analysis community-based multidisciplinary: Topics by Science.gov

Sample records for analysis community-based multidisciplinary

A break-even analysis of a community rehabilitation falls prevention service.

PubMed

Comans, Tracy; Brauer, Sandy; Haines, Terry

2009-06-01

To identify and compare the minimum number of clients that a multidisciplinary falls prevention service delivered through domiciliary or centre-based care needs to treat to allow the service to reach a 'break-even' point. A break-even analysis was undertaken for each of two models of care for a multidisciplinary community rehabilitation falls prevention service. The two models comprised either a centre-based group exercise and education program or a similar program delivered individually in the client's home. The service consisted of a physiotherapist, occupational therapist and therapy assistant. The participants were adults aged over 65 years who had experienced previous falls. Costs were based on the actual cost of running a community rehabilitation team located in Brisbane. Benefits were obtained by estimating the savings gained to society from the number of falls prevented by the program on the basis of the falls reduction rates obtained in similar multidisciplinary programs. It is estimated that a multi-disciplinary community falls prevention team would need to see 57 clients per year to make the service break-even using a centre-based model of care and 78 clients for a domiciliary-based model. The service this study was based on has the capability to see around 300 clients per year in a centre-based service or 200-250 clients per year in a home-based service. Based on the best available estimates of costs of falls, multidisciplinary falls prevention teams in the community targeting people at high risk of falls are worthwhile funding from a societal viewpoint.
Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.

PubMed

St John, Winsome; Wallis, Marianne; James, Heather; McKenzie, Shona; Guyatt, Sheridan

2004-10-01

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.
Comparative Initial and Sustained Engagement in Web-based Training by Behavioral Healthcare Providers in New York State.

PubMed

Talley, Rachel; Chiang, I-Chin; Covell, Nancy H; Dixon, Lisa

2018-06-01

Improved dissemination is critical to implementation of evidence-based practice in community behavioral healthcare settings. Web-based training modalities are a promising strategy for dissemination of evidence-based practice in community behavioral health settings. Initial and sustained engagement of these modalities in large, multidisciplinary community provider samples is not well understood. This study evaluates comparative engagement and user preferences by provider type in a web-based training platform in a large, multidisciplinary community sample of behavioral health staff in New York State. Workforce make-up among platform registrants was compared to the general NYS behavioral health workforce. Training completion by functional job type was compared to characterize user engagement and preferences. Frequently completed modules were classified by credit and requirement incentives. High initial training engagement across professional role was demonstrated, with significant differences in initial and sustained engagement by professional role. The most frequently completed modules across functional job types contained credit or requirement incentives. The analysis demonstrated that high engagement of a web-based training in a multidisciplinary provider audience can be achieved without tailoring content to specific professional roles. Overlap between frequently completed modules and incentives suggests a role for incentives in promoting engagement of web-based training. These findings further the understanding of strategies to promote large-scale dissemination of evidence-based practice in community behavioral health settings.
A practice-based information system for multi-disciplinary care of chronically ill patients: what information do we need? The Community Care Coordination Network Database Group.

PubMed Central

Moran, W. P.; Messick, C.; Guerette, P.; Anderson, R.; Bradham, D.; Wofford, J. L.; Velez, R.

1994-01-01

Primary care physicians provide longitudinal care for chronically ill individuals in concert with many other community-based disciplines. The care management of these individuals requires data not traditionally collected during the care of well, or acutely ill individuals. These data not only concern the patient, in the form of patient functional status, mental status and affect, but also pertain to the caregiver, home environment, and the formal community health and social service system. The goal of the Community Care Coordination Network is to build a primary care-based information system to share patient data and communicate patient related information among the community-based multi-disciplinary teams. One objective of the Community Care Coordination Network is to create a Community Care Database for chronically ill individuals by identifying those data elements necessary for efficient multi-disciplinary care. PMID:7949995
Community-based care for the specialized management of heart failure: an evidence-based analysis.

PubMed

2009-01-01

In August 2008, the Medical Advisory Secretariat (MAS) presented a vignette to the Ontario Health Technology Advisory Committee (OHTAC) on a proposed targeted health care delivery model for chronic care. The proposed model was defined as multidisciplinary, ambulatory, community-based care that bridged the gap between primary and tertiary care, and was intended for individuals with a chronic disease who were at risk of a hospital admission or emergency department visit. The goals of this care model were thought to include: the prevention of emergency department visits, a reduction in hospital admissions and re-admissions, facilitation of earlier hospital discharge, a reduction or delay in long-term care admissions, and an improvement in mortality and other disease-specific patient outcomes.OHTAC approved the development of an evidence-based assessment to determine the effectiveness of specialized community based care for the management of heart failure, Type 2 diabetes and chronic wounds.PLEASE VISIT THE MEDICAL ADVISORY SECRETARIAT WEB SITE AT: www.health.gov.on.ca/ohtas to review the following reports associated with the Specialized Multidisciplinary Community-Based care series.Specialized multidisciplinary community-based care series: a summary of evidence-based analysesCommunity-based care for the specialized management of heart failure: an evidence-based analysisCommunity-based care for chronic wound management: an evidence-based analysisPlease note that the evidence-based analysis of specialized community-based care for the management of diabetes titled: "Community-based care for the management of type 2 diabetes: an evidence-based analysis" has been published as part of the Diabetes Strategy Evidence Platform at this URL: http://www.health.gov.on.ca/english/providers/program/mas/tech/ohtas/tech_diabetes_20091020.htmlPLEASE VISIT THE TORONTO HEALTH ECONOMICS AND TECHNOLOGY ASSESSMENT COLLABORATIVE WEB SITE AT: http://theta.utoronto.ca/papers/MAS_CHF_Clinics_Report.pdf to review the following economic project associated with this series:Community-based Care for the specialized management of heart failure: a cost-effectiveness and budget impact analysis. The objective of this evidence-based analysis was to determine the effectiveness of specialized multidisciplinary care in the management of heart failure (HF). TARGET POPULATION AND CONDITION HF is a progressive, chronic condition in which the heart becomes unable to sufficiently pump blood throughout the body. There are several risk factors for developing the condition including hypertension, diabetes, obesity, previous myocardial infarction, and valvular heart disease.(1) Based on data from a 2005 study of the Canadian Community Health Survey (CCHS), the prevalence of congestive heart failure in Canada is approximately 1% of the population over the age of 12.(2) This figure rises sharply after the age of 45, with prevalence reports ranging from 2.2% to 12%.(3) Extrapolating this to the Ontario population, an estimated 98,000 residents in Ontario are believed to have HF. Disease management programs are multidisciplinary approaches to care for chronic disease that coordinate comprehensive care strategies along the disease continuum and across healthcare delivery systems.(4) Evidence for the effectiveness of disease management programs for HF has been provided by seven systematic reviews completed between 2004 and 2007 (Table 1) with consistency of effect demonstrated across four main outcomes measures: all cause mortality and hospitalization, and heart-failure specific mortality and hospitalization. (4-10) However, while disease management programs are multidisciplinary by definition, the published evidence lacks consistency and clarity as to the exact nature of each program and usual care comparators are generally ill defined. Consequently, the effectiveness of multidisciplinary care for the management of persons with HF is still uncertain. Therefore, MAS has completed a systematic review of specialized, multidisciplinary, community-based care disease management programs compared to a well-defined usual care group for persons with HF. What is the effectiveness of specialized, multidisciplinary, community-based care (SMCCC) compared with usual care for persons with HF? LITERATURE SEARCH STRATEGY: A comprehensive literature search was completed of electronic databases including MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Library and Cumulative Index to Nursing & Allied Health Literature. Bibliographic references of selected studies were also searched. After a review of the title and abstracts, relevant studies were obtained and the full reports evaluated. All studies meeting explicit inclusion and exclusion criteria were retained. Where appropriate, a meta-analysis was undertaken to determine the pooled estimate of effect of specialized multidisciplinary community-based care for explicit outcomes. The quality of the body of evidence, defined as one or more relevant studies was determined using GRADE Working Group criteria. (11) INCLUSION CRITERIA: Randomized controlled trialSystematic review with meta analysisPopulation includes persons with New York Heart Association (NYHA) classification 1-IV HFThe intervention includes a team consisting of a nurse and physician one of which is a specialist in HF management.The control group receives care by a single practitioner (e.g. primary care physician (PCP) or cardiologist)The intervention begins after discharge from the hospitalThe study reports 1-year outcomes The intervention is delivered predominately through home-visitsStudies with mixed populations where discrete data for HF is not reported All cause mortalityAll cause hospitalizationHF specific mortalityHF specific hospitalizationAll cause duration of hospital stayHF specific duration of hospital stayEmergency room visitsQuality of Life One large and seven small randomized controlled trials were obtained from the literature search. A meta-analysis was completed for four of the seven outcomes including: All cause mortalityHF-specific mortalityAll cause hospitalizationHF-specific hospitalization.Where the pooled analysis was associated with significant heterogeneity, subgroup analyses were completed using two primary categories: direct and indirect model of care; andtype of control group (PCP or cardiologist).The direct model of care was a clinic-based multidisciplinary HF program and the indirect model of care was a physician supervised, nurse-led telephonic HF program. All studies, except one, were completed in jurisdictions outside North America. (12-19) Similarly, all but one study had a sample size of less than 250. The mean age in the studies ranged from 65 to 77 years. Six of the studies(12;14-18) included populations with a NYHA classification of II-III. In two studies, the control treatment was a cardiologist (12;15) and two studies reported the inclusion of a dietitian, physiotherapist and psychologist as members of the multidisciplinary team (12;19). ALL CAUSE MORTALITY: Eight studies reported all cause mortality (number of persons) at 1 year follow-up. (12-19) When the results of all eight studies were pooled, there was a statistically significant RRR of 29% with moderate heterogeneity (I(2) of 38%). The results of the subgroup analyses indicated a significant RRR of 40% in all cause mortality when SMCCC is delivered through a direct team model (clinic) and a 35% RRR when SMCCC was compared with a primary care practitioner. HF-SPECIFIC MORTALITY: Three studies reported HF-specific mortality (number of persons) at 1 year follow-up. (15;18;19) When the results of these were pooled, there was an insignificant RRR of 42% with high statistical heterogeneity (I(2) of 60%). The GRADE quality of evidence is moderate for the pooled analysis of all studies. ALL CAUSE HOSPITALIZATION: Seven studies reported all cause hospitalization at 1-year follow-up (13-15;17-19). When pooled, their results showed a statistically insignificant 12% increase in hospitalizations in the SMCCC group with high statistical heterogeneity (I(2) of 81%). A significant RRR of 12% in all cause hospitalization in favour of the SMCCC care group was achieved when SMCCC was delivered using an indirect model (telephonic) with an associated (I(2) of 0%). The Grade quality of evidence was found to be low for the pooled analysis of all studies and moderate for the subgroup analysis of the indirect team care model. HF-SPECIFIC HOSPITALIZATION: Six studies reported HF-specific hospitalization at 1-year follow-up. (13-15;17;19) When pooled, the results of these studies showed an insignificant RRR of 14% with high statistical heterogeneity (I(2) of 60%); however, the quality of evidence for the pooled analysis of was low. DURATION OF HOSPITAL STAY: Seven studies reported duration of hospital stay, four in terms of mean duration of stay in days (14;16;17;19) and three in terms of total hospital bed days (12;13;18). Most studies reported all cause duration of hospital stay while two also reported HF-specific duration of hospital stay. These data were not amenable to meta-analyses as standard deviations were not provided in the reports. However, in general (and in all but one study) it appears that persons receiving SMCCC had shorter hospital stays, whether measured as mean days in hospital or total hospital bed days. EMERGENCY ROOM VISITS: Only one study reported emergency room visits. (14) This was presented as a composite of readmissions and ER visits, where the authors reported that 77% (59/76) of the SMCCC group and 84% (63/75) of the usual care group were either readmitted or had an ER visit within the 1 year of follow-up (P=0.029). (ABSTRACT TRUNCATED)
Moving Beyond Motive-based categories of Targeted Violence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weine, Stevan; Cohen, John; Brannegan, David

Today’s categories for responding to targeted violence are motive-based and tend to drive policies, practices, training, media coverage, and research. These categories are based on the assumption that there are significant differences between ideological and non-ideological actors and between domestic and international actors. We question the reliance on these categories and offer an alternative way to frame the response to multiple forms of targeted violence. We propose adopting a community-based multidisciplinary approach to assess risk and provide interventions that are focused on the pre-criminal space. We describe four capabilities that should be implemented locally by establishing and maintaining multidisciplinary responsemore » teams that combine community and law-enforcement components: (1) community members are educated, making them better able to identify and report patterns associated with elevated risk for violence; (2) community-based professionals are trained to assess the risks for violent behavior posed by individuals; (3) community-based professionals learn to implement strategies that directly intervene in causal factors for those individuals who are at elevated risk; and (4) community-based professionals learn to monitor and assess an individual’s risk for violent behaviors on an ongoing basis. Community-based multidisciplinary response teams have the potential to identify and help persons in the pre-criminal space and to reduce barriers that have traditionally impeded community/law-enforcement collaboration.« less
Multidisciplinary care planning in the primary care management of completed stroke: a systematic review

PubMed Central

Mitchell, Geoffrey K; Brown, Robyn M; Erikssen, Lars; Tieman, Jennifer J

2008-01-01

Background Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care. Methods A Systematic review of Medline, EMBASE, CINAHL (all 1990–2006), Cochrane Library (Issue 1 2006), and grey literature from web based searching of web sites listed in the CCOHA Health Technology Assessment List Analysis used narrative analysis of findings of randomised and non-randomised trials, and observational and qualitative studies of patients with completed stroke in the primary care setting where care planning was undertaken by 1) a multi-disciplinary primary care team or 2) through shared care by primary and secondary providers. Results One thousand and forty-five citations were retrieved. Eighteen papers were included for analysis. Most care planning took part in the context of multidisciplinary team care based in hospitals with outreach to community patients. Mortality rates are not impacted by multidisciplinary care planning. Functional outcomes of the studies were inconsistent. It is uncertain whether the active engagement of GPs and other primary care professionals in the multidisciplinary care planning contributed to the outcomes in the studies showing a positive effect. There may be process benefits from multidisciplinary care planning that includes primary care professionals and GPs. Few studies actually described the tasks and roles GPs fulfilled and whether this matched what was presumed to be provided. Conclusion While multidisciplinary care planning may not unequivocally improve the care of patients with completed stroke, there may be process benefits such as improved task allocation between providers. Further study on the impact of active GP involvement in multidisciplinary care planning is warranted. PMID:18681977
Getting a Cohesive Answer from a Common Start: Scalable Multidisciplinary Analysis through Transformation of a Systems Model

NASA Technical Reports Server (NTRS)

Cole, Bjorn; Chung, Seung

2012-01-01

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

NASA Technical Reports Server (NTRS)

Cole, Bjorn; Chung, Seung H.

2012-01-01

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

PubMed

Omar, A R; Suppiah, N; Chai, P; Chan, Y H; Seow, Y H; Quek, L L; Poh, K K; Tan, H C

2007-06-01

A multidisciplinary disease management (DM) programme in chronic heart failure (CHF) improves clinical outcome. The efficacy of such a programme in a heterogeneous Asian community is not well established. Therefore, we undertook the evaluation of the efficacy of the multidisciplinary community-based DM CHF programme. This was a prospective study involving 154 patients (54 percent male) with a primary diagnosis of CHF, New York Heart Association functional class III/IV CHF, with left ventricular ejection fraction (LVEF) less than 40 percent. The mean age was 65 +/- 12 years and mean LVEF was 27 +/- 9 percent. We evaluated CHF hospitalisation, quality of life, activity status and quality of care (percentage of patients who received ACE inhibitors/angiotensin receptor blockers (ARB) and beta blockers after a period of six months. At six months, there was improvement in the quality of life and activity status (p < 0.001). ACE inhibitors/ARB were maintained in 97 percent of the patients and there was an increased usage of beta blockers (p-value equals 0.001). The rate of CHF hospitalisation was reduced by 68 percent (p-value is less than 0.001) and there was no mortality. The multidisciplinary DM of CHF in a heterogeneous Asian community showed significant improvement in quality of life, quality of care and reduction in CHF hospitalisation.
Multidisciplinary Design Optimization Techniques: Implications and Opportunities for Fluid Dynamics Research

NASA Technical Reports Server (NTRS)

Zang, Thomas A.; Green, Lawrence L.

1999-01-01

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

PubMed

Howe, Amanda; Billingham, Kate; Walters, Christina

2002-11-01

One aim of reform of undergraduate medical education is to achieve a better balance between an emphasis on scientific knowledge and an enhancement of desirable professional attitudes: for example, reducing the core curriculum in biochemistry in order to increase learning opportunities in ethics. This study was based on qualitative data collected from stakeholders involved in community- and primary care-based medical education. Its aim was to consider whether different participants agreed on the desired outcomes of basic medical training, and the contribution of community and primary care settings. Analysis of the data showed that the professional identity of the future doctor is contested, its goals reflective of the 'world view' of the stakeholder, and seen as being highly dependent on the contexts in which students learn. Themes which emerged suggest that medical education may not achieve its goals unless student experiences become less dominated by the context of secondary care and its predominantly technical practice of medicine, and more attention is paid to the personal development of the students. The discussion considers the implications for further reform, and emphasises the role of multidisciplinary tutoring in remodelling the world view of 'tomorrow's doctors'.
Spatial and Temporal Comparison of DNRA Communities in New River Estuary, USA

NASA Astrophysics Data System (ADS)

Song, B.; Lisa, J.; Tobias, C. R.

2016-02-01

Dissimilatory nitrate reduction to ammonium (DNRA) is an important nitrate respiring pathway, competing with denitrification, in various ecosystems. Studies examining the diversity and composition of DNRA communities are limited and their link to DNRA activity is unknown. We conducted a multidisciplinary investigation of sediment communities in the upper reaches of a eutrophic estuary to examine spatial and temporal variation of DNRA community structures and determine their linkage to activities. Sediment samples were collected seasonally from two study sites (AA2 and JAX) in the New River Estuary, North Carolina, USA. 15N-nitrate tracer experiments were conducted to measure potential DNRA rates while abundance of DNRA communities was measured using quantitative PCR of cytochrome C nitrite reductase genes (nrfA). Composition and diversity of DNRA communities were also examined based on next generation sequencing (NGS) of nrfA genes using an Ion Torrent PGM. Bioinformatic analysis was conducted using the FunGene pipeline and Mothur program. Higher DNRA activities were measured at JAX and associated with higher abundance of nrfA genes. Seasonal variation in DNRA rates and nrfA gene abundance was more evident at JAX than AA2. Nitrate concentration and dissolved oxygen in bottom water were significantly and positively correlated with activities and abundance of DNRA communities. The nrfA NGS analysis revealed that spatial variation of DNRA communities was much greater than temporal variation with salinity, dissolved organic carbon, and nitrate as the most important environmental variables affecting these communities. Diversity of DNRA communities was negative correlated with the DNRA rates and nrfA gene abundance, which suggests that dominant members of the DNRA community are responsible for higher rates. Thus, our multidisciplinary study clearly demonstrates the linkage between structure and activities of DNRA communities in the upper reaches of New River Estuary.
Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

PubMed

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

2013-05-01

Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.
On developing the local research environment of the 1990s - The Space Station era

NASA Technical Reports Server (NTRS)

Chase, Robert; Ziel, Fred

1989-01-01

A requirements analysis for the Space Station's polar platform data system has been performed. Based upon this analysis, a cluster, layered cluster, and layered-modular implementation of one specific module within the Eos Data and Information System (EosDIS), an active data base for satellite remote sensing research has been developed. It is found that a distributed system based on a layered-modular architecture and employing current generation work station technologies has the requisite attributes ascribed by the remote sensing research community. Although, based on benchmark testing, probabilistic analysis, failure analysis and user-survey technique analysis, it is found that this architecture presents some operational shortcomings that will not be alleviated with new hardware or software developments. Consequently, the potential of a fully-modular layered architectural design for meeting the needs of Eos researchers has also been evaluated, concluding that it would be well suited to the evolving requirements of this multidisciplinary research community.
Lowering Entry Barriers for Multidisciplinary Cyber(e)-Infrastructures

NASA Astrophysics Data System (ADS)

Nativi, S.

2012-04-01

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

PubMed

Ross, Fiona; O'Tuathail, Claire; Stubberfield, Debbie

2005-04-01

This paper discusses the process of change that took place in an intervention study of standardized multidisciplinary assessment guidelines implemented in a female ward for older people in a District General Hospital in South London. This study was one of nine implementation projects in the South Thames Evidence-Based Practice Project. The relationship between the worlds of research and healthcare practice is uneasy and contested and, as such, is a breeding ground for challenging questions about how evidence can be used to foment change in clinical practice. Recent literature on change highlights the importance of understanding complexity, which informed our approach and analysis. A multifaceted approach to change that comprised evidence-based guidelines, leadership (project leader) and change management was evaluated before and after the implementation by telephone interviews with patients, a postal survey of community staff and interviews with ward staff. A diagnostic analysis of current assessment practice informed the change process. The project leader collected data on adherence. This paper draws on descriptive and qualitative data and addresses the links between contextual issues and the processes and pathways of change, informed by theoretical ideas from the change literature. Key themes emerged: working through others and across boundaries, managing uncertainty and unanticipated challenges. Adherence of ward staff to using the multidisciplinary assessment guidelines was high, with evidence of some dissemination to community staff at follow-up. Three years after the project finished the multidisciplinary assessment is still part of routine clinical practice. The analysis contributes to understanding about the nursing leadership of change within an interprofessional arena of practice. It highlights the importance of understanding the context in relation to the impact and sustainability of change and thus the utility of conducting a diagnostic analysis in the early stages of implementation. This has implications for developing approaches to change in nursing and interprofessional practice in other settings. Using research to change practice needs clinical leaders who are supported by the organization and have the skills to implement research evidence, manage uncertainty and build trust with a range of other professionals.
Grid Generation for Multidisciplinary Design and Optimization of an Aerospace Vehicle: Issues and Challenges

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

2000-01-01

The purpose of this paper is to discuss grid generation issues and to challenge the grid generation community to develop tools suitable for automated multidisciplinary analysis and design optimization of aerospace vehicles. Special attention is given to the grid generation issues of computational fluid dynamics and computational structural mechanics disciplines.
Multidisciplinary conceptual design optimization of aircraft using a sound-matching-based objective function

NASA Astrophysics Data System (ADS)

Diez, Matteo; Iemma, Umberto

2012-05-01

The article presents a novel approach to include community noise considerations based on sound quality in the Multidisciplinary Conceptual Design Optimization (MCDO) of civil transportation aircraft. The novelty stems from the use of an unconventional objective function, defined as a measure of the difference between the noise emission of the aircraft under analysis and a reference 'weakly annoying' noise, the target sound. The minimization of such a merit factor yields an aircraft concept with a noise signature as close as possible to the given target. The reference sound is one of the outcomes of the European Research Project SEFA (Sound Engineering For Aircraft, VI Framework Programme, 2004-2007), and used here as an external input. The aim of the present work is to address the definition and the inclusion of the sound-matching-based objective function in the MCDO of aircraft.
Development of a Virtual Multidisciplinary Lung Cancer Tumor Board in a Community Setting

PubMed Central

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

2013-01-01

Purpose: Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. Methods: Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Results: Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. Conclusion: The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan. PMID:23942505

Feed Safe: a multidisciplinary partnership approach results in a successful mobile application for breastfeeding mothers.

PubMed

White, Becky; White, James; Giglia, Roslyn; Tawia, Susan

2016-05-30

Issue addressed: Mobile applications are increasingly being used in health promotion initiatives. Although there is evidence that developing these mobile health applications in multidisciplinary teams is good practice, there is a gap in the literature with respect to evaluation of the process of this partnership model and how best to disseminate the application into the community. The aim of this paper is twofold, to describe the partnership model in which the Feed Safe application was developed and to investigate what worked in terms of dissemination. Methods: The process of working in partnership was measured using the VicHealth partnership analysis tool for health promotion. The dissemination strategy and reach of the application was measured using both automated analytics data and estimates of community-initiated promotion. Results: The combined average score from the partnership analysis tool was 138 out of a possible 175. A multipronged dissemination strategy led to good uptake of the application among Australian women. Conclusions: Multidisciplinary partnership models are important in the development of health promotion mobile applications. Recognising and utilising the skills of each partner organisation can help expand the reach of mobile health applications into the Australian population and aid in good uptake of health promotion resources. So what?: Developing mobile applications in multidisciplinary partnerships is good practice and can lead to wide community uptake of the health promotion resource.
Listening to Community Voices: Community-Based Research, a First Step in Partnership and Outreach

ERIC Educational Resources Information Center

Heffner, Gail Gunst; Zandee, Gail Landheer; Schwander, Lissa

2003-01-01

This paper offers some historical perspective on alternative research traditions and discusses some of the basic principles of community-based research as a tool for partnership development. The authors then describe an example of how Calvin College, a Christian comprehensive liberal arts college has used a multi-disciplinary approach in…
Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

PubMed

Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

2018-01-01

Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.
Use of Web-based library resources by medical students in community and ambulatory settings.

PubMed

Tannery, Nancy Hrinya; Foust, Jill E; Gregg, Amy L; Hartman, Linda M; Kuller, Alice B; Worona, Paul; Tulsky, Asher A

2002-07-01

The purpose was to evaluate the use of Web-based library resources by third-year medical students. Third-year medical students (147) in a twelve-week multidisciplinary primary care rotation in community and ambulatory settings. Individual user surveys and log file analysis of Website were used. Twenty resource topics were compiled into a Website to provide students with access to electronic library resources from any community-based clerkship location. These resource topics, covering subjects such as hypertension and back pain, linked to curriculum training problems, full-text journal articles, MEDLINE searches, electronic book chapters, and relevant Websites. More than half of the students (69%) accessed the Website on a daily or weekly basis. Over 80% thought the Website was a valuable addition to their clerkship. Web-based information resources can provide curriculum support to students for whom access to the library is difficult and time consuming.
Elder abuse: The role of general practitioners in community-based screening and multidisciplinary action

PubMed

Ries, Nola M; Mansfield, Elise

2018-04-01

There are growing calls for elder abuse screening to be conducted by a range of community-based service providers, including general practitioners (GPs), practice nurses, home care workers and lawyers. Improved screening may be a valuable first step towards improving elder abuse detection and response; however, practitioners need evidence-based strategies for screening and follow-up. This article summarises several brief screening tools for various forms of elder abuse. Screening tool properties and evidence gaps are noted. As elder abuse often requires multidisciplinary responses, initiatives to connect health, legal and other service providers are highlighted. GPs are trusted professionals who are well placed to identify older patients at risk of, or experiencing, various forms of abuse. They should be aware of available screening tools and consider how best to incorporate them into their own practice. They also play an important role in multidisciplinary action to address elder abuse.

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Clients with chronic conditions: community nurse role in a multidisciplinary team.

PubMed

Wilkes, Lesley; Cioffi, Jane; Cummings, Joanne; Warne, Bronwyn; Harrison, Kathleen

2014-03-01

To define and validate the role of the community nurse in a multidisciplinary team caring for clients with chronic and complex needs. A key factor in optimising care for clients with chronic and complex conditions in the community is the use of multidisciplinary teams. A team approach is more effective as it enables better integration of services. The role of the community nurse in the multidisciplinary team has as yet not been delineated. A modified Delphi technique was used in this study. A group of 17 volunteer registered nurses who were experienced in the care of clients with chronic conditions and complex care needs in the community formed a panel of experts. Experts were emailed a series of three questionnaires. Main findings show that the role of the community nurse in a multidisciplinary team for clients with chronic conditions has six main domains - advocate, supporter, coordinator, educator, team member and assessor. A consensus on the role of the community nurse in the multidisciplinary team is described. The six key role domains reaffirm the generic role of the nurse and the validation of the role clarifies and reinforces the centrality of the community nurse in the team. Further refinement of the community nurse role is indicated to increase comprehensiveness of role descriptors particularly for the role domain, advocate. Community nurses working in multidisciplinary teams caring for clients with chronic conditions can define their role as a team member. The working relationship of the community nurse with other health professionals in the multidisciplinary team as a key approach to more integrated care for clients and carers enables the use of this approach to be better understood by all team members. With this increased understanding, community nurses are in a position to build stronger and more effective care teams. © 2013 John Wiley & Sons Ltd.
Developing community based rehabilitation for cancer survivors: organizing for coordination and coherence in practice

PubMed Central

2013-01-01

Background Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts. Methods Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups. A Grounded Theory approach was used to analyze the data. Results A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight the challenges faced in practical implementation of community rehabilitation and point to possible strategies for its enhancement. PMID:24004881
A Requirements-Driven Optimization Method for Acoustic Liners Using Analytic Derivatives

NASA Technical Reports Server (NTRS)

Berton, Jeffrey J.; Lopes, Leonard V.

2017-01-01

More than ever, there is flexibility and freedom in acoustic liner design. Subject to practical considerations, liner design variables may be manipulated to achieve a target attenuation spectrum. But characteristics of the ideal attenuation spectrum can be difficult to know. Many multidisciplinary system effects govern how engine noise sources contribute to community noise. Given a hardwall fan noise source to be suppressed, and using an analytical certification noise model to compute a community noise measure of merit, the optimal attenuation spectrum can be derived using multidisciplinary systems analysis methods. In a previous paper on this subject, a method deriving the ideal target attenuation spectrum that minimizes noise perceived by observers on the ground was described. A simple code-wrapping approach was used to evaluate a community noise objective function for an external optimizer. Gradients were evaluated using a finite difference formula. The subject of this paper is an application of analytic derivatives that supply precise gradients to an optimization process. Analytic derivatives improve the efficiency and accuracy of gradient-based optimization methods and allow consideration of more design variables. In addition, the benefit of variable impedance liners is explored using a multi-objective optimization.
Managing in the interprofessional environment: a theory of action perspective.

PubMed

Rogers, Tim

2004-08-01

Managers of multidisciplinary teams face difficult dilemmas in managing competing interests, diverse perspectives and interpersonal conflicts. This paper illustrates the potential of the theory of action methodology of Argyris and Schön (1974, 1996) to illuminate these problems and contribute to their resolution. An empirical example of a depth-investigation with one multidisciplinary community health care team leader in Australia demonstrates that the theory of action offers a more accurate account of the causal dimensions of her dilemmas and provides more scope for effective intervention than her lay explanation will allow. It also provides a more satisfactory analysis of her difficulties with two common problems identified in the literature: defining the appropriate level of autonomy for team members and developing constructive dialogue across perceived discipline-based differences of opinion. Consequently the theory of action appears to offer enormous promise to managers of multidisciplinary teams wanting to understand and resolve their problems and develop a rigorous reflective practice. Further research on the viability of the theory to facilitate a self-correcting system that can promote learning even under conditions of stress and conflict is suggested and implications for learning and teaching for the multidisciplinary environment are briefly discussed.
Advancing Community–Based Research with Urban American Indian Populations: Multidisciplinary Perspectives

PubMed Central

Hartmann, William E.; Wendt, Dennis C.; Saftner, Melissa A.; Marcus, John; Momper, Sandra L.

2014-01-01

The U.S. has witnessed significant growth among urban AI populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations. PMID:24659391
Translational leadership: new approaches to team development.

PubMed

Harrigan, Rosanne C; Emery, Lori M

2010-01-01

Little is known about how to develop collaborative multidisciplinary research teams. Following a comprehensive needs assessment, we developed a curriculum-based, multi-disciplinary, didactic and experiential Translational Leadership training program grounded in adult learning theory. In addition, we constructed collaborative clinical/translational research experiences for trainees to enhance clinical/translational research skills. KEY PROGRAMMATIC ELEMENTS AND PRELIMINARY FINDINGS: This 15-week Translational Leadership program was generated based on the following premises. Academic translational leadership teams should partner and collaborate, customize, make the program relevant to the culture, create a common language, use the best resources, and establish measurable goals for success. Development of effective collaborative research teams is essential to the management of successful translational research teams. Development of these skills in addition to cultural humility will provide the best infrastructure and human capital committed to the resolution of health disparities. Effective translational research teams are more comfortable with the component team members and the communities where they implement their protocols. Our participants highly valued the diverse experiences from this program; several have succeeded in leading community-based research teams. Our Translational Leadership program offers essential skills using adult learning theory for translational researchers who become capable of leading and participating in translational research teams. We believe including community members in the training of translational research programs is an important asset. The multidisciplinary approach develops skills that are also of significant use to the community and its acceptance of responsibility for its own health.
Use of Web-based library resources by medical students in community and ambulatory settings*

PubMed Central

Tannery, Nancy Hrinya; Foust, Jill E.; Gregg, Amy L.; Hartman, Linda M.; Kuller, Alice B.; Worona, Paul; Tulsky, Asher A.

2002-01-01

Purpose: The purpose was to evaluate the use of Web-based library resources by third-year medical students. Setting/Participants/Resources: Third-year medical students (147) in a twelve-week multidisciplinary primary care rotation in community and ambulatory settings. Methodology: Individual user surveys and log file analysis of Website were used. Results/Outcomes: Twenty resource topics were compiled into a Website to provide students with access to electronic library resources from any community-based clerkship location. These resource topics, covering subjects such as hypertension and back pain, linked to curriculum training problems, full-text journal articles, MEDLINE searches, electronic book chapters, and relevant Websites. More than half of the students (69%) accessed the Website on a daily or weekly basis. Over 80% thought the Website was a valuable addition to their clerkship. Discussion/Conclusion: Web-based information resources can provide curriculum support to students for whom access to the library is difficult and time consuming. PMID:12113515
Distributed Cognition and Process Management Enabling Individualized Translational Research: The NIH Undiagnosed Diseases Program Experience

PubMed Central

Links, Amanda E.; Draper, David; Lee, Elizabeth; Guzman, Jessica; Valivullah, Zaheer; Maduro, Valerie; Lebedev, Vlad; Didenko, Maxim; Tomlin, Garrick; Brudno, Michael; Girdea, Marta; Dumitriu, Sergiu; Haendel, Melissa A.; Mungall, Christopher J.; Smedley, Damian; Hochheiser, Harry; Arnold, Andrew M.; Coessens, Bert; Verhoeven, Steven; Bone, William; Adams, David; Boerkoel, Cornelius F.; Gahl, William A.; Sincan, Murat

2016-01-01

The National Institutes of Health Undiagnosed Diseases Program (NIH UDP) applies translational research systematically to diagnose patients with undiagnosed diseases. The challenge is to implement an information system enabling scalable translational research. The authors hypothesized that similar complex problems are resolvable through process management and the distributed cognition of communities. The team, therefore, built the NIH UDP integrated collaboration system (UDPICS) to form virtual collaborative multidisciplinary research networks or communities. UDPICS supports these communities through integrated process management, ontology-based phenotyping, biospecimen management, cloud-based genomic analysis, and an electronic laboratory notebook. UDPICS provided a mechanism for efficient, transparent, and scalable translational research and thereby addressed many of the complex and diverse research and logistical problems of the NIH UDP. Full definition of the strengths and deficiencies of UDPICS will require formal qualitative and quantitative usability and process improvement measurement. PMID:27785453
Community Resource Curriculum Development: Grades 3-4.

ERIC Educational Resources Information Center

Bentley, Michael L.; And Others

This manual was developed by the Community Resource Curriculum Development Project (CRCDP), a cooperative project to develop multi-disciplinary, multi-ethnic, multi-cultural science/social sciences teaching units based upon the Illinois State Goals for Learning. This manual contains seven teaching units that include several experience-based…
The reablement team's voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement.

PubMed

Hjelle, Kari Margrete; Skutle, Olbjørg; Førland, Oddvar; Alvsvåg, Herdis

2016-01-01

Reablement is an early and time-limited home-based rehabilitation intervention that emphasizes intensive, goal-oriented, and multidisciplinary assistance for people experiencing functional decline. Few empirical studies to date have examined the experiences of the integrated multidisciplinary teams involved in reablement. Accordingly, the aim of this study was to explore and describe how an integrated multidisciplinary team in Norway experienced participation in reablement. An integrated multidisciplinary team consisting of health care professionals with a bachelor's degree (including a physiotherapist, a social educator, occupational therapists, and nurses) and home-based care personnel without a bachelor's degree (auxiliary nurses and nursing assistants) participated in focus group discussions. Qualitative content analysis was used to analyze the resulting data. Three main themes emerged from the participants' experiences with participating in reablement, including "the older adult's goals are crucial", "a different way of thinking and acting - a shift in work culture", and "a better framework for cooperation and application of professional expertise and judgment". The integrated multidisciplinary team and the older adults collaborated and worked in the same direction to achieve the person's valued goals. The team supported the older adults in performing activities themselves rather than completing tasks for them. To facilitate cooperation and application of professional expertise and judgment, common meeting times and meeting places for communication and supervision were necessary. Structural factors that promote integrated multidisciplinary professional decisions include providing common meeting times and meeting places as well as sufficient time to apply professional knowledge when supervising and supporting older persons in everyday activities. These findings have implications for practice and suggest future directions for improving health care services. The shift in work culture from static to dynamic service is time consuming and requires politicians, community leaders, and health care systems to allocate the necessary time to support this approach to thinking and working.
Community Resource Curriculum Development: Grades K-2.

ERIC Educational Resources Information Center

Bentley, Michael L.; And Others

This manual was developed by the Community Resource Curriculum Development Project (CRCDP), a cooperative project to develop multi-disciplinary, multi-ethnic, multi-cultural science/social sciences teaching units based upon the Illinois State Goals for Learning and the Chicago Public Schools outcomes for a seamless kindergarten, first, and second…
An international, multidisciplinary, service-learning program: an option in the dental school curriculum.

PubMed

Martinez-Mier, Esperanza A; Soto-Rojas, Armando E; Stelzner, Sarah M; Lorant, Diane E; Riner, Mary E; Yoder, Karen M

2011-04-01

Many health professions students who treat Spanish-speaking patients in the United States have little concept of their culture and health related traditions. The lack of understanding of these concepts may constitute major barriers to healthcare for these patients. International service-learning experiences allow students to work directly in communities from which patients immigrate and, as a result, students gain a better understanding of these barriers. This article describes the implementation of an international, multidisciplinary, service-learning program in a dental school in the United States. The Indiana University International Service-Learning program in Hidalgo, Mexico began in 1999 as an alternative spring break travel and clinical experience for medical students, focusing on the treatment of acute health problems. Travel-related preparatory sessions were offered, and no learning or service objectives had been developed. The program has evolved to include a multidisciplinary team of dental, medical, nursing, public health and social work students and faculty. The experience is now integrated into a curriculum based on the service-learning model that allows students to use their clinical skills in real-life situations and provides structured time for reflection. The program aims to enhance teaching and foster civic responsibility in explicit partnership with the community. Preparatory sessions have evolved into a multidisciplinary graduate level course with defined learning and service objectives. PROGRAM EVALUATION METHODS: In order to assess the program's operation as perceived by students and faculty and to evaluate student's perceptions of learning outcomes, evaluation tools were developed. These tools included student and faculty evaluation questionnaires, experiential learning journals, and a strengths, weaknesses, opportunities and threats analysis. Evaluation data show that after program participation, students perceived an increase in their cultural awareness, cross-cultural communication skills and understanding of barriers and disparities faced by Latinos in the United States. Faculty evaluations offer insights into the lessons learned through the implementation process. The development of a service-learning based curriculum has posed challenges but has enriched international service experiences.
Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: Development of priority concerns and potential health, nutrition and education interventions

PubMed Central

Casapia, Martin; Joseph, Serene A; Gyorkos, Theresa W

2007-01-01

Background Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus. Methods Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits. Results The top ten priority problems in Belen were identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3) diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low level of education; 8) sexually transmitted diseases; 9) domestic violence; and 10) delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues. Conclusion The two workshops provided valuable insight into the main health and health-related problems facing the community of Belen. The participatory focus of the workshops ensured the active involvement of important stakeholders from Belen. Based on the results of the workshops, effective and essential interventions are now being planned which will contribute to reducing health inequalities in the community. PMID:17623093
Multidisciplinary perspective intervention with community involvement to decrease antibiotic sales in village groceries in Thailand.

PubMed

Arparsrithongsagul, Somsak; Kulsomboon, Vithaya; Zuckerman, Ilene H

2015-03-01

In Thailand, antibiotics are rampantly available in village groceries, despite the fact that it is illegal to sell antibiotics without a pharmacy license. This study implemented a multidisciplinary perspectives intervention with community involvement (MPI&CI), which was developed based on information obtained from focus groups that included multidisciplinary stakeholders. Community leaders in the intervention group were trained to implement MPI&CI in their villages. A quasi-experiment with a pretest-posttest design was conducted. Data were collected from 20 villages in Mahasarakham Province (intervention group) along with another 20 villages (comparison group). Using a generalized linear mixed model Poisson regression with repeated measures, groceries in the intervention group had 87% fewer antibiotics available at postintervention compared with preintervention (relative rate = 0.13; 95% confidence interval = 0.07-0.23), whereas the control group had only an 8% reduction in antibiotic availability (relative rate = 0.92; 95% confidence interval = 0.88-0.97) between the 2 time periods. Further study should be made to assess the sustainability and long-term effectiveness of MPI&CI. © 2013 APJPH.
Patients' and clinicians' experiences of wound care in Canada: a descriptive qualitative study.

PubMed

Woo, K Y; Wong, J; Rice, K; Coelho, S; Haratsidis, E; Teague, L; Rac, V E; Krahn, M

2017-07-01

This study sought to explore patients' and clinicians' perceptions and experiences with the provision of standard care by a home care nurse alone or by a multidisciplinary wound care team. The interviews were conducted using an in-depth semi structured format; following a funnel idea of starting out broad and narrowing down, ensuring that all the necessary topics were covered by the end of the interview. A purposive sample of 16 patients with different wound types were interviewed to ensure that the data would reflect the range and diversity of treatment and care experience. To reflect the diversity of experiences 12 clinicians from various clinical backgrounds were interviewed. Based on the analysis of the interviews, there are four overarching themes: wound care expertise is required across health-care sectors, psychosocial needs of patients with chronic wounds are key barriers to treatment concordance, structured training, and a well-coordinated multidisciplinary team approach. Results of this qualitative study identified different barriers and facilitators that affect the experiences of community-based wound care.

Teleform scannable data entry: an efficient method to update a community-based medical record? Community care coordination network Database Group.

PubMed Central

Guerette, P.; Robinson, B.; Moran, W. P.; Messick, C.; Wright, M.; Wofford, J.; Velez, R.

1995-01-01

Community-based multi-disciplinary care of chronically ill individuals frequently requires the efforts of several agencies and organizations. The Community Care Coordination Network (CCCN) is an effort to establish a community-based clinical database and electronic communication system to facilitate the exchange of pertinent patient data among primary care, community-based and hospital-based providers. In developing a primary care based electronic record, a method is needed to update records from the field or remote sites and agencies and yet maintain data quality. Scannable data entry with fixed fields, optical character recognition and verification was compared to traditional keyboard data entry to determine the relative efficiency of each method in updating the CCCN database. PMID:8563414
A Collaborative Model for Community-Based Health Care Screening of Homeless Adolescents.

ERIC Educational Resources Information Center

Busen, Nancy H.; Beech, Bettina

1997-01-01

A multidisciplinary team from community organizations serving the homeless and from universities collaborated in screening 150 homeless adolescents for psychosocial and physical risks. The population had a history of physical, sexual, and substance abuse as well as high rates of HIV and hepatitis B. Case management by advanced practice nurses was…
Community integration following multidisciplinary rehabilitation for traumatic brain injury.

PubMed

Goranson, Tamara E; Graves, Roger E; Allison, Deborah; La Freniere, Ron

2003-09-01

To determine the extent to which participation in a multidisciplinary rehabilitation programme and patient characteristics predict improvement in community integration following mild-to-moderate traumatic brain injury (TBI). A non-randomized case-control study was conducted employing a pre-test-post-test multiple regression design. Archival data for 42 patients with mild-to-moderate TBI who completed the Community Integration Questionnaire (CIQ) at intake and again 6-18 months later were analysed. Half the sample participated in an intensive outpatient rehabilitation programme that provided multi-modal interventions, while the other half received no rehabilitation. The two groups were matched on age, education and time since injury. On the CIQ Home Integration scale, participation in rehabilitation and female gender predicted better outcome. On the Productivity scale, patients with a lower age at injury had better outcome. Outcome on both of these scales, as well as on the Social Integration scale, was predicted by the baseline pre-test score (initial severity). Overall, multidisciplinary rehabilitation appeared to increase personal independence. It is also concluded that: (1) multivariate analysis can reveal the relative importance of multiple predictors of outcome; (2) different predictors may predict different aspects of outcome; and (3) more sensitive and specific outcome measures are needed.
Applying Agile Methods to the Development of a Community-Based Sea Ice Observations Database

NASA Astrophysics Data System (ADS)

Pulsifer, P. L.; Collins, J. A.; Kaufman, M.; Eicken, H.; Parsons, M. A.; Gearheard, S.

2011-12-01

Local and traditional knowledge and community-based monitoring programs are increasingly being recognized as an important part of establishing an Arctic observing network, and understanding Arctic environmental change. The Seasonal Ice Zone Observing Network (SIZONet, http://www.sizonet.org) project has implemented an integrated program for observing seasonal ice in Alaska. Observation and analysis by local sea ice experts helps track seasonal and inter-annual variability of the ice cover and its use by coastal communities. The ELOKA project (http://eloka-arctic.org) is collaborating with SIZONet on the development of a community accessible, Web-based application for collecting and distributing local observations. The SIZONet project is dealing with complicated qualitative and quantitative data collected from a growing number of observers in different communities while concurrently working to design a system that will serve a wide range of different end users including Arctic residents, scientists, educators, and other stakeholders with a need for sea ice information. The benefits of linking and integrating knowledge from communities and university-based researchers are clear, however, development of an information system in this multidisciplinary, multi-participant context is challenging. Participants are geographically distributed, have different levels of technical expertise, and have varying goals for how the system will be used. As previously reported (Pulsifer et al. 2010), new technologies have been used to deal with some of the challenges presented in this complex development context. In this paper, we report on the challenges and innovations related to working as a multi-disciplinary software development team. Specifically, we discuss how Agile software development methods have been used in defining and refining user needs, developing prototypes, and releasing a production level application. We provide an overview of the production application that includes discussion of a hybrid architecture that combines a traditional relational database, schema-less database, advanced free text search, and the preliminary framework for Semantic Web support. The current version of the SIZONet web application is discussed in relation to the high-value features defined as part of the Agile approach. Preliminary feedback indicates a system that meets the needs of multiple user groups.
"Mano a Mano": Arts-Based Nonfiction Literacy and Content Area Learning

ERIC Educational Resources Information Center

Bryce, Nadine

2012-01-01

At the James Weldon Johnson Leadership Academy in East Harlem, New York, administrators, teachers, students, families, and community-based artists worked together to create a visually explosive environment that reflected enriched learning experiences based on their multidisciplinary study of New York's history. The Mano a Mano ("Hand to…
Hospital-based, Multidisciplinary, youth mentoring and medical exposure program positively influences and reinforces health care career choice: "The Reach One Each One Program early Experience".

PubMed

Danner, Omar K; Lokko, Carl; Mobley, Felicia; Dansby, Montreka; Maze, Michael; Bradley, Brene'; Williams, Elizabeth; Matthews, Leslie Ray; Harrington, Emma; Mack, Lisa; Clark, Clarence; Wilson, Ken; Beech, Derrick; Heron, Sheryl; Childs, Ed

2017-04-01

According to the National Center for Educational Statistics, underrepresented minorities (URMs) are more likely to leave science, technology, engineering and mathematics (STEM) fields at higher rates than their peers during undergraduate studies. Many institutions of higher learning have implemented pipeline programs aimed at preparing and inspiring high school and college aged students in select careers in health sciences with varying levels of success. Research has shown that a health care workforce that mirrors the community they serve is more effective in reducing health disparities and increasing positive health outcomes. We hypothesize that a hospital-based, multidisciplinary youth mentoring and medical exposure program will enhance the decision of URM high school students to choose healthcare careers. A retrospective analysis of the Reach One Each One Program (ROEO) was performed. ROEO is a hospital based, 11-week multidisciplinary youth mentoring and medical exposure program for inner-city high school students. The analysis was based on a phone survey of the twenty-six (26) seniors who completed the program and subsequently graduated from high school between May 2013 and May 2015 to assess the following: 1) College enrollment/attendance, 2) Health profession majors, and 3) Pre-med status. The study was approved by the Morehouse School of Medicine Institutional Review Board. Of the twenty-six students, 23 were female and 3 were male; 25 (96%) of the students were African American and one student was a Caucasian female. Twenty-four (92.3%) of the students were enrolled in college and 2 (7.7%) were scheduled to begin in the spring semester of 2016. Twenty-one of the 24 attending college at the time of the survey (87.5%) were enrolled in a health science degree program and 16 (66.7%) confirmed that they were enrolled in pre-medical (Pre-med) curriculum. Hospital-based, multidisciplinary medical mentoring programs can have a positive impact on the lives and health care career decisions of aspiring URM high school students. Further study will be necessary to validate the most influential components needed for the success of such programs. Copyright © 2016 Elsevier Inc. All rights reserved.
A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team.

PubMed

Rowlands, S; Callen, J

2013-01-01

The aim of the study was to explore how patient information is communicated between health professionals within a multidisciplinary hospital-based lung cancer team and to identify mechanisms to improve these communications. A qualitative method was employed using semi-structured in-depth interviews with a representative sample (n = 22) of members of a multidisciplinary hospital-based lung cancer team including medical, nursing and allied health professionals. Analysis was undertaken using a thematic grounded theory approach to derive key themes to describe communication patterns within the team and how communication could be improved. Two themes with sub-themes were identified: (1) characteristics of communication between team members including the impact of role on direction of communications, and doctors' dominance in communications; and (2) channels of communication including, preference for face-to-face and the suboptimal roles of the Multidisciplinary Team Meeting and the hospital medical record as mediums for communication. Traditional influences of role delineation and the dominance of doctors were found to impact on communication within the multidisciplinary hospital-based lung cancer team. Existing guidelines on implementation of multidisciplinary cancer care fail to address barriers to effective team communication. The paper-based medical record does not support team communications and alternative electronic solutions need to be used. © 2012 Blackwell Publishing Ltd.
American Society of Clinical Oncology Summit on Addressing Obesity Through Multidisciplinary Provider Collaboration: Key Findings and Recommendations for Action.

PubMed

Ligibel, Jennifer A; Alfano, Catherine M; Hershman, Dawn L; Merrill, Janette K; Basen-Engquist, Karen; Bloomgarden, Zachary T; Demark-Wahnefried, Wendy; Dixon, Suzanne; Hassink, Sandra G; Jakicic, John M; Morton, John Magaña; Okwuosa, Tochi M; Powell-Wiley, Tiffany M; Rothberg, Amy E; Stephens, Mark; Streett, Sarah E; Wild, Robert A; Westman, Eric A; Williams, Ronald J; Wollins, Dana S; Hudis, Clifford A

2017-11-01

Given the increasing evidence that obesity increases the risk of developing and dying from malignancy, the American Society of Clinical Oncology (ASCO) launched an Obesity Initiative in 2013 that was designed to increase awareness among oncology providers and the general public of the relationship between obesity and cancer and to promote research in this area. Recognizing that the type of societal change required to impact the obesity epidemic will require a broad-based effort, ASCO hosted the "Summit on Addressing Obesity through Multidisciplinary Collaboration" in 2016. This meeting was held to review current challenges in addressing obesity within the respective health care provider communities and to identify priorities that would most benefit from a collective and cross-disciplinary approach. Efforts focused on four key areas: provider education and training; public education and activation; research; and policy and advocacy. Summit attendees discussed current challenges in addressing obesity within their provider communities and identified priorities that would most benefit from multidisciplinary collaboration. A synopsis of recommendations to facilitate future collaboration, as well as examples of ongoing cooperative efforts, provides a blueprint for multidisciplinary provider collaboration focused on obesity prevention and treatment. © 2017 The Obesity Society.
Constructing Meaning in a Community of Learners: The "Star" Pattern of Talk

ERIC Educational Resources Information Center

Rachamim, Mirit; Orland-Barak, Lily

2016-01-01

We present findings from an in-depth study on a school-based multi-disciplinary learning community in the context of practice teaching in university pre-service education. We elaborate on one of the three predominant patterns of talk identified, the "star" pattern, and show how it created particular power relations in the discourse which…
The challenge of promoting integration: conceptualization, implementation, and assessment of a pilot care delivery model for patients with type 2 diabetes.

PubMed

Nasmith, Louise; Coté, Brigitte; Cox, Joseph; Inkell, Diane; Rubenstein, Heather; Jimenez, Vania; Rodriguez, Rosario; Larouche, Danielle; Contandriopoulos, Andre-Pierre

2004-01-01

The Côte-des-Neiges diabetes pilot project strove to conceptualize, implement, and assess an integrated health care system for Type 2 diabetes. Using a disease management and population-based approach, a multidisciplinary team sought to (1). organize health care in an integrative framework, (2). promote behavior changes in patients to foster self-care, (3). introduce tools to allow family physicians to modify their practices, and (4). encourage local community action to support patients and providers. Information from a needs assessment helped guide the development of the care model, which was implemented over a 1-year period. A preliminary assessment was undertaken using qualitative methods. Data were collected through in-depth interviews, focus groups, participant observation, and document analysis. (1). Physicians and patients appreciated having access to a multidisciplinary team and related services, and personalized communication was preferred to computerized links. (2). Patients also perceived the benefit of individualized assessment and self-care educational sessions allowing them to participate in their illness management. (3). A diabetes care flow sheet altered the management strategies of physicians. (4). Limited time prevented full development of networking efforts to promote community mobilization. Approaches to chronic diseases such as diabetes require integrative health care strategies to support patients and providers in their community. In spite of time constraints, patients perceived the value of education with increasing involvement in their illness, physicians reported changes in their practice, and steps were initiated to mobilize community resources.
Natural disaster management: experience of an academic institution after a 7.8 magnitude earthquake in Ecuador.

PubMed

Cordero-Reyes, A M; Palacios, I; Ramia, D; West, R; Valencia, M; Ramia, N; Egas, D; Rodas, P; Bahamonde, M; Grunauer, M

2017-03-01

This case study describes the implementation of an academic institution's disaster management plan. Case study. USFQ's Medical School developed a six-phase disaster relief plan consisting of: induction, establishing a base camp, crisis management and mental health aid, creation of multidisciplinary teams and multi-agency teams, and reconstruction. Each phase uses a community-oriented approach to foster survivor autonomy and recovery. Our methodology facilitated the successful implementation of multidisciplinary interventions to manage the earthquake's aftermath on the personal, community and regional levels, treated and prevented psychological and physical morbidity among survivors and promoted healthy living conditions and independence. A multidisciplinary response team that addresses medical needs, mental health, education, food, nutrition and sanitation is highly effective in contributing to timely, effective relief efforts. The short- and long-term solutions we describe could be applicable to other academic centres' interventions in future disaster scenarios around the world. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Model-guided fieldwork: practical guidelines for multidisciplinary research on wildlife ecological and epidemiological dynamics

PubMed Central

Restif, Olivier; Hayman, David T S; Pulliam, Juliet R C; Plowright, Raina K; George, Dylan B; Luis, Angela D; Cunningham, Andrew A; Bowen, Richard A; Fooks, Anthony R; O'Shea, Thomas J; Wood, James L N; Webb, Colleen T

2012-01-01

Infectious disease ecology has recently raised its public profile beyond the scientific community due to the major threats that wildlife infections pose to biological conservation, animal welfare, human health and food security. As we start unravelling the full extent of emerging infectious diseases, there is an urgent need to facilitate multidisciplinary research in this area. Even though research in ecology has always had a strong theoretical component, cultural and technical hurdles often hamper direct collaboration between theoreticians and empiricists. Building upon our collective experience of multidisciplinary research and teaching in this area, we propose practical guidelines to help with effective integration among mathematical modelling, fieldwork and laboratory work. Modelling tools can be used at all steps of a field-based research programme, from the formulation of working hypotheses to field study design and data analysis. We illustrate our model-guided fieldwork framework with two case studies we have been conducting on wildlife infectious diseases: plague transmission in prairie dogs and lyssavirus dynamics in American and African bats. These demonstrate that mechanistic models, if properly integrated in research programmes, can provide a framework for holistic approaches to complex biological systems. PMID:22809422
A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.

PubMed

Whitford, David L; Chan, Wai-Sun

2007-06-28

There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more particularly it promises relevance to primary care. Current Controlled Trials ISRCTN70578736.
Providing Computer-Based Information Services to an Academic Community. Final Technical Report.

ERIC Educational Resources Information Center

Bayer, Bernard

The Mechanized Information Center (MIC) at the Ohio State University conducts retrospective and current awareness searches for faculty, students, and staff using data bases for agriculture, chemistry, education, psychology, and social sciences, as well as a multidisciplinary data base. The final report includes (1) a description of the background…
Primary health care teams and the patient perspective: a social network analysis.

PubMed

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

2013-01-01

Multidisciplinary care (MDC) has been proposed as a potential strategy to address the rising challenges of modern health issues. However, it remains unclear as to how patients' health connections may impact on multidisciplinary processes and outcomes. This research aims to gain a deeper understanding of patients' potential role in MDC: i) describe patients' health networks, ii) compare different care groups, iii) gain an understanding of the nature and extent of their interactions, and iv) identify the role of pharmacists within patient networks. In-depth, semi-structured interviews were conducted with asthma patients from Sydney, Australia. Participants were recruited from a range of standard asthma health care access points (community group) and a specialized multidisciplinary asthma clinic (clinic group). Quantitative social network analysis provided structural insight into asthma networks while qualitative social network analysis assisted in interpretation of network data. A total of 47 interviews were conducted (26 community group participants and 21 clinic group participants). Although participants' asthma networks consisted of a range of health care professionals (HCPs), these did not reflect or encourage MDC. Not only did participants favor minimal interaction with any HCP, they preferred sole-charge care and were found to strongly rely on lay individuals such as family and friends. While general practitioners and respiratory specialists were participants' principal choice of HCP, community pharmacists were less regarded. Limited opportunities were presented for HCPs to collaborate, particularly pharmacists. As patients' choices of HCPs may strongly influence collaborative processes and outcomes, this research highlights the need to consider patient perspectives in the development of MDC models in primary care. Copyright © 2013 Elsevier Inc. All rights reserved.
Conceptual design of an e-health strategy for the Spanish health care system.

PubMed

González, Marvin E; Quesada, Gioconda; Urrutia, Ignacio; Gavidia, José V

2006-01-01

The purpose of this article is to describe the design and development of an e-health strategy for the Spanish health care system. Using quality function deployment and benchmarking analysis as an analytical model, a strategy in e-health care is proposed. This article uses the case of a Spanish community to build a general framework for e-health system development. Based on a multi-disciplinary literature, and the specific needs of a community, the process of e-health system development is analyzed and reduced into a series of phases that form an integrated method. Best practice managerial techniques are adapted to the healthcare industry and the inter-relationships between them are mapped in a theoretical model that results in the desired outcomes. This analysis produces a road-map to e-health system development consisting of several phases: analysis of the current situation of the system and determination of objectives; collection and analysis of customer expectations; development of an action plan through cross-evaluation of customer and system needs; cost and strategic analyses; and evaluation and control systems. Managerial implications are provided. The strategy proposed in this article is a prototype and an ongoing study in the Castilla-La Mancha community.
Implementation and evaluation of a community-based medication reconciliation (CMR) system at the hospital-community interface of care.

PubMed

Bailey, Allan L; Moe, Grace; Moe, Jessica; Oland, Ryan

2009-01-01

The WestView community-based medication reconciliation (CMR) aims to decrease medication error risk. A clinical pharmacist visits patients' homes within 72 hours of hospital discharge and compares medications in discharge orders, family physicians' charts, community pharmacy profiles and in the home. Discrepancies are discussed and reconciled with the dispenser, hospital prescriber and follow-up care provider. The CMR demonstrates successful integration that is patient-centred and standardized, bridging the hospital-community interface and improving information flow and communication channels across a family-physician-led multi-disciplinary team. A concurrent research study will evaluate the impact of CMR on health services utilization and to develop a risk prediction model.
Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study.

PubMed

Salem, Yasser; Scott, Anne Hiller; Karpatkin, Herbert; Concert, George; Haller, Leah; Kaminsky, Eva; Weisbrot, Rivky; Spatz, Eugene

2011-01-01

The purpose of this study was to determine the feasibility of providing a community-based aquatic exercise programme and to examine the effects of a group aquatic exercise programme in individuals with multiple sclerosis. This study illustrates the implementation of a multidisciplinary community-based programme in a university community wellness centre coordinated with a local advocacy group. Eleven subjects with multiple sclerosis participated in a 5-week community-based aquatic exercise programme. Aquatic exercises were held twice weekly for 60 minutes and included aerobic exercises, strength training, flexibility exercises, balance training and walking activities. The 10-Metre Walk test, the Berg Balance Scale (BBS), the 'Timed Up and Go' (TUG) test, grip strength and the Modified Fatigue Impact Scale were used to assess motor function. Analysis of the scores demonstrated improved gait speed, BBS, TUG test and grip strength. The average attendance of the training sessions was good (88%), and no incidence of injuries, no incidence of falls and no adverse effects related to the exercise programme were reported. All participants reported that they enjoyed the programme, and they had improved after the training. A community-based aquatic exercise programme is feasible and resulted in improvement in motor functions of individuals with multiple sclerosis. These findings indicate that an aquatic training programme is appropriate and beneficial for individuals with multiple sclerosis and should be considered to augment the rehabilitation of those individuals. This programme may provide a viable model for a community-based wellness programme for people with disability including individuals with multiple sclerosis.
Strengthening Multidisciplinary Research on Climate and Environmental Change

NASA Astrophysics Data System (ADS)

Beer, Tom; Li, Jianping; Alverson, Keith

2014-08-01

The difficulty with multidisciplinary research is finding common ground for scientists, whose approach to a particular scientific problem can differ radically. For example, there is agreement between the geophysical community and the food science and technology community that food security is an important issue. However, the climate change community sees possible solutions coming from more detailed studies on the links between climate change and agriculture, whereas the food science community sees possible solutions emerging from studies of food logistics and supply chains.
Sensitivity Analysis Based Approaches for Mitigating the Effects of Reducible Interval Input Uncertainty on Single- and Multi-Disciplinary Systems Using Multi-Objective Optimization

DTIC Science & Technology

2010-01-01

Multi-Disciplinary, Multi-Output Sensitivity Analysis ( MIMOSA ) .........29 3.1 Introduction to Research Thrust 1...39 3.3 MIMOSA Approach ..........................................................................................41 3.3.1...Collaborative Consistency of MIMOSA .......................................................41 3.3.2 Formulation of MIMOSA

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

PubMed

Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

2017-01-01

New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.
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…
A randomized controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson's disease: study rationale and protocol.

PubMed

Peters, Catherine; Currin, Michelle; Tyson, Sara; Rogers, Anthea; Healy, Susan; McPhail, Steven; Brauer, Sandra G; Heathcote, Katharine; Comans, Tracy

2012-01-09

Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson's disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.
A Comparison of Microbial Community Structures by Depth and Season Under Switchgrass

NASA Astrophysics Data System (ADS)

Fansler, S. J.; Smith, J. L.; Bolton, H.; Bailey, V. L.

2008-12-01

As part of a multidisciplinary study of C sequestration in switchgrass production systems, the soil microbial community structure was monitored at 6 different depths (reaching 90 cm) in both spring and autumn. Microbial community structure was assessed using ribosomal intergenic spacer analysis (RISA), and primers were used specific to either bacteria or fungi, generating microbial community fingerprints for each taxonomic group. Diverse microbial communities for both groups were detected throughout the soil profile. It is notable that while community structure clearly changed with depth, there was the deepest soil samples still retained relatively diverse communities. Seasonally, differences are clearly evident within plots at the surface. As the plots were replicated, significant differences in the community fingerprints with depth and season are reported.
Success and failure in integrated models of nursing for long term conditions: multiple case studies of whole systems.

PubMed

Procter, Susan; Wilson, Patricia Mary; Brooks, Fiona; Kendall, Sally

2013-05-01

Current projections indicate that the UK faces a 252% increase in people aged over 65 with one or more long term conditions (LTC) by 2050. Nurses, managing their own caseloads and clinics, working across sectors and organisational boundaries and as part of a wider multi-disciplinary team, are frequently seen as key to managing this growing demand. However, the evidence base informing the nursing role in managing LTC, the most effective configuration of the multi-disciplinary team and the policy evidence relating to the infrastructure required to support cross organisational working, remains weak. To explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to such models. Case study whole systems analysis using qualitative interview methods. Two community matron services, two primary care (GP) practice nursing services, two hospital based specialist nursing services were purposefully sampled from across England and Wales. Selection criteria were derived using a consensus conference. The nurses in the service, all patients and carers on the caseload, members of the multi-disciplinary team and stakeholders were invited to participate. Semi-structured interviews with all participants, thematic analysis within a whole system framework. The study found high levels of clinical nursing expertise which in the case of the community matrons was meeting the aim of reducing hospital admissions. Both the primary care and hospital nurse specialist indicate similar levels of clinical expertise which was highly valued by medical colleagues and patients. Patients continued to experience fragmented care determined by diagnostic categories rather than patient need and by the specific remit of the clinic or service the patient was using. Patient data systems are still organised around the impact on services and prevalence of disease at an individual level and not around the patient experience of disease. Nurses are making a major contribution to meeting the policy objectives for long term conditions. Primary care nurses and hospital nurse specialists do broadly similar roles. The scope of the nursing roles and services studied were idiosyncratic, opportunistic and reactive, rather than planned and commissioned on an analysis of local population need. Copyright © 2012 Elsevier Ltd. All rights reserved.
Impact of an antimicrobial stewardship program with multidisciplinary cooperation in a community public teaching hospital in Taiwan.

PubMed

Lin, Yu-Shiuan; Lin, I-Fen; Yen, Yung-Feng; Lin, Pei-Ching; Shiu, Yu-Chih; Hu, Hsing-Yi; Yang, Ying-Pi

2013-11-01

Reports of antimicrobial stewardship programs (ASPs) in community hospitals are limited, with the major focus on specific agents, small settings, or short time periods. Here we present the outcomes of cost control, consumption restraint, and quality of care after a 3-year multidisciplinary ASP in a 415-bed community public teaching hospital. Three strategies for improving antimicrobial stewardship were implemented: education, clinical pharmacists-based intervention, and regular outcome announcement. The steering panel of the program was a committee composed of infection specialists, attending physicians, clinical pharmacists, nurses, and medical laboratorists. Semiannual data from July 2009 to June 2012 was analyzed. Antibiotic costs declined from $21,464 to $12,146 per 1,000 patient-days (-43.4%). Approximately $2.5 million was saved in 3 years, and estimated labor cost was $3,935 per month. Defined daily dose per 1,000 patient-days were diminished from 906.7 to 717.5 (-20.9%). Significant reductions were found in the consumption of aminoglycosides, first-generation cephalosporins, and aminopenicillins. However, through comprehensive auditing, increasing consumption of fourth-generation cephalosporins and fluoroquinolones was noticed. No significant difference in the quality of care (ie, length of stay, incidence of health care associated infections, and mortality) was observed. The multidisciplinary ASP was beneficial to reduce antibiotic cost and consumption. The strategies were practical and worthy to be recommended to community health care settings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
RoboCup: Multi-disciplinary Senior Design Project.

ERIC Educational Resources Information Center

Elder, Kevin Lee

A cross-college team of educators has developed a collaborative, multi-disciplinary senior design course at Ohio University. This course offers an attractive opportunity for students from a variety of disciplines to work together in a learning community to accomplish a challenging task. It provides a novel multi-disciplinary learning environment…
Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

PubMed

Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.
Environmental Data Store: A Web-Based System Providing Management and Exploitation for Multi-Data-Type Environmental Data

NASA Astrophysics Data System (ADS)

Ji, P.; Piasecki, M.

2012-12-01

With the rapid growth in data volumes, data diversity and data demands from multi-disciplinary research effort, data management and exploitation are increasingly facing significant challenges for environmental scientific community. We describe Environmental data store (EDS), a system we are developing that is a web-based system following an open source implementation to manage and exploit multi-data-type environmental data. EDS provides repository services for the six fundamental data types, which meet the demands of multi-disciplinary environmental research. These data types are: a) Time Series Data, b) GeoSpatial data, c) Digital Data, d) Ex-Situ Sampling data, e) Modeling Data, f) Raster Data. Through data portal, EDS allows for efficient consuming these six types of data placed in data pool, which is made up of different data nodes corresponding to different data types, including iRODS, ODM, THREADS, ESSDB, GeoServer, etc.. EDS data portal offers unified submission interface for the above different data types; provides fully integrated, scalable search across content from the above different data systems; also features mapping, analysis, exporting and visualization, through integration with other software. EDS uses a number of developed systems, follows widely used data standards, and highlights the thematic, semantic, and syntactic support on the submission and search, in order to advance multi-disciplinary environmental research. This system will be installed and develop at the CrossRoads initiative at the City College of New York.
Sensitivity Analysis of Multidisciplinary Rotorcraft Simulations

NASA Technical Reports Server (NTRS)

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

2017-01-01

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

NASA Astrophysics Data System (ADS)

Lipson, Alberta; Epstein, Ari W.; Bras, Rafael; Hodges, Kip

2007-08-01

We present a descriptive case study of Terrascope, an innovative, year-long, project-based learning community at MIT. Each year, Terrascope students study a particular environmental or Earth-system problem from a multidisciplinary perspective. Terrascope includes both academic and non-academic components; this paper focuses on the academic components. The objectives of the academic subjects, and of the program as a whole, involve helping students develop their team-building, communication, problem-solving, and self-regulatory learning skills. This study focuses on cohorts of students from the first and second years of the program (2002-2003 and 2003-2004); it is based on end-of-semester surveys and focus groups, and on additional focus groups conducted when these students were upperclassmen. Students felt Terrascope helped them make significant improvements in their ability to work in teams and to take on complex, multidisciplinary problems. They felt that the program's two-semester structure gave them an opportunity to develop and nurture these skills, and that the program prepared them well for their later work at MIT. They also felt that being engaged, as freshmen, in a distinct learning community, significantly eased their transition into MIT. We describe lessons learned in the development of Terrascope and offer suggestions for other institutions planning to develop similar programs.
A systematic review on community-based interventions for elder abuse and neglect.

PubMed

Fearing, Gwendolyn; Sheppard, Christine L; McDonald, Lynn; Beaulieu, Marie; Hitzig, Sander L

2017-03-01

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.
Educational Innovations in Academic Medicine and Environmental Trends

PubMed Central

Irby, David M; Wilkerson, LuAnn

2003-01-01

Fifteen educational innovations in academic medicine are described in relation to 5 environmental trends. The first trend, demands for increased clinical productivity, has diminished the learning environment, necessitating new organizational structures to support teaching, such as academies of medical educators, mission-based management, and faculty development. The second trend is multidisciplinary approaches to science and education. This is stimulating the growth of multidisciplinary curricular design and oversight along with integrated curricular structures. Third, the science of learning advocates the use of case-based, active learning methods; learning communities such as societies and colleges; and instructional technology. Fourth, shifting views of health and disease are encouraging the addition of new content in the curriculum. In response, theme committees are weaving content across the curriculum, new courses are being inserted into curricula, and community-based education is providing learning experiences outside of academic medical centers. Fifth, calls for accountability are leading to new forms of performance assessment using objective structured clinical exams, clinical examination exercises, simulators, and comprehensive assessment programs. These innovations are transforming medical education. PMID:12795736
An international comparative overview on the rehabilitation of offenders and effective measures for the prevention of recidivism.

PubMed

Someda, Kei

2009-04-01

The prevention of recidivism has long been a central issue in criminal justice policy. This is justified because an offender who repeatedly commits crime inflicts far greater damage on society than an offender who commits a crime just once in his/her lifetime. For instance, research by the Ministry of Justice of Japan (2007) reveals that only approximately 30% of repeat offenders were responsible for around 60% of the crime committed in Japan from 1948 to 2006. It has been proven that the realization of the rehabilitation of offenders contributes to the reduction of recidivism. The successful rehabilitation of offenders depends in large part upon the effectiveness of the community-based treatment given to offenders based upon an appropriate assessment of multidimensional risk factors and a multidisciplinary approach. In exploring effective community-based treatment of offenders using a multidisciplinary approach, the author touches upon several effective programs from an international comparative view, including: intensive supervision probation/parole (ISP), Drug Court, cognitive behavioral treatment programs and some recent developments related to this field in Japan.
The Spectral Image Processing System (SIPS) - Interactive visualization and analysis of imaging spectrometer data

NASA Technical Reports Server (NTRS)

Kruse, F. A.; Lefkoff, A. B.; Boardman, J. W.; Heidebrecht, K. B.; Shapiro, A. T.; Barloon, P. J.; Goetz, A. F. H.

1993-01-01

The Center for the Study of Earth from Space (CSES) at the University of Colorado, Boulder, has developed a prototype interactive software system called the Spectral Image Processing System (SIPS) using IDL (the Interactive Data Language) on UNIX-based workstations. SIPS is designed to take advantage of the combination of high spectral resolution and spatial data presentation unique to imaging spectrometers. It streamlines analysis of these data by allowing scientists to rapidly interact with entire datasets. SIPS provides visualization tools for rapid exploratory analysis and numerical tools for quantitative modeling. The user interface is X-Windows-based, user friendly, and provides 'point and click' operation. SIPS is being used for multidisciplinary research concentrating on use of physically based analysis methods to enhance scientific results from imaging spectrometer data. The objective of this continuing effort is to develop operational techniques for quantitative analysis of imaging spectrometer data and to make them available to the scientific community prior to the launch of imaging spectrometer satellite systems such as the Earth Observing System (EOS) High Resolution Imaging Spectrometer (HIRIS).
Scientist, Single Cell Analysis Facility | Center for Cancer Research

Cancer.gov

The Cancer Research Technology Program (CRTP) develops and implements emerging technology, cancer biology expertise and research capabilities to accomplish NCI research objectives. The CRTP is an outward-facing, multi-disciplinary hub purposed to enable the external cancer research community and provides dedicated support to NCI’s intramural Center for Cancer Research (CCR).
Using Social Media as a Tool for Learning: A Multi-Disciplinary Study

ERIC Educational Resources Information Center

Delello, Julie A.; McWhorter, Rochell R.; Camp, Kerri M.

2015-01-01

In order to explore the rich dynamics of using social media as a tool for learning within higher education classrooms, researchers across three disciplines: education, human resource development (HRD), and marketing, joined forces seeking ways to focus on learning through a retrospective analysis. Three concepts--engagement, community building,…
Electron Microscopy-Data Analysis Specialist | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION The Cancer Research Technology Program (CRTP) develops and implements emerging technology, cancer biology expertise and research capabilities to accomplish NCI research objectives. The CRTP is an outward-facing, multi-disciplinary hub purposed to enable the external cancer research community and provides dedicated support to NCI’s intramural Center for
Young Children as Intercultural Mediators: Mandarin-Speaking Chinese Families in Britain

ERIC Educational Resources Information Center

Guo, Zhiyan

2014-01-01

This multidisciplinary approach to cultural mediation brings together insights from anthropology, sociology, linguistics and intercultural communication to offer a detailed depiction of family life in immigrant Chinese communities. Utilising a strongly contextualised and evidence-based narrative approach to exploring the nature of child cultural…
Identifying characteristics and practices of multidisciplinary team reviews for patients with severe mental illness: a systematic review.

PubMed

Woody, Charlotte A; Baxter, Amanda J; Harris, Meredith G; Siskind, Dan J; Whiteford, Harvey A

2018-06-01

Multidisciplinary teams in mental health receive limited guidance, leading to inconsistent practices. We undertook a systematic review of the characteristics and practices of multidisciplinary team reviews for patients with severe mental illness or in relevant mental health service settings. Sources published since 2000 were located via academic database and web searches. Results were synthesised narratively. A total of 14 sources were analysed. Important characteristics and practices identified included routine monitoring and evaluation, good communication, equality between team members, and clear documentation practices. Success factors included defined leadership and clear team goals. Four sources described considerations for patients with complex clinical needs, including allocating sufficient time for discussion, maintaining connections with community providers, and ensuring culturally sensitive practices. No single best practice model was found, due to variations in team caseload, casemix, and resourcing levels. However, key ingredients for success were proposed. Sources were mostly descriptive; there remains a lack of evidence-based guidance regarding multidisciplinary team review characteristics and practices.

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

PubMed

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

2013-10-01

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

PubMed

Boissy, Patrick; Corriveau, Hélène; Michaud, François; Labonté, Daniel; Royer, Marie-Pier

2007-01-01

We examined the requirements for robots in home telecare using two focus groups. The first comprised six healthcare professionals involved in geriatric care and the second comprised six elderly people with disabilities living in the community. The concept of an in-home telepresence robot was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering respite and support to caregivers under certain conditions. The shift from a traditional hospital-centred model of care in geriatrics to a home-based model creates opportunities for using telepresence with mobile robotic systems in home telecare.
A School-Linked Health Service for Adolescents in Jerusalem.

ERIC Educational Resources Information Center

Halevy, Ari; And Others

1995-01-01

Describes the Adolescent Health Service and its multidisciplinary, school-linked, community-based health clinic located in Jerusalem (Israel). Reviews of the files of the clinic's first 134 clients indicated that the clinic population was mainly female Jewish residents. Most referrals came from schools. Psychosocial issues and nutrition were the…
Design, implementation and evaluation of a community health training program in an integrated problem-based medical curriculum: a fifteen-year experience at the University of Geneva Faculty of Medicine.

PubMed

Chastonay, Philippe; Vu, Nu Viet; Humair, Jean-Paul; Mpinga, Emmanuel Kabengele; Bernheim, Laurent

2012-01-01

In the literature the need for relevance in medical education and training has been stressed. In the last 40 years medical schools have been challenged to train doctors competent to respond to community health needs. In the mid-90s the University of Geneva Faculty of Medicine introduced an integrated medical curriculum. In this initiative a particular emphasis was put in introducing a 6-year longitudinal and multidisciplinary Community Health Program (CHP). The aims of the present article are to describe the conception, elaboration and implementation of the CHP as well as its evolution over 15 years and the evaluation of its outcomes. The CHP was at its origin elaborated by a small group of highly motivated teachers and later on developed by a multi-disciplinary group of primary care physicians, epidemiologists, public health and bio-ethics specialists, occupational health professionals, lawyers and historians. Evaluation of the program outcomes included educational innovations, new developments of the curriculum and interactions between students and the community. The CHP learning objectives and teaching modalities were defined by the multi-disciplinary group in consensus meetings which triggered a collaborative spirit among teachers and facilitated further developments. The evaluation procedures allowed the monitoring of students' satisfaction which remained high over the years, students' active participation which decreased over time and success at certifying exams which was globally as good as in basic life sciences. The evaluation also assessed outcomes such as educational innovations, new developments of the curriculum and interactions between students and the community. As suggested in the literature, our experience shows that the students' direct exposure and practice in the community health environment is an effective training approach to broaden students' education by offering them a community perspective of health and disease.
Design, implementation and evaluation of a community health training program in an integrated problem-based medical curriculum: a fifteen-year experience at the University of Geneva Faculty of Medicine

PubMed Central

Chastonay, Philippe; Vu, Nu Viet; Humair, Jean-Paul; Mpinga, Emmanuel Kabengele; Bernheim, Laurent

2012-01-01

Background In the literature the need for relevance in medical education and training has been stressed. In the last 40 years medical schools have been challenged to train doctors competent to respond to community health needs. In the mid-90s the University of Geneva Faculty of Medicine introduced an integrated medical curriculum. In this initiative a particular emphasis was put in introducing a 6-year longitudinal and multidisciplinary Community Health Program (CHP). Objectives The aims of the present article are to describe the conception, elaboration and implementation of the CHP as well as its evolution over 15 years and the evaluation of its outcomes. Methods The CHP was at its origin elaborated by a small group of highly motivated teachers and later on developed by a multi-disciplinary group of primary care physicians, epidemiologists, public health and bio-ethics specialists, occupational health professionals, lawyers and historians. Evaluation of the program outcomes included educational innovations, new developments of the curriculum and interactions between students and the community. Results The CHP learning objectives and teaching modalities were defined by the multi-disciplinary group in consensus meetings which triggered a collaborative spirit among teachers and facilitated further developments. The evaluation procedures allowed the monitoring of students’ satisfaction which remained high over the years, students’ active participation which decreased over time and success at certifying exams which was globally as good as in basic life sciences. The evaluation also assessed outcomes such as educational innovations, new developments of the curriculum and interactions between students and the community. Conclusion As suggested in the literature, our experience shows that the students’ direct exposure and practice in the community health environment is an effective training approach to broaden students’ education by offering them a community perspective of health and disease. PMID:22778541
The Use of Psychotropic Medication for People with Intellectual Disabilities and Behaviours That Challenge in the Context of a Community Multidisciplinary Team Approach

ERIC Educational Resources Information Center

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

2018-01-01

Background: The use of psychotropic medication to manage challenging behaviours of people with intellectual disabilities is a contentious issue which NHS England has now focused on. This paper looks to evaluate this within the multidisciplinary context. Method: Records of clients (n = 106) open to a Community Intellectual Disabilities team for…
A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors.

PubMed

Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José

2012-02-01

Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare.
A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients.

PubMed

Nagaviroj, Kittiphon; Anothaisintawee, Thunyarat

2017-06-01

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

PubMed

Straker, Leon M; Smith, Kyla L; Fenner, Ashley A; Kerr, Deborah A; McManus, Alexandra; Davis, Melissa C; Fielding, Angela M; Olds, Tim S; Hagger, Martin S; Smith, Anne J; Abbott, Rebecca A

2012-06-21

Current estimates place just under one quarter of adolescents in Australia as overweight or obese. Adolescence has been identified as a critical period for the development of obesity, yet despite this recognition, there is limited systematic research into or evaluation of interventions for overweight adolescents. Reviews have concluded that there is a substantive evidence gap for effective intervention, but physical activity, lifestyle change and family involvement have been identified as promising foci for treatment. This paper reports on the development of a staggered-entry, waitlist controlled clinical trial to assess the impact of a multidisciplinary intervention aiming to change the poor health trajectory of overweight adolescents and help them avoid morbid obesity in adulthood-Curtin University's Activity, Food and Attitudes Program (CAFAP). 96 adolescents, aged 11-16 years, and parents, will attend twice weekly during an 8 week intensive multidisciplinary program with maintenance follow-up focussed on improving activity, food and attitude habits. Follow-up assessments will be conducted immediately after completing the intensive program, and at 3, 6 and 12 months post intensive program. Main outcomes will be objectively-measured physical activity, sedentary behaviour and activity behaviours; food intake (measured by 3 day diary) and food behaviours; body composition, fitness and physical function; mental and social well-being (quality of life, mood and attitudes), and family functioning. This trial will provide important information to understand whether a community based multidisciplinary intervention can have short and medium term effects on activity and food habits, attitudes, and physical and mental health status of overweight adolescents. Australian New Zealand Clinical Trials Registry ACTRN12611001187932.
Affordable Design: A Methodolgy to Implement Process-Based Manufacturing Cost into the Traditional Performance-Focused Multidisciplinary Design Optimization

NASA Technical Reports Server (NTRS)

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

2000-01-01

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

PubMed

Chaouki, Wahid; Mimouni, Mohsine; Boutayeb, Saber; Hachi, Hafid; Errihani, Hassan; Benjaafar, Noureddine

The multidisciplinary team meeting has become a standard medical practice in oncology. However, no evaluation of this activity was carried out in Morocco. The aim of this study was to evaluate the multidisciplinary team meeting of gynecological mammary cancers in a National Tertiary Referral Center. The study was carried out by retrospective analysis of 207 cases of patients randomly selected among the 1190 cases recruited during the year 2015. Completeness and quality criteria were evaluated. The global completeness rate of passage in multidisciplinary team meeting is 38%. According to the therapeutic specialities, the completeness of passage in multidisciplinary team meeting is 68% of surgery, 35% of medical oncology and 19% of radiotherapy. As far as localizations are concerned, the completeness of passage in multidisciplinary team meeting is 43% for the breast and only 19% for the cervix. A quorum was met 100% of the cases. In 96% of cases the treatment performed is in accordance with the decision of the multidisciplinary team meeting. Eighty-four percent of cases performed multidisciplinary team meeting within less than one month. This analysis shows that the completeness of the transition to multidisciplinary team meeting has not reached the 100% planned by our institution. However, the requirements for conducting the multidisciplinary team meeting were generally met. This study shows an organizational evolution of our structure based on collective and multidisciplinary medical decision. The national obligation measure of multidisciplinary team meeting is necessary. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
Integrated e-Health approach based on vascular ultrasound and pulse wave analysis for asymptomatic atherosclerosis detection and cardiovascular risk stratification in the community.

PubMed

Santana, Daniel Bia; Zócalo, Yanina A; Armentano, Ricardo L

2012-03-01

New strategies are urgently needed to identify subjects at increased risk of atherosclerotic cardiovascular disease (ACVD) development or complications. A National Public University Center (CUiiDARTE) was created in Uruguay, based on six main pillars: 1) integration of experts in different disciplines and creation of multidisciplinary teams, 2) incidence in public and professional education programs to give training in the use of new technologies and to shift the focus from ACVD treatment to disease prevention, 3) implementation of free vascular studies in the community (distributed rather than centralized healthcare), 4) innovation and application of e-Health and noninvasive technology and approaches, 5) design and development of a biomedical approach to determine the target population and patient workflow, and 6) improvement in individual risk estimation and differentiation between aging and ACVD-related arterial changes using population-based epidemiological and statistical patient-specific models. This work describes main features of CUiiDARTE project implementation, the scientific and technological steps and innovations done for individual risk stratification, and sub-clinical ACVD diagnosis. © 2012 IEEE
Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the National PERT™ Consortium members.

PubMed

Barnes, Geoffrey; Giri, Jay; Courtney, D Mark; Naydenov, Soophia; Wood, Todd; Rosovsky, Rachel; Rosenfield, Kenneth; Kabrhel, Christopher

2017-08-01

Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs. An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program. The survey response rate was 80%. Of the 31 institutions that responded (71% academic), 19 had fully functioning PERT programs. These programs were run by steering committees (17/19, 89%) more often than individual physicians (2/19, 11%). Most PERT programs involved 3-5 different specialties (14/19, 74%), which did not vary based on hospital size or academic affiliation. Of programs using multidisciplinary discussions, these occurred via phone or conference call (12/18, 67%), with a minority of these utilizing 'virtual meeting' software (2/12, 17%). Guidelines for appropriate activations were provided at 16/19 (84%) hospitals. Most PERT programs offered around-the-clock catheter-based or surgical care (17/19, 89%). Outpatient follow up usually occurred in personal physician clinics (15/19, 79%) or dedicated PERT clinics (9/19, 47%), which were only available at academic institutions. PERT programs can be implemented, with similar structures, at small and large, community and academic medical centers. While all PERT programs incorporate team-based multi-disciplinary care into their core structure, several different models exist with varying personnel and resource utilization. Understanding how different PERT programs impact clinical care remains to be investigated.
Individualised home-based rehabilitation after stroke in eastern Finland--the client's perspective.

PubMed

Reunanen, Merja A T; Järvikoski, Aila; Talvitie, Ulla; Pyöriä, Outi; Härkäpää, Kristiina

2016-01-01

Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning. © 2015 John Wiley & Sons Ltd.
Mapping remote and multidisciplinary learning barriers: lessons from challenge-based innovation at CERN

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

PubMed

Okato, Ayumi; Hashimoto, Tasuku; Tanaka, Mami; Tachibana, Masumi; Machizawa, Akira; Okayama, Jun; Endo, Mamiko; Senda, Masayoshi; Saito, Naoki; Iyo, Masaomi

2018-01-01

Child abuse and/or neglect is a serious issue, and in many cases, parents are the perpetrators. Hospital-based child protection teams (CPTs) play pivotal roles in the management of not only abused and/or neglected children but also of their parents; this is generally conducted through multidisciplinary practice. The aim of this study is to survey hospital-based CPT members to determine the professions they perceive to be most applicable to participation in CPTs. The participants were members of CPTs affiliated with hospitals that had pediatric emergency departments and which were located in Chiba Prefecture; specifically, 114 CPT members from 23 hospitals responded to this survey. The two main questionnaire items concerned are as follows: 1) each respondent's evaluation of conducting assessments, providing support, and implementing multidisciplinary collaborative practice in the treatment of abusive and negligent parents, and 2) each CPT member's opinion on the professions that are most important for CPT activities. An exploratory factor analysis (EFA) was performed to explore the factor structure of the data, and a correlation analysis was performed using the result obtained. The EFA returned two factors: multidisciplinary collaborative practice (α = 0.84) and assessment and support (α = 0.89). A correlational analysis showed that multidisciplinary collaborative practice had a positive correlation for obstetricians ( r = 0.315, p = 0.001), neonatologists ( r = 0.261, p = 0.007), midwives ( r = 0.248, p = 0.011), and psychiatrists ( r = 0.194, p = 0.048); however, assessment and support was only significantly correlated with midwives ( r = 0.208, p = 0.039). This study showed that hospital-based CPT members highly evaluate multidisciplinary collaborative practice for the management of abusive and/or negligent parents, and they believe that, in addition to pediatric physicians and nurses, perinatal care and mental health professionals are the most important participants in advanced CPT activities.
Changing the Ecology of Climate Communication in Your Organization (Invited)

NASA Astrophysics Data System (ADS)

Chambliss, L.; Lewenstein, B.

2013-12-01

After decades of frustration, scientists have an exciting opportunity to provide the research-based insights necessary for us all to foster a more sustainable future. Yet, individual scientists and researchers are more effective in their communication and public engagement to the extent their organization supports and facilitates such outreach. This presentation will offer strategies for enhancing multi-disciplinary organizational capabilities in climate change communication and public engagement that go beyond the traditional force-feeding of information and data to a largely unreceptive public. Two essential components of a healthy ecology of climate communication at the organizational level are 1) a multi-disciplinary approach and 2) direct engagement with external audiences and stakeholders so that information is flowing in multiple directions. The traditional flow of fact-based information- from scientist through organization/institution to the public - is rarely effective. We will discuss a New York state-focused, research-based effort that is a workable model for how scientists can engage local and state agencies, corporations, NGOs, business leaders, and other actors. In this case, researches collaborated with diverse stakeholders to create a suite of community events, products and online tools with science-based information carefully crafted and targeted to avoid politicization. This effort facilitated education and planning for community, agricultural and business planners who are making decisions now with 20-to 50-year time frames. As an example of a responsive information flow, a community conference 'Climate Smart and Climate Ready' targeted to local and regional planners included sessions on grief and fear, in addition to assessments of regional impact by sector, after input from stakeholders indicated a strong need to blend science delivery with acknowledgment of the emotional field. We will also examine successful ways science-based organizations have become more climate literate and engaged. Having a central entity that brings together the talents of scientists from multiple disciplines is a huge boost to understanding and responding to the changing communication landscape. We will discuss direct ways the scientific community can engage their organization and the public (or more targeted stakeholders) in an integrated and circular pattern of science information delivery. We will also look at indirect methods for raising general awareness of climate change and increasing organizational buy-in, such as harnessing the multi-disciplinary motivation to be energy efficient (nearly all businesses and NGOs) or meet public climate/carbon-reduction commitments (Universities.)
Initial Multidisciplinary Design and Analysis Framework

NASA Technical Reports Server (NTRS)

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

2010-01-01

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

Teaching science, technology, and society to engineering students: a sixteen year journey.

PubMed

Ozaktas, Haldun M

2013-12-01

The course Science, Technology, and Society is taken by about 500 engineering students each year at Bilkent University, Ankara. Aiming to complement the highly technical engineering programs, it deals with the ethical, social, cultural, political, economic, legal, environment and sustainability, health and safety, reliability dimensions of science, technology, and engineering in a multidisciplinary fashion. The teaching philosophy and experiences of the instructor are reviewed. Community research projects have been an important feature of the course. Analysis of teaching style based on a multi-dimensional model is given. Results of outcome measurements performed for ABET assessment are provided. Challenges and solutions related to teaching a large class are discussed.
Multidisciplinary Graduate Training in Social Research Methodology and Computer-Assisted Qualitative Data Analysis: A Hands-On/Hands-Off Course Design

ERIC Educational Resources Information Center

Bourque, Claude Julie; Bourdon, Sylvain

2017-01-01

Drawing on the experience of training graduate students and researchers in qualitative and mixed-methods analysis since the mid-1990s, the authors reflect on the evolution of a multidisciplinary graduate course developed in a Canadian university since 2007. The hands-on/hands-off course design based on the use of NVivo was developed in parallel…

Toward a Sustained, Multi-disciplinary Socioeconomic Community

NASA Astrophysics Data System (ADS)

Pearlman, J.; Pearlman, F.

2014-12-01

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

PubMed

Dunst, Carl J; Bruder, Mary Beth

2005-02-01

155 university faculty teaching students in physical therapy, occupational therapy, speech and language pathology, early childhood special education, or multidisciplinary studies programs were surveyed to assess how the students were taught how to use everyday family and community activities as natural learning opportunities for young children. Analysis showed that the faculty provided very little training in using community activity settings as contexts for children's learning and that physical therapy faculty provided less training in using natural environments as sources of children's learning opportunities than faculty in the other disciplines.
The anatomy of clinical decision-making in multidisciplinary cancer meetings

PubMed Central

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

2016-01-01

Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core disciplines. Evidence of dual-task interference was observed in relation to the meeting chairs’ input and their corresponding surgical input into case reviews. PMID:27310981
Multidisciplinary Analysis and Optimal Design: As Easy as it Sounds?

NASA Technical Reports Server (NTRS)

Moore, Greg; Chainyk, Mike; Schiermeier, John

2004-01-01

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

NASA Astrophysics Data System (ADS)

Fedchenko, Irina

2017-01-01

The paper summarizes the transformation patterns of functional, morphological, social, and administrative structures of planned residential units - district (Russia, Eastern Europe), neighborhood (USA), community (UK, Europe), as the smallest structural and planning elements of the settlements. The study is based on the author's own on-site survey of the existing and new planned residential units, as well as on the analysis of theoretical sources. The multidisciplinary analysis of the theoretical concepts and on-site survey results showed that planned residential units formed in the early twentieth century retain their social and planning importance and identity, evolve and acquire new features and forms. At the same time, according to the current regulatory and legal instruments they remain basic planning elements of urban structure in the early twenty-first century. This paper also includes experimental analysis of the theoretical concepts of planned residential units' transformation, their conceptual planning model and formation principles in the early twenty-first century.
Improving Health Care Management in Primary Care for Homeless People: A Literature Review.

PubMed

Jego, Maeva; Abcaya, Julien; Ștefan, Diana-Elena; Calvet-Montredon, Céline; Gentile, Stéphanie

2018-02-10

Homeless people have poorer health status than the general population. They need complex care management, because of associated medical troubles (somatic and psychiatric) and social difficulties. We aimed to describe the main characteristics of the primary care programs that take care of homeless people, and to identify which could be most relevant. We performed a literature review that included articles which described and evaluated primary care programs for homeless people. Most of the programs presented a team-based approach, multidisciplinary and/or integrated care. They often proposed co-located services between somatic health services, mental health services and social support services. They also tried to answer to the specific needs of homeless people. Some characteristics of these programs were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community's health. Primary health care programs that aimed at taking care of the homeless people should emphasize a multidisciplinary approach and should consider an integrated (mental, somatic and social) care model.
Multidisciplinary tailoring of hot composite structures

NASA Technical Reports Server (NTRS)

Singhal, Surendra N.; Chamis, Christos C.

1993-01-01

A computational simulation procedure is described for multidisciplinary analysis and tailoring of layered multi-material hot composite engine structural components subjected to simultaneous multiple discipline-specific thermal, structural, vibration, and acoustic loads. The effect of aggressive environments is also simulated. The simulation is based on a three-dimensional finite element analysis technique in conjunction with structural mechanics codes, thermal/acoustic analysis methods, and tailoring procedures. The integrated multidisciplinary simulation procedure is general-purpose including the coupled effects of nonlinearities in structure geometry, material, loading, and environmental complexities. The composite material behavior is assessed at all composite scales, i.e., laminate/ply/constituents (fiber/matrix), via a nonlinear material characterization hygro-thermo-mechanical model. Sample tailoring cases exhibiting nonlinear material/loading/environmental behavior of aircraft engine fan blades, are presented. The various multidisciplinary loads lead to different tailored designs, even those competing with each other, as in the case of minimum material cost versus minimum structure weight and in the case of minimum vibration frequency versus minimum acoustic noise.
Forensic archaeology and anthropology : An Australian perspective.

PubMed

Oakley, Kate

2005-09-01

Forensic archaeology is an extremely powerful investigative discipline and, in combination with forensic anthropology, can provide a wealth of evidentiary information to police investigators and the forensic community. The re-emergence of forensic archaeology and anthropology within Australia relies on its diversification and cooperation with established forensic medical organizations, law enforcement forensic service divisions, and national forensic boards. This presents a unique opportunity to develop a new multidisciplinary approach to forensic archaeology/anthropology within Australia as we hold a unique set of environmental, social, and cultural conditions that diverge from overseas models and require different methodological approaches. In the current world political climate, more forensic techniques are being applied at scenes of mass disasters, genocide, and terrorism. This provides Australian forensic archaeology/anthropology with a unique opportunity to develop multidisciplinary models with contributions from psychological profiling, ballistics, sociopolitics, cultural anthropology, mortuary technicians, post-blast analysis, fire analysis, and other disciplines from the world of forensic science.
Student Participation in a Dementia-Outreach Research Project as Community-Based Experiential Learning

ERIC Educational Resources Information Center

Choi, Sora; Park, Myonghwa

2017-01-01

People with dementia (PWD) and their family caregivers need an increasing number of diverse health and social services. A multidisciplinary person-centered approach to dementia services is required to meet the complex needs of PWD and their family caregivers. However, educational programs struggle to prepare health and social work students to meet…
The Begun Center for Violence Prevention Research and Education at Case Western Reserve University

ERIC Educational Resources Information Center

Flannery, Daniel J.; Singer, Mark I.

2015-01-01

Established in the year 2000, the Begun Center for Violence Prevention Research and Education is a multidisciplinary center located at a school of social work that engages in collaborative, community-based research and evaluation that spans multiple systems and disciplines. The Center currently occupies 4,200 sq. ft. with multiple offices and…
Experiences of Two Multidisciplinary Team Members of Systemic Consultations in a Community Learning Disability Service

ERIC Educational Resources Information Center

Johnson, Clair; Viljoen, Nina

2017-01-01

Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…
An Elder Abuse Assessment Team in an Acute Hospital Setting.

ERIC Educational Resources Information Center

The Beth Israel Hospital Elder Assessment Team

1986-01-01

Describes a hospital-based multidisciplinary team designed to assess and respond to cases of suspected abuse or neglect of elders from both institutional and community settings. Presence of the team has increased the hospital staff's awareness of elder abuse and neglect, as well as their willingness to refer suspected cases for further assessment.…
Developing an effective lung cancer program in a community hospital setting.

PubMed

Fischel, Richard J; Dillman, Robert O

2009-07-01

Lung cancer remains the number one cause of cancer-based mortality in men and women. The importance of proper lung cancer care outside of major academic centers cannot be overemphasized because the vast majority of lung cancer care occurs in community hospital settings. We have had the opportunity to develop a highly successful community hospital-based lung cancer program. Utilizing a multidisciplinary approach, we have achieved steadily improving survival rates that are much higher than those observed nationally for patients diagnosed with lung cancer. Key components of this successful program include: (1) a weekly multidisciplinary lung cancer case conference with medical doctor representatives from medical oncology, thoracic surgery, pulmonary medicine, radiology, radiation oncology, and nuclear medicine who discuss patient presentation, test results, treatment history, and plans for therapy; (2) thoracic surgeons skilled in minimally invasive video-assisted thoracoscopic surgery; (3) nurse navigator/coordinators to help patients through the process from detection to recovery and provide a personal bond that greatly improves patient satisfaction; (4) utilization of treatment guidelines for patient-specific treatment strategies; (5) formal continuing medical education; (6) an emphasis on early detection that includes consideration of computed tomography screening of former smokers; (6) a cancer center that allows for many services to be offered at a single location for patient convenience and to promote interdisciplinary care; and (7) access to research protocols. These components have helped us provide a quality lung cancer program in a community hospital setting that is associated with excellent clinical outcomes.
'Chipping in': clinical psychologists' descriptions of their use of formulation in multidisciplinary team working.

PubMed

Christofides, Stella; Johnstone, Lucy; Musa, Meyrem

2012-12-01

To investigate clinical psychologists' accounts of their use of psychological case formulation in multidisciplinary teamwork. A qualitative study using inductive thematic analysis. Ten clinical psychologists working in community and inpatient adult mental health services who identified themselves as using formulation in their multidisciplinary team work participated in semi-structured interviews. Psychological hypotheses were described as shared mostly through informal means such as chipping in ideas during a team discussion rather than through explicit means such as staff training or case presentations that usually only took place once participants had spent time developing their role within the team. Service context and staff's prior experience were also factors in how explicitly formulation was discussed. Participants reported that they believed that this way of working, although often not formally recognized, was valuable and improved the quality of clinical services provided. More investigation into this under-researched but important area of clinical practice is needed, in order to share ideas and support good practice. ©2011 The British Psychological Society.
Fostering resilience among urban youth exposed to violence: a promising area for interdisciplinary research and practice.

PubMed

Jain, Sonia; Cohen, Alison K

2013-12-01

Most studies to date have examined negative effects of exposure to community violence, in line with the deficit-based perspective. However, given that most youth exposed to community violence demonstrate positive adaptation or resilience over time, we suggest a shift in perspective, practices, and policies across systems toward identifying and building individual, family, and community assets and strengths that may more effectively support youth who have been exposed to community violence and related risks into competent, caring, and thriving adults. In this article, we review how resilience has been conceptualized and operationalized within the context of community violence, highlight gaps in literature, and offer directions for future public health research and practice. We illustrate this review with practice-based examples from public health work in the San Francisco Bay Area. Future multidisciplinary longitudinal studies that identify protective processes and successful trajectories and rigorous evaluations of strength-based policies, programs, and protective processes are needed.
[Health community agent: subject of the buccal health practice in Alagoinhas, Bahia state].

PubMed

Rodrigues, Ana Aurea Alécio de Oliveira; Santos, Adriano Maia Dos; Assis, Marluce Maria Araújo

2010-05-01

This study about the work of micro politics was carried out by the Buccal Health Team (ESB) in the Family Health Program (PSF) of Alagoinhas, Bahia State, and has as central theoretical purpose the specific and singular forms in the practice of daily work, using the technologies (hard, light-hard and light). The methodological trajectory is based on the historical-social current in view of a dialectic approach of qualitative nature. The techniques of data collection used were: semi structured interview, observation of the work process and documental analysis. The analysis of the data was oriented by the hermeneutics-dialectics, allowing to compare the different levels of analysis, articulating the theoretical with the empirical evidence. The results reveal that the Family Health Teams are multidisciplinary, but have still not developed an interdisciplinary work, hence occurring juxtaposition of skills. Each unit plans their work process according to the singularities of the social subjects, implementing different characteristics in how to welcome, inform, attend and refer. An effort in changing the work process can be perceived in the perspective of amplified clinic with the health community agent standing out as a social/collective subject.
[Intervention of Schizophrenia From the Community Model].

PubMed

Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Promoting Implementation of Multi-Disciplinary Sustained Ocean Observations

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

NASA Technical Reports Server (NTRS)

Frisch, H. P.

1986-01-01

The IAC program provides the framework required for the development of an extensive multidisciplinary analysis capability. Several NASTRAN related capabilities were developed which can all be expanded in a routine manner to meet in-house unique needs. Plans are to complete the work discussed herein and to provide it to the engineering community through COSMIC. Release is to be after the current IAC Level 2 contract work on the IAC executive system is completed and meshed with the interfacing modules and analysis capabilities under development at the GSFC.
Quality Indicators for Multidisciplinary Team Functioning in Community-Based Children’s Mental Health Services

PubMed Central

Kutash, Krista; Acri, Mary; Pollock, Michele; Armusewicz, Kelsey; Hoagwood, Kimberly Eaton

2014-01-01

The current study examined the organizational social context in 21 community-based programs serving youth at-risk for out-of-home care due to emotional or behavioral disorders and their families and program performance on five quality indicators of team functioning in teams that included a family support specialist. Results indicate that programs with higher performance on structures to facilitate teamwork, informal communication mechanisms among team members, and the ability to integrate family support specialists as equal members of the team showed more positive organizational functioning. Implications for the role of quality indicators in health care reform efforts are discussed. PMID:23873037

[How to improve the visibility of Spanish research in nursing? Reference journals and quality indexes].

PubMed

Lima-Serrano, Marta; Lima-Rodríguez, Joaquín S; Porcel-Gálvez, Ana M; Gil-García, Eugenia

2015-01-01

Research ends when the results are shared in the academic and professional community, and for this reason they need to be published in scientific journals of reference. But the question is where should the results of nursing research be published? Taking into account the expanding context and scientific consolidation of the discipline. To answer this question, an analysis will be made of the benefits and the most common criticisms of the two most important multidisciplinary literature data bases, as well as examining the context of the Spanish nursing journals in these data bases. A description will also be made of the indexing systems, as well as making proposals to contribute to improved visibility of Spanish nursing research through the positioning of its journals. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Community-based child health nurses: an exploration of current practice.

PubMed

Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

2011-12-01

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.
Outcomes for street children and youth under multidisciplinary care in a drop-in centre in Tegucigalpa, Honduras.

PubMed

Souza, Renato; Porten, Klaudia; Nicholas, Sarala; Grais, Rebecca

2011-11-01

There is little evidence to describe the feasibility and outcomes of services for the care of street children and youth in low-income countries. To describe the outcomes of a multidisciplinary case management approach delivered in a drop-in centre for street children and youth. A longitudinal study of street children and youth followed in an urban drop-in centre. Four hundred (400) street children and youth received a multidisciplinary case management therapeutic package based on the community reinforcement approach. The main outcomes were changes in psychological distress, substance abuse and social situation scores. The median follow-up time for the cohort was 18 months. There were reductions in the levels of psychological distress (p = 0.0001) and substance abuse (p ≤ 0.0001) in the cohort as well as an improvement in the social situation of street children and youth (p = 0.0001). There was a main effect of gender (p < 0.001) and a significant interaction of gender over time (p < 0.001) on improvements in levels of psychological distress. Survival analysis showed that the probability of remaining on substances at 12 months was 0.76 (95% CI: 0.69-0.81) and 0.51 (95% CI: 0.42-0.59) at 24 months. At 12 months, fewer female patients remained using substances compared to male (p < 0.01). To be most effective, programmes and strategies for children and youth in street situations in developing countries should target both their health and social needs.
Multidsciplinary heart failure management and end of life care.

PubMed

Ryder, Mary; Beattie, James M; O'Hanlon, Rory; McDonald, Kenneth

2011-12-01

There has been much improvement in the treatment of heart failure over the past decade through the implementation of a multidisciplinary team approach to disease management focused on optimizing medication, the application of device-based therapy, surgical intervention and in promoting the education of patients and carers in self-management. This multidisciplinary strategy has now been extended to try and improve the care of those with advanced heart failure in the latter phases of the disease trajectory nearing the end of their lives. A growing consensus has emerged in the literature that confirms the need to extend multidisciplinary management beyond the early targets of reducing heart failure-related mortality and morbidity to address the significant care needs of those who decline due to the often inexorable progression of this syndrome. Multidisciplinary management facilitates the development of a comprehensive care plan that is specifically tailored to accommodate the requirements of individual patients and their families and fosters a collaborative approach to care to optimize symptom management, avoid potential treatments conflicts, and to fulfil their supportive care needs. Partnership working between the three principal clinical disciplines of cardiology, specialist palliative care and general practice is central to this process and promotes coordinated care across hospital, hospice and community-based services. Advanced heart failure management has improved over time; however, the incorporation of a multidisciplinary care model appears to offer significant promise in dealing with complex care needs of heart failure patients towards the end of life. Delivery of this practice requires the development of bespoke care structures that are relevant to the spectrum of healthcare service environments.
Rationale, design and methods for a staggered-entry, waitlist controlled clinical trial of the impact of a community-based, family-centred, multidisciplinary program focussed on activity, food and attitude habits (Curtin University’s Activity, Food and Attitudes Program—CAFAP) among overweight adolescents

PubMed Central

2012-01-01

Background Current estimates place just under one quarter of adolescents in Australia as overweight or obese. Adolescence has been identified as a critical period for the development of obesity, yet despite this recognition, there is limited systematic research into or evaluation of interventions for overweight adolescents. Reviews have concluded that there is a substantive evidence gap for effective intervention, but physical activity, lifestyle change and family involvement have been identified as promising foci for treatment. Methods This paper reports on the development of a staggered-entry, waitlist controlled clinical trial to assess the impact of a multidisciplinary intervention aiming to change the poor health trajectory of overweight adolescents and help them avoid morbid obesity in adulthood—Curtin University’s Activity, Food and Attitudes Program (CAFAP). 96 adolescents, aged 11–16 years, and parents, will attend twice weekly during an 8 week intensive multidisciplinary program with maintenance follow-up focussed on improving activity, food and attitude habits. Follow-up assessments will be conducted immediately after completing the intensive program, and at 3, 6 and 12 months post intensive program. Main outcomes will be objectively-measured physical activity, sedentary behaviour and activity behaviours; food intake (measured by 3 day diary) and food behaviours; body composition, fitness and physical function; mental and social well-being (quality of life, mood and attitudes), and family functioning. Discussion This trial will provide important information to understand whether a community based multidisciplinary intervention can have short and medium term effects on activity and food habits, attitudes, and physical and mental health status of overweight adolescents. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611001187932. PMID:22721261
Harvest-associated disturbance in upland Ozark forests of the Missouri Ozark Forest Ecosystem Project

Treesearch

Johann N. Bruhn; James J. Wetteroff; Jeanne D. Mihail; Randy G. Jensen; James B. Pickens

2002-01-01

The Missouri Ozark Forest Ecosystem Project (MOFEP) is a long-term, multidisciplinary, landscape-based research program studying effects of even-aged (EAM), uneven-aged (UAM), and no-harvest (NHM) management on forest communities. The first MOFEP timber harvests occurred from May through November 1996. Harvest- related disturbance occurred on 69 of 180 permanent 0.2-ha...
An Evaluation of Applying Blended Practices to Employ Studio-Based Learning in a Large-Enrollment Design Thinking Course

ERIC Educational Resources Information Center

Brown, Sydney E.; Karle, Sarah Thomas; Kelly, Brian

2015-01-01

DSGN110 was a multidisciplinary course teaching first year students enrolled in in a variety of majors about design thinking. The course is offered for the majors of architecture, landscape architecture, interior design, community and regional planning, along with computer science and business students. By blending face-to-face and online…
Chronic heart failure management in Australia -- time for general practice centred models of care?

PubMed

Scott, Ian; Jackson, Claire

2013-05-01

Chronic heart failure (CHF) is an increasingly prevalent problem within ageing populations and accounts for thousands of hospitalisations and deaths annually in Australia. Disease management programs for CHF (CHF-DMPs) aim to optimise care, with the predominant model being cardiologist led, hospital based multidisciplinary clinics with cardiac nurse outreach. However, findings from contemporary observational studies and clinical trials raise uncertainty around the effectiveness and sustainability of traditional CHF-DMPs in real-world clinical practice. To suggest an alternative model of care that involves general practitioners with a special interest in CHF liaising with, and being up-skilled by, specialists within community based, multidisciplinary general practice settings. Preliminary data from trials evaluating primary care based CHF-DMPs are encouraging, and further studies are underway comparing this model of care with traditional hospital based, specialist led CHF-DMPs. Results of studies of similar primary care models targeting diabetes and other chronic diseases suggest potential for its application to CHF.
Utilisation of home-based physician, nurse and personal support worker services within a palliative care programme in Ontario, Canada: trends over 2005-2015.

PubMed

Sun, Zhuolu; Laporte, Audrey; Guerriere, Denise N; Coyte, Peter C

2017-05-01

With health system restructuring in Canada and a general preference by care recipients and their families to receive palliative care at home, attention to home-based palliative care continues to increase. A multidisciplinary team of health professionals is the most common delivery model for home-based palliative care in Canada. However, little is known about the changing temporal trends in the propensity and intensity of home-based palliative care. The purpose of this study was to assess the propensity to use home-based palliative care services, and once used, the intensity of that use for three main service categories: physician visits, nurse visits and care by personal support workers (PSWs) over the last decade. Three prospective cohort data sets were used to track changes in service use over the period 2005 to 2015. Service use for each category was assessed using a two-part model, and a Heckit regression was performed to assess the presence of selectivity bias. Service propensity was modelled using multivariate logistic regression analysis and service intensity was modelled using log-transformed ordinary least squares regression analysis. Both the propensity and intensity to use home-based physician visits and PSWs increased over the last decade, while service propensity and the intensity of nurse visits decreased. Meanwhile, there was a general tendency for service propensity and intensity to increase as the end of life approached. These findings demonstrate temporal changes towards increased use of home-based palliative care, and a shift to substitute care away from nursing to less expensive forms of care, specifically PSWs. These findings may provide a general idea of the types of services that are used more intensely and require more resources from multidisciplinary teams, as increased use of home-based palliative care has placed dramatic pressures on the budgets of local home and community care organisations. © 2016 John Wiley & Sons Ltd.
Linking urban families to community resources in the context of pediatric primary care.

PubMed

Garg, Arvin; Sarkar, Sonia; Marino, Mark; Onie, Rebecca; Solomon, Barry S

2010-05-01

Pediatric guidelines emphasize the importance for healthcare providers to view children in the context of family and community, and promote community resources at visits. In 2006, a Family Help Desk (FHD) was established in an urban academic-based clinic in Baltimore, MD to assist healthcare providers in educating families about available community-based resources. A longitudinal cohort pilot study was conducted during a 6-week period in 2007 to evaluate the impact of the FHD in connecting at-risk families to community resources. Overall, 6% of parents (n=59) who brought their child for a scheduled clinic visit accessed the FHD. Parents had a mean of 1.7 social needs, including after-school programs and childcare (29%), employment (13%), housing (12%), and food (11%). Most parents who utilized the FHD (64%) contacted a community resource or service within 6 months of their clinic visit. Nineteen parents (32%) who utilized the FHD enrolled in community programs. A clinic-based multi-disciplinary model can empower families to connect with community-based resources for basic social needs. The Family Help Desk model has great potential for addressing family psychosocial needs, and educating families about community resources within the context of pediatric primary care. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Multidisciplinary Critical Care and Intensivist Staffing: Results of a Statewide Survey and Association With Mortality.

PubMed

Yoo, Erika J; Edwards, Jeffrey D; Dean, Mitzi L; Dudley, R Adams

2016-06-01

The role of multidisciplinary teams in improving the care of intensive care unit (ICU) patients is not well defined, and it is unknown whether the use of such teams helps to explain prior research suggesting improved mortality with intensivist staffing. We sought to investigate the association between multidisciplinary team care and survival of medical and surgical patients in nonspecialty ICUs. We conducted a community-based, retrospective cohort study of data from 60 330 patients in 181 hospitals participating in a statewide public reporting initiative, the California Hospital Assessment and Reporting Taskforce (CHART). Patient-level data were linked with ICU organizational data collected from a survey of CHART hospital ICUs between December 2010 and June 2011. Clustered logistic regression was used to evaluate the independent effect of multidisciplinary care on the in-hospital mortality of medical and surgical ICU patients. Interactions between multidisciplinary care and intensity of physician staffing were examined to explore whether team care accounted for differences in patient outcomes. After adjustment for patient characteristics and interactions, there was no association between team care and mortality for medical patients. Among surgical patients, multidisciplinary care was associated with a survival benefit (odds ratio 0.79; 95% confidence interval (CI), 0.62-1.00; P = .05). When stratifying by intensity of physician staffing, although the lowest odds of death were observed for surgical patients cared for in ICUs with multidisciplinary teams and high-intensity staffing (odds ratio, 0.77; 95% CI, 0.55-1.09; P = .15), followed by ICUs with multidisciplinary teams and low-intensity staffing (odds ratio 0.84, 95% CI 0.65-1.09, p = 0.19), these differences were not statistically significant. Our results suggest that multidisciplinary team care may improve outcomes for critically ill surgical patients. However, no relationship was observed between intensity of physician staffing and mortality. © The Author(s) 2014.
The “Translators”: Engaging Former Drug Users as Key Research Staff to Design and Implement a Risk Reduction Program for Rural Cocaine Users

PubMed Central

Stewart, Katharine E.; Wright, Patricia B.; Sims, Desi; Tyner, Kathy Russell; Montgomery, Brooke E. E.

2013-01-01

This manuscript describes lessons learned in the development and implementation of a clinical behavioral trial to reduce sexual risk among African-American cocaine users in rural Arkansas, from the perspectives of a multidisciplinary investigative team and community staff members with a history as local drug users who served as “translators.” Recommendations for investigators doing community-based research with active substance users are provided in the following domains: (a) engaging the community during formative research, (b) establishing bidirectional trust, (c) ensuring community voices are heard, and (d) managing conflict. The “translator’s” role is critical to the success of such projects. PMID:22428822
Multiphysics Code Demonstrated for Propulsion Applications

NASA Technical Reports Server (NTRS)

Lawrence, Charles; Melis, Matthew E.

1998-01-01

The utility of multidisciplinary analysis tools for aeropropulsion applications is being investigated at the NASA Lewis Research Center. The goal of this project is to apply Spectrum, a multiphysics code developed by Centric Engineering Systems, Inc., to simulate multidisciplinary effects in turbomachinery components. Many engineering problems today involve detailed computer analyses to predict the thermal, aerodynamic, and structural response of a mechanical system as it undergoes service loading. Analysis of aerospace structures generally requires attention in all three disciplinary areas to adequately predict component service behavior, and in many cases, the results from one discipline substantially affect the outcome of the other two. There are numerous computer codes currently available in the engineering community to perform such analyses in each of these disciplines. Many of these codes are developed and used in-house by a given organization, and many are commercially available. However, few, if any, of these codes are designed specifically for multidisciplinary analyses. The Spectrum code has been developed for performing fully coupled fluid, thermal, and structural analyses on a mechanical system with a single simulation that accounts for all simultaneous interactions, thus eliminating the requirement for running a large number of sequential, separate, disciplinary analyses. The Spectrum code has a true multiphysics analysis capability, which improves analysis efficiency as well as accuracy. Centric Engineering, Inc., working with a team of Lewis and AlliedSignal Engines engineers, has been evaluating Spectrum for a variety of propulsion applications including disk quenching, drum cavity flow, aeromechanical simulations, and a centrifugal compressor flow simulation.
Effectiveness of a multidisciplinary heart failure disease management programme on 1-year mortality

PubMed Central

Laborde-Castérot, Hervé; Agrinier, Nelly; Zannad, Faiez; Mebazaa, Alexandre; Rossignol, Patrick; Girerd, Nicolas; Alla, François; Thilly, Nathalie

2016-01-01

Abstract We performed a multicenter prospective observational cohort study (Epidémiologie et Pronostic de l’Insuffisance Cardiaque Aiguë en Lorraine, Epidemiology and Prognosis of Acute Heart Failure in Lorraine [EPICAL2]) to evaluate the effectiveness on mortality of a community-based multidisciplinary disease management programme (DMP) for heart failure (HF) patients. Between October 2011 and October 2012, 1816 patients, who were hospitalized for acute HF or who developed acute HF during a hospitalization, were included from 21 hospitals in a northeast region of France. At hospital admission, their mean age was 77.3 (standard deviation [SD] 11.6) years and mean left ventricular ejection fraction was 45.0 (SD 16.0)%. A subset of patients were enrolled in a multidimensional DMP for HF (n = 312, 17.2%), based on structured patient education, home monitoring visits by HF-trained nurses, and automatic alerts triggered by significant clinical and biological changes to the patient. The DMP involved general practitioners, nurses, and cardiologists collaborating via an individual web-based medical electronic record. The outcome was all-cause mortality from the 3rd to the 12th month after discharge. During the follow-up, a total of 377 (20.8%) patients died: 321 (21.3%) in the control group and 56 (17.9%) in the DMP group. In a propensity score analysis, DMP was associated with lower 1-year all-cause mortality (hazard ratio 0.65, 95% CI 0.46–0.92). Instrumental variable analysis gave similar results (hazard ratio 0.56, 0.27–1.16). In a real world setting, a multidimensional DMP for HF with structured patient education, home nurse monitoring, and appropriate physician alerts may improve survival when implemented after discharge from hospitalization due to worsening HF. PMID:27631204
A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

PubMed

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

2016-01-01

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

PubMed

DeSisto, Carla L; Estrich, Cameron; Kroelinger, Charlan D; Goodman, David A; Pliska, Ellen; Mackie, Christine N; Waddell, Lisa F; Rankin, Kristin M

2017-11-21

Implementation strategies are imperative for the successful adoption and sustainability of complex evidence-based public health practices. Creating a learning collaborative is one strategy that was part of a recently published compilation of implementation strategy terms and definitions. In partnership with the Centers for Disease Control and Prevention and other partner agencies, the Association of State and Territorial Health Officials recently convened a multi-state Learning Community to support cross-state collaboration and provide technical assistance for improving state capacity to increase access to long-acting reversible contraception (LARC) in the immediate postpartum period, an evidence-based practice with the potential for reducing unintended pregnancy and improving maternal and child health outcomes. During 2015-2016, the Learning Community included multi-disciplinary, multi-agency teams of state health officials, payers, clinicians, and health department staff from 13 states. This qualitative study was conducted to better understand the successes, challenges, and strategies that the 13 US states in the Learning Community used for increasing access to immediate postpartum LARC. We conducted telephone interviews with each team in the Learning Community. Interviews were semi-structured and organized by the eight domains of the Learning Community. We coded transcribed interviews for facilitators, barriers, and implementation strategies, using a recent compilation of expert-defined implementation strategies as a foundation for coding the latter. Data analysis showed three ways that the activities of the Learning Community helped in policy implementation work: structure and accountability, validity, and preparing for potential challenges and opportunities. Further, the qualitative data demonstrated that the Learning Community integrated six other implementation strategies from the literature: organize clinician implementation team meetings, conduct educational meetings, facilitation, promote network weaving, provide ongoing consultation, and distribute educational materials. Convening a multi-state learning collaborative is a promising approach for facilitating the implementation of new reimbursement policies for evidence-based practices complicated by systems challenges. By integrating several implementation strategies, the Learning Community serves as a meta-strategy for supporting implementation.
Coordinating an interdisciplinary disease management conference on a military installation: collaboration between military and civilian communities, lessons learned.

PubMed

Lewis-Fleming, Glenda; Knapp, Casey A

2009-08-01

The needs of individuals with chronic diseases or disabilities are similar whether within military or civilian communities. With finite resources and the continuing global war on terrorism, military treatment facilities (MTFs) may find collaborative, multidisciplinary, continuing education efforts with community agencies invaluable. Collaborative efforts that bring military and civilian communities together can result in innovative programs that offer cost-effective high-quality information to enhance the knowledge and skill level of military families, providers, and other professionals who provide services and care for military eligible beneficiaries. This article addresses the development and implementation of two major multidisciplinary disease management conferences at Naval Medical Center Portsmouth (NMCP), Virginia. It provides an overview of lessons learned in the areas of preplanning, team building, program development, implementation, and evaluation. Despite challenges, tremendous benefits may be reaped from efforts to include diverse target populations from military and civilian communities.
Fast Fragmentation of Networks Using Module-Based Attacks

PubMed Central

Requião da Cunha, Bruno; González-Avella, Juan Carlos; Gonçalves, Sebastián

2015-01-01

In the multidisciplinary field of Network Science, optimization of procedures for efficiently breaking complex networks is attracting much attention from a practical point of view. In this contribution, we present a module-based method to efficiently fragment complex networks. The procedure firstly identifies topological communities through which the network can be represented using a well established heuristic algorithm of community finding. Then only the nodes that participate of inter-community links are removed in descending order of their betweenness centrality. We illustrate the method by applying it to a variety of examples in the social, infrastructure, and biological fields. It is shown that the module-based approach always outperforms targeted attacks to vertices based on node degree or betweenness centrality rankings, with gains in efficiency strongly related to the modularity of the network. Remarkably, in the US power grid case, by deleting 3% of the nodes, the proposed method breaks the original network in fragments which are twenty times smaller in size than the fragments left by betweenness-based attack. PMID:26569610
Quality improvement in the emergency department.

PubMed

Batrich, M; Domerchie, M

1995-09-01

Health care institutions across the country are recognizing that their success is dependent on satisfied patients. The Emergency Department in this community teaching hospital dramatically improved their patient satisfaction rates with a customer-focused program. The effort was based on defining the patient's perception, developing a multidisciplinary team to address the issue, and implementing a plan in which every employee was a part of the solution.
Franklin County, Ohio Deceased Child Review System. Working To Eliminate Preventable Child Deaths. 1992 Annual Report.

ERIC Educational Resources Information Center

Schirner, Pamela; Griggs, Harry

In 1988, Franklin County (Ohio) Children Services (FCCS) initiated the development of a bi-level, community-based, multi-disciplinary process to review all deaths of children in its open caseload, as well as child deaths in families with which FCCS had contact in the previous 12 months. This report examines the work of the Deceased Child Review…

A Conceptual Model of the Pasadena Housing System

NASA Technical Reports Server (NTRS)

Hirshberg, Alan S.; Barber, Thomas A.

1971-01-01

During the last 5 years, there have been several attempts at applying systems analysis to complex urban problems. This paper describes one such attempt by a multidisciplinary team of students, engineers, professors, and community representatives. The Project organization is discussed and the interaction of the different disciplines (the process) described. The two fundamental analysis questions posed by the Project were: "Why do houses deteriorate?" and "Why do people move?" The analysis of these questions led to the development of a conceptual system model of housing in Pasadena. The major elements of this model are described, and several conclusions drawn from it are presented.
Utilization and Effectiveness of Florida's Multidisciplinary Family Service Planning Teams.

ERIC Educational Resources Information Center

Lazear, Katherine; Everett, Judith; Eggers, Terri

This conference paper discusses the results of a study on the effectiveness of Florida's multidisciplinary Family Service Planning Teams (FSPT). The FSPTs were developed to create holistic service plans to enable children with emotional disabilities to live in the community and be successful in school. The FSPTs have become the focus of service…
Improving Student Achievement in a Multidisciplinary Context

ERIC Educational Resources Information Center

Chapman, Amanda; Bloxham, Sue

2004-01-01

This article analyses interim findings of an ongoing action research project into the use of assessment criteria and grade descriptors in the assessment process. The project is multidisciplinary and covers areas as diverse as Sports Sociology, Economics, Youth and Community Studies, and Education. The idea is to equip first-year students with the…
Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)--a realist synthesis.

PubMed

Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey

2017-07-03

Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these mechanisms. Intervention strategies that change the contexts so the mechanisms are triggered to produce desired outcomes will be developed. Feedback on these strategies will be obtained. This realist synthesis aims to develop a framework (underpinned by our programme theory) for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens. PROSPERO CRD42016043506.
NASA's Aeroacoustic Tools and Methods for Analysis of Aircraft Noise

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Lopes, Leonard V.; Burley, Casey L.

2015-01-01

Aircraft community noise is a significant concern due to continued growth in air traffic, increasingly stringent environmental goals, and operational limitations imposed by airport authorities. The ability to quantify aircraft noise at the source and ultimately at observers is required to develop low noise aircraft designs and flight procedures. Predicting noise at the source, accounting for scattering and propagation through the atmosphere to the observer, and assessing the perception and impact on a community requires physics-based aeroacoustics tools. Along with the analyses for aero-performance, weights and fuel burn, these tools can provide the acoustic component for aircraft MDAO (Multidisciplinary Design Analysis and Optimization). Over the last decade significant progress has been made in advancing the aeroacoustic tools such that acoustic analyses can now be performed during the design process. One major and enabling advance has been the development of the system noise framework known as Aircraft NOise Prediction Program2 (ANOPP2). ANOPP2 is NASA's aeroacoustic toolset and is designed to facilitate the combination of acoustic approaches of varying fidelity for the analysis of noise from conventional and unconventional aircraft. The toolset includes a framework that integrates noise prediction and propagation methods into a unified system for use within general aircraft analysis software. This includes acoustic analyses, signal processing and interfaces that allow for the assessment of perception of noise on a community. ANOPP2's capability to incorporate medium fidelity shielding predictions and wind tunnel experiments into a design environment is presented. An assessment of noise from a conventional and Hybrid Wing Body (HWB) aircraft using medium fidelity scattering methods combined with noise measurements from a model-scale HWB recently placed in NASA's 14x22 wind tunnel are presented. The results are in the form of community noise metrics and auralizations.
Cultivating healthy places and communities: evidenced-based nature contact recommendations.

PubMed

Largo-Wight, Erin

2011-02-01

Cultivating healthful places is an important public health focus. This paper presents evidence-based recommendations related to nature contact. A multidisciplinary review was conducted in several fields of study and findings were organized into public health recommendations: (1) cultivate grounds for viewing, (2) maintain healing gardens, (3) incorporate wooded parks and green space in communities, (4) advocate for preservation of pristine wilderness, (5) welcome animals indoors, (6) provide a plethora of indoor potted plants within view, (7) light rooms with bright natural light, (8) provide a clear view of nature outside, (9) allow outside air and sounds in, (10) display nature photography and realistic nature art, (11) watch nature on TV or videos, and (12) listen to recorded sounds of nature. The findings should inform public health promoters in the design of healthy places and communities. Future research needs are highlighted.
Development of a Primary Care-Based Clinic to Support Adults With a History of Childhood Cancer: The Tactic Clinic.

PubMed

Overholser, Linda S; Moss, Kerry M; Kilbourn, Kristin; Risendal, Betsy; Jones, Alison F; Greffe, Brian S; Garrington, Timothy; Leonardi-Warren, Kristin; Yamashita, Traci E; Kutner, Jean S

2015-01-01

Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. Copyright © 2015 Elsevier Inc. All rights reserved.
Childhood Asthma Disparities in Chicago: Developing Approaches to Health Inequities.

PubMed

Martin, Molly A; Kapheim, Melissa Gutierrez; Erwin, Kim; Ignoffo, Stacy; McMahon, Kate; OʼRourke, Amy; Gerald, Lynn B; Barrett, Meredith; Press, Valerie G; Darabi, Houshang; Krishnan, Jerry A

We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated. Cooperative, multidisciplinary efforts grounded in the community can target wicked problems such as asthma.
Mobilizing Rural Communities to Prevent Childhood Obesity: A Tool Kit

ERIC Educational Resources Information Center

Smathers, Carol A.; Lobb, Jennifer M.

2017-01-01

The tool kit Mobilizing Rural Communities to Prevent Childhood Obesity is the product of a seven-state multidisciplinary research project focused on enhancing obesity prevention efforts by integrating community coaching into the work of rural community coalitions. The interactive tool kit is available at no cost both in print form and online, and…
The cycle of violence and victimization: a study of the school-based intervention of a multidisciplinary youth violence-prevention program.

PubMed

Nadel, H; Spellmann, M; Alvarez-Canino, T; Lausell-Bryant, L L; Landsberg, G

1996-01-01

This article reports on the school-based intervention component of a multidisciplinary program intended to reduce and prevent youth violence in the East New York neighborhood of Brooklyn. This intervention is based on three theories. The first theory posits that modifying beliefs, attitudes, and norms will help youths develop behaviors that support nonviolence. The second theoretical construct asserts that enhancing relationships with peers and family will buffer youths from the effects of exposure to violence. Finally, the third theory suggests that changing aspects of the setting and climate that contribute to violent behavior will prevent violence. The school-based intervention, the Safe Harbor, is a victim-assistance and violence-prevention program. The Safe Harbor offers activities including a 20-lesson violence-prevention and victim-assistance curriculum, counseling, parent involvement, teacher training, and school-change campaigns. The evaluation design is a panel study, with cohorts surveyed longitudinally at nonequivalent intervals. One hundred and fifteen seventh- and eighth-grade students who receive the curriculum and other services are the experimental group; the other 879 students in the seventh and eighth grades serve as the comparison group. Baseline data were collected through a survey of the entire school before the program's implementation in January 1995. Subsequent data collection will include interviews and focus groups; future analysis will address how participation in other parts of the Safe Harbor program or other programs in the school affects outcomes. The participation rate for the baseline survey in the experimental group was 86%, in the comparison group 76%. Responses to the survey questions were virtually identical between the two groups. Preliminary analyses reflect a climate of pervasive violence in the school, family, and community. More than half of the sample reported witnessing a severe beating in the school or their community within the past four months. Forty-four percent witnessed someone being attacked with a weapon in their neighborhood. The psychological consequences of exposure to violence were severe-51% of the sample reported post-traumatic stress disorder (PTSD) symptoms. A number of lessons have been learned from implementing and evaluating this project, including the importance of fostering community partnership and strong relationships with the school, and addressing both reactions to victimization and norms and beliefs about aggression.
Developing a program for enhancing youth HIV treatment adherence and risk reduction.

PubMed

Fongkaew, Warunee; Udomkhamsuk, Warawan; Viseskul, Nongkran; Guptaruk, Marisa

2017-12-01

Youth living with HIV face difficult and challenging situations that decrease their adherence to antiretroviral medications. In this study, we developed a pilot program to enhance HIV treatment adherence and risk reduction among youth living with HIV based on collaboration with a community hospital involving a multi-disciplinary healthcare team. Participants were 25 youth living with HIV/AIDS, 18 caregivers, and 12 healthcare providers. The action research process comprised a preliminary stage and four phases of assessment, planning, implementation, and evaluation. This program used "edutainment", participatory learning, and multi-disciplinary collaboration to improve HIV treatment adherence and HIV risk behavior knowledge, motivation, and behavior. Education aimed to improve knowledge of antiretroviral drugs and HIV risk-taking behaviors. Motivation was directed at reframing beliefs and increasing positive attitudes of youth toward treatment adherence and raising awareness about safer sex behaviors. The behavioral skills focused on medication management in daily life activities, problem-solving, refusal and negotiation, and condom use. Findings provided preliminary evidence that the program was practical in a clinical context in a community hospital. © 2017 John Wiley & Sons Australia, Ltd.
Interdisciplinary research and education at the biology-engineering-computer science interface: a perspective.

PubMed

Tadmor, Brigitta; Tidor, Bruce

2005-09-01

Progress in the life sciences, including genome sequencing and high-throughput experimentation, offers an opportunity for understanding biology and medicine from a systems perspective. This 'new view', which complements the more traditional component-based approach, involves the integration of biological research with approaches from engineering disciplines and computer science. The result is more than a new set of technologies. Rather, it promises a fundamental reconceptualization of the life sciences based on the development of quantitative and predictive models to describe crucial processes. To achieve this change, learning communities are being formed at the interface of the life sciences, engineering and computer science. Through these communities, research and education will be integrated across disciplines and the challenges associated with multidisciplinary team-based science will be addressed.
The ElderSmile TimeMap: Benefits of Connecting Statistics With Time and Place.

PubMed

Kum, Susan S; Wang, Hua; Wang, Peng; Jin, Zhu; De La Cruz, Leydis; Northridge, Mary E; Kunzel, Carol; Marshall, Stephen E; Metcalf, Sara S

2015-09-01

Community-based programs are critical for locally targeted public health education and accessible service delivery. Deriving useful information from such programs is important for their own evaluation and improvement and may facilitate research collaboration with partners and experts. Here we present an interactive Web-based application designed for a community-based oral health outreach program called ElderSmile to demonstrate how data can be summarized, filtered, compared, and visualized by time and place to inform program planning, evaluation, and research. The ElderSmile TimeMap ( http://www.acsu.buffalo.edu/∼smetcalf/resources/timemap.html ) is an emergent product of a US National Institutes of Health-funded collaboration of knowledge sharing among multidisciplinary team members at the University at Buffalo, Columbia University, and New York University.
Improving lives using multidisciplinary education: partnering to benefit community, innovation, health, and technology.

PubMed

McClelland, Molly; Kleinke, Darrell

2013-07-01

University students are trained in specific disciplines, which can benefit disabled individuals in a variety of ways, including education, health promotion, assistive technologies, logistics, or design improvement. However, collaboration with other disciplines can have a greater impact on improving the health of disabled individuals than can training in one discipline alone. The University of Detroit Mercy Colleges of Engineering and Nursing have partnered to develop and provide assistive devices to disabled individuals while teaching innovation, technology, and collaboration to students. After 4 years of developing and implementing our multidisciplinary program, numerous unique and helpful assistive devices have been designed, created, and delivered to individuals in our community. More nursing schools should initiate multidisciplinary programs to train and prepare students for workplaces where such innovative, collaborative skills are increasingly sought. Nurses need to be at the forefront of such collaborative work. Copyright 2013, SLACK Incorporated.
Multidisciplinary Approaches to Educational Research: Case Studies from Europe and the Developing World. Routledge Research in Education

ERIC Educational Resources Information Center

Rizvi, Sadaf, Ed.

2011-01-01

This book provides an original perspective on a range of controversial issues in educational and social research through case studies of multi-disciplinary and mixed-method research involving children, teachers, schools and communities in Europe and the developing world. These case studies from researchers "across continents" and…
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…
[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. Copyright © 2015. Published by Elsevier SAS.
Evidence-based health policy-making, hospital funding and health insurance.

PubMed

Palmer, G R

2000-02-07

An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-based approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various disciplines involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political assessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of evidence on the impact of policy options for improving the health status of the community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiatives shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by initiatives such as greater exposure of health professionals to educational inputs with a policy focus; increased contribution of doctors to health services research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.
Public health initiatives in South Africa in the 1940s and 1950s: lessons for a post-apartheid era.

PubMed

Yach, D; Tollman, S M

1993-07-01

Inspiration drawn from South African public health initiatives in the 1940s played an important role in the development of the network of community and migrant health centers in the United States. The first such center at Pholela in Natal emphasized the need for a comprehensive (preventive and curative) service that based its practices on empirical data derived from epidemiological and anthropological research. In addition, community consultation preceded the introduction of new service or research initiatives. The Institute of Family and Community Health in Durban pioneered community-based multidisciplinary training and developed Pholela and other sites as centers for service, teaching, and research. Several important lessons for South African health professionals emerge from the Pholela experience. First, public health models of the past need to be reintroduced locally; second, the training of public health professionals needs to be upgraded and reoriented; third, appropriate research programs need to respond to community needs and address service demands; fourth, community involvement strategies need to be implemented early on; and fifth, funding sources for innovation in health service provision should be sought.
Development of a standardized job description for healthcare managers of metabolic syndrome management programs in Korean community health centers.

PubMed

Lee, Youngjin; Choo, Jina; Cho, Jeonghyun; Kim, So-Nam; Lee, Hye-Eun; Yoon, Seok-Jun; Seomun, GyeongAe

2014-03-01

This study aimed to develop a job description for healthcare managers of metabolic syndrome management programs using task analysis. Exploratory research was performed by using the Developing a Curriculum method, the Intervention Wheel model, and focus group discussions. Subsequently, we conducted a survey of 215 healthcare workers from 25 community health centers to verify that the job description we created was accurate. We defined the role of healthcare managers. Next, we elucidated the tasks of healthcare managers and performed needs analysis to examine the frequency, importance, and difficulty of each of their duties. Finally, we verified that our job description was accurate. Based on the 8 duties, 30 tasks, and 44 task elements assigned to healthcare managers, we found that the healthcare managers functioned both as team coordinators responsible for providing multidisciplinary health services and nurse specialists providing health promotion services. In terms of importance and difficulty of tasks performed by the healthcare managers, which were measured using a determinant coefficient, the highest-ranked task was planning social marketing (15.4), while the lowest-ranked task was managing human resources (9.9). A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs. Copyright © 2014. Published by Elsevier B.V.

A program to form a multidisciplinary data base and analysis for dynamic systems

NASA Technical Reports Server (NTRS)

Taylor, L. W.; Suit, W. T.; Mayo, M. H.

1984-01-01

Diverse sets of experimental data and analysis programs have been assembled for the purpose of facilitating research in systems identification, parameter estimation and state estimation techniques. The data base analysis programs are organized to make it easy to compare alternative approaches. Additional data and alternative forms of analysis will be included as they become available.
Community psychology practice: expanding the impact of psychology's work.

PubMed

Wolff, Tom

2014-11-01

This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Community-Based Wetland Restoration Workshop in the Lower Ninth Ward, New Orleans

NASA Astrophysics Data System (ADS)

Wang, H. F.; Craig, L.; Ross, J. A.; Zepeda, L.; Carpenter, Q.

2010-12-01

Since 2007 a workshop class of University of Wisconsin-Madison students has participated in a community-based project in New Orleans to investigate the feasibility of restoring the Bayou Bienvenue Wetland Triangle (BBWT), which is adjacent to the Lower 9th Ward in New Orleans. This 440-acre region is currently open water but was a cypress forest until the 1970s. Restoration would provide protection from storm surges, restored ecological services, and recreational use. The workshop introduced students to the multidisciplinary skills needed to work effectively with the complex and interconnected issues within a project involving many stakeholders. The stakeholders included the Center for Sustainable Engagement and Development (CSED), Lower 9th Ward residents, non-profits (e.g., Sierra Club, Environmental Defense, Lake Pontchartrain Basin Foundation, National Wildlife Federation), government agencies (e.g., New Orleans Sewerage and Water Board, Army Corps of Engineers), neighborhood groups (e.g., Holy Cross Neighborhood Association, The Village), and universities (Tulane, U. of New Orleans, LSU, U. Colorado-Denver, Southeastern Louisiana). The course ran initially as a Water Resources Management practicum in the first two summers and then as a broader multidisciplinary project with student expertise in hydrology, social science, law, planning, policy analysis, community development, GIS, public health, environmental education and ecological restoration. The project divided into three main components: wetland science, social science, and land tenure and planning. Principal activities in wetland science were to monitor water levels and water quality, inventory flora and fauna, and plant grasses on small “floating islands.” The principal social science activity was to conduct a neighborhood survey about knowledge of the wetland and interest in its restoration. The land tenure and planning activity was to investigate ownership and transfer of property within the wetland because it had been platted with large areas privately owned. A self-published workshop report was produced each of the first three years. Bayou Bienvenue Wetland Triangle with downtown New Orleans in the background. Photo by Travis Scott, U. of Wisconsin-Madison, 2007.
Model-based engineering for laser weapons systems

NASA Astrophysics Data System (ADS)

Panthaki, Malcolm; Coy, Steve

2011-10-01

The Comet Performance Engineering Workspace is an environment that enables integrated, multidisciplinary modeling and design/simulation process automation. One of the many multi-disciplinary applications of the Comet Workspace is for the integrated Structural, Thermal, Optical Performance (STOP) analysis of complex, multi-disciplinary space systems containing Electro-Optical (EO) sensors such as those which are designed and developed by and for NASA and the Department of Defense. The CometTM software is currently able to integrate performance simulation data and processes from a wide range of 3-D CAD and analysis software programs including CODE VTM from Optical Research Associates and SigFitTM from Sigmadyne Inc. which are used to simulate the optics performance of EO sensor systems in space-borne applications. Over the past year, Comet Solutions has been working with MZA Associates of Albuquerque, NM, under a contract with the Air Force Research Laboratories. This funded effort is a "risk reduction effort", to help determine whether the combination of Comet and WaveTrainTM, a wave optics systems engineering analysis environment developed and maintained by MZA Associates and used by the Air Force Research Laboratory, will result in an effective Model-Based Engineering (MBE) environment for the analysis and design of laser weapons systems. This paper will review the results of this effort and future steps.
Pumps, feed and sets: is procurement limiting outcomes?

PubMed

Ojo, Omorogieva

This article aims to review the unique ways in which enteral feed, ancillary items and pumps are procured in the UK and to evaluate whether these are inhibiting innovation and reducing the choices of patients. There are a number of models that have been developed across the UK for the procurement of enteral feed, feeding accessories and pump. The two most common are the hospital-based nutrition support team, which may have an overarching role in the community, and the home enteral nutrition (HEN) team, a multidisciplinary community-based team with skilled health professionals dedicated to the delivery of the enteral nutrition service. While the HEN service has its advantages over other models in the community, it is primarily driven by its clinical role. The lack of significant opportunity for clinical audits and research within the service limits the prospects for service improvement, innovation and patients' choices.
The EuroGEOSS Advanced Operating Capacity

NASA Astrophysics Data System (ADS)

Nativi, S.; Vaccari, L.; Stock, K.; Diaz, L.; Santoro, M.

2012-04-01

The concept of multidisciplinary interoperability for managing societal issues is a major challenge presently faced by the Earth and Space Science Informatics community. With this in mind, EuroGEOSS project was launched on May 1st 2009 for a three year period aiming to demonstrate the added value to the scientific community and society of providing existing earth observing systems and applications in an interoperable manner and used within the GEOSS and INSPIRE frameworks. In the first period, the project built an Initial Operating Capability (IOC) in the three strategic areas of Drought, Forestry and Biodiversity; this was then enhanced into an Advanced Operating Capacity (AOC) for multidisciplinary interoperability. Finally, the project extended the infrastructure to other scientific domains (geology, hydrology, etc.). The EuroGEOSS multidisciplinary AOC is based on the Brokering Approach. This approach aims to achieve multidisciplinary interoperability by developing an extended SOA (Service Oriented Architecture) where a new type of "expert" components is introduced: the Broker. These implement all mediation and distribution functionalities needed to interconnect the distributed and heterogeneous resources characterizing a System of Systems (SoS) environment. The EuroGEOSS AOC is comprised of the following components: • EuroGEOSS Discovery Broker: providing harmonized discovery functionalities by mediating and distributing user queries against tens of heterogeneous services; • EuroGEOSS Access Broker: enabling users to seamlessly access and use heterogeneous remote resources via a unique and standard service; • EuroGEOSS Web 2.0 Broker: enhancing the capabilities of the Discovery Broker with queries towards the new Web 2.0 services; • EuroGEOSS Semantic Discovery Broker: enhancing the capabilities of the Discovery Broker with semantic query-expansion; • EuroGEOSS Natural Language Search Component: providing users with the possibilities to search for resources using natural language queries; • Service Composition Broker: allowing users to compose and execute complex Business Processes, based on the technology developed by the FP7 UncertWeb project. Recently, the EuroGEOSS Brokering framework was presented at the GEO-VIII Plenary and Exhibition in Istanbul and introduced into the GEOSS Common Infrastructure.
Reducing Flood Impacts for Wellbeing of Arctic Communities through Collaboration among Community and Tribal Leaders, Scientists, and Emergency Man

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2016-12-01

In Alaska and the Sakha Republic (Siberia), multiple communities are exposed to flooding every spring. A bilateral and multidisciplinary team was established, as part of the U.S. State Department FY2015-16 U.S.-Russia Peer-to-Peer Dialogue Initiative, to conduct the project Reducing Spring Flood Impacts for Wellbeing of Communities of the North. The project comprised community-based participatory research, education, and cultural activities that used flood sites in Alaska and Siberia as case studies. A diverse and bilateral team (community leaders, scientists, students, and emergency managers) was established to share experiences and identify best practices in mitigating the risk of and improving response to floods.This science-community collaboration has inspired a dialogue between present and future decision makers and community residents. Preliminary analysis revealed that community members in both regions are interested in collaborations with scientists to reduce flood risks and impacts. They are eager to share their experiences. However, scientists have to earn the trust of and develop a rapport with local leaders beforehand. Conflicts arise when communities perceive scientists as governmental representatives due to the fact that most scientific funds come from federal and state grants. Scientists are also held responsible for disasters, due to their roles in disaster forecasting and warnings. In both regions, impacted populations often blame the government for flood impacts; not unreasonably. Originally nomadic, native populations were forced to settle in floodplains by governments. Now, exposed to floods, they regard damage reimbursement as a predominantly governmental responsibility. Scientists can offer long-term solutions that would benefit communities at risk and governmental entities. However, it is important for scientists not to impose solutions, but instead initiate and maintain a dialogue about alternatives, especially as sensitive as relocation.
The social marketing approach: a way to increase reporting and treatment of sexual assault.

PubMed

Boehm, Amnon; Itzhaky, Haya

2004-03-01

Too often communities remain silent in response to cases of sexual assault of children. Members of the community are afraid to report such incidents and victims are reluctant to seek and accept treatment. The purpose of the paper is to examine whether application of a social marketing approach may serve as an effective means for motivating communities to report and victims to seek professional treatment. The paper is based on a case study of an ultra-orthodox Jewish community in Israel, where an informal campaign of silence developed. Using content analysis of documents and in-depth interviews, the research examines the implementation of a social marketing approach by a multidisciplinary team of professionals in the community. It focuses on developments in the community's attitude to sexual abuse, especially with regard to reporting assault and seeking and accepting treatment. The findings show a considerable reduction in the fear that victims and other members of the community felt with regard to exposing the issue; a change among the community leaders, some of whom initially objected to reporting and treatment; introduction of an alternative community dialogue that advocated reporting and treatment; and a rise in the number of reports and of people in treatment. The paper recommends the integration of principles of social marketing in community programs aimed at dealing with sexual assault. In particular, it suggests the identification of competing groups in the community, construction of specific programs for different segments, addressing the no-monetary prices that the change may incur on the different groups, location of appropriate places for distribution of messages, and use of effective personal, as well as public means of communication and promotion.
Multidisciplinary Design, Analysis, and Optimization Tool Development Using a Genetic Algorithm

NASA Technical Reports Server (NTRS)

Pak, Chan-gi; Li, Wesley

2009-01-01

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

NASA Technical Reports Server (NTRS)

Berton, Jeffrey J.

2016-01-01

Acoustic treatment designers have long been able to target specific noise sources inside turbofan engines. Facesheet porosity and cavity depth are key design variables of perforate-over-honeycomb liners that determine levels of noise suppression as well as the frequencies at which suppression occurs. Layers of these structures can be combined to create a robust attenuation spectrum that covers a wide range of frequencies. Looking to the future, rapidly-emerging additive manufacturing technologies are enabling new liners with multiple degrees of freedom, and new adaptive liners with variable impedance are showing promise. More than ever, there is greater flexibility and freedom in liner design. Subject to practical considerations, liner design variables may be manipulated to achieve a target attenuation spectrum. But characteristics of the ideal attenuation spectrum can be difficult to know. Many multidisciplinary system effects govern how engine noise sources contribute to community noise. Given a hardwall fan noise source to be suppressed, and using an analytical certification noise model to compute a community noise measure of merit, the optimal attenuation spectrum can be derived using multidisciplinary systems analysis methods. The subject of this paper is an analytical method that derives the ideal target attenuation spectrum that minimizes noise perceived by observers on the ground.
Membership and management: structures of inter-professional working in community mental health teams for older people in England.

PubMed

Wilberforce, Mark; Tucker, Sue; Abendstern, Michele; Brand, Christian; Giebel, Clarissa Marie; Challis, David

2013-09-01

Community mental health services are regarded as the preferred first tier of specialist psychogeriatric support, with integrated multidisciplinary teams believed to offer improved decision-making and greater continuity of care than separate single-profession services. In England over 400 community mental health teams (CMHTs) form the cornerstone of such support, yet research has neither assessed progress toward integrating key professional disciplines nor the nature of their membership and management arrangements. A self-administered questionnaire was sent to all CMHTs for older people in England, seeking a combination of objective and subjective information on team structure and management. Responses from 376 (88%) teams highlighted broader multidisciplinary membership than found in a 2004 survey, with particular growth in the number of support workers and other unqualified practitioners. Only modest progress was found in the integration of psychologists and social workers within CMHTs. The data also revealed a trend toward "core" team membership, and away from "sessional" membership in which staff may have divided loyalties between services. Multidisciplinary working was reported as beneficial by many respondents, but examples of "silo working" were also found, which may have hampered service delivery in a minority of teams. The reported growth in the number of practitioners without professional registration raises issues about the appropriate skill mix and substitution within CMHTs, while local agencies should review barriers to the integration of psychologists and social workers. Further research is required to explore the quality of multidisciplinary team working.
Evidence of community structure in biomedical research grant collaborations.

PubMed

Nagarajan, Radhakrishnan; Kalinka, Alex T; Hogan, William R

2013-02-01

Recent studies have clearly demonstrated a shift towards collaborative research and team science approaches across a spectrum of disciplines. Such collaborative efforts have also been acknowledged and nurtured by popular extramurally funded programs including the Clinical Translational Science Award (CTSA) conferred by the National Institutes of Health. Since its inception, the number of CTSA awardees has steadily increased to 60 institutes across 30 states. One of the objectives of CTSA is to accelerate translation of research from bench to bedside to community and train a new genre of researchers under the translational research umbrella. Feasibility of such a translation implicitly demands multi-disciplinary collaboration and mentoring. Networks have proven to be convenient abstractions for studying research collaborations. The present study is a part of the CTSA baseline study and investigates existence of possible community-structure in Biomedical Research Grant Collaboration (BRGC) networks across data sets retrieved from the internally developed grants management system, the Automated Research Information Administrator (ARIA) at the University of Arkansas for Medical Sciences (UAMS). Fastgreedy and link-community community-structure detection algorithms were used to investigate the presence of non-overlapping and overlapping community-structure and their variation across years 2006 and 2009. A surrogate testing approach in conjunction with appropriate discriminant statistics, namely: the modularity index and the maximum partition density is proposed to investigate whether the community-structure of the BRGC networks were different from those generated by certain types of random graphs. Non-overlapping as well as overlapping community-structure detection algorithms indicated the presence of community-structure in the BRGC network. Subsequent, surrogate testing revealed that random graph models considered in the present study may not necessarily be appropriate generative mechanisms of the community-structure in the BRGC networks. The discrepancy in the community-structure between the BRGC networks and the random graph surrogates was especially pronounced at 2009 as opposed to 2006 indicating a possible shift towards team-science and formation of non-trivial modular patterns with time. The results also clearly demonstrate presence of inter-departmental and multi-disciplinary collaborations in BRGC networks. While the results are presented on BRGC networks as a part of the CTSA baseline study at UAMS, the proposed methodologies are as such generic with potential to be extended across other CTSA organizations. Understanding the presence of community-structure can supplement more traditional network analysis as they're useful in identifying research teams and their inter-connections as opposed to the role of individual nodes in the network. Such an understanding can be a critical step prior to devising meaningful interventions for promoting team-science, multi-disciplinary collaborations, cross-fertilization of ideas across research teams and identifying suitable mentors. Understanding the temporal evolution of these communities may also be useful in CTSA evaluation. Copyright © 2012. Published by Elsevier Inc.
Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.

PubMed

Wyer, Peter; Stojanovic, Zorica; Shaffer, Jonathan A; Placencia, Mitzy; Klink, Kathleen; Fosina, Michael J; Lin, Susan X; Barron, Beth; Graham, Ian D

2016-04-01

Training programmes in evidence-based practice (EBP) frequently fail to translate their content into practice change and care improvement. We linked multidisciplinary training in EBP to an initiative to decrease 30-day readmissions among patients admitted to a community teaching hospital for heart failure (HF). Hospital staff reflecting all services and disciplines relevant to care of patients with HF attended a 3-day innovative capacity building conference in evidence-based health care over a 3-year period beginning in 2009. The team, facilitated by a conference faculty member, applied a knowledge-to-action model taught at the conference. We reviewed published research, profiled our population and practice experience, developed a three-phase protocol and implemented it in late 2010. We tracked readmission rates, adverse clinical outcomes and programme cost. The protocol emphasized patient education, medication reconciliation and transition to community-based care. Senior administration approved a full-time nurse HF coordinator. Thirty-day HF readmissions decreased from 23.1% to 16.4% (adjusted OR = 0.64, 95% CI = 0.42-0.97) during the year following implementation. Corresponding rates in another hospital serving the same population but not part of the programme were 22.3% and 20.2% (adjusted OR = 0.87, 95% CI = 0.71-1.08). Adherence to mandated HF quality measures improved. Following a start-up cost of $15 000 US, programme expenses balanced potential savings from decreased HF readmissions. Training of a multidisciplinary hospital team in use of a knowledge translation model, combined with ongoing facilitation, led to implementation of a budget neutral programme that decreased HF readmissions. © 2015 John Wiley & Sons, Ltd.
The Role of Multiphysics Simulation in Multidisciplinary Analysis

NASA Technical Reports Server (NTRS)

Rifai, Steven M.; Ferencz, Robert M.; Wang, Wen-Ping; Spyropoulos, Evangelos T.; Lawrence, Charles; Melis, Matthew E.

1998-01-01

This article describes the applications of the Spectrum(Tm) Solver in Multidisciplinary Analysis (MDA). Spectrum, a multiphysics simulation software based on the finite element method, addresses compressible and incompressible fluid flow, structural, and thermal modeling as well as the interaction between these disciplines. Multiphysics simulation is based on a single computational framework for the modeling of multiple interacting physical phenomena. Interaction constraints are enforced in a fully-coupled manner using the augmented-Lagrangian method. Within the multiphysics framework, the finite element treatment of fluids is based on Galerkin-Least-Squares (GLS) method with discontinuity capturing operators. The arbitrary-Lagrangian-Eulerian method is utilized to account for deformable fluid domains. The finite element treatment of solids and structures is based on the Hu-Washizu variational principle. The multiphysics architecture lends itself naturally to high-performance parallel computing. Aeroelastic, propulsion, thermal management and manufacturing applications are presented.
Space Weather in the Machine Learning Era: A Multidisciplinary Approach

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

PubMed

Valentine-Maher, Sarah K; Van Dyk, Elizabeth J; Aktan, Nadine M; Bliss, Julie Beshore

2014-03-01

Nursing programs are challenged to prepare future nurses to provide care and affect determinants of health for individuals and populations. This article advances a pedagogical model for clinical education that builds concepts related to both population-level care and direct care in the community through a contextual learning approach. Because the conceptual pillars and hybrid constructivist approach allow for conceptual learning consistency across experiences, the model expands programmatic capacity to use diverse community clinical sites that accept only small numbers of students. The concept-based and hybrid constructivist learning approach is expected to contribute to the development of broad intellectual skills and lifelong learning. The pillar concepts include determinants of health and nursing care of population aggregates; direct care, based on evidence and best practices; appreciation of lived experience of health and illness; public health nursing roles and relationship to ethical and professional formation; and multidisciplinary collaboration. Copyright 2014, SLACK Incorporated.
The Third Air Force/NASA Symposium on Recent Advances in Multidisciplinary Analysis and Optimization

NASA Technical Reports Server (NTRS)

1990-01-01

The third Air Force/NASA Symposium on Recent Advances in Multidisciplinary Analysis and Optimization was held on 24-26 Sept. 1990. Sessions were on the following topics: dynamics and controls; multilevel optimization; sensitivity analysis; aerodynamic design software systems; optimization theory; analysis and design; shape optimization; vehicle components; structural optimization; aeroelasticity; artificial intelligence; multidisciplinary optimization; and composites.
What have we learned from reporting safety incidents in the Surgical Block?: Cross-sectional descriptive study of two-years of activity of a multidisciplinary analytical group.

PubMed

Caba Barrientos, F; Rodríguez Morillo, A; Galisteo Domínguez, R; Del Nozal Nalda, M; Almeida González, C V; Echevarría Moreno, M

2018-05-01

Incident Reporting Systems (IRS) are considered a tool that facilitates learning and safety culture. Using the experience gained with SENSAR, we evaluated the feasibility and the activity of a multidisciplinary group analyzing incidents in the surgical patient notified to a general community system, that of the Observatory for Patient Safety (OPS). Cross-sectional observational study planned for two years. After training in the analysis, a multidisciplinary group was created in terms of specialties and professional categories, which would analyze the incidents in the surgical patient notified to the OPS. Incidents are classified and their circumstances analyzed. Between March 2015 and 2017, 95 incidents were reported (4 by non-professionals). Doctors reported more than nurses, at 54 (56.84%) vs. 37 (38.94%). The anaesthesia unit reported most at 46 (48.42%) (P=.025). The types of incidents mainly related to the care procedure (30.52%); to the preoperative period (42.10%); and to the place, the surgical area (48.42%). Significant differences were detected according to the origin of the notifier (P=.03). No harm, or minor morbidity, constituted 88% of the incidents. Errors were identified in 79%. The analysis of the incidents directed the measures to be taken. The activity undertaken by the multidisciplinary analytical group during the period of study facilitated knowledge of the system among the professionals and enabled the identification of areas for improvement in the Surgical Block at different levels. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.
Asphalt Artisans: Creating a Community Eco-Map on the Playground.

ERIC Educational Resources Information Center

Fieldhouse, Paul; Bunkowsky, Lisa

2002-01-01

Describes an "eco-count" project that led to the creation of a community map and educational game being painted on an elementary school playground. The multidisciplinary project involved students, teachers, parents, and other community members and the resulting map includes sections related to the local "green environment", "built environment",…
Community Mental Health as a Population-based Mental Health Approach.

PubMed

Yuxuan Cai, Stefanie; Shuen Sheng Fung, Daniel

2016-01-01

Mental health services for youths in Singapore were challenged by accessibility and resource constraints. A community-based mental health program working with schools and other partners was developed to address the population needs. To describe the formation of a community-based mental health program and evaluate the program in terms of its outcome and the satisfaction of the users of this program. Based on needs analyses, a community multidisciplinary team was set up in 15 schools to pilot a new model of care for youths. Implemented progressively over five years, networks of teams were divided into four geographic zones. Each zone had clusters of 10 to 15 schools. These teams worked closely with school counselors. Teams were supported by a psychiatrist and a resident. Interventions were focused on empowering school-based personnel to work with students and families, with the support of the teams. 4,184 students were served of whom 10% were seen by the school counselors and supported by the community team. Only 0.15% required referral to tertiary services. Outcome measured by counselor and teacher ratings showed improvements in the Clinical Global Impression scale and Strengths and Difficulties Questionnaire. These included reductions in conduct problems, emotional problems, hyperactive behaviors and peer problems. Furthermore, prosocial behavior also significantly improved. Preliminary cost effectiveness analyses suggest that community treatments are superior to clinic interventions.

GRC RBCC Concept Multidisciplinary Analysis

NASA Technical Reports Server (NTRS)

Suresh, Ambady

2001-01-01

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

PubMed

Keene, J; Swift, L; Bailey, S; Janacek, G

2001-07-01

The paper describes results from the 'Tracking Project', a new method for examining agency overlap, repeat service use and shared clients/patients amongst social and health care agencies in the community. This is the first project in this country to combine total population databases from a range of social, health care and criminal justice agencies to give a multidisciplinary database for one county (n = 97,162 cases), through standardised anonymisation of agency databases, using SOUNDEX, a software programme. A range of 20 community social and health care agencies were shown to have a large overlap with each other in a two-year period, indicating high proportions of shared patients/clients. Accident and Emergency is used as an example of major overlap: 16.2% (n = 39,992) of persons who attended a community agency had attended Accident and Emergency as compared to 8.2% (n = 775,000) of the total population of the county. Of these, 96% who had attended seven or more different community agencies had also attended Accident and Emergency. Further statistical analysis of Accident and Emergency attendance as a characteristic of community agency populations (n = 39,992) revealed that increasing frequency of attendance at Accident and Emergency was very strongly associated with increasing use of other services. That is, the patients that repeatedly attend Accident and Emergency are much more likely to attend more other agencies, indicating the possibility that they share more problematic or difficult patients. Research questions arising from these data are discussed and future research methods suggested in order to derive predictors from the database and develop screening instruments to identify multiple agency attenders for targeting or multidisciplinary working. It is suggested that Accident and Emergency attendance might serve as an important predictor of multiple agency attendance.
Comparison of Two Multidisciplinary Optimization Strategies for Launch-Vehicle Design

NASA Technical Reports Server (NTRS)

Braun, R. D.; Powell, R. W.; Lepsch, R. A.; Stanley, D. O.; Kroo, I. M.

1995-01-01

The investigation focuses on development of a rapid multidisciplinary analysis and optimization capability for launch-vehicle design. Two multidisciplinary optimization strategies in which the analyses are integrated in different manners are implemented and evaluated for solution of a single-stage-to-orbit launch-vehicle design problem. Weights and sizing, propulsion, and trajectory issues are directly addressed in each optimization process. Additionally, the need to maintain a consistent vehicle model across the disciplines is discussed. Both solution strategies were shown to obtain similar solutions from two different starting points. These solutions suggests that a dual-fuel, single-stage-to-orbit vehicle with a dry weight of approximately 1.927 x 10(exp 5)lb, gross liftoff weight of 2.165 x 10(exp 6)lb, and length of 181 ft is attainable. A comparison of the two approaches demonstrates that treatment or disciplinary coupling has a direct effect on optimization convergence and the required computational effort. In comparison with the first solution strategy, which is of the general form typically used within the launch vehicle design community at present, the second optimization approach is shown to he 3-4 times more computationally efficient.
Unpacking Race, Culture, and Class in Rural Alaska: Native and Non-Native Multidisciplinary Professionals' Perceptions of Child Sexual Abuse

ERIC Educational Resources Information Center

Bubar, Roe; Bundy-Fazioli, Kimberly

2011-01-01

The purpose of this study was to unpack notions of class, culture, and race as they relate to multidisciplinary team (MDT) professionals and their perceptions of prevalence in child sexual abuse cases in Native and non-Native rural Alaska communities. Power and privilege within professional settings is significant for all social work professionals…
The Benefits of Multidisciplinary Learning in Clinical Practice for Law, Finance, and Social Work Students: An Australian Experience

ERIC Educational Resources Information Center

Hyams, Ross; Brown, Grace; Foster, Richard

2013-01-01

In July 2010, the faculties of Law, Business and Economics, and Medicine at Monash University, Australia commenced placing law, finance, and social work students in a multidisciplinary clinic at a community legal service operated by the University. Students from the three disciplines began seeing legal service clients at the same time as a team.…
Learning mechanisms in multidisciplinary teamwork with real customers and open-ended problems

NASA Astrophysics Data System (ADS)

Heikkinen, Juho; Isomöttönen, Ville

2015-11-01

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

PubMed

Marsilio, Marta; Torbica, Aleksandra; Villa, Stefano

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

PubMed

Oltra-Rodríguez, Enrique; Martínez-Riera, José Ramón; Mármol-López, María Isabel; Pastor-Gallardo, Francisco Javier; Gras-Nieto, Elvira; Holgado-Fernández, Ana

To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! Study): study protocol for a cluster randomised controlled trial.

PubMed

Abramsky, Tanya; Devries, Karen; Kiss, Ligia; Francisco, Leilani; Nakuti, Janet; Musuya, Tina; Kyegombe, Nambusi; Starmann, Elizabeth; Kaye, Dan; Michau, Lori; Watts, Charlotte

2012-06-29

Gender based violence, including violence by an intimate partner, is a major global human rights and public health problem, with important connections with HIV risk. Indeed, the elimination of sexual and gender based violence is a core pillar of HIV prevention for UNAIDS. Integrated strategies to address the gender norms, relations and inequities that underlie both violence against women and HIV/AIDS are needed. However there is limited evidence about the potential impact of different intervention models. This protocol describes the SASA! an evaluation of a community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda. The SASA! STUDY is a pair-matched cluster randomised controlled trial being conducted in eight communities in Kampala. It is designed to assess the community-level impact of the SASA! intervention on the following six primary outcomes: attitudes towards the acceptability of violence against women and the acceptability of a woman refusing sex (among male and female community members); past year experience of physical intimate partner violence and sexual intimate partner violence (among females); community responses to women experiencing violence (among women reporting past year physical/sexual partner violence); and past year concurrency of sexual partners (among males). 1583 women and men (aged 18-49 years) were surveyed in intervention and control communities prior to intervention implementation in 2007/8. A follow-up cross-sectional survey of community members will take place in 2012. The primary analysis will be an adjusted cluster-level intention to treat analysis, comparing outcomes in intervention and control communities at follow-up. Complementary monitoring and evaluation and qualitative research will be used to explore and describe the process of intervention implementation and the pathways through which change is achieved. This is one of few cluster randomised trials globally to assess the impact of a gender-focused community mobilisation intervention. The multi-disciplinary research approach will enable us to address questions of intervention impact and mechanisms of action, as well as its feasibility, acceptability and transferability to other contexts. The results will be of importance to researchers, policy makers and those working on the front line to prevent violence against women and HIV. ClinicalTrials.Gov NCT00790959.
A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! Study): study protocol for a cluster randomised controlled trial

PubMed Central

2012-01-01

Background Gender based violence, including violence by an intimate partner, is a major global human rights and public health problem, with important connections with HIV risk. Indeed, the elimination of sexual and gender based violence is a core pillar of HIV prevention for UNAIDS. Integrated strategies to address the gender norms, relations and inequities that underlie both violence against women and HIV/AIDS are needed. However there is limited evidence about the potential impact of different intervention models. This protocol describes the SASA! Study: an evaluation of a community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda. Methods/Design The SASA! Study is a pair-matched cluster randomised controlled trial being conducted in eight communities in Kampala. It is designed to assess the community-level impact of the SASA! intervention on the following six primary outcomes: attitudes towards the acceptability of violence against women and the acceptability of a woman refusing sex (among male and female community members); past year experience of physical intimate partner violence and sexual intimate partner violence (among females); community responses to women experiencing violence (among women reporting past year physical/sexual partner violence); and past year concurrency of sexual partners (among males). 1583 women and men (aged 18–49 years) were surveyed in intervention and control communities prior to intervention implementation in 2007/8. A follow-up cross-sectional survey of community members will take place in 2012. The primary analysis will be an adjusted cluster-level intention to treat analysis, comparing outcomes in intervention and control communities at follow-up. Complementary monitoring and evaluation and qualitative research will be used to explore and describe the process of intervention implementation and the pathways through which change is achieved. Discussion This is one of few cluster randomised trials globally to assess the impact of a gender-focused community mobilisation intervention. The multi-disciplinary research approach will enable us to address questions of intervention impact and mechanisms of action, as well as its feasibility, acceptability and transferability to other contexts. The results will be of importance to researchers, policy makers and those working on the front line to prevent violence against women and HIV. Trial registration ClinicalTrials.Gov NCT00790959 PMID:22747846
Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources.

PubMed

Abdelaziz, Adel; Hany, Mohamed; Atwa, Hani; Talaat, Wagdy; Hosny, Somaya

2016-01-01

In ordinary circumstances, objective structured clinical examination (OSCE) is a resource-intensive assessment method. In case of developing and implementing multidisciplinary OSCE, there is no doubt that the cost will be greater. Through this study a research project was conducted to develop, implement and evaluate a multidisciplinary OSCE model within limited resources. This research project went through the steps of blueprinting, station writing, resources reallocation, implementation and finally evaluation. The developed model was implemented in the Primary Health Care (PHC) program which is one of the pillars of the Community-Based undergraduate curriculum of the Faculty of Medicine, Suez Canal University (FOM-SCU). Data for evaluation of the implemented OSCE model were derived from two resources. First, feedback of the students and assessors through self-administered questionnaires was obtained. Second, evaluation of the OSCE psychometrics was done. The deliverables of this research project included a set of validated integrated multi-disciplinary and low cost OSCE stations with an estimated reliability index of 0.6. After having this experience, we have a critical mass of faculty members trained on blueprinting and station writing and a group of trained assessors, facilitators and role players. Also there is a state of awareness among students on how to proceed in this type of OSCE which renders future implementation more feasible.
Reaping the harvest: nursing student service involvement with a campus gardening project.

PubMed

Ahonen, Kathleen; Lee, Carolyn; Daker, Emily

2012-01-01

The authors describe the development and incorporation of a multidisciplinary community garden as a service project in a baccalaureate nursing cohort in an urban university. The concepts of professional ethics and service, application of nutritional theory to a community cohort, and competencies in community health nursing are briefly discussed and applied to this service project.
A Multidisciplinary Tool for Systems Analysis of Planetary Entry, Descent, and Landing (SAPE)

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

2009-01-01

SAPE is a Python-based multidisciplinary analysis tool for systems analysis of planetary entry, descent, and landing (EDL) for Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune, and Titan. The purpose of SAPE is to provide a variable-fidelity capability for conceptual and preliminary analysis within the same framework. SAPE includes the following analysis modules: geometry, trajectory, aerodynamics, aerothermal, thermal protection system, and structural sizing. SAPE uses the Python language-a platform-independent open-source software for integration and for the user interface. The development has relied heavily on the object-oriented programming capabilities that are available in Python. Modules are provided to interface with commercial and government off-the-shelf software components (e.g., thermal protection systems and finite-element analysis). SAPE runs on Microsoft Windows and Apple Mac OS X and has been partially tested on Linux.
Boston children's hospital community asthma initiative: Five-year cost analyses of a home visiting program.

PubMed

Bhaumik, Urmi; Sommer, Susan J; Giller-Leinwohl, Judith; Norris, Kerri; Tsopelas, Lindsay; Nethersole, Shari; Woods, Elizabeth R

2017-03-01

To evaluate the costs and benefits of the Boston Children's Hospital Community Asthma Initiative (CAI) through reduction of Emergency Department (ED) visits and hospitalizations for the full pilot-phase program participants. A cost-benefit analyses was conducted using hospital administrative data to determine an adjusted Return on Investment (ROI): on all 268 patients enrolled in the CAI program during the 33-month pilot program phase of CAI intervention between October 1, 2005 and June 30, 2008 using a comparison group of 818 patients from a similar cohort in neighboring ZIP codes without CAI intervention. Cost data through June 30, 2013 were used to examine cost changes and calculate an adjusted ROI over a 5-year post-intervention period. CAI patients had a cost reduction greater than the comparison group of $1,216 in Year 1 (P = 0.001), $1,320 in Year 2 (P < 0.001), $1,132 (P = 0.002) in Year 3, $1,123 (P = 0.004) in Year 4, and $997 (P = 0.022) in Year 5. Adjusting for the cost savings for the comparison group, the cost savings from the intervention resulted in an adjusted ROI of 1.91 over 5 years. Community-based, multidisciplinary, coordinated disease management programs can decrease the incidence of costly hospitalizations and ED visits from asthma. An ROI of greater than one, as found in this cost analysis, supports the business case for the provision of community-based asthma services as part of patient-centered medical homes and Accountable Care Organizations.
Effectiveness of a health promotion programme for farmers and fishermen with type-2 diabetes in Taiwan.

PubMed

Chen, Mei-Yen; Huang, Wei-Chao; Peng, Yun-Shing; Guo, Jing-Song; Chen, Chia-Pei; Jong, Ming-Chung; Lin, Hui-Chuan

2011-09-01

This paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme. Improving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations. A quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period. Most of the participants were fishermen or farmers who had <6 years of education (79%) and were elders (68·9 ± 9·5 years). Most of the physiological variables and foot self-care capabilities showed statistically significant improvement after the programme. Furthermore, 37 participants with severe high risk of diabetic foot accepted additional referral treatments, and their peripheral nerve and vascular functions improved. The research outcomes support the value of community-based health promotion programmes in rural areas, incorporating a multidisciplinary health team and culturally competent materials to help the elder rural inhabitants with diabetes enjoy better health and quality of life. © 2011 Blackwell Publishing Ltd.
EMSO: European multidisciplinary seafloor observatory

NASA Astrophysics Data System (ADS)

Favali, Paolo; Beranzoli, Laura

2009-04-01

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

NASA Technical Reports Server (NTRS)

Salas, A. O.; Townsend, J. C.

1999-01-01

Frameworks or problem solving environments that support application development form an active area of research. The Multidisciplinary Optimization Branch at NASA Langley Research Center is investigating frameworks for supporting multidisciplinary analysis and optimization research. The Branch has generated a list of framework requirements, based on the experience gained from the Framework for Interdisciplinary Design Optimization project and the information acquired during a framework evaluation process. In this study, four existing frameworks are examined against these requirements. The results of this examination suggest several topics for further framework research.
Community Engaged Leadership to Advance Health Equity and Build Healthier Communities

PubMed Central

Holden, Kisha; Akintobi, Tabia; Hopkins, Jammie; Belton, Allyson; McGregor, Brian; Blanks, Starla; Wrenn, Glenda

2016-01-01

Health is a human right. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential. Addressing the multi-faceted health needs of ethnically and culturally diverse individuals in the United States is a complex issue that requires inventive strategies to reduce risk factors and buttress protective factors to promote greater well-being among individuals, families, and communities. With growing diversity concerning various ethnicities and nationalities; and with significant changes in the constellation of multiple of risk factors that can influence health outcomes, it is imperative that we delineate strategic efforts that encourage better access to primary care, focused community-based programs, multi-disciplinary clinical and translational research methodologies, and health policy advocacy initiatives that may improve individuals’ longevity and quality of life. PMID:27713839
Lithospheric Structure and Dynamics: Insights Facilitated by the IRIS/PASSCAL Facility

NASA Astrophysics Data System (ADS)

Meltzer, A.

2002-12-01

Through the development of community-based facilities in portable array seismology, a wide-range of seismic methods are now standard tools for imaging the Earth's interior, extending geologic observations made at the surface to depth. The IRIS/PASSCAL program provides the seismological community with the ability to routinely field experimental programs, from high-resolution seismic reflection profiling of the near surface to lithospheric scale imaging with both active and passive source arrays, to understand the tectonic evolution of continents, how they are assembled, disassembled, and modified through time. As our ability to record and process large volumes of data has improved we have moved from simple 1-D velocity models and 2-D structural cross sections of the subsurface to 3-D and 4-D images to correlate complex surface tectonics to processes in the Earth's interior. Data from individual IRIS/PASSCAL experiments has fostered multidisciplinary studies, bringing together geologists, geochemists, and geophysicists to work together on common problems. As data is collected from a variety of tectonic environments around the globe common elements begin to emerge. We now recognize and study the inherent lateral and vertical heterogeneity in the crust and mantle lithosphere and its role in controlling deformation, the importance of low velocity mobile mantle in supporting topography, and the importance of fluids and fluid migration in magmatic and deformational processes. We can image and map faults, fault zones, and fault networks to study them as systems rather than isolated planes of deformation to better understand earthquake nucleation, rupture, and propagation. An additional benefit of these community-based facilities is the pooling of resources to develop effective and sustainable education and outreach programs. These programs attract new students to pursue careers in earth science, engage the general public in the scientific enterprise, raise the profile of the earth sciences, and reveal the importance of earth processes in shaping the environment in which we live. Future challenges facing our community include continued evolution of existing facilities to keep pace with scientific inquiry, routinely utilizing fully 3-D and where appropriate 4-D data sets to understand earth structure and dynamics, and the manipulation, and analysis of large multidisciplinary data sets. Community models should be considered as a mechanism to integrate, analyze, and share data and results within a process oriented framework. Exciting developments on the horizon include EarthScope. To maximize the potential for significant advances in our understanding of tectonic processes, observations from new EarthScope facilities must be integrated with additional geologic data sets of similar quality and resolution. New real-time data streams combined with new data integration, analysis, and visualization tools will provide us with the ability to integrate data across a continuous range of spatial scales providing a new and coherent view of lithospheric dynamics from local to plate scale.
Exploring Methodologies and Indicators for Cross-disciplinary Applications

NASA Astrophysics Data System (ADS)

Bernknopf, R.; Pearlman, J.

2015-12-01

Assessing the impact and benefit of geospatial information is a multidisciplinary task that involves the social, economic and environmental knowledge to formulate indicators and methods. There are use cases that couple the social sciences including economics, psychology, sociology that incorporate geospatial information. Benefit - cost analysis is an empirical approach that uses money as an indicator for decision making. It is a traditional base for a use case and has been applied to geospatial information and other areas. A new use case that applies indicators is Meta Regression analysis, which is used to evaluate transfers of socioeconomic benefits from different geographic regions into a unifying statistical approach. In this technique, qualitative and quantitative variables are indicators, which provide a weighted average of value for the nonmarket good or resource over a large region. The expected willingness to pay for the nonmarket good can be applied to a specific region. A third use case is the application of Decision Support Systems and Tools that have been used for forecasting agricultural prices and analysis of hazard policies. However, new methods for integrating these disciplines into use cases, an avenue to instruct the development of operational applications of geospatial information, are needed. Experience in one case may not be broadly transferable to other uses and applications if multiple disciplines are involved. To move forward, more use cases are needed and, especially, applications in the private sector. Applications are being examined across a multidisciplinary community for good examples that would be instructive in meeting the challenge. This presentation will look at the results of an investigation into directions in the broader applications of use cases to teach the methodologies and use of indicators that have applications across fields of interest.

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

PubMed

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

2015-11-01

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

PubMed

Baquet, Claudia R; Mack, Kelly M; Mishra, Shiraz I; Bramble, Joy; Deshields, Mary; Datcher, Delores; Savoy, Mervin; Brooks, Sandra E; Boykin-Brown, Stephanie; Hummel, Kery

2006-10-15

The unequal burden of cancer in minority and underserved communities nationally and in Maryland is a compelling crisis. The Maryland Special Populations Cancer Research Network (MSPN) developed an infrastructure covering Maryland's 23 jurisdictions and Baltimore City through formal partnerships between the University of Maryland School of Medicine, University of Maryland Statewide Health Network, University of Maryland Eastern Shore, and community partners in Baltimore City, rural Eastern Shore, rural Western Maryland, rural Southern Maryland, and Piscataway Conoy Tribe and statewide American Indians. Guided by the community-based participatory framework, the MSPN undertook a comprehensive assessment (of needs, strengths, and resources available) that laid the foundation for programmatic efforts in community-initiated cancer awareness and education, research, and training. The MSPN infrastructure was used to implement successful and innovative community-based cancer education interventions and technological solutions; conduct education and promotion of clinical trials, cancer health disparities research, and minority faculty cancer research career development; and leverage additional resources for sustainability. MSPN engaged in informed advocacy among decision- and policymakers at state and national levels, and its community-based clinical trials program was recognized by the U.S. Department of Health and Human Services as a Best Practice Award. The solutions to reduce and eliminate cancer health disparities are complex and require comprehensive and focused multidisciplinary cancer health disparities research, training, and education strategies implemented through robust community-academic partnerships. Cancer 2006. (c) American Cancer Society.
Effectiveness of place-based science curriculum projects situated in Hawaiian and Western cultural institutions at an urban high school in Hawai'i

NASA Astrophysics Data System (ADS)

Kuwahara, Jennifer Leslie Hoof

Place-based education is a multidisciplinary and experiential approach to learning that utilizes a local environment or community. This study examined the influences of place attachment and cultural affiliation in the school on student experience and learning in a place-based science course, as well as the course's potential influence on environmentally responsible behaviors. The participants attended an urban high school on O'ahu, Hawai'i. By understanding student reaction to experience in both Western- and Hawaiian-centered classes, this study contributes to the literature on place-based education in relation to how differences in cultural affiliation in a school setting can have varying impacts on place attachment, science literacy, and environmental responsibility. A comparative case study was conducted with students enrolled in the Hawaiian Academy and non-academy students. Analysis of a pre- and post-survey and science content assessments, student documents, field notes, and interview transcripts suggested place-based science has both similar and different impacts on students depending on cultural affiliation within the school. Students in the Hawaiian Academy, as a whole, showed stronger science literacy and environmental responsibility than students in the non-Hawaiian Academy class. However, non-Hawaiian Academy students showed increased place attachment in a spiritual sense. Reactions from both groups suggest a need for smaller learning communities that promote a unity of knowledge rather than distinct courses and disciplines.
Bacterial community characterization and biogeochemistry of sediments from a tropical upwelling system (Cabo Frio, Southeastern Brazil)

NASA Astrophysics Data System (ADS)

Castelo-Branco, R.; Barreiro, A.; Silva, F. S.; Carvalhal-Gomes, S. B. V.; Fontana, L. F.; Mendonça-Filho, J. G.; Vasconcelos, V.

2016-11-01

The Cabo Frio Upwelling System is one of the largest and most productive areas in southeastern Brazil. Although it is well-known that bacterial communities play a crucial role in the biogeochemical cycles and food chain of marine ecosystems, little is known regarding the microbial communities in the sediments of this upwelling region. In this research, we address the effect of different hydrological conditions on the biogeochemistry of sediments and the diversity of bacterial communities. Biogeochemistry profiles of sediments from four sampling stations along an inner-outer transect on the continental shelf were evaluated and denaturing gradient gel electrophoresis (DGGE) of PCR-amplified 16S rRNA gene fragments was used to study the bacterial community composition in these sediments. Our sequencing analysis of excised bands identified Alpha- and Gammaproteobacteria, Bacteroidetes and bacteria belonging to the Firmicutes phyla as the phylogenetic groups, indicating the existence of great diversity in these marine sediments. In this multidisciplinary study, the use of multivariate analysis was crucial for understanding how biogeochemical profiles influence bacterial community distribution. A Principal Component Analysis (PCA) indicated that the biogeochemical variables exhibited a clear spatial pattern that is mainly related to hydrological conditions. A Correspondence Analysis (CA) revealed an important association between certain taxonomic groups and specific sampling locations. Canonical Correspondence Analysis (CCA) demonstrated that the biogeochemistry influences the structure of the bacterial community in sediments. Among the bacterial groups identified, the most taxonomically diverse classes (Alphaproteobacteria and Gammaproteobacteria) were found to be distributed regardless of any studied biogeochemical variables influences, whereas other groups responded to biogeochemical conditions which, in turn, were influenced by hydrological conditions. This finding was observed for members of the two classes in the Bacteroidetes phylum, which were associated with either proteins or carbohydrates.
The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care.

PubMed

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

2018-03-10

In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success. A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used. With these four teams, consisting of 46 health care and social service professionals, we carried out two rounds of focus-group interviews. Moreover, we performed semi-structured interviews with four GPs. We analysed data using a hybrid inductive/deductive thematic analysis. According to the health care and social service professionals in our study, the role of GPs in multidisciplinary teams for elderly care was characterized by the ability to 'see the bigger picture'. We identified five key activities that constitute a successful GP role: networking, facilitating, team building, integrating care elements, and showing leadership. Practice setting and phase of multidisciplinary team development influenced the way in which GPs fulfilled their roles. According to team members, GPs were the central professionals in care services for older people. The opinions of GPs about their own roles were diverse. GPs took an important role in successful care settings for older people. Five key concepts seemed to be important for best practices in care for frail older people: networking (community), facilitating (organization), team building (professional), integrating care elements (patient), and leadership (personal). Team members from primary care and social services indicated that GPs had an indispensable role in such teams. It would be advantageous for GPs to be aware of this attributed role. Attention to leadership competencies and to the diversity of roles in multidisciplinary teams in GP training programmes seems useful. The challenge is to convince GPs to take a lead, also when they are not inclined to take this role in organizing multidisciplinary teams for older people.
Hacking Hackathons: Preparing the next generation for the multidisciplinary world of healthcare technology.

PubMed

Lyndon, Mataroria P; Cassidy, Michael P; Celi, Leo Anthony; Hendrik, Luk; Kim, Yoon Jeon; Gomez, Nicholas; Baum, Nathaniel; Bulgarelli, Lucas; Paik, Kenneth E; Dagan, Alon

2018-04-01

Machine learning in healthcare, and innovative healthcare technology in general, require complex interactions within multidisciplinary teams. Healthcare hackathons are being increasingly used as a model for cross-disciplinary collaboration and learning. The aim of this study is to explore high school student learning experiences during a healthcare hackathon. By optimizing their learning experiences, we hope to prepare a future workforce that can bridge technical and health fields and work seamlessly across disciplines. A qualitative exploratory study utilizing focus group interviews was conducted. Eight high school students from the hackathon were invited to participate in this study through convenience sampling Participating students (n = 8) were allocated into three focus groups. Semi structured interviews were completed, and transcripts evaluated using inductive thematic analysis. Through the structured analysis of focus group transcripts three major themes emerged from the data: (1) Collaboration, (2) Transferable knowledge and skills, and (3) Expectations about hackathons. These themes highlight strengths and potential barriers when bringing this multidisciplinary approach to high school students and the healthcare community. This study found that students were empowered by the interdisciplinary experience during a hackathon and felt that the knowledge and skills gained could be applied in real world settings. However, addressing student expectations of hackathons prior to the event is an area for improvement. These findings have implications for future hackathons and can spur further research into using the hackathon model as an educational experience for learners of all ages. Copyright © 2018 Elsevier B.V. All rights reserved.
A mycological baseline study based on a multidisciplinary approach in a coastal area affected by contaminated torrent input.

PubMed

Capello, M; Carbone, C; Cecchi, G; Consani, S; Cutroneo, L; Di Piazza, S; Greco, G; Tolotti, R; Vagge, G; Zotti, M

2017-06-15

Fungi include a vast group of eukaryotic organisms able to colonise different natural, anthropised and extreme environments, including marine areas contaminated by metals. The present study aims to give a first multidisciplinary characterisation of marine bottom sediments contaminated by metals (Cd, Co, Cr, Cu, Ni, and Zn), originating in the water leakage from an abandoned Fe-Cu sulphide mine (Libiola, north-western Italy), and evaluate how the chemical and physical parameters of water and sediments may affect the benthic fungal communities. Our preliminary results showed the high mycodiversity of the marine sediments studied (13 genera and 23 species of marine fungi isolated), and the great physiological adaptability that this mycobiota evolved in reaction to the effects of the ecotoxic bottom sediment contamination, and associated changes in the seawater parameters. Copyright © 2017 Elsevier Ltd. All rights reserved.
Concept Analysis of Health Care Transition in Adolescents with Chronic Conditions.

PubMed

Ladores, Sigrid

2015-01-01

Children with chronic conditions are living into adulthood and present with unique needs. One such need is their transition from pediatric to adult health care. This paper examined the literature to analyze and synthesize the concept of transition within two contexts, health care and adolescents with chronic conditions. Fifty multidisciplinary sources were included for analysis. A refined, working definition of the concept of health care transition in adolescents with chronic conditions is presented. Results will enable the scientific community to discuss salient issues using well-defined, uniform terminology. Nursing implications are delineated to ensure that these youths thrive into adulthood. Copyright © 2015 Elsevier Inc. All rights reserved.
A Standard Platform for Testing and Comparison of MDAO Architectures

NASA Technical Reports Server (NTRS)

Gray, Justin S.; Moore, Kenneth T.; Hearn, Tristan A.; Naylor, Bret A.

2012-01-01

The Multidisciplinary Design Analysis and Optimization (MDAO) community has developed a multitude of algorithms and techniques, called architectures, for performing optimizations on complex engineering systems which involve coupling between multiple discipline analyses. These architectures seek to efficiently handle optimizations with computationally expensive analyses including multiple disciplines. We propose a new testing procedure that can provide a quantitative and qualitative means of comparison among architectures. The proposed test procedure is implemented within the open source framework, OpenMDAO, and comparative results are presented for five well-known architectures: MDF, IDF, CO, BLISS, and BLISS-2000. We also demonstrate how using open source soft- ware development methods can allow the MDAO community to submit new problems and architectures to keep the test suite relevant.
Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

PubMed

Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

2015-01-01

Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.
What fosters or prevents interprofessional teamworking in primary and community care? A literature review.

PubMed

Xyrichis, Andreas; Lowton, Karen

2008-01-01

The increase in prevalence of long-term conditions in Western societies, with the subsequent need for non-acute quality patient healthcare, has brought the issue of collaboration between health professionals to the fore. Within primary care, it has been suggested that multidisciplinary teamworking is essential to develop an integrated approach to promoting and maintaining the health of the population whilst improving service effectiveness. Although it is becoming widely accepted that no single discipline can provide complete care for patients with a long-term condition, in practice, interprofessional working is not always achieved. This review aimed to explore the factors that inhibit or facilitate interprofessional teamworking in primary and community care settings, in order to inform development of multidisciplinary working at the turn of the century. A comprehensive search of the literature was undertaken using a variety of approaches to identify appropriate literature for inclusion in the study. The selected articles used both qualitative and quantitative research methods. Following a thematic analysis of the literature, two main themes emerged that had an impact on interprofessional teamworking: team structure and team processes. Within these two themes, six categories were identified: team premises; team size and composition; organisational support; team meetings; clear goals and objectives; and audit. The complex nature of interprofessional teamworking in primary care meant that despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited; implications and recommendations for practice are discussed. These findings can inform development of current best practice, although further research needs to be conducted into multidisciplinary teamworking at both the team and organisation level, to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision.
Features and impacts of five multidisciplinary community-university research partnerships.

PubMed

King, Gillian; Servais, Michelle; Forchuk, Cheryl; Chalmers, Heather; Currie, Melissa; Law, Mary; Specht, Jacqueline; Rosenbaum, Peter; Willoughby, Teena; Kertoy, Marilyn

2010-01-01

Despite the increasing number of multidisciplinary community-university research partnerships designed to address real-world issues, little is known about their nature. This article describes the features and impacts of five research partnerships addressing health or social service issues, which constituted a convenience sample from the province of Ontario, Canada. The article describes their characteristics, ways of operating, outputs, types of requests received from community members and mid-term impacts. Requests directed to partnerships were tracked over a 10-month period in 2003 to 2004, using a research contact checklist, and 174 community members later completed an impact questionnaire capturing perceptions of the impacts of the partnerships on personal knowledge and research skill development, organisational/group access to and use of information, and community and organisational development. The data indicated that partnerships had similar priorities and magnitudes of mid-term impacts, yet differed in the scope of their partnering, realm of intended influence and the number of mechanisms used to engage and communicate with target audiences. The partnerships produced different types of outputs and received different types of requests from community members. The findings inform researchers about partnership diversity and help to establish more realistic expectations about the magnitude of partnerships' impacts.
Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes.

PubMed

Kibicho, Jennifer; Pinkerton, Steven D; Owczarzak, Jill; Mkandawire-Valhmu, Lucy; Kako, Peninnah M

2015-01-01

To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Cross-sectional study. Four Midwestern cities in the United States in August through October 2009. 28 community-based pharmacists practicing in 17 pharmacies. Interviews. Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.
Framework for Multidisciplinary Analysis, Design, and Optimization with High-Fidelity Analysis Tools

NASA Technical Reports Server (NTRS)

Orr, Stanley A.; Narducci, Robert P.

2009-01-01

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

PubMed

Moran, Anna; Nancarrow, Susan A; Enderby, Pamela

2015-07-01

This research aims to describe the factors associated with successful employment of allied health and social care assistants in community-based rehabilitation services (CBRS) in England. The research involved the thematic analysis of interviews and focus groups with 153 professionally qualified and assistant staff from 11 older people's interdisciplinary community rehabilitation teams. Data were collected between November 2006 and December 2008. Assistants were perceived as a focal point for care delivery and conduits for enabling a service to achieve goals within interdisciplinary team structures. Nine mechanisms were identified that promoted the successful employment of assistants: (i) Multidisciplinary team input into assistant training and support; (ii) Ensuring the timely assessment of clients by qualified staff; (iii) Establishing clear communication structures between qualified and assistant staff; (iv) Co-location of teams to promote communication and skill sharing; (v) Removing barriers that prevent staff working to their full scope of practice; (vi) Facilitating role flexibility of assistants, while upholding the principles of reablement; (vii) Allowing sufficient time for client-staff interaction; (viii) Ensuring an appropriate ratio of assistant to qualified staff to enable sufficient training and supervision of assistants; and (ix) Appropriately, resourcing the role for training and reimbursement to reflect responsibility. We conclude that upholding these mechanisms may help to optimise the efficiency and productivity of assistant and professionally qualified staff in CBRS. © 2014 John Wiley & Sons Ltd.
Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes

PubMed Central

Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L.; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

2016-01-01

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team’s processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team’s self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR. PMID:27429512
Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

PubMed

Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

2015-11-01

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.
Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia.

PubMed

Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F

2014-09-01

Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.
Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

PubMed

Baum, Fran; Freeman, Toby; Jolley, Gwyn; Lawless, Angela; Bentley, Michael; Värttö, Kaisu; Boffa, John; Labonte, Ronald; Sanders, David

2014-12-01

This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Effectiveness of multidisciplinary therapy on symptomatology and quality of life in women with fibromyalgia.

PubMed

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

2011-01-01

To study the effects of a 3-month multidisciplinary intervention based on exercise and psychological therapy on symptomatology and quality of life in women with fibromyalgia. Seventy-five women with fibromyalgia volunteered to participate and were allocated to a 3-month (3-times/week) multidisciplinary (pool, land-based and psychological session based on the Acceptance and Commitment Therapy) intervention (n=41), or to a usual care group (n=34). Sixty-five women with fibromyalgia completed the study protocol (n=33 multidisciplinary intervention, aged 51.4±7.4 years and n=32 usual care group, aged 50.0±7.3 years). The outcomes variables were Fibromyalgia Impact Questionnaire (FIQ), Short Form Health Survey 36 (SF-36), Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory and Rosenberg Self-Esteem Scale. We observed a significant interaction effect (group*time) for the FIQ total score, the subscales fatigue, stiffness, anxiety and depression, and the subscales of SF-36 physical role, bodily pain, vitality and social functioning. Post-hoc analysis revealed significant improvements in total score of FIQ (p<0.001), fatigue (p=0.001), stiffness (p<0.001), anxiety (p=0.011), depression (p=0.008), physical role (p=0.002), bodily pain (p<0.001), vitality (p<0.001) and social functioning (p<0.001) in the intervention group, whereas in the control group, there was a significant worsening in the subscale depression (p=0.006) and social functioning (p=0.019). A 3-month low-moderate intensity multidisciplinary intervention improved fibromyalgia symptomatology and quality of life in women with fibromyalgia.

Coupled multi-disciplinary simulation of composite engine structures in propulsion environment

NASA Technical Reports Server (NTRS)

Chamis, Christos C.; Singhal, Surendra N.

1992-01-01

A computational simulation procedure is described for the coupled response of multi-layered multi-material composite engine structural components which are subjected to simultaneous multi-disciplinary thermal, structural, vibration, and acoustic loadings including the effect of hostile environments. The simulation is based on a three dimensional finite element analysis technique in conjunction with structural mechanics codes and with acoustic analysis methods. The composite material behavior is assessed at the various composite scales, i.e., the laminate/ply/constituents (fiber/matrix), via a nonlinear material characterization model. Sample cases exhibiting nonlinear geometrical, material, loading, and environmental behavior of aircraft engine fan blades, are presented. Results for deformed shape, vibration frequency, mode shapes, and acoustic noise emitted from the fan blade, are discussed for their coupled effect in hot and humid environments. Results such as acoustic noise for coupled composite-mechanics/heat transfer/structural/vibration/acoustic analyses demonstrate the effectiveness of coupled multi-disciplinary computational simulation and the various advantages of composite materials compared to metals.
From user needs to system specifications: multi-disciplinary thematic seminars as a collaborative design method for development of health information systems.

PubMed

Scandurra, I; Hägglund, M; Koch, S

2008-08-01

This paper presents a new multi-disciplinary method for user needs analysis and requirements specification in the context of health information systems based on established theories from the fields of participatory design and computer supported cooperative work (CSCW). Whereas conventional methods imply a separate, sequential needs analysis for each profession, the "multi-disciplinary thematic seminar" (MdTS) method uses a collaborative design process. Application of the method in elderly homecare resulted in prototypes that were well adapted to the intended user groups. Vital information in the points of intersection between different care professions was elicited and a holistic view of the entire care process was obtained. Health informatics-usability specialists and clinical domain experts are necessary to apply the method. Although user needs acquisition can be time-consuming, MdTS was perceived to efficiently identify in-context user needs, and transformed these directly into requirements specifications. Consequently the method was perceived to expedite the entire ICT implementation process.
Social Network and Content Analysis of the North American Carbon Program as a Scientific Community of Practice

NASA Technical Reports Server (NTRS)

Brown, Molly E.; Ihli, Monica; Hendrick, Oscar; Delgado-Arias, Sabrina; Escobar, Vanessa M.; Griffith, Peter

2015-01-01

The North American Carbon Program (NACP) was formed to further the scientific understanding of sources, sinks, and stocks of carbon in Earth's environment. Carbon cycle science integrates multidisciplinary research, providing decision-support information for managing climate and carbon-related change across multiple sectors of society. This investigation uses the conceptual framework of com-munities of practice (CoP) to explore the role that the NACP has played in connecting researchers into a carbon cycle knowledge network, and in enabling them to conduct physical science that includes ideas from social science. A CoP describes the communities formed when people consistently engage in shared communication and activities toward a common passion or learning goal. We apply the CoP model by using keyword analysis of abstracts from scientific publications to analyze the research outputs of the NACP in terms of its knowledge domain. We also construct a co-authorship network from the publications of core NACP members, describe the structure and social pathways within the community. Results of the content analysis indicate that the NACP community of practice has substantially expanded its research on human and social impacts on the carbon cycle, contributing to a better understanding of how human and physical processes interact with one another. Results of the co-authorship social network analysis demonstrate that the NACP has formed a tightly connected community with many social pathways through which knowledge may flow, and that it has also expanded its network of institutions involved in carbon cycle research over the past seven years.
Building electronic forms for elderly program: integrated care model for high risk elders in Hong Kong.

PubMed

Yiu, Rex; Fung, Vicky; Szeto, Karen; Hung, Veronica; Siu, Ricky; Lam, Johnny; Lai, Daniel; Maw, Christina; Cheung, Adah; Shea, Raman; Choy, Anna

2013-01-01

In Hong Kong, elderly patients discharged from hospital are at high risk of unplanned readmission. The Integrated Care Model (ICM) program is introduced to provide continuous and coordinated care for high risk elders from hospital to community to prevent unplanned readmission. A multidisciplinary working group was set up to address the requirements on developing the electronic forms for ICM program. Six (6) forms were developed. These forms can support ICM service delivery for the high risk elders, clinical documentation, statistical analysis and information sharing.
Second Annual Transformative Vertical Flight Concepts Workshop: Enabling New Flight Concepts Through Novel Propulsion and Energy Architectures

NASA Technical Reports Server (NTRS)

Dudley, Michael R. (Editor); Duffy, Michael; Hirschberg, Michael; Moore, Mark; German, Brian; Goodrich, Ken; Gunnarson, Tom; Petermaier,Korbinian; Stoll, Alex; Fredericks, Bill;

2015-01-01

On August 3rd and 4th, 2015, a workshop was held at the NASA Ames Research Center, located at the Moffett Federal Airfield in California to explore the aviation communities interest in Transformative Vertical Flight (TVF) Concepts. The Workshop was sponsored by the AHS International (AHS), the American Institute of Aeronautics and Astronautics (AIAA), the National Aeronautics and Space Administration (NASA), and hosted by the NASA Aeronautics Research Institute (NARI). This second annual workshop built on the success and enthusiasm generated by the first TVF Workshop held in Washington, DC in August of 2014. The previous Workshop identified the existence of a multi-disciplinary community interested in this topic and established a consensus among the participants that opportunities to establish further collaborations in this area are warranted. The desire to conduct a series of annual workshops augmented by online virtual technical seminars to strengthen the TVF community and continue planning for advocacy and collaboration was a direct outcome of the first Workshop. The second Workshop organizers focused on four desired action-oriented outcomes. The first was to establish and document common stakeholder needs and areas of potential collaborations. This includes advocacy strategies to encourage the future success of unconventional vertiport capable flight concept solutions that are enabled by emerging technologies. The second was to assemble a community that can collaborate on new conceptual design and analysis tools to permit novel configuration paths with far greater multi-disciplinary coupling (i.e., aero-propulsive-control) to be investigated. The third was to establish a community to develop and deploy regulatory guidelines. This community would have the potential to initiate formation of an American Society for Testing and Materials (ASTM) F44 Committee Subgroup for the development of consensus-based certification standards for General Aviation scale vertiport capable flight systems. These standards need to accommodate novel fixed wing concepts that do not fit within the existing Federal Aviation Administration (FAA) rotorcraft certification framework (Code of Federal Regulations, Title 14, Chapter I, Subchapter C, Part 27). The fourth desired outcome was to launch an information campaign to ensure key U.S. Government agencies understand the potential benefits and industry interest in establishing new vertiport capable flight markets. This record of the Workshop proceedings documents Workshop activities and products including summaries of the video recorded technical presentations, overviews of three breakout sessions (Missions Operational Concepts, Prioritized Technical Challenges, Regulatory Roadmap), and a preliminary draft roadmap framework for TVF.

Towards multi-disciplinary HIV cure research: integrating social science with biomedical research

PubMed Central

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

2015-01-01

The quest for a cure for HIV remains a timely and key challenge for the HIV research community. Despite significant scientific advances, current HIV therapy regimens do not completely eliminate the negative impact of HIV on the immune system; and the economic impact of treating all people infected with HIV globally, for the duration of their lifetimes, presents significant challenges. This article discusses, from a multi-disciplinary approach, critical social, behavioral, ethical, and economic issues permeating the HIV cure research agenda. As part of a search for an HIV cure, both the perspective of patients/participants and clinical researchers should be taken into account. In addition, continued efforts should be made to involve and educate the broader community. PMID:26642901
Towards Multidisciplinary HIV-Cure Research: Integrating Social Science with Biomedical Research.

PubMed

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

2016-01-01

The quest for a cure for HIV remains a timely and key challenge for the HIV research community. Despite significant scientific advances, current HIV therapy regimens do not completely eliminate the negative impact of HIV on the immune system; and the economic impact of treating all people infected with HIV globally, for the duration of their lifetimes, presents significant challenges. This article discusses, from a multidisciplinary approach, critical social, behavioral, ethical, and economic issues permeating the HIV-cure research agenda. As part of a search for an HIV cure, both the perspective of patients/participants and clinical researchers should be taken into account. In addition, continued efforts should be made to involve and educate the broader community. Published by Elsevier Ltd.
Diabetes risk evaluation and microalbuminuria (DREAM) studies: ten years of participatory research with a First Nation's home and community model for type 2 diabetes care in Northern Saskatchewan.

PubMed

Pylypchuk, George; Vincent, Lloyd; Wentworth, Joan; Kiss, Alexander; Perkins, Nancy; Hartman, Susan; Ironstand, Laurie; Hoppe, Jacqueline; Tobe, Sheldon W

2008-06-01

To review the DREAM studies and the role of participatory research using a Home and Community Care model in treating First Nations diabetes. Population survey, pilot and prospective randomized trial Review documented history of these studies since inception. Collation of all data from the DREAM studies from 1998 to the present, including interviews with all providers and many of the participants. The DREAM studies were a participatory process providing a needs assessment and became the foundation for this First Nation's Home and Community Care team involvement in providing community-based chronic-disease management. The findings motivated the community to find a process that would lead to needed changes. This participatory research enabled a culturally tailored algorithm of evidence-based management of hypertension and disease management strategies for people with diabetes. These studies demonstrated that in this community the Home and Community Care team could work together with primary care physicians and specialists to prevent the complications of diabetes. The DREAM studies demonstrated in the first controlled trial that with participatory research a systems change is possible; a chronic-disease management model utilizing a trained multidisciplinary Home and Community Care team and informed patients can lead to lower blood pressure in a Canadian First Nations population with diabetes.
Multidisciplinary High-Fidelity Analysis and Optimization of Aerospace Vehicles. Part 2; Preliminary Results

NASA Technical Reports Server (NTRS)

Walsh, J. L.; Weston, R. P.; Samareh, J. A.; Mason, B. H.; Green, L. L.; Biedron, R. T.

2000-01-01

An objective of the High Performance Computing and Communication Program at the NASA Langley Research Center is to demonstrate multidisciplinary shape and sizing optimization of a complete aerospace vehicle configuration by using high-fidelity finite-element structural analysis and computational fluid dynamics aerodynamic analysis in a distributed, heterogeneous computing environment that includes high performance parallel computing. A software system has been designed and implemented to integrate a set of existing discipline analysis codes, some of them computationally intensive, into a distributed computational environment for the design of a high-speed civil transport configuration. The paper describes both the preliminary results from implementing and validating the multidisciplinary analysis and the results from an aerodynamic optimization. The discipline codes are integrated by using the Java programming language and a Common Object Request Broker Architecture compliant software product. A companion paper describes the formulation of the multidisciplinary analysis and optimization system.
The effect of a community mental health training program for multidisciplinary staff.

PubMed

Yang, Bing Xiang; Stone, Teresa E; Davis, Scott A

2018-06-01

Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles. A three-day community mental health training program was offered specifically for interdisciplinary mental health professionals. Using a one-group pre-test post-test design, participants completed a self-assessment of mental health concepts and program evaluation which included asking participants to rate their satisfaction using a five-point Likert scale and to respond to open-ended questions. Forty-eight participants including health professionals from colleges, hospital and community health centers were recruited. Only 8.7% of participants had ever received community mental health training. Post-test evaluation demonstrated improvements in knowledge, and most participants were very satisfied with the program. The findings indicate that this brief interdisciplinary training program had a positive effect in improving knowledge about community mental health concepts and confidence in dealing with people with mental health disorders for multidisciplinary staff working in primary health care areas. Copyright © 2017 Elsevier Inc. All rights reserved.
Public health initiatives in South Africa in the 1940s and 1950s: lessons for a post-apartheid era.

PubMed Central

Yach, D; Tollman, S M

1993-01-01

Inspiration drawn from South African public health initiatives in the 1940s played an important role in the development of the network of community and migrant health centers in the United States. The first such center at Pholela in Natal emphasized the need for a comprehensive (preventive and curative) service that based its practices on empirical data derived from epidemiological and anthropological research. In addition, community consultation preceded the introduction of new service or research initiatives. The Institute of Family and Community Health in Durban pioneered community-based multidisciplinary training and developed Pholela and other sites as centers for service, teaching, and research. Several important lessons for South African health professionals emerge from the Pholela experience. First, public health models of the past need to be reintroduced locally; second, the training of public health professionals needs to be upgraded and reoriented; third, appropriate research programs need to respond to community needs and address service demands; fourth, community involvement strategies need to be implemented early on; and fifth, funding sources for innovation in health service provision should be sought. Images p1044-a p1044-b p1045-a p1046-a p1046-b p1047-a PMID:8328604
User Interface Models for Multidisciplinary Bibliographic Information Dissemination Centers.

ERIC Educational Resources Information Center

Zipperer, W. C.

Two information dissemination centers at University of California at Los Angeles and University of Georgia studied the interactions between computer based search facilities and their users. The study, largely descriptive in nature, investigated the interaction processes between data base users and profile analysis or information specialists in…
RFID-Based Multidisciplinary Educational Platform to Improve the Engineering and Technology Curriculums

ERIC Educational Resources Information Center

Yelamarthi, Kumar

2012-01-01

Multidisciplinary projects involving electrical engineering (EE), mechanical engineering (ME), and computer engineering (CE) students are both exciting and difficult to conceptualize. Answering this challenge, this paper presents a multidisciplinary educational platform on radio frequency identification-based assistive devices. The combination of…
Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives.

PubMed

Kuruvilla, Lisha; Weeks, Greg; Eastman, Peter; George, Johnson

2018-05-01

Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps. Qualitative study utilising three focus groups involving 20 stakeholders. Thematic analysis was carried out using a framework approach and interpreted in the context of the Chronic Care Model for improving primary care for patients with chronic illness. Setting was a large regional Australian palliative care service. Participants included palliative care consumers and clinicians specifically patients, caregivers, physicians, nurses and pharmacists. Five major themes emerged from the focus groups: access to resources, medicines and information; shared care; challenges of polypharmacy; informal caregiver needs and potential roles of a palliative care pharmacist. Gaps in access to medicines/resources, training for generalist practitioners, communication between treating teams and lack of support for patients and carers were cited as factors adversely impacting medication management in community-based palliative care. While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.
Future volcanic lake research: revealing secrets from poorly studied lakes

NASA Astrophysics Data System (ADS)

Rouwet, D.; Tassi, F.; Mora-Amador, R. A.

2012-04-01

Volcanic lake research boosted after the 1986 Lake Nyos lethal gas burst, a limnic rather than volcanic event. This led to the formation of the IAVCEI-Commission on Volcanic Lakes, which grew out into a multi-disciplinary scientific community since the 1990's. At Lake Nyos, a degassing pipe is functional since 2001, and two additional pipes were added in 2011, aimed to prevent further limnic eruption events. There are between 150 and 200 volcanic lakes on Earth. Some acidic crater lakes topping active magmatic-hydrothermal systems are monitored continuously or discontinuously. Such detailed studies have shown their usefulness in volcanic surveillance (e.g. Ruapehu, Yugama-Kusatsu-Shiran, Poás). Others are "Nyos-type" lakes, with possible gas accumulation in bottom waters and thus potentially hazardous. "Nyos-type" lakes tend to remain stably stratified in tropical and sub-tropical climates (meromictic), leading to long-term gas build-up and thus higher potential risk. In temperate climates, such lakes tend to turn over in winter (monomictic), and thus liberating its gas charge yearly. We line out research strategies for the different types of lakes. We believe a complementary, multi-disciplinary approach (geochemistry, geophysics, limnology, biology, statistics, etc.) will lead to new insights and ideas, which can be the base for future following-up and monitoring. After 25 years of pioneering studies on rather few lakes, the scientific community should be challenged to study the many poorly studied volcanic lakes, in order to better constrain the related hazard, based on probabilistic approaches.
Physical Place on Campus: A Report on the Summit on Building Community

ERIC Educational Resources Information Center

Association of College Unions International (NJ1), 2012

2012-01-01

In October 2011, a multidisciplinary group of 50 individuals (students, architects, planners, consultants, campus administrators, and higher education association leaders) met at the University of Wisconsin-Madison to consider the relationship between physical place and campus community. Because a gathering of this type and on this topic had not…
Artful Reading, Spontaneous Design: Integrating Philosophy, English, and Art in a Creativity Cluster

ERIC Educational Resources Information Center

Albrecht, Vera; Comins, Barbara

2014-01-01

This article informs about a multidisciplinary learning community targeting first year students from diverse cultural backgrounds at an urban community college. The combination of English, art, and philosophy of art in a "Creativity Cluster" offers an excellent opportunity for great teaching and learning experiences. Yet, how can faculty…
Microblogging to Foster Connections and Community in a Weekly Graduate Seminar Course

ERIC Educational Resources Information Center

Domizi, Denise P.

2013-01-01

This study investigated the use of microblogs to enhance content learning and to foster community between participants in a weekly multidisciplinary graduate seminar on teaching and pedagogy. Data included students' and instructor's Twitter posts, an initial reaction paper, and an end-of-semester survey to determine if and how students' attitudes…
A method for defining value in healthcare using cancer care as a model.

PubMed

Feeley, Thomas W; Fly, Helen Shafer; Albright, Heidi; Walters, Ronald; Burke, Thomas W

2010-01-01

Value-based healthcare delivery is being discussed in a variety of healthcare forums. This concept is of great importance in the reform of the US healthcare delivery system. Defining and applying the principles of value-based competition in healthcare delivery models will permit future evaluation of various delivery applications. However, there are relatively few examples of how to apply these principles to an existing care delivery system. In this article, we describe an approach for assessing the value created when treating cancer patients in a multidisciplinary care setting within a comprehensive cancer center. We describe the analysis of a multidisciplinary care center that treats head and neck cancers, and we attempt to examine how this center integrates with Porter and Teisberg's (2006) concept of value-based competition based on the results analysis. Using the relationship between outcomes and costs as the definition of value, we developed a methodology to analyze proposed outcomes for a population of patients treated using a multidisciplinary approach, and we matched those outcomes to the costs of the care provided. We present this work as a model for defining value for a subset of patients undergoing active treatment. The method can be applied not only to head and neck treatments, but to other modalities as well. Public reporting of this type of data for a variety of conditions can lead to improved competition in the healthcare marketplace and, as a result, improve outcomes and decrease health expenditures.
Fabrication Materials for a Closed Cycle Brayton Turbine Wheel

NASA Technical Reports Server (NTRS)

Khandelwal, Suresh; Hah, Chunill; Powers, Lynn M.; Stewart, Mark E.; Suresh, Ambady; Owen, Albert K.

2006-01-01

A multidisciplinary analysis of a radial inflow turbine rotor is presented. This work couples high-fidelity fluid, structural, and thermal simulations in a seamless multidisciplinary analysis to investigate the consequences of material selection. This analysis extends multidisciplinary techniques previously demonstrated on rocket turbopumps and hypersonic engines. Since no design information is available for the anticipated Brayton rotating machinery, an existing rotor design (the Brayton Rotating Unit (BRU)) was used in the analysis. Steady state analysis results of a notional turbine rotor indicate that stress levels are easily manageable at the turbine inlet temperature, and stress levels anticipated using either superalloys or ceramics.

The impact of structuring multidisciplinary team conferences mediated by ICT in the treatment of patients with rheumatic diseases.

PubMed

Verhoef, J; Toussaint, P J; Vliet Vlieland, T P M; Zwetsloot-Schonk, J H M

2004-01-01

Communication processes are pervasive in the daily practice of health professionals. Reorganizing these daily practices by introducing ICT, inevitably effects one or more communication processes. Understanding exactly what these effects are, is a major problem in designing and implementing ICT-applications. In this paper we present an analysis of these effects, based on a theory of communication processes. The concept of 'decoupling' is pivotal in our analysis. Based on the identified effects, and some preconditions that have to be met in order for these effects to take place, we derive a number of guidelines for reorganizing communication processes by means of applying ICT. The application of these quidelines will be demonstrated and discussed in the context of the reorganization of a team conference at the Rehabilitation Clinic of the Rheumatology Department of the Leiden University Medical Center (RCRD/LUMC), a multidisciplinary team care setting.
Multidisciplinary Design and Analysis for Commercial Aircraft

NASA Technical Reports Server (NTRS)

Cummings, Russell M.; Freeman, H. JoAnne

1999-01-01

Multidisciplinary design and analysis (MDA) has become the normal mode of operation within most aerospace companies, but the impact of these changes have largely not been reflected at many universities. On an effort to determine if the emergence of multidisciplinary design concepts should influence engineering curricula, NASA has asked several universities (Virginia Tech, Georgia Tech, Clemson, BYU, and Cal Poly) to investigate the practicality of introducing MDA concepts within their undergraduate curricula. A multidisciplinary team of faculty, students, and industry partners evaluated the aeronautical engineering curriculum at Cal Poly. A variety of ways were found to introduce MDA themes into the curriculum without adding courses or units to the existing program. Both analytic and educational tools for multidisciplinary design of aircraft have been developed and implemented.
The National Institute of Environmental Health Sciences Superfund Research Program: a model for multidisciplinary training of the next generation of environmental health scientists.

PubMed

Carlin, Danielle J; Henry, Heather; Heacock, Michelle; Trottier, Brittany; Drew, Christina H; Suk, William A

2018-03-28

The National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) funds university-based, multidisciplinary research on human health and environmental science and engineering with the central goals to understand how hazardous substances contribute to disease and how to prevent exposures to these environmental chemicals. This multi-disciplinary approach allows early career scientists (e.g. graduate students and postdoctoral researchers) to gain experience in problem-based, solution-oriented research and to conduct research in a highly collaborative environment. Training the next generation of environmental health scientists has been an important part of the SRP since its inception. In addition to basic research, the SRP has grown to include support of broader training experiences such as those in research translation and community engagement activities that provide opportunities to give new scientists many of the skills they will need to be successful in their field of research. Looking to the future, the SRP will continue to evolve its training component by tracking and analyzing outcomes from its trainees by using tools such as the NIEHS CareerTrac database system, by increasing opportunities for trainees interested in research that goes beyond US boundaries, and in the areas of bioinformatics and data integration. These opportunities will give them the skills needed to be competitive and successful no matter which employment sector they choose to enter after they have completed their training experience.
Supporting Evidence-Based Practice in Schools with an Online Database of Best Practices

ERIC Educational Resources Information Center

Powers, Joelle D.; Bowen, Natasha K.; Bowen, Gary L.

2011-01-01

In spite of multidisciplinary recommendations to use evidence-based interventions in schools and a growing knowledge base of such practices, most schools are not using empirically supported interventions. On the basis of a careful analysis of barriers to the implementation of the best researched programs, an online, free, and publicly available…
Longitudinal Assessment of Progress in Reasoning Capacity and Relation with Self-Estimation of Knowledge Base

ERIC Educational Resources Information Center

Collard, Anne; Mélot, France; Bourguignon, Jean-Pierre

2015-01-01

The aim of the study was to investigate progress in reasoning capacity and knowledge base appraisal in a longitudinal analysis of data from summative evaluation throughout a medical problem-based learning curriculum. The scores in multidisciplinary discussion of a clinical case and multiple choice questionnaires (MCQs) were studied longitudinally…
Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival.

PubMed

Miller, Daniel L; Mayfield, William R; Luu, Theresa D; Helms, Gerald A; Muster, Alan R; Beckler, Vickie J; Cann, Aaron

2016-05-01

Lung cancer is the most common cause of cancer deaths in the United States. Overall survival is less than 20%, with the majority of patients presenting with advanced disease. The National Lung Screening Trial, performed mainly in academic medical centers, showed that cancer mortality can be reduced with computed tomography (CT) screening compared with chest radiography in high-risk patients. To determine whether this survival advantage can be duplicated in a community-based multidisciplinary thoracic oncology program, we initiated a CT scan screening program for lung cancer within an established health care system. In 2008, we launched a lung cancer CT screening program within the WellStar Health System (WHS) consisting of five hospitals, three health parks, 140 outpatient medical offices, and 12 imaging centers that provide care in a five-county area of approximately 1.4 million people in Metro-Atlanta. Screening criteria incorporated were the International Early Lung Cancer Action Program (2008 to 2010) and National Comprehensive Cancer Network guidelines (2011 to 2013) for moderate- and high-risk patients. A total of 1,267 persons underwent CT lung cancer screening in WHS from 2008 through 2013; 53% were men, 87% were 50 years of age or older, and 83% were current or former smokers. Noncalcified indeterminate pulmonary nodules were found in 518 patients (41%). Thirty-six patients (2.8%) underwent a diagnostic procedure for positive findings on their CT scan; 30 proved to have cancer, 28 (2.2%) primary lung cancer and 2 metastatic cancer, and 6 had benign disease. Fourteen patients (50%) had their lung cancer discovered on their initial CT scan, 11 on subsequent scans associated with indeterminate pulmonary nodules growth and 3 patients who had a new indeterminate pulmonary nodules. Only 15 (54%) of these 28 patients would have qualified as a National Lung Screening Trial high-risk patient; 75% had stage I or II disease. Overall 5-year survival was 64% and 5-year cancer specific survival was 71% in the screened patients, whereas nonscreened lung cancer patients during that time in WHS had an overall survival of only 19% (p < 0.001). A community-based multidisciplinary lung cancer screening program can improve survival of patients with lung cancer outside of a large multicenter study. This survival advantage was caused by a significant stage shift to earlier disease. Lung cancer CT screening may also benefit patients not meeting the National Lung Screening Trial criteria who are at moderate or high risk for lung cancer. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

2016-01-01

Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148
The Earth Science Research Network as Seen Through Network Analysis of the AGU

NASA Astrophysics Data System (ADS)

Narock, T.; Hasnain, S.; Stephan, R.

2017-12-01

Scientometrics is the science of science. Scientometric research includes measurements of impact, mapping of scientific fields, and the production of indicators for use in policy and management. We have leveraged network analysis in a scientometric study of the American Geophysical Union (AGU). Data from the AGU's Linked Data Abstract Browser was used to create a visualization and analytics tools to explore the Earth science's research network. Our application applies network theory to look at network structure within the various AGU sections, identify key individuals and communities related to Earth science topics, and examine multi-disciplinary collaboration across sections. Opportunities to optimize Earth science output, as well as policy and outreach applications, are discussed.
Evidence-based, multidisciplinary approach to the development of a crotalidae polyvalent antivenin (CroFab) protocol at a university hospital.

PubMed

Weant, Kyle A; Johnson, Peter N; Bowers, Rebecca C; Armitstead, John A

2010-03-01

Several thousand people are bitten annually by venomous snakes in the US. While the development of ovine Crotalidae polyvalent immune Fab antivenin (FabAV) for Crotalinae snakebite envenomations has greatly changed the way this clinical presentation is treated, multiple issues complicate its use. From patient assessment and evaluation, to medication preparation and administration, to the management of adverse drug reactions, the use of this antidote carries with it multiple points of possible medication variances. The inappropriate use of this agent can result in adverse patient consequences and a significant financial burden for both the hospital and the patient. To describe an evidence-based, multidisciplinary approach that was taken to ensure optimal, safe, and cost-effective treatment of patients with FabAV. Following an analysis of the available literature, a multidisciplinary committee was formed to construct a protocol for use of FabAV. This group included clinical pharmacists, pharmacy administrators, emergency medicine physicians who specialized in wilderness medicine and pharmacy residents. A multidisciplinary FabAV usage protocol was constructed and implemented to ensure appropriate patient evaluation, FabAV use and preparation, monitoring, and follow-up. This protocol was based on the available literature and the expert opinion of the committee. Through the use of a 24-hour in-house pharmacy resident on-call system, clinical pharmacy services were provided to ensure a multidisciplinary approach to the care of these patients emergently. Although limited, initial data show that this approach is effective and may result in substantial cost savings. Initial results from implementation of a protocol for use of FabAV have limited inappropriate use, reduced medication wastage, and decreased costs.
The School-Based Multidisciplinary Team and Nondiscriminatory Assessment.

ERIC Educational Resources Information Center

Pfeiffer, Steven I.

The potential of multidisciplinary teams to control for possible errors in diagnosis, classification, and placement and to provide a vehicle for ensuring effective outcomes of diagnostic practices is illustrated. The present functions of the school-based multidisciplinary team (also called, for example, assessment team, child study team, placement…
Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease (COPD) Using an Ontario Policy Model

PubMed Central

Chandra, K; Blackhouse, G; McCurdy, BR; Bornstein, M; Campbell, K; Costa, V; Franek, J; Kaulback, K; Levin, L; Sehatzadeh, S; Sikich, N; Thabane, M; Goeree, R

2012-01-01

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-Term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation throughout the airways, parenchyma, and pulmonary vasculature. The inflammation causes repeated cycles of injury and repair in the airway wall— inflammatory cells release a variety of chemicals and lead to cellular damage. The inflammation process also contributes to the loss of elastic recoil pressure in the lung, thereby reducing the driving pressure for expiratory flow through narr
A methodology for selecting optimum organizations for space communities

NASA Technical Reports Server (NTRS)

Ragusa, J. M.

1978-01-01

This paper suggests that a methodology exists for selecting optimum organizations for future space communities of various sizes and purposes. Results of an exploratory study to identify an optimum hypothetical organizational structure for a large earth-orbiting multidisciplinary research and applications (R&A) Space Base manned by a mixed crew of technologists are presented. Since such a facility does not presently exist, in situ empirical testing was not possible. Study activity was, therefore, concerned with the identification of a desired organizational structural model rather than the empirical testing of it. The principal finding of this research was that a four-level project type 'total matrix' model will optimize the effectiveness of Space Base technologists. An overall conclusion which can be reached from the research is that application of this methodology, or portions of it, may provide planning insights for the formal organizations which will be needed during the Space Industrialization Age.
Overview of Sensitivity Analysis and Shape Optimization for Complex Aerodynamic Configurations

NASA Technical Reports Server (NTRS)

Newman, Perry A.; Newman, James C., III; Barnwell, Richard W.; Taylor, Arthur C., III; Hou, Gene J.-W.

1998-01-01

This paper presents a brief overview of some of the more recent advances in steady aerodynamic shape-design sensitivity analysis and optimization, based on advanced computational fluid dynamics. The focus here is on those methods particularly well- suited to the study of geometrically complex configurations and their potentially complex associated flow physics. When nonlinear state equations are considered in the optimization process, difficulties are found in the application of sensitivity analysis. Some techniques for circumventing such difficulties are currently being explored and are included here. Attention is directed to methods that utilize automatic differentiation to obtain aerodynamic sensitivity derivatives for both complex configurations and complex flow physics. Various examples of shape-design sensitivity analysis for unstructured-grid computational fluid dynamics algorithms are demonstrated for different formulations of the sensitivity equations. Finally, the use of advanced, unstructured-grid computational fluid dynamics in multidisciplinary analyses and multidisciplinary sensitivity analyses within future optimization processes is recommended and encouraged.
Comparison of Response Surface and Kriging Models in the Multidisciplinary Design of an Aerospike Nozzle

NASA Technical Reports Server (NTRS)

Simpson, Timothy W.

1998-01-01

The use of response surface models and kriging models are compared for approximating non-random, deterministic computer analyses. After discussing the traditional response surface approach for constructing polynomial models for approximation, kriging is presented as an alternative statistical-based approximation method for the design and analysis of computer experiments. Both approximation methods are applied to the multidisciplinary design and analysis of an aerospike nozzle which consists of a computational fluid dynamics model and a finite element analysis model. Error analysis of the response surface and kriging models is performed along with a graphical comparison of the approximations. Four optimization problems are formulated and solved using both approximation models. While neither approximation technique consistently outperforms the other in this example, the kriging models using only a constant for the underlying global model and a Gaussian correlation function perform as well as the second order polynomial response surface models.
Multidisciplinary analysis and design of printed wiring boards

NASA Astrophysics Data System (ADS)

Fulton, Robert E.; Hughes, Joseph L.; Scott, Waymond R., Jr.; Umeagukwu, Charles; Yeh, Chao-Pin

1991-04-01

Modern printed wiring board design depends on electronic prototyping using computer-based simulation and design tools. Existing electrical computer-aided design (ECAD) tools emphasize circuit connectivity with only rudimentary analysis capabilities. This paper describes a prototype integrated PWB design environment denoted Thermal Structural Electromagnetic Testability (TSET) being developed at Georgia Tech in collaboration with companies in the electronics industry. TSET provides design guidance based on enhanced electrical and mechanical CAD capabilities including electromagnetic modeling testability analysis thermal management and solid mechanics analysis. TSET development is based on a strong analytical and theoretical science base and incorporates an integrated information framework and a common database design based on a systematic structured methodology.
Improving community healthcare for patients with Parkinson's disease: the dutch model.

PubMed

Keus, S H J; Oude Nijhuis, L B; Nijkrake, M J; Bloem, B R; Munneke, M

2012-01-01

Because of the complex nature of Parkinson's disease, a wide variety of health professionals are involved in care. Stepwise, we have addressed the challenges in the provision of multidisciplinary care for this patient group. As a starting point, we have gained detailed insight into the current delivery of allied healthcare, as well as the barriers and facilitators for optimal care. To overcome the identified barriers, a tertiary referral centre was founded; evidence-based guidelines were developed and cost-effectively implemented within regional community networks of specifically trained allied health professionals (the ParkinsonNet concept). We increasingly use ICT to bind these professional networks together and also to empower and engage patients in making decisions about their health. This comprehensive approach is likely to be feasible for other countries as well, so we currently collaborate in a European collaboration to improve community care for persons with Parkinson's disease.
Traditional healing practices among American Muslims: perceptions of community leaders in southeast Michigan.

PubMed

Alrawi, Sara; Fetters, Michael D; Killawi, Amal; Hammad, Adnan; Padela, Aasim

2012-06-01

Despite growing numbers of American Muslims, little empirical work exists on their use of traditional healing practices. We explored the types of traditional healing practices used by American Muslims in southeast Michigan. Twelve semi-structured interviews with American Muslim community leaders identified through a community-academic steering committee were conducted. Using a framework coding structure, a multidisciplinary investigative team identified themes describing traditional healing practices. Traditional healing practices can be categorized into three domains: Islamic religious text based practices, Islamic worship practices, and folk healing practices. Each domain may further contain therapies such as spiritual healing, medicinal herbs, mind body therapy, and dietary prescriptions. Traditional healing practices are utilized in three capacities of care: primary, secondary, and integrative. Our findings demonstrate that American Muslims actively utilize traditional healing practices. Healthcare practitioners caring for this population should be aware of the potential influence of these practices on health behaviors.
Data Access, Interoperability and Sustainability: Key Challenges for the Evolution of Science Capabilities

NASA Astrophysics Data System (ADS)

Walton, A. L.

2015-12-01

In 2016, the National Science Foundation (NSF) will support a portfolio of activities and investments focused upon challenges in data access, interoperability, and sustainability. These topics are fundamental to science questions of increasing complexity that require multidisciplinary approaches and expertise. Progress has become tractable because of (and sometimes complicated by) unprecedented growth in data (both simulations and observations) and rapid advances in technology (such as instrumentation in all aspects of the discovery process, together with ubiquitous cyberinfrastructure to connect, compute, visualize, store, and discover). The goal is an evolution of capabilities for the research community based on these investments, scientific priorities, technology advances, and policies. Examples from multiple NSF directorates, including investments by the Advanced Cyberinfrastructure Division, are aimed at these challenges and can provide the geosciences research community with models and opportunities for participation. Implications for the future are highlighted, along with the importance of continued community engagement on key issues.
Measuring cues for stand-off deception detection based on full-body nonverbal features in body-worn cameras

NASA Astrophysics Data System (ADS)

Bouma, Henri; Burghouts, Gertjan; den Hollander, Richard; van der Zee, Sophie; Baan, Jan; ten Hove, Johan-Martijn; van Diepen, Sjaak; van den Haak, Paul; van Rest, Jeroen

2016-10-01

Deception detection is valuable in the security domain to distinguish truth from lies. It is desirable in many security applications, such as suspect and witness interviews and airport passenger screening. Interviewers are constantly trying to assess the credibility of a statement, usually based on intuition without objective technical support. However, psychological research has shown that humans can hardly perform better than random guessing. Deception detection is a multi-disciplinary research area with an interest from different fields, such as psychology and computer science. In the last decade, several developments have helped to improve the accuracy of lie detection (e.g., with a concealed information test, increasing the cognitive load, or measurements with motion capture suits) and relevant cues have been discovered (e.g., eye blinking or fiddling with the fingers). With an increasing presence of mobile phones and bodycams in society, a mobile, stand-off, automatic deception detection methodology based on various cues from the whole body would create new application opportunities. In this paper, we study the feasibility of measuring these visual cues automatically on different parts of the body, laying the groundwork for stand-off deception detection in more flexible and mobile deployable sensors, such as body-worn cameras. We give an extensive overview of recent developments in two communities: in the behavioral-science community the developments that improve deception detection with a special attention to the observed relevant non-verbal cues, and in the computer-vision community the recent methods that are able to measure these cues. The cues are extracted from several body parts: the eyes, the mouth, the head and the fullbody pose. We performed an experiment using several state-of-the-art video-content-analysis (VCA) techniques to assess the quality of robustly measuring these visual cues.
Unstructured Finite Volume Computational Thermo-Fluid Dynamic Method for Multi-Disciplinary Analysis and Design Optimization

NASA Technical Reports Server (NTRS)

Majumdar, Alok; Schallhorn, Paul

1998-01-01

This paper describes a finite volume computational thermo-fluid dynamics method to solve for Navier-Stokes equations in conjunction with energy equation and thermodynamic equation of state in an unstructured coordinate system. The system of equations have been solved by a simultaneous Newton-Raphson method and compared with several benchmark solutions. Excellent agreements have been obtained in each case and the method has been found to be significantly faster than conventional Computational Fluid Dynamic(CFD) methods and therefore has the potential for implementation in Multi-Disciplinary analysis and design optimization in fluid and thermal systems. The paper also describes an algorithm of design optimization based on Newton-Raphson method which has been recently tested in a turbomachinery application.

Applying social science and public health methods to community-based pandemic planning.

PubMed

Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

2010-11-01

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.
Rotorcraft Optimization Tools: Incorporating Rotorcraft Design Codes into Multi-Disciplinary Design, Analysis, and Optimization

NASA Technical Reports Server (NTRS)

Meyn, Larry A.

2018-01-01

One of the goals of NASA's Revolutionary Vertical Lift Technology Project (RVLT) is to provide validated tools for multidisciplinary design, analysis and optimization (MDAO) of vertical lift vehicles. As part of this effort, the software package, RotorCraft Optimization Tools (RCOTOOLS), is being developed to facilitate incorporating key rotorcraft conceptual design codes into optimizations using the OpenMDAO multi-disciplinary optimization framework written in Python. RCOTOOLS, also written in Python, currently supports the incorporation of the NASA Design and Analysis of RotorCraft (NDARC) vehicle sizing tool and the Comprehensive Analytical Model of Rotorcraft Aerodynamics and Dynamics II (CAMRAD II) analysis tool into OpenMDAO-driven optimizations. Both of these tools use detailed, file-based inputs and outputs, so RCOTOOLS provides software wrappers to update input files with new design variable values, execute these codes and then extract specific response variable values from the file outputs. These wrappers are designed to be flexible and easy to use. RCOTOOLS also provides several utilities to aid in optimization model development, including Graphical User Interface (GUI) tools for browsing input and output files in order to identify text strings that are used to identify specific variables as optimization input and response variables. This paper provides an overview of RCOTOOLS and its use
Object-Oriented MDAO Tool with Aeroservoelastic Model Tuning Capability

NASA Technical Reports Server (NTRS)

Pak, Chan-gi; Li, Wesley; Lung, Shun-fat

2008-01-01

An object-oriented multi-disciplinary analysis and optimization (MDAO) tool has been developed at the NASA Dryden Flight Research Center to automate the design and analysis process and leverage existing commercial as well as in-house codes to enable true multidisciplinary optimization in the preliminary design stage of subsonic, transonic, supersonic and hypersonic aircraft. Once the structural analysis discipline is finalized and integrated completely into the MDAO process, other disciplines such as aerodynamics and flight controls will be integrated as well. Simple and efficient model tuning capabilities based on optimization problem are successfully integrated with the MDAO tool. More synchronized all phases of experimental testing (ground and flight), analytical model updating, high-fidelity simulations for model validation, and integrated design may result in reduction of uncertainties in the aeroservoelastic model and increase the flight safety.
A job analysis of community health workers in the context of integrated nutrition and early child development.

PubMed

Phuka, John; Maleta, Kenneth; Thomas, Mavuto; Gladstone, Melisa

2014-01-01

Stunting and poor child development are major public health concerns in Malawi. Integrated nutrition and early child development (ECD) interventions have shown potential to reduce stunting, but it is not known how these integrated approaches can be implemented in Malawi. In this paper, we aimed to evaluate the current jobs status of community health workers and their potential to implement integrated approaches. This was accomplished by a desk review of nutrition and ECD policy documents, as well as interviews with key informants, community health workers, and community members. We found that Malawi has comprehensive policies and well-outlined coordination structures for nutrition and ECD that advocate for integrated approaches. Strong multidisciplinary interaction exists at central levels but not at the community level. Integration of community health workers from different sectors is limited by workload, logistics, and a lack of synchronized work schedules. Favorable, sound policies and well-outlined coordination structures alone are not enough for the establishment of integrated nutrition and ECD activities. Balanced bureaucratic structures, improved task allocation, and synchronization of work schedules across all relevant sectors are needed for integrated intervention in Malawi. © 2014 New York Academy of Sciences.
Analysis of the social network development of a virtual community for Australian intensive care professionals.

PubMed

Rolls, Kaye Denise; Hansen, Margaret; Jackson, Debra; Elliott, Doug

2014-11-01

Social media platforms can create virtual communities, enabling healthcare professionals to network with a broad range of colleagues and facilitate knowledge exchange. In 2003, an Australian state health department established an intensive care mailing list to address the professional isolation experienced by senior intensive care nurses. This article describes the social network created within this virtual community by examining how the membership profile evolved from 2003 to 2009. A retrospective descriptive design was used. The data source was a deidentified member database. Since 2003, 1340 healthcare professionals subscribed to the virtual community with 78% of these (n = 1042) still members at the end of 2009. The membership profile has evolved from a single-state nurse-specific network to an Australia-wide multidisciplinary and multiorganizational intensive care network. The uptake and retention of membership by intensive care clinicians indicated that they appeared to value involvement in this virtual community. For healthcare organizations, a virtual community may be a communications option for minimizing professional and organizational barriers and promoting knowledge flow. Further research is, however, required to demonstrate a link between these broader social networks, enabling the exchange of knowledge and improved patient outcomes.
Medical Rehabilitation in Natural Disasters: A Review.

PubMed

Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M

2015-09-01

To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
The effectiveness of a community-based health promotion program for rural elders: a quasi-experimental design.

PubMed

Wang, Jeng; Chen, Chu-Yeh; Lai, Li-Ju; Chen, Min-Li; Chen, Mei-Yen

2014-08-01

A community-based health promotion program (CBHP) might be beneficial for the elderly, but evidence is limited. We therefore examined the effect of a CBHP on change of lifestyle, physiological indicators and depression score among seniors in 2 rural areas. A prospective quasi-experimental design involved a total of 520 senior participants living in 6 rural villages, who were clustered and conveniently assigned to 2 intervention groups. Senior nursing students were the interveners for group 1 and community peer supporters for group 2. The primary outcome measure was the change in health-related behavior measured on the geriatric health promotion scale (GHPS). The secondary outcome comprised changes in the short form of the Chinese geriatric depression scale (CGDS-15), fasting blood sugar, total cholesterol, waist circumference and blood pressure. Paired-t test and analysis of covariance were used for statistical inspection. Most of the participants were retired farmers or fishermen >75years of age who had little education. The total scores and all subscales of GHPS, along with some physiological indicators, improved significantly between pretest and post-test in both groups. After adjustment for confounders, intervention in group 1 was more effective than that in group 2 regarding self-protection behaviors. Systolic and diastolic blood pressure was significantly lower in group 2. CBHP programs are valuable for improving healthy lifestyle, fasting blood sugar, blood pressure and depression score among seniors. The low cost and effectiveness of incorporating multidisciplinary resources to help rural elders to maintain a healthy status and a healthier lifestyle. Copyright © 2014 Elsevier Inc. All rights reserved.
Adapting Evidence-Based Interventions to Meet the Needs of Adolescents Growing Up with HIV in South Africa: The VUKA Case Example

PubMed Central

Nestadt, Danielle; Bhana, Arvin; Petersen, Inge; Abrams, Elaine J.; Alicea, Stacey; Holst, Helga; Myeza, Nonhlahla; John, Sally; Small, Latoya; McKay, Mary

2015-01-01

The VUKA family program is one of the only evidence-based interventions to promote positive psychosocial outcomes in South African HIV-infected pre- and early adolescents and their families. In this paper, we discuss the collaborative process by which a multidisciplinary team of clinicians, researchers, counselors, and artists/educators and families adapted and developed VUKA for this population using community-based participatory research methods. We describe the intervention and explore lessons learned that may be applicable across contexts related to international collaboration and adapting evidence-based interventions so that they are likely to be acceptable, feasible, and effective in a given setting and country context. PMID:25984440
Services in the Community for Adults with Psychosis and Intellectual Disabilities: A Delphi Consultation of Professionals' Views

ERIC Educational Resources Information Center

Hemmings, C. P.; Underwood, L. A.; Bouras, N.

2009-01-01

Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…
Roger Tory Peterson Institute Links Interdisciplinary Nature Studies to Increased Community Understanding. Rural Trust Featured Project.

ERIC Educational Resources Information Center

Null, Elizabeth Higgins

The Roger Tory Peterson Institute (Jamestown, New York) has been sparking a regional revival in K-12 nature studies and attracting attention from educators across America. Through summer training sessions and workshops, the Institute introduces multidisciplinary teams of teachers and community members to empirical research techniques for observing…
Multidisciplinary approach for developing a new robotic system for domiciliary assistance to elderly people.

PubMed

Cavallo, F; Aquilano, M; Bonaccorsi, M; Mannari, I; Carrozza, M C; Dario, P

2011-01-01

This paper aims to show the effectiveness of a (inter / multi)disciplinary team, based on the technology developers, elderly care organizations, and designers, in developing the ASTRO robotic system for domiciliary assistance to elderly people. The main issues presented in this work concern the improvement of robot's behavior by means of a smart sensor network able to share information with the robot for localization and navigation, and the design of the robot's appearance and functionalities by means of a substantial analysis of users' requirements and attitude to robotic technology to improve acceptability and usability.
Integrated Modeling of Optical Systems (IMOS): An Assessment and Future Directions

NASA Technical Reports Server (NTRS)

Moore, Gregory; Broduer, Steve (Technical Monitor)

2001-01-01

Integrated Modeling of Optical Systems (IMOS) is a finite element-based code combining structural, thermal, and optical ray-tracing capabilities in a single environment for analysis of space-based optical systems. We'll present some recent examples of IMOS usage and discuss future development directions. Due to increasing model sizes and a greater emphasis on multidisciplinary analysis and design, much of the anticipated future work will be in the areas of improved architecture, numerics, and overall performance and analysis integration.
Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

PubMed

Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

2015-01-01

We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.
A Qualitative Study of Multidisciplinary Providers' Experiences With the Transfer Process for Injured Children and Ideas for Improvement.

PubMed

Gawel, Marcie; Emerson, Beth; Giuliano, John S; Rosenberg, Alana; Minges, Karl E; Feder, Shelli; Violano, Pina; Morrell, Patricia; Petersen, Judy; Christison-Lagay, Emily; Auerbach, Marc

2018-02-01

Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn. Participants (n = 34) included interprofessional providers from sending facilities, transport teams, and receiving facilities. Using the constant comparative method, a multidisciplinary team coded transcripts and collectively refined codes to generate recurrent themes across interviews until theoretical saturation was achieved. Participants reported that the transfer process for injured children is complex, stressful, and necessitates collaboration. The transfer process was perceived to involve numerous interrelated components, including professions, disciplines, and institutions. The 5 themes identified as areas to improve this transfer process included 1) Creation of a unified standard operating procedure that crosses institutions/teams, 2) Enhancing 'shared sense making' of all providers, 3) Improving provider confidence, expertise, and skills in caring for pediatric trauma transfer cases, 4) Addressing organization and environmental factors that may impede/delay transfer, and 5) Fostering institutional and personal relationships. Efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.
Multidisciplinary Shape Optimization of a Composite Blended Wing Body Aircraft

NASA Astrophysics Data System (ADS)

Boozer, Charles Maxwell

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

PubMed

Solar, Ann

2014-06-01

Investigate feasibility and development of a linkage intervention to the evidence-based Individual Placement and Support (IPS) approach to supported employment (SE) for patients with schizophrenia on a mental health unit who want to work in competitive employment. Literature review about the evidence-based IPS approach to SE in schizophrenia and why it might not be implemented in mental health services. Analysis of 10 adult mental health unit multidisciplinary staff interviews for categories in the literature review of IPS implementation barriers and whether these barriers could be overcome. There was lack of full staff knowledge of the IPS approach to SE. However, all staff knew respect for patient choice was paramount, community employment programs existed for the disabled, an outreach linkage process to such a program and ongoing support for people with schizophrenia would be required. There was staff ambivalence about SE for patients with schizophrenia. Despite staff ambivalence about SE for people with schizophrenia there was still enough staff knowledge and openness to shape an IPS linkage intervention from a staff perspective. © The Royal Australian and New Zealand College of Psychiatrists 2014.
Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

PubMed

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.
Multidisciplinary Analysis and Optimization Generation 1 and Next Steps

NASA Technical Reports Server (NTRS)

Naiman, Cynthia Gutierrez

2008-01-01

The Multidisciplinary Analysis & Optimization Working Group (MDAO WG) of the Systems Analysis Design & Optimization (SAD&O) discipline in the Fundamental Aeronautics Program s Subsonic Fixed Wing (SFW) project completed three major milestones during Fiscal Year (FY)08: "Requirements Definition" Milestone (1/31/08); "GEN 1 Integrated Multi-disciplinary Toolset" (Annual Performance Goal) (6/30/08); and "Define Architecture & Interfaces for Next Generation Open Source MDAO Framework" Milestone (9/30/08). Details of all three milestones are explained including documentation available, potential partner collaborations, and next steps in FY09.
A multidisciplinary decision support system for forest fire crisis management.

PubMed

Keramitsoglou, Iphigenia; Kiranoudis, Chris T; Sarimveis, Haralambos; Sifakis, Nicolaos

2004-02-01

A wildland fire is a serious threat for forest ecosystems in Southern Europe affecting severely and irreversibly regions of significant ecological value as well as human communities. To support decision makers during large-scale forest fire incidents, a multidisciplinary system has been developed that provides rational and quantitative information based on the site-specific circumstances and the possible consequences. The system's architecture consists of several distinct supplementary modules of near real-time satellite monitoring and fire forecast using an integrated framework of satellite Remote Sensing, GIS, and RDBMS technologies equipped with interactive communication capabilities. The system may handle multiple fire ignitions and support decisions regarding dispatching of utilities, equipment, and personnel that would appropriately attack the fire front. The operational system was developed for the region of Penteli Mountain in Attika, Greece, one of the mountain areas in the country most hit by fires. Starting from a real fire incident in August 2000, a scenario is presented to illustrate the effectiveness of the proposed approach.
Participatory development of incentives to coexist with jaguars and pumas.

PubMed

Amit, Ronit; Jacobson, Susan K

2018-01-22

Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms. © 2018 Society for Conservation Biology.

Rapid Ethical Assessment on Informed Consent Content and Procedure in Hintalo-Wajirat, Northern Ethiopia: A Qualitative Study.

PubMed

Abay, Serebe; Addissie, Adamu; Davey, Gail; Farsides, Bobbie; Addissie, Thomas

2016-01-01

Informed consent is a key component of bio-medical research involving human participants. However, obtaining informed consent is challenging in low literacy and resource limited settings. Rapid Ethical Assessment (REA) can be used to contextualize and simplify consent information within a given study community. The current study aimed to explore the effects of social, cultural, and religious factors during informed consent process on a proposed HPV-serotype prevalence study. A qualitative community-based REA was conducted in Adigudom and Mynebri Kebeles, Northern Ethiopia, from July to August 2013. Data were collected by a multi-disciplinary team using open ended questions concerning informed consent components in relation to the parent study. The team conducted one-to-one In-Depth Interviews (IDI) and Focus Group Discussions (FGDs) with key informants and community members to collect data based on the themes of the study. Tape recorded data were transcribed in Tigrigna and then translated into English. Data were categorized and thematically analyzed using open coding and content analysis based on pre-defined themes. The REA study revealed a number of socio-cultural issues relevant to the proposed study. Low community awareness about health research, participant rights and cervical cancer were documented. Giving a vaginal sample for testing was considered to be highly embarrassing, whereas giving a blood sample made participants worry that they might be given a result without the possibility of treatment. Verbal consent was preferred to written consent for the proposed study. This rapid ethical assessment disclosed important socio-cultural issues which might act as barriers to informed decision making. The findings were important for contextual modification of the Information Sheet, and to guide the best consent process for the proposed study. Both are likely to have enabled participants to understand the informed consent better and consequently to comply with the study.
OTHER: A multidisciplinary approach to the search for other inhabited worlds

NASA Astrophysics Data System (ADS)

Funes, J.; Lares, M.; De los Rios, M.; Martiarena, M.; Ahumada, A. V.

2017-10-01

We present project OTHER (Otros mundos, tierra, humanidad, and espacio remoto), a multidisciplinary laboratory of ideas, that addresses questions related to the scientific search for extraterrestrial intelligent life such as: what is life? how did it originate? what might be the criteria that we adopt to identify what we might call an extraterrestrial civilization? As a starting point, we consider the Drake equation which offers a platform from which to address these questions in a multidisciplinary approach. As part of the project OTHER, we propose to develop and explain the last two parameters of the Drake equation that we call the cultural factors: the fraction of intelligent civilizations that want or seek to communicate , and the average life time of the same, . The innovation of the project OTHER is the multidisciplinary approach in the context of the Argentine community. Our goal is to provide new ideas that could offer new perspectives on the old question: Are we alone?
Experiences of professionals providing community care for disabled people in Nagasaki and Southampton.

PubMed

Matsusaka, Nobuou; McLellan, David Lindsay

2003-09-01

To report on the factors affecting the resolution of problems experienced by community care professionals and to refine a checklist of methodological issues for future cross-cultural comparative studies. A preliminary comparative study between Japan and the UK. 630 subjects in Nagasaki, Japan and 109 subjects in Southampton, UK who were physically disabled, aged over 40 years, living at home and currently using at least 1 of the community disability care services. Community care professionals from a range of professions were asked about the backgrounds, physical disabilities and needs of their disabled subjects, and the difficulties experienced in providing them with care and rehabilitation services. The proportion of subjects for whom difficulties were experienced in providing services increased with increasing severity of disability in Southampton. By contrast, this trend was less pronounced in Nagasaki where difficulties were reported in approximately 95% of all cases. However, it proved much more difficult to enlist collaboration for this survey in Southampton than in Nagasaki and this led to selection bias in the Southampton sample. The professionals in Nagasaki were hampered by a lack of medical information about their subjects and by a lack of available resources for relieving family members from some of their burden of care. The nature and impact of multidisciplinary team meetings appeared to differ in the 2 countries. It is suggested that the provision of medical information and advice to staff working in community care is a factor of fundamental importance in enabling them to define objectives and to help identify disabled people's care and rehabilitation needs. The means by which such information and advice is shared appeared to differ in the 2 countries. Attenuated resources for community care and poor linkage between care organizations impair the ability of professional staff to resolve problems once they have been identified. It is suggested that each country could learn something from the other in improving the efficiency and impact of multidisciplinary community-based teams. In order to avoid the methodological difficulties in study design and implementation that we experienced, a 7-point checklist has been constructed to assist others who may be planning further cross-cultural studies in this field.
Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results

PubMed Central

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

2018-01-01

Background Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary vs. serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic. Methods We used a mixed-methods approach to conduct a patient-centered, combined implementation and effectiveness study of a multidisciplinary model of lung cancer care. We established a co-located multidisciplinary clinic to study the implementation of this care-delivery model. We identified and engaged key stakeholders from the onset, used their input to develop the program structure, processes, performance benchmarks, and study endpoints (outcome-related process measures, patient- and caregiver-reported outcomes, survival). In this report, we describe the study design, process of implementation, comparative populations, and how they contrast with patients within the local and regional healthcare system. Trial Registration: ClinicalTrials.gov Identifier: NCT02123797. Results Implementation: the multidisciplinary clinic obtained an overall treatment concordance rate of 90% (target >85%). Satisfaction scores were high, with >95% of patients and caregivers rating themselves as being “very satisfied” with all aspects of care from the multidisciplinary team (patient/caregiver response rate >90%). The Reach of the multidisciplinary clinic included a higher proportion of minority patients, more women, and younger patients than the regional population. Comparative effectiveness: The comparative effectiveness trial conducted in the last phase of the study met the planned enrollment per statistical design, with 178 patients in the multidisciplinary arm and 348 in the serial care arm. The multidisciplinary cohort had older age and a higher percentage of racial minorities, with a higher proportion of stage IV patients in the serial care arm. Conclusions This study demonstrates a comprehensive implementation of a multidisciplinary model of lung cancer care, which will advance the science behind implementing this much-advocated clinical care model. PMID:29535915
Perceived Status and Value: The Student-Customer Relationship Inflected by the Inherent Challenges of University-Industry Collaboration

ERIC Educational Resources Information Center

Heikkinen, Juho; Isomöttönen, Ville

2017-01-01

This article examines how students in a multidisciplinary project-based learning course involving real customers perceive their interactions with their customers. The authors conducted a qualitative study and analysed students' learning reports by means of a thematic network analysis. The analysis shows how students perceive their status in…
The Guideline Implementability Decision Excellence Model (GUIDE-M): a mixed methods approach to create an international resource to advance the practice guideline field.

PubMed

Brouwers, Melissa C; Makarski, Julie; Kastner, Monika; Hayden, Leigh; Bhattacharyya, Onil

2015-03-15

Practice guideline (PG) implementability refers to PG features that promote their use. While there are tools and resources to promote PG implementability, none are based on an evidence-informed and multidisciplinary perspective. Our objectives were to (i) create a comprehensive and evidence-informed model of PG implementability, (ii) seek support for the model from the international PG community, (iii) map existing implementability tools on to the model, (iv) prioritize areas for further investigation, and (v) describe how the model can be used by PG developers, users, and researchers. A mixed methods approach was used. Using our completed realist review of the literature of seven different disciplines as the foundation, an iterative consensus process was used to create the beta version of the model. This was followed by (i) a survey of international stakeholders (guideline developers and users) to gather feedback and to refine the model, (ii) a content analysis comparing the model to existing PG tools, and (iii) a strategy to prioritize areas of the model for further research by members of the research team. The Guideline Implementability for Decision Excellence Model (GUIDE-M) is comprised of 3 core tactics, 7 domains, 9 subdomains, 44 attributes, and 40 subattributes and elements. Feedback on the beta version was received from 248 stakeholders from 34 countries. The model was rated as logical, relevant, and appropriate. Seven PG tools were selected and compared to the GUIDE-M: very few tools targeted the Contextualization and Deliberations domain. Also, fewer of the tools addressed PG appraisal than PG development and reporting functions. These findings informed the research priorities identified by the team. The GUIDE-M provides an evidence-informed international and multidisciplinary conceptualization of PG implementability. The model can be used by PG developers to help them create more implementable recommendations, by clinicians and other users to help them be better consumers of PGs, and by the research community to identify priorities for further investigation.
The Childhood Obesity Research Demonstration project: a team approach for supporting a multisite, multisector intervention.

PubMed

Williams, Nancy; Dooyema, Carrie A; Foltz, Jennifer L; Belay, Brook; Blanck, Heidi M

2015-02-01

Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.
A Way Forward: Cooperative Solutions to Our Climate Challenges

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

PubMed Central

Markson, Leona E; Turner, Barbara J; Cocroft, Jim; Houchens, Robert; Fanning, Thomas R

1997-01-01

OBJECTIVE To profile characteristics of clinics caring for persons with advanced HIV infection. DESIGN AND SETTING Survey of clinic directors in New York State. PARTICIPANTS Newly diagnosed Medicaid-enrolled AIDS patients in New York state in federal fiscal years 1987–1992 (n = 6,184) managed by 62 HIV specialty, 53 hospital-based general medicine/primary care, 36 community-based primary care, and 28 other clinics. MEASUREMENTS AND MAIN RESULTS Telephone survey about clinic hours, emphasis on HIV, staffing, procedures, and directors’ rating of care. Estimates of the number of newly diagnosed, Medicaid-enrolled AIDS patients treated in surveyed clinics were obtained from claims data. We found that community-based clinics were significantly more likely to have longer hours, a physician on call, or to accommodate unscheduled care than were hospital-based general medicine/primary care or other types of clinics. Compared with HIV specialty clinics, general medicine/primary care clinics were less likely to have HIV-specific care attributes such as a director of HIV care (98% vs 72%), multidisciplinary conferences on HIV care (83% vs 32%), or a standard initial HIV workup (90% vs 70%). Of general medicine/primary care clinics, most (83%) were staffed by residents and fellows compared with only 68% of HIV or 25% of community-based clinics (p < .001). General medicine/primary care clinics were less likely than community-based clinics to perform Pap smears (75% vs 94%) or to have case managers on payroll (21% vs 81%). CONCLUSIONS In this sample of clinics, hospital-based general medicine/primary care clinics managing the care of Medicaid enrollees with AIDS appeared to have more limited hours and availability of specific services than HIV specialty or community-based clinics.
Justification for a Nuclear Global Health Workforce: multidisciplinary analysis of risk, survivability & preparedness, with emphasis on the triage management of thermal burns.

PubMed

Burkle, Frederick M; Potokar, Tom; Gosney, James E; Dallas, Cham

2017-01-01

Major challenges and crises in global health will not be solved by health alone; requiring rather a multidisciplinary, evidence-based analytical approach to prevention, preparedness and response. One such potential crisis is the continued spread of nuclear weapons to more nations concurrent with the increased volatility of international relations that has significantly escalated the risk of a major nuclear weapon exchange. This study argues for the development of a multidisciplinary global health response agenda based on the reality of the current political analysis of nuclear risk, research evidence suggesting higher-than-expected survivability risk, and the potential for improved health outcomes based on medical advances. To date, the medical consequences of such an exchange are not credibly addressed by any nation at this time, despite recent advances. While no one country could mount such a response, an international body of responders organized in the same fashion as the current World Health Organization's global health workforce initiative for large-scale natural and public health emergencies could enlist and train for just such an emergency. A Nuclear Global Health Workforce is described for addressing the unprecedented medical and public health needs to be expected in the event of a nuclear conflict or catastrophic accident. The example of addressing mass casualty nuclear thermal burns outlines the potential triage and clinical response management of survivors enabled by this global approach.
Global change information support - A north/south coalition

NASA Technical Reports Server (NTRS)

Blados, Walter R.; Cotter, Gladys A.

1993-01-01

On a daily basis we become more aware that our planet, earth, exists in a delicate balance; we, its inhabitants, must be informed caretakers. Global change communities have emerged around the globe to address this multidisciplinary subject. Information systems that integrate text, bibliographic, numeric and visual data are needed to support these global change communities. No one information center can hope to collect all the relevant data. Rather, we must form a coalition, North and South, to collect and provide access to disparate, multidisciplinary sources of information, and to develop standardized tools for documenting and manipulating this data and information. International resources need to be mobilized in a coordinated manner to move us towards this goal. This paper looks at emerging information technologies that can be utilized to build such a system, and outlines some cooperative North/South strategies.
Global change information support: A north-south coalition

NASA Technical Reports Server (NTRS)

Blados, Walter R.; Cotter, Gladys A.

1993-01-01

On a daily basis we become more aware that our planet, earth, exists in a delicate balance; we, its inhabitants, must be informed caretakers. Global change communities have emerged around the globe to address this multidisciplinary subject. Information systems that integrate text, bibliographic, numeric and visual data are needed to support these global change communities. No one information center can hope to collect all the relevant data. Rather, we must form a coalition, North and South, to collect and provide access to disparate, multidisciplinary sources of information, and to develop standardized tools for documenting and manipulating this data and information. International resources need to be mobilized in a coordinated manner to move us towards this goal. This paper looks at emerging information technologies that can be utilized to build such a system, and outlines some cooperative North/South strategies.
Application of advanced multidisciplinary analysis and optimization methods to vehicle design synthesis

NASA Technical Reports Server (NTRS)

Consoli, Robert David; Sobieszczanski-Sobieski, Jaroslaw

1990-01-01

Advanced multidisciplinary analysis and optimization methods, namely system sensitivity analysis and non-hierarchical system decomposition, are applied to reduce the cost and improve the visibility of an automated vehicle design synthesis process. This process is inherently complex due to the large number of functional disciplines and associated interdisciplinary couplings. Recent developments in system sensitivity analysis as applied to complex non-hierarchic multidisciplinary design optimization problems enable the decomposition of these complex interactions into sub-processes that can be evaluated in parallel. The application of these techniques results in significant cost, accuracy, and visibility benefits for the entire design synthesis process.
Sequence analysis to assess labour market participation following vocational rehabilitation: an observational study among patients sick-listed with low back pain from a randomised clinical trial in Denmark

PubMed Central

Lindholdt, Louise; Labriola, Merete; Nielsen, Claus Vinther; Horsbøl, Trine Allerslev; Lund, Thomas

2017-01-01

Introduction The return-to-work (RTW) process after long-term sickness absence is often complex and long and implies multiple shifts between different labour market states for the absentee. Standard methods for examining RTW research typically rely on the analysis of one outcome measure at a time, which will not capture the many possible states and transitions the absentee can go through. The purpose of this study was to explore the potential added value of sequence analysis in supplement to standard regression analysis of a multidisciplinary RTW intervention among patients with low back pain (LBP). Methods The study population consisted of 160 patients randomly allocated to either a hospital-based brief or a multidisciplinary intervention. Data on labour market participation following intervention were obtained from a national register and analysed in two ways: as a binary outcome expressed as active or passive relief at a 1-year follow-up and as four different categories for labour market participation. Logistic regression and sequence analysis were performed. Results The logistic regression analysis showed no difference in labour market participation for patients in the two groups after 1 year. Applying sequence analysis showed differences in subsequent labour market participation after 2 years after baseline in favour of the brief intervention group versus the multidisciplinary intervention group. Conclusion The study indicated that sequence analysis could provide added analytical value as a supplement to traditional regression analysis in prospective studies of RTW among patients with LBP. PMID:28729315
Field of smart structures as seen by those working in it: survey results

NASA Astrophysics Data System (ADS)

Spillman, William B., Jr.; Sirkis, James S.; Gardiner, Peter T.

1995-04-01

There has been considerable discussion in the technical community on a number of questions concerned with smart materials and structures, such as what they are, whether smart materials can be considered a subset of smart structures, whether a smart structure and an intelligent structure are the same thing, etc. This discussion is both fueled and confused by the technical community due to the truly multidisciplinary nature of this new field. Smart materials and structures research involves so many technically diverse fields that it is quite common for one field to completely misunderstand the terminology and state-of-the-art in other fields. In order to ascertain whether a consensus is emerging on a number of these questions, the technical community was surveyed in a number of ways including via the Internet and by direct contact. The purpose of this survey in the final analysis was to better define the smart materials and structures field, its current status and its potential benefits. Results of the survey are presented and discussed.
Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

PubMed

Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

2015-01-01

The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.
Recognizing the ‘sparsely settled forest’: Multi-decade socioecological change dynamics and community exemplars

Treesearch

Derek B. Van Berkel; Bronwyn Rayfield; Sebastián Martinuzzi; Martin J. Lechowicz; Eric White; Kathleen P. Bell; Chris R. Colocousis; Kent F. Kovacs; Anita T. Morzillo; Darla K. Munroe; Benoit Parmentier; Volker C. Radeloff; Brian J. McGill

2018-01-01

Sparsely settled forests (SSF) are poorly studied, coupled natural and human systems involving rural communities in forest ecosystems that are neither largely uninhabited wildland nor forests on the edges of urban areas. We developed and applied a multidisciplinary approach to define, map, and examine changes in the spatial extent and structure of both the landscapes...
"My Daughter Does Not Know How to Make the Chappati": Understanding Food Access among African Immigrants in Lewiston, Maine

ERIC Educational Resources Information Center

Jacobus, Michelle Vazquez; Ahmed, Hussein; Jalali, Reza

2013-01-01

Food access for Maine's growing African refugee population reflects multiple levels of general access to society. To better understand the challenges and opportunities unique to this community, a multidisciplinary team of students, faculty, and community partners integrated the expertise of local residents with the results of a food assessment of…
Promoting Health and Wellness in Underserved Communities: Multidisciplinary Perspectives through Service Learning. Service Learning for Civic Engagement Series

ERIC Educational Resources Information Center

Pelham, Anabel, Ed.; Sills, Elizabeth, Ed.; Eisman, Gerald S., Ed.

2010-01-01

Starting from the premise that the health status, vulnerability to accidents and disease, and life spans are determined by the organization, delivery, and financing (or lack thereof) of health care, this book explores how educators and community caretakers teach the complex web of inter-connection between the micro level of individual health and…
Research Priorities in Mental Health, Justice, and Safety: A Multidisciplinary Stakeholder Report

PubMed Central

Crocker, Anne G.; Nicholls, Tonia L.; Seto, Michael C.; Roy, Laurence; Leclair, Marichelle C.; Brink, Johann; Simpson, Alexander I. F.; Côté, Gilles

2015-01-01

This paper is based on the report following the National Research Agenda Meeting on Mental Health, Justice, and Safety held in Montreal on November 19, 2014, which convened academics; health, social, and legal professionals; and people with lived experience of mental illness from across Canada. The goal was to identify research priorities addressing relevant knowledge gaps and research strategies that can translate into public policy action and improvements in evidence-based services. Participants identified key challenges: (1) inadequate identification and response to needs by civil mental health services and frontline law enforcement, (2) limited specialized resources in forensic and correctional settings, (3) fragmented care and gaps between systems, (4) limited resources for adequate community reintegration, and (5) poor knowledge transfer strategies as obstacles to evidence-based policies. Knowledge gaps were identified in epidemiology and risk reduction, frontline training and programs, forensic and correctional practices, organizations and institutions, knowledge transfer, and rehabilitation. Finally, participants identified potential sources of support to conduct real time research with regard to data collection and sharing. The findings represent a roadmap for how forensic mental health systems can best proceed to address current challenges through research and practice initiatives, drawing from lived, clinical and research experiences of a multidisciplinary group of experts. PMID:26681928

Mechanisms of radiation interaction with DNA: Potential implications for radiation protection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1988-01-01

The Office of Health and Environmental Research (OHER) of the US Department of Energy conducts a broad multidisciplinary research program which includes basic biophysics, biophysical chemistry, molecular and cellular biology as well as experimental animal studies and opportunistic human studies. This research is directed at understanding how low levels of radiation of various qualities produce the spectrum of biological effects that are seen for such exposures. This workshop was entitled ''Mechanisms of Radiation Interaction with DNA: Potential Implications for Radiation Protection.'' It ws jointly sponsored by the Department of Energy and the Commission of European Communities. The aim of themore » workshop was to review the base of knowledge in the area of mechanisms of radiation action at the DNA level, and to explore ways in which this information can be applied to the development of scientifically sound concepts and procedures for use in the field of radiation protection. The overview of research provided by this multidisciplinary group will be helpful to the Office in program planning. This report includes a summary of the presentations, extended abstracts, the meeting agenda, research recommendations, and a list of participants. Individual papers are processed separately for the data base.« less
The Enzyme Function Initiative†

PubMed Central

Gerlt, John A.; Allen, Karen N.; Almo, Steven C.; Armstrong, Richard N.; Babbitt, Patricia C.; Cronan, John E.; Dunaway-Mariano, Debra; Imker, Heidi J.; Jacobson, Matthew P.; Minor, Wladek; Poulter, C. Dale; Raushel, Frank M.; Sali, Andrej; Shoichet, Brian K.; Sweedler, Jonathan V.

2011-01-01

The Enzyme Function Initiative (EFI) was recently established to address the challenge of assigning reliable functions to enzymes discovered in bacterial genome projects; in this Current Topic we review the structure and operations of the EFI. The EFI includes the Superfamily/Genome, Protein, Structure, Computation, and Data/Dissemination Cores that provide the infrastructure for reliably predicting the in vitro functions of unknown enzymes. The initial targets for functional assignment are selected from five functionally diverse superfamilies (amidohydrolase, enolase, glutathione transferase, haloalkanoic acid dehalogenase, and isoprenoid synthase), with five superfamily-specific Bridging Projects experimentally testing the predicted in vitro enzymatic activities. The EFI also includes the Microbiology Core that evaluates the in vivo context of in vitro enzymatic functions and confirms the functional predictions of the EFI. The deliverables of the EFI to the scientific community include: 1) development of a large-scale, multidisciplinary sequence/structure-based strategy for functional assignment of unknown enzymes discovered in genome projects (target selection, protein production, structure determination, computation, experimental enzymology, microbiology, and structure-based annotation); 2) dissemination of the strategy to the community via publications, collaborations, workshops, and symposia; 3) computational and bioinformatic tools for using the strategy; 4) provision of experimental protocols and/or reagents for enzyme production and characterization; and 5) dissemination of data via the EFI’s website, enzymefunction.org. The realization of multidisciplinary strategies for functional assignment will begin to define the full metabolic diversity that exists in nature and will impact basic biochemical and evolutionary understanding, as well as a wide range of applications of central importance to industrial, medicinal and pharmaceutical efforts. PMID:21999478
The Enzyme Function Initiative.

PubMed

Gerlt, John A; Allen, Karen N; Almo, Steven C; Armstrong, Richard N; Babbitt, Patricia C; Cronan, John E; Dunaway-Mariano, Debra; Imker, Heidi J; Jacobson, Matthew P; Minor, Wladek; Poulter, C Dale; Raushel, Frank M; Sali, Andrej; Shoichet, Brian K; Sweedler, Jonathan V

2011-11-22

The Enzyme Function Initiative (EFI) was recently established to address the challenge of assigning reliable functions to enzymes discovered in bacterial genome projects; in this Current Topic, we review the structure and operations of the EFI. The EFI includes the Superfamily/Genome, Protein, Structure, Computation, and Data/Dissemination Cores that provide the infrastructure for reliably predicting the in vitro functions of unknown enzymes. The initial targets for functional assignment are selected from five functionally diverse superfamilies (amidohydrolase, enolase, glutathione transferase, haloalkanoic acid dehalogenase, and isoprenoid synthase), with five superfamily specific Bridging Projects experimentally testing the predicted in vitro enzymatic activities. The EFI also includes the Microbiology Core that evaluates the in vivo context of in vitro enzymatic functions and confirms the functional predictions of the EFI. The deliverables of the EFI to the scientific community include (1) development of a large-scale, multidisciplinary sequence/structure-based strategy for functional assignment of unknown enzymes discovered in genome projects (target selection, protein production, structure determination, computation, experimental enzymology, microbiology, and structure-based annotation), (2) dissemination of the strategy to the community via publications, collaborations, workshops, and symposia, (3) computational and bioinformatic tools for using the strategy, (4) provision of experimental protocols and/or reagents for enzyme production and characterization, and (5) dissemination of data via the EFI's Website, http://enzymefunction.org. The realization of multidisciplinary strategies for functional assignment will begin to define the full metabolic diversity that exists in nature and will impact basic biochemical and evolutionary understanding, as well as a wide range of applications of central importance to industrial, medicinal, and pharmaceutical efforts. © 2011 American Chemical Society
Broadening participation in community problem solving: a multidisciplinary model to support collaborative practice and research.

PubMed

Lasker, Roz D; Weiss, Elisa S

2003-03-01

Over the last 40 years, thousands of communities-in the United States and internationally-have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. In this article, we seek to overcome some of this fragmentation of effort by presenting a multidisciplinary model that lays out the pathways by which broadly participatory processes lead to more effective community problem solving and to improvements in community health. The model, which builds on a broad array of practical experience as well as conceptual and empirical work in multiple fields, is an outgrowth of a joint-learning work group that was organized to support nine communities in the Turning Point initiative. Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and "how-to" questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts.
Team-based care and improved blood pressure control: a community guide systematic review.

PubMed

Proia, Krista K; Thota, Anilkrishna B; Njie, Gibril J; Finnie, Ramona K C; Hopkins, David P; Mukhtar, Qaiser; Pronk, Nicolaas P; Zeigler, Donald; Kottke, Thomas E; Rask, Kimberly J; Lackland, Daniel T; Brooks, Joy F; Braun, Lynne T; Cooksey, Tonya

2014-07-01

Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care, established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient. Team-based care has the potential to improve the quality of hypertension management. The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure (BP) outcomes. An existing systematic review (search period, January 1980-July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003-May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies. Twenty-eight studies in the prior review (1980-2003) and an additional 52 studies from the Community Guide update (2003-2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg). Team-based care increased the proportion of people with controlled BP and reduced both systolic and diastolic BP, especially when pharmacists and nurses were part of the team. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system-level organizational changes and could be an important element of the medical home. Published by Elsevier Inc.
Case Study of an Aboriginal Community-Controlled Health Service in Australia

PubMed Central

Baum, Fran; Lawless, Angela; Labonté, Ronald; Sanders, David; Boffa, John; Edwards, Tahnia; Javanparast, Sara

2016-01-01

Abstract Universal health coverage provides a framework to achieve health services coverage but does not articulate the model of care desired. Comprehensive primary health care includes promotive, preventive, curative, and rehabilitative interventions and health equity and health as a human right as central goals. In Australia, Aboriginal community-controlled health services have pioneered comprehensive primary health care since their inception in the early 1970s. Our five-year project on comprehensive primary health care in Australia partnered with six services, including one Aboriginal community-controlled health service, the Central Australian Aboriginal Congress. Our findings revealed more impressive outcomes in several areas—multidisciplinary work, community participation, cultural respect and accessibility strategies, preventive and promotive work, and advocacy and intersectoral collaboration on social determinants of health—at the Aboriginal community-controlled health service compared to the other participating South Australian services (state-managed and nongovernmental ones). Because of these strengths, the Central Australian Aboriginal Congress’s community-controlled model of comprehensive primary health care deserves attention as a promising form of implementation of universal health coverage by articulating a model of care based on health as a human right that pursues the goal of health equity. PMID:28559679
Quali-quantitative analysis (QQA): why it could open new frontiers for holistic health practice.

PubMed

Bell, Erica

2006-12-15

Holistic health practice is often described as being about understanding the larger contexts of patients, their health services, and their communities. Yet do traditional quantitative and qualitative health research methods produce the best possible evidence for the holistic practices of doctors, nurses, and allied health professionals? This paper argues "no", and examines the potential of a cutting-edge, social science research method--Quali-Quantitative Research (QQA)--for providing better evidence for holistic practice, particularly in small-N populations, such as rural and remote communities. It does so with reference to the international literature on holistic medicine, as well as three holistic health projects conducted in Tasmania: about prevention of falls in older people, adolescent substance abuse, and interventions for children aged 0-5 exposed to domestic violence. The findings suggest that much health research fails to capture rigorously the contextual complexity of holistic health challenges: the multiple different needs of individual patients, and the interprofessional approaches needed to deliver multidisciplinary and multiservice health interventions tailored to meet those needs in particular community contexts. QQA offers a "configurational", case-based, diversity-oriented approach to analysing data that combines qualitative and quantitative techniques to overcome the limitations of both research traditions. The author concludes that QQA could open new frontiers for holistic health by helping doctors, nurses, and allied health professionals answer a fundamental question presented by complex health challenges: "Given this set of whole-of-patient needs, what elements of which interventions in what services would work best in this particular community?"
Breast Cancer and the Environment Research Program

Cancer.gov

The Breast Cancer and the Environment Research Program supports a multidisciplinary network of scientists, clinicians, and community partners to examine the effects of environmental exposures that may predispose a woman to breast cancer throughout her life.
The effect of health care reform on academic medicine in Canada. Editorial Committee of the Canadian Institute for Academic Medicine.

PubMed

Hollenberg, C H

1996-05-15

Although Canadian health care reform has constrained costs and improved efficiency, it has had a profound and mixed effect on Canadian academic medicine. Teaching hospitals have been reduced in number and size, and in patient programs have shifted to ambulatory and community settings. Specialized care programs are now multi-institutional and multidisciplinary. Furthermore, the influence of regional planning bodies has grown markedly. Although these changes have likely improved clinical service, their impact on the quality of clinical education is uncertain. Within the academic clinical department, recruitment of young faculty has been greatly complicated by constraints on licensing, billing numbers, fee-for-service income and research funding. The departmental practice plan based on university funds and fee-for-service income is being replaced by less favourable funding arrangements. However, emphasis on multidisciplinary programs has rendered these departments more flexible in structure. The future of Canadian academic medicine depends on an effective alliance with government. Academia and government must agree, particularly on human-resource requirements, research objectives and the delivery of clinical and academic programs in regional and community settings. The establishment of focal points for academic health sciences planning within academic health sciences centres and within governments would assist in these developments. Finally, government and the academic health sciences sector must work together to remove the current impediments to the recruitment of highly qualified young faculty.
Description of the EUROBIS Program: A Combination of an Epode Community-Based and a Clinical Care Intervention to Improve the Lifestyles of Children and Adolescents with Overweight or Obesity

PubMed Central

Mazzeschi, Claudia; Pazzagli, Chiara; Laghezza, Loredana; Battistini, Dalila; Reginato, Elisa; Perrone, Chiara; Ranucci, Claudia; Fatone, Cristina; Pippi, Roberto; Giaimo, Maria Donata; Verrotti, Alberto; De Giorgi, Giovanni; De Feo, Pierpaolo

2014-01-01

The present paper describes the Epode Umbria Region Obesity Prevention Study (EUROBIS) and aims to implement the C.U.R.I.A.MO. model through the EPODE methodology. The main goal of the EUROBIS is to change the pendency of slope of the actual trend towards the increase in the yearly rates of childhood overweight and obesity in Umbria and to improve healthy lifestyles of children and their parents. The project is the first EPODE program to be performed in Italy. The aims of the Italian EUROBIS study are: (1) a community-based intervention program (CBP) carrying out activities in all primary schools of the Umbria Region and family settings as first step, to reverse the current obesity trend on a long-term basis, and (2) a clinical care program for childhood and adolescent by C.U.R.I.A.MO. model. C.U.R.I.A.MO. model is a multidisciplinary approach to improve three key aspects of healthy lifestyles: nutrition, exercise, and psychological aspects with the strategy of a family-based approach. The community-based intervention and clinical trial provide an innovative valuable model to address the childhood obesity prevention and treatment in Italy. PMID:25162015
Rehabilitation therapy services for stroke patients living at home: systematic review of randomised trials.

PubMed

Legg, L; Langhorne, P

2004-01-31

Stroke-unit care can be valuable for stroke patients in hospital, but effectiveness of outpatient care is less certain. We aimed to assess the effects of therapy-based rehabilitation services targeted at stroke patients resident in the community within 1 year of stroke onset or discharge from hospital. We did a systematic review of randomised trials of outpatient services, including physiotherapy, occupational therapy, and multidisciplinary teams. We used Cochrane collaboration methodology. We identified a heterogeneous group of 14 trials (1617 patients). Therapy-based rehabilitation services for stroke patients living at home reduced the odds of deteriorating in personal activities of daily living (odds ratio 0.72 [95% CI 0.57-0.92], p=0.009) and increased ability of patients to do personal activities of daily living (standardised mean difference 0.14 [95% CI 0.02-0.25], p=0.02). For every 100 stroke patients resident in the community receiving therapy-based rehabilitation services, seven (95% CI 2-11) would not deteriorate. Therapy-based rehabilitation services targeted at selected patients resident in the community after stroke improve ability to undertake personal activities of daily living and reduce risk of deterioration in ability. These findings should be considered in future service planning.
From data to analysis: linking NWChem and Avogadro with the syntax and semantics of Chemical Markup Language

DOE Office of Scientific and Technical Information (OSTI.GOV)

De Jong, Wibe A.; Walker, Andrew M.; Hanwell, Marcus D.

Background Multidisciplinary integrated research requires the ability to couple the diverse sets of data obtained from a range of complex experiments and computer simulations. Integrating data requires semantically rich information. In this paper the generation of semantically rich data from the NWChem computational chemistry software is discussed within the Chemical Markup Language (CML) framework. Results The NWChem computational chemistry software has been modified and coupled to the FoX library to write CML compliant XML data files. The FoX library was expanded to represent the lexical input files used by the computational chemistry software. Conclusions The production of CML compliant XMLmore » files for the computational chemistry software NWChem can be relatively easily accomplished using the FoX library. A unified computational chemistry or CompChem convention and dictionary needs to be developed through a community-based effort. The long-term goal is to enable a researcher to do Google-style chemistry and physics searches.« less
Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England

PubMed Central

Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

2013-01-01

Purpose: Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Method: Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Results: Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. Conclusions: The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. Implications for Rehabilitation The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke. PMID:23530624
Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England.

PubMed

Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

2013-01-01

Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke.
An Assessment of the State-of-the-Art in Multidisciplinary Aeromechanical Analyses

DTIC Science & Technology

2008-01-01

monolithic formulations. In summary, for aerospace structures, partitioned formulations provide fundamental advantages over fully coupled ones, in addition...important frequencies of local analysis directly to global analysis using detailed modeling. Performed ju- diciously, based on a fundamental understanding of...in 2000 has com- prehensively described the problem, and reviewed the status of fundamental understanding, experimental data, and analytical
International academic service learning: lessons learned from students' travel experiences of diverse cultural and health care practices in morocco.

PubMed

Kaddoura, Mahmoud; Puri, Aditi; Dominick, Christine A

2014-01-01

Academic service learning (ASL) is an active teaching-learning approach to engage students in meaningful hands-on activities to serve community-based needs. Nine health professions students from a private college and a private university in the northeastern United States volunteered to participate in an ASL trip to Morocco. The participants were interviewed to reflect on their experiences. This article discusses the lessons learned from students' ASL experiences regarding integrating ASL into educational programs. The authors recommend a paradigm shift in nursing and dental hygiene curricula to appreciate diversity and promote cultural competency, multidisciplinary teamwork, and ethics-based education. Copyright 2014, SLACK Incorporated.
An Assessment of the State-of-the-art in Multidisciplinary Aeromechanical Analyses

NASA Technical Reports Server (NTRS)

Datta, Anubhav; Johnson, Wayne

2008-01-01

This paper presents a survey of the current state-of-the-art in multidisciplinary aeromechanical analyses which integrate advanced Computational Structural Dynamics (CSD) and Computational Fluid Dynamics (CFD) methods. The application areas to be surveyed include fixed wing aircraft, turbomachinery, and rotary wing aircraft. The objective of the authors in the present paper, together with a companion paper on requirements, is to lay out a path for a High Performance Computing (HPC) based next generation comprehensive rotorcraft analysis. From this survey of the key technologies in other application areas it is possible to identify the critical technology gaps that stem from unique rotorcraft requirements.
Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital.

PubMed

Flabeau, O; Laurendeau, G; Laksir, H; Castaings-Pelet, S; Harston, S; Bourdel-Marchasson, I

2013-02-01

Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles. to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital. Prospective observational study in day hospital. Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics. Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066). Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.
How can group-based multidisciplinary rehabilitation for patients with fibromyalgia influence patients' self-efficacy and ability to cope with their illness: a grounded theory approach.

PubMed

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

2017-04-01

To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness. Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self-efficacy is said to influence and predict adaptive coping behaviours and functioning. However, knowledge is lacking on how rehabilitation programmes may influence self-efficacy and ability to cope, from the patients' perspective. Grounded theory study of semi-structured focus group interviews. Participants (n = 17) were included in four focus groups that had completed a two-week multidisciplinary rehabilitation programme together. Interviews were conducted four weeks after each group had completed the programme. The analysis was conducted constant comparatively applying open, axial and selective coding. Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness, experiencing acceptance from others and developing new coping strategies. Thus, patients benefitted from multidisciplinary rehabilitation with stronger self-efficacy and expectations to their future coping. However, limitations in the programme were identified, as the programme was short and intensive with no subsequent follow-up, and social welfare was not sufficiently addressed. Participants also found it difficult to maintain knowledge and were lacking individual sessions with the psychologist and had waited long to receive rehabilitation. Multidisciplinary rehabilitation may advantageously be offered to patients with fibromyalgia. However, earlier action with longer programmes, in which patients' social situation is addressed, comprising individual sessions with the psychologist, with multiple repetitions of the content and follow-up sessions, may further enhance the patients' self-efficacy and coping with their illness. © 2017 John Wiley & Sons Ltd.
Convergence Estimates for Multidisciplinary Analysis and Optimization

NASA Technical Reports Server (NTRS)

Arian, Eyal

1997-01-01

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

Vector control programs in Saint Johns County, Florida and Guayas, Ecuador: successes and barriers to integrated vector management.

PubMed

Naranjo, Diana P; Qualls, Whitney A; Jurado, Hugo; Perez, Juan C; Xue, Rui-De; Gomez, Eduardo; Beier, John C

2014-07-02

Vector-borne diseases (VBDs) and mosquito control programs (MCPs) diverge in settings and countries, and lead control specialists need to be aware of the most effective control strategies. Integrated Vector Management (IVM) strategies, once implemented in MCPs, aim to reduce cost and optimize protection of the populations against VBDs. This study presents a strengths, weaknesses, opportunities, and threats (SWOT) analysis to compare IVM strategies used by MCPs in Saint Johns County, Florida and Guayas, Ecuador. This research evaluates MCPs strategies to improve vector control activities. Methods included descriptive findings of the MCP operations. Information was obtained from vector control specialists, directors, and residents through field trips, surveys, and questionnaires. Evaluations of the strategies and assets of the control programs where obtained through SWOT analysis and within an IVM approach. Organizationally, the Floridian MCP is a tax-based District able to make decisions independently from county government officials, with the oversight of an elected board of commissioners. The Guayas program is directed by the country government and assessed by non-governmental organizations like the World health Organization. Operationally, the Floridian MCP conducts entomological surveillance and the Ecuadorian MCP focuses on epidemiological monitoring of human disease cases. Strengths of both MCPs were their community participation and educational programs. Weaknesses for both MCPs included limitations in budgets and technical capabilities. Opportunities, for both MCPs, are additional funding and partnerships with private, non-governmental, and governmental organizations. Threats experienced by both MCPs included political constraints and changes in the social and ecological environment that affect mosquito densities and control efforts. IVM pillars for policy making were used to compare the information among the programs. Differences included how the Ecuadorian MCP relies heavily on the community for vector control while the American MCP relies on technologies and research. IVM based recommendations direct health policy leaders toward improving surveillance systems both entomologically and epidemiologically, improving community risk perceptions by integrating components of community participation, maximizing resources though the use of applied research, and protecting the environment by selecting low-risk pesticides. Outcomes of the research revealed that inter-sectorial and multidisciplinary interventions are critical to improve public health.
Farzana's Journey: A Children's Book for Research-based, Educational Outreach in Remote Communities of Bangladesh

NASA Astrophysics Data System (ADS)

Peters, C.; Hornberger, G. M.; Machado, M.

2017-12-01

Academics are encouraged to integrate their environmental research with education and societal outreach, but the methods of doing so can be transient and insubstantial. Here, we use a children's book to create a sustainable relationship with vulnerable communities in Bangladesh. Farzana's Journey is a children's book based on current multidisciplinary Vanderbilt University research on the coupling and coevolution of the physical and human systems in coastal Bangladesh. Written, illustrated, and freely distributed in the Bengali-language, the book is a place-based tool to teach rural Bangladesh communities about the natural world and disseminate our scientific findings. The narrative follows a young girl, Farzana, who must walk a long distance to fetch her family's water. Her usual journey develops into an adventure as she meets a variety of animal characters, who relay a story about her ever-changing environment and the subsequent human adaptation. After exploring environmental topics, such as geomorphology, water availability, and climate, Farzana appreciates the uniqueness of her local environment and the adaptations of her ancestors and future generations. Through the development and distribution of the book, we encouraged dialogue, collaboration, and public outreach with scientists, artists, and students concerned with enhancing educational and social opportunity in rural communities. We also ensure a tangible tie through the book itself after the culmination of the research project. The book achieves the primary goal of sparking children's curiosity in the local environment, while also demonstrating an effective means for sustainable educational outreach with impoverished, remote communities.
Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

ERIC Educational Resources Information Center

Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

2016-01-01

UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…
About DCP | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) is the division of the National Cancer Institute (NCI) devoted to cancer prevention research. DCP provides funding and administrative support to clinical and laboratory researchers, community and multidisciplinary teams, and collaborative scientific networks. |
Development and Application of the Collaborative Optimization Architecture in a Multidisciplinary Design Environment

NASA Technical Reports Server (NTRS)

Braun, R. D.; Kroo, I. M.

1995-01-01

Collaborative optimization is a design architecture applicable in any multidisciplinary analysis environment but specifically intended for large-scale distributed analysis applications. In this approach, a complex problem is hierarchically de- composed along disciplinary boundaries into a number of subproblems which are brought into multidisciplinary agreement by a system-level coordination process. When applied to problems in a multidisciplinary design environment, this scheme has several advantages over traditional solution strategies. These advantageous features include reducing the amount of information transferred between disciplines, the removal of large iteration-loops, allowing the use of different subspace optimizers among the various analysis groups, an analysis framework which is easily parallelized and can operate on heterogenous equipment, and a structural framework that is well-suited for conventional disciplinary organizations. In this article, the collaborative architecture is developed and its mathematical foundation is presented. An example application is also presented which highlights the potential of this method for use in large-scale design applications.
Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention.

PubMed

Bell, Jack J; Bauer, Judith D; Capra, Sandra; Pulle, Ranjeev Chrys

2014-12-01

Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, controlled before and after comparative interventional study aligning to the CONSORT guidelines for pragmatic clinical trials. Randomly selected patients receiving individualised nutritional care (baseline) were compared with post-interventional patients receiving a new model of nutritional care promoting nutrition as a medicine, multidisciplinary nutritional care, foodservice enhancements, and improved nutrition knowledge and awareness. Malnutrition was diagnosed using the Academy of Nutrition and Dietetics criteria. Fifty-eight weighed food records were available for each group across a total of 82 patients (n = 44, n = 38). Group demographics were not significantly different with predominantly community dwelling (72%), elderly (82.2 years), female (70%), malnourished (51.0%) patients prone to co-morbidities (median 5) receiving early surgical intervention (median D1). Multidisciplinary nutritional care reduced intake barriers and increased total 24-h energy (6224 vs. 2957 kJ; p < 0.001) and protein (69.0 vs. 33.8 g; p < 0.001) intakes, reduced nutritional deterioration over admission (5.4 vs. 20.5%; p = 0.049), and increased discharge directly back to the community setting (48.0 vs. 17.6%; p = 0.012). Trends suggested a reduction in median length of stay (D13 vs. D14). Inpatient mortality remained low across groups (5.2%, 2.3%). Multidisciplinary nutritional care improves nutrition intake and outcomes in acute hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Surrogate assisted multidisciplinary design optimization for an all-electric GEO satellite

NASA Astrophysics Data System (ADS)

Shi, Renhe; Liu, Li; Long, Teng; Liu, Jian; Yuan, Bin

2017-09-01

State-of-the-art all-electric geostationary earth orbit (GEO) satellites use electric thrusters to execute all propulsive duties, which significantly differ from the traditional all-chemical ones in orbit-raising, station-keeping, radiation damage protection, and power budget, etc. Design optimization task of an all-electric GEO satellite is therefore a complex multidisciplinary design optimization (MDO) problem involving unique design considerations. However, solving the all-electric GEO satellite MDO problem faces big challenges in disciplinary modeling techniques and efficient optimization strategy. To address these challenges, we presents a surrogate assisted MDO framework consisting of several modules, i.e., MDO problem definition, multidisciplinary modeling, multidisciplinary analysis (MDA), and surrogate assisted optimizer. Based on the proposed framework, the all-electric GEO satellite MDO problem is formulated to minimize the total mass of the satellite system under a number of practical constraints. Then considerable efforts are spent on multidisciplinary modeling involving geosynchronous transfer, GEO station-keeping, power, thermal control, attitude control, and structure disciplines. Since orbit dynamics models and finite element structural model are computationally expensive, an adaptive response surface surrogate based optimizer is incorporated in the proposed framework to solve the satellite MDO problem with moderate computational cost, where a response surface surrogate is gradually refined to represent the computationally expensive MDA process. After optimization, the total mass of the studied GEO satellite is decreased by 185.3 kg (i.e., 7.3% of the total mass). Finally, the optimal design is further discussed to demonstrate the effectiveness of our proposed framework to cope with the all-electric GEO satellite system design optimization problems. This proposed surrogate assisted MDO framework can also provide valuable references for other all-electric spacecraft system design.
Supporting Entrepreneurship and Innovation in Higher Education in Poland. OECD Skills Studies

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

This report presents evidence-based analysis on Poland's higher education transformation process towards an innovative, interconnected and multidisciplinary entrepreneurial system, designed to empower its students and staff to demonstrate enterprise, innovation and creativity in teaching, research and societal engagement. Using the OECD-European…
Supporting Entrepreneurship and Innovation in Higher Education in Ireland. OECD Skills Studies

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

This report presents evidence-based analysis on Ireland's higher education transformation process towards an innovative, interconnected and multidisciplinary entrepreneurial system, designed to empower its students and staff to demonstrate enterprise, innovation and creativity in teaching, research and societal engagement. Using the OECD-European…
Adaptive Modeling Language and Its Derivatives

NASA Technical Reports Server (NTRS)

Chemaly, Adel

2006-01-01

Adaptive Modeling Language (AML) is the underlying language of an object-oriented, multidisciplinary, knowledge-based engineering framework. AML offers an advanced modeling paradigm with an open architecture, enabling the automation of the entire product development cycle, integrating product configuration, design, analysis, visualization, production planning, inspection, and cost estimation.
Robust Optimization and Sensitivity Analysis with Multi-Objective Genetic Algorithms: Single- and Multi-Disciplinary Applications

DTIC Science & Technology

2007-01-01

multi-disciplinary optimization with uncertainty. Robust optimization and sensitivity analysis is usually used when an optimization model has...formulation is introduced in Section 2.3. We briefly discuss several definitions used in the sensitivity analysis in Section 2.4. Following in...2.5. 2.4 SENSITIVITY ANALYSIS In this section, we discuss several definitions used in Chapter 5 for Multi-Objective Sensitivity Analysis . Inner
Can specially trained community care workers effectively support patients and their families in the home setting at the end of life?

PubMed

Poulos, Roslyn G; Harkin, Damian; Poulos, Christopher J; Cole, Andrew; MacLeod, Rod

2018-03-01

Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs). An evaluation of the service was undertaken, focussing on the self-reported impact of the service on family carers (FCs), with triangulation of findings from community palliative care teams and CCWs. Service evaluation data were obtained through postal surveys and/or qualitative interviews with FCs, community palliative care teams and CCWs. FCs also reported the experience of their loved one based on 10 items drawn from the Quality of Death and Dying Questionnaire (QODD). Thematic analysis of surveys and interviews found that the support provided by CCWs was valued by FCs for: enabling choice (i.e. to realise end-of-life care in the home); providing practical assistance ("hands-on"); and for emotional support and reassurance. This was corroborated by community palliative care teams and CCWs. Responses by FCs on the QODD items indicated that in the last week of life, effective control of symptoms was occurring and quality of life was being maintained. This study suggests that satisfactory outcomes for patients and their families who wish to have end-of-life care in the home can be enabled with the additional support of specially trained CCWs. A notable benefit of the PCHSP model, which provided specific palliative care vocational training to an existing community care workforce, was a relatively rapid increase in the palliative care workforce across the state. © 2017 John Wiley & Sons Ltd.
Development of a Multi-Disciplinary Aerothermostructural Model Applicable to Hypersonic Flight

NASA Technical Reports Server (NTRS)

Kostyk, Chris; Risch, Tim

2013-01-01

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

PubMed

De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

2017-08-01

The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Cognitive-behavioural treatment for weight loss in primary care: a prospective study.

PubMed

Eichler, Klaus; Zoller, Marco; Steurer, Johann; Bachmann, Lucas M

2007-09-08

Cognitive-behavioural treatment (CBT) is effective for weight loss in obese patients, but such programmes are difficult to implement in primary care. We assessed whether implementation of a community-based CBT weight loss programme for adults in routine care is feasible and prospectively assessed patient outcome. The weight loss programme was provided by a network of Swiss general practitioners in cooperation with a community centre for health education. We chose a five-step strategy focusing on structure of care rather than primarily addressing individual physician behaviour. A multidisciplinary core group of trained CBT instructors acted as the central element of the programme. Overweight and obese adults from the community (BMI >25 kg/m2) were included. We used a patient perspective to report the impact on delivery of care and assessed weight change of consecutive participants prospectively with a follow-up of 12 months. Twenty-eight courses, with 16 group meetings each, were initiated over a period of 3 years. 44 of 110 network physicians referred patients to the programme. 147 of 191 study participants were monitored for one year (attrition rate: 23%). Median weight loss after 12 months for 147 completers was 4 kg (IQR: 1-7 kg; intention-to-treat analysis for 191 participants: 2 kg, IQR: 0-5 kg). The programme produced a clinically meaningful weight loss in our participants, with a relatively low attrition rate. Implementation of an easily accessible CBT programme for weight loss in daily routine primary care is feasible.
Preparing the workforce for healthy aging programs: the Skills for Healthy Aging Resources and Programs (SHARP) model.

PubMed

Frank, Janet C; Altpeter, Mary; Damron-Rodriguez, JoAnn; Driggers, Joann; Lachenmayr, Susan; Manning, Colleen; Martinez, Dana M; Price, Rachel M; Robinson, Patricia

2014-10-01

Current public health and aging service agency personnel have little training in gerontology, and virtually no training in evidence-based health promotion and disease management programs for older adults. These programs are rapidly becoming the future of our community-based long-term care support system. The purpose of this project was to develop and test a model community college career technical education program, Skills for Healthy Aging Resources and Programs (SHARP), for undergraduate college students, current personnel in aging service and community organizations, and others interested in retraining. A multidisciplinary cross-sector team from disciplines of public health, sociology, gerontology and nursing developed four competency-based courses that focus on healthy aging, behavior change strategies, program management, an internship, and an option for leader training in the Chronic Disease Self-Management Program. To enhance implementation and fidelity, intensive faculty development training was provided to all instructors and community agency partners. Baseline and postprogram evaluation of competencies for faculty and students was conducted. Process evaluation for both groups focused on satisfaction with the curricula and suggestions for program improvement. SHARP has been piloted five times at two community colleges. Trainees (n = 113) were primarily community college students (n = 108) and current aging service personnel (n = 5). Statistically significant improvements in all competencies were found for both faculty and students. Process evaluation outcomes identified the needed logical and component adaptations to enhance the feasibility of program implementation, dissemination, and student satisfaction. The SHARP program provides a well-tested, evidence-based effective model for addressing workforce preparation in support of healthy aging service program expansion and delivery. © 2014 Society for Public Health Education.
Multidisciplinary Design, Analysis, and Optimization Tool Development using a Genetic Algorithm

NASA Technical Reports Server (NTRS)

Pak, Chan-gi; Li, Wesley

2008-01-01

Multidisciplinary design, analysis, and optimization using a genetic algorithm is being developed at the National Aeronautics and Space A dministration Dryden Flight Research Center to automate analysis and design process by leveraging existing tools such as NASTRAN, ZAERO a nd CFD codes to enable true multidisciplinary optimization in the pr eliminary design stage of subsonic, transonic, supersonic, and hypers onic aircraft. This is a promising technology, but faces many challe nges in large-scale, real-world application. This paper describes cur rent approaches, recent results, and challenges for MDAO as demonstr ated by our experience with the Ikhana fire pod design.
Probabilistic methods for sensitivity analysis and calibration in the NASA challenge problem

DOE PAGES

Safta, Cosmin; Sargsyan, Khachik; Najm, Habib N.; ...

2015-01-01

In this study, a series of algorithms are proposed to address the problems in the NASA Langley Research Center Multidisciplinary Uncertainty Quantification Challenge. A Bayesian approach is employed to characterize and calibrate the epistemic parameters based on the available data, whereas a variance-based global sensitivity analysis is used to rank the epistemic and aleatory model parameters. A nested sampling of the aleatory–epistemic space is proposed to propagate uncertainties from model parameters to output quantities of interest.
Probabilistic methods for sensitivity analysis and calibration in the NASA challenge problem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Safta, Cosmin; Sargsyan, Khachik; Najm, Habib N.

In this study, a series of algorithms are proposed to address the problems in the NASA Langley Research Center Multidisciplinary Uncertainty Quantification Challenge. A Bayesian approach is employed to characterize and calibrate the epistemic parameters based on the available data, whereas a variance-based global sensitivity analysis is used to rank the epistemic and aleatory model parameters. A nested sampling of the aleatory–epistemic space is proposed to propagate uncertainties from model parameters to output quantities of interest.
Sequence analysis to assess labour market participation following vocational rehabilitation: an observational study among patients sick-listed with low back pain from a randomised clinical trial in Denmark.

PubMed

Lindholdt, Louise; Labriola, Merete; Nielsen, Claus Vinther; Horsbøl, Trine Allerslev; Lund, Thomas

2017-07-20

The return-to-work (RTW) process after long-term sickness absence is often complex and long and implies multiple shifts between different labour market states for the absentee. Standard methods for examining RTW research typically rely on the analysis of one outcome measure at a time, which will not capture the many possible states and transitions the absentee can go through. The purpose of this study was to explore the potential added value of sequence analysis in supplement to standard regression analysis of a multidisciplinary RTW intervention among patients with low back pain (LBP). The study population consisted of 160 patients randomly allocated to either a hospital-based brief or a multidisciplinary intervention. Data on labour market participation following intervention were obtained from a national register and analysed in two ways: as a binary outcome expressed as active or passive relief at a 1-year follow-up and as four different categories for labour market participation. Logistic regression and sequence analysis were performed. The logistic regression analysis showed no difference in labour market participation for patients in the two groups after 1 year. Applying sequence analysis showed differences in subsequent labour market participation after 2 years after baseline in favour of the brief intervention group versus the multidisciplinary intervention group. The study indicated that sequence analysis could provide added analytical value as a supplement to traditional regression analysis in prospective studies of RTW among patients with LBP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Integrating participatory engagement and scientific research to inform causes and solutions to water problems in the River Njoro Watershed Kenya.

NASA Astrophysics Data System (ADS)

Jenkins, M.

2012-12-01

Over the course of 9 years, an international multidisciplinary team of US and Kenyan scientists under the Sustainable Management of Rural Watersheds (SUMAWA) Project, based at Egerton University in Kenya, worked with Kenyan public agencies to apply a variety of participatory methods and outreach activities combined with land use mapping, hydrologic and water system modeling, and other scientific tools and evaluations to investigate and identify solutions to declining water quantity and quality problems affecting communities and environmental and productive sectors in the River Njoro Watershed in Kenya. Traditional participatory rural appraisal techniques were modified to engage low income, informal, and tribal communities in identification of local services, benefits, and groups linked to water and riparian resources and collect their perceptions of water-related problems, priorities, and solution options throughout the watershed. Building on this foundation of insights, information, and engagement on water issues with local communities and other stakeholders, the project designed a research agenda aimed at creating shared scientific understanding of the causes of identified problems and developing and testing promising interventions to address community and stakeholder priority concerns. This presentation will share lessons from the SUMAWA experience of using a problem-driven, solution-oriented, community-based watershed approach to address water resource problems at local scale in a semi-arid African developing country setting.
INTAROS: Development of an integrated Arctic observation system under Horizon 2020

NASA Astrophysics Data System (ADS)

Beszczynska-Möller, Agnieszka; Sandven, Stein; Sagen, Hanne

2017-04-01

INTAROS is a research and innovation action funded under the H2020-BG-09 call for the five-year period 2016-2021. INTAROS will develop an integrated Arctic Observation System (iAOS) by extending, improving and unifying existing systems in the different regions of the Arctic. INTAROS will have a strong multidisciplinary focus, with tools for integration of data from atmosphere, ocean, cryosphere and terrestrial sciences, provided by institutions in Europe, North America and Asia. Satellite earth observation (EO) data plays an increasingly important role in such observing systems, because the amount of EO data for observing the global climate and environment grows year by year. EO data will therefore be integrated into iAOS based on existing products and databases. In situ observing systems are much more limited due to logistical constraints and cost limitations. The sparseness of in situ data is therefore the largest gap in the overall observing system. INTAROS will assess strengths and weaknesses of existing Arctic observing systems and contribute with innovative solutions to fill some of the critical gaps in the selected networks. INTAROS will develop a platform, iAOS, to search for and access data from distributed databases. The evolution into a sustainable Arctic observing system requires coordination, mobilization and cooperation between the existing European and international infrastructures (in-situ and remote, including space-based), the modeling communities and relevant stakeholder groups. INTAROS will include development of community-based observing systems, where local knowledge is merged with scientific data. Multidisciplinary data integrated under INTAROS will contribute to better understanding of interactions and coupling in the complex Arctic ice-ocean-land-atmosphere system. An integrated Arctic Observation System will enable better-informed decisions and better-documented processes within key sectors (e.g. local communities, shipping, tourism, fishing), in order to strengthen the societal and economic role of the Arctic region and support the EU strategy for the Arctic and related maritime and environmental policies. Following the SAON goal, INTAROS will support and strengthen the EU engagement in developing the sustained and coordinated pan-Arctic observing and data sharing systems.
Towards a strategic alignment of public health and primary care practices at local levels - the case of severe and enduring mental illness.

PubMed

Banarsee, Ricky; Kelly, Cornelius; El-Osta, Austen; Thomas, Paul; Brophy, Chris

2018-03-01

The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned. A shared vision for both health and disease management is needed to ensure consistent messaging by all. A three tier system of shared care can help to combine vertical and horizontal integration. This paper uses severe and enduring mental illness as an exemplar to anticipate the design of such a system.
New initiative in studies of Earth's deep interior

NASA Astrophysics Data System (ADS)

Lay, Thorne

A multidisciplinary U.S. research community is undertaking a new coordinated effort to study the state and dynamics of the Earth's deep mantle and core. At an open meeting held at the Massachusetts Institute of Technology, Cambridge, from September 11 to 12, 1992, over 120 Earth scientists gathered to discuss this new program, which is an outgrowth of activity during the previous year by an ad hoc steering committee. The research program will be coordinated by a community-based scientific organization and supported through competitive research proposals submitted to the National Science Foundation with the aim of facilitating cooperative research projects cutting across traditional disciplinary and institutional boundaries.The new organization is the U.S. Studies of the Earth's Deep Interior (SEDI) Coordinating Committee. This committee will facilitate communication among the U.S. SEDI research community, federal funding agencies, the AGU Committee for Studies of the Earth's Interior (SEI), the Union SEDI Committee of the International Union of Geodesy and Geophysics, and the general public (Figure 1).
Exergaming for health: a community-based pediatric weight management program using active video gaming.

PubMed

Christison, Amy; Khan, Huma Ali

2012-04-01

To evaluate the efficacy and feasibility of a multifaceted, community-based weight intervention program for children using exergaming technology (activity-promoting video gaming). This is a prospective observational pilot study. Forty-eight children, between the ages of 8 and 16 years, who are overweight or obese, enrolled in Exergaming for Health, a multidisciplinary weight management program, which used active video gaming. Primary outcome measures were change in body mass index (BMI) z scores. Most children (n = 40, 83%) completed the program and participated in outcome evaluations. The average BMI change was -0.48 kg/m(2) (SD = 0.93), P < .002 (BMI z-score change was -0.072, SD = 0.14, P < .0001). The average Global Self-Worth score improved, screen time and soda intake reduced, and exercise hours per week increased. The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates. A larger randomized controlled trial is needed to confirm these results.
Multi-disciplinary coupling effects for integrated design of propulsion systems

NASA Technical Reports Server (NTRS)

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

1993-01-01

Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions which govern the accurate response of propulsion systems. Results are presented for propulsion system responses including multi-disciplinary coupling effects using coupled multi-discipline thermal, structural, and acoustic tailoring; an integrated system of multi-disciplinary simulators; coupled material behavior/fabrication process tailoring; sensitivities using a probabilistic simulator; and coupled materials, structures, fracture, and probabilistic behavior simulator. The results demonstrate that superior designs can be achieved if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated coupled multi-discipline numerical propulsion system simulator.
Unravel the submesoscale dynamics of the phytoplanktonic community in the NW Mediterranean Sea by in situ observations: the 2015 OSCAHR cruise

NASA Astrophysics Data System (ADS)

Marrec, Pierre; Doglioli, Andrea M.; Grégori, Gérald; Della Penna, Alice; Wagener, Thibaut; Rougier, Gille; Bhairy, Nagib; Dugenne, Mathilde; Lahbib, Soumaya; Thyssen, Melilotus

2017-04-01

Submesoscale phenomena have been recently recognized as a key factor in physical-biological-biogeochemical interactions, even if it remains unclear how these processes affect the global state of the ocean. Significant large-scale impacts of submesoscale structures on primary production and influence on the phytoplankton community structure and diversity have also been reported. In the past decade submesoscale dynamics have been predominately studied through the analysis of numerical simulations. Observing the coupled physical and biogeochemical variability at this scale remains challenging due to the ephemeral nature of submesoscale structures. The in-situ study of such structures necessitates multidisciplinary approaches involving in situ observations, remote sensing and modeling. Last progresses in biogeochemical sensor development and advanced methodology including Lagrangian real-time adaptative strategies represent outstanding opportunities. The OSCAHR (Observing Submesoscale Coupling At High Resolution) campaign has been conducted thanks to a multidisciplinary approach in order to improve the understanding of submesoscale processes. An ephemeral submesoscale structure was first identified in the Ligurian Sea in fall 2015 using both satellite and numerical modeling data before the campaign. Afterwards, advanced observing systems for the physical, biological and biogeochemical characterization of the sea surface layer at a high spatial and temporal frequency were deployed during a 10-days cruise. A MVP (Moving Vessel Profiler) was used to obtain high resolution CTD profiles associated to a new pumping system with 1-m vertical resolution. Moreover, along the ship track, in addition to the standard measurements of seawater surface samples (Chl-a, nutrients, O2, SST, SSS …), we deployed an automated flow cytometer for near real-time characterization of phytoplankton functional groups (from micro-phytoplankton down to cyanobacteria). The observed submesoscale feature presented a cyclonic structure with a relatively cold core surrounded by warmer waters. Six phytoplankton groups were identified across the structure with an unprecedented spatial and temporal resolution. According to our observations, we could quantify the influence of the fast established physical structure on the spatial distribution of the phytoplankton functional groups, giving coherence to the observed community structuration. Moreover, the high resolution of our observations allows us to estimate the growth rate of the main phytoplankton groups. Our innovative adaptative strategy with a multidisciplinary and transversal approach provides a deeper understanding of the marine biogeochemical dynamics through the first trophic levels.
Overall survival after resection of retroperitoneal sarcoma at academic cancer centers versus community cancer centers: An analysis of the National Cancer Data Base.

PubMed

Berger, Nicholas G; Silva, Jack P; Mogal, Harveshp; Clarke, Callisia N; Bedi, Manpreet; Charlson, John; Christians, Kathleen K; Tsai, Susan; Gamblin, T Clark

2018-02-01

Operative resection remains the definitive curative therapy for retroperitoneal sarcoma. Data published recently show a correlation between improved outcomes for complex oncologic operations and treatment at academic centers. For large retroperitoneal sarcomas, operative resection can be complex and require multidisciplinary care. We hypothesized that survival rates vary between type of treating center for patients undergoing resection for retroperitoneal sarcoma. Patients with stage I to III nonmetastatic retroperitoneal sarcomas who underwent operative resection were identified from the National Cancer Database during the years 2004-2013. Treating centers were categorized as academic cancer centers or community cancer centers. Overall survival was analyzed by log-rank test and graphed using Kaplan-Meier method. A total of 2,762 patients were identified. A majority of patients (59.4%, n = 1,642) underwent resection at an academic cancer centers. Median age at diagnosis was 63 years old. Neoadjuvant radiotherapy was more common at academic cancer centers, while adjuvant radiotherapy was more common at community cancer centers. Improved overall survival was seen at academic cancer centers across all stages compared with community cancer centers (P = .014) but, after multivariable Cox regression analysis, was not a significant independent predictor of survival (hazard ratio = 0.91, 95% confidence interval, 0.79-1.04, P = .171). Academic cancer centers exhibited a greater rate of R0 resection (55.9% vs 47.0%, P < .001) and a lesser odds of positive margins (odds ratio 0.83, 95% confidence interval, 0.69-0.99, P = .044) after multivariable logistic regression. Resection for retroperitoneal sarcoma performed at academic cancer centers was an independent predictor of margin-negative resection but was not a statistically significant factor for survival. This observation suggests that site of care may contribute to some aspect of improved oncologic resection for retroperitoneal sarcoma. Copyright © 2017 Elsevier Inc. All rights reserved.
POTENTIAL AQUATIC COMMUNITY IMPROVEMENT THROUGH A MULTIDISCIPLINARY STORMWATER MANAGEMENT EXPERIMENT

EPA Science Inventory

Small-scale urban stream restoration efforts (e.g., riparian planting and in-stream habitat structures) often fail to improve ecological structure and function due the continuous hydrologic and chemical disturbances posed by impervious surfaces upstream. Decentralized stormwater...
'The perfect is the enemy of the good' - ergonomics research and practice. Institute of Ergonomics and Human Factors Annual Lecture 2010.

PubMed

Buckle, Peter

2011-01-01

The relationship between research and practice in ergonomics and human factors has rarely been addressed in the literature. This presents specific problems for researchers when seeking to relate their work to the research community. Equally, practitioners are often frustrated by the lack of appropriate research to meet their needs. This paper seeks to identify current drivers for ergonomics research along with an analysis of how these are changing. Specifically, the use of bibliometric data to assess research output and its impact on a multi-disciplinary subject such as ergonomics is examined. Areas where action may be required to stimulate better research and improved practice are proposed. These include a greater role for the practitioner in completing the circle of knowledge and improving the evidence base for practice with, in particular, practitioners becoming more active in determining research priorities. It is concluded that combined effort is needed by researcher and practitioner communities to enable and promote a more effective understanding of the true impact of ergonomics across industry and society. STATEMENT OF RELEVANCE: The relationship between ergonomics research and practice is examined. Research 'drivers' are identified, including the influence of bibliometric data. Implications for researchers and practitioners are discussed. The role of practitioners in completing the circle of knowledge and improving the ergonomics evidence base is stressed, as is the need to promote the impact of ergonomics across society.
The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

PubMed Central

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-01-01

Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394
Sensitivity Analysis for Multidisciplinary Systems (SAMS)

DTIC Science & Technology

2016-12-01

support both mode-based structural representations and time-dependent, nonlinear finite element structural dynamics. This interim report describes...Adaptation, & Sensitivity Toolkit • Elasticity, heat transfer, & compressible flow • Adjoint solver for sensitivity analysis • High-order finite elements ...PROGRAM ELEMENT NUMBER 62201F 6. AUTHOR(S) Richard D. Snyder 5d. PROJECT NUMBER 2401 5e. TASK NUMBER N/A 5f. WORK UNIT NUMBER Q1FS 7
IAI Capacity Building Activities in the Americas: Fostering Multinational and Multidisciplinary Research

NASA Astrophysics Data System (ADS)

Ohira, M. S.

2007-05-01

The IAI's Training and Education (T&E) activities are designed to encourage capacity building in the Americas and are developed within and in parallel with the IAI research programs in global environmental change (GEC). The IAI has various training priorities: (1) support for graduate students in the form of fellowships through research programs; (2) development of IAI Training Institutes in Interdisciplinary Sciences and Science-Policy Fora; and (3) support for technical workshops, scientific meetings, and seminars. It becomes increasingly evident that institutions such as IAI must provide training and support to policy and decision makers who deal with environmental issues. The IAI Training Institutes emphasize an exchange of information about the various scientific languages, needs, and methodologies of disciplines that study GEC. Particular attention is given to socio-economic impacts and ways in which nations can gain a better understanding of the complex mechanisms, degrees of change, causes, and consequences - and therefore, plan sound public and private policies to minimize problems and maximize opportunities. The IAI has also implemented a Training Institute Seed Grant (TISG) Program as an assessment activity of the Training Institutes to further encourage network building and multinational and multidisciplinary collaboration among its 19 member countries in the Americas. By fostering the development of such new multidisciplinary, multinational teams, the IAI ensures a future generation of professionals who will be engaged in IAI research programs and networks and will lead the integrated science programs in the next decades. Furthermore, IAI has organized Science-Policy Fora, which focus on the science- policy interface and ways to incorporate scientific information into policy and decision-making processes. Participants discussed what scientific information is available, what aspects need to be better understood, translation of scientific information for the nonscientific community, potential uses of technical information, and policy issues that should be incorporated into the scientific community's agenda. Participants are individuals from governmental agencies, national and international organizations, nongovernmental organizations (NGO), universities, and private companies. Various other T&E-based initiatives that contribute to the building of scientific capacity in the Americas are supported by the IAI. Workshops, seminars, conferences, and other venues encourage the exchange of information and data providing scientists and professionals in global change related fields many opportunities to interact and benefit from multinational, multidisciplinary collaborations.
Multidisciplinary Optimization Methods for Aircraft Preliminary Design

NASA Technical Reports Server (NTRS)

Kroo, Ilan; Altus, Steve; Braun, Robert; Gage, Peter; Sobieski, Ian

1994-01-01

This paper describes a research program aimed at improved methods for multidisciplinary design and optimization of large-scale aeronautical systems. The research involves new approaches to system decomposition, interdisciplinary communication, and methods of exploiting coarse-grained parallelism for analysis and optimization. A new architecture, that involves a tight coupling between optimization and analysis, is intended to improve efficiency while simplifying the structure of multidisciplinary, computation-intensive design problems involving many analysis disciplines and perhaps hundreds of design variables. Work in two areas is described here: system decomposition using compatibility constraints to simplify the analysis structure and take advantage of coarse-grained parallelism; and collaborative optimization, a decomposition of the optimization process to permit parallel design and to simplify interdisciplinary communication requirements.
Evolution of Multidisciplinary Translational Teams (MTTs): Insights for Accelerating Translational Innovations

PubMed Central

Calhoun, William J.; Bhavnani, Suresh; Rose, Robert M.; Ameredes, Bill; Brasier, Allan R.

2015-01-01

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

PubMed

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

2015-10-01

There is growing consensus about the factors critical for development and productivity of multidisciplinary teams, but few studies have evaluated their longitudinal changes. We present a longitudinal study of 10 multidisciplinary translational teams (MTTs), based on team process and outcome measures, evaluated before and after 3 years of CTSA collaboration. Using a mixed methods approach, an expert panel of five judges (familiar with the progress of the teams) independently rated team performance based on four process and four outcome measures, and achieved a rating consensus. Although all teams made progress in translational domains, other process and outcome measures were highly variable. The trajectory profiles identified four categories of team performance. Objective bibliometric analysis of CTSA-supported MTTs with positive growth in process scores showed that these teams tended to have enhanced scientific outcomes and published in new scientific domains, indicating the conduct of innovative science. Case exemplars revealed that MTTs that experienced growth in both process and outcome evaluative criteria also experienced greater innovation, defined as publications in different areas of science. Of the eight evaluative criteria, leadership-related behaviors were the most resistant to the interventions introduced. Well-managed MTTs demonstrate objective productivity and facilitate innovation. © 2015 Wiley Periodicals, Inc.
State of the Art Review of Human-Human Collaboration Research: An Integrated, Multidisciplinary Perspective

DTIC Science & Technology

2002-10-31

NJ: Lawrence Erlbaum. Jamal, T. B. & Getz, D. (1995). Collaboration Theory and Community Tourism Planning. Annals of Tourism Planning...Surveys, 31. Jamal, T. B. & Getz, D. (1995). Collaboration Theory and Community Tourism Planning. Annals of Tourism Planning Research, 22 (1...granum/altdocs/dav_alt.htm. Jorn, L. A., Duin, A. H., & Wahlstrom, B. J. (1996). Designing and Managing Virtual Learning ommunities . IEEE
Compiling, costing and funding complex packages of home-based health care.

PubMed

Noyes, Jane; Lewis, Mary

2007-06-01

Nurses play a central role in putting together complex packages of care to support children with complex healthcare needs and their families in the community. However, there is little evidence or guidance to support this area of practice. At present, the process of compiling a care package and obtaining funding takes too long, causing significant delays in discharge and great frustration for parents, children and professionals. This article presents a combination of best practice guidance and, where possible, evidence-based principles that can be adapted and applied to an individual case irrespective of the child's diagnosis. The aim is to assist nurses and other healthcare professionals in organising funding for packages of care, bringing about the desired outcomes of successful discharge and appropriate community support. To work effectively as keyworkers for these children and families nurses need knowledge and skills in relation to: multidisciplinary assessment frameworks and processes, identifying appropriate models of service provision, costing care packages and approaches to obtaining funding. A further article next month will address risk management and clinical governance issues in delivering complex home-based care.
A Case Study of a Co-Instructed Multidisciplinary Senior Capstone Project in Sustainability

ERIC Educational Resources Information Center

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

2014-01-01

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

NASA Astrophysics Data System (ADS)

Wang, Ping; Wu, Guangqiang

2013-03-01

Typical multidisciplinary design optimization(MDO) has gradually been proposed to balance performances of lightweight, noise, vibration and harshness(NVH) and safety for instrument panel(IP) structure in the automotive development. Nevertheless, plastic constitutive relation of Polypropylene(PP) under different strain rates, has not been taken into consideration in current reliability-based and collaborative IP MDO design. In this paper, based on tensile test under different strain rates, the constitutive relation of Polypropylene material is studied. Impact simulation tests for head and knee bolster are carried out to meet the regulation of FMVSS 201 and FMVSS 208, respectively. NVH analysis is performed to obtain mainly the natural frequencies and corresponding mode shapes, while the crashworthiness analysis is employed to examine the crash behavior of IP structure. With the consideration of lightweight, NVH, head and knee bolster impact performance, design of experiment(DOE), response surface model(RSM), and collaborative optimization(CO) are applied to realize the determined and reliability-based optimizations, respectively. Furthermore, based on multi-objective genetic algorithm(MOGA), the optimal Pareto sets are completed to solve the multi-objective optimization(MOO) problem. The proposed research ensures the smoothness of Pareto set, enhances the ability of engineers to make a comprehensive decision about multi-objectives and choose the optimal design, and improves the quality and efficiency of MDO.

A Multidisciplinary Patient Navigation Program Improves Compliance With Adjuvant Breast Cancer Therapy in a Public Hospital.

PubMed

Castaldi, Maria; Safadjou, Saman; Elrafei, Tarek; McNelis, John

Cancer health disparities affecting low-income and minority patients have been well documented to lead to poor outcomes. This report examines the impact of patient navigation on adherence to prescribed adjuvant breast cancer treatment. A multidisciplinary patient navigation program was initiated at a public safety net hospital to improve compliance with 3 National Quality Forum measures: (1) administration of combination chemotherapy for women with Stage (defined by the American Joint Committee on Cancer [AJCC]) T1c, II, or III hormone receptor-negative breast cancer within 120 days; (2) administration of endocrine therapy for women with AJCC Stage T1c, II, or III hormone receptor-positive breast cancer within 365 days; and (3) radiation therapy for women receiving breast-conserving surgery within one year. Implementation of a multidisciplinary patient navigation program reduced time to treatment and improved compliance with adjuvant therapy for breast cancer in an underserved minority community.
Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study

PubMed Central

Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

2017-01-01

Objective To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. Setting A large, non-profit home nursing service in Melbourne, Australia. Participants Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Data collection and analysis Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists’ reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. Results The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. Conclusions A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. PMID:29102998
Physical Therapy in Palliative Care: From Symptom Control to Quality of Life: A Critical Review

PubMed Central

Kumar, Senthil P; Jim, Anand

2010-01-01

Physiotherapy is concerned with identifying and maximizing movement potential, within the spheres of promotion, prevention, treatment and rehabilitation. Physical therapists practice in a broad range of inpatient, outpatient, and community-based settings such as hospice and palliative care centers where as part of a multidisciplinary team of care, they address the physical and functional dimensions of the patients’ suffering. Physiotherapy treatment methods like therapeutic exercise, electrical modalities, thermal modalities, actinotherapy, mechanical modalities, manual physical therapy and assistive devices are useful for a range of life-threatening and life-limiting conditions like cancer and cancer-associated conditions; HIV; neurodegenerative disorders like amyotrophic lateral sclerosis, multiple sclerosis; respiratory disorders like idiopathic pulmonary fibrosis; and altered mental states. The professional armamentarium is still expanding with inclusion of other miscellaneous techniques which were also proven to be effective in improving quality of life in these patients. Considering the scope of physiotherapy in India, and in palliative care, professionals in a multidisciplinary palliative care team need to understand and mutually involve toward policy changes to successfully implement physical therapeutic palliative care delivery. PMID:21218003
A One Health, participatory epidemiology assessment of anthrax (Bacillus anthracis) management in Western Uganda.

PubMed

Coffin, Jeanne L; Monje, Fred; Asiimwe-Karimu, Grace; Amuguni, Hellen Janetrix; Odoch, Terence

2015-03-01

Sporadic anthrax outbreaks have occurred in and around Uganda's Queen Elizabeth National Park (QENP) for years, affecting wildlife, domestic animals, and humans. Reported outbreaks (2004-2005 and 2010) in QENP collectively killed over 500 wild animals and over 400 domestic animals. A 2011 outbreak in Sheema district temporarily froze local markets while killing two humans and seven bovines. One Health is multidisciplinary at its core, yet studies sometimes focus on the effects of animals on human health to the detriment of investigating the surrounding ecological and cultural contexts. Participatory methods connect problems - such as disease - to their context. A multidisciplinary team used participatory epidemiology and conventional structured questionnaires to investigate the impacts of anthrax on human livelihoods and the related perceptions of conservation, public health, and veterinary health efforts in the QENP area. Proximities to previous anthrax outbreaks and to QENP were treated as risk factors in the collection and evaluation of data. Participants' feedback indicates that anthrax prevalence may be greater than officially reported. Community member perceptions about anthrax and other diseases appear to be more closely related to their proximity to QENP than their proximity to anthrax outbreaks. Neither risk factor had a strong effect on knowledge of disease, nor any effect on behaviors associated with disease response or control. Instead, participants reported that social pressures, the economics of poverty, and the lack of health and veterinary infrastructure highly influenced responses to disease. The complex connections between the social needs and the economic context of these communities seem to be undermining current anthrax control and education measures. This livelihood-based decision-making may be unlikely to respond to educational intervention alone. This study provides a strong base for further research and for improvements in effective disease control. Copyright © 2014 Elsevier Ltd. All rights reserved.
Deep-sea benthic community and environmental impact assessment at the Atlantic Frontier

NASA Astrophysics Data System (ADS)

Gage, John D.

2001-05-01

The seabed community provides a sensitive litmus for environmental change. North Sea analysis of benthic populations provides an effective means for monitoring impacts from man's interventions, such as offshore oil exploitation and fishing, against baseline knowledge of the environment. Comparable knowledge of the benthic biology in the deep waters of the Atlantic Frontier beyond the N.E. Atlantic shelf edge is poorly developed. But uncertainties should not encourage assumptions and extrapolations from the better-known conditions on the continental shelf. While sampling at present still provides the best means to assess the health of the deepwater benthic habitat, protocols developed for deep-sea fauna should be applied. These are necessary because of (a) lower faunal densities, (b) higher species richness, (c) smaller body size, and (d) to ensure comparability with other deep-sea data. As in the North Sea, species richness and relative abundance can be analysed from quantitative samples in order to detect impacts. But analysis based on taxonomic sufficiency above species level is premature, even if arguably possible for coastal communities. Measures also need to ensure identifications are not forced to more familiar coastal species without proper study. Species-level analysis may be applied to seabed photographs of megafauna in relation to data on bottom environment, such as currents and the sediment, to monitor the health of the deep-water community. Although the composition of higher taxa in the benthic community is broadly similar to soft sediments on the shelf, concordance in sensitivities is speculative. Moreover, new organisms occur, such as giant protozoan xenophyophores, unknown on the continental shelf, whose sensitivities remain conjectural. Past knowledge of the benthic biology of the deep-water areas off Scotland is based on scattered stations and some more focussed, multidisciplinary studies, and should be significantly augmented by the results from the oil industry-funded Atlantic Margin Environmental Study cruises in 1996 and 1998. A predominantly depth-related pattern in variability applies here as found elsewhere in the deep ocean, and just sufficient knowledge-based predictive power exists to make comprehensive, high-resolution grid surveys unnecessary for the purpose of broad-scale environmental assessment. But new, small-scale site surveys remain necessary because of local-scale variability. Site survey should be undertaken in the context of existing knowledge of the deep sea in the UK area of the Atlantic Frontier and beyond, and can itself usefully be structured as tests of a projection from the regional scale to reduce sampling effort. It is to the benefit of all stakeholders that environmental assessment aspires to the highest scientific standards and contributes meaningfully to context knowledge. By doing so it will reduce uncertainties in future impact assessments and hence contribute usefully to environmental risk management.
Reduced-Order Modeling: New Approaches for Computational Physics

NASA Technical Reports Server (NTRS)

Beran, Philip S.; Silva, Walter A.

2001-01-01

In this paper, we review the development of new reduced-order modeling techniques and discuss their applicability to various problems in computational physics. Emphasis is given to methods ba'sed on Volterra series representations and the proper orthogonal decomposition. Results are reported for different nonlinear systems to provide clear examples of the construction and use of reduced-order models, particularly in the multi-disciplinary field of computational aeroelasticity. Unsteady aerodynamic and aeroelastic behaviors of two- dimensional and three-dimensional geometries are described. Large increases in computational efficiency are obtained through the use of reduced-order models, thereby justifying the initial computational expense of constructing these models and inotivatim,- their use for multi-disciplinary design analysis.
Overview of Decoding across the Disciplines

ERIC Educational Resources Information Center

Boman, Jennifer; Currie, Genevieve; MacDonald, Ron; Miller-Young, Janice; Yeo, Michelle; Zettel, Stephanie

2017-01-01

In this chapter we describe the Decoding the Disciplines Faculty Learning Community at Mount Royal University and how Decoding has been used in new and multidisciplinary ways in the various teaching, curriculum, and research projects that are presented in detail in subsequent chapters.
Multidisciplinary Aerodynamic-Structural Shape Optimization Using Deformation (MASSOUD)

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

2000-01-01

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

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

2000-01-01

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

PubMed

Kunkler, I H; Prescott, R J; Lee, R J; Brebner, J A; Cairns, J A; Fielding, R G; Bowman, A; Neades, G; Walls, A D F; Chetty, U; Dixon, J M; Smith, M E; Gardner, T W; Macnab, M; Swann, S; Maclean, J R

2007-11-01

The TELEMAM trial aimed to assess the clinical effectiveness and costs of telemedicine in conducting breast cancer multi-disciplinary meetings (MDTs). Over 12 months 473 MDT patient discussions in two district general hospitals (DGHs) were cluster randomised (2:1) to the intervention of telemedicine linkage to breast specialists in a cancer centre or to the control group of 'in-person' meetings. Primary endpoints were clinical effectiveness and costs. Economic analysis was based on a cost-minimisation approach. Levels of agreement of MDT members on a scale from 1 to 5 were high and similar in both the telemedicine and standard meetings for decision sharing (4.04 versus 4.17), consensus (4.06 versus 4.20) and confidence in the decision (4.16 versus 4.07). The threshold at which the telemedicine meetings became cheaper than standard MDTs was approximately 40 meetings per year. Telemedicine delivered breast cancer multi-disciplinary meetings have similar clinical effectiveness to standard 'in-person' meetings.
Implementing the WHO/UNICEF Baby Friendly Initiative in the community: a 'hearts and minds' approach.

PubMed

Thomson, Gill; Bilson, Andy; Dykes, Fiona

2012-04-01

to describe a 'hearts and minds' approach to community Baby Friendly Initiative implementation developed from the views of multidisciplinary professionals. a qualitative descriptive study utilising focus groups and interviews, with thematic networks analysis conducted. forty-seven professionals were consulted from two primary health-care facilities located in the North-West of England. thematic networks analysis generated a global theme of a 'hearts and minds approach' to BFI implementation, which embodies emotional and rational engagement. The three underpinning organising themes (and their associated basic themes): 'credible leadership', 'engagement of key partners' and 'changing attitudes and practice' reflect the context, processes and outcomes of a 'hearts and minds' approach. a 'hearts and minds' approach transcends the prescriptive aspects of a macro-level intervention with its emphasis upon audits, training, statistics and 'hard' evidence through valuing other professionals and engaging staff at all levels. It offers insights into how organisational change may move beyond traditional top-down mechanisms for driving change to incorporate ways that value others and promote cooperation and reflection. Copyright © 2011 Elsevier Ltd. All rights reserved.
Using Interdisciplinary Research Methods to Revise and Strengthen the NWS TsunamiReadyTM Community Recognition Program

NASA Astrophysics Data System (ADS)

Scott, C.; Gregg, C. E.; Ritchie, L.; Stephen, M.; Farnham, C.; Fraser, S. A.; Gill, D.; Horan, J.; Houghton, B. F.; Johnson, V.; Johnston, D.

2013-12-01

The National Tsunami Hazard Mitigation Program (NTHMP) partnered with the National Weather Service (NWS) in early 2000 to create the TsunamiReadyTM Community Recognition program. TsunamiReadyTM, modeled after the older NWS StormReadyTM program, is designed to help cities, towns, counties, universities and other large sites in coastal areas reduce the potential for disastrous tsunami-related consequences. To achieve TsunamiReadyTM recognition, communities must meet certain criteria aimed at better preparing a community for tsunami, including specific actions within the following categories: communications and coordination, tsunami warning reception, local warning dissemination, community preparedness, and administration. Using multidisciplinary research methods and strategies from Public Health; Psychology; Political, Social and Physical Sciences and Evaluation, our research team is working directly with a purposive sample of community stakeholders in collaboration and feedback focus group sessions. Invitation to participate is based on a variety of factors including but not limited to an individual's role as a formal or informal community leader (e.g., in business, government, civic organizations), or their organization or agency affiliation to emergency management and response. Community organizing and qualitative research methods are being used to elicit discussion regarding TsunamiReadyTM requirements and the division of requirements based on some aspect of tsunami hazard, vulnerability and risk, such as proximity to active or passive plate margins or subduction zone generated tsunamis versus earthquake-landslide generated tsunamis . The primary aim of this research is to use social science to revise and refine the NWS TsunamiReadyTM Guidelines in an effort to better prepare communities to reduce risk to tsunamis.
Indicators of activity-friendly communities: an evidence-based consensus process.

PubMed

Brennan Ramirez, Laura K; Hoehner, Christine M; Brownson, Ross C; Cook, Rebeka; Orleans, C Tracy; Hollander, Marla; Barker, Dianne C; Bors, Philip; Ewing, Reid; Killingsworth, Richard; Petersmarck, Karen; Schmid, Thomas; Wilkinson, William

2006-12-01

Regular physical activity, even at modest intensities, is associated with many health benefits. Most Americans, however, do not engage in the recommended levels. As practitioners seek ways to increase population rates of physical activity, interventions and advocacy efforts are being targeted to the community level. Yet, advocates, community leaders, and researchers lack the tools needed to assess local barriers to and opportunities for more active, healthy lifestyles. Investigators used a systematic review process to identify key indicators of activity-friendly communities that can assess and improve opportunities for regular physical activity. Investigators conducted a comprehensive literature review of both peer-reviewed literature and fugitive information (e.g., reports and websites) to generate an initial list of indicators for review (n=230). The review included a three-tiered, modified Delphi consensus-development process that incorporated input of international, national, state, and local researchers and practitioners from academic institutions, federal and state government agencies, nonprofit organizations, and funding agencies in public health, transportation, urban planning, parks and recreation, and public policy. Ten promising indicators of activity-friendly communities were identified: land use environment, access to exercise facilities, transportation environment, aesthetics, travel patterns, social environment, land use economics, transportation economics, institutional and organizational policies, and promotion. Collaborative, multidisciplinary approaches are underway to test, refine, and expand this initial list of indicators and to develop measures that communities, community leaders, and policymakers can use to design more activity-friendly community environments.
An integrated modeling and design tool for advanced optical spacecraft

NASA Technical Reports Server (NTRS)

Briggs, Hugh C.

1992-01-01

Consideration is given to the design and status of the Integrated Modeling of Optical Systems (IMOS) tool and to critical design issues. A multidisciplinary spacecraft design and analysis tool with support for structural dynamics, controls, thermal analysis, and optics, IMOS provides rapid and accurate end-to-end performance analysis, simulations, and optimization of advanced space-based optical systems. The requirements for IMOS-supported numerical arrays, user defined data structures, and a hierarchical data base are outlined, and initial experience with the tool is summarized. A simulation of a flexible telescope illustrates the integrated nature of the tools.
Team-Based Care and Improved Blood Pressure Control

PubMed Central

Proia, Krista K.; Thota, Anilkrishna B.; Njie, Gibril J.; Finnie, Ramona K.C.; Hopkins, David P.; Mukhtar, Qaiser; Pronk, Nicolaas P.; Zeigler, Donald; Kottke, Thomas E.; Rask, Kimberly J.; Lackland, Daniel T.; Brooks, Joy F.; Braun, Lynne T.; Cooksey, Tonya

2015-01-01

Context Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care, established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient. Team-based care has the potential to improve the quality of hypertension management. The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure (BP) outcomes. Evidence acquisition An existing systematic review (search period, January 1980–July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003–May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies. Evidence synthesis Twenty-eight studies in the prior review (1980–2003) and an additional 52 studies from the Community Guide update (2003–2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg). Conclusions Team-based care increased the proportion of people with controlled BP and reduced both systolic and diastolic BP, especially when pharmacists and nurses were part of the team. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system–level organizational changes and could be an important element of the medical home. PMID:24933494
System Risk Assessment and Allocation in Conceptual Design

NASA Technical Reports Server (NTRS)

Mahadevan, Sankaran; Smith, Natasha L.; Zang, Thomas A. (Technical Monitor)

2003-01-01

As aerospace systems continue to evolve in addressing newer challenges in air and space transportation, there exists a heightened priority for significant improvement in system performance, cost effectiveness, reliability, and safety. Tools, which synthesize multidisciplinary integration, probabilistic analysis, and optimization, are needed to facilitate design decisions allowing trade-offs between cost and reliability. This study investigates tools for probabilistic analysis and probabilistic optimization in the multidisciplinary design of aerospace systems. A probabilistic optimization methodology is demonstrated for the low-fidelity design of a reusable launch vehicle at two levels, a global geometry design and a local tank design. Probabilistic analysis is performed on a high fidelity analysis of a Navy missile system. Furthermore, decoupling strategies are introduced to reduce the computational effort required for multidisciplinary systems with feedback coupling.
Cloud forest restoration for erosion control in a Kichwa community of the Ecuadorian central Andes Mountains

NASA Astrophysics Data System (ADS)

Backus, L.; Giordanengo, J.; Sacatoro, I.

2013-12-01

The Denver Professional Chapter of Engineers Without Borders (EWB) has begun conducting erosion control projects in the Kichwa communities of Malingua Pamba in the Andes Mountains south of Quito, Ecuador. In many high elevation areas in this region, erosion of volcanic soils on steep hillsides (i.e., < 40%) is severe and often associated with roads, water supply systems, and loss of native cloud forests followed by burning and cultivation of food crops. Following a 2011 investigation of over 75 erosion sites, the multidisciplinary Erosion Control team traveled to Malingua Pamba in October 2012 to conduct final design and project implementation at 5 sites. In partnership with the local communities, we installed woody cloud forest species, grass (sig-sig) contour hedges, erosion matting, and rock structures (toe walls, plunge pools, bank armoring, cross vanes, contour infiltration ditches, etc.) to reduce incision rates and risk of slump failures, facilitate aggradation, and hasten revegetation. In keeping with the EWB goal of project sustainability, we used primarily locally available resources. High school students of the community grew 5000 native trees and some naturalized shrubs in a nursery started by the school principal, hand weavers produced jute erosion mats, and rocks were provided by a nearby quarry. Where possible, local rock was harvested from landslide areas and other local erosion features. Based on follow up reports and photographs from the community and EWB travelers, the approach of using locally available materials installed by the community is successful; plants are growing well and erosion control structures have remained in place throughout the November to April rainy season. The community has continued planting native vegetation at several additional erosion sites. Formal monitoring will be conducted in October 2013, followed by analysis of data to determine if induced meandering and other low-maintenance erosion control techniques are working as planned. For comparison of techniques, we will consider installing check dams in comparable gullies. The October 2013 project will also focus on training the community how to conduct erosion control site assessments, design site-appropriate structures, and implement erosion control and revegetation plans. Following the training, the community will teach these skills to adjacent villages.
Promotion of oral health by community nurses.

PubMed

Garry, Brendan; Boran, Sue

2017-10-02

To explore the enablers and barriers perceived by community nurses in the promotion of oral health in an adult community trust directorate. Oral health care promotion in community care settings is being neglected. England and Wales have witnessed marked improvements in periodontal disease; however, no improvements have been seen in older people. A qualitative methodology was employed, where eight nurses from Band 5 to 7 were interviewed using a semi-structured approach. The data was analysed thematically. Data analysis was organised into four themes: professional self-concept and the development of knowledge, skills and attitudes necessary in the promotion of oral health; the impact an organisation has on the promotion of oral health and an exploration of the enablers and barriers identified by the community nurses while delivering care; the relationships between the nurse and patient and the potential impact on oral health promotion; the concept of self-regard in relation to the promotion of oral health and its overall impact. A commitment to improving oral health and requests for additional educational input were apparent. Organisational enablers and barriers were identified, alongside the crucial role a positive self-regard for oral health care may play in the promotion of oral health. Nurses need relevant education, organisational support, adequate resources and support from a multidisciplinary team to deliver optimal oral health promotion.
From the bench to bedside to babies: translational medicine made possible by funding multidisciplinary team science.

PubMed

Woodruff, Teresa K

2013-10-01

In 2005, The National Institutes of Health (NIH) called upon the scientific community to identify the most intractable problems in science and medicine and describe how we would solve these problems using teams. Our group was one of 8 research communities awarded an 'interdisciplinary research consortium (IRC) grant.' Using the infrastructure of this large, multi-institute grant and a team science approach, we set out to solve the problem of fertility loss in young female cancer patients-work that was not easily funded through other mechanisms. The word 'oncofertility' was coined specifically for the IRC to reflect the intimate partnership between oncology care and fertility care for these patients-two disciplines that would no longer function at arms' length, but as an integrated unit. Catalyzed by the IRC funding mechanism, interdisciplinary teams worked together in unique ways to create a 'bench to bedside to baby' outcome. The grant has now ended, and remarkably, so have the most intractable parts of the original problem. As we look back on what worked and look forward to tackling the next set of fertility-related questions, we are confident that this very special NIH funding mechanism made a meaningful difference in the lives of women and their future children. NIH and the public would be well-served by supporting clinical problem-based, multidisciplinary team science approaches to catalyze fundamental biomedical breakthroughs and create new intellectual environments in which changes in clinical practice and standard of care can be implemented.
The use of failure mode and effect analysis in a radiation oncology setting: the Cancer Treatment Centers of America experience.

PubMed

Denny, Diane S; Allen, Debra K; Worthington, Nicole; Gupta, Digant

2014-01-01

Delivering radiation therapy in an oncology setting is a high-risk process where system failures are more likely to occur because of increasing utilization, complexity, and sophistication of the equipment and related processes. Healthcare failure mode and effect analysis (FMEA) is a method used to proactively detect risks to the patient in a particular healthcare process and correct potential errors before adverse events occur. FMEA is a systematic, multidisciplinary team-based approach to error prevention and enhancing patient safety. We describe our experience of using FMEA as a prospective risk-management technique in radiation oncology at a national network of oncology hospitals in the United States, capitalizing not only on the use of a team-based tool but also creating momentum across a network of collaborative facilities seeking to learn from and share best practices with each other. The major steps of our analysis across 4 sites and collectively were: choosing the process and subprocesses to be studied, assembling a multidisciplinary team at each site responsible for conducting the hazard analysis, and developing and implementing actions related to our findings. We identified 5 areas of performance improvement for which risk-reducing actions were successfully implemented across our enterprise. © 2012 National Association for Healthcare Quality.

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

PubMed

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

2017-06-01

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

PubMed

Cheater, F M; Keane, M

1998-03-01

To find out to what extent nurses were perceived to be participating in audit, to identify factors thought to impede their involvement, and to assess progress towards multidisciplinary audit. Qualitative. Focus groups and interviews. Chairs of audit groups and audit support staff in hospital, community and primary health care and audit leads in health authorities in the North West Region. In total 99 audit leads/support staff in the region participated representing 89% of the primary health care audit groups, 80% of acute hospitals, 73% of community health services, and 59% of purchasers. Many audit groups remain medically dominated despite recent changes to their structure and organisation. The quality of interprofessional relations, the leadership style of the audit chair, and nurses' level of seniority, audit knowledge, and experience influenced whether groups reflected a multidisciplinary, rather than a doctor centred approach. Nurses were perceived to be enthusiastic supporters of audit, although their active participation in the process was considered substantially less than for doctors in acute and community health services. Practice nurses were increasingly being seen as the local audit enthusiasts in primary health care. Reported obstacles to nurses' participation in audit included hierarchical nurse and doctor relationships, lack of commitment from senior doctors and managers, poor organisational links between departments of quality and audit, work load pressures and lack of protected time, availability of practical support, and lack of knowledge and skills. Progress towards multidisciplinary audit was highly variable. The undisciplinary approach to audit was still common, particularly in acute services. Multidisciplinary audit was more successfully established in areas already predisposed towards teamworking or where nurses had high involvement in decision making. Audit support staff were viewed as having a key role in helping teams to adopt a collaborative approach to audit. Although nurses were undertaking audit, and some were leading developments in their settings, a range of structural and organisational, interprofessional and intraprofessional factors was still impeding progress. If the ultimate goal of audit is to improve patient care, the obstacles that make it difficult for nurses to contribute actively to the process must be acknowledged and considered.
Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline

PubMed Central

Coroneos, Christopher J; Voineskos, Sophocles H; Christakis, Marie K; Thoma, Achilleas; Bain, James R; Brouwers, Melissa C

2017-01-01

Objective The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise. Setting The guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries. Participants The evidence interpretation and recommendation consensus team (Canadian OBPI Working Group) was composed of clinicians representing each of Canada's 10 multidisciplinary centres. Outcome measures An electronic modified Delphi approach was used for consensus, with agreement criteria defined a priori. Quality indicators for referral to a multidisciplinary centre were established by consensus. An original meta-analysis of primary nerve repair and review of Canadian epidemiology and burden were previously completed. Results 7 recommendations address clinical gaps and guide identification, referral, treatment and outcome assessment: (1) physically examine for OBPI in newborns with arm asymmetry or risk factors; (2) refer newborns with OBPI to a multidisciplinary centre by 1 month; (3) provide pregnancy/birth history and physical examination findings at birth; (4) multidisciplinary centres should include a therapist and peripheral nerve surgeon experienced with OBPI; (5) physical therapy should be advised by a multidisciplinary team; (6) microsurgical nerve repair is indicated in root avulsion and other OBPI meeting centre operative criteria; (7) the common data set includes the Narakas classification, limb length, Active Movement Scale (AMS) and Brachial Plexus Outcome Measure (BPOM) 2 years after birth/surgery. Conclusions The process established a new network of opinion leaders and researchers for further guideline development and multicentre research. A structured referral form is available for primary care, including referral recommendations. PMID:28132014
Adopting exergy analysis for use in aerospace

NASA Astrophysics Data System (ADS)

Hayes, David; Lone, Mudassir; Whidborne, James F.; Camberos, José; Coetzee, Etienne

2017-08-01

Thermodynamic analysis methods, based on an exergy metric, have been developed to improve system efficiency of traditional heat driven systems such as ground based power plants and aircraft propulsion systems. However, in more recent years interest in the topic has broadened to include applying these second law methods to the field of aerodynamics and complete aerospace vehicles. Work to date is based on highly simplified structures, but such a method could be shown to have benefit to the highly conservative and risk averse commercial aerospace sector. This review justifies how thermodynamic exergy analysis has the potential to facilitate a breakthrough in the optimization of aerospace vehicles based on a system of energy systems, through studying the exergy-based multidisciplinary design of future flight vehicles.
Study of air traffic over KLFIR

NASA Astrophysics Data System (ADS)

Nusyirwan, I. F.; Rohani, J. Mohd

2017-12-01

This paper shares the overview of the work currently being conducted with the Department of Civil Aviation Malaysia related to the air traffic. The aim is to study air traffic performance over KL and KK FIR, and the area of interest in this paper is the Kuala Lumpur Flight Information Region (KLFIR). The air traffic performance parameters includes general air traffic movement such as level allocation, number of movements, sector load analysis and also more specific parameters such as airborne delays, effects of weather to the air movements as well as ground delays. To achieve this, a huge effort has been undertaken that includes live data collection algorithm development and real time statistical analysis algorithm development. The main outcome from this multi-disciplinary work is the long-term analysis on the air traffic performance in Malaysia, which will put the country at par in the aviation community, namely the International Civil Aviation Organization (ICAO).
Implementing web-based ping-pong-type e-communication to enhance staff satisfaction, multidisciplinary cooperation, and clinical effectiveness: A SQUIRE-compliant quality-improving study.

PubMed

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

2016-11-01

Frequent multidisciplinary communication is essential in conducting daily radiotherapy (RT) practice. However, traditional oral or paper-based communication has limitations. E-communication has been suggested, but its effects are still not well demarcated in the field of radiation oncology. In our web-based integrated information platform, we constructed a ping-pong-type e-communication function to transfer specific notations among multidisciplinary RT staffs. The purpose was to test whether applying this e-communication can increase effectiveness of multidisciplinary cooperation when compared with oral or paper-based practice. Staff satisfaction and clinical benefits were also demonstrated. A real-world quality-improving study was conducted in a large center of radiation oncology. Before and after applying multidisciplinary e-communication (from 2014 to 2015), clinical RT staffs were surveyed for their user experience and satisfaction (n = 23). For measuring clinical effectiveness, a secondary database of irradiated head and neck cancer patients was re-analyzed for comparing RT toxicities (n = 402). Applying ping-pong-type multidisciplinary reflective e-communication was the main intervention. For measuring staff satisfaction, eight domains were surveyed, such as timeliness, convenience, and completeness. For measuring clinical effectiveness of multidisciplinary cooperation, event rates of severe (i.e., grade 3-4) RT mucositis and dermatitis were recorded. Overall, when compared with oral communication only, e-communication demonstrated multiple benefits, particularly on notation-review convenience (2.00 ± 1.76 vs 9.19 ± 0.81; P < 0.0001).When compared with paper-based practice, e-communication showed statistically significant benefits on all eight domains, especially on notation-review convenience (5.05 ± 2.11 vs 9.19 ± 0.81; P < 0.0001) and convenience of feedback notation (4.81 ± 1.72 vs 8.76 ± 1.09; P < 0.0001).Moreover, staff satisfaction was gradually increased from oral (3.57 ± 1.94), paper-based (5.57 ± 2.06), to e-communication (8.76 ± 0.70; P < 0.0001). Secondary measurement confirmed these observations.Before and after facilitating multidisciplinary cooperation by using e-communication, severe (i.e., grade 3-4) mucositis and dermatitis were decreased from 21.7% to 10% then to 5.1%. Replacing oral or paper-based practice with e-communication is useful in facilitating RT multidisciplinary teamwork. Staff satisfaction and clinical effectiveness can be increased.
Interdisciplinary Collaboration between Natural and Social Sciences – Status and Trends Exemplified in Groundwater Research

PubMed Central

Seidl, Roman

2017-01-01

Interdisciplinary collaboration, particularly between natural and social sciences, is perceived as crucial to solving the significant challenges facing humanity. However, despite the need for such collaboration being expressed more frequently and intensely, it remains unclear to what degree such collaboration actually takes place, what trends and developments there are and which actors are involved. Previous studies, often based on bibliometric analysis of large bodies of literature, partly observed an increase in interdisciplinary collaboration in general, but in particular, the collaboration among distant fields was less explored. Other more qualitative studies found that interdisciplinary collaboration, particularly between natural and social scientists was not well developed, and obstacles abounded. To shed some light on the actual status and developments of this collaboration, we performed an analysis based on a sample of articles on groundwater research. We first identified journals and articles therein that potentially combined natural and social science aspects of groundwater research. Next, we analysed the disciplinary composition of their authors’ teams, cited references, titles and keywords, making use of our detailed personal expertise in groundwater research and its interdisciplinary aspects. We combined several indicators developed from this analysis into a final classification of the degree of multidisciplinarity of each article. Covering the period between 1990 and 2014, we found that the overall percentage of multidisciplinary articles was in the low single-digit range, with only slight increases over the past decades. The interdisciplinarity of individuals plays a major role compared to interdisciplinarity involving two or more researchers. If collaboration with natural sciences takes place, social science is represented most often by economists. As a side result, we found that journals publishing multidisciplinary research had lower impact factors on average, and multidisciplinary papers were cited much less than mono-disciplinary ones. PMID:28129352
Interdisciplinary Collaboration between Natural and Social Sciences - Status and Trends Exemplified in Groundwater Research.

PubMed

Barthel, Roland; Seidl, Roman

2017-01-01

Interdisciplinary collaboration, particularly between natural and social sciences, is perceived as crucial to solving the significant challenges facing humanity. However, despite the need for such collaboration being expressed more frequently and intensely, it remains unclear to what degree such collaboration actually takes place, what trends and developments there are and which actors are involved. Previous studies, often based on bibliometric analysis of large bodies of literature, partly observed an increase in interdisciplinary collaboration in general, but in particular, the collaboration among distant fields was less explored. Other more qualitative studies found that interdisciplinary collaboration, particularly between natural and social scientists was not well developed, and obstacles abounded. To shed some light on the actual status and developments of this collaboration, we performed an analysis based on a sample of articles on groundwater research. We first identified journals and articles therein that potentially combined natural and social science aspects of groundwater research. Next, we analysed the disciplinary composition of their authors' teams, cited references, titles and keywords, making use of our detailed personal expertise in groundwater research and its interdisciplinary aspects. We combined several indicators developed from this analysis into a final classification of the degree of multidisciplinarity of each article. Covering the period between 1990 and 2014, we found that the overall percentage of multidisciplinary articles was in the low single-digit range, with only slight increases over the past decades. The interdisciplinarity of individuals plays a major role compared to interdisciplinarity involving two or more researchers. If collaboration with natural sciences takes place, social science is represented most often by economists. As a side result, we found that journals publishing multidisciplinary research had lower impact factors on average, and multidisciplinary papers were cited much less than mono-disciplinary ones.
Evaluating the Diagnostic Validity of the Facet-Based Formative Assessment System

ERIC Educational Resources Information Center

DeBarger, Angela H.; DiBello, Louis; Minstrell, Jim; Stout, William; Pellegrino, James; Haertel, Geneva; Feng, Mingyu

2011-01-01

The research design and team constitute a multidisciplinary attack on problems of educational and assessment design in physics instruction. Components of the research include: (a) an Evidence-Centered Design analysis of Diagnoser instructional materials and assessments that provides a view of the evidentiary coherence of the existing system; (b)…
An Evaluation of Policy-Related Rehabilitation Research.

ERIC Educational Resources Information Center

Berkowitz, Monroe; And Others

The monograph evaluates the methodological quality and the policy utility of research in the area of rehabilitation of the handicapped. Analysis was based on a multidisciplinary review of 477 sample reports from more than 4,000 screened project reports. Chapter 1 delineates the nature of the study; Chapter 2 reviews the Federal/State…
A comparison of a short nurse-based and a long multidisciplinary version of structured patient education in irritable bowel syndrome.

PubMed

Ringström, Gisela; Störsrud, Stine; Simrén, Magnus

2012-08-01

Structured multidisciplinary patient group education has positive effects on symptoms, health-related quality of life, and disease-related knowledge in patients with irritable bowel syndrome (IBS), but few studies comparing different forms of educational interventions are available. Our aim was to compare the effects of long multidisciplinary group education with a short nurse-based group education with regard to symptoms, knowledge, quality of life, and satisfaction with the intervention in IBS patients. Patients with IBS according to the Rome II criteria were randomized to either short nurse-based or a long multidisciplinary-based education. The effects were evaluated by self-administered questionnaires at 3, 6, and 12 months after baseline, and compared between the groups. No differences in effects were detected in the between-group comparisons at any of the follow-up assessments. However, positive effects on symptoms, knowledge, quality of life, and satisfaction with the intervention were found in both the short and the long version. A short, nurse-based educational intervention seems to be as efficacious as a longer multidisciplinary version. In both groups, positive effects on patients' well-being were found to a similar extent. This is an important finding that, from a cost-effective perspective, could contribute toward an optimized management of patients with IBS.
Open-Source Sequence Clustering Methods Improve the State Of the Art.

PubMed

Kopylova, Evguenia; Navas-Molina, Jose A; Mercier, Céline; Xu, Zhenjiang Zech; Mahé, Frédéric; He, Yan; Zhou, Hong-Wei; Rognes, Torbjørn; Caporaso, J Gregory; Knight, Rob

2016-01-01

Sequence clustering is a common early step in amplicon-based microbial community analysis, when raw sequencing reads are clustered into operational taxonomic units (OTUs) to reduce the run time of subsequent analysis steps. Here, we evaluated the performance of recently released state-of-the-art open-source clustering software products, namely, OTUCLUST, Swarm, SUMACLUST, and SortMeRNA, against current principal options (UCLUST and USEARCH) in QIIME, hierarchical clustering methods in mothur, and USEARCH's most recent clustering algorithm, UPARSE. All the latest open-source tools showed promising results, reporting up to 60% fewer spurious OTUs than UCLUST, indicating that the underlying clustering algorithm can vastly reduce the number of these derived OTUs. Furthermore, we observed that stringent quality filtering, such as is done in UPARSE, can cause a significant underestimation of species abundance and diversity, leading to incorrect biological results. Swarm, SUMACLUST, and SortMeRNA have been included in the QIIME 1.9.0 release. IMPORTANCE Massive collections of next-generation sequencing data call for fast, accurate, and easily accessible bioinformatics algorithms to perform sequence clustering. A comprehensive benchmark is presented, including open-source tools and the popular USEARCH suite. Simulated, mock, and environmental communities were used to analyze sensitivity, selectivity, species diversity (alpha and beta), and taxonomic composition. The results demonstrate that recent clustering algorithms can significantly improve accuracy and preserve estimated diversity without the application of aggressive filtering. Moreover, these tools are all open source, apply multiple levels of multithreading, and scale to the demands of modern next-generation sequencing data, which is essential for the analysis of massive multidisciplinary studies such as the Earth Microbiome Project (EMP) (J. A. Gilbert, J. K. Jansson, and R. Knight, BMC Biol 12:69, 2014, http://dx.doi.org/10.1186/s12915-014-0069-1).
a System Dynamics Approach for Looking at the Human and Environmental Interactions of Community-Based Irrigation Systems in New Mexico

NASA Astrophysics Data System (ADS)

Ochoa, C. G.; Tidwell, V. C.

2012-12-01

In the arid southwestern United States community water management systems have adapted to cope with climate variability and with socio-cultural and economic changes that have occurred since the establishment of these systems more than 300 years ago. In New Mexico, the community-based irrigation systems were established by Spanish settlers and have endured climate variability in the form of low levels of precipitation and have prevailed over important socio-political changes including the transfer of territory between Spain and Mexico, and between Mexico and the United States. Because of their inherent nature of integrating land and water use with society involvement these community-based systems have multiple and complex economic, ecological, and cultural interactions. Current urban population growth and more variable climate conditions are adding pressure to the survival of these systems. We are conducting a multi-disciplinary research project that focuses on characterizing these intrinsically complex human and natural interactions in three community-based irrigation systems in northern New Mexico. We are using a system dynamics approach to integrate different hydrological, ecological, socio-cultural and economic aspects of these three irrigation systems. Coupled with intensive field data collection, we are building a system dynamics model that will enable us to simulate important linkages and interactions between environmental and human elements occurring in each of these water management systems. We will test different climate variability and population growth scenarios and the expectation is that we will be able to identify critical tipping points of these systems. Results from this model can be used to inform policy recommendations relevant to the environment and to urban and agricultural land use planning in the arid southwestern United States.
Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.

PubMed

Formica, Scott W; Apsler, Robert; Wilkins, Lindsay; Ruiz, Sarah; Reilly, Brittni; Walley, Alexander Y

2018-04-01

Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function. We sent an online screening questionnaire to police and fire departments in all 351 communities in Massachusetts to find instances in which they collaborated with a community-based public health agency to implement a post-overdose outreach and support program. We conducted telephone interviews with communities that implemented this type of program and categorized programs based on their structure, outreach approach, and other key characteristics. Police and fire personnel from 110 of the 351 communities in Massachusetts (31% response rate) completed the screening survey. Among respondents, 21% (23/110) had implemented a collaborative, community-based, post-overdose program with a well-defined process to connect overdose survivors and their personal networks with support services or addiction treatment services. Using data from the interviews, we identified four types of programs: (1) Multi-Disciplinary Team Visit, (2) Police Visit with Referrals, (3) Clinician Outreach, and (4) Location-Based Outreach. This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose. Copyright © 2018 Elsevier B.V. All rights reserved.
Guidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research: A Multidisciplinary View

PubMed Central

2016-01-01

Background As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. Objective To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. Methods A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. Results The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. Conclusions A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community. PMID:27986644
Treatment Disparities among African American Men with Depression: Implications for Clinical Practice

PubMed Central

Hankerson, Sidney H.; Suite, Derek; Bailey, Rahn K.

2015-01-01

A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research. PMID:25702724
Treatment disparities among African American men with depression: implications for clinical practice.

PubMed

Hankerson, Sidney H; Suite, Derek; Bailey, Rahn K

2015-02-01

A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research.
Understanding user needs for carbon monitoring information

NASA Astrophysics Data System (ADS)

Duren, R. M.; Macauley, M.; Gurney, K. R.; Saatchi, S. S.; Woodall, C. W.; Larsen, K.; Reidmiller, D.; Hockstad, L.; Weitz, M.; Croes, B.; Down, A.; West, T.; Mercury, M.

2015-12-01

The objectives of the Understanding User Needs project for NASA's Carbon Monitoring System (CMS) program are to: 1) engage the user community and identify needs for policy-relevant carbon monitoring information, 2) evaluate current and planned CMS data products with regard to their value for decision making, and 3) explore alternative methods for visualizing and communicating carbon monitoring information and associated uncertainties to decision makers and other stakeholders. To meet these objectives and help establish a sustained link between science and decision-making we have established a multi-disciplinary team that combines expertise in carbon-cycle science, engineering, economics, and carbon management and policy. We will present preliminary findings regarding emerging themes and needs for carbon information that may warrant increased attention by the science community. We will also demonstrate a new web-based tool that offers a common framework for facilitating user evaluation of carbon data products from multiple CMS projects.
Online Pharmaceutical Care Provision: Full-Implementation of an eHealth Service Using Design Science Research.

PubMed

Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez

2015-01-01

Chronic diseases are pressing health systems to introduce reforms, focused on primary care and multidisciplinary models. Community pharmacists have developed a new role, addressing pharmaceutical care and services. Information systems and technologies (IST) will have an important role in shaping future healthcare provision. However, the best way to design and implement an IST for pharmaceutical service provision is still an open research question. In this paper, we present a possible strategy based on the use of Design Science Research Methodology (DSRM). The application of the DSRM six stages is described, from the definition and characterization of the problem to the evaluation of the artefact.
Assessing the Impact of a Focused Deterrence Strategy to Combat Intimate Partner Domestic Violence.

PubMed

Sechrist, Stacy M; Weil, John D

2018-03-01

The Offender Focused Domestic Violence Initiative (OFDVI) represents for the first time anywhere the application of the evidence-based focused deterrence policing approach to combat intimate partner domestic violence (IPDV). Through holding offenders accountable, the strategy has resulted in 20% reductions each in IPDV-related calls for police service and arrests. Victim injuries have been significantly reduced and the 1-year IPDV offender recidivism rate is about 16-17%. The backbone of the OFDVI strategy is the multidisciplinary collaboration of law enforcement and community partners which has resulted in identification and resolving system issues which have historically allowed offenders to repeat IPDV without consequence.

Modeling languages for biochemical network simulation: reaction vs equation based approaches.

PubMed

Wiechert, Wolfgang; Noack, Stephan; Elsheikh, Atya

2010-01-01

Biochemical network modeling and simulation is an essential task in any systems biology project. The systems biology markup language (SBML) was established as a standardized model exchange language for mechanistic models. A specific strength of SBML is that numerous tools for formulating, processing, simulation and analysis of models are freely available. Interestingly, in the field of multidisciplinary simulation, the problem of model exchange between different simulation tools occurred much earlier. Several general modeling languages like Modelica have been developed in the 1990s. Modelica enables an equation based modular specification of arbitrary hierarchical differential algebraic equation models. Moreover, libraries for special application domains can be rapidly developed. This contribution compares the reaction based approach of SBML with the equation based approach of Modelica and explains the specific strengths of both tools. Several biological examples illustrating essential SBML and Modelica concepts are given. The chosen criteria for tool comparison are flexibility for constraint specification, different modeling flavors, hierarchical, modular and multidisciplinary modeling. Additionally, support for spatially distributed systems, event handling and network analysis features is discussed. As a major result it is shown that the choice of the modeling tool has a strong impact on the expressivity of the specified models but also strongly depends on the requirements of the application context.
A Web-Based System for Monitoring and Controlling Multidisciplinary Design Projects

NASA Technical Reports Server (NTRS)

Salas, Andrea O.; Rogers, James L.

1997-01-01

In today's competitive environment, both industry and government agencies are under enormous pressure to reduce the time and cost of multidisciplinary design projects. A number of frameworks have been introduced to assist in this process by facilitating the integration of and communication among diverse disciplinary codes. An examination of current frameworks reveals weaknesses in various areas such as sequencing, displaying, monitoring, and controlling the design process. The objective of this research is to explore how Web technology, in conjunction with an existing framework, can improve these areas of weakness. This paper describes a system that executes a sequence of programs, monitors and controls the design process through a Web-based interface, and visualizes intermediate and final results through the use of Java(Tm) applets. A small sample problem, which includes nine processes with two analysis programs that are coupled to an optimizer, is used to demonstrate the feasibility of this approach.
Adolescent sexual assault victims and the legal system: building community relationships to improve prosecution rates.

PubMed

Campbell, Rebecca; Greeson, Megan R; Bybee, Deborah; Fehler-Cabral, Giannina

2012-09-01

Adolescents are at high risk for sexual assault, but few of these crimes are reported to the police and prosecuted by the criminal justice system. To address this problem, communities throughout the United States have implemented multidisciplinary interventions to improve post-assault care for victims and increase prosecution rates. The two most commonly implemented interventions are Sexual Assault Nurse Examiner (SANE) Programs and Sexual Assault Response Teams (SARTs). The purpose of this study was to determine whether community-level context (i.e., stakeholder engagement and collaboration) was predictive of adolescent legal case outcomes, after accounting for "standard" factors that affect prosecution success (i.e., victim, assault, and evidence characteristics). Overall, 40% of the adolescent cases from these two SANE-SART programs (over a 10-year period) were successfully prosecuted. Cases were more likely to be prosecuted for younger victims, those with disabilities, those who knew their offenders, and instances in which the rape evidence collection kit was submitted by police for analysis. After accounting for these influences, multi-level modeling results revealed that in one site decreased allocation of community resources to adolescent sexual assault cases had a significant negative effect on prosecution case outcomes. Results are explained in terms of Wolff's (Am J Community Psychol 29:173-191, 2001) concept of "over-coalitioned" communities and Kelly's (1968) ecological principles.
Multidisciplinary Identification of the Controversial Freedom Fighter Jörg Jenatsch, Assassinated 1639 in Chur, Switzerland

PubMed Central

Haeusler, Martin; Haas, Cordula; Lösch, Sandra; Moghaddam, Negahnaz; Villa, Igor M.; Walsh, Susan; Kayser, Manfred; Seiler, Roger; Ruehli, Frank; Janosa, Manuel; Papageorgopoulou, Christina

2016-01-01

Jörg Jenatsch, a leading freedom fighter during the Thirty Year’s War in Graubünden, Switzerland, was assassinated on carnival 1639. Jenatsch’s controversial biography and the unclear circumstances of his death inspired the formation of various legends, novels and films. In 1959, a skeleton discovered in the cathedral of Chur with remains of wealthy baroque clothing was tentatively attributed to Jenatsch. Here, we reassess the skeleton based on a new exhumation. Our multidisciplinary analysis and the head injuries are consistent with reports of the eyewitnesses of the crime, demonstrating that Jenatsch was killed from behind with a semi-sharp implement, supposedly an axe, as well as by a blow with a broad-surfaced object. Moreover, our facial reconstruction closely matches an oil portrait of Jenatsch, and the HIrisPlex system applied to DNA-extracts from the femoral bone reveals brown eye and dark brown hair colour, which coincides well with the portrait, too. Finally, isotope analysis of the femoral bone and a molar support Jenatsch’s high social status, luxury diet and a high mobility in the last decade of his life. This multidisciplinary approach thus reinforces personal identification and provides additional insight into the life of this important historic person beyond written resources. PMID:28030571
Multidisciplinary Identification of the Controversial Freedom Fighter Jörg Jenatsch, Assassinated 1639 in Chur, Switzerland.

PubMed

Haeusler, Martin; Haas, Cordula; Lösch, Sandra; Moghaddam, Negahnaz; Villa, Igor M; Walsh, Susan; Kayser, Manfred; Seiler, Roger; Ruehli, Frank; Janosa, Manuel; Papageorgopoulou, Christina

2016-01-01

Jörg Jenatsch, a leading freedom fighter during the Thirty Year's War in Graubünden, Switzerland, was assassinated on carnival 1639. Jenatsch's controversial biography and the unclear circumstances of his death inspired the formation of various legends, novels and films. In 1959, a skeleton discovered in the cathedral of Chur with remains of wealthy baroque clothing was tentatively attributed to Jenatsch. Here, we reassess the skeleton based on a new exhumation. Our multidisciplinary analysis and the head injuries are consistent with reports of the eyewitnesses of the crime, demonstrating that Jenatsch was killed from behind with a semi-sharp implement, supposedly an axe, as well as by a blow with a broad-surfaced object. Moreover, our facial reconstruction closely matches an oil portrait of Jenatsch, and the HIrisPlex system applied to DNA-extracts from the femoral bone reveals brown eye and dark brown hair colour, which coincides well with the portrait, too. Finally, isotope analysis of the femoral bone and a molar support Jenatsch's high social status, luxury diet and a high mobility in the last decade of his life. This multidisciplinary approach thus reinforces personal identification and provides additional insight into the life of this important historic person beyond written resources.
Overcoming obstacles to establish a multidisciplinary team approach to hepatobiliary diseases: a working model in a Caribbean setting.

PubMed

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

2014-01-01

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

ERIC Educational Resources Information Center

Braaten, Sheldon, Ed.; And Others

This book presents 17 papers from a 1982 national multidisciplinary conference on services for behaviorally disordered adolescents. The following papers are included: "Programming for Youth in Secondary Schools and the Community," (W. Van Til); "Who's Crazy? II" (C. Michael Nelson); "Correlates of Successful Adaptive Behavior: Comparative Studies…
Astrobiology: Discovering New Worlds of Life.

ERIC Educational Resources Information Center

James, Charles C.; Van Dover, Cindy Lee

2001-01-01

Emphasizes discoveries at the frontiers of science. Includes an instructional poster illustrating the hydrothermal vent communities on the deep ocean floor. Describes research activities related to the new discipline of astrobiology, a multidisciplinary approach to studying the emergence of life in the universe. Research activities include the…
Multidisciplinary and biodanza intervention for the management of fibromyalgia.

PubMed

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

2012-01-01

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

PubMed

Johansson, Gudrun; Eklund, Kajsa; Gosman-Hedström, Gunilla

2010-01-01

As the number of elderly persons with complex health needs is increasing, teams for their care have been recommended as a means of meeting these needs, particularly in the case of elderly persons with multi-diseases. Occupational therapists, in their role as team members, exert significant influence in guiding team recommendations. However, it has been emphasized that there is a lack of sound research to show the impact of teamwork from the perspective of elderly persons. The aim of this paper was to explore literature concerning multidisciplinary teams that work with elderly persons living in the community. The research method was a systematic literature review and a total of 37 articles was analysed. The result describes team organisation, team intervention and outcome, and factors that influence teamwork. Working in a team is multifaceted and complex. It is important to enhance awareness about factors that influence teamwork. The team process itself is also of great importance. Clinical implications for developing effective and efficient teamwork are also presented and discussed.
White Paper Report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: Integrating Multidisciplinary Strategies for Imaging Services in the Developing World

PubMed Central

Mazal, Jonathan; Lexa, Frank; Starikovsky, Anna; Jimenez, Pablo; Jain, Sanjay; DeStigter, Kristen K.; Nathan, Robert; Krebs, Elizabeth; Noble, Vicki; Marks, William; Hirsh, Richard N.; Short, Brad; Sydnor, Ryan; Timmreck-Jackson, Emily; Lungren, Matthew P.; Maxfield, Charles; Azene, Ezana M.; Garra, Brian S.; Choi, Brian G.; Lewin, Jonathan S.; Mollura, Daniel J.

2016-01-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparity. This white paper from the 2011 RAD-AID Conference represents consensus advocacy of multidisciplinary strategies to improve planning, accessibility and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and healthcare disparities including: (1) economic development for radiology service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. PMID:22748790
White paper report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: integrating multidisciplinary strategies for imaging services in the developing world.

PubMed

Everton, Kathryn L; Mazal, Jonathan; Mollura, Daniel J

2012-07-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparities. This white paper from the 2011 RAD-AID conference represents consensus advocacy of multidisciplinary strategies to improve the planning, accessibility, and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and health care disparities, including (1) economic development for radiologic service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. Published by Elsevier Inc.
Barriers to physician identification and treatment of family violence: lessons from five communities.

PubMed

Cohen, S; De Vos, E; Newberger, E

1997-01-01

Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 27-29, 1985), a substantial literature has developed about the limitations of the health care response to family violence. Many contributions have reflected experiences in limited numbers of practice settings (e.g., a single emergency department or hospital). Until 1990, however, there had been no community-based studies. The Robert Wood Johnson Foundation asked a multidisciplinary team from Education Development Center, Inc. and Children's Hospital (Boston) to investigate the health care responses to family violence in five diverse communities. This qualitative study, comprising more than 480 interviews, provided a vivid picture of the barriers facing physicians and other health care providers in identifying, treating, and referring victims of family violence. It also illuminated the relations of the health care systems in these communities with other key sectors, including agencies and the judiciary. The key findings from the five-city study remain relevant because (1) it is the only large-scale, multi-community-based assessment of the barriers facing physicians; (2) it identified, or in some cases confirmed, both institutional and educational barriers limiting the effectiveness of even the most committed physicians; (3) it identified, or in some cases confirmed, specific areas of knowledge, attitudes, and skills development that should be incorporated in medical education; and (4) its conclusions continue to be reflected in subsequent contributions to the literature. In each of these ways, therefore, it informs the other articles in this supplement.
The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study.

PubMed

Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn

2015-08-28

Although a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model. In total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains. We observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures. Our findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.
Community oriented interprofessional health education in Mozambique: one student/one family program.

PubMed

Ferrão, L J; Fernandes, Tito H

2014-01-01

In the remote northern region of Mozambique the ratio of doctors to patients is 1:50,000. In 2007, Lúrio University initiated an innovative, "One Student/One Family" program of teaching and learning for health professions students, to complement their traditional core curriculum. All students of each of the school's six health degree programs complete a curriculum in "Family and Community Health" in each year of their training. Groups of six students from six different health professions training programs make weekly visits to communities, where each student is allocated to a family. Students learn from their families about community life and health issues, within a community where 80% of the population still lacks access to modern health care and rely on indigenous doctors and traditional remedies. In turn, students transmit information to families about modern health care and report to the faculty any major health problems they find. The educational/experiential approach is interprofessional and community-oriented. The main perceived advantages of the program are that it is applied and problem-based learning for students, while simultaneously providing needed healthcare services to the community. The major disadvantages include the complexity of coordinating multidisciplinary groups, the time and distance required of students in traveling to communities, and interpretation of multiple reports with variable data. This community-oriented education program involving students from six disciplines uses nontraditional teaching/learning methods is the basis of the ex libris of Lúrio University.
Collaborative Multidisciplinary Sciences for Analysis and Design of Aerospace Vehicles. Volume 1

DTIC Science & Technology

2017-05-01

AEROSPACE VEHICLES Volume 1 5a. CONTRACT NUMBER FA8650-09-2-3938 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 62201F 6. AUTHOR(S) Raymond M...S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBERDesign and Analysis Branch (AFRL/RQVC) Aerospace Vehicles Division Air Force Research...Laboratory, Aerospace Systems Directorate Wright-Patterson Air Force Base, OH 45433-7542 Air Force Materiel Command, United States Air Force Virginia
Web-based platform for collaborative medical imaging research

NASA Astrophysics Data System (ADS)

Rittner, Leticia; Bento, Mariana P.; Costa, André L.; Souza, Roberto M.; Machado, Rubens C.; Lotufo, Roberto A.

2015-03-01

Medical imaging research depends basically on the availability of large image collections, image processing and analysis algorithms, hardware and a multidisciplinary research team. It has to be reproducible, free of errors, fast, accessible through a large variety of devices spread around research centers and conducted simultaneously by a multidisciplinary team. Therefore, we propose a collaborative research environment, named Adessowiki, where tools and datasets are integrated and readily available in the Internet through a web browser. Moreover, processing history and all intermediate results are stored and displayed in automatic generated web pages for each object in the research project or clinical study. It requires no installation or configuration from the client side and offers centralized tools and specialized hardware resources, since processing takes place in the cloud.
Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK.

PubMed

Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A

2015-03-01

The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.
Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK

PubMed Central

Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, PA

2015-01-01

The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. PMID:24735122
Recent Advances in Multidisciplinary Analysis and Optimization, part 3

NASA Technical Reports Server (NTRS)

Barthelemy, Jean-Francois M. (Editor)

1989-01-01

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

Recent Advances in Multidisciplinary Analysis and Optimization, part 2

NASA Technical Reports Server (NTRS)

Barthelemy, Jean-Francois M. (Editor)

1989-01-01

This three-part document contains a collection of technical papers presented at the Second NASA/Air Force Symposium on Recent Advances in Multidisciplinary Analysis and Optimization, held September 28-30, 1988 in Hampton, Virginia. The topics covered include: helicopter design, aeroelastic tailoring, control of aeroelastic structures, dynamics and control of flexible structures, structural design, design of large engineering systems, application of artificial intelligence, shape optimization, software development and implementation, and sensitivity analysis.
Recent Advances in Multidisciplinary Analysis and Optimization, part 1

NASA Technical Reports Server (NTRS)

Barthelemy, Jean-Francois M. (Editor)

1989-01-01

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

NASA Technical Reports Server (NTRS)

Meissner, Frances T. (Editor)

1988-01-01

The Integrated Multidisciplinary Analysis Tool (IMAT) is a computer software system developed at Langley Research Center. IMAT provides researchers and analysts with an efficient capability to analyze satellite controls systems influenced by structural dynamics. Using a menu-driven executive system, IMAT leads the user through the program options. IMAT links a relational database manager to commercial and in-house structural and controls analysis codes. This paper describes the IMAT software system and how to use it.
Harmonizing disease prevention and police practice in the implementation of HIV prevention programs: Up-stream strategies from Wilmington, Delaware

PubMed Central

2012-01-01

Introduction Improving access to sterile injection equipment is a key component in community-based infectious disease prevention. Implementation of syringe access programs has sometimes been complicated by community opposition and police interference. Case description In 2006, the Delaware legislature authorized a pilot syringe exchange program (SEP). A program designed to prevent, monitor, and respond to possible policing and community barriers before they had a chance to effect program implementation and operation. A program designed to prevent, monitor, and respond to these barriers was planned and implemented by a multidisciplinary team of legal practitioners and public health professionals. Discussion We report on an integrated intervention to address structural barriers to syringe exchange program utilization. This intervention employs community, police and client education combined with systematic surveillance of and rapid response to police interference to preempt the kinds of structural barriers to implementation observed elsewhere. The intervention addresses community concerns and stresses the benefits of syringe exchange programs to officer occupational safety. Conclusions A cohesive effort combining collaboration with and educational outreach to police and community members based on the needs and concerns of these groups as well as SEP clients and potential clients helped establish a supportive street environment for the SEP. Police-driven structural barriers to implementation of public health programs targeting populations engaged in drug use and other illicit behavior can be addressed by up-stream planning, prevention, monitoring and intervention strategies. More research is needed to inform the tailoring of interventions to address police-driven barriers to HIV prevention services, especially among marginalized populations. PMID:22591836
The Canadian Rheumatology Association/ Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondyloarthritis: a national multidisciplinary stakeholder project.

PubMed

Maksymowych, Walter P; Gladman, Dafna; Rahman, Proton; Boonen, Annelies; Bykerk, Vivien; Choquette, Denis; Dimond, Sherry; Fortin, Paul; Karsh, Jacob; Klinkhoff, Alice V; Mosher, Dianne; Mulholland, Ken; Olszynski, Wojciech P; Russell, Anthony S; Savage, Laurie; Shanner, Laura; Shojania, Kam; Starr, Michael; Thomson, Glen; Zummer, Michel; Inman, Robert

2007-11-01

Development of treatment recommendations for arthritis has traditionally relied on the compilation of evidence-based data by experts in the field despite recommendations by various bodies for broad stakeholder input. Our objectives were: (1) To develop evidence-based treatment recommendations for the management of spondyloarthritis (SpA) in Canada that also incorporate the perspective of multiple stakeholders. (2) To generate a procedural template for the multidisciplinary development of treatment recommendations. The process was directed by a steering committee comprising the SPARCC Executive, rheumatologists from academic and community-based practice, patient consumers, and a representative from the John Dossetor Health Ethics Centre. Guidelines established by EULAR and stipulated in the AGREE instrument were followed. First, a working document was drafted that included a referenced summary of the evidence-based data and the 12 national arthritis care standards developed by the Alliance for the Canadian Arthritis Program. Second, a Web-based survey was conducted among patient consumers to address the relevance to patients of 2 primary outcome instruments that assess the effectiveness of treatment. Third, a list of questions was generated for drafting propositions by the ethics consultant. A Delphi consensus exercise was then conducted. Consensus was generated on a final list of 38 treatment recommendations categorized under the subject headings of general management principles, ethical considerations, target groups, definition of target disease, disease monitoring, and specific management recommendations. Using broad stakeholder input, we provide treatment recommendations to guide clinical practice and access to care for patients with SpA in Canada.
The development and exploratory analysis of the Back Pain Attitudes Questionnaire (Back-PAQ)

PubMed Central

Darlow, Ben; Perry, Meredith; Mathieson, Fiona; Stanley, James; Melloh, Markus; Marsh, Reginald; Baxter, G David; Dowell, Anthony

2014-01-01

Objectives To develop an instrument to assess attitudes and underlying beliefs about back pain, and subsequently investigate its internal consistency and underlying structures. Design The instrument was developed by a multidisciplinary team of clinicians and researchers based on analysis of qualitative interviews with people experiencing acute and chronic back pain. Exploratory analysis was conducted using data from a population-based cross-sectional survey. Setting Qualitative interviews with community-based participants and subsequent postal survey. Participants Instrument development informed by interviews with 12 participants with acute back pain and 11 participants with chronic back pain. Data for exploratory analysis collected from New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. 602 valid responses were received. Measures The 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed. Internal consistency was evaluated by the Cronbach α coefficient. Exploratory analysis investigated the structure of the data using Principal Component Analysis. Results The 34-item long form of the scale had acceptable internal consistency (α=0.70; 95% CI 0.66 to 0.73). Exploratory analysis identified five two-item principal components which accounted for 74% of the variance in the reduced data set: ‘vulnerability of the back’; ‘relationship between back pain and injury’; ‘activity participation while experiencing back pain’; ‘prognosis of back pain’ and ‘psychological influences on recovery’. Internal consistency was acceptable for the reduced 10-item scale (α=0.61; 95% CI 0.56 to 0.66) and the identified components (α between 0.50 and 0.78). Conclusions The 34-item long form of the scale may be appropriate for use in future cross-sectional studies. The 10-item short form may be appropriate for use as a screening tool, or an outcome assessment instrument. Further testing of the 10-item Back-PAQ's construct validity, reliability, responsiveness to change and predictive ability needs to be conducted. PMID:24860003
Making a move in exercise referral: co-development of a physical activity referral scheme.

PubMed

Buckley, B J R; Thijssen, D H J; Murphy, R C; Graves, L E F; Whyte, G; Gillison, F B; Crone, D; Wilson, P M; Watson, P M

2018-04-24

Translational research is required to ensure exercise referral schemes (ERSs) are evidence-based and reflect local needs. This article reports process data from the co-development phase of an ERS, providing an insight into (i) factors that must be considered when translating evidence to practice in an ERS setting, and (ii) challenges and facilitators of conducting participatory research involving multiple stakeholders. An ERS was iteratively co-developed by a multidisciplinary stakeholder group (commissioners, managers, practitioners, patients and academics) via five participatory meetings and an online survey. Audio data (e.g. group discussions) and visual data (e.g. whiteboard notes) were recorded and analysed using NVivo-10 electronic software. Factors to consider when translating evidence to practice in an ERS setting included (i) current ERS culture; (ii) skills, safety and accountability; and (iii) resources and capacity. The co-development process was facilitated by needs-analysis, open questions, multidisciplinary debate and reflective practice. Challenges included contrasting views, irregular attendance and (mis)perceptions of evaluation. The multidisciplinary co-development process highlighted cultural and pragmatic issues related to exercise referral provision, resulting in an evidence-based intervention framework designed to be implemented within existing infrastructures. Further work is required to establish the feasibility and effectiveness of the co-developed intervention in practice.
Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

ERIC Educational Resources Information Center

Bathrellou, Eirini; Yannakoulia, Mary; Papanikolaou, Katerina; Pehlivanidis, Artemios; Pervanidou, Panagiota; Kanaka-Gantenbein, Christina; Tsiantis, John; Chrousos, George P.; Sidossis, Labros S.

2010-01-01

Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical…
Process improvement for the safe delivery of multidisciplinary-executed treatments-A case in Y-90 microspheres therapy.

PubMed

Cai, Bin; Altman, Michael B; Garcia-Ramirez, Jose; LaBrash, Jason; Goddu, S Murty; Mutic, Sasa; Parikh, Parag J; Olsen, Jeffrey R; Saad, Nael; Zoberi, Jacqueline E

To develop a safe and robust workflow for yttrium-90 (Y-90) radioembolization procedures in a multidisciplinary team environment. A generalized Define-Measure-Analyze-Improve-Control (DMAIC)-based approach to process improvement was applied to a Y-90 radioembolization workflow. In the first DMAIC cycle, events with the Y-90 workflow were defined and analyzed. To improve the workflow, a web-based interactive electronic white board (EWB) system was adopted as the central communication platform and information processing hub. The EWB-based Y-90 workflow then underwent a second DMAIC cycle. Out of 245 treatments, three misses that went undetected until treatment initiation were recorded over a period of 21 months, and root-cause-analysis was performed to determine causes of each incident and opportunities for improvement. The EWB-based Y-90 process was further improved via new rules to define reliable sources of information as inputs into the planning process, as well as new check points to ensure this information was communicated correctly throughout the process flow. After implementation of the revised EWB-based Y-90 workflow, after two DMAIC-like cycles, there were zero misses out of 153 patient treatments in 1 year. The DMAIC-based approach adopted here allowed the iterative development of a robust workflow to achieve an adaptable, event-minimizing planning process despite a complex setting which requires the participation of multiple teams for Y-90 microspheres therapy. Implementation of such a workflow using the EWB or similar platform with a DMAIC-based process improvement approach could be expanded to other treatment procedures, especially those requiring multidisciplinary management. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic.

PubMed

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

2015-08-01

Value in healthcare is measured in terms of patient outcomes achieved per dollar expended. Outcomes and cost must be measured at the patient level to optimize value. Multidisciplinary clinics have been shown to be effective in providing coordinated and comprehensive care with improved outcomes, yet tend to have higher cost than typical clinics. We sought to lower individual patient cost and optimize value in a pediatric multidisciplinary reconstructive pelvic medicine (RPM) clinic. The RPM clinic is a multidisciplinary clinic that takes care of patients with anomalies of the pelvic organs. The specialties involved include Urology, General Surgery, Gynecology, and Gastroenterology/Motility. From May 2012 to November 2014 we performed time-driven activity-based costing (TDABC) analysis by measuring provider time for each step in the patient flow. Using observed time and the estimated hourly cost of each of the providers we calculated the final cost at the individual patient level, targeting clinic preparation. We utilized Toyota Kata methodology to enhance operational efficiency in an effort to optimize value. Variables measured included cost, time to perform a task, number of patients seen in clinic, percent value-added time (VAT) to patients (face to face time) and family experience scores (FES). At the beginning of the study period, clinic costs were $619 per patient. We reduced conference time from 6 min/patient to 1 min per patient, physician preparation time from 8 min to 6 min and increased Medical Assistant (MA) preparation time from 9.5 min to 20 min, achieving a cost reduction of 41% to $366 per patient. Continued improvements further reduced the MA preparation time to 14 min and the MD preparation time to 5 min with a further cost reduction to $194 (69%) (Figure). During this study period, we increased the number of appointments per clinic. We demonstrated sustained improvement in FES with regards to the families overall experience with their providers. Value added time was increased from 60% to 78% but this was not significant. Time-based cost analysis effectively measures individualized patient cost. We achieved a 69% reduction in clinic preparation costs. Despite this reduction in costs, we were able to maintain VAT and sustain improvements in family experience. In caring for complex patients, lean management methodology enables optimization of value in a multidisciplinary clinic. Copyright © 2015. Published by Elsevier Ltd.
Lung cancer diagnosis and staging in the minimally invasive age with increasing demands for tissue analysis

PubMed Central

Costa, Daniel B.; Wright, Jeffrey; VanderLaan, Paul A.

2015-01-01

The diagnosis and staging of patients with lung cancer in recent decades has increasingly relied on minimally invasive tissue sampling techniques, such as endobronchial ultrasound (EBUS) or endoscopic ultrasound (EUS) needle aspiration, transbronchial biopsy, and transthoracic image guided core needle biopsy. These modalities have been shown to have low complication rates, and provide adequate cellular material for pathologic diagnosis and necessary ancillary molecular testing. As an important component to a multidisciplinary team approach in the care of patients with lung cancer, these minimally invasive modalities have proven invaluable for the rapid and safe acquisition of tissue used for the diagnosis, staging, and molecular testing of tumors to identify the best evidence-based treatment plan. The continuous evolution of the field of lung cancer staging and treatment has translated into improvements in survival and quality of life for patients. Although differences in clinical practice between academic and community hospital settings still exist, improvements in physician education and training as well as adoption of technological advancements should help narrow this gap going forward. PMID:26380180
National Institutes of Health Pathways to Prevention Workshop: Advancing Research to Prevent Youth Suicide.

PubMed

Little, Todd D; Roche, Kathleen M; Chow, Sy-Miin; Schenck, Anna P; Byam, Leslie-Ann

2016-12-06

The National Institutes of Health (NIH) Pathways to Prevention Workshop "Advancing Research to Prevent Youth Suicide" was cosponsored by the NIH Office of Disease Prevention, National Institute of Mental Health, National Institute on Drug Abuse, and National Center for Complementary and Integrative Health. A multidisciplinary working group developed the agenda, and an evidence-based practice center prepared an evidence report that addressed data systems relevant to suicide prevention efforts through a contract with the Agency for Healthcare Research and Quality. During the workshop, experts discussed the evidence and participants commented during open forums. After considering the data from the evidence report, expert presentations, and public comments, an independent panel prepared a draft report that was posted on the NIH Office of Disease Prevention Web site for 5 weeks for public comment. This abridged version of the final report provides a road map for optimizing youth suicide prevention efforts by highlighting strategies for guiding the next decade of research in this area. These strategies include recommendations for improving data systems, enhancing data collection and analysis methods, and strengthening the research and practice community.
Opening Windows of Understanding for Learners in a Global Community

ERIC Educational Resources Information Center

Ashmore, Pamela; Murphy, Carole

2007-01-01

This article presents an innovative approach to diversity education. The approach is multidisciplinary, and it was developed by blending the expertise of anthropological research with the pedagogical skills developed by education specialists. To institutionalize this approach, a unique university-level collaboration occurred between students and…
Florida Marine Education Resources Bibliography. Report Number 51, Florida Sea Grant College.

ERIC Educational Resources Information Center

Gordon, Marjorie R.; Bane, Leni L.

This multidisciplinary, annotated bibliography is offered to K-12 teachers, other educators, librarians, concerned parents, and community leaders to simplify locating and acquiring marine education materials and infusing marine subjects into existing curricula. Included are printed materials currently available from commercial publishers,…
What's New in Elder Abuse Programming? Four Bright Ideas.

ERIC Educational Resources Information Center

Wolf, Rosalie S.; Pillemar, Karl

1994-01-01

Presents four "best practice models" that address problems faced by community agencies working with elder abuse cases: multidisciplinary case consultation team; senior advocate volunteer program; victim support group; and master's of social work degree specialization in adult protective services. Sees their relatively low cost, flexibility, and…
Getting better at chronic care in remote communities: study protocol for a pragmatic cluster randomised controlled of community based management.

PubMed

Schmidt, Barbara; Wenitong, Mark; Esterman, Adrian; Hoy, Wendy; Segal, Leonie; Taylor, Sean; Preece, Cilla; Sticpewich, Alex; McDermott, Robyn

2012-11-21

Prevalence and incidence of diabetes and other common comorbid conditions (hypertension, coronary heart disease, renal disease and chronic lung disease) are extremely high among Indigenous Australians. Recent measures to improve quality of preventive care in Indigenous community settings, while apparently successful at increasing screening and routine check-up rates, have shown only modest or little improvements in appropriate care such as the introduction of insulin and other scaled-up drug regimens in line with evidence-based guidelines, together with support for risk factor reduction. A new strategy is required to ensure high quality integrated family-centred care is available locally, with continuity and cultural safety, by community-based care coordinators with appropriate system supports. The trial design is open parallel cluster randomised controlled trial. The objective of this pragmatic trial is to test the effectiveness of a model of health service delivery that facilitates integrated community-based, intensive chronic condition management, compared with usual care, in rural and remote Indigenous primary health care services in north Queensland. Participants are Indigenous adults (aged 18-65 years) with poorly controlled diabetes (HbA1c>=8.5) and at least one other chronic condition. The intervention is to employ an Indigenous Health Worker to case manage the care of a maximum caseload of 30 participants. The Indigenous Health Workers receive intensive clinical training initially, and throughout the study, to ensure they are competent to coordinate care for people with chronic conditions. The Indigenous Health Workers, supported by the local primary health care (PHC) team and an Indigenous Clinical Support Team, will manage care, including coordinating access to multidisciplinary team care based on best practice standards. Allocation by cluster to the intervention and control groups is by simple randomisation after participant enrolment. Participants in the control group will receive usual care, and will be wait-listed to receive a revised model of the intervention informed by the data analysis. The primary outcome is reduction in HbA1c measured at 18 months. Implementation fidelity will be monitored and a qualitative investigation (methods to be determined) will aim to identify elements of the model which may influence health outcomes for Indigenous people with chronic conditions. This pragmatic trial will test a culturally-sound family-centred model of care with supported case management by IHWs to improve outcomes for people with complex chronic care needs. This trial is now in the intervention phase. Australian New Zealand Clinical Trials Registry ACTR12610000812099.
Implementing web-based ping-pong-type e-communication to enhance staff satisfaction, multidisciplinary cooperation, and clinical effectiveness

PubMed Central

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

2016-01-01

Abstract Background: Frequent multidisciplinary communication is essential in conducting daily radiotherapy (RT) practice. However, traditional oral or paper-based communication has limitations. E-communication has been suggested, but its effects are still not well demarcated in the field of radiation oncology. Objects: In our web-based integrated information platform, we constructed a ping-pong-type e-communication function to transfer specific notations among multidisciplinary RT staffs. The purpose was to test whether applying this e-communication can increase effectiveness of multidisciplinary cooperation when compared with oral or paper-based practice. Staff satisfaction and clinical benefits were also demonstrated. Design and setting: A real-world quality-improving study was conducted in a large center of radiation oncology. Participants and dataset used: Before and after applying multidisciplinary e-communication (from 2014 to 2015), clinical RT staffs were surveyed for their user experience and satisfaction (n = 23). For measuring clinical effectiveness, a secondary database of irradiated head and neck cancer patients was re-analyzed for comparing RT toxicities (n = 402). Interventions: Applying ping-pong-type multidisciplinary reflective e-communication was the main intervention. Outcome measures: For measuring staff satisfaction, eight domains were surveyed, such as timeliness, convenience, and completeness. For measuring clinical effectiveness of multidisciplinary cooperation, event rates of severe (i.e., grade 3–4) RT mucositis and dermatitis were recorded. Results: Overall, when compared with oral communication only, e-communication demonstrated multiple benefits, particularly on notation-review convenience (2.00 ± 1.76 vs 9.19 ± 0.81; P < 0.0001). When compared with paper-based practice, e-communication showed statistically significant benefits on all eight domains, especially on notation-review convenience (5.05 ± 2.11 vs 9.19 ± 0.81; P < 0.0001) and convenience of feedback notation (4.81 ± 1.72 vs 8.76 ± 1.09; P < 0.0001). Moreover, staff satisfaction was gradually increased from oral (3.57 ± 1.94), paper-based (5.57 ± 2.06), to e-communication (8.76 ± 0.70; P < 0.0001). Secondary measurement confirmed these observations. Before and after facilitating multidisciplinary cooperation by using e-communication, severe (i.e., grade 3–4) mucositis and dermatitis were decreased from 21.7% to 10% then to 5.1%. Conclusions: Replacing oral or paper-based practice with e-communication is useful in facilitating RT multidisciplinary teamwork. Staff satisfaction and clinical effectiveness can be increased. PMID:27858876
STARS: An Integrated, Multidisciplinary, Finite-Element, Structural, Fluids, Aeroelastic, and Aeroservoelastic Analysis Computer Program

NASA Technical Reports Server (NTRS)

Gupta, K. K.

1997-01-01

A multidisciplinary, finite element-based, highly graphics-oriented, linear and nonlinear analysis capability that includes such disciplines as structures, heat transfer, linear aerodynamics, computational fluid dynamics, and controls engineering has been achieved by integrating several new modules in the original STARS (STructural Analysis RoutineS) computer program. Each individual analysis module is general-purpose in nature and is effectively integrated to yield aeroelastic and aeroservoelastic solutions of complex engineering problems. Examples of advanced NASA Dryden Flight Research Center projects analyzed by the code in recent years include the X-29A, F-18 High Alpha Research Vehicle/Thrust Vectoring Control System, B-52/Pegasus Generic Hypersonics, National AeroSpace Plane (NASP), SR-71/Hypersonic Launch Vehicle, and High Speed Civil Transport (HSCT) projects. Extensive graphics capabilities exist for convenient model development and postprocessing of analysis results. The program is written in modular form in standard FORTRAN language to run on a variety of computers, such as the IBM RISC/6000, SGI, DEC, Cray, and personal computer; associated graphics codes use OpenGL and IBM/graPHIGS language for color depiction. This program is available from COSMIC, the NASA agency for distribution of computer programs.
Cure4Kids for Kids: school-based cancer education outreach.

PubMed

Van Kirk Villalobos, Aubrey; Quintana, Yuri; Ribeiro, Raul C

2012-01-01

In 2006, St. Jude Children's Research Hospital created Cure4Kids for Kids, a school-based outreach program. The objectives of this community education program are to teach about cancer and healthy lifestyles and to inspire an interest in science and health-related careers. A multidisciplinary team of St. Jude and outside experts developed and pilot tested age-appropriate educational materials and activities with 4th grade students. Eight schools and more than 800 children have participated in the program since 2006. Teachers and students have demonstrated a very positive response to the program for it being both fun and educational. Cure4Kids for Kids resources have been collected into a teacher's kit and are now freely available online at www.cure4kids.org/kids.
Early Experience with a Brief, Multimodal, Multidisciplinary Treatment Program for Fibromyalgia

PubMed Central

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

2014-01-01

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

Development of a Aerothermoelastic-Acoustics Simulation Capability of Flight Vehicles

NASA Technical Reports Server (NTRS)

Gupta, K. K.; Choi, S. B.; Ibrahim, A.

2010-01-01

A novel numerical, finite element based analysis methodology is presented in this paper suitable for accurate and efficient simulation of practical, complex flight vehicles. An associated computer code, developed in this connection, is also described in some detail. Thermal effects of high speed flow obtained from a heat conduction analysis are incorporated in the modal analysis which in turn affects the unsteady flow arising out of interaction of elastic structures with the air. Numerical examples pertaining to representative problems are given in much detail testifying to the efficacy of the advocated techniques. This is a unique implementation of temperature effects in a finite element CFD based multidisciplinary simulation analysis capability involving large scale computations.
Perceived Benefits and Challenges of a Risk-Based Approach to Multidisciplinary Chronic Kidney Disease Care: A Qualitative Descriptive Study.

PubMed

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

2018-01-01

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

PubMed

Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Cazzaniga, Daniele; Liquori, Valentina; Pedrocchi, Alessandra; Vernon, Howard

2017-06-01

To evaluate the effect of a group-based multidisciplinary rehabilitation programme on disability, pain and quality of life in subjects with chronic neck pain. Randomized controlled trial. Specialized rehabilitation centre. A total of 170 patients (mean age of 53 years (13); 121 females). The multidisciplinary group underwent a multidisciplinary rehabilitation programme combining multimodal exercises with psychologist-lead cognitive-behavioural therapy sessions. The general exercise group underwent general physiotherapy. Both groups followed group-based programmes once a week for ten weeks. Additionally, the multidisciplinary group met with the psychologist once a week for a 60-minute session. The Neck Disability Index (primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale and the Short-Form Health Survey. The participants were evaluated before, after training and after 12 months. A linear mixed model for repeated measures was used for each outcome measure. Significant effects ( p-value <0.001) were found over time and between groups for all outcome measures. After training, significant improvements were found for both groups for all outcome measures except kinesiophobia and catastrophizing, which did not change in the control group; however, the improvements were significantly greater for the multidisciplinary group. At 12-month follow-up a clinically meaningful between-group difference of 12.4 Neck Disability Index points was found for disability. A group-based multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to group-based general physiotherapy in improving disability, pain and quality of life of subjects with chronic neck pain. The effects lasted for at least one year.
The future of community nursing: Hospital in the Home.

PubMed

Lee, Gerry; Pickstone, Nicola; Facultad, Jose; Titchener, Karen

2017-04-02

With an increasing ageing population who often have multiple long-term conditions, there is a growing need to provide an alternative type of care to the traditional hospital-based model. 'Hospital in the Home' is a model that provides integrated care for patients in their home. The @home service was established in 2013 by Guy's and St Thomas' NHS Foundation Trust. The service provides health care in patients' home, supporting early discharge from hospital as well as preventing avoidable admissions and readmissions saving valuable hospital bed days and reducing length of stay. This article describes the service available with the use of a case study of a 78-year-old lady who was referred by the London Ambulance Service with exacerbation of chronic obstructive pulmonary disease (COPD). This case study highlights the ability to assess, treat and manage an acutely unwell patient with newly diagnosed heart failure in the community without the need for hospitalisation. This type of integrated care model with a multidisciplinary team is a feasible alternative to the traditional models of care in both the acute and community settings.
PREFACE: New trends in Computer Simulations in Physics and not only in physics

NASA Astrophysics Data System (ADS)

Shchur, Lev N.; Krashakov, Serge A.

2016-02-01

In this volume we have collected papers based on the presentations given at the International Conference on Computer Simulations in Physics and beyond (CSP2015), held in Moscow, September 6-10, 2015. We hope that this volume will be helpful and scientifically interesting for readers. The Conference was organized for the first time with the common efforts of the Moscow Institute for Electronics and Mathematics (MIEM) of the National Research University Higher School of Economics, the Landau Institute for Theoretical Physics, and the Science Center in Chernogolovka. The name of the Conference emphasizes the multidisciplinary nature of computational physics. Its methods are applied to the broad range of current research in science and society. The choice of venue was motivated by the multidisciplinary character of the MIEM. It is a former independent university, which has recently become the part of the National Research University Higher School of Economics. The Conference Computer Simulations in Physics and beyond (CSP) is planned to be organized biannually. This year's Conference featured 99 presentations, including 21 plenary and invited talks ranging from the analysis of Irish myths with recent methods of statistical physics, to computing with novel quantum computers D-Wave and D-Wave2. This volume covers various areas of computational physics and emerging subjects within the computational physics community. Each section was preceded by invited talks presenting the latest algorithms and methods in computational physics, as well as new scientific results. Both parallel and poster sessions paid special attention to numerical methods, applications and results. For all the abstracts presented at the conference please follow the link http://csp2015.ac.ru/files/book5x.pdf
Mapping Remote and Multidisciplinary Learning Barriers: Lessons from "Challenge-Based Innovation" at CERN

ERIC Educational Resources Information Center

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

2018-01-01

This paper presents the experienced difficulties of students participating in the multidisciplinary, remote collaborating engineering design course challenge-based innovation at CERN. This is with the aim to identify learning barriers and improve future learning experiences. We statistically analyse the rated differences between distinct design…
A new concept of a multidisciplinary lymphoedema centre: established in connection to a department of dermatology and the Copenhagen Wound Healing Center.

PubMed

Birkballe, S; Karlsmark, T; Noerregaard, S; Gottrup, F

2012-07-01

Lymphoedema is increasingly recognized as a significant problem in healthcare. The number of patients is growing, posing a future challenge to healthcare systems and economics. Over the past decade, specialized lymphoedema management has been established around the world to accommodate the growing demands. However, information on organization, experiences and outcome are scarce. To conduct a clinical perspective analysis describing the establishment, organization, function and results of a new, multidisciplinary lymphoedema centre functioning as a university hospital unit in connection to a department of dermatology and the Copenhagen Wound Healing Center and integrated as a national expert function in the public healthcare organization of Denmark. Data were collected following the establishment of a lymphoedema centre based on the structured, multidisciplinary organization of lymphoedema management. During the first 4·5 years a total of 8058 patient consultations were performed. The mean duration of symptoms at the first visit was 19 years (range 1-67) and 31% of patients had never received any diagnosis or treatment prior to referral. Complications were found in 48% of referred patients. All patients received appropriate diagnostic investigations and treatment according to best practice. Multidisciplinary assessment involving four or more different healthcare professions was needed in 86% of cases. Research opportunities and expert education of staff were enhanced. A multidisciplinary lymphoedema centre improves management, knowledge and awareness of lymphoedema. This model, with minor adjustments, may be applicable for other regions and countries. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.
An information driven strategy to support multidisciplinary design

NASA Technical Reports Server (NTRS)

Rangan, Ravi M.; Fulton, Robert E.

1990-01-01

The design of complex engineering systems such as aircraft, automobiles, and computers is primarily a cooperative multidisciplinary design process involving interactions between several design agents. The common thread underlying this multidisciplinary design activity is the information exchange between the various groups and disciplines. The integrating component in such environments is the common data and the dependencies that exist between such data. This may be contrasted to classical multidisciplinary analyses problems where there is coupling between distinct design parameters. For example, they may be expressed as mathematically coupled relationships between aerodynamic and structural interactions in aircraft structures, between thermal and structural interactions in nuclear plants, and between control considerations and structural interactions in flexible robots. These relationships provide analytical based frameworks leading to optimization problem formulations. However, in multidisciplinary design problems, information based interactions become more critical. Many times, the relationships between different design parameters are not amenable to analytical characterization. Under such circumstances, information based interactions will provide the best integration paradigm, i.e., there is a need to model the data entities and their dependencies between design parameters originating from different design agents. The modeling of such data interactions and dependencies forms the basis for integrating the various design agents.
Multi-disciplinary coupling for integrated design of propulsion systems

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

PubMed Central

2014-01-01

Background Vector-borne diseases (VBDs) and mosquito control programs (MCPs) diverge in settings and countries, and lead control specialists need to be aware of the most effective control strategies. Integrated Vector Management (IVM) strategies, once implemented in MCPs, aim to reduce cost and optimize protection of the populations against VBDs. This study presents a strengths, weaknesses, opportunities, and threats (SWOT) analysis to compare IVM strategies used by MCPs in Saint Johns County, Florida and Guayas, Ecuador. This research evaluates MCPs strategies to improve vector control activities. Methods Methods included descriptive findings of the MCP operations. Information was obtained from vector control specialists, directors, and residents through field trips, surveys, and questionnaires. Evaluations of the strategies and assets of the control programs where obtained through SWOT analysis and within an IVM approach. Results Organizationally, the Floridian MCP is a tax-based District able to make decisions independently from county government officials, with the oversight of an elected board of commissioners. The Guayas program is directed by the country government and assessed by non-governmental organizations like the World health Organization. Operationally, the Floridian MCP conducts entomological surveillance and the Ecuadorian MCP focuses on epidemiological monitoring of human disease cases. Strengths of both MCPs were their community participation and educational programs. Weaknesses for both MCPs included limitations in budgets and technical capabilities. Opportunities, for both MCPs, are additional funding and partnerships with private, non-governmental, and governmental organizations. Threats experienced by both MCPs included political constraints and changes in the social and ecological environment that affect mosquito densities and control efforts. IVM pillars for policy making were used to compare the information among the programs. Differences included how the Ecuadorian MCP relies heavily on the community for vector control while the American MCP relies on technologies and research. Conclusion IVM based recommendations direct health policy leaders toward improving surveillance systems both entomologically and epidemiologically, improving community risk perceptions by integrating components of community participation, maximizing resources though the use of applied research, and protecting the environment by selecting low-risk pesticides. Outcomes of the research revealed that inter-sectorial and multidisciplinary interventions are critical to improve public health. PMID:24990155
Time-driven activity-based costing to estimate cost of care at multidisciplinary aerodigestive centers.

PubMed

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

2017-09-01

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

NASA Astrophysics Data System (ADS)

Tarolli, Paolo

2014-05-01

From the analysis of Earth surface, we are able to learn a lot about its history and processes. Indeed, different landforms bear the signs of different ages, but also of climate and tectonic forcing. In addition to these processes, also the biota forcing has a role in shaping the landscape, of course at different scale and magnitude if compared with geology. In biotic landscapes the vegetation through the roots influences the soil formation and surface erosion. Biota affect also climate, and as a consequence the mechanisms and erosion rates that control the landscape evolution. However, the question is, if we can suppose that there is an evidence of biota forcing, what is the role of humans? Human activities, more than vegetation, are leaving a significant signature on the Earth, by altering its morphology and ecosystems. Also in this case, the temporal and spatial scale (and also the magnitude) are different respect to geological forcing, but the development of the society during the Holocene was significant (from hunting-gathering to farming to complex societies and metropolis): the increase of the population was related to a progressively increase of intensive agriculture and urbanization. This anthropogenic forcing deeply affected the environment, inducing or reducing erosion, and changing the equilibrium of several ecosystems. The recognition and the analysis of the human induced changes, signatures and processes represent a real challenge for the scientific community to better understand the evolution of our Planet. This analysis can help in scheduling a suitable environmental planning for a sustainable development, and to mitigate the consequences of anthropogenic alteration. Wider multidisciplinary groups based on these studies could be able to understand better the evolution of landscapes and ecosystems during the human era, providing a full dataset of multidisciplinary information that can be used by land managers and local authorities, and by the scientific community as well. The recent remotely sensed technologies (e.g. LIDAR, SAR, SfM) might help to reach part of the mentioned goals. High-resolution topography could really play a strategic and helpful role in the recognition of human-induced geomorphic and anthropogenic features, and the connected erosion. Among the most evident landscape signatures of the human fingerprint, for example, road networks and agricultural practices such as terracing deserve a great importance since significantly affect the erosional processes. A better recognition of these signatures is at the basis to improve the knowledge of the related induced processes. In addition to this, it is necessary to improve, through historical data (e.g. hydrogeological, meteorological, stratigraphy, also archeological data) and modeling, the understanding about the land use changes occurred during the last centuries, focusing on the reasoning behind these changes, and on the analysis of their effects on landscape and processes. Human society relies on the vast diversity of benefits provided by the environment. Soil biodiversity and conservation are part of the driving force behind its regulation. At the same time, human society is deeply affecting the environment with consequences on the landscape. It is therefore fundamental to establish greater management control over the Earth's rapidly changing ecosystems.
ASTROS: A multidisciplinary automated structural design tool

NASA Technical Reports Server (NTRS)

Neill, D. J.

1989-01-01

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

ERIC Educational Resources Information Center

Brookins-Fisher, Jodi; O'Boyle, Irene; Ivanitskaya, Lana

2010-01-01

The purpose of health education is to positively influence the health behavior of individuals and communities, as well as living and working conditions that affect health. The goal of a Healthy Lifestyles course that is offered to undergraduate students enrolled in a university general education program (e.g., liberal arts education, core…
Multidisciplinary Teaming To Promote Effective Management of Type 1 Diabetes for Adolescents.

ERIC Educational Resources Information Center

Strawhacker, MaryAnn Tapper

2001-01-01

By facilitating active participation in treatment, coordinating services, and maximizing community resources, schools can help adolescents build a strong foundation for lifelong diabetes management. This paper presents an overview of intensive diabetes therapy, psychosocial implications of chronic illness in adolescence, the effects of chronic…
Social ecological analysis of an outbreak of pufferfish egg poisoning in a coastal area of Bangladesh.

PubMed

Islam, M Saiful; Luby, Stephen P; Rahman, Mahmudur; Parveen, Shahana; Homaira, Nusrat; Begum, Nur Har; Dawlat Khan, A K M; Sultana, Rebeca; Akhter, Shammi; Gurley, Emily S

2011-09-01

Recurrent outbreaks of marine pufferfish poisoning in Bangladesh highlight the need to understand the context in which the outbreaks occurred. In a recent outbreak investigation, a multidisciplinary team conducted a mixed-method study to identify the demography and clinical manifestation of the victims and to explore different uses of pufferfish, and local buying, selling, and processing practices. The outbreak primarily affected a low income household where an elderly woman collected and cooked pufferfish egg curry. Nine persons consumed the curry, and symptoms developed in 6 (67%) of these persons. Symptoms included vomiting, diarrhea, paresis, and tingling sensation; 2 (22%) persons died. The unstable income of the affected family, food crisis, and the public disposal of unsafe pufferfish byproducts all contributed to the outbreak. A multi-level intervention should be developed and disseminated with the participation of target communities to discourage unsafe discarding of pufferfish scraps and to improve the community knowledge about the risk of consuming pufferfish.
Social Ecological Analysis of an Outbreak of Pufferfish Egg Poisoning in a Coastal Area of Bangladesh

PubMed Central

Islam, M. Saiful; Luby, Stephen P.; Rahman, Mahmudur; Parveen, Shahana; Homaira, Nusrat; Begum, Nur Har; Dawlat Khan, A. K. M.; Sultana, Rebeca; Akhter, Shammi; Gurley, Emily S.

2011-01-01

Recurrent outbreaks of marine pufferfish poisoning in Bangladesh highlight the need to understand the context in which the outbreaks occurred. In a recent outbreak investigation, a multidisciplinary team conducted a mixed-method study to identify the demography and clinical manifestation of the victims and to explore different uses of pufferfish, and local buying, selling, and processing practices. The outbreak primarily affected a low income household where an elderly woman collected and cooked pufferfish egg curry. Nine persons consumed the curry, and symptoms developed in 6 (67%) of these persons. Symptoms included vomiting, diarrhea, paresis, and tingling sensation; 2 (22%) persons died. The unstable income of the affected family, food crisis, and the public disposal of unsafe pufferfish byproducts all contributed to the outbreak. A multi-level intervention should be developed and disseminated with the participation of target communities to discourage unsafe discarding of pufferfish scraps and to improve the community knowledge about the risk of consuming pufferfish. PMID:21896811
Does a 3-month multidisciplinary intervention improve pain, body composition and physical fitness in women with fibromyalgia?

PubMed

Carbonell-Baeza, Ana; Aparicio, Virginia A; Ortega, Francisco B; Cuevas, Ana M; Alvarez, Inmaculada C; Ruiz, Jonatan R; Delgado-Fernandez, Manuel

2011-12-01

To determine the effects of a 3-month multidisciplinary intervention on pain (primary outcome), body composition and physical fitness (secondary outcomes) in women with fibromyalgia (FM). 75 women with FM were allocated to a low-moderate intensity 3-month (three times/week) multidisciplinary (pool, land-based and psychological sessions) programme (n=33) or to a usual care group (n=32). The outcome variables were pain threshold, body composition (body mass index and estimated body fat percentage) and physical fitness (30 s chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go and 6 min walk test). The authors observed a significant interaction effect (group*time) for the left (L) and right (R) side of the anterior cervical (p<0.001) and the lateral epicondyle R (p=0.001) tender point. Post hoc analysis revealed that pain threshold increased in the intervention group (positive) in the anterior cervical R (p<0.001) and L (p=0.012), and in the lateral epicondyle R (p=0.010), whereas it decreased (negative) in the anterior cervical R (p<0.001) and L (p=0.002) in the usual care group. There was also a significant interaction effect for chair sit and reach. Post hoc analysis revealed improvement in the intervention group (p=0.002). No significant improvement attributed to the training was observed in the rest of physical fitness or body composition variables. A 3-month multidisciplinary intervention three times/week had a positive effect on pain threshold in several tender points in women with FM. Though no overall improvements were observed in physical fitness or body composition, the intervention had positive effects on lower-body flexibility.
Multidisciplinary aeroelastic analysis of a generic hypersonic vehicle

NASA Technical Reports Server (NTRS)

Gupta, K. K.; Petersen, K. L.

1993-01-01

This paper presents details of a flutter and stability analysis of aerospace structures such as hypersonic vehicles. Both structural and aerodynamic domains are discretized by the common finite element technique. A vibration analysis is first performed by the STARS code employing a block Lanczos solution scheme. This is followed by the generation of a linear aerodynamic grid for subsequent linear flutter analysis within subsonic and supersonic regimes of the flight envelope; the doublet lattice and constant pressure techniques are employed to generate the unsteady aerodynamic forces. Flutter analysis is then performed for several representative flight points. The nonlinear flutter solution is effected by first implementing a CFD solution of the entire vehicle. Thus, a 3-D unstructured grid for the entire flow domain is generated by a moving front technique. A finite element Euler solution is then implemented employing a quasi-implicit as well as an explicit solution scheme. A novel multidisciplinary analysis is next effected that employs modal and aerodynamic data to yield aerodynamic damping characteristics. Such analyses are performed for a number of flight points to yield a large set of pertinent data that define flight flutter characteristics of the vehicle. This paper outlines the finite-element-based integrated analysis procedures in detail, which is followed by the results of numerical analyses of flight flutter simulation.
Community nurse's knowledge, confidence and experience of the Mental Capacity Act in practice.

PubMed

Marshall, Helen; Sprung, Sally

2016-12-02

The Mental Capacity Act (MCA) is statutory legislation introduced in 2007 to protect and empower people to make decisions for themselves and those who were deemed as unable to make choices would have decisions made on their behalf, often by health professionals. All health professionals must follow the guiding principles of this legislation. Yet a scrutiny report by the House of Lords concluded this legislation was under-used with a lack of knowledge among professionals regarding applying the legislation in practice. A review of the literature also supports these findings. A mixed method study was carried out among adult community nurses to explore if these findings were applicable within a health trust in the North West region. An electronic questionnaire (n=60), focus group (n=7) and a paired interview (n=2) were utilised to collect data regarding community nurse's experience and confidence of using the MCA in practice. Analysis identified key themes: training, knowledge and confidence among staff, working together with the wider multidisciplinary team, empowerment and improving documentation. While findings suggest clear examples of self-appraised confidence and excewllent patient care, there is also scope for development regarding the knowledge and utilisation of the MCA in the clinical practice of community nurses.

Developing a network: the PMM process.

PubMed

Kamara, A

1997-11-01

Since 1988, the Prevention of Maternal Mortality (PMM) Network has developed, implemented and evaluated projects that focus directly on prevention of maternal deaths. The Network, which consists of 11 multidisciplinary teams in West Africa and one at Columbia University, grew from discussions between the Carnegie Corporation of New York and researchers at Columbia School of Public Health. Its goals are: to strengthen capacities in developing countries; to provide program models for preventing maternal deaths; and to inform policymakers about the importance of maternal mortality. This paper describes the development and functioning of the Network. The initial steps included identifying interested partners in Africa and encouraging them to form multidisciplinary teams. Each African team received two grants: one to perform a needs assessment and then another to develop and implement projects based on the results. The Columbia team provided technical assistance in a variety of ways, including site visits, workshops and correspondence. Teams tested program models and reported findings both to local policymakers and in international fora. Collaboration with government and community leaders helped facilitate progress at all stages. At the PMM Network Results Conference in 1996, the teams decided to continue their work by forming the Regional PMM (RPMM) Network, an entirely African entity.
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.
Pharmacist-initiated hepatitis C virus screening in a community pharmacy to increase awareness and link to care at the medical center.

PubMed

Isho, Nadine Y; Kachlic, Marlowe Djuric; Marcelo, Jennifer Chan; Martin, Michelle T

To describe the design and implementation of a pharmacist-led hepatitis C virus (HCV) screening and education program in a community pharmacy with a protocol for linkage to care at the affiliated hepatology clinic for patients born between 1945 and 1965. Outpatient pharmacy affiliated with the University of Illinois Hospital and Health Sciences System. The community pharmacist resident conducted the HCV screening at the health system-based community pharmacy. Community pharmacists provided patients with HCV screening and education while patients waited for their prescriptions to be ready or upon appointment. Patients were given a questionnaire before and after HCV education to assess the impact of pharmacist-provided education on patient knowledge. A protocol was developed to link patients with a positive HCV antibody test result to care with a hepatologist for confirmatory testing at a follow-up appointment at the medical center. Investigators assessed the feasibility of providing the screening and education, recorded the number of patients screened, and recorded the differences in the questionnaire responses before and after education. Pharmacist-led HCV screening services were implemented successfully at the community pharmacy. All patients had a negative antibody result; therefore, linkage to care at the medical center, although available, was not necessary. The self-reported posttest HCV knowledge scores were significantly higher than pretest scores. This article outlines the methodology for providing a multidisciplinary HCV screening, education, and referral program in a community pharmacy affiliated with a medical center. Pharmacist-initiated HCV screening in a community pharmacy can assist with identifying patients at risk for HCV infection and provide patients with linkage to care in the health system. This report may encourage community pharmacists to conduct future prospective trials to evaluate clinical and economic outcomes of community-based HCV screenings. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Multidisciplinary design optimization - An emerging new engineering discipline

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw

1993-01-01

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

NASA Technical Reports Server (NTRS)

Caruso, Pamela W.; Benfield, Michael P. J.; Justice, Stefanie H.

2011-01-01

The Integrated Product Team (IPT) program, led by The University of Alabama in Huntsville (UAH), is a multidisciplinary, multi-university, multi-level program whose goal is to provide opportunities for high school and undergraduate scientists and engineers to translate stakeholder needs and requirements into viable engineering design solutions via a distributed multidisciplinary team environment. The current program supports three projects. The core of the program is the two-semester senior design experience where science, engineering, and liberal arts undergraduate students from UAH, the College of Charleston, Southern University at Baton Rouge, and Ecole Suprieure des Techniques Aronautiques et de Construction Automobile (ESTACA) in Paris, France form multidisciplinary competitive teams to develop system concepts of interest to the local aerospace community. External review boards form to provide guidance and feedback throughout the semester and to ultimately choose a winner from the competing teams. The other two projects, the Innovative Student Project for the Increased Recruitment of Engineering and Science Students (InSPIRESS) Level I and Level II focus exclusively on high school students. InSPIRESS Level I allows high schools to develop a payload to be accommodated on the system being developed by senior design experience teams. InSPIRESS Level II provides local high school students first-hand experience in the senior design experience by allowing them to develop a subsystem or component of the UAH-led system over the two semesters. This program provides a model for NASA centers to engage the local community to become more involved in design projects.
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
Application of a multidisciplinary and integrative weight-of-evidence approach to a 1-year monitoring survey of the Seine River.

PubMed

Barjhoux, Iris; Fechner, Lise C; Lebrun, Jérémie D; Anzil, Adriana; Ayrault, Sophie; Budzinski, Hélène; Cachot, Jérôme; Charron, Laetitia; Chaumot, Arnaud; Clérandeau, Christelle; Dedourge-Geffard, Odile; Faburé, Juliette; François, Adeline; Geffard, Olivier; George, Isabelle; Labadie, Pierre; Lévi, Yves; Munoz, Gabriel; Noury, Patrice; Oziol, Lucie; Quéau, Hervé; Servais, Pierre; Uher, Emmanuelle; Urien, Nastassia; Geffard, Alain

2016-06-08

Quality assessment of environments under high anthropogenic pressures such as the Seine Basin, subjected to complex and chronic inputs, can only be based on combined chemical and biological analyses. The present study integrates and summarizes a multidisciplinary dataset acquired throughout a 1-year monitoring survey conducted at three workshop sites along the Seine River (PIREN-Seine program), upstream and downstream of the Paris conurbation, during four seasonal campaigns using a weight-of-evidence approach. Sediment and water column chemical analyses, bioaccumulation levels and biomarker responses in caged gammarids, and laboratory (eco)toxicity bioassays were integrated into four lines of evidence (LOEs). Results from each LOE clearly reflected an anthropogenic gradient, with contamination levels and biological effects increasing from upstream to downstream of Paris, in good agreement with the variations in the structure and composition of bacterial communities from the water column. Based on annual average data, the global hazard was summarized as "moderate" at the upstream station and as "major" at the two downstream ones. Seasonal variability was also highlighted; the winter campaign was least impacted. The model was notably improved using previously established reference and threshold values from national-scale studies. It undoubtedly represents a powerful practical tool to facilitate the decision-making processes of environment managers within the framework of an environmental risk assessment strategy.
IMAT (Integrated Multidisciplinary Analysis Tool) user's guide for the VAX/VMS computer

NASA Technical Reports Server (NTRS)

Meissner, Frances T. (Editor)

1988-01-01

The Integrated Multidisciplinary Analysis Tool (IMAT) is a computer software system for the VAX/VMS computer developed at the Langley Research Center. IMAT provides researchers and analysts with an efficient capability to analyze satellite control systems influenced by structural dynamics. Using a menu-driven executive system, IMAT leads the user through the program options. IMAT links a relational database manager to commercial and in-house structural and controls analysis codes. This paper describes the IMAT software system and how to use it.
Implementation of PBL Curriculum Involving Multiple Disciplines in Undergraduate Medical Education Programme

ERIC Educational Resources Information Center

Chakravarthi, Srikumar; Haleagrahara, Nagaraja

2010-01-01

This article describes how a multidisciplinary problem-based learning (PBL) curriculum was established at the International Medical University in Malaysia for preclinical education in a 5-semester phase 1 programme. Based on positive feedback from a modified PBL program implemented in one discipline, a multidisciplinary PBL curriculum was…
A Multidisciplinary Process Curriculum in Environmental Education, Grade 2.

ERIC Educational Resources Information Center

Edmonds School District 15, Lynnwood, WA.

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

ERIC Educational Resources Information Center

Solnosky, Ryan; Fairchild, Joshua

2017-01-01

Many engineering faculty have limited skills and/or assessment tools to evaluate team dynamics in multidisciplinary team-based capstone courses. Rapidly deployable tools are needed here to provide proactive feedback to teams to facilitate deeper learning. Two surveys were developed based on industrial and organizational psychology theories around…
Partnerships for parks and physical activity.

PubMed

Shulaker, Bianca D; Isacoff, Jennifer W; Cohen, Deborah A; Marsh, Terry; Wier, Megan; Bhatia, Rajiv

2014-01-01

Given the need for comprehensive and multidisciplinary active living interventions, this article describes an innovative partnership for park design and evaluation. The Trust for Public Land partnered with the RAND Corporation and the San Francisco Department of Public Health to generate context-sensitive active park design, establish evaluation methods, and build the framework for future collaboration. These partners worked together from 2009 to 2012 to design, renovate, and study parks in San Francisco, California. The three partnering organizations are the focus of this article. The Trust for Public Land's Parks for People-Bay Area Program raised more than $16 million to renovate three San Francisco parks, which served as the intervention for a study that initially brought the three partnering organizations together. The authors, who represent the three partners, collaborated to develop the lessons learned. This article is a description and commentary about a partnership that emphasized community involvement and rigorous evaluation. Lessons learned and elements for successful partnerships include collaborating with organizations with differing expertise, deciding upon goals initially, finding a common language, involving local communities, and recognizing the importance and appropriate role of evaluations. The model for collaboration and community involvement presented supports and encourages other organizations to use strategic, multidisciplinary partnerships and highlights the importance of evaluation.
A Framework for Multi-Scale, Multi-Disciplinary Arctic Terrestrial Field Research Design, Nomenclature and Data Management

NASA Astrophysics Data System (ADS)

Charsley-Groffman, L.; Killeffer, T.; Wullschleger, S. D.; Wilson, C. J.

2016-12-01

The Next Generation Ecosystem Experiment, NGEE Arctic, project aims to improve the representation of arctic terrestrial processes and properties in Earth System Models, ESMs, through coordinated multi-disciplinary field-based observations and experiments. NGEE involves nearly one hundred research staff, post docs and students from multiple DOE laboratories and universities who deploy a wide range of in-situ and remote field observation techniques to quantify and understand interactions between the climate system and surface and subsurface coupled thermal-hydrologic, biogeochemical and vegetation processes. Careful attention was given to the design and management of co-located long-term and one off data collection efforts, as well as their data streams. Field research sites at the Barrow Environmental Observatory near Barrow AK and on the Seward Peninsula were designed around the concept of "ecotypes" which co-evolved with readily identified and classified hydro-geomorphic features characteristic of arctic landscapes. NGEE sub-teams focused on 5 unique science questions collaborated to design field sites and develop naming conventions for locations and data types to develop coherent data sets to parameterize, initialize and test a range of site-specific process resolving models to ESMs. Multi-layer mapping products were a critical means of developing a coordinated and coherent observation design, and a centralized data portal and data reporting framework was critical to ensuring meaningful data products for NGEE modelers and Arctic scientific community at large. We present examples of what works and lessons learned for a large multi-disciplinary terrestrial observational research project in the Arctic.
Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure.

PubMed

Monnier, Annelie A; Schouten, Jeroen; Le Maréchal, Marion; Tebano, Gianpiero; Pulcini, Céline; Stanic Benic, Mirjana; Vlahovic-Palcevski, Vera; Milanic, Romina; Adriaenssens, Niels; Versporten, Ann; Huttner, Benedikt; Zanichelli, Veronica; Hulscher, Marlies E; Gyssens, Inge C

2018-06-01

This study was conducted as part of the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project and aimed to develop generic quality indicators (QIs) for responsible antibiotic use in the inpatient setting. A RAND-modified Delphi method was applied. First, QIs were identified by a systematic review. A complementary search was performed on web sites of relevant organizations. Duplicates were removed and disease and patient-specific QIs were combined into generic indicators. The relevance of these QIs was appraised by a multidisciplinary international stakeholder panel through two questionnaires and an in-between consensus meeting. The systematic review retrieved 70 potential generic QIs. The QIs were appraised by 25 international stakeholders with diverse backgrounds (medical community, public health, patients, antibiotic research and development, regulators, governments). Ultimately, 51 QIs were selected in consensus. QIs with the highest relevance score included: (i) an antibiotic plan should be documented in the medical record at the start of the antibiotic treatment; (ii) the results of bacteriological susceptibility testing should be documented in the medical record; (iii) the local guidelines should correspond to the national guidelines but should be adapted based on local resistance patterns; (iv) an antibiotic stewardship programme should be in place at the healthcare facility; and (v) allergy status should be taken into account when antibiotics are prescribed. This systematic and stepwise method combining evidence from literature and stakeholder opinion led to multidisciplinary international consensus on generic inpatient QIs that can be used globally to assess the quality of antibiotic use.
Development of an Enhanced Recovery After Surgery Guideline and Implementation Strategy Based on the Knowledge-to-action Cycle.

PubMed

McLeod, Robin S; Aarts, Mary-Anne; Chung, Frances; Eskicioglu, Cagla; Forbes, Shawn S; Conn, Lesley Gotlib; McCluskey, Stuart; McKenzie, Marg; Morningstar, Beverly; Nadler, Ashley; Okrainec, Allan; Pearsall, Emily A; Sawyer, Jason; Siddique, Naveed; Wood, Trevor

2015-12-01

Enhanced Recovery After Surgery (ERAS) protocols have been shown to increase recovery, decrease complications, and reduce length of stay. However, they are difficult to implement. To develop and implement an ERAS clinical practice guideline (CPG) at multiple hospitals. A tailored strategy based on the Knowledge-to-action (KTA) cycle was used to develop and implement an ERAS CPG at 15 academic hospitals in Canada. This included an initial audit to identify gaps and interviews to assess barriers and enablers to implementation. Implementation included development of an ERAS guideline by a multidisciplinary group, communities of practice led by multidiscipline champions (surgeons, anesthesiologists, and nurses) both provincially and locally, educational tools, and clinical pathways as well as audit and feedback. The initial audit revealed there was greater than 75% compliance in only 2 of 18 CPG recommendations. Main themes identified by stakeholders were that the CPG must be based on best evidence, there must be increased communication and collaboration among perioperative team members, and patient education is essential. ERAS and Pain Management CPGs were developed by a multidisciplinary team and have been adopted at all hospitals. Preliminary data from more than 1000 patients show that the uptake of recommended interventions varies but despite this, mean length of stay has decreased with low readmission rates and adverse events. On the basis of short-term findings, our results suggest that a tailored implementation strategy based on the KTA cycle can be used to successfully implement an ERAS program at multiple sites.
Multidisciplinary Optimization of a Transport Aircraft Wing using Particle Swarm Optimization

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw; Venter, Gerhard

2002-01-01

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

PubMed

Franco-Trigo, L; Tudball, J; Fam, D; Benrimoj, S I; Sabater-Hernández, D

2018-02-21

Collaboration between relevant stakeholders in health service planning enables service contextualization and facilitates its success and integration into practice. Although community pharmacy services (CPSs) aim to improve patients' health and quality of life, their integration in primary care is far from ideal. Key stakeholders for the development of a CPS intended at preventing cardiovascular disease were identified in a previous stakeholder analysis. Engaging these stakeholders to create a shared vision is the subsequent step to focus planning directions and lay sound foundations for future work. This study aims to develop a stakeholder-shared vision of a cardiovascular care model which integrates community pharmacists and to identify initiatives to achieve this vision. A participatory visioning exercise involving 13 stakeholders across the healthcare system was performed. A facilitated workshop, structured in three parts (i.e., introduction; developing the vision; defining the initiatives towards the vision), was designed. The Chronic Care Model inspired the questions that guided the development of the vision. Workshop transcripts, researchers' notes and materials produced by participants were analyzed using qualitative content analysis. Stakeholders broadened the objective of the vision to focus on the management of chronic diseases. Their vision yielded 7 principles for advanced chronic care: patient-centered care; multidisciplinary team approach; shared goals; long-term care relationships; evidence-based practice; ease of access to healthcare settings and services by patients; and good communication and coordination. Stakeholders also delineated six environmental factors that can influence their implementation. Twenty-four initiatives to achieve the developed vision were defined. The principles and factors identified as part of the stakeholder shared-vision were combined in a preliminary model for chronic care. This model and initiatives can guide policy makers as well as healthcare planners and researchers to develop and integrate chronic disease services, namely CPSs, in real-world settings. Copyright © 2018 Elsevier Inc. All rights reserved.
USGS perspectives on an integrated approach to watershed and coastal management

USGS Publications Warehouse

Larsen, Matthew C.; Hamilton, Pixie A.; Haines, John W.; Mason, Jr., Robert R.

2010-01-01

The writers discuss three critically important steps necessary for achieving the goal for improved integrated approaches on watershed and coastal protection and management. These steps involve modernization of monitoring networks, creation of common data and web services infrastructures, and development of modeling, assessment, and research tools. Long-term monitoring is needed for tracking the effectiveness approaches for controlling land-based sources of nutrients, contaminants, and invasive species. The integration of mapping and monitoring with conceptual and mathematical models, and multidisciplinary assessments is important in making well-informed decisions. Moreover, a better integrated data network is essential for mapping, statistical, and modeling applications, and timely dissemination of data and information products to a broad community of users.
[Assertive community treatment: promoting engagement with care of people suffering severe addiction].

PubMed

Morandi, Stéphane; Silva, Benedetta; Monnat, Martine; Bonsack, Charles

2016-06-08

Despite the increasing number of specialized addiction services and the constant deployment of health care resources, a coordinated needs-based treatment is not always available for people with severe drugs and/or alcohol problems. Too often the involved health care professionals feel helpless and overwhelmed by the complexity of the situation. In order to promote the treatment engagement of the hard-to-reach substance users, a multidisciplinary mobile team project for addiction (SIMA) was developed in Lausanne, Switzerland, in 20174. This paper describes the model of intervention, the profile of the population followed during the first year of intervention and illustrates, through two clinical cases, the advantages of this approach.
Reassembling Curricular Concepts: A Multimodal Approach to the Study of Curriculum and Instruction

ERIC Educational Resources Information Center

Tang, Kok-Sing

2011-01-01

Based on the multidisciplinary field of multimodality, this paper offers a theoretical perspective on the construct of a curricular concept which is commonly used in a school curriculum and applies it to an analysis of a typical curricular text and classroom instruction that exposit the physics concept of work-energy. Theorizing a concept as a…

From Chaos and Insecurity to Understanding and Coping: Experienced Benefits of a Group-Based Education Programme for People with Chronic Fatigue Syndrome

ERIC Educational Resources Information Center

Pinxsterhuis, Irma; Strand, Elin Bolle; Stormorken, Eva; Sveen, Unni

2015-01-01

The aim of this study was to elicit participants' experiences with a multidisciplinary patient education programme and their views regarding the usefulness of the programme. Focus group interviews were conducted with 10 participants immediately and nine months following participation in the programme and analysed using thematic analysis.…
From air to land: understanding water resources through plant-based multidisciplinary research.

PubMed

Silva, Lucas C R

2015-07-01

Current global challenges require solutions that cannot be delivered by any one field alone. New developments in the analysis and interpretation of plant-derived climatic records bridge traditional disciplines, advancing understanding of phenomena of great ecological and societal significance, specifically, those related to changes in the terrestrial water cycle. Copyright © 2015 Elsevier Ltd. All rights reserved.
A Survey of Shape Parameterization Techniques

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

1999-01-01

This paper provides a survey of shape parameterization techniques for multidisciplinary optimization and highlights some emerging ideas. The survey focuses on the suitability of available techniques for complex configurations, with suitability criteria based on the efficiency, effectiveness, ease of implementation, and availability of analytical sensitivities for geometry and grids. The paper also contains a section on field grid regeneration, grid deformation, and sensitivity analysis techniques.
Agricultural biodiversity, nutrition, and health: making a difference to hunger and nutrition in the developing world.

PubMed

Frison, Emile A; Smith, Ifeyironwa Francisca; Johns, Timothy; Cherfas, Jeremy; Eyzaguirre, Pablo B

2006-06-01

In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have met with limited success, resulting in renewed calls for food-based approaches. The deployment of agricultural biodiversity is an approach that entails greater use of local biodiversity to ensure dietary diversity. To outline a new strategy proposed by the International Plant Genetic Resources Institute (IPGRI) that employs agricultural biodiversity as the primary resource for food security and health. The authors carried out a meta-analysis to review and assemble existing information on the nutritional and healthful properties of traditional foods based on a diverse set of case studies and food composition and nutritional analysis studies. The methods highlight particular examples of foods where analysis of nutrient and non-nutrient composition reveals important traits to address the growing problems of malnutrition associated with the rise of chronic diseases. Finally, the authors analyze social, economic, and cultural changes that undermine the healthful components of traditional diets. Based on this multidisciplinary and comparative approach, the authors suggest a holistic food-based approach that combines research to assess and document nutritional and healthful properties of traditional foods, investigating options in which nutritionally valuable traditional foods can contribute to better livelihoods, and ways that awareness and promotional campaigns can identify healthful components of traditional diets that fit the needs of urban and market-oriented consumers. There is an urgent need for agricultural research centers, national agricultural research systems, universities, and community-based organizations to work together under a shared policy framework with the aim of developing a strong evidence base linking biodiversity, nutrition, and health. Although these initiatives are still ongoing, the gains realized in small-scale and local pilot efforts have encouraged IPGRI to work with local partners toward the implementation of scale-up efforts in various regions.
Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up.

PubMed

Moll, Line Thorndal; Jensen, Ole Kudsk; Schiøttz-Christensen, Berit; Stapelfeldt, Christina Malmose; Christiansen, David Høyrup; Nielsen, Claus Vinther; Labriola, Merete

2018-06-01

Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments. Secondary outcomes were self-reported pain and disability levels. One-year follow-up RTW rates were estimated by Cox proportional hazard regression adjusted for gender, age, sick leave prior to inclusion, part-time sick leave and clinical diagnosis. Secondary outcomes were analysed using logistic and linear regression analysis for pain and disability, respectively. Results In the MDI group, 50 participants (59%) experienced four or more continuous weeks of RTW while 48 (58%) returned to work in the BI group during the 1 year of follow-up. Results showed a statistically non significant tendency towards a lower rate of RTW in the MDI group than in the BI group (adjusted HR = 0.84, 95% CI 0.54, 1.31). There were no statistically significant differences in secondary outcomes between the MDI and BI groups. Conclusion The brief and the multidisciplinary interventions performed equally with respect to both primary and secondary outcomes. The added focus on RTW in the multidisciplinary group did not improve RTW rates in this group.
Recent Experiences in Multidisciplinary Analysis and Optimization, part 2

NASA Technical Reports Server (NTRS)

Sobieski, J. (Compiler)

1984-01-01

The papers presented at the NASA Symposium on Recent Experiences in Multidisciplinary Analysis and Optimization held at NASA Langley Research Center, Hampton, Virginia, April 24 to 26, 1984 are given. The purposes of the symposium were to exchange information about the status of the application of optimization and the associated analyses in industry or research laboratories to real life problems and to examine the directions of future developments.
The digital eczema centre utrecht.

PubMed

van Os-Medendorp, Harmieke; van Veelen, Carien; Hover, Maaike; Eland-de Kok, Petra; Bruijnzeel-Koomen, Carla; Sonnevelt, Gert-Jan; Mensing, Geert; Pasmans, Suzanne

2010-01-01

The University Medical Centre Utrecht (UMC Utrecht) has developed an eczema portal that combines e-consulting, monitoring and self-management training by a dermatology nurse online for patients and parents of young children with atopic dermatitis (AD). Patient satisfaction with the portal was high. It could be extended to become a Digital Eczema Centre for multidisciplinary collaboration between health-care providers from different locations and the patient. Before starting the construction of the Digital Eczema Centre, the feasibility was examined by carrying out a business case analysis. The purposes, strength and weaknesses showed that the Digital Eczema Centre offered opportunities to improve care for patients with AD. The financial analysis resulted in a medium/best case scenario with a positive result of euro50-240,000 over a period of five years. We expect that the Digital Eczema Centre will increase the accessibility and quality of care. The web-based patient record and the digital chain-of-care promote the involvement of patients, parents and multidisciplinary teams as well as the continuity and coordination of care.
Application of Exactly Linearized Error Transport Equations to AIAA CFD Prediction Workshops

NASA Technical Reports Server (NTRS)

Derlaga, Joseph M.; Park, Michael A.; Rallabhandi, Sriram

2017-01-01

The computational fluid dynamics (CFD) prediction workshops sponsored by the AIAA have created invaluable opportunities in which to discuss the predictive capabilities of CFD in areas in which it has struggled, e.g., cruise drag, high-lift, and sonic boom pre diction. While there are many factors that contribute to disagreement between simulated and experimental results, such as modeling or discretization error, quantifying the errors contained in a simulation is important for those who make decisions based on the computational results. The linearized error transport equations (ETE) combined with a truncation error estimate is a method to quantify one source of errors. The ETE are implemented with a complex-step method to provide an exact linearization with minimal source code modifications to CFD and multidisciplinary analysis methods. The equivalency of adjoint and linearized ETE functional error correction is demonstrated. Uniformly refined grids from a series of AIAA prediction workshops demonstrate the utility of ETE for multidisciplinary analysis with a connection between estimated discretization error and (resolved or under-resolved) flow features.
The EPOS implementation of thematic services for solid Earth sciences

NASA Astrophysics Data System (ADS)

Cocco, Massimo; Consortium, Epos

2014-05-01

The mission of EPOS is to build an efficient and comprehensive multidisciplinary research platform for the solid Earth sciences in Europe. In particular, EPOS is a long-term plan to facilitate integrated use of data, models and facilities from mainly distributed existing, but also new, research infrastructures for Earth Science. EPOS will enable innovative multidisciplinary research for a better understanding of the physical processes controlling earthquakes, volcanic eruptions, unrest episodes, ground stability, and tsunamis as well as those processes driving tectonics and Earth surface dynamics. EPOS will allow the Earth Science community to make a significant step forward by developing new concepts and tools for accurate, durable, and sustainable answers to societal questions concerning geo-hazards and those geodynamic phenomena relevant to the environment and human welfare. EPOS coordinates the existing and new solid Earth RIs within Europe and is building the integrating RI elements. This integration requires a significant coordination between, among others, disciplinary (thematic) communities, national RIs policies and initiatives, as well as geo- and IT-scientists. The RIs that EPOS coordinates include: i) Regionally-distributed geophysical observing systems (seismological and geodetic networks); ii) Local observatories (including geomagnetic, near-fault and volcano observatories); iii) Analytical and experimental laboratories; iv) Integrated satellite data and geological information services. We present the results achieved during the EPOS Preparatory Phase (which will end on October 2014) and the progress towards construction in terms of both the design of the integrated core services (ICS) and the development of thematic core services (TCS) for the different communities participating to the integration plan. We will focus on discussing the strategies adopted to foster the necessary implementation of TCS, clarifying their crucial role as domain-specific service hubs for coordinating and harmonizing national resources/plans with the European dimension of EPOS. We will present the prototype of the ICS central hub as a key contribution for providing multidisciplinary services for solid Earth sciences as well as the glue to keep ICT aspects integrated and rationalized across EPOS. Finally we will present the well-defined role of the EPOS-ERIC Head-Quarter to coordinate and harmonize national RIs and EPOS services (through ICS and TCS) with a clear commitment by national governments. This will be an important opportunity to discuss the EPOS multidisciplinary platform for discoveries to foster scientific excellence in solid Earth research.
Challenges in integrating multidisciplinary data into a single e-infrastructure

NASA Astrophysics Data System (ADS)

Atakan, Kuvvet; Jeffery, Keith G.; Bailo, Daniele; Harrison, Matthew

2015-04-01

The European Plate Observing System (EPOS) aims to create a pan-European infrastructure for solid Earth science to support a safe and sustainable society. The mission of EPOS is to monitor and understand the dynamic and complex Earth system by relying on new e-science opportunities and integrating diverse and advanced Research Infrastructures in Europe for solid Earth Science. EPOS will enable innovative multidisciplinary research for a better understanding of the Earth's physical and chemical processes that control earthquakes, volcanic eruptions, ground instability and tsunami as well as the processes driving tectonics and Earth's surface dynamics. EPOS will improve our ability to better manage the use of the subsurface of the Earth. Through integration of data, models and facilities EPOS will allow the Earth Science community to make a step change in developing new concepts and tools for key answers to scientific and socio-economic questions concerning geo-hazards and geo-resources as well as Earth sciences applications to the environment and to human welfare. EPOS is now getting into its Implementation Phase (EPOS-IP). One of the main challenges during the implementation phase is the integration of multidisciplinary data into a single e-infrastructure. Multidisciplinary data are organized and governed by the Thematic Core Services (TCS) and are driven by various scientific communities encompassing a wide spectrum of Earth science disciplines. TCS data, data products and services will be integrated into a platform "the ICS system" that will ensure their interoperability and access to these services by the scientific community as well as other users within the society. This requires dedicated tasks for interactions with the various TCS-WPs, as well as the various distributed ICS (ICS-Ds), such as High Performance Computing (HPC) facilities, large scale data storage facilities, complex processing and visualization tools etc. Computational Earth Science (CES) services are identified as a transversal activity and as such need to be harmonized and provided within the ICS. In order to develop a metadata catalogue and the ICS system, the content from the entire spectrum of services included in TCS, ICS-Ds as well as CES activities, need to be organized in a systematic manner taking into account global and European IT-standards, while complying with the user needs and data provider requirements.
Vulnerability and adaptation of US shellfisheries to ocean acidification

NASA Astrophysics Data System (ADS)

Ekstrom, Julia A.; Suatoni, Lisa; Cooley, Sarah R.; Pendleton, Linwood H.; Waldbusser, George G.; Cinner, Josh E.; Ritter, Jessica; Langdon, Chris; van Hooidonk, Ruben; Gledhill, Dwight; Wellman, Katharine; Beck, Michael W.; Brander, Luke M.; Rittschof, Dan; Doherty, Carolyn; Edwards, Peter E. T.; Portela, Rosimeiry

2015-03-01

Ocean acidification is a global, long-term problem whose ultimate solution requires carbon dioxide reduction at a scope and scale that will take decades to accomplish successfully. Until that is achieved, feasible and locally relevant adaptation and mitigation measures are needed. To help to prioritize societal responses to ocean acidification, we present a spatially explicit, multidisciplinary vulnerability analysis of coastal human communities in the United States. We focus our analysis on shelled mollusc harvests, which are likely to be harmed by ocean acidification. Our results highlight US regions most vulnerable to ocean acidification (and why), important knowledge and information gaps, and opportunities to adapt through local actions. The research illustrates the benefits of integrating natural and social sciences to identify actions and other opportunities while policy, stakeholders and scientists are still in relatively early stages of developing research plans and responses to ocean acidification.
[Matematical modeling of antibiotic resistance: perspectives from a meta-analysys].

PubMed

Fresnadillo-Martínez, M J; García-Sánchez, E; García-Merino, E; Martín-Del-Rey, A; Rodríguez-Encinas, A; Rodríguez-Sánchez, G; García-Sánchez, J E

2012-09-01

The antibiotic resistance is one of the greatest challenges of the international health community. The study of antibiotic resistance must be a multidisciplinary task and, in this sense, the main goal of this work is to analyze the role that Mathematical Modeling can play in this scenario. A qualitative and cuantitative analysis of the works published in the scientific literature is done by means of a search in the most important databases: MEDLINE, SCOPUS and ISI Web of Science. Consequently, there are few papers related to our topic but the existing works have been published in high-quality and impact international journals. Moreover, we can state that mathematical models are a very important and useful tool to analyze and study both the treatments protocols for resistance prevention and the assesment of control strategies in hospital environtment, or the prediction of the evolution of diseases due to resistant strains.
Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

PubMed Central

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

2017-01-01

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

PubMed

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-08-11

International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. A cross-sectional survey of hospital and community-based DNS in Ireland. Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
International Space Station Configuration Analysis and Integration

NASA Technical Reports Server (NTRS)

Anchondo, Rebekah

2016-01-01

Ambitious engineering projects, such as NASA's International Space Station (ISS), require dependable modeling, analysis, visualization, and robotics to ensure that complex mission strategies are carried out cost effectively, sustainably, and safely. Learn how Booz Allen Hamilton's Modeling, Analysis, Visualization, and Robotics Integration Center (MAVRIC) team performs engineering analysis of the ISS Configuration based primarily on the use of 3D CAD models. To support mission planning and execution, the team tracks the configuration of ISS and maintains configuration requirements to ensure operational goals are met. The MAVRIC team performs multi-disciplinary integration and trade studies to ensure future configurations meet stakeholder needs.
Multidisciplinary Tool for Systems Analysis of Planetary Entry, Descent, and Landing

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.

2011-01-01

Systems analysis of a planetary entry (SAPE), descent, and landing (EDL) is a multidisciplinary activity in nature. SAPE improves the performance of the systems analysis team by automating and streamlining the process, and this improvement can reduce the errors that stem from manual data transfer among discipline experts. SAPE is a multidisciplinary tool for systems analysis of planetary EDL for Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune, and Titan. It performs EDL systems analysis for any planet, operates cross-platform (i.e., Windows, Mac, and Linux operating systems), uses existing software components and open-source software to avoid software licensing issues, performs low-fidelity systems analysis in one hour on a computer that is comparable to an average laptop, and keeps discipline experts in the analysis loop. SAPE uses Python, a platform-independent, open-source language, for integration and for the user interface. Development has relied heavily on the object-oriented programming capabilities that are available in Python. Modules are provided to interface with commercial and government off-the-shelf software components (e.g., thermal protection systems and finite-element analysis). SAPE currently includes the following analysis modules: geometry, trajectory, aerodynamics, aerothermal, thermal protection system, and interface for structural sizing.
Approximation Model Building for Reliability & Maintainability Characteristics of Reusable Launch Vehicles

NASA Technical Reports Server (NTRS)

Unal, Resit; Morris, W. Douglas; White, Nancy H.; Lepsch, Roger A.; Brown, Richard W.

2000-01-01

This paper describes the development of parametric models for estimating operational reliability and maintainability (R&M) characteristics for reusable vehicle concepts, based on vehicle size and technology support level. A R&M analysis tool (RMAT) and response surface methods are utilized to build parametric approximation models for rapidly estimating operational R&M characteristics such as mission completion reliability. These models that approximate RMAT, can then be utilized for fast analysis of operational requirements, for lifecycle cost estimating and for multidisciplinary sign optimization.
Multi-disciplinary optimization of aeroservoelastic systems

NASA Technical Reports Server (NTRS)

Karpel, Mordechay

1991-01-01

New methods were developed for efficient aeroservoelastic analysis and optimization. The main target was to develop a method for investigating large structural variations using a single set of modal coordinates. This task was accomplished by basing the structural modal coordinates on normal modes calculated with a set of fictitious masses loading the locations of anticipated structural changes. The following subject areas are covered: (1) modal coordinates for aeroelastic analysis with large local structural variations; and (2) time simulation of flutter with large stiffness changes.
Relationship between functional vision and balance and mobility performance in community-dwelling older adults.

PubMed

Aartolahti, Eeva; Häkkinen, Arja; Lönnroos, Eija; Kautiainen, Hannu; Sulkava, Raimo; Hartikainen, Sirpa

2013-10-01

Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision, that refers to self-perceived vision-based ability to perform daily activities. The aim of the study was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76-100 years (mean age 81 years, 70 % women) were interviewed using a seven-item functional vision questionnaire (VF-7). Balance and mobility were measured by the Berg balance scale (BBS), timed up and go (TUG), chair stand test, and maximal walking speed. In addition, self-reported fear of falling, depressive symptoms (15-item Geriatric Depression Scale), cognition (Mini-Mental State Examination) and physical activity (Grimby) were assessed. In the analysis, participants were classified into poor, moderate, or good functional vision groups. The poor functional vision group (n = 95) had more comorbidities, depressed mood, cognition decline, fear of falling, and reduced physical activity compared to participants with moderate (n = 222) or good functional vision (n = 259). Participants with poor functional vision performed worse on all balance and mobility tests. After adjusting for gender, age, chronic conditions, and cognition, the linearity remained statistically significant between functional vision and BBS (p = 0.013), TUG (p = 0.010), and maximal walking speed (p = 0.008), but not between functional vision and chair stand (p = 0.069). Poor functional vision is related to weaker balance and mobility performance in community-dwelling older adults. This highlights the importance of widespread assessment of health, including functional vision, to prevent balance impairment and maintain independent mobility among older population.
Multidisciplinary design optimization using multiobjective formulation techniques

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Pagaldipti, Narayanan S.

1995-01-01

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

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