Mapping remote and multidisciplinary learning barriers: lessons from challenge-based innovation at CERN

Science.gov (United States)

Jensen, Matilde Bisballe; Utriainen, Tuuli Maria; Steinert, Martin

2018-01-01

This paper presents the experienced difficulties of students participating in the multidisciplinary, remote collaborating engineering design course challenge-based innovation at CERN. This is with the aim to identify learning barriers and improve future learning experiences. We statistically analyse the rated differences between distinct design activities, educational background and remote vs. co-located collaboration. The analysis is based on a quantitative and qualitative questionnaire (N = 37). Our analysis found significant ranking differences between remote and co-located activities. This questions whether the remote factor might be a barrier for the originally intended learning goals. Further a correlation between analytical and converging design phases was identified. Hence, future facilitators are suggested to help students in the transition from one design phase to the next rather than only teaching methods in the individual design phases. Finally, we discuss how educators address the identified learning barriers when designing future courses including multidisciplinary or remote collaboration.

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.

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.

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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.

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

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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

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

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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

How Multidisciplinary Are the Multidisciplinary Journals Science and Nature?

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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

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.

A Strong Impact of Genetic Background on Gut Microflora in Mice

Directory of Open Access Journals (Sweden)

R. Steven Esworthy

2010-01-01

Full Text Available Genetic background affects susceptibility to ileocolitis in mice deficient in two intracellular glutathione peroxidases, GPx1 and GPx2. The C57BL/6 (B6 GPx1/2 double-knockout (DKO mice have mild ileocolitis, and 129S1/Sv (129 DKO mice have severe inflammation. We used diet to modulate ileocolitis; a casein-based defined diet with AIN76A micronutrients (AIN attenuates inflammation compared to conventional LabDiets. Because luminal microbiota induce DKO ileocolitis, we assessed bacterial composition with automated ribosomal intergenic-spacer analysis (ARISA on cecal DNA. We found that mouse strain had the strongest impact on the composition of microbiota than diet and GPx genotypes. In comparing AIN and LabDiet, DKO mice were more resistant to change than the non-DKO or WT mice. However, supplementing yeast and inulin to AIN diet greatly altered microflora profiles in the DKO mice. From 129 DKO strictly, we found overgrowth of Escherichia coli. We conclude that genetic background predisposes mice to colonization of potentially pathogenic E. coli.

How can group-based multidisciplinary rehabilitation for patients with fibromyalgia influence patients' self-efficacy and ability to cope with their illness: a grounded theory approach

DEFF Research Database (Denmark)

Uggen Rasmussen, Marianne; Amris, K; Rydahl-Hansen, Susan

2017-01-01

Aims and objectives: To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness. Background: Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self...... coding. Results: Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness...

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.

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

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

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

2011-01-01

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

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

Comparing multidisciplinary and brief intervention in employees with different job relations on sick leave due to low back pain: protocol of a randomised controlled trial.

Science.gov (United States)

Pedersen, Pernille; Nielsen, Claus Vinther; Andersen, Morten Hovgaard; Langagergaard, Vivian; Boes, Anders; Jensen, Ole Kudsk; Jensen, Chris; Labriola, Merete

2017-12-16

Low back pain (LBP) is a common problem that affects the lives of many individuals and is a frequent cause of sickness absence. To help this group of individuals resume work, several interventions have been studied. However, not all individuals may profit from the same intervention and the effect of a given intervention on return to work (RTW) may depend on their work situation. The aim of this study is to evaluate whether employees on sick leave due to LBP and with poor job relations will benefit more from a multidisciplinary intervention, while patients with strong job relations will benefit more from a brief intervention. The study is designed as a randomised controlled trial with up to five years of follow-up comparing brief intervention with brief intervention plus multidisciplinary intervention. Employees, aged 18-60 years, are included in the study from March 2011 to August 2016 if they have been on sick leave for 4-12 weeks due to LBP with or without radiculopathy. They are divided into two groups, a group with poor job relations and a group with strong job relations based on their answers in the baseline questionnaire. Each group is randomised 1:1 to receive the brief intervention or brief intervention plus multidisciplinary intervention. The brief intervention comprises a clinical examination and advice offered by a rheumatologist and a physiotherapist, whereas the supplementary multidisciplinary intervention comprises the assignment of a case manager who draws up a rehabilitation plan in collaboration with the participant and the multidisciplinary team. The primary outcome is duration of sickness absence measured by register data. Secondary outcomes include sustainable RTW and questionnaire-based measures of functional capacity. Outcomes will be assessed at one, two and five years of follow-up. This trial will evaluate the effect of brief and multidisciplinary intervention on RTW and functional capacity among employees on sick leave due to LBP with

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

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

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.

Use of Multi-Disciplinary Projects To Develop Competence.

Science.gov (United States)

Trotman-Dickenson, Danusia

1992-01-01

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

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

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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.

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

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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 ...

Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial

NARCIS (Netherlands)

Vonk Noordegraaf, A.; Huirne, J.A.F.; Brölmann, H.A.M.; Emanuel, M.H.; van Kesteren, P.; Kleiverda, G.; Lips, J.P.; Mozes, A.; Thurkow, A.L.; van Mechelen, W.; Anema, J.R.

2012-01-01

Background: Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management

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…

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

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.

The EuroPrevall surveys on the prevalence of food allergies in children and adults: background and study methodology

NARCIS (Netherlands)

Kummeling, I.; Mills, E. N. C.; Clausen, M.; Dubakiene, R.; Pérez, C. Farnãndez; Fernández-Rivas, M.; Knulst, A. C.; Kowalski, M. L.; Lidholm, J.; Le, T.-M.; Metzler, C.; Mustakov, T.; Popov, T.; Potts, J.; van Ree, R.; Sakellariou, A.; Töndury, B.; Tzannis, K.; Burney, P.

2009-01-01

Background: The epidemiological surveys in children and adults of the EU-funded multidisciplinary Integrated Project EuroPrevall, launched in June 2005, were designed to estimate the currently unknown prevalence of food allergy and exposure to known or suspected risk factors for food allergy across

Training multidisciplinary biomedical informatics students: three years of experience.

Science.gov (United States)

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

2008-01-01

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

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

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...

Menkes disease: what a multidisciplinary approach can do

Directory of Open Access Journals (Sweden)

Ojha R

2016-08-01

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

Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial

DEFF Research Database (Denmark)

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

2014-01-01

BACKGROUND: Older adults in nursing home and home-care are a particularly high-risk population for weight loss or poor nutrition. One negative consequence of undernutrition is increased health care costs. Several potentially modifiable nutritional risk factors increase the likelihood of weight loss......-effectiveness of nutritional support among undernourished older adults and none of these have used such a multidisciplinary approach. METHODS: An 11 week cluster randomized trial to assess the cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home...... older adults in home-care and nursing home and contribute to important research. TRIAL REGISTRATION: ClinicalTrials.gov 2013 NCT01873456....

Melanoma in Buckinghamshire: Data from the Inception of the Skin Cancer Multidisciplinary Team

International Nuclear Information System (INIS)

Cubitt, J. J.; Khan, A. A.; Royston, E.; Rughani, M.; Budny, B. G.; Cubitt, J. J.; Middleton, M. R.

2013-01-01

Background. Melanoma incidence is increasing faster than any other cancer in the UK. The introduction of specialist skin cancer multidisciplinary teams intends to improve the provision of care to patients suffering from melanoma. This study aims to investigate the management and survival of patients diagnosed with melanoma around the time of inception of the regional skin cancer multidisciplinary team both to benchmark the service against published data and to enable future analysis of the impact of the specialisation of skin cancer care. Methods. All patients diagnosed with primary cutaneous melanoma between January 1, 2003 and December 3, 2005 were identified. Data on clinical and histopathological features, surgical procedures, complications, disease recurrence and 5-year survival were collected and analysed. Results. Two hundred and fourteen patients were included, 134 female and 80 males. Median Breslow thickness was 0.74 mm (0.7 mm female and 0.8 mm male). Overall 5-year survival was 88% (90% female and 85% male). Discussion. Melanoma incidence in Buckinghamshire is in keeping with published data. Basic demographics details concur with classic melanoma distribution and more recent trends, with increased percentage of superficial spreading and thin melanomas, leading to improved survival are reflected

Strong WW scattering at photon linear colliders

International Nuclear Information System (INIS)

Berger, M.S.

1994-06-01

We investigate the possibility of observing strong interactions of longitudinally polarized weak vector bosons in the process γγ → ZZ at a photon linear collider. We make use of polarization of the photon beams and cuts on the decay products of the Z bosons to enhance the signal relative to the background of transversely polarized ZZ pairs. We find that the background overwhelms the signal unless there are strong resonant effects, as for instance from a technicolor analogue of the hadronic f 2 (1270) meson

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...

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.

A multidisciplinary program for achieving lipid goals in chronic hemodialysis patients

Directory of Open Access Journals (Sweden)

McMillan Robichaud J

2002-11-01

Full Text Available Abstract Background There is little information on how target lipid levels can be achieved in end stage renal disease (ESRD patients in a systematic, multidisciplinary fashion. Methods We retrospectively reviewed a pharmacist-directed hyperlipidemia management program for chronic hemodialysis (HD patients. All 26 adult patients on chronic HD at a tertiary care medical facility were entered into the program. A clinical pharmacist was responsible for laboratory monitoring, patient counseling, and the initiation and dosage adjustment of an appropriate 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA reductase inhibitor (statin using a dosing algorithm and monitoring guidelines. The low-density lipoprotein (LDL cholesterol goal was ≤ 100 mg/dl. A renal dietitian provided nutrition counseling and the nephrologist was notified of potential or existing drug interactions or adverse drug reactions (ADRs. Patients received a flyer containing lipid panel results to encourage compliance. Data was collected at program initiation and for 6 months thereafter. Results At the start of the program, 58% of patients were at target LDL cholesterol. At 6 months, 88% had achieved target LDL (p = 0.015. Mean LDL cholesterol decreased from 96 ± 5 to 80 ± 3 mg/dl (p Conclusions Our findings demonstrate both feasibility and efficacy of a multidisciplinary approach in management of hyperlipidemia in HD patients.

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.

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.

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.

[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.

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 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…

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.

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...

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...

Strong field QED in lepton colliders and electron/laser interactions

Science.gov (United States)

Hartin, Anthony

2018-05-01

The studies of strong field particle physics processes in electron/laser interactions and lepton collider interaction points (IPs) are reviewed. These processes are defined by the high intensity of the electromagnetic fields involved and the need to take them into account as fully as possible. Thus, the main theoretical framework considered is the Furry interaction picture within intense field quantum field theory. In this framework, the influence of a background electromagnetic field in the Lagrangian is calculated nonperturbatively, involving exact solutions for quantized charged particles in the background field. These “dressed” particles go on to interact perturbatively with other particles, enabling the background field to play both macroscopic and microscopic roles. Macroscopically, the background field starts to polarize the vacuum, in effect rendering it a dispersive medium. Particles encountering this dispersive vacuum obtain a lifetime, either radiating or decaying into pair particles at a rate dependent on the intensity of the background field. In fact, the intensity of the background field enters into the coupling constant of the strong field quantum electrodynamic Lagrangian, influencing all particle processes. A number of new phenomena occur. Particles gain an intensity-dependent rest mass shift that accounts for their presence in the dispersive vacuum. Multi-photon events involving more than one external field photon occur at each vertex. Higher order processes which exchange a virtual strong field particle resonate via the lifetimes of the unstable strong field states. Two main arenas of strong field physics are reviewed; those occurring in relativistic electron interactions with intense laser beams, and those occurring in the beam-beam physics at the interaction point of colliders. This review outlines the theory, describes its significant novel phenomenology and details the experimental schema required to detect strong field effects and the

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...

Recent Multidisciplinary Research Initiatives and IODP Drilling in the South China Sea

Science.gov (United States)

Lin, J.; Li, C. F.; Wang, P.; Kulhanek, D. K.

2016-12-01

The South China Sea (SCS) is the largest low-latitude marginal sea in the world. Its formation and evolution are linked to the complex continental-oceanic tectonic interaction of the Eurasian, Pacific, and Indo-Australian plates. Despite its relatively small size and short history, the SCS has undergone nearly a complete Wilson cycle from continental break-up to seafloor spreading to subduction, serving as a natural laboratory for studying the linkages between tectonic, volcanic, and oceanic processes. The last several years have witnessed significant progress in investigation of the SCS through comprehensive research programs using multidisciplinary approaches and enhanced international collaboration. The International Ocean Discovery Program (IODP) Expedition 349 drilled and cored five sites in the SCS in 2014. The expedition successfully obtained the first basaltic rock samples of the SCS relict spreading center, discovered large and frequent deep-sea turbidity events, and sampled multiple seamount volcaniclastic layers. In addition, high-resolution near-seafloor magnetic surveys were conducted in the SCS with survey lines passing near some of the IODP drilling sites. Together the IODP drilling and deep-tow magnetic survey results confirmed, for the first time, that the entire SCS basin might have stopped seafloor spreading at similar ages in early Miocene, providing important constraints on marginal sea geodynamic models. In 2007, IODP Expeditions 367 and 368 will drill the northern margin of the SCS to investigate the mechanisms of rifting to spreading processes. Meanwhile, major progress in studying the SCS processes has also been made through comprehensive multidisciplinary programs, for example, the eight-year-long "South China Sea Deep" initiative, which also supports and encourages strong international collaboration. This presentation will highlight the recent multidisciplinary research initiatives in investigation of the SCS and the important role of

Three-year follow-up of 3-year-old to 5-year-old children after participation in a multidisciplinary or a usual-care obesity treatment program

NARCIS (Netherlands)

Bocca, Gianni; Corpeleijn, Eva; van den Heuvel, Edwin R.; Stolk, Ronald P.; Sauer, Pieter J. J.

2014-01-01

Background & aims: Little is known on the long-term effects of obesity intervention programs in preschool-aged children. We compared the long-term effects of a multidisciplinary treatment program with a usual-care program in seventy-five 3- to 5-year-old overweight or obese children who had

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...

A multidisciplinary approach for the treatment of GIST liver metastasis

Directory of Open Access Journals (Sweden)

Paramo Juan C

2008-05-01

Full Text Available Abstract Background Advanced gastrointestinal stromal tumors (GISTs can metastasize and recur after a long remission period, resulting in serious morbidity, mortality, and complex management issues. Case presentation A 67-year-old woman presented with epigastric fullness, mild jaundice and weight loss with a history of a bowel resection 7 years prior for a primary GIST of the small bowel. The finding of a heterogeneous mass 15.5 cm in diameter replacing most of the left lobe of the liver by ultrasonography and CT, followed by positive cytological studies revealed a metastatic GIST. Perioperative optimization of the patient's nutritional status along with biliary drainage, and portal vein embolization were performed. Imatinib was successful in reducing the tumor size and facilitating surgical resection. Conclusion A well-planned multidisciplinary approach should be part of the standard management of advanced or metastatic GIST.

A multidisciplinary approach for the treatment of GIST liver metastasis

Science.gov (United States)

Radkani, Pejman; Ghersi, Marcelo M; Paramo, Juan C; Mesko, Thomas W

2008-01-01

Background Advanced gastrointestinal stromal tumors (GISTs) can metastasize and recur after a long remission period, resulting in serious morbidity, mortality, and complex management issues. Case presentation A 67-year-old woman presented with epigastric fullness, mild jaundice and weight loss with a history of a bowel resection 7 years prior for a primary GIST of the small bowel. The finding of a heterogeneous mass 15.5 cm in diameter replacing most of the left lobe of the liver by ultrasonography and CT, followed by positive cytological studies revealed a metastatic GIST. Perioperative optimization of the patient's nutritional status along with biliary drainage, and portal vein embolization were performed. Imatinib was successful in reducing the tumor size and facilitating surgical resection. Conclusion A well-planned multidisciplinary approach should be part of the standard management of advanced or metastatic GIST. PMID:18471285

Late mental health changes in tortured refugees in multidisciplinary treatment

DEFF Research Database (Denmark)

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

2010-01-01

to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life......-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort......The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted...

The Multidisciplinary Team Conference's Decision on M-Staging in Patients with Gastric- and Gastroesophageal Cancer is not Accurate without Staging Laparoscopy

DEFF Research Database (Denmark)

Strandby, Rune Broni; Svendsen, Lars Bo; Fallentin, E.

2016-01-01

in the period 2010-2012 were retrospectively reviewed. Patient data were retrieved by searching for specific diagnosis and operation codes in the in-house system. The inclusion criteria were as follows: biopsy-verified cancer of the esophagus, gastroesophageal junction or stomach, and no suspicion of peritoneal......BACKGROUND: The implementation of the multidisciplinary team conference has been shown to improve treatment outcome for patients with gastric- and gastroesophageal cancer. Likewise, the staging laparoscopy has increased the detection of patients with disseminated disease, that is, patients who do...... carcinomatosis or liver metastases on multidisciplinary team conference before staging laparoscopy. Furthermore, an evaluation with staging laparoscopy was required. RESULTS: In total, 222 patients met the inclusion criteria. Most cancers were located in the gastroesophageal junction, n = 171 (77.0%), and most...

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

severity of brain injury, setting and type and timing of rehabilitation offered. We identified a total of 19 studies involving 3480 people. Twelve studies were of good methodological quality and seven were of lower quality, according to the van Tulder scoring system. Within the subgroup of predominantly mild brain injury, 'strong evidence' suggested that most individuals made a good recovery when appropriate information was provided, without the need for additional specific interventions. For moderate to severe injury, 'strong evidence' showed benefit from formal intervention, and 'limited evidence' indicated that commencing rehabilitation early after injury results in better outcomes. For participants with moderate to severe ABI already in rehabilitation, 'strong evidence' revealed that more intensive programmes are associated with earlier functional gains, and 'moderate evidence' suggested that continued outpatient therapy could help to sustain gains made in early post-acute rehabilitation. The context of multi-disciplinary rehabilitation appears to influence outcomes. 'Strong evidence' supports the use of a milieu-oriented model for patients with severe brain injury, in which comprehensive cognitive rehabilitation takes place in a therapeutic environment and involves a peer group of patients. 'Limited evidence' shows that specialist in-patient rehabilitation and specialist multi-disciplinary community rehabilitation may provide additional functional gains, but studies serve to highlight the particular practical and ethical restraints imposed on randomisation of severely affected individuals for whom no realistic alternatives to specialist intervention are available. Problems following ABI vary. Consequently, different interventions and combinations of interventions are required to meet the needs of patients with different problems. Patients who present acutely to hospital with mild brain injury benefit from follow-up and appropriate information and advice. Those with

Balloon measurements of the cosmic microwave background strongly favor a flat cosmos

International Nuclear Information System (INIS)

Schwarzschild, Bertram

2000-01-01

In 1998 two related but independent groups sent balloon-borne microwave telescopes aloft to study fluctuations in the cosmic microwave background (CMB) at fine angular resolution. In August of that year, the Maxima telescope spent one night at 40 km above Texas. And at the end of the year, its ''sister'' telescope, called Boomerang, took advantage of the steady circumpolar winds of the austral summer to complete a 10-day stratospheric circumnavigation of Antarctica. (c) 2000 American Institute of Physics

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 team conferences promote treatment according to guidelines in rectal cancer

DEFF Research Database (Denmark)

Brännström, Fredrik; Kroll Bjerregaard, Jon; Winbladh, Anders

2015-01-01

BACKGROUND: Multidisciplinary team (MDT) conferences have been introduced into standard cancer care, though evidence that it benefits the patient is weak. We used the national Swedish Rectal Cancer Register to evaluate predictors for case discussion at a MDT conference and its impact on treatment...... radiotherapy. These results indirectly support the introduction into clinical practice of discussing all rectal cancer patients at MDT conferences, not least those being treated at low-volume hospitals....... on the implementation of preoperative radiotherapy was evaluated in 1043 patients with pT3c-pT4 M0 tumours, and in 1991 patients with pN+ M0 tumours. RESULTS: Hospital volume, i.e. the number of rectal cancer surgical procedures performed per year, was the major predictor for MDT evaluation. Patients treated...... at hospitals with

Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions.

Science.gov (United States)

Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

This article is the second part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the use of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work. Strong evidence indicates that multidisciplinary rehabilitation benefits cancer survivors and that psychosocial strategies can reduce anxiety and depression. Moderate evidence indicates that interventions can support survivors in returning to the level of sexuality desired and help with return to work. Part 1 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

What constitutes an excellent allied health care professional? A multidisciplinary focus group study

Directory of Open Access Journals (Sweden)

Paans W

2013-09-01

Full Text Available Wolter Paans, Inge Wijkamp, Egbert Wiltens, Marca V Wolfensberger Research and Innovation Group Talent Development in Higher Education and Society, Hanze University of Applied Sciences, Groningen, The Netherlands. Background: Determining what constitutes an excellent allied health care professional (AHCP is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care. Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP. Methods: AHCPs' perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts. Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1 cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2 cooperativity, to effectively work with others in a multidisciplinary context; (3 communicative, to communicate effectively at different levels in complex situations; (4 initiative, to initiate new ideas, to act proactively, and to follow them through; (5 innovative, to devise new ideas and to implement alternatives beyond current practices; (6 introspective, to self-examine and to reflect; (7 broad perspective, to capture the big picture; and (8 evidence-driven, to find and to use scientific evidence to guide one's decisions. Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves. Keywords: clinical

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.

A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.

LENUS (Irish Health Repository)

Whitford, David L

2007-01-01

BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more

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.

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)

OBSERVATION OF STRONG - STRONG AND OTHER BEAM - BEAM EFFECTS IN RHIC

International Nuclear Information System (INIS)

FISCHER, W.; BLASKIEWICZ, M.; BRENNAN, J.M.; CAMERON, P.; CONNOLLY, R.; MONTAG, C.; PEGGS, S.; PILAT, F.; PTITSYN, V.; TEPIKIAN, S.; TRBOJEVIC, D.; VAN ZEIJTS, J.

2003-01-01

RHIC is currently the only hadron collider in which strong-strong beam-beam effects can be seen. For the first time, coherent beam-beam modes were observed in a bunched beam hadron collider. Other beam-beam effects in RHIC were observed in operation and in dedicated experiments with gold ions, deuterons and protons. Observations include measurements of beam-beam induced tune shifts, lifetime and emittance growth measurements with and without beam-beam interaction, and background rates as a function of tunes. During ramps unequal radio frequencies in the two rings cause the crossing points to move longitudinally. Thus bunches experience beam-beam interactions only in intervals and the tunes are modulated. In this article we summarize the most important beam-beam observations made so far

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

Science.gov (United States)

Pak, Chan-gi; Li, Wesley

2009-01-01

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

Auditory intensity processing: Effect of MRI background noise.

Science.gov (United States)

Angenstein, Nicole; Stadler, Jörg; Brechmann, André

2016-03-01

Studies on active auditory intensity discrimination in humans showed equivocal results regarding the lateralization of processing. Whereas experiments with a moderate background found evidence for right lateralized processing of intensity, functional magnetic resonance imaging (fMRI) studies with background scanner noise suggest more left lateralized processing. With the present fMRI study, we compared the task dependent lateralization of intensity processing between a conventional continuous echo planar imaging (EPI) sequence with a loud background scanner noise and a fast low-angle shot (FLASH) sequence with a soft background scanner noise. To determine the lateralization of the processing, we employed the contralateral noise procedure. Linearly frequency modulated (FM) tones were presented monaurally with and without contralateral noise. During both the EPI and the FLASH measurement, the left auditory cortex was more strongly involved than the right auditory cortex while participants categorized the intensity of FM tones. This was shown by a strong effect of the additional contralateral noise on the activity in the left auditory cortex. This means a massive reduction in background scanner noise still leads to a significant left lateralized effect. This suggests that the reversed lateralization in fMRI studies with loud background noise in contrast to studies with softer background cannot be fully explained by the MRI background noise. Copyright © 2016 Elsevier B.V. All rights reserved.

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

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.

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...

Cosmogenic photons strongly constrain UHECR source models

Directory of Open Access Journals (Sweden)

van Vliet Arjen

2017-01-01

Full Text Available With the newest version of our Monte Carlo code for ultra-high-energy cosmic ray (UHECR propagation, CRPropa 3, the flux of neutrinos and photons due to interactions of UHECRs with extragalactic background light can be predicted. Together with the recently updated data for the isotropic diffuse gamma-ray background (IGRB by Fermi LAT, it is now possible to severely constrain UHECR source models. The evolution of the UHECR sources especially plays an important role in the determination of the expected secondary photon spectrum. Pure proton UHECR models are already strongly constrained, primarily by the highest energy bins of Fermi LAT’s IGRB, as long as their number density is not strongly peaked at recent times.

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.

A comparative study: do "clickers" increase student engagement in multidisciplinary clinical microbiology teaching?

Science.gov (United States)

Stevens, Niall T; McDermott, Hélène; Boland, Fiona; Pawlikowska, Teresa; Humphreys, Hilary

2017-04-08

Audience response devices, or "clickers", have been used in the education of future healthcare professionals for several years with varying success. They have been reported to improve the learning experience by promoting engagement and knowledge retention. In 2014, our department evaluated the use of "clickers" in a newly introduced multidisciplinary approach to teaching large groups of third year medical students clinical cases developed around a microbiology theme. Six multidisciplinary teaching sessions covering community-acquired pneumonia, tuberculosis, infective endocarditis, peritonitis, bloodstream infection with pyelonephritis and bacterial meningitis were included in the study. Three involved the use of the "clickers" and three did not. Consenting undergraduate students attended the designated classes and afterwards answered a short online quiz relating to the session. Students also answered a short questionnaire about the "clickers" to gauge their attitudes on the use of these devices. Of 310 students, 294 (94.8%) agreed to participate in the study. Interestingly, the grades of online quizzes after a session where a "clicker" was used were slightly lower. Looking only at the grades of students who engaged completely with the process (n = 19), there was no statistical difference to suggest that the devices had a positive or negative impact on knowledge retention. However, student attitudes to using the devices were positive overall. Fifty-five percent strongly agreed and 27% agreed that teaching sessions where the "clickers" were used were more engaging. Thirty-four percent strongly agreed and 36% agreed that the "clickers" made important concepts more memorable and 54% felt the device enhanced their understanding of the topic being covered. Overall, it appears that "clickers" help in improving student engagement in large classroom environments, enhance the learning experience, and are received positively by medical students but their impact on

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

Genetic background of claw health in dairy cattle

NARCIS (Netherlands)

Spek, van der D.

2015-01-01

<strong>Abstract>

Van der Spek, D. (2015). Genetic background of claw health in dairy cattle. PhD thesis, Wageningen University, the Netherlands.

Claw disorders affect cow welfare and profitability of farms and as such are important traits relevant to dairy cattle breeding.

Low Background Micromegas in CAST

DEFF Research Database (Denmark)

Garza, J G; Aune, S.; Aznar, F.

2014-01-01

Solar axions could be converted into x-rays inside the strong magnetic field of an axion helioscope, triggering the detection of this elusive particle. Low background x-ray detectors are an essential component for the sensitivity of these searches. We report on the latest developments of the Micr...

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.

The reablement team’s voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement

Directory of Open Access Journals (Sweden)

Hjelle KM

2016-11-01

Full Text Available Kari Margrete Hjelle,1,2 Olbjørg Skutle,2,3 Oddvar Førland,2,4 Herdis Alvsvåg4 1Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway; 2Centre for Care Research Western Norway, Bergen University College, Bergen, Norway; 3Department of Health and Social Educators, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway; 4VID Specialized University, Bergen, Norway Background: Reablement is an early and time-limited home-based rehabilitation intervention that emphasizes intensive, goal-oriented, and multidisciplinary assistance for people experiencing functional decline. Few empirical studies to date have examined the experiences of the integrated multidisciplinary teams involved in reablement. Accordingly, the aim of this study was to explore and describe how an integrated multidisciplinary team in Norway experienced participation in reablement.Methods: An integrated multidisciplinary team consisting of health care professionals with a bachelor’s degree (including a physiotherapist, a social educator, occupational therapists, and nurses and home-based care personnel without a bachelor’s degree (auxiliary nurses and nursing assistants participated in focus group discussions. Qualitative content analysis was used to analyze the resulting data.Results: Three main themes emerged from the participants’ experiences with participating in reablement, including “the older adult’s goals are crucial”, “a different way of thinking and acting – a shift in work culture”, and “a better framework for cooperation and application of professional expertise and judgment”. The integrated multidisciplinary team and the older adults collaborated and worked in the same direction to achieve the person’s valued goals. The team supported the older adults in performing activities themselves rather than completing tasks for them. To

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...

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.

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.

Evaluation of effects of an operational multidisciplinary team on antibiotic use in the medium to long term at a French university hospital.

Science.gov (United States)

Demoré, Béatrice; Humbert, Pauline; Boschetti, Emmanuelle; Bevilacqua, Sibylle; Clerc-Urmès, Isabelle; May, Thierry; Pulcini, Céline; Thilly, Nathalie

2017-10-01

Background Antibiotic-resistant bacteria are a major public health problem throughout the world. In 2006, in accordance with the national guidelines for antibiotic use, the CHRU of Nancy created an operational multidisciplinary antibiotic team at one of its sites. In 2011, a cluster-controlled trial showed that the operational multidisciplinary antibiotic team (the intervention) had a favourable short-term effect on antibiotic use and costs. Objective Our objective was to determine whether these effects continued over the medium to long term (that is, 2-7 years after creation of the operational multidisciplinary antibiotic team, 2009-2014). Setting The 1800-bed University Hospital of Nancy (France). Method The effect in the medium to long term is measured according to the same criteria and assessed by the same methods as the first study. A cluster controlled trial was performed on the period 2009-2014. The intervention group comprised 11 medical and surgical wards in settings where the operational multidisciplinary antibiotic team was implemented and the control group comprised 6 wards without this operational team. Main outcome measure Consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1000 patient-days) and costs savings (in €). Results The reduction in antibiotic use and costs continued, but at a lower rate than in the short term (11% between 2009 and 2014 compared with 33% between 2007 and 2009) at the site of the intervention. The principal decreases concerned fluoroquinolones and glycopeptides. At the site without an operational multidisciplinary antibiotic team (the control group), total antibiotic use remained stable. Between 2009 and 2014, costs fell 10.5% in the intervention group and 5.7% in the control group. Conclusion This study shows that it is possible to maintain the effectiveness over time of such an intervention and demonstrates its role in defining a hospital's antibiotic policy.

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

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.

Low Background Micromegas in CAST

CERN Document Server

Garza, J.G.; Aznar, F.; Calvet, D.; Castel, J.F.; Christensen, F.E.; Dafni, T.; Davenport, M.; Decker, T.; Ferrer-Ribas, E.; Galán, J.; García, J.A.; Giomataris, I.; Hill, R.M.; Iguaz, F.J.; Irastorza, I.G.; Jakobsen, A.C.; Jourde, D.; Mirallas, H.; Ortega, I.; Papaevangelou, T.; Pivovaroff, M.J.; Ruz, J.; Tomás, A.; Vafeiadis, T.; Vogel, J.K.

2015-11-16

Solar axions could be converted into x-rays inside the strong magnetic field of an axion helioscope, triggering the detection of this elusive particle. Low background x-ray detectors are an essential component for the sensitivity of these searches. We report on the latest developments of the Micromegas detectors for the CERN Axion Solar Telescope (CAST), including technological pathfinder activities for the future International Axion Observatory (IAXO). The use of low background techniques and the application of discrimination algorithms based on the high granularity of the readout have led to background levels below 10$^{-6}$ counts/keV/cm$^2$/s, more than a factor 100 lower than the first generation of Micromegas detectors. The best levels achieved at the Canfranc Underground Laboratory (LSC) are as low as 10$^{-7}$ counts/keV/cm$^2$/s, showing good prospects for the application of this technology in IAXO. The current background model, based on underground and surface measurements, is presented, as well as ...

Interaction of neutral particles with strong laser fields

Energy Technology Data Exchange (ETDEWEB)

Meuren, Sebastian; Keitel, Christoph H.; Di Piazza, Antonino [Max-Planck-Institut fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany)

2013-07-01

Since the invention of the laser in the 1960s the experimentally available field strengths have continuously increased. The current peak intensity record is 2 x 10{sup 22} W/cm{sup 2} and next generation facilities such as ELI, HiPER and XCELS plan to reach even intensities of the order of 10{sup 24} W/cm{sup 2}. Thus, modern laser facilities are a clean source for very strong external electromagnetic fields and promise new and interesting high-energy physics experiments. In particular, strong laser fields could be used to test non-linear effects in quantum field theory. Earlier we have investigated how radiative corrections modify the coupling of a charged particle inside a strong plane-wave electromagnetic background field. However, a charged particle couples already at tree level to electromagnetic radiation. Therefore, we have now analyzed how the coupling between neutral particles and radiation is affected by a very strong plane-wave electromagnetic background field, when loop corrections are taken into account. In particular, the case of neutrinos is discussed.

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.

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 STRONG STAR Multidisciplinary PTSD Research Consortium

Science.gov (United States)

2014-11-01

peripheral stress response systems, and a ulnerability to subsequent adult stress exposure such that he behavioral impact of adult stress would be greater...Coulbourn Instruments, Whitehall, PA, USA; model # H10-11R- C) with metal walls and a grid shock floor attached to a shock enerator (Coulbourn, # H13 -15...2011) 438–451446Both PNS and CAPS also impacted behavioral re- ponses to fear conditioning and extinction, although in ifferent ways, and rats

The STRONG STAR Multidisciplinary PTSD Research Consortium

Science.gov (United States)

2009-09-01

Smith, 2001). Among 16-year old adolescents who currently reported using alcohol, those who were homozygous for the L-allele (i.e., LL) drank more...history of infertility or be practicing accepted methods of birth control including hormonal contraceptives , diaphragm, or condoms with spermicide...2006 in press) Low Level of Response to Alcohol as Associated with Serotonin Transporter Genotype and High Alcohol Intake in Adolescents . Biol

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.

Environmental 222Rn as a background source in the solar neutrino experiment GALLEX

International Nuclear Information System (INIS)

Wojcik, M.

1996-01-01

The radiochemical neutrino experiment GALLEX is described. Its aim is to measure the flux of low energy solar neutrinos. In this experiment it is essential to suppress strongly the background of environmental origin, like charged cosmic rays, neutrons and gamma rays. In low-level radioactivity measurements performed in deep underground laboratory where flux of charged comic rays is strongly reduced, radon (Rn) exhaled from rock or concrete walls forms a most important strong, time-dependent background component. In this work the impact of Rn on the GALLEX experiment has been discussed and attempts to recognize and minimize its influence on the counter background were described. 63 refs, 22 figs, 11 tabs

Multidisciplinary perspectives on the history of human interactions with life in the ocean

DEFF Research Database (Denmark)

MacDiarmid, Alison; MacKenzie, Brian; Ojaveer, Henn

2016-01-01

-term changes of affected species and define appropriate and realistic management targets. Second, increased multi-and trans-disciplinary effort is required to better understand the relative importance of different human demographic, technological, economic, and cultural drivers on the patterns, intensities......There is an essentially circular interaction between the human social system and the marine ecosystem. The Oceans Past V Conference "Multidisciplinary perspectives on the history of human interactions with life in the ocean" held in Tallinn, Estonia, in May 2015 was an opportunity...... for the presentation and discussion of papers on a diverse array of topics that examined this socio-ecological system from a historical perspective. Here we provide background to the disciplines participating in the conference and to the conference itself. We summarize the conference papers that appear in this special...

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

Directory of Open Access Journals (Sweden)

Glenda Dias Santos

2015-12-01

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

A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients.

Science.gov (United States)

Nagaviroj, Kittiphon; Anothaisintawee, Thunyarat

2017-06-01

Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient's profile, disease status, functional status, patient's symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient's actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home. A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38). Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.

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

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...

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

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

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.

Strong contributions of local background climate to urban heat islands

Science.gov (United States)

Zhao, Lei; Lee, Xuhui; Smith, Ronald B.; Oleson, Keith

2014-07-01

The urban heat island (UHI), a common phenomenon in which surface temperatures are higher in urban areas than in surrounding rural areas, represents one of the most significant human-induced changes to Earth's surface climate. Even though they are localized hotspots in the landscape, UHIs have a profound impact on the lives of urban residents, who comprise more than half of the world's population. A barrier to UHI mitigation is the lack of quantitative attribution of the various contributions to UHI intensity (expressed as the temperature difference between urban and rural areas, ΔT). A common perception is that reduction in evaporative cooling in urban land is the dominant driver of ΔT (ref. 5). Here we use a climate model to show that, for cities across North America, geographic variations in daytime ΔT are largely explained by variations in the efficiency with which urban and rural areas convect heat to the lower atmosphere. If urban areas are aerodynamically smoother than surrounding rural areas, urban heat dissipation is relatively less efficient and urban warming occurs (and vice versa). This convection effect depends on the local background climate, increasing daytime ΔT by 3.0 +/- 0.3 kelvin (mean and standard error) in humid climates but decreasing ΔT by 1.5 +/- 0.2 kelvin in dry climates. In the humid eastern United States, there is evidence of higher ΔT in drier years. These relationships imply that UHIs will exacerbate heatwave stress on human health in wet climates where high temperature effects are already compounded by high air humidity and in drier years when positive temperature anomalies may be reinforced by a precipitation-temperature feedback. Our results support albedo management as a viable means of reducing ΔT on large scales.

Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa

Directory of Open Access Journals (Sweden)

Ennion L

2016-10-01

Full Text Available Liezel Ennion, Anthea Rhoda Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa Background: Major lower limb amputations result in a significant sense of loss, psychological stress, and decrease in function and overall quality of life for the amputee. The holistic, patient-centered prosthetic rehabilitation of an amputee requires input from a team of dedicated health professionals from different disciplines commonly referred to as a multidisciplinary team (MDT. MDT rehabilitation is considered crucial in the reintegration of the amputee into the community, as well as for providing psychological support after limb loss. Multidisciplinary and interdisciplinary rehabilitation has been proven to be more successful than therapy provided by individual therapists in a number of different populations, regardless of the population studied. However, in most developing countries, there is a significant lack of multidisciplinary rehabilitation.Aim: To explore the roles and challenges of the members of the MDT involved in trans-tibial amputation rehabilitation in a rural community in South Africa (SA.Design: An explorative sequential qualitative descriptive study.Setting: A rural district in the KwaZulu Natal province in SA.Participants: Nine prosthetic users, three surgeons, three traditional healers, 17 therapists, four prosthetists, and four community health workers.Instruments for data collection: Semistructured interviews and focus group discussions.Results: The roles of the members of the MDT were clarified, and various members of the MDT highlighted specific challenges relating to their experiences and roles in the rehabilitation team. Lack of interdisciplinary rehabilitation and communication among team members, as well as lack of resources, and patient education negatively impact the rehabilitation of trans-tibial amputees.Conclusion: Aiming to address the limited resources

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...

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…

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...

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

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.

Digital phonocardiographic experiments and signal processing in multidisciplinary fields of university education

Science.gov (United States)

Nagy, Tamás; Vadai, Gergely; Gingl, Zoltán

2017-09-01

Modern measurement of physical signals is based on the use of sensors, electronic signal conditioning, analog-to-digital conversion and digital signal processing carried out by dedicated software. The same signal chain is used in many devices such as home appliances, automotive electronics, medical instruments, and smartphones. Teaching the theoretical, experimental, and signal processing background must be an essential part of improving the standard of higher education, and it fits well to the increasingly multidisciplinary nature of physics and engineering too. In this paper, we show how digital phonocardiography can be used in university education as a universal, highly scalable, exciting, and inspiring laboratory practice and as a demonstration at various levels and complexity. We have developed open-source software templates in modern programming languages to support immediate use and to serve as a basis of further modifications using personal computers, tablets, and smartphones.

Digital phonocardiographic experiments and signal processing in multidisciplinary fields of university education

International Nuclear Information System (INIS)

Nagy, Tamás; Vadai, Gergely; Gingl, Zoltán

2017-01-01

Modern measurement of physical signals is based on the use of sensors, electronic signal conditioning, analog-to-digital conversion and digital signal processing carried out by dedicated software. The same signal chain is used in many devices such as home appliances, automotive electronics, medical instruments, and smartphones. Teaching the theoretical, experimental, and signal processing background must be an essential part of improving the standard of higher education, and it fits well to the increasingly multidisciplinary nature of physics and engineering too. In this paper, we show how digital phonocardiography can be used in university education as a universal, highly scalable, exciting, and inspiring laboratory practice and as a demonstration at various levels and complexity. We have developed open-source software templates in modern programming languages to support immediate use and to serve as a basis of further modifications using personal computers, tablets, and smartphones. (paper)

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...

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

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, ...

Environmental {sup 222}Rn as a background source in the solar neutrino experiment GALLEX

Energy Technology Data Exchange (ETDEWEB)

Wojcik, M. [Uniwersytet Jagiellonski, Cracow (Poland). Inst. Fizyki; BOREXINO

1996-12-31

The radiochemical neutrino experiment GALLEX is described. Its aim is to measure the flux of low energy solar neutrinos. In this experiment it is essential to suppress strongly the background of environmental origin, like charged cosmic rays, neutrons and gamma rays. In low-level radioactivity measurements performed in deep underground laboratory where flux of charged comic rays is strongly reduced, radon (Rn) exhaled from rock or concrete walls forms a most important strong, time-dependent background component. In this work the impact of Rn on the GALLEX experiment has been discussed and attempts to recognize and minimize its influence on the counter background were described. 63 refs, 22 figs, 11 tabs.

Environmental {sup 222}Rn as a background source in the solar neutrino experiment GALLEX

Energy Technology Data Exchange (ETDEWEB)

Wojcik, M [Uniwersytet Jagiellonski, Cracow (Poland). Inst. Fizyki; BOREXINO,

1997-12-31

The radiochemical neutrino experiment GALLEX is described. Its aim is to measure the flux of low energy solar neutrinos. In this experiment it is essential to suppress strongly the background of environmental origin, like charged cosmic rays, neutrons and gamma rays. In low-level radioactivity measurements performed in deep underground laboratory where flux of charged comic rays is strongly reduced, radon (Rn) exhaled from rock or concrete walls forms a most important strong, time-dependent background component. In this work the impact of Rn on the GALLEX experiment has been discussed and attempts to recognize and minimize its influence on the counter background were described. 63 refs, 22 figs, 11 tabs.

Evaluation and Management of Neonatal Dysphagia: Impact of Pharyngoesophageal Motility Studies and Multidisciplinary Feeding Strategy

Science.gov (United States)

Jadcherla, Sudarshan R.; Stoner, Erin; Gupta, Alankar; Bates, D. Gregory; Fernandez, Soledad; Di Lorenzo, Carlo; Linscheid, Thomas

2013-01-01

Background and objectives Abnormal swallowing (dysphagia) among neonates is commonly evaluated using the videofluoroscopic swallow study (VSS). Radiological findings considered high risk for administration of oral feeding include nasopharyngeal reflux, laryngeal penetration, aspiration, or pooling. Our aims were to determine pharyngoesophageal motility correlates in neonates with dysphagia and the impact of multidisciplinary feeding strategy. Methods Twenty dysphagic neonates (mean gestation ± standard deviation [SD] = 30.9 ± 4.9 weeks; median 31.1 weeks; range = 23.7–38.6 weeks) with abnormal VSS results were evaluated at 49.9 ± 16.5 weeks (median 41.36 weeks) postmenstrual age. The subjects underwent a swallow-integrated pharyngoesophageal motility assessment of basal and adaptive swallowing reflexes using a micromanometry catheter and pneumohydraulic water perfusion system. Based on observations during the motility study, multidisciplinary feeding strategies were applied and included postural adaptation, sensory modification, hunger manipulation, and operant conditioning methods. To discriminate pharyngoesophageal manometry correlates between oral feeders and tube feeders, data were stratified based on the primary feeding method at discharge, oral feeding versus tube feeding. Results At discharge, 15 of 20 dysphagic neonates achieved oral feeding success, and the rest required chronic tube feeding. Pharyngoesophageal manometry correlates were significantly different (P dysphagia or its consequences. Manometry may be a better predictor than VSS in identifying patients who are likely to succeed in vigorous intervention programs. PMID:19179881

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

DO PATIENTS WITH CHRONIC LOW BACK PAIN EXPERIENCE PAIN REDUCTION AND FUNCTIONAL IMPROVEMENT AFTER TREATMENT AT A MULTIDISCIPLINARY OUTPATIENT CLINIC?

Directory of Open Access Journals (Sweden)

Norbye Anja

2017-04-01

Full Text Available Background: Low back pain is the most common affliction of the musculoskeletal system. Patients with chronic low back pain cost the society great expenses in treatments and other social benefits; however, the effects of interventions are discussed. The purpose of this study was to determine whether patients with chronic low back pain experience pain reduction and functional improvement after treatment at a multidisciplinary outpatient clinic. Methods: A prospective study design was used, including 446 patients who participated in follow-up questionnaires with data collection at 6 and 12 months after treatment. The primary outcome was alterations in pain and function. Result: By 12 months after treatment, 71.3 % of the included patients had completed the follow-up questionnaires. Based on these questionnaires, we identified statistically significant changes from baseline at all end points, with clinically significant changes in approximately half of the participants (p = 0.000. Conclusion: Treatment of chronic low back pain at a multidisciplinary outpatient clinic resulted in clinically significant pain reduction and functional improvement within 12 months for approximately half of affected patients.

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

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

Health promotion as multi-professional and multi-disciplinary work

Directory of Open Access Journals (Sweden)

Chrisanthy Sotiriadou

2010-01-01

Full Text Available Background: A health promoter is the name given to all those experts who are intended to prevent disease andill health and to increase well-being at the community level. That seems to be a very good and useful idea ingeneral, but can it be achieved by individuals alone?Objective: Review to what extend team work and the concept of team development are a pre-requisite foreffective health promotion. That is the central objective of this article and the answer will be explored through ananalysis of the international literature.Discussion: The first part will set out to define the notions of both health promotion and health promotionspecialists, in order to provide a framework for the multi-professional and multi-disciplinary nature of healthpromotion. The second part will try to establish the meaning of collaboration for health promotion, starting withdefinitions of the concepts: group, team and teamwork. The benefits of collaborative work in health promotionwill be discussed alongside the common barriers that can arise during the process.Conclusions: The article will conclude by proposing the characteristics of a successful team-working healthpromotion group.

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

Directory of Open Access Journals (Sweden)

Horan Sheila

2011-01-01

Full Text Available Abstract Background Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index and objective sleep quality (measured by Actigraphy in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Methods/Design Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI]. Those patients with a sleep disturbance (PSQI >5 will be assigned to either the intervention group (immediate treatment, or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia, and functional outcome

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

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

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.

Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

Energy Technology Data Exchange (ETDEWEB)

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

2013-07-15

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

Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

International Nuclear Information System (INIS)

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

2013-01-01

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

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.

Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2

Directory of Open Access Journals (Sweden)

Weijs Peter JM

2008-12-01

Full Text Available Abstract Background In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. Methods Go4it is a multidisciplinary group treatment that focuses on: 1 increasing awareness of the current dietary and physical activity behaviour (i.e. energy balance behaviour, 2 improving diet, 3 decreasing sedentary behaviour, 4 increasing levels of physical activity, and 5 coping with difficult situations. Go4it consists of 7 sessions with an interval of 2–3 weeks. The effectiveness of the multidisciplinary group treatment compared with usual care (i.e. referral to a dietician was evaluated in a randomised controlled trial. We examined effects on BMI(sds, body composition, energy expenditure, glucose tolerance and insulin resistance (primary outcome measure, as well as dietary and physical activity behaviour and quality of life. An economic evaluation from a societal perspective was conducted alongside the randomised trial to evaluate the cost-effectiveness of the multidisciplinary treatment program vs. usual care. Discussion In this paper we described a multidisciplinary treatment program (Go4it for obese adolescents and the design of a randomised controlled trial and economic evaluation to evaluate its effectiveness and cost-effectiveness. Trial registration Netherlands Trial Register (ISRCTN27626398.

Background reduction in a young interferometer biosensor

NARCIS (Netherlands)

Mulder, H. K P; Subramaniam, V.; Kanger, J. S.

2014-01-01

Integrated optical Young interferometer (IOYI) biosensors are among the most sensitive label-free biosensors. Detection limits are in the range of 20 fg/mm2. The applicability of these sensors is however strongly hampered by the large background that originates from both bulk refractive index

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...

Nonperturbative quantum electrodynamics in a photon-condensate background field

International Nuclear Information System (INIS)

Kikuchi, Y.; Ng, Y.J.

1988-01-01

Analyses of the Schwinger-Dyson (SD) equation for the fermion self-energy have revealed the existence of a QED ultraviolet nonperturbative fixed point which separates a strong-coupling regime from a weak-coupling regime. Here we study the SD equation in the presence of a weak constant photon-condensate background field. This background field does not seem to affect the fixed point. Better approximations or some more realistic background fields may change the result. The investigation is partly motivated by recent heavy-ion experiments

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…

Effects of background music on concentration of workers.

Science.gov (United States)

Huang, Rong-Hwa; Shih, Yi-Nuo

2011-01-01

Background music is a common element in daily living and the workplace. Determination of whether background music affects human work concentration is a relevant concern. Studies have found background music influences human behavior, and this study attempts to understand how background music and listener fondness for types of music affects worker concentration. This study analyzes how different types of background music--and how listeners' degree of preference for the background music--can affect listener concentration in attention testing through Randomized Controlled Trial (RCT). Data were collected from 89 workers. The participants ranged in age between 19 and 28 years old, with an average age of 24 years old. We conclude background music influenced listener attention. This influence has more to do with listener fondness for the music than with type of music. Compared to situations without background music, the likelihood of background music affecting test-taker attention performance is likely to increase with the degree to which the test-taker likes or dislikes the music. It is important not to select music that workers strongly like or dislike when making a selection of background music to avoid negatively affecting worker concentration.

Background of SAM atom-fraction profiles

International Nuclear Information System (INIS)

Ernst, Frank

2017-01-01

Atom-fraction profiles acquired by SAM (scanning Auger microprobe) have important applications, e.g. in the context of alloy surface engineering by infusion of carbon or nitrogen through the alloy surface. However, such profiles often exhibit an artifact in form of a background with a level that anti-correlates with the local atom fraction. This article presents a theory explaining this phenomenon as a consequence of the way in which random noise in the spectrum propagates into the discretized differentiated spectrum that is used for quantification. The resulting model of “energy channel statistics” leads to a useful semi-quantitative background reduction procedure, which is validated by applying it to simulated data. Subsequently, the procedure is applied to an example of experimental SAM data. The analysis leads to conclusions regarding optimum experimental acquisition conditions. The proposed method of background reduction is based on general principles and should be useful for a broad variety of applications. - Highlights: • Atom-fraction–depth profiles of carbon measured by scanning Auger microprobe • Strong background, varies with local carbon concentration. • Needs correction e.g. for quantitative comparison with simulations • Quantitative theory explains background. • Provides background removal strategy and practical advice for acquisition

Background of SAM atom-fraction profiles

Energy Technology Data Exchange (ETDEWEB)

Ernst, Frank

2017-03-15

Atom-fraction profiles acquired by SAM (scanning Auger microprobe) have important applications, e.g. in the context of alloy surface engineering by infusion of carbon or nitrogen through the alloy surface. However, such profiles often exhibit an artifact in form of a background with a level that anti-correlates with the local atom fraction. This article presents a theory explaining this phenomenon as a consequence of the way in which random noise in the spectrum propagates into the discretized differentiated spectrum that is used for quantification. The resulting model of “energy channel statistics” leads to a useful semi-quantitative background reduction procedure, which is validated by applying it to simulated data. Subsequently, the procedure is applied to an example of experimental SAM data. The analysis leads to conclusions regarding optimum experimental acquisition conditions. The proposed method of background reduction is based on general principles and should be useful for a broad variety of applications. - Highlights: • Atom-fraction–depth profiles of carbon measured by scanning Auger microprobe • Strong background, varies with local carbon concentration. • Needs correction e.g. for quantitative comparison with simulations • Quantitative theory explains background. • Provides background removal strategy and practical advice for acquisition.

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.

Time-resolved pulse-counting lock-in detection of laser induced fluorescence in the presence of a strong background emission

Science.gov (United States)

Pelissier, B.; Sadeghi, N.

1996-10-01

We describe a time-resolved pulse-counting system well adapted for the detection of continuous laser induced fluorescence (LIF) signals in repetitive phenomena, when a strong background emission is present. It consists of 256 channels coupled to a first in first out memory and interfaced to a 486 DX 33 PC, for data storage. It accepts time-averaged count rates up to 450 kcount/s. Time between channels can be set from 12.5 ns to several μs and the dead time between two consecutive cycles of the physical phenomena is less than 20 ns. In phase with a chopper, which modulates the laser beam, it adds the observed photon signal to the channel memories when the beam is on and substracts it when the beam is stopped, acting like a lock-in amplifier which detect only the modulated part of the signal. The minimum detectivity on the LIF signal is only limited by the shot noise of the plasma induced emission signal. As an application, we studied the time variation of the Ar+*(2G9/2) metastable ions, detected by LIF, in two types of plasmas. Their radiative lifetime and collisional quenching frequencies were deduced from their decay rate in the afterglow of a pulsed Helicon reactor. We also observed the evolution of their density in a 455 kHz capacitively coupled argon discharge.

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...

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

Directory of Open Access Journals (Sweden)

Petersen Karin D

2011-05-01

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

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.

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.

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...

Multiphoton amplitude in a constant background field

Science.gov (United States)

Ahmad, Aftab; Ahmadiniaz, Naser; Corradini, Olindo; Kim, Sang Pyo; Schubert, Christian

2018-01-01

In this contribution, we present our recent compact master formulas for the multiphoton amplitudes of a scalar propagator in a constant background field using the worldline fomulation of quantum field theory. The constant field has been included nonperturbatively, which is crucial for strong external fields. A possible application is the scattering of photons by electrons in a strong magnetic field, a process that has been a subject of great interest since the discovery of astrophysical objects like radio pulsars, which provide evidence that magnetic fields of the order of 1012G are present in nature. The presence of a strong external field leads to a strong deviation from the classical scattering amplitudes. We explicitly work out the Compton scattering amplitude in a magnetic field, which is a process of potential relevance for astrophysics. Our final result is compact and suitable for numerical integration.

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.

Gender-Role Identity, Attitudes toward Marriage, and Gender-Segregated School Backgrounds.

Science.gov (United States)

Katsurada, Emiko; Sugihara, Yoko

2002-01-01

Investigated the relationship between Japanese college students' gender role identity and attitudes toward marriage, exploring the effects of gender-segregated school backgrounds on gender role identity and attitudes toward marriage. Women without any coeducational school background had relatively strong masculinity and desired to marry at older…

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.

Improving Student Achievement in a Multidisciplinary Context

Science.gov (United States)

Chapman, Amanda; Bloxham, Sue

2004-01-01

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

“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.

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

The effects of multidisciplinary rehabilitation: RePCa-a randomised study among primary prostate cancer patients

DEFF Research Database (Denmark)

Dieperink, K B; Johansen, C; Hansen, Steinbjørn

2013-01-01

Background:The objective of this study is the effectiveness of multidisciplinary rehabilitation on treatment-related adverse effects after completed radiotherapy in patients with prostate cancer (PCa).Methods:In a single-centre oncology unit in Odense, Denmark, 161 PCa patients treated...... with radiotherapy and androgen deprivation therapy were randomly assigned to either a programme of two nursing counselling sessions and two instructive sessions with a physical therapist (n=79) or to usual care (n=82). Primary outcome was Expanded Prostate Cancer Index Composite (EPIC-26) urinary irritative sum......-score.Before radiotherapy, pre-intervention 4 weeks after radiotherapy, and after a 20-week intervention, measurements included self-reported disease-specific quality of life (QoL; EPIC-26, including urinary, bowel, sexual, and hormonal symptoms), general QoL (Short-form-12, SF-12), pelvic floor muscle strength (Modified...

The influence of night sky background on calibration and analysis in H.E.S.S

Energy Technology Data Exchange (ETDEWEB)

Leser, Eva [Potsdam University (Germany); Collaboration: H.E.S.S. Collaboration

2016-07-01

In some regions of the galactic plane, background light by stars (night sky background) poses a severe challenge for the detection of gamma-ray sources. Thorough tests are needed to ensure a good quality of the data analysis, especially in regions with both a strong and inhomogeneous background. Investigation of the influence on calibration and data analysis is started at an early stage in data processing. Different cleaning levels were tested and the event loss rate was evaluated. It is shown that for regions with strong and inhomogeneous night sky background and a powerful source an increased cleaning level is beneficial.

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.

Enhancing Transparency in Multidisciplinary Expert Communication

International Nuclear Information System (INIS)

Hukki, Kristiina; Pulkkinen, Urho

2003-01-01

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

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.

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

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

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. [...

Understanding adults’ strong problem-solving skills based on PIAAC

OpenAIRE

Hämäläinen, Raija; De Wever, Bram; Nissinen, Kari; Cincinnato, Sebastiano

2017-01-01

Purpose Research has shown that the problem-solving skills of adults with a vocational education and training (VET) background in technology-rich environments (TREs) are often inadequate. However, some adults with a VET background do have sound problem-solving skills. The present study aims to provide insight into the socio-demographic, work-related and everyday life factors that are associated with a strong problem-solving performance. Design/methodology/approach The study builds...

Cumulative neutrino background from quasar-driven outflows

Energy Technology Data Exchange (ETDEWEB)

Wang, Xiawei; Loeb, Abraham, E-mail: xiawei.wang@cfa.harvard.edu, E-mail: aloeb@cfa.harvard.edu [Department of Astronomy, Harvard University, 60 Garden Street, Cambridge, MA 02138 (United States)

2016-12-01

Quasar-driven outflows naturally account for the missing component of the extragalactic γ-ray background through neutral pion production in interactions between protons accelerated by the forward outflow shock and interstellar protons. We study the simultaneous neutrino emission by the same protons. We adopt outflow parameters that best fit the extragalactic γ-ray background data and derive a cumulative neutrino background of ∼ 10{sup −7} GeV cm{sup −2} s{sup −1} sr{sup −1} at neutrino energies E {sub ν} ∼> 10 TeV, which naturally explains the most recent IceCube data without tuning any free parameters. The link between the γ-ray and neutrino emission from quasar outflows can be used to constrain the high-energy physics of strong shocks at cosmological distances.

Time-resolved pulse-counting lock-in detection of laser induced fluorescence in the presence of a strong background emission

International Nuclear Information System (INIS)

Pelissier, B.; Sadeghi, N.

1996-01-01

We describe a time-resolved pulse-counting system well adapted for the detection of continuous laser induced fluorescence (LIF) signals in repetitive phenomena, when a strong background emission is present. It consists of 256 channels coupled to a first in first out memory and interfaced to a 486 DX 33 PC, for data storage. It accepts time-averaged count rates up to 450 kcount/s. Time between channels can be set from 12.5 ns to several μs and the dead time between two consecutive cycles of the physical phenomena is less than 20 ns. In phase with a chopper, which modulates the laser beam, it adds the observed photon signal to the channel memories when the beam is on and substracts it when the beam is stopped, acting like a lock-in amplifier which detect only the modulated part of the signal. The minimum detectivity on the LIF signal is only limited by the shot noise of the plasma induced emission signal. As an application, we studied the time variation of the Ar + *( 2 G 9/2 ) metastable ions, detected by LIF, in two types of plasmas. Their radiative lifetime and collisional quenching frequencies were deduced from their decay rate in the afterglow of a pulsed Helicon reactor. We also observed the evolution of their density in a 455 kHz capacitively coupled argon discharge. copyright 1996 American Institute of Physics

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

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,

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

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,…

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.

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.

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

Creating innovative and powerful learners : a multidisciplinary framework

NARCIS (Netherlands)

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

2015-01-01

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

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.…

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.

Managing the pediatric patient with celiac disease: a multidisciplinary approach

Directory of Open Access Journals (Sweden)

Isaac DM

2016-10-01

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

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

International Nuclear Information System (INIS)

Pituskin, Edith; Fairchild, Alysa; Dutka, Jennifer; Gagnon, Lori; Driga, Amy; Tachynski, Patty; Borschneck, Jo-Ann; Ghosh, Sunita

2010-01-01

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

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.

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 ...

Correlation between model observers in uniform background and human observers in patient liver background for a low-contrast detection task in CT

Science.gov (United States)

Gong, Hao; Yu, Lifeng; Leng, Shuai; Dilger, Samantha; Zhou, Wei; Ren, Liqiang; McCollough, Cynthia H.

2018-03-01

Channelized Hotelling observer (CHO) has demonstrated strong correlation with human observer (HO) in both single-slice viewing mode and multi-slice viewing mode in low-contrast detection tasks with uniform background. However, it remains unknown if the simplest single-slice CHO in uniform background can be used to predict human observer performance in more realistic tasks that involve patient anatomical background and multi-slice viewing mode. In this study, we aim to investigate the correlation between CHO in a uniform water background and human observer performance at a multi-slice viewing mode on patient liver background for a low-contrast lesion detection task. The human observer study was performed on CT images from 7 abdominal CT exams. A noise insertion tool was employed to synthesize CT scans at two additional dose levels. A validated lesion insertion tool was used to numerically insert metastatic liver lesions of various sizes and contrasts into both phantom and patient images. We selected 12 conditions out of 72 possible experimental conditions to evaluate the correlation at various radiation doses, lesion sizes, lesion contrasts and reconstruction algorithms. CHO with both single and multi-slice viewing modes were strongly correlated with HO. The corresponding Pearson's correlation coefficient was 0.982 (with 95% confidence interval (CI) [0.936, 0.995]) and 0.989 (with 95% CI of [0.960, 0.997]) in multi-slice and single-slice viewing modes, respectively. Therefore, this study demonstrated the potential to use the simplest single-slice CHO to assess image quality for more realistic clinically relevant CT detection tasks.

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.

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

Science.gov (United States)

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

2017-11-01

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

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.

Multidisciplinary team meetings and their impact on workflow in radiology and pathology departments

Directory of Open Access Journals (Sweden)

O'Briain D Sean

2007-06-01

Full Text Available Abstract Background The development of multidisciplinary team meetings (MDTMs for radiology and pathology is a burgeoning area that increasingly impacts on work processes in both of these departments. The aim of this study was to examine work processes and quantify the time demands on radiologists and pathologists associated with MDTM practices at a large teaching hospital. The observations reported in this paper reflect a general trend affecting hospitals and our conclusions will have relevance for others implementing clinical practice guidelines. Methods For one month, all work related to clinical meetings between pathology and radiology with clinical staff was documented and later analysed. Results The number of meetings to which pathology and radiology contribute at a large university teaching hospital, ranges from two to eight per day, excluding grand rounds, and amounts to approximately 50 meetings per month for each department. For one month, over 300 h were spent by pathologists and radiologists on 81 meetings, where almost 1000 patients were discussed. For each meeting hour, there were, on average, 2.4 pathology hours and 2 radiology hours spent in preparation. Two to three meetings per week are conducted over a teleconferencing link. Average meeting time is 1 h. Preparation time per meeting ranges from 0.3 to 6 h for pathology, and 0.5 to 4 for radiology. The review process in preparation for meetings improves internal quality standards. Materials produced externally (for example imaging can amount to almost 50% of the material to be reviewed on a single patient. The number of meetings per month has increased by 50% over the past two years. Further increase is expected in both the numbers and duration of meetings when scheduling issues are resolved. A changing trend in the management of referred patients with the development of MDTMs and the introduction of teleconferencing was noted. Conclusion Difficulties are being experienced by

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.

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

[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

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.

Motion and operation planning of robotic systems background and practical approaches

CERN Document Server

Gomez-Barvo, Fernando

2015-01-01

This book addresses the broad multi-disciplinary topic of robotics, and presents the basic techniques for motion and operation planning in robotics systems. Gathering contributions from experts in diverse and wide ranging fields, it offers an overview of the most recent and cutting-edge practical applications of these methodologies. It covers both theoretical and practical approaches, and elucidates the transition from theory to implementation. An extensive analysis is provided, including humanoids, manipulators, aerial robots and ground mobile robots. ‘Motion and Operation Planning of Robotic Systems’ addresses the following topics: *The theoretical background of robotics. *Application of motion planning techniques to manipulators, such as serial and parallel manipulators. *Mobile robots planning, including robotic applications related to aerial robots, large scale robots and traditional wheeled robots. *Motion planning for humanoid robots. An invaluable reference text for graduate students and researche...

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

Science.gov (United States)

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

2011-01-01

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

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.

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.

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.

Impact of a Multi-disciplinary C. difficile Action Team

Science.gov (United States)

Heil, Emily; Sivasailam, Bharathi; Park, SoEun; Diaz, Jose; Von Rosenvinge, Erik; Claeys, Kimberly; Hopkins, Teri; Leekha, Surbhi

2017-01-01

Abstract Background Clostridium difficile infection (CDI) is associated with increased length of hospital stay, morbidity, mortality, and cost of hospitalization. Early intervention by experts from multiple areas of practice such as gastroenterology (GI), infectious diseases (ID) and surgery can be essential to optimize care and increase utilization of novel treatment modalities such as fecal microbiota transplant (FMT) and minimally invasive, colon-preserving surgical management. Methods A multi-disciplinary C. difficile action team (MD-CAT) was implemented at University of Maryland Medical Center (UMMC) in March 2016 to engage appropriate specialty consultants in the care of CDI patients. The MD-CAT reviews positive C. difficile tests at UMMC and provides guidance and suggestions to the primary team including optimal antibiotic treatment (for CDI and any concomitant infection), and consultant involvement including ID, surgery, and GI, when appropriate. Using retrospective chart review, CDI patient management and outcomes were compared before and after implementation of the MD-CAT. Differences in the time to consults and frequency of interventional treatment was compared using Chi-square or Wilcoxon Rank-sum test. Results We compared 48 patients with CDI in the pre-intervention with 89 patients in the post-intervention period. Demographic and clinical characteristics of the groups were similar. MD-CAT intervention was associated with frequent (73%) modification or discontinuation of concomitant antibiotics. Median time to GI and ID consults was significantly shorter in the post group (P = 0.007 and P = 0.004, respectively). Five of 89 (5.6%) of patients received FMT or colon-preserving surgical intervention in the post-intervention group compared with no patients in the pre-intervention group. There was no difference in 30-day all-cause mortality or CDI recurrence between groups. Conclusion Early, multi-disciplinary action on patients with CDI increased the

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

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

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.

Orbits in weak and strong bars

CERN Document Server

Contopoulos, George

1980-01-01

The authors study the plane orbits in simple bar models embedded in an axisymmetric background when the bar density is about 1% (weak), 10% (intermediate) or 100% (strong bar) of the axisymmetric density. Most orbits follow the stable periodic orbits. The basic families of periodic orbits are described. In weak bars with two Inner Lindblad Resonances there is a family of stable orbits extending from the center up to the Outer Lindblad Resonance. This family contains the long period orbits near corotation. Other stable families appear between the Inner Lindblad Resonances, outside the Outer Lindblad Resonance, around corotation (short period orbits) and around the center (retrograde). Some families become unstable or disappear in strong bars. A comparison is made with cases having one or no Inner Lindblad Resonance. (12 refs).

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

ΛGR Centennial: Cosmic Web in Dark Energy Background

Science.gov (United States)

Chernin, A. D.

The basic building blocks of the Cosmic Web are groups and clusters of galaxies, super-clusters (pancakes) and filaments embedded in the universal dark energy background. The background produces antigravity, and the antigravity effect is strong in groups, clusters and superclusters. Antigravity is very weak in filaments where matter (dark matter and baryons) produces gravity dominating in the filament internal dynamics. Gravity-antigravity interplay on the large scales is a grandiose phenomenon predicted by ΛGR theory and seen in modern observations of the Cosmic Web.

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.

THE EFFECTS OF THE IONIZING RADIATION BACKGROUND ON GALAXY EVOLUTION

International Nuclear Information System (INIS)

Hambrick, D. Clay; Ostriker, Jeremiah P.; Naab, Thorsten; Johansson, Peter H.

2009-01-01

We find that the amount and nature of the assumed ionizing background can strongly affect galaxy formation and evolution. Galaxy evolution simulations typically incorporate an ultraviolet background which falls off rapidly above z = 3; e.g., that of Haardt and Madau. However, this decline may be too steep to fit the Wilkinson Microwave Anistropy Probe constraints on electron scattering optical depth or observations of intermediate redshift (z ∼ 2-4) Lyα forest transmission. As an alternative, we present simulations of the cosmological formation of individual galaxies with UV backgrounds that decline more slowly at high redshift: both a simple intensity rescaling and the background recently derived by Faucher-Giguere, which softens the spectrum at higher redshifts. We also test an approximation of the X-ray background with a similar z dependence. We find for the test galaxies that an increase in either the intensity or hardness of ionizing radiation generically pushes star formation toward lower redshifts: although overall star formation in the simulation boxes is reduced by 10%-25%, the galaxies show a factor of ∼2 increase in the fraction of stars within a 30 kpc radius that are formed after z = 1. Other effects include late gas inflows enhanced up to 30 times, stellar half-mass radii decreased by up to 30%, central velocity dispersions increased up to 40%, and a strong reduction in substructure. The magnitude of the effects depends on the environmental/accretion properties of the particular galaxy.

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.

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.

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.

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...

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...

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.

Therapeutical Approach of Osteoporosis — a Multidisciplinary Issue

Directory of Open Access Journals (Sweden)

Camelia Gliga

2013-08-01

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

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

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...

Stable monopole-antimonopole string background in SU(2) QCD

International Nuclear Information System (INIS)

Cho, Y.M.; Pak, D.G.

2006-01-01

Motivated by the instability of the Savvidy-Nielsen-Olesen (SNO) vacuum we make a systematic search for a stable magnetic background in pure SU(2) QCD. It is shown that a pair of axially symmetric monopole and antimonopole strings is stable, provided that the distance between the two strings is less than a critical value. The existence of a stable monopole-antimonopole string background strongly supports that a magnetic condensation of monopole-antimonopole pairs can generate a dynamical symmetry breaking, and thus the magnetic confinement of color in QCD

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

Enrichment of foods with omega-3 fatty acids: A multidisciplinary challenge

DEFF Research Database (Denmark)

Jacobsen, Charlotte

2010-01-01

Enrichment of foods with marine omega-3 polyunsaturated fatty acids (PUFA) poses a multidisciplinary challenge to food industry and academia. Although our knowledge about possible health effects of omega-3 PUFA has increased tremendously during the last 30 years, there is still a lot to be learned...... about these healthy fatty acids. Moreover, consumer acceptance and lipid oxidation of omega-3 PUFA-enriched food are other major challenges that the food industry meet when developing omega-3-enriched foods. Two examples on multidisciplinary research projects to overcome some of these challenges...... are given in this article together with cases studies illustrating how lipid oxidation can be prevented in a range of different omega-3-enriched foods....

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.

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.

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

Directory of Open Access Journals (Sweden)

Torisson G

2013-09-01

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

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.

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.

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.

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.

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.

Circumpolar Biodiversity Monitoring Programme coastal biodiversity monitoring background paper

Science.gov (United States)

McLennan, Donald; Anderson, Rebecca D.; Wegeberg, S.; Pettersvik Arvnes, Maria; Sergienko, Liudmila; Behe, Carolina; Moss-Davies, Pitseolak; Fritz, S.; Markon, Carl J.; Christensen, T.; Barry, T.; Price, C.

2016-01-01

In 2014, the United States (U.S.) and Canada agreed to act as co-lead countries for the initial development of the Coastal Expert Monitoring Group (CEMG) as part of the Circumpolar Biodiversity Monitoring Program (CBMP, www. cbmp.is) under the Arctic Council’s Conservation of Arctic Flora and Fauna (CAFF, www.caff.is) working group. The CAFF Management Board approved Terms of Reference for the CEMG in the spring of 2014. The primary goal of the CEMG is to develop a long term, integrated, multi-disciplinary, circumpolar Arctic Coastal Biodiversity Monitoring Plan (the Coastal Plan) that relies on science and Traditional Knowledge, and has direct and relevant application for communities, industry, government decision makers, and other users. In addition to the monitoring plan, the CAFF working group has asked the CBMP, and thus the CEMG, to develop an implementation plan that identifies timeline, costs, organizational structure and partners. This background paper provides a platform for the guidance for the development of the Coastal Plan and is produced by the CEMG with assistance from a number of experts in multiple countries.

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.

Breastfeeding and allergic disease: a multidisciplinary review of the literature (1966-2001) on the mode of early feeding in infancy and its impact on later atopic manifestations

DEFF Research Database (Denmark)

Odijk, J.; Kull, I.; Borres, M.

2003-01-01

Background: Strategies to prevent children from developing allergy have been elaborated on the basis of state-of-the-art reviews of the scientific literature regarding pets and allergies, building dampness and health, and building ventilation and health. A similar multidisciplinary review of infant...... concluded that breastfeeding seems to protect from the development of atopic disease. The effect appears even stronger in children with atopic heredity. If breast milk is unavailable or insufficient, extensively hydrolysed formulas are preferable to unhydrolysed or partially hydrolysed formulas in terms...

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,…

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.

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)

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.

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

Skin Microbiota Workshop: Multidisciplinary Perspectives, Challenges and Opportunities

Science.gov (United States)

2014-12-08

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

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

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

Pairing in the cosmic neutrino background

International Nuclear Information System (INIS)

Alonso, V.; Paredes, R.

1981-07-01

We extend the discussion of the possible superfluidity of the cosmic background of neutrinos beyond the arguments based on the gap equation, originally given by Ginzburg and Zharkov. We show how to develop a simple Ginzburg-Landau liquid model, in analogy with superconductivity. We use it to show how an analysis of the energy spectrum of the universe can be formulated to include general relativistic effects on the superfluid neutrinos. Finally, in view of the Hawking and Collins careful discussion on the rotation and distortion of a spatially homogeneous and isotropic universe, we discuss the vortex dynamics that might be generated on the superfluid by rotations (allowed by the almost isotropy of the microwave background of photons) of up to 2 x 10 -14 second of arc/century, but conclude that rotations of this order of magnitude would be sufficiently strong to deter the existence of the superfluid state. (author)

The fMRI analysis of brain activation in response to face image affected by background images

International Nuclear Information System (INIS)

Shimada, Takamasa; Fukami, Tadanori; Saito, Yoichi

2011-01-01

The stimuli of a face images expressing fear induce the activation in the medial temporal lobe was reported in previous studies. In particular, it was reported that face image expressing fear activated the amygdala and hippo-campus area of brain. In these studies, no background images were used with facial stimuli. However, normal day-to-day images always have a background. We investigated the effect of combining face images expressing fear and different background images. As a result, strong activation was detected in the amygdala and hippocampus area when the lightning background image was used. But strong activation was not detected when the fire background image was used. From the results of questionnaire rating the impression of possibility of experiencing the situation of shown images, it is thought that this difference of impression of possibility made the difference of empathy and caused the difference of brain activation. (author)

Selling a gun to a stranger without a background check: acceptable behaviour?

Science.gov (United States)

Hemenway, David; Azrael, Deborah; Miller, Matthew

2017-06-24

One way that guns get into the wrong hands is via gun sales without a background check. While the large majority of Americans support laws requiring universal background checks, no prior study has assessed whether Americans think it is acceptable behaviour to sell a gun to a stranger without a background check, whether or not there is a law against it. We sponsored a nationally representative survey of over 3900 American adults, oversampling gun owners, using an online panel provided by the survey firm Growth for Knowledge. Over 72% of American adults agree or strongly agree with the statement that 'whether it is legal or not, it is NOT acceptable to sell a gun to a stranger without a background check' and 11% disagree or strongly disagree. Subgroups less likely to agree are young adults, men, conservatives, those with less than a high school education and gun owners. Reducing the number of guns sold without a background check could help reduce the flow of guns to felons. Changes in normative attitudes and behaviours, as well as changes in law, could help accomplish this goal. Most Americans, including gun owners, believe selling a gun to a stranger without a background check is not acceptable behaviour. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Neutrino production by UHECR proton interactions in the infrared background

Energy Technology Data Exchange (ETDEWEB)

Stanev, Todor

2004-08-12

We discuss the contribution of proton photoproduction interactions in the isotropic infrared/optical background to the cosmic neutrino fluxes. This contribution has a strong dependence on the proton injection energy spectrum, and is essential at high redshifts. It is thus closely correlated with the cosmological evolution of the ultra-high energy proton sources and of the infrared background itself. These interactions may also contribute to the source fluxes of neutrinos if the proton sources are located in regions of high infrared emission and magnetic fields.

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.

Multi-disciplinary approach for enhancing orthodontic esthetics – case report

Directory of Open Access Journals (Sweden)

Kalia A

2015-08-01

Full Text Available Ajit Kalia, Nasim Mirdehghan, Sonali Khandekar, Wasu Patil Department of Orthodontics, MA Rangoonwala Dental College, Pune, IndiaBackground: In contemporary dental care, an increasing number of adult patients are now seeking orthodontic treatment with the primary motive of improvement in appearance and achievement of esthetic smile. Proper recognition of the dental and facial defects at the outset of treatment is the most important key to esthetic success and is essential in satisfying the patient's needs. By following the rules of Golden proportion smiles can be made attractive, harmonious, symmetrical, and proportionate. Methodology: Consisted of 22-year-old girl who came for treatment of crowding in maxillary and mandibular arches, abnormal overjet and overbite and had unaesthetic peg lateral.Results: Non-extraction therapy was carried out since the patient had good soft tissue drape, alignment was achieved by expanding the arches and moving teeth in ideal axial inclination. Esthetic smile was attained using composite buildup of upper right peg lateral and minor adjunctive surgery (full thickness periodontal graft on lower right central incisor.Conclusion: The present case report orchestrates interrelationship between various branches of dentistry and orthodontics. It exhibits how multidisciplinary approach can be used to achieve ideal dental esthetics in a 22-year-old girl who was successfully treated for peg shaped lateral incisor, gingival recession, and unaesthetic smile. Keywords: adult orthodontics, peg lateral, gingival recession, golden proportion

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

Black holes a laboratory for testing strong gravity

CERN Document Server

Bambi, Cosimo

2017-01-01

This textbook introduces the current astrophysical observations of black holes, and discusses the leading techniques to study the strong gravity region around these objects with electromagnetic radiation. More importantly, it provides the basic tools for writing an astrophysical code and testing the Kerr paradigm. Astrophysical black holes are an ideal laboratory for testing strong gravity. According to general relativity, the spacetime geometry around these objects should be well described by the Kerr solution. The electromagnetic radiation emitted by the gas in the inner part of the accretion disk can probe the metric of the strong gravity region and test the Kerr black hole hypothesis. With exercises and examples in each chapter, as well as calculations and analytical details in the appendix, the book is especially useful to the beginners or graduate students who are familiar with general relativity while they do not have any background in astronomy or astrophysics.

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...

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.

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...

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...

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.

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....

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)

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

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

Directory of Open Access Journals (Sweden)

Ohde Sachiko

2012-07-01

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

Stochastic backgrounds of relic gravitons: a theoretical appraisal

CERN Document Server

Giovannini, Massimo

2010-01-01

Stochastic backgrounds or relic gravitons, if ever detected, will constitute a prima facie evidence of physical processes taking place during the earliest stages of the evolution of the plasma. The essentials of the stochastic backgrounds of relic gravitons are hereby introduced and reviewed. The pivotal observables customarily employed to infer the properties of the relic gravitons are discussed both in the framework of the $\\Lambda$CDM paradigm as well as in neighboring contexts. The complementarity between experiments measuring the polarization of the Cosmic Microwave Background (such as, for instance, WMAP, Capmap, Quad, Cbi, just to mention a few) and wide band interferometers (e.g. Virgo, Ligo, Geo, Tama) is emphasized. While the analysis of the microwave sky strongly constrains the low-frequency tail of the relic graviton spectrum, wide-band detectors are sensitive to much higher frequencies where the spectral energy density depends chiefly upon the (poorly known) rate of post-inflationary expansion.

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

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

Variations in the geomagnetic and gravitational background associated with two strong earthquakes of the May 2012 sequence in the Po Valley Plain (Italy).

Science.gov (United States)

Straser, Valentino

2013-04-01

Reawakening of seismic activity in the Emilian Po Valley Plain (Italy) resulted in 2,492 earthquakes over five and a half months: 2,270 with M= 7. The mainshock was recorded during the night of 20 May 2012, at 04:03:52 Italian time (02:03:52 UTC) with epicentre in Finale Emilia, at a depth of 6.3km, by the Italian National Institute of Geophysics and Vulcanology (INGV). A long sequence of telluric shocks occurred in the same seismic district in the areas between the provinces of Modena, Ferrara, Mantua, Reggio Emilia, Bologna and Rovigo. In addition to the general devastation plus damage to civil and industrial buildings and the historical heritage, the earthquakes resulted in a total of 27 victims. Concomitant with the two strongest quakes, recorded on 20 and 29 May 2012, respectively, as in the case of others, variations were noted in the geomagnetic background by the LTPA monitoring station in Rome (Italy). The geomagnetic background variations were associated with the appearance of radio-anomalies in a frequency range from 0.1 to 3.0Hz, as well as gravimetric variations found around 60km from the epicentre. The peak accelerations, detected in correspondence with the strongest shocks on 20 and 29 May 2012, were respectively 0.31g and 0.29g. The appearance of the radio-anomalies coincided, from a temporal point of view, with average gravimetric variations of approximately 30µGal around the epicentre areas, concurrent with the mainshock. In this study, both the appearance of radio-anomalies and the gravitational variations recorded before strong earthquakes were related to the dynamics of the fault and a progressive reduction in granulometry in the core of the fracture, until the point of dislocation was reached. The intense friction in the fault and the damping factors produced before the shock are hypothesized as being proportional to the number of radio-anomalies measured. The radio anomaly is an unknown radio emission that has no characteristics (duration

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 ...

Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial.

Science.gov (United States)

Vonk Noordegraaf, Antonie; Huirne, Judith A F; Brölmann, Hans A M; Emanuel, Mark H; van Kesteren, Paul J M; Kleiverda, Gunilla; Lips, Jos P; Mozes, Alexander; Thurkow, Andreas L; van Mechelen, Willem; Anema, Johannes R

2012-02-01

Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed. We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery. The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably. Netherlands Trial Register (NTR): NTR2087.

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.

Cross-impact balances. Applying pair interaction systems and multi-value Kauffman nets to multidisciplinary systems analysis

Science.gov (United States)

Weimer-Jehle, Wolfgang

2008-06-01

Cross-impact analysis is the name for a familiar method for multidisciplinary systems analysis in social sciences and management sciences, especially in technology foresight, technology assessment and scenario planning. A recently proposed form of cross-impact analysis, CIB, may be of interest for physicists, sociophysicists and complex network researchers because the CIB concept reveals considerable relations to some concepts of these research fields. This article describes the basics of CIB analysis framework, its applications in the social sciences, and its relations to the equilibrium points of pair interaction systems, random graphs, and generalized Kauffman nets. Therefore CIB can be seen as a merger of concepts originating in utterly different scientific fields. This may prove to be fruitful for both sides: For sociophysicists as an example of the application of complex network concepts in the social sciences and for cross-impact practitioners as a source of theoretical insights in the background of their tool.

Influence of the DSM-IV Outline for Cultural Formulation on multidisciplinary case conferences in mental health.

Science.gov (United States)

Dinh, Nathalie M H; Groleau, Danielle; Kirmayer, Laurence J; Rodriguez, Charo; Bibeau, Gilles

2012-01-01

The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV-TR) includes an Outline for Cultural Formulation (CF) that identifies cultural information that can be used to modify diagnosis, clinical assessment and treatment plan. This study examined the use of the CF by a Cultural Consultation Service in the psychiatric assessment of patients referred by primary care providers. The study uses conversation analysis of 12 clinical case conferences to explore the ways in which the CF influenced the interaction of a multidisciplinary group of mental health professionals in conceptualizing the implications of patients' cultural background and current context for diagnosis and treatment planning. The results suggest that the CF can be a useful tool for interdisciplinary collaboration and knowledge transfer by providing a framework to systematically introduce different disciplinary perspectives and levels of description that transcend the narrow frame of disorder-centred psychiatric diagnosis, assessment and care.

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.

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

In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success. A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used. With these four teams, consisting of 46 health care and social service professionals, we carried out two rounds of focus-group interviews. Moreover, we performed semi-structured interviews with four GPs. We analysed data using a hybrid inductive/deductive thematic analysis. According to the health care and social service professionals in our study, the role of GPs in multidisciplinary teams for elderly care was characterized by the ability to 'see the bigger picture'. We identified five key activities that constitute a successful GP role: networking, facilitating, team building, integrating care elements, and showing leadership. Practice setting and phase of multidisciplinary team development influenced the way in which GPs fulfilled their roles. According to team members, GPs were the central professionals in care services for older people. The opinions of GPs about their own roles were diverse. GPs took an important role in successful care settings for older people. Five key concepts seemed to be important for best practices in care for frail older people: networking (community), facilitating (organization), team building (professional), integrating care elements (patient), and leadership (personal). Team members from primary care and social services indicated that GPs had an indispensable role in such teams. It would be advantageous for GPs to be aware of this attributed role. Attention to leadership competencies and to the

Emergence of junction dynamics in a strongly interacting Bose mixture

DEFF Research Database (Denmark)

Barfknecht, Rafael Emilio; Foerster, Angela; Zinner, Nikolaj Thomas

We study the dynamics of a one-dimensional system composed of a bosonic background and one impurity in single- and double-well trapping geometries. In the limit of strong interactions, this system can be modeled by a spin chain where the exchange coefficients are determined by the geometry of the...

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

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

Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes.

Science.gov (United States)

Mohandas, Padma; Bewley, Anthony; Taylor, Ruth

2018-03-01

In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life. We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients. We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017. The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition. Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve

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

Strong plasma turbulence in the earth's electron foreshock

Science.gov (United States)

Robinson, P. A.; Newman, D. L.

1991-01-01

A quantitative model is developed to account for the distribution in magnitude and location of the intense plasma waves observed in the earth's electron foreshock given the observed rms levels of waves. In this model, nonlinear strong-turbulence effects cause solitonlike coherent wave packets to form and decouple from incoherent background beam-excited weak turbulence, after which they convect downstream with the solar wind while collapsing to scales as short as 100 m and fields as high as 2 V/m. The existence of waves with energy densities above the strong-turbulence wave-collapse threshold is inferred from observations from IMP 6 and ISEE 1 and quantitative agreement is found between the predicted distribution of fields in an ensemble of such wave packets and the actual field distribution observed in situ by IMP 6. Predictions for the polarization of plasma waves and the bandwidth of ion-sound waves are also consistent with the observations. It is shown that strong-turbulence effects must be incorporated in any comprehensive theory of the propagation and evolution of electron beams in the foreshock. Previous arguments against the existence of strong turbulence in the foreshock are refuted.

Strong plasma turbulence in the earth's electron foreshock

International Nuclear Information System (INIS)

Robinson, P.A.; Newman, D.L.

1991-01-01

A quantitative model is developed to account for the distribution in magnitude and location of the intense plasma waves observed in the Earth's electron foreshock given the observed rms levels of waves. In this model, nonlinear strong-turbulence effects cause solitonlike coherent wave packets to form and decouple from incoherent background beam-excited weak turbulence, after which they convect downstream with the solar wind while collapsing to scales as short as 100 m and fields as high as 2 V m -1 . The existence of waves with energy densities above the strong-turbulence wave-collapse threshold is inferred from observations from IMP 6 and ISEE 1 and quantitative agreement is found between the predicted distribution of fields in an ensemble of such wave packets and the actual field distribution observed in situ by IMP 6. Predictions for the polarization of plasma waves and the bandwidth of ion-sound waves are also consistent with the observations. It is shown that strong-turbulence effects must be incorporated in any comprehensive theory of the propagation and evolution of electron beams in the foreshock. Previous arguments against the existence of strong turbulence in the foreshock are refuted

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...

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

Directory of Open Access Journals (Sweden)

Boot Cécile RL

2009-12-01

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

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

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.

Multidisciplinary response for a radiological accident developed in Argentina

International Nuclear Information System (INIS)

Di Giorgio, Marina; Tadic, Matilde; Vazquez, Marina; Cateriano, Miguel; Jordan, Osvaldo; Rojas, Carlos A.; Portas, M.; Coppola, A.; De Lellis, M. del C.; Dovasio, F.

2010-01-01

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

Managing the patient with osteogenesis imperfecta: a multidisciplinary approach

Directory of Open Access Journals (Sweden)

Marr C

2017-04-01

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

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

3 for the Price of 1: Teaching Chest Pain Risk Stratification in a Multidisciplinary, Problem-based Learning Workshop

Directory of Open Access Journals (Sweden)

Cynthia Burns

2018-03-01

Full Text Available Introduction: Chest pain is a common chief complaint among patients presenting to health systems and often leads to complex and intensive evaluations. While these patients are often cared for by a multidisciplinary team (primary care, emergency medicine, and cardiology, medical students usually learn about the care of these patients in a fragmented, single-specialty paradigm. The present and future care of patients with chest pain is multidisciplinary, and the education of medical students on the subject should be as well. Our objective was to evaluate the effectiveness of a multidisciplinary, problem-based learning workshop to teach third-year medical students about risk assessment for patients presenting with chest pain, specifically focusing on acute coronary syndromes. Methods: To create an educational experience consistent with multidisciplinary team-based care, we designed a multidisciplinary, problem-based learning workshop to provide medical students with an understanding of how patients with chest pain are cared for in a systems-based manner to improve outcomes. Participants included third-year medical students (n=219 at a single, tertiary care, academic medical center. Knowledge acquisition was tested in a pre-/post-retention test study design. Results: Following the workshop, students achieved a 19.7% (95% confidence interval [CI] [17.3–22.2%] absolute increase in scores on post-testing as compared to pre-testing. In addition, students maintained an 11.1% (95% CI [7.2–15.0%] increase on a retention test vs. the pre-test. Conclusion: A multidisciplinary, problem-based learning workshop is an effective method of producing lasting gains in student knowledge about chest pain risk stratification.

The M6 1799 Vendée intraplate earthquake (France) : characterizing the active fault with a multidisciplinary approach.

Science.gov (United States)

Kaub, C.; Perrot, J.; Le Roy, P., Sr.; Authemayou, C.; Bollinger, L.; Hebert, H.; Geoffroy, L.

2017-12-01

The coastal Vendee (France) is located to the south of the intraplate Armorican area. This region is affected by a system of dominantly NW-SE trending shear zones and faults inherited from a long and poly-phased tectonic history since Variscan times. This area currently presents a moderate background seismic activity, but was affected by a significant historical earthquake (magnitude M 6) on the 1799 January 25th. This event generated particularly strong site effects in a Neogene basin located along a major onshore/offshore discontinuity bounding the basin, the Machecoul fault. The objective of this study is to identify and qualify active faults potentially responsible for such major seismic event in order to better constrain the seismic hazard of this area. We adopt for this purpose a multidisciplinary approach including an onshore seismological survey, high-resolution low-penetration offshore seismic data (CHIRP echo sounder, Sparker source and single channel streamer), high-resolution interferometric sonar bathymetry (GeoSwath), compilation of onshore drilling database (BSS, BRGM), and quantitative geomorphology In the meantime, the seismicity of the area was characterized by a network of 10 REFTEK stations, deployed since January 2016 around the Bay of Bourgneuf (MACHE network). About 50 local earthquakes, with coda magnitudes ranging from 0.5 to 3.1 and local magnitude ranging from 0.2 to 2.9 were identified so far. This new database complement a local earthquake catalog acquired since 2011 from previous regional networks. We surveyed the fault segments offshore, in the Bay of Bourgneuf, analyzing 700 km of high-resolution seismic profiles and 40 km² of high-resolution bathymetry acquired during the RETZ1 (2016) and RETZ2 (2017) campaigns, in addition to HR-bathymetry along the fault scarp. Those data are interpreted in conjunction with onshore wells to determine if (and since when) the Machecoul fault controlled tectonically the Neogene sedimentation.

Unbounding entrepreneurial intents of university students: a multidisciplinary perspective

OpenAIRE

Aurora A.C. Teixeira; Rosa Portela Forte

2009-01-01

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

Radial Distribution Functions of Strongly Coupled Two-Temperature Plasmas

Science.gov (United States)

Shaffer, Nathaniel R.; Tiwari, Sanat Kumar; Baalrud, Scott D.

2017-10-01

We present tests of three theoretical models for the radial distribution functions (RDFs) in two-temperature strongly coupled plasmas. RDFs are useful in extending plasma thermodynamics and kinetic theory to strong coupling, but they are usually known only for thermal equilibrium or for approximate one-component model plasmas. Accurate two-component modeling is necessary to understand the impact of strong coupling on inter-species transport, e.g., ambipolar diffusion and electron-ion temperature relaxation. We demonstrate that the Seuferling-Vogel-Toeppfer (SVT) extension of the hypernetted chain equations not only gives accurate RDFs (as compared with classical molecular dynamics simulations), but also has a simple connection with the Yukawa OCP model. This connection gives a practical means to recover the structure of the electron background from knowledge of the ion-ion RDF alone. Using the model RDFs in Effective Potential Theory, we report the first predictions of inter-species transport coefficients of strongly coupled plasmas far from equilibrium. This work is supported by NSF Grant No. PHY-1453736, AFSOR Award No. FA9550-16-1-0221, and used XSEDE computational resources.

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

DEFF Research Database (Denmark)

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

2016-01-01

Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...

Reprocessing WFC3/IR Exposures Affected by Time-Variable Backgrounds

Science.gov (United States)

Brammer, G.

2016-11-01

The background seen in WFC3/IR observations frequently shows strong time-dependent behavior above the constant flux expected for zodiacal continuum light. This is often caused by an emission line of helium at 1.083 μm excited in the sun-illuminated upper atmosphere, when seen in the filters (F105W, F110W) and grisms (G102, G141) sensitive to the feature. The default behavior of the calwf3 pipeline assumes constant source-plus-background fluxes when it performs up-the-ramp fitting to identify cosmic rays and determine the average count rate within a MULTIACCUM IR exposure. calwf3 provides undesirable results in the presence of strongly variable backgrounds, primarily in the form of elevated and non-Gaussian noise in the FLT products. Here we describe methods to improve the noise properties of the reduced products. In the first, we simply turn off the calwf3 crcorr step, treating the IR detector as if it were a CCD, i.e., accumulating flux and reading it out at the end of the exposure. Next, we artificially flatten the ramps in the IMA products and then allow calwf3 to proceed as normal fitting the ramp and identifying CRs. Either of these procedures enable recovery of datasets otherwise corrupted beyond repair and have no discernible effects on photometry of sources in deep combined images.

Cumulative Neutrino and Gamma-Ray Backgrounds from Halo and Galaxy Mergers

Science.gov (United States)

Yuan, Chengchao; Mészáros, Peter; Murase, Kohta; Jeong, Donghui

2018-04-01

The merger of dark matter halos and the gaseous structures embedded in them, such as protogalaxies, galaxies, and groups and clusters of galaxies, results in strong shocks that are capable of accelerating cosmic rays (CRs) to ≳10 PeV. These shocks will produce high-energy neutrinos and γ-rays through inelastic pp collisions. In this work, we study the contributions of these halo mergers to the diffuse neutrino flux and to the nonblazar portion of the extragalactic γ-ray background. We formulate the redshift dependence of the shock velocity, galactic radius, halo gas content, and galactic/intergalactic magnetic fields over the dark matter halo distribution up to a redshift z = 10. We find that high-redshift mergers contribute a significant amount of the CR luminosity density, and the resulting neutrino spectra could explain a large part of the observed diffuse neutrino flux above 0.1 PeV up to several PeV. We also show that our model can somewhat alleviate tensions with the extragalactic γ-ray background. First, since a larger fraction of the CR luminosity density comes from high redshifts, the accompanying γ-rays are more strongly suppressed through γγ annihilations with the cosmic microwave background and the extragalactic background light. Second, mildly radiative-cooled shocks may lead to a harder CR spectrum with spectral indices of 1.5 ≲ s ≲ 2.0. Our study suggests that halo mergers, a fraction of which may also induce starbursts in the merged galaxies, can be promising neutrino emitters without violating the existing Fermi γ-ray constraints on the nonblazar component of the extragalactic γ-ray background.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-02-15

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

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

International Nuclear Information System (INIS)

Hörer, Tal M.; Hebron, Dan; Swaid, Forat; Korin, Alexander; Galili, Offer; Alfici, Ricardo; Kessel, Boris

2016-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

Science.gov (United States)

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

2015-01-01

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

Idiopathic ulcers as an oral manifestation in pediatric patients with AIDS: multidisciplinary management.

Science.gov (United States)

Martinez-Sandoval, B; Ceballos-Hernández, H; Téllez-Rodríguez, J; Xochihua-Díaz, L; Durán-Ibarra, G; Pozos-Guillen, A J

2012-01-01

HIV infection is a major global health problem affecting developing and developed countries alike. HIV infection is associated with multiple oral lesions, some of which are of value in diagnosing the disease. The aim of this report is to describe the clinical manifestations and their multidisciplinary management, in a 6-year-old girl with AIDS. The findings of this case report indicate that, it is essential to be familiar with the early oral manifestations of AIDS in order to understand the patient's dental health needs, apply preventive methods, control caries, and understand the value of oral lesions as diagnostic markers of disease progression in children with HIV infection. A multidisciplinary management is fundamental.

Novel minimally invasive chemoradiation therapy combined with biliary stenting for multidisciplinary approach to unresectable bile duct carcinoma

International Nuclear Information System (INIS)

Suzuki, Masanori; Sato, Takeaki; Umino, Noriaki

2001-01-01

Multidisciplinary treatment is a useful approach to unresectable non-metastatic bile duct carcinoma with invasion of the hepatic artery and portal vein. The authors developed a multidisciplinary treatment consisting of chemoradiation therapy combined with intraluminal bile duct irradiation plus external irradiation and systemic or local chemotherapy. The aim of this regimen was to improve the ability to locally control bile duct carcinoma by intraluminal irradiation and to shorten the treatment period compared to external irradiation therapy alone. According to the treatment schedule whole-body irradiation is performed first and followed by systemic administration of 5-fluorouracil (5-FU, 600 mg/m 2 /day) and cisplatin (CDDP, 10 mg/m 2 /day) after biliary stenting plus simultaneously intraluminal irradiation (8 Gy/week x 3, total 24 Gy) administered with 192 Ir-RALS (Remote After Loading System). Two novel types of applicators specifically designed by the authors for intraluminal radiation of the bile duct were improved. The authors have used this multidisciplinary approach to treat 3 patients with bile duct carcinoma. Its application has shortened the course of multidisciplinary therapy to about 6 weeks, and the patients have surviveed more than 6-8 months without recurrence. (K.H.)

Strengthening Multidisciplinary Research on Climate and Environmental Change

Science.gov (United States)

Beer, Tom; Li, Jianping; Alverson, Keith

2014-08-01

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

Multidisciplinary Shape Optimization of a Composite Blended Wing Body Aircraft

Science.gov (United States)

Boozer, Charles Maxwell

A multidisciplinary shape optimization tool coupling aerodynamics, structure, and performance was developed for battery powered aircraft. Utilizing high-fidelity computational fluid dynamics analysis tools and a structural wing weight tool, coupled based on the multidisciplinary feasible optimization architecture; aircraft geometry is modified in the optimization of the aircraft's range or endurance. The developed tool is applied to three geometries: a hybrid blended wing body, delta wing UAS, the ONERA M6 wing, and a modified ONERA M6 wing. First, the optimization problem is presented with the objective function, constraints, and design vector. Next, the tool's architecture and the analysis tools that are utilized are described. Finally, various optimizations are described and their results analyzed for all test subjects. Results show that less computationally expensive inviscid optimizations yield positive performance improvements using planform, airfoil, and three-dimensional degrees of freedom. From the results obtained through a series of optimizations, it is concluded that the newly developed tool is both effective at improving performance and serves as a platform ready to receive additional performance modules, further improving its computational design support potential.

Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

Directory of Open Access Journals (Sweden)

Sadaksharam Jayachandran

2017-10-01

Full Text Available Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients.

Construction management and economics: the epistemology of a multidisciplinary design science

NARCIS (Netherlands)

Voordijk, Johannes T.

2009-01-01

Research in the field of construction management and economics (CME) can be characterized as a multidisciplinary design science. Results from the sciences and humanities are necessary inputs for this field of research that deals with design, production and operation of the built environment. The

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

Directory of Open Access Journals (Sweden)

Jensen Chris

2012-08-01

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

Equation of state of strongly coupled plasma mixtures

International Nuclear Information System (INIS)

DeWitt, H.E.

1984-01-01

Thermodynamic properties of strongly coupled (high density) plasmas of mixtures of light elements have been obtained by Monte Carlo simulations. For an assumed uniform charge background the equation of state of ionic mixtures is a simple extension of the one-component plasma EOS. More realistic electron screening effects are treated in linear response theory and with an appropriate electron dielectric function. Results have been obtained for the ionic pair distribution functions, and for the electric microfield distribution

Ionizing gas breakdown waves in strong electric fields.

Science.gov (United States)

Klingbeil, R.; Tidman, D. A.; Fernsler, R. F.

1972-01-01

A previous analysis by Albright and Tidman (1972) of the structure of an ionizing potential wave driven through a dense gas by a strong electric field is extended to include atomic structure details of the background atoms and radiative effects, especially, photoionization. It is found that photoionization plays an important role in avalanche propagation. Velocities, electron densities, and temperatures are presented as a function of electric field for both negative and positive breakdown waves in nitrogen.

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.

European Union - Space of Regeneration, Learning and Innovation in the Context of Sustainable Multidisciplinary Research

Directory of Open Access Journals (Sweden)

Florin Răzvan Bălășescu

2010-07-01

Full Text Available Objective The Lisbon Strategy set a new goal for the EU economy: the transition to a knowledge based economy, competitive and sustainable at macro and regional levels, by creating the European Research Area – a geographic area without frontiers for researches, where scientific resources are better managed to create more jobs and improve Europe's competitiveness. That means an interaction between specific and multidisciplinary research network. Approach However, general research methodology sustains the importance of static and revolutionary specific criteria of Scientific Research Programs but also reveals the natural process of multidisciplinary researches. In this context, the European Union could be regarded as a specific and multidisciplinary research area, as a network of flows, connections, relationships, interdependencies, and interferences between natural - experimental and social-humanistic research spheres (economics, management, sociology and complex systems ecology. Prior Work: In this respect some researchers suggested that both natural and social systems could be considered as multidisciplinary complex adaptive systems consisting of specific cluster network connections ( in the form of biotic and abiotic nodes, respectively, the competitive and regional poles with the ability to continuous self-organizing, learning and regenerating process especially in crisis situations. Implications and Value Paper Utility The present paper might be useful to illustrate the contribution of technical-economic and socio-ecological researches to increasing the sustainability framework of European Research Area by considering the transition from the R&D approach (development through research process to the L&D approach (development through learning process.

Mitigation of ^{42}Ar/^{42}K background for the GERDA Phase II experiment

Science.gov (United States)

Lubashevskiy, A.; Agostini, M.; Budjáš, D.; Gangapshev, A.; Gusev, K.; Heisel, M.; Klimenko, A.; Lazzaro, A.; Lehnert, B.; Pelczar, K.; Schönert, S.; Smolnikov, A.; Walter, M.; Zuzel, G.

2018-01-01

Background coming from the ^{42}Ar decay chain is considered to be one of the most relevant for the Gerda experiment, which searches for the neutrinoless double beta decay of ^{76}Ge. The sensitivity strongly relies on the absence of background around the Q-value of the decay. Background coming from ^{42}K, a progeny of ^{42}Ar, can contribute to that background via electrons from the continuous spectrum with an endpoint at 3.5 MeV. Research and development on the suppression methods targeting this source of background were performed at the low-background test facility LArGe . It was demonstrated that by reducing ^{42}K ion collection on the surfaces of the broad energy germanium detectors in combination with pulse shape discrimination techniques and an argon scintillation veto, it is possible to suppress ^{42}K background by three orders of magnitude. This is sufficient for Phase II of the Gerda experiment.

On non-perturbative effects of background fields

International Nuclear Information System (INIS)

Hosoda, Masataka; Yamakoshi, Hitoshi; Shimizu, Tadayoshi.

1986-01-01

APS-index of the Abelian Higgs model is at first obtained in a bounded domain of a disk with radius R. It is shown that the APS-index depends strongly on the behavior of the background fields and becomes integer when boundary effects are taken into account. Next, the electric charge of the vacuum is reconsidered in the momopole field coupled to a massive Dirac particle. It is reconfirmed that the monopole ground state has an electric charge θ/π which changes discontinuously to zero when the fermion mass is zero. (author)

Self-Esteem and Institutionalized Delinquent Offenders: The Role of Background Characteristics.

Science.gov (United States)

Fischer, B. Jerome; Bersani, Carl A.

1979-01-01

The hypothesis studied was derived from the work of control theorists: that self-esteem would be higher for offenders "removed" from conventional ties, lower for those maintaining conventional attachments. Family background and self-esteem scores of 75 male delinquents strongly supported this hypothesis. Implications for incarceration are drawn.…

SUSTAINABLE DEVELOPMENT MULTIDISCIPLINARY COMMITTEE OF SAN MIGUEL ALMAYA

Directory of Open Access Journals (Sweden)

Carolina Mejía-Madero

2013-04-01

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

Jets in a strongly coupled anisotropic plasma

Energy Technology Data Exchange (ETDEWEB)

Fadafan, Kazem Bitaghsir [Shahrood University of Technology, Faculty of Physics, Shahrood (Iran, Islamic Republic of); University of Southampton, STAG Research Centre Physics and Astronomy, Southampton (United Kingdom); Morad, Razieh [University of Cape Town, Department of Physics, Rondebosch (South Africa)

2018-01-15

In this paper, we study the dynamics of the light quark jet moving through the static, strongly coupled N = 4, anisotropic plasma with and without charge. The light quark is presented by a 2-parameters point-like initial condition falling string in the context of the AdS/CFT. We calculate the stopping distance of the light quark in the anisotropic medium and compare it with its isotropic value. We study the dependency of the stopping distance to the both string initial conditions and background parameters such as anisotropy parameter or chemical potential. Although the typical behavior of the string in the anisotropic medium is similar to the one in the isotropic AdS-Sch background, the string falls faster to the horizon depending on the direction of moving. Particularly, the enhancement of quenching is larger in the beam direction. We find that the suppression of stopping distance is more prominent when the anisotropic plasma have the same temperature as the isotropic plasma. (orig.)

Multidisciplinary team working across different tumour types: analysis of a national survey.

Science.gov (United States)

Lamb, B W; Sevdalis, N; Taylor, C; Vincent, C; Green, J S A

2012-05-01

Using data from a national survey, this study aimed to address whether the current model for multidisciplinary team (MDT) working is appropriate for all tumour types. Responses to the 2009 National Cancer Action Team national survey were analysed by tumour type. Differences indicate lack of consensus between MDT members in different tumour types. One thousand one hundred and forty-one respondents from breast, gynaecological, colorectal, upper gastrointestinal, urological, head and neck, haematological and lung MDTs were included. One hundred and sixteen of 136 statements demonstrated consensus between respondents in different tumour types. There were no differences regarding the infrastructure for meetings and team governance. Significant consensus was seen for team characteristics, and respondents disagreed regarding certain aspects of meeting organisations and logistics, and patient-centred decision making. Haematology MDT members were outliers in relation to the clinical decision-making process, and lung MDT members disagreed with other tumour types regarding treating patients with advanced disease. This analysis reveals strong consensus between MDT members from different tumour types, while also identifying areas that require a more tailored approach, such as the clinical decision-making process, and preparation for and the organisation of MDT meetings. Policymakers should remain sensitive to the needs of health care teams working in individual tumour types.

Improving sustainability during hospital design and operation a multidisciplinary evaluation tool

CERN Document Server

Bottero, Marta; Buffoli, Maddalena; Lettieri, Emanuele

2015-01-01

This book describes the Sustainable High Quality Healthcare (SustHealth) project, which had the goal of developing an original multidisciplinary evaluation tool that can be applied to assess and improve hospitals’ overall sustainability. The comprehensive nature of the appraisal offered by this tool exceeds the scope of most current rating systems, which typically permit a thorough evaluation of relevant environmental factors when designing a new building but fail to consider social and economic impacts of the design phase or the performance of the hospital’s operational structure in these fields. The multidisciplinary evaluation system was developed, from its very inception through to its testing, by following a scientific experimental method in which a global perspective was constantly maintained, as opposed to a focus only on specific technical issues. Application of the SustHealth rating tool to a currently functioning hospital, or one under design, will identify weaknesses and guide users to potentia...

On estimating probability of presence from use-availability or presence-background data.

Science.gov (United States)

Phillips, Steven J; Elith, Jane

2013-06-01

A fundamental ecological modeling task is to estimate the probability that a species is present in (or uses) a site, conditional on environmental variables. For many species, available data consist of "presence" data (locations where the species [or evidence of it] has been observed), together with "background" data, a random sample of available environmental conditions. Recently published papers disagree on whether probability of presence is identifiable from such presence-background data alone. This paper aims to resolve the disagreement, demonstrating that additional information is required. We defined seven simulated species representing various simple shapes of response to environmental variables (constant, linear, convex, unimodal, S-shaped) and ran five logistic model-fitting methods using 1000 presence samples and 10 000 background samples; the simulations were repeated 100 times. The experiment revealed a stark contrast between two groups of methods: those based on a strong assumption that species' true probability of presence exactly matches a given parametric form had highly variable predictions and much larger RMS error than methods that take population prevalence (the fraction of sites in which the species is present) as an additional parameter. For six species, the former group grossly under- or overestimated probability of presence. The cause was not model structure or choice of link function, because all methods were logistic with linear and, where necessary, quadratic terms. Rather, the experiment demonstrates that an estimate of prevalence is not just helpful, but is necessary (except in special cases) for identifying probability of presence. We therefore advise against use of methods that rely on the strong assumption, due to Lele and Keim (recently advocated by Royle et al.) and Lancaster and Imbens. The methods are fragile, and their strong assumption is unlikely to be true in practice. We emphasize, however, that we are not arguing against

Effectiveness of multidisciplinary therapy on symptomatology and quality of life in women with fibromyalgia.

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Carbonell-Baeza, A; Aparicio, V A; Chillón, P; Femia, P; Delgado-Fernandez, M; Ruiz, J R

2011-01-01

To study the effects of a 3-month multidisciplinary intervention based on exercise and psychological therapy on symptomatology and quality of life in women with fibromyalgia. Seventy-five women with fibromyalgia volunteered to participate and were allocated to a 3-month (3-times/week) multidisciplinary (pool, land-based and psychological session based on the Acceptance and Commitment Therapy) intervention (n=41), or to a usual care group (n=34). Sixty-five women with fibromyalgia completed the study protocol (n=33 multidisciplinary intervention, aged 51.4±7.4 years and n=32 usual care group, aged 50.0±7.3 years). The outcomes variables were Fibromyalgia Impact Questionnaire (FIQ), Short Form Health Survey 36 (SF-36), Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory and Rosenberg Self-Esteem Scale. We observed a significant interaction effect (group*time) for the FIQ total score, the subscales fatigue, stiffness, anxiety and depression, and the subscales of SF-36 physical role, bodily pain, vitality and social functioning. Post-hoc analysis revealed significant improvements in total score of FIQ (pfibromyalgia symptomatology and quality of life in women with fibromyalgia.

Fear of falling as seen in the Multidisciplinary falls consultation.

Science.gov (United States)

Gaxatte, C; Nguyen, T; Chourabi, F; Salleron, J; Pardessus, V; Delabrière, I; Thévenon, A; Puisieux, F

2011-06-01

Fear of falling may be as debilitating as the fall itself, leading to a restriction in activities and even a loss of autonomy. The main objective was to evaluate the prevalence of the fear of falling among elderly fallers. The secondary objectives were to determine the factors associated with the fear of falling and evaluate the impact of this fear on the activity "getting out of the house". Prospective study conducted between 1995 and 2006 in which fallers and patients at high risk for falling were seen at baseline by the multidisciplinary falls consultation team (including a geriatrician, a neurologist and a physical medicine and rehabilitation physician) and then, again 6 month later, by the same geriatrician. The fear of falling was evaluated with a yes/no question: "are you afraid of falling?". Out of 635 patients with a mean age of 80.6 years, 502 patients (78%) expressed a fear of falling. Patients with fear of falling were not older than those who did not report this fear, but the former were mostly women (Pfear of falling were not going out alone as much as the fearless group (31% vs 53%, Pfearful group admitted to avoiding going out because they were afraid of falling. The strong prevalence of the fear of falling observed in this population and its consequences in terms of restricted activities justifies systematically screening for it in fallers or patients at risk for falling. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Multidisciplinary perspectives of music therapy in adult palliative care.

Science.gov (United States)

O'Kelly, Julian; Koffman, Jonathan

2007-04-01

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

Challenges and Experiences of Building Multidisciplinary Datasets across Cultures

Science.gov (United States)

Jamiyansharav, K.; Laituri, M.; Fernandez-Gimenez, M.; Fassnacht, S. R.; Venable, N. B. H.; Allegretti, A. M.; Reid, R.; Baival, B.; Jamsranjav, C.; Ulambayar, T.; Linn, S.; Angerer, J.

2017-12-01

Efficient data sharing and management are key challenges to multidisciplinary scientific research. These challenges are further complicated by adding a multicultural component. We address the construction of a complex database for social-ecological analysis in Mongolia. Funded by the National Science Foundation (NSF) Dynamics of Coupled Natural and Human (CNH) Systems, the Mongolian Rangelands and Resilience (MOR2) project focuses on the vulnerability of Mongolian pastoral systems to climate change and adaptive capacity. The MOR2 study spans over three years of fieldwork in 36 paired districts (Soum) from 18 provinces (Aimag) of Mongolia that covers steppe, mountain forest steppe, desert steppe and eastern steppe ecological zones. Our project team is composed of hydrologists, social scientists, geographers, and ecologists. The MOR2 database includes multiple ecological, social, meteorological, geospatial and hydrological datasets, as well as archives of original data and survey in multiple formats. Managing this complex database requires significant organizational skills, attention to detail and ability to communicate within collective team members from diverse disciplines and across multiple institutions in the US and Mongolia. We describe the database's rich content, organization, structure and complexity. We discuss lessons learned, best practices and recommendations for complex database management, sharing, and archiving in creating a cross-cultural and multi-disciplinary database.

[Consensus statement for accreditation of multidisciplinary thyroid cancer units].

Science.gov (United States)

Díez, Juan José; Galofré, Juan Carlos; Oleaga, Amelia; Grande, Enrique; Mitjavila, Mercedes; Moreno, Pablo

2016-03-01

Thyroid cancer is the leading endocrine system tumor. Great advances have recently been made in understanding of the origin of these tumors and the molecular biology that makes them grow and proliferate, which have been associated to improvements in diagnostic procedures and increased availability of effective local and systemic treatments. All of the above makes thyroid cancer a paradigm of how different specialties should work together to achieve the greatest benefit for the patients. Coordination of all the procedures and patient flows should continue throughout diagnosis, treatment, and follow-up, and is essential for further optimization of resources and time. This manuscript was prepared at the request of the Working Group on Thyroid Cancer of the Spanish Society of Endocrinology and Nutrition, and is aimed to provide a consensus document on the definition, composition, requirements, structure, and operation of a multidisciplinary team for the comprehensive care of patients with thyroid cancer. For this purpose, we have included contributions by several professionals from different specialties with experience in thyroid cancer treatment at centers where multidisciplinary teams have been working for years, with the aim of developing a practical consensus applicable in clinical practice. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Interpretation of observed cosmic microwave background radiation

International Nuclear Information System (INIS)

Alfven, H.; Mendis, A.

1977-01-01

It is stated that the observed cosmic microwave background radiation, which closely fits a 2.7 K black body spectrum, is generally claimed to be the strongest piece of evidence in support of hot big bang cosmologies by its proponents. It is here stated that the observed radiation corresponds to the distribution of dust in galaxies or protogalaxies with a temperature approximately 110 K at the epoch corresponding to Z approximately 40, and not to a plasma of temperature > approximately 3000 K at an earlier epoch (Z > approximately 1000), as indicated by the canonical model of big bang cosmologies. The claim that the latter lends strong support to hot big bang cosmologies is stated to be without foundation. It is concluded that the microwave background radiation must be explained not in terms of a coupling between matter and radiation at the present epoch, but in terms of a coupling in a previous epoch within the framework of an evolutionary cosmology. (U.K.)

Background approximation in automatic qualitative X-ray-fluorescent analysis

International Nuclear Information System (INIS)

Jordanov, J.; Tsanov, T.; Stefanov, R.; Jordanov, N.; Paunov, M.

1982-01-01

An empirical method of finding the dependence of the background intensity (Isub(bg) on the wavelength is proposed, based on the approximation of the experimentally found values for the background in the course of an automatic qualitative X-ray fluorescent analysis with pre-set curve. It is assumed that the dependence I(lambda) will be well approximated by a curve of the type Isub(bg)=(lambda-lambda sub(o)sup(fsub(1)(lambda))exp[fsub(2)(lambda)] where fsub(1) (lambda) and f 2 (lambda) are linear functions with respect to the sought parameters. This assumption was checked out on a ''pure'' starch background, in which it is not known beforehand which points belong to the background. It was assumed that the dependence I(lambda) can be found from all minima in the spectrum. Three types of minima has been distinguished: 1. the lowest point between two well-solved X-ray lines; 2. a minimum obtained as a result of statistical fluctuations of the measured signal; 3. the lowest point between two overlapped lines. The minima strongly deviating from the background are removed from the obtained set. The sum-total of the remaining minima serves as a base for the approximation of the dependence I(lambda). The unknown parameters are determined by means of the LSM. The approximated curve obtained by this method is closer to the real background than the background determined by the method described by Kigaki Denki, as the effect of all recorded minima is taken into account. As an example the PbTe spectrum recorded with crystal LiF 220 is shown graphically. The curve well describes the background of the spectrum even in the regions in which there are no minima belonging to the background. (authors)

Insights and advances in multidisciplinary critical care: a review of recent research.

Science.gov (United States)

Blot, Stijn; Afonso, Elsa; Labeau, Sonia

2014-01-01

The intensive care unit is a work environment where superior dedication is pivotal to optimize 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 abundance of research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovations in the field. This article broadly summarizes new developments in multidisciplinary intensive care, providing elementary information about advanced insights in the field by briefly describing selected articles bundled in specific topics. Issues considered include cardiovascular care, monitoring, mechanical ventilation, infection and sepsis, nutrition, education, patient safety, pain assessment and control, delirium, mental health, ethics, and outcomes research.

Locally advanced (neglected) breast cancer: the reality? relevance of two cases and reflection how to optimise the multidisciplinary approach

International Nuclear Information System (INIS)

Monnier, L.; Even, C.; Kirova, Y.M.; Even, C.; Cottu, P.H.

2009-01-01

The standard treatment for breast cancer patients with untreated locally advanced breast cancer is neo-adjuvant chemotherapy or hormonal treatment. In some cases, this treatment is followed by surgery and/or radiotherapy when the multidisciplinary approach is present. In some cases of patients presenting metastatic diseases, the radiotherapy is forgotten or proposed late when the local disease is extremely advanced with symptoms and decreased quality of life. Two cases of extremely advanced non operable T4 stage breast cancer are reported and the importance of multidisciplinary approach is discussed. The place and the right time of radiotherapy in this multidisciplinary strategy is reported. (authors)

Multidisciplinary Perspectives towards the Education of Young Low-Income Immigrant Children

Science.gov (United States)

Isik-Ercan, Zeynep; Demir-Dagdas, Tuba; Cakmakci, Huzeyfe; Cava-Tadik, Yasemin; Intepe-Tingir, Seyma

2017-01-01

This paper examines the issues surrounding low-income immigrants in the U.S. and the ways they shape the educational experiences of their young children. Using a multidisciplinary lens including sociology, family studies, education, and mental health, the authors analyse multiple perspectives towards the educational experiences of children in…

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

Directory of Open Access Journals (Sweden)

Gustavo Duarte Ferrari

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

Recent Advances in Multidisciplinary Analysis and Optimization, part 3

Science.gov (United States)

Barthelemy, Jean-Francois M. (Editor)

1989-01-01

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

A Multidisciplinary Engineering Summer School in an Industrial Setting

DEFF Research Database (Denmark)

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

2009-01-01

are capable of collaborating across disciplinary boundaries and exhibit soft competencies, like communication, interpersonal and social skills, time planning, creativity, initiative, and reflection. To prepare a group of engineering and industrial design students to acquire those capabilities......Most university-level engineering studies produce technically skilled engineers. However, typically students face several difficulties when working in multidisciplinary teams when they initiate their industrial careers. In a globalised world, it becomes increasingly important that engineers...

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.

Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: a randomized controlled trial.

Science.gov (United States)

Castel, Antoni; Fontova, Ramon; Montull, Salvador; Periñán, Rocío; Poveda, Maria José; Miralles, Iris; Cascón-Pereira, Rosalia; Hernández, Pilar; Aragonés, Natalia; Salvat, Isabel; Castro, Sonia; Monterde, Sonia; Padrol, Anna; Sala, José; Añez, Cristóbal; Rull, Maria

2013-03-01

Multidisciplinary treatments of fibromyalgia (FM) have demonstrated efficacy. Nevertheless, they have been criticized for not maintaining their benefits and for not being studied for specific populations. Our objectives were to determine the efficacy of a multidisciplinary treatment for FM adapted for patients with low educational levels and to determine the maintenance of its therapeutic benefits during a long-term followup period. Inclusion criteria consisted of female sex, a diagnosis of FM (using American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Patients were randomly assigned to 1 of the 2 treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were functionality, sleep disturbances, pain intensity, catastrophizing, and psychological distress. Analysis was by intent-to-treat and missing data were replaced following the baseline observation carried forward method. One hundred fifty-five participants were recruited. No statistically significant differences regarding pretreatment measures were found between the 2 experimental groups. Overall statistics comparison showed a significant difference between the 2 groups in all of the variables studied (P educational levels is effective in reducing key symptoms of FM. Some improvements were maintained 1 year after completing the multidisciplinary treatment. Copyright © 2013 by the American College of Rheumatology.

Charged Hadron Properties in Background Electric Fields

International Nuclear Information System (INIS)

Detmold, William; Tiburzi, Brian C.; Walker-Loud, Andre

2010-01-01

We report on a lattice calculation demonstrating a novel new method to extract the electric polarizability of charged pseudo-scalar mesons by analyzing two point correlation functions computed in classical background electric fields. A staple component of any electrodynamics or quantum mechanics course is the electric polarizability. Neutral material immersed in a weak external field polarizes, internally setting up an electric dipole moment, aligned so as to minimize the energy. At the atomic level, the electron clouds are distorted creating these microscopic dipole moments. The same process occurs at the hadronic level but the polarization effects are now constrained by the strong force. Polarizabilities of these bound QCD states can be viewed as a distortion of the charged pion cloud of a given hadron. One can use lattice QCD to non-perturbatively compute the quark and gluon interactions in the presence of background electric (or magnetic) fields. For sufficiently weak background fields, the low energy properties of the hadrons can be rigorously computed using effective field theory. With this treatment, a picture of hadrons emerges from chiral dynamics: that of a hadronic core surrounded by a pseudoscalar meson cloud. As some pseudoscalar mesons are charged, polarizabilities of hadrons encode the stiffness of the charged meson cloud (as well as that of the core). The form of pseudoscalar meson polarizabilities is consequently strongly constrained by chiral dynamics. However, beyond the leading order, the results depend upon essentially unknown low-energy constants, which must currently be estimated in a model-dependent fashion. In the case of the charged pion, the experimental measurement of the polarizability has proven difficult, both in the original measurement as well as the most recent published result. Currently, there is a 2-3 sigma discrepancy between the two-loop cPT prediction and the measured charged pion polarizability. New results with higher

Multidisciplinary Techniques and Novel Aircraft Control Systems

Science.gov (United States)

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

2000-01-01

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

Is staff well-being and communication enhanced by multidisciplinary work shift evaluations?

NARCIS (Netherlands)

Sluiter, Judith K.; Bos, Albert P.; Tol, Dirk; Calff, Mart; Krijnen, Margot; Frings-Dresen, Monique H. W.

2005-01-01

Objective: To study the implementation of multidisciplinary structured work shift evaluations at a pediatric intensive care unit (PICU) to enhance team communication. Desogn and setting: Prospective, repeated measurements design, comparison of pre/post measurements and process measures in a Dutch

Evaluating a Professional Development Programme for Implementation of a Multidisciplinary Science Subject

NARCIS (Netherlands)

Visser, Talitha Christine; Coenders, Ferdinand G.M.; Terlouw, C.; Pieters, Julius Marie

2013-01-01

This study aims to evaluate a professional development programme that prepares and assists teachers with the implementation of a multidisciplinary science module, basing the evaluation on participants’ reactions, the first level of Guskey’s five-level model for evaluation (2002). Positive

The importance of a multidisciplinary assistance program in the control of blood pressure in hypertensive elderly patients

Directory of Open Access Journals (Sweden)

Alberto Macedo-Soares

2007-06-01

Full Text Available Objective: To verify if being placed on a geriatric multidisciplinaryassistance program contributes to better blood pressure control.Methods and Design: Cross-section study. Setting: A tertiary-careteaching hospital in São Paulo, Brazil. Participants: 110 hypertensivepatients aged over 60 years. Measurements: Blood pressure of theelderly in the Geriatric Service, called “the reference group”, wasverified. Subsequently, blood pressure of the same elderly patientswas verified after being placed on a multidisciplinary program - “themultidisciplinary group”. Results: A significant difference betweenthe “reference group” x the “multidisciplinary group” was foundregarding the proportion of patients under blood pressure control (p= 0.021. In the “reference group”, 24.7% of patients had controlledblood pressure while in the “multidisciplinary group” this proportionwas 41.1%. Conclusion: Being placed on a geriatric multidisciplinaryassistance exercise program significantly improved blood pressurecontrol in hypertensive elderly.

Integrated Program of Multidisciplinary Education and Research in Mechanics and Physics of Earthquakes

Science.gov (United States)

Lapusta, N.

2011-12-01

Studying earthquake source processes is a multidisciplinary endeavor involving a number of subjects, from geophysics to engineering. As a solid mechanician interested in understanding earthquakes through physics-based computational modeling and comparison with observations, I need to educate and attract students from diverse areas. My CAREER award has provided the crucial support for the initiation of this effort. Applying for the award made me to go through careful initial planning in consultation with my colleagues and administration from two divisions, an important component of the eventual success of my path to tenure. Then, the long-term support directed at my program as a whole - and not a specific year-long task or subject area - allowed for the flexibility required for a start-up of a multidisciplinary undertaking. My research is directed towards formulating realistic fault models that incorporate state-of-the-art experimental studies, field observations, and analytical models. The goal is to compare the model response - in terms of long-term fault behavior that includes both sequences of simulated earthquakes and aseismic phenomena - with observations, to identify appropriate constitutive laws and parameter ranges. CAREER funding has enabled my group to develop a sophisticated 3D modeling approach that we have used to understand patterns of seismic and aseismic fault slip on the Sunda megathrust in Sumatra, investigate the effect of variable hydraulic properties on fault behavior, with application to Chi-Chi and Tohoku earthquake, create a model of the Parkfield segment of the San Andreas fault that reproduces both long-term and short-term features of the M6 earthquake sequence there, and design experiments with laboratory earthquakes, among several other studies. A critical ingredient in this research program has been the fully integrated educational component that allowed me, on the one hand, to expose students from different backgrounds to the

Retrospective analysis of multidisciplinary therapy for locally advanced squamous cell carcinoma of the maxillary sinus

Energy Technology Data Exchange (ETDEWEB)

Yoshida, Hiroshi; Seo, Yuji; Nakajima, Kaori; Miyano, Takashi [Asahikawa Medical Univ., Hokkaido (Japan); Kikuchi, Yuzou [Kanazawa Univ. (Japan). School of Medicine

2002-06-01

The purpose of this study was to retrospectively investigate the efficacy of multidisciplinary therapy (concomitant radiotherapy and intra-arterial infusion of 5-fluorouracil (5-FU) followed by maxillectomy) in the treatment of squamous cell carcinoma of the maxillary sinus. We reviewed 71 patient records with locally advanced but respectable carcinoma of the maxillary sinus treated by means of multidisciplinary therapy between 1978 through 1997. The clinical T factor for these patients, according to the UICC definitions (1997), was 12 for T2, 46 for T3, and 13 for T4. Twelve patients were diagnosed as node-positive at initial presentation. Intra-arterial 5-FU was delivered via a superficial temporal artery in accordance with radiotherapy, and the cumulative 5-FU dose ranged from 2,900 mg to 5,250 mg (median 5,000 mg). The total radiotherapy dose ranged from 29 Gy to 48 Gy (median 48 Gy) with conventional fractionation. Patients underwent radical maxillectomy thereafter. The 5-year overall survival rate and disease-specific survival rate of all the patients were 58% and 68%, respectively. There was no significant correlation of clinical T factor or N factor with disease-specific survival on univariate and multivariate analysis. The overall treatment-related mortality rate was 3.7%. Radiation cataract later developed in all evaluable patients whose lenses were within the treatment volume. About a half of the operable T4 patients survived over 5 years by means of the above-mentioned multidisciplinary therapy. This multidisciplinary therapy should be compared to treatment with a combination of surgery and postoperative chemoradiotherapy. (author)

Retrospective analysis of multidisciplinary therapy for locally advanced squamous cell carcinoma of the maxillary sinus

International Nuclear Information System (INIS)

Yoshida, Hiroshi; Seo, Yuji; Nakajima, Kaori; Miyano, Takashi; Kikuchi, Yuzou

2002-01-01

The purpose of this study was to retrospectively investigate the efficacy of multidisciplinary therapy (concomitant radiotherapy and intra-arterial infusion of 5-fluorouracil (5-FU) followed by maxillectomy) in the treatment of squamous cell carcinoma of the maxillary sinus. We reviewed 71 patient records with locally advanced but respectable carcinoma of the maxillary sinus treated by means of multidisciplinary therapy between 1978 through 1997. The clinical T factor for these patients, according to the UICC definitions (1997), was 12 for T2, 46 for T3, and 13 for T4. Twelve patients were diagnosed as node-positive at initial presentation. Intra-arterial 5-FU was delivered via a superficial temporal artery in accordance with radiotherapy, and the cumulative 5-FU dose ranged from 2,900 mg to 5,250 mg (median 5,000 mg). The total radiotherapy dose ranged from 29 Gy to 48 Gy (median 48 Gy) with conventional fractionation. Patients underwent radical maxillectomy thereafter. The 5-year overall survival rate and disease-specific survival rate of all the patients were 58% and 68%, respectively. There was no significant correlation of clinical T factor or N factor with disease-specific survival on univariate and multivariate analysis. The overall treatment-related mortality rate was 3.7%. Radiation cataract later developed in all evaluable patients whose lenses were within the treatment volume. About a half of the operable T4 patients survived over 5 years by means of the above-mentioned multidisciplinary therapy. This multidisciplinary therapy should be compared to treatment with a combination of surgery and postoperative chemoradiotherapy. (author)

Hanford Site background: Part 1, Soil background for nonradioactive analytes

International Nuclear Information System (INIS)

1993-04-01

Volume two contains the following appendices: Description of soil sampling sites; sampling narrative; raw data soil background; background data analysis; sitewide background soil sampling plan; and use of soil background data for the detection of contamination at waste management unit on the Hanford Site

Liver Transplantation for Hepatocellular Carcinoma beyond Milan Criteria: Multidisciplinary Approach to Improve Outcome

Science.gov (United States)

Kornberg, A.

2014-01-01

The implementation of the Milan criteria (MC) in 1996 has dramatically improved prognosis after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Liver transplantation has, thereby, become the standard therapy for patients with “early-stage” HCC on liver cirrhosis. The MC were consequently adopted by United Network of Organ Sharing (UNOS) and Eurotransplant for prioritization of patients with HCC. Recent advancements in the knowledge about tumor biology, radiographic imaging techniques, locoregional interventional treatments, and immunosuppressive medications have raised a critical discussion, if the MC might be too restrictive and unjustified keeping away many patients from potentially curative LT. Numerous transplant groups have, therefore, increasingly focussed on a stepwise expansion of selection criteria, mainly based on tumor macromorphology, such as size and number of HCC nodules. Against the background of a dramatic shortage of donor organs, however, simple expansion of tumor macromorphology may not be appropriate to create a safe extended criteria system. In contrast, rather the implementation of reliable prognostic parameters of tumor biology into selection process prior to LT is mandatory. Furthermore, a multidisciplinary approach of pre-, peri-, and posttransplant modulating of the tumor and/or the patient has to be established for improving prognosis in this special subset of patients. PMID:27335840

Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

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Wataru Kudaka

2016-01-01

Full Text Available Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS extending to inferior vena cava (IVC and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

What is the role of a specialist regional mesothelioma multidisciplinary team meeting? A service evaluation of one tertiary referral centre in the UK.

Science.gov (United States)

Bibby, Anna C; Williams, Katie; Smith, Sarah; Bhatt, Nidhi; Maskell, Nick A

2016-09-08

Multidisciplinary team meetings are standard care for cancer in the UK and Europe. Professional bodies recommend that mesothelioma cases should be discussed at specialist multidisciplinary team meetings. However, no evidence exists exploring the role of the specialist mesothelioma multidisciplinary team meeting. To evaluate the clinical activity of 1 specialist mesothelioma multidisciplinary team meeting and to determine how often a definitive diagnosis was made, whether the core requirements of the meeting were met and whether there was any associated benefit or detriment. A service evaluation using routinely collected data from 1 specialist mesothelioma multidisciplinary team meeting in a tertiary referral hospital in the South-West of England. All cases discussed between 1/1/2014 and 31/12/2015. The primary outcome measure was whether a definitive diagnosis was made. Secondary outcomes included whether treatment advice was offered, information on clinical trials provided or further investigations suggested. Additional benefits of the multidisciplinary team meeting and time taken from referral to outcome were also collected. A definitive diagnosis was reached in 171 of 210 cases discussed (81%). Mesothelioma was diagnosed in 153/210 (73%). Treatment advice was provided for 127 of 171 diagnostic cases (74%) and further investigations suggested for all 35 non-diagnostic cases. 86/210 cases (41%) were invited to participate in a trial, of whom 43/86 (50%) subsequently enrolled. Additional benefits included the avoidance of postmortem examination if the coroner was satisfied with the multidisciplinary team decision. The overall process from referral to outcome dispatch was specialist mesothelioma multidisciplinary team meeting was effective at making diagnoses and providing recommendations for further investigations or treatment. The core requirements of a specialist mesothelioma multidisciplinary team meeting were met. The process was timely, with most outcomes

On the Frequency Distribution of Neutral Particles from Low-Energy Strong Interactions

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Federico Colecchia

2017-01-01

Full Text Available The rejection of the contamination, or background, from low-energy strong interactions at hadron collider experiments is a topic that has received significant attention in the field of particle physics. This article builds on a particle-level view of collision events, in line with recently proposed subtraction methods. While conventional techniques in the field usually concentrate on probability distributions, our study is, to our knowledge, the first attempt at estimating the frequency distribution of background particles across the kinematic space inside individual collision events. In fact, while the probability distribution can generally be estimated given a model of low-energy strong interactions, the corresponding frequency distribution inside a single event typically deviates from the average and cannot be predicted a priori. We present preliminary results in this direction and establish a connection between our technique and the particle weighting methods that have been the subject of recent investigation at the Large Hadron Collider.

A statistical background noise correction sensitive to the steadiness of background noise.

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Oppenheimer, Charles H

2016-10-01

A statistical background noise correction is developed for removing background noise contributions from measured source levels, producing a background noise-corrected source level. Like the standard background noise corrections of ISO 3741, ISO 3744, ISO 3745, and ISO 11201, the statistical background correction increases as the background level approaches the measured source level, decreasing the background noise-corrected source level. Unlike the standard corrections, the statistical background correction increases with steadiness of the background and is excluded from use when background fluctuation could be responsible for measured differences between the source and background noise levels. The statistical background noise correction has several advantages over the standard correction: (1) enveloping the true source with known confidence, (2) assuring physical source descriptions when measuring sources in fluctuating backgrounds, (3) reducing background corrected source descriptions by 1 to 8 dB for sources in steady backgrounds, and (4) providing a means to replace standardized background correction caps that incentivize against high precision grade methods.

Vocational rehabilitation: a multidisciplinary intervention.

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

2007-09-15

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

[Multidisciplinary practice guideline 'Marfan syndrome'].

Science.gov (United States)

Hilhorst-Hofstee, Yvonne

2013-01-01

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

Multidisciplinary Management of Laryngeal Carcinoma

International Nuclear Information System (INIS)

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

2007-01-01

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

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

NARCIS (Netherlands)

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

2013-01-01

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

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

Science.gov (United States)

2013-11-01

..., Division of Cancer Control & Population Sciences, National Cancer Institute, 9609 Medical Center Drive...), which initiates a coordinated approach to multidisciplinary care. The web-based, organizational survey...

Robust Parameter Coordination for Multidisciplinary Design

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

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

A Multidisciplinary PBL Robot Control Project in Automation and Electronic Engineering

Science.gov (United States)

Hassan, Houcine; Domínguez, Carlos; Martínez, Juan-Miguel; Perles, Angel; Capella, Juan-Vicente; Albaladejo, José

2015-01-01

This paper presents a multidisciplinary problem-based learning (PBL) project consisting of the development of a robot arm prototype and the implementation of its control system. The project is carried out as part of Industrial Informatics (II), a compulsory third-year course in the Automation and Electronic Engineering (AEE) degree program at the…

A multidisciplinary study of significant migrations on the territory of Vojvodina in the 20th century

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Bjeljac Željko

2016-01-01

Full Text Available Migrations of population in a particular area and/or at a particular time represent the phenomenon of global proportions. As such, they require multidisciplinary approach to research. The most common questions posed by the individual, but also multidisciplinary scientific disciplines are: Who is moving? Where are they going? Why do they go? What are the natural and economic conditions of migrations? Why do migrations occur and how they maintain over time? Multidisciplinary research of migrations is very important for a more complete understanding of this process, primarily from the physical, historical, economic, ethnographic, anthropological, legal, politicological, sociological, etc. The aim of the paper is to highlight the importance of multidisciplinary research through the representation of some major migrations in Vojvodina in the 20th century. As a subject of research the following has been singled out: colonization (immigration of population from 1919 to 1930, 1945-1948 (there are some similarities among them (population decline, new social and political conditions and legal regulation, difficulties to get used to new ways of life, mixing folklore and customs with the local population. The paper includes the emigration of the German population from Vojvodina, 1944-1950, as part of one of the largest (e migrations in Europe in the 20th century. This migration, seen from legal, economic, historical and political aspects has consequences today, during the approach of Serbia to the European Union. [Projekat Ministarstva nauke Republike Srbije, br. III47007 i br. III47027

A standardized multidisciplinary approach reduces the use of allogeneic blood products in patients undergoing cardiac surgery.

Science.gov (United States)

Van der Linden, P; De Hert, S; Daper, A; Trenchant, A; Jacobs, D; De Boelpaepe, C; Kimbimbi, P; Defrance, P; Simoens, G

2001-10-01

Individual and institutional practices remain an independent predictor factor for allogeneic blood transfusion. Application of a standardized multidisciplinary transfusion strategy should reduce the use of allogeneic blood transfusion in major surgical patients. This prospective non randomized observational study evaluated the effects of a standardized multidisciplinary transfusion strategy on allogeneic blood products exposure in patients undergoing non-emergent cardiac surgery. The developed strategy involved a standardized blood conservation program and a multidisciplinary allogeneic blood transfusion policy based mainly on clinical judgement, not only on a specific hemoglobin concentration. Data obtained in a first group including patients operated from September 1997 to August 1998 (Group pre: n=321), when the transfusion strategy was progressively developed, were compared to those obtained in a second group, including patients operated from September 1998 to August 1999 (Group post: n=315) when the transfusion strategy was applied uniformly. Patient populations and surgical procedures were similar. Patients in Group post underwent acute normovolemic hemodilution more frequently, had a higher core temperature at arrival in the intensive care unit and presented lower postoperative blood losses at day one. Three hundred forty units of packed red blood cells were transfused in 33% of the patients in Group pre whereas 161 units were transfused in 18% of the patients in Group post (P <0.001). Pre- and postoperative hemoglobin concentrations, mortality and morbidity were not different among groups. Development of a standardized multidisciplinary transfusion strategy markedly reduced the exposure of cardiac surgery patients to allogeneic blood.

[Beneficial effect of a cognitive behavioral and multidisciplinary program in Alzheimer Disease on spouse caregiver anxiety: French study ELMMA].

Science.gov (United States)

Negovanska, V; Hergueta, T; Guichart-Gomez, E; Dubois, B; Sarazin, M; Bungener, C

2011-02-01

Over the last decade, several programs have been developed for caregivers of Alzheimer disease patients. In France however, studies exploring their effects are still scarce. We conducted a study to compare two different interventions: a structured multidisciplinary program versus a classical intervention designed for Alzheimer disease patients and their spouses. Sixteen couples (Alzheimer's disease patient and spouse) residing in our administrative district participated in this monocentric study. For at least two years, these couples participated in a multidisciplinary program (n=8 couples) or received usual care (n=8 couples). The multidisciplinary program involved biannual consultations with a neurologist, a neuropsychologist and a psychologist, in addition to an annual meeting, stratified on the patient's MMSE score, for spouses). Usual care involved biannual consultations with the neurologist. The multidisciplinary program included a psychological intervention based on cognitive behavioral theories and centered on psycho-education, problem solving, adaptation strategies and on prevention of depression and anxiety. The spouses and the patients evaluated the 2-year follow-up during clinical interviews, completed by questionnaires. Sociodemographic data were noted for the patients and their spouses. Levels of depression and anxiety (Mini International Neuropsychiatric Inventory, Montgomery and Asberg Depression Scale, State-Trait Anxiety Inventory), perceived stress (Perceived Stress Scale) and care burden (Zarit Burden Inventory) were evaluated in spouses. Levels of cognitive impairment (Mini Mental State Examination), autonomy (Instrumental Activities of Daily Living), psychological state (Montgomery and Asberg Depression Scale, Covi Anxiety Scale), and behavioral symptoms frequency (Neuropsychiatric Inventory) were assessed in patients. The main significant result showed that the spouses' state of anxiety was lower among participants in the multidisciplinary

Affordable Design: A Methodolgy to Implement Process-Based Manufacturing Cost into the Traditional Performance-Focused Multidisciplinary Design Optimization

Science.gov (United States)

Bao, Han P.; Samareh, J. A.

2000-01-01

The primary objective of this paper is to demonstrate the use of process-based manufacturing and assembly cost models in a traditional performance-focused multidisciplinary design and optimization process. The use of automated cost-performance analysis is an enabling technology that could bring realistic processbased manufacturing and assembly cost into multidisciplinary design and optimization. In this paper, we present a new methodology for incorporating process costing into a standard multidisciplinary design optimization process. Material, manufacturing processes, and assembly processes costs then could be used as the objective function for the optimization method. A case study involving forty-six different configurations of a simple wing is presented, indicating that a design based on performance criteria alone may not necessarily be the most affordable as far as manufacturing and assembly cost is concerned.

Influence of plasma background including neutrals on scrape-off layer filaments using 3D simulations

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D. Schwörer

2017-08-01

Full Text Available This paper investigates the effect of the plasma background, including neutrals in a self-consistent way, on filaments in the scrape-off layer (SOL of fusion devices. A strong dependency of filament motion on background density and temperature is observed. The radial filament motion shows an increase in velocity with decreasing background density and increasing background temperature. In the simulations presented here, three neutral-filament interaction models have been compared, one with a static neutral background, one with no interaction between filaments and neutrals, and one co-evolving the neutrals self consistently with the filaments. With the background conditions employed here, which do not show detachment, there are no significant effects of neutrals on filaments, as by the time the filament reaches maximum velocity, the neutral density has not changed significantly.

Cosmic microwave background power asymmetry from non-Gaussian modulation.

Science.gov (United States)

Schmidt, Fabian; Hui, Lam

2013-01-04

Non-Gaussianity in the inflationary perturbations can couple observable scales to modes of much longer wavelength (even superhorizon), leaving as a signature a large-angle modulation of the observed cosmic microwave background power spectrum. This provides an alternative origin for a power asymmetry that is otherwise often ascribed to a breaking of statistical isotropy. The non-Gaussian modulation effect can be significant even for typical ~10(-5) perturbations while respecting current constraints on non-Gaussianity if the squeezed limit of the bispectrum is sufficiently infrared divergent. Just such a strongly infrared-divergent bispectrum has been claimed for inflation models with a non-Bunch-Davies initial state, for instance. Upper limits on the observed cosmic microwave background power asymmetry place stringent constraints on the duration of inflation in such models.

The interplay of conflict and analogy in multidisciplinary teams.

Science.gov (United States)

Paletz, Susannah B F; Schunn, Christian D; Kim, Kevin H

2013-01-01

Creative teamwork in multidisciplinary teams is a topic of interest to cognitive psychologists on the one hand, and to both social and organizational psychologists on the other. However, the interconnections between cognitive and social layers have been rarely explored. Drawing on mental models and dissonance theories, the current study takes a central variable studied by cognitive psychologists-analogy-and examines its relationship to a central variable examined by social psychologists-conflict. In an observational, field study, over 11h of audio-video data from conversations of the Mars Exploration Rover scientists were coded for different types of analogy and micro-conflicts that reveal the character of underlying psychological mechanisms. Two different types of time-lagged logistic models applied to these data revealed asymmetric patterns of associations between analogy and conflict. Within-domain analogies, but not within-discipline or outside-discipline analogies, preceded science and work process conflicts, suggesting that in multidisciplinary teams, representational gaps in very close domains will be more likely to spark conflict. But analogies also occurred in reaction to conflict: Process and negative conflicts, but not task conflicts, preceded within-discipline analogies, but not to within-domain or outside-discipline analogies. This study demonstrates ways in which cognition can be bidirectionally tied to social processes and discourse. Copyright © 2012 Elsevier B.V. All rights reserved.

Twenty years of multidisciplinary research and practice: the Journal of Occupational Rehabilitation then and now.

Science.gov (United States)

Shaw, William S; Findley, Patricia A; Feuerstein, Michael

2011-12-01

Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation. We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions. The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns. Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.

Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer.

Science.gov (United States)

Ung, Kim Ann; Campbell, Belinda A; Duplan, Danny; Ball, David; David, Steven

2016-06-01

Multidisciplinary team (MDT) meetings are increasingly regarded as a component of multidisciplinary cancer care. We aimed to prospectively measure the impact of MDT meetings on clinicians' management plans for lung oncology patients, and the implementation rate of the meeting recommendations. Consecutive patient cases presented at the weekly lung oncology MDT meetings were prospectively enrolled. Investigators compared the clinicians' management plans pre-meeting with the consensus plans post-meeting. The meeting was considered to have an impact on management plans if ≥1 of the following changes were detected: tumor stage, histology, treatment intent or treatment modality, or if additional investigations were recommended. Investigators reviewed hospital patient records at 4 months to determine if the meeting recommendations were implemented. Reasons for non-implementation were also recorded. Of the 55 eligible cases, the MDT meeting changed management plans in 58% (CI 45-71%; P management plans for lung oncology patients. The majority of MDT recommendations (72%) were implemented into patient care. These findings provide further evidence to support the role of MDT meetings as an essential part of the decision-making process for the optimal multidisciplinary management of patients with cancer. © 2014 Wiley Publishing Asia Pty Ltd.

The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature.

Science.gov (United States)

Pillay, Brindha; Wootten, Addie C; Crowe, Helen; Corcoran, Niall; Tran, Ben; Bowden, Patrick; Crowe, Jane; Costello, Anthony J

2016-01-01

Conducting regular multidisciplinary team (MDT) meetings requires significant investment of time and finances. It is thus important to assess the empirical benefits of such practice. A systematic review was conducted to evaluate the literature regarding the impact of MDT meetings on patient assessment, management and outcomes in oncology settings. Relevant studies were identified by searching OVID MEDLINE, PsycINFO, and EMBASE databases from 1995 to April 2015, using the keywords: multidisciplinary team meeting* OR multidisciplinary discussion* OR multidisciplinary conference* OR case review meeting* OR multidisciplinary care forum* OR multidisciplinary tumour board* OR case conference* OR case discussion* AND oncology OR cancer. Studies were included if they assessed measurable outcomes, and used a comparison group and/or a pre- and post-test design. Twenty-seven articles met inclusion criteria. There was limited evidence for improved survival outcomes of patients discussed at MDT meetings. Between 4% and 45% of patients discussed at MDT meetings experienced changes in diagnostic reports following the meeting. Patients discussed at MDT meetings were more likely to receive more accurate and complete pre-operative staging, and neo-adjuvant/adjuvant treatment. Quality of studies was affected by selection bias and the use of historical cohorts impacted study quality. MDT meetings impact upon patient assessment and management practices. However, there was little evidence indicating that MDT meetings resulted in improvements in clinical outcomes. Future research should assess the impact of MDT meetings on patient satisfaction and quality of life, as well as, rates of cross-referral between disciplines. Copyright © 2015 Elsevier Ltd. All rights reserved.

A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management

Directory of Open Access Journals (Sweden)

Birkholz Torsten

2010-01-01

Full Text Available A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.

Learning Mechanisms in Multidisciplinary Teamwork with Real Customers and Open-Ended Problems

Science.gov (United States)

Heikkinen, Juho; Isomöttönen, Ville

2015-01-01

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…

A systematic analysis of the XMM-Newton background: III. Impact of the magnetospheric environment

Science.gov (United States)

Ghizzardi, Simona; Marelli, Martino; Salvetti, David; Gastaldello, Fabio; Molendi, Silvano; De Luca, Andrea; Moretti, Alberto; Rossetti, Mariachiara; Tiengo, Andrea

2017-12-01

A detailed characterization of the particle induced background is fundamental for many of the scientific objectives of the Athena X-ray telescope, thus an adequate knowledge of the background that will be encountered by Athena is desirable. Current X-ray telescopes have shown that the intensity of the particle induced background can be highly variable. Different regions of the magnetosphere can have very different environmental conditions, which can, in principle, differently affect the particle induced background detected by the instruments. We present results concerning the influence of the magnetospheric environment on the background detected by EPIC instrument onboard XMM-Newton through the estimate of the variation of the in-Field-of-View background excess along the XMM-Newton orbit. An important contribution to the XMM background, which may affect the Athena background as well, comes from soft proton flares. Along with the flaring component a low-intensity component is also present. We find that both show modest variations in the different magnetozones and that the soft proton component shows a strong trend with the distance from Earth.

A Day at the Beach: A Multidisciplinary Business Law Case Study

Science.gov (United States)

Rymsza, Leonard; Saunders, Kurt; Baum, Paul; Tontz, Richard

2010-01-01

This case study, written for use in a multidisciplinary course, exposes students to concepts in business law, economics, and statistics. The case is based upon a hypothetical scenario involving a young woman who, having spent a relaxing day at the beach, heads for home. On the drive home, a flip-flop she is wearing becomes lodged under the gas…

Ergonomics at Volkswagen Brasil. Multidisciplinary work to equalize health, productivity and quality.

Science.gov (United States)

Filus, Rodrigo; Wruca, Rodrigo; Charleaux, Vanessa; Ortega, Auro; Ferreira, Claudio; Jesus, Leandro; Stramari, Anderson; Neufel, Michel; Maia, Uyara

2012-01-01

Following the technological developments and presented to the multidisciplinary processes as automakers, Volkswagen Brazil, represented by its ergonomists, through this paper, shows the importance of ergonomic efficiency of management applied to various levels of life of a product, since its creation to its final implementation on production lines.The preventive work of ergonomists during the processes leading to production of a vehicle is accomplished through assessments on a simulated system called the Digital Factory. Since the initial stages to final product delivery there is a need for a multidisciplinary aligning the concepts of ergonomics, productivity and quality of product. Industrial Engineering, Process Engineering, ergonomists and workers are involved in the analysis made through the Workshop's showing the importance of discussion between the various users of the systems. The processes of series are also equipped with a set of certifications flow of job and planned audits on items that describe processes and applied ergonomics.

Cosmic Infrared Background Fluctuations and Zodiacal Light

Science.gov (United States)

Arendt, Richard G.; Kashlinsky, A.; Moseley, S. H.; Mather, J.

2016-06-01

We performed a specific observational test to measure the effect that the zodiacal light can have on measurements of the spatial fluctuations of the near-IR background. Previous estimates of possible fluctuations caused by zodiacal light have often been extrapolated from observations of the thermal emission at longer wavelengths and low angular resolution or from IRAC observations of high-latitude fields where zodiacal light is faint and not strongly varying with time. The new observations analyzed here target the COSMOS field at low ecliptic latitude where the zodiacal light intensity varies by factors of ˜2 over the range of solar elongations at which the field can be observed. We find that the white-noise component of the spatial power spectrum of the background is correlated with the modeled zodiacal light intensity. Roughly half of the measured white noise is correlated with the zodiacal light, but a more detailed interpretation of the white noise is hampered by systematic uncertainties that are evident in the zodiacal light model. At large angular scales (≳100″) where excess power above the white noise is observed, we find no correlation of the power with the modeled intensity of the zodiacal light. This test clearly indicates that the large-scale power in the infrared background is not being caused by the zodiacal light.

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 ...

Team players against headache: multidisciplinary treatment of primary headaches and medication overuse headache

NARCIS (Netherlands)

Gaul, C.; Visscher, C.M.; Bhola, R.; Sorbi, M.J.; Galli, F.; Rasmussen, A.V.; Jensen, R.

2011-01-01

Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform for

DoReMi workshop on multidisciplinary approaches to evaluating cancer risks associated with low-dose internal contamination

International Nuclear Information System (INIS)

Laurier, D.; Guseva Canu, I.; Bertho, J.M.; Blanchardon, E.; Rage, E.; Baatout, S.; Bouffler, S.; Cardis, E.; Gomolka, M.; Kreuzer, M.; Hall, J.; Kesminiene, A.

2012-01-01

A workshop dedicated to cancer risks associated with low-dose internal contamination was organised in March 2011, in Paris, in the framework of the DoReMi (Low Dose Research towards Multidisciplinary Integration) European Network of Excellence. The aim was to identify the best epidemiological studies that provide an opportunity to develop a multidisciplinary approach to improve the evaluation of the cancer risk associated with internal contamination. This workshop provided an opportunity for in-depth discussions between researchers working in different fields including (but not limited to) epidemiology, dosimetry, biology and toxicology. Discussions confirmed the importance of research on the health effects of internal contamination. Several existing epidemiological studies provide a real possibility to improve the quantification of cancer risk associated with internal emitters. Areas for future multidisciplinary collaborations were identified, that should allow feasibility studies to be carried out in the near future. The goal of this paper is to present an overview of the presentations and discussions that took place during this workshop. (authors)

Dark energy and the cosmic microwave background radiation

Science.gov (United States)

Dodelson, S.; Knox, L.

2000-01-01

We find that current cosmic microwave background anisotropy data strongly constrain the mean spatial curvature of the Universe to be near zero, or, equivalently, the total energy density to be near critical-as predicted by inflation. This result is robust to editing of data sets, and variation of other cosmological parameters (totaling seven, including a cosmological constant). Other lines of argument indicate that the energy density of nonrelativistic matter is much less than critical. Together, these results are evidence, independent of supernovae data, for dark energy in the Universe.

Airfoil flow instabilities induced by background flow oscillations

Energy Technology Data Exchange (ETDEWEB)

Selerowicz, W.C.; Szumowski, A.P. [Technical Univ. Warsaw (Poland)

2002-04-01

The effect of background flow oscillations on transonic airfoil (NACA 0012) flow was investigated experimentally. The oscillations were generated by means of a rotating plate placed downstream of the airfoil. Owing to oscillating chocking of the flow caused by the plate, the airfoil flow periodically accelerated and decelerated. This led to strong variations in the surface pressure and the airfoil loading. The results are presented for two angles of attack, {alpha}=4 and {alpha}=8.5 , which correspond to the attached and separated steady airfoil flows, respectively. (orig.)