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Sample records for multidisciplinary public approach

  1. Halitosis: the multidisciplinary approach

    PubMed Central

    Bollen, Curd ML; Beikler, Thomas

    2012-01-01

    Halitosis, bad breath or oral malodour are all synonyms for the same pathology. Halitosis has a large social and economic impact. For the majority of patients suffering from bad breath, it causes embarrassment and affects their social communication and life. Moreover, halitosis can be indicative of underlying diseases. Only a limited number of scientific publications were presented in this field until 1995. Ever since, a large amount of research is published, often with lack of evidence. In general, intraoral conditions, like insufficient dental hygiene, periodontitis or tongue coating are considered to be the most important cause (85%) for halitosis. Therefore, dentists and periodontologists are the first-line professionals to be confronted with this problem. They should be well aware of the origin, the detection and especially of the treatment of this pathology. In addition, ear–nose–throat-associated (10%) or gastrointestinal/endocrinological (5%) disorders may contribute to the problem. In the case of halitophobia, psychiatrical or psychological problems may be present. Bad breath needs a multidisciplinary team approach: dentists, periodontologists, specialists in family medicine, ear–nose–throat surgeons, internal medicine and psychiatry need to be updated in this field, which still is surrounded by a large taboo. Multidisciplinary bad breath clinics offer the best environment to examine and treat this pathology that affects around 25% of the whole population. This article describes the origin, detection and treatment of halitosis, regarded from the different etiological origins. PMID:22722640

  2. Breakfast: a multidisciplinary approach

    PubMed Central

    2013-01-01

    Background The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. Discussion Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. Summary The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being. PMID:23842429

  3. [Anorexia nervosa: a multidisciplinary approach].

    PubMed

    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. PMID:10983149

  4. Multidisciplinary approaches to solar hydrogen

    PubMed Central

    Bren, Kara L.

    2015-01-01

    This review summarizes three different approaches to engineering systems for the solar-driven evolution of hydrogen fuel from water: molecular, nanomaterials and biomolecular. Molecular systems have the advantage of being highly amenable to modification and detailed study and have provided great insight into photophysics, electron transfer and catalytic mechanism. However, they tend to display poor stability. Systems based on nanomaterials are more robust but also are more difficult to synthesize in a controlled manner and to modify and study in detail. Biomolecular systems share many properties with molecular systems and have the advantage of displaying inherently high efficiencies for light absorption, electron–hole separation and catalysis. However, biological systems must be engineered to couple modules that capture and convert solar photons to modules that produce hydrogen fuel. Furthermore, biological systems are prone to degradation when employed in vitro. Advances that use combinations of these three tactics also are described. Multidisciplinary approaches to this problem allow scientists to take advantage of the best features of biological, molecular and nanomaterials systems provided that the components can be coupled for efficient function. PMID:26052425

  5. Multidisciplinary approaches to solar hydrogen.

    PubMed

    Bren, Kara L

    2015-06-01

    This review summarizes three different approaches to engineering systems for the solar-driven evolution of hydrogen fuel from water: molecular, nanomaterials and biomolecular. Molecular systems have the advantage of being highly amenable to modification and detailed study and have provided great insight into photophysics, electron transfer and catalytic mechanism. However, they tend to display poor stability. Systems based on nanomaterials are more robust but also are more difficult to synthesize in a controlled manner and to modify and study in detail. Biomolecular systems share many properties with molecular systems and have the advantage of displaying inherently high efficiencies for light absorption, electron-hole separation and catalysis. However, biological systems must be engineered to couple modules that capture and convert solar photons to modules that produce hydrogen fuel. Furthermore, biological systems are prone to degradation when employed in vitro. Advances that use combinations of these three tactics also are described. Multidisciplinary approaches to this problem allow scientists to take advantage of the best features of biological, molecular and nanomaterials systems provided that the components can be coupled for efficient function. PMID:26052425

  6. [Multidisciplinary approach to postpartum depression].

    PubMed

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

    2008-06-01

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

  7. Multidisciplinary Approach to Linear Aerospike Nozzle Optimization

    NASA Technical Reports Server (NTRS)

    Korte, J. J.; Salas, A. O.; Dunn, H. J.; Alexandrov, N. M.; Follett, W. W.; Orient, G. E.; Hadid, A. H.

    1997-01-01

    A model of a linear aerospike rocket nozzle that consists of coupled aerodynamic and structural analyses has been developed. A nonlinear computational fluid dynamics code is used to calculate the aerodynamic thrust, and a three-dimensional fink-element model is used to determine the structural response and weight. The model will be used to demonstrate multidisciplinary design optimization (MDO) capabilities for relevant engine concepts, assess performance of various MDO approaches, and provide a guide for future application development. In this study, the MDO problem is formulated using the multidisciplinary feasible (MDF) strategy. The results for the MDF formulation are presented with comparisons against sequential aerodynamic and structural optimized designs. Significant improvements are demonstrated by using a multidisciplinary approach in comparison with the single- discipline design strategy.

  8. Multidisciplinary Approach to Aerospike Nozzle Design

    NASA Technical Reports Server (NTRS)

    Korte, J. J.; Salas, A. O.; Dunn, H. J.; Alexandrov, N. M.; Follett, W. W.; Orient, G. E.; Hadid, A. H.

    1997-01-01

    A model of a linear aerospike rocket nozzle that consists of coupled aerodynamic and structural analyses has been developed. A nonlinear computational fluid dynamics code is used to calculate the aerodynamic thrust, and a three-dimensional finite-element model is used to determine the structural response and weight. The model will be used to demonstrate multidisciplinary design optimization (MDO) capabilities for relevant engine concepts, assess performance of various MDO approaches, and provide a guide for future application development. In this study, the MDO problem is formulated using the multidisciplinary feasible (MDF) strategy. The results for the MDF formulation are presented with comparisons against separate aerodynamic and structural optimized designs. Significant improvements are demonstrated by using a multidisciplinary approach in comparison with the single-discipline design strategy.

  9. Placenta accreta and anesthesia: A multidisciplinary approach

    PubMed Central

    Khokhar, RS; Baaj, J; Khan, MU; Dammas, FA; Rashid, N

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome. PMID:27375391

  10. Multidisciplinary Approaches in Evolutionary Linguistics

    ERIC Educational Resources Information Center

    Gong, Tao; Shuai, Lan; Wu, Yicheng

    2013-01-01

    Studying language evolution has become resurgent in modern scientific research. In this revival field, approaches from a number of disciplines other than linguistics, including (paleo)anthropology and archaeology, animal behaviors, genetics, neuroscience, computer simulation, and psychological experimentation, have been adopted, and a wide scope…

  11. [Tooth erosion - a multidisciplinary approach].

    PubMed

    Strużycka, Izabela; Rusyan, Ewa; Bogusławska-Kapała, Agnieszka

    2016-02-01

    During the last decades, an increasingly greater interest in dental erosion has been observed in clinical dental practice, in dental public health and in dental research because prevalence of erosive tooth wear is still increasing especially in young age group of population. Erosive tooth wear is a multifactorial etiology process characterized by progressive loss of hard dental tissue. It is defined as the exogenous and/or endogenous acids dissolution of the dental tissue, without bacterial involvement. In the development of dental erosive wear, interactions are required which include chemical, biological, behavioral, diet, time, socioeconomic, knowledge, education, and general health factors. Examples of risk groups could be patients with eating disorders, like anorexia nervosa or bulimia nervosa, gastroesophageal reflux disease, chronic alcohol abuse or dependence. Special nutrition habits groups with high consumption of soft or sport drinks, special diets like vegetarian, vegan or raw food diet, the regular intake of drugs, medications and food supplements can also increase the risk for dental erosion. Comprehensive knowledge of the different risk and protective factors is a perquisite for initiating adequate preventive measures. PMID:27000809

  12. Multidisciplinary approaches to climate change questions

    USGS Publications Warehouse

    Middleton, Beth 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.

  13. A Multidisciplinary Approach to Sustainable Management of Watershed Resources

    EPA Science Inventory

    The lack of integration in the study and management of water resource problems suggests the need for a multidisciplinary approach. As practiced in the Shepherd Creek stormwater management study (Cincinnati OH), we envision a multidisciplinary approach involving economic incentive...

  14. A Unified Approach to Modeling Multidisciplinary Interactions

    NASA Technical Reports Server (NTRS)

    Samareh, Jamshid A.; Bhatia, Kumar G.

    2000-01-01

    There are a number of existing methods to transfer information among various disciplines. For a multidisciplinary application with n disciplines, the traditional methods may be required to model (n(exp 2) - n) interactions. This paper presents a unified three-dimensional approach that reduces the number of interactions from (n(exp 2) - n) to 2n by using a computer-aided design model. The proposed modeling approach unifies the interactions among various disciplines. The approach is independent of specific discipline implementation, and a number of existing methods can be reformulated in the context of the proposed unified approach. This paper provides an overview of the proposed unified approach and reformulations for two existing methods. The unified approach is specially tailored for application environments where the geometry is created and managed through a computer-aided design system. Results are presented for a blended-wing body and a high-speed civil transport.

  15. Dynamically Reconfigurable Approach to Multidisciplinary Problems

    NASA Technical Reports Server (NTRS)

    Alexandrov, Natalie M.; Lewis, Robert Michael

    2003-01-01

    The complexity and autonomy of the constituent disciplines and the diversity of the disciplinary data formats make the task of integrating simulations into a multidisciplinary design optimization problem extremely time-consuming and difficult. We propose a dynamically reconfigurable approach to MDO problem formulation wherein an appropriate implementation of the disciplinary information results in basic computational components that can be combined into different MDO problem formulations and solution algorithms, including hybrid strategies, with relative ease. The ability to re-use the computational components is due to the special structure of the MDO problem. We believe that this structure can and should be used to formulate and solve optimization problems in the multidisciplinary context. The present work identifies the basic computational components in several MDO problem formulations and examines the dynamically reconfigurable approach in the context of a popular class of optimization methods. We show that if the disciplinary sensitivity information is implemented in a modular fashion, the transfer of sensitivity information among the formulations under study is straightforward. This enables not only experimentation with a variety of problem formations in a research environment, but also the flexible use of formulations in a production design environment.

  16. A multidisciplinary approach for improving outcomes.

    PubMed

    Sierchio, Grace P

    2003-01-01

    The healthcare environment has been impacted tremendously by higher patient acuity, cost-cutting measures, an increase in litigation, and increased expectations by an educated generation of healthcare consumers. This has led to the need to continually measure, assess, and improve quality. These activities must consider not only patient clinical outcomes, but also customer service ratings and financial outcomes. Quality improvement requires a collaborative approach to succeed, and the need to build a cohesive and effective multidisciplinary team is critical for positive outcomes. Strategies to build a culture of teamwork include incorporating total quality management principles into every level of the organization, seeking participation from every discipline and level of the organization, and recognizing employees for their efforts. Infusion nurses have an excellent opportunity to contribute their expertise to any multidisciplinary team that impacts the outcomes of infusion patients. In addition, team-building and quality improvement may prove to be excellent career moves for infusion nurses looking to further specialize their practice. PMID:12544365

  17. Multidisciplinary approaches to the pressure ulcer problem.

    PubMed

    Bogie, Kath M; Ho, Chester H

    2007-10-01

    Multiple factors affect the specific condition and overall clinical profile of individuals at risk for chronic wounds. The complexity of the pressure ulcer problem lends itself to the application of the National Institute of Health Roadmap Initiative that encourages interdisciplinary research and new organizational models. An overview of research studies relevant to telemedicine and neuromuscular electrical stimulation in the care and prevention of pressure ulcers as well as preliminary results of an innovative multidisciplinary skin care team approach to the primary and tertiary prevention of pressure ulcers are encouraging. The team's pilot study results indicate that patients are satisfied with telehealth provision of care; however, literature and experience also suggest that discrepancies in the inter-rater assessment of wounds using digital photography remain, particularly with regard to wound dimension variables assessed (P<0.01). In another endeavor, the skin care team developed a Longitudinal Analysis with Self-Registration statistical algorithm to assess the effects of electrical stimulation; in a preliminary study, this tool documented improvement in gluteus maximus health and resultant ability to withstand pressure. As the number of groups pursuing multidisciplinary research and care increases, so, too, will the evidence base required to address these common, and complex, chronic wounds. PMID:17978412

  18. Multidisciplinary approach in natural hazards: avoiding misunderstandings

    NASA Astrophysics Data System (ADS)

    Angignard, M.

    2009-04-01

    It is today widely recognised that a multidisciplinary approach is worthwhile when it comes to natural hazards. While the knowledge of scientists from different fields about those problematic is getting deeper everyday, the need for a brighter understanding of natural hazards and the risk they induce becomes more and more obvious. A risk situation cannot be limited to a single scientific field. It involves many components, each of them studied by a specific science. The understanding of the whole question of risk requires a dialogue between those sciences. The large amount of research projects based on a multidisciplinary approach shows that this need for dialogue is known and accepted. However, the participants of such projects encounter a problem in communication: they do not speak the same language. Even though scientists are willing to share with colleagues from other fields, they are facing the hinder of the specific terminology they use in their work. Social scientists, natural scientists and engineering scientists do not speak the same language, although they might use the same words. For instance, basic terms like "risk", "vulnerability", or concepts like "risk management" or "governance" might have very different meanings according to the scientists involved. The approach of risk situation itself is specific to each science. How can this hindrance be avoided? The first step of every research project (and further, every work in group on a risk related situation) could be a framing about terminology. It is necessary that all partners acknowledge the different vocabularies involved, and understand that their background and professional context influences their understanding of terms and concepts. The aim is not to negate those vocabularies, nor to define a new one that would fit to all sciences. It is to ensure that all partners are aware of the possible misunderstandings and accept that others might use other terminologies. Thus, major misunderstandings

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

    PubMed

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

    Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life. PMID:25796677

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

    PubMed

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

    2016-09-01

    After explaining that low back pain is considered the most common pregnancy complication, its pathogenesis, risk factors and the clinical characteristics of the very painful symptoms of this condition are described. As for its approach, it is stressed that it must be multidisciplinary, introducing very important preventive measures, including proper postural hygiene. For its treatment, the methods may be based on non-surgical or pharmacological interventions of a conservative non-invasive nature. Thus, physiotherapy, osteopathic manipulation, multimodal intervention (exercise and education), exercises performed in water environment, acupuncture, etc., have proven to be effective. Finally, it is emphasised that given the significant impact on their quality of life, different health professionals must be proactive and treat the lumbar disease in pregnant women. PMID:26239672

  1. Pemphigus vulgaris: a multidisciplinary approach to management.

    PubMed

    Vinall, Christopher; Stevens, Lucy; McArdle, Paul

    2013-01-01

    Pemphigus vulgaris (PV) is a rare but potentially life-threatening autoimmune disease affecting the mucosa and the skin. The disease is caused by circulating antibodies to desmosomes (important adhesion proteins linking cells together). Disruption of these intercellular connections results in a loss of cohesion between cells (acantholysis). The clinical result of this process is the development of multiple blisters that easily rupture, leaving behind painful sloughing eroded areas of mucosa and/or skin. We report a case of severe PV in a 56-year-old man presenting with widespread, painful, eroded mucocutaneous lesions. The severity of the disease demanded a range of medical and surgical specialties to successfully manage the problem. This paper highlights the importance of an early multidisciplinary team approach to improve the outcome of patients suffering with this disease. PMID:24343801

  2. Pediatric pain management: the multidisciplinary approach

    PubMed Central

    Odell, Shannon; Logan, Deirdre E

    2013-01-01

    Chronic pain in children and adolescents is a growing problem and one that is increasingly being addressed with multidisciplinary treatment teams. This review summarizes different multidisciplinary clinics, focusing specifically on intensive pediatric pain rehabilitation centers. This review offers a summary of the challenges faced by these programs and areas for future study. PMID:24250232

  3. Arthrogryposis in infancy, multidisciplinary approach: case report

    PubMed Central

    2013-01-01

    Background Arthrogryposis multiplex congenita is an etiopathogenetically heterogeneous disorder characterised by non-progressive multiple intra-articular contractures, which can be recognised at birth. The frequency is estimated at 1 in 3,000 newborns. Etiopathogenesis of arthrogryposis is multifactorial. Case presentation We report first 26 weeks of life of a boy with severe arthrogryposis. Owing to the integrated rehabilitation approach and orthopaedic treatment a visible improvement in the range of motion as well as the functionality of the child was achieved. This article proposes a cooperation of various specialists: paediatrician, orthopaedist, specialist of medical rehabilitation and physiotherapist. Conclusions Rehabilitation of a child with arthrogryposis should be early, comprehensive and multidisciplinary. Corrective treatment of knee and hip joints in infants with arthrogryposis should be preceded by the ultrasound control. There are no reports in the literature on the ultrasound imaging techniques which can be used prior to the planned orthopaedic and rehabilitative treatment in infants with arthrogryposis. The experience of our team indicates that such an approach allows to minimise the diagnostic errors and to maintain an effective treatment without the risk of joint destabilisation. PMID:24215600

  4. Hormonal Contraception and Thrombotic Risk: A Multidisciplinary Approach

    PubMed Central

    Chung, Richard J.; Michelson, Alan D.; Neufeld, Ellis J.; Gordon, Catherine M.; Laufer, Marc R.; Emans, S. Jean

    2011-01-01

    Heightened publicity about hormonal contraception and thrombosis risk and the publication of new guidelines by the World Health Organization in 2009 and the Centers for Disease Control and Prevention in 2010 addressing this complex issue have led to multidisciplinary discussions on the special issues of adolescents cared for at our pediatric hospital. In this review of the literature and new guidelines, we have outlined our approach to the complex patients referred to our center. The relative risk of thrombosis on combined oral contraception is three- to fivefold, whereas the absolute risk for a healthy adolescent on this therapy is only 0.05% per year. This thrombotic risk is affected by estrogen dose, type of progestin, mechanism of delivery, and length of therapy. Oral progestin-only contraceptives and transdermal estradiol used for hormone replacement carry minimal or no thrombotic risk. Transdermal, vaginal, or intrauterine contraceptives and injectable progestins need further study. A personal history of thrombosis, persistent or inherited thrombophilia, and numerous lifestyle choices also influence thrombotic risk. In this summary of one hospital's approach to hormone therapies and thrombosis risk, we review relative-risk data and discuss the application of absolute risk to individual patient counseling. We outline our approach to challenging patients with a history of thrombosis, known thrombophilia, current anticoagulation, or family history of thrombosis or thrombophilia. Our multidisciplinary group has found that knowledge of the guidelines and individualized management plans have been particularly useful for informing discussions about hormonal and nonhormonal options across varied indications. PMID:21199853

  5. An Overview of Three Approaches to Multidisciplinary Aeropropulsion Simulations

    NASA Technical Reports Server (NTRS)

    Lawrence, Charles

    1997-01-01

    The broad scope of aeropropulsion multidisciplinary applications necessitates that a collection of approaches, with distinct capabilities, be developed. Three general approaches to multidisciplinary simulations have been identified. The three approaches; loosely coupled, coupled process, and multiphysics, provide a comprehensive collection of capabilities for multidisciplinary aeropropulsion analysis. At the data access level, or loosely coupled approach of coupling, existing disciplinary simulations are run, data is generated, and made available and used for subsequent analysis. The data must be in the correct format for implementation by the subsequent analysis but the subsequent code need not directly communicate with the previous code. At the process level, or coupled process approach of coupling, individual disciplinary codes are used, similarly to the loosely coupled approach, however, in the coupled process approach the disciplinary codes need to run concurrently with each other. The system of equation coupled approach, or multiphysics approach, addresses those applications whose characteristics require that the disciplines be coupled at the fundamental equation level to accurately, or more efficiently, capture the multidisciplinary physics of the problem. No one of these approaches, by itself, addresses all of the community needs in this area. However, collectively the three approaches encompass all of the multidisciplinary applications which have been identified thus far. Multiple approaches to multidisciplinary simulations will be needed as long as the applications and their requirements remain as diverse as they currently are today.

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

    ERIC Educational Resources Information Center

    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.…

  7. New Approaches to HSCT Multidisciplinary Design and Optimization

    NASA Technical Reports Server (NTRS)

    Schrage, Daniel P.; Craig, James I.; Fulton, Robert E.; Mistree, Farrokh

    1999-01-01

    New approaches to MDO have been developed and demonstrated during this project on a particularly challenging aeronautics problem- HSCT Aeroelastic Wing Design. To tackle this problem required the integration of resources and collaboration from three Georgia Tech laboratories: ASDL, SDL, and PPRL, along with close coordination and participation from industry. Its success can also be contributed to the close interaction and involvement of fellows from the NASA Multidisciplinary Analysis and Optimization (MAO) program, which was going on in parallel, and provided additional resources to work the very complex, multidisciplinary problem, along with the methods being developed. The development of the Integrated Design Engineering Simulator (IDES) and its initial demonstration is a necessary first step in transitioning the methods and tools developed to larger industrial sized problems of interest. It also provides a framework for the implementation and demonstration of the methodology. Attachment: Appendix A - List of publications. Appendix B - Year 1 report. Appendix C - Year 2 report. Appendix D - Year 3 report. Appendix E - accompanying CDROM.

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

    NASA Technical Reports Server (NTRS)

    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.

  9. A Multidisciplinary Approach to Improving SCIP Compliance.

    PubMed

    Huntington, Ciara R; Strayer, Melissa; Huynh, Toan; Green, John M

    2015-07-01

    The Surgical Care Improvement Project (SCIP) is a national program aimed at reducing perioperative complications and is a quality benchmark metric for Centers for Medicare and Medicaid Services. This study evaluates whether a multidisciplinary program improved an institution's compliance with SCIP measures. Analysis of the facility's performance data identified three key areas of SCIP noncompliance: 1) timely discontinuation of perioperative antibiotics and urinary catheters, 2) initiation of venous thromboembolism prophylaxis, and 3) perioperative beta blocker administration. Multidisciplinary teams collaborated with providers and department chairs in reviewing and enable SCIP compliance. Anesthesia staff managed preoperative antibiotics. SCIP-compliant order sets, venous thromboembolism pop-up alerts, and progress note templates were added to the electronic medical record. Standardized education was provided to explain SCIP requirements, review noncompliant cases, and update teams on SCIP performance. Data were captured from January 2009 to March 2014. Ten SCIP fallouts were reported for general surgery specialties in January 2013, when the SCIP compliance project launched. Specifically, colon-related surgery achieved 100 per cent compliance. Six months after implementation, overall SCIP compliance at our institution improved by 65 per cent (from 90.7-98.6% compliance). PMID:26140888

  10. The Multifile Multidisciplinary (Horizontal) Search Approach--Justification and Principles.

    ERIC Educational Resources Information Center

    Bar, Jacob

    1988-01-01

    Discusses the rationale, principles, required tools, advantages, and disadvantages of the Multifile Multidisciplinary (Horizontal) Search approach to searching online databases. It is noted that this approach is characterized by the use of a large number of files spanning a wide variety of disciplines. (12 references) (MES)

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

    ERIC Educational Resources Information Center

    Burke, Anne; Peterson, Shelley Stagg

    2007-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

    implement the proposed approach. The communication data structure required for the proposed approach will be studied in detail. This work will demonstrate the feasibility of using multi-level parallelization approach in multidisciplinary analysis applications.

  13. Determinants of Food Safety Risks: A Multi-disciplinary Approach

    ERIC Educational Resources Information Center

    Knight, Andrew; Warland, Rex

    2005-01-01

    This research employs a multi-disciplinary approach by developing a model that draws upon psychometric, cultural, and reflexive modernization perspectives of risk perception. Using data from a 1999 national telephone survey, we tested our model on three food risks ? pesticides, Salmonella, and fat. Results showed that perceptions of risks do vary…

  14. Teaching the Multidisciplinary Team Approach in a Geriatrics Miniresidency.

    ERIC Educational Resources Information Center

    Jackson, J. Edward; And Others

    1990-01-01

    A description is provided of the miniresidency program in geriatrics at the University of California, San Diego, School of Medicine which focuses on the multidisciplinary approach to the care of geriatric patients. Observations are given as to the program's effectiveness. (GLR)

  15. [A multidisciplinary approach to cardiac rehabilitation].

    PubMed

    Barbet, Régis; Caux, Christelle; Brysse, Lydie; Foy, Mireille; Cardon, Cindy

    2015-03-01

    The rehabilitation of a coronary patient involves numerous professionals in a global care approach. The objective is to reintroduce physical activity and put in place lifestyle changes, in order to reduce the risk factors. Therapeutic education is an essential part of this support. PMID:26040143

  16. Multidisciplinary Approach to the Management of Myopathies

    PubMed Central

    M. King, Wendy; Kissel, John T.

    2013-01-01

    Purpose of Review Aside from some inflammatory myopathies and very few genetic disorders, there are no therapies that make most patients with myopathies stronger. Consequently, the management of these patients can be frustrating for patients and their families as well as the clinicians taking care of them. Treatment of these patients must involve a comprehensive approach focused on limiting the secondary effects of skeletal muscle weakness, managing comorbidities associated with specific diseases, and, most importantly, optimizing patients’ functional abilities and quality of life in terms of their ability to accomplish activities of daily living. While the approach to each patient differs depending on their disease, certain common themes can be addressed in each patient. This review highlights an approach centered on four conceptual themes (“the Four S’s”): Strength therapies, Supportive care, Symptomatic therapies, and pSychological support. Recent Findings Although relatively few well-designed studies have been done that highlight conservative management of patients with various myopathies, an emerging literature helps guide the clinician in certain key areas, especially in relation to cardiac and pulmonary management of these patients. Summary While disease-altering therapies have proven elusive for many muscle diseases, a multimodal approach to the conservative and supportive care of these patients can markedly improve their quality of life. Pharmacologic treatment options for specific myopathies will not be addressed in this article but are covered elsewhere in this issue of CONTINUUM. PMID:24305452

  17. Intrauterine baclofen exposure: a multidisciplinary approach.

    PubMed

    Moran, Lisa R; Almeida, Pamela G; Worden, Susan; Huttner, Kenneth M

    2004-08-01

    Maternal use of the antispasmodic baclofen during pregnancy is an uncommon clinical scenario and leads to uncertainty regarding neonatal risks. We present a team-based, peripartum management plan designed for safe monitoring and minimizing the risk of neonatal withdrawal after unusual drug exposure. Incorporating the expertise of neonatology, nursing, pharmacy, neurology, and the lactation service, as well as parental input, this consensus approach was implemented in a case of maternal oral baclofen use with a successful outcome for the infant and family. PMID:15286268

  18. Execution of Multidisciplinary Design Optimization Approaches on Common Test Problems

    NASA Technical Reports Server (NTRS)

    Balling, R. J.; Wilkinson, C. A.

    1997-01-01

    A class of synthetic problems for testing multidisciplinary design optimization (MDO) approaches is presented. These test problems are easy to reproduce because all functions are given as closed-form mathematical expressions. They are constructed in such a way that the optimal value of all variables and the objective is unity. The test problems involve three disciplines and allow the user to specify the number of design variables, state variables, coupling functions, design constraints, controlling design constraints, and the strength of coupling. Several MDO approaches were executed on two sample synthetic test problems. These approaches included single-level optimization approaches, collaborative optimization approaches, and concurrent subspace optimization approaches. Execution results are presented, and the robustness and efficiency of these approaches an evaluated for these sample problems.

  19. [Subarachnoid hemorrhage: epidemiology, social impact and a multidisciplinary approach].

    PubMed

    Ingelmo Ingelmo, I; Fàbregas Julià, N; Rama-Maceiras, P; Hernández-Palazón, J; Rubio Romero, R; Carmona Aurioles, J

    2010-12-01

    Cerebrovascular disease, whether ischemic or hemorrhagic, is a worldwide problem, representing personal tragedy, great social and economic consequences, and a heavy burden on the health care system. Estimated to be responsible for up to 10% of mortality in industrialized countries, cerebrovascular disease also affects individuals who are still in the workforce, with consequent loss of productive years. Subarachnoid hemorrhage (SAH) is a type of cerebrovascular accident that leads to around 5% of all strokes. SAH is most often due to trauma but may also be spontaneous, in which case the cause may be a ruptured intracranial aneurysm (80%) or arteriovenous malformation or any other abnormality of the blood or vessels (20%). Although both the diagnosis and treatment of aneurysmal SAH has improved in recent years, related morbidity and mortality remains high: 50% of patients die from the initial hemorrhage or later complications. If patients whose brain function is permanently damaged are added to the count, the percentage of cases leading to severe consequences rises to 70%. The burden of care of patients who are left incapacitated by SAH falls to the family or to private and public institutions. The economic cost is considerable and the loss of quality of life for both the patient and the family is great. Given the magnitude of this problem, the provision of adequate prophylaxis is essential; also needed are organizational models that aim to reduce mortality as well as related complications. Aneurysmal SAH is a condition which must be approached in a coordinated, multidisciplinary way both during the acute phase and throughout rehabilitation in order to lower the risk of unwanted outcomes. PMID:21298906

  20. Assessing and Evaluating Multidisciplinary Translational Teams: A Mixed Methods Approach

    PubMed Central

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

    2014-01-01

    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. PMID:24064432

  1. The Brokering Approach for Multidisciplinary Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Nativi, Stefano

    2013-04-01

    Global sustainability research requires an integrated multidisciplinary effort underpinned by a collaborative environment discovering and accessing heterogeneous data across disciplines. Traditionally, interoperability has been achieved by implementing federation of systems. The federating approach entails the adoption of a set of common technologies and standards. This presentation argues that for complex (and uncontrolled) environments such as global, multidisciplinary, and voluntary-based infrastructures, federated solutions proved not to be well-accepted. In fact, the adoption of a limited common set of technologies and standards raises a couple of important issues: (a) high level entry barriers for both data producers and users; (b) lack of appropriateness to address domain specificities. More recently, a new interoperability approach was successfully experimented: the brokering approach. This presentation identifies the principles of brokering, and gives examples of practical implementation relating to data discovery, semantic searching, and data access. The benefit of the brokering approach includes: (a) lowers barriers to participation in distributed systems for both users and resource providers (minimal burden or cost impact on existing systems); (b) accelerates interconnection of disparate systems; (c) facilitates sustainability, reusability, extensibility, and flexibility of multidisciplinary infrastructures; (d) removes need to impose common (e.g. federal, "top-down") specifications and software components enabling a more adaptive "bottom-up" evolution of infrastructures. The Brokering approach was considered and successfully adopted by cross-disciplinary initiatives (e.g. GEOSS: Global Earth Observation System of Systems; several European FP7 programmes, NSIDC, etc. ); recently, the NSF EarthCube initiative funded a project dealing with "Data Broker".

  2. The Brokering Approach for Multidisciplinary Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Nativi, S.

    2012-12-01

    Global sustainability research requires an integrated multidisciplinary effort underpinned by a collaborative environment discovering and accessing heterogeneous data across disciplines. Traditionally, interoperability has been achieved by implementing federation of systems. The federating approach entails the adoption of a set of common technologies and standards. This presentation argues that for complex (and uncontrolled) environments such as global, multidisciplinary, and voluntary-based infrastructures, federated solutions proved not to be well-accepted. In fact, the adoption of a limited common set of technologies and standards raises a couple of important issues: (a) high level entry barriers for both data producers and users; (b) lack of appropriateness to address domain specificities. Recently, a new interoperability approach was successfully experimented: the brokering approach. This presentation identifies the principles of brokering, and gives examples of practical implementation relating to data discovery, semantic searching, and data access. The benefit of the brokering approach includes: (a) lowers barriers to participation in distributed systems for both users and resource providers (minimal burden or cost impact on existing systems); (b) accelerates interconnection of disparate systems; (c) facilitates sustainability, reusability, extensibility, and flexibility of multidisciplinary infrastructures; (d) removes need to impose common (e.g. federal, "top-down") specifications and software components enabling a more adaptive "bottom-up" evolution of infrastructures. The Brokering approach was successfully analyzed and used by cross-disciplinary initiatives (e.g. GEOSS: Global Earth Observation System of Systems; several European FP7 programmes, NSIDC, etc. ); recently, the NSF EarthCube initiative funded a project dealing with "Data Broker".

  3. Multidisciplinary approach to tumors of the pancreas and biliary tree.

    PubMed

    Brown, Kimberly M

    2009-02-01

    Tumors of the pancreas and biliary tree remain formidable challenges to patients and clinicians. These tumors elude early detection, rapidly spread locally and systemically, and frequently recur despite apparently complete resection. Cystic tumors of the pancreas, however, may represent a subset of patients who do not uniformly require aggressive resection, and a thoughtful, evidence-based approach to work-up allows for the rational application of surgical therapy. Increasing evidence supports treating patients who have pancreaticobiliary disease in a multidisciplinary setting. PMID:19186234

  4. Theoretical description of teaching-learning processes: a multidisciplinary approach.

    PubMed

    Bordogna, C M; Albano, E V

    2001-09-10

    A multidisciplinary approach based on concepts from sociology, educational psychology, statistical physics, and computational science is developed for the theoretical description of teaching-learning processes that take place in the classroom. The emerging model is consistent with well-established empirical results, such as the higher achievements reached working in collaborative groups and the influence of the structure of the group on the achievements of the individuals. Furthermore, another social learning process that takes place in massive interactions among individuals via the Internet is also investigated. PMID:11531550

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

    PubMed

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

    2011-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  7. An aggressive multidisciplinary approach reduces mortality in rhinocerebral mucormycosis

    PubMed Central

    Palejwala, Sheri K.; Zangeneh, Tirdad T.; Goldstein, Stephen A.; Lemole, G. Michael

    2016-01-01

    Background: Rhinocerebral mucormycosis occurs in immunocompromised hosts with uncontrolled diabetes, solid organ transplants, and hematologic malignancies. Primary disease is in the paranasal sinuses but often progresses intracranially, via direct extension or angioinvasion. Rhinocerebral mucormycosis is rapidly fatal with a mortality rate of 85%, even when maximally treated with surgical debridement, antifungal therapy, and correction of underlying processes. Methods: We performed a retrospective chart review of patients with rhinocerebral mucormycosis from 2011 to 2014. These patients were analyzed for symptoms, surgical and medical management, and outcome. We found four patients who were diagnosed with rhinocerebral mucormycosis. All patients underwent rapid aggressive surgical debridement and were started on antifungal therapy on the day of diagnosis. Overall, we observed a mortality rate of 50%. Results: An early aggressive multidisciplinary approach with surgical debridement, antifungal therapy, and correction of underlying disease have been shown to improve survivability in rhinocerebral mucormycosis. Conclusion: A multidisciplinary approach to rhinocerebral mucormycosis with otolaryngology, neurosurgery, and ophthalmology, infectious disease and medical intensivists can help reduce mortality in an otherwise largely fatal disease. Even despite these measures, outcomes remain poor, and a high index of suspicion must be maintained in at-risk populations, in order to rapidly execute a multifaceted approach. PMID:27280057

  8. Landslide risk analysis: a multi-disciplinary methodological approach

    NASA Astrophysics Data System (ADS)

    Sterlacchini, S.; Frigerio, S.; Giacomelli, P.; Brambilla, M.

    2007-11-01

    from 2 840 000 to 9 350 000 €, depending on the selected temporal scenario and the expected closing time of the potentially affected structures. The multi-disciplinary approach discussed in this study may assist local decision makers in determining the nature and magnitude of the expected losses due to a dangerous event, which can be anticipated in a given study area, during a specified time period. Besides, a preventive knowledge of the prospective physical effects and economic consequences may help local decision makers to choose the best prevention and mitigation options and to decide how to allocate resources properly, so that potential benefits are maximised at an acceptable cost.

  9. Menkes disease: what a multidisciplinary approach can do

    PubMed Central

    Ojha, Rahul; Prasad, Asuri N

    2016-01-01

    Disorders of copper homeostasis are currently recognized across the life span. Their recognition and links to human disease have spanned several decades, beginning with the recognition of a degenerative disorder in the offspring of sheep grazing in copper-deficient pastures, through to the description of infants suffering from a progressive neurodegenerative disorder characterized by epileptic seizures, developmental regression, failure to thrive, and an unusual hair quality (giving the condition its distinctive label of “kinky hair disease”). In this review, we trace the historical background and describe the biochemistry and physiology of copper metabolism and transport, inheritance patterns, molecular genetics, and genotype–phenotype correlations based on current understanding of the disorder. It is clear from the clinical presentations and variants that disorders of copper homeostasis include phenotypes ranging from mild occipital horn syndrome to intermediate and severe forms of classical Menkes disease. The symptoms involve multiple organ systems such as brain, lung, gastrointestinal tract, urinary tract, connective tissue, and skin. A multisystem disorder needs a multidisciplinary approach to care, as treatment interventions permit longer survival for some individuals. Animal models have been developed to help screen treatment options and provide a better understanding of these disorders in the laboratory. Finally, we propose a multidisciplinary approach to promote continued research (both basic and clinical) to improve survival, quality of life, and care for these conditions. PMID:27574440

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

    PubMed

    Ojha, Rahul; Prasad, Asuri N

    2016-01-01

    Disorders of copper homeostasis are currently recognized across the life span. Their recognition and links to human disease have spanned several decades, beginning with the recognition of a degenerative disorder in the offspring of sheep grazing in copper-deficient pastures, through to the description of infants suffering from a progressive neurodegenerative disorder characterized by epileptic seizures, developmental regression, failure to thrive, and an unusual hair quality (giving the condition its distinctive label of "kinky hair disease"). In this review, we trace the historical background and describe the biochemistry and physiology of copper metabolism and transport, inheritance patterns, molecular genetics, and genotype-phenotype correlations based on current understanding of the disorder. It is clear from the clinical presentations and variants that disorders of copper homeostasis include phenotypes ranging from mild occipital horn syndrome to intermediate and severe forms of classical Menkes disease. The symptoms involve multiple organ systems such as brain, lung, gastrointestinal tract, urinary tract, connective tissue, and skin. A multisystem disorder needs a multidisciplinary approach to care, as treatment interventions permit longer survival for some individuals. Animal models have been developed to help screen treatment options and provide a better understanding of these disorders in the laboratory. Finally, we propose a multidisciplinary approach to promote continued research (both basic and clinical) to improve survival, quality of life, and care for these conditions. PMID:27574440

  11. Surgical therapy in transsexual patients: a multi-disciplinary approach.

    PubMed

    Monstrey, S; Hoebeke, P; Dhont, M; De Cuypere, G; Rubens, R; Moerman, M; Hamdi, M; Van Landuyt, K; Blondeel, P

    2001-01-01

    A transsexual patient has the constant and persistent conviction that he or she belongs to the opposite sex, thus creating a deeply seated gender identity conflict. With psychotherapy being unsuccessful, it has been proven that in carefully selected patients, gender reassignment or adjusting the body to the mind (both with hormones and surgery) is the best way to normalize their lives. Optimal treatment of these patients requires the multidisciplinary approach of a gender team with the input of several specialties. Such a team consists of a nucleus of physicians who sees the patient more frequently: the psychiatrist, the endocrinologist, the plastic surgeon, the gynecologist and the urologist and a more peripheral group that sees the patients more incidentally: the psychologist, the otorhinolaryngologist, the dermatologist, the speech therapist, the lawyer, the nurse and the social worker. Between 1987 and 1999, a total of 71 male-to-female (MTF) and 54 female-to-male transsexuals have undergone gender confirming surgery in our hospital. This article gives a review and an update on the different surgical procedures as well as on the outcome in our patient population. The results in this series of patients clearly demonstrate that a close cooperation of the different surgical specialties, within our multidisciplinary gender team, is the key to success in treating transsexual patients. PMID:11758101

  12. A Multidisciplinary Approach to Mixer-Ejector Analysis and Design

    NASA Technical Reports Server (NTRS)

    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.

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

    PubMed

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

    2006-04-01

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

  14. Revisiting cardiovascular calcification: A multifaceted disease requiring a multidisciplinary approach.

    PubMed

    Hutcheson, Joshua D; Goettsch, Claudia; Rogers, Maximillian A; Aikawa, Elena

    2015-10-01

    The presence of cardiovascular calcification significantly predicts patients' morbidity and mortality. Calcific mineral deposition within the soft cardiovascular tissues disrupts the normal biomechanical function of these tissues, leading to complications such as heart failure, myocardial infarction, and stroke. The realization that calcification results from active cellular processes offers hope that therapeutic intervention may prevent or reverse the disease. To this point, however, no clinically viable therapies have emerged. This may be due to the lack of certainty that remains in the mechanisms by which mineral is deposited in cardiovascular tissues. Gaining new insight into this process requires a multidisciplinary approach. The pathological changes in cell phenotype that lead to the physicochemical deposition of mineral and the resultant effects on tissue biomechanics must all be considered when designing strategies to treat cardiovascular calcification. In this review, we overview the current cardiovascular calcification paradigm and discuss emerging techniques that are providing new insight into the mechanisms of ectopic calcification. PMID:26358815

  15. Multidisciplinary Approach for Patients Hospitalized With Heart Failure.

    PubMed

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

    2015-10-01

    Acute heart failure describes the rapid deterioration, over minutes, days or hours, of symptoms and signs of heart failure. Its management is an interdisciplinary challenge that requires the cooperation of various specialists. While emergency providers, (interventional) cardiologists, heart surgeons, and intensive care specialists collaborate in the initial stabilization of acute heart failure patients, the involvement of nurses, discharge managers, and general practitioners in the heart failure team may facilitate the transition from inpatient care to the outpatient setting and improve acute heart failure readmission rates. This review highlights the importance of a multidisciplinary approach to acute heart failure with particular focus on the chain-of-care delivered by the various services within the healthcare system. PMID:26409892

  16. Clinical features and multidisciplinary approaches to dementia care

    PubMed Central

    Grand, Jacob HG; Caspar, Sienna; MacDonald, Stuart WS

    2011-01-01

    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 pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by

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

    PubMed Central

    Bordoni, Bruno; Marelli, Fabiola; Bordoni, Giovannni

    2016-01-01

    The diaphragm is the primary muscle involved in breathing and other non-primarily respiratory functions such as the maintenance of correct posture and lumbar and sacroiliac movement. It intervenes to facilitate cleaning of the upper airways through coughing, facilitates the evacuation of the intestines, and promotes the redistribution of the body’s blood. The diaphragm also has the ability to affect the perception of pain and the emotional state of the patient, functions that are the subject of this article. The aim of this article is to gather for the first time, within a single text, information on the nonrespiratory functions of the diaphragm muscle and its analgesic and emotional response functions. It also aims to highlight and reflect on the fact that when the diaphragm is treated manually, a daily occurrence for manual operators, it is not just an area of musculature that is treated but the entire body, including the psyche. This reflection allows for a multidisciplinary approach to the diaphragm and the collaboration of various medical and nonmedical practitioners, with the ultimate goal of regaining or improving the patient’s physical and mental well-being. PMID:27013884

  18. Treatment timing and multidisciplinary approach in Apert syndrome

    PubMed Central

    Fadda, Maria Teresa; Ierardo, Gaetano; Ladniak, Barbara; Di Giorgio, Gianni; Caporlingua, Alessandro; Raponi, Ingrid; Silvestri, Alessandro

    2015-01-01

    Summary Apert syndrome is a rare congenital disorder characterized by craniosynostosis, midface hypoplasia and symmetric syndactyly of hands and feet. Abnormalities associated with Apert syndrome include premature fusion of coronal sutures system (coronal sutures and less frequently lambdoid suture) resulting in brachiturricephalic dismorphism and impaired skull base growth. After this brief explanation it is clear that these anatomical abnormalities may have a negative impact on the ability to perform essential functions. Due to the complexity of the syndrome a multidisciplinary (respiratory, cerebral, maxillo-mandibular, dental, ophthalmic and orthopaedic) approach is necessary in treating the psychological, aesthetic and functional issues. The aim of this paper is to analyse the different functional issues and surgical methods trying to enhance results through a treatment plan which includes different specialities involved in Apert syndrome treatment. Reduced intellectual capacity is associated to the high number of general anaesthesia the small patients are subject to. Therefore the diagnostic and therapeutic treatment plan in these patients has established integrated and tailored surgical procedures based on the patients’ age in order to reduce the number of general anaesthesia, thus simplifying therapy for both Apert patients and their family members. PMID:26330906

  19. [Multidisciplinary approach to the treatment of patients with diabetic foot].

    PubMed

    Pityk, O I; Prasol, V O; Boĭko, V V; Babynkin, A B

    2013-12-01

    Diabetic foot (DF) is considered now the main cause of amputations of lower limbs. The analysis of the results of 266 percutaneous endovascular interventions (EV) performed during 2008-2012 in 245 patients with ischemic and neuroishemic DF was carried out. 76% of the patients underwent percutaneous balloon angioplasty (PBA), 24%--PBA + stenting. 91% of EV were technically successful. In 95% of the patients who achieved recovery of the main flow in the occluded arterial segment, clinical improvement was observed in the form of disappearance of the pain and start of the healing of ulcer-necrotic lesions of the foot. The main causes of technical failure (9%) were impossibility to pass through long calcified occlusions of infrainguinal arteries. The complication rate was 10.5%, major amputation--5.2%, mortality--0.8%. Long-term results were shown by the combined rate of amputation-free survival after 1, 3 and 5 years follow-up which made up respectively, 86%, 70% and 43%. EV is an effective treatment for patients with DF and an integrated multidisciplinary approach to achieve high limb salvage rates in the long-term period. PMID:25726682

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

    PubMed

    2016-07-01

    While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem. Providing great care to a victim of elder abuse requires time and setting up a circumstance whereby one can actually communicate with the patient reliably and alone. While most states require providers to report suspected cases of elder abuse to Adult Protective Services, there is little evidence this requirement has incentivized more reports in the same way a similar requirement has prompted providers to report cases of suspected child abuse. Investigators advise ED leaders to train and empower every member of their team to identify potential signs of elder abuse. PMID:27439225

  1. A MULTIDISCIPLINARY APPROACH TO STORMWATER MANAGEMENT AT THE WATERSHED SCALE.

    EPA Science Inventory

    Stormwater runoff from extensive impervious surfaces in urban and suburban areas has led to human safety risks and stream ecosystem impairment, triggering an interest in watershed-scale retrofit stormwater management. Such stormwater management is of multidisciplinary relevance, ...

  2. A MULTIDISCIPLINARY APPROACH TO STORMWATER MANAGEMENT AT THE catchment SCALE

    EPA Science Inventory

    Stormwater runoff from extensive impervious surfaces in urban and suburban areas has led to human safety risks and stream ecosystem impairment, triggering an interest in catchment-scale retrofit stormwater management. Such stormwater management is of multidisciplinary relevance, ...

  3. Philosophizing about Teacher Dissatisfaction: A Multidisciplinary Hermeneutic Approach

    ERIC Educational Resources Information Center

    Santoro, Doris A.

    2015-01-01

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

  4. Diversity in Collaborative Research Communities: A Multicultural, Multidisciplinary Thesis Writing Group in Public Health

    ERIC Educational Resources Information Center

    Guerin, Cally; Xafis, Vicki; Doda, Diana V.; Gillam, Marianne H.; Larg, Allison J.; Luckner, Helene; Jahan, Nasreen; Widayati, Aris; Xu, Chuangzhou

    2013-01-01

    Writing groups for doctoral students are generally agreed to provide valuable learning spaces for Ph.D. candidates. Here an academic developer and the eight members of a writing group formed in a Discipline of Public Health provide an account of their experiences of collaborating in a multicultural, multidisciplinary thesis writing group. We…

  5. Teaching culturally sensitive care to dental students: a multidisciplinary approach.

    PubMed

    Donate-Bartfield, Evelyn; Lobb, William K; Roucka, Toni M

    2014-03-01

    Dental schools must prepare future dentists to deliver culturally sensitive care to diverse patient populations, but there is little agreement on how best to teach these skills to students. This article examines this question by exploring the historical and theoretical foundations of this area of education in dentistry, analyzes what is needed for students to learn to provide culturally sensitive care in a dental setting, and identifies the discipline-specific skills students must master to develop this competence. The problems associated with single-discipline, lecture-based approaches to teaching culturally sensitive care are outlined, and the advantages of an interdisciplinary, patient-centered, skills-based approach to teaching culturally sensitive care are described. The authors advocate for an approach to teaching culturally sensitive care that builds upon learning in the behavioral sciences, ethics, and public health. Component skills and perspectives offered by each of these curriculum areas are identified, and their contributions to the teaching of culturally sensitive care are described. Finally, the need to consider the timing of this instruction in the dental curriculum is examined, along with instructional advantages associated with an approach that is shared by faculty across the curriculum. PMID:24609347

  6. Importance of multidisciplinary approach in diagnosis of histoplasmosis*

    PubMed Central

    de Oliveira, Patricia Botini; de Abreu, Marilda Aparecida Milanez Morgado; Mattos, Antônio Luiz de Arruda

    2016-01-01

    A patient with systemic involvement, initially treated as tuberculosis, is presented in this report. There were only two painful subcutaneous nodules, from which we arrived at the correct diagnosis of histoplasmosis. The patient was attended by several experts in the fields of infectious diseases, nephrology and internal medicine, but the diagnosis was only possible after dermatological examination and skin biopsy. This case values multidisciplinary interaction between dermatologists and other medical areas for diagnosis of cases with atypical manifestations. PMID:27438207

  7. Importance of multidisciplinary approach in diagnosis of histoplasmosis.

    PubMed

    Oliveira, Patricia Botini de; Abreu, Marilda Aparecida Milanez Morgado de; Mattos, Antônio Luiz de Arruda

    2016-01-01

    A patient with systemic involvement, initially treated as tuberculosis, is presented in this report. There were only two painful subcutaneous nodules, from which we arrived at the correct diagnosis of histoplasmosis. The patient was attended by several experts in the fields of infectious diseases, nephrology and internal medicine, but the diagnosis was only possible after dermatological examination and skin biopsy. This case values multidisciplinary interaction between dermatologists and other medical areas for diagnosis of cases with atypical manifestations. PMID:27438207

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

    PubMed

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

    2015-02-01

    Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. PMID:25649388

  9. New Approaches to HSCT Multidisciplinary Design and Optimization

    NASA Technical Reports Server (NTRS)

    Schrage, D. P.; Craig, J. I.; Fulton, R. E.; Mistree, F.

    1996-01-01

    The successful development of a capable and economically viable high speed civil transport (HSCT) is perhaps one of the most challenging tasks in aeronautics for the next two decades. At its heart it is fundamentally the design of a complex engineered system that has significant societal, environmental and political impacts. As such it presents a formidable challenge to all areas of aeronautics, and it is therefore a particularly appropriate subject for research in multidisciplinary design and optimization (MDO). In fact, it is starkly clear that without the availability of powerful and versatile multidisciplinary design, analysis and optimization methods, the design, construction and operation of im HSCT simply cannot be achieved. The present research project is focused on the development and evaluation of MDO methods that, while broader and more general in scope, are particularly appropriate to the HSCT design problem. The research aims to not only develop the basic methods but also to apply them to relevant examples from the NASA HSCT R&D effort. The research involves a three year effort aimed first at the HSCT MDO problem description, next the development of the problem, and finally a solution to a significant portion of the problem.

  10. Culture, Health, and Science: A Multidisciplinary Liberal Arts Alternative to the Public Health Major.

    PubMed

    Morgan, Lynn M; Knight, Sabina; Gubrium, Aline C

    2016-01-01

    Since the 2003 call by the Institute of Medicine to educate undergraduates in public health, various models have emerged for incorporating public health into the liberal arts and sciences. One model is a professionalized public health major that uses core public health competencies to prepare a workforce of health professionals. A second model offers a broad-based public health major rooted in liberal arts principles, resisting the utilitarian trend toward human capital formation. A third model resists even the label of "public health," preferring instead to introduce undergraduates to many ways of analyzing human health and healing. The multidisciplinary Culture, Health, and Science Program, based on six key commitments for preparing liberal arts students to analyze health and respond to global health challenges, is offered as an alternative to the public health major. PMID:26857453

  11. Multidisciplinary approach to treatment of radiation-induced chest wall sarcoma.

    PubMed

    Kara, H Volkan; Gandolfi, Brad M; Williams, Judson B; D'Amico, Thomas A; Zenn, Michael R

    2016-08-01

    Radiation-induced sarcoma (RIS) is a rare complication following therapeutic external irradiation for lung cancer patients. Patients with RIS may develop recurrence or metastasis of the previous disease and also at high risk for early chest wall complications following operation, which requires close follow-up and multidisciplinary approach. We present a challenging case of RIS with a multidisciplinary teamwork in the decision-making and successful management. PMID:25663293

  12. A Multidisciplinary Approach for Managing Severely Malaligned Lower Molars.

    PubMed

    Keinan, David; Birnboim-Blaum, Galit; Webber, Mariel

    2016-01-01

    An impacted mandibular molar is a common clinical situation that may damage adjacent teeth and impair periodontal health. Improper treatment brings the risk of damaging adjacent vital tissues. The risk can be reduced by early diagnosis and extraction of the impacted tooth by an experienced clinician. However, in clinical cases of two impacted molars, it may be beneficial for the patient to save at least one molar. This can be achieved by orthodontic alignment of one of the molars, while extracting the other. The decision should be based upon prognosis and risks for each procedure and for both teeth. The case presented here demonstrates a recommended clinical decision-making process before treatment, followed by monitored multidisciplinary treatment with adaptations made as the treatment progresses. PMID:26939154

  13. Salvaging the Infected Breast Tissue Expander: A Standardized Multidisciplinary Approach

    PubMed Central

    Selber, Jesse C.; Crosby, Melissa; Raad, Issam I.; Butler, Charles E.; Villa, Mark T.; Kronowitz, Steven J.; Clemens, Mark W.; Garvey, Patrick; Yang, Wei; Baumann, Donald P.

    2016-01-01

    Background: Infections of breast tissue expander (TE) are complex, often requiring TE removal and hospitalization, which can delay further adjuvant therapy and add to the overall costs of breast reconstruction. Therefore, to reduce the rate of TE removal, hospitalization, and costs, we created a standardized same-day multidisciplinary outpatient quality improvement protocol for diagnosing and treating patients with early signs of TE infection. Methods: We prospectively evaluated 26 consecutive patients who developed a surgical site infection between February 2013 and April 2014. On the same day, patients were seen in the Plastic Surgery and Infectious Diseases clinics, underwent breast ultrasonography with or without periprosthetic fluid aspiration, and were prescribed a standardized empiric oral or intravenous antimicrobial regimen active against biofilm-embedded microorganisms. All patients were managed as per our established treatment algorithm and were followed up for a minimum of 1 year. Results: TEs were salvaged in 19 of 26 patients (73%). Compared with TE-salvaged patients, TE-explanted patients had a shorter median time to infection (20 vs 40 days; P = 0.09), a significantly higher median temperature at initial presentation [99.8°F; interquartile range (IQR) = 2.1 vs 98.3°F; IQR = 0.4°F; P = 0.01], and a significantly longer median antimicrobial treatment duration (28 days; IQR = 27 vs 21 days; IQR = 14 days; P = 0.05). The TE salvage rates of patients whose specimen cultures yielded no microbial growth, Staphylococcus species, and Pseudomonas were 92%, 75%, and 0%, respectively. Patients who had developed a deep-seated pocket infection were significantly more likely than those with superficial cellulitis to undergo TE explantation (P = 0.021). Conclusions: Our same-day multidisciplinary diagnostic and treatment algorithm not only yielded a TE salvage rate higher than those previously reported but also decreased the rate of hospitalization, decreased

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

    PubMed Central

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

    2016-01-01

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

  15. [Sensory functions and Alzheimer's disease: a multi-disciplinary approach].

    PubMed

    Kenigsberg, Paul-Ariel; Aquino, Jean-Pierre; Berard, Alain; Boucart, Muriel; Bouccara, Didier; Brand, Gérard; Charras, Kevin; Garcia-Larrea, Luis; Gzil, Fabrice; Krolak-Salmon, Pierre; Madjlessi, Arach; Malaquin-Pavan, Évelyne; Penicaud, Luc; Platel, Hervé; Pozzo, Thierry; Reintjens, Christophe; Salmon, Éric; Vergnon, Laurent; Robert, Philippe

    2015-09-01

    Relations between sensory functions and Alzheimer's disease are still under-explored. To understand them better, the Fondation Médéric Alzheimer has brought together a multi-disciplinary expert group. Aristote's five senses must be enhanced by today's knowledge of proprioception, motor cognition and pain perception. When cognition breaks down, the person with dementia perceives the world around her with her sensory experience, yet is unable to integrate all this information to understand the context. The treatment of multiple sensory inputs by the brain is closely linked to cognitive processes. Sensory deficits reduce considerably the autonomy of people with dementia in their daily life and their relations with others, increase their social isolation and the risk of accidents. Professionals involved with neurodegenerative diseases remain poorly aware of sensory deficits, which can bias the results of cognitive tests. However, there are simple tools to detect these deficits, notably for vision, hearing and balance disorders, which can be corrected. Many interventions for cognitive rehabilitation or quality of life improvement are based on sensory functions. The environment of people with dementia must be adapted to become understandable, comfortable, safe and eventually therapeutic. PMID:26395297

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

    PubMed

    Vašáková, Martina; Matěj, Radoslav

    2016-01-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

    Brose, Steven W; Wali, Eisha

    2014-01-01

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

  19. Effective glycemic management in hospitalized patients: a multidisciplinary approach.

    PubMed

    Bolton, Margaret; Richard, Anita; Blonde, Lawrence; Burshell, Alan

    2007-01-01

    The dual purpose of this process paper is to describe the implementation of an intensive insulin infusion program against multiple barriers, despite the increasing evidence in the literature supporting glycemic control, and to report the glucose outcomes. Traditional hyperglycemic management has been done either by subcutaneous sliding scale or intravenous insulin infusions based on absolute glucose numbers. A review of the literature, with particular evidence within the cardiothoracic surgical (CTS) population, has shown significant deleterious effects of even mild hyperglycemia.Increasing evidence supporting prevention of hyperglycemia, along with an unsatisfactory review of current methods used in-house, prompted the initiation of a pilot program to improve current methods utilizing insulin therapy. A multidisciplinary committee was formed consisting of the director of the intensive care unit, a dietician, a nursing unit director, a charge nurse, an endocrinologist, and two endocrinology nurse practitioners with extensive experience in intensive insulin therapy, including continuous subcutaneous insulin infusion. A review of literature was performed to evaluate available data and intravenous insulin infusion algorithms used by published authors. The CTS population was chosen as well as the intensive care unit. Nursing barriers in particular were extensive, and the use of a velocity driven insulin protocol required didactic instruction as well as individual reinforcement. All education, algorithm development, and oversight of patients were primarily performed by the nurse practitioners with immediate endocrinologist availability if needed. A review of glucose results indicated a significant reduction in hyperglycemia with a decrease in hypoglycemia and facilitated transition to subcutaneous therapy when necessary. PMID:21603515

  20. [Multidisciplinary approach of hip fractures based on Hungarian data].

    PubMed

    Juhász, Krisztina; Turchányi, Béla; Mintál, Tibor; Somogyi, Péter

    2016-09-01

    Hip fractures are described by increased mortality, loss of quality of life, functional decline and burden of diseases. They show a growing number worldwide. The aim of the present study is to summarise the existing data on the incidence, mortality, complications and rehabilitation of hip fractures, which relevance is reported only by few studies. To reduce mortality and complications of hip fractures the authors emphasize the importance of primary treatment within 12 hours, appropriate selection of surgical methods corresponding to the fracture type after the assessment of femoral head viability, vitamin D supplementation, same conditions for primary treatment during everyday of the week, and an adequate acute treatment and rehabilitation for patient's general health status. In the future integrated processing of multidisciplinary results of hip fractures based on Hungarian data can support the development of efficient treatment and prevention strategies, which can be advantageous for the patient, families, health care system, and the society, too, by the reduction of costly complications of hip fracture healing and mortality. Orv. Hetil., 2016, 157(37), 1469-1475. PMID:27615197

  1. RESTORING SUBURBAN WATERSHEDS USING A MULTIDISCIPLINARY APPROACH TO STORMWATER MANAGEMENT

    EPA Science Inventory

    In mixed-use, suburban watersheds, stormwater runoff from impervious surfaces on both public and private property impairs stream ecosystems. Decentralized stormwater management, which distributes stormwater infiltration and retention devices throughout watersheds, is more effect...

  2. Imaging of presacral masses--a multidisciplinary approach.

    PubMed

    Patel, Nishant; Maturen, Katherine E; Kaza, Ravi K; Gandikota, Girish; Al-Hawary, Mahmoud M; Wasnik, Ashish P

    2016-01-01

    Our objective is to describe an approach for retrorectal/presacral mass evaluation on imaging with attention to imaging features, allowing for refinement of the differential diagnosis of these masses. Elaborate on clinically relevant features that may affect biopsy or surgical approach, of which the radiologist should be aware. A review of current literature regarding the diagnosis and treatment of retrorectal/presacral masses was performed with attention to specific findings, which may lend refinement to the differential diagnosis of these masses. Cases were obtained by searching through a radiology database at a single institution after Institutional Review Board approval. Recent advances in imaging and treatment methods have led to the increased role of radiology in both imaging and tissue diagnosis of retrorectal masses. Surgical philosophies surrounding the treatment of these masses have not significantly changed in recent years, but there are a few key factors of which the radiologist must be aware. The radiologist can offer refinement of the differential diagnosis of retrorectal masses and can elaborate on salient findings which could alter the need for neoadjuvant chemoradiation therapy, pre-surgical tissue diagnosis and surgical approach. This article presents an imaging approach to retrorectal/presacral masses with emphasis on findings which can dictate the ultimate need for neoadjuvant therapy and pre-surgical tissue diagnosis and alter the preferred surgical approach. This article consolidates key findings, so radiologists can become more clinically relevant in the evaluation of these masses. PMID:26828969

  3. The Development of a Multi-Disciplinary Educational Programme in Biomedical Diagnostics: A Novel Approach

    ERIC Educational Resources Information Center

    MacCormac, Aoife; O'Brien, Emma; O'Kennedy, Richard

    2011-01-01

    This paper describes the development of a taught Master's course in biomedical diagnostics using a novel multi-disciplinary approach. This course, the first of its kind in Ireland, covers the science and technology underlying the development of medical diagnostic devices that detect early markers of diseases such as cancer. The ethical impact of…

  4. Management of Prosthetic Thrombosis During Pregnancy: Importance of a Multidisciplinary Approach.

    PubMed

    Celiento, Michele; Levantino, Maurizio; Cela, Vito; Cioni, Roberto; Guarracino, Fabio; Bortolotti, Uberto

    2015-05-01

    A 40-year-old female of African origin presented in the 32nd week of her second pregnancy with thrombosis of a bileaflet mechanical prosthesis implanted in the mitral position. After an emergency cesarean section, she was successfully treated by means of a multidisciplinary approach. PMID:26901915

  5. School-Based HIV Prevention: A Multidisciplinary Approach.

    ERIC Educational Resources Information Center

    Kerr, Dianne L.; And Others

    This manual was written to help school-based professionals implement school health education programs to prevent the spread of the human immunodeficiency virus (HIV). The manual provides a framework and plan to promote an interdisciplinary approach to HIV education in schools. The manual begins with a review of basic facts about acquired immune…

  6. Starting an ePortfolio: A Multi-Disciplinary Approach

    ERIC Educational Resources Information Center

    Zinger, Lana; Sinclair, Alicia

    2014-01-01

    ePortfolio integrates technology with a student's academic course work and have increasingly become an integral part of higher education curriculum. They allow students to showcase their academic work in a fresh way on a digital platform. Traditionally, however, ePortfolio is implemented from a single discipline approach. This project aimed to…

  7. New Approaches for Virus Detection through Multidisciplinary Partnerships.

    PubMed

    Fawcett, Helen; Ünlü, M Selim; Connor, John H

    2016-06-10

    A critical requirement for controlling outbreaks of viral infection is sensitive and accurate diagnostics, which can be expensive and are frequently located in resource-intensive clinical laboratories. Outbreaks of many viral infections occur in countries where healthcare resources are limited and clinical laboratories scarce. This creates a fulfillment gap, one that could be filled through the development of inexpensive, sensitive, easy to use, and portable diagnostics. Here we describe our efforts to develop a diagnostic technology that detects viruses without needing to label the particle directly. Our approach has the advantage of speed and assay simplicity while maintaining high sensitivity. Essential in this approach has been the assembly of an integrated, diverse, and interdisciplinary team that worked together to evaluate technologies, spin-out a company, and produce a product for infectious disease diagnostics. The synergy of different individuals with complementary skills has been critical for the development of our transformative technology. PMID:27627625

  8. Multidisciplinary treatment approach for enhancement of implant esthetics.

    PubMed

    Wang, Hom-Lay; Shotwell, Jeffrey L; Itose, Tatsumasa; Neiva, Rodrigo F

    2005-03-01

    A "team approach" that includes different specialties from the initial stages of implant treatment is important to achieve predictable and esthetically pleasing outcomes in compromised dental replacement cases. This report describes a severely compromised case that was properly managed by the combined efforts of a team of specialists. Briefly, prior to tooth extraction, orthodontic forced eruption was applied to coronally displace the attachment apparatus (i.e., hard and soft tissues). Then, atraumatic tooth extraction together with immediate implant placement was performed. The "sandwich bone augmentation" technique was used to augment the deficient buccal alveolar ridge. A second stage surgery was performed 6 months after healing, revealing 100% of bone fill/augmentation. This technique allowed fabrication of a final restoration that respected the proportions of the natural dentition in a case that would otherwise result in a poor esthetic outcome. PMID:15764941

  9. A multidisciplinary approach to scars: a narrative review

    PubMed Central

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

    The purpose of this article is to carry out a narrative review regarding the approach to scars through complementary and alternative medicine focusing on osteopathy, naturopathy, and other minor methods and traditional rehabilitative medicines, such as physiotherapy and manual therapies. We analyzed the existing literature regarding the possible influences of techniques relaxing the diaphragm – both manual and psychophysical relaxing techniques – and the consequent local response to events leading to scar tissue healing. The objective of the study is to become a useful instrument of knowledge for those manual therapists and professionals who deal with patients affected by discontinuity of the skin surface due to trauma or surgery. This article also intends to stimulate research in order to find and propose new methods of scar treatment, taking into consideration the information gained so far from other complementary and alternative disciplines. PMID:26316774

  10. A multidisciplinary approach to scars: a narrative review.

    PubMed

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

    The purpose of this article is to carry out a narrative review regarding the approach to scars through complementary and alternative medicine focusing on osteopathy, naturopathy, and other minor methods and traditional rehabilitative medicines, such as physiotherapy and manual therapies. We analyzed the existing literature regarding the possible influences of techniques relaxing the diaphragm - both manual and psychophysical relaxing techniques - and the consequent local response to events leading to scar tissue healing. The objective of the study is to become a useful instrument of knowledge for those manual therapists and professionals who deal with patients affected by discontinuity of the skin surface due to trauma or surgery. This article also intends to stimulate research in order to find and propose new methods of scar treatment, taking into consideration the information gained so far from other complementary and alternative disciplines. PMID:26316774

  11. A Multidisciplinary Approach to Castleman Disease of the Neck.

    PubMed

    Shams, Alexandra A; Ahmed, Mostafa M; Scalzitti, Nicholas J; Howell, Della L; Hall, Jordan M; Ritter, John L; Maturo, Stephen C

    2016-02-01

    Castleman disease (CD) is a rare lymphoproliferative disorder that occurs in adults and rarely in the pediatric population. The disease is characterized by slowly enlarging masses that can form anywhere within the lymphatic system. It is an uncommon cause of a neck mass in both children and adults that presents insidiously and nonspecifically. A 21-year-old woman was referred to the otolaryngology service because of an asymptomatic neck mass found incidentally on computed tomographic imaging 15 months earlier. On repeat imaging, the lesion was characterized as a homogenously enhancing soft tissue mass and appeared stable in size compared with previous studies. Given the nondiagnostic radiologic features, tissue sampling was pursued, first using fine-needle aspiration and ultimately excisional biopsy. The excision revealed histopathology consistent with unicentric, hyaline-vascular CD. Excision is the gold standard for treatment of this variant of CD. The patient was referred to the hematology/oncology service but was subsequently lost to follow-up. This case illustrates a rare cause of a neck mass in a young adult and exemplifies the extremely broad differential in this setting. In addition, it highlights the importance of a systematic and thorough approach to diagnosing neck masses in children and adults. PMID:26840960

  12. A Multidisciplinary Approach to High Throughput Nuclear Magnetic Resonance Spectroscopy.

    PubMed

    Pourmodheji, Hossein; Ghafar-Zadeh, Ebrahim; Magierowski, Sebastian

    2016-01-01

    Nuclear Magnetic Resonance (NMR) is a non-contact, powerful structure-elucidation technique for biochemical analysis. NMR spectroscopy is used extensively in a variety of life science applications including drug discovery. However, existing NMR technology is limited in that it cannot run a large number of experiments simultaneously in one unit. Recent advances in micro-fabrication technologies have attracted the attention of researchers to overcome these limitations and significantly accelerate the drug discovery process by developing the next generation of high-throughput NMR spectrometers using Complementary Metal Oxide Semiconductor (CMOS). In this paper, we examine this paradigm shift and explore new design strategies for the development of the next generation of high-throughput NMR spectrometers using CMOS technology. A CMOS NMR system consists of an array of high sensitivity micro-coils integrated with interfacing radio-frequency circuits on the same chip. Herein, we first discuss the key challenges and recent advances in the field of CMOS NMR technology, and then a new design strategy is put forward for the design and implementation of highly sensitive and high-throughput CMOS NMR spectrometers. We thereafter discuss the functionality and applicability of the proposed techniques by demonstrating the results. For microelectronic researchers starting to work in the field of CMOS NMR technology, this paper serves as a tutorial with comprehensive review of state-of-the-art technologies and their performance levels. Based on these levels, the CMOS NMR approach offers unique advantages for high resolution, time-sensitive and high-throughput bimolecular analysis required in a variety of life science applications including drug discovery. PMID:27294925

  13. A Multidisciplinary Approach to High Throughput Nuclear Magnetic Resonance Spectroscopy

    PubMed Central

    Pourmodheji, Hossein; Ghafar-Zadeh, Ebrahim; Magierowski, Sebastian

    2016-01-01

    Nuclear Magnetic Resonance (NMR) is a non-contact, powerful structure-elucidation technique for biochemical analysis. NMR spectroscopy is used extensively in a variety of life science applications including drug discovery. However, existing NMR technology is limited in that it cannot run a large number of experiments simultaneously in one unit. Recent advances in micro-fabrication technologies have attracted the attention of researchers to overcome these limitations and significantly accelerate the drug discovery process by developing the next generation of high-throughput NMR spectrometers using Complementary Metal Oxide Semiconductor (CMOS). In this paper, we examine this paradigm shift and explore new design strategies for the development of the next generation of high-throughput NMR spectrometers using CMOS technology. A CMOS NMR system consists of an array of high sensitivity micro-coils integrated with interfacing radio-frequency circuits on the same chip. Herein, we first discuss the key challenges and recent advances in the field of CMOS NMR technology, and then a new design strategy is put forward for the design and implementation of highly sensitive and high-throughput CMOS NMR spectrometers. We thereafter discuss the functionality and applicability of the proposed techniques by demonstrating the results. For microelectronic researchers starting to work in the field of CMOS NMR technology, this paper serves as a tutorial with comprehensive review of state-of-the-art technologies and their performance levels. Based on these levels, the CMOS NMR approach offers unique advantages for high resolution, time-sensitive and high-throughput bimolecular analysis required in a variety of life science applications including drug discovery. PMID:27294925

  14. A multidisciplinary approach to overreaching detection in endurance trained athletes.

    PubMed

    Le Meur, Yann; Hausswirth, Christophe; Natta, Françoise; Couturier, Antoine; Bignet, Frank; Vidal, Pierre Paul

    2013-02-01

    In sport, high training load required to reach peak performance pushes human adaptation to their limits. In that process, athletes may experience general fatigue, impaired performance, and may be identified as overreached (OR). When this state lasts for several months, an overtraining syndrome is diagnosed (OT). Until now, no variable per se can detect OR, a requirement to prevent the transition from OR to OT. It encouraged us to further investigate OR using a multivariate approach, including physiological, biomechanical, cognitive, and perceptive monitoring. Twenty-four highly trained triathletes were separated into an overload group and a normo-trained group (NT) during 3 wk of training. Given the decrement of their running performance, 11 triathletes were diagnosed as OR after this period. A discriminant analysis showed that the changes of eight parameters measured during a maximal incremental test could explain 98.2% of the OR state (lactatemia, heart rate, biomechanical parameters and effort perception). Variations in heart rate and lactatemia were the two most discriminating factors. When the multifactorial analysis was restricted to these variables, the classification score reached 89.5%. Catecholamines and creatine kinase concentrations at rest did not change significantly in both groups. Running pattern was preserved and cognitive performance decrement was observed only at exhaustion in OR subjects. This study showed that monitoring various variables is required to prevent the transition between NT and OR. It emphasized that an OR index, which combines heart rate and blood lactate concentration changes after a strenuous training period, could be helpful to routinely detect OR. PMID:23195630

  15. Training health professionals: a multidisciplinary team approach in a university-based weight-loss program.

    PubMed

    Brehm, B J; Rourke, K M; Cassell, C

    1999-01-01

    In a university-based weight-loss program for preadolescent girls, a multidisciplinary team delivered the intervention. The team included a nurse/health educator, an exercise physiologist, a psychologist, five dietitians, and 17 dietetics, nursing, and medical students, The six-month program provided 12 educational sessions in nutrition, stress management, behavior modification, and exercise. Concurrent sessions for parents addressed comparable educational topics and parenting skills. Dietitians and student research assistants (n = 19) were surveyed regarding their participation on a multidisciplinary team and their acquisition of new knowledge/skills. The survey included both open-ended questions and Likert-type statements. Results indicate that participation enhanced knowledge of nutrition counseling/education (chi = 1.6) as well as appreciation for research (chi = 1.8) and for the multidisciplinary team approach (chi = 1.7). Qualitative data reinforce the benefits of the multidisciplinary experience and multiskill training. Exercise, stress management, parenting skills, and psychological techniques were perceived as important skills to develop for professional careers. PMID:10614555

  16. OECI accreditation at Veneto Institute of Oncology IOV - IRCCS, general framework and multidisciplinary approach.

    PubMed

    Chiusole, Daniela; Cioffredi, Piero; Basso, Umberto; Bortolami, Alberto; Crivellari, Gino; Gennaro, Gisella; Spina, Romina; Opocher, Giuseppe

    2015-01-01

    The aim of this article is to describe the accreditation process of the Veneto Institute of Oncology (IOV-IRCCS) according to the Organisation of European Cancer Institutes (OECI) model, with particular reference to the standards for the multidisciplinary approach. Through the analysis of the process and the activities of each multidisciplinary team (MDT) and the development, at a regional level, of diagnostic, therapeutic, and care pathways (PDTA), all the necessary steps to meet the OECI standards have been determined. Adjustment is ongoing. We are working on the inclusion of the MDT registration forms in the electronic medical records and on the possibility to extend the OECI model to the MDT not based at IOV, but participated in by IOV professionals. The sarcoma MDT has achieved results demonstrating that the OECI framework has allowed the professionals involved in the multidisciplinary meeting to systematically share the clinical information of the patient, who can benefit from better continuity of care. The model has also provided greater clarity in the management of patients who are enrolled in clinical trials and deviate from Guide Lines (GL)/PDTA. The accreditation process according to the OECI model has added value to the IOV's already well-developed multidisciplinary activities. PMID:27096271

  17. Seasonal hazards and health risks in lower-income countries: field testing a multi-disciplinary approach.

    PubMed

    Few, Roger; Lake, Iain; Hunter, Paul R; Tran, Pham Gia; Thien, Vu Trong

    2009-01-01

    Understanding how risks to human health change as a result of seasonal variations in environmental conditions is likely to become of increasing importance in the context of climatic change, especially in lower-income countries. A multi-disciplinary approach can be a useful tool for improving understanding, particularly in situations where existing data resources are limited but the environmental health implications of seasonal hazards may be high. This short article describes a multi-disciplinary approach combining analysis of changes in levels of environmental contamination, seasonal variations in disease incidence and a social scientific analysis of health behaviour. The methodology was field-tested in a peri-urban environment in the Mekong Delta, Vietnam, where poor households face alternate seasonal extremes in the local environment as the water level in the Delta changes from flood to dry season. Low-income households in the research sites rely on river water for domestic uses, including provision of drinking water, and it is commonly perceived that the seasonal changes alter risk from diarrhoeal diseases and other diseases associated with contamination of water. The discussion focuses on the implementation of the methodology in the field, and draws lessons from the research process that can help in refining and developing the approach for application in other locations where seasonal dynamics of disease risk may have important consequences for public health. PMID:20102583

  18. Controlling rabies through a multidisciplinary, public health system in Trujillo, La Libertad, Peru

    PubMed Central

    Seneschall, Charlotte; Luna-Farro, Maria

    2013-01-01

    Rabies remains endemic in Peru. In 1983, Latin America and the Caribbean promised to eliminate canine-transmitted rabies from the continent. This led to Peru introducing a multidisciplinary public health system for controlling and managing rabies across the country. The system consists of mass canine vaccination campaigns, post exposure prophylaxis and monitoring aggressor animals for signs of rabies. The Peruvian city of Trujillo, La Libertad, is an urban area where dogs are the principal reservoir for rabies. The disease burden of rabies in Trujillo, La Libertad is currently minimal, with no rabies cases in humans for over 10 years, and only three canine cases. No human deaths due to rabies have occurred for several decades. From this it can be inferred that antirabies systems such as this do have real effects in reducing cases of human rabies at a grass roots level. PMID:24392679

  19. Multidisciplinary approach to genomics research in Africa: the AfriCRAN model

    PubMed Central

    Butali, Azeez; Mossey, Peter; Tiffin, Nikki; Adeyemo, Wasiu; Eshete, Mekonen; Mumena, Chrispinanus; Audu, Rosemary; Onwuamah, Chika; Agbenorku, Pius; Ogunlewe, Mobolanle; Adebola, Adetokunbo; Olasoji, Hecto; Aregbesola, Babatunde; Braimah, Ramat; Oladugba, Abimibola; Onah, Ifeanyichukwu; Adebiyi, Ezekiel; Olaitan, Peter; Abdur-Rahman, Lukman; Adeyemo, Adebowale

    2015-01-01

    This article is an outcome of the African Craniofacial Anomalies Research Network (AfriCRAN) Human Hereditary and Health (H3A) grant planning meeting in 2012 in Lagos, Nigeria. It describes the strengths of a multidisciplinary team approach to solving complex genetic traits in the craniofacial region. It also highlights the different components and argues for the composition of similar teams to fast track the discovery of disease genes, diagnostic tools, improved clinical treatment and ultimately prevention of diseases. PMID:26523171

  20. Multi-Disciplinary Approach to Trace Contamination of Streams and Beaches

    USGS Publications Warehouse

    Nickles, James

    2008-01-01

    Concentrations of fecal-indicator bacteria in urban streams and ocean beaches in and around Santa Barbara occasionally can exceed public-health standards for recreation. The U.S. Geological Survey (USGS), working with the City of Santa Barbara, has used multi-disciplinary science to trace the sources of the bacteria. This research is helping local agencies take steps to improve recreational water quality. The USGS used an approach that combined traditional hydrologic and microbiological data, with state-of-the-art genetic, molecular, and chemical tracer analysis. This research integrated physical data on streamflow, ground water, and near-shore oceanography, and made extensive use of modern geophysical and isotopic techniques. Using those techniques, the USGS was able to evaluate the movement of water and the exchange of ground water with near-shore ocean water. The USGS has found that most fecal bacteria in the urban streams came from storm-drain discharges, with the highest concentrations occurring during storm flow. During low streamflow, the concentrations varied as much as three-fold, owing to variable contribution of non-point sources such as outdoor water use and urban runoff to streamflow. Fecal indicator bacteria along ocean beaches were from both stream discharge to the ocean and from non-point sources such as bird fecal material that accumulates in kelp and sand at the high-tide line. Low levels of human-specific Bacteroides, suggesting fecal material from a human source, were consistently detected on area beaches. One potential source, a local sewer line buried beneath the beach, was found not to be responsible for the fecal bacteria.

  1. A multi-disciplinary approach for the structural monitoring of Cultural Heritages in a seismic area

    NASA Astrophysics Data System (ADS)

    Fabrizia Buongiorno, Maria; Musacchio, Massimo; Guerra, Ignazio; Porco, Giacinto; Stramondo, Salvatore; Casula, Giuseppe; Caserta, Arrigo; Speranza, Fabio; Doumaz, Fawzi; Giovanna Bianchi, Maria; Luzi, Guido; Ilaria Pannaccione Apa, Maria; Montuori, Antonio; Gaudiosi, Iolanda; Vecchio, Antonio; Gervasi, Anna; Bonali, Elena; Romano, Dolores; Falcone, Sergio; La Piana, Carmelo

    2014-05-01

    In the recent years, the concepts of seismic risk vulnerability and structural health monitoring have become very important topics in the field of both structural and civil engineering for the identification of appropriate risk indicators and risk assessment methodologies in Cultural Heritages monitoring. The latter, which includes objects, building and sites with historical, architectural and/or engineering relevance, concerns the management, the preservation and the maintenance of the heritages within their surrounding environmental context, in response to climate changes and natural hazards (e.g. seismic, volcanic, landslides and flooding hazards). Within such a framework, the complexity and the great number of variables to be considered require a multi-disciplinary approach including strategies, methodologies and tools able to provide an effective monitoring of Cultural Heritages form both scientific and operational viewpoints. Based on this rationale, in this study, an advanced, technological and operationally-oriented approach is presented and tested, which enables measuring and monitoring Cultural Heritage conservation state and geophysical/geological setting of the area, in order to mitigate the seismic risk of the historical public goods at different spatial scales*. The integration between classical geophysical methods with new emerging sensing techniques enables a multi-depth, multi-resolution, and multi-scale monitoring in both space and time. An integrated system of methodologies, instrumentation and data-processing approaches for non-destructive Cultural Heritage investigations is proposed, which concerns, in detail, the analysis of seismogenetic sources, the geological-geotechnical setting of the area and site seismic effects evaluation, proximal remote sensing techniques (e.g. terrestrial laser scanner, ground-based radar systems, thermal cameras), high-resolution aerial and satellite-based remote sensing methodologies (e.g. aeromagnetic surveys

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

    PubMed Central

    Gillespie, Brigid M; Kang, Evelyn; Roberts, Shelley; Lin, Frances; Morley, Nicola; Finigan, Tracey; Homer, Allison; Chaboyer, Wendy

    2015-01-01

    Purpose To identify and describe the strategies and processes used by multidisciplinary teams of health care professionals to reduce surgical site infections (SSIs). Materials and methods An integrative review of the research literature was undertaken. Searches were conducted in April 2015. Following review of the included studies, data were abstracted using summary tables and the methodological quality of each study assessed using the Standards for Quality Improvement Reporting Excellence guidelines by two reviewers. Discrepancies were dealt with through consensus. Inductive content analysis was used to identify and describe the strategies/processes used by multidisciplinary health care teams to prevent SSI. Results and discussion In total, 13 studies met the inclusion criteria. Of these, 12 studies used quantitative methods, while a single study used qualitative interviews. The majority of the studies were conducted in North America. All quantitative studies evaluated multifaceted quality-improvement interventions aimed at preventing SSI in patients undergoing surgery. Across the 13 studies reviewed, the following multidisciplinary team-based approaches were enacted: using a bundled approach, sharing responsibility, and, adhering to best practice. The majority of studies described team collaborations that were circumscribed by role. None of the reviewed studies used strategies that included the input of allied health professionals or patient participation in SSI prevention. Conclusion Patient-centered interventions aimed at increasing patient participation in SSI prevention and evaluating the contributions of allied health professionals in team-based SSI prevention requires future research. PMID:26508870

  3. The multidisciplinary approach in the diagnosis of idiopathic pulmonary fibrosis: a patient case-based review.

    PubMed

    Tomassetti, Sara; Piciucchi, Sara; Tantalocco, Paola; Dubini, Alessandra; Poletti, Venerino

    2015-03-01

    Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressively fibrosing interstitial pneumonia that is associated with a significantly worse prognosis than other forms of chronic interstitial pneumonia. An early and accurate diagnosis of IPF is important to enable the initiation of disease-specific therapies, which have the potential to reduce disease progression, and the avoidance of inappropriate and potentially harmful drugs. Establishing an accurate diagnosis of IPF can be challenging. Recent studies and international guidelines advocate the importance of a multidisciplinary team (MDT) in the initial diagnostic assessment of patients with suspected IPF. Typical MDT members include a pulmonologist, a radiologist and a pathologist, with further input from a thoracic surgeon, a rheumatologist, a specialist nurse and an occupational physician where appropriate. Multidisciplinary diagnosis is considered the gold standard because it can improve the accuracy of diagnosis of IPF, avoid unnecessary testing (e.g. lung biopsy), and optimise patient management. Here we highlight the strengths and limitations of the multidisciplinary approach to IPF diagnosis through MDT discussion of two patient cases. PMID:25726558

  4. The importance of a multidisciplinary approach for solid earth geophysics in Seafloor Observatories data analysis

    NASA Astrophysics Data System (ADS)

    Embriaco, Davide; De Caro, Mariagrazia; De Santis, Angelo; Etiope, Giuseppe; Frugoni, Francesco; Giovanetti, Gabriele; Lo Bue, Nadia; Marinaro, Giuditta; Monna, Stephen; Montuori, Caterina; Sgroi, Tiziana; Beranzoli, Laura; Favali, Paolo

    2016-04-01

    Continuous time-series in deep ocean waters are the basis for an original approach in ocean exploration. The observation of phenomena variability over time is key to understanding many Earth processes, among which: hydrothermal systems, active tectonics, and ecosystem life cycles. Geo-hazards at sea have often been studied with a single-parameter approach on a short time-scale, but it is now becoming clear that to understand these phenomena and, specifically, to identify precursors to very energetic events, such as mega-earthquakes, tsunamis and volcanic eruptions, continuous long-term multiparameter monitoring is strongly needed. In fact, given a signal of interest, by using several sensors recording simultaneously it is possible to identify the contribution of different sources to this signal, and to be less prone to false associations. In Europe, large cabled systems with marine sensors are being developed for near real-time and real-time long-term monitoring of ocean processes within the EMSO (European Multidisciplinary Seafloor and water column Observatory www.emso-eu.org) Research Infrastructure. Obtaining good quality long-term multiparameter data from sensors on-board seafloor observatories, which are the base of a multidisciplinary approach, is a challenging task. We describe the main steps we have taken to retrieve good quality multiparametric data acquired by GEOSTAR class seafloor observatories, both standalone and cabled, deployed at various sites offshore European coast during the last decade. Starting from this data we show the application of a multidisciplinary approach with some examples coming from experiments in EMSO sites.

  5. Bridging the gap between mental and physical health: a multidisciplinary approach.

    PubMed

    Vreeland, Betty

    2007-01-01

    People with serious mental illnesses have higher rates of morbidity and premature mortality compared with the general population. This population loses from 13 to over 20 years of life compared with their nonpsychiatric cohorts. A multitude of factors contribute to this silent tragedy. A major problem is that multiple barriers exist, making it difficult for individuals with serious mental illness to access quality health care. Additionally, compared with the average American, people with serious mental illness are more likely to engage in unhealthy lifestyle practices, such as lack of regular physical activity, poor nutrition and overeating, smoking and other substance abuse, irregular and inadequate sleep, and failure to visit health care practitioners regularly. These unhealthy behaviors and the added burden of anti-psychotic medication side effects increase the risk for cardiac and metabolic diseases. However, best-practice models exist that provide the knowledge and tools to assist people with serious mental illness in making informed decisions about healthier lifestyle behaviors, including addressing tobacco use and excess weight. The challenge is how to integrate these practices effectively into routine behavioral health care. The growing problem of premature death calls for urgent public action to transform the current mental health care system into a more integrated system of care. Because of their holistic training and approach to care, nurses are well prepared to work collaboratively with both mental and physical health care providers and systems. In the new mental health care system, both psychiatric and physical health care providers will need to broaden their treatment paradigm to address the whole person. An integral part of behavioral health services will be to ensure that the health status of all individuals is assessed, that there are medical monitoring protocols in place for people taking antipsychotic medication, that each individual has a

  6. Multidisciplinary Oncoplastic Approach Reduces Infection in Chest Wall Resection and Reconstruction for Malignant Chest Wall Tumors

    PubMed Central

    Malahias, Marco N.; Balasubramanian, Balapathiran; Djearaman, Madava G.; Naidu, Babu; Grainger, Melvin F.; Kalkat, Maninder

    2016-01-01

    Background: Management of complex thoracic defects post tumor extipiration is challenging because of the nature of pathology, the radical approach, and the insertion of prosthetic material required for biomechanical stability. Wound complications pose a significant problem that can have detrimental effect on patient outcome. The authors outline an institutional experience of a multidisciplinary thoracic oncoplastic approach to improve outcomes. Methods: Prospectively collected data from 71 consecutive patients treated with chest wall resection and reconstruction were analyzed (2009–2015). The demographic data, comorbidities, operative details, and outcomes with special focus on wound infection were recorded. All patients were managed in a multidisciplinary approach to optimize perioperative surgical planning. Results: Pathology included sarcoma (78%), locally advanced breast cancer (15%), and desmoids (6%), with age ranging from 17 to 82 years (median, 42 years) and preponderance of female patients (n = 44). Chest wall defects were located anterior and anterolateral (77.5%), posterior (8.4%), and apical axillary (10%) with skeletal defect size ranging from 56 to 600 cm2 (mean, 154 cm2). Bony reconstruction was performed using polyprolene mesh, methyl methacrylate prosthesis, and titanium plates. Soft tissue reconstructions depended on size, location, and flap availability and were achieved using regional, distant, and free tissue flaps. The postoperative follow-up ranged from 5 to 70 months (median, 32 months). All flaps survived with good functional and aesthetic outcome, whereas 2 patients experienced surgical site infection (2.8%). Conclusions: Multidisciplinary thoracic oncoplastic maximizes outcome for patients with large resection of chest wall tumors with reduction in surgical site infection and wound complications particularly in association with rigid skeletal chest wall reconstruction. PMID:27536488

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

    PubMed

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

    2014-01-01

    Millions of children in polluted cities are showing brain detrimental effects. Urban children exhibit brain structural and volumetric abnormalities, systemic inflammation, olfactory, auditory, vestibular and cognitive deficits v low-pollution controls. Neuroinflammation and blood-brain-barrier (BBB) breakdown target the olfactory bulb, prefrontal cortex and brainstem, but are diffusely present throughout the brain. Urban adolescent Apolipoprotein E4 carriers significantly accelerate Alzheimer pathology. Neurocognitive effects of air pollution are substantial, apparent across all populations, and potentially clinically relevant as early evidence of evolving neurodegenerative changes. The diffuse nature of the neuroinflammation and neurodegeneration forces to employ a weight of evidence approach incorporating current clinical, cognitive, neurophysiological, radiological and epidemiological research. Pediatric air pollution research requires extensive multidisciplinary collaborations to accomplish a critical goal: to protect exposed children through multidimensional interventions having both broad impact and reach. Protecting children and teens from neural effects of air pollution should be of pressing importance for public health. PMID:25161617

  8. No-Pass Zone: Multidisciplinary Approach to Responding to Patient Needs.

    PubMed

    Lee, Tracy L; Crouse, Marlene; Gipson, Kelly

    2016-01-01

    A nurse's need to juggle multiple priorities often leads to delays in responses to patient call lights, which may result in the patient's needs not being met quickly. Low patient satisfaction scores related to hospital staff responding to patient needs created urgency for this system to implement the No-Pass Zone, a multidisciplinary team approach to responding to call lights. A successful implementation of this intervention resulted in patients' needs being met more quickly as indicated by improved Hospital Consumer Assessment of Health Care Providers and Systems performance postimplementation. PMID:26845421

  9. [A multidisciplinary approach for the optimal treatment of problem behaviour in dementia].

    PubMed

    Ettema, Henriëtte

    2016-06-01

    Problem behaviours in one form or another are very common in nursing home residents with dementia. In order to manage these challenging behaviours pharmacological and psychosocial interventions are necessary. Psychosocial interventions have gained a more central role due to negative affects of pharmacological treatment. This case study describes the multidisciplinary approach of problem behaviour in an 85 year old nursing home patient with dementia. Those involved in caring for this patient initiated changes that led to a more adequate treatment and ultimately a decrease in the problematic behaviour. PMID:27098423

  10. Recognition and rehabilitation of the female athlete triad/tetrad: a multidisciplinary approach.

    PubMed

    Temme, Kate E; Hoch, Anne Z

    2013-01-01

    While the benefits of physical activity are numerous, the female athlete triad poses a significant health risk to young athletes. Emerging research links the triad to endothelial dysfunction--a sentinel event in cardiovascular disease--suggesting that this complex interplay of metabolic and endocrine factors may be described more accurately as a tetrad. Effective treatment of the triad/tetrad requires a multidisciplinary approach. Emphasis must be placed on prevention, recognition, and treatment of triad for the promotion of healthy nutritional and activity profiles in female athletes across their lifespans. PMID:23669090

  11. Refractory lung metastasis from breast cancer treated with multidisciplinary therapy including an immunological approach.

    PubMed

    Takada, Masahiro; Terunuma, Hiroshi; Deng, Xuewen; Dewan, Md Zahidunnabi; Saji, Shigehira; Kuroi, Katsumasa; Yamamoto, Naoki; Toi, Masakazu

    2011-01-01

    A suggestive case of metastatic disease from breast cancer is reported. The HER-2-positive tumor was refractory to several agents, including anti-HER-2 therapy, trastuzumab, and lapatinib. After re-induction of trastuzumab in combination with activated natural killer (NK) cell injection therapy, tumor markers decreased, and finally a synergistic effect of taxane and capecitabine led to treatment response. This case suggests that multidisciplinary therapy including an immunological approach might be a breakthrough in the treatment of refractory disease. PMID:20354831

  12. Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature

    PubMed Central

    Manatakis, Dimitrios K.; Delis, Spiridon G.; Ptohis, Nikolaos; Korkolopoulou, Penelope; Dervenis, Christos

    2015-01-01

    Hemangiopericytoma is a rare primary tumor originating from Zimmerman's pericytes, with significant metastatic potential. Hepatic metastatic disease requires an aggressive approach by a multidisciplinary team of dedicated oncology specialists, to prolong survival in selected patients. We report on a patient with recurrent hepatic metastases of grade II intracranial hemangiopericytoma 5 years after initial treatment, managed by a stepwise combination of liver resection, radiofrequency ablation, and transarterial embolization. Although metastatic disease implies hematogenous dissemination, long-term survival after liver resection has been reported and major hepatectomies are justified in patients with adequate local control. Liver resections combined with transarterial embolization are highly recommended, due to hypervascularity of the tumor. PMID:26090247

  13. Multidisciplinary approach to sex education of spinal cord-injured patients.

    PubMed

    Evans, R L; Halar, E M; DeFreece, A B; Larsen, G L

    1976-05-01

    The need for sex education of spinal cord-injured patients is often unmet by current rehabilitation programs. In the programs which do exist, therapeutic objectives vary widely, indicating a need for clarity and communication among professionals. An interdisciplinary approach to evaluating and treating sexual dysfunction is described which provides information to patients and families about sexual disorders related to spinal injury and offers counseling services to patients experiencing problems in their altered sex relations. Physiological, psychological, and social aspects of human sexuality as they are integrated into a multidisciplinary sex education program are discussed with specific recommendations for content which should be included in the information-giving counseling process. PMID:1265117

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

    SciTech Connect

    McCalla, J.L.

    1985-03-01

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

  15. Predicting ectotherm disease vector spread—benefits from multidisciplinary approaches and directions forward

    NASA Astrophysics Data System (ADS)

    Thomas, Stephanie Margarete; Beierkuhnlein, Carl

    2013-05-01

    The occurrence of ectotherm disease vectors outside of their previous distribution area and the emergence of vector-borne diseases can be increasingly observed at a global scale and are accompanied by a growing number of studies which investigate the vast range of determining factors and their causal links. Consequently, a broad span of scientific disciplines is involved in tackling these complex phenomena. First, we evaluate the citation behaviour of relevant scientific literature in order to clarify the question "do scientists consider results of other disciplines to extend their expertise?" We then highlight emerging tools and concepts useful for risk assessment. Correlative models (regression-based, machine-learning and profile techniques), mechanistic models (basic reproduction number R 0) and methods of spatial regression, interaction and interpolation are described. We discuss further steps towards multidisciplinary approaches regarding new tools and emerging concepts to combine existing approaches such as Bayesian geostatistical modelling, mechanistic models which avoid the need for parameter fitting, joined correlative and mechanistic models, multi-criteria decision analysis and geographic profiling. We take the quality of both occurrence data for vector, host and disease cases, and data of the predictor variables into consideration as both determine the accuracy of risk area identification. Finally, we underline the importance of multidisciplinary research approaches. Even if the establishment of communication networks between scientific disciplines and the share of specific methods is time consuming, it promises new insights for the surveillance and control of vector-borne diseases worldwide.

  16. There is a need for a multidisciplinary approach to patient safety.

    PubMed

    Taneva, Svetlena

    2013-01-01

    In the lead paper, Zimmerman et al. explore the role of problem and solution ownership in solution adoption by front-line healthcare staff. The front-line ownership (FLO) approach suggested by the authors proposes a shift in leadership style such that managers act as enablers of patient safety improvement efforts by front-line staff (i.e., a bottom-up management style). From a systems perspective, it would be necessary to examine contributing factors to patient safety problems, including process, workflow, task requirements etc., in order to effectively utilize a solution-oriented approach such as FLO. These factors would be difficult to identify by clinical staff alone. There is a need for a multidisciplinary approach to patient safety management in healthcare. PMID:23803351

  17. [The multidisciplinary team approach to the treatment of bipolar disorder: an overview].

    PubMed

    Machado-Vieira, Rodrigo; Santin, Aida; Soares, Jair C

    2004-10-01

    Bipolar disorder is a chronic and recurrent disorder, and many factors have been associated with its course and prognosis. Dysfunction in social, professional or family life has been correlated with poor outcomes and increased risk of relapse and recurrence, especially when the patient does not adhere to the treatment regimen. Within the last decade, new treatments, intended to promote better adherence and minimize the risk of morbidity or hospitalization, have been tested. The multidisciplinary team approach attempts to educate patients and their families about such factors. Herein, we evaluate the therapeutic efficacy of this approach in applying the various psychosocial interventions employed in the treatment of bipolar disorder. The objective of this approach is early identification of prodromal symptoms in order to prevent hospitalization and behavioral dysfunction. PMID:15597141

  18. Effects of a Multidisciplinary Approach to Improve Volume of Diagnostic Material in CT-Guided Lung Biopsies

    PubMed Central

    Ferguson, Philip E.; Sales, Catherine M.; Hodges, Dalton C.; Sales, Elizabeth W.

    2015-01-01

    Background Recent publications have emphasized the importance of a multidisciplinary strategy for maximum conservation and utilization of lung biopsy material for advanced testing, which may determine therapy. This paper quantifies the effect of a multidisciplinary strategy implemented to optimize and increase tissue volume in CT-guided transthoracic needle core lung biopsies. The strategy was three-pronged: (1) once there was confidence diagnostic tissue had been obtained and if safe for the patient, additional biopsy passes were performed to further increase volume of biopsy material, (2) biopsy material was placed in multiple cassettes for processing, and (3) all tissue ribbons were conserved when cutting blocks in the histology laboratory. This study quantifies the effects of strategies #1 and #2. Design This retrospective analysis comparing CT-guided lung biopsies from 2007 and 2012 (before and after multidisciplinary approach implementation) was performed at a single institution. Patient medical records were reviewed and main variables analyzed include biopsy sample size, radiologist, number of blocks submitted, diagnosis, and complications. The biopsy sample size measured was considered to be directly proportional to tissue volume in the block. Results Biopsy sample size increased 2.5 fold with the average total biopsy sample size increasing from 1.0 cm (0.9–1.1 cm) in 2007 to 2.5 cm (2.3–2.8 cm) in 2012 (P<0.0001). The improvement was statistically significant for each individual radiologist. During the same time, the rate of pneumothorax requiring chest tube placement decreased from 15% to 7% (P = 0.065). No other major complications were identified. The proportion of tumor within the biopsy material was similar at 28% (23%–33%) and 35% (30%–40%) for 2007 and 2012, respectively. The number of cases with at least two blocks available for testing increased from 10.7% to 96.4% (P<0.0001). Conclusions The effect of this multidisciplinary strategy to CT

  19. [Multidisciplinary approach of the obese child to the dietary residency of "Clairs Vallons"].

    PubMed

    Vande Weyer, M; Bolterys, S; Guzman, E

    2005-09-01

    of the symptom. The therapeutic work to the Dietary Residency of "Clairs Vallons" consists therefore in a global approach of the child within a multidisciplinary team (pediatrician, dietitian, psychologist, physiotherapist, social assistant, orthofenist, educator and teacher) all united around the concept "to eat happy". PMID:16240863

  20. A Multidisciplinary Approach with Hyperbaric Oxygen Therapy Improve Outcome in Snake Bite Injuries

    PubMed Central

    Korambayil, Pradeoth Mukundan; Ambookan, Prashanth Varkey; Abraham, Siju Varghese; Ambalakat, Ajay

    2015-01-01

    Aim: Snakebite injuries are common in tropical India among those who are involved in outdoor activities. These injuries results in cellulitis, gangrene at the bite area, bleeding manifestations, compartment syndrome, regional lymphadenopathy, septicemia, hypotension, and disseminated intravascular coagulation (DIC) resulting in significant morbidity and mortality. The purpose of this study is to share our experience of multidisciplinary approach in the management of snakebite injuries of the extremities with various treatment modalities including hyperbaric oxygen (HBO) therapy, surgical debridement, and soft tissue reconstruction to provide an effective treatment for snake bite injuries. Methods: The study was conducted in the Department of Plastic Surgery, during the period October 2012–December 2014, wherein all the patients who were admitted with snakebite injuries were enrolled and the patients treated in plastic surgery department were included into the study. Out of total 766 patients, there were 323 patients treated with anti snake venom (ASV) and 29 died among the treated patients; 205 patients belonged to pediatric age group. Results: Out of 112 patients referred to Department of Plastic Surgery, 50 cases presented with cellulitis, 24 patients with compartment syndrome, and 38 patients were referred for the management of soft tissue cover over the extremities. Among 112 patients, 77 involved the lower extremity and 35 the upper extremity. Conclusion: Multidisciplinary approach including hyperbaric oxygen (HBO) therapy improves outcome in the management of snakebite injuries of the extremities. PMID:26862269

  1. Taking ergonomics to the bedside--a multi-disciplinary approach to designing safer healthcare.

    PubMed

    Norris, Beverley; West, Jonathan; Anderson, Oliver; Davey, Grace; Brodie, Andrea

    2014-05-01

    A multi-disciplinary approach to designing safer healthcare was utilised to investigate risks in the bed-space in elective surgical wards. The Designing Out Medical Error (DOME) project brought together clinicians, designers, psychologists, human factors and business expertise to develop solutions for the highest risk healthcare processes. System mapping and risk assessment techniques identified nearly 200 potential failure modes in hand hygiene, isolation of infection, vital signs monitoring, medication delivery and handover of information. Solutions addressed issues such as the design of equipment, reminders, monitoring, feedback and standardisation. Some of the solutions, such as the CareCentre™, which brings many of the processes and equipment together into one easy to access workstation at the foot of the bed, have been taken forward to clinical trials and manufacture. The project showed the value of the multi-disciplinary and formal human factors approaches to healthcare design for patient safety. In particular, it demonstrates the application of human factors to a complete design cycle and provides a case study for the activities required to reach a safe, marketable product. PMID:24135560

  2. A multi-disciplinary team approach to managing natural resource damages liability

    SciTech Connect

    Campbell, T.A.

    1995-12-31

    In 1989, the Exxon-Valdez oil spill and its impacts to Prince William Sound aroused the nation`s concern about the natural resources. As a result, federal and state trustees have dramatically increased the attention and effort given natural resource damages (NRD) both from an ecological and liability perspective. NRD liability is a mixed bag of problems. Successful management of that liability requires consideration of scientific (i.e., biological, toxicological, etc.) economic, engineering, legal and policy issues. A logical solution to NRD liability ultimately requires an interactive multi-disciplinary team approach that factors in the perspective of each relevant disciplines. If any one of these disciplines is excluded, the solution is vulnerable to failure. For example, an attorney is taught to reach solutions based on legal considerations and concerns. An attorney does not think like an economist, biologists or engineer and, therefore, without input from all relevant disciplines the attorney will likely reach a valid legal conclusion which adequately addresses only one aspect of the NRD liability quagmire. Further, a PRP must be cognizant that NRD trustees, both federal and state, are with few exceptions considering the PRP`s NRD liability using all relevant disciplines. Therefore, environmental liability managers must use a multi-disciplinary team approach in order to ensure a logical, defendable mixed solution to a mixed bag of problems.

  3. Multidisciplinary Approach to the Treatment of Concomitant Rectal and Vaginal Prolapse.

    PubMed

    Jallad, Karl; Gurland, Brooke

    2016-06-01

    Rectal prolapse and vaginal prolapse have traditionally been treated as separate entities despite sharing a common pathophysiology. This compartmentalized approach often leads to frustration and suboptimal outcomes. In recent years, there has been a shift to a more patient-centered, multidisciplinary approach. Procedures to repair pelvic organ prolapse are divided into three categories: abdominal, perineal, and a combination of both. Most commonly, a combined minimally invasive abdominal sacral colpopexy and ventral rectopexy is performed to treat concomitant rectal and vaginal prolapse. Combining the two procedures adds little operative time and offers complete pelvic floor repair. The choice of minimally invasive abdominal prolapse repair versus perineal repair depends on the patient's comorbidities, previous surgeries, preference to avoid mesh, and physician's expertise. Surgeons should at least be able to identify these patients and provide the appropriate treatment or refer them to specialized centers. PMID:27247534

  4. Multidisciplinary, multimodal approach for a child with a traumatic facial scar.

    PubMed

    Admani, Shehla; Gertner, Jeffrey W; Grosman, Amanda; Shumaker, Peter R; Uebelhoer, Nathan S; Krakowski, Andrew C

    2015-03-01

    The treatment of disfiguring and disabling scars remains a field of active study, reinvigorated with recent advances in techniques and technologies. A variety of approaches can be utilized depending on scar characteristics, location, degree of tissue loss, and associated contractures. Just as traumatic scars can be complex and heterogeneous, the corresponding paradigm for treatment must also be flexible and multimodal for optimal improvement. This report describes a 3-year-old girl with a "mixed" (atrophic/hypertrophic), violaceous, contracted facial scar from a dog bite. It was treated with a novel approach utilizing a multidisciplinary pediatric scar team to combine autologous fat grafting, ablative fractional laser resurfacing, pulsed-dye laser, and laser-assisted delivery of a corticosteroid as concurrent, multimodal therapy to optimize the outcome. PMID:25922954

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

    PubMed Central

    Grant, Cynthia L; Lusk, Jaimie L

    2015-01-01

    As health care trends toward a system of care approach, providers from various disciplines strive to collaborate to provide optimal care for their patients. While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicidality, standardized clinical guidelines for such an approach do not yet exist. In this article, the authors propose the adoption of the therapeutic risk management of the suicidal patient (TRMSP) to improve suicide risk assessment and management within multidisciplinary systems of care. The TRMSP, which has been fully articulated in previous articles, involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. Augmenting clinical risk assessments with reliable and valid structured instruments serves several functions, including ensuring important aspects of suicide are addressed, establishing a baseline for suicidal thoughts and behaviors, facilitating interprofessional communication, and mitigating risk. Similarly, a two-dimensional risk stratification qualifying suicide risk in terms of both severity and temporality can enhance communication across providers and settings and improve understanding of acute crises in the context of chronic risk. Finally, safety planning interventions allow providers and patients to collaboratively create a personally meaningful plan for managing a suicidal crisis that can be continually modified across time with multiple providers in different care settings. In a busy care environment, the TRMSP can provide concrete guidance on conducting clinically and medicolegally sound suicide risk assessment and management. This collaborative and comprehensive process would potentially improve care of patients with suicidality, optimize clinical resources, decrease unnecessary and costly admissions, and mitigate medicolegal risk. The TRMSP may

  6. Management of Charcot–Marie–Tooth disease: improving long-term care with a multidisciplinary approach

    PubMed Central

    McCorquodale, Donald; Pucillo, Evan M; Johnson, Nicholas E

    2016-01-01

    Charcot–Marie–Tooth (CMT) disease is the most common inherited neuropathy and one of the most common inherited diseases in humans. The diagnosis of CMT is traditionally made by the neurologic specialist, yet the optimal management of CMT patients includes genetic counselors, physical and occupational therapists, physiatrists, orthotists, mental health providers, and community resources. Rapidly developing genetic discoveries and novel gene discovery techniques continue to add a growing number of genetic subtypes of CMT. The first large clinical natural history and therapeutic trials have added to our knowledge of each CMT subtype and revealed how CMT impacts patient quality of life. In this review, we discuss several important trends in CMT research factors that will require a collaborative multidisciplinary approach. These include the development of large multicenter patient registries, standardized clinical instruments to assess disease progression and disability, and increasing recognition and use of patient-reported outcome measures. These developments will continue to guide strategies in long-term multidisciplinary efforts to maintain quality of life and preserve functionality in CMT patients. PMID:26855581

  7. Education on breast disease in an obstetrics and gynecology training program: a multidisciplinary approach.

    PubMed

    Rosa, C; Kiley, K C; Reeves, T A; McPhail, J F; Morgenstern, L L

    1990-04-01

    Breast cancer affects one in ten women during their lifetime. Recognizing the importance of early detection in the prognosis of this condition, the American Board of Obstetrics and Gynecology has stated guidelines encouraging breast disease education in obstetrics and gynecology training programs. To fulfill this academic responsibility, we have organized a multidisciplinary Breast Disease Detection and Treatment Clinic where patients with abnormal mammograms or any breast-related complaints are evaluated and managed. In cooperation with the radiology department and general surgery service, a mammogram review conference has been instituted. Abnormal mammograms are reviewed with a radiologist. Our activities have been coordinated such that a general surgery staff member and resident are present during the breast clinic hours to review mammograms and to examine the patients with the gynecologist, providing immediate consultation. Needle aspiration of breast cysts, repeat imaging studies, and general surgery referrals for breast biopsies are performed as indicated. The patient receives integrated care of her breast problem in one visit, and our residents gain the experience of diagnosing and managing breast problems which, before establishment of this clinic, were referred to the general surgery department. This multidisciplinary approach developed in our institution helps us provide the most efficient care to our patients, while providing our residents with integrated teaching and training concerning the diagnosis and management of breast disease. PMID:2314793

  8. The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients

    PubMed Central

    Aoki, Shiro; Hirayama, Junko; Nakamori, Masahiro; Yoshikawa, Mineka; Nezu, Tomohisa; Kubo, Satoshi; Nagano, Yuka; Nagao, Akiko; Yamane, Naoya; Nishikawa, Yuichi; Takamoto, Megumi; Ueno, Hiroki; Ochi, Kazuhide; Maruyama, Hirofumi; Yamamoto, Hiromi; Matsumoto, Masayasu

    2016-01-01

    Dysphagia occurs in acute stroke patients at high rates, and many of them develop aspiration pneumonia. Team approaches with the cooperation of various professionals have the power to improve the quality of medical care, utilizing the specialized knowledge and skills of each professional. In our hospital, a multidisciplinary participatory swallowing team was organized. The aim of this study was to clarify the influence of a team approach on dysphagia by comparing the rates of pneumonia in acute stroke patients prior to and post team organization. All consecutive acute stroke patients who were admitted to our hospital between April 2009 and March 2014 were registered. We analyzed the difference in the rate of pneumonia onset between the periods before team organization (prior period) and after team organization (post period). Univariate and multivariate analyses were performed using a Cox proportional hazards model to determine the predictors of pneumonia. We recruited 132 acute stroke patients from the prior period and 173 patients from the post period. Pneumonia onset was less frequent in the post period compared with the prior period (6.9% vs. 15.9%, respectively; p = 0.01). Based on a multivariate analysis using a Cox proportional hazards model, it was determined that a swallowing team approach was related to pneumonia onset independent from the National Institutes of Health Stroke Scale score on admission (adjusted hazard ratio 0.41, 95% confidence interval 0.19–0.84, p = 0.02). The multidisciplinary participatory swallowing team effectively decreased the pneumonia onset in acute stroke patients. PMID:27138162

  9. Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach

    PubMed Central

    Wentzel, Jobke; Van Gemert-Pijnen, Julia EWC

    2013-01-01

    Background Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. Objective In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Methods Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. Results The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end

  10. Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge

    PubMed Central

    Berry, Jonathan; Nisbet, Angus; Bloomfield, David; Burkill, Guy

    2013-01-01

    Abstract The purpose of this article is to familiarize the reader with the anatomy of the major pelvic nerves and the clinical features of associated lumbosacral plexopathies. To demonstrate this we illustrate several cases of malignant lumbosacral plexopathy on computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography. A new lumbosacral plexopathy in a patient with a prior history of abdominal or pelvic malignancy is usually of malignant etiology. Biopsies may be required to definitively differentiate tumour from posttreatment fibrosis, and in cases of inconclusive sampling or where biopsies are not possible, follow-up imaging may be necessary. In view of the complexity of clinical findings often confounded by a history of prior surgery and/or radiotherapy, a multidisciplinary approach between oncologists, neurologists, and radiologists is often required for what can be a diagnostic challenge. PMID:24433993

  11. Interim palatal lift prosthesis as a constituent of multidisciplinary approach in the treatment of velopharyngeal incompetence

    PubMed Central

    Raj, Vineet; Aeran, Himanshu

    2012-01-01

    The velopharynx is a tridimensional muscular valve located between the oral and nasal cavities, consisting of the lateral and posterior pharyngeal walls and the soft palate, and controls the passage of air. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to a lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy; though optimal results often require a multidisciplinary approach for the restoration of both anatomical and physiological defect. We report a case of 56 year old male patient presenting with hypernasal speech pattern and velopharyngeal insufficiency secondary to cleft palate which had been surgically corrected 18 years ago. The patient was treated with a combination of speech therapy and palatal lift prosthesis employing interim prostheses in various phases before the insertion of definitive appliance. This phase-wise treatment plan helped to improve patient's compliance and final outcome. PMID:23236578

  12. Fine Needle Aspiration Cytology vs. the Postoperative Histology - the Continuing Need for Multi-Disciplinary Approach?

    PubMed

    Gill, G; Kalyanasundaram, K; Varughese, G; Wilson, P; Varadhan, L

    2016-07-01

    We set out to investigate the concordance rates that were observed between fine needle aspiration cytology (FNA) compared with that of the post operative histology obtained for thyroid nodules over an 8 year period at a large university hospital.A retrospective analysis of 355 cases was conducted; patients operated for hyperthyroidism were excluded for the purposes of this study. We identified malignancy in a total of 101 cases (28%) The chance of malignancy with 2 Thy1 specimens was 5% in this study and 9% was observed in those with a Thy 2 FNA. On the converse, 7% of patient had malignant cytology on FNA though post-operative histology turned out to be benign.This therefore highlights the potential for discordance between thyroid FNA cytology and post-operative histology in the assessment of any thyroid nodule and thus reinforcing the need for a multidisciplinary approach in the assessment of all thyroid nodules. PMID:27223871

  13. Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses.

    PubMed

    Mocerino, Carmela; Iannaci, Giuseppe; Sapere, Patrizia; Luise, Rossella; Canonico, Silvestro; Gambardella, Antonio

    2016-09-01

    Angiosarcomas are malignant tumors of endovascular origin, which may be divided into primary and secondary forms. Secondary breast angiosarcomas are an increasing problem, especially in patients treated with breast-conserving surgery followed by radiotherapy.We report a case of radiation-induced angiosarcoma of the breast in a 77-year-old woman who presented with a suspect lesion in her left breast. Excisional biopsy and subsequent immunohistochemical staining of the specimen was performed. Histological report was diagnostic for low-intermediate grade angiosarcoma. The tumor cells were diffusely positive for CD31 and CD34. We performed surgical resection with mastectomy.A multidisciplinary approach with bleomycin-based electrochemotherapy, radiation treatment, and chemotherapy with pegylated liposomal doxorubicin has been most useful to control subsequent local relapses. To date, the patient is under close observation and is performing well. No recurrence has been demonstrated after ending of chemotherapy. PMID:26872968

  14. A multidisciplinary approach to Alzheimer's disease: who should be members of the team?

    PubMed

    Jurkowski, C L

    1998-04-27

    The treatment goal for persons with Alzheimer's disease (AD) is to maintain the highest level of function possible and to minimize behavioral disturbances. Since multiple factors have an impact on function, a multidisciplinary approach to treatment and care is most effective. Whereas the primary-care physician can diagnose AD in most patients, data collection and routine examinations can be conducted by a nurse practitioner/clinical nurse specialist, and nonprofessional staff can often do mental status testing. Nutritionists, pharmacists, geropsychiatrists, home-healthcare case managers, elder-law attorneys, support services, and caregivers all fill important roles as members of the "AD team." With two AD drugs currently available and several impending new introductions, pharmacotherapy is becoming an increasingly more critical treatment option. PMID:9617847

  15. Multidisciplinary approach to R&D in vitiligo, a neglected skin disease.

    PubMed

    Valle, Yan; Lotti, Torello M; Hercogova, Jana; Schwartz, Robert A; Korobko, Igor V

    2012-01-01

    A global interest in therapies for neglected diseases is rising, but traditional biopharma research and development (R&D) process is prohibitively expensive to justify cost of their development. Vitiligo is a multifactorial orphan disease that affects at minimum 35 million people worldwide, yet no therapeutic solutions exist. The present authors describe a budget-minded pursuit of the new therapy development for vitiligo, which includes a multidiscipline collaboration and effective bridging between academic research, biobanking, and bioinformatics. The present authors anticipate that the present authors' "theoretically induced and empirically guided" discovery process will enable development of more leads, with a much greater probability of success and under tighter budgets compared with those of the biopharma company. Ultimately, the multidisciplinary approach described below facilitates the collaborative development of personalized treatments for different patient subpopulations in vitiligo and other neglected diseases. PMID:23237032

  16. A case of small bowel mesenteric pneumatosis: A multidisciplinary approach to clinical interpretation and intervention

    PubMed Central

    Johnstone, Christopher; Salih, Tamir; Saha, Arin

    2016-01-01

    Introduction Pneumatosis of the small bowel mesentery is rare and the preserve of case reports. This case report describes the importance of a multi-disciplinary team (MDT) approach to rare pathologies. Case report A 78-year-old man presented to our unit with a two-day history of upper abdominal pain associated with nausea and intermittent vomiting. An urgent computed tomography (CT) scan was organised. The scan was grossly abnormal and difficult to interpret; it was reported as widespread intra-mural gas within the small bowel wall most likely secondary to extensive small bowel ischaemia. Although surgical intervention was very high risk (predicted P-possum mortality of over 60%) and there was a strong possibility that the patient would not recover from surgery, the disparity between clinical and radiological findings meant that a diagnostic laparoscopy was indicated. A diagnostic laparoscopy showed that the small bowel itself was normal but there was extensive gas within the mesentery, caused by a band adhesion which had eroded into the peritoneal layer of the small bowel mesentery. Discussion Pneumatosis of the small bowel mesentery is a pathological sign rather than a diagnosis and is characterised by gas within the mesenteric sleeves. It is likely associated with significant morbidity and therefore rarely observed as the majority with this sign would not be deemed suitable for surgical intervention. Conclusion The case highlights an unusual pathology, rare imaging findings, the importance of a multi-disciplinary approach and the value of clear communication and informed consent when considering major intervention or surgery. PMID:27082993

  17. How to Boost the Breast Tumor Bed? A Multidisciplinary Approach in Eight Steps

    SciTech Connect

    Kirova, Youlia M. Fournier-Bidoz, Nathalie; Servois, Vincent; Laki, Fatima; Pollet, Guillaume A.; Salmon, Remy; Thomas, Alexandra; Dendale, Remi; Bollet, Marc A.; Campana, Francois M.D.; Fourquet, Alain

    2008-10-01

    Purpose: To describe a new procedure for breast radiotherapy that will improve tumor bed localization and radiotherapy treatment using a multidisciplinary approach. Patients and Methods: This pilot study was conducted by departments of radiation oncology, surgery, and radiology. A new procedure has been implemented, summarized as eight steps: from pre-surgery contrast CT to surgery, tumor bed planning target volume (PTV) determination, and finally breast and tumor bed irradiation. Results: Twenty patients presenting with T1N0M0 tumors were enrolled in the study. All patients underwent lumpectomy with the placement of surgical clips in the tumor bed region. During surgery, 1 to 5 clips were placed in the lumpectomy cavity before the plastic procedure. All patients underwent pre- and postoperative CT scans in the treatment position. The two sets of images were registered with a match-point registration. All volumes were contoured and the results evaluated. The PTV included the clips region, the gross tumor volume, and the surgical scar, with an overall margin of 5-10 mm in all directions, corresponding to localization and setup uncertainties. For each patient the boost PTV was discussed and compared with our standard forward-planned PTV. Conclusions: We demonstrate the feasibility of a tumor bed localization and treatment procedure that seems adaptable to routine practice. Our study shows the advantages of a multidisciplinary approach for tumor bed localization and treatment. The use of more than 1 clip associated with pre- to postoperative CT image registration allows better definition of the PTV boost volume.

  18. A multidisciplinary approach to the evaluation and management of interstitial cystitis/bladder pain syndrome: an ideal model of care

    PubMed Central

    Gupta, Priyanka; Gaines, Natalie; Sirls, Larry T.

    2015-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a complex syndrome that has long been treated with bladder directed therapies, which often fail to address the multiple underlying etiologies that can contribute to this disease process. This disease often involves symptoms that extend beyond the bladder and involve the pelvic floor making it crucial for clinicians to approach the patient using a multidisciplinary team. This article will discuss the underlying etiologies for IC/BPS and describe the multidisciplinary approach which we have found to be extremely successful in managing this patient population. PMID:26816861

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

    PubMed

    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. PMID:27145433

  20. A Systematic Approach for Quantitative Analysis of Multidisciplinary Design Optimization Framework

    NASA Astrophysics Data System (ADS)

    Kim, Sangho; Park, Jungkeun; Lee, Jeong-Oog; Lee, Jae-Woo

    An efficient Multidisciplinary Design and Optimization (MDO) framework for an aerospace engineering system should use and integrate distributed resources such as various analysis codes, optimization codes, Computer Aided Design (CAD) tools, Data Base Management Systems (DBMS), etc. in a heterogeneous environment, and need to provide user-friendly graphical user interfaces. In this paper, we propose a systematic approach for determining a reference MDO framework and for evaluating MDO frameworks. The proposed approach incorporates two well-known methods, Analytic Hierarchy Process (AHP) and Quality Function Deployment (QFD), in order to provide a quantitative analysis of the qualitative criteria of MDO frameworks. Identification and hierarchy of the framework requirements and the corresponding solutions for the reference MDO frameworks, the general one and the aircraft oriented one were carefully investigated. The reference frameworks were also quantitatively identified using AHP and QFD. An assessment of three in-house frameworks was then performed. The results produced clear and useful guidelines for improvement of the in-house MDO frameworks and showed the feasibility of the proposed approach for evaluating an MDO framework without a human interference.

  1. Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach.

    PubMed

    Ellis, Michael J; Leddy, John; Willer, Barry

    2016-01-01

    Historically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to school and sports activities in the majority of athletes, an important proportion will develop persistent concussion symptoms characteristic of post-concussion syndrome (PCS). Recent advances in exercise science, neuroimaging, and clinical research suggest that the clinical manifestations of PCS are mediated by unique pathophysiological processes that can be identified by features of the clinical history and physical examination as well as the use of graded aerobic treadmill testing. Athletes who develop PCS represent a unique population whose care must be individualized and must incorporate a rehabilitative strategy that promotes enhanced recovery of concussion-related symptoms while preventing physical deconditioning. In this review, we present our evolving evidence-based approach to evaluation and management of athletes with PCS that aims to identify the pathophysiological mechanisms mediating persistent concussion symptoms and guides the initiation of individually tailored rehabilitation programs that target these processes. In addition, we outline the important qualified roles that multi-disciplinary healthcare professionals can play in the management of this patient population, and discuss where future research efforts must be focused to further evaluate this evolving pathophysiological approach. PMID:27605923

  2. Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach

    PubMed Central

    Ellis, Michael J.; Leddy, John; Willer, Barry

    2016-01-01

    Historically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to school and sports activities in the majority of athletes, an important proportion will develop persistent concussion symptoms characteristic of post-concussion syndrome (PCS). Recent advances in exercise science, neuroimaging, and clinical research suggest that the clinical manifestations of PCS are mediated by unique pathophysiological processes that can be identified by features of the clinical history and physical examination as well as the use of graded aerobic treadmill testing. Athletes who develop PCS represent a unique population whose care must be individualized and must incorporate a rehabilitative strategy that promotes enhanced recovery of concussion-related symptoms while preventing physical deconditioning. In this review, we present our evolving evidence-based approach to evaluation and management of athletes with PCS that aims to identify the pathophysiological mechanisms mediating persistent concussion symptoms and guides the initiation of individually tailored rehabilitation programs that target these processes. In addition, we outline the important qualified roles that multi-disciplinary healthcare professionals can play in the management of this patient population, and discuss where future research efforts must be focused to further evaluate this evolving pathophysiological approach. PMID:27605923

  3. Multidisciplinary Approach to Rehabilitation. Report from the Study Group. Institute on Rehabilitation Issues (13th, Little Rock, Arkansas, October 1986).

    ERIC Educational Resources Information Center

    Hope, Robert; And Others

    This manual is the response of a National Institute on Rehabilitation Issues (IRI) Prime Study Group to charges given to the group by the National IRI Planning Committee to develop a meaningful training and resource document on the multidisciplinary approach to vocational rehabilitation. The guide is organized in seven chapters that cover the…

  4. A multi-disciplinary approach to sugarcane research at the USDA, ARS, Sugarcane Research Unit in Houma

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The mission of the Sugarcane Research Unit (SRU) is to provide research-based solutions that enhance the viability of domestic sugarcane industry. To accomplish this mission, SRU uses a multidisciplinary approach to develop improved varieties and environmentally friendly production strategies. Cons...

  5. Critical Education for Work: Multidisciplinary Approaches. Social and Policy Issues in Education: The David C. Anchin Series.

    ERIC Educational Resources Information Center

    Lakes, Richard D., Ed.

    This book expands the meaning of today's education for work by offering five multidisciplinary approaches--school-to-work transitions, gender equity, labor education, economic democracy, and vocational education--revealing the complexities of personal, social, and cultural transformation. "Critical Education for Work" (Richard D. Lakes) is an…

  6. A multidisciplinary methodological approach for slope stability assessment of an area prone to shallow landslides

    NASA Astrophysics Data System (ADS)

    Bordoni, Massimiliano; Meisina, Claudia; Valentino, Roberto; Bittelli, Marco; Battista Bischetti, Gian; Vercesi, Alberto; Chersich, Silvia; Giuseppina Persichillo, Maria

    2016-04-01

    Rainfall-induced shallow landslides are widespread slope instabilities phenomena in several hilly and mountainous contexts all over the world. Due to their high density of diffusion also in small areas, they can provoke important damages to terrains, infrastructures, buildings, and, sometimes, loss of human lives. Shallow landslides affect superficial soils of limited thickness (generally lower than 2 m), located above weathered or not bedrock levels. Their triggering mechanism is strictly linked to the hydrological response of the soils to rainfall events. Thus, it becomes fundamental a comprehensive analysis of the soil properties which can influence the susceptibility of a slope to shallow landslides. In this study, a multidisciplinary approach was followed for the characterization of the soils and the individuation of the triggering conditions in an area particularly prone to shallow failures, for slope stability assessment. This area corresponded to the hilly sector of North-Eastern Oltrepò Pavese (Lombardy Region, Northern Italy), where the density of shallow landslides is really high, reaching more than 36 landslides per km2. The soils of the study area were analyzed through a multidisciplinary characterization, which took into account for the main geotechnical, mechanical and mineralogical parameters and also for the main pedological features of the materials. This approach allowed for identifying the main features and the horizons which could influence the soil behavior in relation to the conditions that are preparatory to shallow landslides development. In a test-site slope, representative of the main geomorphological, geological and landslides distribution characteristics typical of the study area, a continuous in time monitoring of meteorological (rainfall amount, air temperature, air humidity, atmospheric pressure, net solar radiation, wind speed and direction) and hydrological (soil water content, pore water pressure) parameters was implemented. In

  7. The Oncosurgery Approach to Managing Liver Metastases from Colorectal Cancer: A Multidisciplinary International Consensus

    PubMed Central

    De Gramont, Aimery; Figueras, Joan; Guthrie, Ashley; Kokudo, Norihiro; Kunstlinger, Francis; Loyer, Evelyne; Poston, Graeme; Rougier, Philippe; Rubbia-Brandt, Laura; Sobrero, Alberto; Tabernero, Josep; Teh, Catherine; Van Cutsem, Eric

    2012-01-01

    An international panel of multidisciplinary experts convened to develop recommendations for the management of patients with liver metastases from colorectal cancer (CRC). The aim was to address the main issues facing the CRC hepatobiliary multidisciplinary team (MDT) when managing such patients and to standardize the treatment patients receive in different centers. Based on current evidence, the group agreed on a number of issues including the following: (a) the primary aim of treatment is achieving a long disease-free survival (DFS) interval following resection; (b) assessment of resectability should be performed with high-quality cross-sectional imaging, staging the liver with magnetic resonance imaging and/or abdominal computed tomography (CT), depending on local expertise, staging extrahepatic disease with thoracic and pelvic CT, and, in selected cases, fluorodeoxyglucose positron emission tomography with ultrasound (preferably contrast-enhanced ultrasound) for intraoperative staging; (c) optimal first-line chemotherapy—doublet or triplet chemotherapy regimens combined with targeted therapy—is advisable in potentially resectable patients; (d) in this situation, at least four courses of first-line chemotherapy should be given, with assessment of tumor response every 2 months; (e) response assessed by the Response Evaluation Criteria in Solid Tumors (conventional chemotherapy) or nonsize-based morphological changes (antiangiogenic agents) is clearly correlated with outcome; no imaging technique is currently able to accurately diagnose complete pathological response but high-quality imaging is crucial for patient management; (f) the duration of chemotherapy should be as short as possible and resection achieved as soon as technically possible in the absence of tumor progression; (g) the number of metastases or patient age should not be an absolute contraindication to surgery combined with chemotherapy; (h) for synchronous metastases, it is not advisable to

  8. Integrated therapeutic approaches in head and neck cancer: the importance of multidisciplinary team management.

    PubMed

    Perri, Francesco; Muto, Paolo; Aversa, Corrado; Daponte, Antonio; Della Vittoria, Giuseppina; Pepe, Stefano; Caponigro, Francesco

    2013-07-01

    Multidisciplinary team (MDT) is of paramount importance in the approach to patients with head and neck cancer. Its aim is to provide the best diagnostic work-up, tumor staging, and treatment. Furthermore, the prognosis of patients who are managed by MDT is usually better. MDT has a great value in all presentation settings. The role of the pathologist in the team is of utmost importance, in particular with regards to information provided on Human Papilloma Virus (HPV) status, which has a well acknowledged independent prognostic value mainly in oropharyngeal carcinoma. In early stage disease, namely in T1-2 N0 M0 patients, the meetings within the MDT mainly involve surgeons and radiation therapists. Surgery represents the mainstay of treatment, while radiation therapy is a suitable alternative, in particular in patients with advanced age, poor performance status and comorbidities. In locally advanced disease, surgeons, medical oncologists and radiotherapists are the key people, since different approaches have been carried out. In operable patients, adjuvant chemoradiation is indicated when resection margins are involved or close, or in presence of extracapsular nodal spread. Concurrent chemoradiotherapy, preceded or not by induction chemotherapy, is the favourite approach in this setting when surgery is strictly not indicated. In recurrent/metastatic disease chemotherapy and best supportive care are the main options, although local treatments, such as reirradiation and salvage surgery, are also worth considering. The standard chemotherapy treatment has finally evolved after about 30 years, and strong efforts are being pursued to further improve the outcome, mainly with the addition of new drugs. PMID:23194421

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

    PubMed

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

    2015-09-01

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

  10. Place of Arterial Embolization in Severe Blunt Hepatic Trauma: A Multidisciplinary Approach

    SciTech Connect

    Monnin, Valerie Sengel, Christian; Thony, Frederic; Bricault, Ivan; Voirin, David; Letoublon, Christian; Broux, Christophe; Ferretti, Gilbert

    2008-09-15

    This study evaluates the efficacy of arterial embolization (AE) for blunt hepatic traumas (BHT) as part of a combined management strategy based on the hemodynamic status of patients and CT findings. From 2000 to 2005, 84 patients were admitted to our hospital for BHT. Of these, 14 patients who had high-grade injuries (grade III [n = 2], grade IV [n = 9], grade V [n = 3]) underwent AE because of arterial bleeding and were included in the study. They were classified into three groups according to their hemodynamic status: (1) unresponsive shock, (2) shock improved with resuscitation, and (3) hemodynamic stability. Four patients (group 1) underwent, first, laparotomy with packing and, then, AE for persistent bleeding. Ten patients who were hemodynamically stable (group 1) or even unstable (group 2) underwent AE first, based on CT findings. AE was successful in all cases. The mortality rate was 7% (1/14). Only two angiography-related complications (gallbladder infarction) were reported. Liver-related complications (abdominal compartment syndrome and biliary complications) were frequent and often required secondary interventions. Our multidisciplinary approach for the management of BHT gives a main role to embolization, even for hemodynamically unstable patients. In this strategy AE is very efficient and has a low complication rate.

  11. Role of interventional nephrology in the multidisciplinary approach to hemodialysis vascular access care

    PubMed Central

    Beathard, Gerald A.

    2015-01-01

    Dialysis vascular access planning, creation, and management is of critical importance to the dialysis patient population. It requires a multidisciplinary approach involving patients and their families, dialysis facility staff, the nephrologist, the surgeon, and the interventionalist. With the emergence of interventional nephrology as a subspecialty of nephrology, the nephrologist is increasingly providing both the nephrology and interventional aspects of care, and in some areas, the surgical functions as well. Most of these interventional nephrologists work in freestanding outpatient dialysis access centers (DACs). Large clinical studies published over the past 10 years demonstrate that the interventional nephrologist can manage the problems associated with dialysis access dysfunction effectively, safely, and economically. A recently published study based upon United States Medicare claims data in which a DAC patient group (n = 27,613) and a hospital outpatient department patient group (HOPD group; n = 27,613) were compared using propensity score matching techniques showed that patients treated in the DACs had significantly better clinical outcomes (P<0.001). This included fewer vascular access-related infections (0.18 vs. 0.29), fewer septicemia-related hospitalizations (0.15 vs. 0.18), and a lower mortality rate (47.9% vs. 53.5%). PMID:26484036

  12. Experimental testicular tissue banking to generate spermatogenesis in the future: A multidisciplinary team approach.

    PubMed

    Sadri-Ardekani, Hooman; McLean, Thomas W; Kogan, Stanley; Sirintrapun, Joseph; Crowell, Kathryn; Yousif, Mustafa Q; Hodges, Steve J; Petty, John; Pranikoff, Thomas; Sieren, Leah; Zeller, Kristen; Atala, Anthony

    2016-04-15

    Spermatogonial stem cell (SSC) loss due to cancer treatment, developmental disorder or genetic abnormality may cause permanent infertility. Cryopreservation of ejaculated sperm is an effective method of fertility preservation in adult males at risk of infertility. However this is not an option in pre-pubertal boys because spermatogenesis has not yet started, and it is difficult in adolescents who are not sexually mature. Therefore testicular tissue cryopreservation to preserve SSCs for future generation of spermatogenesis, either in vivo or in vitro, could be an option for these groups of patients. Although SSC transplantation has been successful in several species including non-human primates, it is still experimental in humans. There are several remaining concerns which need to be addressed before initiating trials of human SSC autotransplantation. Establishment of a testicular tissue banking system is a fundamental step towards using SSC technology as a fertility preservation method. It is important to understand the consultation, harvesting the testicular tissue, histological evaluation, cryopreservation, and long term storage aspects. We describe here a multidisciplinary approach to establish testicular tissue banking for males at risk of infertility. PMID:26917042

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

    PubMed Central

    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

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

    PubMed Central

    Walker, Craig M; Bunch, Frank T; Cavros, Nick G; Dippel, Eric J

    2015-01-01

    Peripheral arterial disease (PAD) is frequently diagnosed after permanent damage has occurred, resulting in a high rate of morbidity, amputation, and loss of life. Early and ongoing diagnosis and treatment is required for this progressive disease. Lifestyle modifications can prevent or delay disease progression and improve symptoms. Limb-sparing endovascular interventions can restore circulation based on appropriate diagnostic testing to pinpoint vascular targets, and intervention must occur as early as possible to ensure optimal clinical outcomes. An algorithm for the diagnosis and management of PAD was developed to enable a collaborative approach between the family practice and primary care physician or internist and various specialists that may include a diabetologist, endocrinologist, smoking cessation expert, hypertension and lipid specialist, endovascular interventionalist, vascular surgeon, orthopedist, neurologist, nurse practitioner, podiatrist, wound healing expert, and/or others. A multidisciplinary team working together has the greatest chance of providing optimal care for the patient with PAD and ensuring ongoing surveillance of the patient’s overall health, ultimately resulting in better quality of life and increased longevity for patients with PAD. PMID:26203234

  15. A multidisciplinary approach to promoting healthy subsistence fish consumption in culturally distinct communities.

    PubMed

    Driscoll, David; Sorensen, Asta; Deerhake, Marion

    2012-03-01

    Methyl mercury is a potent neurotoxin that causes developmental delays in young and unborn children and has been linked to neurological and cardiovascular degeneration in adults. Methyl mercury is the basis of a state-sponsored fish advisory to limit consumption of local fish in North Carolina. This study employed methods and analytic constructs from the behavioral and social sciences to assess the determinants of subsistence fishing and to promote informed fish consumption among culturally distinct and lower income subsistence fishers in southeastern North Carolina. Formative research revealed that Native American and African American were more likely than Latino residents to know of the fish advisory, and to practice procurement and preparation strategies that are mistakenly believed to render locally caught fish safe for consumption. Fish advisories were developed for each community to promote informed fish consumption intentions among residents who consume local fish. The interventions were successful in increasing knowledge and healthy intentions among most residents. Adherence to some safe fish consumption practices were constrained by cultural and economic factors. These results demonstrate the utility of multidisciplinary approaches for assessing and reducing human exposure to methyl mercury through subsistence fish consumption. PMID:21730195

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

    PubMed Central

    Montesi, Luca; El Ghoch, Marwan; Brodosi, Lucia; Calugi, Simona; Marchesini, Giulio; Dalle Grave, Riccardo

    2016-01-01

    The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner”) as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. PMID:27013897

  17. Closing the Gaps and Filling the STEM Pipeline: A Multidisciplinary Approach

    NASA Astrophysics Data System (ADS)

    Doerschuk, Peggy; Bahrim, Cristian; Daniel, Jennifer; Kruger, Joseph; Mann, Judith; Martin, Cristopher

    2016-04-01

    There is a growing demand for degreed science, technology, engineering and mathematics (STEM) professionals, but the production of degreed STEM students is not keeping pace. Problems exist at every juncture along the pipeline. Too few students choose to major in STEM disciplines. Many of those who do major in STEM drop out or change majors. Females and minorities remain underrepresented in STEM. The success rate of college students who are from low-income background or first-generation students is much lower than that of students who do not face such challenges. Some of those who successfully complete their degree need help in making the transition to the workforce after graduation. A program at Lamar University takes a multidisciplinary approach to addressing these problems. It is designed to recruit, retain and transition undergraduates to careers in STEM, focusing its efforts on five science disciplines and on these "at-risk" students. The program was supported by a 5-year grant from the National Science Foundation and is supported through August 31, 2016 by Lamar University and a grant from ExxonMobil. A formal assessment plan documents the program's success. The program received an award from the Texas Higher Education Board for its contributions towards Closing the Gaps in Higher Education in Texas. This paper describes the program's theoretical framework, research questions, methods, evaluation plan, and instruments. It presents an analysis of the results achieved using these methods and implications for improvements to the program resulting from lessons learned.

  18. Closing the Gaps and Filling the STEM Pipeline: A Multidisciplinary Approach

    NASA Astrophysics Data System (ADS)

    Doerschuk, Peggy; Bahrim, Cristian; Daniel, Jennifer; Kruger, Joseph; Mann, Judith; Martin, Cristopher

    2016-08-01

    There is a growing demand for degreed science, technology, engineering and mathematics (STEM) professionals, but the production of degreed STEM students is not keeping pace. Problems exist at every juncture along the pipeline. Too few students choose to major in STEM disciplines. Many of those who do major in STEM drop out or change majors. Females and minorities remain underrepresented in STEM. The success rate of college students who are from low-income background or first-generation students is much lower than that of students who do not face such challenges. Some of those who successfully complete their degree need help in making the transition to the workforce after graduation. A program at Lamar University takes a multidisciplinary approach to addressing these problems. It is designed to recruit, retain and transition undergraduates to careers in STEM, focusing its efforts on five science disciplines and on these "at-risk" students. The program was supported by a 5-year grant from the National Science Foundation and is supported through August 31, 2016 by Lamar University and a grant from ExxonMobil. A formal assessment plan documents the program's success. The program received an award from the Texas Higher Education Board for its contributions towards Closing the Gaps in Higher Education in Texas. This paper describes the program's theoretical framework, research questions, methods, evaluation plan, and instruments. It presents an analysis of the results achieved using these methods and implications for improvements to the program resulting from lessons learned.

  19. Environmental assessment of Mangrove communities in Tarut Bay, Eastern Arabian Peninsula, based on multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Al-Ali, A. M.; Del Campo, A. G.; Rocha, C.

    2015-04-01

    Tarut Bay contains some of the most important mangrove forests in the Arabian Gulf countries, which are facing significant anthropogenic pressures. A multidisciplinary approach based on remote sensing, fieldwork, and chemical analysis was adopted in order to identify the pressures facing the mangrove communities in Tarut Bay and subsequently evaluate its current environmental condition. The analysis focused on the 2011 to 2014 timeframe in particular. The results indicate that the mangrove communities in Tarut Bay cover currently around 11.32 square km. Two major mangrove cover changes were identified in the area during the studied period, with a net loss of around 0.675 square km happening in the interim. The analysis adopted the Normalized Difference Vegetation Index (NDVI) to evaluate the temporal change in vegetation concentration. Moreover, the study evaluated the overall pollution condition of 19 mangrove communities in Tarut Bay to be medium based on the Pollution Load Index (PLI). Nevertheless, some of the mangrove communities in Tarut Bay are very healthy while others are very polluted and require immediate action to improve their pollution status. The findings of this work led to recommending mangrove improvement measures to address further deterioration and disappearance of mangrove communities, including the re-opening of natural inlets and avoiding residential developments on the mangrove coast.

  20. von Willebrand disease, pregnancy and neuraxial anesthesia: a multi-disciplinary approach for successful regional anesthesia.

    PubMed

    Kailash, F; Wilkerson, D

    2009-05-01

    Fearing the devastating neurological complications in a parturient with the von Willebrand disease secondary to paucity of studies defining the guidelines to assess the risk of bleeding complications, anesthesiologists are often reluctant to administer neuroaxial anesthesia. We present a case report of a parturient with type I von Willebrand disease who presented for induction of labor at 39 weeks of gestation. After consultation with the hematologist well ahead of the conception, appropriate laboratory workup including clotting factor levels including FVIII, vWF:RcoF, vWF:Ag on different occasions peripartum, and provision of adequate prophylactic medical treatment, she underwent Cesarean section under epidural anesthesia without neurological or bleeding complications. von Willebrand disease is the most common inherited bleeding disorder that may result in various bleeding complications in a parturient as a result of hemostatic challenges during pregnancy. Yet the recommendations are based on anecdotal observations of the authors of small case series and surveys. Our case report emphasizes the importance of advanced planning, careful patient assessment, and multi-disciplinary team approach for the successful regional anesthesia as suggested by the guidelines based on clinical experiences. PMID:19475813

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

    PubMed Central

    Inafuku, Hitoshi; Nakamoto, Tomoko; Taira, Yusuke; Taira, Rie; Tsubakimoto, Maho; Totsuka, Yuichi; Kuniyoshi, Yukio; Tamaki, Tomoko; Aoyama, Hajime

    2016-01-01

    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. PMID:27239357

  2. Multi-disciplinary approach for enhancing orthodontic esthetics – case report

    PubMed Central

    Kalia, Ajit; Mirdehghan, Nasim; Khandekar, Sonali; Patil, Wasu

    2015-01-01

    Background 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 unesthetic 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 unesthetic smile. PMID:26316821

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

    PubMed

    Montesi, Luca; El Ghoch, Marwan; Brodosi, Lucia; Calugi, Simona; Marchesini, Giulio; Dalle Grave, Riccardo

    2016-01-01

    The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient-therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called "lifestyle trainer" or "healthy lifestyle practitioner") as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. PMID:27013897

  4. How Public Is Public Administration? A Constitutional Approach of Publicness

    ERIC Educational Resources Information Center

    Ringeling, Arthur

    2015-01-01

    Both in Public Administration and in practice, there is a loss of the concept of public. A view became dominant in which markets were superior to governments and public to private. Not only did the esteem of the public sphere diminish, but also its significance in our reasoning and teaching. It became less clear what the public sphere stood for.…

  5. Multidisciplinary Approach for Earthquake Atmospheric Precursors Validation by Joint Satellite and Ground Based Observations

    NASA Astrophysics Data System (ADS)

    Ouzounov, D. P.; Pulinets, S. A.; Hattori, K.; Liu, J. G.; Parrot, M.; Kafatos, M.; Yang, T. F.; Jhuang, H.; Taylor, P.; Ohyama, K.; Kon, S.

    2010-12-01

    Previous studies have shown that there were electromagnetic (EM) effects in the atmosphere/ionosphere caused by some strong earthquakes. Several major earthquakes are accompanied by an intensification of the vertical transport of charged aerosols in the lower atmosphere. These processes lead to the generation of external electric currents in specific regions of the atmosphere and the modifications, by DC electric fields, in the ionosphere-atmosphere electric circuit. Our methodology of integrated satellite terrestrial framework (ISTF) is based on the use of multi-sensor data and a cross-correlation between ground and satellite observations to record any atmospheric thermal anomalies and ionospheric perturbations associated with these activities. We record thermal infrared data from the Aqua, GOES, POES satellites and DEMETER provides space plasma variations related to the growth of the DC electric field. Simultaneously we continuously monitor ground-based multi-parameter GPS/TEC, ion concentration, radon, and magnetic field array data. We integrate these joint observations into the Lithosphere-Atmosphere-Ionosphere Coupling (LAIC) model. The significance of this combined satellite and ground-based analysis is that it permits us to generate hindcasts of historical seismicity in Japan, Taiwan (2003-2009) and recent catastrophic events in Italy (M6.3, 2009), Haiti (M7.0, 2010) and Chile (M8.8, 2010). This joint analysis of ground and satellite data during the time of major earthquakes has shown the presence of persistent anomalies in the atmosphere over regions of maximum stress (along plate boundaries), and are not of meteorological origin, since they are stationary over the same region. Our approach provides the framework for a multidisciplinary validation of earthquake precursors and we are looking forward to validating this approach over high seismicity regions.

  6. Training Multidisciplinary Scholars in Science Policy for Careers in Academia, Private Sector, and Public Service

    NASA Astrophysics Data System (ADS)

    Kenney, M. A.

    2015-12-01

    Regardless of a graduate student's ultimate career ambitions, it is becoming increasingly important to either develop skills to successfully transition into non-academic careers or to be able to understand the societal benefits of basic and applied research programs. In this talk I will provide my prospective -- from working in academia, the Federal government, and as an independent consultant -- about the training that we need for graduate students to navigate the jungle gym of career opportunities available (or not available) after they graduate. In particular, I will speak to the need for science policy training, in which scientific and coordination skills are put to use to help support societal decisions. I will assert that, to effectively train graduate students, it is necessary to provide experiences in multidisciplinary, policy-relevant scholarship to build marketable skills critical for a student's professional development.

  7. A multidisciplinary approach to the study of cultural heritage environments: Experience at the Palatina Library in Parma.

    PubMed

    Pasquarella, C; Balocco, C; Pasquariello, G; Petrone, G; Saccani, E; Manotti, P; Ugolotti, M; Palla, F; Maggi, O; Albertini, R

    2015-12-01

    The aim of this paper is to describe a multidisciplinary approach including biological and particle monitoring, and microclimate analysis associated with the application of the Computational Fluid Dynamic (CFD). This approach was applied at the Palatina historical library in Parma. Monitoring was performed both in July and in December, in the absence of visitors and operators. Air microbial monitoring was performed with active and passive methods. Airborne particles with a diameter of ≥0.3, ≥0.5, ≥1 and ≥5 μm/m3, were counted by a laser particle counter. The surface contamination of shelves and manuscripts was assessed with nitrocellulose membranes. A spore trap sampler was used to identify both viable and non-viable fungal spores by optical microscope. Microbiological contaminants were analyzed through cultural and molecular biology techniques. Microclimatic parameters were also recorded. An infrared thermal camera provided information on the surface temperature of the different building materials, objects and components. Transient simulation models, for coupled heat and mass-moisture transfer, taking into account archivist and general public movements, combined with the related sensible and latent heat released into the environment, were carried out applying the CFD-FE (Finite Elements) method. Simulations of particle tracing were carried out. A wide variability in environmental microbial contamination, both for air and surfaces, was observed. Cladosporium spp., Alternaria spp., Aspergillus spp., and Penicillium spp. were the most frequently found microfungi. Bacteria such as Streptomyces spp., Bacillus spp., Sphingomonas spp., and Pseudoclavibacter as well as unculturable colonies were characterized by molecular investigation. CFD simulation results obtained were consistent with the experimental data on microclimatic conditions. The tracing and distribution of particles showed the different slice planes of diffusion mostly influenced by the convective

  8. Efficient Multidisciplinary Analysis Approach for Conceptual Design of Aircraft with Large Shape Change

    NASA Technical Reports Server (NTRS)

    Chwalowski, Pawel; Samareh, Jamshid A.; Horta, Lucas G.; Piatak, David J.; McGowan, Anna-Maria R.

    2009-01-01

    The conceptual and preliminary design processes for aircraft with large shape changes are generally difficult and time-consuming, and the processes are often customized for a specific shape change concept to streamline the vehicle design effort. Accordingly, several existing reports show excellent results of assessing a particular shape change concept or perturbations of a concept. The goal of the current effort was to develop a multidisciplinary analysis tool and process that would enable an aircraft designer to assess several very different morphing concepts early in the design phase and yet obtain second-order performance results so that design decisions can be made with better confidence. The approach uses an efficient parametric model formulation that allows automatic model generation for systems undergoing radical shape changes as a function of aerodynamic parameters, geometry parameters, and shape change parameters. In contrast to other more self-contained approaches, the approach utilizes off-the-shelf analysis modules to reduce development time and to make it accessible to many users. Because the analysis is loosely coupled, discipline modules like a multibody code can be easily swapped for other modules with similar capabilities. One of the advantages of this loosely coupled system is the ability to use the medium- to high-fidelity tools early in the design stages when the information can significantly influence and improve overall vehicle design. Data transfer among the analysis modules are based on an accurate and automated general purpose data transfer tool. In general, setup time for the integrated system presented in this paper is 2-4 days for simple shape change concepts and 1-2 weeks for more mechanically complicated concepts. Some of the key elements briefly described in the paper include parametric model development, aerodynamic database generation, multibody analysis, and the required software modules as well as examples for a telescoping wing

  9. Lipohypertrophy and metabolic disorders in HIV patients on antiretroviral therapy: a systematic multidisciplinary clinical approach

    PubMed Central

    Sculier, Delphine; Toutous-Trellu, Laurence; Verolet, Charlotte; Matthes, Nicolas; Lecompte, Thanh; Calmy, Alexandra

    2014-01-01

    had osteopenia and osteoporosis on the spine and 44.8% and 6.6% on the hip neck. Factors associated with a VAT≥130 cm2 included male gender (OR 3.7 [95% CI 1.7–8.2] p<0.001), triglycerides ≥2 mmol/L (OR 2.6 [95% CI 1.3–5.4] P<0.01) and increase in BMI category (OR 1.8 [95% CI 1.2–2.8] p<0.01). Conclusions Lipohypertrophy is a prevalent feature of fat redistribution among HIV patients on treatment. Risk factors for LH include male gender, dyslipidemia and overweight. Glucose impairment and bone disorders are also common. A multidisciplinary approach is important to identify and promptly address these disorders. Acknowledgments The “Groupe Lipo & Metabolism” team. PMID:25394066

  10. Asymmetric connectivity of spawning aggregations of a commercially important marine fish using a multidisciplinary approach

    PubMed Central

    Jackson, Alexis; Marinone, Silvio Guido; Erisman, Brad; Moreno-Baez, Marcia; Girón-Nava, Alfredo; Pfister, Tad; Aburto-Oropeza, Octavio; Torre, Jorge

    2014-01-01

    Understanding patterns of larval dispersal is key in determining whether no-take marine reserves are self-sustaining, what will be protected inside reserves and where the benefits of reserves will be observed. We followed a multidisciplinary approach that merged detailed descriptions of fishing zones and spawning time at 17 sites distributed in the Midriff Island region of the Gulf of California with a biophysical oceanographic model that simulated larval transport at Pelagic Larval Duration (PLD) 14, 21 and 28 days for the most common and targeted predatory reef fish, (leopard grouper Mycteroperca rosacea). We tested the hypothesis that source–sink larval metapopulation dynamics describing the direction and frequency of larval dispersal according to an oceanographic model can help to explain empirical genetic data. We described modeled metapopulation dynamics using graph theory and employed empirical sequence data from a subset of 11 sites at two mitochondrial genes to verify the model predictions based on patterns of genetic diversity within sites and genetic structure between sites. We employed a population graph describing a network of genetic relationships among sites and contrasted it against modeled networks. While our results failed to explain genetic diversity within sites, they confirmed that ocean models summarized via graph and adjacency distances over modeled networks can explain seemingly chaotic patterns of genetic structure between sites. Empirical and modeled networks showed significant similarities in the clustering coefficients of each site and adjacency matrices between sites. Most of the connectivity patterns observed towards downstream sites (Sonora coast) were strictly asymmetric, while those between upstream sites (Baja and the Midriffs) were symmetric. The best-supported gene flow model and analyses of modularity of the modeled networks confirmed a pulse of larvae from the Baja Peninsula, across the Midriff Island region and towards the

  11. Asymmetric connectivity of spawning aggregations of a commercially important marine fish using a multidisciplinary approach.

    PubMed

    Munguia-Vega, Adrian; Jackson, Alexis; Marinone, Silvio Guido; Erisman, Brad; Moreno-Baez, Marcia; Girón-Nava, Alfredo; Pfister, Tad; Aburto-Oropeza, Octavio; Torre, Jorge

    2014-01-01

    Understanding patterns of larval dispersal is key in determining whether no-take marine reserves are self-sustaining, what will be protected inside reserves and where the benefits of reserves will be observed. We followed a multidisciplinary approach that merged detailed descriptions of fishing zones and spawning time at 17 sites distributed in the Midriff Island region of the Gulf of California with a biophysical oceanographic model that simulated larval transport at Pelagic Larval Duration (PLD) 14, 21 and 28 days for the most common and targeted predatory reef fish, (leopard grouper Mycteroperca rosacea). We tested the hypothesis that source-sink larval metapopulation dynamics describing the direction and frequency of larval dispersal according to an oceanographic model can help to explain empirical genetic data. We described modeled metapopulation dynamics using graph theory and employed empirical sequence data from a subset of 11 sites at two mitochondrial genes to verify the model predictions based on patterns of genetic diversity within sites and genetic structure between sites. We employed a population graph describing a network of genetic relationships among sites and contrasted it against modeled networks. While our results failed to explain genetic diversity within sites, they confirmed that ocean models summarized via graph and adjacency distances over modeled networks can explain seemingly chaotic patterns of genetic structure between sites. Empirical and modeled networks showed significant similarities in the clustering coefficients of each site and adjacency matrices between sites. Most of the connectivity patterns observed towards downstream sites (Sonora coast) were strictly asymmetric, while those between upstream sites (Baja and the Midriffs) were symmetric. The best-supported gene flow model and analyses of modularity of the modeled networks confirmed a pulse of larvae from the Baja Peninsula, across the Midriff Island region and towards the

  12. On the Need for a Multidisciplinary Approach to Education for Knowledge Management.

    ERIC Educational Resources Information Center

    Chaudhry, Abdus Sattar; Higgins, Susan

    2003-01-01

    Reports the findings of a study of knowledge management courses included in the curriculum of academic disciplines of business, computing, and information based on a review of course descriptions from Web sites of universities in different countries. Describes level of courses, curriculum areas and topics, and the multidisciplinary nature of the…

  13. A Comprehensive, Multidisciplinary Approach to Providing Health Care for Children in Out-of-Home Care.

    ERIC Educational Resources Information Center

    Blatt, Steven D.; And Others

    1997-01-01

    Describes ENHANCE (Excellence in Health Care for Abused and Neglected Children) of Onondaga County, New York, a comprehensive, multidisciplinary clinic for children in out-of-home care involving pediatrics, child psychology, nursing, child development, and child welfare components. Also presents profiles of the health, mental health, and…

  14. A Multidisciplinary Research Team Approach to Computer-Aided Drafting (CAD) System Selection. Final Report.

    ERIC Educational Resources Information Center

    Franken, Ken; And Others

    A multidisciplinary research team was assembled to review existing computer-aided drafting (CAD) systems for the purpose of enabling staff in the Design Drafting Department at Linn Technical College (Missouri) to select the best system out of the many CAD systems in existence. During the initial stage of the evaluation project, researchers…

  15. The Carolina Abecedarian Project: A Longitudinal and Multidisciplinary Approach to the Prevention of Developmental Retardation.

    ERIC Educational Resources Information Center

    Ramey, Craig T.; And Others

    This progress report describes the subjects, program and curriculum development, and collected psychological and medical data of the Carolina Abecedarian Project, an intervention program, begun in 1972. The purpose of this project is to bring together a multidisciplinary team of researchers to demonstrate that the developmental retardation of…

  16. The Campus Lake Learning Community: Promoting a Multidisciplinary Approach to Environmental Problem Solving

    ERIC Educational Resources Information Center

    Walsh, Maud; Jenkins, Dorothy; Powell, Katrina; Rusch, Kelly

    2005-01-01

    A multidisciplinary learning community provided environmental management students the opportunity to work with students in different classes and majors to create designs for improving the appearance and environmental quality of a lake on a university campus. The experience increased student appreciation for the contribution of other disciplines in…

  17. A Multidisciplinary Approach to the Treatment of Co-occurring Opioid Use Disorder and Posttraumatic Stress Disorder in Pregnancy: A Case Report

    PubMed Central

    Goodman, Daisy J.; Milliken, Catherine U.; Theiler, Regan N.; Nordstrom, Benjamin R.; Akerman, Sarah C.

    2016-01-01

    Perinatal opioid use disorders negatively impact maternal and neonatal outcomes and are a public health problem of increasing severity. More than half of women with a substance use disorder have a history of posttraumatic stress disorder that, if not adequately addressed, can impede substance use disorder treatment. This case report describes complexities in the treatment of a pregnant woman with opioid use disorder and posttraumatic stress disorder and reviews the psychotherapeutic and pharmacologic approaches available to treat these co-occurring disorders in pregnancy. This case demonstrates the importance of early screening and intervention for co-occurring posttraumatic stress disorder in pregnant women who use substances, in a closely coordinated, multidisciplinary approach to improve outcomes for women and their infants. PMID:26457976

  18. A Multidisciplinary Approach to the Treatment of Co-occurring Opioid Use Disorder and Posttraumatic Stress Disorder in Pregnancy: A Case Report.

    PubMed

    Goodman, Daisy J; Milliken, Catherine U; Theiler, Regan N; Nordstrom, Benjamin R; Akerman, Sarah C

    2015-01-01

    Perinatal opioid use disorders negatively impact maternal and neonatal outcomes and are a public health problem of increasing severity. More than half of women with a substance use disorder have a history of posttraumatic stress disorder that, if not adequately addressed, can impede substance use disorder treatment. This case report describes complexities in the treatment of a pregnant woman with opioid use disorder and posttraumatic stress disorder and reviews the psychotherapeutic and pharmacologic approaches available to treat these co-occurring disorders in pregnancy. This case demonstrates the importance of early screening and intervention for co-occurring posttraumatic stress disorder in pregnant women who use substances in a closely coordinated, multidisciplinary approach to improve outcomes for women and their infants. PMID:26457976

  19. A pilot study: reports of benefits from a 6-month, multidisciplinary, shared medical appointment approach for heart failure patients.

    PubMed

    Lin, Andrew; Cavendish, Jeffrey; Boren, Denise; Ofstad, Trish; Seidensticker, Daniel

    2008-12-01

    ABSTRACT Heart failure continues to be the leading cause of hospitalization among older adults. Noncompliance with medications, dietary indiscretion, failure to recognize symptoms, and failed social support systems contribute to increased morbidity. Multidisciplinary medical approaches have proven successful for heart failure. In 2004, the Naval Medical Center San Diego started a multidisciplinary shared medical appointment for patients with complicated cases of heart failure. Patients enrolled in the heart failure clinic were monitored prospectively for 6 months. Validated questionnaires concerning satisfaction with care, self-care management, depression, and quality-of-life measures were administered at baseline and 6 months after enrollment. Thirty-nine individuals were enrolled in the clinic, with 33 completing 6 months of follow-up monitoring to date. Hospital admissions for any cause decreased from 11 to eight, whereas congestive heart failure-related admissions decreased from four to two. There was a total of six deaths. During the 6 months of enrollment, use of angiotensin-converting enzyme inhibitors and beta-receptor blockers had absolute increases of 20% and 19%, respectively. Statistically significant improvements were seen in the Beck Depression Inventory and Self-Care Management Index results. A multidisciplinary approach to heart failure patients using the shared medical appointment model can improve patient satisfaction, enhance quality of life, and help reduce hospitalizations while improving provider efficiency. PMID:19149341

  20. Contribution of soil fauna to soil functioning in degraded environments: a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Gargiulo, Laura; Mele, Giacomo; Moradi, Jabbar; Kukla, Jaroslav; Jandová, Kateřina; Frouz, Jan

    2016-04-01

    . All replicates were subjected to soil respiration measurement by means of chemical titration method. Then some replicates were destructively analyzed for PLFA and ergosterol and others were used for the 3D soil image analysis of the soil pore system. The soil cores were imaged using X-ray microtomography and three-dimensional image processing was performed in order to obtain 3D reconstructions and preliminary analysis of the identified biopores. The experimental approach used in this multidisciplinary study showed a promising potential to provide new useful information about the widely differentiated contribution of many types of macrofauna to the formation of the soil pore system and to the development of the soil microbial functions in different types of environments.

  1. A multidisciplinary approach for analysing landslide susceptibility in Abruzzo piedmont (Italy)

    NASA Astrophysics Data System (ADS)

    Sciarra, Marco; Urbano, Tullio; Coco, Laura

    2016-04-01

    Landslide susceptibility is the probability or likelihood that a landslide phenomenon happens in a specific area and in a not determined date, based on the correlation of controlling factors with distribution of past events. The present work presents a landslide susceptibility analysis assessment in the Feltrino Stream basin and minor surrounding coastal basins in south-eastern Abruzzo Region (Central Italy). The work was based on a multidisciplinary approach involving GIS (Geographic Information System) processing and geomorphological field survey. The study area, as well as the whole Italian Adriatic hills, is characterized by moderate to high landslide susceptibility, because of the complex geological, geomorphological and climatic features. Geologically, the bedrock is mainly characterised by marine deposits composed by clay-sandstone-conglomerate lithology belonging to Upper Pliocene - Lower Pleistocene, and locally by marine to continental transitional deposits belonging to Middle Pleistocene. The bedrock is largely covered by near-surface continental deposits composed by clay-silt-sand-gravel lithology ranging in age from Upper Pleistocene to Holocene. From the geomorphological viewpoint, the area is involved in different landslides phenomena (rock falls, rotational, translational and complex landslides, earth flows) which affect ~15% of the overall surface area. The landslide susceptibility study was carried out through a geostatistical analysis of landslides driver factors. Air-photos analysis was conducted for larger landslides and hillslope areas. The identified landslides were corroborated through a detailed geomorphological field survey. The methodology involved three main steps. Firstly, the main driver factors, directly or indirectly linked to slope instability, were defined and mapped by DTM processing, air-photos analysis and detailed geomorphological field survey. Morphological, geological and geomorphological factors were considered: slope

  2. Clade perseverance from Mesozoic to present: a multidisciplinary approach to interpretation of pattern and process.

    PubMed

    Barnes, David K A

    2002-10-01

    Two clades of marine bryozoans, cyclostomes and cheilostomes, exemplify the benefits of applying a multidisciplinary approach to the interpretation of long-term evolutionary patterns. The cyclostome bryozoans were dominant in the Mesozoic; since that era, they have decreased in absolute terms and the cheilostomes have come to exceed them in both abundance and diversity. Many studies of living assemblages of the encrusting members of these two clades indicate that cheilostomes are superior space competitors, but paleontological studies suggest that competition between the two taxa has not been escalating over geological time. Both clades occur throughout the world's oceans and seas, and recent work in the geographical extremes has shown that the relative success of the clades varies markedly from place to place. In this study, the importance of differential patterns of recruitment and cumulative space occupation in the two clades was evaluated over four years and in two environments, one temperate and one polar. In both of these environments, peaks of recruitment and space occupation by the two clades were out of phase. The different strategies and outcomes of spatial competition are examined, largely using data from the literature. Only recently has it been realized that tied outcomes of competition are stable alternative results and not simply transitory phases. Many competitive encounters involving cyclostomes result in ties, implying that their strategy is based on persistence rather than dominance. When different indices and models are used to analyze competition data from the two clades, the interpretation varies markedly with methodology. The differences in patterns of recruitment, space occupation, and spatial competition have influenced both our understanding of how the two clades have persisted alongside each other and our perception of cheilostome superiority. Analysis of fluid dynamics has shown that small differences in the mechanical structure of

  3. Multidisciplinary approach to assess the sensitivity of dwarf tomato plants to low-LET ionising radiation

    NASA Astrophysics Data System (ADS)

    De Micco, Veronica; De Pascale, Stefania; Aronne, Giovanna; Paradiso, Roberta; Vitaglione, Paola; Turano, Mimmo; Arena, Carmen

    Ionising radiation, acting alone or in interaction with microgravity and other environmental constraints, may affect plant at molecular, morpho-structural and physiological level. The intensity of the plant’s response depends on the properties of radiation and on the features of the plant itself. Indeed, different species are characterised by different susceptibility to radiation which may change during the life course. The aim of this research was to study the radiosensitivity to low-LET ionising radiation of plants of dwarf tomato (Solanum lycopersicum L. ‘Microtom’) at two phenological phases (vegetative and reproductive), within the purpose of analysing plants for consideration as candidates for Bioregenerative Life Support Systems (BLSS) in Space. To pursue this objective, plants of the cultivar Microtom were irradiated with different doses of X-rays either at the stage of the second true leaf (VP - vegetative phase) or when at least one flower was blossomed (RP - reproductive phase). Plant’s response to ionising radiation was assessed through a multidisciplinary approach combining genetic analyses, ecophysiological measurements, morpho-anatomical characterisation of leaves and fruits, nutritional analyses of fruits. Growth, molecular and morpho-functional traits were measured during plant development up to fruiting in both VP and RP plant groups, and compared with non-irradiated control plants. Plant growth was monitored weekly recording parameters such as plant height, number of leaves, leaf area, flowering and fruiting rate. Potential DNA alterations were explored through Random Amplified Polymorphic DNA (RAPD) technique. The efficiency of the photosynthetic apparatus was evaluated by determining photosynthetic pigment composition, photochemistry and leaf gas exchanges. Leaf and fruit structure were analysed through light and epi-fluorescence microscopy. Leaf anatomical traits related to photosynthetic efficiency, and to structural radioprotection

  4. Part 1: Participatory Ergonomics Approach to Waste Container Handling Utilizing a Multidisciplinary Team

    SciTech Connect

    Zalk, D.M.; Tittiranonda, P.; Burastero, S.; Biggs, T.W.; Perry, C.M.; Tageson, R.; Barsnick, L.

    2000-02-07

    This multidisciplinary team approach to waste container handling, developed within the Grassroots Ergonomics process, presents participatory ergonomic interpretations of quantitative and qualitative aspects of this process resulting in a peer developed training. The lower back, shoulders, and wrists were identified as frequently injured areas, so these working postures were a primary focus for the creation of the workers' training. Handling procedures were analyzed by the team to identify common cycles involving one 5 gallon (60 pounds), two 5 gallons (60 and 54 pounds), 30 gallon (216 pounds), and 55 gallon (482 pounds) containers: lowering from transporting to/from transport vehicles, loading/unloading on transport vehicles, and loading onto pallet. Eleven experienced waste container handlers participated in this field analysis. Ergonomic exposure assessment tools measuring these field activities included posture analysis, posture targeting, Lumbar Motion Monitor{trademark} (LMM), and surface electromyography (sEMG) for the erector spinae, infraspinatus, and upper trapezius muscles. Posture analysis indicates that waste container handlers maintained non-neutral lower back postures (flexion, lateral bending, and rotation) for a mean of 51.7% of the time across all activities. The right wrist was in non-neutral postures (radial, ulnar, extension, and flexion) a mean of 30.5% of the time and the left wrist 31.4%. Non-neutral shoulder postures (elevation) were the least common, occurring 17.6% and 14.0% of the time in the right and left shoulders respectively. For training applications, each cycle had its own synchronized posture analysis and posture target diagram. Visual interpretations relating to the peak force modifications of the posture target diagrams proved to be invaluable for the workers' understanding of LMM and sEMG results (refer to Part II). Results were reviewed by the team's field technicians and their interpretations were developed into ergonomic

  5. Investigation of type-I interferon dysregulation by arenaviruses : a multidisciplinary approach.

    SciTech Connect

    Kozina, Carol L.; Moorman, Matthew Wallace; Branda, Catherine; Wu, Meiye; Manginell, Ronald Paul; Ricken, James Bryce; James, Conrad D.; Negrete, Oscar A.; Misra, Milind; Carson, Bryan D.

    2011-09-01

    This report provides a detailed overview of the work performed for project number 130781, 'A Systems Biology Approach to Understanding Viral Hemorrhagic Fever Pathogenesis.' We report progress in five key areas: single cell isolation devices and control systems, fluorescent cytokine and transcription factor reporters, on-chip viral infection assays, molecular virology analysis of Arenavirus nucleoprotein structure-function, and development of computational tools to predict virus-host protein interactions. Although a great deal of work remains from that begun here, we have developed several novel single cell analysis tools and knowledge of Arenavirus biology that will facilitate and inform future publications and funding proposals.

  6. Multidisciplinary Perspectives on Higher Education for the Public Good. Number 1, 2005

    ERIC Educational Resources Information Center

    Martinez, Magdalena, Ed.; Pasque, Penny A., Ed.; Bowman, Nick, Ed.; Chambers, Tony, Ed.

    2005-01-01

    The National Forum on Higher Education for the Public Good, along with the American Association for Higher Education (AAHE), American College Personnel Association (ACPA), American Educational Research Association (AERA), Association for Institutional Research (AIR), and Association for the Study of Higher Education (ASHE), have committed…

  7. Learning geomicrobiology as a team using microbial mats, a multidisciplinary approach.

    PubMed

    Rios-Velazquez, Carlos; Casillas-Martinez, Lilliam; Visscher, Pieter T

    2007-01-01

    Microbial mats are one of the best suited laminar organo-sedimentary ecosystems for students from different educational backgrounds to visualize the direct relationship between microbes and minerals. We have used tropical hypersaline microbial mats from Puerto Rico as educational tools to promote active learning of geomicrobiology introductory concepts for undergraduate students organized in multidisciplinary teams with biological and geological backgrounds. Besides field trips and independent research projects focused on microbial mats, four intensive workshops and one capstone activity were designed to expose students to the different geomicrobiology subdisciplines (microbiology, molecular biology, geology, and geochemistry). The teaching-learning process was assessed using pre- and posttests, group discussions, activities including Gallery Walks and exquisite cadaver's, case studies, and focal interviews. While the posttest showed a significant difference in conceptual understanding, the Gallery Walk and the capstone activities demonstrated increase in the depth, coherence, and thoughtfulness in answering questions, including a clear integration of the different subdisciplines during their presentations. Finally, the main themes described by the students as important outcomes of their participation in the Research at Undergraduate Institutions: Microbial Observatory (RUI-MO) program were: (i) the opportunity to study and learn new and different science disciplines, (ii) the microbial mats were excellent tools to learn from and integrate different science disciplines, and (iii) working in multidisciplinary teams gave them the opportunity to learn from their peers' discipline backgrounds. To our knowledge this is the first educational initiative that uses tropical hypersaline microbial mats to teach geomicrobiology in a multidisciplinary fashion. PMID:23653817

  8. Dynamics of organic matter and microbial populations in amended soil: a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Gigliotti, Giovanni; Pezzolla, Daniela; Zadra, Claudia; Albertini, Emidio; Marconi, Gianpiero; Turchetti, Benedetta; Buzzini, Pietro

    2013-04-01

    The application of organic amendments to soils, such as pig slurry, sewage sludge and compost is considered a tool for improving soil fertility and enhancing C stock. The addition of these different organic materials allows a good supply of nutrients for plants but also contributes to C sequestration, affects the microbial activity and the transformation of soil organic matter (SOM). Moreover, the addition of organic amendment has gained importance as a source of greenhouse gas (GHG) emissions and then as a cause of the "Global Warming". Therefore, it is important to investigate the factors controlling the SOM mineralization in order to improve soil C sequestration and decreasing at the same time the GHG emissions. The quality of organic matter added to the soil will play an important role in these dynamics, affecting the microbial activity and the changes in microbial community structure. A laboratory, multidisciplinary experiment was carried out to test the effect of the amendment by anaerobic digested livestock-derived organic materials on labile organic matter evolution and on dynamics of microbial population, this latter both in terms of consistence of microbial biomass, as well as in terms of microbial biodiversity. Different approaches were used to study the microbial community structure: chemical (CO2 fluxes, WEOC, C-biomass, PLFA), microbiological (microbial enumeration) and molecular (DNA extraction and Roche 454, Next Generation Sequencing, NGS). The application of fresh digestate, derived from the anaerobic treatment of animal wastes, affected the short-term dynamics of microbial community, as reflected by the increase of CO2 emissions immediately after the amendment compared to the control soil. This is probably due to the addition of easily available C added with the digestate, demonstrating that this organic material was only partially stabilized by the anaerobic process. In fact, the digestate contained a high amounts of available C, which led to

  9. Multidisciplinary approach to evaluate flood damage for residential buildings: first results in Northern Italy

    NASA Astrophysics Data System (ADS)

    Luino, Fabio

    2015-04-01

    the aims was to provide public administrations a management tool to help them use damage information. For this purpose a GIS-based model was created that can simulate flood events and evaluate potential direct economic loss due to a catastrophe based on thorough land knowledge coupled with the description of various physical elements of the natural event. The multidisciplinary method can be summarized in the following steps: 1) Event description: definition of flood parameters (flooded area and water level). This definition is possible because of real-time measurements or event simulation through a hydraulic model; 2) Identifying the affected assets in the flooded area; 3) Evaluation of the degree of damage to the exposed elements as a function of event magnitude identified from the measurement of floodwater depths of an event; 4) Attribution of an economic value to exposed assets. Quantification of economic loss by multiplying the economic value of damaged assets and the degree of damage. The methodology can be used to estimate the damage from the impact of floodwater on exposed elements (direct damage) and to quantify the resulting economic loss (tangible damage).

  10. Utah Flooding Hazard: Raising Public Awareness through the Creation of Multidisciplinary Web-Based Maps

    NASA Astrophysics Data System (ADS)

    Castleton, J.; Erickson, B.; Bowman, S. D.; Unger, C. D.

    2014-12-01

    The Utah Geological Survey's (UGS) Geologic Hazards Program has partnered with the U.S. Army Corps of Engineers to create geologically derived web-based flood hazard maps. Flooding in Utah communities has historically been one of the most damaging geologic hazards. The most serious floods in Utah have generally occurred in the Great Salt Lake basin, particularly in the Weber River drainage on the western slopes of the Wasatch Range, in areas of high population density. With a growing population of 2.9 million, the state of Utah is motivated to raise awareness about the potential for flooding. The process of increasing community resiliency to flooding begins with identification and characterization of flood hazards. Many small communities in areas experiencing rapid growth have not been mapped completely by the Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps (FIRM). Existing FIRM maps typically only consider drainage areas that are greater than one square mile in determining flood zones and do not incorporate geologic data, such as the presence of young, geologically active alluvial fans that indicate a high potential for debris flows and sheet flooding. Our new flood hazard mapping combines and expands on FEMA data by incorporating mapping derived from 1:24,000-scale UGS geologic maps, LiDAR data, digital elevation models, and historical aerial photography. Our flood hazard maps are intended to supplement the FIRM maps to provide local governments and the public with additional flood hazard information so they may make informed decisions, ultimately reducing the risk to life and property from flooding hazards. Flooding information must be widely available and easily accessed. One of the most effective ways to inform the public is through web-based maps. Web-based flood hazard maps will not only supply the public with the flood information they need, but also provides a platform to add additional geologic hazards to an easily accessible format.

  11. Multidisciplinary approach to evaluate landslide susceptibility along highway in northern Calabria, Italy

    NASA Astrophysics Data System (ADS)

    Muto, Francesco; Conforti, Massimo; Critelli, Salvatore; Fabbricatore, Davide; Filomena, Luciana; Rago, Valeria; Robustelli, Gaetano; Scarciglia, Fabio; Versace, Pasquale

    2014-05-01

    The interaction of landslides with linear infrastructures is often the cause of disasters. In Italy landslide impact on roads, railways and buildings cause millions of Euro per year in damage and restoration as well. The proposed study is aimed to the landslide susceptibility evaluation using a multidisciplinary approach: geological and geomorphological survey, statistical analysis and GIS technique, along a section of highway "A3 (Salerno-Reggio Calabria)" between Cosenza Sud and Altilia, northern Calabria. This study is included in a wider research project, named: PON01-01503, Landslides Early Warning-Sistemi integrati per il monitoraggio e la mitigazione del rischio idrogeologico lungo le grandi vie di comunicazione - aimed at the hydrogeological risk mitigation and at the early warning along the highways. The work was first based on air-photo interpretations and field investigations, in order to realize the geological map, geomorphological map and landslide inventory map. In the study area the geomorphology is strongly controlled by its bedrock geology and tectonics. The bedrock geology consists of Neogene sedimentary rocks that cover a thick stack of allochthonous nappes. These nappes consist of crystalline rocks mainly gneiss, phyllite and schist. A total of 835 landslides were mapped and the type of movement are represented mainly by slides and complex and subordinately flow. In order to estimate and validate landslide susceptibility the landslides were divided in two group. One group (training set) was used to prepare susceptibility map and the second group (validation set) to validate the map. Then, the selection of predisposing factors was performed, according with the geological and geomorphological settings of the study area: lithology, distance from tectonic elements, land use, slope, aspect, stream power index (SPI) and plan curvature. In order to evaluate landslide susceptibility Conditional Analysis was applied to Unique Conditions Units (UCUs

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

    PubMed Central

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

    2014-01-01

    Millions of children in polluted cities are showing brain detrimental effects. Urban children exhibit brain structural and volumetric abnormalities, systemic inflammation, olfactory, auditory, vestibular and cognitive deficits v low-pollution controls. Neuroinflammation and blood-brain-barrier (BBB) breakdown target the olfactory bulb, prefrontal cortex and brainstem, but are diffusely present throughout the brain. Urban adolescent Apolipoprotein E4 carriers significantly accelerate Alzheimer pathology. Neurocognitive effects of air pollution are substantial, apparent across all populations, and potentially clinically relevant as early evidence of evolving neurodegenerative changes. The diffuse nature of the neuroinflammation and neurodegeneration forces to employ a weight of evidence approach incorporating current clinical, cognitive, neurophysiological, radiological and epidemiological research. Pediatric air pollution research requires extensive multidisciplinary collaborations to accomplish a critical goal: to protect exposed children through multidimensional interventions having both broad impact and reach. Protecting children and teens from neural effects of air pollution should be of pressing importance for public health. PMID:25161617

  13. CERN's approach to public outreach

    NASA Astrophysics Data System (ADS)

    Landua, Rolf

    2016-03-01

    CERN's communication goes beyond publishing scientific results. Education and outreach are equally important ways of communicating with the general public, and in particular with the young generation. Over the last decade, CERN has significantly increased its efforts to accommodate the very large interest of the general public (about 300,000 visit requests per year), by ramping up its capacity for guided tours from 25,000 to more than 100,000 visitors per year, by creating six new of state-of-the-art exhibitions on-site, by building and operating a modern physics laboratory for school teachers and students, and by showing several traveling exhibitions in about 10 countries per year. The offer for school teachers has also been expanded, to 35-40 weeks of teacher courses with more than 1000 participants from more than 50 countries per year. The talk will give an overview about these and related activities.

  14. Static, Dynamic and Semantic Dimensions: Towards a Multidisciplinary Approach of Social Networks Analysis

    NASA Astrophysics Data System (ADS)

    Thovex, Christophe; Trichet, Francky

    The objective of our work is to extend static and dynamic models of Social Networks Analysis (SNA), by taking conceptual aspects of enterprises and institutions social graph into account. The originality of our multidisciplinary work is to introduce abstract notions of electro-physic to define new measures in SNA, for new decision-making functions dedicated to Human Resource Management (HRM). This paper introduces a multidimensional system and new measures: (1) a tension measure for social network analysis, (2) an electrodynamic, predictive and semantic system for recommendations on social graphs evolutions and (3) a reactance measure used to evaluate the individual stress at work of the members of a social network.

  15. Improving Scientific Communication and Publication Output in a Multidisciplinary Laboratory: Changing Culture Through Staff Development Workshops

    SciTech Connect

    Noonan, Christine F.; Stratton, Kelly G.

    2015-07-13

    Communication plays a fundamental role in science and engineering disciplines. However, many higher education programs provide little, if any, technical communication coursework. Without strong communication skills scientists and engineers have less opportunity to publish, obtain competitive research funds, or grow their careers. This article describes the role of scientific communication training as an innovative staff development program in a learning-intensive workplace – a national scientific research and development laboratory. The findings show that involvement in the workshop has increased overall participating staff annual publications by an average of 61 percent compared to their pre-workshop publishing performance as well as confidence level in their ability to write and publish peer-reviewed literature. Secondary benefits include improved information literacy skills and the development of informal communities of practice. This work provides insight into adult education in the workplace.

  16. Comprehensive multidisciplinary pain center approach to the treatment of low back pain.

    PubMed

    Rosomoff, H L; Rosomoff, R S

    1991-10-01

    The primary objective of our program is full function. Other objectives include relief or decrease in pain with the abolition of pain medication, elimination of assistive devices, low or zero disability rating, job satisfaction with return to work and leisure activities without limitations, independence from the health care system, prevention of reinjury, and optimum wellness. The intense, multidisciplinary program described involves a full-time multidisciplinary staff, complete patient involvement, weight control, physical restoration and conditioning, home program maintenance, pacing, body mechanics, energy-saving techniques, reinjury prevention education, pain control and elimination, drug detoxification, behavioral modification, biofeedback, relaxation, imagery, individual and group therapy, family therapy, assertiveness training, stress management, coping skills, vocational counseling, job planning/development/simulation, achievement of maximal function, immediate return to work at discharge, and follow-up care. It is possible to return 86% of these patients to full function and work; they may have some residual pain, which should eventually remit. The 14% who fail are hardcore patients with major behavioral problems, although, to be fair, there are still unanswered questions to resolve. These people have problems that cannot be eliminated within the limit of time with which we have to work with the patient. Lastly, these patients can be disturbed and dangerous, as evidenced by the headline of "A Former Patient Shoots, Kills, New York Neurosurgeon, Self, Wife." PMID:1840392

  17. Identification of kinship and occupant status in Mongolian noble burials of the Yuan Dynasty through a multidisciplinary approach.

    PubMed

    Cui, Yinqiu; Song, Li; Wei, Dong; Pang, Yuhong; Wang, Ning; Ning, Chao; Li, Chunmei; Feng, Binxiao; Tang, Wentao; Li, Hongjie; Ren, Yashan; Zhang, Chunchang; Huang, Yanyi; Hu, Yaowu; Zhou, Hui

    2015-01-19

    The Yuan Dynasty (AD 1271-1368) was the first dynasty in Chinese history where a minority ethnic group (Mongols) ruled. Few cemeteries containing Mongolian nobles have been found owing to their tradition of keeping burial grounds secret and their lack of historical records. Archaeological excavations at the Shuzhuanglou site in the Hebei province of China led to the discovery of 13 skeletons in six separate tombs. The style of the artefacts and burials indicate the cemetery occupants were Mongol nobles. However, the origin, relationships and status of the chief occupant (M1m) are unclear. To shed light on the identity of the principal occupant and resolve the kin relationships between individuals, a multidisciplinary approach was adopted, combining archaeological information, stable isotope data and molecular genetic data. Analysis of autosomal, mitochondrial and Y-chromosomal DNA show that some of the occupants were related. The available evidence strongly suggests that the principal occupant may have been the Mongol noble Korguz. Our study demonstrates the power of a multidisciplinary approach in elucidating information about the inhabitants of ancient historical sites. PMID:25487330

  18. Identification of kinship and occupant status in Mongolian noble burials of the Yuan Dynasty through a multidisciplinary approach

    PubMed Central

    Cui, Yinqiu; Song, Li; Wei, Dong; Pang, Yuhong; Wang, Ning; Ning, Chao; Li, Chunmei; Feng, Binxiao; Tang, Wentao; Li, Hongjie; Ren, Yashan; Zhang, Chunchang; Huang, Yanyi; Hu, Yaowu; Zhou, Hui

    2015-01-01

    The Yuan Dynasty (AD 1271–1368) was the first dynasty in Chinese history where a minority ethnic group (Mongols) ruled. Few cemeteries containing Mongolian nobles have been found owing to their tradition of keeping burial grounds secret and their lack of historical records. Archaeological excavations at the Shuzhuanglou site in the Hebei province of China led to the discovery of 13 skeletons in six separate tombs. The style of the artefacts and burials indicate the cemetery occupants were Mongol nobles. However, the origin, relationships and status of the chief occupant (M1m) are unclear. To shed light on the identity of the principal occupant and resolve the kin relationships between individuals, a multidisciplinary approach was adopted, combining archaeological information, stable isotope data and molecular genetic data. Analysis of autosomal, mitochondrial and Y-chromosomal DNA show that some of the occupants were related. The available evidence strongly suggests that the principal occupant may have been the Mongol noble Korguz. Our study demonstrates the power of a multidisciplinary approach in elucidating information about the inhabitants of ancient historical sites. PMID:25487330

  19. A Multidisciplinary Approach to Full Mouth Rehabilitation and Solving the Dilemma of Wriggling Dentures- A Case Report

    PubMed Central

    Nidawani, Prakash; Galagali, Girish; Reddy, E Srinivas; Behera, Sidhartha S P

    2014-01-01

    A successful management of full mouth rehabilitation demands a multi-disciplinary approach for its long lasting success. The present case report is intended to give an insight into the use of multiple treatment modalities to achieve a balanced, efficient and biomechanically successful prosthodontic treatment with acceptable aesthetics. Treatment of a maxillary and mandibular bilateral distal free end edentulous arch along with upper and lower anterior teeth requires plenty of contemporary and conventional prosthodontic treatment modalities. Management of distal extension situation provides complexity of biomechanical problems due to the three dimensional movements of the distal extension denture. A distal most implant can convert a distal extension RPD from a tooth and tissue supported prosthesis to a tooth and implant supported prosthesis which provides a definite stop thus enhancing the retention and stability of the prosthesis, eliminating the problems often associated with a tooth and tissue supported distal extension RPD. How to cite the article: Nidawani P, Galagali G, Reddy ES, Behera SS. A Multidisciplinary Approach to Full Mouth Rehabilitation and Solving the Dilemma of Wriggling Dentures- A Case Report. J Int Oral Health 2014;6(2):136-40. PMID:24876716

  20. A Multidisciplinary Approach to Anesthetic Management of a Parturient with Severe Aortic Stenosis

    PubMed Central

    Tyagaraj, Kalpana; Gutman, David A.; Belliveau, Lynn; Sadiq, Adnan; Feierman, Dennis E.

    2015-01-01

    In order to optimize anesthetic management and avoid adverse maternal and fetal outcomes, a clear understanding of the changes in cardiovascular physiology that occur during pregnancy is paramount. The effects of normal gestation on the cardiovascular system are particularly significant in a parturient with cardiac valvular pathology. We present a case of a 27-year-old G2P0 at 37 weeks with a past medical history of diabetes, macrosomia, congenital bicuspid aortic valve with severe stenosis (valve area 0.7 cm2) who was scheduled for elective C-section. A multidisciplinary discussion involving cardiologists, cardiac surgeons, obstetric surgeons, neonatal intensivists, perfusion staff, anesthesiologists, and nursing staff was held to formulate a plan for the perioperative management of this parturient. Also, contingency plans were formulated and discussed with the care providers, in the event of acute decompensation of the mother and baby and possible need for emergency aortic valvuloplasty and/or aortic valve replacement. PMID:26090237

  1. Transformative Learning Approaches for Public Relations Pedagogy

    ERIC Educational Resources Information Center

    Motion, Judy; Burgess, Lois

    2014-01-01

    Public relations educators are frequently challenged by students' flawed perceptions of public relations. Two contrasting case studies are presented in this paper to illustrate how socially-oriented paradigms may be applied to a real-client project to deliver a transformative learning experience. A discourse-analytic approach is applied…

  2. Svalbard Integrated Arctic Earth Observing System (sios): Facilitating Easy Access to Multidisciplinary Arctic Data Through the Brokering Approach.

    NASA Astrophysics Data System (ADS)

    Bye, B. L.; Godøy, Ø.

    2014-12-01

    Environmental and climate changes are important elements of our global challenges. They are observed at a global scale and in particular in the Arctic. In order to give better estimates of the future changes, the Arctic has to be monitored and analyzed by a multi-disciplinary observation system that will improve Earth System Models. The best chance to achieve significant results within a relatively short time frame is found in regions with a large natural climate gradient, and where processes sensitive to the expected changes are particularly important. Svalbard and the surrounding ocean areas fulfil all these criteria. The vision for SIOS is to be a regional observational system for long term acquisition and proliferation of fundamental knowledge on global environmental change within an Earth System Science perspective in and around Svalbard. SIOS will systematically develop and implement methods for how observational networks are to be construed. The distributed SIOS data management system (SDMS) will be implemented through a combination of technologies tailored to the multi-disciplinary nature of the Arctic data. One of these technologies is The Brokering approach or "Framework". The Brokering approach provides a series of services such as discovery, access, transformation and semantics support to enable translation from one discipline/culture to another. This is exactly the challenges the SDMS will have to handle and thus the Brokering approach is integrated in the design of the system. A description of the design strategy for the SDMS that includes The Brokering approach will be presented. The design and implementation plans for the SDMS are based on research done in the EU funded ESFRI project SIOS and examples of solutions for interoperable systems producing Arctic datasets and products coordinated through SIOS will be showcased. The reported experience from SIOS brokering approach will feed into the process of developing a sustainable brokering governance

  3. Cancer Portal Project: A Multidisciplinary Approach to Cancer Care Among Hispanic Patients

    PubMed Central

    Gany, Francesca; Ramirez, Julia; Nierodzick, Mary Lynn; McNish, Thelma; Lobach, Iryna; Leng, Jennifer

    2011-01-01

    Purpose: This study investigates the impact of a multilingual, multidisciplinary team targeting social and economic determinants of cancer treatment adherence among at-risk Hispanic immigrants. Methods: Patients were recruited at 10 hospital-based cancer clinics in New York City between December 2008 and November 2009. This is a nested cohort study of Hispanic patients and their sociodemographic characteristics, areas of needed assistance, and reported impact of meeting service needs on keeping appointments. At the core of the intervention is the trained, bilingual Portal Access Facilitator, who assesses needs and synchronizes an individualized set of transdisciplinary services for each patient. Results: A total of 328 Hispanic patients participated in the study. Of these, 89% preferred to speak Spanish in the health care setting, and 17% had no health insurance. The most common cancer diagnosis among participants was breast cancer (35%) followed by GI (17%) and gynecologic (16%) cancers. Patients most commonly requested financial support (59%), food support (37%), transportation assistance (21%), social work services (14%), psychosocial support (6%), help with health insurance issues (5%), and legal services (5%). In a follow-up assessment of high-need patients in urgent need of financial support, 86% reported that portal services helped them attend cancer care and treatment appointments, and 72% reported that portal services decreased worry about their care. Conclusion: Most patients reported that financial, social, and logistical support would help them attend their appointments for cancer care and treatment. Further multidisciplinary interventions should be implemented and evaluated to address social and economic determinants in cancer care for this population. PMID:21532808

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

    PubMed Central

    Reynolds, Stacey

    2015-01-01

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

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

    PubMed

    Reynolds, Stacey

    2015-01-01

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

  6. What Do We Tell People to Do during Earthquake Shaking in Emerging Countries? A Multidisciplinary Approach

    NASA Astrophysics Data System (ADS)

    Tucker, B. E.; Rodgers, J. E.; Tobin, L. T.; Cedillos, V.; Tshering, K. D.; Kumar, H.; Jomo, J.

    2015-12-01

    Providing advice on what to do during shaking in developing nations with high earthquake hazard and vulnerable buildings is a daunting task at the intersection of public policy and science. In areas where most buildings are masonry, earthen or concrete and are at high risk of collapse in strong shaking, advice may differ from the "Drop, Cover and Hold On" message given where residential construction is light timber (less lethal) and building codes are enforced. People in emerging countries are often unsure whether to evacuate or "run out" of the building, or to remain inside and protect oneself with Drop, Cover and Hold On, going to a marked "Safe Zone" or one of several other actions. GeoHazards International approached this problem by bringing together scientific research from multiple disciplines: seismology, epidemiology, structural engineering, risk communication, and sociology. We brought together researchers and practitioners, who applied scientific principles and professional judgment to the limited data on effectiveness of various protective actions in emerging countries. We developed guidance on what message creators and policymakers should consider; the process for developing message content and forms; and the people to involve. A responsible message must account for not only the local tectonic environment and site conditions, but also building vulnerability, the presence of safe open space, how people are killed and injured in earthquakes, population exposure, and the beliefs, customs and social context that affect how messages are received and acted upon. We found that local agencies should make a policy decision on the appropriate action, based on local scientific and technical information, because no one protective action will protect the majority in every context. The safest specific action varies according to where people are located, whether they will be safer where they are or by moving, and whether they can make it to the safer place before

  7. A Multidisciplinary Approach to Research in Small-Scale Societies: Studying Emotions and Facial Expressions in the Field.

    PubMed

    Crivelli, Carlos; Jarillo, Sergio; Fridlund, Alan J

    2016-01-01

    Although cognitive science was multidisciplinary from the start, an under-emphasis on anthropology has left the field with limited research in small scale, indigenous societies. Neglecting the anthropological perspective is risky, given that once-canonical cognitive science findings have often been shown to be artifacts of enculturation rather than cognitive universals. This imbalance has become more problematic as the increased use of Western theory-driven approaches, many of which assume human uniformity ("universality"), confronts the absence of a robust descriptive base that might provide clarifying or even contrary evidence. We highlight the need for remedies to such shortcomings by suggesting a two-fold methodological shift. First, studies conducted in indigenous societies can benefit by relying on multidisciplinary research groups to diminish ethnocentrism and enhance the quality of the data. Second, studies devised for Western societies can readily be adapted to the changing settings encountered in the field. Here, we provide examples, drawn from the areas of emotion and facial expressions, to illustrate potential solutions to recurrent problems in enhancing the quality of data collection, hypothesis testing, and the interpretation of results. PMID:27486420

  8. A Multidisciplinary Approach to Research in Small-Scale Societies: Studying Emotions and Facial Expressions in the Field

    PubMed Central

    Crivelli, Carlos; Jarillo, Sergio; Fridlund, Alan J.

    2016-01-01

    Although cognitive science was multidisciplinary from the start, an under-emphasis on anthropology has left the field with limited research in small scale, indigenous societies. Neglecting the anthropological perspective is risky, given that once-canonical cognitive science findings have often been shown to be artifacts of enculturation rather than cognitive universals. This imbalance has become more problematic as the increased use of Western theory-driven approaches, many of which assume human uniformity (“universality”), confronts the absence of a robust descriptive base that might provide clarifying or even contrary evidence. We highlight the need for remedies to such shortcomings by suggesting a two-fold methodological shift. First, studies conducted in indigenous societies can benefit by relying on multidisciplinary research groups to diminish ethnocentrism and enhance the quality of the data. Second, studies devised for Western societies can readily be adapted to the changing settings encountered in the field. Here, we provide examples, drawn from the areas of emotion and facial expressions, to illustrate potential solutions to recurrent problems in enhancing the quality of data collection, hypothesis testing, and the interpretation of results. PMID:27486420

  9. An evidence-based multidisciplinary approach to the management of hepatocellular carcinoma (HCC): The Alberta HCC algorithm

    PubMed Central

    Burak, Kelly W; Kneteman, Norman M

    2010-01-01

    Hepatocellular carcinoma (HCC) is one of only a few malignancies with an increasing incidence in North America. Because the vast majority of HCCs occur in the setting of a cirrhotic liver, management of this malignancy is best performed in a multidisciplinary group that recognizes the importance of liver function, as well as patient and tumour characteristics. The Barcelona Clinic Liver Cancer (BCLC) staging system is preferred for HCC because it incorporates the tumour characteristics (ie, tumour-node-metastasis stage), the patient’s performance status and liver function according to the Child-Turcotte-Pugh classification, and then links the BCLC stage to recommended therapeutic interventions. However, the BCLC algorithm does not recognize the potential role of radiofrequency ablation for very early stage HCC, the expanding role of liver transplantation in the management of HCC, the role of transarterial chemoembolization in single large tumours, the potential role of transarterial radioembolization with 90Yttrium and the limited evidence for using sorafenib in Child-Turcotte-Pugh class B cirrhotic patients. The current review article presents an evidence-based approach to the multidisciplinary management of HCC along with a new algorithm for the management of HCC that incorporates the BCLC staging system and the authors’ local selection criteria for resection, ablative techniques, liver transplantation, transarterial chemoembolization, transarterial radioembolization and sorafenib in Alberta. PMID:21157578

  10. Ebola a reality of modern Public Health; need for Surveillance, Preparedness and Response Training for Health Workers and other multidisciplinary teams: a case for Uganda

    PubMed Central

    Bazeyo, William; Bagonza, James; Halage, Ali; Okure, Gildo; Mugagga, Malimbo; Musoke, Robert; Tumwebaze, Mathias; Tusiime, Suzan; Ssendagire, Steven; Nabukenya, Immaculate; Pande, Steven; Aanyu, Christine; Etajak, Samuel; Rutebemberwa, Elizeus

    2015-01-01

    Introduction West Africa is experiencing the largest ever reported Ebola outbreak. Over 20,000 people have been infected of which about 9000 have died. It is possible that lack of community understanding of the epidemic and lack of institutional memory and inexperienced health workers could have led to the rapid spread of the disease. In this paper, we share Uganda's experiences on how the capacity of health workers and other multidisciplinary teams can be improved in preparing and responding to Ebola outbreaks. Methods Makerere University School of Public Health in collaboration with the Ministry of Health and the African Field Epidemiology Network (AFENET), trained health care workers and other multidisciplinary teams from six border districts of Uganda so as to increase their alertness and response capabilities towards Ebola. We used participatory training methods to impart knowledge and skills and guided participants to develop district epidemic response plans. Communities were sensitized about Ebola through mass media, IEC materials, and infection control and prevention materials were distributed in districts. Results We trained 210 health workers and 120 other multidisciplinary team members on Ebola surveillance, preparedness and response. Evaluation results demonstrated a gain in knowledge and skills. Communities were sensitized about Ebola and Districts received person protective equipments and items for infection prevention. Epidemic Preparedness and Response plans were also developed. Conclusion Training of multidisciplinary teams improves the country's preparedness, alertness and response capabilities in controlling Ebola. West African countries experiencing Ebola outbreaks could draw lessons from the Uganda experience to contain the outbreak. PMID:26301008

  11. Scoliosis Surgery in Cystic Fibrosis: Surgical Considerations and the Multidisciplinary Approach of a Rare Case

    PubMed Central

    Fall, Andrew

    2016-01-01

    Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17. She underwent a posterior spinal fusion T2-L3 with the use of unilateral segmental instrumentation. Preoperative workup included respiratory, cardiac, anaesthetic, endocrine, and dietician reviews, as well as bone density optimisation with zoledronic acid and prophylactic antibiotics. Surgical time was 150 minutes and intraoperative blood loss was 47% of total blood volume. Postoperative intensive care included noninvasive ventilation, antibiotic cover, pain management, chest physiotherapy, pancreatic enzyme supplementation, and nutritional support. She was discharged on day 9. At follow-up she had a good cosmetic outcome, no complaints of her back, and stable respiratory function. Multidisciplinary perioperative care and meticulous surgical technique may reduce the associated risks of major surgery in CF patients, while achieving adequate deformity correction and a good functional outcome. PMID:27413564

  12. Gorlin-Goltz syndrome – a medical condition requiring a multidisciplinary approach

    PubMed Central

    Kiwilsza, Małgorzata; Sporniak-Tutak, Katarzyna

    2012-01-01

    Summary Gorlin-Goltz syndrome is a rare genetic condition showing a variable expressiveness. It is inherited in a dominant autosomal way. The strongest characteristic of the disease includes multiple basal cell carcinomas, jaw cysts, palmar and plantar pits, skeletal abnormalities and other developmental defects. Owing to the fact that the condition tends to be a multisystemic disorder, familiarity of various medical specialists with its manifestations may reduce the time necessary for providing a diagnosis. It will also enable them to apply adequate methods of treatment and secondary prevention. In this study, we present symptoms of the disease, its diagnostic methods and currently used treatments. We searched 2 scientific databases: Medline (EBSCO) and Science Direct, for the years 1996 to 2011. In our search of abstracts, key words included nevoid basal cell carcinoma syndrome and Gorlin-Goltz syndrome. We examined 287 studies from Medline and 80 from Science Direct, all published in English. Finally, we decided to use 60 papers, including clinical cases and literature reviews. Patients with Gorlin-Goltz syndrome need particular multidisciplinary medical care. Knowledge of multiple and difficult to diagnose symptoms of the syndrome among professionals of various medical specialties is crucial. The consequences of the disease pose a threat to the health and life of patients. Therefore, an early diagnosis creates an opportunity for effective prevention and treatment of the disorder. Prevention is better than cure. PMID:22936202

  13. Role of multidisciplinary approach in a case of Langerhans cell histiocytosis with initial periodontal manifestations

    PubMed Central

    Cisternino, Angelo; Asa’ad, Farah; Fusco, Nicola; Ferrero, Stefano; Rasperini, Giulio

    2015-01-01

    Introduction: Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasia of unknown etiology occurring in both children and adults. This condition is characterized by an abnormal proliferation of Langerhans cells that may virtually affect all sites in the human body. Oral manifestations of LCH could be the first clinical sign of disease and its periodontal localization could be easily mistaken for other more common entities, such as chronic periodontitis, aggressive periodontitis, and necrotizing ulcerative periodontitis. Case presentation: A 32-years old female visited a private dental practice with a chief complaint of sensitivity in the mandibular left first molar. Clinical and radiographic examination revealed deep periodontal pocket, recession, furcation involvement, mobility, severe alveolar bone destruction and a diagnosis of aggressive periodontitis was rendered. Multiple tooth extractions were carried out due to progressive periodontal destruction with impaired healing and development of ulcerative lesions. Multidisciplinary investigation demonstrated that the periodontal involvement was a manifestation of an underlying systemic disease. A biopsy of a bone lesion was therefore performed, revealing the presence of multifocal single system LCH. Conclusion: The identification of periodontal LCH is not trivial given that it may clinically resemble other periodontal disease entities. The dentist can be the first health care personnel to unravel the presence of an underlying systemic LCH. PMID:26722570

  14. Mad Dogs, Vampires, and Zombie Ants: A Multidisciplinary Approach to Teaching Neuroscience, Behavior, and Microbiology

    PubMed Central

    Esteban, David J.; Holloway, Kevin S.

    2015-01-01

    Viruses, parasites, and some bacteria use host organisms to complete their lifecycle. These infectious agents are able to hijack host processes to replicate and transmit to the next host. While we tend to think of infections as just making us sick, they are also capable of changing host behavior. In fact, many infectious agents are able to mediate host behavior in ways that can enhance transmission of the disease. In this course we explore the process of host behavior mediation by infectious agents, combining aspects of multiple fields including neurobiology, animal behavior, infectious disease microbiology, and epidemiology. The goals for this course are: 1) To explore the neurological and behavioral effects of infectious organisms on their hosts, in particular pathogen mediation of host behavior to the benefit of the pathogen, 2) to introduce students to primary literature in a multidisciplinary field, and 3) when applicable, to address cultural/historical/mythological perspectives that might alter societal norms and pressures and influence the impact of the biological processes of behavior modification by infections. PMID:25838806

  15. Multidisciplinary Approach to Identify and Mitigate the Hazard from Induced Seismicity in Oklahoma

    NASA Astrophysics Data System (ADS)

    Holland, A. A.; Keller, G. R., Jr.; Darold, A. P.; Murray, K. E.; Holloway, S. D.

    2014-12-01

    Oklahoma has experienced a very significant increase in seismicity rates over the last 5 years with the greatest increase occurring in 2014. The observed rate increase indicates that the seismic hazard for at least some parts of Oklahoma has increased significantly. Many seismologists consider the large number of salt-water disposal wells operating in Oklahoma as the largest contributing factor to this increase. However, unlike many cases of seismicity induced by injection, the greatest increase is occurring over a very large area, about 15% of the state. There are more than 3,000 disposal wells currently operating within Oklahoma along with injection volumes greater than 2010 rates. These factors add many significant challenges to identifying potential cases of induced seismicity and understanding the contributing factors well enough to mitigate such occurrences. In response to a clear need for a better geotechnical understanding of what is occurring in Oklahoma, a multi-year multidisciplinary study some of the most active areas has begun at the University of Oklahoma. This study includes additional seismic monitoring, better geological and geophysical characterization of the subsurface, hydrological and reservoir modeling, and geomechanical studies to better understand the rise in seismicity rates. The Oklahoma Corporation Commission has added new rules regarding reporting and monitoring of salt-water disposal wells, and continue to work with the Oklahoma Geological Survey and other researchers.

  16. Mad dogs, vampires, and zombie ants: a multidisciplinary approach to teaching neuroscience, behavior, and microbiology.

    PubMed

    Esteban, David J; Holloway, Kevin S

    2015-01-01

    Viruses, parasites, and some bacteria use host organisms to complete their lifecycle. These infectious agents are able to hijack host processes to replicate and transmit to the next host. While we tend to think of infections as just making us sick, they are also capable of changing host behavior. In fact, many infectious agents are able to mediate host behavior in ways that can enhance transmission of the disease. In this course we explore the process of host behavior mediation by infectious agents, combining aspects of multiple fields including neurobiology, animal behavior, infectious disease microbiology, and epidemiology. The goals for this course are: 1) To explore the neurological and behavioral effects of infectious organisms on their hosts, in particular pathogen mediation of host behavior to the benefit of the pathogen, 2) to introduce students to primary literature in a multidisciplinary field, and 3) when applicable, to address cultural/historical/mythological perspectives that might alter societal norms and pressures and influence the impact of the biological processes of behavior modification by infections. PMID:25838806

  17. Increasing Efficiency in Evaluation of Chronic Cough: A Multidisciplinary, Collaborative Approach.

    PubMed

    Patton, Cynthia M; Lim, Kaiser G; Ramlow, Luke W; White, Kathleen M

    2015-01-01

    Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources. PMID:26426318

  18. Scoliosis Surgery in Cystic Fibrosis: Surgical Considerations and the Multidisciplinary Approach of a Rare Case.

    PubMed

    Mataliotakis, George I; Tsirikos, Athanasios I; Pearson, Karen; Urquhart, Don S; Smith, Carolyn; Fall, Andrew

    2016-01-01

    Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17. She underwent a posterior spinal fusion T2-L3 with the use of unilateral segmental instrumentation. Preoperative workup included respiratory, cardiac, anaesthetic, endocrine, and dietician reviews, as well as bone density optimisation with zoledronic acid and prophylactic antibiotics. Surgical time was 150 minutes and intraoperative blood loss was 47% of total blood volume. Postoperative intensive care included noninvasive ventilation, antibiotic cover, pain management, chest physiotherapy, pancreatic enzyme supplementation, and nutritional support. She was discharged on day 9. At follow-up she had a good cosmetic outcome, no complaints of her back, and stable respiratory function. Multidisciplinary perioperative care and meticulous surgical technique may reduce the associated risks of major surgery in CF patients, while achieving adequate deformity correction and a good functional outcome. PMID:27413564

  19. Effectiveness of three treatment strategies on occupational limitations and quality of life for patients with non-specific chronic low back pain: Is a multidisciplinary approach the key feature to success: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Chronic low back pain (cLBP) is a significant public health problem, being the primary cause of work absenteeism, as well as affecting sufferers’ quality of life, in industrialized society. International guidelines recommend intensive multidisciplinary approaches for patients with cLBP. However, these costly and time-consuming programs can only be offered to a minority of the most heavily affected patients and therefore do not seem likely to respond to public health requirements. Lighter programs may be an alternative to full time hospital-based programs with valuable results in terms of disability and occupational activity for cLBP patients. It is therefore important to define both what the determining components of management to improve activity restriction are and how to treat a larger number of patients more effectively at a lower cost. The aim of this study is to compare three programs with various levels of intensity and multidisciplinary. Methods/Design This paper describes the protocol for a prospective, randomized, controlled, clinical trial in working aged patients with cLBP. Three treatment strategies are compared: (1) intensive and multidisciplinary program conducted in a rehabilitation center; (2) less intensive outpatient program conducted by a private physiotherapist; (3) mixed strategy combining the same out program with a multidisciplinary intervention. The primary outcome of the trial is the impact of the mixed strategy on being able to work compared to hospital centered-program and out program. The secondary outcome is the impact of the mixed strategy on quality of life and social ability compared to the two others programs. The intervention part of the trial programs will take 5 weeks and observational follow-up will take 12 months. The sample size will be 180 participants (60 for each arm). The project has been approved by the Ethical Committee of Angers Hospital, France. Discussion On the hypothesis that a multidisciplinary

  20. Forced orthodontic extrusion and use of CAD/CAM for reconstruction of grossly destructed crown: A multidisciplinary approach

    PubMed Central

    Kumar, Rahul; Patil, Suvarna

    2012-01-01

    The aim of this study is to present a report of a case where forced orthodontic extrusion and computer-aided design and computer-aided manufacturing (CAD/CAM) technique was used for reconstruction of right maxillary central incisor with grossly destructed crown. Aesthetic rehabilitation of a fractured maxillary right central incisor was performed employing a multidisciplinary approach i.e. conventional endodontic treatment followed by orthodontic extrusion and final restoration using CAD-CAM and one piece milled zirconia post and core with full coverage zirconia crown. After the procedure being completed, periapical radiographs taken at 3 month follow up period demonstrated that the post and core remained well adapted to post space and there was a complete healing of periapical lesion. This technique can provide a complete aesthetic rehabilitation of a grossly destructed tooth without hampering the biological width and thus has a better prognosis. PMID:22557823

  1. Forced orthodontic extrusion and use of CAD/CAM for reconstruction of grossly destructed crown: A multidisciplinary approach.

    PubMed

    Kumar, Rahul; Patil, Suvarna

    2012-04-01

    The aim of this study is to present a report of a case where forced orthodontic extrusion and computer-aided design and computer-aided manufacturing (CAD/CAM) technique was used for reconstruction of right maxillary central incisor with grossly destructed crown. Aesthetic rehabilitation of a fractured maxillary right central incisor was performed employing a multidisciplinary approach i.e. conventional endodontic treatment followed by orthodontic extrusion and final restoration using CAD-CAM and one piece milled zirconia post and core with full coverage zirconia crown. After the procedure being completed, periapical radiographs taken at 3 month follow up period demonstrated that the post and core remained well adapted to post space and there was a complete healing of periapical lesion. This technique can provide a complete aesthetic rehabilitation of a grossly destructed tooth without hampering the biological width and thus has a better prognosis. PMID:22557823

  2. [A Case of a Multidisciplinary Team Approach to Serious Hand-Foot Syndrome Induced by High-Dose Cytarabine Therapy].

    PubMed

    Sakurada, Hiroaki; Aoi, Miki; Yuge, Masaaki; Sugimura, Yuriko; Kitamura, Kunio; Yamamura, Masumi; Tachi, Tomoya; Teramachi, Hitomi

    2016-07-01

    A 40's year-old female patient with acute myeloblastic leukemia received high-dose cytarabine(HD-Ara-C)as her third induction therapy. Because the pharmacist in charge noticed on a prior interview that she had experienced a mild skin eruption similar to hand-foot syndrome(HFS)in the previous round oftherapy(idarubicin and cytarabine), heparinoid lotion and hypoallergenic soap were used to prevent HFS. However, HFS occurred on day 3, and further developed on day 6 to grade 3 with painful erythema, swelling, and paresthesia affecting the entire surface of both hands. We cared for her with moisturization, lifestyle guidance, rotation of steroid ointment, and occlusive dressing techniques according to a multidisciplinary team approach composed ofa hematologist, dermatologist, pharmacist, and nurse. Her symptoms resolved on day 40. PMID:27431642

  3. [Current diagnosis and the multidisciplinary approach to the treatment of bone metastases in patients with prostate cancer].

    PubMed

    Satoh, Takefumi; Ishiyama, Hiromichi

    2016-01-01

    Prostate cancer is now the most commonly diagnosed cancer in Japanese men. In 2015, it is estimated 98,400 new cases are diagnosed. In addition, bone is the most common site for metastasis in prostate cancer, and many patients will develop bone metastases during the natural course of their disease. However, current advances in the diagnosis/treatment of metastatic prostate cancer, lead to change treatment strategy dramatically. In fact, bone metastasis has been changed 'palliative' to 'targeted organ', aimed to extend overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). We review the multiple issues involved in current diagnosis and the multidisciplinary approach to the treatment of bone metastases in patients with prostate cancer, and future directions. PMID:26793893

  4. [Hip Fracture--Epidemiology, Management and Liaison Service. Multidisciplinary approach for the treatment of proximal femoral fractures].

    PubMed

    Sawaguchi, Takeshi; Shigemoto, Kenji

    2015-04-01

    Multidisciplinary approach for proximal femoral fracture was organized in the hospital. Inter and intra division obstacles were discussed. After general consensus of the team was obtained, manuals and guidelines of the each division were prepared. In addition to this, the electrical chart specific for the proximal femoral fracture was made which enables to eliminate in-hospital reference letters. As the results, all patients were examined by internal medicine doctors at the time of admission. Average interval from the time of admission to surgery became 1.3 days. Closer relationship with psychiatrist made early detection and treatment of delirium possible. After changing the system to check the antiosteoporosis medication at the time of discharge by the ward pharmacist dramatically increased the prescription rate form 39 percent to 95 percent. PMID:25814013

  5. Multidisciplinary approach for the treatment of a complicated crown-root fracture in a young patient: a case report.

    PubMed

    de Castro, José Carlos Monteiro; Poi, Wilson Roberto; Pedrini, Denise; Tiveron, Adelisa Rodolfo Ferreira; Brandini, Daniela Atili; de Castro, Mara Antônio Monteiro

    2011-10-01

    Crown-root fractures in permanent teeth cause esthetic and functional problems. This paper reports the case of a complicated crown-root fracture in the maxillary right central incisor of a young patient who was treated with a multidisciplinary approach in two phases. A modified Widman flap, root canal therapy, glass fiber post cementation, and adhesive tooth fragment reattachment were performed shortly after an accident. Satisfactory esthetic and functional outcomes were obtained. However, the patient did not attend follow-up visits and returned after 7 years. During this second phase, the clinical and radiographic examination showed stability and adaptation of the fragment and good periodontal health conditions, but crown darkening and a radiolucent image associated with the root apex of the fractured tooth were also observed. The periapical lesion was surgically removed by apicoectomy, and the esthetics were recovered with a direct composite resin veneer on the traumatized tooth. PMID:21909497

  6. Multidisciplinary Care.

    PubMed

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

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

  7. Measuring health outcomes of a multidisciplinary care approach in individuals with chronic environmental conditions using an abbreviated symptoms questionnaire

    PubMed Central

    Fox, Roy; Sampalli, Tara; Fox, Jonathan

    2008-01-01

    The Nova Scotia Environmental Health Centre is a treatment facility for individuals with chronic environmental conditions such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, chronic respiratory conditions and in some cases chronic pain. The premise of care is to provide a patient-centred multidisciplinary care approach leading to self-management strategies. In order to measure the outcome of the treatment in these complex problems, with overlapping diagnoses, symptoms in many body systems and suspected environmental triggers, a detailed symptoms questionnaire was developed specifically for this patient population and validated. Results from a pilot study in which an abbreviated symptoms questionnaire based on the top reported symptoms captured in previous research was used to measure the efficacy of a multidisciplinary care approach in individuals with multiple chemical sensitivity are presented in this paper. The purpose of this study was to examine the extent, type and patterns of changes over time in the top reported symptoms with treatment measured using the abbreviated symptoms questionnaire. A total of 183 active and 109 discharged patients participated in the study where the health status was measured at different time periods of follow up since the commencement of treatment at the Centre. The findings from this study were successful in generating an initial picture of the nature and type of changes in these symptoms. For instance, symptoms such as difficulty concentrating, sinus conditions and tiredness showed early improvement, within the first 6 months of being in treatment, while others, such as fatigue, hoarseness or loss of voice, took longer while others showed inconsistent changes warranting further enquiry. A controlled longitudinal study is planned to confirm the findings of the pilot study. PMID:21197341

  8. A multidisciplinary geological and geophysical approach to define structural and hydrogeological implications of the Molinaccio spring (Spello, Italy)

    NASA Astrophysics Data System (ADS)

    Ercoli, Maurizio; Pauselli, Cristina; Forte, Emanuele; Di Matteo, Lucio; Mazzocca, Massimiliano; Frigeri, Alessandro; Federico, Costanzo

    2012-02-01

    In this paper, a multidisciplinary geological and geophysical approach has been applied in the complex area of Molinaccio spring (Spello, Umbria, Central Italy) to: 1) understand the large-scale geologic and tectonic structure of the area; 2) define the hydrogeological behavior of the various formations in relationship with the identified structural elements; 3) highlight at small-scale the tectonic structures and their relationships with the water caption tunnel, which is the draining structure of a still working, ancient Roman aqueduct giving water to the village of Spello and to the surrounding plain. Our approach includes different techniques like Ground Penetrating Radar (GPR) and Electrical Resistivity Tomography (ERT), direct geological investigations, archaeological studies, GIS data collection and integration. The GPR data revealed, in the area of the water-caption tunnel, two main tectonic structures, both also confirmed by ERT data: the presence of a zone (maximum 2 m wide), interpreted as a normal fault area and an overthrust that puts in contact the permeable Scaglia Rossa limestone (Early Turonian-Middle Eocene), and the Scaglia Variegata-Cinerea marly limestones (Middle Eocene-Upper Oligocene) on the footwall, characterized by lower hydraulic permeability. Using some rough information available on the sub-surface path of the tunnel, that shows a sharp bend after a long straight course, together with the geophysical images, was possible to describe how Romans built the tunnel: they probably followed the wet outcropping rock during the excavation, and changed abruptly the dig direction when they intercepted the normal fault area, aligning then the excavation along its strike. This latter result is important also because recently a multidisciplinary project has been developed to restore and exploit the entire water supply structure, which is not only a well-preserved example of Roman remains with high archaeological value, but also a vital

  9. A multidisciplinary approach to the management of temporomandibular joint ankylosis in a sickle-cell anemia patient in a resource-limited setting

    PubMed Central

    Braimah, Ramat Oyebunmi; Oladejo, Taoreed; Olarinoye, Timothy Oyetunde; Adetoye, Adedapo Omowonuola; Osho, Patrick Olanrewaju

    2016-01-01

    This report describes the multidisciplinary management of a 35-year-old female sickle-cell anemia patient who had unilateral bony ankylosis of the left temporomandibular joint secondary to septic arthritis. She was managed by a team comprising of maxillofacial surgeons, anesthetists, otorhinolaryngologist, and hematologist. Unilateral left interpositional arthroplasty and ipsilateral coronoidectomy through a postrami approach were done and followed by aggressive jaw physiotherapy in the postsurgical period. No perioperative morbidity was encountered. Mouth opening of 3.5 cm was achieved and maintained 7 months after surgery. Challenges and rationale for the use of a multidisciplinary team approach in treatment of such cases were discussed.

  10. A multidisciplinary approach to the management of temporomandibular joint ankylosis in a sickle-cell anemia patient in a resource-limited setting.

    PubMed

    Braimah, Ramat Oyebunmi; Oladejo, Taoreed; Olarinoye, Timothy Oyetunde; Adetoye, Adedapo Omowonuola; Osho, Patrick Olanrewaju

    2016-01-01

    This report describes the multidisciplinary management of a 35-year-old female sickle-cell anemia patient who had unilateral bony ankylosis of the left temporomandibular joint secondary to septic arthritis. She was managed by a team comprising of maxillofacial surgeons, anesthetists, otorhinolaryngologist, and hematologist. Unilateral left interpositional arthroplasty and ipsilateral coronoidectomy through a postrami approach were done and followed by aggressive jaw physiotherapy in the postsurgical period. No perioperative morbidity was encountered. Mouth opening of 3.5 cm was achieved and maintained 7 months after surgery. Challenges and rationale for the use of a multidisciplinary team approach in treatment of such cases were discussed. PMID:27563622

  11. A multidisciplinary approach for the conservation of a building of the seventeenth century

    NASA Astrophysics Data System (ADS)

    Angelini, E.; Grassini, S.; Corbellini, S.; Parvis, M.; Piantanida, M.

    2010-09-01

    A long-term multidisciplinary conservation study is actually in progress inside the Villa della Regina, a prestigious Savoy residence built in the seventeenth century and recently restored. The walls of some rooms of the Villa are decorated with precious tin-mercury mirrors, that are baked with a reflective coating constituted of a tin-mercury compound surrounded by liquid mercury. The reflective layer is very soft, thus any restoration is difficult to be performed and can lead to a complete destruction of the artifact. Amalgam corrosion is a very slow process and, although there is no way to prevent the oxidation of the reflective layer, the conservation state of the artifacts may be improved by keeping them in a controlled environment. For this reason, a monitoring system has been designed and installed that is based on a wireless network of extremely compact sensors, for temperature and relative humidity measurements. The sensors have been specifically designed to satisfy the requirements for use in cultural heritage field and the system allows one to automatically collect the data that can be analyzed with the final aim to establish a correlation between the environmental conditions and the conservation state of the artifacts. A restoration has been carried out by producing in situ an amalgam inlay on the corroded area to slow down the release of liquid mercury in order to avoid also possible unsafe conditions for staff and visitors. In addition, a sensor has been developed which is based on a prototypical plastic optical fiber for the detection of low concentration Hg vapors to ensure the safe conditions in the Villa rooms. The sensor is being tested in laboratory.

  12. Psychiatric Approaches for Disorders of Sex Development: Experience of a Multidisciplinary Team

    PubMed Central

    Özbaran, Burcu; Özen, Samim; Gökşen, Damla; Korkmaz, Özlem; Onay, Hüseyin; Özkınay, Ferda; Çoğulu, Özgür; Erermiş, Serpil; Köse, Sezen; Avanoğlu, Ali; Ulman, İbrahim; Darcan, Şükran

    2013-01-01

    Objective: Disorders of sex development (DSD) are a group of congenital medical conditions that affect life as a whole. In this study, we aimed to reflect the experience of a multidisciplinary team in the clinical/psychiatric follow-up of a group of children and adolescents with DSD. Methods: The study group consisted of 51 patients diagnosed with DSD. The Kiddie-Schedule for Affective Disorders and Schizophrenia, Wechsler Intelligence Scale for Children-Revised, Draw a Person Test and Children’s Apperception Test, and the Clinical Global Impression Scale (CGIS) were used for psychiatric evaluations. Results: The mean age of the patients was 7.8 years (median: 7.8; min: 1.0; max: 18.0). Genetic evaluation showed 46,XX configuration in 15 patients (29.4%) and 46,XY in 35 (68.6%). One patient (2.0%) was diagnosed to have a sex chromosome disorder. Forty patients (78.4%) had no problems with their given gender identity and gender role. Thirty-four (66.7%) patients had normal intellectual capacity. Twenty-eight (54.9%) patients did not have any psychiatric problem. Depression, anxiety disorders, attention deficit/hyperactivity disorder, and adjustment disorders were the common diagnoses. The mean score of symptom severity on CGIS-severity-baseline was 6.15±0.68 and after one year, it was 1.46±0.51 (Z=-3.236 p=0.001). The mean score of CGI–Improvement was 1.23±0.44. Conclusion: It is important to identify and treat the psychiatric disorders encountered in patients with DSD. A psychiatrist needs to be included in the professional team following these patients. Examination and observation results need to be shared by holding periodic team meetings to establish a wholesome point of view for every unique child. Conflict of interest:None declared. PMID:24379031

  13. Mud volcanoes in central Italy: Subsoil characterization through a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Rainone, M. L.; Rusi, S.; Torrese, P.

    2015-04-01

    Mud volcanoes are common geological phenomenons observed worldwide as in Italy. They are well described in the scientific literature for their morphological, tectonic and hydrogeological features. They represent not only a relevant geological and geomorphological interest but also not negligible elements of hazard and risk associated with the presence of soft and pliable sediments and with the possible unexpected emission of gas and mud. Therefore, the understanding of their structure and hydrogeological circuits in the subsurface is an important key to define hazard and risk conditions in the adjacent areas. This paper deals with a multidisciplinary study including geophysical and hydrochemical surveys undertaken at the Pineto (central Italy) mud volcano site to achieve an interpretative conceptual model explaining the shallow upward migration of deep mud fluids. Shallow electrical and seismic imaging of the mud volcano was obtained using two dimensional and three dimensional (2D-3D) electrical resistivity tomography and 2D reflection seismic surveys. The hydrochemical properties of the rising fluids were assessed by means of seasonal measurements of the chemical-physical parameters, the concentrations of major ions, and some natural isotopes. This mud volcano or mud lump appears as a dome of about 15 × 10 m in size. The height of the crater is 2 m approximately, while the diameter of the crater is 2.5 m. Emission of fluids and solids (cold brine, mud, gas) occurs from this crater. Upper Pliocene-lower Pleistocene foredeep pelitic deposits (over-compacted clays with silty-sandy levels) overlain by clayey-silty deposits crop out in the area. The survey results seem to reveal that the uprising of deep fluids does not occur exactly below the mud volcano at present. Instead, a high conductivity body is present within a fractured zone in the pelitic deposits at 60 m approximately to the ENE. The probable occurrence of a high permeability layer approximately between 20

  14. Ten years of a multidisciplinary diabetic foot team approach in Sao Paulo, Brazil

    PubMed Central

    Batista, Fábio; Augusto Magalhães, Antonio; Gamba, Mônica; Nery, Caio; Cardoso, Cristina

    2010-01-01

    Diabetes mellitus can cause devastating foot problems including loss of protective sensation with subsequent ulcerations and amputations. The natural history and pathophysiology of diabetic foot ulcers is best understood and managed by a multiprofessional team approach. The main factors for prevention and treatment of these devastating diabetic foot conditions are shown, with special attention to education of the patient. This approach decreases the morbidity of the disease, besides its economical and social feasibility. PMID:22396805

  15. Characterization of a small-scale drainage basin in Central Portugal - a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Correia, Carla G.; Azevedo, José Manuel; Rodrigues, Nelson V.; Figueiredo, Fernando P. O.

    2015-04-01

    This study presents a multidisciplinary characterization of a small-scale watershed encompassing its topography, geology, local and regional tectonics, morphometry of the drainage system, soil type, land use and climatology. All this parameters are important controllers of the groundwater circulation and storage, as well as the localization of the recharge areas. It also identifies the piezometric changes, the upper (or phreatic) aquifer flow and the major recharge areas. Simultaneously, it includes the hydrochemical classification and the active hydrogeochemical processes occurring on the local aquifers. The combined analysis of these data is necessary for interpreting the hydrodynamics of the local aquifer units. The research focused on the surrounding domains of Olhos da Fervença spring, particularly in the Fervença watershed, a small-scale drainage basin close to Cantanhede city (Coimbra District, Portugal). This watershed is located on a rural area within the Vouga hydrographic basin. The methodology included: (1) delimitation of the watershed; (2) geometric (or physiographic) characterization of the basin; (3) analysis of the digital elevation model to quantify the slopes and to detect structural alignments that influence the surface and groundwater flow; (4) geologic characterization of the basin; (5) description of the soil type and the land use; (6) classification of the regional climatic conditions; (7) inventory and regular hydrogeologic characterization of wells (diameter, depth, wellhead and piezometry); (8) elaboration of piezometric maps in order to identify the groundwater flow; (9) groundwater sampling and in situ measurement of physico-chemical parameters (pH, groundwater temperature, specific electrical conductivity, Eh, dissolved oxygen, HCO3); (10) conducting laboratorial hydrochemical analyzes (Cl, NO3, SO4, PO4, Ca, Na, Mg, K, Fe, Mn, Al); (11) groundwater classification, hydrochemical interpretation and identification of the water

  16. Transdisciplinary approaches to building the capacity of the public health workforce.

    PubMed

    Taub, Alyson

    2003-01-01

    The thesis of this article is that public health professionals working across disciplines can have a greater impact on the health of the public than they can working independently. A conceptual model, the HERP (Health Care Services, Education, Research, Policy) Transdisciplinary Model, is proposed to support the thesis. The model differentiates transdisciplinary approaches from multidisciplinary, interdisciplinary, and other similar efforts. Methods for strengthening the public health workforce through application of the transdisciplinary approach to research, professional education, and practice are discussed. The key roles played by epidemiological research, the cardiovascular disease (CVD) care team, and health education/health promotion in CVD prevention in developing countries are highlighted. CVD prevention in sub-Saharan Africa is used as an example in discussing the model and the transdisciplinary approach. PMID:13677413

  17. Where do adaptive shifts occur during invasion A multidisciplinary approach to unravel cold adaptation in a tropical ant species invading the Mediterranean zone

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although evolution is now recognized as improving the invasive success of populations, where and when key adaptation event(s) occur often remains unclear. Here we used a multidisciplinary approach to disentangle the eco-evolutionary scenario of invasion of a Mediterranean zone (i.e. Israel) by the t...

  18. A MULTIDISCIPLINARY APPROACH TO THE REHABILITATION OF A COLLEGIATE FOOTBALL PLAYER FOLLOWING ANKLE FRACTURE: A CASE REPORT

    PubMed Central

    Kaplan, Lee D.; Musto, Tony; Gaunaurd, Ignacio A.; Gailey, Robert S.; Kelley, William P.; Alemi, Timothy J.; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A.; West, Dustin C.

    2016-01-01

    ABSTRACT Background and Purpose Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. Case Description A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. Outcomes The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m2 to 30.6 kg/m2. Discussion This case report illustrates the positive effects of a

  19. Perspectives on a Multidisciplinary Team Approach to Implementation of Planned Emergent Use Research

    PubMed Central

    Racedo Africano, Carlos J.; De Moraes, Alice Gallo; Smischney, Nathan J.

    2015-01-01

    In this paper we present the viewpoints of three members of a research team, on the approach to teamwork in the development of an emergent use clinical trial when dealing with diversity of opinions, in order to facilitate stakeholder buy-in. We also discuss a specific approach to the coordination of the team members, which in our opinion had a positive impact on the implementation of the project. We also comment on the influence of the team organization in the timeline and completion of a clinical trial. We hope to start a conversation on team dynamics in the design of clinical trials, especially in the context of emergent use research. PMID:26386913

  20. Oncology Teaching: A Multidisciplinary Approach for Second-Year Medical Students

    ERIC Educational Resources Information Center

    Elkort, Richard; Mozden, Peter J.

    1975-01-01

    A Boston University School of Medicine course in oncology is described which covers basic science correlates, diagnostic approaches, treatment modalities, and psycho-social aspects. Based on five years experience, the course is considered a successful means of correlating basic and clinical information for second- and third-year medical students.…

  1. A two-step multidisciplinary approach to treat recurrent esophageal strictures in children with epidermolysis bullosa dystrophica.

    PubMed

    Vowinkel, Thorsten; Laukoetter, Mike; Mennigen, Rudolf; Hahnenkamp, Klaus; Gottschalk, Antje; Boschin, Matthias; Frosch, Michael; Senninger, Norbert; Tübergen, Dirk

    2015-06-01

    In children with severe generalized recessive dystrophic epidermolysis bullosa (RDEB), esophageal scarring leads to esophageal strictures with dysphagia, followed by malnutrition and delayed development. We describe a two-step multidisciplinary therapeutic approach to overcome malnutrition and growth retardation. In Step 1, under general anesthesia, orthograde balloon dilation of the esophagus is followed by gastrostomy creation using a direct puncture technique. In Step 2, further esophageal strictures are treated by retrograde dilation via the established gastrostomy; this step requires only a short sedation period. A total of 12 patients (median age 7.8 years, range 6 weeks to 17 years) underwent successful orthograde balloon dilation of esophageal strictures combined with direct puncture gastrostomy. After 12 and 24 months in 11 children, a substantial improvement of growth and nutrition was achieved (body mass index [BMI] standard deviation score [SDS] + 0.59 and + 0.61, respectively). In one child, gastrostomy was removed because of skin ulcerations after 10 days. Recurrent esophageal strictures were treated successfully in five children. The combined approach of balloon dilation and gastrostomy is technically safe in children with RDEB, and helps to promote catch-up growth and body weight. In addition, recurrent esophageal strictures can be treated successfully without general anesthesia in a retrograde manner via the established gastrostomy. PMID:25590175

  2. A multidisciplinary, science-based approach to the economics of climate change.

    PubMed

    Carlin, Alan

    2011-04-01

    Economic analyses of environmental mitigation and other interdisciplinary public policy issues can be much more useful if they critically examine what other disciplines have to say, insist on using the most relevant observational data and the scientific method, and examine lower cost alternatives to the change proposed. These general principles are illustrated by applying them to the case of climate change mitigation, one of the most interdisciplinary of public policy issues. The analysis shows how use of these principles leads to quite different conclusions than those of most previous such economic analyses, as follows: The economic benefits of reducing CO(2) emissions may be about two orders of magnitude less than those estimated by most economists because the climate sensitivity factor (CSF) is much lower than assumed by the United Nations because feedback is negative rather than positive and the effects of CO(2) emissions reductions on atmospheric CO(2) appear to be short rather than long lasting. The costs of CO(2) emissions reductions are very much higher than usually estimated because of technological and implementation problems recently identified. Geoengineering such as solar radiation management is a controversial alternative to CO(2) emissions reductions that offers opportunities to greatly decrease these large costs, change global temperatures with far greater assurance of success, and eliminate the possibility of low probability, high consequence risks of rising temperatures, but has been largely ignored by economists. CO(2) emissions reductions are economically unattractive since the very modest benefits remaining after the corrections for the above effects are quite unlikely to economically justify the much higher costs unless much lower cost geoengineering is used.The risk of catastrophic anthropogenic global warming appears to be so low that it is not currently worth doing anything to try to control it, including geoengineering. PMID:21695026

  3. A Multidisciplinary, Science-Based Approach to the Economics of Climate Change

    PubMed Central

    Carlin, Alan

    2011-01-01

    Economic analyses of environmental mitigation and other interdisciplinary public policy issues can be much more useful if they critically examine what other disciplines have to say, insist on using the most relevant observational data and the scientific method, and examine lower cost alternatives to the change proposed. These general principles are illustrated by applying them to the case of climate change mitigation, one of the most interdisciplinary of public policy issues. The analysis shows how use of these principles leads to quite different conclusions than those of most previous such economic analyses, as follows: The economic benefits of reducing CO2 emissions may be about two orders of magnitude less than those estimated by most economists because the climate sensitivity factor (CSF) is much lower than assumed by the United Nations because feedback is negative rather than positive and the effects of CO2 emissions reductions on atmospheric CO2 appear to be short rather than long lasting.The costs of CO2 emissions reductions are very much higher than usually estimated because of technological and implementation problems recently identified.Geoengineering such as solar radiation management is a controversial alternative to CO2 emissions reductions that offers opportunities to greatly decrease these large costs, change global temperatures with far greater assurance of success, and eliminate the possibility of low probability, high consequence risks of rising temperatures, but has been largely ignored by economists.CO2 emissions reductions are economically unattractive since the very modest benefits remaining after the corrections for the above effects are quite unlikely to economically justify the much higher costs unless much lower cost geoengineering is used.The risk of catastrophic anthropogenic global warming appears to be so low that it is not currently worth doing anything to try to control it, including geoengineering. PMID:21695026

  4. Reducing health inequalities in people with learning disabilities: a multi-disciplinary team approach to care under general anaesthesia.

    PubMed

    Clough, S; Shehabi, Z; Morgan, C

    2016-05-27

    Background There remains significant inequality in health and healthcare in people with learning disabilities (LD). A lack of coordination and the episodic nature of care provision are contributory factors. Recognising the need to improve outcomes for this group, we evaluate a multi-disciplinary team (MDT) approach to care whereby additional medical procedures are carried out under the same episode of general anaesthesia (GA) as dental treatment for people with severe LD. This is the first published evaluation of its kind in the UK.Aim To evaluate the need and outcomes of an MDT approach to care among people with severe LD receiving dental treatment under GA.Method One hundred patients with severe LD and behaviour that challenges attended Barts Health Dental Hospital for dental assessment and subsequent treatment under GA. Details of failed or forthcoming medical interventions were determined. Where appropriate, care was coordinated with the relevant medical team.Findings Twenty-one percent (n = 21/100) had recent medical interventions attempted that had been abandoned, and 7.0% (n = 7/100) had future investigations or treatment planned under GA with medical specialties. An MDT approach was indicated in 28.0% (n = 28/100). For such complex cases, a successful MDT outcome was achieved in 89.3% (n = 25/28). This included ophthalmological/orthoptic, ENT and gastroenterological interventions in addition to medical imaging.Conclusion An MDT approach to care for people with LD offers improved patient-centred outcomes in addition to financial and resource efficiency. It requires a high level of cooperation between specialties, with consideration of the practicalities of a shared surgical space and equipment needs. Re-shaping of services and contractual flexibility are essential to support the future implementation of MDTs and to ensure long-term sustainability. Adoption of a holistic culture in the care of this vulnerable patient group is encouraged. PMID:27228934

  5. An interdisciplinary approach to teaching in a multi-disciplinary context - A model for teaching geociences?

    NASA Astrophysics Data System (ADS)

    Salmun, H.

    2015-12-01

    As a major component of an NSF-funded STEM program, a seminar-style course called the Catalyst Seminar was developed and offered over three consecutive semesters. The program included undergraduate students in the geosciences, computer science, mathematics and physics. The Catalyst Seminar was designed to expose scholars to the interdisciplinary research options and careers in these disciplines. The Seminar also provided a venue for scholars to meet regularly, build a sense of community and to engage in research projects that would enhance their preparation for multi and interdisciplinary careers in the sciences. The first semester of the Seminar was devoted to Exposure and Connections, accomplished through lectures by invited speakers on topics related to the disciplines participating in the Program. Scholars were required to read journal articles related to the lectures and to write a final short paper reflecting on the experience, all activities that are known to students at this level. Overall, this was a somewhat passive learning approach to research in classrooms. In the following two semesters a more active approach to engage students in interdisciplinary research was used. Students were asked to take ownership of their learning process through disciplinary and interdisciplinary engagement in a project. In one semester this process was guided by the seminar coordinator who was in charge of selecting and leading the 'research project' which although challenging to scholars, was 'safe' enough that answers were readily available. In the other semester the approach was student-centered, with a coordinator that merely facilitated the formation of interdisciplinary research teams that took complete charge of the entire research enterprise. I will discuss our observations and assessment of the outcomes of this instructional experience with relation to the teaching of geoscience, in particular to attracting students into this field.

  6. Evaluating the risk of phospholipidosis using a new multidisciplinary pipeline approach.

    PubMed

    Goracci, Laura; Buratta, Sandra; Urbanelli, Lorena; Ferrara, Giuseppina; Di Guida, Riccardo; Emiliani, Carla; Cross, Simon

    2015-03-01

    Phospholipidosis (PLD) is an undesirable potential side-effect of drugs, and cationic amphiphilic drugs (CADs) represent the main class of PLD inducers. A CADs toxicophore has been recently proposed, although the CADs definition is far from being trivial. In this work we derive a three-dimensional CADs toxicophore (here named PLD-phore) using a molecular interaction field approach, and test its suitability to discriminate between PLD inducers and non-inducers in a virtual screening approach. Ten commercially available compounds predicted to be PLD inducers and non-inducers based on their similarity to the PLD-phore were experimentally tested for PLD induction using two cell-based in vitro assays (fluorescent lipid uptake, activity of secreted lysosomal β-hexosaminidase). When a positive effect was observed, the PLD induction was also confirmed by transmission electron microscopy. Two exceptions to the general statement about CADs and PLD induction were detected and discussed, and for one compound the cell-based in-vitro assays lead to different outcomes. PMID:25544686

  7. A multi-disciplinary approach for the integrated assessment of multiple risks in delta areas.

    NASA Astrophysics Data System (ADS)

    Sperotto, Anna; Torresan, Silvia; Critto, Andrea; Marcomini, Antonio

    2016-04-01

    The assessment of climate change related risks is notoriously difficult due to the complex and uncertain combinations of hazardous events that might happen, the multiplicity of physical processes involved, the continuous changes and interactions of environmental and socio-economic systems. One important challenge lies in predicting and modelling cascades of natural and man -made hazard events which can be triggered by climate change, encompassing different spatial and temporal scales. Another regard the potentially difficult integration of environmental, social and economic disciplines in the multi-risk concept. Finally, the effective interaction between scientists and stakeholders is essential to ensure that multi-risk knowledge is translated into efficient adaptation and management strategies. The assessment is even more complex at the scale of deltaic systems which are particularly vulnerable to global environmental changes, due to the fragile equilibrium between the presence of valuable natural ecosystems and relevant economic activities. Improving our capacity to assess the combined effects of multiple hazards (e.g. sea-level rise, storm surges, reduction in sediment load, local subsidence, saltwater intrusion) is therefore essential to identify timely opportunities for adaptation. A holistic multi-risk approach is here proposed to integrate terminology, metrics and methodologies from different research fields (i.e. environmental, social and economic sciences) thus creating shared knowledge areas to advance multi risk assessment and management in delta regions. A first testing of the approach, including the application of Bayesian network analysis for the assessment of impacts of climate change on key natural systems (e.g. wetlands, protected areas, beaches) and socio-economic activities (e.g. agriculture, tourism), is applied in the Po river delta in Northern Italy. The approach is based on a bottom-up process involving local stakeholders early in different

  8. Towards an optimal multidisciplinary approach to breast cancer treatment for older women.

    PubMed

    Thavarajah, Nemica; Menjak, Ines; Trudeau, Maureen; Mehta, Rajin; Wright, Frances; Leahey, Angela; Ellis, Janet; Gallagher, Damian; Moore, Jennifer; Bristow, Bonnie; Kay, Noreen; Szumacher, Ewa

    2015-01-01

    The treatment of breast cancer presents specifc concerns that are unique to the needs of older female patients. While treatment of early breast cancer does not vary greatly with age, the optimal management of older women with breast cancer often requires complex interdisciplinary supportive care due to multiple comorbidities. This article reviews optimal approaches to breast cancer in women 65 years and older from an interdisciplinary perspective. A literature review was conducted using MEDLINE and EMBASE, choosing articles concentrated on the management of older breast cancer patients from the point of view of several disciplines, including geriatrics, radiation oncology, medical oncology, surgical oncology, psychooncology, palliative care, nursing, and social work. This patient population requires interprofessional collaboration from the time of diagnosis, throughout treatment and into the recovery period. Thus, we recommend an interdisciplinary program dedicated to the treat ment of older women with breast cancer to optimize their cancer care. PMID:26897863

  9. The Seine system: introduction to a multidisciplinary approach of the functioning of a regional river system.

    PubMed

    Billen, Gilles; Garnier, Josette; Mouchel, Jean-Marie; Silvestre, Marie

    2007-04-01

    The Seine basin (France) is dominated by the megalopolis of Paris (10 millions inhabitants), surrounded by intensive agricultural areas: it represents an important example of regional territory strongly affected by anthropogenic activity. In the scope of the PIREN-Seine program, an interdisciplinary study of this basin was conducted. This paper introduces a special issue of the Science of the Total Environment devoted to the results of this program. It summarizes the main features of the Seine river system, the physical characteristics of its drainage network and its watershed, and the nature and spatial distribution of human activities. The scientific approaches used for the study of the system are described, emphasizing the role of material budgeting, mathematical modeling and historical reconstruction. Some functional characteristics of the Seine watershed and drainage network are summarized, showing that the system is now essentially controlled by anthropogenic constraints. PMID:17250875

  10. A multidisciplinary approach and surgical tips in major amputations of diabetic patients.

    PubMed

    Rosati, Marco; Lisanti, Michele; Baluganti, Alessandro; Andreani, Lorenzo; Rizzo, Loredana; Piaggesi, Alberto

    2012-12-01

    We aim to describe the results obtained in major amputations (transtibial and transfemoral) of diabetic patients followed with a close combined approach (medical and surgical). We evaluated 37 cases with an average age of 73.55 years. All were admitted in our Diabetology Department where they were monitored and treated in order to reach a new balance concerning cardiac failure, anemia, and other pathologies. Then, the orthopedic surgeons operate choosing an adequate level for amputation and pointing about adequate stump covering, accurate vessel, perineural and periosteal hemostasis, and nerve thermoablation. Reading literature we discovered in our series an improvement concerning perioperative mortality, considering the high average age and the bad general conditions of our patients; at the same time, we obtained an improvement about neuromas and ghost limb syndrome versus literature. About walking capabilities we had similar results compared to previous papers, obtaining the worst results for thigh amputations. PMID:22847822