the colossal achievements took place during the course of the sixty-year tenure of Dr. Roscoe Brady at the National Institutes of Health. These include the recognition of the enzymatic defect involved, the isolation and characterization of the protein, the localization and characterization of the gene and its nearby pseudogene, as well as the identification of the first mutant alleles in patients. The first treatment for Gaucher disease, enzyme replacement therapy, was conceived of, developed and tested at the Clinical Center of the National Institutes of Health. Advances including recombinant production of the enzyme, the development of mouse models, pioneering gene therapy experiments, high throughput screens of small molecules and the generation of induced pluripotent stem cell models have all helped to catapult research in Gaucher disease into the twenty-first century. The appreciation that mutations in the glucocerebrosidase gene are an important risk factor for parkinsonism further expands the impact of this work. However, major challenges still remain, some of which are described here, that will provide opportunities, excitement and discovery for the next generations of Gaucher investigators. Published by Elsevier Inc.

Ethnobotany of Mallorca (Balearic islands): a multidisciplinary approach.

Science.gov (United States)

Carrió, Esperança; Vallès, Joan

2012-09-01

In this communication, we provide some basic methodological and practical ideas for plant knowledge comparisons among different predefined natural regions of the Mediterranean island of Mallorca, in the frame of an ongoing project in this area. The final goal of this work is to present a tool to find out to what extent plant knowledge is similar in the different regions. We use an uncommon approach to ethnobotanical studies in terms of multidisciplinary methodology. We base our arguments on social anthropology methods, using a diversity index (the Sorensen similarity coefficient), and we also explain the botanical part of the investigation. Our preliminary results reveal few differences among the three natural regions considered on the island, which we believe could find their explanation in geographic, botanical and cultural aspects.

The NASA Langley Multidisciplinary Uncertainty Quantification Challenge

Science.gov (United States)

Crespo, Luis G.; Kenny, Sean P.; Giesy, Daniel P.

2014-01-01

This paper presents the formulation of an uncertainty quantification challenge problem consisting of five subproblems. These problems focus on key aspects of uncertainty characterization, sensitivity analysis, uncertainty propagation, extreme-case analysis, and robust design.

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

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...

A multidisciplinary approach to team nursing within a low secure service: the team leader role.

Science.gov (United States)

Nagi, Claire; Davies, Jason; Williams, Marie; Roberts, Catherine; Lewis, Roger

2012-01-01

This article critically examines the clinical utility of redesigning a nursing practice model within the Intensive Support and Intervention Service, a new low secure mental health facility in the United Kingdom. Specifically, the "team nursing" approach to care delivery has been adapted to consist of multidisciplinary team leaders as opposed to nursing team leaders. The authors describe the role, properties, and functions of the multidisciplinary team leader approach. The authors provide examples of the benefits and challenges posed to date and the ways in which potential barriers have been overcome. Nursing care leadership can be provided by multidisciplinary staff. An adapted model of team nursing can be implemented in a low secure setting. © 2011 Wiley Periodicals, Inc.

Learning mechanisms in multidisciplinary teamwork with real customers and open-ended problems

Science.gov (United States)

Heikkinen, Juho; Isomöttönen, Ville

2015-11-01

Recently, there has been a trend towards adding a multidisciplinary or multicultural element to traditional monodisciplinary project courses in computing and engineering. In this article, we examine the implications of multidisciplinarity for students' learning experiences during a one-semester project course for real customers. We use a qualitative research approach and base our analysis on students' learning reports on three instances of a project course titled Multidisciplinary working life project. The main contribution of this article is the unified theoretical picture of the learning mechanisms stemming from multidisciplinarity. Our main conclusions are that (1) students generally have a positive view of multidisciplinarity; (2) multidisciplinary teams enable students to better identify their own expertise, which leads to increased occupational identity; and (3) learning experiences are not fixed, as team spirit and student attitude play an important role in how students react to challenging situations arising from introduction of the multidisciplinarity.

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

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.

On-Going Nuclear Physics and Technology Research Programmes in Europe

International Nuclear Information System (INIS)

Vaz, Pedro

2007-01-01

Innovative nuclear technology applications have emerged in recent years and triggered an unprecedented interest of different communities of scientists worldwide, concerned by the multidisciplinary scientific, technical and engineering aspects of such applications. ADS (Accelerator Driven Systems, for the transmutation of highly radiotoxic nuclear waste), EA (Energy Amplifiers, for the production of energy), Spallation Neutron Sources (for multiple applications such as in Bio-Sciences, Medicine, Material Science), Radioactive Ion Beams (of relevance for fundamental Nuclear Physics and Astrophysics, for applications in Medicine, amongst many others) are examples of applications that address a set of common multidisciplinary, leading edge and cross-cutting issues and research topics. Other applications being considered for High-Energy Physics purposes consist on facilities aiming at producing intense neutrino beams.The sustainability of nuclear energy as an economically competitive, environmentally friend and proliferation resistant technology to meet mankind's growing energy demand has imposed in recent years the consideration of new (Generation IV) or non-conventional types of nuclear reactors, operating with non-standard coolants, higher-energy neutron spectra, higher temperatures, amongst other issues. The safety and operational aspects of these nuclear energy systems share with the nuclear technology applications previously referred (ADS, EA, SNS, etc.) a set of common scientific and technical issues.In this paper, the scientific, technical and engineering topics and issues of relevance for the implementation and deployment of some of the systems previously described are briefly presented. A set of selected major on-going R and D programmes and experiments involving international collaborations of scientists and consortia of institutions are succinctly described

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.

Optic issues in ongoing ERL projects

International Nuclear Information System (INIS)

Smith, S.L.; Muratori, B.D.; Owen, H.L.; Hoffstaetter, G.H.; Litvinenko, V.N.; Ben-Zvi, I.; Bai, M.; Beebe-Wang, J.; Blaskiewicz, M.; Calaga, R.; Fischer, W.; Chang, X.Y.; Kayran, D.; Kewisch, J.; MacKay, W.W.; Montag, C.; Parker, B.; Ptitsyn, V.; Roser, T.; Ruggiero, A.; Satogata, T.; Surrow, B.; Tepikian, S.; Trbojevic, D.; Yakimenko, V.; Zhang, S.Y.; Piot, Ph.

2006-01-01

A wide range of optics issues for energy recovery linac (ERL)-based projects are illustrated through the presentation of ongoing projects covering both light sources, at Cornell and Daresbury and high energy and nuclear physics accelerators at the Brookhaven National Laboratory. This presented range of projects demonstrates how the different designs teams see the challenges of studying and solving optics issues for their particular project's ERLs, with studies appropriate to the stage of maturity of the project. Finally, as an illustration of the complexity and detail behind a single aspect of ERL optics design we present an overview of the highly important generic topic of longitudinal phase space evolution in ERLs

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...

What influences patient decision-making in amyotrophic lateral sclerosis multidisciplinary care? A study of patient perspectives.

Science.gov (United States)

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2012-01-01

Patients with amyotrophic lateral sclerosis (ALS) are required to make decisions concerning quality of life and symptom management over the course of their disease. Clinicians perceive that patients' ability to engage in timely decision-making is extremely challenging. However, we lack patient perspectives on this issue. This study aimed to explore patient experiences of ALS, and to identify factors influencing their decision-making in the specialized multidisciplinary care of ALS. An exploratory study was conducted. Fourteen patients from two specialized ALS multidisciplinary clinics participated in semistructured interviews that were audio recorded and transcribed. Data were analyzed for emergent themes. Decision-making was influenced by three levels of factors, ie, structural, interactional, and personal. The structural factor was the decision-making environment of specialized multidisciplinary ALS clinics, which supported decision-making by providing patients with disease-specific information and specialized care planning. Interactional factors were the patient experiences of ALS, including patients' reaction to the diagnosis, response to deterioration, and engagement with the multidisciplinary ALS team. Personal factors were patients' personal philosophies, including their outlook on life, perceptions of control, and planning for the future. Patient approaches to decision-making reflected a focus on the present, rather than anticipating future progression of the disease and potential care needs. Decision-making for symptom management and quality of life in ALS care is enhanced when the patient's personal philosophy is supported by collaborative relationships between the patient and the multidisciplinary ALS team. Patients valued the support provided by the multidisciplinary team; however, their focus on living in the present diverged from the efforts of health professionals to prepare patients and their carers for the future. The challenge facing health

Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results.

Science.gov (United States)

Huber, Stephan; Priebe, Janosch A; Baumann, Kaja-Maria; Plidschun, Anne; Schiessl, Christine; Tölle, Thomas R

2017-12-04

Even though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases. The objective of this paper was to report on the retrospective short-term results of a digital multidisciplinary pain app for the treatment of LBP. Kaia is a mobile app that digitalizes multidisciplinary pain treatment and is in the market as a medical product class I. For the current study, the data of anonymized Kaia users was retrospectively analyzed. User data were evaluated for 12 weeks regarding duration of use and effect on in-app user reported pain levels, using the numerical rating scale (NRS), depending on whether LBP was classified as acute, subacute, or chronic back pain according to current guidelines. Data of 180 users were available. The mean age of the users was 33.9 years (SD 10.9). Pain levels decreased from baseline NRS 4.8 to 3.75 for all users at the end of the observation period. Users who completed 4, 8, or 12 weeks showed an even more pronounced decrease in pain level NRS (baseline 4.9 [SD 1.7] versus 3.6 [SD 1.5] at 4 weeks; baseline 4.7 [SD 1.8] versus 3.2 [SD [2.0] at 8 weeks; baseline 4.6 [SD 2.2] versus 2.6 [SD 2.0] at 12 weeks). In addition, subgroup analysis of acute, subacute, or chronic classification revealed no significant main effect of group (P>.30) on the reduction of pain. Conclusions: This retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective randomized controlled trials (RCTs) will adjust for potential bias and selection effects. This retrospective study showed that in a pre

Development of a brief multidisciplinary education programme for patients with osteoarthritis

Directory of Open Access Journals (Sweden)

Moe Rikke H

2011-11-01

questions are addressed. As part of an ongoing process, a patient representative regularly attends the MEP and gives feedback concerning content and perceived value. Conclusion A MEP has been developed to enhance self-management in patients with OA attending a multidisciplinary OA outpatient clinic. The effectiveness of the MEP followed by individual consultations with members of the multidisciplinary team is currently evaluated in a randomised controlled trial with respect to patient satisfaction and functioning.

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

Perceived Benefits and Challenges of a Risk-Based Approach to Multidisciplinary Chronic Kidney Disease Care: A Qualitative Descriptive Study.

Science.gov (United States)

Smekal, Michelle D; Tam-Tham, Helen; Finlay, Juli; Donald, Maoliosa; Benterud, Eleanor; Thomas, Chandra; Quinn, Robert R; Tam, Kin; Manns, Braden J; Tonelli, Marcello; Bello, Aminu; Tangri, Navdeep; Hemmelgarn, Brenda R

2018-01-01

The kidney failure risk equation (KFRE) provides an estimate of risk of progression to kidney failure, and may guide clinical care. We aimed to describe patient, family, and health care provider's perspectives of the perceived benefits and challenges of using a risk-based approach to guide care delivery for patients with advanced chronic kidney disease (CKD), and refine implementation based on their input. We used qualitative methodology to explore perceived benefits and challenges of implementing a risk-based approach (using the KFRE) to determine eligibility for multidisciplinary CKD care in Southern Alberta. We obtained perspectives from patients and families through focus groups, as well as input from health care providers through interviews and open-ended responses from an online survey. Twelve patients/family members participated in 2 focus groups, 16 health care providers participated in an interview, and 40 health care providers responded to the survey. Overall, participants felt that a KFRE-based approach had the potential to improve efficiency of the clinics by targeting care to patients at highest risk of kidney failure; however, they also expressed concerns about the impact of loss of services for lower risk individuals. Participants also articulated concerns about a perceived lack of capacity for adequate CKD patient care in the community. Our implementation strategy was modified as a result of participants' feedback. We identified benefits and challenges to implementation of a risk-based approach to guide care of patients with advanced CKD. Based on these results, our implementation strategy has been modified by removing the category of referral back to primary care alone, and instead having that decision made jointly by nephrologists and patients among low-risk patients.

Status of the ELIMED multidisciplinary and medical beam-line at ELI-Beamlines

International Nuclear Information System (INIS)

Romano, F; Cirrone, G A P; Cuttone, G; Schillaci, F; Scuderi, V; Amico, A; Candiano, G; Larosa, G; Leanza, R; Manna, R; Marchese, V; Milluzzo, G; Petringa, G; Pipek, J; Giordanengo, S; Guarachi, L F; Marchetto, F; Sacchi, R; Korn, G; Margarone, D

2017-01-01

Nowadays, one of the biggest challenges consists in using high intensity laser-target interaction to generate high-energy ions for medical purposes, eventually replacing the old paradigm of acceleration characterized by huge and complex machines. In order to investigate the feasibility of using laser-driven ion beams for multidisciplinary application, a dedicated beam transport line will be installed at the ELI-Beamlines facility in Prague (CZ), as a part of the User-oriented ELIMAIA beam-line dedicated to ion acceleration and their potential applications. The beam-line section dedicated to transport and dosimetric endpoints is called ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) and will be developed by the INFN-LNS. (paper)

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.)

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

Getting a Cohesive Answer from a Common Start: Scalable Multidisciplinary Analysis through Transformation of a System Model

Science.gov (United States)

Cole, Bjorn; Chung, Seung H.

2012-01-01

One of the challenges of systems engineering is in working multidisciplinary problems in a cohesive manner. When planning analysis of these problems, system engineers must tradeoff time and cost for analysis quality and quantity. The quality is associated with the fidelity of the multidisciplinary models and the quantity is associated with the design space that can be analyzed. The tradeoff is due to the resource intensive process of creating a cohesive multidisciplinary system model and analysis. Furthermore, reuse or extension of the models used in one stage of a product life cycle for another is a major challenge. Recent developments have enabled a much less resource-intensive and more rigorous approach than handwritten translation scripts or codes of multidisciplinary models and their analyses. The key is to work from a core system model defined in a MOF-based language such as SysML and in leveraging the emerging tool ecosystem, such as Query-View- Transform (QVT), from the OMG community. SysML was designed to model multidisciplinary systems and analyses. The QVT standard was designed to transform SysML models. The Europa Hability Mission (EHM) team has begun to exploit these capabilities. In one case, a Matlab/Simulink model is generated on the fly from a system description for power analysis written in SysML. In a more general case, a symbolic mathematical framework (supported by Wolfram Mathematica) is coordinated by data objects transformed from the system model, enabling extremely flexible and powerful tradespace exploration and analytical investigations of expected system performance.

Getting a Cohesive Answer from a Common Start: Scalable Multidisciplinary Analysis through Transformation of a Systems Model

Science.gov (United States)

Cole, Bjorn; Chung, Seung

2012-01-01

One of the challenges of systems engineering is in working multidisciplinary problems in a cohesive manner. When planning analysis of these problems, system engineers must trade between time and cost for analysis quality and quantity. The quality often correlates with greater run time in multidisciplinary models and the quantity is associated with the number of alternatives that can be analyzed. The trade-off is due to the resource intensive process of creating a cohesive multidisciplinary systems model and analysis. Furthermore, reuse or extension of the models used in one stage of a product life cycle for another is a major challenge. Recent developments have enabled a much less resource-intensive and more rigorous approach than hand-written translation scripts between multi-disciplinary models and their analyses. The key is to work from a core systems model defined in a MOF-based language such as SysML and in leveraging the emerging tool ecosystem, such as Query/View/Transformation (QVT), from the OMG community. SysML was designed to model multidisciplinary systems. The QVT standard was designed to transform SysML models into other models, including those leveraged by engineering analyses. The Europa Habitability Mission (EHM) team has begun to exploit these capabilities. In one case, a Matlab/Simulink model is generated on the fly from a system description for power analysis written in SysML. In a more general case, symbolic analysis (supported by Wolfram Mathematica) is coordinated by data objects transformed from the systems model, enabling extremely flexible and powerful design exploration and analytical investigations of expected system performance.

Exploring Forms of Triangulation to Facilitate Collaborative Research Practice: Reflections From a Multidisciplinary Research Group

Directory of Open Access Journals (Sweden)

Tarja Tiainen

2006-10-01

Full Text Available This article contains critical reflections of a multidisciplinary research group studying the human and technological dynamics around some newly offered electronic services in a specific rural area of Finland. For their research, the group adopted ethnography. On facing the challenges of doing ethnographic research in a multidisciplinary setting, the group evolved its own breed of research practice based on multiple forms of triangulation. This implied the use of multiple data sources, methods, theories, and researchers, in different combinations. One of the outcomes of the work is a model for collaborative research. It highlights, among others, the importance of creating a climate for collaboration within the research group and following a process of individual and collaborative writing to achieve the potential benefits of such research. The article also identifies a set of remaining challenges relevant to collaborative research.

Teacher perspectives on science literacy in multilingual classrooms –multidisciplinary explorations

DEFF Research Database (Denmark)

Hajer, Maaike; Nielsen, Birgitte Lund; Tytler, Russell

using Clarke & Hollingworth (2002) (referred to as C&H) model for analyzing teacher development as connections between teachers personal domain of knowledge and beliefs, practice domain of experimenting in the classroom, domain of consequence including salient student outcomes and the external domain...... that requires multidisciplinary cooperation. The Swedish Science and Literacy Teaching (SALT)project focuses on the questions How do science teachers address literacy skills in classes with secondary students in a multilingual classroom? and How can an explicit focus on literacy development become an integrated...... part of science teachers’ practice and thinking? The multidisciplinary team includes expertise in applied linguistics (text analysis, second language teaching), science pedagogy and teacher professional development. Having gathered the SALT data, the challenge in this phase is in the analysis. How can...

What influences patient decision-making in amyotrophic lateral sclerosis multidisciplinary care? A study of patient perspectives

Directory of Open Access Journals (Sweden)

Hogden A

2012-11-01

Full Text Available Anne Hogden,1 David Greenfield,1 Peter Nugus,1 Matthew C Kiernan21Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, 2Prince of Wales Clinical School, University of New South Wales, and Neuroscience Research Australia, Sydney, New South Wales, AustraliaBackground: Patients with amyotrophic lateral sclerosis (ALS are required to make decisions concerning quality of life and symptom management over the course of their disease. Clinicians perceive that patients’ ability to engage in timely decision-making is extremely challenging. However, we lack patient perspectives on this issue. This study aimed to explore patient experiences of ALS, and to identify factors influencing their decision-making in the specialized multidisciplinary care of ALS.Methods: An exploratory study was conducted. Fourteen patients from two specialized ALS multidisciplinary clinics participated in semistructured interviews that were audio recorded and transcribed. Data were analyzed for emergent themes.Results: Decision-making was influenced by three levels of factors, ie, structural, interactional, and personal. The structural factor was the decision-making environment of specialized multidisciplinary ALS clinics, which supported decision-making by providing patients with disease-specific information and specialized care planning. Interactional factors were the patient experiences of ALS, including patients’ reaction to the diagnosis, response to deterioration, and engagement with the multidisciplinary ALS team. Personal factors were patients’ personal philosophies, including their outlook on life, perceptions of control, and planning for the future. Patient approaches to decision-making reflected a focus on the present, rather than anticipating future progression of the disease and potential care needs.Conclusion: Decision-making for symptom management and quality of life in ALS care is enhanced when the

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.

Mimicking Bone - Chemical and Physical Challenges

Directory of Open Access Journals (Sweden)

Sophie C Cox

2014-08-01

Full Text Available It is known that chemical and physical features of bone contribute to its functionality, reactivity and mechanical performance. This fundamental rationale underpins the author’s research strategy. This paper presents a summary of efforts to fabricate a synthetic structure, referred to as a scaffold, that both chemically and physical emulates the intricate structure of bone. An understanding of key features of bone tissue that contribute to its remarkable properties is presented as a background to this work. Novel work aimed at improving the understanding of the synthesis of a ceramic biomaterial, namely hydroxyapatite, that is chemically similar to bone mineral is discussed. A case study involving the manufacture of porous scaffolds by 3D printing is also presented. In summary, this article highlights a number of on-going challenges that multidisciplinary tissue engineers aim to solve to get one step closer to mimicking bone, which clinically could improve the quality of life for millions of people worldwide.    Photo credit: By Doc. RNDr. Josef Reischig, CSc. (Author's archive [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0], via Wikimedia Commons

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.

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.

Control of energy and matter at nanoscales: challenges and opportunities for plasma nanoscience in a sustainability age

International Nuclear Information System (INIS)

Ostrikov, Kostya

2011-01-01

Plasma nanoscience is an emerging multidisciplinary research field at the cutting edge of a large number of disciplines including but not limited to physics and chemistry of plasmas and gas discharges, materials science, surface science, nanoscience and nanotechnology, solid-state physics, space physics and astrophysics, photonics, optics, plasmonics, spintronics, quantum information, physical chemistry, biomedical sciences and related engineering subjects. This paper examines the origin, progress and future perspectives of this research field driven by the global scientific and societal challenges. The future potential of plasma nanoscience to remain a highly topical area in the global research and technological agenda in the age of fundamental-level control for a sustainable future is assessed using a framework of the five Grand Challenges for Basic Energy Sciences recently mapped by the US Department of Energy. It is concluded that the ongoing research is very relevant and is expected to substantially expand to competitively contribute to the solution of all of these Grand Challenges. The approach to controlling energy and matter at nano- and subnanoscales is based on identifying the prevailing carriers and transfer mechanisms of the energy and matter at the spatial and temporal scales that are most relevant to any particular nanofabrication process. Strong accent is made on the competitive edge of the plasma-based nanotechnology in applications related to the major socio-economic issues (energy, food, water, health and environment) that are crucial for a sustainable development of humankind. Several important emerging topics, opportunities and multidisciplinary synergies for plasma nanoscience are highlighted. The main nanosafety issues are also discussed and the environment- and human health-friendly features of plasma-based nanotech are emphasized.

Control of energy and matter at nanoscales: challenges and opportunities for plasma nanoscience in a sustainability age

Science.gov (United States)

(Ken Ostrikov, Kostya

2011-05-01

Plasma nanoscience is an emerging multidisciplinary research field at the cutting edge of a large number of disciplines including but not limited to physics and chemistry of plasmas and gas discharges, materials science, surface science, nanoscience and nanotechnology, solid-state physics, space physics and astrophysics, photonics, optics, plasmonics, spintronics, quantum information, physical chemistry, biomedical sciences and related engineering subjects. This paper examines the origin, progress and future perspectives of this research field driven by the global scientific and societal challenges. The future potential of plasma nanoscience to remain a highly topical area in the global research and technological agenda in the age of fundamental-level control for a sustainable future is assessed using a framework of the five Grand Challenges for Basic Energy Sciences recently mapped by the US Department of Energy. It is concluded that the ongoing research is very relevant and is expected to substantially expand to competitively contribute to the solution of all of these Grand Challenges. The approach to controlling energy and matter at nano- and subnanoscales is based on identifying the prevailing carriers and transfer mechanisms of the energy and matter at the spatial and temporal scales that are most relevant to any particular nanofabrication process. Strong accent is made on the competitive edge of the plasma-based nanotechnology in applications related to the major socio-economic issues (energy, food, water, health and environment) that are crucial for a sustainable development of humankind. Several important emerging topics, opportunities and multidisciplinary synergies for plasma nanoscience are highlighted. The main nanosafety issues are also discussed and the environment- and human health-friendly features of plasma-based nanotech are emphasized.

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…

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...

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.

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...

Canonical duality theory unified methodology for multidisciplinary study

CERN Document Server

Latorre, Vittorio; Ruan, Ning

2017-01-01

This book on canonical duality theory provides a comprehensive review of its philosophical origin, physics foundation, and mathematical statements in both finite- and infinite-dimensional spaces. A ground-breaking methodological theory, canonical duality theory can be used for modeling complex systems within a unified framework and for solving a large class of challenging problems in multidisciplinary fields in engineering, mathematics, and the sciences. This volume places a particular emphasis on canonical duality theory’s role in bridging the gap between non-convex analysis/mechanics and global optimization.  With 18 total chapters written by experts in their fields, this volume provides a nonconventional theory for unified understanding of the fundamental difficulties in large deformation mechanics, bifurcation/chaos in nonlinear science, and the NP-hard problems in global optimization. Additionally, readers will find a unified methodology and powerful algorithms for solving challenging problems in comp...

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.

Mathematical sciences with multidisciplinary applications in honor of professor Christiane Rousseau and in recognition of the Mathematics for Planet Earth initiative

CERN Document Server

2016-01-01

This book is the fourth in a multidisciplinary series which brings together leading researchers in the STEAM-H disciplines (Science, Technology, Engineering, Agriculture, Mathematics and Health) to present their perspective on advances in their own specific fields, and to generate a genuinely interdisciplinary collaboration that transcends parochial subject-matter boundaries. All contributions are carefully edited, peer-reviewed, reasonably self-contained, and pedagogically crafted for a multidisciplinary readership. Contributions are drawn from a variety of fields including mathematics, statistics, game theory and behavioral sciences, biomathematics and physical chemistry, computer science and human-centered computing. This volume is dedicated to Professor Christiane Rousseau, whose work inspires the STEAM-H series, in recognition of her passion for the mathematical sciences and her on-going initiative, the Mathematics of Planet Earth paradigm of interdisciplinarity. The volume's primary goal is to enhance i...

Infertility: Ongoing Global challenge of new millennium

Directory of Open Access Journals (Sweden)

Kantibhai Naranbhai Sonaliya

2016-06-01

Full Text Available Background: Infertility tends to be the global challenge even in the second decade of the new millennium. Especially in developing countries like India, it is still one the most lethal social evil responsible for a big proportion of cases of psychological disturbances including suicide. Again, recently, few conditions other than communicable or Non-communicable diseases are given place among the categories of significant public health problems like Road Traffic Accidents, Burns, Poisoning, drowning and few more. But, for developing countries like India, the list is incomplete without inclusion of Infertility (there may be several others also. In public health, tuberculosis, leprosy and some other diseases are considered social diseases which produce social stigma for the patients and/or his family members.1 In same manner, Infertility is an important cause of social stigmatization since centuries for a couple suffering from, especially for woman involved. During a transitory phase of industrialization and socio-economic development, the situation is changed a minute smidgen at urban areas of India but at rural parts, sub-urban or even at urban slums (mainly among pockets of recent migrants the situation is as same as a few hundred years ago. A female of no religion, caste, social status or higher level of education are barred from some stringent mores related to infertility. Infertile females are still not allowed to take part in so many religious or social ceremonies; on the contrary, they have to face more harassment including domestic violence than their counterparts, who have given birth to the child. Due to social, psychological, economic disturbances, they are forced to take multiple sorts of treatments including religious quacks. So many infertile women are exploited physically and economically also in such weird ways of treatment to gain a pregnancy.

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...

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.

GEOWOW: a drought scenario for multidisciplinary data access and use

Science.gov (United States)

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

2013-04-01

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

Proposal of a model for multidisciplinary treatment program of chronic migraine with medication overuse: preliminary study.

Science.gov (United States)

Grazzi, L; Prunesti, A; Bussone, G

2015-05-01

The treatment of patients with chronic migraine associated with medication overuse is challenging in clinical practice; different strategies of treatment have been recently developed, multidisciplinary treatment approaches have been developed in academic headache centers. Education and support of patients are necessary to improve patients' adherence to pharmacological treatments as well as to non-pharmacological therapies. This study reports a clinical experience conducted at our Headache center with a group of female patients, suffering from chronic migraine complicated by medication overuse, treated by a multidisciplinary approach and followed for a period of 1 year after withdrawal. Results confirm the efficacy of a multifaceted treatment to manage this problematic category of patients.

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.

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

Science.gov (United States)

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Preparedness for ongoing Ebola virus infection: how to welcome it?

Directory of Open Access Journals (Sweden)

Sora Yasri

2015-06-01

Full Text Available The problem of Ebola virus infection is the big global concern. Preparedness for ongoing Ebola virus infection is the topic that should be discussed. In fact, it is necessary to set up a biosecurity system to protect against the present Ebola outbreak. The medical personnel have to prepare for fighting the problem. The management of the present outbreak requires international collaboration and control of cross-border disease transmission is also the big challenge. The good case study is the Hajj scenario.

On the Ongoing Evolution of Very High Frequency Power Supplies

DEFF Research Database (Denmark)

Knott, Arnold; Andersen, Toke Meyer; Kamby, Peter

2013-01-01

The ongoing demand for smaller and lighter power supplies is driving the motivation to increase the switching frequencies of power converters. Drastic increases however come along with new challenges, namely the increase of switching losses in all components. The application of power circuits used...... in radio frequency transmission equipment helps to overcome those. However those circuits were not designed to meet the same requirements as power converters. This paper summarizes the contributions in recent years in application of very high frequency (VHF) technologies in power electronics, describes...

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

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…

Challenges and Approaches to Make Multidisciplinary Team Meetings Interoperable - The KIMBo Project.

Science.gov (United States)

Krauss, Oliver; Holzer, Karl; Schuler, Andreas; Egelkraut, Reinhard; Franz, Barbara

2017-01-01

Multidisciplinary team meetings (MDTMs) are already in use for certain areas in healthcare (e.g. treatment of cancer). Due to the lack of common standards and accessibility for the applied IT systems, their potential is not yet completely exploited. Common requirements for MDTMs shall be identified and aggregated into a process definition to be automated by an application architecture utilizing modern standards in electronic healthcare, e.g. HL7 FHIR. To identify requirements, an extensive literature review as well as semi-structured expert interviews were conducted. Results showed, that interoperability and flexibility in terms of the process are key requirements to be addressed. An architecture blueprint as well as an aggregated process definition were derived from the insights gained. To evaluate the feasibility of identified requirements, methods of explorative prototyping in software engineering were used. MDTMs will become an important part of modern and future healthcare but the need for standardization in terms of interoperability is imminent.

Towards Multidisciplinary HIV-Cure Research: Integrating Social Science with Biomedical Research.

Science.gov (United States)

Grossman, Cynthia I; Ross, Anna Laura; Auerbach, Judith D; Ananworanich, Jintanat; Dubé, Karine; Tucker, Joseph D; Noseda, Veronica; Possas, Cristina; Rausch, Dianne M

2016-01-01

The quest for a cure for HIV remains a timely and key challenge for the HIV research community. Despite significant scientific advances, current HIV therapy regimens do not completely eliminate the negative impact of HIV on the immune system; and the economic impact of treating all people infected with HIV globally, for the duration of their lifetimes, presents significant challenges. This article discusses, from a multidisciplinary approach, critical social, behavioral, ethical, and economic issues permeating the HIV-cure research agenda. As part of a search for an HIV cure, both the perspective of patients/participants and clinical researchers should be taken into account. In addition, continued efforts should be made to involve and educate the broader community. Published by Elsevier Ltd.

Multi-disciplinary engineering for cyber-physical production systems data models and software solutions for handling complex engineering projects

CERN Document Server

Lüder, Arndt; Gerhard, Detlef

2017-01-01

This book discusses challenges and solutions for the required information processing and management within the context of multi-disciplinary engineering of production systems. The authors consider methods, architectures, and technologies applicable in use cases according to the viewpoints of product engineering and production system engineering, and regarding the triangle of (1) product to be produced by a (2) production process executed on (3) a production system resource. With this book industrial production systems engineering researchers will get a better understanding of the challenges and requirements of multi-disciplinary engineering that will guide them in future research and development activities. Engineers and managers from engineering domains will be able to get a better understanding of the benefits and limitations of applicable methods, architectures, and technologies for selected use cases. IT researchers will be enabled to identify research issues related to the development of new methods, arc...

Improving outcomes following reconstruction of pressure sores in spinal injury patients: A multidisciplinary approach.

Science.gov (United States)

Tadiparthi, S; Hartley, A; Alzweri, L; Mecci, M; Siddiqui, H

2016-07-01

Pressure sore treatment in spinal injury patients is challenging. A multidisciplinary approach with joint management by the plastic surgery and spinal injury teams was initiated at our institution in 2005 to improve patient care and surgical outcomes following reconstruction. This study assessed the surgical outcomes following reconstruction using the team approach and to compare inpatient stay and readmissions for complications before and after the multidisciplinary protocol was introduced. A retrospective review of consecutive patients in the multidisciplinary pressure sore clinic was performed. Data were collected on patient demographics, reconstructive techniques, surgical outcomes and readmission for any complications. In total, 45 patients with 60 pressure sores (grade 3 or 4) were reviewed in the joint clinic between 2005 and 2011. The majority of patients were paraplegic (78%), while the remaining 22% were tetraplegic. Ischial sores were the most common (45%) followed by trochanteric (23%) and sacral (20%) sores. Multiple sores were noted in 44% of patients. Flap reconstruction was required in 32 patients (71%); after a mean follow-up time of 33 months (range 25-72 months), there were three (9%) major complications (two recurrences of pressure sores and one sinus) and seven (22%) minor complications. After introduction of patient care pathways through the multidisciplinary approach, the rate of readmission for complications decreased from 14% to 5.5% and inpatient stay upon readmission reduced from 65 to 45 days. Implementation of a multidisciplinary approach was key to optimising surgical outcomes, achieving a low recurrence rate (6%) and reducing readmissions. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

Science.gov (United States)

Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

2015-01-01

The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

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.

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).

C-ITS as Multidisciplinary Area with High Demand on Telecommunications Solutions

Directory of Open Access Journals (Sweden)

Tomas Zelinka

2014-08-01

Full Text Available Cooperative Intelligent Transport Systems (C-ITS are concentrated on transportation systems with goal to improve usability, efficiency and safety of the existing as well as newly constructed transportation infrastructure. These concepts are associated with high society expectations that C-ITS will principally participate in resolving of continuously growing transportation challenges. C-ITS represents typical multidisciplinary area where effective cooperation of wide range of different disciplines is the key condition of the success. Possible approach to treatment of requirements on telecommunication services in C-ITS applications is presented.

Challenges experienced by parents living with a child with attention ...

African Journals Online (AJOL)

Results: Five themes emerged: burden of care; emotional effects; social effects; impact of the educational challenges, and attempts to cope with the burden of care. ... Health care practitioners need to take note of the challenges inherent to parenting a child with ADHD in order to provide multi-disciplinary interventions aimed ...

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.

Earthquake forewarning — A multidisciplinary challenge from the ground up to space

Science.gov (United States)

Freund, Friedemann

2013-08-01

Most destructive earthquakes nucleate at between 5-7 km and about 35-40 km depth. Before earthquakes, rocks are subjected to increasing stress. Not every stress increase leads to rupture. To understand pre-earthquake phenomena we note that igneous and high-grade metamorphic rocks contain defects which, upon stressing, release defect electrons in the oxygen anion sublattice, known as positive holes. These charge carriers are highly mobile, able to flow out of stressed rocks into surrounding unstressed rocks. They form electric currents, which emit electromagnetic radiation, sometimes in pulses, sometimes sustained. The arrival of positive holes at the ground-air interface can lead to air ionization, often exclusively positive. Ionized air rising upward can lead to cloud condensation. The upward flow of positive ions can lead to instabilities in the mesosphere, to mesospheric lightning, to changes in the Total Electron Content (TEC) at the lower edge of the ionosphere, and electric field turbulences. Advances in deciphering the earthquake process can only be achieved in a broadly multidisciplinary spirit.

The MOOC and Learning Analytics Innovation Cycle (MOLAC): A Reflective Summary of Ongoing Research and Its Challenges

Science.gov (United States)

Drachsler, H.; Kalz, M.

2016-01-01

The article deals with the interplay between learning analytics and massive open online courses (MOOCs) and provides a conceptual framework to situate ongoing research in the MOOC and learning analytics innovation cycle (MOLAC framework). The MOLAC framework is organized on three levels: On the micro-level, the data collection and analytics…

Next Generation Innovation Policy and Grand Challenges

NARCIS (Netherlands)

Kuhlmann, Stefan; Rip, Arie

2018-01-01

The paper explores transformative ways to address Grand Challenges, while locating them in a broader diagnosis of ongoing changes. Coping with Grand Challenges is a challenge in its own right, for policy as well as for science, technology, and innovation actors. The paper presents building blocks

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

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....

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.

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

Workshop and conference on Grand Challenges applications and software technology

Energy Technology Data Exchange (ETDEWEB)

1993-12-31

On May 4--7, 1993, nine federal agencies sponsored a four-day meeting on Grand Challenge applications and software technology. The objective was to bring High-Performance Computing and Communications (HPCC) Grand Challenge applications research groups supported under the federal HPCC program together with HPCC software technologists to: discuss multidisciplinary computational science research issues and approaches, identify major technology challenges facing users and providers, and refine software technology requirements for Grand Challenge applications research. The first day and a half focused on applications. Presentations were given by speakers from universities, national laboratories, and government agencies actively involved in Grand Challenge research. Five areas of research were covered: environmental and earth sciences; computational physics; computational biology, chemistry, and materials sciences; computational fluid and plasma dynamics; and applications of artificial intelligence. The next day and a half was spent in working groups in which the applications researchers were joined by software technologists. Nine breakout sessions took place: I/0, Data, and File Systems; Parallel Programming Paradigms; Performance Characterization and Evaluation of Massively Parallel Processing Applications; Program Development Tools; Building Multidisciplinary Applications; Algorithm and Libraries I; Algorithms and Libraries II; Graphics and Visualization; and National HPCC Infrastructure.

Clinical vocabulary as a boundary object in multidisciplinary care management of multiple chemical sensitivity, a complex and chronic condition.

Science.gov (United States)

Sampalli, Tara; Shepherd, Michael; Duffy, Jack

2011-04-14

Research has shown that accurate and timely communication between multidisciplinary clinicians involved in the care of complex and chronic health conditions is often challenging. The domain knowledge for these conditions is heterogeneous, with poorly categorized, unstructured, and inconsistent clinical vocabulary. The potential of boundary object as a technique to bridge communication gaps is explored in this study. A standardized and controlled clinical vocabulary was developed as a boundary object in the domain of a complex and chronic health condition, namely, multiple chemical sensitivity, to improve communication among multidisciplinary clinicians. A convenience sample of 100 patients with a diagnosis of multiple chemical sensitivity, nine multidisciplinary clinicians involved in the care of patients with multiple chemical sensitivity, and 36 clinicians in the community participated in the study. Eighty-two percent of the multidisciplinary and inconsistent vocabulary was standardized using the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED(®) CT as a reference terminology. Over 80% of the multidisciplinary clinicians agreed on the overall usefulness of having a controlled vocabulary as a boundary object. Over 65% of clinicians in the community agreed on the overall usefulness of the vocabulary. The results from this study are promising and will be further evaluated in the domain of another complex chronic condition, ie, chronic pain. The study was conducted as a preliminary analysis for developing a boundary object in a heterogeneous domain of knowledge.

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

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

The Ongoing and Open-Ended Simulation

Science.gov (United States)

Cohen, Alexander

2016-01-01

This case study explores a novel form of classroom simulation that differs from published examples in two important respects. First, it is ongoing. While most simulations represent a single learning episode embedded within a course, the ongoing simulation is a continuous set of interrelated events and decisions that accompany learning throughout…

Energy efficiency and the law: A multidisciplinary approach

Directory of Open Access Journals (Sweden)

Willemien du Plessis

2015-01-01

Full Text Available South Africa is an energy-intensive country. The inefficient use of, mostly, coal-generated energy is the cause of South Africa's per capita contribution to greenhouse gas emissions, pollution and environmental degradation and negative health impacts. The inefficient use of the country's energy also amounts to the injudicious use of natural resources. Improvements in energy efficiency are an important strategy to stabilise the country's energy crisis. Government responded to this challenge by introducing measures such as policies and legislation to change energy consumption patterns by, amongst others, incentivising the transition to improved energy efficiencies. A central tenet underpinning this review is that the law and energy nexus requires a multidisciplinary approach as well as a multi-pronged adoption of diverse policy instruments to effectively transform the country's energy use patterns. Numerous, innovative instruments are introduced by relevant legislation to encourage the transformation of energy generation and consumption patterns of South Africans. One such innovative instrument is the ISO 50001 energy management standard. It is a voluntary instrument, to plan for, measure and verify energy-efficiency improvements. These improvements may also trigger tax concessions. In this paper, the nature and extent of the various policy instruments and legislation that relate to energy efficiency are explored, while the interactions between the law and the voluntary ISO 50001 standard and between the law and the other academic disciplines are highlighted. The introduction of energy-efficiency measures into law requires a multidisciplinary approach, as lawyers may be challenged to address the scientific and technical elements that characterise these legal measures and instruments. Inputs by several other disciplines such as engineering, mathematics or statistics, accounting, environmental management and auditing may be needed. Law is often

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

Multi-disciplinary scientists as global change adaptation anchors: Filling the gaps in the Boundary Organization paradigm

Science.gov (United States)

Terando, A. J.; Collazo, J.

2017-12-01

Boundary organizations, entities that facilitate the co-production and translation of scientific research in decision making processes, have been promoted as a means to assist global change adaptation, particularly in the areas of landscape conservation and natural resource management. However, scientists can and often still must perform a similar role and act as anchoring agents within wicked adaptation problems that involve a myriad of actors, values, scientific uncertainties, governance structures, and multidisciplinary research needs. We illustrate one such case study in Puerto Rico's Bosque Modelo (Model Forest) where we discuss an ongoing scientific effort to undertake a multi-objective landscape conservation design project that intersects with the Bosque Modelo geography and goals. Perspectives are provided from two research ecologists, one with a background in terrestrial ecology who has worked at the intersection of science, conservation, and government for over 30 years, and the other with a multi-disciplinary background in earth sciences, climatology, and terrestrial ecology. We frame our discussion around the learning process that accompanies the development of global change scenarios that are both useful and useable for a wide spectrum of scientists, and the likelihood that scientifically informed adaptive management actions will ultimately be implemented in this complex and changing landscape.

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.

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.

MIX-MEDIA NARRATIVES WORKSHOP: MULTIDISCIPLINARY TEAMS’ PRODUCTION

Directory of Open Access Journals (Sweden)

Sonia Liliana da Silva Vieira

2017-11-01

Full Text Available The development of creation and content production teams, regarding design and digital publishing areas, their processes and transdisciplinary knowledge, are making deep changes in media production structures, and in its own professional sustainability model. The Mix-media Narratives Workshop that took place at Universidade da Beira Interior (Portugal intended to simulate the reality of production structures and the recent integrated digital writing paradigm, as well as to evaluate the several multi and transdisciplinary challenges that may be present in the creation of digital media contents. Design, journalism and film production students were not only confronted with real editorial development situations, but also with professional feedback, which was possible due to a partnership with the newspaper Expresso.pt. A fellow editor from this newspaper kept track of the sessions, with the help and presence of professors from many of the courses involved. Data gathered from observation notes, pictures and video during laboratorial work meetings, was compiled and crossed with research results, analyses and comments made by the participant professors and Expresso. pt editor’s observations. Our goal was to analyze in which way future workers will deal with the challenging task of collaborating with multidisciplinary teams and produce mix-media content with real publishing purpose.

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

Insights from early experience of a Rare Disease Genomic Medicine Multidisciplinary Team: a qualitative study.

Science.gov (United States)

Ormondroyd, Elizabeth; Mackley, Michael P; Blair, Edward; Craft, Jude; Knight, Julian C; Taylor, John; Taylor, Jenny C; Wilkie, Andrew Om; Watkins, Hugh

2017-06-01

Whole-exome/whole-genome sequencing (WES/WGS) has the potential to enhance genetic diagnosis of rare disease, and is increasingly becoming part of routine clinical care in mainstream medicine. Effective translation will require ongoing efforts in a number of areas including: selection of appropriate patients, provision of effective consent, pre- and post-test genetic counselling, improving variant interpretation algorithms and practices, and management of secondary findings including those found incidentally and those actively sought. Allied to this is the need for an effective education programme for all members of clinical teams involved in care of patients with rare disease, as well as to maintain public confidence in the use of these technologies. We established a Genomic Medicine Multidisciplinary Team (GM-MDT) in 2014 to build on the experiences of earlier successful research-based WES/WGS studies, to address these needs and to review results including pertinent and secondary findings. Here we report on a qualitative study of decision-making in the GM-MDT combined with analysis of semi-structured interviews with GM-MDT members. Study findings show that members appreciate the clinical and scientific diversity of the GM-MDT and value it for education and oversight. To date, discussions have focussed on case selection including the extent and interpretation of clinical and family history information required to establish likely monogenic aetiology and inheritance model. Achieving a balance between effective use of WES/WGS - prioritising cases in a diverse and highly complex patient population where WES/WGS will be tractable - and meeting the recruitment targets of a large project is considered challenging.

Steam generator life cycle management challenges - on-going and new build

International Nuclear Information System (INIS)

Spekkens, P.

2009-01-01

Ontario Power Generation (OPG) is committed to the safe, reliable, and cost-effective operation of its fleet of CANDU plants. Steam Generators (SGs) are a major component of the heat transport system in these plants and maintaining their health is an essential element to achieving plant safety, reliability and economic performance. OPG has been actively engaged in formal life cycle management of its SGs for about 15 years. Over this time, we have developed stable, mature, detailed life cycle plans for each of our plants on a unit by unit, and in some cases, SG by SG, basis. These plans have been externally reviewed over the years by our regulator and by other third-party experts, and they've been acknowledged as being among the best life cycle plans anywhere. Although we are pleased that our life cycle plans are as detailed and mature as they are, we certainly aren't fully satisfied because they're not perfect. Even if they were perfect at any point in time, they wouldn't be for very long because the environment is constantly changing, both the technical environment and the business environment. This paper presents some of these challenges and offers some possible solutions or suggestions based on OPG's experience. The paper describes the background on SG life cycle management in OPG, i.e. what it is and how we do it. Then it presents challenges in the following areas: despite having some very detailed and technically strong life cycle plans, we still face some technical issues; in addition, we face challenges in integrating these plans into the overall business processes within the company; up until now, our life cycle planning has been aimed at early-and mid-life in our units. But our units are aging and we are now within sight, at least in a life cycle management sense, of a point at which decisions need to be made on refurbishment, life extension or retirement of the units. We need to adjust our life cycle management approach as we approach those major

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.

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 ...

Can monaural temporal masking explain the ongoing precedence effect?

Science.gov (United States)

Freyman, Richard L; Morse-Fortier, Charlotte; Griffin, Amanda M; Zurek, Patrick M

2018-02-01

The precedence effect for transient sounds has been proposed to be based primarily on monaural processes, manifested by asymmetric temporal masking. This study explored the potential for monaural explanations with longer ("ongoing") sounds exhibiting the precedence effect. Transient stimuli were single lead-lag noise burst pairs; ongoing stimuli were trains of 63 burst pairs. Unlike with transients, monaural masking data for ongoing sounds showed no advantage for the lead, and are inconsistent with asymmetric audibility as an explanation for ongoing precedence. This result, along with supplementary measurements of interaural time discrimination, suggests different explanations for transient and ongoing precedence.

Exploring the rewards and challenges of paediatric palliative care work - a qualitative study of a multi-disciplinary children's hospice care team.

Science.gov (United States)

Taylor, Johanna; Aldridge, Jan

2017-12-16

Children's hospices are a key provider of palliative care for children and young people with life-limiting and life-threatening conditions. However, despite recent policy attention to the provision of paediatric palliative care, little is known about the role of children's hospice staff and the factors that may impact on their wellbeing at work. This study explored the rewards and challenges of working in a children's hospice with an aim to identify staff support and development needs. We conducted an exploratory, qualitative study involving thematic analysis of semi-structured interviews with 34 staff and three focus groups with 17 staff working in a multi-disciplinary care team in a UK children's hospice. Participants identified rewards and challenges related to the direct work of caring for children and their families; team dynamics and organisational structures; and individual resilience and job motivation. Participants described the work as emotionally intensive and multi-faceted; 'getting it right' for children was identified as a strong motivator and reward, but also a potential stressor as staff strived to maintain high standards of personalised and emotional care. Other factors were identified as both a reward and stressor, including team functioning, the allocation of work, meeting parent expectations, and the hospice environment. Many participants identified training needs for different aspects of the role to help them feel more confident and competent. Participants also expressed concerns about work-related stress, both for themselves and for colleagues, but felt unable to discuss this at work. Informal support from colleagues and group clinical reflection were identified as primary resources to reflect on and learn from work and for emotional support. However, opportunities for this were limited. Providing regular, structured, and dedicated clinical reflection provides a mechanism through which children's hospice staff can come together for support and

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…

The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care.

Science.gov (United States)

Grol, Sietske M; Molleman, Gerard R M; Kuijpers, Anne; van der Sande, Rob; Fransen, Gerdine A J; Assendelft, Willem J J; Schers, Henk J

2018-03-10

diversity of roles in multidisciplinary teams in GP training programmes seems useful. The challenge is to convince GPs to take a lead, also when they are not inclined to take this role in organizing multidisciplinary teams for older people.

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

International Nuclear Information System (INIS)

Schultz, Courtney A.

2012-01-01

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is done under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.

A Multidisciplinary Investigation of a Polycythemia Vera Cancer Cluster of Unknown Origin

Science.gov (United States)

Seaman, Vincent; Dearwent, Steve M; Gable, Debra; Lewis, Brian; Metcalf, Susan; Orloff, Ken; Tierney, Bruce; Zhu, Jane; Logue, James; Marchetto, David; Ostroff, Stephen; Hoffman, Ronald; Xu, Mingjiang; Carey, David; Erlich, Porat; Gerhard, Glenn; Roda, Paul; Iannuzzo, Joseph; Lewis, Robert; Mellow, John; Mulvihill, Linda; Myles, Zachary; Wu, Manxia; Frank, Arthur; Gross-Davis, Carol Ann; Klotz, Judith; Lynch, Adam; Weissfeld, Joel; Weinberg, Rona; Cole, Henry

2010-01-01

Cancer cluster investigations rarely receive significant public health resource allocations due to numerous inherent challenges and the limited success of past efforts. In 2008, a cluster of polycythemia vera, a rare blood cancer with unknown etiology, was identified in northeast Pennsylvania. A multidisciplinary group of federal and state agencies, academic institutions, and local healthcare providers subsequently developed a multifaceted research portfolio designed to better understand the cause of the cluster. This research agenda represents a unique and important opportunity to demonstrate that cancer cluster investigations can produce desirable public health and scientific outcomes when necessary resources are available. PMID:20617023

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.

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…

[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.

Multi-disciplinary coupling effects 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 which govern the accurate response of propulsion systems. Results are presented for propulsion system responses including multi-disciplinary coupling effects using coupled multi-discipline thermal, structural, and acoustic tailoring; an integrated system of multi-disciplinary simulators; coupled material behavior/fabrication process tailoring; sensitivities using a probabilistic simulator; and coupled materials, structures, fracture, and probabilistic behavior simulator. The results demonstrate that superior designs can be achieved if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated coupled multi-discipline numerical propulsion system simulator.

Ongoing experiments: diagnostics requirements

International Nuclear Information System (INIS)

Dickerman, C.E.

1976-01-01

The paper reviews the fuel motion diagnostics needs for ongoing LMFBR safety experiments over approximately the next five years, with the discussion centered on TREAT. Brief comments on the direction in which clad motion diagnostics requirements are expected to develop are also presented

Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

Science.gov (United States)

Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

2015-11-01

Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

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.

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…

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...

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

The relationship between event-based prospective memory and ongoing task performance in chimpanzees (Pan troglodytes.

Directory of Open Access Journals (Sweden)

Theodore A Evans

Full Text Available Prospective memory is remembering to do something at a future time. A growing body of research supports that prospective memory may exist in nonhuman animals, but the methods used to test nonhuman prospective memory differ from those used with humans. The current work tests prospective memory in chimpanzees using a method that closely approximates a typical human paradigm. In these experiments, the prospective memory cue was embedded within an ongoing task. Tokens representing food items could be used in one of two ways: in a matching task with pictures of items (the ongoing task or to request a food item hidden in a different location at the beginning of the trial. Chimpanzees had to disengage from the ongoing task in order to use the appropriate token to obtain a higher preference food item. In Experiment 1, chimpanzees effectively matched tokens to pictures, when appropriate, and disengaged from the ongoing task when the token matched the hidden item. In Experiment 2, performance did not differ when the target item was either hidden or visible. This suggested no effect of cognitive load on either the prospective memory task or the ongoing task, but performance was near ceiling, which may have contributed to this outcome. In Experiment 3, we created a more challenging version of the task. More errors on the matching task occurred before the prospective memory had been carried out, and this difference seemed to be limited to the hidden condition. This finding parallels results from human studies and suggests that working memory load and prospective memory may have a similar relationship in nonhuman primates.

Improving patient safety in radiology: a work in progress

International Nuclear Information System (INIS)

Sze, Raymond W.

2008-01-01

The purpose of this paper is to share the experiences, including successes and failures, as well as the ongoing process of developing and implementing a safety program in a large pediatric radiology department. Building a multidisciplinary pediatric radiology safety team requires successful recruitment of team members, selection of a team leader, and proper and ongoing training and tools, and protected time. Challenges, including thorough examples, are presented on improving pediatric radiology safety intradepartmentally, interdepartmentally, and institutionally. Finally, some major challenges to improving safety in pediatric radiology, and healthcare in general, are presented along with strategies to overcome these challenges. Our safety program is a work in progress; this article is a personal account and the reader is asked for tolerance of its occasional subjective tone and contents. (orig.)

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...

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...

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...

Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

Science.gov (United States)

Stevenson, Marvaretta M; Irwin, Tonia; Lowry, Terry; Ahmed, Maleka Z; Walden, Thomas L; Watson, Melanie; Sutton, Linda

2013-05-01

Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.

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

Science.gov (United States)

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

2014-03-01

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

Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective

Science.gov (United States)

Johnson, Robert W.; Alvarez-Pasquin, Marie-José; Bijl, Marc; Franco, Elisabetta; Gaillat, Jacques; Clara, João G.; Labetoulle, Marc; Michel, Jean-Pierre; Naldi, Luigi; Sanmarti, Luis S.; Weinke, Thomas

2015-01-01

Herpes zoster (HZ) is primarily a disease of nerve tissue but the acute and longer-term manifestations require multidisciplinary knowledge and involvement in their management. Complications may be dermatological (e.g. secondary bacterial infection), neurological (e.g. long-term pain, segmental paresis, stroke), ophthalmological (e.g. keratitis, iridocyclitis, secondary glaucoma) or visceral (e.g. pneumonia, hepatitis). The age-related increased incidence of HZ and its complications is thought to be a result of the decline in cell-mediated immunity (immunosenescence), higher incidence of comorbidities with age and social-environmental changes. Individuals who are immunocompromised as a result of disease or therapy are also at increased risk, independent of age. HZ and its complications (particularly postherpetic neuralgia) create a significant burden for the patient, carers, healthcare systems and employers. Prevention and treatment of HZ complications remain a therapeutic challenge despite recent advances. This is an overview of the multidisciplinary implications and management of HZ in which the potential contribution of vaccination to reducing the incidence HZ and its complications are also discussed. PMID:26478818

Recent advances in multidisciplinary management of hepatocellular carcinoma

Science.gov (United States)

Gomaa, Asmaa I; Waked, Imam

2015-01-01

The incidence of hepatocellular carcinoma (HCC) is increasing, and it is currently the second leading cause of cancer-related death worldwide. Potentially curative treatment options for HCC include resection, transplantation, and percutaneous ablation, whereas palliative treatments include trans-arterial chemoembolization (TACE), radioembolization, and systemic treatments. Due to the diversity of available treatment options and patients’ presentations, a multidisciplinary team should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved molecular-targeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC. PMID:25866604

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

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.

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...

Evidence and research in rectal cancer

International Nuclear Information System (INIS)

Valentini, Vincenzo; Beets-Tan, Regina; Borras, Josep M.; Krivokapic, Zoran; Leer, Jan Willem; Pahlman, Lars; Roedel, Claus; Schmoll, Hans Joachim; Scott, Nigel; Velde, Cornelius Van de; Verfaillie, Christine

2008-01-01

The main evidences of epidemiology, diagnostic imaging, pathology, surgery, radiotherapy, chemotherapy and follow-up are reviewed to optimize the routine treatment of rectal cancer according to a multidisciplinary approach. This paper reports on the knowledge shared between different specialists involved in the design and management of the multidisciplinary ESTRO Teaching Course on Rectal Cancer. The scenario of ongoing research is also addressed. In this time of changing treatments, it clearly appears that a common standard for large heterogeneous patient groups have to be substituted by more individualised therapies based on clinical-pathological features and very soon on molecular and genetic markers. Only trained multidisciplinary teams can face this new challenge and tailor the treatments according to the best scientific evidence for each patient

Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.

Directory of Open Access Journals (Sweden)

Kathrin M Cresswell

Full Text Available There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making.We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9.We drew on data from 17 participants (approximately eight per roundtable, six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs".Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.

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.

Hyperinsulinaemic hypoglycaemia - a diagnostic challenge. A report of two atypical cases.

Directory of Open Access Journals (Sweden)

Renata Baronaite Hansen

2015-07-01

Patient 2 was diagnosed with a benign insulinoma and 5 years later with metastatic disease. Conclusion: The authors conclude that insulinomas are rare entities which often present a diagnostic and therapeutic challenge. In such cases, patient referral to tertiary multidisciplinary centers is recommended.

Benefits of multidisciplinary teamwork in the management of breast cancer

Directory of Open Access Journals (Sweden)

Taylor C

2013-08-01

Full Text Available Cath Taylor,1 Amanda Shewbridge,2 Jenny Harris,1 James S Green3,4 1Florence Nightingale School of Nursing and Midwifery, King’s College London, London UK; 2Breast Cancer Services, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Urology, Barts Health NHS Trust, London, UK; 4Department of Health and Social Care, London South Bank University, London, UK Abstract: The widespread introduction of multidisciplinary team (MDT-work for breast cancer management has in part evolved due to the increasing complexity of diagnostic and treatment decision-making. An MDT approach aims to bring together the range of specialists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled trial evidence of their effectiveness. Clinical consensus is generally favorable on the benefits of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment from a specialist center, and evidence continues to accrue from comparative studies of clinical benefits of an MDT approach, including improved survival. Patients’ views of the MDT model of decision-making (and in particular its impact on involvement in decisions about their care have been under-researched. Barriers to effective teamwork and poor decision-making include excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been associated with improved patient experience and quality of life. This paper examines the evidence for the benefits of MDT-work, in particular for breast cancer. Evidence is considered within a context of growing cancer incidence at a time of increased financial restraint, and it may now be important to

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.

The Google Online Marketing Challenge and Research Opportunities

Science.gov (United States)

Neale, Larry; Treiblmaier, Horst; Henderson, Vani; Hunter, Lee; Hudson, Karen; Murphy, Jamie

2009-01-01

The Google Online Marketing Challenge is an ongoing collaboration between Google and academics, to give students experiential learning. The Challenge gives student teams US$200 in AdWords, Google's flagship advertising product, to develop online marketing campaigns for actual businesses. The end result is an engaging in-class exercise that…

Buyer-Seller Interaction Patterns During Ongoing Service Exchange

NARCIS (Netherlands)

W. van der Valk (Wendy)

2007-01-01

textabstractThis dissertation focuses on the ongoing interactions that take place between buyers and sellers of business services after the contract has been signed. This ongoing interaction is important since services are produced and consumed simultaneously; therefore, both buyer and seller have

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.

“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.

[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.

Challenges and progress in turbomachinery design systems

International Nuclear Information System (INIS)

Van den Braembussche, R A

2013-01-01

This paper first describes the requirements that a modern design system should meet, followed by a comparison between design systems based on inverse design or optimization techniques. The second part of the paper presents the way these challenges are realized in an optimization method combining an Evolutionary theory and a Metamodel. Extensions to multi-disciplinary, multi-point and multi-objective optimization are illustrated by examples

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.

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.

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…

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

Directory of Open Access Journals (Sweden)

Walker CM

2015-07-01

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

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.

Multidisciplinary quality assurance and control in oncological trials: Perspectives from European Organisation for Research and Treatment of Cancer (EORTC).

Science.gov (United States)

2017-11-01

Quality assurance (QA) programmes are one of the mainstays of clinical research and constitute the pillars on which European Organisation for Research Treatment of Cancer (EORTC) delivers multidisciplinary therapeutic progress. Changing practice treatments require solid evidence-based data, which can only be achieved if integral QA is part of the infrastructure sustaining research projects. Cancer treatment is a multimodality approach, which is often applied either in sequence and/or in combination. Each modality plays a key role in cancer control. The modalities by which QA is applied varies substantially within and across the disciplines. In addition, translational and diagnostic disciplines take an increasing role in the era of precision medicine. Building on the structuring effect of clinical research with fully integrated multidisciplinary QA programmes associated with the solutions addressing the chain of custody for biological material and data integrity as well as compliance ensure at the same time validity of clinical research output but also have a training effect on health care providers, who are more likely to apply such principles as routine. The principles of QA are therefore critical to be embedded in multidisciplinary infrastructure to guarantee therapeutic progress. These principles also provide the basis for the functioning of multidisciplinary tumour board. However, technical, operational and economic challenges which go with the implementation of such programmes require optimal know-how and the coordination of the multiple expertise and such efforts are best achieved through centralised infrastructure. Copyright © 2017 Elsevier Ltd. All rights reserved.

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...

Active and Healthy Ageing as a Wicked Problem: The Contribution of a Multidisciplinary Research University.

Science.gov (United States)

Riva, Giuseppe; Graffigna, Guendalina; Baitieri, Maddalena; Amato, Alessandra; Bonanomi, Maria Grazia; Valentini, Paolo; Castelli, Guido

2014-01-01

The quest for an active and healthy ageing can be considered a "wicked problem." It is a social and cultural problem, which is difficult to solve because of incomplete, changing, and contradictory requirements. These problems are tough to manage because of their social complexity. They are a group of linked problems embedded in the structure of the communities in which they occur. First, they require the knowledge of the social and cultural context in which they occur. They can be solved only by understanding of what people do and why they do it. Second, they require a multidisciplinary approach. Wicked problems can have different solutions, so it is critical to capture the full range of possibilities and interpretations. Thus, we suggest that Università Cattolica del Sacro Cuore (UCSC) is well suited for accepting and managing this challenge because of its applied research orientation, multidisciplinary approach, and integrated vision. After presenting the research activity of UCSC, we describe a possible "systems thinking" strategy to consider the complexity and interdependence of active ageing and healthy living.

A Way Forward: Cooperative Solutions to Our Climate Challenges

Science.gov (United States)

Little, L. J.; Byrne, J. M.

2014-12-01

Solving the global climate crisis is a multidisciplinary challenge. The world is seeking solutions to climate change. The climate research and education community must move beyond the realm of debating the science - we MUST provide the solutions. The research community understands the science and many of the solutions very well. This project will address the specifics of solutions involving social, political and science disciplines. The content is targeted to multidisciplinary education at the senior undergraduate and graduate levels in universities and colleges. Humanity has already changed the climate and current greenhouse gas emission (GHG) projections indicate our world will warm 2-6° C within a young person's lifetime. We must coordinate societal mitigation and adaptation policies, programs and technology transformations. There is now a dramatic need for many, many highly trained multidisciplinary climate change solutions professionals that understand the complexities of the challenges and can work through the social, political and science tribulations needed to sustain communities around the world. This proposed education project: Provides an introduction to the social, political, technical, health and well-being challenges of climate change; Defines and describes the unprecedented changes to personal and community lifestyle, and consumption of energy and other resources; Examines ways and means for rapid transition of energy systems from fossil fuels to clean renewable technologies. Evaluates redevelopment of our infrastructure to withstand increasing weather extremes; Inventories possible abandonment and/or protection of infrastructure that cannot be redeveloped or reworked, particularly with respect to coastal zones where substantial populations currently live. We propose an online living textbook project. Chapter contributions will be invited from outstanding solutions research professionals from around the world. The online presence is the best means

Simulation-based multidisciplinary team training decreases time to critical operations for trauma patients.

Science.gov (United States)

Murphy, Margaret; Curtis, Kate; Lam, Mary K; Palmer, Cameron S; Hsu, Jeremy; McCloughen, Andrea

2018-05-01

Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia. Two concurrent four-year periods, before and after implementation of a simulation based multidisciplinary trauma team training program were compared for differences in time to critical operations, Emergency Department (ED) length of stay (LOS) and patient mortality. There were 2389 major trauma patients admitted to the hospital during the study, 1116 in the four years preceding trauma team training (the PREgroup) and 1273 in the subsequent 4 years (the POST group). There were no differences between the groups with respect to gender, body region injured, incidence of polytrauma, and pattern of arrival to ED. The POST group was older (median age 54 versus 43 years, p team training was associated with a reduction in time to critical operation while overall ED length of stay increased. Simulation is promoted as a platform for training teams; but the complexity of trauma care challenges efforts to demonstrate direct links between multidisciplinary team training and improved outcomes. There remain considerable gaps in knowledge as to how team training impacts health service delivery and patient outcomes. Retrospective comparative therapeutic/care management study, Level III evidence. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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...

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...

Multidisciplinary team approach in the oral rehabilitation of patients with cleidocranial dysplasia to achieve a functional aesthetic outcome.

Science.gov (United States)

Patel, D; Patel, N; Brennan, P A; Kwok, J

2017-11-01

Cleidocranial dysplasia is a hereditary congenital disorder that results in delayed ossification of midline structures, and is caused by mutations in the RunX2 (runt-related transcription factor 2) gene located on the short arm of chromosome 6. Successful treatment depends on multidisciplinary assessment and a comprehensive staged treatment plan. We present a case series of 12 patients who were managed with a specifically tailored combination of surgery, orthodontics, and prosthodontics to provide a functional dentition and restore their smile and facial contour. Successful dental rehabilitation can be challenging in this group because patients often have multiple dental anomalies and a reduced quantity and density of alveolar bone. Rehabilitation with early intervention and a carefully planned multidisciplinary approach has been successful in the long term. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The Co-creation, Connectivism and Collaboration Jigsaw; assembling the puzzle pieces for a successful multi-disciplinary student learning experience

OpenAIRE

Bassford, Marie; O'Sullivan, Angela; Bacon, Joanne; Crisp, Annette; Nichols-Drew, L.; Fowler, Mark R.

2017-01-01

CrashEd is a multi-disciplinary, cross-Faculty, University project that arose from five academics’ collaborative commitment to develop a car crash scenario as a widening participation activity. The success of the outreach project culminated in the inspiration to develop more academically challenging forensic scenarios for study at Higher Education level. The ethos of the Forensic Investigation module is on realistic, scenario-based learning and assessment methods, and involves subject special...

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.…

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.

An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

Science.gov (United States)

Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

2004-01-01

The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

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.

Experience of Southern Chinese: new challenges in treating young female breast cancer patients at child-bearing age--a call for multi-disciplinary collaboration.

Science.gov (United States)

Kwong, Ava; Chu, Annie Tsz-Wai

2012-01-01

Compared with western populations, Southern Chinese, especially those residing in Hong Kong, are experiencing increasing breast cancer incidence and also a younger onset of breast cancer. Combating this problem and treating young women with breast cancer poses specific challenges and complicated considerations. With reference to the postponement in the age of marriage and reproduction in modern societies, the issue of fertility after breast cancer, especially for high-risk young patients, is one significant quality of life concern that cannot be underestimated as a secondary medical topic. While the issue has its significance and is confronting front-line breast cancer care teams of different disciplines, related research is mostly on Caucasians. In cultures where the traditional expectation on women for child-bearing is still prominent, young breast cancer patients may endure significant distress over fertility options after breast cancer. There is a lack of related data on Asian breast cancer survivors at child-bearing age, which calls for a pressing need to encourage qualitative groundwork, case reports, and cohort experiences in hope for providing insight and arouse research interest. In order to provide a long-term comprehensive multidisciplinary management service with encouragement to encompass prospects for a positive future among young breast cancer survivors, relevant disciplines need to collaborate and work efficaciously together both on clinical and research aspects of cancer-related fertility issues.

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.

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

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)

A Method for Knowledge Management and Communication Within and Across Multidisciplinary Teams

Directory of Open Access Journals (Sweden)

Don Flynn

2009-06-01

Full Text Available The use of knowledge management (KM and communication tools in an applied scientific arena where research is performed and knowledge must be managed within and across multidisciplinary teams and organizations is a challenge. Teams of scientists and engineers from up to 17 different technical specialties required knowledge management tools for developing multiple environmental impact statements under challenging circumstances. Factors that contributed to the success of the KM tools included 1 pairing of project staff with Knowledge Systems staff to determine system requirements, 2 the use of the tools by the team as they were being developed thus allowing many opportunities for feedback and interaction, 3 developing the tools to approximate the overall project structure and work flow already in place, 4 providing immediate assistance to the project team as they learned to use the new KM tools, and 5 replacing earlier practices with the new KM approach by "burning the bridges" to past practices after the team had learned to use the new KM tools.

Qualitative Analysis of Round-Table Discussions on the Business Case and Procurement Challenges for Hospital Electronic Prescribing Systems

Science.gov (United States)

Cresswell, Kathrin M.; Slee, Ann; Coleman, Jamie; Williams, Robin; Bates, David W.; Sheikh, Aziz

2013-01-01

Objectives There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making. Materials and Methods We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9. Results We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing “wants” and aspirations from organizational “needs”. Discussion and conclusions Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management. PMID:24260213

Radiosynoviorthesis in the treatment of chronic synoviorthesis. Multidisciplinary focuses

International Nuclear Information System (INIS)

Morin Zorrilla, Jose

2006-01-01

Those near 50 years of application of the radiosinovectomy like effective alternative in the treatment of the chronic synovitis of different origin, indicate the convenience and in cause the necessity to integrate focuses, knowledge and technologies in order to reach satisfactory results. In the marks of a brunch project of the Agency of Nuclear Energy and Technologies of Advanced the efforts of several institutions are joined with the purpose of introducing in Cuba this useful one and in certain cases obligatory therapeutic modality. The work talks about the problem, the boarding multidisciplinary, the global focuses, the advances and the challenges are indicated that has this modality of the metabolic radiotherapy. In the experience of the development of radiopharmaceutical for radiosinovectomy, is considered that it is not possible to reach the level of excellence that the treatment with open sources requires without the active participation of specialists of different profiles as vectors of the integration of institutions that give their experience and the focus of their institution (Author)

Virtual physiological human: training challenges.

Science.gov (United States)

Lawford, Patricia V; Narracott, Andrew V; McCormack, Keith; Bisbal, Jesus; Martin, Carlos; Bijnens, Bart; Brook, Bindi; Zachariou, Margarita; Freixa, Jordi Villà I; Kohl, Peter; Fletcher, Katherine; Diaz-Zuccarini, Vanessa

2010-06-28

The virtual physiological human (VPH) initiative encompasses a wide range of activities, including structural and functional imaging, data mining, knowledge discovery tool and database development, biomedical modelling, simulation and visualization. The VPH community is developing from a multitude of relatively focused, but disparate, research endeavours into an integrated effort to bring together, develop and translate emerging technologies for application, from academia to industry and medicine. This process initially builds on the evolution of multi-disciplinary interactions and abilities, but addressing the challenges associated with the implementation of the VPH will require, in the very near future, a translation of quantitative changes into a new quality of highly trained multi-disciplinary personnel. Current strategies for undergraduate and on-the-job training may soon prove insufficient for this. The European Commission seventh framework VPH network of excellence is exploring this emerging need, and is developing a framework of novel training initiatives to address the predicted shortfall in suitably skilled VPH-aware professionals. This paper reports first steps in the implementation of a coherent VPH training portfolio.

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....

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....

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

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.

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...

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.

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

Efficacy, safety and tolerability of ongoing statin plus ezetimibe versus doubling the ongoing statin dose in hypercholesterolemic Taiwanese patients: an open-label, randomized clinical trial

Directory of Open Access Journals (Sweden)

Yu Chih-Chieh

2012-05-01

Full Text Available Abstract Background Reducing low-density lipoprotein cholesterol (LDL-C is associated with reduced risk for major coronary events. Despite statin efficacy, a considerable proportion of statin-treated hypercholesterolemic patients fail to reach therapeutic LDL-C targets as defined by guidelines. This study compared the efficacy of ezetimibe added to ongoing statins with doubling the dose of ongoing statin in a population of Taiwanese patients with hypercholesterolemia. Methods This was a randomized, open-label, parallel-group comparison study of ezetimibe 10 mg added to ongoing statin compared with doubling the dose of ongoing statin. Adult Taiwanese hypercholesterolemic patients not at optimal LDL-C levels with previous statin treatment were randomized (N = 83 to ongoing statin + ezetimibe (simvastatin, atorvastatin or pravastatin + ezetimibe at doses of 20/10, 10/10 or 20/10 mg or doubling the dose of ongoing statin (simvastatin 40 mg, atorvastatin 20 mg or pravastatin 40 mg for 8 weeks. Percent change in total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C and triglycerides, and specified safety parameters were assessed at 4 and 8 weeks. Results At 8 weeks, patients treated with statin + ezetimibe experienced significantly greater reductions compared with doubling the statin dose in LDL-C (26.2% vs 17.9%, p = 0.0026 and total cholesterol (20.8% vs 12.2%, p = 0.0003. Percentage of patients achieving treatment goal was greater for statin + ezetimibe (58.6% vs doubling statin (41.2%, but the difference was not statistically significant (p = 0.1675. The safety and tolerability profiles were similar between treatments. Conclusion Ezetimibe added to ongoing statin therapy resulted in significantly greater lipid-lowering compared with doubling the dose of statin in Taiwanese patients with hypercholesterolemia. Studies to assess clinical outcome benefit are ongoing. Trial registration Registered at ClinicalTrials.gov: NCT00652327

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

Early Experience with a Brief, Multimodal, Multidisciplinary Treatment Program for Fibromyalgia

Science.gov (United States)

Vincent, Ann; Whipple, Mary O.; Oh, Terry H.; Guderian, Janet A.; Barton, Debra L.; Luedtke, Connie A.

2014-01-01

Fibromyalgia is a complex, heterogeneous disorder for which a multidisciplinary individualized approach is currently advocated. We executed a 1 week multidisciplinary fibromyalgia clinical program with 7 patients, based on our previous experience with our existing 1.5 day multidisciplinary fibromyalgia program that has demonstrated both short- and long-term benefits. The current expanded program was not designed as a clinical study, but rather as a clinical feasibility assessment and was multidisciplinary in nature, with cognitive behavioral therapy, activity pacing and graded exercise therapy as major components. We assessed changes in individual patients at 1 week and 3 months following the program utilizing validated self-report measures of pain, fatigue, and self-efficacy. All patients indicated at least small improvements in pain and physical symptoms both at 1 week and 3 months and all but one patient showed improvement in self-efficacy at 1 week and 3 months. Similar trends were observed for fatigue. Based on our early clinical experience, we conclude that the 1 week multidisciplinary fibromyalgia program is logistically feasible and has potential for clinical efficacy. Further research is needed and is planned to test the clinical efficacy of this program and compare it with other interventions. PMID:24315246

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.

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.....

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...

Myositis in the head and neck: challenges in diagnosis and management.

Science.gov (United States)

Ratansi, R; Fabbroni, G; Kanatas, A

2017-09-01

Myositis in the head and neck may present with non-specific symptoms, and radiographically may mimic malignancy. Multidisciplinary management is often essential, and we describe the challenges in an effort to raise awareness of the condition. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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.

Applied Linguistics: The Challenge of Theory

Science.gov (United States)

McNamara, Tim

2015-01-01

Language has featured prominently in contemporary social theory, but the relevance of this fact to the concerns of Applied Linguistics, with its necessary orientation to practical issues of language in context, represents an ongoing challenge. This article supports the need for a greater engagement with theory in Applied Linguistics. It considers…

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

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.

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.

A Team Formation Framework for Managing Diversity in Multidisciplinary Engineering Project

Directory of Open Access Journals (Sweden)

Shawqi Mohammed Hossain

2017-02-01

Full Text Available Team formation is one of the essential elements in constructing effective teamwork of any team size that requires different skill sets. Diversity in team encourages students to challenge and compete with one another while searching for new ideas, which in turn can lead to a better team performance. In a well-functioning diverse teams, the students who performed poorly may gain benefit by observing how excellent students approach the assignments. They may also benefit by getting advice and assistance from the excellent students. Studies have shown that Malaysian university graduates lack of team skills. The purpose of this paper is to propose a framework for forming a diverse multidisciplinary team among engineering undergraduates based on selected criteria such as individual personality type, gender, and other relevant demographic information. The proposed framework can also be used to design an automated team-formation system based on the identified metrics. The purpose of the framework is to consolidate the existing team formation literature, and to develop and test interventions for maximizing individual member and team performance as a whole that makes an effective team. For this study, a multidisciplinary approach was used where first year engineering students from three different faculties, namely Faculty of Electrical Engineering (FKE, Faculty of Mechanical Engineering (FKM, and Faculty of Biosciences and Medical Engineering (FBME at Universiti Teknologi Malaysia (UTM worked on an innovation project using the Conceive, Design, Implement, and Operate (CDIO framework. Keirsey Temperament Sorter was used as an instrument to identify an individual's personality type.

Improving outcomes in lung cancer: the value of the multidisciplinary health care team

Directory of Open Access Journals (Sweden)

Denton E

2016-03-01

Full Text Available Eve Denton,1 Matthew Conron2 1Allergy, Immunology and Respiratory Department, Alfred Hospital, 2Department of Respiratory and Sleep Medicine, St Vincent's Hospital, Melbourne, VIC, Australia Abstract: Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed. Keywords: lung cancer, multidisciplinary care, mortality, tumor board

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: Searching the evidence to guide the decision

Energy Technology Data Exchange (ETDEWEB)

Oh, In Jae; Ahn, Sung Ja [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

2017-03-15

Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article.

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: Searching the evidence to guide the decision

International Nuclear Information System (INIS)

Oh, In Jae; Ahn, Sung Ja

2017-01-01

Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article

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.

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

Multidisciplinary Inverse Reliability Analysis Based on Collaborative Optimization with Combination of Linear Approximations

Directory of Open Access Journals (Sweden)

Xin-Jia Meng

2015-01-01

Full Text Available Multidisciplinary reliability is an important part of the reliability-based multidisciplinary design optimization (RBMDO. However, it usually has a considerable amount of calculation. The purpose of this paper is to improve the computational efficiency of multidisciplinary inverse reliability analysis. A multidisciplinary inverse reliability analysis method based on collaborative optimization with combination of linear approximations (CLA-CO is proposed in this paper. In the proposed method, the multidisciplinary reliability assessment problem is first transformed into a problem of most probable failure point (MPP search of inverse reliability, and then the process of searching for MPP of multidisciplinary inverse reliability is performed based on the framework of CLA-CO. This method improves the MPP searching process through two elements. One is treating the discipline analyses as the equality constraints in the subsystem optimization, and the other is using linear approximations corresponding to subsystem responses as the replacement of the consistency equality constraint in system optimization. With these two elements, the proposed method realizes the parallel analysis of each discipline, and it also has a higher computational efficiency. Additionally, there are no difficulties in applying the proposed method to problems with nonnormal distribution variables. One mathematical test problem and an electronic packaging problem are used to demonstrate the effectiveness of the proposed method.

Multidisciplinary Cooperation by Students in a European University of Applied Sciences

Science.gov (United States)

Kamphorst, Jan Cornelis

2018-01-01

Today, multidisciplinary cooperation is an important objective of higher vocational education in Europe as well as other countries. The aim of this study was to explore how, and to what extent, fourth year bachelor students from different domains cooperate in multidisciplinary teams at two research centers. Data for 71 students were collected with…

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)

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.

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...

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.

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

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.

Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial

NARCIS (Netherlands)

van Eijk-Hustings, Yvonne; Kroese, Mariëlle; Tan, Frans; Boonen, Annelies; Bessems-Beks, Monique; Landewé, Robert

2013-01-01

This study aimed to examine the effectiveness of a multidisciplinary intervention with aftercare (MD) compared to aerobic exercise (AE) and usual care (UC) in recently diagnosed patients with fibromyalgia (FM). In a Zelen-like design, eligible patients from the outpatient rheumatology clinics of

The relation of ongoing brain activity, evoked neural responses, and cognition

Directory of Open Access Journals (Sweden)

Sepideh Sadaghiani

2010-06-01

Full Text Available Ongoing brain activity has been observed since the earliest neurophysiological recordings and is found over a wide range of temporal and spatial scales. It is characterized by remarkably large spontaneous modulations. Here, we review evidence for the functional role of these ongoing activity fluctuations and argue that they constitute an essential property of the neural architecture underlying cognition. The role of spontaneous activity fluctuations is probably best understood when considering both their spatiotemporal structure and their functional impact on cognition. We first briefly argue against a ‘segregationist’ view on ongoing activity, both in time and space, countering this view with an emphasis on integration within a hierarchical spatiotemporal organization of intrinsic activity. We then highlight the flexibility and context-sensitivity of intrinsic functional connectivity that suggest its involvement in functionally relevant information processing. This role in information processing is pursued by reviewing how ongoing brain activity interacts with afferent and efferent information exchange of the brain with its environment. We focus on the relationship between the variability of ongoing and evoked brain activity, and review recent reports that tie ongoing brain activity fluctuations to variability in human perception and behavior. Finally, these observations are discussed within the framework of the free-energy principle which – applied to human brain function - provides a theoretical account for a non-random, coordinated interaction of ongoing and evoked activity in perception and behaviour.

Postoperative ascitic leaks: the ongoing challenge.

Science.gov (United States)

Rosemurgy, A S; Statman, R C; Murphy, C G; Albrink, M H; McAllister, E W

1992-06-01

The leak of ascitic fluid from surgical incisions is thought to be associated with a very high mortality rate. There have been few reports, however, focusing on the clinical characteristics, management, or mortality rates of this condition. During a 10-year period, 18 patients with postoperative ascitic fluid leaks were treated. All patients had ascites before surgery and all had liver disease; in 13 of the 18 patients alcoholic liver disease was the cause of ascites. Ten of the 18 patients died (56%). Midline incisions were more often associated with recalcitrant leaks and fatal complications than were transverse incisions. Early consideration of fascial dehiscence and prompt repair is emphasized. The most effective predictor of survival was cessation of the leak.

Plant genetic resources for food and agriculture: opportunities and challenges emerging from the science and information technology revolution.

Science.gov (United States)

Halewood, Michael; Chiurugwi, Tinashe; Sackville Hamilton, Ruaraidh; Kurtz, Brad; Marden, Emily; Welch, Eric; Michiels, Frank; Mozafari, Javad; Sabran, Muhamad; Patron, Nicola; Kersey, Paul; Bastow, Ruth; Dorius, Shawn; Dias, Sonia; McCouch, Susan; Powell, Wayne

2018-03-01

Contents Summary 1407 I. Introduction 1408 II. Technological advances and their utility for gene banks and breeding, and longer-term contributions to SDGs 1408 III. The challenges that must be overcome to realise emerging R&D opportunities 1410 IV. Renewed governance structures for PGR (and related big data) 1413 V. Access and benefit sharing and big data 1416 VI. Conclusion 1417 Acknowledgements 1417 ORCID 1417 References 1417 SUMMARY: Over the last decade, there has been an ongoing revolution in the exploration, manipulation and synthesis of biological systems, through the development of new technologies that generate, analyse and exploit big data. Users of Plant Genetic Resources (PGR) can potentially leverage these capacities to significantly increase the efficiency and effectiveness of their efforts to conserve, discover and utilise novel qualities in PGR, and help achieve the Sustainable Development Goals (SDGs). This review advances the discussion on these emerging opportunities and discusses how taking advantage of them will require data integration and synthesis across disciplinary, organisational and international boundaries, and the formation of multi-disciplinary, international partnerships. We explore some of the institutional and policy challenges that these efforts will face, particularly how these new technologies may influence the structure and role of research for sustainable development, ownership of resources, and access and benefit sharing. We discuss potential responses to political and institutional challenges, ranging from options for enhanced structure and governance of research discovery platforms to internationally brokered benefit-sharing agreements, and identify a set of broad principles that could guide the global community as it seeks or considers solutions. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

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.

The ultimate challenge of pregnancy-associated breast carcinoma

International Nuclear Information System (INIS)

Raja, R.; Tahira, A.

2005-01-01

Pregnancy associated breast carcinoma requires making judicious use of all diagnostic modalities and the therapeutic options of surgery, irradiation, chemotherapy and hormonal therapy to enhance survival rates. Individualization of treatment for each patient is the key to success. The effects on future fertility, the time interval before next conception, and whether to breast feed or not are all well-documented. A multidisciplinary coordinated team approach to this ultimate challenge of patient care will prove fruitful. (author)

Ongoing Model Development Analyzing Glass Fracture

DEFF Research Database (Denmark)

Molnar, G.; Bojtar, I.; Nielsen, Jens Henrik

2013-01-01

Present subject deals with an ongoing experimental and numerical analysis of inplane loaded glass plates. The main goal of the investigation is to develop a hybrid – discrete and finite element – model which could follow the fracture process in annealed and in tempered glass. Measurements of the ...... an overview of the structure of the research and a summary of current status archived so far.......Present subject deals with an ongoing experimental and numerical analysis of inplane loaded glass plates. The main goal of the investigation is to develop a hybrid – discrete and finite element – model which could follow the fracture process in annealed and in tempered glass. Measurements...... of the residual stress state before failure and high-speed camera recordings of the failure are being performed in order to verify the numerical model. The primary goal of this research is to follow the overall fracture of a structural element – e.g. beam – loaded inplane. Present paper would like to give...

Quality of care using a multidisciplinary team in the emergency room

DEFF Research Database (Denmark)

Christensen, Dorthea; Maaløe, Rikke; Jensen, Nanna Martin

2011-01-01

Bispebjerg Hospital has implemented a multidisciplinary team reception of critically ill and severely injured patients at the Emergency Department (ED), termed emergency call (EC) and trauma call (TC). The aim of this study was to describe the course, medical treatment and outcome for patients re...... received by this multidisciplinary team and to evaluate the quality of acute medical treatment of these patients....

Development of a Multi-Disciplinary Aerothermostructural Model Applicable to Hypersonic Flight

Science.gov (United States)

Kostyk, Chris; Risch, Tim

2013-01-01

The harsh and complex hypersonic flight environment has driven design and analysis improvements for many years. One of the defining characteristics of hypersonic flight is the coupled, multi-disciplinary nature of the dominant physics. In an effect to examine some of the multi-disciplinary problems associated with hypersonic flight engineers at the NASA Dryden Flight Research Center developed a non-linear 6 degrees-of-freedom, full vehicle simulation that includes the necessary model capabilities: aerothermal heating, ablation, and thermal stress solutions. Development of the tool and results for some investigations will be presented. Requirements and improvements for future work will also be reviewed. The results of the work emphasize the need for a coupled, multi-disciplinary analysis to provide accurate

A multidisciplinary TBI inpatient rehabilitation programme for active duty service members as part of a randomized clinical trial.

Science.gov (United States)

Braverman, S E; Spector, J; Warden, D L; Wilson, B C; Ellis, T E; Bamdad, M J; Salazar, A M

1999-06-01

To design and describe an effective rehabilitation programme for use in an ongoing trial on the efficacy of multidisciplinary brain injury rehabilitation for moderately head injury military service members. Treatment arm of a randomized control trial. US military tertiary care hospital inpatient rehabilitation programme. Sixty seven active duty military with moderate to severe TBI who were randomized to the treatment arm of the protocol. Eight week rehabilitation programme combining group and individual therapies with an inpatient milieu-oriented neuropsychological focus. Group therapies included fitness, planning and organization, cognitive skills, work skills, medication, and milieu groups, and community re-entry outings. Individual therapy included neuropsychology, work therapy, occupational therapy, and speech and language pathology. Successful return to work and return to duty. At 1 year follow-up, 64 patients returned to work (96%) and 66% (44/67) returned to duty. The described rehabilitation programme demonstrates one successful effort to rehabilitate active duty military service members with TBI who have the potential to return to duty.

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

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...

Exploring team working and shared leadership in multi-disciplinary cancer care.

Science.gov (United States)

Willcocks, Stephen George

2018-02-05

Purpose The purpose of this paper is to explore the relevance of shared leadership to multi-disciplinary cancer care. It examines the policy background and applies concepts from shared leadership to this context. It includes discussion of the implications and recommendations. Design/methodology/approach This is a conceptual paper examining policy documents and secondary literature on the topic. While it focuses on the UK National Health Services, it is also relevant to other countries given they follow a broadly similar path with regard to multi-disciplinary working. Findings The paper suggests that shared leadership is a possible way forward for multi-disciplinary cancer care, particularly as policy developments are supportive of this. It shows that a shared perspective is likely to be beneficial to the further development of multi-disciplinary working. Research limitations/implications Adopting shared leadership needs to be explored further using appropriate empirical research. Practical implications The paper offers comments on the implications of introducing shared leadership and makes recommendations including being aware of the barriers to its implementation. Originality/value The paper offers an alternative view on leadership in the health-care context.

Multidisciplinary teaching in swimming: methodological reflection and proposal of check list

Directory of Open Access Journals (Sweden)

Sofia Canossa

2007-12-01

Full Text Available The present study proposes a new multidisciplinary approach related to teaching in swimming. Swimming is an interdisciplinary physical activity, which can be truly important at the level of the motor learning and experimentation in aquatic activities. In the present manuscript, it was compared the present reality of teaching in Swimming with a new perspective, this one with a multidisciplinary scope. Following the referred analysis, it was presented a discussion about the orientation and adequacy of the contents of the Swimming curriculum for children and youngsters, which are populations with specific characteristics and development necessities. In this sense, after stating the relevance of a multidisciplinary perspective, it was proposed a new approach for basic aquatic motor skills acquisition based on four disciplines: swimming, water polo, synchronised swimming and platform diving. This was made taking into account the initial stage of swimming teaching, i.e., aquatic readiness. This proposal aims mainly at implementing the teaching of Swimming at a multidisciplinary point of view that, in our opinion, is urgent, namely due to the small expression that the aquatic modalities traditionally considered as swimming satellites (water polo, synchronised swimming and platform diving have in the Portuguese sports context.

A Nurse-Led Innovation in Education: Implementing a Collaborative Multidisciplinary Grand Rounds.

Science.gov (United States)

Matamoros, Lisa; Cook, Michelle

2017-08-01

Multidisciplinary grand rounds provides an opportunity to promote excellence in patient care through scholarly presentations and interdisciplinary collaboration with an innovative approach. In addition, multidisciplinary grand rounds serves to recognize expertise of staff, mentor and support professional development, and provide a collaborative environment across all clinical disciplines and support services. This article describes a process model developed by nurse educators for implementing a multidisciplinary grand rounds program. The components of the process model include topic submissions, coaching presenters, presentations, evaluations, and spreading the work. This model can be easily implemented at any organization. J Contin Educ Nurs. 2017;48(8):353-357. Copyright 2017, SLACK Incorporated.

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)

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

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

Exploring Challenges of Self-Monitoring for Senior Adults

DEFF Research Database (Denmark)

Verdezoto, Nervo; Grönvall, Erik; Vincentz, Sofie

In this paper we discuss some of the challenges and opportunities for the implementation of self-monitoring technologies in senior adults everyday lives. We present our experiences from a self-monitoring case study. We further describe our design process as part of the ongoing Lev Vel Project...

LMI–based robust controller design approach in aircraft multidisciplinary design optimization problem

Directory of Open Access Journals (Sweden)

Qinghua Zeng

2015-07-01

Full Text Available This article proposes a linear matrix inequality–based robust controller design approach to implement the synchronous design of aircraft control discipline and other disciplines, in which the variation in design parameters is treated as equivalent perturbations. Considering the complicated mapping relationships between the coefficient arrays of aircraft motion model and the aircraft design parameters, the robust controller designed is directly based on the variation in these coefficient arrays so conservative that the multidisciplinary design optimization problem would be too difficult to solve, or even if there is a solution, the robustness of design result is generally poor. Therefore, this article derives the uncertainty model of disciplinary design parameters based on response surface approximation, converts the design problem of the robust controller into a problem of solving a standard linear matrix inequality, and theoretically gives a less conservative design method of the robust controller which is based on the variation in design parameters. Furthermore, the concurrent subspace approach is applied to the multidisciplinary system with this kind of robust controller in the design loop. A multidisciplinary design optimization of a tailless aircraft as example is shown that control discipline can be synchronous optimal design with other discipline, especially this method will greatly reduce the calculated amount of multidisciplinary design optimization and make multidisciplinary design optimization results more robustness of flight performance.

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...

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

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...

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.

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.

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...

Surgical center: challenges and strategies for nurses in managerial activities.

Science.gov (United States)

Martins, Fabiana Zerbieri; Dall'Agnoll, Clarice Maria

2017-02-23

Analyze the challenges and strategies of nurses performing managerial activities in a surgical center. Exploratory, descriptive study with a qualitative approach, involving six nurses by means of the Focus Group Technique, between April and August 2013. Data were submitted to thematic content analysis. The main challenges noted were deficiency of material resources, communication noise, adequacy of personnel downsizing, and relationships with the multidisciplinary team. Key strategies include construction of co-management spaces to promote integration among professionals, conflict resolution and exchange of knowledge. Managerial activities involve the promotion of dialogic moments to coordinate the different processes in the surgical center to provide inputs to expand safety and quality of services provided.

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, ...

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

Ongoing Space Physics - Astrophysics Connections

OpenAIRE

Eichler, David

2005-01-01

I review several ongoing connections between space physics and astrophysics: a) Measurements of energetic particle spectra have confirmed theoretical prediction of the highest energy to which shocks can accelerate particles, and this has direct bearing on the origin of the highest energy cosmic rays. b) Mass ejection in solar flares may help us understand photon ejection in the giant flares of magnetar outbursts. c) Measurements of electron heat fluxes in the solar wind can help us understand...

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

DEFF Research Database (Denmark)

Fisker, Annette; Langberg, Henning; Petersen, Tom

2013-01-01

this type of intervention, and the implementation of a return-to-work (RTW)-coordinator is suggested as an effective strategy in this process. The purpose of this paper is to describe the study protocol and present a new type of intervention, where the physiotherapist both has the role as RTW...... after a period of sick leave. It seems that a multidisciplinary intervention, including cooperation between the health sector, the social sector and in the work place, has a positive effect on days off work due to musculoskeletal disorders and particularly low back pain. It is a challenge to coordinate...

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

Multidisciplinary practice experience of nursing faculty and their collaborators for primary health care in Korea.

Science.gov (United States)

Kim, Mi Ja; Chung, Hyang-In Cho; Ahn, Yang Heui

2008-03-01

This study aimed to describe the range of participation of nursing faculty members and their collaborators in multidisciplinary primary health care in Korea and to analyze facilitators, benefits, barriers, and learned lessons. An exploratory descriptive research design was utilized. A total of 13 nursing faculty members and 13 multidisciplinary collaborators were interviewed face to face using a brief questionnaire and semi-structured interview guide. Descriptive statistics, comparative analysis, and content analysis were used for data analysis. About 43% of the nursing faculty had multidisciplinary primary health care experience. Facilitators included a government-funded research/demonstration project, personal belief and expertise in primary health care, and well-delineated role boundaries. Benefits included improved quality of life, more convenient community life, meeting multifaceted needs of community residents, and enhanced research activities. Barriers were lack of teamwork; territoriality and self-protective behaviors; lack of insight into primary health care among stakeholders; nurses undervaluing their work; and the rigid bureaucratic system of public health centers. Learned lessons were the importance of teamwork and its synergistic benefits, the importance of conducting clinically relevant research, having the government's support in the improvement of public health, developing health policies through multidisciplinary primary health care (M-D PHC) work, and respecting each other's territory and expertise. 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

The challenge of wolf recovery: an ongoing dilemma for state managers

Science.gov (United States)

Mech, L. David

2013-01-01

“Dave, would you do another legal declaration on the wolf for us?” The weary voice on the phone belonged to Mike Jimenez, Northern Rocky Mountain Wolf Management and Science Coordinator for the U.S. Fish and Wildlife Service (FWS). He was calling from Wyoming to ask me to prepare a document to address a legal challenge to the FWS’s August 2012 delisting of the wolf (Canis lupus) in Wyoming, a highly controversial move. Mike’s tone reflected the reality that — as so many wildlife biologists know and live each day — wildlife management is mainly people management. This contention could not be truer for managing any wildlife species than for managing the wolf. Dubbed “the beast of waste and desolation” by Teddy Roosevelt (The Wilderness Hunter 1893/1900), wolves had been universally hated as prolific predators of valuable livestock and game. Around the turn of the 20th century, members of the U.S. Biological Survey and various state agents, ranchers, cowboys, and other frontiersmen poisoned and persecuted wolves, extirpating them from most of the contiguous United States (Young and Goldman 1944). By 1967, Minnesota and nearby Isle Royale National Park in Michigan held the only remaining wolves in the Lower 48 states, prompting the FWS to place the wolf on the Endangered Species List (established by the Endangered Species Preservation Act of 1966). The wolf then became the list’s poster species, and the timing was ideal: Silent Spring (Carson 1962) had just seeded and fertilized the environmental movement, which blossomed on Earth Day (April 22, 1970) into the environmental revolution. “Save the wolf!” became one of the movement’s rallying cries. And save the wolf we did.

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.

The feasibility and efficacy of a multidisciplinary intervention with aftercare meetings for fibromyalgia

NARCIS (Netherlands)

Kroese, Mariëlle; Schulpen, Guy; Bessems, Monique; Nijhuis, Frans; Severens, Johan; Landewé, Robert

2009-01-01

The objective of this study is to examine the feasibility and long-term results of a 12-week multidisciplinary part-time daycare intervention with five aftercare meetings in fibromyalgia (FM) patients. One hundred and five patients diagnosed with FM started with a multidisciplinary intervention and

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

Directory of Open Access Journals (Sweden)

Procter S

2015-04-01

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

GEOSS: Addressing Big Data Challenges

Science.gov (United States)

Nativi, S.; Craglia, M.; Ochiai, O.

2014-12-01

In the sector of Earth Observation, the explosion of data is due to many factors including: new satellite constellations, the increased capabilities of sensor technologies, social media, crowdsourcing, and the need for multidisciplinary and collaborative research to face Global Changes. In this area, there are many expectations and concerns about Big Data. Vendors have attempted to use this term for their commercial purposes. It is necessary to understand whether Big Data is a radical shift or an incremental change for the existing digital infrastructures. This presentation tries to explore and discuss the impact of Big Data challenges and new capabilities on the Global Earth Observation System of Systems (GEOSS) and particularly on its common digital infrastructure called GCI. GEOSS is a global and flexible network of content providers allowing decision makers to access an extraordinary range of data and information at their desk. The impact of the Big Data dimensionalities (commonly known as 'V' axes: volume, variety, velocity, veracity, visualization) on GEOSS is discussed. The main solutions and experimentation developed by GEOSS along these axes are introduced and analyzed. GEOSS is a pioneering framework for global and multidisciplinary data sharing in the Earth Observation realm; its experience on Big Data is valuable for the many lessons learned.

MUSE: Challenges to integrate the Multi-Disciplinary field of BB access in one project

NARCIS (Netherlands)

Fatome, J.; Pitois, S.; Kamagate, A.; Maillotte, H.; Massoubre., D.; González-Herráez, G.-H.; Smedt, A. de; Brink, R. van den

2006-01-01

The present paper discusses the managerial challenges of the MUSE integrated project on multi service broadband access. It addresses different aspects such as matrix organisation, project office, consensus process, standardisation, dissemination, and quality control.

Challenge Based Innovation gala

CERN Multimedia

CERN. Geneva; Utriainen, Tuuli Maria; Toivonen, Harri; Nordberg, Markus

2014-01-01

Challenge Based Innovation gala   There’s a new experiment starting in CERN called IdeaLab where we work together with detector R&D researchers to help them to bridge their knowledge into a more human, societally oriented context. Currently we are located in B153, but will move our activities to a new facility next to the Globe in May 2014. One of our first pilot projects is a 5 month course CBI (Challenge Based Innovation) where two multidisciplinary student teams join forces with Edusafe & TALENT projects at CERN. Their goal is to discover what kind of tools for learning could be created in collaboration with the two groups. After months of user interviews and low resolution prototyping they are ready to share the results with us in the form of an afternoon gala. We warmly welcome you to join us to see the students' results and experience the prototypes they have conceived. The event is in three parts, you are welcome to visit all of them,...

Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process.

Science.gov (United States)

Evangelista, Viviane Canhizares; Domingos, Thiago da Silva; Siqueira, Fernanda Paula Cerântola; Braga, Eliana Mara

2016-01-01

to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team. descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis. from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization. care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.

Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

DEFF Research Database (Denmark)

Tengberg, L. T.; Bay-Nielsen, M.; Bisgaard, T.

2017-01-01

Background: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery...... = 0·004). Conclusion: The introduction of a multidisciplinary perioperative protocol was associated with a significant reduction in postoperative mortality in patients undergoing AHA surgery. NCT01899885 (http://www.clinicaltrials.gov)....

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.…

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

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.

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...

Water Policy Reforms in South Korea: A Historical Review and Ongoing Challenges for Sustainable Water Governance and Management

Directory of Open Access Journals (Sweden)

Ik-Chang Choi

2017-09-01

Full Text Available This study aims to provide an opinion on the state-of-the-art of changes and reforms of water policies in South Korea, as well as the challenges along with their implications for sustainable water governance and management. In parallel with change in water resource characteristics generated by physical, environmental and socio-economic challenges such as: (1 uncertainties about climate change (flooding and drought including seasonal and regional variation in precipitation; (2 significant increase in water use caused by rapid urbanization and population growth in industrialized urban areas; (3 inadequate water pricing mechanism which covers only around 80% of the production cost and makes it harder to maintain water systems; and (4 recursive water quality degradation and conflicts over water rights between regions resulting from non-point source pollution in highland versus lowland areas, Korean water policies have been developed through diverse reforms over 100 years. Nevertheless, new challenges for sustainable water management are continuously emerging. To meet those challenges we provide two ideas: (i provider-gets-principle (payment for ecosystem services of cost-benefit sharing among stakeholders who benefit from water use; and (ii water pricing applying full-cost pricing-principle internalizing environmental externalities caused by the intensive water use. Funds secured from the application of those methods would facilitate: (1 support for upstream (rural low income householders suffering from economic restrictions; (2 improvement in water facilities; and (3 efficient water use and demand management in South Korea’s water sectors. We expect that this paper can examine the lessons relevant to challenges that South Korea faces and offer some implications on the formulation of new integration and further reforms of the institutions, laws and organizations responsible for managing water resources in South Korea.

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

Science.gov (United States)

2012-01-01

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

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…

Multigenerational challenges in academic medicine: UCDavis's responses.

Science.gov (United States)

Howell, Lydia Pleotis; Servis, Gregg; Bonham, Ann

2005-06-01

Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

Challenges of technological trends in nursing and coping strategies ...

African Journals Online (AJOL)

Background: Technology in nursing has been shown to reduce redundancy and improve efficiency of work. Information Communication and technology (ICT) incorporation in nursing at Kenyatta national Hospital (KNH) has been ongoing for some years yet the uptake seemingly is slow. Challenges that could be associated ...

The evolving role of the breast physician in the multidisciplinary breast team.

Science.gov (United States)

Brennan, Meagan; Spillane, Andrew

2007-10-01

Breast physicians are medical practitioners trained in the diagnosis and management of breast disease. This relatively small group of specialized clinicians has a unique and expanding role in multidisciplinary breast teams in Australia and New Zealand. With minimal available published works, this article studies the varied roles that breast physicians carry out and the way they participate in the multidisciplinary team. Investigation of their current roles in breast medicine identified breast physicians providing a broad range of clinical care in public and private breast clinics and breast screening programmes as well as holding academic and administrative positions in clinical and non-clinical organizations. Numerous benefits for patients and for specialist breast clinicians working in partnership with breast physicians were identified. Breast surgeons are often the most advantaged by the contributions made by the breast physician to the multidisciplinary breast-care team with breast physicians particularly adding value to the service provided by breast surgeons. Breast physicians are well-trained, highly valuable members of the multidisciplinary breast team with a skill set that may enhance patient care at all stages from diagnosis to treatment to follow up.

Challenge Based Innovation @ mediterranean - final presentations & prototype expo

CERN Multimedia

CERN. Geneva

2015-01-01

Challenge Based Innovation @ mediterranean - Final presentations & prototype expo Challenge Based Innovation (CBI) is a six-month project course, where multidisciplinary student teams and their instructors collaborate with researchers at CERN to discover novel solutions for the future of humankind. The projects are an elaborate mixture, where societal, human-driven needs meet research at CERN. More info about CBI from the course website, cbi-course.com The Gala on 10.12. will introduce the proof-of concept prototypes the four student teams have developed to answer a wide range of societal challenges, inspired by people and research at CERN.   Dress code: a suit / dress  is not required - come as you are! Register for live attendance & CERN access for external visitors. Webcast and/or recorded presentations will be available here in the Indico page for anyone interested.  The space is limited to 50 participants, so act quickly! &...

Challenge Based Innovation @ mediterranean - final presentations & prototype expo

CERN Multimedia

CERN. Geneva

2016-01-01

Challenge Based Innovation @ mediterranean - Final presentations & prototype expo Note - presentation location has been changed to the council chamber (503-1-001) due to the large amount of signups. External participants are guided from the main reception (building 33), more information over email on Wednesday. Prototype presentations are still at IdeaSquare (3179) 18.00 - 19.30, guided walking from the presentations.  Challenge Based Innovation (CBI) is a four month project course, where multidisciplinary student teams and their instructors collaborate with researchers at CERN to discover novel solutions for the future of humankind. The projects are an elaborate mixture, where societal, human-driven needs meet research at CERN. More info about CBI from the course website, cbi-course.com The Gala on 1.12. will introduce the proof-of concept prototypes the five student teams have developed to answer a wide range of societal challenges, inspired by people and r...

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...

The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

Directory of Open Access Journals (Sweden)

Hyun Ho Han

2016-03-01

Full Text Available BackgroundThe prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center.MethodsThe multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation.ResultsThe abortion rate was 28% (3/11. The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91% reported that they were satisfied with the multidisciplinary management in our center.ConclusionsAlthough a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

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.

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.

Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Directory of Open Access Journals (Sweden)

Knight CL

2017-03-01

Full Text Available Caroline L Knight, Catherine Nelson-Piercy Division of Women’s Health, Women’s Health Academic Centre, King’s College London and King’s Health Partners, St Thomas’ Hospital, London, UK Abstract: Systemic lupus erythematosus (SLE is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal–neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy. In pregnancy, early referral for hospital-coordinated care, involvement of obstetricians and rheumatologists (and other specialists as required, an individual management plan, regular reviews, and early recognition of flares and complications are all important. Women are at risk of lupus flares, worsening renal impairment, onset of or worsening hypertension, preeclampsia, and/or venous thromboembolism, and miscarriage, intrauterine growth restriction, preterm delivery, and/or neonatal lupus syndrome (congenital heart block or neonatal lupus erythematosus. A cesarean section may be required in certain obstetric contexts (such as urgent preterm delivery for maternal and/or fetal well-being, but vaginal birth should be the aim for the majority of women. Postnatally, an ongoing individual management plan remains important, with neonatal management where necessary and rheumatology follow-up. This article explores the challenges at each stage of pregnancy, discusses the effect of SLE on pregnancy and

The Challenges of Recruiting Patients into a Sham Surgery Trial

DEFF Research Database (Denmark)

Hare, Kristoffer Borbjerg; Lohmander, Stefan; Roos, Ewa M.

the challenges in recruiting patients into a placebo controlled surgical trial of arthroscopic partial meniscectomy. Materials and Methods Results presented are from an ongoing RCT where patients aged 35-55 with an MRI confirmed degenerative medial meniscus tear were randomized to arthroscopic partial...

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

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...

HEP technologies to address medical imaging challenges

CERN Multimedia

CERN. Geneva

2016-01-01

Developments in detector technologies aimed at solving challenges in present and future CERN experiments, particularly at the LHC, have triggered exceptional advances in the performance of medical imaging devices, allowing for a spectacular progress in in-vivo molecular imaging procedures, which are opening the way for tailored therapies of major diseases. This talk will briefly review the recent history of this prime example of technology transfer from HEP experiments to society, will describe the technical challenges being addressed by some ongoing projects, and will present a few new ideas for further developments and their foreseeable impact.

The psychological complexity of predictive testing for late onset neurogenetic diseases and hereditary cancers: implications for multidisciplinary counselling and for genetic education.

Science.gov (United States)

Evers-Kiebooms, G; Welkenhuysen, M; Claes, E; Decruyenaere, M; Denayer, L

2000-09-01

Increasing knowledge about the human genome has resulted in the availability of a steadily increasing number of predictive DNA-tests for two major categories of diseases: neurogenetic diseases and hereditary cancers. The psychological complexity of predictive testing for these late onset diseases requires careful consideration. It is the main aim of the present paper to describe this psychological complexity, which necessitates an adequate and systematic multidisciplinary approach, including psychological counselling, as well as ongoing education of professionals and of the general public. Predictive testing for neurogenetic diseases--in an adequate counselling context--so far elicits optimism regarding the short- and mid-term impact of the predictive test result. The psychosocial impact has been most widely studied for Huntington's disease. Longitudinal studies are of the utmost importance in evaluating the long-term impact of predictive testing for neurogenetic diseases on the tested person and his/her family. Given the more recent experience with predictive DNA-testing for hereditary cancers, fewer published scientific data are available. Longitudinal research on the mid- and long-term psychological impact of the predictive test result is essential. Decision making regarding health surveillance or preventive surgery after being detected as a carrier of one of the relevant mutations should receive special attention. Tailoring the professional approach--inside and outside genetic centres--to the families' needs is a continuous challenge. Even if a continuous effort is made, several important questions remain unanswered, last but not least the question regarding the best strategy to guarantee that the availability of predictive genetic testing results in a reduction of suffering caused by genetic disease and in an improvement of the quality of life of families confronted with genetic disease.

Multidisciplinary education in geriatric medicine. Continuing experience at the Middlesex Hospital.

Science.gov (United States)

Beynon, G P; Croker, J

1983-01-01

The unique feature about the course in teaching geriatric medicine to undergraduates at the Middlesex Hospital is its multidisciplinary nature. The course lasts for three weeks during the first or second clinical year and involves medical students together with student physiotherapists, nurses and occupational therapists. All take part in seminars, ward rounds and multidisciplinary case presentations. A full-time course organizer funded by the School of Nursing manages the course. Assessment includes MCQ and course evaluation questionnaire and an essay.

Multidisciplinary ENVIROMIS conferences as a tool connecting climate information producers and users

Science.gov (United States)

Gordov, E. P.; Lykosov, V. N.; Gordova, Yu E.; Genina, E. Yu

2016-11-01

The paper describes a regular multidisciplinary conference and early carrier scientists’ school ENVIROMIS as a tool for facilitation of cooperation of specialists in different fields of environmental sciences and users of research results. The conference addresses critically important issues occurring in environmental sciences, namely, crossing disciplinary borders of this multidisciplinary research area, young scientists’ training and diminishing a gap between science and decision-making. The viability of the approach to the Schools organization is proved by the fact that single event turned into a series, quite a few young participants successfully defended their PhD thesis and a number of researchers became Doctors of Science, several international multidisciplinary projects, initiated at these conferences, have been successfully carried out. Researchers from Russia and foreign countries show undiminishing interest to these conferences.

Time course of ongoing activity during neuritis and following axonal transport disruption.

Science.gov (United States)

Satkeviciute, Ieva; Goodwin, George; Bove, Geoffrey M; Dilley, Andrew

2018-05-01

Local nerve inflammation (neuritis) leads to ongoing activity and axonal mechanical sensitivity (AMS) along intact nociceptor axons and disrupts axonal transport. This phenomenon forms the most feasible cause of radiating pain, such as sciatica. We have previously shown that axonal transport disruption without inflammation or degeneration also leads to AMS but does not cause ongoing activity at the time point when AMS occurs, despite causing cutaneous hypersensitivity. However, there have been no systematic studies of ongoing activity during neuritis or noninflammatory axonal transport disruption. In this study, we present the time course of ongoing activity from primary sensory neurons following neuritis and vinblastine-induced axonal transport disruption. Whereas 24% of C/slow Aδ-fiber neurons had ongoing activity during neuritis, few (disruption of axonal transport without inflammation does not lead to ongoing activity in sensory neurons, including nociceptors, but does cause a rapid and transient development of AMS. Because it is proposed that AMS underlies mechanically induced radiating pain, and a transient disruption of axonal transport (as previously reported) leads to transient AMS, it follows that processes that disrupt axonal transport, such as neuritis, must persist to maintain AMS and the associated symptoms. NEW & NOTEWORTHY Many patients with radiating pain lack signs of nerve injury on clinical examination but may have neuritis, which disrupts axonal transport. We have shown that axonal transport disruption does not induce ongoing activity in primary sensory neurons but does cause transient axonal mechanical sensitivity. The present data complete a profile of key axonal sensitivities following axonal transport disruption. Collectively, this profile supports that an active peripheral process is necessary for maintained axonal sensitivities.

Reducing ongoing product design decision-making bias

NARCIS (Netherlands)

Antioco, M.; Moenaert, R.K.; Lindgreen, A.

2008-01-01

The objective of this exploratory study is to add to our understanding of ongoing product design decision-making to reduce eventual decision-making bias. Six research questions are formulated with the aim to establish if and how functional membership and informal patterns of communication within an

Health care multidisciplinary teams: The sociotechnical approach for an integrated system-wide perspective.

Science.gov (United States)

Marsilio, Marta; Torbica, Aleksandra; Villa, Stefano

The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another. Drawing on a system perspective of organizations, the authors analyze the organizational patterns that promote and support multidisciplinary teams and how they interrelate and interact to enforce the organization work system. The authors develop a modified sociotechnical system (STS) model to understand how the two dimensions of technical (devices/tools, layout/organization of space, core process standardization) and social (organizational structure, management of human resources and operations) can facilitate the implementation of multidisciplinary teams in health care. The study conducts an empirical analysis based on a sample of hospital adopters of transcatheter aortic valve implantation using the revised STS model. The modified STS model applied to the case studies improves our understanding of the critical implementation factors of a multidisciplinary approach and the importance of coordinating radical changes in the technical and the social subsystems of health care organizations. The analysis informs that the multidisciplinary effort is not a sequential process and that the interplay between the two subsystems needs to be managed efficaciously as an integrated organizational whole to deliver the goals set. Hospital managers must place equal focus on the closely interrelated technical and social dimensions by investing in (a) shared layouts and spaces that cross the boundaries of the specialized health care units, (b) standardization of the core processes through the implementation of local clinical pathways, (c) structured knowledge management mechanisms, (d) the creation of clinical directorates, and (e) the design of a planning and budgeting system that

Can a multi-disciplinary assessment approach improve outcomes for children with attention deficit hyperactivity disorder?

Science.gov (United States)

Bor, William; Heath, Fiona; Heussler, Honey; Reuter, Rebecca; Perrett, Carmel; Lee, Erica

2013-10-01

Public, consumer and professional views about attention deficit hyperactivity disorder, its assessment and treatment - especially with medication - remain a highly contested domain. Parents in particular express disquiet with services. One response to this tension is a multidisciplinary evaluation. Parental and education perceptions of this process have not been evaluated previously. A community multidisciplinary approach was assessed in terms of diagnostic outcomes and client satisfaction. A comprehensive multidisciplinary structured assessment of the first 50 referred children with severe attentional problems was documented. Demographic and symptom/behavioural profiles, developmental history and indicated multi-disciplinary evaluation were recorded. A team consensus process arrived at diagnostic classification. Post-assessment satisfaction of parents and school staff was surveyed. Thirteen children (26%) were diagnosed with attention deficit hyperactivity disorder and three commenced stimulants. The majority of parents and educators were satisfied with the service. A multidisciplinary assessment clinic for children presenting with attention problems resulted in minimal prescribing. Overall, education staff and parents were satisfied with the service. The model may be a suitable response to the multiple concerns in the community.

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

Programmatic challenges in obtaining and confirming the pneumococcal vaccination status of cochlear implant recipients.

Science.gov (United States)

Carpenter, Ryan M; Limb, Charles J; Francis, Howard W; Gottschalk, Barbara; Niparko, John K

2010-10-01

Bacterial meningitis represents a substantial concern for individuals with cochlear implants (CIs). Chart review and direct patient and family correspondence to ascertain vaccination status. Information dissemination via brochure and electronic media, ongoing reminders of the importance of vaccination when confirmation of vaccination was not received. Marked improvement in vaccination rates ranging from 49% to 99% across different patient populations. Importantly, many patients received their vaccinations only after follow-up reminders. Ensuring optimal vaccination of all CI recipients against high-risk pathogens is a significantly challenging task. Maximizing vaccination rates in CI users will require an ongoing, active effort of information dissemination, documentation of compliance, and well-designed behavioral systems to streamline the pragmatic challenges in vaccination delivery.

Impact of F-18 FDG-PET for the Clinical Multidisciplinary Evaluation of Dementia

DEFF Research Database (Denmark)

Prakash, Vineet; Vestergård, Karsten; Frost, Majbritt

PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET d...... or Frontotemporal dementia.                       CLINICAL RELEVANCE/APPLICATION            F18-FDG Brain PET with visual and automated analyses can be valuable  in a diagnostic algorithim for the work up of dementia when the cause is uncertain.......PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET...... patients had FDG-PET scans with visual and automated analyses. At a multidisciplinary meeting attended by a neuroradiologist and PET specialist, a pre-PET diagnosis, type of dementia and management plan was composed by a neurologist on the basis of clinical assessment, MRI, neuropsychometry...

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.

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

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.

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.

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.

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.

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 ...

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

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....

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.

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. [...

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. [...

The future of hydrogen - opportunities and challenges

International Nuclear Information System (INIS)

Ball, Michael; Wietschel, Martin

2009-01-01

The following article is reproduced from 'The Hydrogen Economy: Opportunities and Challenges', edited by Michael Ball and Martin Wietschel, to be published by Cambridge University Press in June 2009. In the light of ever-increasing global energy use, the increasing cost of energy services, concerns over energy supply security, climate change and local air pollution, this book centres around the question of how growing energy demand for transport can be met in the long term. Given the sustained interest in and controversial discussion of the prospects of hydrogen, the authors highlight the opportunities and the challenges of introducing hydrogen as alternative fuel in the transport sector from an economic, technical and environmental point of view. Through its multi-disciplinary approach the book provides a broad range of researchers, decision makers and policy makers with a solid and wide-ranging knowledge base concerning the hydrogen economy. (author)

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,

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...

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

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

Multi-disciplinary rehabilitation for acquired brain injury in adults of working age.

Science.gov (United States)

Turner-Stokes, Lynne; Pick, Anton; Nair, Ajoy; Disler, Peter B; Wade, Derick T

2015-12-22

Evidence from systematic reviews demonstrates that multi-disciplinary rehabilitation is effective in the stroke population, in which older adults predominate. However, the evidence base for the effectiveness of rehabilitation following acquired brain injury (ABI) in younger adults has not been established, perhaps because this scenario presents different methodological challenges in research. To assess the effects of multi-disciplinary rehabilitation following ABI in adults 16 to 65 years of age. We ran the most recent search on 14 September 2015. We searched the Cochrane Injuries Group Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (OvidSP), Web of Science (ISI WOS) databases, clinical trials registers, and we screened reference lists. Randomised controlled trials (RCTs) comparing multi-disciplinary rehabilitation versus routinely available local services or lower levels of intervention; or trials comparing an intervention in different settings, of different intensities or of different timing of onset. Controlled clinical trials were included, provided they met pre-defined methodological criteria. Three review authors independently selected trials and rated their methodological quality. A fourth review author would have arbitrated if consensus could not be reached by discussion, but in fact, this did not occur. As in previous versions of this review, we used the method described by Van Tulder 1997 to rate the quality of trials and to perform a 'best evidence' synthesis by attributing levels of evidence on the basis of methodological quality. Risk of bias assessments were performed in parallel using standard Cochrane methodology. However, the Van Tulder system provided a more discriminative evaluation of rehabilitation trials, so we have continued to use it for our primary synthesis of evidence. We subdivided trials in terms of

Exploration of fluorine chemistry at the multidisciplinary interface of chemistry and biology.

Science.gov (United States)

Ojima, Iwao

2013-07-05

Over the last three decades, my engagement in "fluorine chemistry" has evolved substantially because of the multidisciplinary nature of the research programs. I began my research career as a synthetic chemist in organometallic chemistry and homogeneous catalysis directed toward organic synthesis. Then, I was brought into a very unique world of "fluorine chemistry" in the end of 1970s. I started exploring the interface of fluorine chemistry and transition metal homogeneous catalysis first, which was followed by amino acids, peptides, and peptidomimetics for medicinal chemistry. Since then, I have been exploring the interfaces of fluorine chemistry and multidisciplinary fields of research involving medicinal chemistry, chemical biology, cancer biology, and molecular imaging. This perspective intends to cover my fruitful endeavor in the exploration of fluorine chemistry at the multidisciplinary interface of chemistry and biology in a chronological order to show the evolution of my research interest and strategy.

Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain: study protocol of a randomized controlled trial.

Science.gov (United States)

Fisker, Annette; Langberg, Henning; Petersen, Tom; Mortensen, Ole Steen

2013-03-13

Musculoskeletal disorders account for one third of the long-term absenteeism in Denmark and the number of individuals sick listed for more than four weeks is increasing. Compared to other diagnoses, patients with musculoskeletal diseases, including low back pain, are less likely to return to work after a period of sick leave. It seems that a multidisciplinary intervention, including cooperation between the health sector, the social sector and in the work place, has a positive effect on days off work due to musculoskeletal disorders and particularly low back pain. It is a challenge to coordinate this type of intervention, and the implementation of a return-to-work (RTW)-coordinator is suggested as an effective strategy in this process. The purpose of this paper is to describe the study protocol and present a new type of intervention, where the physiotherapist both has the role as RTW-coordinator and treating the patient. A randomized controlled trial (RCT) is currently on-going. The RCT includes 770 patients with low back pain of minimum four weeks who are referred to an outpatient back centre. The study population consists of patients, who are sick-listed or at risk of sick-leave due to LBP. The control group is treated with usual care in a team of a physiotherapist, a chiropractor, a rheumatologist and a social worker employed at the centre. The Intervention group is treated with usual care and in addition intervention of a psychologist, an occupational physician, an ergonomist, a case manager from the municipal sickness benefit office, who has the authority in the actual case concerning sickness benefit payment and contact to the patients employer/work place. The treating physiotherapist is the RTW-coordinator. Outcome will be reported at the end of treatment as well as 6 and 12 months follow up. The primary outcome is number of days off work. Secondary outcomes are disability, pain, and quality of life. The study will follow the recommendations in CONSORT

The challenges of dysphagia in treating motor neurone disease.

Science.gov (United States)

Vesey, Siobhan

2017-07-01

Motor neurone disease (MND) is a relatively rare degenerative disorder. Its impacts are manifested in progressive loss of motor function and often accompanied by wider non-motor changes. Swallowing and speech abilities are frequently severely impaired. Effective management of dysphagia (swallowing difficulty) symptoms and nutritional care requires a holistic multidisciplinary approach. Care must be patient focused, facilitate patient decision making, and support planning towards end of life care. This article discusses the challenges of providing effective nutritional care to people living with motor neurone disease who have dysphagia.

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

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.…

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments

Science.gov (United States)

Dougherty, Scott; Beaton, Andrea; Nascimento, Bruno R; Zühlke, Liesl J; Khorsandi, Maziar; Wilson, Nigel

2018-01-01

Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs. PMID:29440834

Detecting and quantifying ongoing decay of organic archaeological remains - a discussion of different approaches

DEFF Research Database (Denmark)

Matthiesen, Henning

2015-01-01

are well protected and are not undergoing rapid decay, and it requires a detailed knowledge of decay processes and rates. For instance it is well established that the presence of water is of paramount importance for the preservation of organic material, and there are several examples where archaeological....... Thus, for the management of archaeological sites it is necessary to develop tools and methods that allow us to discover ongoing decay as fast as possible. Furthermore, in order to prioritize between excavation, in situ preservation and mitigation the decay rate should be evaluated on a quantitative...... scale to determine if the archaeological remains can be preserved for centuries, decades or only a few years under different conditions. This is a challenging task as archaeological sites and materials are often heterogeneous and have been subjected to different site formation processes. This paper...

Searching for Grey Literature for Systematic Reviews: Challenges and Benefits

Science.gov (United States)

Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

2014-01-01

There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic…

Abdominal tuberculosis. On-going challenge to gastroenterologists

International Nuclear Information System (INIS)

Ibrahim, Mahgoub; Osuba, Abimbola

2005-01-01

The aim of this study is to record the observations and experience on the diagnosis and management of abdominal tuberculosis (TB) and to highlight the difficulties in the diagnosis and management of this condition. Two hundred consecutive patients attending the Gastroenterology Department of the King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia between May 1991 and May 2001, suspected with abdominal TB were investigated. A detailed clinical history and physical examination were obtained. Data of 75 confirmed cases of abdominal TB were analyzed. The most common presenting symptoms were anorexia (84%), abdominal pain (84%) and weight loss (72%). Abdominal tenderness was the most common clinical finding, followed by ascites and abdominal mass (42%). The chest radiograph suggestive of pulmonary TB was diagnosed in 24 patients (32%). Computed tomographic (CT) scanning revealed abnormalities in all 51 patients who underwent the procedure, while positive findings were observed by abdominal ultrasound in 66% of the tested patients. Histopathological examination of patients showed tuberculosis granuloma, while acid fast bacilli were seen in 34%. Mycobacterium tuberculosis was identified by microbiological methods in 60% of patients. The most common presenting symptoms were anorexia (84%), abdominal pain (84%) and weight loss (72%). Abdominal tenderness was the most common clinical finding, followed by ascites and abdominal mass (42%). The chest radiograph suggestive of pulmonary TB was diagnosed in 24 patients (32%). Computed tomographic (CT) scanning revealed abnormalities in all 51 patients who underwent the procedure, while positive findings were observed by abdominal ultrasound in 66% of the tested patients. Histopathological examination of patients showed tuberculous granuloma, while acid fast bacilli were seen in 34%. Mycobacterium tuberculosis was identified by microbiological methods in 60% of patients. A high index of clinical suspicion is required to make an early diagnosis of abdominal TB. Suspicion should be aroused, particularly in patients having a combination of anorexia, abdominal pain, weight loss and ascites. Diagnosis requires the utilization of a combination of various diagnostic procedures especially abdominal ultrasound, CT scan and endoscopy, which provides a high diagnostic yield in this disease. A normal chest radiograph does not exclude the presence of abdominal TB. A timely use of laparoscopy are often required to prevent surgical intervention. (author)

"Smartening Up": Ongoing Challenges for Australia's Outback

Science.gov (United States)

Cradduck, Lucy

2016-01-01

As the international community moves inexorably towards a "smart" future, the position of Australia's non-urban areas in that future is less certain. The (re-elected) Australian federal government made a commitment to moving Australian cities forward as part of the international "smart city" movement. However, the effectiveness…

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...

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...

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 ...

Science–policy challenges for biodiversity, public health and urbanization: examples from Belgium

International Nuclear Information System (INIS)

Keune, H; De Blust, G; Van den Berge, K; Brosens, D; Van Herzele, A; Simoens, I; Kretsch, C; Gilbert, M; Linard, C; Flandroy, L; Versteirt, V; Hartig, T; De Keersmaecker, L; Eggermont, H; Dessein, J; Vanwambeke, S; Prieur-Richard, A H; Wittmer, H; Martens, P; Mathijs, E

2013-01-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human–nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem–human/public health–urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed. (letter)

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

Radiological input during paediatric multidisciplinary team meetings and its influence on clinical patient management.

Science.gov (United States)

Llewellyn-Jones, Glyn; Pereira, John

2016-04-01

There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.

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.

In Absentia: An Exploratory Study of How Patients Are Considered in Multidisciplinary Cancer Team Meetings

NARCIS (Netherlands)

Hahlweg, P.; Hoffmann, J.; Harter, M.; Frosch, D.L.; Elwyn, G.; Scholl, I.

2015-01-01

BACKGROUND: Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and

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.

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.

Multidisciplinary Management: Model of Excellence in the Management Applied to Products and Services

OpenAIRE

Guerreiro , Evandro ,; Costa Neto , Pedro ,; Moreira Filho , Ulysses ,

2014-01-01

Part 1: Knowledge-Based Performance Improvement; International audience; The Multidisciplinary Management is the guiding vision of modern organizations and the systems thinking which requires new approaches to organizational excellence and quality management process. The objective of this article is to present a model for multidisciplinary management of quality applied to products and services based on American, Japanese, and Brazilian National Quality Awards. The methodology used to build th...

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.

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.

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.

Challenges and Opportunities of Implementing District-based Health Information System in Ethiopia

DEFF Research Database (Denmark)

Mengiste, Shegaw Anagaw

2005-01-01

This paper has analyzed the challenges of sustainability and scalability of HIS. The empirical analysis was conducted in a backward and disadvantaged region of Ethiopia. An ongoing process of HISP (Health Information System Program) was addressed and the main challenges in the implementation...... of sustainable and scalable district-based health information system in the context of Primary Health Care (PHC) sector in Ethiopia were identified. Human resource, infrastructure, and HIS related problems are the main challenges hindering the implementation of sustainable and scalable district-based health...... information systems in the region....

Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.

Science.gov (United States)

Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna

2018-01-01

Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.

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

Low-educated women with chronic pain were less often selected to multidisciplinary rehabilitation programs.

Directory of Open Access Journals (Sweden)

Anne Hammarström

Full Text Available BACKGROUND: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. METHODS: The population consisted of consecutive patients (n = 595 women, 266 men referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS. RESULTS: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98, even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high- and low-educated men. CONCLUSION: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.

Domestic Violence Offender Treatment and Multidisciplinary Treatment Teams: The Role of "Treatment" Victim Advocates.

Science.gov (United States)

Richards, Tara N; Gover, Angela R

2018-03-01

In Colorado, "treatment victim advocates" (TVAs) serve alongside providers and probation/parole officers on "multidisciplinary treatment teams" (MTTs) to oversee domestic violence offender's treatment. Although this model provides an opportunity for victim safety concerns to be heard, the utility of using victim advocates as advisors regarding interventions for domestic violence offenders has yet to be studied. Using survey data and narrative responses from TVAs ( N = 37), the current study examines the challenges and opportunities TVAs face while serving on MTTs. Results suggest that, overall, TVAs are successful in communicating with other members of the MTT, are confident that their perspectives are valued in the offender decision-making process, and are able to provide a wide variety of services and referrals to the victims with whom they are engaged. Implications and recommendations for the Colorado model as well as correctional professionals managing domestic violence offenders internationally are presented and discussed.

[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

Cross-Cultural Communication Training for Students in Multidisciplinary Research Area of Biomedical Engineering

Directory of Open Access Journals (Sweden)

Shigehiro Hashimoto

2014-08-01

Full Text Available Biomedical Engineering makes multidisciplinary research area, which includes biology, medicine, engineering and others. Communication training is important for students, who have a potential to develop Biomedical Engineering. Communication is not easy in a multidisciplinary research area, because each area has its own background of thinking. Because each nation has its own background of culture, on the other hand, international communication is not easy, either. A cross-cultural student program has been designed for communication training in the multidisciplinary research area. Students from a variety of backgrounds of research area and culture have joined in the program: mechanical engineering, material science, environmental engineering, science of nursing, dentist, pharmacy, electronics, and so on. The program works well for communication training in the multidisciplinary research area of biomedical engineering. Foreign language and digital data give students chance to study several things: how to make communication precisely, how to quote previous data. The experience in the program helps students not only understand new idea in the laboratory visit, but also make a presentation in the international research conference. The program relates to author's several experiences: the student internship abroad, the cross-cultural student camp, multi PhD theses, various affiliations, and the creation of the interdisciplinary department.

The impact of the multidisciplinary team in the management of individuals with diabetic foot ulcers: a systematic review.

Science.gov (United States)

Buggy, A; Moore, Z

2017-06-02

To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.

The myriad challenges of the Paris Agreement

Science.gov (United States)

Mitchell, Dann; Allen, Myles R.; Hall, Jim W.; Muller, Benito; Rajamani, Lavanya; Le Quéré, Corinne

2018-05-01

The much awaited and intensely negotiated Paris Agreement was adopted on 12 December 2015 by the Parties to the United Nations Framework Convention on Climate Change. The agreement set out a more ambitious long-term temperature goal than many had anticipated, implying more stringent emissions reductions that have been under-explored by the research community. By its very nature a multidisciplinary challenge, filling the knowledge gap requires not only climate scientists, but the whole Earth system science community, as well as economists, engineers, lawyers, philosophers, politicians, emergency planners and others to step up. To kick start cross-disciplinary discussions, the University of Oxford's Environmental Change Institute focused its 25th anniversary conference upon meeting the challenges of the Paris Agreement for science and society. This theme issue consists of review papers, opinion pieces and original research from some of the presentations within that meeting, covering a wide range of issues underpinning the Paris Agreement. This article is part of the theme issue `The Paris Agreement: understanding the physical and social challenges for a warming world of 1.5°C above pre-industrial levels'.

Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach.

Science.gov (United States)

Jonely, Holly; Brismée, Jean-Michel; Desai, Mehul J; Reoli, Rachel

2015-02-01

Sacroiliac joint pain and dysfunction affect 15-25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction. A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises. The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient's Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient's rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up. A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up.

The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics

Directory of Open Access Journals (Sweden)

Andrew M Quinn

2014-01-01

Full Text Available The Partners HealthCare system′s Clinical Fellowship in Pathology Informatics (Boston, MA, USA faces ongoing challenges to the delivery of its core curriculum in the forms of: (1 New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2 taxing electronic health record (EHR and laboratory information system (LIS implementations; and (3 increasing interest in the subspecialty at the academic medical centers (AMCs in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows′ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship′s core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among

The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics.

Science.gov (United States)

Quinn, Andrew M; Klepeis, Veronica E; Mandelker, Diana L; Platt, Mia Y; Rao, Luigi K F; Riedlinger, Gregory; Baron, Jason M; Brodsky, Victor; Kim, Ji Yeon; Lane, William; Lee, Roy E; Levy, Bruce P; McClintock, David S; Beckwith, Bruce A; Kuo, Frank C; Gilbertson, John R

2014-01-01

The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows' ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the

Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

Directory of Open Access Journals (Sweden)

Valerie J. Ehlers

2013-02-01

Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviewswere conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

Directory of Open Access Journals (Sweden)

Valerie J. Ehlers

2013-02-01

Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit (MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviews were conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% (n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

SWS European Chapter Meeting on wetland restoration-Challenges and opportunities

DEFF Research Database (Denmark)

Hoffmann, Carl Christian; Brix, Hans; Kronvang, Brian B.

2014-01-01

1. Introduction Wetland loss and degradation in Europe have been extreme andare still ongoing. By way of example, at least two-thirds of all shal-low lakes, bogs and wet meadows have been lost in Denmark since1784. The challenge for wetland scientists in Europe is to reversethe loss of wetlands a...

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.

Ongoing development of digital radiotherapy plan review tools

International Nuclear Information System (INIS)

Ebert, M.A.; Hatton, J.; Cornes, D.

2011-01-01

Full text: To describe ongoing development of software to support the review of radiotherapy treatment planning system (TPS) data. The 'SWAN' software program was conceived in 2000 and initially developed for the RADAR (TROG 03.04) prostate radiotherapy trial. Validation of the SWAN program has been occurring via implementation by TROG in support of multiple clinical trials. Development has continued and the SWAN software program is now supported by modular components which comprise the 'SW AN system'. This provides a comprehensive set of tools for the review, analysis and archive of TPS exports. The SWAN system has now been used in support of over 20 radiotherapy trials and to review the plans of over 2,000 trial participants. The use of the system for the RADAR trial is now culminating in the derivation of dose-outcomes indices for prostate treatment toxicity. Newly developed SWAN tools include enhanced remote data archive/retrieval, display of dose in both relative and absolute modes, and interfacing to a Matlab-based add-on ('VAST') that allows quantitative analysis of delineated volumes including regional overlap statistics for multi-observer studies. Efforts are continuing to develop the SWAN system in the context of international collaboration aimed at harmonising the quality-assurance activities of collaborative trials groups. Tools such as the SWAN system are essential for ensuring the collection of accurate and reliable evidence to guide future radiotherapy treatments. One of the principal challenges of developing such a tool is establishing a development path that will ensure its validity and applicability well into the future.

Body mass index and response to a multidisciplinary treatment of fibromyalgia.

Science.gov (United States)

Castel, Antoni; Castro, Sonia; Fontova, Ramon; Poveda, Maria José; Cascón-Pereira, Rosalia; Montull, Salvador; Padrol, Anna; Qanneta, Rami; Rull, Maria

2015-02-01

The purpose of this study is to determine whether there are some differences in the treatment responses to a multidisciplinary fibromyalgia (FM) treatment related with the baseline body mass index (BMI) of the participants. Inclusion criteria consisted of female sex, a diagnosis of FM (American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Baseline BMI was determined, and patients were randomly assigned to one of the two treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were pain intensity, functionality, catastrophizing, psychological distress, health-related quality of life, and sleep disturbances. One hundred thirty patients participated in the study. No statistical significant differences regarding pre-treatment outcomes were found among the different BMI subgroups, and between the two experimental conditions for each BMI category. General linear model analysis showed a significant interaction group treatment × time in pain intensity (p treatment × time. There are not differences among normal weight, overweight and obese patients with FM regarding their response to a multidisciplinary treatment programme for FM which combines pharmacological treatment, education, physical therapy and cognitive behavioural therapy.

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.

Eye-movements and ongoing task processing.

Science.gov (United States)

Burke, David T; Meleger, Alec; Schneider, Jeffrey C; Snyder, Jim; Dorvlo, Atsu S S; Al-Adawi, Samir

2003-06-01

This study tests the relation between eye-movements and thought processing. Subjects were given specific modality tasks (visual, gustatory, kinesthetic) and assessed on whether they responded with distinct eye-movements. Some subjects' eye-movements reflected ongoing thought processing. Instead of a universal pattern, as suggested by the neurolinguistic programming hypothesis, this study yielded subject-specific idiosyncratic eye-movements across all modalities. Included is a discussion of the neurolinguistic programming hypothesis regarding eye-movements and its implications for the eye-movement desensitization and reprocessing theory.

Strengths, weaknesses, opportunities, threats.

Science.gov (United States)

2002-12-01

Meeting fellow older people enthusiasts is always a pleasure and this month's encounters particularly so. The annual conference of the two RCN older people forums offered its usual blend of innovative ideas, stimulating debate, esoteric humour and a camaraderie shared with strangers as well as friends. Working with multidisciplinary colleagues on the West Midlands pilot development programme for leaders of older people services was equally inspiring. Despite the ongoing challenges of competing priorities, inadequate resources and ageist attitudes, committed teams around the UK are striving to offer high quality services to older people.

Role of the multidisciplinary team in the care of the tracheostomy patient

Science.gov (United States)

Bonvento, Barbara; Wallace, Sarah; Lynch, James; Coe, Barry; McGrath, Brendan A

2017-01-01

Tracheostomies are used to provide artificial airways for increasingly complex patients for a variety of indications. Patients and their families are dependent on knowledgeable multidisciplinary staff, including medical, nursing, respiratory physiotherapy and speech and language therapy staff, dieticians and psychologists, from a wide range of specialty backgrounds. There is increasing evidence that coordinated tracheostomy multidisciplinary teams can influence the safety and quality of care for patients and their families. This article reviews the roles of these team members and highlights the potential for improvements in care. PMID:29066907

Challenges and opportunities in dermal/transdermal delivery

Science.gov (United States)

Paudel, Kalpana S; Milewski, Mikolaj; Swadley, Courtney L; Brogden, Nicole K; Ghosh, Priyanka; Stinchcomb, Audra L

2010-01-01

Transdermal drug delivery is an exciting and challenging area. There are numerous transdermal delivery systems currently available on the market. However, the transdermal market still remains limited to a narrow range of drugs. Further advances in transdermal delivery depend on the ability to overcome the challenges faced regarding the permeation and skin irritation of the drug molecules. Emergence of novel techniques for skin permeation enhancement and development of methods to lessen skin irritation would widen the transdermal market for hydrophilic compounds, macromolecules and conventional drugs for new therapeutic indications. As evident from the ongoing clinical trials of a wide variety of drugs for various clinical conditions, there is a great future for transdermal delivery of drugs. PMID:21132122

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.

Enhancement of the Investigations of Global Marine Challenges Through the European Multidisciplinary Seafloor and water-column Observatory (EMSO) Research Infrastructure (RI)

Science.gov (United States)

Lo Bue, N.; Materia, P.; Embriaco, D.; Beranzoli, L.; Favali, P.; Leijala, U.; Pavan, G.; Best, M.; Ó Conchubhair, D.; O'Rourke, E.

2017-12-01

The approach of ocean observations has changed significantly over the past decades. Thanks to the development of new technologies improving the monitoring systems and also to the recent marine strategies such as the blue growth that support long term sustainable growth in marine sectors as a whole, it is now possible to better assess environmental issues. Long term multiparametric observations enable concurrent monitoring of a variety of natural and anthropogenic processes responsible for the alteration of marine ecosystems. This innovative process has been adopted by RIs, which have the ability to promote these unique cooperation opportunities via their global networks of observational infrastructures. EMSO (http://www.emso-eu.org) is a marine RI that contributes to further exploration and monitoring of European-scale oceans. This monitoring allows for a better understanding of various parameters from the upper layer of the water column through the deep sea and into the seafloor. The multidisciplinary approach taken by the EMSO RI assists in addressing questions across issues of climate change, marine ecosystems, and geohazards. For example, the growing societal implications due to geohazards require accurate and cross-disciplinary research involving a global community. A global and multidisciplinary approach is the key driver that allows us to better investigate the causes of geohazards in their worldwide distribution, and to produce reliable regional and global models. RIs, also represent a powerful tool in assessing the impacts of anthropogenic noise levels on marine fauna. Several studies have already shown how the significant variety of submarine acoustic pollution on a daily basis can have a substantial effect on the health and communication abilities of marine fauna. The constant noise pollution may produce physiological degradation in marine fauna and may also negatively impact several ecosystems. Finally, RIs play a crucial role in the sharing of

A Multidisciplinary Approach to Decommissioning Offshore Wells Using Stakeholder Engagement, Risk Identification, and the United Nations Sustainable Development Goals

Science.gov (United States)

Battalora, L.; Prasad, M.

2017-12-01

Context/PurposeThe typical oil and gas project lifecycle includes acquisition, exploration, drilling, production, and decommissioning phases. The oil and gas industry (Industry) has become proactive in identifying and mitigating health, safety, security, environment, and social responsibility risks during these phases as well as designing for sustainable development. With many fields reaching the end stages of the lifecycle, Industry is faced with the challenge of identifying and evaluating risks in the decommissioning phase. The level of challenge is increased when planning for the decommissioning of offshore wells. This paper describes tools that can be applied in the multidisciplinary design of the decommissioning program including use of the United Nations Sustainable Development Goals (SDGs). MethodsStakeholder engagement is key to a successful project. Typical stakeholders in an oil and gas project include the community, regulatory agencies, federal, state, and local governments, private investors, academia, and non-governmental organizations. Before engagement begins, stakeholders must be identified as well as their level of influence in the project. Relationships between stakeholders are "mapped" providing a better understanding of priorities and areas of concentration. Project risks are identified and ranked according to likelihood and impact. Mitigations are matched to risks. Sustainable development is implemented through acknowledgement of societal, economic, and environmental impacts in engineering design. InterpretationRecently, the United Nations Development Programme (UNDP), the International Finance Corporation (IFC) and IPIECA, the global oil and gas industry association for environmental and social issues, partnered to develop the publication, Mapping the oil and gas industry to the Sustainable Development Goals: An Atlas. SDGs have been linked to Industry operations and can serve as a guide for the offshore decommissioning phase Conclusion

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

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…

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…

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

Mapping the Challenges of Magnesium Battery.

Science.gov (United States)

Song, Jaehee; Sahadeo, Emily; Noked, Malachi; Lee, Sang Bok

2016-05-05

Rechargeable Mg battery has been considered a major candidate as a beyond lithium ion battery technology, which is apparent through the tremendous works done in the field over the past decades. The challenges for realization of Mg battery are complicated, multidisciplinary, and the tremendous work done to overcome these challenges is very hard to organize in a regular review paper. Additionally, we claim that organization of the huge amount of information accumulated by the great scientific progress achieved by various groups in the field will shed the light on the unexplored research domains and give clear perspectives and guidelines for next breakthrough to take place. In this Perspective, we provide a convenient map of Mg battery research in a form of radar chart of Mg electrolytes, which evaluates the electrolyte under the important components of Mg batteries. The presented radar charts visualize the accumulated knowledge on Mg battery and allow for navigation of not only the current research state but also future perspective of Mg battery at a glance.

Wanted: interdisciplinary, multidisciplinary, and knowledge translation and exchange training for students of public health.

Science.gov (United States)

Mishra, Lipi; Banerjee, Ananya T; MacLennan, Mary E; Gorczynski, Paul F; Zinszer, Kate A

2011-01-01

Students vocalized their concern with public health training programs in Canada at the 2010 CPHA Centennial Conference. Given these concerns, we reviewed the objectives and curricula of public health graduate (master's) programs in Canada. Our objective was to understand to what extent public and population health graduate programs in Canada support interdisciplinary, multidisciplinary and knowledge translation and exchange (KTE) training. This was achieved through a review of all public and population health master's programs in Canada identified from the public health graduate programs listed on the Public Health Agency of Canada website (n = 33) plus an additional four programs that were not originally captured on the list. Of the 37 programs reviewed, 28 (76%) stated that interdisciplinary, multidisciplinary or cross-disciplinary training opportunities are of value to their program, with 12 programs (32%) providing multidisciplinary or interdisciplinary training opportunities in their curriculum. Only 14 (38%) of the 37 programs provided value statements of KTE activities in their program goals or course objectives, with 10 (27%) programs offering KTE training in their curriculum. This review provides a glimpse into how public health programs in Canada value and support interdisciplinary and multidisciplinary collaboration as well as KTE activities.

Development of multidisciplinary practical lessons through research-action methodology in the faculties of computer science and educational psychology

OpenAIRE

Pertegal-Felices, María Luisa; Navarro Soria, Ignasi; Jimeno-Morenilla, Antonio; Gil, David

2010-01-01

Computer science studies possess a strong multidisciplinary vocation; most graduates do their professional work elsewhere of a computing environment, in collaboration with professionals from many different areas. However, the training offered in computer science studies lacks that multidisciplinary, focusing more on purely technical aspects. The campus, a place where studies of very different nature exist side by side, may constitute an excellent basis for conducting multidisciplinary trainin...

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

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

Time-driven activity-based costing to estimate cost of care at multidisciplinary aerodigestive centers.

Science.gov (United States)

Garcia, Jordan A; Mistry, Bipin; Hardy, Stephen; Fracchia, Mary Shannon; Hersh, Cheryl; Wentland, Carissa; Vadakekalam, Joseph; Kaplan, Robert; Hartnick, Christopher J

2017-09-01

Providing high-value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers. Retrospective chart review. Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic utilization by patients as well as patient diet outcomes after treatment. Patients were stratified into neurologically complex and neurologically noncomplex groups. The cost of care for patients requiring surgical intervention was five and three times as expensive of the cost of care for patients not requiring surgery for neurologically noncomplex and complex patients, respectively. Following treatment, 50% and 55% of complex and noncomplex patients returned to normal diet, whereas 83% and 87% of patients experienced improved diets, respectively. Additionally, multidisciplinary team-based care for children with laryngeal clefts potentially achieves 20% to 40% cost savings. These findings demonstrate how time-driven activity-based costing can be used to estimate and compare patient costs in multidisciplinary aerodigestive centers. 2c. Laryngoscope, 127:2152-2158, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

FY 2017 Site Sustainability Plan

Energy Technology Data Exchange (ETDEWEB)

Pope, Jason E.

2016-11-30

For more than 50 years, the United States (U.S.) Department of Energy’s (DOE’s) Pacific Northwest National Laboratory (PNNL) has advanced the frontiers of science and technology through courageous discovery and innovation. Our multidisciplinary team of more than 4,400 scientists, engineers, and support professionals is tackling global sustainability challenges in our science, energy, environmental, and security missions. For example, our research on how human and natural systems interact is critical to informing sustainable solutions to the nation’s energy and environmental challenges. PNNL is equally committed to sustainability right here at home, and we are making excellent progress toward the goals described in this plan. We are working on ongoing challenges, such as reducing the energy required to meet our research mission and promoting conservation among our employees.

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.

[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.

The political challenges of nuclear waste

International Nuclear Information System (INIS)

Andren, Mats; Strandberg, Urban

2005-01-01

This anthology is made up of nine essays on the nuclear waste issue, both its political, social and technical aspects, with the aim to create a platform for debate and planning of research. The contributions are titled: 'From clean energy to dangerous waste - the regulatory management of nuclear power in the Swedish welfare society. An economic-historic review , 'The course of the high-level waste into the national political arena', 'The technical principles behind the Swedish repository for spent fuels', 'Waste, legitimacy and local citizenship', 'Nuclear issues in societal planning', 'Usefulness or riddance - transmutation or just disposal?', 'National nuclear fuel policy in an European Union?', 'Conclusion - the challenges of the nuclear waste issue', 'Final words - about the need for critical debate and multi-disciplinary research'

Recent Advances and Challenges towards Sustainable Polyhydroxyalkanoate (PHA) Production.

Science.gov (United States)

Kourmentza, Constantina; Plácido, Jersson; Venetsaneas, Nikolaos; Burniol-Figols, Anna; Varrone, Cristiano; Gavala, Hariklia N; Reis, Maria A M

2017-06-11

Sustainable biofuels, biomaterials, and fine chemicals production is a critical matter that research teams around the globe are focusing on nowadays. Polyhydroxyalkanoates represent one of the biomaterials of the future due to their physicochemical properties, biodegradability, and biocompatibility. Designing efficient and economic bioprocesses, combined with the respective social and environmental benefits, has brought together scientists from different backgrounds highlighting the multidisciplinary character of such a venture. In the current review, challenges and opportunities regarding polyhydroxyalkanoate production are presented and discussed, covering key steps of their overall production process by applying pure and mixed culture biotechnology, from raw bioprocess development to downstream processing.

Tuberculosis remains a challenge despite economic growth in Panama.

Science.gov (United States)

Tarajia, M; Goodridge, A

2014-03-01

Tuberculosis (TB) is a disease associated with inequality, and wise investment of economic resources is considered critical to its control. Panama has recently secured its status as an upper-middle-income country with robust economic growth. However, the prioritisation of resources for TB control remains a major challenge. In this article, we highlight areas that urgently require action to effectively reduce TB burden to minimal levels. Our conclusions suggest the need for fund allocation and a multidisciplinary approach to ensure prompt laboratory diagnosis, treatment assurance and workforce reinforcement, complemented by applied and operational research, development and innovation.

Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study.

Science.gov (United States)

Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P

2014-05-19

User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often

The anatomy of clinical decision-making in multidisciplinary cancer meetings

Science.gov (United States)

Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

2016-01-01

Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core

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.

Multidisciplinary management of the patients with cerebral aneurysm - Preliminary experience

International Nuclear Information System (INIS)

Gomez Hoyos, Juan Fernando; Celis Mejia, Jorge Ignacio; Yepez Sanchez, Carlos Jaime; Duque Botero, Julieta

1998-01-01

A Actually, complex pathologies are treated according to a decision, which is adopted, by a group of specialists from different fields concerned to the same disease. The intention is to have success that is reflected in a low morbimortality and the most complete recovery to permit patients to return their previous life activities. Depending the status of each patient, type of aneurysm and its location, different techniques are performed to exclude them from circulation. Microneurosurgery, aneurysmatic sac embolization with platinum detachable coils and vessel originating aneurysm balloon occlusion The main objective of this work is to demonstrate that both microneurosurgery, classic technique in the cerebral aneurysms management but in continuing development, and endovascular therapy are not excluded, and their effectiveness depends in a strict selection criteria of patients and a comprehensive medical management before, during and after treatment by a multidisciplinary group. Also, to evaluate both techniques based on different indexes, including the ongoing evolution. In this work the preliminary experience of the Neurovascular Group at the Clinica Cardiovascular Santa Maria in Medellin, during the period of time from December 1996 until May 1998.45 patients with 47 aneurysm were treated 55.3% aneurysmatic lesions were treated by endovascular therapy and the remaining (44.7%) by microneurosurgery. 26 patients and same number of aneurysmatic lesions composed the endovascular group, the age range was between 20 and 70 years. 80.0% were women, 20.0% men. 53.8% complained from subarachnoid hemorrhage signs and symptoms. 36.0% were in a Hunt and Hess score scale of III and 84.7% complete success was achieved. 3 patients died, 2 of them were in IV and V Hunt and Hess score scale, respectively. The surgical group composed by 19 patients with 21 lesions and an age range between 31 and 78 years. 64.8% were women and 71,5% had confirmed diagnosis of subarachnoid hemorrhage

Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

Science.gov (United States)

Beder, Joan; Postiglione, Paul

2013-01-01

For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

Multidisciplinary team management in thoracic oncology: more than just a concept?

Science.gov (United States)

Powell, Helen A; Baldwin, David R

2014-06-01

Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working. There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. ©ERS 2014.

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)

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.

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...

Some current experimental challenges in elementary particle physics

Energy Technology Data Exchange (ETDEWEB)

Cline, D.B. (California Univ., Los Angeles (USA). Dept. of Physics)

1990-06-01

We describe three experimental challenges for experimental elementary particle physics: (1) the ongoing search for flavor changing weak neutral currents, including future prospect for a anti BB factory, (2) the status of the tests of the standard model in the W, Z and t quark sectors and (3) some current search for physics beyond the standard model, to include the possibility of searching for CPT violation using a {Phi} factory. (orig.).

Risk-based analysis and decision making in multi-disciplinary environments

Science.gov (United States)

Feather, Martin S.; Cornford, Steven L.; Moran, Kelly

2003-01-01

A risk-based decision-making process conceived of and developed at JPL and NASA, has been used to help plan and guide novel technology applications for use on spacecraft. These applications exemplify key challenges inherent in multi-disciplinary design of novel technologies deployed in mission-critical settings. 1) Cross-disciplinary concerns are numerous (e.g., spacecraft involve navigation, propulsion, telecommunications). These concems are cross-coupled and interact in multiple ways (e.g., electromagnetic interference, heat transfer). 2) Time and budget pressures constrain development, operational resources constrain the resulting system (e.g., mass, volume, power). 3) Spacecraft are critical systems that must operate correctly the first time in only partially understood environments, with no chance for repair. 4) Past experience provides only a partial guide: New mission concepts are enhanced and enabled by new technologies, for which past experience is lacking. The decision-making process rests on quantitative assessments of the relationships between three classes of information - objectives (the things the system is to accomplish and constraints on its operation and development), risks (whose occurrence detracts from objectives), and mitigations (options for reducing the likelihood and or severity of risks). The process successfully guides experts to pool their knowledge, using custom-built software to support information gathering and decision-making.

Stimulating high impact HIV-related cardiovascular research: recommendations from a multidisciplinary NHLBI Working Group on HIV-related heart, lung, and blood disease.

Science.gov (United States)

Shah, Monica R; Cook, Nakela; Wong, Renee; Hsue, Priscilla; Ridker, Paul; Currier, Judith; Shurin, Susan

2015-02-24

The clinical challenges confronting patients with human immunodeficiency virus (HIV) have shifted from acquired immunodeficiency syndrome (AIDS)-related illnesses to chronic diseases, such as coronary artery disease, chronic lung disease, and chronic anemia. With the growing burden of HIV-related heart, lung, and blood (HLB) disease, the National Heart, Lung, and Blood Institute (NHLBI) recognizes it must stimulate and support HIV-related HLB research. Because HIV offers a natural, accelerated model of common pathological processes, such as inflammation, HIV-related HLB research may yield important breakthroughs for all patients with HLB disease. This paper summarizes the cardiovascular recommendations of an NHLBI Working Group, Advancing HIV/AIDS Research in Heart, Lung, and Blood Diseases, charged with identifying scientific priorities in HIV-related HLB disease and developing recommendations to promote multidisciplinary collaboration among HIV and HLB investigators. The working group included multidisciplinary sessions, as well as HLB breakout sessions for discussion of disease-specific issues, with common themes about scientific priorities and strategies to stimulate HLB research emerging in all 3 groups. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Multidisciplinary diabetes care with and without bariatric surgery in overweight people: a randomised controlled trial.

Science.gov (United States)

Wentworth, John M; Playfair, Julie; Laurie, Cheryl; Ritchie, Matthew E; Brown, Wendy A; Burton, Paul; Shaw, Jonathan E; O'Brien, Paul E

2014-07-01

Bariatric surgery improves glycaemia in obese people with type 2 diabetes, but its effects are uncertain in overweight people with this disease. We aimed to identify whether laparoscopic adjustable gastric band surgery can improve glucose control in people with type 2 diabetes who were overweight but not obese. We did an open-label, parallel-group, randomised controlled trial between Nov 1, 2009, and June 30, 2013, at one centre in Melbourne, Australia. Patients aged 18-65 years with type 2 diabetes and a BMI between 25 and 30 kg/m2 were randomly assigned (1:1), by computer-generated random sequence, to receive either multidisciplinary diabetes care plus laparoscopic adjustable gastric band surgery or multidisciplinary diabetes care alone. The primary outcome was diabetes remission 2 years after randomisation, defined as glucose concentrations of less than 7.0 mmol/L when fasting and less than 11.1 mmol/L 2 h after 75 g oral glucose, at least two days after stopping glucose-lowering drugs. Analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000286246. 51 patients were randomised to the multidisciplinary care plus gastric band group (n=25) or the multidisciplinary care only group (n=26), of whom 23 participants and 25 participants, respectively, completed follow-up to 2 years. 12 (52%) participants in the multidisciplinary care plus gastric band group and two (8%) participants in the multidisciplinary care only group achieved diabetes remission (difference in proportions 0.44, 95% CI 0.17-0.71; p=0.0012). One (4%) participant in the gastric band group needed revisional surgery and four others (17%) had a total of five episodes of food intolerance due to excessive adjustment of the band. When added to multidisciplinary care, laparoscopic adjustable gastric band surgery for overweight people with type 2 diabetes improves glycaemic control with an acceptable adverse event profile

Challenges of the ILC Main Linac

International Nuclear Information System (INIS)

Ross, Marc

2007-01-01

With the completion of the ILC Reference Design Report (RDR), we begin the next phase of the project - development of the Engineering Design. Our strategy and priorities come from the identification, contained in the RDR, of scientific and engineering challenges of the ILC. First among these is the cost of the main linac which, including the associated earthworks and cooling/power systems, amounts to 60% of the ILC total cost. Next is the challenge to reach the highest practical gradient since this R and D has the largest cost leverage of any of the ongoing programs. Finally, we have to understand the beam dynamics and beam tuning processes in the main linac, as we will not have the opportunity to do full (or even large) scale tests of these before the linac is constructed.

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

OpenAIRE

Hasenauer, Rainer; Fi8lo, Peter; Störi, Herbert

2013-01-01

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

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

Policy recommendations for addressing privacy challenges associated with cell-based research and interventions.

Science.gov (United States)

Ogbogu, Ubaka; Burningham, Sarah; Ollenberger, Adam; Calder, Kathryn; Du, Li; El Emam, Khaled; Hyde-Lay, Robyn; Isasi, Rosario; Joly, Yann; Kerr, Ian; Malin, Bradley; McDonald, Michael; Penney, Steven; Piat, Gayle; Roy, Denis-Claude; Sugarman, Jeremy; Vercauteren, Suzanne; Verhenneman, Griet; West, Lori; Caulfield, Timothy

2014-02-03

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors' clinical information for research and regulatory purposes, and existing practices that limit research participants' ability to control what is done with their genetic data, amplify the privacy concerns. To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that privacy risks associated with cell

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.

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.

Successful ongoing pregnancies after vitrification of oocytes.

Science.gov (United States)

Lucena, Elkin; Bernal, Diana Patricia; Lucena, Carolina; Rojas, Alejandro; Moran, Abby; Lucena, Andrés

2006-01-01

To demonstrate the efficiency of vitrifying mature human oocytes for different clinical indications. Descriptive case series. Cryobiology laboratory, Centro Colombiano de Fertilidad y Esterilidad-CECOLFES LTDA. (Bogotá, Colombia). Oocyte vitrification was offered as an alternative management for patients undergoing infertility treatment because of ovarian hyperstimulation syndrome, premature ovarian failure, natural ovarian failure, male factor, poor response, or oocyte donation. Mature oocytes were obtained from 33 donor women and 40 patients undergoing infertility treatment. Oocytes were retrieved by ultrasound-guided transvaginal aspiration and vitrified with the Cryotops method, with 30% ethylene glycol, 30% dimethyl sulfoxide, and 0.5 mol/L sucrose. Viability was assessed 3 hours after thawing. The surviving oocytes were inseminated by intracytoplasmic sperm injection. Fertilization was evaluated after 24 hours. The zygotes were further cultured in vitro for up to 72 hours until time of embryo transfer. Recovery, viability, fertilization, and pregnancy rates. Oocyte vitrification with the Cryotop method resulted in high rates of recovery, viability, fertilization, cleavage, and ongoing pregnancy. Vitrification with the Cryotop method is an efficient, fast, and economical method for oocyte cryopreservation that offers high rates of survival, fertilization, embryo development, and ongoing normal pregnancies, providing a new alternative for the management of female infertility.

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.

Air pollution and detrimental effects on children's brain. The need for a multidisciplinary approach to the issue complexity and challenges.

Science.gov (United States)

Calderón-Garcidueñas, Lilian; Torres-Jardón, Ricardo; Kulesza, Randy J; Park, Su-Bin; D'Angiulli, Amedeo

2014-01-01

Millions of children in polluted cities are showing brain detrimental effects. Urban children exhibit brain structural and volumetric abnormalities, systemic inflammation, olfactory, auditory, vestibular and cognitive deficits v low-pollution controls. Neuroinflammation and blood-brain-barrier (BBB) breakdown target the olfactory bulb, prefrontal cortex and brainstem, but are diffusely present throughout the brain. Urban adolescent Apolipoprotein E4 carriers significantly accelerate Alzheimer pathology. Neurocognitive effects of air pollution are substantial, apparent across all populations, and potentially clinically relevant as early evidence of evolving neurodegenerative changes. The diffuse nature of the neuroinflammation and neurodegeneration forces to employ a weight of evidence approach incorporating current clinical, cognitive, neurophysiological, radiological and epidemiological research. Pediatric air pollution research requires extensive multidisciplinary collaborations to accomplish a critical goal: to protect exposed children through multidimensional interventions having both broad impact and reach. Protecting children and teens from neural effects of air pollution should be of pressing importance for public health.

A Translation Dictionary of Phrasal Verbs: An Ongoing Project ...

African Journals Online (AJOL)

A Translation Dictionary of Phrasal Verbs: An Ongoing Project. ... Abstract. The paper centres on a plan for an English-Arabic phrasal verb dictionary for Arab trainee translators. Such a dictionary ... AJOL African Journals Online. HOW TO USE ...

The dentist's role within the multi-disciplinary team maintaining quality of life for oral cancer patients in light of recent advances in radiotherapy.

Science.gov (United States)

Brody, Sarah; Omer, Osama; McLoughlin, Jacinta; Stassen, Leo

2013-01-01

Every year in Ireland over 400 people are diagnosed with head and neck cancer. Oral cancer, a specific type of head and neck cancer, is usually treated with surgery and often requires radiotherapy (RT). However, side effects of RT treatment, which include mucositis, xerostomia, radiation caries, trismus and osteoradionecrosis, can seriously compromise a patient's quality of life. Treatment for oral cancer patients is managed in a multidisciplinary team. General dental practitioners (GDPs), consultant/specialist dentists and oral-maxillofacial surgeons play an important role in these patients' care. Recent advances in the delivery of RT have not only improved locoregional control and survival rates, but have also reduced the incidence and severity of RT-associated side effects; however, no mode of RT delivery has successfully eliminated side effects. The role of dentists is essential in maintaining oral health and all patients should be dentally screened prior to commencing RT. Recent reports have attempted to standardise the quality of care for the oral cancer patient and have highlighted the significance of the role of the GDP. Despite the advancements in RT delivery, the dental team is still faced with a number of challenges, including the high number of patients lost to follow-up dental care, lack of an effective treatment for xerostomia, poor patient compliance, and a lack of standardised guidelines and funding. Addressing these challenges will involve increased communication between all members of the multidisciplinary team and increased involvement of the GDP, thereby ensuring that dental care continues to evolve concurrently with new methods of RT delivery.

Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.

Science.gov (United States)

Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi

2018-02-26

1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

A New Multidisciplinary Design Optimization Method Accounting for Discrete and Continuous Variables under Aleatory and Epistemic Uncertainties

Directory of Open Access Journals (Sweden)

Hong-Zhong Huang

2012-02-01

Full Text Available Various uncertainties are inevitable in complex engineered systems and must be carefully treated in design activities. Reliability-Based Multidisciplinary Design Optimization (RBMDO has been receiving increasing attention in the past decades to facilitate designing fully coupled systems but also achieving a desired reliability considering uncertainty. In this paper, a new formulation of multidisciplinary design optimization, namely RFCDV (random/fuzzy/continuous/discrete variables Multidisciplinary Design Optimization (RFCDV-MDO, is developed within the framework of Sequential Optimization and Reliability Assessment (SORA to deal with multidisciplinary design problems in which both aleatory and epistemic uncertainties are present. In addition, a hybrid discrete-continuous algorithm is put forth to efficiently solve problems where both discrete and continuous design variables exist. The effectiveness and computational efficiency of the proposed method are demonstrated via a mathematical problem and a pressure vessel design problem.

A multidisciplinary study of a small, temporarily open/closed South ...

African Journals Online (AJOL)

In 2005/2006 a multidisciplinary research programme that included studies on the hydrodynamics, sediment dynamics, macronutrients, microalgae, macrophytes, zoobenthos, hyperbenthos, zooplankton, ichthyoplankton, fish and birds of the temporarily open/closed East Kleinemonde Estuary was conducted. Particular ...

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

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,…

[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.

MPIRUN: A Portable Loader for Multidisciplinary and Multi-Zonal Applications

Science.gov (United States)

Fineberg, Samuel A.; Woodrow, Thomas S. (Technical Monitor)

1994-01-01

Multidisciplinary and multi-zonal applications are an important class of applications in the area of Computational Aerosciences. In these codes, two or more distinct parallel programs or copies of a single program are utilized to model a single problem. To support such applications, it is common to use a programming model where a program is divided into several single program multiple data stream (SPMD) applications, each of which solves the equations for a single physical discipline or grid zone. These SPMD applications are then bound together to form a single multidisciplinary or multi-zonal program in which the constituent parts communicate via point-to-point message passing routines. One method for implementing the message passing portion of these codes is with the new Message Passing Interface (MPI) standard. Unfortunately, this standard only specifies the message passing portion of an application, but does not specify any portable mechanisms for loading an application. MPIRUN was developed to provide a portable means for loading MPI programs, and was specifically targeted at multidisciplinary and multi-zonal applications. Programs using MPIRUN for loading and MPI for message passing are then portable between all machines supported by MPIRUN. MPIRUN is currently implemented for the Intel iPSC/860, TMC CM5, IBM SP-1 and SP-2, Intel Paragon, and workstation clusters. Further, MPIRUN is designed to be simple enough to port easily to any system supporting MPI.

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.

Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

DEFF Research Database (Denmark)

Huys, Raoul; Jirsa, Viktor K; Darokhan, Ziauddin

2016-01-01

attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization...

Lateralization of noise-burst trains based on onset and ongoing interaural delays.

Science.gov (United States)

Freyman, Richard L; Balakrishnan, Uma; Zurek, Patrick M

2010-07-01

The lateralization of 250-ms trains of brief noise bursts was measured using an acoustic pointing technique. Stimuli were designed to assess the contribution of the interaural time delay (ITD) of the onset binaural burst relative to that of the ITDs in the ongoing part of the train. Lateralization was measured by listeners' adjustments of the ITD of a pointer stimulus, a 50-ms burst of noise, to match the lateral position of the target train. Results confirmed previous reports of lateralization dominance by the onset burst under conditions in which the train is composed of frozen tokens and the ongoing part contains multiple ambiguous interaural delays. In contrast, lateralization of ongoing trains in which fresh noise tokens were used for each set of two alternating (left-leading/right-leading) binaural pairs followed the ITD of the first pair in each set, regardless of the ITD of the onset burst of the entire stimulus and even when the onset burst was removed by gradual gating. This clear lateralization of a long-duration stimulus with ambiguous interaural delay cues suggests precedence mechanisms that involve not only the interaural cues at the beginning of a sound, but also the pattern of cues within an ongoing sound.

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)

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,…

Informing via Research: Methods, Challenges and Success when Using a Multi-Disciplinary Team and Reverse Engineering Analysis Processes to Answer a 200 Year Old Question

Directory of Open Access Journals (Sweden)

Melinda H. Connor

2014-10-01

Full Text Available The goal of this study was to develop the foundation for the creation of a 21st century spiritual which could be used to mitigate the effects of stress and violence. Using a multi-disciplinary team and basing the work in the music of the antebellum Negro Spiritual (a group of 6000 works, reverse engineering, extensive use of engineering principles and utilization of existing databases was done to aid in the analysis of the neurological and physiological impact of the musical form and development of an applicable theory.

Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 - what is making elimination so difficult?

Science.gov (United States)

Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Baggieri, Melissa; Magurano, Fabio; Rota, Maria Cristina

2017-09-14

We report an ongoing measles outbreak in Italy, with over 4,400 cases reported in 20 Regions from January to August 2017. Median age was 27 years, 88% of the cases were unvaccinated. The highest incidence was in infants below one year of age and 7% of cases occurred among healthcare workers. Three deaths occurred and two cases of encephalitis were reported. Wide immunity gaps and nosocomial transmission are major challenges to measles elimination in Italy. This article is copyright of The Authors, 2017.

Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy.

Science.gov (United States)

Akiyama, Yuji; Iwaya, Takeshi; Endo, Fumitaka; Shioi, Yoshihiro; Kumagai, Motoi; Takahara, Takeshi; Otsuka, Koki; Nitta, Hiroyuki; Koeda, Keisuke; Mizuno, Masaru; Kimura, Yusuke; Suzuki, Kenji; Sasaki, Akira

2017-12-01

We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer. We retrospectively reviewed 85 consecutive patients with esophageal cancer who underwent radical esophagectomy via right thoracotomy or thoracoscopic surgery with gastric tube reconstruction. Twenty-one patients were enrolled in the non-intervention group (group N) from May 2011 to September 2012, 31 patients in the perioperative rehabilitation group (group R) from October 2012 to April 2014, and 33 patients in the multidisciplinary support team group (group S) from May 2014 to September 2015. Morbidity rates were 38, 45.2, and 42.4% for groups N, R, and S, respectively. Although there were no significant differences in the incidence of pneumonia among the groups, the durations of fever and C-reactive protein positivity were shorter in group S. Moreover, postoperative oral intake commenced earlier [5.9 (5-8) days] and postoperative hospital stay was shorter [19.6 (13-29) days] for group S. The intervention by a perioperative multidisciplinary support team for radical esophagectomy was effective in preventing the progression and prolongation of pneumonia as well as earlier ambulation, oral feeding, and shortening of postoperative hospitalization.

Identifying challenges in project consultants engagement practices

Science.gov (United States)

Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

2017-10-01

Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

Universal patterns underlying ongoing wars and terrorism

OpenAIRE

Spagat, M; Johnson, N. F; Restrepo, J. A; Becerra, O; Bohórquez, J. C; Restrepo, E. M; Zarama, R

2006-01-01

we report a remarkable universality in the patterns of violence in three high profile ongoing wars, and in global terrorism. Our results suggest that these quite different conflict arenas currently feature a common type of enemy, i.e. the various insurgent forces are beginning to operate in a similar way regardles of their underlying idealogies, motivations and the terrain in which they operate. We provide a microscopic theory to explain our main observations. This theory treats the insurgent...

SPHERE's 'Dress Sense' a Multi-disciplinary approach to designing wearable technology to improve health

Directory of Open Access Journals (Sweden)

Amelia Martin

2015-10-01

Full Text Available Background Healthcare systems face financial challenges, with a greater number of the population living longer with long term conditions. In order to deliver safe, high quality care within these constraints, we must place more emphasis on preventing illness than treating illness. We can use the science of behaviour change, health, and technology to create solutions to these problems. An example of innovation in this field include SPHERE’s multidisciplinary project entitled ‘Dress Sense’, with the aim to create a piece of wearable technology to improve health. Description This competition was run by SPHERE (Sensor Platform for HEalthcare in a Residential Environment which focuses on developing sensor systems to monitor health and wellbeing in the home. The teams comprised of computer scientists, medical professionals, students and school children, engineers, fashion designers and textile artists. They were provided with a kit including Arduino software, sensors and other items to make wearable computers. There were no constraints on what they could produce, except for a deadline of 3 weeks. The end project was judged according to the innovation and usefulness of the overall concept; the functionality, usability and desirability (aesthetics of the constructed device and the multi-displinary component. The idea was to foster open innovation in order to share ideas between specialities. Conclusions Ideas included tackling diabetic medical adherence through a wearable band to sensors woven into socks to prevent deep vein thrombosis. The winning concept was, ‘Yo’ a support system to aid cognitive behaviour therapy, through wearable products and accessories, to help those who begin CBT, stay motivated to engage effectively with therapy. This project highlighs how through multi-disciplinary collaboration and including the younger generation, innovative effective ideas can be found to harness digital technology to improve health.

Effectiveness of cytochrome C and cepharanthin for leukopenia following multidisciplinary treatment

International Nuclear Information System (INIS)

Tabata, Kumiko; Endow, Masaru; Suzuki, Hirotoshi

1986-01-01

Leukopenia is one of important problems for multidisciplinary treatment of malignant tumor. We could not be able to take a continuous cancer therapy because of leukopenia. And then we had a study of effectiveness combination treatment of cytochrome C with cepharanthin for leukopenia of cancer patient. We carried on the study of 3 classifications of treatment as follows, a) cytochrome C only, b) combined cytochrome C with cepharanthin, and c) control group without drugs. Bone marrow potentiality is individual differentiation and then the group was administrated both cytochrome C and cepharanthin following radiotherapy associated with postoperative breast cancer. The above description lead to conclusion that combination treatment of cytochrome C and cepharanthin was available for protective drugs from multidisciplinary treatment induced leukemia. (author)

Support for global science: Remote sensing's challenge

Science.gov (United States)

Estes, J. E.; Star, J. L.

1986-01-01

Remote sensing uses a wide variety of techniques and methods. Resulting data are analyzed by man and machine, using both analog and digital technology. The newest and most important initiatives in the U. S. civilian space program currently revolve around the space station complex, which includes the core station as well as co-orbiting and polar satellite platforms. This proposed suite of platforms and support systems offers a unique potential for facilitating long term, multidisciplinary scientific investigations on a truly global scale. Unlike previous generations of satellites, designed for relatively limited constituencies, the space station offers the potential to provide an integrated source of information which recognizes the scientific interest in investigating the dynamic coupling between the oceans, land surface, and atmosphere. Earth scientist already face problems that are truly global in extent. Problems such as the global carbon balance, regional deforestation, and desertification require new approaches, which combine multidisciplinary, multinational research teams, employing advanced technologies to produce a type, quantity, and quality of data not previously available. The challenge before the international scientific community is to continue to develop both the infrastructure and expertise to, on the one hand, develop the science and technology of remote sensing, while on the other hand, develop an integrated understanding of global life support systems, and work toward a quantiative science of the biosphere.

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

Effect of a multidisciplinary treatment program on eating behavior in overweight and obese preschool children.

Science.gov (United States)

Bocca, Gianni; Kuitert, Mirije W B; Sauer, Pieter J J; Corpeleijn, Eva

2018-04-25

The effects of multidisciplinary treatment programs on eating behavior in overweight preschool-aged children are largely unknown. We evaluated a multidisciplinary intervention program on eating behavior in 3- to 5-year-old overweight children, comparing them with children given standard treatment. We also assessed the parental eating behavior changes and investigated associations between parents and children. We randomized 75 children to a multidisciplinary intervention or to a standard care program. During a 16-week period, children and parents in the multidisciplinary group were given dietary advice, physical activity sessions and, for parents only, psychological counseling. Children and parents in the standard group visited a pediatrician 3 times and were given information on a healthy lifestyle. At baseline, after 16 weeks, and after 12 months, children were measured and parents completed the Dutch Child Eating Behavior Questionnaire (DEBQ-C) for their children and the DEBQ for themselves. At the three time points, 70 (93.3%), 57 (91.9%), and 42 (73.7%) DEBQ-Cs were analyzed. We found no differences in the changes in eating behavior between the two groups over time. In both groups, there was a significant increase in restrained eating behavior present at 16 weeks, however, this was no longer present at 12 months. We found no associations between changes in eating behavior between the children and their parents. A multidisciplinary obesity intervention program in preschool-aged children induced more restrained eating behavior between baseline and 16 weeks. However, there was no difference with the children in the standard care group.

Achondroplasia: anaesthetic challenges for caesarean section.

Science.gov (United States)

Dubiel, L; Scott, G A; Agaram, R; McGrady, E; Duncan, A; Litchfield, K N

2014-08-01

Pregnancy in women with achondroplasia presents major challenges for anaesthetists and obstetricians. We report the case of a woman with achondroplasia who underwent general anaesthesia for an elective caesarean section. She was 99cm in height and her condition was further complicated by severe kyphoscoliosis and previous back surgery. She was reviewed in the first trimester at the anaesthetic high-risk clinic. A multidisciplinary team was convened to plan her peripartum care. Because of increasing dyspnoea caesarean section was performed at 32weeks of gestation. She received a general anaesthetic using a modified rapid-sequence technique with remifentanil and rocuronium. The intraoperative period was complicated by desaturation and high airway pressures. The woman's postoperative care was complicated by respiratory compromise requiring high dependency care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Planetary Cartography - Activities and Current Challenges

Science.gov (United States)

Nass, Andrea; Di, Kaichang; Elgner, Stephan; van Gasselt, Stephan; Hare, Trent; Hargitai, Henrik; Karachevtseva, Irina; Kereszturi, Akos; Kersten, Elke; Kokhanov, Alexander; Manaud, Nicolas; Roatsch, Thomas; Rossi, Angelo Pio; Skinner, James, Jr.; Wählisch, Marita

2018-05-01

Maps are one of the most important tools for communicating geospatial information between producers and receivers. Geospatial data, tools, contributions in geospatial sciences, and the communication of information and transmission of knowledge are matter of ongoing cartographic research. This applies to all topics and objects located on Earth or on any other body in our Solar System. In planetary science, cartography and mapping have a history dating back to the roots of telescopic space exploration and are now facing new technological and organizational challenges with the rise of new missions, new global initiatives, organizations and opening research markets. The focus of this contribution is to introduce the community to the field of planetary cartography and its historic foundation, to highlight some of the organizations involved and to emphasize challenges that Planetary Cartography has to face today and in the near future.

Challenges When Using Jurimetrics in Brazil—A Survey of Courts

Directory of Open Access Journals (Sweden)

Bruna Armonas Colombo

2017-10-01

Full Text Available Jurimetrics is the application of quantitative methods, usually statistics, to law. An important step to implement a jurimetric analysis is to extract raw data from courts and organize that data in a way that can be processed. Most of the raw data is unstructured and written in natural language, which stands as a challenge to Computer Science experts. As it requires expertise in law, statistics, and computer science, jurimetrics is a multidisciplinary field. When trying to implement a jurimetric system in Brazil, additional challenges were identified due to the heterogeneity of the different court systems, the lack of standards, and how the open data laws in Brazil are interpreted and implemented. In this article, we present a survey of Brazilian courts in terms of readiness to implement a jurimetric system. Analyzing a sample of data, we have found, in light of Brazil’s open data regulation, privacy issues and technical issues. Finally, we propose a roadmap that encompasses both technology and public policy to meet those challenges.

Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

Directory of Open Access Journals (Sweden)

Elinton Adami CHAIM

Full Text Available ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

Multi-Disciplinary Design Support using Hardware-in-the-Loop Simulation

NARCIS (Netherlands)

Visser, P.M.; Groothuis, M.A.; Broenink, Johannes F.

2004-01-01

This paper describes a method using Hardware-in-the-Loop Simulation as a means for multidisciplinary design support. The method presented here, aims at supporting the design of heterogeneous embedded control systems. The method considers the implementation process as a stepwise refinement from

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

Developing dimensions for a multicomponent multidisciplinary approach to obesity management: a qualitative study.

Science.gov (United States)

Cochrane, Anita J; Dick, Bob; King, Neil A; Hills, Andrew P; Kavanagh, David J

2017-10-16

There have been consistent recommendations for multicomponent and multidisciplinary approaches for obesity management. However, there is no clear agreement on the components, disciplines or processes to be considered within such an approach. In this study, we explored multicomponent and multidisciplinary approaches through an examination of knowledge, skills, beliefs, and recommendations of stakeholders involved in obesity management. These stakeholders included researchers, practitioners, educators, and patients. We used qualitative action research methods, including convergent interviewing and observation, to assist the process of inquiry. The consensus was that a multicomponent and multidisciplinary approach should be based on four central meta-components (patient, practitioner, process, and environmental factors), and specific components of these factors were identified. Psychologists, dieticians, exercise physiologists and general practitioners were nominated as key practitioners to be included. A complex condition like obesity requires that multiple components be addressed, and that both patients and multiple disciplines are involved in developing solutions. Implementing cycles of continuous improvement to deal with complexity, instead of trying to control for it, offers an effective way to deal with complex, changing multisystem problems like obesity.

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom.

Science.gov (United States)

Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O'Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. The study consisted of a national survey with descriptive statistics and thematic analysis. A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients' wishes to be expressed. Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients' nonmedical needs.

The proliferation of multidisciplinary team meetings (MDTMs): how can radiology departments continue to support them all?

International Nuclear Information System (INIS)

Balasubramaniam, Ravivarma; Subesinghe, Manil; Smith, Jonathan T.

2015-01-01

To quantify the changes in multidisciplinary team meeting (MDTM) workload for consultant radiologists working in a single UK tertiary referral cancer institution, assess its impact and suggest solutions to these challenges. The annual number of MDTM cases was collated over a 5-year period (2009 - 2013). Qualitative information was obtained through questionnaire-based interviews of 47 consultant radiologists. Data analysed included number of MDTMs involved with, type of MDTM (oncological or non-oncological), time allocation for preparation and perceived deficiencies in the current MDTM. Thirteen thousand and forty-nine cases were discussed in MDTMs in 2009 with a continued yearly increase over the 5-year period. Fifty-five percent of MDTM attendances were at oncological MDTMs. Consultant radiologists attended a median of two MDTMs per week, each requiring 4 hours time commitment; 60 % used out-of-hours time for MDTM preparation. The most frequently cited MDTM deficiency was lack of sufficient clinical input. The MDTM is a challenging but worthwhile demand on the modern radiologist's time. Solutions to the increasing MDTM workload include demonstration of the benefits of MDTMs to hospital administrators to justify additional resources required, improving MDTM efficiency and ensuring this increased workload is accurately represented and remunerated in individual job plans. (orig.)

The proliferation of multidisciplinary team meetings (MDTMs): how can radiology departments continue to support them all?

Energy Technology Data Exchange (ETDEWEB)

Balasubramaniam, Ravivarma; Subesinghe, Manil; Smith, Jonathan T. [St. James' University Hospital, Leeds Teaching Hospitals NHS Trust, Department of Clinical Radiology, Leeds (United Kingdom)

2015-12-15

To quantify the changes in multidisciplinary team meeting (MDTM) workload for consultant radiologists working in a single UK tertiary referral cancer institution, assess its impact and suggest solutions to these challenges. The annual number of MDTM cases was collated over a 5-year period (2009 - 2013). Qualitative information was obtained through questionnaire-based interviews of 47 consultant radiologists. Data analysed included number of MDTMs involved with, type of MDTM (oncological or non-oncological), time allocation for preparation and perceived deficiencies in the current MDTM. Thirteen thousand and forty-nine cases were discussed in MDTMs in 2009 with a continued yearly increase over the 5-year period. Fifty-five percent of MDTM attendances were at oncological MDTMs. Consultant radiologists attended a median of two MDTMs per week, each requiring 4 hours time commitment; 60 % used out-of-hours time for MDTM preparation. The most frequently cited MDTM deficiency was lack of sufficient clinical input. The MDTM is a challenging but worthwhile demand on the modern radiologist's time. Solutions to the increasing MDTM workload include demonstration of the benefits of MDTMs to hospital administrators to justify additional resources required, improving MDTM efficiency and ensuring this increased workload is accurately represented and remunerated in individual job plans. (orig.)

United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

Science.gov (United States)

Updike, Randall G.; Ellis, Eugene G.; Page, William R.; Parker, Melanie J.; Hestbeck, Jay B.; Horak, William F.

2013-01-01

Along the nearly 3,200 kilometers (almost 2,000 miles) of the United States–Mexican border, in an area known as the Borderlands, we are witnessing the expression of the challenges of the 21st century. This circular identifies several challenge themes and issues associated with life and the environment in the Borderlands, listed below. The challenges are not one-sided; they do not originate in one country only to become problems for the other. The issues and concerns of each challenge theme flow in both directions across the border, and both nations feel their effects throughout the Borderlands and beyond. The clear message is that our two nations, the United States and Mexico, face the issues in these challenge themes together, and the U.S. Geological Survey (USGS) understands it must work with its counterparts, partners, and customers in both countries.Though the mission of the USGS is not to serve as land manager, law enforcer, or code regulator, its innovation and creativity and the scientific and technical depth of its capabilities can be directly applied to monitoring the conditions of the landscape. The ability of USGS scientists to critically analyze the monitored data in search of signals and trends, whether they lead to negative or positive results, allows us to reach significant conclusions—from providing factual conclusions to decisionmakers, to estimating how much of a natural resource exists in a particular locale, to predicting how a natural hazard phenomenon will unfold, to forecasting on a scale from hours to millennia how ecosystems will behave.None of these challenge themes can be addressed strictly by one or two science disciplines; all require well-integrated, cross-discipline thinking, data collection, and analyses. The multidisciplinary science themes that have become the focus of the USGS mission parallel the major challenges in the border region between Mexico and the United States. Because of this multidisciplinary approach, the USGS

Prospective memory in young and older adults: the effects of task importance and ongoing task load.

Science.gov (United States)

Smith, Rebekah E; Hunt, R Reed

2014-01-01

Remembering to perform an action in the future, called prospective memory, often shows age-related differences in favor of young adults when tested in the laboratory. Recently Smith, Horn, and Bayen (2012; Aging, Neuropsychology, and Cognition, 19, 495) embedded a PM task in an ongoing color-matching task and manipulated the difficulty of the ongoing task by varying the number of colors on each trial of the task. Smith et al. found that age-related differences in PM performance (lower PM performance for older adults relative to young adults) persisted even when older adults could perform the ongoing task as well or better than the young adults. The current study investigates a possible explanation for the pattern of results reported by Smith et al. by including a manipulation of task emphasis: for half of the participants the prospective memory task was emphasize, while for the other half the ongoing color-matching task was emphasized. Older adults performed a 4-color version of the ongoing color-matching task, while young adults completed either the 4-color or a more difficult 6-color version of the ongoing task. Older adults failed to perform as well as the young adults on the prospective memory task regardless of task emphasis, even when older adults were performing as well or better than the young adults on the ongoing color-matching task. The current results indicate that the lack of an effect of ongoing task load on prospective memory task performance is not due to a perception that one or the other task is more important than the other.

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

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

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

Science.gov (United States)

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

2016-01-01

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

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

OpenAIRE

Kim, Mi Ja; Chung, Hyang-In Cho; Ahn, Yang Heui

2008-01-01

This study aimed to describe the range of participation of nursing faculty members and their collaborators in multidisciplinary primary health care in Korea and to analyze facilitators, benefits, barriers, and learned lessons. Methods: An exploratory descriptive research design was utilized. A total of 13 nursing faculty members and 13 multidisciplinary collaborators were interviewed face to face using a brief questionnaire and semi-structured interview guide. Descriptive statistics, compa...

Commentary: Pediatric eHealth Interventions: Common Challenges During Development, Implementation, and Dissemination

Science.gov (United States)

Steele, Ric G.; Connelly, Mark A.; Palermo, Tonya M.; Ritterband, Lee M.

2014-01-01

Objective To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. Methods The article draws on the existing eHealth literature and the authors’ collective experience in pediatric eHealth research. Results and conclusions The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. PMID:24816766

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.

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,

A Multidisciplinary Model for Development of Intelligent Computer-Assisted Instruction.

Science.gov (United States)

Park, Ok-choon; Seidel, Robert J.

1989-01-01

Proposes a schematic multidisciplinary model to help developers of intelligent computer-assisted instruction (ICAI) identify the types of required expertise and integrate them into a system. Highlights include domain types and expertise; knowledge acquisition; task analysis; knowledge representation; student modeling; diagnosis of learning needs;…

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...

Improving post-stroke dysphagia outcomes through a standardized and multidisciplinary protocol: an exploratory cohort study.

Science.gov (United States)

Gandolfi, Marialuisa; Smania, Nicola; Bisoffi, Giulia; Squaquara, Teresa; Zuccher, Paola; Mazzucco, Sara

2014-12-01

Stroke is a major cause of dysphagia. Few studies to date have reported on standardized multidisciplinary protocolized approaches to the management of post-stroke dysphagia. The aim of this retrospective cohort study was to evaluate the impact of a standardized multidisciplinary protocol on clinical outcomes in patients with post-stroke dysphagia. We performed retrospective chart reviews of patients with post-stroke dysphagia admitted to the neurological ward of Verona University Hospital from 2004 to 2008. Outcomes after usual treatment for dysphagia (T- group) were compared versus outcomes after treatment under a standardized diagnostic and rehabilitative multidisciplinary protocol (T+ group). Outcome measures were death, pneumonia on X-ray, need for respiratory support, and proportion of patients on tube feeding at discharge. Of the 378 patients admitted with stroke, 84 had dysphagia and were enrolled in the study. A significantly lower risk of in-hospital death (odds ratio [OR] 0.20 [0.53-0.78]), pneumonia (OR 0.33 [0.10-1.03]), need for respiratory support (OR 0.48 [0.14-1.66]), and tube feeding at discharge (OR 0.30 [0.09-0.91]) was recorded for the T+ group (N = 39) as compared to the T- group (N = 45). The adjusted OR showed no difference between the two groups for in-hospital death and tube feeding at discharge. Use of a standardized multidisciplinary protocolized approach to the management of post-stroke dysphagia may significantly reduce rates of aspiration pneumonia, in-hospital mortality, and tube feeding in dysphagic stroke survivors. Consistent with the study's exploratory purposes, our findings suggest that the multidisciplinary protocol applied in this study offers an effective model of management of post-stroke dysphagia.

What are the roles of carers in decision-making for amyotrophic lateral sclerosis multidisciplinary care?

Directory of Open Access Journals (Sweden)

Hogden A

2013-02-01

patients' best interest; communication breakdown between patient, carer, and service providers; the confronting nature of disease information; credibility of Internet sites; carer coping strategies; lack of support for the carer; and the burden of care.Conclusion: Carers enhance ALS patient-centered care through their participation in decision-making. They collaborate with patients and health professionals to form a decision-making triad within specialized multidisciplinary ALS clinical care. Nevertheless, health professional engagement with carers as collaborative partners is acknowledged to be a significant challenge.Keywords: motor neuron disease, carer experience, patient-centered care, health literacy, health care triad, barriers and facilitators

History and future of the Multidisciplinary Association for Psychedelic Studies (MAPS).

Science.gov (United States)

Emerson, Amy; Ponté, Linnae; Jerome, Lisa; Doblin, Rick

2014-01-01

This article describes the teenage vision of the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) that humanity's future would be aided by the therapeutic and spiritual potential of psychedelic substances. The article traces the trajectory of MAPS from inception in 1986 to its present, noting future goals with respect to research, outreach, and harm reduction. MAPS was created as a non-profit psychedelic pharmaceutical company in response to the 1985 scheduling of 3,4-methylenedioxymethamphetamine (MDMA). Overcoming many hurdles, MAPS developed the first double-blind, placebo-controlled trial of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) and plans for FDA prescription approval in 2021. MAPS' program of research expanded to include a trial of lysergic acid diethylamide (LSD)-assisted psychotherapy for anxiety when facing life-threatening illness, observational studies of ibogaine in the treatment of addiction, and studies of MDMA for social anxiety in people with autism spectrum disorders. MAPS meets the challenges of drug development through a clinical research team led by a former Novartis drug development professional experienced in the conduct, monitoring, and analysis of clinical trials. MAPS' harm-reduction efforts are intended to avoid backlash and build a post-prohibition world by assisting non-medical users to transform difficult psychedelic experiences into opportunities for growth.

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....

Fruitful Solutions for Challenges in Distant Teams : -A Case Study

OpenAIRE

Salaterä, Emmi; Brandt, Sofie

2009-01-01

We are currently in an ongoing internationalisation period, demanding organizations to coordinate activities spanning geographically through time and traditional boundaries. Co-workers begin to work more frequently geographically dispersed from each other creating new challenges for leaders and organisations all over the world. The distance requires groups to use technology to cooperate, bringing both advantages and disadvantages. These changes demand organizations to go from traditional team...

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

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.

MOBASE : a framework for managing shared, multi-disciplinary printer information

NARCIS (Netherlands)

Okwudire, C.G.U.

2012-01-01

The report is intended for anyone who is interested in model-based systems engineering, particularly in how to efficiently manage shared, multi-disciplinary information useful for synthesis of complex, mechatronics systems such as those developed by Océ. Of course, the capacity for reasoning at a

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

Planning for the Future of Geo-Cybereducation: Outcomes of the Workshop, Challenges, and Future Directions

Science.gov (United States)

Ryan, J. G.; Eriksson, S. C.

2010-12-01

Inspired by the recommendations of the NSF report “Fostering Learning in the Networked World: The Cyberlearning Opportunity and Challenge” (NSF08204), the NSF National STEM Digital Learning program funded “Planning for the Future of Geocybereducation” Workshop sought to bring together leaders from the geoscience education community, from major geoscience research initiatives, and from the growing public- and private-sector geoscience information community. The objectives of the workshop were to begin conversations aimed at identifying best practices and tools for geoscience cyber-education, in the context of both the changing nature of learners and of rapidly evolving geo-information platforms, and to provide guidance to the NSF as to necessary future directions and needs for funding. 65 participants met and interacted live for the two-day workshop, with ongoing post-meeting virtual interactions via a collaborative workspace (www.geocybered.ning.com). Topics addressed included the rapidly changing character of learners, the growing capabilities of geoscience information systems and their affiliated tools, and effective models for collaboration among educators, researchers and geoinformation specialists. Discussions at the meeting focused on the implications of changing learners on the educational process, the challenges for teachers and administrators in keeping pace, and on the challenges of communication among these divergent professional communities. Ongoing virtual discussions and collaborations have produced a draft workshop document, and the workshop conveners are maintaining the workshop site as a venue for ongoing discussion and interaction. Several key challenges were evident from the workshop discussions and subsequent interactions: a) the development of most of the large geoinformatics and geoscience research efforts were not pursued with education as a significant objective, resulting in limited financial support for such activities after the

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

Schizoaffective disorder--an ongoing challenge for psychiatric nosology.

Science.gov (United States)

Jäger, M; Haack, S; Becker, T; Frasch, K

2011-04-01

Schizoaffective disorder is a common diagnosis in mental health services. The present article aims to provide an overview of diagnostic reliability, symptomatology, outcome, neurobiology and treatment of schizoaffective disorder. Literature was identified by searches in "Medline" and "Cochrane Library". The diagnosis of schizoaffective disorder has a low reliability. There are marked differences between the current diagnostic systems. With respect to psychopathological symptoms, no clear boundaries were found between schizophrenia, schizoaffective disorder and affective disorders. Common neurobiological factors were found across the traditional diagnostic categories. Schizoaffective disorder according to ICD-10 criteria, but not to DSM-IV criteria, shows a more favorable outcome than schizophrenia. With regard to treatment, only a small and heterogeneous database exists. Due to the low reliability and questionable validity there is a substantial need for revision and unification of the current diagnostic concepts of schizoaffective disorder. If future diagnostic systems return to Kraepelin's dichotomous classification of non-organic psychosis or adopt a dimensional diagnostic approach, schizoaffective disorder will disappear from the psychiatric nomenclature. A nosological model with multiple diagnostic entities, however, would be compatible with retaining the diagnostic category of schizoaffective disorder. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Managing patients with heart failure: a qualitative study of multidisciplinary teams with specialist heart failure nurses.

Science.gov (United States)

Glogowska, Margaret; Simmonds, Rosemary; McLachlan, Sarah; Cramer, Helen; Sanders, Tom; Johnson, Rachel; Kadam, Umesh T; Lasserson, Daniel S; Purdy, Sarah

2015-09-01

The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams that include specialist heart failure nurses when caring for the management of heart failure patients. We used a qualitative in-depth interview study nested in a broader ethnographic study of unplanned admissions in heart failure patients (HoldFAST). We interviewed 24 clinicians across primary, secondary, and community care in 3 locations in the Midlands, South Central, and South West of England. Within a framework of the role and contribution of the heart failure specialist nurse, our study identified 2 thematic areas that the clinicians agreed still represent particular challenges when working with heart failure patients. The first was communication with patients, in particular explaining the diagnosis and helping patients to understand the condition. The participants recognized that such communication was most effective when they had a long-term relationship with patients and families and that the specialist nurse played an important part in achieving this relationship. The second was communication within the team. Multidisciplinary input was especially needed because of the complexity of many patients and issues around medications, and the participants believed the specialist nurse may facilitate team communication. The study highlights the role of specialist heart failure nurses in delivering education tailored to patients and facilitating better liaison among all clinicians, particularly when dealing with the management of comorbidities and drug regimens. The way in which specialist nurses were able to be caseworkers for their patients was perceived as a method of ensuring coordination and continuity of care. © 2015 Annals of Family Medicine, Inc.

Multidisciplinary management of clear-cell renal cell carcinoma in Africa and the Middle East: current practice and recommendations for improvement

Directory of Open Access Journals (Sweden)

Zekri J

2015-07-01

Full Text Available Jamal Zekri,1 Lydia M Dreosti,2 Marwan Ghosn,3 Emad Hamada,4 Mohamed Jaloudi,5 Ola Khorshid,6 Blaha Larbaoui7 1College of Medicine, King Faisal Specialist Hospital and Research Centre, Alfaisal University, Jeddah, Saudi Arabia; 2Department of Medical Oncology, University of Pretoria, Pretoria, South Africa; 3Faculty of Medicine Hematology, Oncology Department, Saint Joseph University, Beirut, Lebanon; 4Faculty of Medicine, Cairo University, Kasr Alainy, Cairo, Egypt; 5Oncology Hematology Department, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates; 6National Cancer Institute, Cairo University, Kasr El Ainy, Cairo, Egypt; 7Oncology Service, Université Djillali Liabés, Sidi Bel Abbés, Algeria Abstract: The management of renal cell carcinoma (RCC has evolved considerably in recent years. This report represents the consensus of 22 relevant medical specialists from Africa and the Middle East region engaged in the management of RCC. Partial or radical nephrectomy is the standard of care for most patients with localized RCC. It is essential that patients are followed up appropriately after surgery to enable local and distant relapses to be identified and treated promptly. The treatment of advanced/metastatic disease has changed dramatically with the introduction of targeted therapies. Follow-up of these patients enables therapy optimization and assessment of response to treatment. There was universal agreement on the importance of management of RCC by a multidisciplinary team supported by a multidisciplinary tumor board. Barriers hindering this approach were identified. These included lack of awareness of the benefits of multidisciplinary team role, poor communication among relevant disciplines, time constraints, and specifics of private practice. Other challenges include shortage of expert specialists as urologists and oncologists and lack of local management guidelines in some countries. Solutions were proposed and discussed. Medical

Multidisciplinary study of the use of ICT in the digitization of ...

African Journals Online (AJOL)

Multidisciplinary study of the use of ICT in the digitization of pedagogical and ... of the Moroccan education system are constantly proclaiming the importance of ... This longitudinal study measures the use of ICTs in educational practices for ...

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.

Improved tank car design development : ongoing studies on sandwich structures

Science.gov (United States)

2009-03-02

The Government and industry have a common interest in : improving the safety performance of railroad tank cars carrying : hazardous materials. Research is ongoing to develop strategies : to maintain the structural integrity of railroad tank cars carr...

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.

[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.

Ongoing child welfare services: Understanding the relationship of worker and organizational characteristics to service provision.

Science.gov (United States)

Lwin, Kristen; Fluke, John; Trocmé, Nico; Fallon, Barbara; Mishna, Faye

2018-06-01

Ongoing child welfare services are put in place after completion of the initial maltreatment investigation when there is a perceived need to mitigate the risk of future harm. The knowledge of how clinical, worker, and organizational characteristics interact with this decision to provide ongoing child welfare services is not well integrated in the research literature. Using secondary data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008, this study's primary objective is to understand the relationship of clinical, worker, and organizational characteristics to the decision to transfer a case to ongoing child welfare services and their relative contribution to the transfer decision in Canada. Findings indicate that several clinical level variables are associated with families receiving ongoing services. Additionally, organizational factors, such as type of services offered by the organization and the number of employee support programs available to workers, significantly predicted the decision to transfer a case to ongoing services. While no worker factors, such as education, amount of training, experience, or caseload, were associated with ongoing service receipt, the intraclass correlation coefficient of the final three-level parsimonious model indicated substantial clustering at the worker level. Results indicate that Canadian child welfare workers make decisions differently based on factors not available in the current study and that what would be deemed as important worker characteristics do not necessarily predict this outcome. Findings and implications for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

Science.gov (United States)

Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

2015-10-01

Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

A surrogate based multistage-multilevel optimization procedure for multidisciplinary design optimization

NARCIS (Netherlands)

Yao, W.; Chen, X.; Ouyang, Q.; Van Tooren, M.

2011-01-01

Optimization procedure is one of the key techniques to address the computational and organizational complexities of multidisciplinary design optimization (MDO). Motivated by the idea of synthetically exploiting the advantage of multiple existing optimization procedures and meanwhile complying with

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 ...

Agile development for a multi-disciplinary bicycle stability test bench

NARCIS (Netherlands)

Cooke, A.G.; Bonnema, Gerrit Maarten; Poelman, Wim; Scheidl, R.; Jakoby, B.

2012-01-01

Agile software development methods are used extensively in the software industry. This paper describes an argument to explain why these methods can be used within a multi-disciplinary project and provides a concrete description on how to implement such a method, using a case-study to support the

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

A multi-disciplinary review of late Quaternary palaeoclimates and environments for Lesotho

Directory of Open Access Journals (Sweden)

Jennifer M. Fitchett

2016-07-01

Full Text Available Lesotho provides a unique context for palaeoclimatic research. The small country is entirely landlocked by South Africa, yet has considerable variation in topography, climate, and associated vegetation over an approximate east-west transect. The region has been of archaeological interest for over a century, and hosts many Early to Late Stone Age sites with occupation preceding 80 000 years before present. The eastern Lesotho highlands are of interest to periglacial and glacial geomorphologists because of their well-preserved relict landforms and contentious evidence for permafrost and niche glaciation during the late Quaternary. However, continuous proxy records for palaeoenvironmental reconstructions for Lesotho are scarce and hampered by a range of methodological shortfalls. These challenges include uncertain ages, poor sampling resolution, and proxies extracted from archaeological excavations for which there may be bias in selection. Inferences on palaeoclimates are thus based predominantly on archaeological and palaeogeomorphological evidence for discrete periods during the late Quaternary. This review paper presents a more detailed multidisciplinary synthesis of late Quaternary conditions in Lesotho. We simultaneously considered the varying data that contribute to the under-studied palaeoenvironmental record for southern Africa. The collective palaeoenvironmental data for eastern Lesotho were shown to be relatively contradictory, with considerable variations in contemporaneous palaeoclimatic conditions within the study area. We argue that although methodological challenges may contribute to this variation, the marked changes in topography result in contrasting late Quaternary palaeoenvironments. Such environments are characterised by similar contrasting microclimates and niche ecologies as are witnessed in the contemporary landscape. These spatial variations within a relatively small landlocked country are of importance in understanding

A multi-disciplinary approach to medication safety and the implication for nursing education and practice.

Science.gov (United States)

Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet

2014-02-01

Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in

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

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.

Improving recovery time following heart transplantation: the role of the multidisciplinary health care team

Directory of Open Access Journals (Sweden)

Roussel MG

2013-08-01

Full Text Available Maureen G Roussel,1 Noreen Gorham,2 Lynn Wilson,2 Abeel A Mangi2 1Heart and Vascular Center, Yale-New Haven Hospital, New Haven, CT, USA; 2Center for Advanced Heart Failure, Mechanical Circulatory Support and Cardiac Transplantation, Yale New Haven Heart and Vascular Institute, Yale-New Haven Hospital, New Haven, CT, USA Background: The care of cardiac transplant patients is complex requiring a finely orchestrated endeavor to save a patient’s life. Given the chronic and complex nature of these patients, multiple disciplines are involved in their care. Recognizing difficulties with communication among team members and striving for improved efficiencies in our pretransplant listing process and in our inpatient care, our team was prompted to change the existing approach to patient care related to heart transplantation. Methods: Daily multidisciplinary rounds were instituted and the format of the weekly Multidisciplinary Review Committee (MDRC meetings was modified with the list of attendees broadened to include a larger interdisciplinary team. Additionally, the approach to patient care was analyzed for process improvement. Results: The quality improvements are improved communication and throughput, quantified in an 85% decrease in time to complete transplant evaluation, a 37% decrease in median length of stay posttransplantation, and a 33% reduction in the 30 day readmission rate. In addition, pre- and posttransplant caregivers now participate in MDRC in person or via an electronic meeting platform to support the continuum of care. Quality metrics were chosen and tracked via a transparent electronic platform allowing all involved to assess progress toward agreed upon goals. These were achieved in an 18 month time period following the recruitment of new leadership and invested team members working together as a multidisciplinary team to improve the quality of cardiac transplant care. Discussion: Implementation of daily multidisciplinary rounds and

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

Classroom Collaboration: Implementing Consultation-Based Intervention in Five Multidisciplinary Teams.

Science.gov (United States)

Kuralt, Sally K.

This study attempted system-wide institutionalization of a consultation-based ancillary service delivery model into the norms and work behaviors of the elementary school organization, through modifying the role and function of members of existent school-based multidisciplinary Child Study Teams (CSTs) and the demonstration of the potential of the…

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.…

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.

Rule-Based Multidisciplinary Tool for Unsteady Reacting Real-Fluid Flows, Phase II

Data.gov (United States)

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

New treatment directions for IPF: current status of ongoing and upcoming clinical trials.

Science.gov (United States)

Macagno, Francesco; Varone, Francesco; Leone, Paolo Maria; Mari, Pier-Valerio; Panico, Loredana; Berardini, Ludovica; Richeldi, Luca

2017-07-01

The main objective of this review is to explore the wide and expanding field of new clinical trials in IPF. Recent trials have confirmed the efficacy of the approved drugs pirfenidone and nintedanib; nonetheless, the discovery of new biological pathways has opened new horizons in this field. Areas covered: New strategies against matrix deposition are under study and so is for the role of immunity and autoimmunity. Recent advances in the use of stem cells are opening new possibilities for the recovery of damaged lung tissues. The role of microbioma is under investigation in order to evaluate the use of antibiotics in IPF treatment. Analysing all the new and the upcoming clinical trials, we are trying to offer a comprehensive view of the emerging new frontiers in the treatment of IPF. Expert commentary: The key points for the ongoing and upcoming clinical trials will be to avoid previous mistakes and to choose carefully both study populations and efficacy endpoints. The exciting possibility to enrol patients with progressive lung fibrosis, both idiopathic and not, could be a next step forward. How the existing therapies will fit in a futurist scenario of personalized medicine is still a challenge.

Multidisciplinary Collaboration in Professional Networks for PD A Mixed-Method Analysis

NARCIS (Netherlands)

Eijk, M. van; Bloem, B.R.; Nijhuis, F.A.P.; Koetsenruijter, J.; Vrijhoef, H.J.; Munneke, M.; Wensing, M.; Faber, M.J.

2015-01-01

BACKGROUND: ParkinsonNet, a nationwide organization with regionally oriented professional health networks in TheNetherlands, aims to improve the quality of Parkinson care. Facilitation of multidisciplinary collaboration is a key objective of ParkinsonNet. OBJECTIVES: This study examined whether the

Multidisciplinary teamwork as a crucial competence in modern engineering education programs

NARCIS (Netherlands)

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

2009-01-01

The current process of designing and developing new industrial products has become more differentiated and complex. This has resulted in the need for multidisciplinary teams from the initial product development stage. Because engineers are mainly educated in designing typical technical product

Sustainable Transportation Systems Research Group: Ongoing and Past Activities

OpenAIRE

Gkritza, Konstantina "Nadia"; Hurtado, Davis Chacon; Gkartzonikas, Christos; Ke, Yue; Losada, Lisa L

2017-01-01

This presentation describes the ongoing and past activities of the Sustainable Transportation Systems Research (STSR) group at Purdue University (https://engineering.purdue.edu/STSRG). The STSR group aims to achieve green, safe, efficient, and equitable transportation systems by studying and modeling transportation externalities, using state of the art statistical, econometric, and economic analysis tools.

Challenges in Swedish hydropower – politics, economics and rights

Directory of Open Access Journals (Sweden)

Kristina Ek

2017-10-01

Full Text Available Two systems working in parallel have contributed to implementation difficulties in Swedish water governance. While the old system is designed to be predictable and stable over time, the new system is intended to be transparent and holistic, guided by the principles of Integrated Water Resource Management. The paper disentangles the challenges in Swedish water governance and proposes a blueprint for future research. The proposed research project is unique in the sense that it explores the imbalances between the new and the old water governance systems from a multi-disciplinary perspective, elaborating upon the clashes between the traditional, nationally based regulatory system and the new holistic water governance system from legal, political and economic perspectives.

The Rare Cancer Network: ongoing studies and future strategy

Directory of Open Access Journals (Sweden)

Mahmut Ozsahin

2014-08-01

Full Text Available The Rare Cancer Network (RCN was formed in the early 1990’s to create a global network that could pool knowledge and resources in the studies of rare malignancies whose infrequency prevented both their study with prospective clinical trials. To date, the RCN has initiated 74 studies resulting in 46 peer reviewed publications. The First International Symposium of the Rare Cancer Network took place in Nice in March of 2014. Status updates and proposals for new studies were heard for fifteen topics. Ongoing studies continue for cardiac sarcomas, thyroid cancers, glomus tumors, and adult medulloblastomas. New proposals were presented at the symposium for primary hepatic lymphoma, solitary fibrous tumors, Rosai-Dorfman disease, tumors of the ampulla of Vater, salivary gland tumors, anorectal melanoma, midline nuclear protein in testes carcinoma, pulmonary lymphoepithelioma-like carcinoma, adenoid cystic carcinoma of the trachea, osteosarcomas of the mandible, and extra-cranial hemangiopericytoma. This manuscript presents the abstracts of those proposals and updates on ongoing studies, as well a brief summary of the vision and future of the RCN.

Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

Science.gov (United States)

Huys, Raoul; Jirsa, Viktor K.; Darokhan, Ziauddin; Valentiniene, Sonata; Roland, Per E.

2016-01-01

Neurons in the primary visual cortex spontaneously spike even when there are no visual stimuli. It is unknown whether the spiking evoked by visual stimuli is just a modification of the spontaneous ongoing cortical spiking dynamics or whether the spontaneous spiking state disappears and is replaced by evoked spiking. This study of laminar recordings of spontaneous spiking and visually evoked spiking of neurons in the ferret primary visual cortex shows that the spiking dynamics does not change: the spontaneous spiking as well as evoked spiking is controlled by a stable and persisting fixed point attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization is that it avoids the need for a system reorganization following visual stimulation, and impedes the transition of spontaneous spiking to evoked spiking and the propagation of spontaneous spiking from layer 4 to layers 2–3. PMID:26778982

Bridging Gaps in Multidisciplinary Head and Neck Cancer Care: Nursing Coordination and Case Management

International Nuclear Information System (INIS)

Wiederholt, Peggy A.; Connor, Nadine P.; Hartig, Gregory K.; Harari, Paul M.

2007-01-01

Patients with advanced head and neck cancer face not only a life-threatening malignancy, but also a remarkably complex treatment regimen that can affect their cosmetic appearance and ability to speak, breathe, and swallow. These patients benefit from the coordinated interaction of a multidisciplinary team of specialists and a comprehensive plan of care to address their physical and psychosocial concerns, manage treatment-related toxicities, and prevent or limit long-term morbidities affecting health-related quality of life. Although little has been published on patient-provider communication with a multidisciplinary team, evidence has suggested that gaps often occur in communication between patients and providers, as well as between specialists. These communication gaps can hinder the multidisciplinary group from working toward common patient-centered goals in a coordinated 'interdisciplinary' manner. We discuss the role of a head-and-neck oncology nurse coordinator at a single institution in bridging gaps across the continuum of care, promoting an interdisciplinary team approach, and enhancing the overall quality of patient-centered head-and-neck cancer care

Setting up a parathyroid multidisciplinary team meeting: one year's experience, outcomes and learning points.

Science.gov (United States)

Hancox, S H; Sinnott, J D; Kirkland, P; Lipscomb, D; Owens, E; Howlett, D C

2018-03-01

A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology. Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness. Seventy-nine new referrals were discussed throughout the year; 43 per cent were recommended for surgery, 41 per cent had a trial of conservative or medical management before re-discussion, and 16 per cent required further imaging. Ninety-two per cent of patients underwent an ultrasound, single-photon emission computed tomography/computed tomography or nuclear medicine (sestamibi) scan prior to the meeting. All ultrasound scans were performed by a consultant radiologist. The multidisciplinary team meeting has been successful, with perceived benefits for patients, improved imaging evaluation and efficiency of referral pathways, leading to more appropriate patient management.