On Developing a Taxonomy for Multidisciplinary Design Optimization: A Decision-Based Perspective

NASA Technical Reports Server (NTRS)

Lewis, Kemper; Mistree, Farrokh

1995-01-01

In this paper, we approach MDO from a Decision-Based Design (DBD) perspective and explore classification schemes for designing complex systems and processes. Specifically, we focus on decisions, which are only a small portion of the Decision Support Problem (DSP) Technique, our implementation of DBD. We map coupled nonhierarchical and hierarchical representations from the DSP Technique into the Balling-Sobieski (B-S) framework (Balling and Sobieszczanski-Sobieski, 1994), and integrate domain-independent linguistic terms to complete our taxonomy. Application of DSPs to the design of complex, multidisciplinary systems include passenger aircraft, ships, damage tolerant structural and mechanical systems, and thermal energy systems. In this paper we show that Balling-Sobieski framework is consistent with that of the Decision Support Problem Technique through the use of linguistic entities to describe the same type of formulations. We show that the underlying linguistics of the solution approaches are the same and can be coalesced into a homogeneous framework with which to base the research, application, and technology MDO upon. We introduce, in the Balling-Sobieski framework, examples of multidisciplinary design, namely, aircraft, damage tolerant structural and mechanical systems, and thermal energy systems.

Integrating Cost Engineering and Project Management in a Junior Engineering Economics Course and a Senior Capstone Project Design Course

ERIC Educational Resources Information Center

Tickles, Virginia C.; Li, Yadong; Walters, Wilbur L.

2013-01-01

Much criticism exists concerning a lack of focus on real-world problem-solving in the science, technology, engineering and mathematics (STEM) infrastructures. Many of these critics say that current educational infrastructures are incapable in preparing future scientists and engineers to solve the complex and multidisciplinary problems this society…

From, by, and for the OSSD: Software Engineering Education Using an Open Source Software Approach

ERIC Educational Resources Information Center

Huang, Kun; Dong, Yifei; Ge, Xun

2006-01-01

Computing is a complex, multidisciplinary field that requires a range of professional proficiencies. Computing students are expected to develop in-depth knowledge and skills, integrate and apply their knowledge flexibly to solve complex problems, and work successfully in teams. However, many students who graduate with degrees in computing fail to…

A multidisciplinary approach to solving computer related vision problems.

PubMed

Long, Jennifer; Helland, Magne

2012-09-01

This paper proposes a multidisciplinary approach to solving computer related vision issues by including optometry as a part of the problem-solving team. Computer workstation design is increasing in complexity. There are at least ten different professions who contribute to workstation design or who provide advice to improve worker comfort, safety and efficiency. Optometrists have a role identifying and solving computer-related vision issues and in prescribing appropriate optical devices. However, it is possible that advice given by optometrists to improve visual comfort may conflict with other requirements and demands within the workplace. A multidisciplinary approach has been advocated for solving computer related vision issues. There are opportunities for optometrists to collaborate with ergonomists, who coordinate information from physical, cognitive and organisational disciplines to enact holistic solutions to problems. This paper proposes a model of collaboration and examples of successful partnerships at a number of professional levels including individual relationships between optometrists and ergonomists when they have mutual clients/patients, in undergraduate and postgraduate education and in research. There is also scope for dialogue between optometry and ergonomics professional associations. A multidisciplinary approach offers the opportunity to solve vision related computer issues in a cohesive, rather than fragmented way. Further exploration is required to understand the barriers to these professional relationships. © 2012 The College of Optometrists.

New Approaches to HSCT Multidisciplinary Design and Optimization

NASA Technical Reports Server (NTRS)

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

1996-01-01

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

A Matrix-Free Algorithm for Multidisciplinary Design Optimization

NASA Astrophysics Data System (ADS)

Lambe, Andrew Borean

Multidisciplinary design optimization (MDO) is an approach to engineering design that exploits the coupling between components or knowledge disciplines in a complex system to improve the final product. In aircraft design, MDO methods can be used to simultaneously design the outer shape of the aircraft and the internal structure, taking into account the complex interaction between the aerodynamic forces and the structural flexibility. Efficient strategies are needed to solve such design optimization problems and guarantee convergence to an optimal design. This work begins with a comprehensive review of MDO problem formulations and solution algorithms. First, a fundamental MDO problem formulation is defined from which other formulations may be obtained through simple transformations. Using these fundamental problem formulations, decomposition methods from the literature are reviewed and classified. All MDO methods are presented in a unified mathematical notation to facilitate greater understanding. In addition, a novel set of diagrams, called extended design structure matrices, are used to simultaneously visualize both data communication and process flow between the many software components of each method. For aerostructural design optimization, modern decomposition-based MDO methods cannot efficiently handle the tight coupling between the aerodynamic and structural states. This fact motivates the exploration of methods that can reduce the computational cost. A particular structure in the direct and adjoint methods for gradient computation motivates the idea of a matrix-free optimization method. A simple matrix-free optimizer is developed based on the augmented Lagrangian algorithm. This new matrix-free optimizer is tested on two structural optimization problems and one aerostructural optimization problem. The results indicate that the matrix-free optimizer is able to efficiently solve structural and multidisciplinary design problems with thousands of variables and constraints. On the aerostructural test problem formulated with thousands of constraints, the matrix-free optimizer is estimated to reduce the total computational time by up to 90% compared to conventional optimizers.

A Matrix-Free Algorithm for Multidisciplinary Design Optimization

NASA Astrophysics Data System (ADS)

Lambe, Andrew Borean

Multidisciplinary design optimization (MDO) is an approach to engineering design that exploits the coupling between components or knowledge disciplines in a complex system to improve the final product. In aircraft design, MDO methods can be used to simultaneously design the outer shape of the aircraft and the internal structure, taking into account the complex interaction between the aerodynamic forces and the structural flexibility. Efficient strategies are needed to solve such design optimization problems and guarantee convergence to an optimal design. This work begins with a comprehensive review of MDO problem formulations and solution algorithms. First, a fundamental MDO problem formulation is defined from which other formulations may be obtained through simple transformations. Using these fundamental problem formulations, decomposition methods from the literature are reviewed and classified. All MDO methods are presented in a unified mathematical notation to facilitate greater understanding. In addition, a novel set of diagrams, called extended design structure matrices, are used to simultaneously visualize both data communication and process flow between the many software components of each method. For aerostructural design optimization, modern decomposition-based MDO methods cannot efficiently handle the tight coupling between the aerodynamic and structural states. This fact motivates the exploration of methods that can reduce the computational cost. A particular structure in the direct and adjoint methods for gradient computation. motivates the idea of a matrix-free optimization method. A simple matrix-free optimizer is developed based on the augmented Lagrangian algorithm. This new matrix-free optimizer is tested on two structural optimization problems and one aerostructural optimization problem. The results indicate that the matrix-free optimizer is able to efficiently solve structural and multidisciplinary design problems with thousands of variables and constraints. On the aerostructural test problem formulated with thousands of constraints, the matrix-free optimizer is estimated to reduce the total computational time by up to 90% compared to conventional optimizers.

Key Gaps for Enabling Plant Growth in Future Missions

NASA Technical Reports Server (NTRS)

Anderson, Molly; Motil, Brian; Barta, Dan; Fritsche, Ralph; Massa, Gioia; Quincy, Charlie; Romeyn, Matthew; Wheeler, Ray; Hanford, Anthony

2017-01-01

Growing plants to provide food or psychological benefits to crewmembers is a common vision for the future of human spaceflight, often represented in media and in serious concept studies. The complexity of controlled environment agriculture, and plant growth in microgravity have and continue to be the subject of dedicated scientific research. However, actually implementing these systems in a way that will be cost effective, efficient, and sustainable for future space missions is a complex, multi-disciplinary problem. Key questions exist in many areas: human medical research in nutrition and psychology, horticulture, plant physiology and microbiology, multi-phase microgravity fluid physics, hardware design and technology development, and system design, operations and mission planning. This paper describes key knowledge gaps identified by a multi-disciplinary working group within the National Aeronautics and Space Administration (NASA). It also begins to identify solutions to the simpler questions identified by the group based on work initiated in 2017. Growing plants to provide food or psychological benefits to crewmembers is a common vision for the future of human spaceflight, often represented in media and in serious concept studies. The complexity of controlled environment agriculture, and plant growth in microgravity have and continue to be the subject of dedicated scientific research. However, actually implementing these systems in a way that will be cost effective, efficient, and sustainable for future space missions is a complex, multi-disciplinary problem. Key questions exist in many areas: human medical research in nutrition and psychology, horticulture, plant physiology and microbiology, multi-phase microgravity fluid physics, hardware design and technology development, and system design, operations and mission planning. This paper describes key knowledge gaps identified by a multi-disciplinary working group within the National Aeronautics and Space Administration (NASA). It also begins to identify solutions to the simpler questions identified by the group based on work initiated in 2017.

Facilitating Argumentative Knowledge Construction through a Transactive Discussion Script in CSCL

ERIC Educational Resources Information Center

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

2013-01-01

Learning to argue is prerequisite to solving complex problems in groups, especially when they are multidisciplinary and collaborate online. Environments for Computer-Supported Collaborative Learning (CSCL) can be designed to facilitate argumentative knowledge construction. This study investigates how argumentative knowledge construction in…

Multidisciplinary full-mouth rehabilitation with soft tissue regeneration in the esthetic zone.

PubMed

Liebermann, Anja; Frei, Stefan; Pinheiro Dias Engler, Madalena Lucia; Zuhr, Otto; Prandtner, Otto; Edelhoff, Daniel; Saeidi Pour, Reza

2018-01-01

Oral rehabilitation often requires a multidisciplinary approach including restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension. The presence of gingival recessions can be associated with numerous factors, such as brushing or preparation trauma and persistent inflammation of the gingiva due to inadequate marginal fit of restorations. Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Especially in patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted. This case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long-term polymethyl methacrylate provisionals as a communication tool between all parts involved. All-ceramic crowns were inserted after periodontal healing as definitive rehabilitation. Complex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician. © 2017 Wiley Periodicals, Inc.

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.

The Transformation from Multidisciplinarity to Interdisciplinarity: A Case Study of a Course Involving the Status of Arab Citizens of Israel

ERIC Educational Resources Information Center

Tayler, Marilyn R.

2014-01-01

The author demonstrates that entry-level students can achieve a more comprehensive understanding of complex problems through an explicitly interdisciplinary approach than through a merely multidisciplinary approach, using the process described in Repko's (2014) "Introduction to Interdisciplinary Studies." Repko takes the…

Problems in merging Earth sensing satellite data sets

NASA Technical Reports Server (NTRS)

Smith, Paul H.; Goldberg, Michael J.

1987-01-01

Satellite remote sensing systems provide a tremendous source of data flow to the Earth science community. These systems provide scientists with data of types and on a scale previously unattainable. Looking forward to the capabilities of Space Station and the Earth Observing System (EOS), the full realization of the potential of satellite remote sensing will be handicapped by inadequate information systems. There is a growing emphasis in Earth science research to ask questions which are multidisciplinary in nature and global in scale. Many of these research projects emphasize the interactions of the land surface, the atmosphere, and the oceans through various physical mechanisms. Conducting this research requires large and complex data sets and teams of multidisciplinary scientists, often working at remote locations. A review of the problems of merging these large volumes of data into spatially referenced and manageable data sets is presented.

A global, multi-disciplinary, multi-sectorial initiative to combat leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN).

PubMed

Durski, Kara N; Jancloes, Michel; Chowdhary, Tej; Bertherat, Eric

2014-06-05

Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory confirmation. The complexity that surrounds the transmission dynamics, particularly in epidemic situations, requires a coordinated, multi-disciplinary effort. Therefore, the Global Leptospirosis Environmental Action Network (GLEAN) was developed to improve global and local strategies of how to predict, prevent, detect, and intervene in leptospirosis outbreaks in order to prevent and control leptospirosis in high-risk populations.

A Global, Multi-Disciplinary, Multi-Sectorial Initiative to Combat Leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN)

PubMed Central

Durski, Kara N.; Jancloes, Michel; Chowdhary, Tej; Bertherat, Eric

2014-01-01

Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory confirmation. The complexity that surrounds the transmission dynamics, particularly in epidemic situations, requires a coordinated, multi-disciplinary effort. Therefore, the Global Leptospirosis Environmental Action Network (GLEAN) was developed to improve global and local strategies of how to predict, prevent, detect, and intervene in leptospirosis outbreaks in order to prevent and control leptospirosis in high-risk populations. PMID:24905245

Experimental Physical Sciences Vitae 2017

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

Kippen, Karen Elizabeth; Del Mauro, Diana; Patterson, Eileen Frances

Frequently our most basic research experiments stimulate solutions for some of the most intractable national security problems, such as nuclear weapons stewardship, homeland security, intelligence and information analysis, and nuclear and alternative energy. This publication highlights our talented and creative staff who deliver solutions to these complex scientific and technological challenges by conducting cutting-edge multidisciplinary physical science research.

Investigating the Intertwinement of Knowledge, Value, and Experience of Upper Secondary Students' Argumentation Concerning Socioscientific Issues

ERIC Educational Resources Information Center

Rundgren, Carl-Johan; Eriksson, Martin; Rundgren, Shu-Nu Chang

2016-01-01

This study aims to explore students' argumentation and decision-making relating to an authentic socioscientific issue (SSI)--the problem of environmental toxins in fish from the Baltic Sea. A multi-disciplinary instructional module, designed in order to develop students' skills to argue about complex SSI, was successfully tested. Seven science…

A general neurologist's perspective on the urgent need to apply resilience thinking to the prevention and treatment of Alzheimer's disease.

PubMed

Pomorska, Grazyna; Ockene, Judith K

2017-11-01

The goal of this article was to look at the problem of Alzheimer's disease (AD) through the lens of a socioecological resilience-thinking framework to help expand our view of the prevention and treatment of AD. This serious and complex public health problem requires a holistic systems approach. We present the view that resilience thinking, a theoretical framework that offers multidisciplinary approaches in ecology and natural resource management to solve environmental problems, can be applied to the prevention and treatment of AD. Resilience thinking explains a natural process that occurs in all complex systems in response to stressful challenges. The brain is a complex system, much like an ecosystem, and AD is a disturbance (allostatic overload) within the ecosystem of the brain. Resilience thinking gives us guidance, direction, and ideas about how to comprehensively prevent and treat AD and tackle the AD epidemic.

Improving medication safety and diabetes management in Hong Kong: a multidisciplinary approach.

PubMed

Chung, A Ys; Anand, S; Wong, I Ck; Tan, K Cb; Wong, C Ff; Chui, W Cm; Chan, E W

2017-04-01

Patients with diabetes often require complex medication regimens. The positive impact of pharmacists on improving diabetes management or its co-morbidities has been recognised worldwide. This study aimed to characterise drug-related problems among diabetic patients in Hong Kong and their clinical significance, and to explore the role of pharmacists in the multidisciplinary diabetes management team by evaluating the outcome of their clinical interventions. An observational study was conducted at the Diabetes Clinic of a public hospital in Hong Kong from October 2012 to March 2014. Following weekly screening, and prior to the doctor's consultation, selected high-risk patients were interviewed by a pharmacist for medication reconciliation and review. Drug-related problems were identified and documented by the pharmacist who presented clinical recommendations to doctors to optimise a patient's drug regimen and resolve or prevent potential drug-related problems. A total of 522 patients were analysed and 417 drug-related problems were identified. The incidence of patients with drug-related problems was 62.8% with a mean of 0.9 (standard deviation, 0.6) drug-related problems per patient. The most common categories of drug-related problems were associated with dosing (43.9%), drug choice (17.3%), and non-allergic adverse reactions (15.6%). Drugs most frequently involved targeted the endocrine or cardiovascular system. The majority (71.9%) of drug-related problems were of moderate clinical significance and 28.1% were considered minor problems. Drug-related problems were totally solved (50.1%) and partially solved (11.0%) by doctors' acceptance of pharmacist recommendations, or received acknowledgement from doctors (5.5%). Pharmacists, in collaboration with the multidisciplinary team, demonstrated a positive impact by identifying, resolving, and preventing drug-related problems in patients with diabetes. Further plans for sustaining pharmacy service in the Diabetes Clinic would enable further studies to explore the long-term impact of pharmacists in improving patients' clinical outcomes in diabetes management.

A Web-Based Monitoring System for Multidisciplinary Design Projects

NASA Technical Reports Server (NTRS)

Rogers, James L.; Salas, Andrea O.; Weston, Robert P.

1998-01-01

In today's competitive environment, both industry and government agencies are under pressure to reduce the time and cost of multidisciplinary design projects. New tools have been introduced to assist in this process by facilitating the integration of and communication among diverse disciplinary codes. One such tool, a framework for multidisciplinary computational environments, is defined as a hardware and software architecture that enables integration, execution, and communication among diverse disciplinary processes. An examination of current frameworks reveals weaknesses in various areas, such as sequencing, displaying, monitoring, and controlling the design process. The objective of this research is to explore how Web technology, integrated with an existing framework, can improve these areas of weakness. This paper describes a Web-based system that optimizes and controls the execution sequence of design processes; and monitors the project status and results. The three-stage evolution of the system with increasingly complex problems demonstrates the feasibility of this approach.

Validation workflow for a clinical Bayesian network model in multidisciplinary decision making in head and neck oncology treatment.

PubMed

Cypko, Mario A; Stoehr, Matthaeus; Kozniewski, Marcin; Druzdzel, Marek J; Dietz, Andreas; Berliner, Leonard; Lemke, Heinz U

2017-11-01

Oncological treatment is being increasingly complex, and therefore, decision making in multidisciplinary teams is becoming the key activity in the clinical pathways. The increased complexity is related to the number and variability of possible treatment decisions that may be relevant to a patient. In this paper, we describe validation of a multidisciplinary cancer treatment decision in the clinical domain of head and neck oncology. Probabilistic graphical models and corresponding inference algorithms, in the form of Bayesian networks, can support complex decision-making processes by providing a mathematically reproducible and transparent advice. The quality of BN-based advice depends on the quality of the model. Therefore, it is vital to validate the model before it is applied in practice. For an example BN subnetwork of laryngeal cancer with 303 variables, we evaluated 66 patient records. To validate the model on this dataset, a validation workflow was applied in combination with quantitative and qualitative analyses. In the subsequent analyses, we observed four sources of imprecise predictions: incorrect data, incomplete patient data, outvoting relevant observations, and incorrect model. Finally, the four problems were solved by modifying the data and the model. The presented validation effort is related to the model complexity. For simpler models, the validation workflow is the same, although it may require fewer validation methods. The validation success is related to the model's well-founded knowledge base. The remaining laryngeal cancer model may disclose additional sources of imprecise predictions.

Complex multidisciplinary system composition for aerospace vehicle conceptual design

NASA Astrophysics Data System (ADS)

Gonzalez, Lex

Although, there exists a vast amount of work concerning the analysis, design, integration of aerospace vehicle systems, there is no standard for how this data and knowledge should be combined in order to create a synthesis system. Each institution creating a synthesis system has in house vehicle and hardware components they are attempting to model and proprietary methods with which to model them. This leads to the fact that synthesis systems begin as one-off creations meant to answer a specific problem. As the scope of the synthesis system grows to encompass more and more problems, so does its size and complexity; in order for a single synthesis system to answer multiple questions the number of methods and method interface must increase. As a means to curtail the requirement that the increase of an aircraft synthesis systems capability leads to an increase in its size and complexity, this research effort focuses on the idea that each problem in aerospace requires its own analysis framework. By focusing on the creation of a methodology which centers on the matching of an analysis framework towards the problem being solved, the complexity of the analysis framework is decoupled from the complexity of the system that creates it. The derived methodology allows for the composition of complex multi-disciplinary systems (CMDS) through the automatic creation and implementation of system and disciplinary method interfaces. The CMDS Composition process follows a four step methodology meant to take a problem definition and progress towards the creation of an analysis framework meant to answer said problem. The unique implementation of the CMDS Composition process take user selected disciplinary analysis methods and automatically integrates them, together in order to create a syntactically composable analysis framework. As a means of assessing the validity of the CMDS Composition process a prototype system (AVDDBMS) has been developed. AVD DBMS has been used to model the Generic Hypersonic Vehicle (GHV), an open source family of hypersonic vehicles originating from the Air Force Research Laboratory. AVDDBMS has been applied in three different ways in order to assess its validity: Verification using GHV disciplinary data, Validation using selected disciplinary analysis methods, and Application of the CMDS Composition Process to assess the design solution space for the GHV hardware. The research demonstrates the holistic effect that selection of individual disciplinary analysis methods has on the structure and integration of the analysis framework.

Continuity in health care: lessons from supply chain management.

PubMed

Meijboom, Bert R; Bakx, Saskia J W G C; Westert, Gert P

2010-01-01

In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations.

Multiprofessional education to stimulate collaboration: a circular argument and its consequences.

PubMed

Roodbol, Petrie F

2010-01-01

The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance.

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

PubMed

Saitoh, Shinji

2010-01-01

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

Transforming Multidisciplinary Customer Requirements to Product Design Specifications

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

A modular approach to large-scale design optimization of aerospace systems

NASA Astrophysics Data System (ADS)

Hwang, John T.

Gradient-based optimization and the adjoint method form a synergistic combination that enables the efficient solution of large-scale optimization problems. Though the gradient-based approach struggles with non-smooth or multi-modal problems, the capability to efficiently optimize up to tens of thousands of design variables provides a valuable design tool for exploring complex tradeoffs and finding unintuitive designs. However, the widespread adoption of gradient-based optimization is limited by the implementation challenges for computing derivatives efficiently and accurately, particularly in multidisciplinary and shape design problems. This thesis addresses these difficulties in two ways. First, to deal with the heterogeneity and integration challenges of multidisciplinary problems, this thesis presents a computational modeling framework that solves multidisciplinary systems and computes their derivatives in a semi-automated fashion. This framework is built upon a new mathematical formulation developed in this thesis that expresses any computational model as a system of algebraic equations and unifies all methods for computing derivatives using a single equation. The framework is applied to two engineering problems: the optimization of a nanosatellite with 7 disciplines and over 25,000 design variables; and simultaneous allocation and mission optimization for commercial aircraft involving 330 design variables, 12 of which are integer variables handled using the branch-and-bound method. In both cases, the framework makes large-scale optimization possible by reducing the implementation effort and code complexity. The second half of this thesis presents a differentiable parametrization of aircraft geometries and structures for high-fidelity shape optimization. Existing geometry parametrizations are not differentiable, or they are limited in the types of shape changes they allow. This is addressed by a novel parametrization that smoothly interpolates aircraft components, providing differentiability. An unstructured quadrilateral mesh generation algorithm is also developed to automate the creation of detailed meshes for aircraft structures, and a mesh convergence study is performed to verify that the quality of the mesh is maintained as it is refined. As a demonstration, high-fidelity aerostructural analysis is performed for two unconventional configurations with detailed structures included, and aerodynamic shape optimization is applied to the truss-braced wing, which finds and eliminates a shock in the region bounded by the struts and the wing.

Multidisciplinary Optimization Approach for Design and Operation of Constrained and Complex-shaped Space Systems

NASA Astrophysics Data System (ADS)

Lee, Dae Young

The design of a small satellite is challenging since they are constrained by mass, volume, and power. To mitigate these constraint effects, designers adopt deployable configurations on the spacecraft that result in an interesting and difficult optimization problem. The resulting optimization problem is challenging due to the computational complexity caused by the large number of design variables and the model complexity created by the deployables. Adding to these complexities, there is a lack of integration of the design optimization systems into operational optimization, and the utility maximization of spacecraft in orbit. The developed methodology enables satellite Multidisciplinary Design Optimization (MDO) that is extendable to on-orbit operation. Optimization of on-orbit operations is possible with MDO since the model predictive controller developed in this dissertation guarantees the achievement of the on-ground design behavior in orbit. To enable the design optimization of highly constrained and complex-shaped space systems, the spherical coordinate analysis technique, called the "Attitude Sphere", is extended and merged with an additional engineering tools like OpenGL. OpenGL's graphic acceleration facilitates the accurate estimation of the shadow-degraded photovoltaic cell area. This technique is applied to the design optimization of the satellite Electric Power System (EPS) and the design result shows that the amount of photovoltaic power generation can be increased more than 9%. Based on this initial methodology, the goal of this effort is extended from Single Discipline Optimization to Multidisciplinary Optimization, which includes the design and also operation of the EPS, Attitude Determination and Control System (ADCS), and communication system. The geometry optimization satisfies the conditions of the ground development phase; however, the operation optimization may not be as successful as expected in orbit due to disturbances. To address this issue, for the ADCS operations, controllers based on Model Predictive Control that are effective for constraint handling were developed and implemented. All the suggested design and operation methodologies are applied to a mission "CADRE", which is space weather mission scheduled for operation in 2016. This application demonstrates the usefulness and capability of the methodology to enhance CADRE's capabilities, and its ability to be applied to a variety of missions.

[Advocating for the Inclusion of Psychologists in Family Health Teams in Ontario, Canada].

PubMed

Grenier, Jean; Chomienne, Marie-Hélène; Gaboury, Isabelle

Objectives This article advocates in favor of increasing the accessibility of psychological services in primary health care by focusing more specifically on the relevance of including psychologists in family health teams in primary care in Ontario.Methods The authors present their advocacy from two levels of information: 1) the main results of a demonstration project funded by the Primary Health Care Transition Fund (PHCTF) in which psychologists were integrated into family practices; and 2) experiences and general observations drawn from the combined experiences of the authors from the last decade regarding the inclusion of psychologists in primary care.Results Main results from the demonstration project: 1) highly prevalent mental illnesses (anxiety & mood disorders) are amenable to psychological interventions; 2) psychologists and family physicians are natural and complementary allies in primary care; 3) the cost of integrating psychologists to provide psychological interventions can be off-set by a reduction in physicians' mental health billing. Main observations drawn from authors' combined experiences in primary care: 1) relatively few psychologists work in family health teams in Ontario; 2) most non-pharmacological mental health interventions in primary care involve generic counselling, problem solving, educational groups, and linking to community resources; 3) lack of understanding of the difference between evidence-based psychological treatments and generic counselling; 4) many multidisciplinary clinics unfortunately benefit from only one type of non-medical mental health professional as part of their team to see all cases, independent of the level of complexity on the patient's side, and independent of the level of expertise or supervised training on the provider side; 5) multidisciplinary teams in primary care need various mental health professionals to cover for a wide range of presenting problems and levels of complexity/co-morbidities.Conclusion Our demonstration project combined with our continued clinical experience in primary care is consistent with the scientific literature on the topic of psychological services in primary care. Common mental health problems are highly prevalent. Societal costs are high. Accurate diagnosis is crucial. There are psychological treatments proven to work, and that are cost-effective. We can build on existing multidisciplinary teams and structures in place and also innovate by finding creative mechanisms linking the public and private sectors such as in the Australian primary care system. Interdisciplinary teams should integrate a judicious mix of pertinent skills with the right balance of varying levels of competencies to efficiently address varying levels of problem complexities and co-morbidities. At the moment, there is a gap to be filled in multidisciplinary primary care teams and psychologists are already extensively trained and available to fill this gap.

Multiprofessional education to stimulate collaboration: a circular argument and its consequences

PubMed Central

Roodbol, Petrie F.

2010-01-01

The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance. PMID:21818197

The Problem of Size in Robust Design

NASA Technical Reports Server (NTRS)

Koch, Patrick N.; Allen, Janet K.; Mistree, Farrokh; Mavris, Dimitri

1997-01-01

To facilitate the effective solution of multidisciplinary, multiobjective complex design problems, a departure from the traditional parametric design analysis and single objective optimization approaches is necessary in the preliminary stages of design. A necessary tradeoff becomes one of efficiency vs. accuracy as approximate models are sought to allow fast analysis and effective exploration of a preliminary design space. In this paper we apply a general robust design approach for efficient and comprehensive preliminary design to a large complex system: a high speed civil transport (HSCT) aircraft. Specifically, we investigate the HSCT wing configuration design, incorporating life cycle economic uncertainties to identify economically robust solutions. The approach is built on the foundation of statistical experimentation and modeling techniques and robust design principles, and is specialized through incorporation of the compromise Decision Support Problem for multiobjective design. For large problems however, as in the HSCT example, this robust design approach developed for efficient and comprehensive design breaks down with the problem of size - combinatorial explosion in experimentation and model building with number of variables -and both efficiency and accuracy are sacrificed. Our focus in this paper is on identifying and discussing the implications and open issues associated with the problem of size for the preliminary design of large complex systems.

Application of response surface techniques to helicopter rotor blade optimization procedure

NASA Technical Reports Server (NTRS)

Henderson, Joseph Lynn; Walsh, Joanne L.; Young, Katherine C.

1995-01-01

In multidisciplinary optimization problems, response surface techniques can be used to replace the complex analyses that define the objective function and/or constraints with simple functions, typically polynomials. In this work a response surface is applied to the design optimization of a helicopter rotor blade. In previous work, this problem has been formulated with a multilevel approach. Here, the response surface takes advantage of this decomposition and is used to replace the lower level, a structural optimization of the blade. Problems that were encountered and important considerations in applying the response surface are discussed. Preliminary results are also presented that illustrate the benefits of using the response surface.

Sensitivity based coupling strengths in complex engineering systems

NASA Technical Reports Server (NTRS)

Bloebaum, C. L.; Sobieszczanski-Sobieski, J.

1993-01-01

The iterative design scheme necessary for complex engineering systems is generally time consuming and difficult to implement. Although a decomposition approach results in a more tractable problem, the inherent couplings make establishing the interdependencies of the various subsystems difficult. Another difficulty lies in identifying the most efficient order of execution for the subsystem analyses. The paper describes an approach for determining the dependencies that could be suspended during the system analysis with minimal accuracy losses, thereby reducing the system complexity. A new multidisciplinary testbed is presented, involving the interaction of structures, aerodynamics, and performance disciplines. Results are presented to demonstrate the effectiveness of the system reduction scheme.

STARS: An integrated general-purpose finite element structural, aeroelastic, and aeroservoelastic analysis computer program

NASA Technical Reports Server (NTRS)

Gupta, Kajal K.

1991-01-01

The details of an integrated general-purpose finite element structural analysis computer program which is also capable of solving complex multidisciplinary problems is presented. Thus, the SOLIDS module of the program possesses an extensive finite element library suitable for modeling most practical problems and is capable of solving statics, vibration, buckling, and dynamic response problems of complex structures, including spinning ones. The aerodynamic module, AERO, enables computation of unsteady aerodynamic forces for both subsonic and supersonic flow for subsequent flutter and divergence analysis of the structure. The associated aeroservoelastic analysis module, ASE, effects aero-structural-control stability analysis yielding frequency responses as well as damping characteristics of the structure. The program is written in standard FORTRAN to run on a wide variety of computers. Extensive graphics, preprocessing, and postprocessing routines are also available pertaining to a number of terminals.

Recommending Research Profiles for Multidisciplinary Academic Collaboration

ERIC Educational Resources Information Center

Gunawardena, Sidath Deepal

2013-01-01

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

Small farms, cash crops, agrarian ideals, and international development.

PubMed

Effland, Anne

2010-01-01

This address is an exploration of a lifetime of disparate and often conflicting observations about how different people view what is right and good for agriculture, food, and farmers around the world. The exploration utilizes the concept of wicked problems to focus on the issue of differing historical interpretations of global agricultural development. Sandra Batie defines wicked problems as "dynamically complex, ill-structured, public problems" for which "there can be radically different views and understanding of the problem by different stakeholders, with no unique 'correct' view." The wicked problem construct is applied to four core ideas in the history of agricultural development -- small farms, cash crops, agrarian ideals, and international development -- to demonstrate the potential for using this concept to approach complex problems of historical interpretation and contribute to solutions to the challenges of global agricultural development. The author suggests historians should acknowledge contradictory interpretations adn work toward reconciliation and synthesis, where it is possible and, where not, toward a clear explication of the basis for remaining differences. The author also encourages historians to seek multidisciplinary research opportunities that will help bring insights about historical context to policy deliberations.

Solving ordinary differential equations by electrical analogy: a multidisciplinary teaching tool

NASA Astrophysics Data System (ADS)

Sanchez Perez, J. F.; Conesa, M.; Alhama, I.

2016-11-01

Ordinary differential equations are the mathematical formulation for a great variety of problems in science and engineering, and frequently, two different problems are equivalent from a mathematical point of view when they are formulated by the same equations. Students acquire the knowledge of how to solve these equations (at least some types of them) using protocols and strict algorithms of mathematical calculation without thinking about the meaning of the equation. The aim of this work is that students learn to design network models or circuits in this way; with simple knowledge of them, students can establish the association of electric circuits and differential equations and their equivalences, from a formal point of view, that allows them to associate knowledge of two disciplines and promote the use of this interdisciplinary approach to address complex problems. Therefore, they learn to use a multidisciplinary tool that allows them to solve these kinds of equations, even students of first course of engineering, whatever the order, grade or type of non-linearity. This methodology has been implemented in numerous final degree projects in engineering and science, e.g., chemical engineering, building engineering, industrial engineering, mechanical engineering, architecture, etc. Applications are presented to illustrate the subject of this manuscript.

Quality assurance strategies for investigating IAQ problems

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

Collett, C.W.; Ross, J.A.; Sterling, E.M.

Thousands of buildings have now been investigated throughout North America and western Europe. The evaluative strategies and protocols used by various investigators have been described in the scientific and protocols used by various investigators have been described in the scientific and technical literature, including those used by government agencies, private consultants, researchers, and physicians. Review of these strategies shows a consistency and commonly in approach, despite differences in terminology and organization. Most of the published protocols recognize the need to employ a multidisciplinary approach to the evaluation of indoor environmental problems, an approach that views buildings as complex, dynamic systems.more » The multidisciplinary approaches advocated by investigators gather information about the physical building (architectural), the mechanical systems that control indoor environmental conditions (engineering), the type and extent of occupant health and comfort concerns (medical), the objective quality of the air (industrial hygiene) and the occupants subjective perceptions of conditions in their work environment (social science). These components have generally been organized into a series of steps or phases, with each phase extending the information gathered from the preceding phase until a point when the causes of problems may be identified.« less

A multidisciplinary approach of the problem of noise nuisance in urban environment

NASA Astrophysics Data System (ADS)

Rabah, Derbal Cobis; Hamza, Zeghlache

2002-05-01

More often the problem of noise and sonic pollution, particularly in urban sites, is studied by different disciplines such as physics, the acoustics, the psychoacoustics, the medicine and others. It is independently of each other that these sciences are often approaching this subject. Some studies are carried out in laboratories taking noise as samples cut off their realistic context. Urban noise is studied as well by making an abstraction of the different contextual parameters by idealizing a rather complex sonic environment. The noise, according to this present approach, is suposed to react with surounding space, and it takes the form and the quality of the place by defining and requalifying it. It is found that the contextual aspects such as social, cultural or even symbolic dimensions modulate the listening conditions and the perception quality of the noise and even the living and the daily practice of the urban space. The multiparameter dimension study of the noise in an urban context is necessary to better work out the problem and to try to come up with some practical and efficient solutions. The little amount of studies based on such multidisciplinary approach, confort well our effort to go ahead with this methodological approach.

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

PubMed

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

2015-01-01

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

[Multidisciplinary treatment of orofacial pain].

PubMed

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

2016-11-01

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

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

PubMed Central

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

2016-01-01

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

Multidisciplinary Design Techniques Applied to Conceptual Aerospace Vehicle Design. Ph.D. Thesis Final Technical Report

NASA Technical Reports Server (NTRS)

Olds, John Robert; Walberg, Gerald D.

1993-01-01

Multidisciplinary design optimization (MDO) is an emerging discipline within aerospace engineering. Its goal is to bring structure and efficiency to the complex design process associated with advanced aerospace launch vehicles. Aerospace vehicles generally require input from a variety of traditional aerospace disciplines - aerodynamics, structures, performance, etc. As such, traditional optimization methods cannot always be applied. Several multidisciplinary techniques and methods were proposed as potentially applicable to this class of design problem. Among the candidate options are calculus-based (or gradient-based) optimization schemes and parametric schemes based on design of experiments theory. A brief overview of several applicable multidisciplinary design optimization methods is included. Methods from the calculus-based class and the parametric class are reviewed, but the research application reported focuses on methods from the parametric class. A vehicle of current interest was chosen as a test application for this research. The rocket-based combined-cycle (RBCC) single-stage-to-orbit (SSTO) launch vehicle combines elements of rocket and airbreathing propulsion in an attempt to produce an attractive option for launching medium sized payloads into low earth orbit. The RBCC SSTO presents a particularly difficult problem for traditional one-variable-at-a-time optimization methods because of the lack of an adequate experience base and the highly coupled nature of the design variables. MDO, however, with it's structured approach to design, is well suited to this problem. The result of the application of Taguchi methods, central composite designs, and response surface methods to the design optimization of the RBCC SSTO are presented. Attention is given to the aspect of Taguchi methods that attempts to locate a 'robust' design - that is, a design that is least sensitive to uncontrollable influences on the design. Near-optimum minimum dry weight solutions are determined for the vehicle. A summary and evaluation of the various parametric MDO methods employed in the research are included. Recommendations for additional research are provided.

Clinic-friendly screening for cognitive and mental health problems in school-aged youth with epilepsy.

PubMed

Asato, Miya R; Doss, Julia L; Plioplys, Sigita

2015-07-01

Cognitive, psychiatric, psychosocial, and behavioral difficulties are common in youth with epilepsy. Collectively, these comorbidities can be referred to as mental health problems as they reflect brain and behavioral function. Detection and treatment of mental health problems remain an unmet need in epilepsy care that can impact epilepsy, psychosocial, scholastic, and quality-of-life outcomes. Given limited resources in everyday pediatric epilepsy practice, this targeted review provides a stratified plan and suggested tools for screening school-aged youth with epilepsy for the presence of mental health problems. Comanagement of epilepsy and associated comorbidities is a newer concept that may help address the complex, long-term needs of patients by using a multidisciplinary team approach and by engaging primary care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

A Multidisciplinary Clerkship in Emergency Medicine.

ERIC Educational Resources Information Center

And Others; Marshall, Carter L.

1979-01-01

At the New Jersey Medical School, an obligatory, multidisciplinary, fourth-year emergency medicine clerkship requires ambulance duty, emergency room rotation, medical specialty lectures, and a cardiac life support providers course. Particular problems associated with multidisciplinary courses are discussed. (Author/JMD)

Chemistry, manufacturing and controls in passive transdermal drug delivery systems.

PubMed

Goswami, Tarun; Audett, Jay

2015-01-01

Transdermal drug delivery systems (TDDS) are used for the delivery of the drugs through the skin into the systemic circulation by applying them to the intact skin. The development of TDDS is a complex and multidisciplinary affair which involves identification of suitable drug, excipients and various other components. There have been numerous problems reported with respect to TDDS quality and performance. These problems can be reduced by appropriately addressing chemistry, manufacturing and controls requirements, which would thereby result in development of robust TDDS product and processes. This article provides recommendations on the chemistry, manufacturing and controls focusing on the unique technical aspects of TDDS.

Improving the Aircraft Design Process Using Web-Based Modeling and Simulation

NASA Technical Reports Server (NTRS)

Reed, John A.; Follen, Gregory J.; Afjeh, Abdollah A.; Follen, Gregory J. (Technical Monitor)

2000-01-01

Designing and developing new aircraft systems is time-consuming and expensive. Computational simulation is a promising means for reducing design cycle times, but requires a flexible software environment capable of integrating advanced multidisciplinary and multifidelity analysis methods, dynamically managing data across heterogeneous computing platforms, and distributing computationally complex tasks. Web-based simulation, with its emphasis on collaborative composition of simulation models, distributed heterogeneous execution, and dynamic multimedia documentation, has the potential to meet these requirements. This paper outlines the current aircraft design process, highlighting its problems and complexities, and presents our vision of an aircraft design process using Web-based modeling and simulation.

Improving the Aircraft Design Process Using Web-based Modeling and Simulation

NASA Technical Reports Server (NTRS)

Reed, John A.; Follen, Gregory J.; Afjeh, Abdollah A.

2003-01-01

Designing and developing new aircraft systems is time-consuming and expensive. Computational simulation is a promising means for reducing design cycle times, but requires a flexible software environment capable of integrating advanced multidisciplinary and muitifidelity analysis methods, dynamically managing data across heterogeneous computing platforms, and distributing computationally complex tasks. Web-based simulation, with its emphasis on collaborative composition of simulation models, distributed heterogeneous execution, and dynamic multimedia documentation, has the potential to meet these requirements. This paper outlines the current aircraft design process, highlighting its problems and complexities, and presents our vision of an aircraft design process using Web-based modeling and simulation.

Do endothelial cells dream of eclectic shape?

PubMed

Bentley, Katie; Philippides, Andrew; Ravasz Regan, Erzsébet

2014-04-28

Endothelial cells (ECs) exhibit dramatic plasticity of form at the single- and collective-cell level during new vessel growth, adult vascular homeostasis, and pathology. Understanding how, when, and why individual ECs coordinate decisions to change shape, in relation to the myriad of dynamic environmental signals, is key to understanding normal and pathological blood vessel behavior. However, this is a complex spatial and temporal problem. In this review we show that the multidisciplinary field of Adaptive Systems offers a refreshing perspective, common biological language, and straightforward toolkit that cell biologists can use to untangle the complexity of dynamic, morphogenetic systems. Copyright © 2014 Elsevier Inc. All rights reserved.

Phase Transitions in Combinatorial Optimization Problems: Basics, Algorithms and Statistical Mechanics

NASA Astrophysics Data System (ADS)

Hartmann, Alexander K.; Weigt, Martin

2005-10-01

A concise, comprehensive introduction to the topic of statistical physics of combinatorial optimization, bringing together theoretical concepts and algorithms from computer science with analytical methods from physics. The result bridges the gap between statistical physics and combinatorial optimization, investigating problems taken from theoretical computing, such as the vertex-cover problem, with the concepts and methods of theoretical physics. The authors cover rapid developments and analytical methods that are both extremely complex and spread by word-of-mouth, providing all the necessary basics in required detail. Throughout, the algorithms are shown with examples and calculations, while the proofs are given in a way suitable for graduate students, post-docs, and researchers. Ideal for newcomers to this young, multidisciplinary field.

A Multidisciplinary Approach to Sustainable Management of Watershed Resources

EPA Science Inventory

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

[New approaches in pharmacology: numerical modelling and simulation].

PubMed

Boissel, Jean-Pierre; Cucherat, Michel; Nony, Patrice; Dronne, Marie-Aimée; Kassaï, Behrouz; Chabaud, Sylvie

2005-01-01

The complexity of pathophysiological mechanisms is beyond the capabilities of traditional approaches. Many of the decision-making problems in public health, such as initiating mass screening, are complex. Progress in genomics and proteomics, and the resulting extraordinary increase in knowledge with regard to interactions between gene expression, the environment and behaviour, the customisation of risk factors and the need to combine therapies that individually have minimal though well documented efficacy, has led doctors to raise new questions: how to optimise choice and the application of therapeutic strategies at the individual rather than the group level, while taking into account all the available evidence? This is essentially a problem of complexity with dimensions similar to the previous ones: multiple parameters with nonlinear relationships between them, varying time scales that cannot be ignored etc. Numerical modelling and simulation (in silico investigations) have the potential to meet these challenges. Such approaches are considered in drug innovation and development. They require a multidisciplinary approach, and this will involve modification of the way research in pharmacology is conducted.

An Optimization Code for Nonlinear Transient Problems of a Large Scale Multidisciplinary Mathematical Model

NASA Astrophysics Data System (ADS)

Takasaki, Koichi

This paper presents a program for the multidisciplinary optimization and identification problem of the nonlinear model of large aerospace vehicle structures. The program constructs the global matrix of the dynamic system in the time direction by the p-version finite element method (pFEM), and the basic matrix for each pFEM node in the time direction is described by a sparse matrix similarly to the static finite element problem. The algorithm used by the program does not require the Hessian matrix of the objective function and so has low memory requirements. It also has a relatively low computational cost, and is suited to parallel computation. The program was integrated as a solver module of the multidisciplinary analysis system CUMuLOUS (Computational Utility for Multidisciplinary Large scale Optimization of Undense System) which is under development by the Aerospace Research and Development Directorate (ARD) of the Japan Aerospace Exploration Agency (JAXA).

Adapting postdoctoral training to interdisciplinary science in the 21st century: the Cancer Prevention Fellowship Program at the National Cancer Institute.

PubMed

Chang, Shine; Hursting, Stephen D; Perkins, Susan N; Dores, Graça M; Weed, Douglas L

2005-03-01

Preparing junior scientists for careers in the health sciences has become an immense challenge for many reasons, including the emerging demand for multidisciplinary approaches to solving problems in the health sciences. For those choosing careers in hybrid and interdisciplinary fields, the "traditional" postdoctoral training model may not perform well, particularly in light of other problems that plague postdoctoral success. New approaches are required. Using the interdisciplinary field of cancer prevention as an example, the authors describe the Cancer Prevention Fellowship Program (CPFP) of the National Cancer Institute, a three-year postdoctoral program of which the goal is to provide its fellows with a strong foundation in cancer prevention through education, mentored research, and structured professional development training activities that emphasize multidisciplinary approaches and leadership skills. Over time, the CPFP has incorporated the best aspects of the traditional postdoctoral training model with newer training approaches in an effort to overcome existing problems in postdoctoral training and to address the additional complexities inherent in training those who seek careers in interdisciplinary science. Many aspects of the CPFP, including an efficient infrastructure, a dedicated staff, a capacity to provide educational activities, and the provision of rich research opportunities, may translate well to other postdoctoral programs that face similar issues.

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.

Acute severe asthma presenting in late pregnancy.

PubMed

Holland, S M; Thomson, K D

2006-01-01

Asthma is the commonest pre-existing medical condition to complicate pregnancy. Acute severe asthma in pregnancy is rare, but poses difficult problems. In particular, the decision about when and where to deliver the fetus is complex, since maternal response to asthma treatment is unpredictable. We report the successful management of a parturient presenting with acute severe asthma at 37 weeks' gestation. The controversies involved and the importance of adopting a multi-disciplinary team approach to optimise maternal and neonatal outcomes are discussed.

Enterocutaneous fistulas: an overview.

PubMed

Whelan, J F; Ivatury, R R

2011-06-01

Enterocutaneous fistulas remain a difficult management problem. The basis of management centers on the prevention and treatment of sepsis, control of fistula effluent, and fluid and nutritional support. Early surgery should be limited to abscess drainage and proximal defunctioning stoma formation. Definitive procedures for a persistent fistula are indicated in the late postoperative period, with resection of the fistula segment and reanastomosis of healthy bowel. Even more complex are the enteroatmospheric fistulas in the open abdomen. These enteric fistulas require the highest level of multidisciplinary approach for optimal outcomes.

Presynaptic Inhibition in the Striatum of the Basal Ganglia Improves Pattern Classification and Thus Promotes Superior Goal Selection

PubMed Central

Schwab, David J.; Houk, James C.

2015-01-01

This review article takes a multidisciplinary approach to understand how presynaptic inhibition in the striatum of the basal ganglia (BG) contributes to pattern classification and the selection of goals that control behavior. It is a difficult problem both because it is multidimensional and because it is has complex system dynamics. We focus on the striatum because, as the main site for input to the BG, it gets to decide what goals are important to consider. PMID:26696840

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

Integrated aerodynamic-structural design of a forward-swept transport wing

NASA Technical Reports Server (NTRS)

Haftka, Raphael T.; Grossman, Bernard; Kao, Pi-Jen; Polen, David M.; Sobieszczanski-Sobieski, Jaroslaw

1989-01-01

The introduction of composite materials is having a profound effect on aircraft design. Since these materials permit the designer to tailor material properties to improve structural, aerodynamic and acoustic performance, they require an integrated multidisciplinary design process. Futhermore, because of the complexity of the design process, numerical optimization methods are required. The utilization of integrated multidisciplinary design procedures for improving aircraft design is not currently feasible because of software coordination problems and the enormous computational burden. Even with the expected rapid growth of supercomputers and parallel architectures, these tasks will not be practical without the development of efficient methods for cross-disciplinary sensitivities and efficient optimization procedures. The present research is part of an on-going effort which is focused on the processes of simultaneous aerodynamic and structural wing design as a prototype for design integration. A sequence of integrated wing design procedures has been developed in order to investigate various aspects of the design process.

The challenges of meeting nutritional requirements in children and adults with epidermolysis bullosa: proceedings of a multidisciplinary team study day.

PubMed

Hubbard, L; Haynes, L; Sklar, M; Martinez, A E; Mellerio, J E

2011-08-01

This is a report of a study day held in London on 3 March 2010 to discuss measures with which to meet the nutritional requirements of patients with epidermolysis bullosa (EB). Members of national and international multidisciplinary teams (MDTs) caring for patients with EB attended this event. The study day focused on four challenging aspects of management intimately associated with nutritional status in EB, necessitating close cooperation between MDT members: iron-deficiency anaemia, gastrostomy placement and feeding, muscle mass and mobility, and dental health. The study day provided a unique forum for dietitians, doctors, nurses, physiotherapists, psychologists, psychotherapists, dentists, dental hygienists and occupational therapists to share knowledge and debate problems common to all who strive to promote best practice in this rare and complex group of conditions. © The Author(s). CED © 2011 British Association of Dermatologists.

Using Sustainability Themes and Multidisciplinary Approaches to Enhance STEM Education

ERIC Educational Resources Information Center

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

2015-01-01

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

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.

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.

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.

Multidisciplinary Optimization Branch Experience Using iSIGHT Software

NASA Technical Reports Server (NTRS)

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

1999-01-01

The Multidisciplinary Optimization (MDO) Branch at NASA Langley Research Center is investigating frameworks for supporting multidisciplinary analysis and optimization research. An optimization framework call improve the design process while reducing time and costs. A framework provides software and system services to integrate computational tasks and allows the researcher to concentrate more on the application and less on the programming details. A framework also provides a common working environment and a full range of optimization tools, and so increases the productivity of multidisciplinary research teams. Finally, a framework enables staff members to develop applications for use by disciplinary experts in other organizations. Since the release of version 4.0, the MDO Branch has gained experience with the iSIGHT framework developed by Engineous Software, Inc. This paper describes experiences with four aerospace applications: (1) reusable launch vehicle sizing, (2) aerospike nozzle design, (3) low-noise rotorcraft trajectories, and (4) acoustic liner design. All applications have been successfully tested using the iSIGHT framework, except for the aerospike nozzle problem, which is in progress. Brief overviews of each problem are provided. The problem descriptions include the number and type of disciplinary codes, as well as all estimate of the multidisciplinary analysis execution time. In addition, the optimization methods, objective functions, design variables, and design constraints are described for each problem. Discussions on the experience gained and lessons learned are provided for each problem. These discussions include the advantages and disadvantages of using the iSIGHT framework for each case as well as the ease of use of various advanced features. Potential areas of improvement are identified.

Aircraft family design using enhanced collaborative optimization

NASA Astrophysics Data System (ADS)

Roth, Brian Douglas

Significant progress has been made toward the development of multidisciplinary design optimization (MDO) methods that are well-suited to practical large-scale design problems. However, opportunities exist for further progress. This thesis describes the development of enhanced collaborative optimization (ECO), a new decomposition-based MDO method. To support the development effort, the thesis offers a detailed comparison of two existing MDO methods: collaborative optimization (CO) and analytical target cascading (ATC). This aids in clarifying their function and capabilities, and it provides inspiration for the development of ECO. The ECO method offers several significant contributions. First, it enhances communication between disciplinary design teams while retaining the low-order coupling between them. Second, it provides disciplinary design teams with more authority over the design process. Third, it resolves several troubling computational inefficiencies that are associated with CO. As a result, ECO provides significant computational savings (relative to CO) for the test cases and practical design problems described in this thesis. New aircraft development projects seldom focus on a single set of mission requirements. Rather, a family of aircraft is designed, with each family member tailored to a different set of requirements. This thesis illustrates the application of decomposition-based MDO methods to aircraft family design. This represents a new application area, since MDO methods have traditionally been applied to multidisciplinary problems. ECO offers aircraft family design the same benefits that it affords to multidisciplinary design problems. Namely, it simplifies analysis integration, it provides a means to manage problem complexity, and it enables concurrent design of all family members. In support of aircraft family design, this thesis introduces a new wing structural model with sufficient fidelity to capture the tradeoffs associated with component commonality, but of appropriate fidelity for aircraft conceptual design. The thesis also introduces a new aircraft family concept. Unlike most families, the intent is not necessarily to produce all family members. Rather, the family includes members for immediate production and members that address potential future market conditions and/or environmental regulations. The result is a set of designs that yield a small performance penalty today in return for significant future flexibility to produce family members that respond to new market conditions and environmental regulations.

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

Campbell, Philip LaRoche

At the end of his life, Stephen Jay Kline, longtime professor of mechanical engineering at Stanford University, completed a book on how to address complex systems. The title of the book is 'Conceptual Foundations of Multi-Disciplinary Thinking' (1995), but the topic of the book is systems. Kline first establishes certain limits that are characteristic of our conscious minds. Kline then establishes a complexity measure for systems and uses that complexity measure to develop a hierarchy of systems. Kline then argues that our minds, due to their characteristic limitations, are unable to model the complex systems in that hierarchy. Computers aremore » of no help to us here. Our attempts at modeling these complex systems are based on the way we successfully model some simple systems, in particular, 'inert, naturally-occurring' objects and processes, such as what is the focus of physics. But complex systems overwhelm such attempts. As a result, the best we can do in working with these complex systems is to use a heuristic, what Kline calls the 'Guideline for Complex Systems.' Kline documents the problems that have developed due to 'oversimple' system models and from the inappropriate application of a system model from one domain to another. One prominent such problem is the Procrustean attempt to make the disciplines that deal with complex systems be 'physics-like.' Physics deals with simple systems, not complex ones, using Kline's complexity measure. The models that physics has developed are inappropriate for complex systems. Kline documents a number of the wasteful and dangerous fallacies of this type.« less

Breaking CFD Bottlenecks in Gas-Turbine Flow-Path Design

NASA Technical Reports Server (NTRS)

Davis, Roger L.; Dannenhoffer, John F., III; Clark, John P.

2010-01-01

New ideas are forthcoming to break existing bottlenecks in using CFD during design. CAD-based automated grid generation. Multi-disciplinary use of embedded, overset grids to eliminate complex gridding problems. Use of time-averaged detached-eddy simulations as norm instead of "steady" RANS to include effects of self-excited unsteadiness. Combined GPU/Core parallel computing to provide over an order of magnitude increase in performance/price ratio. Gas-turbine applications are shown here but these ideas can be used for other Air Force, Navy, and NASA applications.

Factitious Disorders and Cardiothoracic Surgery: The Ongoing Multidisciplinary Challenges of a Complex Case

PubMed Central

Firstenberg, Michael S.; Sirak, John H.; Sun, Benjamin; Kasick, David P.

2009-01-01

Chronic factitious disorder, Munchausen's syndrome, can be challenging to manage—particularly when complaints and symptoms suggest medical or surgical emergencies. We present a patient whose problems have spanned many years and a great distance. Hopefully, with a greater awareness of this disease, as this patient continues to seek health care in many different hospitals, the implications of timely access to information, good histories and physical exams, and an index of suspicion can assist in potentially avoiding unnecessary, expensive, and invasive evaluations. PMID:20029640

Responding to the Challenge of Survival: Multidisciplinary Language Courses

ERIC Educational Resources Information Center

Champagne, Roland A.

1978-01-01

Multidisciplinary language courses offer hope for integrating language courses into a university undergraduate curriculum. Such courses use a target language, such as French, to explore problems in another discipline. (Author)

Sediment measurement in estuarine and coastal areas

NASA Technical Reports Server (NTRS)

Shelley, P. E.

1976-01-01

A survey of uses of estuarine and coastal areas is given. Problems associated with these uses are discussed, and data needs for intelligent management of these valuable areas are outlined. Suspended sediment measurements are seen to be one of the greatest needs. To help understand the complexity of the problem, a brief discussion of sediment mechanics is given, including sediment sources, characteristics, and transport. The impact of sediment mechanics on its direct measurement (sampling and analysis) is indicated, along with recommendations for directly obtaining representative data. Indirect measurement of suspended sediment by remote sensors is discussed both theoretically and in the light of some recent experiences. The need for an integrated, multidisciplinary program to solve the problem of quantitatively measuring suspended sediment with remote sensors is stressed, and several important considerations of such a program and benefits to be derived therefrom are briefly addressed.

Breaking down silos: engaging students to help fix the US health care system.

PubMed

Kumarasamy, Mathu A; Sanfilippo, Fred P

2015-01-01

The field of health care is becoming a team effort as patient care becomes increasingly complex and multifaceted. Despite the need for multidisciplinary education, there persists a lack of student engagement and collaboration among health care disciplines, which presents a growing concern as students join the workforce. In October 2013, the Emory-Georgia Tech Healthcare Innovation Program organized a student driven symposium entitled "US Healthcare: What's Broken and How to Fix It: The Student Perspective". The symposium engaged students from multiple disciplines to work together in addressing problems associated with US health care delivery. The symposium was organized and carried out by a diverse group of student leaders from local institutions who adopted a multidisciplinary approach throughout the planning process. The innovative planning process leading up to the symposium revealed that many of the student-discipline groups lacked an understanding of one another's role in health care, and that students were interested in learning how to work together to leverage each other's profession. The symposium was widely attended and positively received by students and faculty from the Atlanta metropolitan area, and has since helped to promote interdepartmental collaboration and multidisciplinary education across institutions. The student symposium will become an annual event and incorporate broader discipline representation, as well as a patient perspective. Proposals for additional institution-wide, multidisciplinary educational offerings are being addressed with the help of faculty and health care providers across the network. Accordingly, the implementation of student-driven symposia to engage students and stimulate institution-wide changes may be a beneficial and cost-effective means for academic health centers looking to facilitate multidisciplinary health care education.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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.

The potential application of the blackboard model of problem solving to multidisciplinary design

NASA Technical Reports Server (NTRS)

Rogers, J. L.

1989-01-01

Problems associated with the sequential approach to multidisciplinary design are discussed. A blackboard model is suggested as a potential tool for implementing the multilevel decomposition approach to overcome these problems. The blackboard model serves as a global database for the solution with each discipline acting as a knowledge source for updating the solution. With this approach, it is possible for engineers to improve the coordination, communication, and cooperation in the conceptual design process, allowing them to achieve a more optimal design from an interdisciplinary standpoint.

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

NASA Astrophysics Data System (ADS)

Terando, A. J.; Collazo, J.

2017-12-01

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

[Indication guidelines for medical rehabilitation in the context of disease management programmes].

PubMed

Raspe, Heiner

2005-02-01

In current and upcoming disease management programmes in Germany, the provision of medical services is strongly oriented on ICD diagnoses and on services traditionally provided by the statutory health insurance. Multidisciplinary services, such as medical rehabilitation, mostly covered by other payers (e.g. pension funds) are not taken into account. On the other hand, many chronically-ill patients have complex and multifocal health complaints that are best addressed by multidisciplinary interventions. Considering this inherent deficit, in 2002 the German Society of Rehabilitation Sciences has initiated the research project "Indication Guidelines" aimed at developing indication criteria for rehabilitation in the context of disease management programmes. The concept presented in this paper relies on three basic requirements: 1. Impaired participation (according to ICF) caused by multifocal deficits leads to the definition of goals for rehabilitation, taking into account clinical and legal aspects as well as the patients preferences. 2. Multifocal health problems are best addressed by a multidisciplinary rehabilitation programme as it is currently provided by the German pension funds. 3. Scientific evidence has to demonstrate that these programmes are very likely to be effective (positive rehabilitation prognosis, evidence-based rehabilitation). Further requirements include adequate instruction of patients, as well as intensive and prolonged after-care. Both could be very well integrated into comprehensive disease management programmes.

Realizing Improvement through Team Empowerment (RITE): A Team-based, Project-based Multidisciplinary Improvement Program.

PubMed

Larson, David B; Mickelsen, L Jake; Garcia, Kandice

2016-01-01

Performance improvement in a complex health care environment depends on the cooperation of diverse individuals and groups, allocation of time and resources, and use of effective improvement methods. To address this challenge, we developed an 18-week multidisciplinary training program that would also provide a vehicle for effecting needed improvements, by using a team- and project-based model. The program began in the radiology department and subsequently expanded to include projects from throughout the medical center. Participants were taught a specific method for team-based problem solving, which included (a) articulating the problem, (b) observing the process, (c) analyzing possible causes of problems, (d) identifying key drivers, (e) testing and refining interventions, and (f) providing for sustainment of results. Progress was formally reviewed on a weekly basis. A total of 14 teams consisting of 78 participants completed the course in two cohorts; one project was discontinued. All completed projects resulted in at least modest improvement. Mean skill scores increased from 2.5/6 to 4.5/6 (P < .01), and the mean satisfaction score was 4.7/5. Identified keys to success include (a) engagement of frontline staff, (b) teams given authority to make process changes, (c) capable improvement coaches, (d) a physician-director with improvement expertise and organizational authority, (e) capable administrative direction, (f) supportive organizational leaders, (g) weekly progress reviews, (h) timely educational material, (i) structured problem-solving methods, and ( j ) multiple projects working simultaneously. The purpose of this article is to review the program, including the methods and results, and discuss perceived keys to program success. © RSNA, 2016.

Execution of Multidisciplinary Design Optimization Approaches on Common Test Problems

NASA Technical Reports Server (NTRS)

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

1997-01-01

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

Configuration Management of an Optimization Application in a Research Environment

NASA Technical Reports Server (NTRS)

Townsend, James C.; Salas, Andrea O.; Schuler, M. Patricia

1999-01-01

Multidisciplinary design optimization (MDO) research aims to increase interdisciplinary communication and reduce design cycle time by combining system analyses (simulations) with design space search and decision making. The High Performance Computing and Communication Program's current High Speed Civil Transport application, HSCT4.0, at NASA Langley Research Center involves a highly complex analysis process with high-fidelity analyses that are more realistic than previous efforts at the Center. The multidisciplinary processes have been integrated to form a distributed application by using the Java language and Common Object Request Broker Architecture (CORBA) software techniques. HSCT4.0 is a research project in which both the application problem and the implementation strategy have evolved as the MDO and integration issues became better understood. Whereas earlier versions of the application and integrated system were developed with a simple, manual software configuration management (SCM) process, it was evident that this larger project required a more formal SCM procedure. This report briefly describes the HSCT4.0 analysis and its CORBA implementation and then discusses some SCM concepts and their application to this project. In anticipation that SCM will prove beneficial for other large research projects, the report concludes with some lessons learned in overcoming SCM implementation problems for HSCT4.0.

Support for global science: Remote sensing's challenge

NASA Technical Reports Server (NTRS)

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

1986-01-01

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

International disaster research

NASA Technical Reports Server (NTRS)

Silverstein, Martin Elliot

1991-01-01

No existing telecommunications system can be expected to provide strategy and tactics appropriate to the complex, many faceted problem of disaster. Despite the exciting capabilities of space, communications, remote sensing, and the miracles of modern medicine, complete turnkey transfers to the disaster problem do not make the fit, and cannot be expected to do so. In 1980, a Presidential team assigned the mission of exploring disaster response within the U.S. Federal Government encountered an unanticipated obstacle: disaster was essentially undefined. In the absence of a scientifically based paradigm of disaster, there can be no measure of cost effectiveness, optimum design of manpower structure, or precise application of any technology. These problems spawned a 10-year, multidisciplinary study designed to define the origins, anatomy, and necessary management techniques for catastrophes. The design of the study necessarily reflects interests and expertise in disaster medicine, emergency medicine, telecommunications, computer communications, and forencsic sciences. This study is described.

A basis for a visual language for describing, archiving and analyzing functional models of complex biological systems

PubMed Central

Cook, Daniel L; Farley, Joel F; Tapscott, Stephen J

2001-01-01

Background: We propose that a computerized, internet-based graphical description language for systems biology will be essential for describing, archiving and analyzing complex problems of biological function in health and disease. Results: We outline here a conceptual basis for designing such a language and describe BioD, a prototype language that we have used to explore the utility and feasibility of this approach to functional biology. Using example models, we demonstrate that a rather limited lexicon of icons and arrows suffices to describe complex cell-biological systems as discrete models that can be posted and linked on the internet. Conclusions: Given available computer and internet technology, BioD may be implemented as an extensible, multidisciplinary language that can be used to archive functional systems knowledge and be extended to support both qualitative and quantitative functional analysis. PMID:11305940

Podiatry evaluation of a chitosan gelling fibre dressing in diabetic foot ulceration.

PubMed

Walker, Angela

2016-06-23

The purpose of this small evaluation on five patients presenting to community podiatry services in Birmingham with foot ulceration was to explore common problems associated with diabetes and other high-risk conditions and illustrate the clinical effectiveness and experience of using a chitosan absorbent gelling fibre dressing (KytoCel®, Aspen Medical). Each of these case studies bought their individual complex issues and complications that affected the healing process. General wound care involved debridement, if required, dressings, pressure redistribution addressing footwear needs, systemic antibiotics where required, and shared care with the multidisciplinary team (MDT) in secondary care where appropriate.

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.

[Role of intraosteal administration of antibiotics in treatment of local oral mucinous carcinoma].

PubMed

Ivanov, V M; Ivanova, O V; Sheĭkin, M V

2013-01-01

The problems of prophylaxis of infectious complications in the treatment of oral local mucinous carcinoma are considered relevant to 204 respective cases. More favourable results of the combined and complex treatment of the patients were shown when a multidisciplinary approach was used with obligatory participation of stomatologists. Special stomatologic prophylactic and therapeutic procedures with using reamberin orally and intravenously in the chemo- and radiotherapy and adequate antibiotic therapy during the surgical operation resulted in less frequent infectious complications, that was in favour of the patients life quality. Intraosteal administration of antibiotics was shown preferable.

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.

Multidisciplinary Consensus on the Nonadherence to Clinical Management of Inhaled Therapy in Spanish asthma patients.

PubMed

López-Viña, Antolín; Giner, Jordi; Molina, Jesús; Palicio, Javier; Plaza, Javier; Quintano, José Antonio; Quirce, Santiago; Soria, Cristina; Uréndez, Ana María; Plaza, Vicente

2017-08-01

Rates of nonadherence to asthma treatment in Spain are between 24% and 76%, which results in poor disease control and increased health care costs. The main objective of this multidisciplinary consensus was to investigate the opinions of health professionals and patients regarding adherence to inhaled therapy in Spain. The results will help to identify the causes of nonadherence and to establish strategies to detect and correct the problem. This research was conducted by using a modified Delphi method organized into 2 rounds and involving a panel of 64 physicians, 16 nurses, and 10 community pharmacists. In addition, 70 patients with asthma completed a simplified 1-round survey, based on the Delphi questionnaire. The items proposed to reach a consensus included topics such as impact and causes of nonadherence, as well as strategies to improve adherence to treatment. Expert panelists reached a consensus on ~80% of the items proposed. They agreed that the lack of control in asthma has an important economic impact. The causes of nonadherence with more agreement were the patients' beliefs about treatment and the complexity of the inhalation devices. Panelists agreed that the most important strategies to improve adherence were modification of patients' beliefs, training of professionals in the management of adherence, and personalization of interventions. Most patients only agreed with items that referred to strategies to improve adherence. Although the problems, impact, causes, and interventions regarding nonadherence to asthma treatment are known, adequate monitoring of adherence to treatment is not performed. A multidisciplinary and personalized approach is necessary to control and improve adherence. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Reconfigurable Model Execution in the OpenMDAO Framework

NASA Technical Reports Server (NTRS)

Hwang, John T.

2017-01-01

NASA's OpenMDAO framework facilitates constructing complex models and computing their derivatives for multidisciplinary design optimization. Decomposing a model into components that follow a prescribed interface enables OpenMDAO to assemble multidisciplinary derivatives from the component derivatives using what amounts to the adjoint method, direct method, chain rule, global sensitivity equations, or any combination thereof, using the MAUD architecture. OpenMDAO also handles the distribution of processors among the disciplines by hierarchically grouping the components, and it automates the data transfer between components that are on different processors. These features have made OpenMDAO useful for applications in aircraft design, satellite design, wind turbine design, and aircraft engine design, among others. This paper presents new algorithms for OpenMDAO that enable reconfigurable model execution. This concept refers to dynamically changing, during execution, one or more of: the variable sizes, solution algorithm, parallel load balancing, or set of variables-i.e., adding and removing components, perhaps to switch to a higher-fidelity sub-model. Any component can reconfigure at any point, even when running in parallel with other components, and the reconfiguration algorithm presented here performs the synchronized updates to all other components that are affected. A reconfigurable software framework for multidisciplinary design optimization enables new adaptive solvers, adaptive parallelization, and new applications such as gradient-based optimization with overset flow solvers and adaptive mesh refinement. Benchmarking results demonstrate the time savings for reconfiguration compared to setting up the model again from scratch, which can be significant in large-scale problems. Additionally, the new reconfigurability feature is applied to a mission profile optimization problem for commercial aircraft where both the parametrization of the mission profile and the time discretization are adaptively refined, resulting in computational savings of roughly 10% and the elimination of oscillations in the optimized altitude profile.

Scale in Remote Sensing and GIS: An Advancement in Methods Towards a Science of Scale

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.

1998-01-01

The term "scale", both in space and time, is central to remote sensing and geographic information systems (GIS). The emergence and widespread use of GIS technologies, including remote sensing, has generated significant interest in addressing scale as a generic topic, and in the development and implementation of techniques for dealing explicitly with the vicissitudes of scale as a multidisciplinary issue. As science becomes more complex and utilizes databases that are capable of performing complex space-time data analyses, it becomes paramount that we develop the tools and techniques needed to operate at multiple scales, to work with data whose scales are not necessarily ideal, and to produce results that can be aggregated or disaggregated in ways that suit the decision-making process. Contemporary science is constantly coping with compromises, and the data available for a particular study rarely fit perfectly with the scales at which the processes being investigated operate, or the scales that policy-makers require to make sound, rational decisions. This presentation discusses some of the problems associated with scale as related to remote sensing and GIS, and describes some of the questions that need to be addressed in approaching the development of a multidisciplinary "science of scale". Techniques for dealing with multiple scaled data that have been developed or explored recently are described as a means for recognizing scale as a generic issue, along with associated theory and tools that can be of simultaneous value to a large number of disciplines. These can be used to seek answers to a host of interrelated questions in the interest of providing a formal structure for the management and manipulation of scale and its universality as a key concept from a multidisciplinary perspective.

Scale in Remote Sensing and GIS: An Advancement in Methods Towards a Science of Scale

NASA Technical Reports Server (NTRS)

Quattrochi, D. A.

1998-01-01

The term "scale", both in space and time, is central to remote sensing and Geographic Information Systems (GIS). The emergence and widespread use of GIS technologies, including remote sensing, has generated significant interest in addressing scale as a generic topic, and in the development and implementation of techniques for dealing explicitly with the vicissitudes of scale as a multidisciplinary issue. As science becomes more complex and utilizes databases that are capable of performing complex space-time data analyses, it becomes paramount that we develop the tools and techniques needed to operate at multiple scales, to work with data whose scales are not necessarily ideal, and to produce results that can be aggregated or disaggregated ways that suit the decision-making process. Contemporary science is constantly coping with compromises, and the data available for a particular study rarely fit perfectly with the scales at which the processes being investigated operate, or the scales that policy-makers require to make sound, rational decisions. This presentation discusses some of the problems associated with scale as related to remote sensing and GIS, and describes some of the questions that need to be addressed in approaching the development of a multidisciplinary "science of scale". Techniques for dealing with multiple scaled data that have been developed or explored recently are described as a means for recognizing scale as a generic issue, along with associated theory and tools that can be of simultaneous value to a large number of disciplines. These can be used to seek answers to a host of interrelated questions in the interest of providing a formal structure for the management and manipulation of scale and its universality as a key concept from a multidisciplinary perspective.

Architecture of autonomous systems

NASA Technical Reports Server (NTRS)

Dikshit, Piyush; Guimaraes, Katia; Ramamurthy, Maya; Agrawala, Ashok; Larsen, Ronald L.

1986-01-01

Automation of Space Station functions and activities, particularly those involving robotic capabilities with interactive or supervisory human control, is a complex, multi-disciplinary systems design problem. A wide variety of applications using autonomous control can be found in the literature, but none of them seem to address the problem in general. All of them are designed with a specific application in mind. In this report, an abstract model is described which unifies the key concepts underlying the design of automated systems such as those studied by the aerospace contractors. The model has been kept as general as possible. The attempt is to capture all the key components of autonomous systems. With a little effort, it should be possible to map the functions of any specific autonomous system application to the model presented here.

Architecture of autonomous systems

NASA Technical Reports Server (NTRS)

Dikshit, Piyush; Guimaraes, Katia; Ramamurthy, Maya; Agrawala, Ashok; Larsen, Ronald L.

1989-01-01

Automation of Space Station functions and activities, particularly those involving robotic capabilities with interactive or supervisory human control, is a complex, multi-disciplinary systems design problem. A wide variety of applications using autonomous control can be found in the literature, but none of them seem to address the problem in general. All of them are designed with a specific application in mind. In this report, an abstract model is described which unifies the key concepts underlying the design of automated systems such as those studied by the aerospace contractors. The model has been kept as general as possible. The attempt is to capture all the key components of autonomous systems. With a little effort, it should be possible to map the functions of any specific autonomous system application to the model presented here.

Multidisciplinary cancer care: does it improve outcomes?

PubMed

Brar, Savtaj S; Hong, Nicole Look; Wright, Frances C

2014-10-01

Multidisciplinary care has been advocated as a solution for increasingly complex treatment decisions in cancer patients. The impact of multidisciplinary care on patient survival has been studied, but evidence is limited by poor methodological quality. Lack of conclusive evidence for increased survival is balanced against improvements in quality of care, guideline adherence, reduction in wait times, and greater satisfaction for patients and care providers. © 2014 Wiley Periodicals, Inc.

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.

Growth and Development of Three-Dimensional Plant Form.

PubMed

Whitewoods, Christopher D; Coen, Enrico

2017-09-11

Plants can generate a spectacular array of complex shapes, many of which exhibit elaborate curvature in three dimensions, illustrated for example by orchid flowers and pitcher-plant traps. All of these structures arise through differential growth. Recent findings provide fresh mechanistic insights into how regional cell behaviours may lead to tissue deformations, including anisotropies and curvatures, which shape growing volumes and sheets of cells. Here were review our current understanding of how genes, growth, mechanics, and evolution interact to generate diverse structures. We illustrate problems and approaches with the complex three-dimensional trap of the bladderwort, Utricularia gibba, to show how a multidisciplinary approach can be extended to new model systems to understand how diverse plant shapes can develop and evolve. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Developing and evaluating interventions that are applicable and relevant to inpatients and those who care for them; a multiphase, pragmatic action research approach.

PubMed

Bell, Jack J; Rossi, Tony; Bauer, Judith D; Capra, Sandra

2014-08-18

Randomised controlled trials may be of limited use to evaluate the multidisciplinary and multimodal interventions required to effectively treat complex patients in routine clinical practice; pragmatic action research approaches may provide a suitable alternative. A multiphase, pragmatic, action research based approach was developed to identify and overcome barriers to nutritional care in patients admitted to a metropolitan hospital hip-fracture unit. Four sequential action research cycles built upon baseline data including 614 acute hip-fracture inpatients and 30 purposefully sampled clinicians. Reports from Phase I identified barriers to nutrition screening and assessment. Phase II reported post-fracture protein-energy intakes and intake barriers. Phase III built on earlier results; an explanatory mixed-methods study expanded and explored additional barriers and facilitators to nutritional care. Subsequent changes to routine clinical practice were developed and implemented by the treating team between Phase III and IV. These were implemented as a new multidisciplinary, multimodal nutritional model of care. A quasi-experimental controlled, 'before-and-after' study was then used to compare the new model of care with an individualised nutritional care model. Engagement of the multidisciplinary team in a multiphase, pragmatic action research intervention doubled energy and protein intakes, tripled return home discharge rates, and effected a 75% reduction in nutritional deterioration during admission in a reflective cohort of hip-fracture inpatients. This approach allowed research to be conducted as part of routine clinical practice, captured a more representative patient cohort than previously reported studies, and facilitated exploration of barriers and engagement of the multidisciplinary healthcare workers to identify and implement practical solutions. This study demonstrates substantially different findings to those previously reported, and is the first to demonstrate that multidisciplinary, multimodal nutrition care reduces intake barriers, delivers a higher proportional increase in protein and energy intake compared with baseline than other published intervention studies, and improves patient outcomes when compared with individualised nutrition care. The findings are considered highly relevant to clinical practice and have high translation validity. The authors strongly encourage the development of similar study designs to investigate complex health problems in elderly, multi-morbid patient populations as a way to evaluate and change clinical practice.

Developing and evaluating interventions that are applicable and relevant to inpatients and those who care for them; a multiphase, pragmatic action research approach

PubMed Central

2014-01-01

Background Randomised controlled trials may be of limited use to evaluate the multidisciplinary and multimodal interventions required to effectively treat complex patients in routine clinical practice; pragmatic action research approaches may provide a suitable alternative. Methods A multiphase, pragmatic, action research based approach was developed to identify and overcome barriers to nutritional care in patients admitted to a metropolitan hospital hip-fracture unit. Results Four sequential action research cycles built upon baseline data including 614 acute hip-fracture inpatients and 30 purposefully sampled clinicians. Reports from Phase I identified barriers to nutrition screening and assessment. Phase II reported post-fracture protein-energy intakes and intake barriers. Phase III built on earlier results; an explanatory mixed-methods study expanded and explored additional barriers and facilitators to nutritional care. Subsequent changes to routine clinical practice were developed and implemented by the treating team between Phase III and IV. These were implemented as a new multidisciplinary, multimodal nutritional model of care. A quasi-experimental controlled, ‘before-and-after’ study was then used to compare the new model of care with an individualised nutritional care model. Engagement of the multidisciplinary team in a multiphase, pragmatic action research intervention doubled energy and protein intakes, tripled return home discharge rates, and effected a 75% reduction in nutritional deterioration during admission in a reflective cohort of hip-fracture inpatients. Conclusions This approach allowed research to be conducted as part of routine clinical practice, captured a more representative patient cohort than previously reported studies, and facilitated exploration of barriers and engagement of the multidisciplinary healthcare workers to identify and implement practical solutions. This study demonstrates substantially different findings to those previously reported, and is the first to demonstrate that multidisciplinary, multimodal nutrition care reduces intake barriers, delivers a higher proportional increase in protein and energy intake compared with baseline than other published intervention studies, and improves patient outcomes when compared with individualised nutrition care. The findings are considered highly relevant to clinical practice and have high translation validity. The authors strongly encourage the development of similar study designs to investigate complex health problems in elderly, multi-morbid patient populations as a way to evaluate and change clinical practice. PMID:25135226

Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

PubMed

Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

2015-04-01

Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P < 0.001). Multidisciplinary clinical hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

An Algorithm for Integrated Subsystem Embodiment and System Synthesis

NASA Technical Reports Server (NTRS)

Lewis, Kemper

1997-01-01

Consider the statement,'A system has two coupled subsystems, one of which dominates the design process. Each subsystem consists of discrete and continuous variables, and is solved using sequential analysis and solution.' To address this type of statement in the design of complex systems, three steps are required, namely, the embodiment of the statement in terms of entities on a computer, the mathematical formulation of subsystem models, and the resulting solution and system synthesis. In complex system decomposition, the subsystems are not isolated, self-supporting entities. Information such as constraints, goals, and design variables may be shared between entities. But many times in engineering problems, full communication and cooperation does not exist, information is incomplete, or one subsystem may dominate the design. Additionally, these engineering problems give rise to mathematical models involving nonlinear functions of both discrete and continuous design variables. In this dissertation an algorithm is developed to handle these types of scenarios for the domain-independent integration of subsystem embodiment, coordination, and system synthesis using constructs from Decision-Based Design, Game Theory, and Multidisciplinary Design Optimization. Implementation of the concept in this dissertation involves testing of the hypotheses using example problems and a motivating case study involving the design of a subsonic passenger aircraft.

Expert-guided evolutionary algorithm for layout design of complex space stations

NASA Astrophysics Data System (ADS)

Qian, Zhiqin; Bi, Zhuming; Cao, Qun; Ju, Weiguo; Teng, Hongfei; Zheng, Yang; Zheng, Siyu

2017-08-01

The layout of a space station should be designed in such a way that different equipment and instruments are placed for the station as a whole to achieve the best overall performance. The station layout design is a typical nondeterministic polynomial problem. In particular, how to manage the design complexity to achieve an acceptable solution within a reasonable timeframe poses a great challenge. In this article, a new evolutionary algorithm has been proposed to meet such a challenge. It is called as the expert-guided evolutionary algorithm with a tree-like structure decomposition (EGEA-TSD). Two innovations in EGEA-TSD are (i) to deal with the design complexity, the entire design space is divided into subspaces with a tree-like structure; it reduces the computation and facilitates experts' involvement in the solving process. (ii) A human-intervention interface is developed to allow experts' involvement in avoiding local optimums and accelerating convergence. To validate the proposed algorithm, the layout design of one-space station is formulated as a multi-disciplinary design problem, the developed algorithm is programmed and executed, and the result is compared with those from other two algorithms; it has illustrated the superior performance of the proposed EGEA-TSD.

Computational Issues Associated with Temporally Deforming Geometries Such as Thrust Vectoring Nozzles

NASA Technical Reports Server (NTRS)

Boyalakuntla, Kishore; Soni, Bharat K.; Thornburg, Hugh J.; Yu, Robert

1996-01-01

During the past decade, computational simulation of fluid flow around complex configurations has progressed significantly and many notable successes have been reported, however, unsteady time-dependent solutions are not easily obtainable. The present effort involves unsteady time dependent simulation of temporally deforming geometries. Grid generation for a complex configuration can be a time consuming process and temporally varying geometries necessitate the regeneration of such grids for every time step. Traditional grid generation techniques have been tried and demonstrated to be inadequate to such simulations. Non-Uniform Rational B-splines (NURBS) based techniques provide a compact and accurate representation of the geometry. This definition can be coupled with a distribution mesh for a user defined spacing. The present method greatly reduces cpu requirements for time dependent remeshing, facilitating the simulation of more complex unsteady problems. A thrust vectoring nozzle has been chosen to demonstrate the capability as it is of current interest in the aerospace industry for better maneuverability of fighter aircraft in close combat and in post stall regimes. This current effort is the first step towards multidisciplinary design optimization which involves coupling the aerodynamic heat transfer and structural analysis techniques. Applications include simulation of temporally deforming bodies and aeroelastic problems.

Podiatric involvement in multidisciplinary falls-prevention clinics in Australia.

PubMed

Menz, Hylton B; Hill, Keith D

2007-01-01

Falls in older people are a major public health problem, and there is increasing evidence that foot problems and inappropriate footwear increase the risk of falls. Several multidisciplinary prevention clinics have been established to address the problem of falls; however, the role of podiatry in these clinics has not been clearly defined. The aims of this study were to determine the level of podiatric involvement in multidisciplinary falls clinics in Australia and to describe the assessments undertaken and interventions provided by podiatrists in these settings. A database of falls clinics was developed through consultation with departments of health in each state and territory. Clinic managers were contacted and surveyed as to whether the clinic incorporated podiatry services. If so, the podiatrists were contacted and asked to complete a brief questionnaire regarding their level of involvement and the assessment procedures and interventions offered. Of the 36 clinics contacted, 25 completed the survey. Only four of these clinics reported direct podiatric involvement. Despite the limited involvement of podiatry in these clinics, all of the clinic managers stated that they considered podiatry to have an important role to play in falls prevention. Podiatry service provision in falls clinics varied considerably in relation to eligibility criteria, assessments undertaken, and interventions provided. Despite the recognition that foot problems and inappropriate footwear are risk factors for falls, podiatry currently has a relatively minor and poorly defined role in multidisciplinary falls-prevention clinics in Australia.

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.

Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience.

PubMed

Juarez, M; Price, E; Collins, D; Williamson, L

2010-01-01

Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services. To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital. 1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems. 448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter. Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services. Copyright 2010 Elsevier Ltd. All rights reserved.

The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis

PubMed Central

Benedict, Ralph H.B.; Gromisch, Elizabeth S.; DeLuca, John

2012-01-01

Cognitive dysfunction is observed in about half of people with multiple sclerosis (MS), and MS health-care professionals face the challenge of screening, assessing, and treating patients for cognitive problems. Considering the inconsistent or limited empirical evidence to assist in this task, a multidisciplinary consensus conference of MS experts, sponsored by the Consortium of Multiple Sclerosis Centers (CMSC), was held on September 24, 2010, to address these issues. Key articles from the literature on these topics were distributed prior to the meeting, and CMSC member professionals were surveyed on clinical practices related to screening, assessment, and treatment for cognitive problems. The purpose of the meeting was threefold: 1) to achieve a multidisciplinary perspective on practices for screening, monitoring, evaluating, and treating MS patients for cognitive problems; 2) to propose consensus candidate measures for screening and/or monitoring for cognitive problems in MS that neurologists or nurses might administer on a regular basis; and 3) to propose consensus treatment approaches from a multidisciplinary perspective. This article summarizes the conclusions of the conference participants and provides preliminary suggestions for screening and brief assessment. PMID:24453735

Implementation and Performance Issues in Collaborative Optimization

NASA Technical Reports Server (NTRS)

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

1996-01-01

Collaborative optimization is a multidisciplinary design architecture that is well-suited to large-scale multidisciplinary optimization problems. This paper compares this approach with other architectures, examines the details of the formulation, and some aspects of its performance. A particular version of the architecture is proposed to better accommodate the occurrence of multiple feasible regions. The use of system level inequality constraints is shown to increase the convergence rate. A series of simple test problems, demonstrated to challenge related optimization architectures, is successfully solved with collaborative optimization.

The importance of multidisciplinary team management of patients with non-small-cell lung cancer

PubMed Central

Ellis, P.M.

2012-01-01

Historically, a simple approach to the treatment of non-small-cell lung cancer (nsclc) was applicable to nearly all patients. Recently, a more complex treatment algorithm has emerged, driven by both pathologic and molecular phenotype. This increasing complexity underscores the importance of a multidisciplinary team approach to the diagnosis, treatment, and supportive care of patients with nsclc. A team approach to management is important at all points: from diagnosis, through treatment, to end-of-life care. It also needs to be patient-centred and must involve the patient in decision-making concerning treatment. Multidisciplinary case conferencing is becoming an integral part of care. Early integration of palliative care into the team approach appears to contribute significantly to quality of life and potentially extends overall survival for these patients. Supportive approaches, including psychosocial and nutrition support, should be routinely incorporated into the team approach. Challenges to the implementation of multidisciplinary care require institutional commitment and support. PMID:22787414

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

Decision Making Under Uncertainty and Complexity: A Model-Based Scenario Approach to Supporting Integrated Water Resources Management

NASA Astrophysics Data System (ADS)

Liu, Y.; Gupta, H.; Wagener, T.; Stewart, S.; Mahmoud, M.; Hartmann, H.; Springer, E.

2007-12-01

Some of the most challenging issues facing contemporary water resources management are those typified by complex coupled human-environmental systems with poorly characterized uncertainties. In other words, major decisions regarding water resources have to be made in the face of substantial uncertainty and complexity. It has been suggested that integrated models can be used to coherently assemble information from a broad set of domains, and can therefore serve as an effective means for tackling the complexity of environmental systems. Further, well-conceived scenarios can effectively inform decision making, particularly when high complexity and poorly characterized uncertainties make the problem intractable via traditional uncertainty analysis methods. This presentation discusses the integrated modeling framework adopted by SAHRA, an NSF Science & Technology Center, to investigate stakeholder-driven water sustainability issues within the semi-arid southwestern US. The multi-disciplinary, multi-resolution modeling framework incorporates a formal scenario approach to analyze the impacts of plausible (albeit uncertain) alternative futures to support adaptive management of water resources systems. Some of the major challenges involved in, and lessons learned from, this effort will be discussed.

Growth and development after oesophageal atresia surgery: Need for long-term multidisciplinary follow-up.

PubMed

IJsselstijn, Hanneke; Gischler, Saskia J; Toussaint, Leontien; Spoel, Marjolein; Zijp, Monique H M van der Cammen-van; Tibboel, Dick

2016-06-01

Survival rates in oesophageal atresia patients have reached over 90%. In long-term follow-up studies the focus has shifted from purely surgical or gastrointestinal evaluation to a multidisciplinary approach. We reviewed the literature on the long-term morbidity of these patients and discuss mainly issues of physical growth and neurodevelopment. We conclude that growth problems - both stunting and wasting - are frequently seen, but that sufficient longitudinal data are lacking. Therefore, it is unclear whether catch-up growth into adolescence and adulthood occurs. Data on determinants of growth retardation are also lacking in current literature. Studies on neurodevelopment beyond preschool age are scarce but oesophageal atresia patients seem at risk for academic problems and motor function delay. Many factors contribute to the susceptibility to growth and development problems and we propose a multidisciplinary follow-up schedule into adulthood future care which may help improve quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

Heikkinen, Juho; Isomöttönen, Ville

2015-01-01

Recently, there has been a trend towards adding a multidisciplinary or multicultural element to traditional monodisciplinary project courses in computing and engineering. In this article, we examine the implications of multidisciplinarity for students' learning experiences during a one-semester project course for real customers. We use a…

Can we make sense of multidisciplinary co-operation in primary care by considering routines and rules?

PubMed

Elissen, Arianne M J; van Raak, Arno J A; Paulus, Aggie T G

2011-01-01

Although it is widely acknowledged that the complex health problems of chronically ill and elderly persons require care provision across organisational and professional boundaries, achieving widespread multidisciplinary co-operation in primary care has proven problematic. We developed an explanation for this on the basis of the concepts of routines (patterns of behaviour) and rules, which form a relatively new yet promising perspective for studying co-operation in health-care. We used data about primary care providers situated in the Dutch region of Limburg, a region that, despite high numbers of chronically and elderly persons, has traditionally few healthcare centres and where multidisciplinary co-operation is limited. A qualitative study design was used, in which interviews and documents were the main data sources. Semi-structured interviews were conducted with providers from six primary care professions in the Dutch region of Limburg; relevant documents included co-operation agreements, annual reports and internal memos. To analyse the evidence, several data matrices were developed and all data were structured according to the main concepts under study, i.e. routines and rules. Although more research is needed, our study suggests that the emergence of more extensive multidisciplinary co-operation in primary care is hampered by the organisational rules and regulations prevailing in the sector. By emphasising individual care delivery rather than co-operation, these rules stimulate the perseverance of diversity between the routines by which providers perform their solo care delivery activities, rather than the creation of the amount of compatibility between those routines that is necessary for the current, rather limited shape of multidisciplinary co-operation to expand. Further research should attempt to validate this explanation by utilising a larger research population and systematically operationalising the rules existing in the legal and--more importantly--organisational environment of primary care. © 2010 Blackwell Publishing Ltd.

Review of battery powered embedded systems design for mission-critical low-power applications

NASA Astrophysics Data System (ADS)

Malewski, Matthew; Cowell, David M. J.; Freear, Steven

2018-06-01

The applications and uses of embedded systems is increasingly pervasive. Mission and safety critical systems relying on embedded systems pose specific challenges. Embedded systems is a multi-disciplinary domain, involving both hardware and software. Systems need to be designed in a holistic manner so that they are able to provide the desired reliability and minimise unnecessary complexity. The large problem landscape means that there is no one solution that fits all applications of embedded systems. With the primary focus of these mission and safety critical systems being functionality and reliability, there can be conflicts with business needs, and this can introduce pressures to reduce cost at the expense of reliability and functionality. This paper examines the challenges faced by battery powered systems, and then explores at more general problems, and several real-world embedded systems.

Key Gaps for Enabling Plant Growth in Future Missions

NASA Technical Reports Server (NTRS)

Anderson, Molly S.; Barta, Daniel; Douglas, Grace; Fritsche, Ralph; Massa, Gioia; Wheeler, Ray; Quincy, Charles; Romeyn, Matthew; Motil, Brian; Hanford, Anthony

2017-01-01

Growing plants to provide food or psychological benefits to crewmembers is a common vision for the future of human spaceflight, often represented both in media and in serious concept studies. The complexity of controlled environment agriculture and of plant growth in microgravity have and continue to be the subject of dedicated scientific research. However, actually implementing these systems in a way that will be cost effective, efficient, and sustainable for future space missions is a complex, multi-disciplinary problem. Key questions exist in many areas: human research in nutrition and psychology, horticulture, plant physiology and microbiology, multi-phase microgravity fluid physics, hardware design and technology development, and system design, operations and mission planning. The criticality of the research, and the ideal solution, will vary depending on the mission and type of system implementation being considered.

Acute Management of the Traumatically Injured Pelvis.

PubMed

Skitch, Steven; Engels, Paul T

2018-02-01

Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists). This article explores this complex clinical problem and provides a practical approach to its management. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Regional Multiteam Systems in Cancer Care Delivery

PubMed Central

Monson, John R.T.; Rizvi, Irfan; Savastano, Ann; Green, James S.A.; Sevdalis, Nick

2016-01-01

Teamwork is essential for addressing many of the challenges that arise in the coordination and delivery of cancer care, especially for the problems that are presented by patients who cross geographic boundaries and enter and exit multiple health care systems at various times during their cancer care journeys. The problem of coordinating the care of patients with cancer is further complicated by the growing number of treatment options and modalities, incompatibilities among the vast variety of technology platforms that have recently been adopted by the health care industry, and competing and misaligned incentives for providers and systems. Here we examine the issue of regional care coordination in cancer through the prism of a real patient journey. This article will synthesize and elaborate on existing knowledge about coordination approaches for complex systems, in particular, in general and cancer care multidisciplinary teams; define elements of coordination derived from organizational psychology and human factors research that are applicable to team-based cancer care delivery; and suggest approaches for improving multidisciplinary team coordination in regional cancer care delivery and avenues for future research. The phenomenon of the mobile, multisystem patient represents a growing challenge in cancer care. Paradoxically, development of high-quality, high-volume centers of excellence and the ease of virtual communication and data sharing by using electronic medical records have introduced significant barriers to effective team-based cancer care. These challenges urgently require solutions. PMID:27650833

The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial.

PubMed

Singer, Susanne; Roick, Julia; Meixensberger, Jürgen; Schiefke, Franziska; Briest, Susanne; Dietz, Andreas; Papsdorf, Kirsten; Mössner, Joachim; Berg, Thomas; Stolzenburg, Jens-Uwe; Niederwieser, Dietger; Keller, Annette; Kersting, Anette; Danker, Helge

2018-06-01

We examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients. In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling. Thirteen wards were randomized and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7; p = 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6; p = 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0; p = 0.52). NCT01859429 CONCLUSIONS: Financial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.

Stronger Disciplinary Identities in Multidisciplinary Research Schools

ERIC Educational Resources Information Center

Geschwind, Lars; Melin, Göran

2016-01-01

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

Percutaneous treatment of complex biliary stone disease using endourological technique and literature review

PubMed Central

Korkes, Fernando; Carneiro, Ariê; Nasser, Felipe; Affonso, Breno Boueri; Galastri, Francisco Leonardo; de Oliveira, Marcos Belotto; Macedo, Antônio Luiz de Vasconcellos

2015-01-01

Most biliary stone diseases need to be treated surgically. However, in special cases that traditional biliary tract endoscopic access is not allowed, a multidisciplinary approach using hybrid technique with urologic instrumental constitute a treatment option. We report a case of a patient with complex intrahepatic stones who previously underwent unsuccessful conventional approaches, and who symptoms resolved after treatment with hybrid technique using an endourologic technology. We conducted an extensive literature review until October 2012 of manuscripts indexed in PubMed on the treatment of complex gallstones with hybrid technique. The multidisciplinary approach with hybrid technique using endourologic instrumental represents a safe and effective treatment option for patients with complex biliary stone who cannot conduct treatment with conventional methods. PMID:26061073

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

PubMed

2016-07-01

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

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…

Hierarchial parallel computer architecture defined by computational multidisciplinary mechanics

NASA Technical Reports Server (NTRS)

Padovan, Joe; Gute, Doug; Johnson, Keith

1989-01-01

The goal is to develop an architecture for parallel processors enabling optimal handling of multi-disciplinary computation of fluid-solid simulations employing finite element and difference schemes. The goals, philosphical and modeling directions, static and dynamic poly trees, example problems, interpolative reduction, the impact on solvers are shown in viewgraph form.

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…

[Errors in wound management].

PubMed

Filipović, Marinko; Novinscak, Tomislav

2014-10-01

Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions.

STARSITE Program: Search To Assess Re- sources, Social, Institutional, Technical, and Environmental, toward a decision-making mechanism

NASA Technical Reports Server (NTRS)

1972-01-01

The systems approach was used in the seminar on the complex multidisciplinary problem of housing and related environment conditions. The main areas of study are the following; historical overview of housing; diagrammatic presentation of the problem; technological innovations and contributions; management, economic, legal, and political considerations; environment and natural resources; human needs and behavior; model of the housing industry; and potential for implementation. It is felt that a greater attempt should be made to transfer aerospace technology to the housing industry; however, the emphasis of the conference was directed to the modern management techniques developed by NASA. Among the conclusions are the following: The extent and character of the housing problem should be defined. Increased coordination of housing programs within and between Federal agencies is essential. Development of physically sophisticated building systems requires Federal support. New towns of differing life styles need to be created. Physiological and psychological reactions to environmental enclosure need to be defined.

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

ERIC Educational Resources Information Center

Lakes, Richard D., Ed.

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

Developing a framework for qualitative engineering: Research in design and analysis of complex structural systems

NASA Technical Reports Server (NTRS)

Franck, Bruno M.

1990-01-01

The research is focused on automating the evaluation of complex structural systems, whether for the design of a new system or the analysis of an existing one, by developing new structural analysis techniques based on qualitative reasoning. The problem is to identify and better understand: (1) the requirements for the automation of design, and (2) the qualitative reasoning associated with the conceptual development of a complex system. The long-term objective is to develop an integrated design-risk assessment environment for the evaluation of complex structural systems. The scope of this short presentation is to describe the design and cognition components of the research. Design has received special attention in cognitive science because it is now identified as a problem solving activity that is different from other information processing tasks (1). Before an attempt can be made to automate design, a thorough understanding of the underlying design theory and methodology is needed, since the design process is, in many cases, multi-disciplinary, complex in size and motivation, and uses various reasoning processes involving different kinds of knowledge in ways which vary from one context to another. The objective is to unify all the various types of knowledge under one framework of cognition. This presentation focuses on the cognitive science framework that we are using to represent the knowledge aspects associated with the human mind's abstraction abilities and how we apply it to the engineering knowledge and engineering reasoning in design.

Multidisciplinary chronic pain management in a rural Canadian setting.

PubMed

Burnham, Robert; Day, Jeremiah; Dudley, Wallace

2010-01-01

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

Formal and heuristic system decomposition methods in multidisciplinary synthesis. Ph.D. Thesis, 1991

NASA Technical Reports Server (NTRS)

Bloebaum, Christina L.

1991-01-01

The multidisciplinary interactions which exist in large scale engineering design problems provide a unique set of difficulties. These difficulties are associated primarily with unwieldy numbers of design variables and constraints, and with the interdependencies of the discipline analysis modules. Such obstacles require design techniques which account for the inherent disciplinary couplings in the analyses and optimizations. The objective of this work was to develop an efficient holistic design synthesis methodology that takes advantage of the synergistic nature of integrated design. A general decomposition approach for optimization of large engineering systems is presented. The method is particularly applicable for multidisciplinary design problems which are characterized by closely coupled interactions among discipline analyses. The advantage of subsystem modularity allows for implementation of specialized methods for analysis and optimization, computational efficiency, and the ability to incorporate human intervention and decision making in the form of an expert systems capability. The resulting approach is not a method applicable to only a specific situation, but rather, a methodology which can be used for a large class of engineering design problems in which the system is non-hierarchic in nature.

A Multidisciplinary PBL Robot Control Project in Automation and Electronic Engineering

ERIC Educational Resources Information Center

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

2015-01-01

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

Teaching Computing in a Multidisciplinary Way in Social Studies Classes in School--A Case Study

ERIC Educational Resources Information Center

von Wangenheim, Christiane Gresse; Alves, Nathalia Cruz; Rodrigues, Pedro Eurico; Hauck, Jean Carlo

2017-01-01

In order to be well-educated citizens in the 21st century, children need to learn computing in school. However, implementing computing education in schools faces several practical problems, such as lack of computing teachers and time in an already overloaded curriculum. A solution can be a multidisciplinary approach, integrating computing…

A better communcation with the patients improves the management of HIV disease: a nonsystematic review

PubMed Central

TZANEVA, VALENTINA; IACOB, TEODORA

2013-01-01

The human immunodeficiency virus (HIV) is a blood-borne, sexually transmissible virus which belongs to a subset of viruses called retroviruses. Patients with HIV disease face problems like stigma, discrimination, poverty and marginalization. These problems also affect the physician-patient communication in HIV disease. Learning to conduct a consultation is a complex skill which is gradually learned and perfected during training and career. Good physician-patient communication in HIV disease demands medical professional competence, good communication skills, ethical behaviour, respect of patient’s dignity, good teamwork skills and maintaining confidentiality. The most important aspect of patient care is education, which should include empowering patients with basic knowledge about HIV infection, methods of transmission, progression, prognosis, and prevention. A multidisciplinary approach that uses the special skills of nurses, pharmacists, nutritionists, social workers, and case managers is desirable. Effective methods for clinicians to support such development are needed. PMID:26527943

Psychiatric Aspects of Dementia

PubMed Central

Onyike, Chiadi U.

2016-01-01

Purpose of Review: The psychiatric aspects of dementia are increasingly recognized as significant contributors to distress, disability, and care burden, and, thus, are of increasing interest to practicing neurologists. This article examines how psychiatric disorders are entwined with dementia and describes the predictive, diagnostic, and therapeutic implications of the psychiatric symptoms of dementia. Recent Findings: Psychiatric disorders, particularly depression and schizophrenia, are associated with higher risk for late-life dementia. Psychiatric phenomena also define phenotypes such as frontotemporal dementia and dementia with Lewy bodies, cause distress, and amplify dementia-related disabilities. Management requires a multidisciplinary team, a problem-solving stance, programs of care, and pharmacologic management. Recent innovations include model programs that provide structured problem-solving interventions and tailored in-home care. Summary: There is new appreciation of the complexity of the relationship between psychiatric disorders and dementia as well as the significance of this relationship for treatment, community services, and research. PMID:27042910

Multi-Disciplinary Type Creativity Education for Students from 15 years old to Bachelor Level in College of Technology

NASA Astrophysics Data System (ADS)

Yotsuyanagi, Takao; Ikeda, Senri; Suzuki, Katsuhiko; Kobayashi, Hiroshi; Sakuraba, Hiroshi; Shoji, Akira; Itoh, Masahiko

Creativity is the most fundamental keyword for engineers to solve the various problems in manufacturing products. This engineering “learning” cannot be achieved without the real experiences, especially by the teens who have the curiosity to know everything. New educational program has been innovated in Miyagi National College of Technology. This new curriculum started as “03C” in 2003. It involves two laboratories for mixed-departments type grouping, which intend to cultivate the creative ability for the 2nd year students in College Course and the 1st year students in Advanced Course as Engineering Design. This paper presents the trial of the new educational program on the cultivating creative ability designed for teen-agers, and discusses the processes in detail, results and further problems. This program will progress still more with continuous improvement of manufacturing subjects in cooperative with educational-industrial complex.

NASA Aeronautics Multidisciplinary Analysis and Design Fellowship Program

NASA Technical Reports Server (NTRS)

Grossman, B.; Guerdal, Z.; Haftka, R. T.; Kapania, R. K.; Mason, W. H.; Mook, D. T.

1998-01-01

For a number of years, Virginia Tech had been on the forefront of research in the area of multidisciplinary analysis and design. In June of 1994, faculty members from aerospace and ocean engineering, engineering science and mechanics, mechanical engineering, industrial engineering, mathematics and computer sciences, at Virginia Tech joined together to form the Multidisciplinary Analysis and Design (MAD) Center for Advanced Vehicles. The center was established with the single goal: to perform research that is relevant to the needs of the US industry and to foster collaboration between the university, government and industry. In October of 1994, the center was chosen by NASA headquarters as one of the five university centers to establish a fellowship program to develop a graduate program in multidisciplinary analysis and design. The fellowship program provides full stipend and tuition support for seven U. S. students per year during their graduate studies. To advise us regarding the problems faced by the industry, an industrial advisory board has been formed consisting of representatives from industry as well as government laboratories. The function of the advisory board is to channel information from its member companies to faculty members concerning problems that need research attention in the general area of multidisciplinary design optimization (MDO). The faculty and their graduate students make proposals to the board on how to address these problems. At the annual board meeting in Blacksburg, the board discusses the proposals and suggests which students get funded under the NASA fellowship program. All students participating in the program are required to spend 3-6 months in industry working on their research projects. We are completing the third year of the fellowship program and have had three advisory board meetings in Blacksburg.

Prader-Willi Syndrome: Clinical Aspects

PubMed Central

Elena, Grechi; Bruna, Cammarata; Benedetta, Mariani; Stefania, Di Candia; Giuseppe, Chiumello

2012-01-01

Prader-Willi Syndrome (PWS) is a complex multisystem genetic disorder that shows great variability, with changing clinical features during a patient's life. The syndrome is due to the loss of expression of several genes encoded on the proximal long arm of chromosome 15 (15q11.2–q13). The complex phenotype is most probably caused by a hypothalamic dysfunction that is responsible for hormonal dysfunctions and for absence of the sense of satiety. For this reason a Prader-Willi (PW) child develops hyperphagia during the initial stage of infancy that can lead to obesity and its complications. During infancy many PW child display a range of behavioural problems that become more noticeable in adolescence and adulthood and interfere mostly with quality of life. Early diagnosis of PWS is important for effective long-term management, and a precocious multidisciplinary approach is fundamental to improve quality of life, prevent complications, and prolong life expectancy. PMID:23133744

Development of Computer-Assisted Virtual Field Trips to Support Multidisciplinary Learning

ERIC Educational Resources Information Center

Jacobson, Astrid R.; Militello, Roberta; Baveye, Philippe C.

2009-01-01

Multidisciplinary courses are being developed at a number of US colleges and universities to highlight the connections between the rise or fall of world civilizations and the sustainable or unsustainable uses of soil and water resources. The content presented in these courses is complex because it includes concepts from disciplines as varied as…

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

PubMed

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

2017-06-01

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

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource.

PubMed

Berghmans, Bary

2018-05-01

Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results. Because pelvic floor muscle disorders contribute significantly to CPP and SD, there is rationale for physiotherapy. However, physiotherapy is a widely underused and untapped resource, which has its place in the multidisciplinary approach to these health problems. Computer-aided and manual searches and methodological quality assessment were carried out for meta-analyses, systematic reviews, and randomized controlled trials (RCTs) published between 1990 and 2017 investigating classification, assessment, and (physiotherapeutic) treatment of pelvic pain and/or female SD defined by the keywords below. Expert opinions were sought via interviews. Due to a lack of sufficient relevant medical information, referral data, and test results, focused physiotherapy is difficult to administer adequately. However, recent quality studies indicate significant clinical effects of physiotherapy for CPP and female SD, and experts advocate a multidisciplinary approach that includes physiotherapy. Because of its holistic approach, physiotherapy can contribute significantly to the multidisciplinary assessment and treatment of CPP and female SD.

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.

Multidisciplinary Approach to Aerospike Nozzle Design

NASA Technical Reports Server (NTRS)

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

1997-01-01

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

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.

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.

Analytical and Computational Properties of Distributed Approaches to MDO

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

2000-01-01

Historical evolution of engineering disciplines and the complexity of the MDO problem suggest that disciplinary autonomy is a desirable goal in formulating and solving MDO problems. We examine the notion of disciplinary autonomy and discuss the analytical properties of three approaches to formulating and solving MDO problems that achieve varying degrees of autonomy by distributing the problem along disciplinary lines. Two of the approaches-Optimization by Linear Decomposition and Collaborative Optimization-are based on bi-level optimization and reflect what we call a structural perspective. The third approach, Distributed Analysis Optimization, is a single-level approach that arises from what we call an algorithmic perspective. The main conclusion of the paper is that disciplinary autonomy may come at a price: in the bi-level approaches, the system-level constraints introduced to relax the interdisciplinary coupling and enable disciplinary autonomy can cause analytical and computational difficulties for optimization algorithms. The single-level alternative we discuss affords a more limited degree of autonomy than that of the bi-level approaches, but without the computational difficulties of the bi-level methods. Key Words: Autonomy, bi-level optimization, distributed optimization, multidisciplinary optimization, multilevel optimization, nonlinear programming, problem integration, system synthesis

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.

[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.

The NASA Langley Multidisciplinary Uncertainty Quantification Challenge

NASA Technical Reports Server (NTRS)

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

2014-01-01

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

Sub-problem Optimization With Regression and Neural Network Approximators

NASA Technical Reports Server (NTRS)

Guptill, James D.; Hopkins, Dale A.; Patnaik, Surya N.

2003-01-01

Design optimization of large systems can be attempted through a sub-problem strategy. In this strategy, the original problem is divided into a number of smaller problems that are clustered together to obtain a sequence of sub-problems. Solution to the large problem is attempted iteratively through repeated solutions to the modest sub-problems. This strategy is applicable to structures and to multidisciplinary systems. For structures, clustering the substructures generates the sequence of sub-problems. For a multidisciplinary system, individual disciplines, accounting for coupling, can be considered as sub-problems. A sub-problem, if required, can be further broken down to accommodate sub-disciplines. The sub-problem strategy is being implemented into the NASA design optimization test bed, referred to as "CometBoards." Neural network and regression approximators are employed for reanalysis and sensitivity analysis calculations at the sub-problem level. The strategy has been implemented in sequential as well as parallel computational environments. This strategy, which attempts to alleviate algorithmic and reanalysis deficiencies, has the potential to become a powerful design tool. However, several issues have to be addressed before its full potential can be harnessed. This paper illustrates the strategy and addresses some issues.

Feeding problems of infants and toddlers

PubMed Central

Bernard-Bonnin, Anne-Claude

2006-01-01

OBJECTIVE To propose a diagnostic and therapeutic approach to feeding problems in early childhood. QUALITY OF EVIDENCE Articles were retrieved through a MEDLINE search from January 1990 to December 2005 using the MeSH terms eating disorders, infant, and child. Recommended practice is based mainly on levels II and III evidence. MAIN MESSAGE Feeding problems are classified under structural abnormalities, neurodevelopmental disabilities, and behavioural disorders, with overlap between categories. A medical approach also needs an evaluation of diet and an assessment of the interaction between parent and child. Treating medical or surgical conditions, increasing caloric intake, and counseling about general nutrition can alleviate mild to moderate problems. More complicated cases should be referred to multidisciplinary teams. Behavioural therapy aims to foster appropriate behaviour and discourage maladaptive behaviour. CONCLUSION Feeding problems in early childhood often have multifactorial causes and a substantial behavioural component. Family physicians have a key role in detecting problems, offering advice, managing mildly to moderately severe cases, and referring more complicated cases to multidisciplinary teams. PMID:17279184

Multidisciplinary Education in Transportation. Proceedings of a Conference conducted by the Highway Research Board (University of Pennsylvania, Philadelphia, September 7 and 8, 1973).

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Transportation Research Board.

A discussion of the problem of providing multidisciplinary education in transportation and a means for educators to communicate their approaches and experiences provided the purpose of the conference. Among the areas discussed were the comprehensiveness of transportation education, societal issues, systems aspects, transportation research,…

The Loci Multidisciplinary Simulation System Overview and Status

NASA Technical Reports Server (NTRS)

Luke, Edward A.; Tong, Xiao-Ling; Tang, Lin

2002-01-01

This paper will discuss the Loci system, an innovative tool for developing tightly coupled multidisciplinary three dimensional simulations. This presentation will overview some of the unique capabilities of the Loci system to automate the assembly of numerical simulations from libraries of fundamental computational components. We will discuss the demonstration of the Loci system on coupled fluid-structure problems related to RBCC propulsion systems.

Multidisciplinary Optimization Branch Experience Using iSIGHT Software

NASA Technical Reports Server (NTRS)

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

1999-01-01

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

Variable-Complexity Multidisciplinary Optimization on Parallel Computers

NASA Technical Reports Server (NTRS)

Grossman, Bernard; Mason, William H.; Watson, Layne T.; Haftka, Raphael T.

1998-01-01

This report covers work conducted under grant NAG1-1562 for the NASA High Performance Computing and Communications Program (HPCCP) from December 7, 1993, to December 31, 1997. The objective of the research was to develop new multidisciplinary design optimization (MDO) techniques which exploit parallel computing to reduce the computational burden of aircraft MDO. The design of the High-Speed Civil Transport (HSCT) air-craft was selected as a test case to demonstrate the utility of our MDO methods. The three major tasks of this research grant included: development of parallel multipoint approximation methods for the aerodynamic design of the HSCT, use of parallel multipoint approximation methods for structural optimization of the HSCT, mathematical and algorithmic development including support in the integration of parallel computation for items (1) and (2). These tasks have been accomplished with the development of a response surface methodology that incorporates multi-fidelity models. For the aerodynamic design we were able to optimize with up to 20 design variables using hundreds of expensive Euler analyses together with thousands of inexpensive linear theory simulations. We have thereby demonstrated the application of CFD to a large aerodynamic design problem. For the predicting structural weight we were able to combine hundreds of structural optimizations of refined finite element models with thousands of optimizations based on coarse models. Computations have been carried out on the Intel Paragon with up to 128 nodes. The parallel computation allowed us to perform combined aerodynamic-structural optimization using state of the art models of a complex aircraft configurations.

Challenges and Experiences of Building Multidisciplinary Datasets across Cultures

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Whale Multi-Disciplinary Studies: A Marine Education Infusion Unit. Northern New England Marine Education Project.

ERIC Educational Resources Information Center

Maine Univ., Orono. Coll. of Education.

This multidisciplinary unit deals with whales, whaling lore and history, and the interaction of the whale with the complex marine ecosystem. It seeks to teach adaptation of marine organisms. It portrays the concept that man is part of the marine ecosystem and man's activities can deplete and degrade marine ecosystems, endangering the survival of…

A Geometry Based Infra-structure for Computational Analysis and Design

NASA Technical Reports Server (NTRS)

Haimes, Robert

1997-01-01

The computational steps traditionally taken for most engineering analysis (CFD, structural analysis, and etc.) are: Surface Generation - usually by employing a CAD system; Grid Generation - preparing the volume for the simulation; Flow Solver - producing the results at the specified operational point; and Post-processing Visualization - interactively attempting to understand the results For structural analysis, integrated systems can be obtained from a number of commercial vendors. For CFD, these steps have worked well in the past for simple steady-state simulations at the expense of much user interaction. The data was transmitted between phases via files. Specifically the problems with this procedure are: (1) File based. Information flows from one step to the next via data files with formats specified for that procedure. (2) 'Good' Geometry. A bottleneck in getting results from a solver is the construction of proper geometry to be fed to the grid generator. With 'good' geometry a grid can be constructed in tens of minutes (even with a complex configuration) using unstructured techniques. (3) One-Way communication. All information travels on from one phase to the next. Until this process can be automated, more complex problems such as multi-disciplinary analysis or using the above procedure for design becomes prohibitive.

Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary healthcare systems for Indigenous Australians.

PubMed

Bailie, Jodie; Cunningham, Frances Clare; Bainbridge, Roxanne Gwendalyn; Passey, Megan E; Laycock, Alison Frances; Bailie, Ross Stewart; Larkins, Sarah L; Brands, Jenny S M; Ramanathan, Shanthi; Abimbola, Seye; Peiris, David

2018-01-01

Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or 'wicked' problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health.

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

PubMed

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

2017-11-01

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

Multidisciplinary Concurrent Design Optimization via the Internet

NASA Technical Reports Server (NTRS)

Woodard, Stanley E.; Kelkar, Atul G.; Koganti, Gopichand

2001-01-01

A methodology is presented which uses commercial design and analysis software and the Internet to perform concurrent multidisciplinary optimization. The methodology provides a means to develop multidisciplinary designs without requiring that all software be accessible from the same local network. The procedures are amenable to design and development teams whose members, expertise and respective software are not geographically located together. This methodology facilitates multidisciplinary teams working concurrently on a design problem of common interest. Partition of design software to different machines allows each constituent software to be used on the machine that provides the most economy and efficiency. The methodology is demonstrated on the concurrent design of a spacecraft structure and attitude control system. Results are compared to those derived from performing the design with an autonomous FORTRAN program.

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.

Symposium on Spina Bifida (Denver, Colorado, November, 1969).

ERIC Educational Resources Information Center

Colorado Univ., Denver. Medical Center.

The objectives of the symposium were to define the problems of the child with spina bifida and to present practical means of management, using a multi-disciplinary team approach. Eight papers defining the problem cover the epidemiology of spina bifida, pathophysiology, musculoskeletal defects, incontinence of bladder and bowel, problems of…

Developing teamwork skills in capstone design courses.

PubMed

Goldberg, Jay

2010-01-01

The majority of our biomedical engineering graduates will eventually work in an industry where they will be part of multidisciplinary teams that use the collective skills, expertise, experience, and training of each team member. Diversity within these teams provides different perspectives, opinions, and ways of viewing problems, leading to a larger set of potential solutions. Successful careers require engineers to be able to function on multidisciplinary teams.

A General-Purpose Optimization Engine for Multi-Disciplinary Design Applications

NASA Technical Reports Server (NTRS)

Patnaik, Surya N.; Hopkins, Dale A.; Berke, Laszlo

1996-01-01

A general purpose optimization tool for multidisciplinary applications, which in the literature is known as COMETBOARDS, is being developed at NASA Lewis Research Center. The modular organization of COMETBOARDS includes several analyzers and state-of-the-art optimization algorithms along with their cascading strategy. The code structure allows quick integration of new analyzers and optimizers. The COMETBOARDS code reads input information from a number of data files, formulates a design as a set of multidisciplinary nonlinear programming problems, and then solves the resulting problems. COMETBOARDS can be used to solve a large problem which can be defined through multiple disciplines, each of which can be further broken down into several subproblems. Alternatively, a small portion of a large problem can be optimized in an effort to improve an existing system. Some of the other unique features of COMETBOARDS include design variable formulation, constraint formulation, subproblem coupling strategy, global scaling technique, analysis approximation, use of either sequential or parallel computational modes, and so forth. The special features and unique strengths of COMETBOARDS assist convergence and reduce the amount of CPU time used to solve the difficult optimization problems of aerospace industries. COMETBOARDS has been successfully used to solve a number of problems, including structural design of space station components, design of nozzle components of an air-breathing engine, configuration design of subsonic and supersonic aircraft, mixed flow turbofan engines, wave rotor topped engines, and so forth. This paper introduces the COMETBOARDS design tool and its versatility, which is illustrated by citing examples from structures, aircraft design, and air-breathing propulsion engine design.

Enhanced Multiobjective Optimization Technique for Comprehensive Aerospace Design. Part A

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi; Rajadas, John N.

1997-01-01

A multidisciplinary design optimization procedure which couples formal multiobjectives based techniques and complex analysis procedures (such as computational fluid dynamics (CFD) codes) developed. The procedure has been demonstrated on a specific high speed flow application involving aerodynamics and acoustics (sonic boom minimization). In order to account for multiple design objectives arising from complex performance requirements, multiobjective formulation techniques are used to formulate the optimization problem. Techniques to enhance the existing Kreisselmeier-Steinhauser (K-S) function multiobjective formulation approach have been developed. The K-S function procedure used in the proposed work transforms a constrained multiple objective functions problem into an unconstrained problem which then is solved using the Broyden-Fletcher-Goldfarb-Shanno (BFGS) algorithm. Weight factors are introduced during the transformation process to each objective function. This enhanced procedure will provide the designer the capability to emphasize specific design objectives during the optimization process. The demonstration of the procedure utilizes a computational Fluid dynamics (CFD) code which solves the three-dimensional parabolized Navier-Stokes (PNS) equations for the flow field along with an appropriate sonic boom evaluation procedure thus introducing both aerodynamic performance as well as sonic boom as the design objectives to be optimized simultaneously. Sensitivity analysis is performed using a discrete differentiation approach. An approximation technique has been used within the optimizer to improve the overall computational efficiency of the procedure in order to make it suitable for design applications in an industrial setting.

The 6-year attendance of a multidisciplinary prostate cancer clinic in Italy: incidence of management changes.

PubMed

Magnani, Tiziana; Valdagni, Riccardo; Salvioni, Roberto; Villa, Sergio; Bellardita, Lara; Donegani, Simona; Nicolai, Nicola; Procopio, Giuseppe; Bedini, Nice; Rancati, Tiziana; Zaffaroni, Nadia

2012-10-01

Study Type - Therapy (decision analysis) Level of Evidence 2b. What's known on the subject? and What does the study add? The benefits of the multidisciplinary approach in oncology are widely recognised. In particular, managing patients with prostate cancer within a multidisciplinarity and multiprofessional context is of paramount importance, to address the complexity of a disease where patients may be offered multiple therapeutic and observational options handled by different specialists and having severe therapy-induced side-effects. The present study describes the establishing of a multidisciplinary clinic at the Prostate Cancer Programme of Milan Istituto Nazionale dei Tumori, its effects on the quality of care provided, and strategies implemented to meet upcoming needs and improve quality standards. Having analysed the data of the 2260 multidisciplinary clinics held from March 2005 to March 2011, our dynamic and modifiable organisational model was evaluated for ways to optimise the human resources, offer high-quality standards, meet new needs and ultimately reduce costs. The study is focused on the organisational aspects and adds a perspective from one of the major oncological centres of reference in Italy and in Europe. To describe the establishing of a multidisciplinary clinic for men with prostate cancer at the Istituto Nazionale Tumori, Milan. • To evaluate the quality of care provided and to describe the management changes implemented to improve standards and meet new needs. In March 2005, we established a multidisciplinary clinic comprising weekly clinics and case-discussion sessions. • We have altered the organisational model periodically to meet new needs and improve quality. We held 2260 multidisciplinary clinics up to March 2011. • For stage distribution, patients with low-risk prostate cancer increased to a peak of 61% in 2009, probably because of the anticipation of diagnosis and the active surveillance expertise of the Prostate Cancer Programme at Istituto Nazionale Tumori, Milan. The slight decrease in 2010 might be due to the availability of robot-assisted prostatectomy in several hospitals in Milan, and the start of a multicentre active surveillance protocol in December 2009. • In terms of the efficacy of our multidisciplinary strategy, 11% of drug therapies (mostly hormones) prescribed outside our institute were terminated in the multidisciplinary clinic, and 6% of indications formulated in the multidisciplinary clinics were altered during the case-discussion sessions. The multidisciplinary approach needs to be adaptable to meet new needs and improve quality. • Our experience has proved successful for both physicians and patients. The team agrees on strategies; complex cases are managed by a multidisciplinary team; dedicated psychologists contribute their knowledge and perspectives; and patients report the feeling of being cared for. © 2012 BJU INTERNATIONAL.

Facilitating Open-Ended Problem Solving: Training Engineering TAs To Facilitate Open-Ended Problem Solving.

ERIC Educational Resources Information Center

Streveler, Ruth A.; King, Robert H.

2000-01-01

Describes and evaluates a four-session training program for Multidisciplinary Engineering Laboratory (MEL) teaching assistants at the Colorado School of Mines. The sessions focus attention on student development approaches to learning. (EV)

A methodology towards virtualisation-based high performance simulation platform supporting multidisciplinary design of complex products

NASA Astrophysics Data System (ADS)

Ren, Lei; Zhang, Lin; Tao, Fei; (Luke) Zhang, Xiaolong; Luo, Yongliang; Zhang, Yabin

2012-08-01

Multidisciplinary design of complex products leads to an increasing demand for high performance simulation (HPS) platforms. One great challenge is how to achieve high efficient utilisation of large-scale simulation resources in distributed and heterogeneous environments. This article reports a virtualisation-based methodology to realise a HPS platform. This research is driven by the issues concerning large-scale simulation resources deployment and complex simulation environment construction, efficient and transparent utilisation of fine-grained simulation resources and high reliable simulation with fault tolerance. A framework of virtualisation-based simulation platform (VSIM) is first proposed. Then the article investigates and discusses key approaches in VSIM, including simulation resources modelling, a method to automatically deploying simulation resources for dynamic construction of system environment, and a live migration mechanism in case of faults in run-time simulation. Furthermore, the proposed methodology is applied to a multidisciplinary design system for aircraft virtual prototyping and some experiments are conducted. The experimental results show that the proposed methodology can (1) significantly improve the utilisation of fine-grained simulation resources, (2) result in a great reduction in deployment time and an increased flexibility for simulation environment construction and (3)achieve fault tolerant simulation.

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

PubMed

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

2013-01-01

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

The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.

PubMed

Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

2017-01-01

Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.

Management of venous ulcers: State of the art.

PubMed

Marola, Silvia; Ferrarese, Alessia; Solej, Mario; Enrico, Stefano; Nano, Mario; Martino, Valter

2016-09-01

Venous ulceration is a complex and serious problem that affects 1-2% of the global elderly population (>65 years), and its incidence is constantly increasing. The population group with higher risk of development of venous ulceration is the elderly. These lesions have a significant negative impact on patients' quality of life. Our aim was to analyze the state of the art, starting with the medical literature review. The evidence supports that managing chronic wounds with a multidisciplinary wound care team significantly increases wound healing and reduces the severity of wound-associated pain and the required daily wound treatments compared with persons who are not managed by such a team. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. 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.

Occupational therapy in India: focus on functional recovery and need for empowerment

PubMed Central

Samuel, Reema; Jacob, K. S.

2017-01-01

While there have been significant advances in treatments for mental disorders over the past century, cure for many mental disorders remains elusive. The complex problems of mental illness require a multi-sectoral, multi-disciplinary and multi-dimensional approach to care. The need for focus on biopsychosocial model rather than on biomedical practise, client-centred rather than physician-oriented care, personal rather than clinical recovery, are often preached but rarely practiced. The lack of emphasis on functioning and the limited workforce and evidence base complicate issues related to the care of people with chronic mental illness in India. The role of occupational therapy in bridging the gap between symptomatic improvement and functional recovery is discussed. PMID:28827877

Severe psychosocial compromise in idiopathic trigeminal neuralgia: case report.

PubMed

Siqueira, Silvia R D T; Teixeira, Manoel J; de Siqueira, José T T

2010-03-01

This article describes a 60-year-old man with 17 years of idiopathic trigeminal neuralgia (ITN) which affected tooth brushing for 6 years, causing severe dental complications and psychosocial problems. Case report. Following ITN diagnosis, this patient underwent neurosurgery (microcompression of the trigeminal ganglion with a balloon) with immediate relief, but after three months, pain recurred and was accompanied by dysesthesia and periodontal disease. After dental treatment, he had complete alleviation of pain and no further need of medication over the following 3 years. The intense suffering of this patient represents the importance of a multidisciplinary evaluation for pain-caused secondary complications. ITN is a simple diagnosis but may have complex course. Appropriately trained health professionals are necessary to evaluate and treat these patients.

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.

Active Control of F/A-18 Vertical Tail Buffeting using Piezoelectric Actuators

NASA Technical Reports Server (NTRS)

Sheta, Essam F.; Moses, Robert W.; Huttsell, Lawerence J.; Harrand, Vincent J.

2003-01-01

Vertical tail buffeting is a serious multidisciplinary problem that limits the performance of twin-tail fighter aircraft. The buffet problem occurs at high angles of attack when the vortical flow breaks down ahead of the vertical tails resulting in unsteady and unbalanced pressure loads on the vertical tails. This paper describes a multidisciplinary computational investigation for buffet load alleviation of full F/A-18 aircraft using distributed piezoelectric actuators. The inboard and outboard surfaces of the vertical tail are equipped with piezoelectric actuators to control the buffet responses in the first bending and torsion modes. The electrodynamics of the smart structure are expressed with a three-dimensional finite element model. A single-input-single-output controller is designed to drive the active piezoelectric actuators. High-fidelity multidisciplinary analysis modules for the fluid dynamics, structure dynamics, electrodynamics of the piezoelectric actuators, fluid-structure interfacing, and grid motion are integrated into a multidisciplinary computing environment that controls the temporal synchronization of the analysis modules. Peak values of the power spectral density of tail tip acceleration are reduced by as much as 22% in the first bending mode and by as much as 82% in the first torsion mode. RMS values of tip acceleration are reduced by as much as 12%.

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.

The Human Sciences Program and the Future.

ERIC Educational Resources Information Center

Carter, Jack L.

1982-01-01

Discusses the interdisciplinary/multidisciplinary nature of the BSCS Human Sciences Program and problems associated with the development, dissemination, and use of such curricula. Poses a series of questions related to these problems and discusses influences of single-issues pressure groups on science teaching. (JN)

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

Multi-disciplinary decision making in general practice.

PubMed

Kirby, Ann; Murphy, Aileen; Bradley, Colin

2018-04-09

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

[Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness].

PubMed

Sakalauskiene, Giedre

2009-01-01

Low back pain is a global worldwide problem. A great attention is given to correction of this health status by a wide range of rehabilitation specialists. Some single or integrated physical factors, physiotherapy, specific and nonspecific physical exercises, alternative methods of treatment, also the complex of multidisciplinary rehabilitation means are applied in the management of low back pain. The evidence-based data are analyzed in order to identify which nonpharmacological means are effective in pain correction; in addition, the effectiveness of various methods and models of low back pain management are compared in this article. Research data evaluating the impact effectiveness of single or integrated means of rehabilitation are very controversial. There are no evidence-based specific recommendations for the correction of this health status objectively assessing advantages of physiotherapy or physical factors and referring the definite indications of their prescription. It is thought that multidisciplinary rehabilitation is most effective in management of chronic low back pain. The positive results depend on the experience of a physician and other rehabilitation specialists. A patient's motivation to participate in the process of pain control is very important. It is recommended to inform a patient about the effectiveness of administered methods. There is a lack of evidence-based trials evaluating the effectiveness of nonpharmacological methods of pain control in Lithuania. Therefore, the greater attention of researchers and administrative structures of health care should be given to this problem in order to develop the evidence-based guidelines for an effective correction of low back pain.

A case for safety leadership team training of hospital managers.

PubMed

Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S

2011-01-01

Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.

Rehabilitation after traumatic brain injury.

PubMed

Barnes, M P

1999-01-01

Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabilitation and emphasises the importance of valid and reliable outcome measures. The evidence of the efficacy of a rehabilitation programme is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive technology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellectual, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative stage and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.

Second Quarter Report Environmental Biosciences Program

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

Lawrence C. Mohr, M.D.

2002-10-31

In May 2002, the United States Department of Energy (DOE) signed Assistance Instrument Number DE-FC09-02CH11109 with the Medical University of South Carolina (MUSC) to support the Environmental Biosciences Program (EBP). This funding instrument replaces DOE Assistance Instrument Number DE-FC02-98CH10902. EBP is an integrated, multidisciplinary scientific program, employing a range of research initiatives to identify, study and resolve environmental health risk issues. These initiatives are consistent with the Medical University's role as a comprehensive state-supported health sciences institution and the nation's need for new and better approaches to the solution of a complex and expansive array of environment-related health problems. Themore » intrinsic capabilities of a comprehensive health sciences institution enable the Medical University to be a national resource for the scientific investigation of environmental health issues. EBP's success in convening worldwide scientific expertise is due in part to the inherent credibility the Medical University brings to the process of addressing these complex issues.« less

Environmental Biosciences Program Third Quarter Report

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

Lawrence C. Mohr, M.D.

2003-01-31

In May 2002, the United States Department of Energy (DOE) signed Assistance Instrument Number DE-FC09-02CH11109 with the Medical University of South Carolina (MUSC) to support the Environmental Biosciences Program (EBP). This funding instrument replaces DOE Assistance Instrument Number DE-FC02-98CH10902. EBP is an integrated, multidisciplinary scientific program, employing a range of research initiatives to identify, study and resolve environmental health risk issues. These initiatives are consistent with the Medical University's role as a comprehensive state-supported health sciences institution and the nation's need for new and better approaches to the solution of a complex and expansive array of environment-related health problems. Themore » intrinsic capabilities of a comprehensive health sciences institution enable the Medical University to be a national resource for the scientific investigation of environmental health issues. EBP's success in convening worldwide scientific expertise is due in part to the inherent credibility the Medical University brings to the process of addressing these complex issues.« less

MUSC Environmental Biosciences Program First Quarter Report May - June, 2002

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

Lawrence C. Mohr

2002-07-31

In May 2002, the United States Department of Energy (DOE) signed Assistance Instrument Number DE-FC02-98CH11109 with the Medical University of South Carolina (MUSC) to support the Environmental Biosciences Program (EBP). This funding instrument replaces DOE Assistance Instrument Number DE-FC02-98CH10902. EBP is an integrated, multidisciplinary scientific program, employing a range of research initiatives to identify, study and resolve environmental health risk issues. These initiatives are consistent with the Medical University's role as a comprehensive state-supported health sciences institution and the nation's need for new and better approaches to the solution of a complex and expansive array of environment-related health problems. Themore » intrinsic capabilities of a comprehensive health sciences institution enable the Medical University to be a national resource for the scientific investigation of environmental health issues. EBP's success in convening worldwide scientific expertise is due in part to the inherent credibility the Medical University brings to the process of addressing these complex issues.« less

Using Systems Thinking to train future leaders in global health.

PubMed

Paxton, Anne; Frost, Laura J

2017-07-09

Systems Thinking provides a useful set of concepts and tools that can be used to train students to be effective and innovative global health leaders in an ever-changing and often chaotic world. This paper describes an experiential, multi-disciplinary curriculum that uses Systems Thinking to frame and analyse global health policies and practices. The curriculum uses case studies and hands-on activities to deepen students' understanding of the following concepts: complex adaptive systems, dynamic complexity, inter-relationships, feedback loops, policy resistance, mental models, boundary critique, leverage points, and multi-disciplinary, multi-sectoral, and multi-stakeholder thinking and action. A sample of Systems Thinking tools for analysing global health policies and practices are also introduced.

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.

Healthy soils healthy people: Unraveling the complexity

USDA-ARS?s Scientific Manuscript database

The linkage between soil and human health is undoubtedly a complex and multidisciplinary issue. The recognition that soil can influence human health is not a novelty; it has been recognized scientifically for decades. However, the advancement in understanding soil health/quality has renewed interest...

Comparative Properties of Collaborative Optimization and Other Approaches to MDO

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

1999-01-01

We, discuss criteria by which one can classify, analyze, and evaluate approaches to solving multidisciplinary design optimization (MDO) problems. Central to our discussion is the often overlooked distinction between questions of formulating MDO problems and solving the resulting computational problem. We illustrate our general remarks by comparing several approaches to MDO that have been proposed.

Comparative Properties of Collaborative Optimization and other Approaches to MDO

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

1999-01-01

We discuss criteria by which one can classify, analyze, and evaluate approaches to solving multidisciplinary design optimization (MDO) problems. Central to our discussion is the often overlooked distinction between questions of formulating MDO problems and solving the resulting computational problem. We illustrate our general remarks by comparing several approaches to MDO that have been proposed.

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

PubMed

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

2012-01-01

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

A Multidisciplinary Approach to a Pediatric Difficult Airway Simulation Course.

PubMed

Lind, Meredith Merz; Corridore, Marco; Sheehan, Cameron; Moore-Clingenpeel, Melissa; Maa, Tensing

2018-02-01

Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork. Participants completed pre- and postworkshop questionnaires. Results Thirty-nine trainees participated over the 3-year study period. Compared with their precourse responses, participants' postcourse responses indicated either agreement or strong agreement that the multidisciplinary format (1) helped in the development of team communication skills and (2) was preferred over single-discipline training. Improvement in confidence in managing critical airway situations and in advanced airway management skills was significant ( P < .05). Eighty-one percent of participants had improved confidence in following the hospital's critical airway protocol, and 64% were better able to locate advanced airway management equipment. Discussion Multiple subspecialists manage pediatric respiratory failure, where successful care requires complex handoffs and teamwork. Multidisciplinary education to teach advanced airway management, teamwork, and communication skills is practical and preferred by learners and is possible to achieve despite differences in experience. Future study is required to better understand the impact of this course on patient care outcomes. Implications for Practice Implementation of a pediatric difficult airway course through simulation-based team training is feasible and preferred by learners among multiple disciplines. A multidisciplinary approach exposes previously unrecognized knowledge gaps and allows for better communication and collaboration among the fields.

Heuristic decomposition for non-hierarchic systems

NASA Technical Reports Server (NTRS)

Bloebaum, Christina L.; Hajela, P.

1991-01-01

Design and optimization is substantially more complex in multidisciplinary and large-scale engineering applications due to the existing inherently coupled interactions. The paper introduces a quasi-procedural methodology for multidisciplinary optimization that is applicable for nonhierarchic systems. The necessary decision-making support for the design process is provided by means of an embedded expert systems capability. The method employs a decomposition approach whose modularity allows for implementation of specialized methods for analysis and optimization within disciplines.

Leadership, governance and partnerships are essential One Health competencies.

PubMed

Stephen, Craig; Stemshorn, Barry

2016-12-01

One Health is held as an approach to solve health problems in this era of complexity and globalization, but inadequate attention has been paid to the competencies required to build successful teams and programs. Most of the discussion on developing One Health teams focuses on creating cross-disciplinary awareness and technical skills. There is, however, evidence that collaborative, multi-disciplinary teams need skills, processes and institutions that enable policy and operations to be co-managed and co-delivered across jurisdictions. We propose that competencies in leadership and human resources; governance and infrastructure; and partnership and stakeholder engagement are essential, but often overlooked One Health attributes. Competencies in these staple attributes of leadership and management need to be more prominent in training and One Health capacity development. Although One Health has been in existence for over a decade, there has been no systematic evaluation of the essential attributes of successful and sustainable One Health programs. As such, much of this paper borrows from experience in other sectors dealing with complex, cross and inter-sectoral problems. Our objective is to advocate for increased investment in One Health leadership, governance and partnership skills to balance the focus on creating cross-disciplinary awareness and technical proficiency in order to maintain One Health as a viable approach to health issues at the human-animal-environment interface.

2014 Future Earth Young Scientists Conference on Integrated Science and Knowledge Co-Production for Ecosystems and Human Well-Being †

PubMed Central

Shiue, Ivy; Samberg, Leah; Kulohoma, Benard; Dogaru, Diana; Wyborn, Carina; Hamel, Perrine; Jørgensen, Peter Søgaard; Lussier, Paul; Sundaram, Bharath; Lim, Michelle; Tironi, Antonio

2014-01-01

Effective integration in science and knowledge co-production is a challenge that crosses research boundaries, climate regions, languages and cultures. Early career scientists are crucial in the identification of, and engagement with, obstacles and opportunities in the development of innovative solutions to complex and interconnected problems. On 25–31 May 2014, International Council for Science and International Social Science Council, in collaboration with the International Network of Next-Generation Ecologists and Institute for New Economic Thinking: Young Scholars Initiative, assembled a group of early career researchers with diverse backgrounds and research perspectives to reflect on and debate relevant issues around ecosystems and human wellbeing in the transition towards green economy, funded by the German Research Foundation, at Villa Vigoni, Italy. As a group of young scientists, we have come to a consensus that collaboration and communication among a diverse group of peers from different geographic regions could break down the barriers to multi-disciplinary research designed to solve complex global-scale problems. We also propose to establish a global systematic thinking to monitor global socio-ecological systems and to develop criteria for a “good” anthropocene. Finally, we aim to bridge gaps among research, the media, and education from a governance perspective linking with “sustainable development goals”. PMID:25390795

Distributed Parallel Processing and Dynamic Load Balancing Techniques for Multidisciplinary High Speed Aircraft Design

NASA Technical Reports Server (NTRS)

Krasteva, Denitza T.

1998-01-01

Multidisciplinary design optimization (MDO) for large-scale engineering problems poses many challenges (e.g., the design of an efficient concurrent paradigm for global optimization based on disciplinary analyses, expensive computations over vast data sets, etc.) This work focuses on the application of distributed schemes for massively parallel architectures to MDO problems, as a tool for reducing computation time and solving larger problems. The specific problem considered here is configuration optimization of a high speed civil transport (HSCT), and the efficient parallelization of the embedded paradigm for reasonable design space identification. Two distributed dynamic load balancing techniques (random polling and global round robin with message combining) and two necessary termination detection schemes (global task count and token passing) were implemented and evaluated in terms of effectiveness and scalability to large problem sizes and a thousand processors. The effect of certain parameters on execution time was also inspected. Empirical results demonstrated stable performance and effectiveness for all schemes, and the parametric study showed that the selected algorithmic parameters have a negligible effect on performance.

Evaluation of Methods for Multidisciplinary Design Optimization (MDO). Part 2

NASA Technical Reports Server (NTRS)

Kodiyalam, Srinivas; Yuan, Charles; Sobieski, Jaroslaw (Technical Monitor)

2000-01-01

A new MDO method, BLISS, and two different variants of the method, BLISS/RS and BLISS/S, have been implemented using iSIGHT's scripting language and evaluated in this report on multidisciplinary problems. All of these methods are based on decomposing a modular system optimization system into several subtasks optimization, that may be executed concurrently, and the system optimization that coordinates the subtasks optimization. The BLISS method and its variants are well suited for exploiting the concurrent processing capabilities in a multiprocessor machine. Several steps, including the local sensitivity analysis, local optimization, response surfaces construction and updates are all ideally suited for concurrent processing. Needless to mention, such algorithms that can effectively exploit the concurrent processing capabilities of the compute servers will be a key requirement for solving large-scale industrial design problems, such as the automotive vehicle problem detailed in Section 3.4.

OpenMDAO: Framework for Flexible Multidisciplinary Design, Analysis and Optimization Methods

NASA Technical Reports Server (NTRS)

Heath, Christopher M.; Gray, Justin S.

2012-01-01

The OpenMDAO project is underway at NASA to develop a framework which simplifies the implementation of state-of-the-art tools and methods for multidisciplinary design, analysis and optimization. Foremost, OpenMDAO has been designed to handle variable problem formulations, encourage reconfigurability, and promote model reuse. This work demonstrates the concept of iteration hierarchies in OpenMDAO to achieve a flexible environment for supporting advanced optimization methods which include adaptive sampling and surrogate modeling techniques. In this effort, two efficient global optimization methods were applied to solve a constrained, single-objective and constrained, multiobjective version of a joint aircraft/engine sizing problem. The aircraft model, NASA's nextgeneration advanced single-aisle civil transport, is being studied as part of the Subsonic Fixed Wing project to help meet simultaneous program goals for reduced fuel burn, emissions, and noise. This analysis serves as a realistic test problem to demonstrate the flexibility and reconfigurability offered by OpenMDAO.

Emerging Challenges and Opportunities for Education and Research in Weed Science

PubMed Central

Chauhan, Bhagirath S.; Matloob, Amar; Mahajan, Gulshan; Aslam, Farhena; Florentine, Singarayer K.; Jha, Prashant

2017-01-01

In modern agriculture, with more emphasis on high input systems, weed problems are likely to increase and become more complex. With heightened awareness of adverse effects of herbicide residues on human health and environment and the evolution of herbicide-resistant weed biotypes, a significant focus within weed science has now shifted to the development of eco-friendly technologies with reduced reliance on herbicides. Further, with the large-scale adoption of herbicide-resistant crops, and uncertain climatic optima under climate change, the problems for weed science have become multi-faceted. To handle these complex weed problems, a holistic line of action with multi-disciplinary approaches is required, including adjustments to technology, management practices, and legislation. Improved knowledge of weed ecology, biology, genetics, and molecular biology is essential for developing sustainable weed control practices. Additionally, judicious use of advanced technologies, such as site-specific weed management systems and decision support modeling, will play a significant role in reducing costs associated with weed control. Further, effective linkages between farmers and weed researchers will be necessary to facilitate the adoption of technological developments. To meet these challenges, priorities in research need to be determined and the education system for weed science needs to be reoriented. In respect of the latter imperative, closer collaboration between weed scientists and other disciplines can help in defining and solving the complex weed management challenges of the 21st century. This consensus will provide more versatile and diverse approaches to innovative teaching and training practices, which will be needed to prepare future weed science graduates who are capable of handling the anticipated challenges of weed science facing in contemporary agriculture. To build this capacity, mobilizing additional funding for both weed research and weed management education is essential. PMID:28928765

Emerging Challenges and Opportunities for Education and Research in Weed Science.

PubMed

Chauhan, Bhagirath S; Matloob, Amar; Mahajan, Gulshan; Aslam, Farhena; Florentine, Singarayer K; Jha, Prashant

2017-01-01

In modern agriculture, with more emphasis on high input systems, weed problems are likely to increase and become more complex. With heightened awareness of adverse effects of herbicide residues on human health and environment and the evolution of herbicide-resistant weed biotypes, a significant focus within weed science has now shifted to the development of eco-friendly technologies with reduced reliance on herbicides. Further, with the large-scale adoption of herbicide-resistant crops, and uncertain climatic optima under climate change, the problems for weed science have become multi-faceted. To handle these complex weed problems, a holistic line of action with multi-disciplinary approaches is required, including adjustments to technology, management practices, and legislation. Improved knowledge of weed ecology, biology, genetics, and molecular biology is essential for developing sustainable weed control practices. Additionally, judicious use of advanced technologies, such as site-specific weed management systems and decision support modeling, will play a significant role in reducing costs associated with weed control. Further, effective linkages between farmers and weed researchers will be necessary to facilitate the adoption of technological developments. To meet these challenges, priorities in research need to be determined and the education system for weed science needs to be reoriented. In respect of the latter imperative, closer collaboration between weed scientists and other disciplines can help in defining and solving the complex weed management challenges of the 21st century. This consensus will provide more versatile and diverse approaches to innovative teaching and training practices, which will be needed to prepare future weed science graduates who are capable of handling the anticipated challenges of weed science facing in contemporary agriculture. To build this capacity, mobilizing additional funding for both weed research and weed management education is essential.

Down Syndrome Health Screening--The Fife Model

ERIC Educational Resources Information Center

Jones, Jill; Hathaway, Dorothy; Gilhooley, Mary; Leech, Amanda; MacLeod, Susan

2010-01-01

People with Down syndrome have a greater risk of developing a range of health problems, including cardiac problems, thyroid disorders, sensory impairments, reduced muscle tone (hypotonia) and Alzheimer's disease. Despite this increased risk, regular screening is not typically offered to individuals with Down syndrome. A multidisciplinary health…

A Multidisciplinary Approach to Dental Erosion: A Case Report

PubMed Central

Guldag, M. Ustun; Buyukkaplan, U. Sebnem; Ay, Zuhal Yetkin; Katirci, Gunseli

2008-01-01

Chemical erosion is the loss of superficial tooth structure by chemical action in the continued presence of demineralizing agents. This can be prominent in patients with oral habits such as constant citrus ingestion (like lemon chewing), chlorinated swimming pool water or gastrointestinal problems that produce repeated exposure of teeth to gastric acids. In this case report, a multidisciplinary approach to restore the severe wear due to dental erosion by proper techniques and materials was presented. PMID:19212520

[Multidisciplinary approach in public health research. The example of accidents and safety at work].

PubMed

Lert, F; Thebaud, A; Dassa, S; Goldberg, M

1982-01-01

This article critically analyses the various scientific approaches taken to industrial accidents, particularly in epidemiology, ergonomie and sociology, by attempting to outline the epistemological limitations in each respective field. An occupational accident is by its very nature not only a physical injury but also an economic, social and legal phenomenon, which more so than illness, enables us to examine the problems posed by the need for a multidisciplinary approach in Public Health research.

[Application of digital design of orthodontic-prosthodontic multidisciplinary treatment plan in esthetic rehabilitation of anterior teeth].

PubMed

Liu, Y S; Li, Z; Zhao, Y J; Ye, H Q; Zhou, Y Q; Hu, W J; Liu, Y S; Xun, C L; Zhou, Y S

2018-02-18

To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. The medians of scores of DP treatment plan and OP treatment plan were calculated and analyzed by IBM SPSS 20. The median of scores of DP treatment plan was 8.4, the minimum value was 6.9 and the maximum value was 9.3. The median of scores of OP treatment plan was 9.0, the minimum value was 7.9 and the maximum value was 9.6. The median of scores of OP was significantly higher than that of DP (Z=-3.23, P<0.01). Finally, 12 patients chose OP treatment plans and 8 patients chose DP treatment plans. For cases with complex esthetic problems in anterior teeth, a digital workflow can demonstrate final treatment outcome and help patients make suitable treatment decisions. In our study, the orthodontic-prosthodontic multidisciplinary treatment plan is feasible which can provide predictions of treatment outcome and improve esthetic outcome with patients' satisfaction.

Palliative care consultation, quality-of-life measurements, and bereavement for end-of-life care in patients with lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition).

PubMed

Griffin, John P; Koch, Kathryn A; Nelson, Judith E; Cooley, Mary E

2007-09-01

To develop clinical practice guidelines for application of palliative care consultation, quality-of-life measurements, and appropriate bereavement activities for patients with lung cancer. To review the pertinent medical literature on palliative care consultation, quality-of-life measurements, and bereavement for patients with lung cancer, developing multidisciplinary discussions with authorities in these areas, and evolving written guidelines for end-of-life care of these patients. Palliative care consultation has developed into a new specialty with credentialing of experts in this field based on extensive experience with patients in end-of-life circumstances including those with lung cancer. Bereavement studies of the physical and emotional morbidity of family members and caregivers before, during, and after the death of a cancer patient have supported truthful communication, consideration of psychological problems, effective palliative care, understanding of the patient's spiritual and cultural background, and sufficient forewarning of impending death. Multidisciplinary investigations and experiences, with emphasis on consultation and delivery of palliative care, timely use of quality-of-life measurements for morbidities of treatment modalities and prognosis, and an understanding of the multifaceted complexities of the bereavement process, have clarified additional responsibilities of the attending physician.

Healthcare professionals' agreement on clinical relevance of drug-related problems among elderly patients.

PubMed

Bech, Christine Flagstad; Frederiksen, Tine; Villesen, Christine Tilsted; Højsted, Jette; Nielsen, Per Rotbøll; Kjeldsen, Lene Juel; Nørgaard, Lotte Stig; Christrup, Lona Louring

2018-02-01

Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems' clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss' κ. Main outcome measure Healthcare professionals' agreement on clinical relevance of drug related problems, using Fleiss' κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0-2) and 46% of higher clinical relevance (level 3-4). Only slight agreement (κ = 0.12) was found between the panellists' classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.

Critical issues in NASA information systems

NASA Technical Reports Server (NTRS)

1987-01-01

The National Aeronautics and Space Administration has developed a globally-distributed complex of earth resources data bases since LANDSAT 1 was launched in 1972. NASA envisages considerable growth in the number, extent, and complexity of such data bases, due to the improvements expected in its remote sensing data rates, and the increasingly multidisciplinary nature of its scientific investigations. Work already has begun on information systems to support multidisciplinary research activities based on data acquired by the space station complex and other space-based and terrestrial sources. In response to a request from NASA's former Associate Administrator for Space Science and Applications, the National Research Council convened a committee in June 1985 to identify the critical issues involving information systems support to space science and applications. The committee has suggested that OSSA address four major information systems issues; centralization of management functions, interoperability of user involvement in the planning and implementation of its programs, and technology.

Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

NASA Technical Reports Server (NTRS)

Lung, Shun-fat; Pak, Chan-gi

2008-01-01

Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization (MDAO) tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

NASA Technical Reports Server (NTRS)

Lung, Shun-fat; Pak, Chan-gi

2008-01-01

Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization [MDAO] tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

The multidisciplinary treatment plan: a format for enhancing activity therapy department involvement.

PubMed

Lang, E; Mattson, M

1985-01-01

A structured, goal-oriented format for enhancing the involvement of activity therapy disciplines in the multidisciplinary treatment planning process has been developed in a large private psychiatric teaching hospital. The format, an adaptation of the problem-oriented record, encompasses formal procedures for identifying and recording relevant problems, goals, methods, and objectives for activity therapy treatment. The benefits of this approach include the development of specific, measurable, attainable functional goals; increased accountability in treatment planning and delivery; less time spent in documentation; and education of other staff about the role and function of activities therapy. Patients have a better understanding of their goals and the steps needed to achieve them and show increased participation in the therapy process.

Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

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

Wise, H F; Smith, L K; Einsweiler, R C

This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protectionmore » Agency, and National Science Foundation. (PSB)« less

Medico-legal investigations of the Airbus, A320 crash upon Mount Ste-Odile, France.

PubMed

Ludes, B; Tracqui, A; Pfitzinger, H; Kintz, P; Levy, F; Disteldorf, M; Hutt, J M; Kaess, B; Haag, R; Memheld, B

1994-09-01

The authors present the medico-legal investigations and identification after the aircrash of the Airbus A320 upon the Mount Sainte-Odile (France). The identification team comprising investigators from the gendarmerie, forensic pathologists, odontologists, and scientists of the Institute from Legal Medecine rapidly retrieved and identified 85 of the 87 victims, with 17 being identified through DNA typing, three through fingerprints and the remaining through dental records and specific physical or X-ray findings. Full autopsies were performed on all fatalities to determine patterns of injury and cause of death. Results lead us to point out the importance of a multidisciplinary team of forensic practitioners especially trained for managing medico-legal investigation in mass disaster and the ability of DNA technology to solve complex identification problems.

[The role of multidisciplinary tumor board discussions in treatment decisions].

PubMed

Jerusalem, G; Coucke, P

2011-01-01

The diagnosis and treatment of cancer is complex. Multidisciplinary tumor board discussions optimise the care of patients suffering from cancer. The most promising and rational treatment is chosen taking into account the opinion from all participants. Quality of life is important if only a palliative approach can be offered. The final decision concerning the treatment will be taken by the patient because he/she has the right to refuse the best treatment for personal reasons.

Geoinformatics: Transforming data to knowledge for geosciences

USGS Publications Warehouse

Sinha, A.K.; Malik, Z.; Rezgui, A.; Barnes, C.G.; Lin, K.; Heiken, G.; Thomas, W.A.; Gundersen, L.C.; Raskin, R.; Jackson, I.; Fox, P.; McGuinness, D.; Seber, D.; Zimmerman, H.

2010-01-01

An integrative view of Earth as a system, based on multidisciplinary data, has become one of the most compelling reasons for research and education in the geosciences. It is now necessary to establish a modern infrastructure that can support the transformation of data to knowledge. Such an information infrastructure for geosciences is contained within the emerging science of geoinformatics, which seeks to promote the utilizetion and integration of complex, multidisciplinary data in seeking solutions to geosciencebased societal challenges.

The correction of maxillary defciency with internal distraction devices: a multidisciplinary approach.

PubMed

Oz, A Alper; Ozer, Mete; Eroglu, Lütfi; Ozdemir, Oguz Suleyman

2013-09-01

The purpose of this case report is to present the orthodontic, surgical and restorative treatments in the case of an operated cleft lip and palate and severe maxillary defciency in a 14-year-old female patient. Only orthodontic treatment could be ineffcient for cleft lip and palate patients characterized with maxillary hypoplasia. Orthodontic and surgical treatment shows suffcient results, especially with severe skeletal defciency. A cleft lip and palate patient required complex multidisciplinary treatment to preserve health and restore esthetics. Dental leveling and alignment of the maxillary and mandibular teeth were provided before the surgery. Maxillary advancement and clockwise rotation of the maxillary-mandibular complex was applied by a Le Fort 1 osteotomy with two internal distraction devices. After the active treatment including orthodontic treatment and orthognathic surgery, upper full mouth ceramic restoration was applied. This report shows the efficiency of internal distraction devices in cleft lip palate patients and exemplifes the multidisciplinary care required for such diffcult cases. Clinical signifcance: Stable improved occlusion and skeletal relations were observed after a follow-up examination period of 12 months.

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

PubMed Central

Fox, Roy; Sampalli, Tara; Fox, Jonathan

2008-01-01

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

Reconfigurability in MDO Problem Synthesis. Part 1

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

2004-01-01

Integrating autonomous disciplines into a problem amenable to solution presents a major challenge in realistic multidisciplinary design optimization (MDO). We propose a linguistic approach to MDO problem description, formulation, and solution we call reconfigurable multidisciplinary synthesis (REMS). With assistance from computer science techniques, REMS comprises an abstract language and a collection of processes that provide a means for dynamic reasoning about MDO problems in a range of contexts. The approach may be summarized as follows. Description of disciplinary data according to the rules of a grammar, followed by lexical analysis and compilation, yields basic computational components that can be assembled into various MDO problem formulations and solution algorithms, including hybrid strategies, with relative ease. The ability to re-use the computational components is due to the special structure of the MDO problem. The range of contexts for reasoning about MDO spans tasks from error checking and derivative computation to formulation and reformulation of optimization problem statements. In highly structured contexts, reconfigurability can mean a straightforward transformation among problem formulations with a single operation. We hope that REMS will enable experimentation with a variety of problem formulations in research environments, assist in the assembly of MDO test problems, and serve as a pre-processor in computational frameworks in production environments. This paper, Part 1 of two companion papers, discusses the fundamentals of REMS. Part 2 illustrates the methodology in more detail.

Reconfigurability in MDO Problem Synthesis. Part 2

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

2004-01-01

Integrating autonomous disciplines into a problem amenable to solution presents a major challenge in realistic multidisciplinary design optimization (MDO). We propose a linguistic approach to MDO problem description, formulation, and solution we call reconfigurable multidisciplinary synthesis (REMS). With assistance from computer science techniques, REMS comprises an abstract language and a collection of processes that provide a means for dynamic reasoning about MDO problems in a range of contexts. The approach may be summarized as follows. Description of disciplinary data according to the rules of a grammar, followed by lexical analysis and compilation, yields basic computational components that can be assembled into various MDO problem formulations and solution algorithms, including hybrid strategies, with relative ease. The ability to re-use the computational components is due to the special structure of the MDO problem. The range of contexts for reasoning about MDO spans tasks from error checking and derivative computation to formulation and reformulation of optimization problem statements. In highly structured contexts, reconfigurability can mean a straightforward transformation among problem formulations with a single operation. We hope that REMS will enable experimentation with a variety of problem formulations in research environments, assist in the assembly of MDO test problems, and serve as a pre-processor in computational frameworks in production environments. Part 1 of two companion papers, discusses the fundamentals of REMS. This paper, Part 2 illustrates the methodology in more detail.

Ten-Year Research Update Review: Psychiatric Problems in Children with Epilepsy

ERIC Educational Resources Information Center

Plioplys, Sigita; Dunn, David W.; Caplan, Rochelle

2007-01-01

The research on epilepsy, a neuropsychiatric disorder characterized by seizures, psychopathology, cognitive, and linguistic problems among children in the age group of 0 to 18 years is reported. Early identification of children with epilepsy (CWE) and the development of multidisciplinary management strategies would advance relevant clinical…

Improving Children's Problem Eating and Mealtime Behaviours: An Evaluative Study of a Single Session Parent Education Programme

ERIC Educational Resources Information Center

Fraser, Kim; Wallis, Marianne; St. John, Winsome

2004-01-01

Objective: To evaluate the effectiveness of a "single session" group, early intervention, multidisciplinary, education programme (entitled the "Fun not Fuss with Food" group programme) designed to improve children's problem eating and mealtime behaviours. Design: A quasi-experimental time-series design incorporating data…

Provocative Opinion: Fads in Science Teaching

ERIC Educational Resources Information Center

Parry, R. W.

1975-01-01

Criticizes the post-Sputnik wave of multi-disciplinary science curricula aimed at teaching the students about social problems and how science can help solve these problems. Suggests that science teaching should concentrate more on the basics of a given discipline and should be taught be specialists rather than generalists. (MLH)

Recognizing Physical Disability as a Social Problem.

ERIC Educational Resources Information Center

Blake, Charles

Physical disability is an enormous psychosocio-economic-medical problem that affects over 24 million Americans. Public policy endorses a multi-disciplinary approach in analyzing this issue. Legislation has broadened the meaning of physical disability to include persons with mental and emotional disorders. Some of the costs associated with physical…

Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

PubMed

Dalla Paola, Luca

2013-12-01

Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. © 2013 The Author. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

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.

Multi-level systems modeling and optimization for novel aircraft

NASA Astrophysics Data System (ADS)

Subramanian, Shreyas Vathul

This research combines the disciplines of system-of-systems (SoS) modeling, platform-based design, optimization and evolving design spaces to achieve a novel capability for designing solutions to key aeronautical mission challenges. A central innovation in this approach is the confluence of multi-level modeling (from sub-systems to the aircraft system to aeronautical system-of-systems) in a way that coordinates the appropriate problem formulations at each level and enables parametric search in design libraries for solutions that satisfy level-specific objectives. The work here addresses the topic of SoS optimization and discusses problem formulation, solution strategy, the need for new algorithms that address special features of this problem type, and also demonstrates these concepts using two example application problems - a surveillance UAV swarm problem, and the design of noise optimal aircraft and approach procedures. This topic is critical since most new capabilities in aeronautics will be provided not just by a single air vehicle, but by aeronautical Systems of Systems (SoS). At the same time, many new aircraft concepts are pressing the boundaries of cyber-physical complexity through the myriad of dynamic and adaptive sub-systems that are rising up the TRL (Technology Readiness Level) scale. This compositional approach is envisioned to be active at three levels: validated sub-systems are integrated to form conceptual aircraft, which are further connected with others to perform a challenging mission capability at the SoS level. While these multiple levels represent layers of physical abstraction, each discipline is associated with tools of varying fidelity forming strata of 'analysis abstraction'. Further, the design (composition) will be guided by a suitable hierarchical complexity metric formulated for the management of complexity in both the problem (as part of the generative procedure and selection of fidelity level) and the product (i.e., is the mission best achieved via a large collection of interacting simple systems, or a relatively few highly capable, complex air vehicles). The vastly unexplored area of optimization in evolving design spaces will be studied and incorporated into the SoS optimization framework. We envision a framework that resembles a multi-level, mult-fidelity, multi-disciplinary assemblage of optimization problems. The challenge is not simply one of scaling up to a new level (the SoS), but recognizing that the aircraft sub-systems and the integrated vehicle are now intensely cyber-physical, with hardware and software components interacting in complex ways that give rise to new and improved capabilities. The work presented here is a step closer to modeling the information flow that exists in realistic SoS optimization problems between sub-contractors, contractors and the SoS architect.

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

PubMed

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

2011-12-01

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

Management of complex abdominal wall defects associated with penetrating abdominal trauma.

PubMed

Arul, G Suren; Sonka, B J; Lundy, J B; Rickard, R F; Jeffery, S L A

2015-03-01

The paradigm of Damage Control Surgery (DCS) has radically improved the management of abdominal trauma, but less well described are the options for managing the abdominal wall itself in an austere environment. This article describes a series of patients with complex abdominal wall problems managed at the UK-led Role 3 Medical Treatment Facility (MTF) in Camp Bastion, Afghanistan. Contemporaneous review of a series of patients with complex abdominal wall injuries who presented to the Role 3 MTF between July and November 2012. Five patients with penetrating abdominal trauma associated with significant damage to the abdominal wall were included. All patients were managed using DCS principles, leaving the abdominal wall open at the end of the first procedure. Subsequent management of the abdominal wall was determined by a multidisciplinary team of general and plastic surgeons, intensivists and specialist nurses. The principles of management identified included minimising tissue loss on initial laparotomy by joining adjacent wounds and marginal debridement of dead tissue; contraction of the abdominal wall was minimised by using topical negative pressure dressing and dermal-holding sutures. Definitive closure was timed to allow oedema to settle and sepsis to be controlled. Closure techniques include delayed primary closure with traction sutures, components separation, and mesh closure with skin grafting. A daily multidisciplinary team discussion was invaluable for optimal decision making regarding the most appropriate means of abdominal closure. Dermal-holding sutures were particularly useful in preventing myostatic contraction of the abdominal wall. A simple flow chart was developed to aid decision making in these patients. This flow chart may prove especially useful in a resource-limited environment in which returning months or years later for closure of a large ventral hernia may not be possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Applications of Parallel Process HiMAP for Large Scale Multidisciplinary Problems

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.; Potsdam, Mark; Rodriguez, David; Kwak, Dochay (Technical Monitor)

2000-01-01

HiMAP is a three level parallel middleware that can be interfaced to a large scale global design environment for code independent, multidisciplinary analysis using high fidelity equations. Aerospace technology needs are rapidly changing. Computational tools compatible with the requirements of national programs such as space transportation are needed. Conventional computation tools are inadequate for modern aerospace design needs. Advanced, modular computational tools are needed, such as those that incorporate the technology of massively parallel processors (MPP).

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.

Hereditary diffuse gastric cancer: how to look for and how to manage it.

PubMed

Polom, Karol; Marrelli, Daniele; D'Ignazio, Alessia; Roviello, Franco

2018-06-04

With a current molecular revolution, hereditary gastric cancer represents a small group of patients that require a special multidisciplinary treatment. Surgeons being a member of the multidisciplinary teams are an important part of the diagnosis, treatment and follow-up of these patients. The prophylactic nature of the gastrectomy with all different problems associated with this procedure need to be widely discussed with patients. We present a review of how to look for and how to manage a hereditary diffuse-type gastric cancer.

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.

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

Use of High Fidelity Methods in Multidisciplinary Optimization-A Preliminary Survey

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.; Kwak, Dochan (Technical Monitor)

2002-01-01

Multidisciplinary optimization is a key element of design process. To date multidiscipline optimization methods that use low fidelity methods are well advanced. Optimization methods based on simple linear aerodynamic equations and plate structural equations have been applied to complex aerospace configurations. However, use of high fidelity methods such as the Euler/ Navier-Stokes for fluids and 3-D (three dimensional) finite elements for structures has begun recently. As an activity of Multidiscipline Design Optimization Technical Committee (MDO TC) of AIAA (American Institute of Aeronautics and Astronautics), an effort was initiated to assess the status of the use of high fidelity methods in multidisciplinary optimization. Contributions were solicited through the members MDO TC committee. This paper provides a summary of that survey.

Halitosis: the multidisciplinary approach.

PubMed

Bollen, Curd M L; Beikler, Thomas

2012-06-01

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

Algorithmic Perspectives on Problem Formulations in MDO

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia M.; Lewis, Robert Michael

2000-01-01

This work is concerned with an approach to formulating the multidisciplinary optimization (MDO) problem that reflects an algorithmic perspective on MDO problem solution. The algorithmic perspective focuses on formulating the problem in light of the abilities and inabilities of optimization algorithms, so that the resulting nonlinear programming problem can be solved reliably and efficiently by conventional optimization techniques. We propose a modular approach to formulating MDO problems that takes advantage of the problem structure, maximizes the autonomy of implementation, and allows for multiple easily interchangeable problem statements to be used depending on the available resources and the characteristics of the application problem.

Scan to Bim for 3d Reconstruction of the Papal Basilica of Saint Francis in Assisi in Italy

NASA Astrophysics Data System (ADS)

Angelini, M. G.; Baiocchi, V.; Costantino, D.; Garzia, F.

2017-05-01

The historical building heritage, present in the most of Italian cities centres, is, as part of the construction sector, a working potential, but unfortunately it requires planning of more complex and problematic interventions. However, policies to support on the existing interventions, together with a growing sensitivity for the recovery of assets, determine the need to implement specific studies and to analyse the specific problems of each site. The purpose of this paper is to illustrate the methodology and the results obtained from integrated laser scanning activity in order to have precious architectural information useful not only from the cultural heritage point of view but also to construct more operative and powerful tools, such as BIM (Building Information Modelling) aimed to the management of this cultural heritage. The Papal Basilica and the Sacred Convent of Saint Francis in Assisi in Italy are, in fact, characterized by unique and complex peculiarities, which require a detailed knowledge of the sites themselves to ensure visitor's security and safety. For such a project, we have to take in account all the people and personnel normally present in the site, visitors with disabilities and finally the needs for cultural heritage preservation and protection. This aim can be reached using integrated systems and new technologies, such as Internet of Everything (IoE), capable of connecting people, things (smart sensors, devices and actuators; mobile terminals; wearable devices; etc.), data/information/knowledge and processes to reach the desired goals. The IoE system must implement and support an Integrated Multidisciplinary Model for Security and Safety Management (IMMSSM) for the specific context, using a multidisciplinary approach.

Phylogeographic, ancient DNA, fossil and morphometric analyses reveal ancient and modern introductions of a large mammal: the complex case of red deer (Cervus elaphus) in Ireland

NASA Astrophysics Data System (ADS)

Carden, Ruth F.; McDevitt, Allan D.; Zachos, Frank E.; Woodman, Peter C.; O'Toole, Peter; Rose, Hugh; Monaghan, Nigel T.; Campana, Michael G.; Bradley, Daniel G.; Edwards, Ceiridwen J.

2012-05-01

The problem of how and when the island of Ireland attained its contemporary fauna has remained a key question in understanding Quaternary faunal assemblages. We assessed the complex history and origins of the red deer (Cervus elaphus) in Ireland using a multi-disciplinary approach. Mitochondrial sequences of contemporary and ancient red deer (dating from c 30,000 to 1700 cal. yr BP) were compared to decipher possible source populations of red deer in Ireland, in addition to craniometric analyses of skulls from candidate regions to distinguish between different colonization scenarios. Radiocarbon dating was undertaken on all bone fragments that were previously undated. Finally, a comprehensive review of the scientific literature, unpublished reports and other sources of data were also searched for red deer remains within Irish palaeontological and archaeological contexts. Despite being present in Ireland prior to the Last Glacial Maximum (LGM), there is a notable scarcity of red deer from the Younger Dryas stadial period until the Neolithic. The presence of red deer in Irish archaeological sites then occurs more frequently relative to other species. One population in the southwest of Ireland (Co. Kerry) shared haplotypes with the ancient Irish specimens and molecular dating and craniometric analysis suggests its persistence in Ireland since the Neolithic period. The synthesis of the results from this multi-disciplinary study all indicate that red deer were introduced by humans during the Irish Neolithic period and that one of these populations persists today. In conjunction with recent results from other species, Neolithic people from Ireland's nearest landmass, Britain, played a vital role in establishing its contemporary fauna and flora.

A Multidisciplinary Approach to Learning Disability: Handbook for the Classroom Teacher.

ERIC Educational Resources Information Center

Newton, Jerry, Ed.

Designed to help teachers better understand the problems of learning disabled (LD) child, the manual explains the basic causes of LD and presents solutions to problems professionals face in working with this population. The manual contains the following chapters and authors: "The Teacher with a Learning Disabled Child," (P. Ackerman), "The…

Impact of developing a multidisciplinary coded dataset standard on administrative data accuracy for septoplasty, septorhinoplasty and nasal trauma surgery.

PubMed

Nouraei, S A R; Hudovsky, A; Virk, J S; Saleh, H A

2017-04-01

This study aimed to develop a multidisciplinary coded dataset standard for nasal surgery and to assess its impact on data accuracy. An audit of 528 patients undergoing septal and/or inferior turbinate surgery, rhinoplasty and/or septorhinoplasty, and nasal fracture surgery was undertaken. A total of 200 septoplasties, 109 septorhinoplasties, 57 complex septorhinoplasties and 116 nasal fractures were analysed. There were 76 (14.4 per cent) changes to the primary diagnosis. Septorhinoplasties were the most commonly amended procedures. The overall audit-related income change for nasal surgery was £8.78 per patient. Use of a multidisciplinary coded dataset standard revealed that nasal diagnoses were under-coded; a significant proportion of patients received more precise diagnoses following the audit. There was also significant under-coding of both morbidities and revision surgery. The multidisciplinary coded dataset standard approach can improve the accuracy of both data capture and information flow, and, thus, ultimately create a more reliable dataset for use outcomes and health planning.

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.

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.

Development of a Composite Tailoring Procedure for Airplane Wings

NASA Technical Reports Server (NTRS)

Chattopadhyay, Aditi

2000-01-01

The quest for finding optimum solutions to engineering problems has existed for a long time. In modern times, the development of optimization as a branch of applied mathematics is regarded to have originated in the works of Newton, Bernoulli and Euler. Venkayya has presented a historical perspective on optimization in [1]. The term 'optimization' is defined by Ashley [2] as a procedure "...which attempts to choose the variables in a design process so as formally to achieve the best value of some performance index while not violating any of the associated conditions or constraints". Ashley presented an extensive review of practical applications of optimization in the aeronautical field till about 1980 [2]. It was noted that there existed an enormous amount of published literature in the field of optimization, but its practical applications in industry were very limited. Over the past 15 years, though, optimization has been widely applied to address practical problems in aerospace design [3-5]. The design of high performance aerospace systems is a complex task. It involves the integration of several disciplines such as aerodynamics, structural analysis, dynamics, and aeroelasticity. The problem involves multiple objectives and constraints pertaining to the design criteria associated with each of these disciplines. Many important trade-offs exist between the parameters involved which are used to define the different disciplines. Therefore, the development of multidisciplinary design optimization (MDO) techniques, in which different disciplines and design parameters are coupled into a closed loop numerical procedure, seems appropriate to address such a complex problem. The importance of MDO in successful design of aerospace systems has been long recognized. Recent developments in this field have been surveyed by Sobieszczanski-Sobieski and Haftka [6].

Multidisciplinary workshops: learning to work together.

PubMed

Fatchett, Anita; Taylor, Dawn

2013-03-01

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

Multidisciplinary strategies in the management of early chronic kidney disease.

PubMed

Martínez-Ramírez, Héctor R; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Hernández-Herrera, Aurora; Cueto-Manzano, Alfonso M

2013-11-01

Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

How interdisciplinary teams can create multi-disciplinary education: the interplay between team processes and educational quality.

PubMed

Stalmeijer, Renee E; Gijselaers, Wim H; Wolfhagen, Ineke H A P; Harendza, Sigrid; Scherpbier, Albert J J A

2007-11-01

Many undergraduate medical education programmes offer integrated multi-disciplinary courses, which are generally developed by a team of teachers from different disciplines. Research has shown that multi-disciplinary teams may encounter problems, which can be detrimental to productive co-operation, which in turn may diminish educational quality. Because we expected that charting these problems might yield suggestions for addressing them, we examined the relationships between team diversity, team processes and course quality. We administered a questionnaire to participants from 21 interdisciplinary teams from 1 Dutch and 1 German medical school, both of which were reforming their curriculum. An adapted questionnaire on team learning behaviours, which had been validated in business contexts, was used to collect data on team processes, team learning behaviours and diversity within teams. We examined the relationship between the team factors and educational quality measures of the courses designed by the teams. A total of 84 teachers (60%) completed the questionnaire. Bivariate correlation analysis showed that several aspects of diversity, conflict, working climate and learning behaviour were correlated with course quality. The negative effects of the diversity measures, notably, value diversity, on other team processes and course quality and the positive association between psychological safety and team learning suggest that educational quality might be improved by enhancing the functioning of multi-disciplinary teams responsible for course development. The relationship between team processes and educational quality should be studied among larger study populations. Student ratings should also be considered in measuring educational quality.

A galactose-functionalized dendritic siRNA-nanovector to potentiate hepatitis C inhibition in liver cells

NASA Astrophysics Data System (ADS)

Lakshminarayanan, Abirami; Reddy, B. Uma; Raghav, Nallani; Ravi, Vijay Kumar; Kumar, Anuj; Maiti, Prabal K.; Sood, A. K.; Jayaraman, N.; Das, Saumitra

2015-10-01

A RNAi based antiviral strategy holds the promise to impede hepatitis C viral (HCV) infection overcoming the problem of emergence of drug resistant variants, usually encountered in the interferon free direct-acting antiviral therapy. Targeted delivery of siRNA helps minimize adverse `off-target' effects and maximize the efficacy of therapeutic response. Herein, we report the delivery of siRNA against the conserved 5'-untranslated region (UTR) of HCV RNA using a liver-targeted dendritic nano-vector functionalized with a galactopyranoside ligand (DG). Physico-chemical characterization revealed finer details of complexation of DG with siRNA, whereas molecular dynamic simulations demonstrated sugar moieties projecting ``out'' in the complex. Preferential delivery of siRNA to the liver was achieved through a highly specific ligand-receptor interaction between dendritic galactose and the asialoglycoprotein receptor. The siRNA-DG complex exhibited perinuclear localization in liver cells and co-localization with viral proteins. The histopathological studies showed the systemic tolerance and biocompatibility of DG. Further, whole body imaging and immunohistochemistry studies confirmed the preferential delivery of the nucleic acid to mice liver. Significant decrease in HCV RNA levels (up to 75%) was achieved in HCV subgenomic replicon and full length HCV-JFH1 infectious cell culture systems. The multidisciplinary approach provides the `proof of concept' for restricted delivery of therapeutic siRNAs using a target oriented dendritic nano-vector.A RNAi based antiviral strategy holds the promise to impede hepatitis C viral (HCV) infection overcoming the problem of emergence of drug resistant variants, usually encountered in the interferon free direct-acting antiviral therapy. Targeted delivery of siRNA helps minimize adverse `off-target' effects and maximize the efficacy of therapeutic response. Herein, we report the delivery of siRNA against the conserved 5'-untranslated region (UTR) of HCV RNA using a liver-targeted dendritic nano-vector functionalized with a galactopyranoside ligand (DG). Physico-chemical characterization revealed finer details of complexation of DG with siRNA, whereas molecular dynamic simulations demonstrated sugar moieties projecting ``out'' in the complex. Preferential delivery of siRNA to the liver was achieved through a highly specific ligand-receptor interaction between dendritic galactose and the asialoglycoprotein receptor. The siRNA-DG complex exhibited perinuclear localization in liver cells and co-localization with viral proteins. The histopathological studies showed the systemic tolerance and biocompatibility of DG. Further, whole body imaging and immunohistochemistry studies confirmed the preferential delivery of the nucleic acid to mice liver. Significant decrease in HCV RNA levels (up to 75%) was achieved in HCV subgenomic replicon and full length HCV-JFH1 infectious cell culture systems. The multidisciplinary approach provides the `proof of concept' for restricted delivery of therapeutic siRNAs using a target oriented dendritic nano-vector. Electronic supplementary information (ESI) available: Spectral data and experimental details. See DOI: 10.1039/c5nr02898a

Multi-disciplinary management of complex pressure sore reconstruction: 5-year review of experience in a spinal injuries centre

PubMed Central

Choudry, M; White, C; Mecci, M; Siddiqui, H

2017-01-01

INTRODUCTION In our regional spinal injuries unit, complex pressure ulcer reconstruction is facilitated by a monthly multidisciplinary team clinic. This study reviews a series of the more complex of these patients who underwent surgery as a joint case between plastics and other surgical specialties, aiming to provide descriptive data as well as share the experience of treating these complex wounds. MATERIALS AND METHODS Patients operated on as a joint case from 2010 to 2014 were identified through a locally held database and hospital records were then retrospectively reviewed for perioperative variables. Descriptive statistics were collected. RESULTS 12 patients underwent 15 procedures as a joint collaboration between plastic surgery and other surgical specialties: one with spinal surgery, 12 with orthopaedic and two with both orthopaedic and urology involvement. Ischial and trochanteric wounds accounted for 88% of cases with five Girdlestone procedures being performed and 12 requiring soft-tissue flap reconstruction. Mean operative time was 3.8hours. Four patients required high-dependency care and 13 patients received long-term antibiotics. Only three minor complications (20%) were seen with postoperative wound dehiscence. DISCUSSION The multidisciplinary team clinic allows careful assessment and selection of patients appropriate for surgical reconstruction and to help match expectations and limitations imposed by surgery, which are likely to influence their current lifestyle in this largely independent patient group. Collaboration with other specialties gives the best surgical outcome both for the present episode as well as leaving avenues open for potential future reconstruction. PMID:27490980

Computational Investigation and Validation of Twin-Tail Buffet Response Including Dynamics and Control

NASA Technical Reports Server (NTRS)

Kandil, Osama A.

1998-01-01

Multidisciplinary tools for prediction of single rectangular-tail buffet are extended to single swept-back-tail buffet in transonic-speed flow, and multidisciplinary tools for prediction and control of twin-tail buffet are developed and presented. The configuration model consists of a sharp-edged delta wing with single or twin tails that are oriented normal to the wing surface. The tails are treated as cantilevered beams fixed at the root and allowed to oscillate in both bending and torsion. This complex multidisciplinary problem is solved sequentially using three sets of equations on a dynamic single or multi-block grid structure. The first set is the unsteady, compressible, Reynolds-averaged Navier-Stokes equations which are used for obtaining the flow field vector and the aerodynamic loads on the tails. The Navier-Stokes equations are solved accurately in time using the implicit, upwind, flux-difference splitting, finite volume scheme. The second set is the coupled bending and torsion aeroelastic equations of cantilevered beams which are used for obtaining the bending and torsion deflections of the tails. The aeroelastic equations'are solved accurately in time using, a fifth-order-accurate Runge-Kutta scheme. The third set is the grid-displacement equations and the rigid-body dynamics equations, which are used for updating the grid coordinates due to the tail deflections and rigid-body motions. The tail-buffet phenomenon is predicted for highly-swept, single vertical tail placed at the plane of geometric symmetry, and for highly-swept, vertical twin tails placed at three different spanwise separation distances. The investigation demonstrates the effects of structural inertial coupling and uncoupling of the bending and torsion modes of vibration, spanwise positions of the twin-tail, angle of attack, and pitching and rolling dynamic motions of the configuration model on the tail buffet loading and response. The fundamental issue of twin-tail buffet alleviation is addressed using two active flow-control methods. These methods are the tangential leading-edge blowing and the flow suction from the leading-edge vortex cores along their paths. Qualitative and quantitative comparisons with the available experimental data are presented. The comparisons indicate that the present multidisciplinary aeroelastic analysis tools are robust, accurate and efficient.

Saudi lung cancer management guidelines 2017

PubMed Central

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

BACKGROUND: Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS: The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. RESULTS: Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. CONCLUSION: A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country. PMID:29118855

Saudi lung cancer management guidelines 2017.

PubMed

Jazieh, Abdul Rahman; Al Kattan, Khaled; Bamousa, Ahmed; Al Olayan, Ashwaq; Abdelwarith, Ahmed; Ansari, Jawaher; Al Twairqi, Abdullah; Al Fayea, Turki; Al Saleh, Khalid; Al Husaini, Hamed; Abdelhafiez, Nafisa; Mahrous, Mervat; Faris, Medhat; Al Omair, Ameen; Hebshi, Adnan; Al Shehri, Salem; Al Dayel, Foad; Bamefleh, Hanaa; Khalbuss, Walid; Al Ghanem, Sarah; Loutfi, Shukri; Khankan, Azzam; Al Rujaib, Meshael; Al Ghamdi, Majed; Ibrahim, Nagwa; Swied, Abdulmonem; Al Kayait, Mohammad; Datario, Marie

2017-01-01

Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country.

Multidisciplinary Alternatives to CPAP Program for CPAP-Intolerant Patients

PubMed Central

Shelgikar, Anita Valanju; Aronovich, Sharon; Stanley, Jeffrey J.

2017-01-01

Continuous positive airway pressure (CPAP) intolerance remains a persistent problem for many obstructive sleep apnea patients. Clinicians and researchers continue to search for other effective treatment modalities given the well-documented sequelae associated with untreated obstructive sleep apnea. A multidisciplinary “Alternatives to CPAP program” (ALT) can facilitate systematic evaluation of non-CPAP therapies appropriate for an individual patient. We review successful strategies and barriers encountered during implementation of an ALT at our institution. Creation of similar programs in private practice and academic settings can help medical, dental, and surgical sleep medicine specialists coordinate evaluation and treatment of CPAP-intolerant patients. Citation: Shelgikar AV, Aronovich S, Stanley JJ. Multidisciplinary alternatives to CPAP program for CPAP-intolerant patients. J Clin Sleep Med. 2017;13(3):505–510. PMID:28095977

The Aged Residential Care Healthcare Utilization Study (ARCHUS): a multidisciplinary, cluster randomized controlled trial designed to reduce acute avoidable hospitalizations from long-term care facilities.

PubMed

Connolly, Martin J; Boyd, Michal; Broad, Joanna B; Kerse, Ngaire; Lumley, Thomas; Whitehead, Noeline; Foster, Susan

2015-01-01

To assess effect of a complex, multidisciplinary intervention aimed at reducing avoidable acute hospitalization of residents of residential aged care (RAC) facilities. Cluster randomized controlled trial. RAC facilities with higher than expected hospitalizations in Auckland, New Zealand, were recruited and randomized to intervention or control. A total of 1998 residents of 18 intervention facilities and 18 control facilities. A facility-based complex intervention of 9 months' duration. The intervention comprised gerontology nurse specialist (GNS)-led staff education, facility bench-marking, GNS resident review, and multidisciplinary (geriatrician, primary-care physician, pharmacist, GNS, and facility nurse) discussion of residents selected using standard criteria. Primary end point was avoidable hospitalizations. Secondary end points were all acute admissions, mortality, and acute bed-days. Follow-up was for a total of 14 months. The intervention did not affect main study end points: number of acute avoidable hospital admissions (RR 1.07; 95% CI 0.85-1.36; P = .59) or mortality (RR 1.11; 95% CI 0.76-1.61; P = .62). This multidisciplinary intervention, packaging selected case review, and staff education had no overall impact on acute hospital admissions or mortality. This may have considerable implications for resourcing in the acute and RAC sectors in the face of population aging. Australian and New Zealand Clinical Trials Registry (ACTRN12611000187943). Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France.

PubMed

de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique

2014-04-07

The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

Implementation of a multidisciplinary guideline improves preterm infant admission temperatures.

PubMed

Harer, M W; Vergales, B; Cady, T; Early, A; Chisholm, C; Swanson, J R

2017-11-01

Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team. Clinical practice changes in the guideline included: increasing operating room temperatures, obtaining a 10-min axillary temperature, using an exothermic mattress for all infants <35 weeks, and using a polyethylene wrap for infants <32 weeks. The baseline rate of hypothermia (<36.5 °CC) was 63%. Three PDSA cycles data were completed on 168 consecutive preterm births. The post-implementation rate of hypothermia (<36.5 °C) was reduced to 30% (P<0.001). The incidence of moderate hypothermia (< 36 °C) was reduced from a baseline of 29% to a rate of 9% (P<0.001). Use of a multidisciplinary guideline to increase preterm NICU admission temperatures resulted in a decrease in hypothermic infants.

High Speed Civil Transport Design Using Collaborative Optimization and Approximate Models

NASA Technical Reports Server (NTRS)

Manning, Valerie Michelle

1999-01-01

The design of supersonic aircraft requires complex analysis in multiple disciplines, posing, a challenge for optimization methods. In this thesis, collaborative optimization, a design architecture developed to solve large-scale multidisciplinary design problems, is applied to the design of supersonic transport concepts. Collaborative optimization takes advantage of natural disciplinary segmentation to facilitate parallel execution of design tasks. Discipline-specific design optimization proceeds while a coordinating mechanism ensures progress toward an optimum and compatibility between disciplinary designs. Two concepts for supersonic aircraft are investigated: a conventional delta-wing design and a natural laminar flow concept that achieves improved performance by exploiting properties of supersonic flow to delay boundary layer transition. The work involves the development of aerodynamics and structural analyses, and integration within a collaborative optimization framework. It represents the most extensive application of the method to date.

The challenges in defining and measuring diagnostic error.

PubMed

Zwaan, Laura; Singh, Hardeep

2015-06-01

Diagnostic errors have emerged as a serious patient safety problem but they are hard to detect and complex to define. At the research summit of the 2013 Diagnostic Error in Medicine 6th International Conference, we convened a multidisciplinary expert panel to discuss challenges in defining and measuring diagnostic errors in real-world settings. In this paper, we synthesize these discussions and outline key research challenges in operationalizing the definition and measurement of diagnostic error. Some of these challenges include 1) difficulties in determining error when the disease or diagnosis is evolving over time and in different care settings, 2) accounting for a balance between underdiagnosis and overaggressive diagnostic pursuits, and 3) determining disease diagnosis likelihood and severity in hindsight. We also build on these discussions to describe how some of these challenges can be addressed while conducting research on measuring diagnostic error.

Numerical difficulties associated with using equality constraints to achieve multi-level decomposition in structural optimization

NASA Technical Reports Server (NTRS)

Thareja, R.; Haftka, R. T.

1986-01-01

There has been recent interest in multidisciplinary multilevel optimization applied to large engineering systems. The usual approach is to divide the system into a hierarchy of subsystems with ever increasing detail in the analysis focus. Equality constraints are usually placed on various design quantities at every successive level to ensure consistency between levels. In many previous applications these equality constraints were eliminated by reducing the number of design variables. In complex systems this may not be possible and these equality constraints may have to be retained in the optimization process. In this paper the impact of such a retention is examined for a simple portal frame problem. It is shown that the equality constraints introduce numerical difficulties, and that the numerical solution becomes very sensitive to optimization parameters for a wide range of optimization algorithms.

[CHRONIC RENAL FAILURE AND PREGNANCY--A CASE REPORT].

PubMed

Amaliev, G M; Uchikova, E; Malinova, M

2015-01-01

Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure. Determining the optimum time for authorization birth depends on the condition of the mother, the condition of the fetus and the rate of progression of renal failure, and the deadline the pregnancy should be terminated is 35 weeks. We present a case of a patient with chronic renal failure, with favorable perinatal outcome.

Optimization in the systems engineering process

NASA Technical Reports Server (NTRS)

Lemmerman, Loren A.

1993-01-01

The essential elements of the design process consist of the mission definition phase that provides the system requirements, the conceptual design, the preliminary design and finally the detailed design. Mission definition is performed largely by operations analysts in conjunction with the customer. The result of their study is handed off to the systems engineers for documentation as the systems requirements. The document that provides these requirements is the basis for the further design work of the design engineers at the Lockheed-Georgia Company. The design phase actually begins with conceptual design, which is generally conducted by a small group of engineers using multidisciplinary design programs. Because of the complexity of the design problem, the analyses are relatively simple and generally dependent on parametric analyses of the configuration. The result of this phase is a baseline configuration from which preliminary design may be initiated.

Reflective practice and its implications for pharmacy education.

PubMed

Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-02-12

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

Collaborative simulation method with spatiotemporal synchronization process control

NASA Astrophysics Data System (ADS)

Zou, Yisheng; Ding, Guofu; Zhang, Weihua; Zhang, Jian; Qin, Shengfeng; Tan, John Kian

2016-10-01

When designing a complex mechatronics system, such as high speed trains, it is relatively difficult to effectively simulate the entire system's dynamic behaviors because it involves multi-disciplinary subsystems. Currently,a most practical approach for multi-disciplinary simulation is interface based coupling simulation method, but it faces a twofold challenge: spatial and time unsynchronizations among multi-directional coupling simulation of subsystems. A new collaborative simulation method with spatiotemporal synchronization process control is proposed for coupling simulating a given complex mechatronics system across multiple subsystems on different platforms. The method consists of 1) a coupler-based coupling mechanisms to define the interfacing and interaction mechanisms among subsystems, and 2) a simulation process control algorithm to realize the coupling simulation in a spatiotemporal synchronized manner. The test results from a case study show that the proposed method 1) can certainly be used to simulate the sub-systems interactions under different simulation conditions in an engineering system, and 2) effectively supports multi-directional coupling simulation among multi-disciplinary subsystems. This method has been successfully applied in China high speed train design and development processes, demonstrating that it can be applied in a wide range of engineering systems design and simulation with improved efficiency and effectiveness.

Sustainable Remediation of Legacy Mine Drainage: A Case Study of the Flight 93 National Memorial.

PubMed

Emili, Lisa A; Pizarchik, Joseph; Mahan, Carolyn G

2016-03-01

Pollution from mining activities is a global environmental concern, not limited to areas of current resource extraction, but including a broader geographic area of historic (legacy) and abandoned mines. The pollution of surface waters from acid mine drainage is a persistent problem and requires a holistic and sustainable approach to addressing the spatial and temporal complexity of mining-specific problems. In this paper, we focus on the environmental, socio-economic, and legal challenges associated with the concurrent activities to remediate a coal mine site and to develop a national memorial following a catastrophic event. We provide a conceptual construct of a socio-ecological system defined at several spatial, temporal, and organizational scales and a critical synthesis of the technical and social learning processes necessary to achieving sustainable environmental remediation. Our case study is an example of a multi-disciplinary management approach, whereby collaborative interaction of stakeholders, the emergence of functional linkages for information exchange, and mediation led to scientifically informed decision making, creative management solutions, and ultimately environmental policy change.

Rehabilitation of a One-day-Old Neonate with Cleft Lip and Palate using Palatal Obturator: A Case Report.

PubMed

Bansal, Rajesh; Kumar Pathak, Ashish; Bhatia, Baldev; Gupta, Sailesh; Kumar Gautam, Keshav

2012-05-01

Feeding a neonate with a complete cleft lip and palate is difficult pursuit due to communication between oral cavity and nasal cavity. A multidisciplinary approach is required to manage the complex problems involved in case of such neonates and their families. Present case is of a 1-day-old neonate having complete bilateral cleft lip and palate for which palatal obturator was constructed. A stepwise simple, easy and uncomplicated procedure for making accurate impressions, maxillary cast and fabrication of palatal obturator in infants with cleft lip and palate has been presented. The objective to present this case report is to emphasize the fact that how these palatal obturators /plates help in feeding, speech/language development, presurgical orthopedics and prevent other associated otorhinolaryngeal problems. How to cite this article: Bansal R, Pathak AK, Bhatia B, Gupta S, Gautam KK. Rehabilitation of a One-day Old Neonate with Cleft Lip and Palate using Palatal Obturator: A Case Report. Int J Clin Pediatr Dent 2012;5(2):145-147.

Med-psych units. Financial viability and quality assurance.

PubMed

Fogel, B S

1989-01-01

Although medical-psychiatric units may have unique advantages for treating patients with combined medical and psychiatric illness, they may be costly to run, and their success requires a sound financial basis. This begins with filling beds and instituting a waiting list, and then setting admission priorities to regulate case mix deliberately to address financial as well as ethical and clinical considerations. Development of short-stay geropsychiatric evaluation services may offset financial problems associated with long stays of elderly patients requiring definitive treatment for complex conditions. Data are presented to show the effectiveness of deliberate regulation of case mix. Regarding quality assurance, key issues include maintaining documentation to meet HCFA standards for DRG exemption, and effectively integrating physical and psychiatric care, with a special focus on drug interactions and psychiatric toxicities of medical drugs. Effective multidisciplinary treatment planning meeting help in this effort, as do periodic walking rounds focusing specifically on pharmacologic issues. Denials of payment by third parties are most likely to be a problem when both the medical and the psychiatric illness are subacute but their interaction requires conjoint inpatient treatment. Prospective work with PROs can minimize retrospective denials.

Development of the US3D Code for Advanced Compressible and Reacting Flow Simulations

NASA Technical Reports Server (NTRS)

Candler, Graham V.; Johnson, Heath B.; Nompelis, Ioannis; Subbareddy, Pramod K.; Drayna, Travis W.; Gidzak, Vladimyr; Barnhardt, Michael D.

2015-01-01

Aerothermodynamics and hypersonic flows involve complex multi-disciplinary physics, including finite-rate gas-phase kinetics, finite-rate internal energy relaxation, gas-surface interactions with finite-rate oxidation and sublimation, transition to turbulence, large-scale unsteadiness, shock-boundary layer interactions, fluid-structure interactions, and thermal protection system ablation and thermal response. Many of the flows have a large range of length and time scales, requiring large computational grids, implicit time integration, and large solution run times. The University of Minnesota NASA US3D code was designed for the simulation of these complex, highly-coupled flows. It has many of the features of the well-established DPLR code, but uses unstructured grids and has many advanced numerical capabilities and physical models for multi-physics problems. The main capabilities of the code are described, the physical modeling approaches are discussed, the different types of numerical flux functions and time integration approaches are outlined, and the parallelization strategy is overviewed. Comparisons between US3D and the NASA DPLR code are presented, and several advanced simulations are presented to illustrate some of novel features of the code.

Loci-STREAM Version 0.9

NASA Technical Reports Server (NTRS)

Wright, Jeffrey; Thakur, Siddharth

2006-01-01

Loci-STREAM is an evolving computational fluid dynamics (CFD) software tool for simulating possibly chemically reacting, possibly unsteady flows in diverse settings, including rocket engines, turbomachines, oil refineries, etc. Loci-STREAM implements a pressure- based flow-solving algorithm that utilizes unstructured grids. (The benefit of low memory usage by pressure-based algorithms is well recognized by experts in the field.) The algorithm is robust for flows at all speeds from zero to hypersonic. The flexibility of arbitrary polyhedral grids enables accurate, efficient simulation of flows in complex geometries, including those of plume-impingement problems. The present version - Loci-STREAM version 0.9 - includes an interface with the Portable, Extensible Toolkit for Scientific Computation (PETSc) library for access to enhanced linear-equation-solving programs therein that accelerate convergence toward a solution. The name "Loci" reflects the creation of this software within the Loci computational framework, which was developed at Mississippi State University for the primary purpose of simplifying the writing of complex multidisciplinary application programs to run in distributed-memory computing environments including clusters of personal computers. Loci has been designed to relieve application programmers of the details of programming for distributed-memory computers.

Needs and Opportunities for Uncertainty-Based Multidisciplinary Design Methods for Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Zang, Thomas A.; Hemsch, Michael J.; Hilburger, Mark W.; Kenny, Sean P; Luckring, James M.; Maghami, Peiman; Padula, Sharon L.; Stroud, W. Jefferson

2002-01-01

This report consists of a survey of the state of the art in uncertainty-based design together with recommendations for a Base research activity in this area for the NASA Langley Research Center. This report identifies the needs and opportunities for computational and experimental methods that provide accurate, efficient solutions to nondeterministic multidisciplinary aerospace vehicle design problems. Barriers to the adoption of uncertainty-based design methods are identified. and the benefits of the use of such methods are explained. Particular research needs are listed.

Optimising Inter-Disciplinary Problem-Based Learning in Postgraduate Environmental and Science Education: Recommendations from a Case Study

ERIC Educational Resources Information Center

Redshaw, Clare H; Frampton, Ian

2014-01-01

As the value of multi-disciplinary working in the business and research worlds is becoming more recognised, the number of inter-disciplinary postgraduate environmental and health sciences courses is also increasing. Equally, the popularity of problem-based learning (PBL) is expected to grow and influence instructional approaches in many…

Teaching the bioinformatics of signaling networks: an integrated approach to facilitate multi-disciplinary learning.

PubMed

Korcsmaros, Tamas; Dunai, Zsuzsanna A; Vellai, Tibor; Csermely, Peter

2013-09-01

The number of bioinformatics tools and resources that support molecular and cell biology approaches is continuously expanding. Moreover, systems and network biology analyses are accompanied more and more by integrated bioinformatics methods. Traditional information-centered university teaching methods often fail, as (1) it is impossible to cover all existing approaches in the frame of a single course, and (2) a large segment of the current bioinformation can become obsolete in a few years. Signaling network offers an excellent example for teaching bioinformatics resources and tools, as it is both focused and complex at the same time. Here, we present an outline of a university bioinformatics course with four sample practices to demonstrate how signaling network studies can integrate biochemistry, genetics, cell biology and network sciences. We show that several bioinformatics resources and tools, as well as important concepts and current trends, can also be integrated to signaling network studies. The research-type hands-on experiences we show enable the students to improve key competences such as teamworking, creative and critical thinking and problem solving. Our classroom course curriculum can be re-formulated as an e-learning material or applied as a part of a specific training course. The multi-disciplinary approach and the mosaic setup of the course have the additional benefit to support the advanced teaching of talented students.

A multidisciplinary Earth science research program in China

NASA Astrophysics Data System (ADS)

Dong, Shuwen; Li, Tingdong; Gao, Rui; Hou, Hesheng; Li, Yingkang; Zhang, Shihong; Keller, G. Randy; Liu, Mian

2011-09-01

Because China occupies a large and geologically complex region of central and eastern Asia, the country may hold the keys to resolving many basic problems in the Earth sciences, such as how continental collision with India produced China's interconnected array of large intraplate structures, and what links exist between these structures and natural resources. To learn more, the Chinese government has launched SinoProbe, a major research initiative focusing on multidisciplinary imaging of the three-dimensional (3-D) structure and composition of the Chinese continental lithosphere and its evolution through geologic history. This effort is also motivated by China's need for a comprehensive and systematic evaluation of its natural resources and a better understanding of potential geohazards. SinoProbe is funded by the Chinese Ministry of Finance, managed by the Chinese Ministry of Land and Resources, and organized by the Chinese Academy of Geological Sciences. More than 960 investigators and engineers are currently involved with the program, not counting international collaborators. Most of them are affiliated with the Chinese Academy of Geological Sciences, the Chinese Academy of Sciences, the Ministry of Education (i.e., universities), and the China Earthquake Administration. The initial phase of the program (2008-2012), with funding equivalent to about US$164 million, is testing the feasibility of new technologies in geophysical and geochemical exploration and deep continental drilling by focusing on a series of profiles (Figure 1).

Multidisciplinary perspectives on banana (Musa spp.) domestication

PubMed Central

Perrier, Xavier; De Langhe, Edmond; Donohue, Mark; Lentfer, Carol; Vrydaghs, Luc; Bakry, Frédéric; Carreel, Françoise; Hippolyte, Isabelle; Horry, Jean-Pierre; Jenny, Christophe; Lebot, Vincent; Risterucci, Ange-Marie; Tomekpe, Kodjo; Doutrelepont, Hugues; Ball, Terry; Manwaring, Jason; de Maret, Pierre; Denham, Tim

2011-01-01

Original multidisciplinary research hereby clarifies the complex geodomestication pathways that generated the vast range of banana cultivars (cvs). Genetic analyses identify the wild ancestors of modern-day cvs and elucidate several key stages of domestication for different cv groups. Archaeology and linguistics shed light on the historical roles of people in the movement and cultivation of bananas from New Guinea to West Africa during the Holocene. The historical reconstruction of domestication processes is essential for breeding programs seeking to diversify and improve banana cvs for the future. PMID:21730145

What problem are you working on?

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

None

2013-11-21

Superconductors, supercomputers, new materials, clean energy, big science - ORNL researchers' work is multidisciplinary and world-leading. Hear them explain it in their own words in this video first shown at UT-Battelle's 2013 Awards Night.

What problem are you working on?

ScienceCinema

None

2018-05-07

Superconductors, supercomputers, new materials, clean energy, big science - ORNL researchers' work is multidisciplinary and world-leading. Hear them explain it in their own words in this video first shown at UT-Battelle's 2013 Awards Night.

Observations on computational methodologies for use in large-scale, gradient-based, multidisciplinary design incorporating advanced CFD codes

NASA Technical Reports Server (NTRS)

Newman, P. A.; Hou, G. J.-W.; Jones, H. E.; Taylor, A. C., III; Korivi, V. M.

1992-01-01

How a combination of various computational methodologies could reduce the enormous computational costs envisioned in using advanced CFD codes in gradient based optimized multidisciplinary design (MdD) procedures is briefly outlined. Implications of these MdD requirements upon advanced CFD codes are somewhat different than those imposed by a single discipline design. A means for satisfying these MdD requirements for gradient information is presented which appear to permit: (1) some leeway in the CFD solution algorithms which can be used; (2) an extension to 3-D problems; and (3) straightforward use of other computational methodologies. Many of these observations have previously been discussed as possibilities for doing parts of the problem more efficiently; the contribution here is observing how they fit together in a mutually beneficial way.

The Component Packaging Problem: A Vehicle for the Development of Multidisciplinary Design and Analysis Methodologies

NASA Technical Reports Server (NTRS)

Fadel, Georges; Bridgewood, Michael; Figliola, Richard; Greenstein, Joel; Kostreva, Michael; Nowaczyk, Ronald; Stevenson, Steve

1999-01-01

This report summarizes academic research which has resulted in an increased appreciation for multidisciplinary efforts among our students, colleagues and administrators. It has also generated a number of research ideas that emerged from the interaction between disciplines. Overall, 17 undergraduate students and 16 graduate students benefited directly from the NASA grant: an additional 11 graduate students were impacted and participated without financial support from NASA. The work resulted in 16 theses (with 7 to be completed in the near future), 67 papers or reports mostly published in 8 journals and/or presented at various conferences (a total of 83 papers, presentations and reports published based on NASA inspired or supported work). In addition, the faculty and students presented related work at many meetings, and continuing work has been proposed to NSF, the Army, Industry and other state and federal institutions to continue efforts in the direction of multidisciplinary and recently multi-objective design and analysis. The specific problem addressed is component packing which was solved as a multi-objective problem using iterative genetic algorithms and decomposition. Further testing and refinement of the methodology developed is presently under investigation. Teaming issues research and classes resulted in the publication of a web site, (http://design.eng.clemson.edu/psych4991) which provides pointers and techniques to interested parties. Specific advantages of using iterative genetic algorithms, hurdles faced and resolved, and institutional difficulties associated with multi-discipline teaming are described in some detail.

Respiratory disorders in paediatric age: orthodontic diagnosis and treatment in dysmetabolic obese children and allergic slim children.

PubMed

Favero, L; Arreghini, A; Cocilovo, F; Favero, V

2013-09-01

Obesity and allergic susceptibility are worsening problems in the most industrialised countries. With different mechanisms, they both lead to a deterioration of children's life quality because they affect the respiratory system, leading to asthma and respiratory disorders such as mouth breathing and obstructive sleep apnoea. The latter are related to specific types of malocclusions that require an early diagnosis and specific multidisciplinary treatment. The purpose of this work is to show the characteristic signs and symptoms of these disorders in children of the two phenotypes (allergic and slim, obese and dysmetabolic). Intercepting such issues allows both pediatricians and paediatric dentists to refer the child to a multidisciplinary team of specialists able to deal, in a holistic way, with both the physical and behavioural causes, and also with the consequences on systemic and craniofacial development in particular. The literature available on this topic in the years between 1997 and 2011 was reviewed, paying special attention to prevention, paediatric visits, diagnostic tools and treatment options for each of the two conditions. Dysmetabolic obese children and allergic slim children have specific respiratory problems during rest and exercise. Mouth breathing and obstructive sleep apnoea are due to an abnormal craniofacial development and can cause serious systemic problems in adulthood. Intercepting early signs of pathognomonic symptoms of sleep aponea and mouth breathing permits to treat children with an early multidisciplinary approach, and allows for proper physical and psychological development of the child.

Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma

PubMed Central

Yavuz, Atacan; Ağralı, Ömer Birkan; Çalışkan, Zeynep Lale; Türkaydın, Dilek; Sertgöz, Atilla; Doğan, Başak

2014-01-01

Radiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient's aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy. PMID:24523971

Multidisciplinary design integration system for a supersonic transport aircraft

NASA Technical Reports Server (NTRS)

Dovi, A. R.; Wrenn, G. A.; Barthelemy, J.-F. M.; Coen, P. G.; Hall, L. E.

1992-01-01

An aircraft preliminary design system which provides the multidisciplinary communications and couplings between several engineering disciplines is described. A primary benefit of this system is to demonstrate advanced technology multidisciplinary design integration methodologies. The current version includes the disciplines of aerodynamics and structures. Contributing engineering disciplines are coupled using the Global Sensitivity Equation approach to influence the global design optimization problem. A high speed civil transport configuration is used for configuration trade studies. Forty four independent design variables are used to control the cross-sectional areas of wing rib and spar caps and the thicknesses of wingskincover panels. A total of 300 stress, strain, buckling and displacement behavioral constraints and minimum gages on the design variables were used to optimize the idealized wing structure. The goal of the designs to resize the wing cover panels and internal structure for minimum mass.

Impact of structural optimization with aeroelastic/multidisciplinary constraints on helicopter rotor design

NASA Technical Reports Server (NTRS)

Friedmann, Peretz P.

1992-01-01

This paper presents a review of the state-of-the-art in the field of structural optimization when applied to vibration reduction of helicopters in forward flight with aeroelastic and multidisciplinary constraints. It emphasizes the application of the modern approach where the optimization is formulated as a mathematical programming problem and the objective function consists of the vibration levels at the hub and behavior constraints are imposed on the blade frequencies, aeroelastic stability margins as well as on a number of additional ingredients which can have a significant effect on the overall performance and flight mechanics of the helicopter. It is shown that the integrated multidisciplinary optimization of rotorcraft offers the potential for substantial improvements which can be achieved by careful preliminary design and analysis without requiring additional hardware such as rotor vibration absorbers or isolation systems.

Helicopter vibration reduction using structural optimization with aeroelastic/multidisciplinary constraints - A survey

NASA Technical Reports Server (NTRS)

Friedmann, Peretz P.

1991-01-01

This paper presents a survey of the state-of-the-art in the field of structural optimization when applied to vibration reduction of helicopters in forward flight with aeroelastic and multidisciplinary constraints. It emphasizes the application of the modern approach where the optimization is formulated as a mathematical programming problem, the objective function consists of the vibration levels at the hub, and behavior constraints are imposed on the blade frequencies and aeroelastic stability margins, as well as on a number of additional ingredients that can have a significant effect on the overall performance and flight mechanics of the helicopter. It is shown that the integrated multidisciplinary optimization of rotorcraft offers the potential for substantial improvements, which can be achieved by careful preliminary design and analysis without requiring additional hardware such as rotor vibration absorbers of isolation systems.

Implementing Multidisciplinary and Multi-Zonal Applications Using MPI

NASA Technical Reports Server (NTRS)

Fineberg, Samuel A.

1995-01-01

Multidisciplinary and multi-zonal applications are an important class of applications in the area of Computational Aerosciences. In these codes, two or more distinct parallel programs or copies of a single program are utilized to model a single problem. To support such applications, it is common to use a programming model where a program is divided into several single program multiple data stream (SPMD) applications, each of which solves the equations for a single physical discipline or grid zone. These SPMD applications are then bound together to form a single multidisciplinary or multi-zonal program in which the constituent parts communicate via point-to-point message passing routines. Unfortunately, simple message passing models, like Intel's NX library, only allow point-to-point and global communication within a single system-defined partition. This makes implementation of these applications quite difficult, if not impossible. In this report it is shown that the new Message Passing Interface (MPI) standard is a viable portable library for implementing the message passing portion of multidisciplinary applications. Further, with the extension of a portable loader, fully portable multidisciplinary application programs can be developed. Finally, the performance of MPI is compared to that of some native message passing libraries. This comparison shows that MPI can be implemented to deliver performance commensurate with native message libraries.

A continuum of sociotechnical requirements for patient-centered problem lists.

PubMed

Collins, Sarah; Tsivkin, Kira; Hongsermeier, Tonya; Dubois, David; Nandigam, Hari Krishna; Rocha, Roberto A

2013-01-01

Specific requirements for patient-centered health information technology remain ill-defined. To create operational definitions of patient-centered problem lists, we propose a continuum of sociotechnical requirements with five stages: 1) Intradisciplinary Care Planning: Viewing and searching for problems by discipline; 2) Multi-disciplinary Care Planning: Categorizing problem states to meet discipline-specific needs; 3) Interdisciplinary Care Planning: Sharing and linking problems between disciplines; 4) Integrated and Coordinated Care Planning: Associating problems with assessments, tasks, interventions and outcomes across disciplines for coordination, knowledge development, and reporting; and 5) Patient-Centered Care Planning: Engaging patients in identification of problems and maintenance of their problem list.

Evidence-based ergonomics: a model and conceptual structure proposal.

PubMed

Silveira, Dierci Marcio

2012-01-01

In Human Factors and Ergonomics Science (HFES), it is difficult to identify what is the best approach to tackle the workplace and systems design problems which needs to be solved, and it has been also advocated as transdisciplinary and multidisciplinary the issue of "How to solve the human factors and ergonomics problems that are identified?". The proposition on this study is to combine the theoretical approach for Sustainability Science, the Taxonomy of the Human Factors and Ergonomics (HFE) discipline and the framework for Evidence-Based Medicine in an attempt to be applied in Human Factors and Ergonomics. Applications of ontologies are known in the field of medical research and computer science. By scrutinizing the key requirements for the HFES structuring of knowledge, it was designed a reference model, First, it was identified the important requirements for HFES Concept structuring, as regarded by Meister. Second, it was developed an evidence-based ergonomics framework as a reference model composed of six levels based on these requirements. Third, it was devised a mapping tool using linguistic resources to translate human work, systems environment and the complexities inherent to their hierarchical relationships to support future development at Level 2 of the reference model and for meeting the two major challenges for HFES, namely, identifying what problems should be addressed in HFE as an Autonomous Science itself and proposing solutions by integrating concepts and methods applied in HFES for those problems.

Establishing a multidisciplinary PBL curriculum in the School of Stomatology at Wuhan University.

PubMed

Wang, Ge; Tai, Baojun; Huang, Cui; Bian, Zhuan; Shang, Zhenjun; Wang, Qian; Song, Guangtai

2008-05-01

This article describes how a multidisciplinary problem-based learning (PBL) curriculum was established at the School of Stomatology at Wuhan University (WHUSS) in China for preclinical education in a seven-year dental school program. Based on positive feedback from a modified PBL program implemented in one discipline, a multidisciplinary PBL curriculum was established. PBL training for facilitators and students, development of resource materials, curriculum design, and case writing were done in a manner that is consistent with the characteristics and learning style preferences of Chinese dental students. About 80 percent of the lectures were kept in the new PBL program. The multidisciplinary PBL curriculum has been successful in helping dental students mentally construct an understanding of the interrelationship between dental knowledge and basic science concepts. The experience at WHUSS indicates that there are clear benefits for students in the PBL format. A benefit to faculty is that PBL tutorial facilitators were partly liberated from their traditional roles and developed additional skills for facilitating. However, conflict arises when PBL-trained students encounter the traditional exam-centered education system.

Compatibility between wood production and other values and uses on forested lands: a problem analysis.

Treesearch

Charles E. Peterson; Robert A. Monserud

2002-01-01

We provide background documentation for the Pacific Northwest Research Station’s Wood Compatibility Initiative, a 5-year multidisciplinary research effort that began in response to 1997 Congressional direction. This problem analysis was the initial effort to examine the state of knowledge regarding compatibility between wood production and other values and to develop a...

The Universities and Environmental Quality--Commitment to Problem Focused Education. A Report to The President's Environmental Quality Council.

ERIC Educational Resources Information Center

Steinhart, John S.; Cherniack, Stacie

This report is based on a study of a few of the multidisciplinary enviromental programs in over 30 universities. The study was undertaken to discover what kind of programs have been tried, which ones have been successful, and how the federal government might encourage effective interdisciplinary problem-focused programs. The report reviews the…

Phase 2 of CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study of Problems with Language Development--Terminology

ERIC Educational Resources Information Center

Bishop, Dorothy V. M.; Snowling, Margaret J.; Thompson, Paul A.; Greenhalgh, Trisha

2017-01-01

Background: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider…

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.

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

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

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

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

The geriatric assessment.

PubMed

Elsawy, Bassem; Higgins, Kim E

2011-01-01

The geriatric assessment is a multidimensional, multidisciplinary assessment designed to evaluate an older person's functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. It is usually initiated when the physician identifies a potential problem. Specific elements of physical health that are evaluated include nutrition, vision, hearing, fecal and urinary continence, and balance. The geriatric assessment aids in the diagnosis of medical conditions; development of treatment and follow-up plans; coordination of management of care; and evaluation of long-term care needs and optimal placement. The geriatric assessment differs from a standard medical evaluation by including nonmedical domains; by emphasizing functional capacity and quality of life; and, often, by incorporating a multidisciplinary team. It usually yields a more complete and relevant list of medical problems, functional problems, and psychosocial issues. Well-validated tools and survey instruments for evaluating activities of daily living, hearing, fecal and urinary continence, balance, and cognition are an important part of the geriatric assessment. Because of the demands of a busy clinical practice, most geriatric assessments tend to be less comprehensive and more problem-directed. When multiple concerns are presented, the use of a "rolling" assessment over several visits should be considered. Academy of Family Physicians.

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

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

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

A Multidisciplinary Breast Cancer Brain Metastases Clinic: The University of North Carolina Experience.

PubMed

McKee, Megan J; Keith, Kevin; Deal, Allison M; Garrett, Amy L; Wheless, Amy A; Green, Rebecca L; Benbow, Julie M; Dees, E Claire; Carey, Lisa A; Ewend, Matthew G; Anders, Carey K; Zagar, Timothy M

2016-01-01

Breast cancer brain metastasis (BCBM) confers a poor prognosis and is unusual in requiring multidisciplinary care in the metastatic setting. The University of North Carolina at Chapel Hill (UNC-CH) has created a BCBM clinic to provide medical and radiation oncology, neurosurgical, and supportive services to this complex patient population. We describe organization and design of the clinic as well as characteristics, treatments, and outcomes of the patients seen in its first 3 years. Clinical and demographic data were collected from patients in a prospectively maintained database. Descriptive statistics are reported as percentages and means. The Kaplan-Meier method was used to estimate time-to-event outcomes. Sixty-five patients were seen between January 2012 and January 2015. At the time of presentation to the BCBM clinic, most patients (74%) had multiple (≥2) brain metastases and had received prior systemic (77%) and whole-brain radiation therapy and/or central nervous system stereotactic radiosurgery (65%) in the metastatic setting. Seventy-eight percent returned for a follow-up visit; 32% were enrolled in a clinical trial. Median time from diagnosis of brain metastasis to death was 2.11 years (95% confidence interval [CI] 1.31-2.47) for all patients, 1.15 years (95% CI 0.4-2.43) for triple-negative breast cancer, 1.31 years (95% CI 0.51-2.52) for hormone receptor-positive/HER2- breast cancer, and 3.03 years (95% CI lower limit 1.94, upper limit not estimable) for HER2+ breast cancer (p = .0037). Patients with BCBM have unique and complex needs that require input from several oncologic disciplines. The development of the UNC-CH multidisciplinary BCBM clinic is a model that can be adapted at other centers to provide coordinated care for patients with a challenging and complex disease. Patients with breast cancer brain metastases often require unique multidisciplinary care to meet the numerous and uncommon challenges associated with their conditions. Here, the development and characteristics of a clinic designed specifically to provide for the multidisciplinary needs of patients with breast cancer brain metastases are described. This clinic may serve as a model for other institutions interested in creating specialty clinics with similar objectives. ©AlphaMed Press.

A bis(3-hydroxy-4-pyridinone)-EDTA derivative as a strong chelator for M3+ hard metal ions: complexation ability and selectivity.

PubMed

Gama, Sofia; Dron, Paul; Chaves, Silvia; Farkas, Etelka; Santos, M Amélia

2009-08-21

The study of chelating compounds is very important to solve problems related to human metal overload. 3-Hydroxy-3-pyridinones (HP), namely deferiprone, have been clinically used for chelating therapy of Fe and Al over the last decade. A multi-disciplinary search for alternative molecules led us to develop poly-(3-hydroxy-4-pyridinones) to increase metal chelation efficacy. We present herein a complexation study of a new bis-(3-hydroxy-4-pyridinone)-EDTA derivative with a set of M(3+) hard metal ions (M = Fe, Al, Ga), as well as Zn(2+), a biologically relevant metal ion. Thus a systematic aqueous solution equilibrium study was performed using potentiometric and spectroscopic techniques (UV-Vis, NMR methods). These set of results enables the establishment of specific models as well as the determination of thermodynamic stability constants and coordination modes of the metal complexes. The results indicate that this ligand has a higher affinity for chelating to these hard metal ions than deferiprone, and that the coordination occurs mostly through the HP moieties. Furthermore, it was also found that this ligand has a higher selectivity for chelating to M(3+) hard metal ions (M = Fe, Al, Ga) than Zn(2+).

[Perspective applications of multi-species probiotics in the prevention of antibiotic-associated diarrhea].

PubMed

Uspenskiĭ, Iu P; Zakharenko, S M; Fominykh, Iu A

2013-01-01

The problem of antibiotic-associated conditions is one of the most actual problems of clinical practice. The antibiotic-associated diarrhea is a multidisciplinary problem. Investigations of the small intestine microecological status and assessment of microflora at the patients receiving antibiotics testifies to dysbiosis existence. In article results of open-label investigation of a multispecies probiotic RioFlora Balance using for antibiotic-associated diarrhea prophylaxis in patients used antibacterial therapy are presented.

Problems in counting and paying for multidisciplinary outpatient clinics.

PubMed

Jackson, T; Sevil, P

1997-01-01

Policy-makers have always found it problematic to formulate fair and consistent counting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended and unintended consequences in the context of Victoria's introduction of output-based funding for outpatient services.

Computational study of engine external aerodynamics as a part of multidisciplinary optimization procedure

NASA Astrophysics Data System (ADS)

Savelyev, Andrey; Anisimov, Kirill; Kazhan, Egor; Kursakov, Innocentiy; Lysenkov, Alexandr

2016-10-01

The paper is devoted to the development of methodology to optimize external aerodynamics of the engine. Optimization procedure is based on numerical solution of the Reynolds-averaged Navier-Stokes equations. As a method of optimization the surrogate based method is used. As a test problem optimal shape design of turbofan nacelle is considered. The results of the first stage, which investigates classic airplane configuration with engine located under the wing, are presented. Described optimization procedure is considered in the context of multidisciplinary optimization of the 3rd generation, developed in the project AGILE.

Myofascial low back pain treatment.

PubMed

Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

2014-09-01

Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

[Problematizing the multidisciplinary residency in oncology: a practical teaching protocol from the perspective of nurse residents].

PubMed

Melo, Myllena Cândida de; Queluci, Gisella de Carvalho; Gouvêa, Mônica Villela

2014-08-01

To investigate practical teaching of nurse residents in a multidisciplinary residency in oncology. A qualitative descriptive study grounded in the problematization methodology and its steps, represented by the Maguerez Arch. Data were analyzed using content analysis. Potentiating and limiting elements of the residency guided the design of a practical teaching protocol from the perspective of residents, structured in three stages: Welcoming and ambience; Nursing care for problem situations; and, Evaluation process. Systematization of practical teaching promoted the autonomy of individuals and the approximation of teaching to reality, making residency less strenuous, stressful and distressing.

The Pursuit of Chronically Reliable Neural Interfaces: A Materials Perspective.

PubMed

Guo, Liang

2016-01-01

Brain-computer interfaces represent one of the most astonishing technologies in our era. However, the grand challenge of chronic instability and limited throughput of the electrode-tissue interface has significantly hindered the further development and ultimate deployment of such exciting technologies. A multidisciplinary research workforce has been called upon to respond to this engineering need. In this paper, I briefly review this multidisciplinary pursuit of chronically reliable neural interfaces from a materials perspective by analyzing the problem, abstracting the engineering principles, and summarizing the corresponding engineering strategies. I further draw my future perspectives by extending the proposed engineering principles.

Implementing an ICT-Based Polypharmacy Management Program in Italy.

PubMed

Arcopinto, M; Cataldi, M; De Luca, V; Orlando, V; Simeone, G; D'Assante, R; Postiglione, A; Guida, A; Trama, U; Illario, M; Ferrara, N; Coscioni, E; Iaccarino, G; Cuccaro, P; D'Onofrio, G; Vigorito, C; Cittadini, A; Menditto, E

2017-01-01

Although there is evidence of a growing awareness of the problem, no official policy statements or regulatory guidelines on polypharmacy have been released up to date by Italian Health Authorities. Medication review, application of appropriateness criteria and computerized prescription support systems are all possible approaches in order to improve the quality of prescribing in older persons. More focused training courses on multimorbidity and polytherapy management are encouraged. Furthermore a multidisciplinary approach integrating different health care professionals (physicians, pharmacists, and nurses) may positively impact on reducing the sense of fear related to discontinue or substitute drugs prescribed by others; the fragmentation of therapy among different specialists; reducing costs; and improving adverse drug reaction detection and reporting. Aiming at achieving the individualized pharmacotherapy, a multidisciplinary approach starting with identification of patients and risk for drug-related problems, followed by medication review overtime and use of inappropriateness criteria, supported by computerized systems has been proposed.

Crowdsourced 'R&D' and medical research.

PubMed

Callaghan, Christian William

2015-09-01

Crowdsourced R&D, a research methodology increasingly applied to medical research, has properties well suited to large-scale medical data collection and analysis, as well as enabling rapid research responses to crises such as disease outbreaks. Multidisciplinary literature offers diverse perspectives of crowdsourced R&D as a useful large-scale medical data collection and research problem-solving methodology. Crowdsourced R&D has demonstrated 'proof of concept' in a host of different biomedical research applications. A wide range of quality and ethical issues relate to crowdsourced R&D. The rapid growth in applications of crowdsourced R&D in medical research is predicted by an increasing body of multidisciplinary theory. Further research in areas such as artificial intelligence may allow better coordination and management of the high volumes of medical data and problem-solving inputs generated by the crowdsourced R&D process. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Multidisciplinary optimization of a controlled space structure using 150 design variables

NASA Technical Reports Server (NTRS)

James, Benjamin B.

1993-01-01

A controls-structures interaction design method is presented. The method coordinates standard finite-element structural analysis, multivariable controls, and nonlinear programming codes and allows simultaneous optimization of the structure and control system of a spacecraft. Global sensitivity equations are used to account for coupling between the disciplines. Use of global sensitivity equations helps solve optimization problems that have a large number of design variables and a high degree of coupling between disciplines. The preliminary design of a generic geostationary platform is used to demonstrate the multidisciplinary optimization method. Design problems using 15, 63, and 150 design variables to optimize truss member sizes and feedback gain values are solved and the results are presented. The goal is to reduce the total mass of the structure and the vibration control system while satisfying constraints on vibration decay rate. Incorporation of the nonnegligible mass of actuators causes an essential coupling between structural design variables and control design variables.

The Fluid Dynamics of Competitive Swimming

NASA Astrophysics Data System (ADS)

Wei, Timothy; Mark, Russell; Hutchison, Sean

2014-01-01

Nowhere in sport is performance so dependent on the interaction of the athlete with the surrounding medium than in competitive swimming. As a result, understanding (at least implicitly) and controlling (explicitly) the fluid dynamics of swimming are essential to earning a spot on the medal stand. This is an extremely complex, highly multidisciplinary problem with a broad spectrum of research approaches. This review attempts to provide a historical framework for the fluid dynamics-related aspects of human swimming research, principally conducted roughly over the past five decades, with an emphasis on the past 25 years. The literature is organized below to show a continuous integration of computational and experimental technologies into the sport. Illustrations from the authors' collaborations over a 10-year period, coupling the knowledge and experience of an elite-level coach, a lead biomechanician at USA Swimming, and an experimental fluid dynamicist, are intended to bring relevance and immediacy to the review.

Current Status of Obstetric Anaesthesia: Improving Satisfaction and Safety

PubMed Central

Ranasinghe, J Sudharma; Birnbach, David

2009-01-01

Summary The Centers for Disease Control and Prevention (CDC) reported in 2003 that although the maternal mortality rate has decreased by 99% since 1900, there has been no further decrease in the last two decades1. A more recent report indicates a rate of 11.8 per 100,000 live births2, although anaesthesia-related maternal mortality and morbidity has considerably decreased over the last few decades. Despite the growing complexity of problems and increasing challenges such as pre-existing maternal disease, obesity, and the increasing age of pregnant mothers, anaesthesia related maternal mortality is extremely rare in the developed world. The current safety has been achieved through changes in training, service, technical advances and multidisciplinary approach to care. The rates of general anaesthesia for cesarean delivery have decreased and neuraxial anaesthetics have become the most commonly used techniques. Neuraxial techniques are largely safe and effective, but potential complications, though rare, can be severe. PMID:20640111

Respiratory tract infections in the immunocompromised.

PubMed

Godbole, Gauri; Gant, Vanya

2013-05-01

Pulmonary infections are particularly common in the immunosuppressed host. This review discusses emerging threats, newer modalities of diagnostic tests and emerging treatment options, and also highlights the increasing problem of antimicrobial resistance. Nosocomial pneumonia is increasingly due to multidrug-resistant Gram-negative organisms in immunosuppressed patients. Viral pneumonias remain a very significant threat, present atypically and carry a high mortality. Aspergillosis remains the most common fungal infection, and infections due to Mucorales are increasing. Multidrug-resistant tuberculosis is on the increase throughout the world. Mixed infections are common and early bronchoscopy with appropriate microbiological tests, including molecular diagnostics, optimise management and reduce mortality. Pulmonary infection remains the most frequent infectious complication in the immunocompromised host. These complex infections are often mixed, have atypical presentations and can be due to multidrug-resistant organisms. Multidisciplinary involvement in specialist centres with appropriate diagnostics, treatment and infection control improves outcome. There is a desperate need for new antimicrobial agents active against Gram-negative pathogens.

[Law and educational components of patient's safety in surgery].

PubMed

Sazhin, V P; Karsanov, A M; Maskin, S S

2018-01-01

To evaluate law and educational components of patient's safety (PS) in surgery. In order to analyze complex causes of adverse outcomes in surgery we performed an interviewing of 110 surgeons, 42 emergency physicians and 25 health care managers. The main keynote consisted in assessing law and educational components of PS. The study revealed significant professional shortcomings in law PS level and low educational and motivational activity of physicians of all specialties. Multi-faceted nature of PS problem requires multidisciplinary training of modern surgeons not only in the knowledge of key risk factors for adverse outcomes, but also in satisfaction of non-medical expectations of patients. Due to numerous objective reasons Russian surgical school should have the opportunity not to blindly copy the experience of our foreign colleagues, but to scientifically substantiate the development of own national security system both for surgical patients and medical workers themselves.

Limitations of the Millennium Development Goals: a literature review

PubMed Central

Fehling, Maya; Nelson, Brett D.; Venkatapuram, Sridhar

2013-01-01

With the Millennium Development Goals (MDGs) showing uneven progress, this review identifies possible limitations arising from the MDG framework itself rather than extrinsic issues. A multidisciplinary literature review was conducted with a focus on limitations in the formulation of the MDGs, their structure, content and implementation. Of 1837 MDG-related articles, 90 met criteria for analysis. Articles describe MDGs as being created by only a few stakeholders without adequate involvement by developing countries and overlooking development objectives previously agreed upon. Others claim MDGs are unachievable and simplistic, not adapted to national needs, do not specify accountable parties and reinforce vertical interventions. While MDGs have promoted increased health and well-being in many countries by recognising and deliberating on the possible constraints of the MDG framework, the post-2015 agenda may have even greater impact. Complex problems have simple, easy to understand, wrong answers (Henry Louis Mencken) PMID:24266508

Knowing, Being, and Doing: Aboriginal and Non-Aboriginal Collaboration in Cancer Services

PubMed Central

Zubrzycki, Joanna; Shipp, Rick; Jones, Victoria

2017-01-01

This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government–funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce. PMID:28682709

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

PubMed Central

Riveros-Perez, Efrain; Hermesch, Amy C; Barbour, Linda A; Hawkins, Joy L

2018-01-01

Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem. A multidisciplinary-team approach to the management of aplastic anemia in pregnancy is necessary to coordinate prenatal care, optimize maternofetal outcomes, and plan peripartum interventions. Conservative transfusion management is critical to prevent alloimmunization. Although a safe threshold-platelet count for neuraxial anesthesia has not been established, selection of anesthetic technique must be evaluated on a case-to-case basis. PMID:29535558

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

Mundaca, Luis; Neij, Lena; Worrell, Ernst

The growing complexities of energy systems, environmental problems and technology markets are driving and testing most energy-economy models to their limits. To further advance bottom-up models from a multidisciplinary energy efficiency policy evaluation perspective, we review and critically analyse bottom-up energy-economy models and corresponding evaluation studies on energy efficiency policies to induce technological change. We use the household sector as a case study. Our analysis focuses on decision frameworks for technology choice, type of evaluation being carried out, treatment of market and behavioural failures, evaluated policy instruments, and key determinants used to mimic policy instruments. Although the review confirms criticismmore » related to energy-economy models (e.g. unrealistic representation of decision-making by consumers when choosing technologies), they provide valuable guidance for policy evaluation related to energy efficiency. Different areas to further advance models remain open, particularly related to modelling issues, techno-economic and environmental aspects, behavioural determinants, and policy considerations.« less

Management of functional abdominal pain and irritable bowel syndrome in children and adolescents.

PubMed

Chiou, Eric; Nurko, Samuel

2010-06-01

Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are among the most commonly diagnosed medical problems in pediatrics. Symptom-based Rome III criteria for FAP and IBS have been validated and help the clinician in making a positive diagnosis. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Over the years, a wide range of therapies have been proposed and studied. The lack of a single, proven intervention highlights the complex interplay of biopsychosocial factors probably involved in the development of childhood FAP and IBS, and the need for a multidisciplinary, integrated approach. This article reviews the current literature on the efficacy of pharmacologic, dietary and psychosocial interventions for FAP and IBS in children and adolescents.

Functional abdominal pain and irritable bowel syndrome in children and adolescents

PubMed Central

Chiou, Eric; Nurko, Samuel

2011-01-01

Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are both associated with recurrent abdominal pain and are among the most commonly diagnosed medical problems in pediatrics. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Based on the biopsychosocial model of functional disease, the Rome III criteria have helped frame FAP and IBS in terms of being a positive diagnosis and not a diagnosis of exclusion. However, the lack of a single, proven intervention highlights the complex interplay of pathologic mechanisms likely involved in the development of childhood FAP and IBS and the need for a multidisciplinary, integrated approach. This article discusses the epidemiology, proposed mechanisms, clinical approach and therapeutic options for the management of FAP and IBS in children and adolescents. PMID:21731470

Testing for EMC (electromagnetic compatibility) in the clinical environment.

PubMed

Paperman, D; David, Y; Martinez, M

1996-01-01

Testing for electromagnetic compatibility (EMC) in the clinical environment introduces a host of complex conditions not normally encountered under laboratory conditions. In the clinical environment, various radio-frequency (RF) sources of electromagnetic interference (EMI) may be present throughout the entire spectrum of interest. Isolating and analyzing the impact from the sources of interference to medical devices involves a multidisciplinary approach based on training in, and knowledge of, the following: operation of medical devices and their susceptibility to EMI; RF propagation modalities and interaction theory; spectrum analysis systems and techniques (preferably with signature analysis capabilities) and calibrated antennas; the investigation methodology of suspected EMC problems, and testing protocols and standards. Using combinations of standard test procedures adapted for the clinical environment with personnel that have an understanding of radio-frequency behavior increases the probability of controlling, proactively, EMI in the clinical environment, thus providing for a safe and more effective patient care environment.

A Mechanics-Based Framework Leading to Improved Diagnosis and Treatment of Hydrocephalus

NASA Astrophysics Data System (ADS)

Cohen, Benjamin; Soren, Vedels; Wagshul, Mark; Egnor, Michael; Voorhees, Abram; Wei, Timothy

2007-11-01

Hydrocephalus is defined as an accumulation of cerebrospinal fluid (CSF) in the cranium, at the expense of brain tissue. The result is a disruption of the normal pressure and/or flow dynamics of the intracranial blood and CSF. We seek to introduce integral control volume analysis to the study of hydrocephalus. The goal is to provide a first principles framework to integrate a broad spectrum of sometimes disparate investigations into a highly complex, multidisciplinary problem. The general technique for the implementation of control volumes to hydrocephalus will be presented. This includes factors faced in choosing control volumes and making the required measurements to evaluate mass and momentum conservation. In addition, the use of our Digital Particle Image Velocimetry (DPIV) processing program has been extended to measure the displacement of the ventricles' walls from Magnetic Resonance (MR) images. This is done to determine the volume change of the intracranial fluid spaces.

Rational Solutions for Challenges of the New Mellennium

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

Gover, J.; Guray, P.G.

We have reviewed ten major public problems challenging our Nation as it enters the new millennium. These are defense, healthcare costs, education, aging population, energy and environment, crime, low productivity growth services, income distribution, regulations, and infrastructure. These problems share several features. First, each is so large, if it were soIved; it would have major impact on the U.S. economy. Second, each is resident in a socioeconomic system containing non-linear feedback loops and an adaptive human element. Third, each can only be solved by our political system, yet these problems are not responsive to piecemeal problem solving, the approach traditionallymore » used by policy makers. However, unless each problem is addressed in the context of the system in which it resides, the solution maybe worse than the problem. Our political system is immersed in reams of disconnected, unintelligible information skewed by various special interests to suggest policies favoring their particular needs. Help is needed, if rational solutions that serve public interests are to be forged for these ten probIems, The simulation and modeIing tools of physical scientists, engineers, economists, social scientists, public policy experts, and others, bolstered by the recent explosive growth in massively parallel computing power, must be blended together to synthesize models of the complex systems in which these problems are resident. These models must simulate the seemingly chaotic human element inherent in these systems and support policymakers in making informed decKlons about the future. We propose altering the policy development process by incorporating more modeling, simulation and analysis to bring about a revolution in policy making that takes advantage of the revolution in engineering emerging from simulation and modeling. While we recommend major research efforts to address each of these problems, we also observe these to be very complex, highly interdependent, multi-disciplinary problems; it will challenge the U.S. community of individual investigator researchers to make the cultural transformation necessary to address these problems in a team environment. Furthermore, models that simulate future behavior of these complex systems will not be exacq therefore, researchers must be prepared to use the modeling and simulation tools they develop to propose experiments to Congress. We recommend that ten laboratories owned by the American public be selected in an interagency competition to each manage and host a $1 billion/yertr National effort, each focused on one of these ten problems. Much of the supporting research and subsystem modeling work will be conducted at U.S. universities and at private firms with relevant expertise. Success of the Manhattan Project at the middle of the 20th century provides evidence this leadership model works.« less

Multidisciplinary teamwork and communication training.

PubMed

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

2011-04-01

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

Modeling and Analysis of Multidiscipline Research Teams at NASA Langley Research Center: A Systems Thinking Approach

NASA Technical Reports Server (NTRS)

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

1998-01-01

Multidisciplinary analysis and design is inherently a team activity due to the variety of required expertise and knowledge. As a team activity, multidisciplinary research cannot escape the issues that affect all teams. The level of technical diversity required to perform multidisciplinary analysis and design makes the teaming aspects even more important. A study was conducted at the NASA Langley Research Center to develop a model of multidiscipline teams that can be used to help understand their dynamics and identify key factors that influence their effectiveness. The study sought to apply the elements of systems thinking to better understand the factors, both generic and Langley-specific, that influence the effectiveness of multidiscipline teams. The model of multidiscipline research teams developed during this study has been valuable in identifying means to enhance team effectiveness, recognize and avoid problem behaviors, and provide guidance for forming and coordinating multidiscipline teams.

Multidisciplinary Information System of Assyrian Cuneiform Tablets Enhancing New Research Possibilities via Heterogeneous Data in Records

NASA Astrophysics Data System (ADS)

Valach, J.; Štefcová, P.; Bruna, R.; Zemánek, P.

2017-08-01

This paper outlines recently started project dedicated to creation and development of information system for cuneiform tablets. The contribution deals with the architecture of a virtual collection of cuneiform tablets, conceived as a complex system combining and integrating several domains of information obtained from various types of analyses. The research team includes experts from the field of collection conservation with philologists and researchers in the 3D scanning and physical measurement. Multidisciplinary databases like the one described, represent a new tool in digital humanities and help to improve accessibility of collections to public and researchers.

Reducing pre-operative length of stay for enterocutaneous fistula repair with a multi-disciplinary approach.

PubMed

Chamberlain, Mark; Dwyer, Rebecca

2015-01-01

Pre-operative assessment of complex surgical patients can be a lengthy process, albeit essential to minimise complication rates. In a tertiary referral unit specialising in the surgical repair of entercutaneous fistulas, a baseline audit revealed an average in-patient length of stay of 30.1 days, mainly caused by poor co-ordination between specialities. After the introduction of a weekly multi-disciplinary team meeting and the formalisation of a patient pathway, this admission length was reduced to 5.7 days (p<0.01), resulting in significant savings to the department.

Multidisciplinary aerospace design optimization: Survey of recent developments

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw; Haftka, Raphael T.

1995-01-01

The increasing complexity of engineering systems has sparked increasing interest in multidisciplinary optimization (MDO). This paper presents a survey of recent publications in the field of aerospace where interest in MDO has been particularly intense. The two main challenges of MDO are computational expense and organizational complexity. Accordingly the survey is focussed on various ways different researchers use to deal with these challenges. The survey is organized by a breakdown of MDO into its conceptual components. Accordingly, the survey includes sections on Mathematical Modeling, Design-oriented Analysis, Approximation Concepts, Optimization Procedures, System Sensitivity, and Human Interface. With the authors' main expertise being in the structures area, the bulk of the references focus on the interaction of the structures discipline with other disciplines. In particular, two sections at the end focus on two such interactions that have recently been pursued with a particular vigor: Simultaneous Optimization of Structures and Aerodynamics, and Simultaneous Optimization of Structures Combined With Active Control.

Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity

PubMed Central

Lorca, Rebeca; Rozado, José; Alvarez-Cabo, Rubén; Calvo, Juan; Pascual, Isaac; Cigarrán, Helena; Rodríguez, Isabel; Morís, César

2017-01-01

Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease. It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects. Pathology of BAV is still not well known and many questions are unresolved. In this manuscript we review some aspects on bicuspid aortopathy, a heterogeneous and frequent disease in which like some authors have previously described, complex gene environment are present. Further investigations and, what is more, multidisciplinary teams are needed to improve our knowledge on this really fascinating disease. PMID:28616342

SEMPATH Ontology: modeling multidisciplinary treatment schemes utilizing semantics.

PubMed

Alexandrou, Dimitrios Al; Pardalis, Konstantinos V; Bouras, Thanassis D; Karakitsos, Petros; Mentzas, Gregoris N

2012-03-01

A dramatic increase of demand for provided treatment quality has occurred during last decades. The main challenge to be confronted, so as to increase treatment quality, is the personalization of treatment, since each patient constitutes a unique case. Healthcare provision encloses a complex environment since healthcare provision organizations are highly multidisciplinary. In this paper, we present the conceptualization of the domain of clinical pathways (CP). The SEMPATH (SEMantic PATHways) Oontology comprises three main parts: 1) the CP part; 2) the business and finance part; and 3) the quality assurance part. Our implementation achieves the conceptualization of the multidisciplinary domain of healthcare provision, in order to be further utilized for the implementation of a Semantic Web Rules (SWRL rules) repository. Finally, SEMPATH Ontology is utilized for the definition of a set of SWRL rules for the human papillomavirus) disease and its treatment scheme. © 2012 IEEE

For multidisciplinary research on the application of remote sensing to water resources problems. [including crop yield, watershed soils, and vegetation mapping in Wisconsin

NASA Technical Reports Server (NTRS)

Kiefer, R. W. (Principal Investigator)

1979-01-01

Research on the application of remote sensing to problems of water resources was concentrated on sediments and associated nonpoint source pollutants in lakes. Further transfer of the technology of remote sensing and the refinement of equipment and programs for thermal scanning and the digital analysis of images were also addressed.

Development and Applications of a Modular Parallel Process for Large Scale Fluid/Structures Problems

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.; Kwak, Dochan (Technical Monitor)

2002-01-01

A modular process that can efficiently solve large scale multidisciplinary problems using massively parallel supercomputers is presented. The process integrates disciplines with diverse physical characteristics by retaining the efficiency of individual disciplines. Computational domain independence of individual disciplines is maintained using a meta programming approach. The process integrates disciplines without affecting the combined performance. Results are demonstrated for large scale aerospace problems on several supercomputers. The super scalability and portability of the approach is demonstrated on several parallel computers.

Development and Applications of a Modular Parallel Process for Large Scale Fluid/Structures Problems

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.; Byun, Chansup; Kwak, Dochan (Technical Monitor)

2001-01-01

A modular process that can efficiently solve large scale multidisciplinary problems using massively parallel super computers is presented. The process integrates disciplines with diverse physical characteristics by retaining the efficiency of individual disciplines. Computational domain independence of individual disciplines is maintained using a meta programming approach. The process integrates disciplines without affecting the combined performance. Results are demonstrated for large scale aerospace problems on several supercomputers. The super scalability and portability of the approach is demonstrated on several parallel computers.

Applications of aerospace technology in biology and medicine

NASA Technical Reports Server (NTRS)

Brown, J. N.

1974-01-01

The results of the medically related activities of the NASA Application Team Program at the Research Triangle Institute are presented. The RTI team, a multidisciplinary team of scientists and engineers, acted as an information and technology interface between NASA and individuals, institutions, and agencies involved in biomedical research and clinical medicine. The Team has identified 40 new problems for investigation, has accomplished 7 technology applications, 6 potential technology application, 4 impacts, has closed 54 old problems, and has a total of 47 problems under active investigation.

Music Information Retrieval.

ERIC Educational Resources Information Center

Downie, J. Stephen

2003-01-01

Identifies MIR (Music Information Retrieval) computer system problems, historic influences, current state-of-the-art, and future MIR solutions through an examination of the multidisciplinary approach to MIR. Highlights include pitch; temporal factors; harmonics; tone; editorial, textual, and bibliographic facets; multicultural factors; locating…

GridTool: A surface modeling and grid generation tool

NASA Technical Reports Server (NTRS)

Samareh-Abolhassani, Jamshid

1995-01-01

GridTool is designed around the concept that the surface grids are generated on a set of bi-linear patches. This type of grid generation is quite easy to implement, and it avoids the problems associated with complex CAD surface representations and associated surface parameterizations. However, the resulting surface grids are close to but not on the original CAD surfaces. This problem can be alleviated by projecting the resulting surface grids onto the original CAD surfaces. GridTool is designed primary for unstructured grid generation systems. Currently, GridTool supports VGRID and FELISA systems, and it can be easily extended to support other unstructured grid generation systems. The data in GridTool is stored parametrically so that once the problem is set up, one can modify the surfaces and the entire set of points, curves and patches will be updated automatically. This is very useful in a multidisciplinary design and optimization process. GridTool is written entirely in ANSI 'C', the interface is based on the FORMS library, and the graphics is based on the GL library. The code has been tested successfully on IRIS workstations running IRIX4.0 and above. The memory is allocated dynamically, therefore, memory size will depend on the complexity of geometry/grid. GridTool data structure is based on a link-list structure which allows the required memory to expand and contract dynamically according to the user's data size and action. Data structure contains several types of objects such as points, curves, patches, sources and surfaces. At any given time, there is always an active object which is drawn in magenta, or in their highlighted colors as defined by the resource file which will be discussed later.

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.

Update on chronic complex patient malnutrition

PubMed

Álvarez Hernández, Julia

2017-05-08

The Scientific Committee of the Sociedad Española de Nutrición Parenteral y Enteral (SENPE) and the Nutricia Advanced Medical Nutrition company began this Course some years ago, and now, it is a referent course in the multidisciplinary training of Clinical Nutrition. With this issue we review the advances in Clinical Nutrition in different situations and, this year, the topic is the malnutrition in chronic complex patients.

Tracheal stenosis: our experience at a tertiary care centre in India with special regard to cause and management.

PubMed

Nair, Satish; Mohan, Sharad; Mandal, Ghanashyam; Nilakantan, Ajith

2014-01-01

Tracheal stenosis (TS), a challenging problem, is a known complication of prolonged intubation and tracheostomy. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience with severe TS with regards to patient characteristics, cause and management. A retrospective analysis of 20 patients of severe TS treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with severe TS who required surgical intervention. Exclusion criteria were patients with associated laryngeal stenosis and TS due to cancer. Demographic data was recorded and findings relating to aetiology, characteristics of stenosis and the various aspects of therapeutic procedures performed are discussed with review of literature. Descriptive analysis of data were performed SPSS 18. Results of the 20 patients, 17 patients (85 %) developed TS post tracheostomy, or post intubation and subsequent tracheostomy. 13 Patients (65 %) had true stenosis of which 7 patients (35 %) had simple web or circumferential fibrosis and 6 patients (30 %) had complex stenosis. Seven patients (35 %) had granulations causing severe TS which were mostly suprastomal (5 patients), stomal (5 patients) and combined stomal and suprastomal (3 patients). The average length of stenosis was 3.57 cm (0.5-8 cm). Montgomery t tube insertion was a common procedure in 18 patients (90 %) pre or post intervention. Each patient underwent an average of 3.4 procedures during their course of treatment which included rigid bronchoscopy and mechanical debulking, Nd YAG laser, KTP laser, balloon dilatation and use of stents. Among the 7 patients with granulations 100 % successful decanulation was noted with endoscopic management whereas in 13 patients with true stenosis, 10 patients (76.9 %) required open surgical management (8 tracheal resection and anastomosis and 2 tracheoplasty) with 80 % successful decanulation, 2 patients (15.4 %) were treated with endoscopy with 100 % successful decanulation and 1 patient (7.7 %) was a non surgical candidate on stent. Of the total 20 patients with severe TS in this series, 17 (85 %) of patients who were decanulated, asymptomatic on routine daily activities with normal FFB were considered cured. TS is a challenging condition requiring a highly skilled multidisciplinary team for adequate management. Prolonged intubation and tracheostomy are the common causes leading to tracheal stenosis. Simple tracheal stenosis is easier to manage than a complex stenosis which usually requires an open surgical procedure for successful management. Presence of conditions like tracheoesophageal fistula and long segment tracheomalacia are poor factors for successful management. In our cases successful decanulation was possible in 85 % of the patients following a systematic multidisciplinary approach.

Multi-disciplinary team meetings in stroke rehabilitation: an observation study and conceptual framework.

PubMed

Tyson, S F; Burton, L; McGovern, A

2014-12-01

To explore how multi-disciplinary team meetings operate in stroke rehabilitation. Non-participant observation of multi-disciplinary team meetings and semi-structured interviews with attending staff. Twelve meetings were observed (at least one at each site) and 18 staff (one psychologist, one social worker; four nurses; four physiotherapists four occupational therapists, two speech and language therapists, one stroke co-ordinator and one stroke ward manager) were interviewed in eight in-patient stroke rehabilitation units. Multi-disciplinary team meetings in stroke rehabilitation were complex, demanding and highly varied. A model emerged which identified the main inputs to influence conduct of the meetings were personal contributions of the members and structure and format of the meetings. These were mediated by the team climate and leadership skills of the chair. The desired outputs; clinical decisions and the attributes of apparently effective meetings were identified by the staff. A notable difference between the meetings that staff considered effective and those that were not, was their structure and format. Successful meetings tended to feature a set agenda, structured documentation; formal use of measurement tools; pre-meeting preparation and skilled chairing. These features were often absent in meetings perceived to be ineffective. The main features of operation of multi-disciplinary team meetings have been identified which will enable assessment tools and interventions to improve effectiveness to be developed. © The Author(s) 2014.

Children's Behavior Responses to TV Food Advertisements

ERIC Educational Resources Information Center

Clancy-Hepburn, Katherine; And Others

1974-01-01

Two preliminary studies of children's responses to TV advertisements demonstrate the complexity of responses and indicate the need for research conducted within a multidisciplinary framework. The use of the entire family as the unit of analysis is suggested. (Author/RH)

A Spector over the Earth.

ERIC Educational Resources Information Center

Murphy, Michael E.

1990-01-01

Discusses the disciplinary make up of the study of the greenhouse effect, suggesting that physics, chemistry, earth science, social studies, and religion classes are all appropriate arenas for discussions of the topic. Highlights resources available to teach this complex multidisciplinary topic. (DMM)

Curriculum Development for the Achievement of Multiple Goals in the Agri-Food Industry.

ERIC Educational Resources Information Center

Stonehouse, D. P.

1994-01-01

The agri-food industry is concerned with maximizing global food output while preventing environmental damage. Agricultural education focuses on multidisciplinary, holistic, and integrative approaches that enhance student capabilities to address this complex issue. (SK)

Effectiveness of an intensive multidisciplinary headache treatment program.

PubMed

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

2009-07-01

To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P < .001), tension-type headache days (P < .001), frequency of migraine attacks (P = .004), and depression score (P < .001) was seen at the follow-up after 22 (+/-2) weeks. Comparing the intensive multidisciplinary program with primary care, repeated measures ANOVAs revealed significant time x group interactions for migraine days (P = .020), tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology responds especially well to this intensive treatment program, whereas effects on tension-type headaches were realized by both multidisciplinary programs. Randomized controlled trials and subgroup analysis are needed to find out if these results can be replicated and which patient characteristics allow for sufficient improvements for headache sufferers even with less complex treatment.

Trends in modeling Biomedical Complex Systems

PubMed Central

Milanesi, Luciano; Romano, Paolo; Castellani, Gastone; Remondini, Daniel; Liò, Petro

2009-01-01

In this paper we provide an introduction to the techniques for multi-scale complex biological systems, from the single bio-molecule to the cell, combining theoretical modeling, experiments, informatics tools and technologies suitable for biological and biomedical research, which are becoming increasingly multidisciplinary, multidimensional and information-driven. The most important concepts on mathematical modeling methodologies and statistical inference, bioinformatics and standards tools to investigate complex biomedical systems are discussed and the prominent literature useful to both the practitioner and the theoretician are presented. PMID:19828068

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy.

PubMed

Bonciani, Manila; Barsanti, Sara; Murante, Anna Maria

2017-04-04

Several countries have co-located General Practitioners (GPs) in Primary Care Centres (PCCs) with other health and social care professionals in order to improve integrated care. It is not clear whether the co-location of a multidisciplinary team actually facilitates a positive patient experience concerning GP care. The aim of this study was to verify whether the co-location of GPs in PCCs is associated positively with patient satisfaction with their GP when patients have experience of a multidisciplinary team. We also investigated whether patients who frequently use health services, due to their complex needs, benefitted the most from the co-location of a multidisciplinary team. The study used data from a population survey carried out in Tuscany (central Italy) at the beginning of 2015 to evaluate the patients' experience and satisfaction with their GPs. Multilevel linear regression models were implemented to verify the relationship between patient satisfaction and co-location. This key explanatory variable was measured by considering both the list of GPs working in PCCs and the answers of surveyed patients who had experienced the co-location of their GP in a multidisciplinary team. We also explored the effect modification on patient satisfaction due to the use of hospitalisation, access to emergency departments and visits with specialists, by performing the multilevel modelling on two strata of patient data: frequent and non-frequent health service users. A sample of 2025 GP patients were included in the study, 757 of which were patients of GPs working in a PCC. Patient satisfaction with their GP was generally positive. Results showed that having a GP working within a PCC and the experience of the co-located multidisciplinary team were associated with a higher satisfaction (p < 0.01). For non-frequent users of health services on the other hand, the co-location of multidisciplinary team in PCCs was not significantly associated with patient satisfaction, whereas for frequent users, the strength of relationships identified in the overall model increased (p < 0.01). The co-location of GPs with other professionals and their joint working as experienced in PCCs seems to represent a greater benefit for patients, especially for those with complex needs who use primary care, hospitals, emergency care and specialized care frequently.

A descriptive model for a multidisciplinary unit for colorectal and pelvic malformations.

PubMed

Vilanova-Sanchez, Alejandra; Halleran, Devin R; Reck-Burneo, Carlos A; Gasior, Alessandra C; Weaver, Laura; Fisher, Meghan; Wagner, Andrea; Nash, Onnalisa; Booth, Kristina; Peters, Kaleigh; Williams, Charae; Brown, Sarah Mayer; Lu, Peter; Fuchs, Molly; Diefenbach, Karen; Leonard, Jeffrey R; Hewitt, Geri; McCracken, Kate; Di Lorenzo, Carlo; Wood, Richard J; Levitt, Marc A

2018-04-19

Patients with anorectal malformations (ARM), Hirschsprung disease (HD), and colonic motility disorders often require care from specialists across a variety of fields, including colorectal surgery, urology, gynecology, and GI motility. We sought to describe the process of creating a collaborative process for the care of these complex patients. We developed a model of a devoted center for these conditions that includes physicians, psychologists, social workers, nurses, and advanced practice nurses. Our weekly planning strategy includes a meeting with representatives of all specialties to review all patients prior to evaluation in our multidisciplinary clinic, followed by combined exams under anesthesia or surgical intervention as needed. There are 31 people working directly in the Center at present. From the Center's start in 2014 until 2017, 1258 patients were cared for from all 50 United States and 62 countries. 360 patients had an ARM (110 had a cloacal malformation, 11 had cloacal exstrophy), 223 presented with HD, 71 had a spinal malformation or injury causing neurogenic bowel, 321 had severe functional constipation or colonic dysmotility, and 162 had other diagnoses including familial polyposis, Crohn's disease, or ulcerative colitis. We have had 170 multidisciplinary meetings, 170 multispecialty outpatient, and 52 nurse practitioner clinics. In our bowel management program we have seen a total of 514 patients in 36 sessions. This is the first report describing the design of a multidisciplinary team approach for patients with colorectal and complex pelvic malformations. We found that approaching these patients in a collaborative way allows for combined medical and surgical decisions with many providers simultaneously, facilitates therapy, and can potentially improve patient outcomes. We hope that this model will help establish new-devoted centers in other locations to encourage centralized care for these rare malformations. IV. Copyright © 2018. Published by Elsevier Inc.

The efficacy of an iterative "sequence of prevention" approach to injury prevention by a multidisciplinary team in professional rugby union.

PubMed

Tee, Jason C; Bekker, Sheree; Collins, Rob; Klingbiel, Jannie; van Rooyen, Ivan; van Wyk, David; Till, Kevin; Jones, Ben

2018-02-14

Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union. Observational longitudinal cohort study. Epidemiological injury data was collected from a professional rugby union team for 5 consecutive seasons. Following each season, these data informed multidisciplinary intervention strategies to reduce injury risk. The effectiveness of these strategies was iteratively assessed to inform future interventions. Specific examples of intervention strategies are provided. Overall team injury burden displayed a likely beneficial decrease (-8%; injury rate ratio (IRR) 0.9, 95%CI 0.9-1.0) from 2012 to 2016. This was achieved through a most likely beneficial improvement in non-contact injury burden (-39%; IRR 0.6, 95%CI 0.6-0.7). Contact injury burden was increased, but to a lesser extent (+18%; IRR 1.2, 95%CI 1.1-1.3, most likely harmful) during the same period. The range of skills required to effectively manage complex injury phenomena in professional collision sport crosses disciplinary boundaries. The evidence presented here points to the effectiveness of a multidisciplinary approach to reducing injury risk. This model will likely be applicable across a range of team and individual sports. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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.

A new standard model for milk yield in dairy cows based on udder physiology at the milking-session level.

PubMed

Gasqui, Patrick; Trommenschlager, Jean-Marie

2017-08-21

Milk production in dairy cow udders is a complex and dynamic physiological process that has resisted explanatory modelling thus far. The current standard model, Wood's model, is empirical in nature, represents yield in daily terms, and was published in 1967. Here, we have developed a dynamic and integrated explanatory model that describes milk yield at the scale of the milking session. Our approach allowed us to formally represent and mathematically relate biological features of known relevance while accounting for stochasticity and conditional elements in the form of explicit hypotheses, which could then be tested and validated using real-life data. Using an explanatory mathematical and biological model to explore a physiological process and pinpoint potential problems (i.e., "problem finding"), it is possible to filter out unimportant variables that can be ignored, retaining only those essential to generating the most realistic model possible. Such modelling efforts are multidisciplinary by necessity. It is also helpful downstream because model results can be compared with observed data, via parameter estimation using maximum likelihood and statistical testing using model residuals. The process in its entirety yields a coherent, robust, and thus repeatable, model.

Systematic review of the clinical and genetic aspects of Prader-Willi syndrome

PubMed Central

2011-01-01

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that is caused by the lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. This syndrome has a characteristic phenotype including severe neonatal hypotonia, early-onset hyperphagia, development of morbid obesity, short stature, hypogonadism, learning disabilities, behavioral problems, and psychiatric problems. PWS is an example of a genetic condition caused by genomic imprinting. It can occur via 3 main mechanisms that lead to the absence of expression of paternally inherited genes in the 15q11.2-q13 region: paternal microdeletion, maternal uniparental disomy, and an imprinting defect. Over 99% of PWS cases can be diagnosed using DNA methylation analysis. Early diagnosis of PWS is important for effective long-term management. Growth hormone (GH) treatment improves the growth, physical phenotype, and body composition of patients with PWS. In recent years, GH treatment in infants has been shown to have beneficial effects on the growth and neurological development of patients diagnosed during infancy. There is a clear need for an integrated multidisciplinary approach to facilitate early diagnosis and optimize management to improve quality of life, prevent complications, and prolong life expectancy in patients with PWS. PMID:21503198

Systematic review of the clinical and genetic aspects of Prader-Willi syndrome.

PubMed

Jin, Dong Kyu

2011-02-01

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that is caused by the lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. This syndrome has a characteristic phenotype including severe neonatal hypotonia, early-onset hyperphagia, development of morbid obesity, short stature, hypogonadism, learning disabilities, behavioral problems, and psychiatric problems. PWS is an example of a genetic condition caused by genomic imprinting. It can occur via 3 main mechanisms that lead to the absence of expression of paternally inherited genes in the 15q11.2-q13 region: paternal microdeletion, maternal uniparental disomy, and an imprinting defect. Over 99% of PWS cases can be diagnosed using DNA methylation analysis. Early diagnosis of PWS is important for effective long-term management. Growth hormone (GH) treatment improves the growth, physical phenotype, and body composition of patients with PWS. In recent years, GH treatment in infants has been shown to have beneficial effects on the growth and neurological development of patients diagnosed during infancy. There is a clear need for an integrated multidisciplinary approach to facilitate early diagnosis and optimize management to improve quality of life, prevent complications, and prolong life expectancy in patients with PWS.

Framing climate change and spatial planning: how risk communication can be improved.

PubMed

de Boer, J

2007-01-01

Taking the role of frames into account may significantly add to the tools that have been developed for communication and learning on complex risks and benefits. As part of a larger multidisciplinary study into climate-related forms of sense-making this paper explores which frames are used by the citizens of Western European countries and, in particular, the Netherlands. Three recent multi-national public opinion surveys were analysed to examine beliefs about climate change in the context of beliefs about energy technology and concerns about other environmental issues, such as natural disasters. It appeared that many citizens had only vague ideas about the energy situation and that these do not constitute an unequivocal frame for climate issues. In contrast, the results suggest that the long-lasting rainfall and severe floods in Central Europe have had a significant impact. Climate change was often framed in a way that articulates its associations with rain- and river-based problems. This result is extremely important for risk communication, because especially in the Netherlands with its vulnerable coastal zones climate change may produce many more consequences than rain- and river-based problems only.

Lessons Learned During Solutions of Multidisciplinary Design Optimization Problems

NASA Technical Reports Server (NTRS)

Patnaik, Suna N.; Coroneos, Rula M.; Hopkins, Dale A.; Lavelle, Thomas M.

2000-01-01

Optimization research at NASA Glenn Research Center has addressed the design of structures, aircraft and airbreathing propulsion engines. During solution of the multidisciplinary problems several issues were encountered. This paper lists four issues and discusses the strategies adapted for their resolution: (1) The optimization process can lead to an inefficient local solution. This deficiency was encountered during design of an engine component. The limitation was overcome through an augmentation of animation into optimization. (2) Optimum solutions obtained were infeasible for aircraft and air-breathing propulsion engine problems. Alleviation of this deficiency required a cascading of multiple algorithms. (3) Profile optimization of a beam produced an irregular shape. Engineering intuition restored the regular shape for the beam. (4) The solution obtained for a cylindrical shell by a subproblem strategy converged to a design that can be difficult to manufacture. Resolution of this issue remains a challenge. The issues and resolutions are illustrated through six problems: (1) design of an engine component, (2) synthesis of a subsonic aircraft, (3) operation optimization of a supersonic engine, (4) design of a wave-rotor-topping device, (5) profile optimization of a cantilever beam, and (6) design of a cvlindrical shell. The combined effort of designers and researchers can bring the optimization method from academia to industry.

Community-oriented integrated care and health promotion - views from the street.

PubMed

Thomas, Paul; Burch, Tony; Ferlie, Ewan; Jenkins, Rachel; Wright, Fiona; Sachar, Amrit; Ruprah-Shah, Baljeet

2015-09-03

On the 1st and 2nd May 2015, participants at the RCGP London City Health Conference debated practical ways to achieve integrated care at community level. In five connected workshops, participants reviewed current work and identified ways to overcome some of the problems that had become apparent. In this paper, we summarise the conclusions of each workshop, and provide an overall comment. There are layers of complexity in community-oriented integrated care that are not apparent at first sight. The difficult thing is not persuading people that it matters, but finding ways to do it that are practical and sustainable. The dynamic and complex nature of the territory is bewildering. The expectation of silo-operating and linear thinking, and the language and models that encourage it, pervade health and social care. Comprehensive integration is possible, but the theory and practice are unfamiliar to many. Images, theories and models are needed to help people from all parts of the system to see big pictures and focused detail at the same time and oscillate between them to envision-integrated whole systems. Infrastructure needs to enable this, with coordination hubs, locality-based multidisciplinary meetings and cycles of inter-organisational improvement to nurture relationships across organisational boundaries.

Multidisciplinary, Nurse-Led Psychiatric Consultation in Nursing Homes: A Pilot Study in Clinical Practice.

PubMed

Koekkoek, Bauke; van Baarsen, Carlijn; Steenbeek, Mirella

2016-07-01

To determine the effects of multidisciplinary, nurse-led psychiatric consultation on behavioral problems of nursing home residents. Residents often suffer from psychiatric symptoms, while staff psychiatric expertise varies. A pre-post study was conducted in seven homes using the Neuropsychiatric Inventory Nursing Home version (NPI-NH). In 71 consultations during 18 months, 56-75% of residents suffered from agitation/aggression, depression, anxiety, and disinhibition. Post-intervention (n = 54), frequency, and severity of psychiatric symptoms were significantly and clinically meaningfully reduced. Also, staff suffered from less work stress. Nurse-led psychiatric consultation is valuable to both nursing home residents and staff. © 2015 Wiley Periodicals, Inc.

Ambulatory surgery and anaesthesia in HUKM, a teaching hospital in Malaysia: the first two years experience.

PubMed

Norsidah, A M; Yahya, N; Adeeb, N; Lim, A L

2001-03-01

Ambulatory or day care surgery is still in its infancy in this part of the world. Our newly built university affiliated hospital started its Day Surgery Centre in February 1998. It is the first multidisciplinary ambulatory surgery centre in a teaching hospital in the country. It caters for Orthopaedic surgery, Urology, Plastic surgery, Otorhinolaryngology, General surgery, Paediatric surgery and Ophthalmology. We have done 2,604 cases and our unanticipated admission rate is less than 2%. There has been no major morbidity or mortality. The problems of setting up a multidisciplinary ambulatory centre in a teaching hospital are discussed.

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.

Art Therapy for Chronic Pain: Applications and Future Directions

ERIC Educational Resources Information Center

Angheluta, Anne-Marie; Lee, Bonnie K.

2011-01-01

Chronic pain is acknowledged as a phenomenological experience resulting from biological, psychological, and social interactions. Consequently, treatment for this complex and debilitating health phenomenon is often approached from multidisciplinary and biopsychosocial perspectives. One approach to treating chronic pain involves implementing…

OPTIMAL CONTROL THEORY FOR SUSTAINABLE ENVIRONMENTAL MANAGEMENT

EPA Science Inventory

Sustainable management of the human and natural systems, taking into account their interactions, has become paramount. To achieve this complex multidisciplinary objective, systems theory based techniques prove useful. The proposed work is a step in that direction. Taking a food w...

New optical museum at Saint-Petersburg for education and training

NASA Astrophysics Data System (ADS)

Vasil'ev, V. N.; Stafeef, S. K.; Tomilin, M. G.

2009-06-01

Nowadays the educational problem of teaching optics and photonics is to attract the young generation to the wonderful and magic world of light, optical science, technology and systems. The main issue is to explain that in the course of last several hundred years optics has been representing the most clear world view for humanity. In fact, the optics itself is a multidisciplinary complex of independent scientific directions, and, moreover, it has always been a generator of new fields of knowledge. Besides, optics and photonics are the fields within which the most fundamental problems of today's reality are to be resolved. It is absolutely necessary to encourage our scholars in getting optics and photonics education as an alternative physical basis to gaining solely computer knowledge. The main obstacle is the poor connection between program of optical education and the real optical researches, disintegration of different branches of the optical science, the demographic situation, some problems with teaching mathematics and physics at schools, and the collision between traditional educational methods and the mentality of the new generation. In Russia the Saint-Petersburg State University of Information Technologies, Mechanics and Optics offers partial solution to these problems: the organization of a real place for interactive optical science in a form of a new museum of optics, intended for education and training, seems to be the most effective way. This was the main reason for establishing such a museum in Saint-Petersburg at the end of 2008.

Revascularization heart team recommendations as an adjunct to appropriate use criteria for coronary revascularization in patients with complex coronary artery disease.

PubMed

Sanchez, Carlos E; Dota, Anthony; Badhwar, Vinay; Kliner, Dustin; Smith, A J Conrad; Chu, Danny; Toma, Catalin; Wei, Lawrence; Marroquin, Oscar C; Schindler, John; Lee, Joon S; Mulukutla, Suresh R

2016-10-01

To evaluate how a comprehensive evidence-based clinical review by a multidisciplinary revascularization heart team on treatment decisions for revascularization in patients with complex coronary artery disease using SYNTAX scores combined with Society of Thoracic Surgeons-derived clinical variables can be additive to the utilization of Appropriate Use Criteria for coronary revascularization. Decision-making regarding the use of revascularization for coronary artery disease has come under major scrutiny due to inappropriate overuse of revascularization. There is little data in routine clinical practice evaluating how a structured, multidisciplinary heart team approach may be used in combination with the Appropriate Use Criteria for revascularization. From May 1, 2012 to January 1, 2015, multidisciplinary revascularization heart team meetings were convened to discuss evidence-based management of 301 patients with complex coronary artery disease. Heart team recommendations were adjudicated with the Appropriate Use Criteria for coronary revascularization for each clinical scenario using the Society for Cardiovascular Angiography and Interventions' Quality Improvement Toolkit (SCAI-QIT) Appropriate Use Criteria App. Concordance of the Heart Team to Appropriate Use Criteria had a 99.3% appropriate primary indication for coronary revascularization. Among patients who underwent percutaneous revascularization, 34.9% had an inappropriate or uncertain indication as recommended by the Heart Team. Patients with uncertain or inappropriate percutaneous coronary interventions had significantly higher SYNTAX score (27.3 ± 6.6; 28.5 ± 5.5; 19.2 ± 6; P < 0.0001) and Society of Thoracic Surgeons-Predicted Risk of Mortality (6.1% ± 4.7%; 8.1% ± 6.3%; 3.7% ± 4.1%; P < 0.0081) compared to appropriate indications, frequently had concomitant forms of advanced comorbidities and frailty in the setting of symptomatic coronary artery disease. A formal, multidisciplinary revascularization heart team can provide proper validation for clinical decisions and should be considered in combination with the Appropriate Use Criteria for coronary revascularization to formulate revascularization strategies for individuals in a patient-centered fashion. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Methodological Problems on the Way to Integrative Human Neuroscience.

PubMed

Kotchoubey, Boris; Tretter, Felix; Braun, Hans A; Buchheim, Thomas; Draguhn, Andreas; Fuchs, Thomas; Hasler, Felix; Hastedt, Heiner; Hinterberger, Thilo; Northoff, Georg; Rentschler, Ingo; Schleim, Stephan; Sellmaier, Stephan; Tebartz Van Elst, Ludger; Tschacher, Wolfgang

2016-01-01

Neuroscience is a multidisciplinary effort to understand the structures and functions of the brain and brain-mind relations. This effort results in an increasing amount of data, generated by sophisticated technologies. However, these data enhance our descriptive knowledge , rather than improve our understanding of brain functions. This is caused by methodological gaps both within and between subdisciplines constituting neuroscience, and the atomistic approach that limits the study of macro- and mesoscopic issues. Whole-brain measurement technologies do not resolve these issues, but rather aggravate them by the complexity problem. The present article is devoted to methodological and epistemic problems that obstruct the development of human neuroscience. We neither discuss ontological questions (e.g., the nature of the mind) nor review data, except when it is necessary to demonstrate a methodological issue. As regards intradisciplinary methodological problems, we concentrate on those within neurobiology (e.g., the gap between electrical and chemical approaches to neurophysiological processes) and psychology (missing theoretical concepts). As regards interdisciplinary problems, we suggest that core disciplines of neuroscience can be integrated using systemic concepts that also entail human-environment relations. We emphasize the necessity of a meta-discussion that should entail a closer cooperation with philosophy as a discipline of systematic reflection. The atomistic reduction should be complemented by the explicit consideration of the embodiedness of the brain and the embeddedness of humans. The discussion is aimed at the development of an explicit methodology of integrative human neuroscience , which will not only link different fields and levels, but also help in understanding clinical phenomena.

Methodological Problems on the Way to Integrative Human Neuroscience

PubMed Central

Kotchoubey, Boris; Tretter, Felix; Braun, Hans A.; Buchheim, Thomas; Draguhn, Andreas; Fuchs, Thomas; Hasler, Felix; Hastedt, Heiner; Hinterberger, Thilo; Northoff, Georg; Rentschler, Ingo; Schleim, Stephan; Sellmaier, Stephan; Tebartz Van Elst, Ludger; Tschacher, Wolfgang

2016-01-01

Neuroscience is a multidisciplinary effort to understand the structures and functions of the brain and brain-mind relations. This effort results in an increasing amount of data, generated by sophisticated technologies. However, these data enhance our descriptive knowledge, rather than improve our understanding of brain functions. This is caused by methodological gaps both within and between subdisciplines constituting neuroscience, and the atomistic approach that limits the study of macro- and mesoscopic issues. Whole-brain measurement technologies do not resolve these issues, but rather aggravate them by the complexity problem. The present article is devoted to methodological and epistemic problems that obstruct the development of human neuroscience. We neither discuss ontological questions (e.g., the nature of the mind) nor review data, except when it is necessary to demonstrate a methodological issue. As regards intradisciplinary methodological problems, we concentrate on those within neurobiology (e.g., the gap between electrical and chemical approaches to neurophysiological processes) and psychology (missing theoretical concepts). As regards interdisciplinary problems, we suggest that core disciplines of neuroscience can be integrated using systemic concepts that also entail human-environment relations. We emphasize the necessity of a meta-discussion that should entail a closer cooperation with philosophy as a discipline of systematic reflection. The atomistic reduction should be complemented by the explicit consideration of the embodiedness of the brain and the embeddedness of humans. The discussion is aimed at the development of an explicit methodology of integrative human neuroscience, which will not only link different fields and levels, but also help in understanding clinical phenomena. PMID:27965548

Integrated care: theory to practice.

PubMed

Stokes, Jonathan; Checkland, Kath; Kristensen, Søren Rud

2016-10-01

'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. We suggest realistic expectations of what integration of care alone can achieve and additional research questions. © The Author(s) 2016.

Where elder abuse and the justice system collide: police power, parens patriae, and 12 recommendations.

PubMed

Connolly, Marie-Therese

2010-01-01

This article discusses the intersection of the justice system and elder abuse, arguing for a multidisciplinary framework for approaching the problem. It concludes with 12 recommendations for enhancing the justice system's response to elder abuse.

Shifting Paradigms in Management Education: What Happens When We Take Groups Seriously.

ERIC Educational Resources Information Center

Mundell, Bryan; Pennarola, Ferdinando

1999-01-01

An Italian university's capstone business administration course is designed around andragogical principles. Students spend 90% of their time in independent teamwork on multidisciplinary problems. The course uses information technology in the form of databases and networked computers. (SK)

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

PubMed

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

2011-02-01

Over the last decade, several programs have been developed for caregivers of Alzheimer disease patients. In France however, studies exploring their effects are still scarce. We conducted a study to compare two different interventions: a structured multidisciplinary program versus a classical intervention designed for Alzheimer disease patients and their spouses. Sixteen couples (Alzheimer's disease patient and spouse) residing in our administrative district participated in this monocentric study. For at least two years, these couples participated in a multidisciplinary program (n=8 couples) or received usual care (n=8 couples). The multidisciplinary program involved biannual consultations with a neurologist, a neuropsychologist and a psychologist, in addition to an annual meeting, stratified on the patient's MMSE score, for spouses). Usual care involved biannual consultations with the neurologist. The multidisciplinary program included a psychological intervention based on cognitive behavioral theories and centered on psycho-education, problem solving, adaptation strategies and on prevention of depression and anxiety. The spouses and the patients evaluated the 2-year follow-up during clinical interviews, completed by questionnaires. Sociodemographic data were noted for the patients and their spouses. Levels of depression and anxiety (Mini International Neuropsychiatric Inventory, Montgomery and Asberg Depression Scale, State-Trait Anxiety Inventory), perceived stress (Perceived Stress Scale) and care burden (Zarit Burden Inventory) were evaluated in spouses. Levels of cognitive impairment (Mini Mental State Examination), autonomy (Instrumental Activities of Daily Living), psychological state (Montgomery and Asberg Depression Scale, Covi Anxiety Scale), and behavioral symptoms frequency (Neuropsychiatric Inventory) were assessed in patients. The main significant result showed that the spouses' state of anxiety was lower among participants in the multidisciplinary program, compared with the classical neurological intervention. It also was found that the spouses and the patients who participated in this multidisciplinary program were less depressed. This study shows that a multidisciplinary structured intervention, with only two annual consultations and one annual meeting for spouses, can contribute to decrease significantly the spouses' state of anxiety. Further studies including a larger number of subjects should be conducted to confirm these findings. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Safety and operations of hydrogen fuel infrastructure in northern climates : a collaborative complex systems approach.

DOT National Transportation Integrated Search

2010-10-07

"This project examined the safety and operation of hydrogen (H2) fueling system infrastructure in : northern climates. A multidisciplinary team lead by the University of Vermont (UVM), : combined with investigators from Zhejiang and Tsinghua Universi...

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

PubMed

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

2015-10-01

Globally, the management of chronic heart failure (CHF) challenges health systems. The high burden of disease and the costs associated with hospitalization adversely affect individuals, families, and society. Improved quality, access, efficiency, and equity of CHF care can be achieved by using multidisciplinary care approaches if there is adherence and fidelity to the program's elements. The goal of this article was to summarize evidence and make recommendations for advancing practice, education, research, and policy in the multidisciplinary management of patients with CHF. Essential elements of multidisciplinary management of CHF were identified from meta-analyses and clinical practice guidelines. The study factors were discussed from the perspective of the health care system, providers, patients, and their caregivers. Identified gaps in evidence were used to identify areas for future focus in CHF multidisciplinary management. Although there is high-level evidence (including several meta-analyses) for the efficacy of management programs for CHF, less evidence exists to determine the benefit attributable to individual program components or to identify the specific content of effective components and the manner of their delivery. Health care system, provider, and patient factors influence health care models and the effective management of CHF and require focus and attention. Extrapolating trial findings to clinical practice settings is limited by the heterogeneity of study populations and the implementation of models of intervention beyond academic health centers, where practice environments differ considerably. Ensuring that individual programs are both developed and assessed that consider these factors is integral to ensuring adherence and fidelity with the core dimensions of disease management necessary to optimize patient and organizational outcomes. Recognizing the complexity of the multidisciplinary CHF interventions will be important in advancing the design, implementation, and evaluation of the interventions. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Developing person-centred practice in hip fracture care for older people.

PubMed

Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

2016-12-14

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

Airway Problems in Neonates—A Review of the Current Investigation and Management Strategies

PubMed Central

Mok, Quen

2017-01-01

Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal “communication” in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy. Further imaging techniques help to delineate other commonly associated abnormalities. Echocardiography is also important to confirm any associated cardiac abnormality. In this review, the merits and disadvantages of the various investigations now available to the clinician will be discussed. The current therapeutic strategies are discussed, and the review will focus on the most challenging conditions that cause the biggest management conundrums, specifically laryngotracheal cleft, congenital tracheal stenosis, and tracheobronchomalacia. Management of acquired stenosis secondary to airway injury from endotracheal intubation will also be discussed as this is a common problem. Slide tracheoplasty is the preferred surgical option for long-segment tracheal stenosis, and results have improved significantly. Stents are occasionally required for residual or recurrent stenosis following surgical repair. There is sufficient evidence that a multidisciplinary team approach for managing complex airway issues provides the best results for the patient. There is ongoing progress in the field with newer diagnostic tools as well as development of innovative management techniques, such as biodegradable stents and stem cell-based tracheal transplants, leading to a much better prognosis for these children in the future. PMID:28424763

Conflict in Context: Understanding Local to Global Security.

ERIC Educational Resources Information Center

Mertz, Gayle; Lieber, Carol Miller

This multidisciplinary guide provides middle and high school teachers and students with inquiry-based tools to support their exploration of emerging local, national, international, and transboundary security issues. Students are introduced to critical thinking, problem solving, and peacemaking strategies that will help them better understand…

Rationale for Research on Including Sustainable Agriculture in the High School Agricultural Education Curriculum.

ERIC Educational Resources Information Center

Williams, David L.; Dollisso, Awoke D.

1998-01-01

Sustainable agriculture is a multidisciplinary approach to food and fiber problems. Its inclusion in the secondary curriculum would enrich and align it with social concerns. Research is needed in the scholarship functions of discovery, integrative approaches, and teaching. (SK)

Facilitating Learning in Multidisciplinary Groups with Transactive CSCL Scripts

ERIC Educational Resources Information Center

Noroozi, Omid; Teasley, Stephanie D.; Biemans, Harm J. A.; Weinberger, Armin; Mulder, Martin

2013-01-01

Knowledge sharing and transfer are essential for learning in groups, especially when group members have different disciplinary expertise and collaborate online. Computer-Supported Collaborative Learning (CSCL) environments have been designed to facilitate transactive knowledge sharing and transfer in collaborative problem-solving settings. This…

Population Geography: Problems, Concepts, and Prospects.

ERIC Educational Resources Information Center

Peters, Gary L.; Larkin, Robert P.

This book introduces secondary students to population geography. Material from other disciplines is included because the study of population is multidisciplinary. It is presented in eleven chapters. The introduction considers definitions of concepts and aspects of population geography, explaining the emphasis on spatial patterns of population…

Leadership Theory for School Psychologists: Leading for Systems Change

ERIC Educational Resources Information Center

Burns, Matthew K.; Preast, June L.; Kilpatrick, Kayla D.; Taylor, Crystal N.; Young, Helen; Aguilar, Lisa; Allen, Amanda; Copeland, Christa; Haider, Aqdas; Henry, Lauren

2017-01-01

School psychologists are often seen as leaders in schools. They lead data teams, problem-solving teams, multidisciplinary evaluation teams, and crisis response teams. They are also perceived as leaders regarding intervention, multitiered systems of support, behavior support, collaboration, consultation, special education, assessment, and…

Multidisciplinary optimization of controlled space structures with global sensitivity equations

NASA Technical Reports Server (NTRS)

Padula, Sharon L.; James, Benjamin B.; Graves, Philip C.; Woodard, Stanley E.

1991-01-01

A new method for the preliminary design of controlled space structures is presented. The method coordinates standard finite element structural analysis, multivariable controls, and nonlinear programming codes and allows simultaneous optimization of the structures and control systems of a spacecraft. Global sensitivity equations are a key feature of this method. The preliminary design of a generic geostationary platform is used to demonstrate the multidisciplinary optimization method. Fifteen design variables are used to optimize truss member sizes and feedback gain values. The goal is to reduce the total mass of the structure and the vibration control system while satisfying constraints on vibration decay rate. Incorporating the nonnegligible mass of actuators causes an essential coupling between structural design variables and control design variables. The solution of the demonstration problem is an important step toward a comprehensive preliminary design capability for structures and control systems. Use of global sensitivity equations helps solve optimization problems that have a large number of design variables and a high degree of coupling between disciplines.

Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit.

PubMed

Krishnan, Singhan; Nash, Fiona; Baker, Neil; Fowler, Duncan; Rayman, Gerry

2008-01-01

To assess changes in diabetic lower-extremity amputation rates in a defined relatively static population over an 11-year period following the introduction of a multidisciplinary foot team. All diabetic patients with foot problems admitted to Ipswich Hospital, a large district general hospital, were identified by twice-weekly surveillance of all relevant in-patient areas and outcomes including amputations recorded. The incidence of major amputations fell 62%, from 7.4 to 2.8 per 100,000 of the general population. Total amputation rates also decreased (40.3%) but to a lesser extent due to a small increase in minor amputations. Expressed as incidence per 10,000 people with diabetes, total amputations fell 70%, from 53.2 to 16.0, and major amputations fell 82%, from 36.4 to 6.7. Significant reductions in total and major amputation rates occurred over the 11-year period following improvements in foot care services including multidisciplinary team work.

A Multidisciplinary Approach to Mixer-Ejector Analysis and Design

NASA Technical Reports Server (NTRS)

Hendricks, Eric, S.; Seidel, Jonathan, A.

2012-01-01

The design of an engine for a civil supersonic aircraft presents a difficult multidisciplinary problem to propulsion system engineers. There are numerous competing requirements for the engine, such as to be efficient during cruise while yet quiet enough at takeoff to meet airport noise regulations. The use of mixer-ejector nozzles presents one possible solution to this challenge. However, designing a mixer-ejector which will successfully address both of these concerns is a difficult proposition. Presented in this paper is an integrated multidisciplinary approach to the analysis and design of these systems. A process that uses several low-fidelity tools to evaluate both the performance and acoustics of mixer-ejectors nozzles is described. This process is further expanded to include system-level modeling of engines and aircraft to determine the effects on mission performance and noise near airports. The overall process is developed in the OpenMDAO framework currently being developed by NASA. From the developed process, sample results are given for a notional mixer-ejector design, thereby demonstrating the capabilities of the method.

Multidisciplinary Multiobjective Optimal Design for Turbomachinery Using Evolutionary Algorithm

NASA Technical Reports Server (NTRS)

2005-01-01

This report summarizes Dr. Lian s efforts toward developing a robust and efficient tool for multidisciplinary and multi-objective optimal design for turbomachinery using evolutionary algorithms. This work consisted of two stages. The first stage (from July 2003 to June 2004) Dr. Lian focused on building essential capabilities required for the project. More specifically, Dr. Lian worked on two subjects: an enhanced genetic algorithm (GA) and an integrated optimization system with a GA and a surrogate model. The second stage (from July 2004 to February 2005) Dr. Lian formulated aerodynamic optimization and structural optimization into a multi-objective optimization problem and performed multidisciplinary and multi-objective optimizations on a transonic compressor blade based on the proposed model. Dr. Lian s numerical results showed that the proposed approach can effectively reduce the blade weight and increase the stage pressure ratio in an efficient manner. In addition, the new design was structurally safer than the original design. Five conference papers and three journal papers were published on this topic by Dr. Lian.

Unsteady, Transonic Flow Around Delta Wings Undergoing Coupled and Natural Modes Response: A Multidisciplinary Problem

NASA Technical Reports Server (NTRS)

Menzies, Margaret Anne

1996-01-01

The unsteady, three-dimensional Navier-Stokes equations coupled with the Euler equations of rigid-body dynamics are sequentially solved to simulate and analyze the aerodynamic response of a high angle of attack delta wing undergoing oscillatory motion. The governing equations of fluid flow and dynamics of the multidisciplinary problem are solved using a time-accurate solution of the laminar, unsteady, compressible, full Navier- Stokes equations with the implicit, upwind, Roe flux-difference splitting, finite-volume scheme and a four-stage Runge-Kutta scheme, respectively. The primary model under consideration consists of a 65 deg swept, sharp-edged, cropped delta wing of zero thickness at 20 deg angle of attack. In a freestream of Mach 0.85 and Reynolds number of 3.23 x 10(exp 6), the flow over the upper surface of the wing develops a complex shock system which interacts with the leading-edge primary vortices producing vortex breakdown. The effect of the oscillatory motion of the wing on the vortex breakdown and overall aerodynamic response is detailed to provide insight to the complicated physics associated with unsteady flows and the phenomenon of wing rock. Forced sinusoidal single and coupled mode rolling and pitching motion is presented for the wing in a transonic freestream. The Reynolds number, frequency of oscillation, and the phase angle are varied. Comparison between the single and coupled mode forced rolling and pitching oscillation cases illustrate the effects of coupling the motion. This investigation shows that even when coupled, forced rolling oscillation at a reduced frequency of 2(pi) eliminates the vortex breakdown which results in an increase in lift. The coupling effect for in phase forced oscillations show that the lift coefficient of the pitching-alone case and the rolling-moment coefficient of the rolling-alone case dominate the resulting response. However, with a phase lead in the pitching motion, the coupled motion results in a non-periodic response of the rolling moment. The second class of problems involve releasing the wing in roll to respond to the flowfield. Two models of sharp-edged delta wings, the previous 65 deg swept model and an 80 deg swept, sharp-edged delta wing, are used to observe the aerodynamic response of a wing free to roll in a transonic and subsonic freestream, respectively. These cases demonstrate damped oscillations, self-sustained limit cycle oscillations, and divergent rolling oscillations. Ultimately, an active control model using a mass injection system was applied on the surface of the wing to suppress the self-sustained limit cycle oscillation known as wing rock. Comparisons with experimental investigations complete this study, validating the analysis and illustrating the complex details afforded by computational investigations.

User's guide for ENSAERO: A multidisciplinary program for fluid/structural/control interaction studies of aircraft (release 1)

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.

1994-01-01

Strong interactions can occur between the flow about an aerospace vehicle and its structural components resulting in several important aeroelastic phenomena. These aeroelastic phenomena can significantly influence the performance of the vehicle. At present, closed-form solutions are available for aeroelastic computations when flows are in either the linear subsonic or supersonic range. However, for aeroelasticity involving complex nonlinear flows with shock waves, vortices, flow separations, and aerodynamic heating, computational methods are still under development. These complex aeroelastic interactions can be dangerous and limit the performance of aircraft. Examples of these detrimental effects are aircraft with highly swept wings experiencing vortex-induced aeroelastic oscillations, transonic regime at which the flutter speed is low, aerothermoelastic loads that play a critical role in the design of high-speed vehicles, and flow separations that often lead to buffeting with undesirable structural oscillations. The simulation of these complex aeroelastic phenomena requires an integrated analysis of fluids and structures. This report presents a summary of the development, applications, and procedures to use the multidisciplinary computer code ENSAERO. This code is based on the Euler/Navier-Stokes flow equations and modal/finite-element structural equations.

Development of a Multi-Disciplinary Computing Environment (MDICE)

NASA Technical Reports Server (NTRS)

Kingsley, Gerry; Siegel, John M., Jr.; Harrand, Vincent J.; Lawrence, Charles; Luker, Joel J.

1999-01-01

The growing need for and importance of multi-component and multi-disciplinary engineering analysis has been understood for many years. For many applications, loose (or semi-implicit) coupling is optimal, and allows the use of various legacy codes without requiring major modifications. For this purpose, CFDRC and NASA LeRC have developed a computational environment to enable coupling between various flow analysis codes at several levels of fidelity. This has been referred to as the Visual Computing Environment (VCE), and is being successfully applied to the analysis of several aircraft engine components. Recently, CFDRC and AFRL/VAAC (WL) have extended the framework and scope of VCE to enable complex multi-disciplinary simulations. The chosen initial focus is on aeroelastic aircraft applications. The developed software is referred to as MDICE-AE, an extensible system suitable for integration of several engineering analysis disciplines. This paper describes the methodology, basic architecture, chosen software technologies, salient library modules, and the current status of and plans for MDICE. A fluid-structure interaction application is described in a separate companion paper.

Job Loss: An Individual Level Review and Model.

ERIC Educational Resources Information Center

DeFrank, Richard S.; Ivancevich, John M.

1986-01-01

Reviews behavioral, medical, and social science literature to illustrate the complexity and multidisciplinary nature of the job loss experience and provides a conceptual model to examine individual responses to job loss. Emphasizes the importance of including organizational-relevant variables in individual level conceptualizations and proposed…

The physiology of stress and effects on immune health in ruminants

USDA-ARS?s Scientific Manuscript database

As researchers have continued to explore the complex interactions among stress and production parameters such as growth, feed efficiency, and health, multidisciplinary efforts have emerged leading to a greater understanding of homeostatic regulation. The immune system can be regulated by several dif...

Recent patents therapeutic agents for cancer.

PubMed

Li, Xun; Xu, Wenfang

2006-06-01

Cancer is one of the most dreaded diseases with a complex pathogenesis, which threats human life greatly. Multidisciplinary scientific investigations are making best efforts to combat this disease and put to the identification of novel anticancer agents. Patent anticancer agents registered in China are therefore increasing dramatically during the past ten years, which will be reviewed briefly in this article. platinum complexes anthracycline analogs (including doxorubicin derivatives) quinoline analogs podophyllotoxins analogs taxane analogs camptothecin (CPT) analogs.

Aeromedical Factors in Aviator Fatigue, Crew Work/Rest Schedules and Extended Flight Operations: An Annotated Bibliography.

DTIC Science & Technology

1981-01-01

complex is a common psychological reaction to stress, which causes a chronic overactivity of the higher brain centers and the vagal-parasympathetic...continuous military operations in which other complex man-machine systems were being used. In addition, we found great interest in multidisciplinary...2. Adams, J. T. 1967. Fatigue in helicopter aircrews in combat. In: Aeromedical aspects of helicopter operations in the tac- tical situation

[Multidisciplinary oncopalliative meeting: Aims and pratical recommendations].

PubMed

Goldwasser, François; Nisenbaum, Nathalie; Vinant, Pascale; Balladur, Elisabeth; Dauchy, Sarah; Farota-Romejko, Idriss; Colombet, Isabelle; Alby, Marie-Laure; Giroux, Julie; Larrouy, Anne; Destaintot, Elisabeth; Garcon, Luc; Legrand, Danièle; Marin, Isabelle

2018-05-01

Progress leads to increase life duration at the metastatic stage but metastatic disease is most often lethal. Decision-making is necessary for an increasing period of care, beyond evidence-based medicine, dealing with complexity and uncertain benefit/risk ratio. This requires to inform the patient realistically, to discuss prognostication, to develop anticipated written preferences. These changes mean to pass from a medicine based on informed consent to medicine based on respect of the patient wishes even if it can be complex to determine. A new multidisciplinarity is needed, centered on the meaning of the care, the proportionality of the care, the anticipated patient trajectory. The ASCO has published recommendations on early palliative care. The timing and the quality of the discussion between palliative care specialists and oncologists is crucial. We propose 10 steps to organize a multidisciplinary onco-palliative meeting, as it appears the key for the organization of care in non-curable disease. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

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.

Innovative health care delivery teams: learning to be a team player is as important as learning other specialised skills.

PubMed

Fitzgerald, Anneke; Davison, Graydon

2008-01-01

The purpose of the paper is to show that free flowing teamwork depends on at least three aspects of team life: functional diversity, social cohesion and superordinate identity. The paper takes the approach of a discussion, arguing for a strong need to understand multidisciplinary and cross-functional barriers for achieving team goals in the context of health care. These barriers include a strong medically dominated business model, historically anchored delineations between professional identities and a complex organisational environment where individuals may have conflicting goals. The paper finds that the complexity is exacerbated by the differences between and within health care teams. It illustrates the differences by presenting the case of an operating theatre team. Whilst the paper recommends some ideas for acquiring these skills, further research is needed to assess effectiveness and influence of team skills training on optimising multidisciplinary interdependence in the health care environment. The paper shows that becoming a team member requires team membership skills.

A systematic literature review of the key challenges for developing the structure of public health economic models.

PubMed

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-04-01

To identify the key methodological challenges for public health economic modelling and set an agenda for future research. An iterative literature search identified papers describing methodological challenges for developing the structure of public health economic models. Additional multidisciplinary literature searches helped expand upon important ideas raised within the review. Fifteen articles were identified within the formal literature search, highlighting three key challenges: inclusion of non-healthcare costs and outcomes; inclusion of equity; and modelling complex systems and multi-component interventions. Based upon these and multidisciplinary searches about dynamic complexity, the social determinants of health, and models of human behaviour, six areas for future research were specified. Future research should focus on: the use of systems approaches within health economic modelling; approaches to assist the systematic consideration of the social determinants of health; methods for incorporating models of behaviour and social interactions; consideration of equity; and methodology to help modellers develop valid, credible and transparent public health economic model structures.

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.

Teacher's Guide, Ecology, Grade 7.

ERIC Educational Resources Information Center

Yadkin Valley Economic Development District, Inc., Walnut Cove, NC.

This teacher's guide has been constructed to assist in developing and implementing a life science course with an environment/ecological unit for Grade 7. Designed primarily for use with other science units, it offers numerous multidisciplinary activities which emphasize involvement in problem-solving through open-ended investigation rather than…

Learning Disabilities: An Interdisciplinary Perspective.

ERIC Educational Resources Information Center

Zollinger, Ruth H., Ed.; Klein, Nancy K., Ed.

Presented are six papers originally delivered at a colloquium series on the problems of the learning disabled child, with emphasis on a multidisciplinary perspective. In "One Psychologist's Perspective on Learning Disabilities," J. Kessler provides an overview of the field with sections on definition and identification, etiology, testing as a…

Teacher's Guide, Ecology, Grade 10.

ERIC Educational Resources Information Center

Yadkin Valley Economic Development District, Inc., Walnut Cove, NC.

This teacher's guide has been constructed to assist in developing and implementing a life science course with an environment/ecological unit for Grade 10. Designed primarily for use with other science units, it offers numerous multidisciplinary activities which emphasize involvement in problem-solving through open-ended investigation rather than…

Pull and Push in Educational Innovation: Study of an Interfaculty Programme.

ERIC Educational Resources Information Center

Barnett, S. A.; Brown, Valerie A.

1981-01-01

A multidisciplinary, holistic course was introduced at the Australian National University to relate scientific evidence to the demands of decision making and problem solving. Student participants are shown to improve in independent judgment and decline in dogmatism. Program design and implementation are discussed. (MSE)

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…

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.

Application of remote sensing to water resources problems

NASA Technical Reports Server (NTRS)

Clapp, J. L.

1972-01-01

The following conclusions were reached concerning the applications of remote sensing to water resources problems: (1) Remote sensing methods provide the most practical method of obtaining data for many water resources problems; (2) the multi-disciplinary approach is essential to the effective application of remote sensing to water resource problems; (3) there is a correlation between the amount of suspended solids in an effluent discharged into a water body and reflected energy; (4) remote sensing provides for more effective and accurate monitoring, discovery and characterization of the mixing zone of effluent discharged into a receiving water body; and (5) it is possible to differentiate between blue and blue-green algae.

A grid generation system for multi-disciplinary design optimization

NASA Technical Reports Server (NTRS)

Jones, William T.; Samareh-Abolhassani, Jamshid

1995-01-01

A general multi-block three-dimensional volume grid generator is presented which is suitable for Multi-Disciplinary Design Optimization. The code is timely, robust, highly automated, and written in ANSI 'C' for platform independence. Algebraic techniques are used to generate and/or modify block face and volume grids to reflect geometric changes resulting from design optimization. Volume grids are generated/modified in a batch environment and controlled via an ASCII user input deck. This allows the code to be incorporated directly into the design loop. Generated volume grids are presented for a High Speed Civil Transport (HSCT) Wing/Body geometry as well a complex HSCT configuration including horizontal and vertical tails, engine nacelles and pylons, and canard surfaces.

Six easy steps on how to create a lean sigma value stream map for a multidisciplinary clinical operation.

PubMed

Lee, Emily; Grooms, Richard; Mamidala, Soumya; Nagy, Paul

2014-12-01

Value stream mapping (VSM) is a very useful technique to visualize and quantify the complex workflows often seen in clinical environments. VSM brings together multidisciplinary teams to identify parts of processes, collect data, and develop interventional ideas. An example involving pediatric MRI with general anesthesia VSM is outlined. As the process progresses, the map shows a large delay between the fax referral and the date of the scheduled and registered appointment. Ideas for improved efficiency and metrics were identified to measure improvement within a 6-month period, and an intervention package was developed for the department. Copyright © 2014. Published by Elsevier Inc.

Managing MDO Software Development Projects

NASA Technical Reports Server (NTRS)

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

2002-01-01

Over the past decade, the NASA Langley Research Center developed a series of 'grand challenge' applications demonstrating the use of parallel and distributed computation and multidisciplinary design optimization. All but the last of these applications were focused on the high-speed civil transport vehicle; the final application focused on reusable launch vehicles. Teams of discipline experts developed these multidisciplinary applications by integrating legacy engineering analysis codes. As teams became larger and the application development became more complex with increasing levels of fidelity and numbers of disciplines, the need for applying software engineering practices became evident. This paper briefly introduces the application projects and then describes the approaches taken in project management and software engineering for each project; lessons learned are highlighted.

A multidisciplinary database for global distribution

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

Wolfe, P.J.

The issue of selenium toxicity in the environment has been documented in the scientific literature for over 50 years. Recent studies reveal a complex connection between selenium and human and animal populations. This article introduces a bibliographic citation database on selenium in the environment developed for global distribution via the Internet by the University of Wyoming Libraries. The database incorporates material from commercial sources, print abstracts, indexes, and U.S. government literature, resulting in a multidisciplinary resource. Relevant disciplines include, biology, medicine, veterinary science, botany, chemistry, geology, pollution, aquatic sciences, ecology, and others. It covers the years 1985-1996 for most subjectmore » material, with additional years being added as resources permit.« less

General internal medicine at the crossroads of prosperity and despair: caring for patients with chronic diseases in an aging society.

PubMed

Larson, E B

2001-05-15

During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.

The Emergence of Dominant Design(s) in Large Scale Cyber-Infrastructure Systems

ERIC Educational Resources Information Center

Diamanti, Eirini Ilana

2012-01-01

Cyber-infrastructure systems are integrated large-scale IT systems designed with the goal of transforming scientific practice by enabling multi-disciplinary, cross-institutional collaboration. Their large scale and socio-technical complexity make design decisions for their underlying architecture practically irreversible. Drawing on three…

Untreated pain, narcotics regulation, and global health ideologies.

PubMed

King, Nicholas B; Fraser, Veronique

2013-01-01

Pain management is marginalized or ignored, with millions of people worldwide unnecessarily living with untreated pain. Reducing global inequalities in untreated pain requires a concerted global effort, say Veronique Fraser and colleagues, which must attend to the complexity of pain and promote multimodal, multidisciplinary pain management.

Computational Systems for Multidisciplinary Applications

NASA Technical Reports Server (NTRS)

Soni, Bharat; Haupt, Tomasz; Koomullil, Roy; Luke, Edward; Thompson, David

2002-01-01

In this paper, we briefly describe our efforts to develop complex simulation systems. We focus first on four key infrastructure items: enterprise computational services, simulation synthesis, geometry modeling and mesh generation, and a fluid flow solver for arbitrary meshes. We conclude by presenting three diverse applications developed using these technologies.

[The role of practitioner in the management of sexual aggression].

PubMed

Boudhrfâa, Khaled; Ouhibi, Janet; Gara, Med Faouzi

2007-09-01

Sexual violences constitue a problem of public health whose frequency is alarming in all the contries. Any doctor, what ever his specialization must feel concerned by this medical problem. Thi report helps and guides doctors to find the best manner to expecting and reception of victims. RECOMMANDATION: The principal objectives of sexual violence victims managment are: 1) To ensure near the victim and the family a multidisciplinary, psycho-medicosocial managment to accomodate and inform the victim. The multidisciplinary team joins together psychological, doctors, welfare officers and other professionals of health. Organization of reception center specialized open 24 hours a day with structuring of regional network and training of professionals of health in order to ensure a follow-up of the victims and to evaluate the results of this managment. 2) To ensure a medical managment of optimal competence (examination with care) in order to avoid with the victims of sexual abuse the repetation of the genital examinations. Collection on a structured file of all the data elements as well as the medico-legal elements wich can contribute to establish the proof of the aggression (taking away for cytology and molecular biology). 3) To prevent the infections risks, the pregnancy and psychological risks of after-effects. In conclusion, the managment of the supposed victim must be global, prolonged, and multidisciplinary. It will comprise medical care, a psychological follow-up to organize without imposing it and finally without forgetting medico-legal aspects.

Capturing the Diversity of Transition from a Multidisciplinary Perspective

ERIC Educational Resources Information Center

Burns, Edgar

2010-01-01

The broad utility of the concept of transition in many disciplines provides career educators and career advisory personnel with expanded opportunities to explore fresh solutions to problems they meet in the course of their work. Further practical solutions become available by continuing to seek applications of the concept. Career transition…

Bulimia: Book for Therapist and Client.

ERIC Educational Resources Information Center

Bauer, Barbara G.; And Others

This book was written for practitioners working with bulimic clients and for clients themselves. Bulimia is presented as a multidimensional problem requiring a multidisciplinary team approach to treatment. An introductory chapter presents six treatment sessions with a bulimic client which provide an overview of the experiences and attitudes of the…

A Multidisciplinary Approach to Sexual Dysfunction in Medical Education

ERIC Educational Resources Information Center

Foley, Sallie; Wittmann, Daniela; Balon, Richard

2010-01-01

Objective: Addressing sexual health concerns in medical practice has been an emerging concept for the past two decades. However, there have been very few educational opportunities in medical training that would prepare future physicians for such a responsibility. Since assessing and treating sexual problems requires knowledge that encompasses many…

Disinfection of Common Waterborne Pathogens

ERIC Educational Resources Information Center

Swim, Edward W.

2010-01-01

As part of an integrative learning experience at the end of a sophomore Calculus II course at the United States Military Academy, this project served as a multidisciplinary problem-solving exercise that explored the connections among mathematics, biology, and other fields of study. During a seven-lesson block of instruction, this module was…

Summary and Evaluation of the Regional Educational Diagnostic Treatment Center 1966-1969.

ERIC Educational Resources Information Center

Bureau of Elementary and Secondary Education (DHEW/OE), Washington, DC.

A diagnostic treatment center for learning disabilities and emotional problems was developed to serve six school systems. Evaluation by the multidisciplinary staff covered behavior, family background, health, and intellectual, perceptual motor, emotional, and educational functioning. Treatment plans, developed by the team which subsequently met…

The AIBS In Yugoslavia: Programs in Biomedical Engineering

ERIC Educational Resources Information Center

Thompson, Mary-Frances

1978-01-01

Programs in biomedical engineering have been developing worldwide since World War II. This article describes a multidisciplinary program which operates in Yugoslavia through a cooperative effort between that county and the AIBS. A major problem has been the slowness with which hospitals accept the concept of biomedical engineering. (MA)

Group Participation and Satisfaction: Results from a PBL Computer-Supported Module

ERIC Educational Resources Information Center

Ochoa, Theresa A.; Gottschall, Holly; Stuart, Shannon K.

2004-01-01

Special education policy requires schools to make disciplinary decisions concerning students with disabilities within a multidisciplinary team. In order to respond to this mandate, teacher educators must ensure that teachers have group collaboration and decision making skills. This article describes a multimedia problem-based learning module…

Computer Games: Increase Learning in an Interactive Multidisciplinary Environment.

ERIC Educational Resources Information Center

Betz, Joseph A.

1996-01-01

Discusses the educational uses of computer games and simulations and describes a study conducted at the State University of New York College at Farmingdale that used the computer game "Sim City 2000." Highlights include whole systems learning, problem solving, student performance, nonparametric statistics, and treatment of experimental…

Two Undergraduate Process Modeling Courses Taught Using Inductive Learning Methods

ERIC Educational Resources Information Center

Soroush, Masoud; Weinberger, Charles B.

2010-01-01

This manuscript presents a successful application of inductive learning in process modeling. It describes two process modeling courses that use inductive learning methods such as inquiry learning and problem-based learning, among others. The courses include a novel collection of multi-disciplinary complementary process modeling examples. They were…

Patient Communication: A Multidisciplinary Approach Using Animated Cartoons

ERIC Educational Resources Information Center

Leiner, Marie; Handal, Gilbert; Williams, Darryl

2004-01-01

Communication is a major problem in the management of patients. Miscommunication occurs frequently in populations with low reading skills, illiteracy does not completely account for the observed low rates of recall of communicated information. Transmission of the message also plays an important role. Successful strategies to improve communication…

The Multidisciplinary Imperative in Higher Education. Research & Occasional Paper Series. CSHE.11.10

ERIC Educational Resources Information Center

King, C. Judson

2010-01-01

Disciplines codify related knowledge and have developed powerful approaches that enable both solutions to a wide variety of problems and efficient further extension of knowledge. Individual disciplines have translated into individual departments within universities. Academic departments tend to turn inward, deepening the knowledge within the…

A Multidisciplinary Osteoporosis Service-Based Action Research Study

ERIC Educational Resources Information Center

Whitehead, Dean; Keast, John; Montgomery, Val; Hayman, Sue

2004-01-01

Objective: To investigate an existing Trust-based osteoporosis service's preventative activity, determine any issues and problems and use this data to reorganise the service, as part of a National Health Service Executive/Regional Office-commissioned and funded study. Setting: A UK Hospital Trust's Osteoporosis Service. Design & Method: A…

Optimal Structures for Multimedia Instruction. Final Report.

ERIC Educational Resources Information Center

Goguen, Joseph; And Others

This 2-year study, which took a multidisciplinary approach to the problem of discovering principles for designing effective multimedia instruction, focused on the effects on instructional effectiveness of the discourse structure of instructional materials and the coordination of multiple instructional media. The task domain was a logic box said to…

[Sportsmen's groin. Definition, differential diagnostics and therapy].

PubMed

Muschaweck, U; Gollwitzer, H; Conze, J

2015-02-01

Groin pain in athletes is a common problem and can have extensive consequences for professional athletes. The anatomical and functional complexity of the groin as well as radiating pain from remote anatomical regions can make the differential diagnostic a challenge and requires special attention. As there are a wide variety of possible causes for groin pain, a multidisciplinary approach is required. The treating orthopedic surgeon needs to pay special attention to prearthritic hip deformities to avoid irreversible damage of the hip joint. By a meticulous patient history and identification of the pain character, followed by clinical, sonographic and radiographic investigations, a differential diagnosis can usually be achieved. Besides typical orthopedic causes pathological findings particularly in the area of the groin need to be considered, clarified and adequately treated; therefore, a clear terminology of the different diseases is necessary. Sportsmen's groin is not a hernia but should be perceived as a separate entity due to its typical pain character and detection of a measurable protrusion of the posterior wall of the inguinal canal by ultrasound.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children.

PubMed

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-11-13

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children.

CONDUIT: A New Multidisciplinary Integration Environment for Flight Control Development

NASA Technical Reports Server (NTRS)

Tischler, Mark B.; Colbourne, Jason D.; Morel, Mark R.; Biezad, Daniel J.; Levine, William S.; Moldoveanu, Veronica

1997-01-01

A state-of-the-art computational facility for aircraft flight control design, evaluation, and integration called CONDUIT (Control Designer's Unified Interface) has been developed. This paper describes the CONDUIT tool and case study applications to complex rotary- and fixed-wing fly-by-wire flight control problems. Control system analysis and design optimization methods are presented, including definition of design specifications and system models within CONDUIT, and the multi-objective function optimization (CONSOL-OPTCAD) used to tune the selected design parameters. Design examples are based on flight test programs for which extensive data are available for validation. CONDUIT is used to analyze baseline control laws against pertinent military handling qualities and control system specifications. In both case studies, CONDUIT successfully exploits trade-offs between forward loop and feedback dynamics to significantly improve the expected handling, qualities and minimize the required actuator authority. The CONDUIT system provides a new environment for integrated control system analysis and design, and has potential for significantly reducing the time and cost of control system flight test optimization.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children

PubMed Central

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-01-01

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children. PMID:26580646

The Growing Problem of New Psychoactive Substances (NPS).

PubMed

Madras, Bertha K

The term "new psychoactive substances" (NPS) can be defined as individual drugs in pure form or in complex preparations that are not scheduled under the Single Convention on Narcotic Drugs (1961) or the Convention on Psychotropic Substances (1971). NPS may be categorized by chemical structure, by psychoactive properties, by biological targets, or by source (plant, synthetic, or combined). The emergence of hundreds of NPS in the past decade is challenging for public health and drug policies globally. The novelty of NPS, their ambiguous legal status, ability to evade toxicological tests, swift adaptation to legal restrictions, global Internet marketing, and scant public knowledge of their adverse effects are among the key drivers of this twenty-first century phenomenon. Multi-disciplinary research in areas of biology, epidemiology, prevention, and web analytics are needed to develop effective responses in a domain capable of overwhelming current international conventions and national drug control policies. Ultimately, research-guided prevention education will fortify societies against this tidal wave.

Association of Midfacial Fractures with Ophthalmic Injury

PubMed Central

Politis, Constantinus; Kluyskens, Alexandra; Dormaar, Titiaan

2017-01-01

The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women. The main cause of trauma was road traffic accidents. Forty-one patients suffered an ophthalmic injury following the fracture. Twelve of them had a persistent ophthalmic problem. Ophthalmic examination is necessary during the initial management. The time window for preservation of sight is small and treatment should be started immediately. Development of an emergency trauma scale that includes fractures, symptoms of visual impairment, and patient history is recommended and should stimulate a multidisciplinary approach of complex cases. PMID:28523083

Bioenvironmental Engineering: An Interdisciplinary Approach to Training Environmental Engineers at Rutgers University

NASA Astrophysics Data System (ADS)

Uchrin, Christoph; Krogmann, Uta; Gimenez, Daniel

2010-05-01

It is becoming increasingly apparent that environmental problems have become extremely complex, involving inter- and multidisciplinary expertise. Furthermore, the nature of environmental episodes requires practitioners who are flexible in designing appropriate solution approaches. As a result, there is a high demand for environmental engineering graduates in the professional sector as well as graduate schools. At Rutgers University, we have designed and are now delivering an undergraduate curriculum that melds a strong background in basic and applied sciences with a rigorous sequence of design oriented engineering courses, all focused on producing graduates who view the environment in a holistic sense, rather than a narrow, medium oriented manner. Since the implementation of the program in 2004 student numbers have doubled and half of the students graduate with honors. The undergraduate program is complemented by the new Environmental Engineering option of the Graduate Program in Environmental Sciences. The undergraduate program and the graduate option are served by a highly committed faculty of seven full-time members and one part-time member.

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.

Phase-based treatment of a complex severely mentally ill case involving complex posttraumatic stress disorder and psychosis related to Dandy Walker syndrome.

PubMed

Mauritz, Maria W; van de Sande, Roland; Goossens, Peter J J; van Achterberg, Theo; Draijer, Nel

2014-01-01

For patients with comorbid complex posttraumatic stress disorder (PTSD) and psychotic disorder, trauma-focused therapy may be difficult to endure. Phase-based treatment including (a) stabilization, (b) trauma-focused therapy, and (c) integration of personality with recovery of connection appears to be the treatment of choice. The objective of this article is to describe and evaluate the therapeutic process of a single case from a holistic perspective. We present a case report of a 47-year-old woman treated for severe complex PTSD resulting from repeated sexual and physical abuse in early childhood and moderate psychotic symptoms stemming from Dandy Walker Syndrome with hydrocephalus. The patient was treated with quetiapine (600-1,000 mg) and citalopram (40 mg). Stabilization consisted of intensive psychiatric nursing care in the home and stabilizing group treatment for complex PTSD. After stabilization, the following symptom domains showed improvement: self-regulation, self-esteem, assertiveness, avoidance of social activities, and negative cognitions. However, intrusions and arousal persisted and were therefore subsequently treated with prolonged imaginary exposure that also included narrative writing assignments and a final closing ritual. This intensive multidisciplinary, phase-based approach proved effective: All symptoms of complex PTSD were in full remission. Social integration and recovery were promoted with the reduction of polypharmacy and the provision of social skills training and lifestyle training. The present case shows a phase-based treatment approach with multidisciplinary collaborative care to be effective for the treatment of a case of complex PTSD with comorbid psychotic disorder stemming from severe neurological impairment. Replication of this promising approach is therefore called for.

Constipation: causes and cures.

PubMed

Christer, Ruth; Robinson, Liz; Bird, Clare

Constipation is a common but poorly understood problem. Within the UK it is estimated that three million GP consultations relate to constipation every year. It is a problem that could affect any person at any time, yet it is often preventable. There is no accepted definition for constipation, however, and it is open to individual interpretation. Some may describe constipation as passing hard stools, others may describe it as infrequent defaecation. Constipation can affect a person's physical, psychological and social wellbeing. Nurses are in a key position to help with this problem, although a multidisciplinary approach is needed if treatment is to be successful.

Evaluation of the impact of a clinical pathway on the organization of a multidisciplinary dental sleep clinic.

PubMed

Ten Berge, D M; Braem, M J; Altenburg, A; Dieltjens, M; Van de Heyning, P H; Vanhaecht, K; Vanderveken, O M

2014-05-01

Clinical pathways are used to organize complex care processes by providing structure and standardization. The multidisciplinary approach of oral appliance (OA) therapy for sleep-disordered breathing (SDB) is a complex and dynamic process suitable for such a structured pathway approach. A clinical pathway for patients referred for OA therapy was developed and implemented. The aim of this study was to evaluate the impact of this clinical pathway on the time to delivery of the OA and the organization of the multidisciplinary dental sleep clinic (MDSC). The latter was achieved using the care process self-evaluation tool (CPSET). First, development and implementation of the clinical pathway gave structure and shortened the mean time to delivery by 102 days (240 ± 70 vs. 138 ± 33 days) (Mann-Whitney U: P < 0.001). Second, the CPSET scores were obtained in a cohort of 49 healthcare professionals involved in the pathway. Overall, patient-focused organization received the highest scores (80.5 ± 9.0%), whereas cooperation with primary care received the lowest score (66.7 ± 12.4%). This is the first project on clinical pathways in OA therapy for SDB. The implementation of the pathway in our MDSC has created a significant shortening of the time to delivery. A first evaluation of the clinical pathway using the CPSET scores indicates that all disciplines involved should be thoroughly informed in an ongoing approach.

HIV Education in the Formal Curriculum

ERIC Educational Resources Information Center

Nsubuga, Yusuf K.; Bonnet, Sandrine

2009-01-01

The AIDS epidemic presents a complex of issues that require global answers, involving entire societies. The only sustainable solution is to include all sectors of society in a multidisciplinary collaboration, within which the formal education system plays a key role in delivering a comprehensive response to the disease at the national level.…

Integrated Multidisciplinary Assessment of Environmentally Realistic Complex Mixtures of Drinking Water Disinfection ByProducts (DBPs) (The 4Lab Study)

EPA Science Inventory

More than 600 DBPs have been identified; yet ~50% of the total organic halide from chlorination is unidentified. Epidemiology studies suggest associations between human use of chlorinated water and reproductive/developmental effects (pregnancy loss, low birth weight), that are un...

Management and treatment of mucosal melanoma of the genital tract.

PubMed

Vaccari, Sabina; Barisani, Alessia; Dika, Emi; Fanti, Pier A; DE Iaco, Pierandrea; Gurioli, Carlotta; Tosti, Giulio

2017-06-01

The melanoma of the genital mucosa is a rare melanocytic neoplasm that affects both sexes. The diagnosis is often delayed; videodermatoscopy may represent a useful diagnostic tool. The treatment is complex and multidisciplinary. We report the main diagnostic features and therapeutic approaches for mucosal melanoma of the genital tract.

Voice of Experience International Research Infrastructure and the Impact of Export Control Regulations

ERIC Educational Resources Information Center

Kulakowski, Elliott C.; Chronister, Lynne; Molfese, Victoria; Slocum, Michael; Studman, Cliff; Waugaman, Paul

2007-01-01

Research today has become very complex, often involving international collaborations among multidisciplinary teams. Many institutions, especially those in less economically developed countries, have a great deal of expertise to contribute to these collaborations, but often lack the instrumentation, training, and research management infrastructure…

Book Review: "The Rhizosphere: Biochemistry and Organic Substances at the Soil-Plant Interface, Second Edition"

USDA-ARS?s Scientific Manuscript database

The complexity of the biological, chemical, and physical interactions occurring in the volume of soil surrounding the root of a growing plant dictates that a multidisciplinary approach must be taken to improve our understanding of this rhizosphere. Hence, "The Rhizosphere: Biochemistry and Organic S...

The Integration of Children Dependent on Medical Technology into Public Schools

ERIC Educational Resources Information Center

Raymond, Jill A.

2009-01-01

Advances in medicine have increased the survival rates of children with complex medical conditions, including those who are dependent on technology such as ventilators and tracheostomies. The process of integrating children dependent on medical technology into public schools requires the collaboration of a multidisciplinary team to ensure that…

Decision Making/The Chesapeake Bay. An Interdisciplinary Environmental Education Curriculum Unit.

ERIC Educational Resources Information Center

Maryland Univ., College Park. Science Teaching Center.

This multidisciplinary, self-contained curriculum unit focuses on the management of the Chesapeake Bay, a threatened and complex environmental system. Major unit goals include identifying and analyzing conflicting interests, issues, and public policies concerning the Bay, and determining their effects on people and the environment. The unit…

Enhanced Podcasts for Teaching Biochemistry to Veterinary Students

ERIC Educational Resources Information Center

Gough, Kevin C.

2011-01-01

The teaching of biochemistry within medical disciplines presents certain challenges; firstly to relay a large body of complex facts and abstract concepts, and secondly to motivate students that this relatively difficult topic is worth their time to study. Here, nutrient biochemistry was taught within a multidisciplinary module as part of an…

Military Design Insights for Online Education Program Evaluation: A Revised Theoretical Construct

ERIC Educational Resources Information Center

Culkin, David T.

2017-01-01

This theoretical development article examines how design methodology currently applied in United States military doctrine can offer insights into the increasingly complex arena of program evaluations of online modes for adult distance education. The article presents key themes that emerge from a multidisciplinary literature review. These themes…

From Data to Improved Decisions: Operations Research in Healthcare Delivery.

PubMed

Capan, Muge; Khojandi, Anahita; Denton, Brian T; Williams, Kimberly D; Ayer, Turgay; Chhatwal, Jagpreet; Kurt, Murat; Lobo, Jennifer Mason; Roberts, Mark S; Zaric, Greg; Zhang, Shengfan; Schwartz, J Sanford

2017-11-01

The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems. Decision making is the process of choosing between possible solutions to a problem with respect to certain metrics. OR concepts can help systematically improve decision making through efficient modeling techniques while accounting for relevant constraints. Depending on the problem, methods that are part of OR (e.g., linear programming, Markov Decision Processes) or methods that are derived from related fields (e.g., regression from statistics) can be incorporated into the solution approach. This paper highlights the characteristics of different OR methods that have been applied to healthcare decision making and provides examples of emerging research opportunities. We illustrate OR applications in healthcare using previous studies, including diagnosis and treatment of diseases, organ transplants, and patient flow decisions. Further, we provide a selection of emerging areas for utilizing OR. There is a timely need to inform practitioners and policy makers of the benefits of using OR techniques in solving healthcare problems. OR methods can support the development of sustainable long-term solutions across disease management, service delivery, and health policies by optimizing the performance of system elements and analyzing their interaction while considering relevant constraints.

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.

Replace, reuse, recycle: improving the sustainable use of phosphorus by plants.

PubMed

Baker, Alison; Ceasar, S Antony; Palmer, Antony J; Paterson, Jaimie B; Qi, Wanjun; Muench, Stephen P; Baldwin, Stephen A

2015-06-01

The 'phosphorus problem' has recently received strong interest with two distinct strands of importance. The first is that too much phosphorus (P) is entering into waste water, creating a significant economic and ecological problem. Secondly, while agricultural demand for phosphate fertilizer is increasing to maintain crop yields, rock phosphate reserves are rapidly declining. Unravelling the mechanisms by which plants sense, respond to, and acquire phosphate can address both problems, allowing the development of crop plants that are more efficient at acquiring and using limited amounts of phosphate while at the same time improving the potential of plants and other photosynthetic organisms for nutrient recapture and recycling from waste water. In this review, we attempt to synthesize these important but often disparate parts of the debate in a holistic fashion, since solutions to such a complex problem require integrated and multidisciplinary approaches that address both P supply and demand. Rapid progress has been made recently in our understanding of local and systemic signalling mechanisms for phosphate, and of expression and regulation of membrane proteins that take phosphate up from the environment and transport it within the plant. We discuss the current state of understanding of such mechanisms involved in sensing and responding to phosphate stress. We also discuss approaches to improve the P-use efficiency of crop plants and future direction for sustainable use of P, including use of photosynthetic organisms for recapture of P from waste waters. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Acute Complex Care Model: An organizational approach for the medical care of hospitalized acute complex patients.

PubMed

Pietrantonio, Filomena; Orlandini, Francesco; Moriconi, Luca; La Regina, Micaela

2015-12-01

Chronic diseases are the major cause of death (59%) and disability worldwide, representing 46% of global disease burden. According to the Future Hospital Commission of the Royal College of Physicians, Medical Division (MD) will be responsible for all hospital medical services, from emergency to specialist wards. The Hospital Acute Care Hub will bring together the clinical areas of the MD that focus on the management of acute medical patients. The Chronic Care Model (CCM) places the patient at the center of the care system enhancing the community's social and health support, pathways and structures to keep chronic, frail, poly-pathological people at home or out of the hospital. The management of such patients in the hospital still needs to be solved. Hereby, we propose an innovative model for the management of the hospital's acute complex patients, which is the hospital counterpart of the CCM. The target population are acutely ill complex and poly-pathological patients (AICPPs), admitted to hospital and requiring high technology resources. The mission is to improve the management of medical admissions through pre-defined intra-hospital tracks and a global, multidisciplinary, patient-centered approach. The ACCM leader is an internal medicine specialist (IMS) who summarizes health problems, establishes priorities, and restores health balance in AICPPs. The epidemiological transition leading to a progressive increase in "chronically unstable" and complex patients needing frequent hospital treatment, inevitably enhances the role of hospital IMS in the coordination and delivery of care. ACCM represents a practical response to this epochal change of roles. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Malaria in India: The Center for the Study of Complex Malaria in India

PubMed Central

Das, Aparup; Anvikar, Anupkumar R.; Cator, Lauren J.; Dhiman, Ramesh C.; Eapen, Alex; Mishra, Neelima; Nagpal, Bhupinder N.; Nanda, Nutan; Raghavendra, Kamaraju; Read, Andrew F.; Sharma, Surya K.; Singh, Om P.; Singh, Vineeta; Sinnis, Photini; Srivastava, Harish C.; Sullivan, Steven A.; Sutton, Patrick L.; Thomas, Matthew B.; Carlton, Jane M.; Valecha, Neena

2012-01-01

Malaria is a major public health problem in India and one which contributes significantly to the overall malaria burden in Southeast Asia. The National Vector Borne Disease Control Program of India reported ~1.6 million cases and ~1100 malaria deaths in 2009. Some experts argue that this is a serious underestimation and that the actual number of malaria cases per year is likely between 9 and 50 times greater, with an approximate 13-fold underestimation of malaria-related mortality. The difficulty in making these estimations is further exacerbated by (i) highly variable malaria eco-epidemiological profiles, (ii) the transmission and overlap of multiple Plasmodium species and Anopheles vectors, (iii) increasing antimalarial drug resistance and insecticide resistance, and (iv) the impact of climate change on each of these variables. Simply stated, the burden of malaria in India is complex. Here we describe plans for a Center for the Study of Complex Malaria in India (CSCMi), one of ten International Centers of Excellence in Malaria Research (ICEMRs) located in malarious regions of the world recently funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health. The CSCMi is a close partnership between Indian and United States scientists, and aims to address major gaps in our understanding of the complexity of malaria in India, including changing patterns of epidemiology, vector biology and control, drug resistance, and parasite genomics. We hope that such a multidisciplinary approach that integrates clinical and field studies with laboratory, molecular, and genomic methods will provide a powerful combination for malaria control and prevention in India. PMID:22142788

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.

Motility, digestive and nutritional problems in Esophageal Atresia.

PubMed

Gottrand, Madeleine; Michaud, Laurent; Sfeir, Rony; Gottrand, Frédéric

2016-06-01

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a rare congenital malformation. Digestive and nutritional problems remain frequent in children with EA both in early infancy and at long-term follow-up. These patients are at major risk of presenting with gastroesophageal reflux and its complications, such as anastomotic strictures. Esophageal dysmotility is constant, and can have important consequences on feeding and nutritional status. Patients with EA need a systematic follow-up with a multidisciplinary team. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Creation of expert centers on endometriosis].

PubMed

Daraï, Emile; Bendifallah, Sofiane; Chabbert-Buffet, Nathalie; Golfier, François

2017-12-01

Endometriosis is a frequent pathology with a high incidence of deep infiltrating endometriosis and complex forms that can affect 20% of patients with endometriosis. The incidence of infertility associated with endometriosis can reach 50%. The complexity of care requires the creation of expert centers working in networks with general practitioners. Criteria for defining these expert centers are being drawn up, based on structural criteria (multidisciplinary consultation meeting), links with medical assistance structures for procreation and activity criteria for severe and complex forms (number of interventions per center and per surgeon). Copyright © 2017. Published by Elsevier Masson SAS.

State of science: occupational slips, trips and falls on the same level.

PubMed

Chang, Wen-Ruey; Leclercq, Sylvie; Lockhart, Thurmon E; Haslam, Roger

2016-07-01

Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial.

Hospitalization of Children with Down Syndrome

PubMed Central

Tenenbaum, Ariel; Hanna, Rana N.; Averbuch, Diana; Wexler, Isaiah D.; Chavkin, Maor; Merrick, Joav

2014-01-01

Introduction: Children with Down syndrome present with multiple medical problems in a higher prevalence compared with the general population, which may lead to hospitalizations. Methods: Analysis of 560 hospitalizations of 162 children aged 0–16 years with Down syndrome at Hadassah Medical Center during the years 1988–2007 compared with data on children in the general population, hospitalized at the same period. Data was collected from patient files and statistical data from the Ministry of Health. Results: Respiratory infections were the leading cause for hospitalization of children with Down syndrome. The number of hospitalizations of children with Down syndrome compared to the number of all children, who were hospitalized was surprisingly similar to their proportion in the general population. Eleven children died during their hospitalization (five heart failure, three sepsis, one respiratory tract infection, and one due to complication after surgery). Nine of the 11 had a congenital heart anomaly. Conclusion: Children with Down syndrome can present with complex medical issues and we support the concept of a multidisciplinary team that has experience and knowledge to serve as a “one stop shop” for these individuals and their families, with timely visits in which a comprehensive evaluation is performed, problems attended to and prevention plans applied. In this way, we may prevent morbidity, hospitalizations, and mortality. PMID:24688981

Team science and the physician-scientist in the age of grand health challenges.

PubMed

Steer, Clifford J; Jackson, Peter R; Hornbeak, Hortencia; McKay, Catherine K; Sriramarao, P; Murtaugh, Michael P

2017-09-01

Despite remarkable advances in medical research, clinicians face daunting challenges from new diseases, variations in patient responses to interventions, and increasing numbers of people with chronic health problems. The gap between biomedical research and unmet clinical needs can be addressed by highly talented interdisciplinary investigators focused on translational bench-to-bedside medicine. The training of talented physician-scientists comfortable with forming and participating in multidisciplinary teams that address complex health problems is a top national priority. Challenges, methods, and experiences associated with physician-scientist training and team building were explored at a workshop held at the Second International Conference on One Medicine One Science (iCOMOS 2016), April 24-27, 2016, in Minneapolis, Minnesota. A broad range of scientists, regulatory authorities, and health care experts determined that critical investments in interdisciplinary training are essential for the future of medicine and healthcare delivery. Physician-scientists trained in a broad, nonlinear, cross-disciplinary manner are and will be essential members of science teams in the new age of grand health challenges and the birth of precision medicine. Team science approaches have accomplished biomedical breakthroughs once considered impossible, and dedicated physician-scientists have been critical to these achievements. Together, they translate into the pillars of academic growth and success. © 2017 New York Academy of Sciences.

Model-based image analysis of a tethered Brownian fibre for shear stress sensing

PubMed Central

2017-01-01

The measurement of fluid dynamic shear stress acting on a biologically relevant surface is a challenging problem, particularly in the complex environment of, for example, the vasculature. While an experimental method for the direct detection of wall shear stress via the imaging of a synthetic biology nanorod has recently been developed, the data interpretation so far has been limited to phenomenological random walk modelling, small-angle approximation, and image analysis techniques which do not take into account the production of an image from a three-dimensional subject. In this report, we develop a mathematical and statistical framework to estimate shear stress from rapid imaging sequences based firstly on stochastic modelling of the dynamics of a tethered Brownian fibre in shear flow, and secondly on a novel model-based image analysis, which reconstructs fibre positions by solving the inverse problem of image formation. This framework is tested on experimental data, providing the first mechanistically rational analysis of the novel assay. What follows further develops the established theory for an untethered particle in a semi-dilute suspension, which is of relevance to, for example, the study of Brownian nanowires without flow, and presents new ideas in the field of multi-disciplinary image analysis. PMID:29212755

ICME — A Mere Coupling of Models or a Discipline of Its Own?

NASA Astrophysics Data System (ADS)

Bambach, Markus; Schmitz, Georg J.; Prahl, Ulrich

Technically, ICME — Integrated computational materials engineering — is an approach for solving advanced engineering problems related to the design of new materials and processes by combining individual materials and process models. The combination of models by now is mainly achieved by manual transformation of the output of a simulation to form the input to a subsequent one. This subsequent simulation is either performed at a different length scale or constitutes a subsequent step along the process chain. Is ICME thus just a synonym for the coupling of simulations? In fact, most ICME publications up to now are examples of the joint application of selected models and software codes to a specific problem. However, from a systems point of view, the coupling of individual models and/or software codes across length scales and along material processing chains leads to highly complex meta-models. Their viability has to be ensured by joint efforts from science, industry, software developers and independent organizations. This paper identifies some developments that seem necessary to make future ICME simulations viable, sustainable and broadly accessible and accepted. The main conclusion is that ICME is more than a multi-disciplinary subject but a discipline of its own, for which a generic structural framework has to be elaborated and established.

Supramolecular Biofunctional Materials

PubMed Central

Zhou, Jie; Li, Jie; Du, Xuewen; Xu, Bing

2017-01-01

This review discusses supramolecular biofunctional materials, a novel class of biomaterials formed by small molecules that are held together via noncovalent interactions. The complexity of biology and relevant biomedical problems not only inspire, but also demand effective molecular design for functional materials. Supramolecular biofunctional materials offer (almost) unlimited possibilities and opportunities to address challenging biomedical problems. Rational molecular design of supramolecular biofunctional materials exploit powerful and versatile noncovalent interactions, which offer many advantages, such as responsiveness, reversibility, tunability, biomimicry, modularity, predictability, and, most importantly, adaptiveness. In this review, besides elaborating on the merits of supramolecular biofunctional materials (mainly in the form of hydrogels and/or nanoscale assemblies) resulting from noncovalent interactions, we also discuss the advantages of small peptides as a prevalent molecular platform to generate a wide range of supramolecular biofunctional materials for the applications in drug delivery, tissue engineering, immunology, cancer therapy, fluorescent imaging, and stem cell regulation. This review aims to provide a brief synopsis of recent achievements at the intersection of supramolecular chemistry and biomedical science in hope of contributing to the multidisciplinary research on supramolecular biofunctional materials for a wide range of applications. We envision that supramolecular biofunctional materials will contribute to the development of new therapies that will ultimately lead to a paradigm shift for developing next generation biomaterials for medicine. PMID:28319779

Surveying multidisciplinary aspects in real-time distributed coding for Wireless Sensor Networks.

PubMed

Braccini, Carlo; Davoli, Franco; Marchese, Mario; Mongelli, Maurizio

2015-01-27

Wireless Sensor Networks (WSNs), where a multiplicity of sensors observe a physical phenomenon and transmit their measurements to one or more sinks, pertain to the class of multi-terminal source and channel coding problems of Information Theory. In this category, "real-time" coding is often encountered for WSNs, referring to the problem of finding the minimum distortion (according to a given measure), under transmission power constraints, attainable by encoding and decoding functions, with stringent limits on delay and complexity. On the other hand, the Decision Theory approach seeks to determine the optimal coding/decoding strategies or some of their structural properties. Since encoder(s) and decoder(s) possess different information, though sharing a common goal, the setting here is that of Team Decision Theory. A more pragmatic vision rooted in Signal Processing consists of fixing the form of the coding strategies (e.g., to linear functions) and, consequently, finding the corresponding optimal decoding strategies and the achievable distortion, generally by applying parametric optimization techniques. All approaches have a long history of past investigations and recent results. The goal of the present paper is to provide the taxonomy of the various formulations, a survey of the vast related literature, examples from the authors' own research, and some highlights on the inter-play of the different theories.

Contemporary Evaluation and Management of the Diabetic Foot

PubMed Central

Sumpio, Bauer E.

2012-01-01

Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695

Supramolecular biofunctional materials.

PubMed

Zhou, Jie; Li, Jie; Du, Xuewen; Xu, Bing

2017-06-01

This review discusses supramolecular biofunctional materials, a novel class of biomaterials formed by small molecules that are held together via noncovalent interactions. The complexity of biology and relevant biomedical problems not only inspire, but also demand effective molecular design for functional materials. Supramolecular biofunctional materials offer (almost) unlimited possibilities and opportunities to address challenging biomedical problems. Rational molecular design of supramolecular biofunctional materials exploit powerful and versatile noncovalent interactions, which offer many advantages, such as responsiveness, reversibility, tunability, biomimicry, modularity, predictability, and, most importantly, adaptiveness. In this review, besides elaborating on the merits of supramolecular biofunctional materials (mainly in the form of hydrogels and/or nanoscale assemblies) resulting from noncovalent interactions, we also discuss the advantages of small peptides as a prevalent molecular platform to generate a wide range of supramolecular biofunctional materials for the applications in drug delivery, tissue engineering, immunology, cancer therapy, fluorescent imaging, and stem cell regulation. This review aims to provide a brief synopsis of recent achievements at the intersection of supramolecular chemistry and biomedical science in hope of contributing to the multidisciplinary research on supramolecular biofunctional materials for a wide range of applications. We envision that supramolecular biofunctional materials will contribute to the development of new therapies that will ultimately lead to a paradigm shift for developing next generation biomaterials for medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.

State of science: occupational slips, trips and falls on the same level *

PubMed Central

Chang, Wen-Ruey; Leclercq, Sylvie; Lockhart, Thurmon E.; Haslam, Roger

2016-01-01

Abstract Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial. PMID:26903401

Evolution of the scientific basis for dentistry and its impact on dental education: past, present, and future.

PubMed

Slavkin, Harold C

2012-01-01

Science is the fuel for technology and the foundation for understanding the human condition. In dental education, as in all health professions, science informs a basic understanding of development, is essential to understand the structure and function of biological systems, and is prerequisite to understand and perform diagnostics, therapeutics, and clinical outcomes in the treatment of diseases and disorders. During the last seventy-five years, biomedical science has transformed from discipline-based scientists working on a problem to multidisciplinary research teams working to solve complex problems of significance to the larger society. Over these years, we witnessed the convergence of the biological and digital revolutions with clinical health care in medical, dental, pharmacy, nursing, and allied health care professional education. Biomedical science informs our understanding, from human genes and their functions to populations, health disparities, and the biosphere. Science is a "way of knowing," an international enterprise, a prerequisite for the health professions, and a calling and adventure to the curious mind. Science, the activity of doing science, is in the national self-interest, in the defense of a nation, and critical to the improvement of the human condition. In the words of Vannevar Bush, "science is the endless frontier."

Contemporary evaluation and management of the diabetic foot.

PubMed

Sumpio, Bauer E

2012-01-01

Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field.

Multidisciplinary field surveys as the new norm: Integrating geosciences to characterize the fate of carbon in a geothermal fumarole

NASA Astrophysics Data System (ADS)

Sheik, C.; Giovannelli, D.; Cox, A. D.; Hummer, D. R.; Pratt, K.; Thomas, D.; Viveiros, M. F.

2016-12-01

Has a reviewer ever asked you, "Why didn't you measure x, y, and z for this manuscript"? After venting your frustration to anyone who'll listen, you start to think maybe they're right and the study would benefit from a few extra measurements. Modern science demands multidisciplinary projects, data integration, and a holistic understanding of complex biogeochemical systems. With this in mind, we integrating field sampling into an early career scientist workshop. We asked, "Can we assemble early career scientists from disparate geoscience fields and effectively characterize carbon reservoirs and fluxes at a geologically active site?" Here, we present the results of an integrated, multidisciplinary, and co-located sampling effort carried out during the Second Deep Carbon Observatory Early Career Science Workshop 2015 in the Azores, Portugal. At the fumarole site, sediments lithology indicate a recent lacustrine deposition. All sediments show a degree of hydrothermal alteration, especially with depth. Carbonates were observed throughout the site as well as sulfur minerals jarosite and alunite. Temperatures of ejected waters quickly cooled from near boiling, to ambient 30 oC within an 35 m flow channel. Sediment surface gases (H2S, CO2 and CH4) were highly elevated at the site indicating a strong degassing influence. Analysis of noble gas isotopes unequivocally confirm the existence of mantle-derived fluids in the fumarole gases. Waters and sediments taken from mid-point within the channel were elevated in concentrations of all elements measured, especially elemental sulfur and copper. The organic matter content of sediments was typically low in the channel. Microbial analyses also show a strong temperature-dependent relationship, with Archaea dominating at higher temperatures and Bacteria at lower temperatures. Evidence of sulfur utilizing archaea were present in both ribosomal and metagenome libraries. Together, our interdisciplinary approach demonstrates, unsurprisingly, that collesing a diverse group of geoscientists to characterize a natural system is highly advantageous and productive. However, this approach also highlights the ever present problem of how to fund such highly interdisciplinary, field oriented, research.

Earthquake sequence simulations with measured properties for JFAST core samples

NASA Astrophysics Data System (ADS)

Noda, Hiroyuki; Sawai, Michiyo; Shibazaki, Bunichiro

2017-08-01

Since the 2011 Tohoku-Oki earthquake, multi-disciplinary observational studies have promoted our understanding of both the coseismic and long-term behaviour of the Japan Trench subduction zone. We also have suggestions for mechanical properties of the fault from the experimental side. In the present study, numerical models of earthquake sequences are presented, accounting for the experimental outcomes and being consistent with observations of both long-term and coseismic fault behaviour and thermal measurements. Among the constraints, a previous study of friction experiments for samples collected in the Japan Trench Fast Drilling Project (JFAST) showed complex rate dependences: a and a-b values change with the slip rate. In order to express such complexity, we generalize a rate- and state-dependent friction law to a quadratic form in terms of the logarithmic slip rate. The constraints from experiments reduced the degrees of freedom of the model significantly, and we managed to find a plausible model by changing only a few parameters. Although potential scale effects between lab experiments and natural faults are important problems, experimental data may be useful as a guide in exploring the huge model parameter space. This article is part of the themed issue 'Faulting, friction and weakening: from slow to fast motion'.

A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study

PubMed Central

McGlinchey, Regina E.; Milberg, William P.; Fonda, Jennifer R.; Fortier, Catherine Brawn

2017-01-01

Many US veterans of Afghanistan and Iraq have multiple physical and psychiatric problems. A major focus of research has been on determining the effects of mild Traumatic Brain Injury (mTBI), but mTBI is rarely diagnosed in the absence of co-occurring conditions such as blast exposure, post-traumatic stress disorder (PTSD), depression, substance abuse, etc. These potentially interactive psychological and physical conditions produce complex patterns of cognitive, psychological, and physical symptoms that impede civilian reintegration and complicate efficient and effective treatment planning. The Translational Research Center for TBI and Stress Disorders (TRACTS) has developed a multidisciplinary approach to the assessment of deployment trauma and its consequences in veterans of these wars. The prospective TRACTS longitudinal cohort study conducts state-of-the-art assessments in the domains of biomedical function, lifetime head trauma, psychological function encompassing deployment experience and lifetime exposure to traumatic events, neuropsychological function, and structural and functional neuroimaging. The TRACTS longitudinal cohort study is the first of its kind to comprehensively evaluate lifetime incidence of TBI and PTSD in these veterans, in addition to those incurred during military deployment. The protocol has begun to reveal information that will help improve understanding of the complex pathophysiology associated with co-occurring mTBI and related stress disorders. PMID:28211592

Extracellular Electron Transfer and Survival Strategies in Acid Mine Drainage Impacted Soils

NASA Astrophysics Data System (ADS)

Gorby, Y. A.; Senko, J.

2011-12-01

Acid mine drainage (AMD) is a prominent and increasing problem in the greater Appalachian region of the United States and throughout the world. Recognition of the importance of extracellular electron transfer (EET) in microbial communities has provided a fertile research environment for multidisciplinary collaborations to emerge and effectively address complex questions with important environmental implications. Our research focuses on the components, strategies and mechanisms of EET in soil systems impacted by AMD and extends to other biogeochemical systems typified by steep redox gradients. Organisms within acid mine drainage use Fe(II) as their primary electron donor and couple Fe(II) oxidation to the reduction of oxygen as the terminal electron acceptor. Biogenic minerals formed by this process completely encase microbes in think deposits that would seem to limit diffusion of both Fe(II) and O2 for access by the organisms. We have developed methods for catalytically removing biogenic minerals revealing microorganisms and a fine network of filamentous extracellular material. Here we present a status report of our efforts to characterize the molecular and electronic properties of these filaments and to address the hypothesis that at least some of these filaments are electrically conductive microbial nanowires that facilitate electron transfer reactions within this complex biogeochemical system.

EPA Scientific Knowledge Management Assessment and ...

EPA Pesticide Factsheets

A series of activities have been conducted by a core group of EPA scientists from across the Agency. The activities were initiated in 2012 and the focus was to increase the reuse and interoperability of science software at EPA. The need for increased reuse and interoperability is linked to the increased complexity of environmental assessments in the 21st century. This complexity is manifest in the form of problems that require integrated multi-disciplinary solutions. To enable the means to develop these solutions (i.e., science software systems) it is necessary to integrate software developed by disparate groups representing a variety of science domains. Thus, reuse and interoperability becomes imperative. This report briefly describes the chronology of activities conducted by the group of scientists to provide context for the primary purpose of this report, that is, to describe the proceedings and outcomes of the latest activity, a workshop entitled “Workshop on Advancing US EPA integration of environmental and information sciences”. The EPA has been lagging in digital maturity relative to the private sector and even other government agencies. This report helps begin the process of improving the agency’s use of digital technologies, especially in the areas of efficiency and transparency. This report contributes to SHC 1.61.2.

Community-oriented integrated care and health promotion – views from the street

PubMed Central

Thomas, Paul; Burch, Tony; Ferlie, Ewan; Jenkins, Rachel; Wright, Fiona; Sachar, Amrit; Ruprah-Shah, Baljeet

2015-01-01

Abstract On the 1st and 2nd May 2015, participants at the RCGP London City Health Conference debated practical ways to achieve integrated care at community level. In five connected workshops, participants reviewed current work and identified ways to overcome some of the problems that had become apparent. In this paper, we summarise the conclusions of each workshop, and provide an overall comment. There are layers of complexity in community-oriented integrated care that are not apparent at first sight. The difficult thing is not persuading people that it matters, but finding ways to do it that are practical and sustainable. The dynamic and complex nature of the territory is bewildering. The expectation of silo-operating and linear thinking, and the language and models that encourage it, pervade health and social care. Comprehensive integration is possible, but the theory and practice are unfamiliar to many. Images, theories and models are needed to help people from all parts of the system to see big pictures and focused detail at the same time and oscillate between them to envision-integrated whole systems. Infrastructure needs to enable this, with coordination hubs, locality-based multidisciplinary meetings and cycles of inter-organisational improvement to nurture relationships across organisational boundaries. PMID:26550036

Earthquake sequence simulations with measured properties for JFAST core samples.

PubMed

Noda, Hiroyuki; Sawai, Michiyo; Shibazaki, Bunichiro

2017-09-28

Since the 2011 Tohoku-Oki earthquake, multi-disciplinary observational studies have promoted our understanding of both the coseismic and long-term behaviour of the Japan Trench subduction zone. We also have suggestions for mechanical properties of the fault from the experimental side. In the present study, numerical models of earthquake sequences are presented, accounting for the experimental outcomes and being consistent with observations of both long-term and coseismic fault behaviour and thermal measurements. Among the constraints, a previous study of friction experiments for samples collected in the Japan Trench Fast Drilling Project (JFAST) showed complex rate dependences: a and a - b values change with the slip rate. In order to express such complexity, we generalize a rate- and state-dependent friction law to a quadratic form in terms of the logarithmic slip rate. The constraints from experiments reduced the degrees of freedom of the model significantly, and we managed to find a plausible model by changing only a few parameters. Although potential scale effects between lab experiments and natural faults are important problems, experimental data may be useful as a guide in exploring the huge model parameter space.This article is part of the themed issue 'Faulting, friction and weakening: from slow to fast motion'. © 2017 The Author(s).

Coal industry in America. A bibliography and guide to studies. [2827 references with brief abstracts

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

Munn, R.F.

1977-01-01

It is clearly desirable that research on the coal industry and the problems associated with it be carried on as efficiently and intelligently as possible. Unfortunately, the scattered nature of the literature militates against this. Even the most conscientious scholar finds it increasingly difficult to keep abreast of the literature in his own field. It is generally quite impossible for him to follow that of other disciplines. Thus it is idle to expect the sociologist to scan medical journals or the economist to master the literature of psychology. And yet, it seems clear that fruitful study of many of themore » problems associated with the coal industry must utilize a multi-disciplinary approach. The chief purpose of this guide is to aid in such multi-disciplinary research. The principal emphasis has been placed on the social sciences. The enormous body of literature in the science and technology of mining is outside the scope of this work. Titles dealing with technology and geology are included only if they contain a significant amount of material of potential interest to the historian or social scientist. Every effort has been made to include titles of real significance and works whose bibliographies will serve as a guide to those interested in a specific area or problem.« less

HSCT4.0 Application: Software Requirements Specification

NASA Technical Reports Server (NTRS)

Salas, A. O.; Walsh, J. L.; Mason, B. H.; Weston, R. P.; Townsend, J. C.; Samareh, J. A.; Green, L. L.

2001-01-01

The software requirements for the High Performance Computing and Communication Program High Speed Civil Transport application project, referred to as HSCT4.0, are described. The objective of the HSCT4.0 application project is to demonstrate the application of high-performance computing techniques to the problem of multidisciplinary design optimization of a supersonic transport configuration, using high-fidelity analysis simulations. Descriptions of the various functions (and the relationships among them) that make up the multidisciplinary application as well as the constraints on the software design arc provided. This document serves to establish an agreement between the suppliers and the customer as to what the HSCT4.0 application should do and provides to the software developers the information necessary to design and implement the system.

Bullying - effects, prevalence and strategies for detection.

PubMed

Carr-Gregg, Michael; Manocha, Ramesh

2011-03-01

The mental, physical, social and academic consequences of bullying have an enormous impact on human and social capital. This article describes the effects and prevalence of bullying on young people and presents strategies for its detection. Strategies for the facilitation of a multidisciplinary approach to bullying in adolescents are also presented. Given the existing high rate of bullying, assessment should be incorporated into a standard psychosocial screening routine in the general practitioner's clinic. Effective management is a multidisciplinary effort, involving parents, teachers and school officials, the GP, and mental health professionals. Given the variable effectiveness of schools in tackling bullying, GPs play an important role in identifying at risk patients, screening for psychiatric comorbidities, counselling families about the problem, and advocating for bullying prevention in their communities.

Novel Multidisciplinary Models Assess the Capabilities of Smart Structures to Manage Vibration, Sound, and Thermal Distortion in Aeropropulsion Components

NASA Technical Reports Server (NTRS)

Saravanos, Dimitris A.

1997-01-01

The development of aeropropulsion components that incorporate "smart" composite laminates with embedded piezoelectric actuators and sensors is expected to ameliorate critical problems in advanced aircraft engines related to vibration, noise emission, and thermal stability. To facilitate the analytical needs of this effort, the NASA Lewis Research Center has developed mechanics and multidisciplinary computational models to analyze the complicated electromechanical behavior of realistic smart-structure configurations operating in combined mechanical, thermal, and acoustic environments. The models have been developed to accommodate the particular geometries, environments, and technical challenges encountered in advanced aircraft engines, yet their unique analytical features are expected to facilitate application of this new technology in a variety of commercial applications.

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

PubMed

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

2017-10-01

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

Exploring Corn-Ethanol As A Complex Problem To Teach Sustainability Concepts Across The Science-Business-Liberal Arts Curriculum

NASA Astrophysics Data System (ADS)

Oches, E. A.; Szymanski, D. W.; Snyder, B.; Gulati, G. J.; Davis, P. T.

2012-12-01

The highly interdisciplinary nature of sustainability presents pedagogic challenges when sustainability concepts are incorporated into traditional disciplinary courses. At Bentley University, where over 90 percent of students major in business disciplines, we have created a multidisciplinary course module centered on corn ethanol that explores a complex social, environmental, and economic problem and develops basic data analysis and analytical thinking skills in several courses spanning the natural, physical, and social sciences within the business curriculum. Through an NSF-CCLI grant, Bentley faculty from several disciplines participated in a summer workshop to define learning objectives, create course modules, and develop an assessment plan to enhance interdisciplinary sustainability teaching. The core instructional outcome was a data-rich exercise for all participating courses in which students plot and analyze multiple parameters of corn planted and harvested for various purposes including food (human), feed (animal), ethanol production, and commodities exchanged for the years 1960 to present. Students then evaluate patterns and trends in the data and hypothesize relationships among the plotted data and environmental, social, and economic drivers, responses, and unintended consequences. After the central data analysis activity, students explore corn ethanol production as it relates to core disciplinary concepts in their individual classes. For example, students in Environmental Chemistry produce ethanol using corn and sugar as feedstocks and compare the efficiency of each process, while learning about enzymes, fermentation, distillation, and other chemical principles. Principles of Geology students examine the effects of agricultural runoff on surface water quality associated with extracting greater agricultural yield from mid-continent croplands. The American Government course examines the role of political institutions, the political process, and various stakeholders in developing and implementing policy on renewable fuels standards and ethanol production targets for the U.S. In Microeconomics students learn cost-benefit analysis and other concepts by applying economics principles to the corn ethanol problem. Following the disciplinary activities, students are asked to reconsider the central corn ethanol problem and evaluate it from a sustainability perspective. Assessment is ongoing, although initial results suggest that undergraduate students have difficulty integrating knowledge across multiple disciplines when evaluating a complex sustainability problem. Based on our initial assessment, we are exploring ways to modify the corn ethanol module as well as fine-tune the assessment instruments to provide the most effective outcomes possible. Because there are commonly institutional barriers to team teaching and other methods of cross-disciplinary instruction, we are recruiting faculty from additional disciplines to adapt and implement the corn ethanol module as a way of integrating sustainability concepts across the curriculum. Our goal is to teach complex, trans-disciplinary problem-solving and have students explore ways in which sustainability issues must be addressed through the application of concepts from the environmental and social sciences, public policy, and economics.

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.

Multidisciplinary Design Optimization of a Full Vehicle with High Performance Computing

NASA Technical Reports Server (NTRS)

Yang, R. J.; Gu, L.; Tho, C. H.; Sobieszczanski-Sobieski, Jaroslaw

2001-01-01

Multidisciplinary design optimization (MDO) of a full vehicle under the constraints of crashworthiness, NVH (Noise, Vibration and Harshness), durability, and other performance attributes is one of the imperative goals for automotive industry. However, it is often infeasible due to the lack of computational resources, robust simulation capabilities, and efficient optimization methodologies. This paper intends to move closer towards that goal by using parallel computers for the intensive computation and combining different approximations for dissimilar analyses in the MDO process. The MDO process presented in this paper is an extension of the previous work reported by Sobieski et al. In addition to the roof crush, two full vehicle crash modes are added: full frontal impact and 50% frontal offset crash. Instead of using an adaptive polynomial response surface method, this paper employs a DOE/RSM method for exploring the design space and constructing highly nonlinear crash functions. Two NMO strategies are used and results are compared. This paper demonstrates that with high performance computing, a conventionally intractable real world full vehicle multidisciplinary optimization problem considering all performance attributes with large number of design variables become feasible.

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.

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

NASA Technical Reports Server (NTRS)

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

1994-01-01

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

Outcome of physiotherapy as part of a multidisciplinary rehabilitation in an unselected polio population with one-year follow-up: an uncontrolled study.

PubMed

Bertelsen, Merete; Broberg, Susse; Madsen, Ellen

2009-01-01

The aim of this study was to evaluate the outcome of physiotherapy as part of a multidisciplinary rehabilitation. Prospective uncontrolled intervention study. Fifty patients with late effects of polio, first time referred to physiotherapy at the Danish Society of Polio and Accident Victims (PTU) Rehabilitation Centre. The intervention was physiotherapy as an essential part of an individually planned multidisciplinary rehabilitation. The outcome measures Six-Minute Walk Test and Timed-Stands Test were used to assess the functional capacity. Quality of life was evaluated by Medical Outcome Survey Short Form (SF-36) and fatigue by Multidimensional Fatigue Inventory (MFI-20). Patients were tested at baseline; 3 months after the start of rehabilitation and at one-year follow-up. The patients showed significantly better functional capacity on all measurements 3 months after start of intervention and at one-year follow-up. The patients showed significant improvement in 3 of the SF-36 dimensions regarding quality of life, but only the improvement in "general health" remained after one year. This study shows that patients with late effects of polio, who experience new problems related to polio, can benefit from an individually planned multidisciplinary intervention with emphasis on physiotherapy, and the improvement in physical capacity and general health can remain at one-year follow-up.

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

PubMed

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

2015-02-01

The purpose of this study is to determine whether there are some differences in the treatment responses to a multidisciplinary fibromyalgia (FM) treatment related with the baseline body mass index (BMI) of the participants. Inclusion criteria consisted of female sex, a diagnosis of FM (American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Baseline BMI was determined, and patients were randomly assigned to one of the two treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were pain intensity, functionality, catastrophizing, psychological distress, health-related quality of life, and sleep disturbances. One hundred thirty patients participated in the study. No statistical significant differences regarding pre-treatment outcomes were found among the different BMI subgroups, and between the two experimental conditions for each BMI category. General linear model analysis showed a significant interaction group treatment × time in pain intensity (p < .01), functionality (p < .0001), catastrophizing (p < .01), psychological distress (p < .0001), sleep index problems (p < .0001), and health-related quality of life (p < .05). No significant interactions were found in BMI × time, and in BMI × group treatment × time. There are not differences among normal weight, overweight and obese patients with FM regarding their response to a multidisciplinary treatment programme for FM which combines pharmacological treatment, education, physical therapy and cognitive behavioural therapy.

The Problematics of Postmodernism: The Double-Voiced Honors Canon.

ERIC Educational Resources Information Center

McCracken, Tim

Honors education is not immune from the current controversy concerning the role of the literary canon. Indeed, the problem seems especially crucial for honors programs, for their curriculums are often multi-disciplinary in their approaches to culture and history. The solution may lie in what Linda Hutcheon calls the "poetics of the…