multi-disciplinary clinical study: Topics by Science.gov

Sample records for multi-disciplinary clinical study

Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.

PubMed

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

2004-10-01

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.
Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics.

PubMed

Rullo, Jordan; Faubion, Stephanie S; Hartzell, Rose; Goldstein, Sue; Cohen, Deborah; Frohmader, Karla; Winter, Ashley G; Mara, Kristin; Schroeder, Darrell; Goldstein, Irwin

2018-05-19

Sexual dysfunction is often complex and biopsychosocial. Traditional sexual health care management involves individual providers not in a multi-disciplinary setting. A multi-disciplinary team may consist of a medical provider, pelvic floor physical therapist, and sex therapist. The aim was to explore the patient perceptions of benefit from management of their sexual dysfunction by a biopsychosocial multi-disciplinary team. A survey was e-mailed to women patients seen by multi-disciplinary teams at 2 different settings: San Diego Sexual Medicine or Mayo Clinic Women's Health Clinic during a 27-month period. Data are reported using summary statistics for age and count for remaining survey responses. Cochran-Armitage tests for trend were used to compare pre- and post-comfort levels. Main outcome measures included perceived benefit of being managed in a team-based model of care, level of benefit and satisfaction from each provider, and difference from pre-conceived level of comfort to actual comfort after each provider visit. 89 of 270 e-mailed surveys were analyzed. Patient populations (mean age 47.6, range 23-77 years) were similar between sites. Overall, 82% of respondents reported moderate/great benefit from the team-based model; 72.1% reported management by all 3 providers valuable/extremely valuable; and 84.3% were somewhat/very satisfied with the model. Women endorsed specific ways in which they benefitted from the team-based model including: improved sexual function (58.1%), feeling validated (72.1%) and listened to (62.8%), that they better understood their health concerns (65.1%), that their partner better understood their health concerns (46.5%), and feeling normal (46.5%). There were no significant differences between the 2 clinics in terms of patient-perceived benefit, value, or satisfaction. The team-based model of care for management of sexual dysfunction in women including a medical provider, physical therapist, and sex therapist is associated with patient-perceived benefit, satisfaction, and value. Rullo J, Faubion S, Hartzell R, et al. Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics. Sex Med 2018;XX:XXX-XXX. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Aortic valve replacement in a Jehovah’s Witness: a case of multi-disciplinary clinical management for bloodless surgery

PubMed Central

Park, John Jungpa; Lang, Christopher C; Manson, Lynn; Brackenbury, Edward T

2012-01-01

An 81-year-old female Jehovah’s Witness (JW) patient with severe aortic stenosis required aortic valve replacement (AVR). However, the patient’s religious beliefs precluded the use of primary blood components. Since the definitive treatment of AVR required bloodless open heart surgery, careful peri-operative plans were set forth by a multi-disciplinary team involving the cardiothoracic surgeon, haematologist and anaesthetist. The patient went on to successfully recover postoperatively. This case highlights: 1) The importance of carefully navigating through the most recent clinical and ethical protocol involved in the surgical management of JW’s. 2) The importance of preparing individually tailored pre, intra and postoperative plans that are delivered through a multi-disciplinary clinical team to ensure the best and safest possible outcomes. PMID:22665474
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.
TELEMAM: a cluster randomised trial to assess the use of telemedicine in multi-disciplinary breast cancer decision making.

PubMed

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

2007-11-01

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

PubMed Central

Avery, Robert A.; Katowitz, James A.; Fisher, Michael J.; Heidary, Gena; Dombi, Eva; Packer, Roger J.; Widemann, Brigitte C.

2016-01-01

Children and adults with Neurofibromatosis type 1 (NF1), a common autosomal dominant condition, manifest a variety of ophthalmologic conditions. Plexiform neurofibromas involving the eyelid, orbit, periorbital and facial structures (termed OPPN) can result in significant visual loss in children. Equally important, OPPNs can cause significant alteration in physical appearance secondary to proptosis, ptosis, and facial disfigurement, leading to social embarrassment and decreased self-esteem. Despite NF1 being a relatively common disease in which routine ophthalmologic examinations are required, no formal recommendations for clinical care of children with OPPNs exist. While medical and surgical interventions have been reported, there are no agreed upon criteria for when OPPN require therapy and which treatment produces the best outcome. Since a multi-disciplinary team of specialists (oculofacial plastics, pediatric ophthalmology, neuro-ophthalmology, medical genetics and neuro-oncology) direct management decisions, the absence of a uniform outcome measure that represents visual and or aesthetic sequelae complicates the design of evidence based studies and feasible clinical trials. In September 2013, a multi-disciplinary task force, composed of pediatric practitioners from tertiary care centers experienced in caring for children with OPPN, was convened to address the lack of clinical care guidelines for children with OPPN. This consensus statement provides recommendations for ophthalmologic monitoring and outlines treatment indications, forthcoming biologic therapy, while also discussing challenges to performing clinical trials in this complicated condition. PMID:27817916
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.
APEX_SCOPE: A graphical user interface for visualization of multi-modal data in inter-disciplinary studies.

PubMed

Kanbar, Lara J; Shalish, Wissam; Precup, Doina; Brown, Karen; Sant'Anna, Guilherme M; Kearney, Robert E

2017-07-01

In multi-disciplinary studies, different forms of data are often collected for analysis. For example, APEX, a study on the automated prediction of extubation readiness in extremely preterm infants, collects clinical parameters and cardiorespiratory signals. A variety of cardiorespiratory metrics are computed from these signals and used to assign a cardiorespiratory pattern at each time. In such a situation, exploratory analysis requires a visualization tool capable of displaying these different types of acquired and computed signals in an integrated environment. Thus, we developed APEX_SCOPE, a graphical tool for the visualization of multi-modal data comprising cardiorespiratory signals, automated cardiorespiratory metrics, automated respiratory patterns, manually classified respiratory patterns, and manual annotations by clinicians during data acquisition. This MATLAB-based application provides a means for collaborators to view combinations of signals to promote discussion, generate hypotheses and develop features.
Development of knowledge tests for multi-disciplinary emergency training: a review and an example.

PubMed

Sørensen, J L; Thellesen, L; Strandbygaard, J; Svendsen, K D; Christensen, K B; Johansen, M; Langhoff-Roos, P; Ekelund, K; Ottesen, B; Van Der Vleuten, C

2015-01-01

The literature is sparse on written test development in a post-graduate multi-disciplinary setting. Developing and evaluating knowledge tests for use in multi-disciplinary post-graduate training is challenging. The objective of this study was to describe the process of developing and evaluating a multiple-choice question (MCQ) test for use in a multi-disciplinary training program in obstetric-anesthesia emergencies. A multi-disciplinary working committee with 12 members representing six professional healthcare groups and another 28 participants were involved. Recurrent revisions of the MCQ items were undertaken followed by a statistical analysis. The MCQ items were developed stepwise, including decisions on aims and content, followed by testing for face and content validity, construct validity, item-total correlation, and reliability. To obtain acceptable content validity, 40 out of originally 50 items were included in the final MCQ test. The MCQ test was able to distinguish between levels of competence, and good construct validity was indicated by a significant difference in the mean score between consultants and first-year trainees, as well as between first-year trainees and medical and midwifery students. Evaluation of the item-total correlation analysis in the 40 items set revealed that 11 items needed re-evaluation, four of which addressed content issues in local clinical guidelines. A Cronbach's alpha of 0.83 for reliability was found, which is acceptable. Content and construct validity and reliability were acceptable. The presented template for the development of this MCQ test could be useful to others when developing knowledge tests and may enhance the overall quality of test development. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Center for Prostate Disease Research

MedlinePlus

... 2017 Cancer Statistics programs Clinical Research Program Synopsis Leadership Multi-Disciplinary Clinic Staff Listing 2017 Cancer Statistics Basic Science Research Program Synopsis Leadership Gene Expression Data Research Achievements Staff Listing Lab ...
Future Directions in Medical Physics: Models, Technology, and Translation to Medicine

NASA Astrophysics Data System (ADS)

Siewerdsen, Jeffrey

The application of physics in medicine has been integral to major advances in diagnostic and therapeutic medicine. Two primary areas represent the mainstay of medical physics research in the last century: in radiation therapy, physicists have propelled advances in conformal radiation treatment and high-precision image guidance; and in diagnostic imaging, physicists have advanced an arsenal of multi-modality imaging that includes CT, MRI, ultrasound, and PET as indispensible tools for noninvasive screening, diagnosis, and assessment of treatment response. In addition to their role in building such technologically rich fields of medicine, physicists have also become integral to daily clinical practice in these areas. The future suggests new opportunities for multi-disciplinary research bridging physics, biology, engineering, and computer science, and collaboration in medical physics carries a strong capacity for identification of significant clinical needs, access to clinical data, and translation of technologies to clinical studies. In radiation therapy, for example, the extraction of knowledge from large datasets on treatment delivery, image-based phenotypes, genomic profile, and treatment outcome will require innovation in computational modeling and connection with medical physics for the curation of large datasets. Similarly in imaging physics, the demand for new imaging technology capable of measuring physical and biological processes over orders of magnitude in scale (from molecules to whole organ systems) and exploiting new contrast mechanisms for greater sensitivity to molecular agents and subtle functional / morphological change will benefit from multi-disciplinary collaboration in physics, biology, and engineering. Also in surgery and interventional radiology, where needs for increased precision and patient safety meet constraints in cost and workflow, development of new technologies for imaging, image registration, and robotic assistance can leverage collaboration in physics, biomedical engineering, and computer science. In each area, there is major opportunity for multi-disciplinary collaboration with medical physics to accelerate the translation of such technologies to clinical use. Research supported by the National Institutes of Health, Siemens Healthcare, and Carestream Health.
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
Development of an Agile Knowledge Engineering Framework in Support of Multi-Disciplinary Translational Research

PubMed Central

Borlawsky, Tara B.; Dhaval, Rakesh; Hastings, Shannon L.; Payne, Philip R. O.

2009-01-01

In October 2006, the National Institutes of Health launched a new national consortium, funded through Clinical and Translational Science Awards (CTSA), with the primary objective of improving the conduct and efficiency of the inherently multi-disciplinary field of translational research. To help meet this goal, the Ohio State University Center for Clinical and Translational Science has launched a knowledge management initiative that is focused on facilitating widespread semantic interoperability among administrative, basic science, clinical and research computing systems, both internally and among the translational research community at-large, through the integration of domain-specific standard terminologies and ontologies with local annotations. This manuscript describes an agile framework that builds upon prevailing knowledge engineering and semantic interoperability methods, and will be implemented as part this initiative. PMID:21347164
Development of an agile knowledge engineering framework in support of multi-disciplinary translational research.

PubMed

Borlawsky, Tara B; Dhaval, Rakesh; Hastings, Shannon L; Payne, Philip R O

2009-03-01

In October 2006, the National Institutes of Health launched a new national consortium, funded through Clinical and Translational Science Awards (CTSA), with the primary objective of improving the conduct and efficiency of the inherently multi-disciplinary field of translational research. To help meet this goal, the Ohio State University Center for Clinical and Translational Science has launched a knowledge management initiative that is focused on facilitating widespread semantic interoperability among administrative, basic science, clinical and research computing systems, both internally and among the translational research community at-large, through the integration of domain-specific standard terminologies and ontologies with local annotations. This manuscript describes an agile framework that builds upon prevailing knowledge engineering and semantic interoperability methods, and will be implemented as part this initiative.
Multi-disciplinary coupling effects for integrated design of propulsion systems

NASA Technical Reports Server (NTRS)

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

1993-01-01

Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions which govern the accurate response of propulsion systems. Results are presented for propulsion system responses including multi-disciplinary coupling effects using coupled multi-discipline thermal, structural, and acoustic tailoring; an integrated system of multi-disciplinary simulators; coupled material behavior/fabrication process tailoring; sensitivities using a probabilistic simulator; and coupled materials, structures, fracture, and probabilistic behavior simulator. The results demonstrate that superior designs can be achieved if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated coupled multi-discipline numerical propulsion system simulator.
Healthcare Students' Perceptions of a Simulated Interprofessional Consultation in an Outpatient Clinic

ERIC Educational Resources Information Center

Pitout, H.; Human, A.; Treadwell, I.; Sobantu, N. A.

2016-01-01

Newly graduated healthcare workers should appreciate the importance of teamwork and each profession's unique role in a multi-disciplinary team. At Medunsa, an institution for higher education of healthcare professionals, each profession's teaching occurs independently. This study explores the perceptions of healthcare students and their…
Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome: an international and multi-disciplinary Delphi survey.

PubMed

Reiman, M P; Thorborg, K; Covington, K; Cook, C E; Hölmich, P

2017-06-01

Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally defined from international publications and presentations was utilized. All six domains (subjective examination, patient-reported outcome measures, physical examination, special tests, physical performance measures, and diagnostic imaging) had at least one descriptor with 75% consensus agreement for diagnosis and assessment of FAIS. Diagnostic imaging was the domain with the highest level of agreement. Domains such as patient-reported outcome measures (PRO's) and physical examination were identified as non-diagnostic measures (rather as assessments of disease impact). Although it also had the greatest level of variability in description of examination domains, diagnostic imaging continues to be the preeminent diagnostic measure for FAIS. No single domain should be utilized as the sole diagnostic or assessment parameter for FAIS. While not all investigated domains provide diagnostic capability for FAIS, those that do not are able to serve purpose as a measure of disease impact (e.g., impairments and activity limitations). The clinical relevance of this Delphi survey is the understanding that a comprehensive assessment measuring both diagnostic capability and disease impact most accurately reflects the patient with FAIS. V.
Multi-disciplinary clinical study of Smith-Magenis syndrome (deletion 17p11.2)

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

Greenberg, F.; Lewis, R.A.; Potocki, L.

1996-03-29

Smith-Magenis syndrome (SMS) is a multiple congenital anomaly, mental retardation (MCA/MR) syndrome associated with deletion of chromosome 17 band p11.2. As part of a multi-disciplinary clinical, cytogenetic, and molecular approach to SMS, detailed clinical studies including radiographic neurologic, developmental, ophthalmologic, otolaryngologic, and audiologic evaluations were performed on 27 SMS patients. Significant findings include otolaryngologic abnormalities in 94%, eye abnormalities in 85%, sleep abnormalities (especially reduced REM sleep) in 75%, hearing impairment in 68% (approximately 65% conductive and 35% sensorineural), scoliosis in 65% brain abnormalities (predominantly ventriculomegaly) in 52%, cardiac abnormalities in at least 37%, renal anomalies (especially duplication of themore » collecting system) in 35%, low thyroxine levels in 29%, low immunoglobulin levels in 23%, and forearm abnormalities in 16%. The measured IQ ranged between 20-78, most patients falling in the moderate range of mental retardation at 40-54, although several patients scored in the mild or borderline range. The frequency of these many abnormalities in SMS suggests that patients should be evaluated thoroughly for associated complications both at the time of diagnosis and at least annually thereafter. 42 refs., 2 figs., 3 tabs.« less
From user needs to system specifications: multi-disciplinary thematic seminars as a collaborative design method for development of health information systems.

PubMed

Scandurra, I; Hägglund, M; Koch, S

2008-08-01

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

MEDES clinical research facility as a tool to prepare ISSA space flights

NASA Astrophysics Data System (ADS)

Maillet, A.; Traon, A. Pavy-Le

This new multi-disciplinary medical experimentation center provides the ideal scientific, medical and technical environment required for research programs and to prepare international space station Alpha (ISSA) missions, where space and healthcare industries can share their expertise. Different models are available to simulate space flight effects (bed-rest, confinement,…). This is of particular interest for research in Human psychology, physiology, physiopathology and ergonomics, validation of biomedical materials and procedures, testing of drugs, and other healthcare related products. This clinical research facility (CRF) provides valuable services in various fields of Human research requiring healthy volunteers. CRF is widely accessible to national and international, scientific, medical and industrial organisations. Furthermore, users have at their disposal the multi-disciplinary skills of MEDES staff and all MEDES partners on a single site.
Use of Multi-Disciplinary Projects To Develop Competence.

ERIC Educational Resources Information Center

Trotman-Dickenson, Danusia

1992-01-01

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

ERIC Educational Resources Information Center

Ng, Vincent; Lau, Chloe; Shum, Pearl

2012-01-01

Recently, there are many good examples of how multi-disciplinary learning can support students to learn collaboratively and not solely focus on a single professional sector. During the Fall 2011 and Spring 2012 semesters, we have attempted to gather students studying different professional domains together. Students from the Department of…
RoboCup: Multi-disciplinary Senior Design Project.

ERIC Educational Resources Information Center

Elder, Kevin Lee

A cross-college team of educators has developed a collaborative, multi-disciplinary senior design course at Ohio University. This course offers an attractive opportunity for students from a variety of disciplines to work together in a learning community to accomplish a challenging task. It provides a novel multi-disciplinary learning environment…
Evaluation of the quality of care of a multi-disciplinary Risk Factor Assessment and Management Programme for Hypertension (RAMP-HT).

PubMed

Yu, Esther Yee Tak; Wan, Eric Yuk Fai; Chan, Karina Hiu Yen; Wong, Carlos King Ho; Kwok, Ruby Lai Ping; Fong, Daniel Yee Tak; Lam, Cindy Lo Kuen

2015-06-19

There is some evidence to support a risk-stratified, multi-disciplinary approach to manage patients with hypertension in primary care. The aim of this study is to evaluate the quality of care (QOC) of a multi-disciplinary Risk Assessment and Management Programme for Hypertension (RAMP-HT) for hypertensive patients in busy government-funded primary care clinics in Hong Kong. The objectives are to develop an evidence-based, structured and comprehensive evaluation framework on quality of care, to enhance the QOC of the RAMP-HT through an audit spiral of two evaluation cycles and to determine the effectiveness of the programme in reducing cardiovascular disease (CVD) risk. A longitudinal study is conducted using the Action Learning and Audit Spiral methodologies to measure whether pre-set target standards of care intended by the RAMP-HT are achieved. A structured evaluation framework on the quality of structure, process and outcomes of care has been developed based on the programme objectives and literature review in collaboration with the programme workgroup and health service providers. Each participating clinic is invited to complete a structure of care evaluation questionnaire in each evaluation cycle. The data of all patients who have enrolled into the RAMP-HT in the pre-defined evaluation periods are used for the evaluation of the process and outcomes of care in each evaluation cycle. For evaluation of the effectiveness of RAMP-HT, the primary outcomes including blood pressure (both systolic and diastolic), low-density lipoprotein cholesterol and estimated 10-year CVD risk of RAMP-HT participants are compared to those of hypertensive patients in usual care without RAMP-HT. The QOC and effectiveness of the RAMP-HT in improving clinical and patient-reported outcomes for patients with hypertension in normal primary care will be determined. Possible areas for quality enhancement and standards of good practice will be established to inform service planning and policy decision making.
Multi-disciplinary management for patients with oligometastases to the brain: results of a 5 year cohort study.

PubMed

Maclean, Jillian; Fersht, Naomi; Singhera, Mausam; Mulholland, Paul; McKee, Orla; Kitchen, Neil; Short, Susan C

2013-06-27

The incidence of oligometastases to the brain in good performance status patients is increasing due to improvements in systemic therapy and MRI screening, but specific management pathways are often lacking. We established a multi-disciplinary brain metastases clinic with specific referral guidelines and standard follow-up for good prognosis patients with the view that improving the process of care may improve outcomes. We evaluated patient demographic and outcome data for patients first seen between February 2007 and November 2011. The clinic was feasible to run and referrals were appropriate. 87% of patients referred received a localised therapy during their treatment course. 114 patients were seen and patient numbers increased during the 5 years that the clinic has been running as relationships between clinicians were developed. Median follow-up for those still alive was 23.1 months (6.1-79.1 months). Primary treatments were: surgery alone 52%, surgery plus whole brain radiotherapy (WBRT) 9%, radiosurgery 14%, WBRT alone 23%, supportive care 2%. 43% received subsequent treatment for brain metastases. 25%, 11% and 15% respectively developed local neurological progression only, new brain metastases only or both. Median overall survival following brain metastases diagnosis was 16.0 months (range 1-79.1 months). Breast (32%) and NSCLC (26%) were the most common primary tumours with median survivals of 26 and 16.9 months respectively (HR 0.6, p=0.07). Overall one year survival was 55% and two year survival 31.5%. 85 patients died of whom 37 (44%) had a neurological death. Careful patient selection and multi-disciplinary management identifies a subset of patients with oligometastatic brain disease who benefit from aggressive local treatment. A dedicated joint neurosurgical/ neuro-oncology clinic for such patients is feasible and effective. It also offers the opportunity to better define management strategies and further research in this field. Consideration should be given to defining specific management pathways for these patients within general oncology practice.
[The model program of psycho-social treatment and staff training].

PubMed

Ikebuchi, Emi

2012-01-01

The model program of psycho-social treatment and staff training were reported in this issue. The mission of model program is supporting recovery of persons with mental illness and their family as well as empowering their hope and sense of values. The personal support specialists belonging to multi-disciplinary team have responsibility to support life-long process of recovery across hospitalization, out-patients clinic, day treatment, and outreach service. The shared value of multi-disciplinary team (the community life supporting team) is recovery so that the team renders self directive life, various alternatives of their lives, and peer group with models of recovery to persons with mental illness. There should be several technologies which are used in the team such as engagement, psycho-education, cognitive-behavior therapy, care-management, cooperating with other resources. The responsibility, assessment and evaluation techniques, guarantee of opportunities for training, and auditing system of the team and process of treatment are important factors to educate team staff. Raising effective multi-disciplinary team requires existence of a mentor or good model near the team.
The Multi-Disciplinary Graduate Program in Educational Research. Final Report, Part IV; The Utilization of Sociological Ideas in Organizational Planning: A Case Study.

ERIC Educational Resources Information Center

Lazarsfeld, Paul F., Ed.

This document, the fourth in the final report on the Multi-Disciplinary Graduate Program in Educational Research, is a qualitative case study designed to show the form of sociological contributions to and the role of sociologists in policy formulation at an American Educational Research Association (AERA) colloquium. Discussions at the conference…
Simulating the Multi-Disciplinary Care Team Approach: Enhancing Student Understanding of Anatomy through an Ultrasound-Anchored Interprofessional Session

ERIC Educational Resources Information Center

Luetmer, Marianne T.; Cloud, Beth A.; Youdas, James W.; Pawlina, Wojciech; Lachman, Nirusha

2018-01-01

Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL)…
Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) program: A new standard of care for injured workers in Hong Kong.

PubMed

Law, S W; Szeto, G P Y; Chau, W W; Chan, Carol; Kwok, Anthony W L; Lai, H S; Lee, Ryan K L; Griffith, James F; Hung, L K; Cheng, J C Y

2016-08-10

The objective of this study is to evaluate the effects of the Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) Program on reducing chronic disability among injured workers and improving efficiency of work rehabilitation process. A cohort of patients with workplace injuries in the lower back were recruited from orthopaedics clinics and assigned to either MORE group (n= 139) or control group (n= 106). Patients in MORE group received an early MRI screening and a coordinated multi-disciplinary management, while patients in the control group received conventional care. Outcome variables are time to return-to-work (RTW) from date of injury, waiting time for MRI screening and time to medical assessment board (MAB). Patients in the MORE Program had significantly shorter duration for RTW (MORE: 6.1 months, 12.8 months, p< 0.01), and more RTW cases (n= 64, 46.0%) compared to CONTROL group (n= 29, 27.4%). The MORE group also had much shorter waiting time for MRI scans (91.85 vs. 309.2 days, p< 0.001) and MAB referral after MRI scans (97.2 vs. 178.9 days, p= 0.001) compared to CONTROL group. The MORE Program which emphasizes early intervention and early MRI screening, is shown to be effective in shortening sick leave and improving RTW outcomes of injured workers.
Pressure ulcer multidisciplinary teams via telemedicine: a pragmatic cluster randomized stepped wedge trial in long term care.

PubMed

Stern, Anita; Mitsakakis, Nicholas; Paulden, Mike; Alibhai, Shabbir; Wong, Josephine; Tomlinson, George; Brooker, Ann-Sylvia; Krahn, Murray; Zwarenstein, Merrick

2014-02-24

The study was conducted to determine the clinical and cost effectiveness of enhanced multi-disciplinary teams (EMDTs) vs. 'usual care' for the treatment of pressure ulcers in long term care (LTC) facilities in Ontario, Canada We conducted a multi-method study: a pragmatic cluster randomized stepped-wedge trial, ethnographic observation and in-depth interviews, and an economic evaluation. Long term care facilities (clusters) were randomly allocated to start dates of the intervention. An advance practice nurse (APN) with expertise in skin and wound care visited intervention facilities to educate staff on pressure ulcer prevention and treatment, supported by an off-site hospital based expert multi-disciplinary wound care team via email, telephone, or video link as needed. The primary outcome was rate of reduction in pressure ulcer surface area (cm2/day) measured on before and after standard photographs by an assessor blinded to facility allocation. Secondary outcomes were time to healing, probability of healing, pressure ulcer incidence, pressure ulcer prevalence, wound pain, hospitalization, emergency department visits, utility, and cost. 12 of 15 eligible LTC facilities were randomly selected to participate and randomized to start date of the intervention following the stepped wedge design. 137 residents with a total of 259 pressure ulcers (stage 2 or greater) were recruited over the 17 month study period. No statistically significant differences were found between control and intervention periods on any of the primary or secondary outcomes. The economic evaluation demonstrated a mean reduction in direct care costs of $650 per resident compared to 'usual care'. The qualitative study suggested that onsite support by APN wound specialists was welcomed, and is responsible for reduced costs through discontinuation of expensive non evidence based treatments. Insufficient allocation of nursing home staff time to wound care may explain the lack of impact on healing. Enhanced multi-disciplinary wound care teams were cost effective, with most benefit through cost reduction initiated by APNs, but did not improve the treatment of pressure ulcers in nursing homes. Policy makers should consider the potential yield of strengthening evidence based primary care within LTC facilities, through outreach by APNs. ClinicalTrials.gov identifier NCT01232764.
Success and failure in integrated models of nursing for long term conditions: multiple case studies of whole systems.

PubMed

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

2013-05-01

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

PubMed Central

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

2015-01-01

The quest for a cure for HIV remains a timely and key challenge for the HIV research community. Despite significant scientific advances, current HIV therapy regimens do not completely eliminate the negative impact of HIV on the immune system; and the economic impact of treating all people infected with HIV globally, for the duration of their lifetimes, presents significant challenges. This article discusses, from a multi-disciplinary approach, critical social, behavioral, ethical, and economic issues permeating the HIV cure research agenda. As part of a search for an HIV cure, both the perspective of patients/participants and clinical researchers should be taken into account. In addition, continued efforts should be made to involve and educate the broader community. PMID:26642901
A prospective cohort study assessing clinical referral management & workforce allocation within a UK regional medical genetics service.

PubMed

Benjamin, Caroline; Houghton, Catherine; Foo, Claire; Edgar, Chris; Mannion, Gail; Birch, Jan; Ellis, Ian; Weber, Astrid

2015-08-01

Ensuring patient access to genomic information in the face of increasing demand requires clinicians to develop innovative ways of working. This paper presents the first empirical prospective observational cohort study of UK multi-disciplinary genetic service delivery. It describes and explores collaborative working practices including the utilisation and role of clinical geneticists and non-medical genetic counsellors. Six hundred and fifty new patients referred to a regional genetics service were tracked through 850 clinical contacts until discharge. Referral decisions regarding allocation of lead health professional assigned to the case were monitored, including the use of initial clinical contact guidelines. Significant differences were found in the cases led by genetic counsellors and those led by clinical geneticists. Around a sixth, 16.8% (109/650) of referrals were dealt with by a letter back to the referrer or re-directed to another service provider and 14.8% (80/541) of the remaining patients chose not to schedule an appointment. Of the remaining 461 patients, genetic counsellors were allocated as lead health professional for 46.2% (213/461). A further 61 patients did not attend. Of those who did, 86.3% (345/400) were discharged after one or two appointments. Genetic counsellors contributed to 95% (784/825) of total patient contacts. They provided 93.7% (395/432) of initial contacts and 26.8% (106/395) of patients were discharged at that point. The information from this study informed a planned service re-design. More research is needed to assess the effectiveness and efficiency of different models of collaborative multi-disciplinary working within genetics services.
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.
Multi-disciplinary coupling for integrated design of propulsion systems

NASA Technical Reports Server (NTRS)

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

1993-01-01

Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions for determining the true response of propulsion systems. Results are presented for propulsion system responses including multi-discipline coupling effects via (1) coupled multi-discipline tailoring, (2) an integrated system of multidisciplinary simulators, (3) coupled material-behavior/fabrication-process tailoring, (4) sensitivities using a probabilistic simulator, and (5) coupled materials/structures/fracture/probabilistic behavior simulator. The results show that the best designs can be determined if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated interactive multi-discipline numerical propulsion system simulator.
Developing Clinical Information Needs and Systems. Final Grant Report.

ERIC Educational Resources Information Center

Noback, Richardson K.; Byrd, Gary D.

This report represents the extended research following an initial three-year grant reported on in 1975. Goals were: (1) to enact, observe, and assess the results of a program in which medical librarians become integral members of multi-disciplinary patient care and educational teams; and (2) to test the ability of these Clinical Medical Librarians…
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…
Development of a Multi-Disciplinary Aerothermostructural Model Applicable to Hypersonic Flight

NASA Technical Reports Server (NTRS)

Kostyk, Chris; Risch, Tim

2013-01-01

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

DTIC Science & Technology

2010-01-01

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

[The Chinese expert consensus on clinical practice of "medically unexplained symptoms"].

PubMed

2017-02-01

"Medically unexplained symptoms" (MUS) are commonly seen in all clinical specialties. The preliminary investigations in China show a prevalence of MUS in 4.15%-18.2% of clinical patients. Based on international and national guidelines and the most advanced studies, a Chinese expert consensus on clinical practice of MUS is reached through three rounds of discussion seminars by 25 experts from various specialties including psychiatry, internal medicine, surgery, gynecology-obstetrics, otorhinolar-yngology and traditional Chinese medicine. Clinical doctors should be alert of patients whose discomfort complaints cannot be explained by organic conditions after thorough physical examination and necessary laboratory tests. MUS should be recognized as early as possible so as to avoid complicating iatrogenic factors. A full bio-psycho-social evaluation of the patient is the basic structure of understanding MUS patients. In clinical practice, a trustful doctor-patient relationship is the first step of successful treatment. Then after a reasonable clinical evaluation, explain to the patient that it is a harmless functional symptom, communicate with the patient and reach an acceptable therapeutic goal, help the patient understand the symptoms in a psycho-somatic aspect and rebuild confidence of getting back to normal life. Patients with mild symptoms can be treated by doctors in various specialties, from whom the patient seeks help. Patients with severe symptoms need multi-disciplinary care including specific psychotherapy. Pharmaceutical treatment includes symptom alleviating drugs and antidepressants. In clinical care of patients with "MUS" , a full bio-psycho-social evaluation, a good doctor-patient relationship, a treatment plan according to the severity of symptoms, and a multi-disciplinary cooperation should be noted and practiced.
ICF Core Set for Head and Neck Cancer: Do the Categories Discriminate Among Clinically Relevant Subgroups of Patients?

ERIC Educational Resources Information Center

Tschiesner, Uta; Oberhauser, Cornelia; Cieza, Alarcos

2011-01-01

The multidisciplinary assessment of functioning in patients with head and neck cancer (HNC) according to the "ICF Core Set for Head and Neck Cancer" (ICF-HNC) was developed in an international and multi-disciplinary approach. The ICF-HNC is an application of the ICF that was adopted by the World Health Organization. The objective of this study was…
Exploring team working and shared leadership in multi-disciplinary cancer care.

PubMed

Willcocks, Stephen George

2018-02-05

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

PubMed

Zhu, Y M; Zhang, H; Ni, S; Wang, J; Li, D Z; Liu, S Y

2016-05-23

To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap (FJF) to repair the defects following tumor resection, and to analyze the effect of multi-disciplinary treatment on their survival. Fifty-eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap (FJF) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed. The success rate of flap transplantation was 91.4% (53/58). The 2-year overall survival rates (OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67.5% and 49.3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short-term complications had a better two-year OSR (59.0%) than the group with short-term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2-year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi-disciplinary treatment group had a significantly better 2-year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016). Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi-disciplinary treatment can significantly improve the survival rate of late-stage hypopharyngeal and cervical esophageal cancer patients.
Multi-level of Fidelity Multi-Disciplinary Design Optimization of Small, Solid-Propellant Launch Vehicles

NASA Astrophysics Data System (ADS)

Roshanian, Jafar; Jodei, Jahangir; Mirshams, Mehran; Ebrahimi, Reza; Mirzaee, Masood

A new automated multi-level of fidelity Multi-Disciplinary Design Optimization (MDO) methodology has been developed at the MDO Laboratory of K.N. Toosi University of Technology. This paper explains a new design approach by formulation of developed disciplinary modules. A conceptual design for a small, solid-propellant launch vehicle was considered at two levels of fidelity structure. Low and medium level of fidelity disciplinary codes were developed and linked. Appropriate design and analysis codes were defined according to their effect on the conceptual design process. Simultaneous optimization of the launch vehicle was performed at the discipline level and system level. Propulsion, aerodynamics, structure and trajectory disciplinary codes were used. To reach the minimum launch weight, the Low LoF code first searches the whole design space to achieve the mission requirements. Then the medium LoF code receives the output of the low LoF and gives a value near the optimum launch weight with more details and higher fidelity.
[Taking evaluation of post-marketing as point of cut-in to promote systematic research of traditional Chinese medicine].

PubMed

Wang, Yong-yan; Wang, Zhi-fei; Xie, Yan-ming

2014-09-01

Research on post-marketing Chinese medicine should be the systematic study from application to mechanism. Clinical evaluation is the basis of mechanism study, we can find the clue from clinical evaluation, then make a mechanism study to find the reason, then apply the results to clinic. So it is a virtuous circle. In order to achieve it, we cannot be limited to traditional Chinese medicine, we should form multi-disciplinary team under the direction of grand science thinking, try hard to put industry-university-research institute collaboration association to use, and if necessary, explore the new model of the whole nation system. An appropriate operation mechanism is very important.
The Johns Hopkins RTR Consortium: A Collaborative Approach to Advance Translational Science and Standardize Clinical Monitoring of Restorative Transplantation

DTIC Science & Technology

2014-10-01

Changes in Approach b. Problems/Delays and Plans for Resolution c. Changes that Impacted Expenditures d. Changes in use or care of vertebrate animals...the field of Restorative Transplantation matures , significant opportunities are emerging for transplant researchers and clinicians to capitalize on...that the maturing field of Restorative Transplantation will benefit the most from the establishment of a multi-institutional, multi-disciplinary
Crisis checklists for in-hospital emergencies: expert consensus, simulation testing and recommendations for a template determined by a multi-institutional and multi-disciplinary learning collaborative.

PubMed

Subbe, Christian P; Kellett, John; Barach, Paul; Chaloner, Catriona; Cleaver, Hayley; Cooksley, Tim; Korsten, Erik; Croke, Eilish; Davis, Elinor; De Bie, Ashley Jr; Durham, Lesley; Hancock, Chris; Hartin, Jilian; Savijn, Tracy; Welch, John

2017-05-08

'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology. A scoping study of the literature was followed by a multi-institutional and multi-disciplinary international learning collaborative. We sought to achieve a consensus on procedures and clinical simulation technology to determine the requirements, develop and test a safe using a checklist template that is rapidly accessible to assist in emergency management of common events for general ward use. Safety considerations about deteriorating patients were agreed upon and summarized. A consensus was achieved among an international group of experts on currently available checklist formats performing poorly in simulation testing as first responders in general ward clinical crises. The Crisis Checklist Collaborative ratified a consensus template for a general ward checklist that provides a list of issues for first responders to address (i.e. 'Check In'), a list of prompts regarding common omissions (i.e. 'Stop & Think'), and, a list of items required for the safe "handover" of patients that remain on the general ward (i.e. 'Check Out'). Simulation usability assessment of the template demonstrated feasibility for clinical management of deteriorating patients. Emergency checklists custom-designed for general ward patients have the potential to guide the treatment speed and reliability of responses for emergency management of patients with abnormal physiology while minimizing the risk of adverse events. Interventional trials are needed.
[A hospital stay without bedsores].

PubMed

Papas, Anne; Dérémience, Virginie; Tettiravou, Lucia; De Poix, Alix Tyrel

2013-10-01

A hospital stay without bedsores. The skin of elderly people is thin and fragile. After extended bed-rest, the skin's resources are rapidly depleted. The risk of bedsores becomes imminent. But a high-quality multi-disciplinary partnership can prevent bedsores in elderly patients with multiple illnesses. Example around a clinical case.
Assessing Caregiver Information Needs: A Brief Questionnaire.

ERIC Educational Resources Information Center

Simonton, Linda J.; Haugland, S. M.

A diagnostic evaluation for a person with suspected Alzheimer's disease is usually initiated by family members whose concerns go beyond strictly medical issues. To determine precisely what questions families want answered, a 15-point questionnaire was developed at a multi-disciplinary geriatric assessment clinic. Caregivers were asked to rate each…
The Wisconsin Network for Health Research (WiNHR): a statewide, collaborative, multi-disciplinary, research group.

PubMed

Bailey, Howard; Agger, William; Baumgardner, Dennis; Burmester, James K; Cisler, Ron A; Evertsen, Jennifer; Glurich, Ingrid; Hartman, David; Yale, Steven H; DeMets, David

2009-12-01

In response to the goals of the Wisconsin Partnership Program and the National Institutes of Health (NIH) Initiatives to Improve Healthcare, the Wisconsin Network for Health Research (WiNHR) was formed. As a collaborative, multi-disciplinary statewide research network, WiNHR encourages and fosters the discovery and application of scientific knowledge for researchers and practitioners throughout Wisconsin. The 4 founding institutions--Aurora Health Care/Center for Urban Population Health (CUPH), Gundersen Lutheran Medical Foundation, Marshfield Clinic Research Foundation, and the University of Wisconsin-Madison--representing geographically diverse areas of the state, are optimistic and committed to WiNHR's success. This optimism is based on the relevance of its goals to public health, the quality of statewide health care research, and, most importantly, the residents of Wisconsin who recognize the value of health research.
The Wisconsin Network for Health Research (WiNHR): A Statewide, Collaborative, Multi-disciplinary, Research Group

PubMed Central

Bailey, Howard; Agger, William; Baumgardner, Dennis; Burmester, James K.; Cisler, Ron A.; Evertsen, Jennifer; Glurich, Ingrid; Hartman, David; Yale, Steven H.; DeMets, David

2010-01-01

In response to the goals of the Wisconsin Partnership Program and the National Institutes of Health (NIH) Initiatives to Improve Healthcare, the Wisconsin Network for Health Research (WiNHR) was formed. As a collaborative, multi-disciplinary statewide research network, WiNHR encourages and fosters the discovery and application of scientific knowledge for researchers and practitioners throughout Wisconsin. The 4 founding institutions—Aurora Health Care/Center for Urban Population Health (CUPH), Gundersen Lutheran Medical Foundation, Marshfield Clinic Research Foundation, and the University of Wisconsin-Madison—representing geographically diverse areas of the state, are optimistic and committed to WiNHR’s success. This optimism is based on the relevance of its goals to public health, the quality of statewide health care research, and, most importantly, the residents of Wisconsin who recognize the value of health research. PMID:20131687
United States History: A Multi-Ethnic, Non-Sexist, Multi-Disciplinary Resource Guide for High School Teachers.

ERIC Educational Resources Information Center

Hohenfeldt, Harold H., Ed.

The first part of this resource guide is designed to help secondary teachers provide a multi-ethnic/non-sexist thrust to United States history. The second part will help them develop a multi-disciplinary approach to U.S. history. Part one is organized by the following ethnic groups: Blacks, Asians, Europeans, Hispanics, Jews, American Indians, and…
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.
Developing a program for enhancing youth HIV treatment adherence and risk reduction.

PubMed

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

2017-12-01

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

PubMed

Abramowitz, Moshe Z; Polackiewicz, Jacob; Grinshpoon, Alexander

2011-02-22

A key strategy for improving the quality of mental health care is the design and implementation of a mechanism for on-site inspection and clinical auditing. We discuss the use of checklists in auditing providing an objective, comprehensive system for recording and analyzing multi-disciplinary, clinical auditing in mental health services. We believe such an approach can identify potential risks and allow for better decision making.
Is it time to use checklists in mental health care auditing?

PubMed Central

Abramowitz, Moshe Z.; Polackiewicz, Jacob; Grinshpoon, Alexander

2011-01-01

A key strategy for improving the quality of mental health care is the design and implementation of a mechanism for on-site inspection and clinical auditing. We discuss the use of checklists in auditing providing an objective, comprehensive system for recording and analyzing multi-disciplinary, clinical auditing in mental health services. We believe such an approach can identify potential risks and allow for better decision making. PMID:25478101
Robust Optimization and Sensitivity Analysis with Multi-Objective Genetic Algorithms: Single- and Multi-Disciplinary Applications

DTIC Science & Technology

2007-01-01

multi-disciplinary optimization with uncertainty. Robust optimization and sensitivity analysis is usually used when an optimization model has...formulation is introduced in Section 2.3. We briefly discuss several definitions used in the sensitivity analysis in Section 2.4. Following in...2.5. 2.4 SENSITIVITY ANALYSIS In this section, we discuss several definitions used in Chapter 5 for Multi-Objective Sensitivity Analysis . Inner
Students Learning from Patients: Let's Get Real in Medical Education

ERIC Educational Resources Information Center

Bleakley, Alan; Bligh, John

2008-01-01

Medical students must be prepared for working in inter-professional and multi-disciplinary clinical teams centred on a patient's care pathway. While there has been a good deal of rhetoric surrounding patient-centred medical education, there has been little attempt to conceptualise such a practice beyond the level of describing education of…
The development of accurate and high quality radiotherapy treatment delivery

NASA Astrophysics Data System (ADS)

Griffiths, Susan E.

Accurate radiotherapy delivery is required for curing cancer. Historical radiotherapy accuracy studies at Leeds (1983-1991) are discussed in context of when radiographers were not involved in practice design. The seminal research was unique in being led by a radiographer practitioner, and in prospectively studying the accuracy of different techniques within one department. The viability of alignment of treatment beams with marks painted on a patient's skin varied daily, and, using film I showed that the alignment of treatment on anatomy varied. I then led 6 sequential studies with collaborating oncologists. Unique outcomes were in identifying the origins of treatment inaccuracies, implementing and evidencing changes in multi-disciplinary practice, thus improving accuracy and reproducibility generally and achieving accuracy for the pelvis to within current norms. Innovations included: discontinuation of painted skin marks and developing whole-body patient positioning using lasers, tattoos, and standardised supports; unification of set-up conditions through planning and treatment; planning normal tissue margins round target tissue to allow for inaccuracies (1985); improved manual shielding methods, changed equipment usage, its quality assurance and design; influenced the development of portal imaging and image analysis. Consequences and current implications. The research, still cited internationally, contributed to clinical management of lymphoma, and critically underpins contemporary practice. It led to my becoming the first radiographer invited into multi-disciplinary collaborative work, to advise in the first multi-centre clinical trials to consider treatment delivery accuracy, contribute to books written from within other disciplines and inform guidelines for good practice so helping to improve practices, with recent publications. I thus led my profession into research activity. Later work included development of a national staffing formula for radiotherapy Centres, and contributing to the evidence-base for improved National radiotherapy resourcing. I recently researched and developed a textbook (second edition) on quality in treatment delivery.

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

PubMed

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

2014-02-01

Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in pharmacological knowledge to junior nursing staff and pre-registration nursing students. This paper argues that the 'five rights' principle during medication administration is not enough for holistic medication safety and explains two reasons why there is a need for strengthened multi-disciplinary team-work to achieve greater patient safety. To accomplish this, nurses need to have sufficient knowledge of pharmacology and medication safety issues. These findings have important educational implications and point to the requirement for the incorporation of medication management and pharmacology in to the teaching curriculum for nursing students. There is also a call for continuing professional development opportunities for nurses working in clinical settings. © 2014.
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.
Multi-disciplinary interoperability challenges (Ian McHarg Medal Lecture)

NASA Astrophysics Data System (ADS)

Annoni, Alessandro

2013-04-01

Global sustainability research requires multi-disciplinary efforts to address the key research challenges to increase our understanding of the complex relationships between environment and society. For this reason dependence on ICT systems interoperability is rapidly growing but, despite some relevant technological improvement is observed, in practice operational interoperable solutions are still lacking. Among the causes is the absence of a generally accepted definition of "interoperability" in all its broader aspects. In fact the concept of interoperability is just a concept and the more popular definitions are not addressing all challenges to realize operational interoperable solutions. The problem become even more complex when multi-disciplinary interoperability is required because in that case solutions for interoperability of different interoperable solution should be envisaged. In this lecture the following definition will be used: "interoperability is the ability to exchange information and to use it". In the lecture the main challenges for addressing multi-disciplinary interoperability will be presented and a set of proposed approaches/solutions shortly introduced.
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.
Making the Most of Multi-Disciplinary Undergraduate Research Conferences

ERIC Educational Resources Information Center

Hill, Jennifer; West, Harry; Kneale, Pauline

2018-01-01

This is the second of two Directions articles, which together offer guidance to help the reader gain the maximum benefit from participating in institutional and national multi-disciplinary undergraduate research conferences. The earlier article introduced undergraduate research conferences, summarized the key benefits of participating in such…
Interprofessional E-Learning and Collaborative Work: Practices and Technologies

ERIC Educational Resources Information Center

Bromage, Adrian, Ed.; Clouder, Lynn, Ed.; Thistlethwaite, Jill, Ed.; Gordon, Frances, Ed.

2010-01-01

Interprofessionalism, an emerging model and philosophy of multi-disciplinary and multi-agency working, has in increasingly become an important means of cultivating joint endeavors across varied and diverse disciplinary and institutional settings. This book is therefore, an important source for understanding how interprofessionalism can be promoted…
Breast cancer screening in the era of density notification legislation: summary of 2014 Massachusetts experience and suggestion of an evidence-based management algorithm by multi-disciplinary expert panel.

PubMed

Freer, Phoebe E; Slanetz, Priscilla J; Haas, Jennifer S; Tung, Nadine M; Hughes, Kevin S; Armstrong, Katrina; Semine, A Alan; Troyan, Susan L; Birdwell, Robyn L

2015-09-01

Stemming from breast density notification legislation in Massachusetts effective 2015, we sought to develop a collaborative evidence-based approach to density notification that could be used by practitioners across the state. Our goal was to develop an evidence-based consensus management algorithm to help patients and health care providers follow best practices to implement a coordinated, evidence-based, cost-effective, sustainable practice and to standardize care in recommendations for supplemental screening. We formed the Massachusetts Breast Risk Education and Assessment Task Force (MA-BREAST) a multi-institutional, multi-disciplinary panel of expert radiologists, surgeons, primary care physicians, and oncologists to develop a collaborative approach to density notification legislation. Using evidence-based data from the Institute for Clinical and Economic Review, the Cochrane review, National Comprehensive Cancer Network guidelines, American Cancer Society recommendations, and American College of Radiology appropriateness criteria, the group collaboratively developed an evidence-based best-practices algorithm. The expert consensus algorithm uses breast density as one element in the risk stratification to determine the need for supplemental screening. Women with dense breasts and otherwise low risk (<15% lifetime risk), do not routinely require supplemental screening per the expert consensus. Women of high risk (>20% lifetime) should consider supplemental screening MRI in addition to routine mammography regardless of breast density. We report the development of the multi-disciplinary collaborative approach to density notification. We propose a risk stratification algorithm to assess personal level of risk to determine the need for supplemental screening for an individual woman.
Diagnostic Classification 0-3: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood.

ERIC Educational Resources Information Center

Zero to Three: National Center for Infants, Toddlers and Families, Washington, DC.

The diagnostic framework presented in this manual seeks to address the need for a systematic, multi-disciplinary, developmentally based approach to the classification of mental health and developmental difficulties in the first 4 years of life. An introduction discusses clinical approaches to assessment and diagnosis, gives an overview of the…
Multi-disciplinary rehabilitation for acquired brain injury in adults of working age.

PubMed

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

2015-12-22

Evidence from systematic reviews demonstrates that multi-disciplinary rehabilitation is effective in the stroke population, in which older adults predominate. However, the evidence base for the effectiveness of rehabilitation following acquired brain injury (ABI) in younger adults has not been established, perhaps because this scenario presents different methodological challenges in research. To assess the effects of multi-disciplinary rehabilitation following ABI in adults 16 to 65 years of age. We ran the most recent search on 14 September 2015. We searched the Cochrane Injuries Group Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (OvidSP), Web of Science (ISI WOS) databases, clinical trials registers, and we screened reference lists. Randomised controlled trials (RCTs) comparing multi-disciplinary rehabilitation versus routinely available local services or lower levels of intervention; or trials comparing an intervention in different settings, of different intensities or of different timing of onset. Controlled clinical trials were included, provided they met pre-defined methodological criteria. Three review authors independently selected trials and rated their methodological quality. A fourth review author would have arbitrated if consensus could not be reached by discussion, but in fact, this did not occur. As in previous versions of this review, we used the method described by Van Tulder 1997 to rate the quality of trials and to perform a 'best evidence' synthesis by attributing levels of evidence on the basis of methodological quality. Risk of bias assessments were performed in parallel using standard Cochrane methodology. However, the Van Tulder system provided a more discriminative evaluation of rehabilitation trials, so we have continued to use it for our primary synthesis of evidence. We subdivided trials in terms of severity of brain injury, setting and type and timing of rehabilitation offered. We identified a total of 19 studies involving 3480 people. Twelve studies were of good methodological quality and seven were of lower quality, according to the van Tulder scoring system. Within the subgroup of predominantly mild brain injury, 'strong evidence' suggested that most individuals made a good recovery when appropriate information was provided, without the need for additional specific interventions. For moderate to severe injury, 'strong evidence' showed benefit from formal intervention, and 'limited evidence' indicated that commencing rehabilitation early after injury results in better outcomes. For participants with moderate to severe ABI already in rehabilitation, 'strong evidence' revealed that more intensive programmes are associated with earlier functional gains, and 'moderate evidence' suggested that continued outpatient therapy could help to sustain gains made in early post-acute rehabilitation. The context of multi-disciplinary rehabilitation appears to influence outcomes. 'Strong evidence' supports the use of a milieu-oriented model for patients with severe brain injury, in which comprehensive cognitive rehabilitation takes place in a therapeutic environment and involves a peer group of patients. 'Limited evidence' shows that specialist in-patient rehabilitation and specialist multi-disciplinary community rehabilitation may provide additional functional gains, but studies serve to highlight the particular practical and ethical restraints imposed on randomisation of severely affected individuals for whom no realistic alternatives to specialist intervention are available. Problems following ABI vary. Consequently, different interventions and combinations of interventions are required to meet the needs of patients with different problems. Patients who present acutely to hospital with mild brain injury benefit from follow-up and appropriate information and advice. Those with moderate to severe brain injury benefit from routine follow-up so their needs for rehabilitation can be assessed. Intensive intervention appears to lead to earlier gains, and earlier intervention whilst still in emergency and acute care has been supported by limited evidence. The balance between intensity and cost-effectiveness has yet to be determined. Patients discharged from in-patient rehabilitation benefit from access to out-patient or community-based services appropriate to their needs. Group-based rehabilitation in a therapeutic milieu (where patients undergo neuropsychological rehabilitation in a therapeutic environment with a peer group of individuals facing similar challenges) represents an effective approach for patients requiring neuropsychological rehabilitation following severe brain injury. Not all questions in rehabilitation can be addressed by randomised controlled trials or other experimental approaches. For example, trial-based literature does not tell us which treatments work best for which patients over the long term, and which models of service represent value for money in the context of life-long care. In the future, such questions will need to be considered alongside practice-based evidence gathered from large systematic longitudinal cohort studies conducted in the context of routine clinical practice.
Nurses collaborating with cross disciplinary networks: starting to integrate genomics into practice.

PubMed

Adegbola, Maxine

2010-07-01

Nurses and other health-care providers are poised to include genetic discoveries into practice settings and to translate such knowledge for consumer benefit within culturally appropriate contexts. Nurses must seek collaboration with multi-disciplinary networks both locally and internationally. They must also capitalize on the expertise of other seasoned researchers in order to gain national and international exposure, recognition, and funding. Scholarly tailgating is using network relationships to achieve one's professional goals, and capitalizing on expert knowledge from seasoned researchers, educators, and practitioners from diverse international groups. By using scholarly tailgating principles, nurses can become important agents of change for multi-disciplinary networks, and thereby assist in decreasing health disparities. The purpose of this document is to encourage and inspire nurses to seek collaborative multi-disciplinary networks to enable genomic integration into health-care practice and education. Strategies for integrating genomics into practice settings are discussed.
Radiologist participation in multi-disciplinary teams in breast cancer improves reflective practice, decision making and isolation.

PubMed

Alcantara, S B; Reed, W; Willis, K; Lee, W; Brennan, P; Lewis, S

2014-09-01

This study aims to explore Australian radiologists' experiences of participating in breast cancer multi-disciplinary team (MDT) meetings to identify enablers and barriers to participation as well their perception of confidence and patient care. Qualitative methods incorporating observation and interviews were used. Twenty-one breast cancer MDT meetings were observed across Sydney to study the dynamics of the meetings, the level of participation by radiologists and their most important interactions. Qualitative semi-structured interviews were conducted with 10 radiologists participating in these meetings regarding participation, educational opportunities and improvements to work practices. Radiologists' participation in breast cancer MDT meetings is influenced by the type of meeting they attend with higher levels of participation and a more dominant 'valued' role being evident in pre-interventional meetings. The key themes to emerge from the data include the importance of 'sharing experiences', the 'radiologist-pathologist relationship' and the value of 'continuing participation'. Radiologists believed their confidence in their clinical decision making increased when there was immediate feedback from pathologists. This study highlights the benefits of radiologists regularly participating in breast cancer MDT meetings in terms of continuing professional education resulting from collegial experiential learning. Radiologists' perceived patient care and workplace isolation were improved by sharing experiences with other cancer care colleagues. © 2013 John Wiley & Sons Ltd.
Invasive placental disease: the impact of a multi-disciplinary team approach to management.

PubMed

Smulian, John C; Pascual, Ana-Liza; Hesham, Helai; Qureshey, Emma; Bijoy Thomas, M; Depuy, Amy M; Flicker, Amanda B; Scorza, William E

2017-06-01

To determine the impact of a structured multi-disciplinary management strategy on clinical outcomes in women with invasive placental disease (IPD). This was a retrospective cohort study of consecutive women having peripartum hysterectomies with IPD over seven years. For the most recent three years, a structured multidisciplinary team (MDT) reviewed each suspected case, created a management plan, and implemented that plan. Outcomes were compared between cases delivered prior to and after the MDT process was started. There were 47 pregnancies with IPD, of which 31 (66.0%) were suspected antenatally and 40 (85.1%) had a prior uterine surgery. An MDT approach was performed in 19 (40.4%) cases. In the MDT group, there were longer operative times (260 min versus 181 min, p = 0.0001), less blood loss (1200 mL versus 2500 mL, p = 0.009), less administration of blood products (47.4% versus 85.7%, p = 0.005), and higher intraoperative lowest mean arterial pressures (MAPs) (57 mmHg versus 48 mmHg, p = 0.002, when compared to the No-MDT (n = 28) approach. No differences were found for other outcomes. Clinically meaningful improvements of less blood loss, fewer transfusions, and higher intraoperative MAPs suggest that MDT cases were more stable intraoperatively, which over a larger number of patients, should translate into improved outcomes.
Political violence and mental health: a multi-disciplinary review of the literature on Nepal.

PubMed

Tol, Wietse A; Kohrt, Brandon A; Jordans, Mark J D; Thapa, Suraj B; Pettigrew, Judith; Upadhaya, Nawaraj; de Jong, Joop T V M

2010-01-01

Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psychosocial wellbeing in Nepal. A systematic search of six databases resulted in the identification of 572 studies, of which 44 were included in the review. These studies investigated the influence of political violence on contextual variables that shape mental health and psychosocial wellbeing, and examined psychological distress and mental disorders in the context of political violence. The majority of studies addressed the mental health of Bhutanese refugees in Nepal and the impact of the Maoist People's War. Based upon these results from Nepal, we discuss a number of issues of concern to international researchers and practitioners and present policy and research recommendations. Specifically, we consider (a) the need for longitudinal multi-disciplinary research into protective and risk factors, including agency, of psychological distress and mental disorders in situations of political violence, (b) the continuing controversy regarding the PTSD construct, and (c) the lack of robust findings regarding the effectiveness of mental health and psychosocial support.
The Multi-Disciplinary Graduate Program in Educational Research. Final Report, Part II; Methodoloqical Trilogy.

ERIC Educational Resources Information Center

Lazarsfeld, Paul F., Ed.

Part two of a seven-section, final report on the Multi-Disciplinary Graduate Program in Educational Research, this document contains discussions of quantification and reason analysis. Quantification is presented as a language consisting of sentences (graphs and tables), words, (classificatory instruments), and grammar (rules for constructing and…
Determinants of Food Safety Risks: A Multi-disciplinary Approach

ERIC Educational Resources Information Center

Knight, Andrew; Warland, Rex

2005-01-01

This research employs a multi-disciplinary approach by developing a model that draws upon psychometric, cultural, and reflexive modernization perspectives of risk perception. Using data from a 1999 national telephone survey, we tested our model on three food risks ? pesticides, Salmonella, and fat. Results showed that perceptions of risks do vary…
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.
Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training.

PubMed

Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

2014-12-14

To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day's training utilising real clinical examples. Pre and post-course evaluation comprised participants' patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams' knowledge and safety attitudes.
Endoscopic non-technical skills team training: The next step in quality assurance of endoscopy training

PubMed Central

Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

2014-01-01

AIM: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. METHODS: A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day’s training utilising real clinical examples. Pre and post-course evaluation comprised participants’ patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. RESULTS: Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. CONCLUSION: A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams’ knowledge and safety attitudes. PMID:25516665
Simulating the multi-disciplinary care team approach: Enhancing student understanding of anatomy through an ultrasound-anchored interprofessional session.

PubMed

Luetmer, Marianne T; Cloud, Beth A; Youdas, James W; Pawlina, Wojciech; Lachman, Nirusha

2018-01-01

Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students. An ultrasound demonstration of structures of the upper limb was incorporated into the gross anatomy courses for first-year MD (n = 53) and PT (n = 28) students. Immediately before the learning experience, all students took an individual readiness assurance test (iRAT) based on clinical concepts regarding the assigned study material. Students observed while a physical medicine and rehabilitation physician demonstrated the use of ultrasound as a diagnostic and procedural tool for the shoulder and elbow. Following the demonstration, students worked within interprofessional teams (n = 14 teams, 5-6 students per team) to review the related anatomy on dissected specimens. At the end of the session, students worked within interprofessional teams to complete a collaborative clinical case-based multiple choice post-test. Team scores were compared to the mean individual score within each team with the Wilcoxon signed-rank test. Students scored higher on the collaborative post-test (95.2 ±10.2%) than on the iRAT (66.1 ± 13.9% for MD students and 76.2 ±14.2% for PT students, P < 0.0001). Results suggest that this interprofessional team activity facilitated an improved understanding and clinical application of anatomy. Anat Sci Educ 11: 94-99. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.
Interconnecting Multidiscilinary Data Infrastructures: From Federation to Brokering Framework

NASA Astrophysics Data System (ADS)

Nativi, S.

2014-12-01

Standardization and federation activities have been played an essential role to push interoperability at the disciplinary and cross-disciplinary level. However, they demonstrated not to be sufficient to resolve important interoperability challenges, including: disciplinary heterogeneity, cross-organizations diversities, cultural differences. Significant international initiatives like GEOSS, IODE, and CEOS demonstrated that a federation system dealing with global and multi-disciplinary domain turns out to be rater complex, raising more the already high entry level barriers for both Providers and Users. In particular, GEOSS demonstrated that standardization and federation actions must be accompanied and complemented by a brokering approach. Brokering architecture and its implementing technologies are able to implement an effective interoperability level among multi-disciplinary systems, lowering the entry level barriers for both data providers and users. This presentation will discuss the brokering philosophy as a complementary approach for standardization and federation to interconnect existing and heterogeneous infrastructures and systems. The GEOSS experience will be analyzed, specially.

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

ERIC Educational Resources Information Center

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

2011-01-01

This paper describes the development of a taught Master's course in biomedical diagnostics using a novel multi-disciplinary approach. This course, the first of its kind in Ireland, covers the science and technology underlying the development of medical diagnostic devices that detect early markers of diseases such as cancer. The ethical impact of…
Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

ERIC Educational Resources Information Center

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

2010-01-01

Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical…
Breast Cancer Screening in the Era of Density Notification Legislation: Summary of 2014 Massachusetts Experience and Suggestion of An Evidence-Based Management Algorithm by Multi-disciplinary Expert Panel

PubMed Central

Freer, Phoebe E.; Slanetz, Priscilla J.; Haas, Jennifer S.; Tung, Nadine M.; Hughes, Kevin S.; Armstrong, Katrina; Semine, A. Alan; Troyan, Susan L.; Birdwell, Robyn L.

2015-01-01

Purpose Stemming from breast density notification legislation in Massachusetts effective 2015, we sought to develop a collaborative evidence-based approach to density notification that could be used by practitioners across the state. Our goal was to develop an evidence-based consensus management algorithm to help patients and health care providers follow best practices to implement a coordinated, evidence-based, cost-effective, sustainable practice and to standardize care in recommendations for supplemental screening. Methods We formed the Massachusetts Breast Risk Education and Assessment Task Force (MA-BREAST) a multi-institutional, multi-disciplinary panel of expert radiologists, surgeons, primary care physicians, and oncologists to develop a collaborative approach to density notification legislation. Using evidence-based data from the Institute for Clinical and Economic Review (ICER), the Cochrane review, National Comprehensive Cancer Network (NCCN) guidelines, American Cancer Society (ACS) recommendations, and American College of Radiology (ACR) appropriateness criteria, the group collaboratively developed an evidence-based best-practices algorithm. Results The expert consensus algorithm uses breast density as one element in the risk stratification to determine the need for supplemental screening. Women with dense breasts and otherwise low risk (<15% lifetime risk), do not routinely require supplemental screening per the expert consensus. Women of high risk (>20% lifetime) should consider supplemental screening MRI in addition to routine mammography regardless of breast density. Conclusion We report the development of the multi-disciplinary collaborative approach to density notification. We propose a risk stratification algorithm to assess personal level of risk to determine the need for supplemental screening for an individual woman. PMID:26290416
Engagement and learning: an exploratory study of situated practice in multi-disciplinary stroke rehabilitation.

PubMed

Horton, Simon; Howell, Alison; Humby, Kate; Ross, Alexandra

2011-01-01

Active participation is considered to be a key factor in stroke rehabilitation. Patient engagement in learning is an important part of this process. This study sets out to explore how active participation and engagement are 'produced' in the course of day-to-day multi-disciplinary stroke rehabilitation. Ethnographic observation, analytic concepts drawn from discourse analysis (DA) and the perspective and methods of conversation analysis (CA) were applied to videotaped data from three sessions of rehabilitation therapy each for two patients with communication impairments (dysarthria, aphasia). Engagement was facilitated (and hindered) through the interactional work of patients and healthcare professionals. An institutional ethos of 'right practice' was evidenced in the working practices of therapists and aligned with or resisted by patients; therapeutic activity type (impairment, activity or functional focus) impacted on the ways in which patient engagement was developed and sustained. This exploration of multi-disciplinary rehabilitation practice adds a new dimension to our understanding of the barriers and facilitators to patient engagement in the learning process and provides scope for further research. Harmonising the rehabilitation process across disciplines through more focused attention to ways in which patient participation is enhanced may help improve the consistency and quality of patient engagement.
Predictors of clinic satisfaction among adult survivors of childhood cancer.

PubMed

Absolom, Kate; Greenfield, Diana; Ross, Richard; Horne, Beverly; Davies, Helena; Glaser, Adam; Simpson, Adrian; Waite, Heather; Eiser, Christine

2006-07-01

Childhood cancer survivors experience a wide range of late-effects. As survival rates improve, follow-up in paediatric clinics becomes less feasible, and alternative models of care have been proposed. In this study, satisfaction among those attending a traditional paediatric late-effects clinic was compared with a multi-disciplinary clinic in an adult setting. Survivors (adult clinic n=93, paediatric clinic n=105, age 16-39 years) completed measures of symptoms, understanding of vulnerability to late-effects, purpose of follow-up, satisfaction and number of topics discussed. Predictors of satisfaction were: number of topics discussed, greater understanding of the purpose of follow-up and sex. Females, and those reporting longer waiting time were less satisfied. Aspects of clinic organisation, including shorter waiting times and opportunities to discuss health concerns, are more important in determining patient satisfaction than clinic type. Survivors' understanding of the purpose of follow-up is also integral in determining satisfaction.
Coupled multi-disciplinary simulation of composite engine structures in propulsion environment

NASA Technical Reports Server (NTRS)

Chamis, Christos C.; Singhal, Surendra N.

1992-01-01

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

ERIC Educational Resources Information Center

Skinner, Rachael; Joiner, Chris; Chesters, Liz; Bates, Louise; Scrivener, Louise

2011-01-01

There appears to be some degree of hesitation and lack of confidence among professionals in conducting capacity assessments. This document explains a two-phase process developed and implemented by a multi-disciplinary group of professionals during a pilot project. The first phase in the decision making process is to determine to what extent the…
Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach.

PubMed

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

2016-01-01

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

PubMed

Chu, Constance R; Andriacchi, Thomas P

2015-07-01

Osteoarthritis (OA) is a leading cause of human suffering and disability for which disease-modifying treatments are lacking. OA occurs through complex and dynamic interplays between diverse factors over long periods of time. The traditional research and clinical focus on OA, the end stage disease, obscured understanding pathogenesis prior to reaching a common pathway defined by pain and functional deficits, joint deformity, and radiographic changes. To emphasize disease modification and prevention, we describe a multi-disciplinary systems-based approach encompassing biology, mechanics, and structure to define pre-osteoarthritic disease processes. Central to application of this model is the concept of "pre-osteoarthritis," conditions where clinical OA has not yet developed. Rather, joint homeostasis has been compromised and there are potentially reversible markers for heightened OA risk. Key messages from this perspective are (i) to focus research onto defining pre-OA through identifying and validating biological, mechanical, and imaging markers of OA risk, (ii) to emphasize multi-disciplinary approaches, and (iii) to propose that developing personalized interventions to address reversible markers of OA risk in healthy joints may be the key to prevention. Ultimately, a systems-based analysis of OA pathogenesis shows potential to transform clinical practice by facilitating development and testing of new strategies to prevent or delay the onset of osteoarthritis. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach

PubMed Central

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

2016-01-01

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

PubMed

Wood, J J; Metcalfe, C; Paes, A; Sylvester, P; Durdey, P; Thomas, M G; Blazeby, J M

2008-10-01

It is mandatory for treatment decisions for patients with colorectal cancer to be made within the context of a multi-disciplinary team (MDT) meeting. It is currently uncertain, however, how to best evaluate the quality of MDT decision-making. This study examined MDT decision-making by studying whether MDT treatment decisions were implemented and investigated the reasons why some decisions changed after the meeting. Consecutive MDT treatment decisions were prospectively recorded. Implementation of decisions was studied by examining hospital records. Reasons for changes in MDT decisions were identified. In all, 201 consecutive treatment decisions were analysed, concerning 157 patients. Twenty decisions (10.0%, 95% confidence interval 6.3-15.2%) were not implemented. Looking at the reasons for nonimplementation, nine (40%) related to co-morbidity, seven (35%) to patient choice, two changed in light of new clinical information, one doctor changed a decision and for one changed decision, no reason was apparent. When decisions changed, the final treatment was always more conservative than was originally planned and decisions were more likely to change for colon rather than rectal cancer (P = 0.024). The vast majority of colorectal MDT decisions were implemented and when decisions changed, it mostly related to patient factors that had not been taken into account. Analysis of the implementation of team decisions is an informative process to monitor the quality of MDT decision-making.
Laser spectroscopy applied to environmental, ecological, food safety, and biomedical research.

PubMed

Svanberg, Sune; Zhao, Guangyu; Zhang, Hao; Huang, Jing; Lian, Ming; Li, Tianqi; Zhu, Shiming; Li, Yiyun; Duan, Zheng; Lin, Huiying; Svanberg, Katarina

2016-03-21

Laser spectroscopy provides many possibilities for multi-disciplinary applications in environmental monitoring, in the ecological field, for food safety investigations, and in biomedicine. The paper gives several examples of the power of multi-disciplinary applications of laser spectroscopy as pursued in our research group. The studies utilize mostly similar and widely applicable spectroscopic approaches. Air pollution and vegetation monitoring by lidar techniques, as well as agricultural pest insect monitoring and classification by elastic scattering and fluorescence spectroscopy are described. Biomedical aspects include food safety applications and medical diagnostics of sinusitis and otitis, with strong connection to the abatement of antibiotics resistance development.
A journey in the field of health: From social psychology to multi-disciplinarity.

PubMed

Herzlich, Claudine

2018-03-01

"Health psychology" is a newer sub-discipline whose research methodologies, theories, and practices were borrowed from diverse areas of psychology. It appeared later in France than in the United States or United Kingdom. In 1966, I adopted a perspective between anthropology and psycho-sociology of medicine. I never have self-identified as a "Health Psychologist", continuing to work outside of disciplinary boundary constraints, but studied health questions moving first from psychology (and anthropology), through social psychology to sociology. By the 1980s, I adopted an even broader multi-disciplinary approach to health, as the HIV/AIDS epidemic urgently challenged health researchers/practitioners, in France and worldwide.
Science as a general education: Conceptual science should constitute the compulsory core of multi-disciplinary undergraduate degrees.

PubMed

Charlton, Bruce G

2006-01-01

It is plausible to assume that in the future science will form the compulsory core element both of school curricula and multi-disciplinary undergraduate degrees. But for this to happen entails a shift in the emphasis and methods of science teaching, away from the traditional concern with educating specialists and professionals. Traditional science teaching was essentially vocational, designed to provide precise and comprehensive scientific knowledge for practical application. By contrast, future science teaching will be a general education, hence primarily conceptual. Its aim should be to provide an education in flexible rationality. Vocational science teaching was focused on a single-discipline undergraduate degree, but a general education in abstract systematic thinking is best inculcated by studying several scientific disciplines. In this sense, 'science' is understood as mathematics and the natural sciences, but also the abstract and systematic aspects of disciplines such as economics, linguistics, music theory, history, sociology, political science and management science. Such a wide variety of science options in a multi-disciplinary degree will increase the possibility of student motivation and aptitude. Specialist vocational science education will progressively be shifted to post-graduate level, in Masters and Doctoral programs. A multi-disciplinary and conceptually-based science core curriculum should provide an appropriate preparation for dealing with the demands of modern societies; their complex and rapidly changing social systems; and the need for individual social and professional mobility. Training in rational conceptual thinking also has potential benefits to human health and happiness, since it allows people to over-ride inappropriate instincts, integrate conflicting desires and pursue long-term goals.
Trans-disciplinary community groups: an initiative for improving healthcare.

PubMed

Sideras, James Demetri

2016-01-01

In the context of budget constraints and the current quality crisis facing UK healthcare, the purpose of this paper is to examine the use of trans-disciplinary community groups (TCG)--an innovative and inexpensive initiative for improving patient care. Using an action research study, TCG was implemented within a private healthcare firm for vulnerable adults. Qualitative data were gathered over 12 months from 33 participants using depth interviews and focus groups. TCG led to improved patient activities and increased patient decision-making and confidence in self-advocacy. Key prerequisites were top management commitment, democratic leadership and employee empowerment. However, staff nurses resisted TCG because they were inclined to using managerial control and their own independent clinical judgements. Whilst the findings from this study should not be generalized across all healthcare sectors, its results could be replicated in contexts where there is wide commitment to TCG and where managers adopt a democratic style of leadership. Researchers could take this study further by exploring the applicability of TCG in public healthcare organizations or other multi-disciplinary service contexts. The findings of this research paper provide policy makers and healthcare managers with practical insights on TCG and the factors that are likely to obstruct and facilitate its implementation. Adopting TCG could enable healthcare managers to ameliorate their services with little or no extra cost, which is especially important in a budget constraint context and the current quality crisis facing UK healthcare.
Integrated web-based viewing and secure remote access to a clinical data repository and diverse clinical systems.

PubMed

Duncan, R G; Saperia, D; Dulbandzhyan, R; Shabot, M M; Polaschek, J X; Jones, D T

2001-01-01

The advent of the World-Wide-Web protocols and client-server technology has made it easy to build low-cost, user-friendly, platform-independent graphical user interfaces to health information systems and to integrate the presentation of data from multiple systems. The authors describe a Web interface for a clinical data repository (CDR) that was moved from concept to production status in less than six months using a rapid prototyping approach, multi-disciplinary development team, and off-the-shelf hardware and software. The system has since been expanded to provide an integrated display of clinical data from nearly 20 disparate information systems.
Sun Protection; A risk management approach

NASA Astrophysics Data System (ADS)

Diffey, Brian

2017-10-01

Sun Protection differentiates itself from other texts by adopting a risk-management approach to determine whether, how, and in what circumstances, harm might be caused, and to explore the feasibility of various strategies in controlling exposure to solar UV radiation. This multi-disciplinary book covers topics from climatology through human exposure to sunlight, as well as biological and clinical effects of UV radiation to physical and chemical strategies for photoprotection.
Association for medical education and research in substance abuse.

PubMed

Samet, Jeffrey H; Galanter, Marc; Bridden, Carly; Lewis, David C

2006-01-01

The Association for Medical Education and Research in Substance Abuse (AMERSA) is a multi-disciplinary organization committed to health professional faculty development in substance abuse. In 1976, members of the Career Teachers Training Program in Alcohol and Drug Abuse, a US federally funded multi-disciplinary faculty development program, formed AMERSA. The organization grew from 59 founding members, who were primarily medical school faculty, to over 300 health professionals from a spectrum of disciplines including physicians, nurses, social workers, dentists, allied health professionals, psychologists and other clinical educators who are responsible for advancing substance abuse education. AMERSA members promote substance abuse education among health professionals by developing curricula, promulgating relevant policy and training health professional faculty to become excellent teachers in this field. AMERSA influences public policy by offering standards for improving substance abuse education. The organization publishes a peer-reviewed, quarterly journal, Substance Abuse, which emphasizes research on the education and training of health professions and also includes original clinical and prevention research. Each year, the AMERSA National Conference brings together researchers and health professional educators to learn about scientific advances and exemplary teaching approaches. In the future, AMERSA will continue to pursue this mission of advancing and supporting health professional faculty who educate students and trainees to address substance abuse in patients and clients.
Role expectations in dementia care among family physicians and specialists.

PubMed

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-09-01

The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Physicians' clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the "bad cop" to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Future research could further explore physicians' and other multi-disciplinary members' perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario.
Role Expectations in Dementia Care Among Family Physicians and Specialists

PubMed Central

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-01-01

Background The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Methods Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Results Physicians’ clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the “bad cop” to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Conclusions Future research could further explore physicians’ and other multi-disciplinary members’ perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario. PMID:25232368

Banff schema for grading pancreas allograft rejection: working proposal by a multi-disciplinary international consensus panel.

PubMed

Drachenberg, C B; Odorico, J; Demetris, A J; Arend, L; Bajema, I M; Bruijn, J A; Cantarovich, D; Cathro, H P; Chapman, J; Dimosthenous, K; Fyfe-Kirschner, B; Gaber, L; Gaber, O; Goldberg, J; Honsová, E; Iskandar, S S; Klassen, D K; Nankivell, B; Papadimitriou, J C; Racusen, L C; Randhawa, P; Reinholt, F P; Renaudin, K; Revelo, P P; Ruiz, P; Torrealba, J R; Vazquez-Martul, E; Voska, L; Stratta, R; Bartlett, S T; Sutherland, D E R

2008-06-01

Accurate diagnosis and grading of rejection and other pathological processes are of paramount importance to guide therapeutic interventions in patients with pancreas allograft dysfunction. A multi-disciplinary panel of pathologists, surgeons and nephrologists was convened for the purpose of developing a consensus document delineating the histopathological features for diagnosis and grading of rejection in pancreas transplant biopsies. Based on the available published data and the collective experience, criteria for the diagnosis of acute cell-mediated allograft rejection (ACMR) were established. Three severity grades (I/mild, II/moderate and III/severe) were defined based on lesions known to be more or less responsive to treatment and associated with better- or worse-graft outcomes, respectively. The features of chronic rejection/graft sclerosis were reassessed, and three histological stages were established. Tentative criteria for the diagnosis of antibody-mediated rejection were also characterized, in anticipation of future studies that ought to provide more information on this process. Criteria for needle core biopsy adequacy and guidelines for pathology reporting were also defined. The availability of a simple, reproducible, clinically relevant and internationally accepted schema for grading rejection should improve the level of diagnostic accuracy and facilitate communication between all parties involved in the care of pancreas transplant recipients.
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.
Where Creativity Meets Technology: A Library-Led, Multi-Disciplinary Online Showcase for Artworks, Creative Writings, and Movies Displayed with 3D and HTML5 Technology

ERIC Educational Resources Information Center

Wong, Shun Han Rebekah

2015-01-01

This article introduces the Hong Kong Baptist University's Heritage project (http://heritage.lib.hkbu.edu.hk/), a multi-disciplinary online showcase for curriculum-related creative outputs that were produced by faculty and students of the university. Initiated and led by the University Library, this project was a collaborative effort with six…
Unique medical issues in adult patients with mucopolysaccharidoses.

PubMed

Mitchell, John; Berger, Kenneth I; Borgo, Andrea; Braunlin, Elizabeth A; Burton, Barbara K; Ghotme, Kemel A; Kircher, Susanne G; Molter, David; Orchard, Paul J; Palmer, James; Pastores, Gregory M; Rapoport, David M; Wang, Raymond Y; White, Klane

2016-10-01

The mucopolysaccharidoses are a group of inherited metabolic diseases caused by deficiencies in enzymes involved in the sequential degradation of glycosaminoglycans (GAGs) leading to substrate accumulation in various tissues and organs. GAG accumulation can cause growth retardation and progressive damage to respiratory, cardiovascular, musculoskeletal, nervous, gastrointestinal, auditory, and visual systems. In the past, few people with severe phenotypic mucopolysaccharidosis (MPS) reached adulthood. However, better methods for diagnosis, multi-disciplinary care, and new therapies have extended lifespan, leading to an increasing number of patients surviving beyond childhood. The growing number of adult MPS patients poses significant challenges for clinicians who may not be familiar with the clinical manifestations of MPS. In addition, as new interventions have changed the natural history of these disorders, it is difficult to anticipate both the impact on life expectancy and other complications that may occur as these patients age. Because the MPS disorders are multi-organ diseases, their management requires a coordinated multi-disciplinary approach. Here we discuss the unique pattern of medical issues and multi-organ involvement in adult patients with MPS and identify the challenges that are associated with management of MPS. This review is based on information from an expert investigator meeting with MPS specialists held October 2-4, 2014 in Dublin, Ireland, as well as on current literature searches focusing on MPS and adults. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

PubMed

Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

2001-06-01

Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.
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.
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
Selection of a turbine cooling system applying multi-disciplinary design considerations.

PubMed

Glezer, B

2001-05-01

The presented paper describes a multi-disciplinary cooling selection approach applied to major gas turbine engine hot section components, including turbine nozzles, blades, discs, combustors and support structures, which maintain blade tip clearances. The paper demonstrates benefits of close interaction between participating disciplines starting from early phases of the hot section development. The approach targets advancements in engine performance and cost by optimizing the design process, often requiring compromises within individual disciplines.
Toward a Sustained, Multi-disciplinary Socioeconomic Community

NASA Astrophysics Data System (ADS)

Pearlman, J.; Pearlman, F.

2014-12-01

Over the last several years the availability of geospatial data has evolved from a scarce and expensive resource, primarily provided by governmental organizations to an abundant resource, often sourced at no or minimum charge by a much broader community including citizen scientists. In an upcoming workshop (October 28/29, 2014), the consequences of the changing technology, data, and policy landscape will be examined thus evaluating the emerging new data-driven paradigms, and advancing the state-of-the-art methodologies to measure the resulting socioeconomic impacts. Providers and users of geospatial data span a broad range of multi-disciplinary areas include policy makers and analysts, financial analysts, economists, geospatial practitioners and other experts from government, academia and the private sector. This presentation will focus on the emerging plan for a sustained, multi-disciplinary community to identify and pursue exemplary use cases for further research and applications. Considerations will include the necessary outreach enablers for such a project.
A practice-based information system for multi-disciplinary care of chronically ill patients: what information do we need? The Community Care Coordination Network Database Group.

PubMed Central

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

1994-01-01

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

PubMed

Luo, Jake; Apperson-Hansen, Carolyn; Pelfrey, Clara M; Zhang, Guo-Qiang

2014-11-30

Cross-institutional cross-disciplinary collaboration has become a trend as researchers move toward building more productive and innovative teams for scientific research. Research collaboration is significantly changing the organizational structure and strategies used in the clinical and translational science domain. However, due to the obstacles of diverse administrative structures, differences in area of expertise, and communication barriers, establishing and managing a cross-institutional research project is still a challenging task. We address these challenges by creating an integrated informatics platform to reduce the barriers to biomedical research collaboration. The Request Management System (RMS) is an informatics infrastructure designed to transform a patchwork of expertise and resources into an integrated support network. The RMS facilitates investigators' initiation of new collaborative projects and supports the management of the collaboration process. In RMS, experts and their knowledge areas are categorized and managed structurally to provide consistent service. A role-based collaborative workflow is tightly integrated with domain experts and services to streamline and monitor the life-cycle of a research project. The RMS has so far tracked over 1,500 investigators with over 4,800 tasks. The research network based on the data collected in RMS illustrated that the investigators' collaborative projects increased close to 3 times from 2009 to 2012. Our experience with RMS indicates that the platform reduces barriers for cross-institutional collaboration of biomedical research projects. Building a new generation of infrastructure to enhance cross-disciplinary and multi-institutional collaboration has become an important yet challenging task. In this paper, we share the experience of developing and utilizing a collaborative project management system. The results of this study demonstrate that a web-based integrated informatics platform can facilitate and increase research interactions among investigators.
Research Report for GeSCI Meta-Review of ICT in Education

ERIC Educational Resources Information Center

LeBaron, John; McDonough, Elizabeth

2009-01-01

The purpose of this research is to provide a multi-disciplinary, multi-methodological meta-review of literature for understanding the global complexity and exponential growth of information and communication technologies (ICT). The scope of the literature review behind this research is limited to studies published between 2006 and 2008. It…
Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment.

PubMed

Thillai, K; Repana, D; Korantzis, I; Kane, P; Prachalias, A; Ross, P

2016-09-01

In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radiofrequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (42%) were identified as resectable or potentially resectable and 11 (36%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation. Copyright © 2016 Elsevier Ltd. All rights reserved.
What contributes to driving ability in Parkinson's disease.

PubMed

Cubo, Esther; Martinez Martin, Pablo; Gonzalez, Miguel; Bergareche, Alberto; Campos, Victor; Fernández, José Manuel; Alvárez, María; Bayes, Angels

2010-01-01

To determine the most significant clinical predictors that influence driving ability in Parkinson disease (PD). National-multi-centre, cross-sectional study covering PD outpatients. Clinical assessment was based on the following questionnaires: cognition (SCOPA-Cog); motor impairment and disabilities (SCOPA motor); depression/anxiety; sleep (SCOPA-Sleep); psychosis and severity/global impairment (HY and CISI-PD). Driving status data was obtained using a standardized questionnaire. Comparisons between drivers and ex-drivers were calculated using chi(2) and Student t-tests as appropriate. Multi-variate logistic regression analysis was performed to identify independent driving ability clinical predictors. Compared with the drivers, the ex-drivers were older (p = 0.00005), had longer disease duration (p = 0.03), had more overall cognitive dysfunction (p = 0.004) and had greater motor impairment, as measured by the CISI (p = 0.02), HY stage (p = 0.034) and by the SCOPA-motor scale (p = 0.002) and difficulty in activities of daily life (p = 0.002). In the regression model analysis, aging and ADL impairment were the principal clinical predictors that differentiated drivers from ex-drivers. Although overall driving impairment in PD is associated with advancing disease severity, driving ability seems to be more strongly influenced by age and ADL impairment. Multi-disciplinary teams are required to assess driving ability in patients with PD and develop rehabilitation measures for safer driving.
[Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

PubMed

Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

2015-04-01

The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.
Analysis of a Multi Disciplinary Approach to Gun Misuse and the Need for a Paradigm Shift in Terminology

DTIC Science & Technology

2016-12-01

may pave the way for addressing other issues of common interdisciplinary concern. 14. SUBJECT TERMS interdisciplinary approach integration ...for some degree of integration of these disciplinary approaches. Specifically, this thesis addresses the following five questions: • Do commonly held...for evaluating the integration of the various disciplinary approaches to gun misuse is apparently still lacking within the reviewed literature. The
Using the framework method for the analysis of qualitative data in multi-disciplinary health research.

PubMed

Gale, Nicola K; Heath, Gemma; Cameron, Elaine; Rashid, Sabina; Redwood, Sabi

2013-09-18

The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
Librarians as Part of Cross-Disciplinary, Multi-Institutional Team Projects: Experiences from the VIVO Collaboration

PubMed Central

Garcia-Milian, Rolando; Norton, Hannah F.; Auten, Beth; Davis, Valrie I.; Holmes, Kristi L.; Johnson, Margeaux; Tennant, Michele R.

2013-01-01

Cross-disciplinary, team-based collaboration is essential for addressing today’s complex research questions, and librarians are increasingly entering into such collaborations. This study identifies skills needed as librarians integrate into cross-disciplinary teams, based on the experiences of librarians involved in the development and implementation of VIVO, a research discovery and collaboration platform. Participants discussed the challenges, skills gained, and lessons learned throughout the project. Their responses were analyzed in the light of the science of team science literature, and factors affecting collaboration on the VIVO team were identified. Skills in inclusive thinking, communication, perseverance, adaptability, and leadership were found to be essential. PMID:23833333
Impact of a Multi-disciplinary C. difficile Action Team

PubMed Central

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

2017-01-01

Abstract Background Clostridium difficile infection (CDI) is associated with increased length of hospital stay, morbidity, mortality, and cost of hospitalization. Early intervention by experts from multiple areas of practice such as gastroenterology (GI), infectious diseases (ID) and surgery can be essential to optimize care and increase utilization of novel treatment modalities such as fecal microbiota transplant (FMT) and minimally invasive, colon-preserving surgical management. Methods A multi-disciplinary C. difficile action team (MD-CAT) was implemented at University of Maryland Medical Center (UMMC) in March 2016 to engage appropriate specialty consultants in the care of CDI patients. The MD-CAT reviews positive C. difficile tests at UMMC and provides guidance and suggestions to the primary team including optimal antibiotic treatment (for CDI and any concomitant infection), and consultant involvement including ID, surgery, and GI, when appropriate. Using retrospective chart review, CDI patient management and outcomes were compared before and after implementation of the MD-CAT. Differences in the time to consults and frequency of interventional treatment was compared using Chi-square or Wilcoxon Rank-sum test. Results We compared 48 patients with CDI in the pre-intervention with 89 patients in the post-intervention period. Demographic and clinical characteristics of the groups were similar. MD-CAT intervention was associated with frequent (73%) modification or discontinuation of concomitant antibiotics. Median time to GI and ID consults was significantly shorter in the post group (P = 0.007 and P = 0.004, respectively). Five of 89 (5.6%) of patients received FMT or colon-preserving surgical intervention in the post-intervention group compared with no patients in the pre-intervention group. There was no difference in 30-day all-cause mortality or CDI recurrence between groups. Conclusion Early, multi-disciplinary action on patients with CDI increased the proportion of patients undergoing active specialty consultation and improved use of concomitant antibiotics. A larger sample size is needed to determine the effects of such a team on other clinical outcomes. Figure 1 Time to GI Consult Figure 2 Time to ID Consult Disclosures All authors: No reported disclosures.
Outcomes research and drug development.

PubMed

Duttagupta, Sandeep

2010-07-01

With increasing health care cost, focus needs to be given towards value-for-money, especially in the context of innovative drugs. A multi-disciplinary approach towards drug development is important in order to demonstrate the value of innovation to physicians and patients. Input into the drug development process at various stages of clinical trials must incorporate patient-focused endpoints and analyses. Demonstrating value of drugs will help ensure that innovative therapies should be seen as health care investment and not expense.

Digestive cancer management in Asia: position statements: a report on GI Oncology Summit in 2011.

PubMed

Sung, Joseph J Y; Ng, Enders K W; Lin, Jaw-Town; Ho, K Y; Ji, Jia-Fu; Sugano, Kentaro; Poon, Ronnie T P; Chan, Anthony T C; Goh, Khean-Lee; Han, Kwang-Hyub; Chen, Leo L T; Wu, Kai-Chun; Ng, Simon S M; Bresalier, Robert S; Chan, Francis K L

2012-09-01

With the rising incidence of digestive cancers in the Asia Pacific region and the advancement in diagnosis, management and palliation in these conditions, the clinical burden on oncologists is ever increasing. This Summit meeting was called to discuss the optimal management of digestive cancers and the role of Gastroenterologists. Experts from Asia Pacific countries in the fields of medical, oncologic, surgical and endoscopic management of cancers in the esophagus, stomach, colon/rectum and the liver reviewed the literature and their practice. 18 position statements were drafted, debated and voted. It was agreed that the burden on GI cancer is increasing. More research will be warranted on chemotherapy, chemoprevention, cost-effectiveness of treatment and nutrition. Cancer management guidelines should be developed in this region when more clinical data are available. In order to improve care to patients, a multi-disciplinary team coordinated by a "cancer therapist" is proposed. This cancer therapist can be a gastroenterologist, a surgeon or any related discipline who have acquired core competence training. This training should include an attachment in a center-of-excellence in cancer management for no less than 12 months. The management of GI cancer should be an integrated multi-disciplinary approach and training for GI cancer therapists should be provided for. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Managing pregnant women with serious mental illness: using the Edinburgh Postnatal Depression Scale as a marker of anxiety and depressive symptoms.

PubMed

Nguyen, Thinh N; Faulkner, Deb; Allen, Suzanna; Hauck, Yvonne L; Frayne, Jacqueline; Rock, Daniel; Rampono, Jonathan

2010-11-01

To examine the course of depressive and anxiety symptoms using serial measurements of the Edinburgh Postnatal Depression Scale (EPDS) in pregnant women with serious mental illness (SMI) attending a specialist multi-disciplinary antenatal clinic in Perth, Western Australia. A retrospective review of case notes was undertaken for 48 Western Australian pregnant women with schizophrenia and related psychoses and bipolar affective disorders who attended the Childbirth and Mental Illness (CAMI) antenatal clinic between December 2007 and November 2009. Of these patients, 27 completed the EPDS at booking (first appointment) and at 32 weeks gestation. Additional variables collected were demographic data, gestation at booking, and attendance rates for these 27 women, and for comparison another 21 women who did not complete the EPDS for one or both screening periods. Mean total EPDS score decreased from 12.2 (SD 7.6) at booking to 8.5 (SD 6.4) at 32 weeks gestation (p = 0.007). Overall mean attendance rates and number of appointments were similar to the non-SMI population and in keeping with standard guidelines. We speculate from these preliminary findings that being managed by a consistent small multi-disciplinary team and knowing that they will be supported throughout their pregnancy could lead to improvement of anxiety and depressive symptoms in pregnant women with SMI, and has the potential to increase their attendance for antenatal care.
A pilot study on understanding the journey of advanced prostate cancer patients.

PubMed

Wagholikar, Amol; Fung, Maggie; Nelson, Colleen

2011-01-01

To understand the journey of advanced prostate cancer patients for supporting development of an innovative patient journey browser. Prostate cancer is one of the common cancers in Australia. Due to the chronic nature of the disease, it is important to have effective disease management strategy and care model. Multi-disciplinary care is a well-proven approach for chronic disease management. The Multi-disciplinary team (MDT) can function more effectively if all the required information is available for the clinical decision support. The development of innovative technology relies on an accurate understanding of the advanced prostate cancer patient's journey over a prolonged period. This need arises from the fact that advanced prostate cancer patients may follow various treatment paths and change their care providers. As a result of this, it is difficult to understand the actual sources of patient's clinical records and their treatment patterns. The aim of the research is to understand variable sources of clinical records, treatment patterns, alternative therapies, over the counter (OTC) medications of advanced prostate cancer patients. This study provides better and holistic understanding of advanced prostate cancer journey. The study was conducted through an on-line survey developed to seek and analyse the responses from the participants. The on-line questionnaire was carefully developed through consultations with the clinical researchers at the Australian Prostate Cancer Research Centre-Queensland, prostate cancer support group representatives and health informaticians at the Australian E-Health Research Centre. The non-identifying questionnaire was distributed to the patients through prostate cancer support groups in Queensland, Australia. The pilot study was carried out between August 2010 and December 2010. The research made important observations about the advanced prostate cancer journey. It showed that General Practitioner (GP) was the common source of patient's clinical records (41%) followed by Urologist (14%) and other clinicians (14%). The data analysis also showed that selenium was the common complementary supplement (55%) used by the patients and about 48% patients did not use any OTC drugs. The most common OTC used by the patients was Paracetamol (about 45%). The results have provided a foundation to the architecture of the proposed technology solution. The outcomes of this study are incorporated in design of the proposed patient journey browser system. A basic version of the system is currently being used at the advanced prostate cancer MDT meetings.
Application of the multi-disciplinary thematic seminar method in two homecare cases - a comparative study.

PubMed

Scandurra, Isabella; Hägglund, Maria; Koch, Sabine

2008-01-01

A significant problem with current health information technologies is that they poorly support collaborative work of healthcare professionals, sometimes leading to a fragmentation of workflow and disruption of healthcare processes. This paper presents two homecare cases, both applying multi-disciplinary thematic seminars (MdTS) as a collaborative method for user needs elicitation and requirements specification. This study describes the MdTS application to elicit user needs from different perspectives to coincide with collaborative professions' work practices in two cases. Despite different objectives, the two cases validated that MdTS emphasized the "points of intersection" in cooperative work. Different user groups with similar, yet distinct needs reached a common understanding of the entire work process, agreed upon requirements and participated in the design of prototypes supporting cooperative work. MdTS was applicable in both exploratory and normative studies aiming to elicit the specific requirements in a cooperative environment.
Practical approach to the gastrointestinal manifestations of cystic fibrosis.

PubMed

Bolia, Rishi; Ooi, Chee Y; Lewindon, Peter; Bishop, Jonathan; Ranganathan, Sarath; Harrison, Jo; Ford, Kristyn; van der Haak, Natalie; Oliver, Mark R

2018-05-16

Cystic fibrosis (CF) is the most common, life-shortening, genetic illness affecting children in Australia and New Zealand. The genetic abnormality results in abnormal anion transport across the apical membrane of epithelial cells in a number of organs, including the lungs, gastrointestinal tract, liver and genito-urinary tract. Thus, CF is a multi-system disorder that requires a multi-disciplinary approach. Respiratory disease is the predominant cause of both morbidity and mortality in patients with CF. However, there are significant and clinically relevant gastrointestinal, liver, pancreatic and nutritional manifestations that must be detected and managed in a timely and structured manner. The aim of this review is to provide evidence-based information and clinical algorithms to guide the nutritional and gastrointestinal management of patients with CF. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Evaluation of the quality of care of a multi-disciplinary risk factor assessment and management programme (RAMP) for diabetic patients

PubMed Central

2012-01-01

Background Type 2 Diabetes Mellitus (DM) is a common chronic disease associated with multiple clinical complications. Management guidelines have been established which recommend a risk-stratified approach to managing these patients in primary care. This study aims to evaluate the quality of care (QOC) and effectiveness of a multi-disciplinary risk assessment and management programme (RAMP) for type 2 diabetic patients attending government-funded primary care clinics in Hong Kong. The evaluation will be conducted using a structured and comprehensive evidence-based evaluation framework. Method/design For evaluation of the quality of care, a longitudinal study will be conducted using the Action Learning and Audit Spiral methodologies to measure whether the pre-set target standards for criteria related to the structure and process of care are achieved. Each participating clinic will be invited to complete a Structure of Care Questionnaire evaluating pre-defined indicators which reflect the setting in which care is delivered, while process of care will be evaluated against the pre-defined indicators in the evaluation framework. Effectiveness of the programme will be evaluated in terms of clinical outcomes, service utilization outcomes, and patient-reported outcomes. A cohort study will be conducted on all eligible diabetic patients who have enrolled into RAMP for more than one year to compare their clinical and public service utilization outcomes of RAMP participants and non-participants. Clinical outcome measures will include HbA1c, blood pressure (both systolic and diastolic), lipids (low-density lipoprotein cholesterol) and future cardiovascular diseases risk prediction; and public health service utilization rate will include general and specialist outpatient, emergency department attendances, and hospital admissions annually within 5 years. For patient-reported outcomes, a total of 550 participants and another 550 non-participants will be followed by telephone to monitor quality of life, patient enablement, global rating of change in health and private health service utilization at baseline, 6, 12, 36 and 60 months. Discussion The quality of care and effectiveness of the RAMP in enhancing the health for patients with type 2 diabetes will be determined. Possible areas for quality enhancement will be identified and standards of good practice can be established. The information will be useful in guiding service planning and policy decision making. PMID:23216708
Evaluation of the quality of care of a multi-disciplinary risk factor assessment and management programme (RAMP) for diabetic patients.

PubMed

Fung, Colman S C; Chin, Weng Yee; Dai, Daisy S K; Kwok, Ruby L P; Tsui, Eva L H; Wan, Yuk Fai; Wong, Wendy; Wong, Carlos K H; Fong, Daniel Y T; Lam, Cindy L K

2012-12-05

Type 2 Diabetes Mellitus (DM) is a common chronic disease associated with multiple clinical complications. Management guidelines have been established which recommend a risk-stratified approach to managing these patients in primary care. This study aims to evaluate the quality of care (QOC) and effectiveness of a multi-disciplinary risk assessment and management programme (RAMP) for type 2 diabetic patients attending government-funded primary care clinics in Hong Kong. The evaluation will be conducted using a structured and comprehensive evidence-based evaluation framework. For evaluation of the quality of care, a longitudinal study will be conducted using the Action Learning and Audit Spiral methodologies to measure whether the pre-set target standards for criteria related to the structure and process of care are achieved. Each participating clinic will be invited to complete a Structure of Care Questionnaire evaluating pre-defined indicators which reflect the setting in which care is delivered, while process of care will be evaluated against the pre-defined indicators in the evaluation framework.Effectiveness of the programme will be evaluated in terms of clinical outcomes, service utilization outcomes, and patient-reported outcomes. A cohort study will be conducted on all eligible diabetic patients who have enrolled into RAMP for more than one year to compare their clinical and public service utilization outcomes of RAMP participants and non-participants. Clinical outcome measures will include HbA1c, blood pressure (both systolic and diastolic), lipids (low-density lipoprotein cholesterol) and future cardiovascular diseases risk prediction; and public health service utilization rate will include general and specialist outpatient, emergency department attendances, and hospital admissions annually within 5 years. For patient-reported outcomes, a total of 550 participants and another 550 non-participants will be followed by telephone to monitor quality of life, patient enablement, global rating of change in health and private health service utilization at baseline, 6, 12, 36 and 60 months. The quality of care and effectiveness of the RAMP in enhancing the health for patients with type 2 diabetes will be determined. Possible areas for quality enhancement will be identified and standards of good practice can be established. The information will be useful in guiding service planning and policy decision making.
Exploring the rewards and challenges of paediatric palliative care work - a qualitative study of a multi-disciplinary children's hospice care team.

PubMed

Taylor, Johanna; Aldridge, Jan

2017-12-16

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

EPA Science Inventory

Managing coastal resources for resiliency and sustainability often requires integrative, multi-disciplinary approaches across varying spatial and temporal scales to engage stakeholders and inform decision-makers. We discuss case studies integrating wetland ecology, economics, soc...
Using multi-disciplinary strategic master facilities planning for organizations experiencing programmatic re-direction

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

Heubach, J.G.; Weimer, W.C.; Bruce, W.A.

Facility master planning is critical to the future productivity of a laboratory and the quality of worklife for the laboratory staff. For organizations undergoing programmatic re-direction, a master facility planning approach linked to the organization`s strategic planning process is even more important. Major changes in an organization such as programmatic re-direction can significantly impact a broad range of variables which exceed the expertise of traditional planning teams, e.g., capacity variability, work team organization, organizational culture, and work process simplification. By expanding the diversity of the participants of the planning team, there is a greater likelihood that a research organization`s scientific,more » organizational, economic, and employees` needs can be meshed in the strategic plan and facility plan. Recent recommendations from facility planners suggest drawing from diverse fields in building multi-disciplinary planning teams: Architecture, engineering, natural science, social psychology, and strategic planning (Gibson,1993). For organizations undergoing significant operational or culture change, the master facility planning team should also include members with expertise in organizational effectiveness, industrial engineering, human resources, and environmental psychology. A recent planning and design project provides an example which illustrates the use of an expanded multi-disciplinary team engaged in planning laboratory renovations for a research organization undergoing programmatic re-direction. The purpose of the proposed poster session is to present a multi-disciplinary master facility planning process linked to an organization`s strategic planning process or organizational strategies.« less
Initiating an undiagnosed diseases program in the Western Australian public health system.

PubMed

Baynam, Gareth; Broley, Stephanie; Bauskis, Alicia; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharron; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Schofield, Lyn; Helmholz, Petra; Palmer, Richard; Kung, Stefanie; Walker, Caroline E; Molster, Caron; Lewis, Barry; Mina, Kym; Beilby, John; Pathak, Gargi; Poulton, Cathryn; Groza, Tudor; Zankl, Andreas; Roscioli, Tony; Dinger, Marcel E; Mattick, John S; Gahl, William; Groft, Stephen; Tifft, Cynthia; Taruscio, Domenica; Lasko, Paul; Kosaki, Kenjiro; Wilhelm, Helene; Melegh, Bela; Carapetis, Jonathan; Jana, Sayanta; Chaney, Gervase; Johns, Allison; Owen, Peter Wynn; Daly, Frank; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

2017-05-03

New approaches are required to address the needs of complex undiagnosed diseases patients. These approaches include clinical genomic diagnostic pipelines, utilizing intra- and multi-disciplinary platforms, as well as specialty-specific genomic clinics. Both are advancing diagnostic rates. However, complementary cross-disciplinary approaches are also critical to address those patients with multisystem disorders who traverse the bounds of multiple specialties and remain undiagnosed despite existing intra-specialty and genomic-focused approaches. The diagnostic possibilities of undiagnosed diseases include genetic and non-genetic conditions. The focus on genetic diseases addresses some of these disorders, however a cross-disciplinary approach is needed that also simultaneously addresses other disorder types. Herein, we describe the initiation and summary outcomes of a public health system approach for complex undiagnosed patients - the Undiagnosed Diseases Program-Western Australia (UDP-WA). Briefly the UDP-WA is: i) one of a complementary suite of approaches that is being delivered within health service, and with community engagement, to address the needs of those with severe undiagnosed diseases; ii) delivered within a public health system to support equitable access to health care, including for those from remote and regional areas; iii) providing diagnoses and improved patient care; iv) delivering a platform for in-service and real time genomic and phenomic education for clinicians that traverses a diverse range of specialties; v) retaining and recapturing clinical expertise; vi) supporting the education of junior and more senior medical staff; vii) designed to integrate with clinical translational research; and viii) is supporting greater connectedness for patients, families and medical staff. The UDP-WA has been initiated in the public health system to complement existing clinical genomic approaches; it has been targeted to those with a specific diagnostic need, and initiated by redirecting existing clinical and financial resources. The UDP-WA supports the provision of equitable and sustainable diagnostics and simultaneously supports capacity building in clinical care and translational research, for those with undiagnosed, typically rare, conditions.
Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and Canada.

PubMed

Rio, A; Cawadias, E

2007-02-01

The management of amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) has shifted from an attitude of nihilism to treatments that prolong survival and offer hope. Nutrition is an integral component of ALS/MND care requiring coordination among acute and community multi-disciplinary teams (MDT). Evidence-based nutrition guidelines exist for this patient group but their use among dietitians is unknown. The aim of this study was to survey the knowledge, practice and guideline use of dietitians working in ALS/MND centres/clinics across England, Wales, Northern Ireland (EWNI) and Canada. Dietetic contact details were obtained from the Motor Neurone Disease Association (MNDA) and the ALS Society of Canada (ALSSC) websites. Telephone interviews were conducted with 23 dietitians using a standardized questionnaire. Multi-disciplinary team membership was high (78%). Only 22% dietitians had >4-years experience in ALS/MND care. Dietitians reported using body weight, percentage weight loss (PWL) and body mass index (BMI) to assess nutritional status. Equations used to estimate energy and protein requirements differed. Most frequent dietary advice was high calorie, texture modification and prescription nutritional supplements. Artificial nutrition and hydration (ANH) was discussed when patients developed dysphagia, energy intake was inadequate, weight loss of 10% or forced vital capacity (FVC) was reduced. A percutaneous endoscopic gastrostomy (PEG) service was available at all clinics/centres. Nutritional assessment techniques and dietary advice should be standardized. Dietetic collaboration at national and international level is recommended to reduce professional isolation. Training and support in ALS/MND nutrition should be made available as part of post-dietetic registration. Further dietetic research is required to stimulate nutritional care.
Preparing to understand and use science in the real world: interdisciplinary study concentrations at the Technical University of Darmstadt.

PubMed

Liebert, Wolfgang J

2013-12-01

In order to raise awareness of the ambiguous nature of scientific-technological progress, and of the challenging problems it raises, problems which are not easily addressed by courses in a single discipline and cannot be projected onto disciplinary curricula, Technical University of Darmstadt has established three interdisciplinary study concentrations: "Technology and International Development", "Environmental Sciences", and "Sustainable Shaping of Technology and Science". These three programmes seek to overcome the limitations of strictly disciplinary research and teaching by developing an integrated, problem-oriented approach. For example, one course considers fundamental nuclear dilemmas and uses role-playing techniques to address a controversy in the area of nuclear security. At the same time, incorporating interdisciplinary teaching into a university that is organized around mono- or multi-disciplinary faculties also poses a number of challenges. Recognition in disciplinary curricula, and appropriate organizational support and funding are examples of those challenges. It is expected that science and engineering students, empowered by such interdisciplinary study programmes, will be better prepared to act responsibly with regard to scientific and technological challenges.
OHIO RIVER BASIN ENERGY STUDY: HEALTH ASPECTS

EPA Science Inventory

This report was prepared as part of the Ohio River Basin Energy Study (ORBES), a multi-disciplinary program supported by the Environmental Protection Agency. It attempts to establish health damage functions for energy resource extraction, conversion (i.e., burning of coal to prod...
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.
Developing Multi-Agency Leadership in Education

ERIC Educational Resources Information Center

Close, Paul

2012-01-01

This article contributes to the growing debate around how we understand and develop multi-agency leadership in children and young people's services. Bringing together a range of inter-disciplinary research, it presents a framework for multi-agency leadership development, which, it argues, is well theorised, multi-level and versed in key field…
Process Improvement Through Tool Integration in Aero-Mechanical Design

NASA Technical Reports Server (NTRS)

Briggs, Clark

2010-01-01

Emerging capabilities in commercial design tools promise to significantly improve the multi-disciplinary and inter-disciplinary design and analysis coverage for aerospace mechanical engineers. This paper explores the analysis process for two example problems of a wing and flap mechanical drive system and an aircraft landing gear door panel. The examples begin with the design solid models and include various analysis disciplines such as structural stress and aerodynamic loads. Analytical methods include CFD, multi-body dynamics with flexible bodies and structural analysis. Elements of analysis data management, data visualization and collaboration are also included.
Application of best practice approaches for designing decision support tools: The preparatory education about clinical trials (PRE-ACT) study

PubMed Central

Fleisher, Linda; Ruggieri, Dominique G.; Miller, Suzanne M.; Manne, Sharon; Albrecht, Terrance; Buzaglo, Joanne; Collins, Michael A.; Katz, Michael; Kinzy, Tyler G.; Liu, Tasnuva; Manning, Cheri; Charap, Ellen Specker; Millard, Jennifer; Miller, Dawn M.; Poole, David; Raivitch, Stephanie; Roach, Nancy; Ross, Eric A.; Meropol, Neal J.

2014-01-01

Objective This article describes the rigorous development process and initial feedback of the PRE-ACT (Preparatory Education About Clinical Trials) web-based- intervention designed to improve preparation for decision making in cancer clinical trials. Methods The multi-step process included stakeholder input, formative research, user testing and feedback. Diverse teams (researchers, advocates and developers) participated including content refinement, identification of actors, and development of video scripts. Patient feedback was provided in the final production period and through a vanguard group (N = 100) from the randomized trial. Results Patients/advocates confirmed barriers to cancer clinical trial participation, including lack of awareness and knowledge, fear of side effects, logistical concerns, and mistrust. Patients indicated they liked the tool’s user-friendly nature, the organized and comprehensive presentation of the subject matter, and the clarity of the videos. Conclusion The development process serves as an example of operationalizing best practice approaches and highlights the value of a multi-disciplinary team to develop a theory-based, sophisticated tool that patients found useful in their decision making process. Practice implications Best practice approaches can be addressed and are important to ensure evidence-based tools that are of value to patients and supports the usefulness of a process map in the development of e-health tools. PMID:24813474
A multi-scale, multi-disciplinary approach for assessing the technological, economic and environmental performance of bio-based chemicals.

PubMed

Herrgård, Markus; Sukumara, Sumesh; Campodonico, Miguel; Zhuang, Kai

2015-12-01

In recent years, bio-based chemicals have gained interest as a renewable alternative to petrochemicals. However, there is a significant need to assess the technological, biological, economic and environmental feasibility of bio-based chemicals, particularly during the early research phase. Recently, the Multi-scale framework for Sustainable Industrial Chemicals (MuSIC) was introduced to address this issue by integrating modelling approaches at different scales ranging from cellular to ecological scales. This framework can be further extended by incorporating modelling of the petrochemical value chain and the de novo prediction of metabolic pathways connecting existing host metabolism to desirable chemical products. This multi-scale, multi-disciplinary framework for quantitative assessment of bio-based chemicals will play a vital role in supporting engineering, strategy and policy decisions as we progress towards a sustainable chemical industry. © 2015 Authors; published by Portland Press Limited.
Disciplining Bioethics: Towards a Standard of Methodological Rigor in Bioethics Research

PubMed Central

Adler, Daniel; Shaul, Randi Zlotnik

2012-01-01

Contemporary bioethics research is often described as multi- or interdisciplinary. Disciplines are characterized, in part, by their methods. Thus, when bioethics research draws on a variety of methods, it crosses disciplinary boundaries. Yet each discipline has its own standard of rigor—so when multiple disciplinary perspectives are considered, what constitutes rigor? This question has received inadequate attention, as there is considerable disagreement regarding the disciplinary status of bioethics. This disagreement has presented five challenges to bioethics research. Addressing them requires consideration of the main types of cross-disciplinary research, and consideration of proposals aiming to ensure rigor in bioethics research. PMID:22686634

Microcomputer Technology in Schools: Issues for Research.

ERIC Educational Resources Information Center

Kane, Janet H.; And Others

This exploratory, multi-disciplinary study, which was undertaken to identify a research agenda for the educational implementation and impact of microprocessing technology, used case study methodology to explore the relationship between the social contexts and the microcomputer innovation. Three geographically distinct school districts with a…
Technological Revolutions: Some Implications for the Social Studies

ERIC Educational Resources Information Center

Kane, Paul W.

1975-01-01

The advantages of a social studies program, centered on the various technological revolutions -- human, agricultural, urban, industrial, and humanizing -- are a multi-disciplinary approach, the use of inquiry skills, wide coverage of history and nations through a framework of concepts, and discussion of ethnocentrism. (JH)
[How to evaluate the application of Clinical Governance tools in the management of hospitalized hyperglycemic patients: results of a multicentric study].

PubMed

De Belvis, Antonio Giulio; Specchia, Maria Lucia; Ferriero, Anna Maria; Capizzi, Silvio

2017-01-01

Risk management is a key tool in Clinical Governance. Our project aimed to define, share, apply and measure the impact of tools and methodologies for the continuous improvement of quality of care, especially in relation to the multi-disciplinary and integrated management of the hyperglycemic patient in hospital settings. A training project, coordinated by a scientific board of experts in diabetes and health management and an Expert Meeting with representatives of all the participating centers was launched in 2014. The project involved eight hospitals through the organization of meetings with five managers and 25 speakers, including diabetologists, internists, pharmacists and nurses. The analysis showed a wide variability in the adoption of tools and processes towards a comprehensive and coordinated management of hyperglycemic patients.
75 FR 27990 - Mid-Atlantic Fishery Management Council (MAFMC); Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... presentation on Climate Change and Responses in a Coupled Marine System; the Mid-Atlantic surfclam (MASC) model is being developed as part of a multi-disciplinary study looking at adaptation to climate change in a...
The cultural construction of interdisciplinarity: Doctoral student socialization in an interdisciplinary neuroscience program

NASA Astrophysics Data System (ADS)

Holley, Karri A.

Using the methodologies of individual and group interviews, observation, and document analysis, this dissertation examines the experiences of doctoral students enrolled in an interdisciplinary neuroscience program. A framework drawn from theories of organizational socialization is employed to understand the influence of an interdisciplinary program on doctoral student socialization. While abundant previous literature exists in regards to the socialization of doctoral students, such literature largely concentrates the disciplinary experience. The escalating import of globalization and shifting fiscal realities place new demands on Ph.D. programs and doctoral students to work as part of collaborative research teams, produce interdisciplinary knowledge, and integrate theory and practice. The increasing influence of such factors requires a new focus on interdisciplinarity and the changing Ph.D. The goal of this dissertation is to expand the existing framework of socialization by documenting the influence of such obstacles on knowledge acquisition, identity development, and professional investment. This study focuses on how interdisciplinary identities are constructed by doctoral students through individual interaction with the social environment and cultural context. Particular attention is given to the structural and cultural obstacles that doctoral students must negotiate as they navigate an interdisciplinary program. The study expands on the previous literature regarding doctoral student socialization by focusing on identity development, specifically a student's symbolic identity as a neuroscientist, a student's disciplinary identity (related to her professional background and undergraduate experiences), and a multi-disciplinary identity that allows for connections across disciplinary boundaries. In contrast to the traditional concepts of identity which focus on boundaries and differences as an inherent part of self-definition, the structure of identity advanced here instead explores what factors connect individuals who are working in different areas of study. Faculty and peers perform important roles in this process, by modeling the relevance of collaborative research and engaging students in multi-disciplinary conversation.
Implementation and evaluation of a community-based medication reconciliation (CMR) system at the hospital-community interface of care.

PubMed

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

2009-01-01

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

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

PubMed

Sihoe, Alan D L

2016-02-01

A clinical pathway provides a scheduled, objective protocol for the multi-disciplinary, evidence-based management of patients with a specific condition or undergoing a specific procedure. In implementing a clinical pathway for the care of patients receiving video-assisted thoracic surgery (VATS) in Hong Kong, many insights were gained into what makes a clinical pathway work: meticulous preparation and team-building are keys to success; the pathway must be constantly reviewed and revisions made in response to evolving clinical need; and data collection is a key element to allow auditing and clinical research. If these can be achieved, a clinical pathway delivers not only measurable improvements in patient outcomes, but also fundamentally complements clinical advances such as VATS. This article narrates the story of how the clinical pathway for VATS in Hong Kong was created and evolved, highlighting how the above lessons were learned.
A Loader for Executing Multi-Binary Applications on the Thinking Machines CM-5: It's Not Just for SPMD Anymore

NASA Technical Reports Server (NTRS)

Becker, Jeffrey C.

1995-01-01

The Thinking Machines CM-5 platform was designed to run single program, multiple data (SPMD) applications, i.e., to run a single binary across all nodes of a partition, with each node possibly operating on different data. Certain classes of applications, such as multi-disciplinary computational fluid dynamics codes, are facilitated by the ability to have subsets of the partition nodes running different binaries. In order to extend the CM-5 system software to permit such applications, a multi-program loader was developed. This system is based on the dld loader which was originally developed for workstations. This paper provides a high level description of dld, and describes how it was ported to the CM-5 to provide support for multi-binary applications. Finally, it elaborates how the loader has been used to implement the CM-5 version of MPIRUN, a portable facility for running multi-disciplinary/multi-zonal MPI (Message-Passing Interface Standard) codes.
Multi-Disciplinary Knowledge Synthesis for Human Health Assessment on Earth and in Space

NASA Astrophysics Data System (ADS)

Christakos, G.

We discuss methodological developments in multi-disciplinary knowledge synthesis (KS) of human health assessment. A theoretical KS framework can provide the rational means for the assimilation of various information bases (general, site-specific etc.) that are relevant to the life system of interest. KS-based techniques produce a realistic representation of the system, provide a rigorous assessment of the uncertainty sources, and generate informative health state predictions across space-time. The underlying epistemic cognition methodology is based on teleologic criteria and stochastic logic principles. The mathematics of KS involves a powerful and versatile spatiotemporal random field model that accounts rigorously for the uncertainty features of the life system and imposes no restriction on the shape of the probability distributions or the form of the predictors. KS theory is instrumental in understanding natural heterogeneities, assessing crucial human exposure correlations and laws of physical change, and explaining toxicokinetic mechanisms and dependencies in a spatiotemporal life system domain. It is hoped that a better understanding of KS fundamentals would generate multi-disciplinary models that are useful for the maintenance of human health on Earth and in Space.
Radiology and Enterprise Medical Imaging Extensions (REMIX).

PubMed

Erdal, Barbaros S; Prevedello, Luciano M; Qian, Songyue; Demirer, Mutlu; Little, Kevin; Ryu, John; O'Donnell, Thomas; White, Richard D

2018-02-01

Radiology and Enterprise Medical Imaging Extensions (REMIX) is a platform originally designed to both support the medical imaging-driven clinical and clinical research operational needs of Department of Radiology of The Ohio State University Wexner Medical Center. REMIX accommodates the storage and handling of "big imaging data," as needed for large multi-disciplinary cancer-focused programs. The evolving REMIX platform contains an array of integrated tools/software packages for the following: (1) server and storage management; (2) image reconstruction; (3) digital pathology; (4) de-identification; (5) business intelligence; (6) texture analysis; and (7) artificial intelligence. These capabilities, along with documentation and guidance, explaining how to interact with a commercial system (e.g., PACS, EHR, commercial database) that currently exists in clinical environments, are to be made freely available.
A crisis in chronic pain care: an ethical analysis. Part three: Toward an integrative, multi-disciplinary pain medicine built around the needs of the patient.

PubMed

Giordano, James; Schatman, Michael E

2008-01-01

A number of variables have contributed to the current crisis in chronic pain care and are affected by, and affect, the philosophies and politics that influence the socio-economic climate of the American healthcare system. Thus, we posit that managing the crisis in chronic pain care in the United States is contingent upon the development of a multi-focal healthcare paradigm that more thoroughly enables and fortifies research, its translation (in education and practice), and the implementation of, and support for, both the curative and healing approaches in medicine in general, and pain care specifically. These steps necessitate re-examination, if not revision of the health care system and its economics. The ethical imperative to consider and prudently employ cutting-edge diagnostic and therapeutic technologies in pain medicine is obligatory. However, "supply side prudence" is of little value if "demand side accessibility" is lacking. Revisions to health insurance plans advocated by the in-coming administration seek to create uniformity in basic health care services based upon re-assessment of the clinical effectiveness (versus merely cost) of treatments, including those that are "high tech." These plans attempt to allow every patient a more complete ability to deliberatively work with physicians to access those services and resources that maximize health functioning and goals. But even given these revisions, authentic pain care must take into account the interactive contexts of the painient individual. The biopsychosocial model of chronic pain management may have significant practical and ethical worth in this regard. A system of pain treatment operating from a biopsychosocial perspective necessitates integrative multi-disciplinarity. We propose a tiered, multi-disciplinary paradigm based upon the differing needs of each specific patient. But establishing such a system does not guarantee access, and distribution of these services and resources requires economic support to ensure that capabilities are more broadly available (i.e., supplied), and afforded as needed and wanted (i.e., demanded). Toward this end, we posit the need to focus upon, and more fully integrate 1) education, 2) multi-disciplinary care (including re-vivification of MPCs), 3) policies that allow financial subsidies that afford patients the latitude to access and utilize such expanded resources appropriately to meet identified medical needs, and 4) medico-legal initiatives and statutes that protect and enable patients and physicians. The proposed changes comport with a number of ethical systems in that they support the basic deontic structure of the profession and allow for a richer, more finely grained articulation of clinical and ethical responsibilities within the scope of particular general, specialty, and sub-specialty practices.
Community Resource Curriculum Development: Grades 3-4.

ERIC Educational Resources Information Center

Bentley, Michael L.; And Others

This manual was developed by the Community Resource Curriculum Development Project (CRCDP), a cooperative project to develop multi-disciplinary, multi-ethnic, multi-cultural science/social sciences teaching units based upon the Illinois State Goals for Learning. This manual contains seven teaching units that include several experience-based…
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.
Strategies for waste management in small and medium towns of developing countries: a case study of India.

PubMed

Sundaravadivel, M; Vigneswaran, S

2003-01-01

This paper evaluates the issues of waste management in small and medium towns (SMTs) (with population in the range of 10,000-100,000) of India, and identifies the need for a multi-disciplinary approach encompassing technological, economic and financial aspects of the issues to effect improvements. A comprehensive set of cross-disciplinary strategies is suggested to improve the prevailing conditions with environmentally appropriate, economically efficient and financially self-sustaining waste management services. Based on a case study of four SMTs in the State of Tamil Nadu in India, this paper evaluates the application of the suggested strategies and offers policy recommendations.
Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the National PERT™ Consortium members.

PubMed

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

2017-08-01

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

ERIC Educational Resources Information Center

Ghaoui, Claude, Ed.

2004-01-01

"E-Education Applications: Human Factors and Innovative Approaches" enforces the need to take multi-disciplinary and/or inter-disciplinary approaches, when solutions for e-education (or online-, e-learning) are introduced. By focusing on the issues that have impact on the usability of e-learning, the book specifically fills-in a gap in this area,…
Learning of Core Disciplinary Ideas: Efficacy Comparison of Two Contrasting Modes of Science Instruction

ERIC Educational Resources Information Center

Schuster, David; Cobern, William W.; Adams, Betty A. J.; Undreiu, Adriana; Pleasants, Brandy

2018-01-01

Science curricula and teaching methods vary greatly, depending in part on which facets of science are emphasized, e.g., core disciplinary ideas or science practices and process skills, and perspectives differ considerably on desirable pedagogies. Given the multi-faceted nature of science and the variety of teaching methods found in practice, it is…
Clinical governance and infection control in the United Kingdom.

PubMed

Masterson, R G; Teare, E L

2001-01-01

The recent organizational changes in the NHS have at their core the concept of clinical governance. Although initially poorly defined and understood this term has now taken on a clear identity, placing quality alongside fiscal probity and corporate governance at the top of NHS priorities. Integral to clinical governance are the basic elements of clear national standards for services and treatments that are to be locally delivered through assured, monitored, high quality healthcare. It is within this framework that workers in infection control must develop their own methods of applying clinical governance. This review explores the implications that the strategy of clinical governance holds for the speciality of infection control, emphasizing the benefits its active adoption can bring and highlighting the key relevance of clinical risk management in this setting. It illustrates clinical governance as a tool to engage colleagues on a multi-disciplinary front, most particularly the crucial link to senior Trust management.
Arizona Conserve Water Educators Guide

ERIC Educational Resources Information Center

Project WET Foundation, 2007

2007-01-01

This award-winning, 350-page, full-color book provides a thorough study of Arizona water resources from a water conservation perspective. Its background section contains maps, graphs, diagrams and photos that facilitate the teaching of 15 interactive, multi-disciplinary lessons to K-12 students. In addition, 10 Arizona case studies are highlighted…

Therapeutic strategies in Sickle Cell Anemia: The past present and future.

PubMed

Fernandes, Queenie

2017-06-01

Sickle Cell Anemia (SCA) was one of the first hemoglobinopathies to be discovered. It is distinguished by the mutation-induced expression of a sickle cell variant of hemoglobin (HbS) that triggers erythrocytes to take a characteristic sickled conformation. The complex physiopathology of the disease and its associated clinical complications has initiated multi-disciplinary research within its field. This review attempts to lay emphasis on the evolution, current standpoint and future scope of therapeutic strategies in SCA. Copyright © 2017 Elsevier Inc. All rights reserved.
Ocular Sarcoidosis

PubMed Central

Pasadhika, Sirichai; Rosenbaum, James T

2015-01-01

Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations. PMID:26593141
Power in the nursing home: the case of a special care unit.

PubMed

McLean, A

2001-01-01

This article examines the effects and nature of power in a special care unit of a nursing home devoted to elders with dementia and/or disturbed behaviors. Drawing from two case studies and contemporary theories on power, I illustrate how the hierarchical structure of the clinic, together with the diffuseness and pervasiveness of disciplinary power, serves to shape the lives of--and to constrain the resistance opportunities open to--elders within the clinic. I also discuss the dilemma facing ethnographers of the clinic who may witness the sometimes disastrous effects of power but feel incapable, in their positions as researchers, of challenging the actions of clinical staff. At the same time, I observe how the contradictions of disciplinary power are often experienced by clinical staff who themselves struggle between taking actions they feel they must and those they would prefer. Far from acceding to the impotency that clinical anthropologists too often feel within a research setting, I argue that they can help to incite in their clinical colleagues the urgency of carrying out more productive alternatives to conventional "disciplinary" practices.
Community Resource Curriculum Development: Grades K-2.

ERIC Educational Resources Information Center

Bentley, Michael L.; And Others

This manual was developed by the Community Resource Curriculum Development Project (CRCDP), a cooperative project to develop multi-disciplinary, multi-ethnic, multi-cultural science/social sciences teaching units based upon the Illinois State Goals for Learning and the Chicago Public Schools outcomes for a seamless kindergarten, first, and second…
An Introduction to Early Childhood Studies. Second Edition

ERIC Educational Resources Information Center

Maynard, Trisha, Ed.; Thomas, Nigel, Ed.

2009-01-01

The second edition of this best-selling textbook provides students and practitioners with a broad introduction to, and critical analysis of, the main theories and issues within the field of early childhood studies. The book adopts a multi-disciplinary approach and pulls together all the key themes involved in the study of young children and…
TRIAD: The Translational Research Informatics and Data Management Grid

PubMed Central

Payne, P.; Ervin, D.; Dhaval, R.; Borlawsky, T.; Lai, A.

2011-01-01

Objective Multi-disciplinary and multi-site biomedical research programs frequently require infrastructures capable of enabling the collection, management, analysis, and dissemination of heterogeneous, multi-dimensional, and distributed data and knowledge collections spanning organizational boundaries. We report on the design and initial deployment of an extensible biomedical informatics platform that is intended to address such requirements. Methods A common approach to distributed data, information, and knowledge management needs in the healthcare and life science settings is the deployment and use of a service-oriented architecture (SOA). Such SOA technologies provide for strongly-typed, semantically annotated, and stateful data and analytical services that can be combined into data and knowledge integration and analysis “pipelines.” Using this overall design pattern, we have implemented and evaluated an extensible SOA platform for clinical and translational science applications known as the Translational Research Informatics and Data-management grid (TRIAD). TRIAD is a derivative and extension of the caGrid middleware and has an emphasis on supporting agile “working interoperability” between data, information, and knowledge resources. Results Based upon initial verification and validation studies conducted in the context of a collection of driving clinical and translational research problems, we have been able to demonstrate that TRIAD achieves agile “working interoperability” between distributed data and knowledge sources. Conclusion Informed by our initial verification and validation studies, we believe TRIAD provides an example instance of a lightweight and readily adoptable approach to the use of SOA technologies in the clinical and translational research setting. Furthermore, our initial use cases illustrate the importance and efficacy of enabling “working interoperability” in heterogeneous biomedical environments. PMID:23616879
TRIAD: The Translational Research Informatics and Data Management Grid.

PubMed

Payne, P; Ervin, D; Dhaval, R; Borlawsky, T; Lai, A

2011-01-01

Multi-disciplinary and multi-site biomedical research programs frequently require infrastructures capable of enabling the collection, management, analysis, and dissemination of heterogeneous, multi-dimensional, and distributed data and knowledge collections spanning organizational boundaries. We report on the design and initial deployment of an extensible biomedical informatics platform that is intended to address such requirements. A common approach to distributed data, information, and knowledge management needs in the healthcare and life science settings is the deployment and use of a service-oriented architecture (SOA). Such SOA technologies provide for strongly-typed, semantically annotated, and stateful data and analytical services that can be combined into data and knowledge integration and analysis "pipelines." Using this overall design pattern, we have implemented and evaluated an extensible SOA platform for clinical and translational science applications known as the Translational Research Informatics and Data-management grid (TRIAD). TRIAD is a derivative and extension of the caGrid middleware and has an emphasis on supporting agile "working interoperability" between data, information, and knowledge resources. Based upon initial verification and validation studies conducted in the context of a collection of driving clinical and translational research problems, we have been able to demonstrate that TRIAD achieves agile "working interoperability" between distributed data and knowledge sources. Informed by our initial verification and validation studies, we believe TRIAD provides an example instance of a lightweight and readily adoptable approach to the use of SOA technologies in the clinical and translational research setting. Furthermore, our initial use cases illustrate the importance and efficacy of enabling "working interoperability" in heterogeneous biomedical environments.
Hearing the voices of service user researchers in collaborative qualitative data analysis: the case for multiple coding.

PubMed

Sweeney, Angela; Greenwood, Kathryn E; Williams, Sally; Wykes, Til; Rose, Diana S

2013-12-01

Health research is frequently conducted in multi-disciplinary teams, with these teams increasingly including service user researchers. Whilst it is common for service user researchers to be involved in data collection--most typically interviewing other service users--it is less common for service user researchers to be involved in data analysis and interpretation. This means that a unique and significant perspective on the data is absent. This study aims to use an empirical report of a study on Cognitive Behavioural Therapy for psychosis (CBTp) to demonstrate the value of multiple coding in enabling service users voices to be heard in team-based qualitative data analysis. The CBTp study employed multiple coding to analyse service users' discussions of CBT for psychosis (CBTp) from the perspectives of a service user researcher, clinical researcher and psychology assistant. Multiple coding was selected to enable multiple perspectives to analyse and interpret data, to understand and explore differences and to build multi-disciplinary consensus. Multiple coding enabled the team to understand where our views were commensurate and incommensurate and to discuss and debate differences. Through the process of multiple coding, we were able to build strong consensus about the data from multiple perspectives, including that of the service user researcher. Multiple coding is an important method for understanding and exploring multiple perspectives on data and building team consensus. This can be contrasted with inter-rater reliability which is only appropriate in limited circumstances. We conclude that multiple coding is an appropriate and important means of hearing service users' voices in qualitative data analysis. © 2012 John Wiley & Sons Ltd.
[A new psycho-dermatology clinic in Israel: our first year experience].

PubMed

Orion, Edith; Ben-Avi, Orit

2011-01-01

Psychodermatology involves the interrelationships between the skin and the mind, especially when considering the formation and evolution of certain common skin conditions. It appears that 30-40% of dermatology patients suffer from certain psychological problems as defined by the ICD-10, in a way that influences their disease severity and progression, as well as their quality of Life. Treatment of such cases requires a multi-disciplinary approach and should involve both a dermatologist and a mental health specialist working together In this article, the authors summarize the preliminary experience of the first year of the only psychodermatology clinic in Israel in several decades, work methods and patients' characteristics and preliminary conclusions.
A prospective, multi-method, multi-disciplinary, multi-level, collaborative, social-organisational design for researching health sector accreditation [LP0560737

PubMed Central

Braithwaite, Jeffrey; Westbrook, Johanna; Pawsey, Marjorie; Greenfield, David; Naylor, Justine; Iedema, Rick; Runciman, Bill; Redman, Sally; Jorm, Christine; Robinson, Maureen; Nathan, Sally; Gibberd, Robert

2006-01-01

Background Accreditation has become ubiquitous across the international health care landscape. Award of full accreditation status in health care is viewed, as it is in other sectors, as a valid indicator of high quality organisational performance. However, few studies have empirically demonstrated this assertion. The value of accreditation, therefore, remains uncertain, and this persists as a central legitimacy problem for accreditation providers, policymakers and researchers. The question arises as to how best to research the validity, impact and value of accreditation processes in health care. Most health care organisations participate in some sort of accreditation process and thus it is not possible to study its merits using a randomised controlled strategy. Further, tools and processes for accreditation and organisational performance are multifaceted. Methods/design To understand the relationship between them a multi-method research approach is required which incorporates both quantitative and qualitative data. The generic nature of accreditation standard development and inspection within different sectors enhances the extent to which the findings of in-depth study of accreditation process in one industry can be generalised to other industries. This paper presents a research design which comprises a prospective, multi-method, multi-level, multi-disciplinary approach to assess the validity, impact and value of accreditation. Discussion The accreditation program which assesses over 1,000 health services in Australia is used as an exemplar for testing this design. The paper proposes this design as a framework suitable for application to future international research into accreditation. Our aim is to stimulate debate on the role of accreditation and how to research it. PMID:16968552
A prospective analysis of implementation of multi-disciplinary team decisions in breast cancer.

PubMed

English, Rachel; Metcalfe, Chris; Day, James; Rayter, Zenon; Blazeby, Jane M

2012-09-01

Multi-disciplinary teams (MDTs) management of patients with cancer is mandatory in the United Kingdom, and auditing team decision-making by examining rates of decision implementation and reasons for nonimplementation may inform this practice. Consecutive breast cancer MDT decisions, subsequent decision implementation, and reasons for nonimplementation were prospectively recorded. Factors associated with nonimplementation of the MDT decision were analyzed with logistic regression. Of 289 consecutive MDT decisions involving 210 women, 20 (6.9%, 95% CIs 4.3%-10.5%) were not implemented. Most changed MDT decisions did so because of patient preferences (n = 13, 65%), with the discovery of new clinical information (n = 3) and individual doctor's views (n = 4) also leading to decision nonimplementation. MDT decisions were significantly less likely to be adhered to in patients with confirmed malignant disease compared to those with benign or 'unknown' disease categories (p < 0.001) and MDT decisions in older patients were significantly more likely not to be implemented than in younger patients (p = 0.002). Auditing nonimplementation of MDT recommendations and examining reasons for changed decisions is a useful process to monitor team performance and to identify factors that need more attention during the MDT meeting to ensure that the process makes optimal patient centered decisions. © 2012 Wiley Periodicals, Inc.
The impact of education and training interventions for nurses and other health care staff involved in the delivery of stroke care: An integrative review.

PubMed

Jones, Stephanie P; Miller, Colette; Gibson, Josephine M E; Cook, Julie; Price, Chris; Watkins, Caroline L

2018-02-01

The aim of this review was to explore the impact of stroke education and training of nurses and other health care staff involved in the delivery of stroke care. We performed an integrative review, following PRISMA guidance where possible. We searched MEDLINE, ERIC, PubMed, AMED, EMBASE, HMIC, CINAHL, Google Scholar, IBSS, Web of Knowledge, and the British Nursing Index from 1980 to 2016. Any intervention studies were included if they focused on the education or training of nurses and other health care staff in relation to stroke care. Articles that appeared to meet the inclusion criteria were read in full. Data were extracted from the articles, and the study quality assessed by two researchers. We assessed risk of bias of included studies using a pre-specified tool based on Cochrane guidance. Our initial search identified 2850 studies of which 21 met the inclusion criteria. Six studies were randomised controlled trials, and one was an interrupted time series. Fourteen studies were quasi-experimental: eight were pretest-posttest; five were non-equivalent groups; one study had a single assessment. Thirteen studies used quality of care outcomes and eight used a patient outcome measure. None of the studies was identified as having a low risk of bias. Only nine studies used a multi-disciplinary approach to education and training and nurses were often taught alone. Interactive education and training delivered to multi-disciplinary stroke teams, and the use of protocols or guidelines tended to be associated with a positive impact on patient and quality of care outcomes. Practice educators should consider the delivery of interactive education and training delivered to multi-disciplinary groups, and the use of protocols or guidelines, which tend to be associated with a positive impact on both patient and quality of care outcomes. Future research should incorporate a robust design. Copyright © 2017. Published by Elsevier Ltd.
Identification of key characteristics of male reproductive toxicants as an approach for screening and sorting mechanistic evidence.

EPA Science Inventory

The application of systematic review practices in human health assessment includes integration of multi-disciplinary evidence from epidemiological, experimental, and mechanistic studies. Although mode of action analysis relies on the evaluation of mechanistic and toxicological ou...
Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.

PubMed

Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A

2013-04-01

The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.
Investigating Ecosystems Services in the Arid Southwest

EPA Science Inventory

The Southwest Ecosystem Services Project (SwESP) is an integrated, multi-disciplinary, multi-agency project focused on how to identify, characterize, and quantify the ecosystem services in the southwestern United States and northern Mexico. The southwestern landscape is highly d...
Environmental Data Store: A Web-Based System Providing Management and Exploitation for Multi-Data-Type Environmental Data

NASA Astrophysics Data System (ADS)

Ji, P.; Piasecki, M.

2012-12-01

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

ERIC Educational Resources Information Center

Donnelly, Debra J.

2018-01-01

Traditional privileging of the printed text has been considerably eroded by rapid technological advancement and in Australia, as elsewhere, many History teaching programs feature an array of multi-modal historical representations. Research suggests that engagement with the visual and multi-modal constructs has the potential to enrich the pedagogy…
Troubling the Boundaries: Overcoming Methodological Challenges in a Multi-Sectoral and Multi-Jurisdictional HIV/HCV Policy Scoping Review

ERIC Educational Resources Information Center

Hare, Kathleen A.; Dubé, Anik; Marshall, Zack; Gahagan, Jacqueline; Harris, Gregory E.; Tucker, Maryanne; Dykeman, Margaret; MacDonald, Jo-Ann

2016-01-01

Policy scoping reviews are an effective method for generating evidence-informed policies. However, when applying guiding methodological frameworks to complex policy evidence, numerous, unexpected challenges can emerge. This paper details five challenges experienced and addressed by a policy trainee-led, multi-disciplinary research team, while…
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.
Computer-assisted education and interdisciplinary breast cancer diagnosis

NASA Astrophysics Data System (ADS)

Whatmough, Pamela; Gale, Alastair G.; Wilson, A. R. M.

1996-04-01

The diagnosis of breast disease for screening or symptomatic women is largely arrived at by a multi-disciplinary team. We report work on the development and assessment of an inter- disciplinary computer based learning system to support the diagnosis of this disease. The diagnostic process is first modelled from different viewpoints and then appropriate knowledge structures pertinent to the domains of radiologist, pathologist and surgeon are depicted. Initially the underlying inter-relationships of the mammographic diagnostic approach were detailed which is largely considered here. Ultimately a system is envisaged which will link these specialties and act as a diagnostic aid as well as a multi-media educational system.

Towards a Psychology of Media Education

ERIC Educational Resources Information Center

Lehtonen, Miika; Miloseva, Lence; Page, Tom; Thorsteinsson, Gisli

2008-01-01

This study will introduce some of the fundamentals and rationale for the Psychology of Media Education based on Developmental Psychology. It is an important area of study of a modern teacher profession and teacher education and a new field of multi-, inter- and trans-disciplinary knowledge and research. We argue that without a doubt the different…
Institutionalizing Global Citizenship: A Critical Analysis of Higher Education Programs and Curricula

ERIC Educational Resources Information Center

Aktas, Fatih; Pitts, Kate; Richards, Jessica C.; Silova, Iveta

2017-01-01

While higher education internationalization efforts have traditionally been associated with the expansion of study abroad experiences, the recruitment of international students and scholars, as well as the growth of area studies and language programs, the past decade has seen an increase in a variety of multi-disciplinary approaches to…
A STUDY OF THE INFLUENCE OF OUTDOOR ENVIRONMENT INCLUDING COMBUSTION RELATED PRODUCTS ON THE INDOOR ENVIRONMENT (ASTHMA INITIATIVE)

EPA Science Inventory

This project is a component of a multi-disciplinary collaboration between NHEERL, NERL, and NRMRL to develop and evaluate methods to examine the role of environmental factors on the induction and exacerbation of asthma within the Long-term Child Development Study (LCDS). This pr...
Integrating Health Information Systems into a Database Course: A Case Study

ERIC Educational Resources Information Center

Anderson, Nicole; Zhang, Mingrui; McMaster, Kirby

2011-01-01

Computer Science is a rich field with many growing application areas, such as Health Information Systems. What we suggest here is that multi-disciplinary threads can be introduced to supplement, enhance, and strengthen the primary area of study in a course. We call these supplementary materials "threads," because they are executed…
Infusing Technology Driven Design Thinking in Industrial Design Education: A Case Study

ERIC Educational Resources Information Center

Mubin, Omar; Novoa, Mauricio; Al Mahmud, Abdullah

2017-01-01

Purpose: This paper narrates a case study on design thinking-based education work in an industrial design honours program. Student projects were developed in a multi-disciplinary setting across a Computing and Engineering faculty that allowed promoting technologically and user-driven innovation strategies. Design/methodology/approach: A renewed…
Research Studies Index. Authors and Subjects. Volume 1 through Volume 43 (1929-1975).

ERIC Educational Resources Information Center

Drazan, Joseph, Comp.; Scott, Paula, Comp.

This volume contains author and subject indexes for volumes 1 through 43 (1929-1975) of "Research Studies," a scholarly, multi-disciplinary quarterly published at Washington State University. Each author index entry includes the title, volume, and inclusive pagination of the article. The subject index is a keyword-out-of-context…
'Taking public health out of the ghetto': the policy and practice of multi-disciplinary public health in the United Kingdom.

PubMed

Evans, David

2003-09-01

Until recently, a medical qualification was required for senior public health posts in the UK National Health Service. Since 1997, the new Labour government has expressed its intention to take public health 'out of the ghetto' and to develop multi-disciplinary public health. In particular, it has announced the creation of a new senior professional role of specialist in public health equivalent to the consultant in public health medicine, and open to a range of disciplines. This paper asks 'what is really going on with the policy and practice of multi-disciplinary public health in the UK?' The answer draws on recent debates in the sociology of the professions, in particular the theoretical perspectives of Freidson (Profession of Medicine: a Study of the Sociology of Applied Knowledge, Dodd, Mead & Co, New York, 1970; Professional Powers: a Study of the Institutionalization of Formal Knowledge, University of Chicago Press, Chicago, 1986) and Larson (The Rise of Professionalism: a Sociological Analysis, University of California Press, Berkeley, 1977) concerning the 'professional project', Foucault's (Ideol. Consciousness 6 (1979) 5) notion of 'governmentality' and Harrison and Wood's (Public Admin. 77 (1999) 751) concept of 'manipulated emergence'. Key characteristics of the professional project are 'autonomy', the profession's ability to control its technical knowledge and application, and 'dominance', control over the work of others in the health care division of labour. Although useful as an explanatory framework for the period 1972-1997, the concept of the professional project does not easily explain the process of change since 1997. Here Foucault's concept of governmentality is helpful. Governmentality entails all those procedures, techniques, mechanisms, institutions and knowledges that empower political programmes. Professions are part of the process of governmentality, and their autonomy is always contingent upon the wider political context. Thus public health doctors have not abandoned the professional project; they have simply accepted the political reality that the boundaries need to shift rapidly from a politically unsustainable medical/non-medical distinction to one between those with and without expert knowledge. The concept of manipulated emergence helps explain why, having expressed a commitment towards multi-disciplinary public health, the government has not supported its policy more fully.
Radiological clinical trials: Proposal of a problem-finding questionnaire to improve study success.

PubMed

Valdora, Francesca; Bignotti, Bianca; Calabrese, Massimo; Houssami, Nehmat; Tagliafico, Alberto

2016-12-26

To develop a survey to help define the main problems in radiological clinical trials. Since 2006, we have managed seven different radiological clinical trials recruiting patients in academic and non-academic centres. We developed a preliminary questionnaire using a four-round Delphi approach to identify problems occurring in radiological clinical trials run at our centre. We investigated the recruitment experience, involvement of all multi-disciplinary team members and main obstacles to completing the projects. A final round of Delphi processes elucidated solutions to the identified problems. Among 19/20 (95%) respondents, 10 (53%) were young physicians (under 35 years old), and the respondents included non-faculty members, fellows, residents, and undergraduate students. Ninety-four percent (18/19) of respondents showed interest in conducting clinical trials. On a scale of 1 to 10, the problems with higher/worse scores (8-9) were related to technical or communication problems. The most frequent problems across all studies were technical problems related to clinical trial equipment, insufficient willingness to participate, obstacles to understanding the design of electronic-case report form and extra work. The developed questionnaire identified the main recurring problems in radiological clinical trials as perceived by end-users and helped define possible solutions that are mostly related to having dedicated clinical trial research staff.
Multidisciplinary Approaches to Educational Research: Case Studies from Europe and the Developing World. Routledge Research in Education

ERIC Educational Resources Information Center

Rizvi, Sadaf, Ed.

2011-01-01

This book provides an original perspective on a range of controversial issues in educational and social research through case studies of multi-disciplinary and mixed-method research involving children, teachers, schools and communities in Europe and the developing world. These case studies from researchers "across continents" and…
Implementation of secondary fracture prevention services after hip fracture: a qualitative study using extended Normalization Process Theory.

PubMed

Drew, Sarah; Judge, Andrew; May, Carl; Farmer, Andrew; Cooper, Cyrus; Javaid, M Kassim; Gooberman-Hill, Rachael

2015-04-23

National and international guidance emphasizes the need for hospitals to have effective secondary fracture prevention services, to reduce the risk of future fractures in hip fracture patients. Variation exists in how hospitals organize these services, and there remain significant gaps in care. No research has systematically explored reasons for this to understand how to successfully implement these services. The objective of this study was to use extended Normalization Process Theory to understand how secondary fracture prevention services can be successfully implemented. Forty-three semi-structured interviews were conducted with healthcare professionals involved in delivering secondary fracture prevention within 11 hospitals that receive patients with acute hip fracture in one region in England. These included orthogeriatricians, fracture prevention nurses and service managers. Extended Normalization Process Theory was used to inform study design and analysis. Extended Normalization Process Theory specifies four constructs relating to collective action in service implementation: capacity, potential, capability and contribution. The capacity of healthcare professionals to co-operate and co-ordinate their actions was achieved using dedicated fracture prevention co-ordinators to organize important processes of care. However, participants described effective communication with GPs as challenging. Individual potential and commitment to operationalize services was generally high. Shared commitments were promoted through multi-disciplinary team working, facilitated by fracture prevention co-ordinators. Healthcare professionals had capacity to deliver multiple components of services when co-ordinators 'freed up' time. As key agents in its intervention, fracture prevention coordinators were therefore indispensable to effective implementation. Aside from difficulty of co-ordination with primary care, the intervention was highly workable and easily integrated into practice. Nevertheless, implementation was threatened by under-staffed and under-resourced services, lack of capacity to administer scans and poor patient access. To ensure ongoing service delivery, the contributions of healthcare professionals were shaped by planning, in multi-disciplinary team meetings, the use of clinical databases to identify patients and define the composition of clinical work and monitoring to improve clinical practice. Findings identify and describe elements needed to implement secondary fracture prevention services successfully. The study highlights the value of Normalization Process Theory to achieve comprehensive understanding of healthcare professionals' experiences in enacting a complex intervention.
Availability and feasibility of structured, routine collection of comorbidity data in a colorectal cancer multi-disciplinary team (MDT) setting.

PubMed

Abukar, A A; Ramsanahie, A; Martin-Lumbard, K; Herrington, E R; Winslow, V; Wong, S; Ahmed, S; Thaha, M A

2018-05-03

Availability of comorbidity assessment at multi-disciplinary team (MDT) discussions is cornerstone in making the MDT process more robust and decisive in optimising treatment and improving quality of survivorship. Comorbidity assessments using tools, such as the ACE-27 questionnaire would aid in optimising the decision-making process at MDTs so that treatment decisions can be made without delay. This study determined the availability of comorbidity data in a CRC MDT and the feasibility of routine comorbidity data collection using the validated ACE-27 questionnaire. Secondary aims determined the optimal time and method of collecting comorbidity data. A retrospective mapping exercise (phase I; 6-months) examined the availability of comorbidity data within the MDT. Phase II prospectively collected comorbidity data using ACE-27 for a 3-month period following a short pilot. In phase I, 73/135 (54%) patients had comorbidity data readily available informing the MDT discussion; 62 patients lacked this information. After a review of the patient records, it was clear that 41 of these 62 also had comorbidities and 21 out of the 135 had ≥ 2 major system disorders. Common referral sources to the MDT were surgical outpatient clinics (42%) and the endoscopy unit (13%). The average lead-time from referral to MDT discussion was 14 days. In phase II, an ACE-27 questionnaire was prospectively administered in 50 patients, mean age 54 years (range 20-84). Male: female ratio 26:24. Average time to administer ACE-27 was 4.8 min (range 1-15). The phase I study confirmed the widely acknowledged view of poor comorbidity data availability within a CRC MDT. Phase II demonstrated the feasibility of routinely collecting comorbidity data using ACE-27.
Integration: An Elusive Concept

ERIC Educational Resources Information Center

George, Beena; Delcoure, Natalya

2012-01-01

The need for multi-disciplinary integration in business school education has been well-established. However, academics and business practitioners have raised serious concerns regarding the achievement of this program learning goal. This paper examines how graduate business programs address and evaluate the learning goal of multi-disciplinary…
Optimizing regional collaborative efforts to achieve long-term discipline-specific objectives

USDA-ARS?s Scientific Manuscript database

Current funding programs focused on multi-disciplinary, multi-agency approaches to regional issues can provide opportunities to address discipline-specific advancements in scientific knowledge. Projects funded through the Agricultural Research Service, Joint Fire Science Program, and the Natural Re...
Advanced Multi-Axis Spine Testing: Clinical Relevance and Research Recommendations

PubMed Central

Holsgrove, Timothy P.; Nayak, Nikhil R.; Welch, William C.

2015-01-01

Back pain and spinal degeneration affect a large proportion of the general population. The economic burden of spinal degeneration is significant, and the treatment of spinal degeneration represents a large proportion of healthcare costs. However, spinal surgery does not always provide improved clinical outcomes compared to non-surgical alternatives, and modern interventions, such as total disc replacement, may not offer clinically relevant improvements over more established procedures. Although psychological and socioeconomic factors play an important role in the development and response to back pain, the variation in clinical success is also related to the complexity of the spine, and the multi-faceted manner by which spinal degeneration often occurs. The successful surgical treatment of degenerative spinal conditions requires collaboration between surgeons, engineers, and scientists in order to provide a multi-disciplinary approach to managing the complete condition. In this review, we provide relevant background from both the clinical and the basic research perspectives, which is synthesized into several examples and recommendations for consideration in increasing translational research between communities with the goal of providing improved knowledge and care. Current clinical imaging, and multi-axis testing machines, offer great promise for future research by combining invivo kinematics and loading with in-vitro testing in six degrees of freedom to offer more accurate predictions of the performance of new spinal instrumentation. Upon synthesis of the literature, it is recommended that in-vitro tests strive to recreate as many aspects of the in-vivo environment as possible, and that a physiological preload is a critical factor in assessing spinal biomechanics in the laboratory. A greater link between surgical procedures, and the outcomes in all three anatomical planes should be considered in both the in-vivo and in-vitro settings, to provide data relevant to quality of motion, and stability. PMID:26273552
Fathead Minnow Steroidogenesis: In Silico Analyses Reveals Tradeoffs Between Nominal Target Efficacy and Robustness to Cross-talk

EPA Science Inventory

This paper presents the formulation and evaluation of a mechanistic mathematical model of fathead minnow ovarian steroidogenesis. The model presented in the present study was adpated from other models developed as part of an integrated, multi-disciplinary computational toxicolog...
A Multi-Disciplinary Inquiry of Secular and Christian Approaches to Sex Education

ERIC Educational Resources Information Center

Yu, Chong Ho; Lee, Hyun Seo

2018-01-01

Secular scholars have criticized Christian education and counseling on sex as restrictive, ineffective, and outdated. The authors of the current study explored both common non-Christian and Christian approaches to human sexuality with reference to overarching domains of religion, philosophy, psychology, sociology, and anthropology. Secular…
Using Evaluation Research as a Means for Policy Analysis in a "New" Mission-Oriented Policy Context

ERIC Educational Resources Information Center

Amanatidou, Effie; Cunningham, Paul; Gök, Abdullah; Garefi, Ioanna

2014-01-01

Grand challenges stress the importance of multi-disciplinary research, a multi-actor approach in examining the current state of affairs and exploring possible solutions, multi-level governance and policy coordination across geographical boundaries and policy areas, and a policy environment for enabling change both in science and technology and in…
Maxwell's color statistics: from reduction of visible errors to reduction to invisible molecules.

PubMed

Cat, Jordi

2014-12-01

This paper presents a cross-disciplinary and multi-disciplinary account of Maxwell's introduction of statistical models of molecules for the composition of gases. The account focuses on Maxwell's deployment of statistical models of data in his contemporaneous color researches as established in Cambridge mathematical physics, especially by Maxwell's seniors and mentors. The paper also argues that the cross-disciplinary, or cross-domain, transfer of resources from the natural and social sciences took place in both directions and relied on the complex intra-disciplinary, or intra-domain, dynamics of Maxwell's researches in natural sciences, in color theory, physical astronomy, electromagnetism and dynamical theory of gases, as well as involving a variety of types of communicating and mediating media, from material objects to concepts, techniques and institutions.
Assessing prescribing of NSAIDs, antiplatelets, and anticoagulants in Canadian family medicine using chart review.

PubMed

Hamilton, Kevin; Davis, Christine; Falk, Jamie; Singer, Alex; Bugden, Shawn

2016-10-01

Background Drug-related problems have been identified as a major contributor to emergency room visits, hospitalizations, and death. The most commonly implicated medications are nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelets, and anticoagulants. Considering a significant proportion of these harms are preventable, indicators to identify risky prescribing before they lead to harm have been developed. Objective To examine the prevalence and patterns of potentially inappropriate prescriptions (PIPs) in a primary care population who are using high-risk medications. Setting This study was performed within two multi-disciplinary family medicine teaching clinics in Winnipeg, Canada. Method A cross-sectional electronic/paper chart audit was conducted within two multi-disciplinary family medicine teaching clinics to evaluate the prevalence of 13 evidence-based high-risk prescriptions. Patients were included if they were prescribed an oral NSAID, antiplatelet, or an anticoagulant within the 12 month period between June 2012 and June 2013. Main outcome measure The proportion of PIPs associated with an increased bleeding risk for NSAIDs, antiplatelets, and anticoagulants. Results Of the 567 patients included in the review, 198 (35 %) patients had received at least 1 PIP in the past year. The most common PIP was the use of an oral NSAID with one or more GI risk factors without adequate gastro-protection. Only 34 (6 %) of these patients received a full medication review performed by a pharmacist. Although not statistically significant, patients who received a medication review had fewer inappropriate prescriptions (27 % with review, 35 % without). Conclusion Over one-third of the patients who were using high-risk medications were using them potentially inappropriately. Although pharmacists have been shown to reduce the amount of inappropriate prescribing, very few patients using these medications were referred to the pharmacist for a full medication review. These data suggest that there is opportunity for the identification and assessment of these patients when prescribing or dispensing these high-risk medications.
Integrating Assessment Matrices in Feedback Loops to Promote Research Skill Development in Postgraduate Research Projects

ERIC Educational Resources Information Center

Venning, Jackie; Buisman-Pijlman, Femke

2013-01-01

Assessment tasks can focus student efforts in what they choose to study. This paper describes the development and initial application of an assessment matrix to support student learning in postgraduate research studies at the University of Adelaide. Students and supervisors in the multi-disciplinary Master programmes also benefit from the clear…

A Framework for Multi-Scale, Multi-Disciplinary Arctic Terrestrial Field Research Design, Nomenclature and Data Management

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

EPA Science Inventory

The Waste Analysis Sampling, Testing and Evaluation (WASTE) Program is a multi-year, multi-disciplinary program designed to elicit the source and fate of environmentally significant trace materials as a solid waste progresses through management processes. s part of the WASTE Prog...
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.
A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity.

PubMed

Chelminski, Paul R; Ives, Timothy J; Felix, Katherine M; Prakken, Steven D; Miller, Thomas M; Perhac, J Stephen; Malone, Robert M; Bryant, Mary E; DeWalt, Darren A; Pignone, Michael P

2005-01-13

Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up.
A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

PubMed Central

Chelminski, Paul R; Ives, Timothy J; Felix, Katherine M; Prakken, Steven D; Miller, Thomas M; Perhac, J Stephen; Malone, Robert M; Bryant, Mary E; DeWalt, Darren A; Pignone, Michael P

2005-01-01

Background Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. Methods Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. Results Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). Conclusions A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up. PMID:15649331
Clinical considerations and key issues in the management of patients with Erdheim-Chester Disease: a seven case series.

PubMed

Mazor, Roei D; Manevich-Mazor, Mirra; Kesler, Anat; Aizenstein, Orna; Eshed, Iris; Jaffe, Ronald; Pessach, Yakov; Goldberg, Ilan; Sprecher, Eli; Yaish, Iris; Gural, Alexander; Ganzel, Chezi; Shoenfeld, Yehuda

2014-12-01

Erdheim-Chester Disease (ECD), a non Langerhans' cell histiocytosis of orphan nature and propensity for multi-systemic presentations, comprises an intricate medical challenge in terms of diagnosis, treatment and complication management. The objectives are to report the clinical, radiological and pathological characteristics, as well as cardinal therapeutic approaches to ECD patients and to provide clinical analyses of the medical chronicles of these complex patients. Patients with biopsy proven ECD were audited by a multi-disciplinary team of specialists who formed a coherent timeline of all the substantial clinical events in the evolution of their patients' illness. Seven patients (five men, two women) were recruited to the study. The median age at presentation was 53 years (range: 39 to 62 years). The median follow-up time was 36 months (range: 1 to 72 months). Notable ECD involvement sites included the skeleton (seven), pituitary gland (seven), retroperitoneum (five), central nervous system (four), skin (four), lungs and pleura (four), orbits (three), heart and great vessels (three) and retinae (one). Prominent signs and symptoms were fever (seven), polyuria and polydipsia (six), ataxia and dysarthria (four), bone pain (four), exophthalmos (three), renovascular hypertension (one) and dyspnea (one). The V600E BRAF mutation was verified in three of six patients tested. Interferon-α treatment was beneficial in three of six patients treated. Vemurafenib yielded dramatic neurological improvement in a BRAF mutated patient. Infliximab facilitated pericardial effusion volume reduction. Cladribine improved cerebral blood flow originally compromised by perivenous lesions. ECD is a complex, multi-systemic, clonal entity coalescing both neoplastic and inflammatory elements and strongly dependent on impaired RAS/RAF/MEK/ERK signaling.
TSI-Enhanced Pedagogical Agents to Engage Learners in Virtual Worlds

ERIC Educational Resources Information Center

Leung, Steve; Virwaney, Sandeep; Lin, Fuhua; Armstrong, AJ; Dubbelboer, Adien

2013-01-01

Building pedagogical applications in virtual worlds is a multi-disciplinary endeavor that involves learning theories, application development framework, and mediated communication theories. This paper presents a project that integrates game-based learning, multi-agent system architecture (MAS), and the theory of Transformed Social Interaction…
Drug resistant Skeletal Tuberculosis in a tertiary care centre in South India.

PubMed

Arockiaraj, J; Balaji, G S; Cherian, V M; T S, Jepegnanam; Thomas, B P; Michael, Joy S; Poonnoose, P M

2018-03-01

Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically.898 patients were treated for skeletal tuberculosis during the period of 2006-2013 (96 months). 478 (53.2%) patients were treated for tubercular spondylitis and 420 (46.8%) for extra-spinal skeletal tuberculosis. Ninety two patients (10.2%) had documented resistance to the anti-tubercular drugs. There were 42 mono resistant tuberculosis cases (4.7%), 13 poly resistant cases (1.4%), 33 multi-drug resistant cases (MDR TB) (3.7%) and 4 (0.4%) extremely drug resistant tuberculosis cases (XDR). All the patients were treated medically as per drug susceptibility patterns and protocols. Surgery was performed when indicated in 59 (66%) cases. 85% completed their course of treatment and were successfully healed as per pre-set clinical, biochemical and radiological criteria. The remaining were lost to follow up. One patient died as a result of post op respiratory infection. The prevalence of Multi-drug resistant tuberculosis patients in our centre was 3.7% and that of Extremely drug resistant tuberculosis cases was 0.4%. A Multi-disciplinary approach with drug susceptibility tests, sensitive drugs, and surgery if required is essential. Health education is essential to improve awareness among health care professionals about the danger of drug resistance in tuberculosis.
Development of Tunneling Spectroscopy Apparatus for Kelvin and Sub-Kelvin Measurements of Superconducting Energy Gaps by Multi-disciplinary students at a Liberal Arts University

NASA Astrophysics Data System (ADS)

Eckhardt, Matt

2014-03-01

Tunneling spectroscopy is an important technique used to measure the superconducting energy gap, a feature that is at the heart of the nature of superconductivity in various materials. In this presentation, we report the progress and results in developing high-resolution tunneling spectroscopy experimental platforms in a helium three cryostat, a 3 Kelvin cryocooler and a helium dip-tester. The experimental team working in a liberal arts university is a multi-disciplinary group consisting of one physics major, chemisty majors and a biology major. Students including non-physics majors learned and implemented current-voltage measurement techniques, vacuum system engineering, built electronic boxes and amplifier circuits from scratch, built custom multi-conductor cables for thermometry and current-voltage measurements, and performed conductance measurements. We report preliminary results. Acknowledgments: We acknowledge support from National Science Foundation Grant # DMR-1206561.
Low-frequency seismic events in a wider volcanological context

NASA Astrophysics Data System (ADS)

Neuberg, J. W.; Collombet, M.

2006-12-01

Low-frequency seismic events have been in the centre of attention for several years, particularly on volcanoes with highly viscous magmas. The ultimate aim is to detect changes in volcanic activity by identifying changes in the seismic behaviour in order to forecast an eruption, or in case of an ongoing eruption, forecast the short and longterm behaviour of the volcanic system. A major boost in recent years arose through several attempts of multi-parameter volcanic monitoring and modelling programs, which allowed multi-disciplinary groups of volcanologists to interpret seismic signals together with, e.g. ground deformation, stress field analysis and petrological information. This talk will give several examples of such multi-disciplinary projects, focussing on the joint modelling of seismic source processes for low-frequency events together with advanced magma flow models, and the signs of magma movement in the deformation and stress field at the surface.
Are the changes in observed functioning after multi-disciplinary rehabilitation of patients with fibromyalgia associated with changes in pain self-efficacy?

PubMed

Rasmussen, Marianne Uggen; Amris, Kirstine; Rydahl-Hansen, Susan; Danneskiold-Samsoe, Bente; Mortensen, Erik Lykke; Christensen, Robin; H Sjölund, Bengt

2017-08-01

To examine the hypothesis that change in pain self-efficacy is associated with observed and self-reported activity, pain intensity, catastrophizing, and quality of life after multi-disciplinary rehabilitation of fibromyalgia patients. In-depth analyses of secondary outcomes of a randomized-controlled trial. Women (N = 187) with fibromyalgia. Outcomes were Pain Self-Efficacy, Assessment of Motor and Process Skills (AMPS), SF-36 Physical Function (SF-36-PF), pain intensity, and SF-36 Mental Composite Score (SF-36-MCS) to assess quality of life and pain catastrophizing. Individual and group associations between outcomes were examined. Individual changes in pain self-efficacy were not associated with changes in observed activity: AMPS motor (r s = 0.08, p = 0.27) and process (r s = 0.12, p = 0.11), not even in those patients with a clinically relevant improvement in observed functioning (38.5%), and only weakly or moderatly with changes in SF-36-PF; (r s = 0.31, p < 0.0001), SF-36-MSC; (r s = 0.41, p < 0.0001), and pain catastrophizing (r s = -0.31, p < 0.0001). No differences in pain self-efficacy were observed between the rehabilitated group and controls (difference: 1.61; 95% CI: -0.84 to 4.06; p = 0.24). However, a subgroup (34%) had a clinically relevant improvement in pain self-efficacy. This group was younger (mean age 41.4 vs. 45.8, p = 0.01), more recently diagnosed (1.8 vs. 2.8 years, p = 0.003), but had an unresolved welfare situation (59% vs. 40%, p = 0.02). The main hypothesis was falsified, as there was no association between pain self-efficacy and actual performance of activity. The relation to functioning may be limited to perceived, cognitive-emotional aspects, as indicated by the weak to moderate correlations to the self-reported measures. Implications for Rehabilitation Improvement in observed activity post multi-disciplinary rehabilitation was not associated with change in pain self-efficacy. Patients performed better after rehabilitation, but did not perceive to have improved their capacity. The relationship between pain self-efficacy and functioning may be limited to cognitive-emotional aspects rather than actual activity. Both observational and self-reported measures should be included in evaluating outcomes of rehabilitation for patients with fibromyalgia.
BREAD: a European coordination action for broadband for all

NASA Astrophysics Data System (ADS)

Van Daele, P.

2006-10-01

The BREAD - co-ordination action, funded by the European Commission through the Framework 6 Programme (FP6) aims at developing a multi-disciplinary approach for the realization of the 'Broadband for All' concept within Europe, bringing together societal, economic, regulatory and technological disciplines and presenting information from regional "success stories" of actual deployment. The EU objective of achieving "Broadband for All" will not be reached by solely a 'technology push' strategy but will need this multi-disciplinary approach and sharing of views and knowledge to develop new strategies and good practice recommendations in the area of 'Broadband for All'. As a co-ordination action the project wants to unite all players active in the field of the end-to-end broadband provisioning for all. It performs a multi-technological analysis of the current and evolving situation, starting from the roadmap information generated by different projects and IST instruments which focus on specific technological domains. The BREAD consortium simultaneously studies the techno-economic, societal and regulatory aspects of this "Broadband for All" concept. It tries to identify the impact of the EU regulatory framework on the successful implementation of new broadband communication services.
N plus 2 Supersonic Concept Development and Systems Integration

NASA Technical Reports Server (NTRS)

Wedge, Harry R.; Bonet, John; Magee, Todd; Chen, Daniel; Hollowell, Steve; Kutzmann, Aaron; Mortlock, Alan; Stengle, Josh; Nelson, Chet; Adamson, Eric;

2010-01-01

Supersonic airplanes for two generations into the future (N+2, 2020-2025 EIS) were designed: the 100 passenger 765-072B, and the 30 passenger 765-076E. Both achieve a trans-Atlantic range of about 4000nm. The larger 765-072B meets fuel burn and emissions goals forecast for the 2025 time-frame, and the smaller 765-076E improves the boom and confidence in utilization that accompanies lower seat count. The boom level of both airplanes was reduced until balanced with performance. The final configuration product is two "realistic", non-proprietary future airplane designs, described in sufficient detail for subsequent multi-disciplinary design and optimization, with emphasis on the smaller 765-076E because of its lower boom characteristics. In addition IGES CAD files of the OML lofts of the two example configurations, a non-proprietary parametric engine model, and a first-cycle Finite Element Model are also provided for use in future multi-disciplinary analysis, optimization, and technology evaluation studies.

Characterization and differentiation of Italian Parma, San Daniele and Toscano dry-cured hams: a multi-disciplinary approach.

PubMed

Laureati, Monica; Buratti, Susanna; Giovanelli, Gabriella; Corazzin, Mirco; Lo Fiego, Domenico P; Pagliarini, Ella

2014-01-01

This study aimed at characterizing the sensory quality of Italian PDO dry-cured Parma, San Daniele and Toscano hams, applying a multi-disciplinary approach. Ham sensory profile as well as physico-chemical, aromatic, morphological and textural characteristics was investigated. There was a great difference between Toscano ham and Parma and San Daniele hams, which were more similar even though differentiated. Toscano ham showed higher scores for pork-meat odor, saltiness, dryness, fibrousness and hardness; accordingly, this ham was described by a high NaCl content and by high values of instrumental hardness, cohesiveness, gumminess and chewiness. Parma ham was characterized by a cured flavor, whereas San Daniele ham showed a wider fatty area and higher pH values. Parma and San Daniele hams were also described by higher values of sweetness, RGB color values and water activity. Sensory characteristics evaluated by trained assessors were correlated to instrumental measures, indicating that instrumental devices can be effectively applied for dry-cured ham characterization. © 2013.
A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education.

PubMed

Kilty, Caroline; Wiese, Anel; Bergin, Colm; Flood, Patrick; Fu, Na; Horgan, Mary; Higgins, Agnes; Maher, Bridget; O'Kane, Grainne; Prihodova, Lucia; Slattery, Dubhfeasa; Stoyanov, Slavi; Bennett, Deirdre

2017-11-22

High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs. Group Concept Mapping (GCM) is an integrated mixed methods approach to generating expert group consensus. A multi-disciplinary group of experts were invited to participate in the GCM process via an online platform. Multi-dimensional scaling and hierarchical cluster analysis were used to analyse participant inputs in regard to barriers, facilitators and priorities. Participants identified facilitators and barriers in ten domains within clinical learning environments. Domains rated most important were those which related to residents' connection to and engagement with more senior doctors. Organisation and conditions of work and Time to learn with senior doctors during patient care were rated as the most difficult areas in which to make improvements. High quality PGME requires that residents engage and connect with senior doctors during patient care, and that they are valued and supported both as learners and service providers. Academic medicine and health service managers must work together to protect these elements of CLEs, which not only shape learning, but impact quality of care and patient safety.
A multi-disciplinary approach for the integrated assessment of water alterations under climate change

NASA Astrophysics Data System (ADS)

Sperotto, Anna; Torresan, Silvia; Molina, Jose Luis; Pulido Velazquez, Manuel; Critto, Andrea; Marcomini, Antonio

2017-04-01

Understanding the co-evolution and interrelations between natural and human pressures on water systems is required to ensure a sustainable management of resources under uncertain climate change conditions. To pursue multi-disciplinary research is therefore necessary to consider the multiplicity of stressors affecting water resources, take into account alternative perspectives (i.e. social, economic and environmental objective and priorities) and deal with uncertainty which characterize climate change scenarios. However, approaches commonly adopted in water quality assessment are predominantly mono-disciplinary, single-stressors oriented and apply concepts and models specific of different academic disciplines (e.g. physics, hydrology, ecology, sociology, economy) which, in fact, seldom shed their conceptual blinders failing to provide truly integrated results. In this context, the paper discusses the benefits and limits of adopting a multi-disciplinary approach where different knowledge domains collaborate and quantitative and qualitative information, coming from multiple conceptual and model-based research, are integrated in a harmonic manner. Specifically, Bayesian Networks are used as meta-modelling tool for structuring and combining the probabilistic information available in existing hydrological models, climate change and land use projections, historical observations and expert opinion. The developed network allows to perform a stochastic multi-risk assessment considering the interlacing between climate (i.e. irregularities in water regime) and land use changes (i.e. agriculture, urbanization) and their cascading impacts on water quality parameters (i.e. nutrients loadings). Main objective of the model is the development of multi-risk scenarios to assess and communicate the probability of not meeting a "Good chemical water status" over future timeframe taking into account projected climatic and not climatic conditions. The outcomes are finally used to identify tradeoffs between different water uses and perspectives, thus promoting the implementation of best practices for adaptation and management with ancillary co-benefits and cross-sectoral implications (i.e. tourism, fishing, biodiversity). Some preliminary results, describing the application of the model in the Dese-Zero river estuary, one of the main tributaries of the Venice Lagoon in Italy, will be here presented and discussed.
E-Learning and Development: Lessons from Multi-Disciplinary Capacity Strengthening

ERIC Educational Resources Information Center

Babu, Suresh Chandra

2014-01-01

This paper documents the experience and lessons from implementing an e-learning program aimed at creating multidisciplinary research capacity. It presents a case study of bringing together a multidisciplinary group of professionals on-line to learn the skills needed to be a successful researcher in the context of HIV/AIDS and food security…
Problem Solving for the Twenty-First Century: Global Education Activities in the Social Studies Curriculum (K-12).

ERIC Educational Resources Information Center

Peters, Richard

Educators are encouraged in this document to practice a multi-disciplinary approach in the classroom to prepare students for new management styles in an interrelated society. The first section on perceptions covers the following: information processing (planning, implementing, assessing); the learning process (exploration, invention, application);…
Effects of Experiential-Based Videos in Multi-Disciplinary Learning

ERIC Educational Resources Information Center

Jabbar, Khalid Bin Abdul; Ong, Alex; Choy, Jeanette; Lim, Lisa

2013-01-01

This study examined the use of authentic experiential-based videos in self-explanation activities on 32 polytechnic students' learning and motivation, using a mixed method quasi-experimental design. The control group analysed a set of six pre-recorded videos of a subject performing the standing broad jump (SBJ). The experimental group captured…
Center for Collegiate Mental Health (CCMH) 2009 Pilot Study: Executive Summary. Publication No. STA 09-160 MPC105808

ERIC Educational Resources Information Center

Center for Collegiate Mental Health, 2009

2009-01-01

The Center for Collegiate Mental Health (CCMH) represents a collaborative, multi-disciplinary effort combining the expertise of mental health treatment providers, psychological researchers, industry, and information sciences and technology. This report outlines a preliminary effort to describe the range of information on college student mental…

Structure and Evolution of Scientific Collaboration Networks in a Modern Research Collaboratory

ERIC Educational Resources Information Center

Pepe, Alberto

2010-01-01

This dissertation is a study of scientific collaboration at the Center for Embedded Networked Sensing (CENS), a modern, multi-disciplinary, distributed laboratory involved in sensor network research. By use of survey research and network analysis, this dissertation examines the collaborative ecology of CENS in terms of three networks of…
Student Action for the Valley Environment (SAVE).

ERIC Educational Resources Information Center

Phoenix Union High School District, AZ.

A multi-disciplinary approach to environmental studies for high school students, combining the areas of earth science, social science, and health education, is developed in this guide. Student Action for the Valley Environment (SAVE) is primarily a simulation program concerned with a serious problem of today--the survival of life in the cities. It…
Knowledge Production within the Innovation System: A Case Study from the United Kingdom

ERIC Educational Resources Information Center

Wilson-Medhurst, Sarah

2010-01-01

This paper focuses on a key issue for university managers, educational developers and teaching practitioners: that of producing new operational knowledge in the innovation system. More specifically, it explores the knowledge required to guide individual and institutional styles of teaching and learning in a large multi-disciplinary faculty. The…
Towards the Successful Integration of Design Thinking in Industrial Design Education

ERIC Educational Resources Information Center

Mubin, Omar; Novoa, Mauricio; Al Mahmud, Abdullah

2016-01-01

This paper narrates a case study on design thinking based education work in an industrial design honours program. Student projects were developed in a multi-disciplinary setting across a Computing and Engineering faculty that allowed promoting technologically and user driven innovation strategies. A renewed culture and environment for Industrial…
Bioreactors in Everyday Life: Ethanol and the Maize Craze

ERIC Educational Resources Information Center

Bowman, Silas

2010-01-01

This project served as a capstone event for the United States Military Academy sophomore Calculus II course. This multi-disciplinary problem-solving exercise motivated the link between math and biology and many other fields of study. The seven-lesson block of instruction was developed to show students how mathematics play a role in every…
Using Social Media as a Tool for Learning: A Multi-Disciplinary Study

ERIC Educational Resources Information Center

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

2015-01-01

In order to explore the rich dynamics of using social media as a tool for learning within higher education classrooms, researchers across three disciplines: education, human resource development (HRD), and marketing, joined forces seeking ways to focus on learning through a retrospective analysis. Three concepts--engagement, community building,…
Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

ERIC Educational Resources Information Center

Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

2010-01-01

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…
NAAMES Photo Essay

NASA Image and Video Library

2017-12-08

Environmental chemist Cleo Davie-Martin’s quiet lab will soon be filled by a team of multi-disciplinary scientists to study how phytoplankton affect Earth’s atmosphere. --- The North Atlantic Aerosols and Marine Ecosystems Study (NAAMES) is a five year investigation to resolve key processes controlling ocean system function, their influences on atmospheric aerosols and clouds and their implications for climate. Michael Starobin joined the NAAMES field campaign on behalf of Earth Expeditions and NASA Goddard Space Flight Center’s Office of Communications. He presented stories about the important, multi-disciplinary research being conducted by the NAAMES team, with an eye towards future missions on the NASA drawing board. This is a NAAMES photo essay put together by Starobin, a collection of 49 photographs and captions. Photo and Caption Credit: Michael Starobin NASA image use policy NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram
Reorganising hospitals to implement a patient-centered model of care: Effects on clinical practice and professional relationships in the Italian NHS.

PubMed

Liberati, Elisa Giulia; Gorli, Mara; Scaratti, Giuseppe

2015-01-01

The purpose of this paper is to understand how the introduction of a patient-centered model (PCM) in Italian hospitals affects the pre-existent configuration of clinical work and interacts with established intra/inter-professional relationships. Qualitative multi-phase study based on three main sources: health policy analysis, an exploratory interview study with senior managers of eight Italian hospitals implementing the PCM, and an in-depth case study that involved managerial and clinical staff of one Italian hospital implementing the PCM. The introduction of the PCM challenges clinical work and professional relationships, but such challenges are interpreted differently by the organisational actors involved, thus giving rise to two different "narratives of change". The "political narrative" (the views conveyed by formal policies and senior managers) focuses on the power shifts and conflict between nurses and doctors, while the "workplace narrative" (the experiences of frontline clinicians) emphasises the problems linked to the disruption of previous discipline-based inter-professional groups. Medical disciplines, rather than professional groupings, are the main source of identification of doctors and nurses, and represent a crucial aspect of clinicians' professional identity. Although the need for collaboration among medical disciplines is acknowledged, creating multi-disciplinary groups in practice requires the sustaining of new aggregators and binding forces. This study suggests further acknowledgment of the inherent complexity of the political and workplace narratives of change rather than interpreting them as the signal of irreconcilable perspectives between managers and clinicians. By addressing the specific issues regarding which the political and workplace narratives clash, relationship of trust may be developed through which problems can be identified, mutually acknowledged, articulated, and solved.
Cross-disciplinarity in the advance of Antarctic ecosystem research.

PubMed

Gutt, J; Isla, E; Bertler, A N; Bodeker, G E; Bracegirdle, T J; Cavanagh, R D; Comiso, J C; Convey, P; Cummings, V; De Conto, R; De Master, D; di Prisco, G; d'Ovidio, F; Griffiths, H J; Khan, A L; López-Martínez, J; Murray, A E; Nielsen, U N; Ott, S; Post, A; Ropert-Coudert, Y; Saucède, T; Scherer, R; Schiaparelli, S; Schloss, I R; Smith, C R; Stefels, J; Stevens, C; Strugnell, J M; Trimborn, S; Verde, C; Verleyen, E; Wall, D H; Wilson, N G; Xavier, J C

2018-02-01

The biodiversity, ecosystem services and climate variability of the Antarctic continent and the Southern Ocean are major components of the whole Earth system. Antarctic ecosystems are driven more strongly by the physical environment than many other marine and terrestrial ecosystems. As a consequence, to understand ecological functioning, cross-disciplinary studies are especially important in Antarctic research. The conceptual study presented here is based on a workshop initiated by the Research Programme Antarctic Thresholds - Ecosystem Resilience and Adaptation of the Scientific Committee on Antarctic Research, which focussed on challenges in identifying and applying cross-disciplinary approaches in the Antarctic. Novel ideas and first steps in their implementation were clustered into eight themes. These ranged from scale problems, through risk maps, and organism/ecosystem responses to multiple environmental changes and evolutionary processes. Scaling models and data across different spatial and temporal scales were identified as an overarching challenge. Approaches to bridge gaps in Antarctic research programmes included multi-disciplinary monitoring, linking biomolecular findings and simulated physical environments, as well as integrative ecological modelling. The results of advanced cross-disciplinary approaches can contribute significantly to our knowledge of Antarctic and global ecosystem functioning, the consequences of climate change, and to global assessments that ultimately benefit humankind. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.
Navigating the fine line between benefit and risk in chronic atrial fibrillation: rationale and design of the Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY).

PubMed

Carrington, Melinda J; Ball, Jocasta; Horowitz, John D; Marwick, Thomas H; Mahadevan, Gnanadevan; Wong, Chiew; Abhayaratna, Walter P; Haluska, Brian; Thompson, David R; Scuffham, Paul A; Stewart, Simon

2013-06-20

Health outcomes associated with atrial fibrillation (AF) continue to be poor and standard management often does not provide clinical stability. The Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY) compares the efficacy of a post-discharge, nurse-led, multi-disciplinary programme to optimise AF management with usual care. SAFETY is a prospective, multi-centre, randomised controlled trial with blinded-endpoint adjudication. A target of 320 hospitalised patients with a chronic form of AF will be randomised (stratified by "rate" versus "rhythm" control) to usual post-discharge care or the SAFETY Intervention (SI). The SI involves home-based assessment, extensive clinical profiling and the application of optimal gold-standard pharmacology which is individually tailored according to a "traffic light" framework based on clinical stability, risk profile and therapeutic management. The primary endpoint is event-free survival from all-cause death or unplanned readmission during 18-36 months follow-up. Secondary endpoints include rate of recurrent hospital stay, treatment success (i.e. maintenance of rhythm or rate control and/or application of anti-thrombotic therapy without a bleeding event) and cost-efficacy. With study recruitment to be completed in early 2012, the results of this study will be available in early 2014. If positive, SAFETY will represent a potentially cost-effective and readily applicable strategy to improve health outcomes in high risk individuals discharged from hospital with chronic AF. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
24 CFR 585.205 - Eligible activities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for basic skills instruction and education, job training and job development, leadership and... planning and development of multi-disciplinary educational and employment training curricula, leadership...
24 CFR 585.205 - Eligible activities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... for basic skills instruction and education, job training and job development, leadership and... planning and development of multi-disciplinary educational and employment training curricula, leadership...
24 CFR 585.205 - Eligible activities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... for basic skills instruction and education, job training and job development, leadership and... planning and development of multi-disciplinary educational and employment training curricula, leadership...
24 CFR 585.205 - Eligible activities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... for basic skills instruction and education, job training and job development, leadership and... planning and development of multi-disciplinary educational and employment training curricula, leadership...
24 CFR 585.205 - Eligible activities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... for basic skills instruction and education, job training and job development, leadership and... planning and development of multi-disciplinary educational and employment training curricula, leadership...
Bringing the Tools of Big Science to Bear on Local Environmental Challenges

ERIC Educational Resources Information Center

Bronson, Scott; Jones, Keith W.; Brown, Maria

2013-01-01

We describe an interactive collaborative environmental education project that makes advanced laboratory facilities at Brookhaven National Laboratory accessible for one-year or multi-year science projects for the high school level. Cyber-enabled Environmental Science (CEES) utilizes web conferencing software to bring multi-disciplinary,…
A Data Book of Child and Adolescent Injury.

ERIC Educational Resources Information Center

National Center for Education in Maternal and Child Health, Washington, DC.

This booklet contains 54 graphs and accompanying narrative which summarize available data on child and adolescent non-natural injuries and deaths and are intended to help in the multi-disciplinary and multi-agency "Healthy People 2000" campaign to improve the nation's health and prevent needless child and adolescent injuries. Graphs illustrate…
Systems thinking for understanding and predicting regional and local climate change effects on human health & well being: workshop process

EPA Science Inventory

EPA’s Systems Thinking Advisory Team (STAT) was engaged to guide a multi-disciplinary (health officials, modelers, climate change scientists, city planners, ecologists, and architects), multi-agency (EPA, CDC, State and Country officials) team in the use systems thinking, diagram...
Development of Integrative STEM Curriculum: A Multiple Case Study of Multi-Disciplinary Teams in Two Pennsylvania High Schools

ERIC Educational Resources Information Center

Rider-Bertrand, Joey H.

2017-01-01

At the start of the 21st century, STEM education was a new priority in many schools as the focus shifted from separate disciplines to integrative STEM education. Unfortunately, there was limited research to offer guidance to practitioners (Brown, 2012; Honey, Pearson & Schweingruber, 2014). This qualitative, multiple case study explored the…

Participatory Concepts of Multidisciplinary/Professional Working on an Early Childhood Studies Degree Course in the UK

ERIC Educational Resources Information Center

Bath, Caroline

2011-01-01

This paper aims to explore democratic values in higher education pedagogies, as related to an Early Childhood Studies (ECS) degree course in an English university. It seeks to find out what constitutes a multi-disciplinary course from both student and tutor perspectives. It is contextualised by the concepts of participation embedded in the idea of…
Promoting High-Quality Cancer Care and Equity Through Disciplinary Diversity in Team Composition.

PubMed

Parsons, Susan K; Fineberg, Iris C; Lin, Mingqian; Singer, Marybeth; Tang, May; Erban, John K

2016-11-01

Disciplinary diversity in team composition is a valuable vehicle for oncology care teams to provide high-quality, person-centered comprehensive care. Such diversity facilitates care that effectively addresses the complex needs (biologic, psychosocial, and spiritual) of the whole person. The concept of professional or disciplinary diversity centers on differences in function, education, and culture, reflecting variety and heterogeneity in the perspectives of team members contributing to care. Thorough understanding of the skills, knowledge, and education related to each team member's professional or lay expertise is critical for members to be able to optimize the team's potential. Furthermore, respect and appreciation for differences and similarities across disciplinary cultures allow team members to create a positive collaboration dynamic that maintains a focus on the care of the person with cancer. We present a case study of one oncology team's provision of care to the patient, a Chinese immigrant woman with breast cancer. The case illuminates the strengths and challenges of disciplinary diversity in team composition in assessing and addressing potential barriers to care. Coordinated sharing of information among the varied team members facilitated understanding and care planning focused on the patient's concerns, needs, and strengths. Importantly, collaboration across the disciplinarily diverse set of team members facilitated high-quality oncology care and promoted equity in access to the full range of care options, including enrollment on a National Cancer Institute-sponsored clinical trial. Further implications of disciplinary diversity in oncology care teams are considered for both clinical practice and research.
Social Pharmacy and Clinical Pharmacy—Joining Forces

PubMed Central

Almarsdottir, Anna Birna; Granas, Anne Gerd

2015-01-01

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, “What’s in a name?” and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large. PMID:28970374
Current advances in esophageal cancer proteomics.

PubMed

Uemura, Norihisa; Kondo, Tadashi

2015-06-01

We review the current status of proteomics for esophageal cancer (EC) from a clinician's viewpoint. The ultimate goal of cancer proteomics is the improvement of clinical outcome. The proteome as a functional translation of the genome is a straightforward representation of genomic mechanisms that trigger carcinogenesis. Cancer proteomics has identified the mechanisms of carcinogenesis and tumor progression, detected biomarker candidates for early diagnosis, and provided novel therapeutic targets for personalized treatments. Our review focuses on three major topics in EC proteomics: diagnostics, treatment, and molecular mechanisms. We discuss the major histological differences between EC types, i.e., esophageal squamous cell carcinoma and adenocarcinoma, and evaluate the clinical significance of published proteomics studies, including promising diagnostic biomarkers and novel therapeutic targets, which should be further validated prior to launching clinical trials. Multi-disciplinary collaborations between basic scientists, clinicians, and pathologists should be established for inter-institutional validation. In conclusion, EC proteomics has provided significant results, which after thorough validation, should lead to the development of novel clinical tools and improvement of the clinical outcome for esophageal cancer patients. This article is part of a Special Issue entitled: Medical Proteomics. Copyright © 2014 Elsevier B.V. All rights reserved.
Social Pharmacy and Clinical Pharmacy-Joining Forces.

PubMed

Almarsdottir, Anna Birna; Granas, Anne Gerd

2015-12-22

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, "What's in a name?" and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large.
Hydroclimatological data and analyses from a headwaters region of Mongolia as boundary objects in interdisciplinary climate change research

NASA Astrophysics Data System (ADS)

Venable, N. B. H.

2017-09-01

Collaborative work on increasingly complex hydroclimatic investigations often crosses disciplinary boundaries. Elements of scientific inquiry, such as data or the results of analyses can become objectified, or capable of being adopted and/or adapted by users from multiple disciplinary realms. These objects often provide a bridge for collaborative endeavors, or are used as tools by individuals pursuing multi-disciplinary work. Boundary object terminology was first formalized and applied by social scientists. However, few examples of the application of this useful framework are found in the hydrologic literature. The construct is applied here to identify and discuss how common research products and processes are used both internally and externally through providing examples from a project examining the historical and paleo proxy-based hydroclimatology of a headwaters region of Mongolia. The boundary object concept is valuable to consider when conducting and critiquing basic research, collaborating across multiple disciplinary teams as when studying climate change issues, as an individual researcher working in a cross boundary sense using methods from differing disciplines to answer questions, and/or when one group adapts the work of another to their own research problems or interpretive needs, as occurred with selected products of this project.
Unstructured Finite Volume Computational Thermo-Fluid Dynamic Method for Multi-Disciplinary Analysis and Design Optimization

NASA Technical Reports Server (NTRS)

Majumdar, Alok; Schallhorn, Paul

1998-01-01

This paper describes a finite volume computational thermo-fluid dynamics method to solve for Navier-Stokes equations in conjunction with energy equation and thermodynamic equation of state in an unstructured coordinate system. The system of equations have been solved by a simultaneous Newton-Raphson method and compared with several benchmark solutions. Excellent agreements have been obtained in each case and the method has been found to be significantly faster than conventional Computational Fluid Dynamic(CFD) methods and therefore has the potential for implementation in Multi-Disciplinary analysis and design optimization in fluid and thermal systems. The paper also describes an algorithm of design optimization based on Newton-Raphson method which has been recently tested in a turbomachinery application.
Using focused ethnography in paediatric settings to explore professionals' and parents' attitudes towards expertise in managing chronic kidney disease stage 3-5.

PubMed

Nightingale, Ruth; Sinha, Manish D; Swallow, Veronica

2014-09-18

Interactions between parents and healthcare professionals are essential when parents of children with chronic conditions are learning to share expertise about clinical care, but limited evidence exists on how they actually interact. This paper discusses the use of focused ethnography in paediatric settings as an effective means of exploring attitudes towards expertise. The paper draws on repeated observations, interviews and field-notes involving the parents of six children with chronic kidney disease, and 28 healthcare professionals at two, tertiary, children's hospital-based units. Data were analysed using the Framework approach and the concepts of expertise and self-management. Our study highlighted rewards and challenges associated with focused ethnography in this context. Rewards included the ability to gain a richer understanding of the complex phenomena of mutual acknowledgement of expertise that occurs during parent/ healthcare professional interactions. Challenges related to gaining informed consent and ensuring potential participants had an adequate understanding of the purpose of the study. Two dimensions of parental expertise around their child (personal and clinical) were evident in our data. Parents' and professionals' expertise about the child and their condition was acknowledged and exchanged as parents learnt to share clinical-care with the multi-disciplinary team. Healthcare professionals acknowledged parents' need to understand aspects of each of the eight disciplinary knowledge bases relating to their child's management and recognised parents' expert knowledge of their child, found ways to mobilise this knowledge, and wove parents' expertise into the management plan. Parents spoke of the degree to which their own expert knowledge of their child complemented healthcare professionals' clinical knowledge. However, ambivalence around expertise was evident as both parents and healthcare professionals questioned what the expertise was, and who the expert was. Our discussion focuses on the ways healthcare professionals and parents share expertise around the child's condition as parents take on responsibility for home-based clinical care. Our findings point to focused ethnography being an effective way of capturing new insights into parent and professional interactions in a paediatric setting and mutual acknowledgement of expertise; these insights may help redress the reported limitations of previous, retrospective studies.
Necrotizing pancreatitis: new definitions and a new era in surgical management.

PubMed

Rosenberg, Andrew; Steensma, Elizabeth A; Napolitano, Lena M

2015-02-01

Necrotizing pancreatitis is a challenging condition that requires surgical treatment commonly and is associated with substantial morbidity and mortality. Over the past decade, new definitions have been developed for standardization of severity of acute and necrotizing pancreatitis, and new management techniques have emerged based on prospective, randomized clinical trials. Review of English-language literature. A new international classification of acute pancreatitis has been developed by PANCREA (Pancreatitis Across Nations Clinical Research and Education Alliance) to replace the Atlanta Classification. It is based on the actual local (whether pancreatic necrosis is present or not, whether it is sterile or infected) and systemic determinants (whether organ failure is present or not, whether it is transient or persistent) of severity. Early management requires goal-directed fluid resuscitation (with avoidance of over-resuscitation and abdominal compartment syndrome), assessment of severity of pancreatitis, diagnostic computed tomography (CT) imaging to assess for necrotizing pancreatitis, consideration of endoscopic retrograde cholangiopancreatography (ERCP) for biliary pancreatitis and early enteral nutrition support. Antibiotic prophylaxis is not recommended. Therapeutic antibiotics are required for treatment of documented infected pancreatic necrosis. The initial treatment of infected pancreatic necrosis is percutaneous catheter or endoscopic (transgastric/transduodenal) drainage with a second drain placement as required. Lack of clinical improvement after these initial procedures warrants consideration of minimally invasive techniques for pancreatic necrosectomy including video-assisted retroperitoneal debridement (VARD), minimally invasive retroperitoneal pancreatectomy (MIRP), or transluminal direct endoscopic necrosectomy (DEN). Open necrosectomy is associated with substantial morbidity, but to date no randomized trial has documented superiority of either minimally invasive or open surgical technique. Additional trials are underway to address this. Severe acute and necrotizing pancreatitis requires a multi-disciplinary treatment strategy that must be individualized for each patient. Optimal treatment of necrotizing pancreatitis now requires a staged, multi-disciplinary, minimally invasive "step-up" approach that includes a team of interventional radiologists, therapeutic endoscopists, and surgeons.
Social Studies Teachers' Beliefs Regarding and Understanding of Teaching Content Area Reading Skills: A Multi-Case Study

ERIC Educational Resources Information Center

Wood, Robin L.

2017-01-01

The purpose of this multiple case study was to understand the beliefs held by content area social studies teachers who teach reading. The rationale for this study is that students in the 21st century must be able to meet the demands of disciplinary literacy to compete in the workforce. The data from the semi-structured interviews and classroom…
Multi-disciplinary clinical protocol for the diagnosis of bulbar amyotrophic lateral sclerosis.

PubMed

Chiaramonte, Rita; Di Luciano, Carmela; Chiaramonte, Ignazio; Serra, Agostino; Bonfiglio, Marco

2018-04-23

The objective of this study was to examine the role of different specialists in the diagnosis of amyotrophic lateral sclerosis (ALS), to understand changes in verbal expression and phonation, respiratory dynamics and swallowing that occurred rapidly over a short period of time. 22 patients with bulbar ALS were submitted for voice assessment, ENT evaluation, Multi-Dimensional Voice Program (MDVP), spectrogram, electroglottography, fiberoptic endoscopic evaluation of swallowing. In the early stage of the disease, the oral tract and velopharyngeal port were involved. Three months after the initial symptoms, most of the patients presented hoarseness, breathy voice, dysarthria, pitch modulation problems and difficulties in pronunciation of explosive, velar and lingual consonants. Values of MDVP were altered. Spectrogram showed an additional formant, due to nasal resonance. Electroglottography showed periodic oscillation of the vocal folds only during short vocal cycle. Swallowing was characterized by weakness and incoordination of oro-pharyngeal muscles with penetration or aspiration. A specific multidisciplinary clinical protocol was designed to report vocal parameters and swallowing disorders that changed more quickly in bulbar ALS patients. Furthermore, the patients were stratified according to involvement of pharyngeal structures, and severity index. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.
Early-Career Professional Development Training for Stakeholder-Relevant, Interdisciplinary Research

NASA Astrophysics Data System (ADS)

Rosendahl, D. H.; Bamzai, A.; Mcpherson, R. A.

2015-12-01

There are many challenges to conducting inter- or multi-disciplinary research because basic research, applied research, management processes, disciplines, and even sub-disciplines have been "siloed" for so long that many research and management professionals find it difficult to communicate common interests and research needs. It is clear that the next generation of researchers must overcome these disciplinary biases and engage in more open dialogue with other disciplines and the management community in order to be better positioned to collaborate, speak a common language, and understand each other's needs. The U.S. Department of the Interior's South Central Climate Science Center recently conducted a professional development workshop for 28 early-career researchers involved in climate-related research across the South-Central U.S. The participants consisted of graduate students, postdocs, and junior faculty representing 17 different natural and social science disciplines and seven Universities/Institutions. The workshop provided the participants with guidance and instruction on how to overcome the identified challenges in conducting "actionable" research and how to better navigate multi-institutional and multi- or inter-disciplinary research. The workshop was comprised of: (1) a series of instructional presentations organized into themed sessions; (2) two keynote addresses to provide a broader perspective; (3) a real-world case study activity; (4) individual and group projects/presentations; and (5) field trips. In addition, we purposely created informal opportunities for participants to network, which met the goal of facilitating interdisciplinary interactions. An overview of the workshop experience will be provided, including a focus on those aspects leading to its ultimate success and recommendations for how to develop and implement a similar early-career workshop for your own purposes.
Remote Versus Local Forcing of Chlorophyll Variability in the South Atlantic Bight

NASA Technical Reports Server (NTRS)

Signorini, Sergio R.; McClain, Charles R.

2006-01-01

This TM documents results of analyses addressing the local versus remote forcing of chlorophyll variability on the shelf and slope regions of the South Atlantic Bight (SAB) based on satellite-derived products and a limited amount of in situ data. This study is part of a larger multi-disciplinary, multi-institutional effort to study the Eastern U.S. Continental Shelf carbon budget (U.S. Eastern Continental Shelf Carbon Budget: Modeling, Data Assimilation, and Analysis, U.S. ECoS), a project funded by the NASA Earth System Enterprise Interdisciplinary Science Program that started in the summer of 2004.
Technology-Rich Learning Environments in Elementary and Secondary Schools: An Interactive Study of Physical Settings and Educational Change.

ERIC Educational Resources Information Center

Stuebing, Susan; And Others

This paper reviews an ongoing study on the physical settings of education with technology at the elementary and high school levels. The study, which is multi-disciplinary in nature, is based in sites in the process of change in teaching strategies, using learning technology as a catalyst for this change to take place. The focus of the study is on…
Strategies for mHealth research: lessons from 3 mobile intervention studies.

PubMed

Ben-Zeev, Dror; Schueller, Stephen M; Begale, Mark; Duffecy, Jennifer; Kane, John M; Mohr, David C

2015-03-01

The capacity of Mobile Health (mHealth) technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research. mHealth research entails several unique characteristics, including collaboration with technologists at all phases of a project, reliance on regional telecommunication infrastructure and commercial mobile service providers, and deployment and evaluation of interventions "in the wild", with participants using mobile tools in uncontrolled environments. In the current paper, we summarize the lessons our multi-institutional/multi-disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations. First, we describe three ongoing projects that we draw from to illustrate throughout the paper. We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful. Finally, we discuss mHealth research challenges (i.e. evolving technology, mobile phone selection, user characteristics, the deployment environment, and mHealth system "bugs and glitches"), and provide recommendations for identifying and resolving barriers, or preventing their occurrence altogether.
Strategies for mHealth research: lessons from 3 mobile intervention studies

PubMed Central

Ben-Zeev, Dror; Schueller, Stephen M.; Begale, Mark; Duffecy, Jennifer; Kane, John M.; Mohr, David C.

2014-01-01

The capacity of Mobile Health (mHealth) technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research. mHealth research entails several unique characteristics, including collaboration with technologists at all phases of a project, reliance on regional telecommunication infrastructure and commercial mobile service providers, and deployment and evaluation of interventions “in the wild”, with participants using mobile tools in uncontrolled environments. In the current paper, we summarize the lessons our multi-institutional/multi-disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations. First, we describe three ongoing projects that we draw from to illustrate throughout the paper. We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful. Finally, we discuss mHealth research challenges (i.e. evolving technology, mobile phone selection, user characteristics, the deployment environment, and mHealth system “bugs and glitches”), and provide recommendations for identifying and resolving barriers, or preventing their occurrence altogether. PMID:24824311
Constructing Meaning in a Community of Learners: The "Star" Pattern of Talk

ERIC Educational Resources Information Center

Rachamim, Mirit; Orland-Barak, Lily

2016-01-01

We present findings from an in-depth study on a school-based multi-disciplinary learning community in the context of practice teaching in university pre-service education. We elaborate on one of the three predominant patterns of talk identified, the "star" pattern, and show how it created particular power relations in the discourse which…
A Multi- and Cross-Disciplinary Capstone Experience in Engineering Art: Animatronic Polar Bear

ERIC Educational Resources Information Center

Sirinterlikci, Arif; Toukonen, Kayne; Mason, Steve; Madison, Russel

2005-01-01

An animatronic robot was designed and constructed for the 2003 Annual Student Robotic Technology and Engineering Challenge organized by the Robotics International (RI) association of the Society of Manufacturing Engineers (SME). It was also the senior capstone design project for two of the design team members. After a thorough study of body and…
The Impact of Technology Integration upon Collegiate Pedagogy from the Lens of Multiple Disciplines

ERIC Educational Resources Information Center

Swanson, Joan Ann

2016-01-01

Technology integration on college campuses has become both a reality and necessity to meet the demands for function and flow in an ever advancing world of learning. This study qualitatively reviewed how a multi-disciplinary sample of collegiate instructors viewed technology and how they incorporated it into their pedagogy. Results indicated a…
Directory of Rural Studies Scholars and Educators.

ERIC Educational Resources Information Center

Hatch, Carol S., Comp.

This directory is a compendium of over 600 scholars and educators in a range of disciplines throughout the United States who are actively involved in research or teaching of rural issues. It is intended as a resource for those individuals and for other professionals, providing access to one another and aiding a multi-disciplinary approach to rural…

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 benchmark-multi-disciplinary study of the interaction between the Chesapeake Bay and adjacent waters of the Virginian Sea

NASA Technical Reports Server (NTRS)

Hargis, W. J., Jr.

1981-01-01

The social and economic importance of estuaries are discussed. Major focus is on the Chesapeake Bay and its interaction with the adjacent waters of the Virginia Sea. Associated multiple use development and management problems as well as their internal physical, geological, chemical, and biological complexities are described.
The Unit of Analysis in Mathematics Education: Bridging the Political-Technical Divide?

ERIC Educational Resources Information Center

Ernest, Paul

2016-01-01

Mathematics education is a complex, multi-disciplinary field of study which treats a wide range of diverse but interrelated areas. These include the nature of mathematics, the learning of mathematics, its teaching, and the social context surrounding both the discipline and applications of mathematics itself, as well as its teaching and learning.…
Embracing Social Sustainability in Design Education: A Reflection on a Case Study in Haiti

ERIC Educational Resources Information Center

Kjøllesdal, Anders; Asheim, Jonas; Boks, Casper

2014-01-01

Sustainable design issues are complex and multi-faceted and need integration in the education of young designers. Current research recommends a holistic view based on problem-solving and inter-disciplinary work, yet few design educators have brought these ideas to their full consequence. Sustainability education for designers is still often rooted…
What Is a Child? Children's Perceptions, the Cambridge Primary Review and Implications for Education

ERIC Educational Resources Information Center

Adams, Kate

2014-01-01

Debate about the definition of a "child" occurs in multi-disciplinary contexts, most recently located in the new sociology of childhood where social constructionism is the dominant discourse. Given that the child's voice has become an increasingly valued component of research, this paper reports on one aspect of a study which explored…
Analysis of the physiotherapy industry: challenges for marketing.

PubMed

Sheppard, L

1996-01-01

The physiotherapy industry can be analysed using Porter's (1979) five forces. Physiotherapy uses medical, geographic and funding segmentation. The power of the buyers in these segments is considerable. Substitutes are posing a threat to physiotherapy with few barriers to entry to operate in the health care environment. The suppliers, particularly doctors, have significant power in referring clients. Competitive rivalry for these clients can exist between individual physiotherapists and multi-disciplinary clinics. The difference in orientation of private and public physiotherapy can also be a basis for rivalry. Repositioning to view the client as both the supplier and recipients enables the physiotherapy industry to gain competitive advantage and ensures long term growth.
Acute transfusion reactions: an update.

PubMed

Scorer, T; Doughty, H

2014-01-01

Over the last decade the use of blood products by the United Kingdom (UK) military has increased significantly; with the increase in transfusion comes an increased incidence of transfusion-related incidents. Acute transfusion reactions (ATRs) are a common consequence of transfusion, which vary widely in their severity and are likely to be under-reported, although reporting is a regulatory requirement. This paper discusses the importance of identifying ATRs and managing them appropriately. It introduces a flowchart (due to be incorporated in the next version of Joint Service Publication (JSP) 999, Clinical Guidelines for Operations (CGOs)), which is designed to assist the military multi-disciplinary team caring for patients in the operational environment.
The role of positron emission tomography in the diagnosis, staging and response assessment of non-small cell lung cancer

PubMed Central

Ali, Jason M.; Tasker, Angela; Peryt, Adam; Aresu, Giuseppe; Coonar, Aman S.

2018-01-01

Lung cancer is a common disease and the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Following diagnosis of lung cancer, accurate staging is essential to guide clinical management and inform prognosis. Positron emission tomography (PET) in conjunction with computed tomography (CT)—as PET-CT has developed as an important tool in the multi-disciplinary management of lung cancer. This article will review the current evidence for the role of 18F-fluorodeoxyglucose (FDG) PET-CT in NSCLC diagnosis, staging, response assessment and follow up. PMID:29666818
Securing Information with Complex Optical Encryption Networks

DTIC Science & Technology

2015-08-11

Network Security, Network Vulnerability , Multi-dimentional Processing, optoelectronic devices 16. SECURITY CLASSIFICATION OF: 17. LIMITATION... optoelectronic devices and systems should be analyzed before the retrieval, any hostile hacker will need to possess multi-disciplinary scientific...sophisticated optoelectronic principles and systems where he/she needs to process the information. However, in the military applications, most military
Networking Cyberinfrastructure Resources to Support Global, Cross-disciplinary Science

NASA Astrophysics Data System (ADS)

Lehnert, K.; Ramamurthy, M. K.

2016-12-01

Geosciences are globally connected by nature and the grand challenge problems like climate change, ocean circulations, seasonal predictions, impact of volcanic eruptions, etc. all transcend both disciplinary and geographic boundaries, requiring cross-disciplinary and international partnerships. Cross-disciplinary and international collaborations are also needed to unleash the power of cyber- (or e-) infrastructure (CI) by networking globally distributed, multi-disciplinary data, software, and computing resources to accelerate new scientific insights and discoveries. While the promises of a global and cross-disciplinary CI are exhilarating and real, a range of technical, organizational, and social challenges needs to be overcome in order to achieve alignment and linking of operational data systems, software tools, and computing facilities. New modes of collaboration require agreement on and governance of technical standards and best practices, and funding for necessary modifications. This presentation will contribute the perspective of domain-specific data facilities to the discussion of cross-disciplinary and international collaboration in CI development and deployment, in particular those of IEDA (Interdisciplinary Earth Data Alliance) serving the solid Earth sciences and Unidata serving atmospheric sciences. Both facilities are closely involved with the US NSF EarthCube program that aims to network and augment existing Geoscience CI capabilities "to make disciplinary boundaries permeable, nurture and facilitate knowledge sharing, …, and enhance collaborative pursuit of cross-disciplinary research" (EarthCube Strategic Vision), while also collaborating internationally to network domain-specific and cross-disciplinary CI resources. These collaborations are driven by the substantial benefits to the science community, but create challenges, when operational and funding constraints need to be balanced with adjustments to new joint data curation practices and interoperability standards.
Drug safety evaluation of sorafenib for treatment of solid tumors: consequences for the risk assessment and management of cancer patients.

PubMed

Huillard, Olivier; Boissier, Emilie; Blanchet, Benoit; Thomas-Schoemann, Audrey; Cessot, Anatole; Boudou-Rouquette, Pascaline; Durand, Jean-Philippe; Coriat, Romain; Giroux, Julie; Alexandre, Jerome; Vidal, Michel; Goldwasser, Francois

2014-05-01

Sorafenib is a multi-tyrosine kinase inhibitor (TKI). Considerable clinical experience has been accumulated since its first Phase III clinical trial in metastatic renal cancer patients in 2007. The management of its early acute toxicity in fit patients is well known. The management of prolonged treatment becomes the new challenge. Using sorafenib as a key word for PubMed search, we review preclinical and clinical data and discuss the pharmacokinetics and pharmacodynamics of sorafenib, its acute and cumulative toxicities and their consequences for patient management. The systematic multi-disciplinary risk assessment of cancer patients prior to TKI initiation reduces the risks of acute and late toxicity, especially drug-drug interactions and arterial risks. Sarcopenia is now identified as a major risk of severe toxicity. The very diverse clinical pictures of cumulative toxicity must be known. The monitoring of sorafenib systemic exposure is helpful especially in elderly patients. Moreover, at disease progression, it allows distinguishing between underexposure to sorafenib and truly acquired resistance to the drug. The optimal use of sorafenib should allow improving the reported results of flat-dose. Finally, most of this knowledge could be used for the development and optimal use of the other TKIs.
Innovative Treatments for Cancer:. The Impact of Delivering siRNAs, Chemotherapies, and Preventative Agents Using Nanoformulations

NASA Astrophysics Data System (ADS)

Hook, Sara S.; Farrell, Dorothy; Hinkal, George W.; Ptak, Krzystzof; Grodzinski, Piotr; Panaro, Nicholas J.

2013-09-01

A multi-disciplinary approach to research epitomized by the emerging field of cancer nanotechnology can catalyze scientific developments and enable clinical translation beyond what we currently utilize. Engineers, chemists, and physical scientists are teaming up with cancer biologists and clinical oncologists to attack the vast array of cancer malignancies using materials at the nanoscale. We discuss how nanoformulations are enabling the targeted, efficient, delivery of not only genetic therapies such silencing RNAs, but also conventional cytotoxic agents and small molecules which results in decreased systemic toxicity and improved therapeutic index. As preventative approaches, there are various imaging agents and devices are being developed for screening purposes as well as new formulations of sunscreens, neutraceuticals, and cancer vaccines. The goal then of incorporating nanotechnology into clinical applications is to achieve new and more effective ways of diagnosing, treating, and preventing cancer to ultimately change the lives of patients worldwide.
Mono-disciplinary or multidisciplinary back pain guidelines? How can we achieve a common message in primary care?

PubMed

Breen, Alan C; van Tulder, Maurits W; Koes, Bart W; Jensen, Irene; Reardon, Rhoda; Bronfort, Gert

2006-05-01

Description of a workshop entitled "Sharing Guidelines for Low Back Pain Between Primary Health Care Providers: Toward a Common Message in Primary Care" that was held at the Fifth International Forum on Low Back Pain in Primary Care in Canada in May 2002. Despite a considerable degree of acceptance of current evidence-based guidelines, in practice, primary health care providers still do not share a common message. The objective of the workshop was to describe the outcomes of a workshop on the sharing of guidelines in primary care. The Fifth International Forum on Low Back Pain Research in Primary Care focused on relations between stakeholders in the primary care management of back pain. Participants in this workshop contributed to an open discussion on "how and why" evidence-based guidelines about back pain do or do not work in practice. Ways to minimise the factors that inhibit implementation were discussed in the light of whether guidelines are mono-disciplinary or multidisciplinary. Examples of potential issues for debate were contained in introductory presentations. The prospects for improving implementation and reducing barriers, and the priorities for future research, were then considered by an international group of researchers. This paper summarises the conclusions of three researcher subgroups that focused on the sharing of guidelines under the headings of: (1) the content, (2) the development process, and (3) implementation. How to share the evidence and make it meaningful to practice stakeholders is the main challenge of guideline implementation. There is a need to consider the balance between the strength of evidence in multidisciplinary guidelines and the utility/feasibility of mono-disciplinary guidelines. The usefulness of both mono-disciplinary and multidisciplinary guidelines was agreed on. However, in order to achieve consistent messages, mono-disciplinary guidelines should have a multidisciplinary parent. In other words, guidelines should be developed and monitored by a multidisciplinary team, but may be transferred to practice by mono-disciplinary messengers. Despite general agreement that multi-faceted interventions are most effective for implementing guidelines, the feasibility of doing this in busy clinical settings is questioned. Research is needed from local implementation pilots and quality monitoring studies to understand how to develop and deliver the contextual understanding required. This relates to processes of care as well as outcomes, and to social factors and policymaking as well as health care interventions. We commend these considerations to all who are interested in the challenges of achieving better-integrated, evidence-based care for people with back pain.
Seasonal hazards and health risks in lower-income countries: field testing a multi-disciplinary approach.

PubMed

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

2009-12-21

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

PubMed

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

2013-02-01

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

ERIC Educational Resources Information Center

Carrier, Anne; And Others

1986-01-01

Provides an annotated list of instructional resources for teaching about the Holocaust in secondary schools. Included are textbooks, multi-disciplinary units, eyewitness accounts, fiction, poetry, anthologies, and audio visual materials. (JDH)
Community Engaged Leadership to Advance Health Equity and Build Healthier Communities

PubMed Central

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

2016-01-01

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

PubMed

Ohba, Shinsuke; Hojo, Hironori; Chung, Ung-Il

2012-07-01

THERE ARE THREE COMPONENTS FOR THE CREATION OF NEW TISSUES: cell sources, scaffolds, and bioactive factors. Unlike conventional medical strategies, regenerative medicine requires not only analytical approaches but also integrative ones. Basic research has identified a number of bioactive factors that are necessary, but not sufficient, for organogenesis. In skeletal development, these factors include bone morphogenetic proteins (BMPs), transforming growth factor β TGF-β, Wnts, hedgehogs (Hh), fibroblast growth factors (FGFs), insulin-like growth factors (IGFs), SRY box-containing gene (Sox) 9, Sp7, and runt-related transcription factors (Runx). Clinical and preclinical studies have been extensively performed to apply the knowledge to bone and cartilage regeneration. Given the large number of findings obtained so far, it would be a good time for a multi-disciplinary, collaborative effort to optimize these known factors and develop appropriate drug delivery systems for delivering them.
Virtopsy: Touch-free autopsy.

PubMed

Badam, Raj Kumar; Sownetha, Triekan; Babu, D B Gandhi; Waghray, Shefali; Reddy, Lavanya; Garlapati, Komali; Chavva, Sunanda

2017-01-01

The word "autopsy" denotes "to see with own eyes." Autopsy (postmortem) is a process that includes a thorough examination of a corpse noting everything related to anatomization, surface wounds, histological and culture studies. Virtopsy is a term extracted from two words "virtual" and "autopsy." It employs imaging methods that are routinely used in clinical medicine such as computed tomography and magnetic resonance imaging in the field of autopsy, to find the reason for death. Virtopsy is a multi-disciplinary technology that combines forensic medicine and pathology, roentgenology, computer graphics, biomechanics, and physics. It is rapidly gaining importance in the field of forensics. This approach has been recently used by forensic odontologists, but yet to make its own mark in the field. This article mainly deals with "virtopsy" where in various articles were web searched, relevant data was selected, extracted, and summarized here.
The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care

PubMed Central

Chee, Nigel

2017-01-01

The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a ‘bundle’ of principles to reduce delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium. The purpose of this analysis is to review the current literature and develop a mnemonic, which may help facilitate collaborative working for patients with delirium. Electronic databases were searched for non-pharmacological managements of delirium within intensive care settings, after 2006. Critical appraisal using Critical Appraisal Skills Programme methodology was completed by the author. Multi-intervention approaches and bundles are successful at reducing delirium days, and in some cases, reducing hospital length of stay. The key components of these bundles include spontaneous breathing trials, daily sedation holds, addressing pain relief, early mobilisation and to a small extent normalisation of a daily routine. There is limited research into the role of therapy within this patient group, but there is a role for cognitive therapy, functional tasks, and a greater rehab emphasis within other patient populations such as stroke and elderly care. The critical care population have similar rehabilitation needs to these groups, and therefore would benefit from similar treatment plans. Critical care patients with delirium may benefit from a range of additional therapeutic activities to reduce the duration of delirium. The D.E.L.I.R.I.U.M mnemonic has been developed to encompass all the key elements of current delirium research in a simplistic memorable fashion. Further work is needed to trial the usefulness of the mnemonic in clinical practice to enable the entire multi-disciplinary team work collaboratively to reduce delirium with the intensive care. PMID:29123562

Towards understanding the epidemiology of Neisseria meningitidis in the African meningitis belt: a multi-disciplinary overview.

PubMed

Agier, Lydiane; Martiny, Nadège; Thiongane, Oumy; Mueller, Judith E; Paireau, Juliette; Watkins, Eleanor R; Irving, Tom J; Koutangni, Thibaut; Broutin, Hélène

2017-01-01

Neisseria meningitidis is the major cause of seasonal meningitis epidemics in the African meningitis belt. In the changing context of a reduction in incidence of serogroup A and an increase in incidence of serogroups W and C and of Streptococcus pneumoniae, a better understanding of the determinants driving the disease transmission dynamics remains crucial to improving bacterial meningitis control. The literature was searched to provide a multi-disciplinary overview of the determinants of meningitis transmission dynamics in the African meningitis belt. Seasonal hyperendemicity is likely predominantly caused by increased invasion rates, sporadic localized epidemics by increased transmission rates, and larger pluri-annual epidemic waves by changing population immunity. Carriage likely involves competition for colonization and cross-immunity. The duration of immunity likely depends on the acquisition type. Major risk factors include dust and low humidity, and presumably human contact rates and co-infections; social studies highlighted environmental and dietary factors, with supernatural explanations. Efforts should focus on implementing multi-country, longitudinal seroprevalence and epidemiological studies, validating immune markers of protection, and improving surveillance, including more systematic molecular characterizations of the bacteria. Integrating climate and social factors into disease control strategies represents a high priority for optimizing the public health response and anticipating the geographic evolution of the African meningitis belt. Copyright © 2016. Published by Elsevier Ltd.
Super-volcanic investigations

NASA Astrophysics Data System (ADS)

Till, Christy B.; Pritchard, Matthew; Miller, Craig A.; Brugman, Karalee K.; Ryan-Davis, Juliet

2018-04-01

Multi-disciplinary analyses of Earth's most destructive volcanic systems show that continuous monitoring and an understanding of each volcano's quirks, rather than a single unified model, are key to generating accurate hazard assessments.
Severe group A streptococcal infections in a paediatric intensive care unit.

PubMed

Lithgow, Anna; Duke, Trevor; Steer, Andrew; Smeesters, Pierre Robert

2014-09-01

To describe the clinical presentation, management and outcomes for children with invasive group A streptococcal (GAS) infection in a paediatric intensive care unit (PICU). We reviewed the clinical and laboratory records of patients admitted to a PICU in Melbourne with invasive GAS infection from April 2010 to April 2013. Outcomes recorded included survival, organ failure, need for extracorporeal support, renal replacement therapy and prolonged neuromuscular weakness. Twelve cases of invasive GAS infection were identified. The most common clinical presentations were pneumonia (n=5), bacteraemia with no septic focus (n=4) and septic arthritis (n=3). Necrotising fasciitis occurred in one patient and another patient presented with ischaemic lower limbs requiring amputation. Of the eight isolates with available emm typing results, the most common emm type was emm1 (n=4) followed by emm4, 12 and 22. Nine patients had multi-organ failure. Ten patients required mechanical ventilation for a median duration of 8 days. Nine patients required inotropic and/or vasopressor support and four patients extracorporeal membrane oxygenation support. Eleven patients survived. A prolonged period of neuromuscular weakness following the initial severe illness was common (n=5), but most children returned to normal or near normal neurological function. Invasive GAS disease in children may cause severe multi-organ failure with resultant prolonged intensive care stay and significant morbidity. However, a high rate of survival and return to normal functioning may be achieved with multi-system intensive care support and multi-disciplinary rehabilitation. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
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.
Indian Society of Neuro-Oncology consensus guidelines for the contemporary management of medulloblastoma.

PubMed

Gupta, Tejpal; Sarkar, Chitra; Rajshekhar, Vedantam; Chatterjee, Sandip; Shirsat, Neelam; Muzumdar, Dattatreya; Pungavkar, Sona; Chinnaswamy, Girish; Jalali, Rakesh

2017-01-01

The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes. The Indian Society of Neuro-Oncology (ISNO) constituted an expert multi-disciplinary panel with adequate representation from all stakeholders to prepare national consensus guidelines for the contemporary management of medulloblastoma. Minimum desirable, as well as preferable though optional recommendations (as appropriate), were developed and adopted for the pre-surgical work-up including neuroimaging; neurosurgical management including surgical principles, techniques, and complications; neuropathology reporting and molecular testing; contemporary risk-stratification in the molecular era; appropriate adjuvant therapy (radiotherapy and chemotherapy); and follow-up schedule in medulloblastoma. The current document represents a broad consensus reached amongst various stakeholders within the neuro-oncology community involved in the contemporary curative-intent management of children with medulloblastoma. It provides both general as well as specific guidelines and recommendations to be adopted by physicians and health care providers across India to achieve uniformity of care, improve disease-related outcomes, and compare results between institutions within the country.
Identification of relevant functional issues for the care of patients with acute arthritis by health professionals, using the ICF framework and a multi-disciplinary focus group approach.

PubMed

Zochling, J; Grill, E; Alten, R; Ernst, J; Stucki, G; Braun, J

2007-01-01

To identify the most relevant problems to be addressed in the multi-disciplinary care of patients with acute arthritis using focus groups of health professionals followed by a Delphi process. Focus group and Delphi methodology were applied. The focus groups were conducted at three specialist rheumatology hospital clinics in Germany, each group comprising rheumatologists, nurses, physiotherapists, occupational therapists, psychologists and social workers. The participants were asked to decide which categories of the International Classification of Functioning, Disability and Health (ICF) are relevant to the care of patients with acute inflammatory arthritis. The results from the focus groups were then followed by an anonymous Delphi process. Twenty-six health professionals participated in the 3 focus groups. 167 of the second-level ICF categories (63% of all second-level categories) were considered as relevant by the rheumatology health professionals. Items from all four components, Body Functions, Body Structures, Activities and Participation and Environmental Factors were represented. Agreement between focus groups and between different health professional groups was substantial for all components with the exception of Environmental Factors (Cohen's kappa 0.23). The involvement of experts from different health professions is a valuable tool to identify typical patient characteristics, expressed as distinct ICF categories, to aid in patient care in the acute rheumatology setting. Acute patient care cannot and should not be separated from ongoing long-term management.
The discipline survey: a new measure of parental discipline.

PubMed

Socolar, Rebecca; Savage, Eric; Devellis, Robert F; Evans, Hughes

2004-01-01

To develop a new measure of parental discipline of children encompassing a broad array of types of discipline and modes of administration. Parents of 12- to 19-month-old children were interviewed using a new 45-item structured survey about discipline in general pediatric clinics in North Carolina and Alabama. Demographic data describing the population studied were linked from another study in which these families were participating. Principal component analysis and confirmatory reliability analysis were used to define subscales and determine which items were retained in the survey. One hundred eighty-two parents were interviewed about disciplinary practices. Disciplinary subscales were robust for a number of disciplinary types (monitoring, verbal communication, modeling behavior, corporal punishment, and ignoring) and modes of administration (follow-through, consistency, positive demeanor, negative demeanor). The Discipline Survey is a promising new measure of parental discipline. A survey instrument to assess disciplinary practices like the one developed fills a gap and can enhance research methodology for those interested in the effects of interventions on parental discipline.
Traffic incident management resource management.

DOT National Transportation Integrated Search

2009-01-01

The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...
Authorship in Multi-Disciplinary, Multi-National North-South Research Projects: Issues of Equity, Capacity and Accountability

ERIC Educational Resources Information Center

Jeffery, Roger

2014-01-01

The challenges of ensuring equity among partners of very different academic power and status, across continents, within complex research projects involving differing disciplines with their own norms, and balancing needs for capacity development of individuals and for institutions can be major sources of conflicts. While each of these concerns has…
Involvement in Transportation Through Career and Curriculum Planning: Seminar Proceedings (University of North Florida, June 18-22, 1973).

ERIC Educational Resources Information Center

Smith, Jay A., Jr., Ed.

The document offers texts of papers presented at a multi-disciplinary and multi-audience transportation seminar conducted by the Department of Transportation and Logistics of the University of Northern Florida. An understanding of transportation career opportunities and manpower requirements was sought by those attending: career counselors,…
A Review of the Empirical Generations at Work Research: Implications for School Leaders and Future Research

ERIC Educational Resources Information Center

Edge, Karen

2014-01-01

Most schools currently employ three generations of teachers and leaders: Baby Boomers (1946-65), Generation X (1966-80) and Generation Y (1981-2003). However, the implications for school leaders of multi-generational schools remain relatively unexplored. This paper examines the empirical multi-disciplinary generations at work evidence to identify…
Assessing the Impact of a Multi-Disciplinary Peer-Led-Team Learning Program on Undergraduate STEM Education

ERIC Educational Resources Information Center

Carlson, Kerri; Celotta, Dayius Turvold; Curran, Erin; Marcus, Mithra; Loe, Melissa

2016-01-01

There has been a national call to transition away from the traditional, passive, lecture-based model of STEM education towards one that facilitates learning through active engagement and problem solving. This mixed-methods research study examines the impact of a supplemental Peer-Led Team Learning (PLTL) program on knowledge and skill acquisition…
Education and Care for Adolescents and Adults with Autism: A Guide for Professionals and Carers

ERIC Educational Resources Information Center

Wall, Kate

2007-01-01

Using case studies and examples that show the reader how to put theory into practice in multi-disciplinary settings, "Education and Care for Adolescents and Adults with Autism" explains how changes in policy and provision have affected how young people and adults with autism are cared for and educated. The author highlights current problematic…
International Disability Educational Alliance (IDEAnet)

DTIC Science & Technology

2011-12-01

engineer ing projects , capacity- building education programs, interactive online tools, and advocacy on disability rights. Initially, the CIR focused...lead to a long-term project for data collection in Kenya and other parts of the world where similar studies are underway. D1: Design and...of 206 and to f acilitate multi- and in ter-disciplinary teamwork between rehabilitation professionals The course/training includes both
Thinking about Our Future: War, Society, and the Environment. A Series of Lesson Plans.

ERIC Educational Resources Information Center

Harik, Ramsay M.

This packet of 11 lesson plans is designed to help high school social studies classes examine socio-political issues facing the post-Cold War world. Though its multi-disciplinary approach touches upon a number of current topics, the packet's particular focus is on the wide-ranging impact of war and militarism on the planet's growing ecological…
A Support Group for Parents of Children on a Waiting List for an Assessment for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Connolly, Micaela; Gersch, Irvine

2013-01-01

Parents of children waiting for a diagnostic assessment for autism spectrum disorder (ASD) experience distress and anxiety while they wait. The present small-scale study took place in a multi-disciplinary therapeutic service in Ireland for children with ASD and was run between April and September 2011. The first author, an educational psychologist…
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…
Creating Cross-disciplinary Courses.

PubMed

Reynolds, Elaine R

2012-01-01

Because of its focus on the biological underpinnings of action and behavior, neuroscience intersects with many fields of human endeavor. Some of these cross-disciplinary intersections have been long standing, while others, such as neurotheology or neuroeconomics, are more recently formed fields. Many undergraduate institutions have sought to include cross-disciplinary courses in their curriculum because this style of pedagogy is often seen as applicable to real world problems. However, it can be difficult for faculty with specialized training within their discipline to expand beyond their own fields to offer cross-disciplinary courses. I have been creating a series of multi- or cross-disciplinary courses and have found some strategies that have helped me successfully teach these classes. I will discuss general strategies and tools in developing these types of courses including: 1) creating mixed experience classrooms of students and contributing faculty 2) finding the right tools that will allow you to teach to a mixed population without prerequisites 3) examining the topic using multiple disciplinary perspectives 4) feeding off student experience and interest 5) assessing the impact of these courses on student outcomes and your neuroscience program. This last tool in particular is important in establishing the validity of this type of teaching for neuroscience students and the general student population.
Creating Cross-disciplinary Courses

PubMed Central

Reynolds, Elaine R.

2012-01-01

Because of its focus on the biological underpinnings of action and behavior, neuroscience intersects with many fields of human endeavor. Some of these cross-disciplinary intersections have been long standing, while others, such as neurotheology or neuroeconomics, are more recently formed fields. Many undergraduate institutions have sought to include cross-disciplinary courses in their curriculum because this style of pedagogy is often seen as applicable to real world problems. However, it can be difficult for faculty with specialized training within their discipline to expand beyond their own fields to offer cross-disciplinary courses. I have been creating a series of multi- or cross-disciplinary courses and have found some strategies that have helped me successfully teach these classes. I will discuss general strategies and tools in developing these types of courses including: 1) creating mixed experience classrooms of students and contributing faculty 2) finding the right tools that will allow you to teach to a mixed population without prerequisites 3) examining the topic using multiple disciplinary perspectives 4) feeding off student experience and interest 5) assessing the impact of these courses on student outcomes and your neuroscience program. This last tool in particular is important in establishing the validity of this type of teaching for neuroscience students and the general student population. PMID:23494491
Global Visions: A Global Exploration of Cultures by Region for the Intermediate Grades Using a Multi-Disciplinary Approach. Office for Equity Education's Multicultural Education Resource Series.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia. Office for Equity Education.

This 10-lesson unit blends social studies skills, concepts, and attitudes with language arts, art, and interpersonal relations in a 2-week study of cultures. Using a global perspective, students learn about four geographic regions of the earth (polar, temperate, tropical, desert), adaptation and change in the environment, different aspects of…

Participatory Games: Experiential learning to bridge disciplines

NASA Astrophysics Data System (ADS)

Coughlan, E.; Suarez, P.; Mendler de Suarez, J.; Bachofen, C.

2014-12-01

While the benefits of multi-disciplinary education have been extolled, there is more to success than producing students who are able to articulate the theorems of all pertinent disciplines. Here, we will describe case studies in which participatory scenario exercises and games can make the difference between memorizing information from an "outside" discipline, and actually internalizing the priorities and complications of the issue from an alien perspective. Case studies include teaching Red Cross community-based volunteers the Probability Distribution Function of seasonal rainfall forecasts, as well as requiring students of Columbia University's Master's Program in Climate and Society to study both natural and social aspects of climate. Games create a model system of the world, in which players assume a role and make decisions with consequences, facing complex feedback loops. Taking such roles catalyzes "AHA" moments that effectively bring home the intricacies of disciplinary paradigms outside of one's own.
Using Disciplinary Literacy to Develop Coherence in History Teacher Education: The Clinical Rounds Project

ERIC Educational Resources Information Center

Bain, Robert B.

2012-01-01

Since 2005, the author and Elizabeth Moje have been engaged in a project to create a more coherent and cohesive program to prepare secondary teachers at the University of Michigan, a project they call the Clinical Rounds Project. Central to this effort has been their use of "disciplinary literacy" to build connections and enhance…
Meso level multi-disciplinary approach for reduction of pre-treatment loss to follow-up in Revised National Tuberculosis Control Program, Delhi, India.

PubMed

Sharma, Nandini; Chandra, Shivani; Dhuria, Meera; Kohli, Charu; Chopra, Kamal Kishore; Aggarwal, Nishi; Sachdeva, Kuldeep

2017-10-01

Universal access to tuberculosis (TB) care services emphasizes early detection and initiation of treatment for all pulmonary TB patients. Pre-treatment loss to follow-up patients needs to be actively tracked and treated to break the chain of transmission in the community. MATERIALS AND METHODS: A questionnaire based cross sectional study of a sample of 340 patients who were pre-treatment loss to follow-up was conducted from November 2011 to March 2012 in Delhi. Qualitative study involved focused group discussions with paramedical providers using a topic outline guide, patients were interviewed using semi-structured questionnaire and brainstorming of program managers to elicit reasons, suggestions and health seeking behavior among those who were pre-treatment loss to follow-up. Preference for private practitioners (64.4%), lack of trust in government health system (26.7%), inconvenient time of Directly Observed Treatment (DOT) centre (18.5%) and wrong patient address (14%) were the main reasons for pre-treatment loss to follow-up. Paramedical provider's opinion elicited in focused group discussion was that there is an increased tendency of pre-treatment loss to follow-up in drug addicts and home-less patients. Brainstorming with program managers revealed that a lack of trust in allopathic system of medicine and human resource constraints were the leading causes of pre-treatment loss to follow-up. A Meso level multi disciplinary model with community participation through Resident Welfare Associations (RWAs) has been designed based on the above findings. The model suggests mutual collaboration between government and non government agencies for promotion of International Standards of TB care in private clinics, de addiction services and social welfare schemes through RWAs. There is a need for Advocacy Communication and Social Mobilization on a large scale. Collaboration with Resident Welfare Associations (RWAs) and with practitioners from alternate systems of medicine should be encouraged. Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.
Where is nursing in academic nursing? Disciplinary discourses, identities and clinical practice: a critical perspective from Ireland.

PubMed

McNamara, Martin S

2010-03-01

To elicit the languages of legitimation of senior nursing academics and national leaders and to investigate the extent to which distinctive disciplinary identities and discourses are embedded in them. Over six years after Irish nursing education became established in the higher education sector, an investigation into the disciplinary maturity of the field is overdue. A constructivist-structuralist research design was used; data were elicited by means of naturalistic professional conversations and subjected to critical discourse analytic methods to interrogate their structuring and structured character. The focus here is on the latter. The languages of legitimation of Irish nursing's key disciplinary custodians were elicited and subjected to a critical discourse analysis informed by a theoretical framework that helps to explicate the bases of claims to academic legitimacy embedded in these languages. Clinical practice figures as a problematic component of Irish nursing's academic identity and disciplinary discourse. Yet a focus on clinical practice is seen as central to the autonomy, integrity and distinctiveness of nursing as an academic discipline as well as to the legitimacy and credibility of those who claim to profess it. The overall consensus on the state of academic nursing in Ireland is that of a field characterised by low autonomy, high density, weak specialisation and disciplinary immaturity. The analysis highlights the need for academic nursing to reconfigure its relationships with clinical nursing, increase its intellectual autonomy, enhance its internal coherence, strengthen the epistemic power of its knowledge base and critically evaluate the ways the past should inform current and future practices and identities. The production and dissemination of knowledge for nursing policy and practice provides the foundation for nursing education. If clinical practice is not central to the educational and research activities of nurse academics, the relevance of academic nursing to its professional base and its status and future trajectory as a distinct presence in academia, will continue to be questioned.
The role of mental health in the inmate disciplinary process: a national survey.

PubMed

Krelstein, Michael S

2002-01-01

An effective system of inmate discipline is an important aspect of a safely run prison or jail. Historically, mentally ill inmates have had few or no protections against discipline routinely applied to their non-mentally ill peers. Arising from recent class action lawsuits challenging the quality of mental health care delivery in the nation's prisons, prison mental health professionals have been called on to play an increasing role in the inmate disciplinary process. Referral questions include whether an inmate is competent to proceed with disciplinary proceedings and whether mental illness may have contributed to the rule violation. Prison mental health professionals participating in inmate disciplinary proceedings must therefore be familiar with relevant clinical, legal, and ethics issues. Little has been written in the psychiatric literature, however, examining this important role for prison mental health professionals. After first reviewing core legal and constitutional concepts, the author presents the results of a nationwide survey examining the role for mental health professionals in the inmate disciplinary process. To the author's knowledge, this is the first study to provide a comprehensive review of this subject.
Clinical evaluation of the radiolanthanide terbium-152: first-in-human PET/CT with 152Tb-DOTATOC.

PubMed

Baum, Richard P; Singh, Aviral; Benešová, Martina; Vermeulen, Christiaan; Gnesin, Silvano; Köster, Ulli; Johnston, Karl; Müller, Dirk; Senftleben, Stefan; Kulkarni, Harshad R; Türler, Andreas; Schibli, Roger; Prior, John O; van der Meulen, Nicholas P; Müller, Cristina

2017-10-31

The existence of theragnostic pairs of radionuclides allows the preparation of radiopharmaceuticals for diagnostic and therapeutic purposes. Radiolanthanides, such as 177 Lu, are successfully used for therapeutic purposes; however, a perfect diagnostic match is currently not available for clinical use. A unique, multi-disciplinary study was performed using 152 Tb (T 1/2 = 17.5 h, Eβ + average = 1140 keV, Iβ + = 20.3%), which resulted in the first-in-human PET/CT images with this promising radionuclide. For this purpose, 152 Tb was produced via a spallation process followed by mass separation at ISOLDE, CERN. The chemical separation and quality control, performed at PSI, resulted in a pure product in sufficient yields. Clinical PET phantom studies revealed an increased image noise level, because of the smaller β + branching ratio of 152 Tb as compared to standard PET nuclides at matched activity concentrations; however, the expected recovery would be comparable at matched signal-to-noise ratios in clinical PET. 152 Tb was used for labeling DOTATOC, at Zentralklinik Bad Berka, and administered to a patient for a first-in-human clinical study. PET scans were performed over a period of 24 h, allowing the visualization of even small metastases with increased tumor-to-background contrast over time. Based on the results obtained in this work, it can be deduced that PET/CT imaging with 152 Tb-labeled targeting agents has promise for clinical application and may be particularly interesting for pre-therapeutic dosimetry.
Comparative assessment of crash causal factors and IVHS countermeasures

DOT National Transportation Integrated Search

1994-01-01

The National Highway Traffic Safety Administrations Office of Crash Avoidance Research, in : conjunction with the Research and Special Programs Administrations Volpe National : Transportation Systems Center, has underway a multi-disciplinary pr...
Laying the Groundwork.

ERIC Educational Resources Information Center

Kretchmer, Mark R.

2000-01-01

Discusses how to avoid costly errors in high-tech retrofits through proper planning and coordination. Guidelines are offered for selecting cable installers, using multi-disciplinary consulting engineering firm, and space planning when making high-tech retrofits. (GR)
Amyloidosis involving the respiratory system: 5-year's experience of a multi-disciplinary group's activity.

PubMed

Scala, Raffaele; Maccari, Uberto; Madioni, Chiara; Venezia, Duccio; La Magra, Lidia Calogera

2015-01-01

Amyloidosis may involve the respiratory system with different clinical-radiological-functional patterns which are not always easy to be recognized. A good level of knowledge of the disease, an active integration of the pulmonologist within a multidisciplinary setting and a high level of clinical suspicion are necessary for an early diagnosis of respiratory amyloidosis. The aim of this retrospective study was to evaluate the number and the patterns of amyloidosis involving the respiratory system. We searched the cases of amyloidosis among patients attending the multidisciplinary rare and diffuse lung disease outpatients' clinic of Pulmonology Unit of the Hospital of Arezzo from 2007 to 2012. Among the 298 patients evaluated during the study period, we identified three cases of amyloidosis with involvement of the respiratory system, associated or not with other extra-thoracic localizations, whose diagnosis was histo-pathologically confirmed after the pulmonologist, the radiologist, and the pathologist evaluation. Our experience of a multidisciplinary team confirms that intra-thoracic amyloidosis is an uncommon disorder, representing 1.0% of the cases of rare and diffuse lung diseases referred to our center. The diagnosis of the disease is not always easy and quick as the amyloidosis may involve different parts of the respiratory system (airways, pleura, parenchyma). It is therefore recommended to remind this orphan disease in the differential diagnosis of the wide clinical scenarios the pulmonologist may intercept in clinical practice.
Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

PubMed

Randall-James, James; Coles, Steven

2018-02-08

The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.
Amyloidosis involving the respiratory system: 5-year's experience of a multi-disciplinary group's activity

PubMed Central

Scala, Raffaele; Maccari, Uberto; Madioni, Chiara; Venezia, Duccio; La Magra, Lidia Calogera

2015-01-01

Amyloidosis may involve the respiratory system with different clinical-radiological-functional patterns which are not always easy to be recognized. A good level of knowledge of the disease, an active integration of the pulmonologist within a multidisciplinary setting and a high level of clinical suspicion are necessary for an early diagnosis of respiratory amyloidosis. The aim of this retrospective study was to evaluate the number and the patterns of amyloidosis involving the respiratory system. We searched the cases of amyloidosis among patients attending the multidisciplinary rare and diffuse lung disease outpatients' clinic of Pulmonology Unit of the Hospital of Arezzo from 2007 to 2012. Among the 298 patients evaluated during the study period, we identified three cases of amyloidosis with involvement of the respiratory system, associated or not with other extra-thoracic localizations, whose diagnosis was histo-pathologically confirmed after the pulmonologist, the radiologist, and the pathologist evaluation. Our experience of a multidisciplinary team confirms that intra-thoracic amyloidosis is an uncommon disorder, representing 1.0% of the cases of rare and diffuse lung diseases referred to our center. The diagnosis of the disease is not always easy and quick as the amyloidosis may involve different parts of the respiratory system (airways, pleura, parenchyma). It is therefore recommended to remind this orphan disease in the differential diagnosis of the wide clinical scenarios the pulmonologist may intercept in clinical practice. PMID:26229565
The Study on Collaborative Manufacturing Platform Based on Agent

NASA Astrophysics Data System (ADS)

Zhang, Xiao-yan; Qu, Zheng-geng

To fulfill the trends of knowledge-intensive in collaborative manufacturing development, we have described multi agent architecture supporting knowledge-based platform of collaborative manufacturing development platform. In virtue of wrapper service and communication capacity agents provided, the proposed architecture facilitates organization and collaboration of multi-disciplinary individuals and tools. By effectively supporting the formal representation, capture, retrieval and reuse of manufacturing knowledge, the generalized knowledge repository based on ontology library enable engineers to meaningfully exchange information and pass knowledge across boundaries. Intelligent agent technology increases traditional KBE systems efficiency and interoperability and provides comprehensive design environments for engineers.
The MAPP research network: a novel study of urologic chronic pelvic pain syndromes

PubMed Central

2014-01-01

Urologic chronic pelvic pain syndrome (UCPPS) may be defined to include interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The hallmark symptom of UCPPS is chronic pain in the pelvis, urogenital floor, or external genitalia often accompanied by lower urinary tract symptoms. Despite numerous past basic and clinical research studies there is no broadly identifiable organ-specific pathology or understanding of etiology or risk factors for UCPPS, and diagnosis relies primarily on patient reported symptoms. In addition, there are no generally effective therapies. Recent findings have, however, revealed associations between UCPPS and “centralized” chronic pain disorders, suggesting UCPPS may represent a local manifestation of more widespread pathology in some patients. Here, we describe a new and novel effort initiated by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the U.S. National Institutes of Health (NIH) to address the many long standing questions regarding UCPPS, the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. The MAPP Network approaches UCPPS in a systemic manner, in which the interplay between the genitourinary system and other physiological systems is emphasized. The network’s study design expands beyond previous research, which has primarily focused on urologic organs and tissues, to utilize integrated approaches to define patient phenotypes, identify clinically-relevant subgroups, and better understand treated natural history and pathophysiology. Thus, the MAPP Network provides an unprecedented, multi-layered characterization of UCPPS. Knowledge gained is expected to provide important insights into underlying pathophysiology, a foundation for better segmenting patients for future clinical trials, and ultimately translation into improved clinical management. In addition, the MAPP Network’s integrated multi-disciplinary research approach may serve as a model for studies of urologic and non-urologic disorders that have proven refractory to past basic and clinical study. Trial registration ClinicalTrials.gov identifier: NCT01098279 “Chronic Pelvic Pain Study of Individuals with Diagnoses or Symptoms of Interstitial Cystitis and/or Chronic Prostatitis (MAPP-EP)”. PMID:25085007
A Cross-Sectional Study of the Psychological Needs of Adults Living with Cystic Fibrosis

PubMed Central

Pakhale, Smita; Baron, Justine; Armstrong, Michael; Tasca, Georgio; Gaudet, Ena; Aaron, Shawn; Cameron, William; Balfour, Louise

2015-01-01

Background Depression and anxiety are prevalent in people with cystic fibrosis (CF), yet psychological services are rarely accessible in CF clinics. This cross-sectional single center study reports on a psychological needs assessment of people with CF. Methods We asked adults attending a CF clinic, without integrated psychological services, to complete a psychological needs assessment survey that included items on: a) past access to psychological services (via a CF referral service), b) concerns relevant to discuss with a psychologist, and c) their likelihood of accessing psychological services if available at the CF clinic, and standardized measures of depression (CES-D) and anxiety (GAD-7). Results We enrolled 49 participants and 45 (91.8%) completed the survey. Forty percent reported elevated symptoms of depression and 13% had elevated anxiety. A majority of individuals (72.2% and 83.3%, respectively) indicated they would be likely to use psychological services, if available at the clinic. Concerns considered most relevant to discuss with a psychologist were: 1) worries (51.1%), 2) mood (44.4%), 3) life stress (46.6%), 4) adjustment to CF (42.2%), 5) life transitions (42.2%) and 6) quality of life (42.2%). Conclusions This study highlights the rationale for screening adults with CF for depression and anxiety, and to facilitate provision of psychological services and preventative mental health interventions as an integral component of multi-disciplinary CF care. PMID:26102351
An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases.

PubMed

Doğan, Mehmet-Sinan; Callea, Michele; Yavuz, Ìzzet; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayse; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

2015-05-01

This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clinical examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved.
Multi-Disciplinary System Reliability Analysis

NASA Technical Reports Server (NTRS)

Mahadevan, Sankaran; Han, Song

1997-01-01

The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code developed under the leadership of NASA Lewis Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multi-disciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.
Disciplinary supervision following ethics complaints: goals, tasks, and ethical dimensions.

PubMed

Thomas, Janet T

2014-11-01

Clinical supervision is considered an integral component of the training of psychologists, and most of the professional literature is focused on this type of supervision. But psychologists also may supervise fully credentialed colleagues in other circumstances. One such context occurs when licensing boards mandate supervision as part of a disciplinary order. When supervision is provided in disciplinary cases, there are significant implications for the ethical dimensions of the supervisory relationship and concomitant ethical challenges for supervisors. Not only are the goals, objectives, and supervisory tasks of disciplinary supervision distinct from other types of supervision, but the supervisor's ethical responsibilities also encompass unique dimensions. Competence, informed consent, boundaries, confidentiality, and documentation are examined. Recommendations for reports to licensing boards include a statement of the clinical or ethical problems instigating discipline, description of how these problems have been addressed, and an assessment of the supervisee's current practices and ability to perform competently. © 2014 Wiley Periodicals, Inc.
Evaluation of educational preparation for cancer and palliative care nursing for children and adolescents in England.

PubMed

Long, Tony; Hale, Claire; Sanderson, Linda; Tomlinson, Peter; Carr, Kristina

2008-02-01

This paper reports the findings of a study which was carried out to evaluate the educational preparation of cancer and palliative care nurses in England. The study was carried out in three stages and covered the following areas; documentary analysis of curriculae, assessment of practice, patients and professionals views of threshold and expert practice. The findings suggested that although there was widespread compliance with a national standard for cancer nursing, this was not the case for palliative care nursing. There was uncertainty about what should be assessed in practice and ambiguity about what was actually assessed. Partnership with children and their parents, clinical skills, multi-disciplinary working, and personal attributes were the main foci for expectations of threshold practice but an expert panel had difficulty in describing the attributes of higher level practice. The paper also describes how some of recommendations from the study are being taken forward in current policy and practice.
A multi-disciplinary approach to the removal of emerging contaminants in municipal wastewater treatment plans in New York State, 2003-2004

USGS Publications Warehouse

Philips, Patrick J.; Stinson, Beverley; Zaugg, Steven D.; Furlong, Edward T.; Kolpin, Dana W.; Esposito, Kathleen; Bodniewicz, B.; Pape, R.; Anderson, J.

2005-01-01

The second phase of the study focused on one of the most common wastewater treatment processes operated in the United States, the Activated Sludge process. Using four controlled parallel activated sludge pilots, a more detailed assessment of the impact of Sludge Retention Time (SRT) on the reduction or removal of ECs was performed.
[Accepting a mastectomy thanks to socio-aesthetics].

PubMed

Arquillière, Agnès; Blanc, Nathalie

2012-12-01

For women of all ages, a mastectomy can affect their body image and femininity. Poor management, both physical and emotional, of a breast removal, can have major consequences on a patient's intimate, family and social life. In the framework of the multi-disciplinary treatment of breast cancer, a team in Lyon carried out a study on the impact of including socio-aesthetic practices in the overall care.

[Anorexia and refusal to eat in the elderly].

PubMed

Hazif-Thomas, Cyril; Thomas, Philippe

2016-01-01

The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential. Copyright © 2015. Published by Elsevier Masson SAS.
Introduction to the Arizona Sky Island Arthropod Project (ASAP): Systematics, biogeography, ecology, and population genetics of arthropods of the Madrean Sky Islands

Treesearch

Wendy Moore; Wallace M. Meyer; Jeffrey A. Eble; Kimberly Franklin; John F. Wiens; Richard C. Brusca

2013-01-01

The Arizona Sky Island Arthropod Project (ASAP) is a new multi-disciplinary research program at the University of Arizona that combines systematics, biogeography, ecology, and population genetics to study origins and patterns of arthropod diversity along elevation gradients and among mountain ranges in the Madrean Sky Island Region. Arthropods represent taxonomically...
Virtopsy: Touch-free autopsy

PubMed Central

Badam, Raj Kumar; Sownetha, Triekan; Babu, D. B. Gandhi; Waghray, Shefali; Reddy, Lavanya; Garlapati, Komali; Chavva, Sunanda

2017-01-01

The word “autopsy” denotes “to see with own eyes.” Autopsy (postmortem) is a process that includes a thorough examination of a corpse noting everything related to anatomization, surface wounds, histological and culture studies. Virtopsy is a term extracted from two words “virtual” and “autopsy.” It employs imaging methods that are routinely used in clinical medicine such as computed tomography and magnetic resonance imaging in the field of autopsy, to find the reason for death. Virtopsy is a multi-disciplinary technology that combines forensic medicine and pathology, roentgenology, computer graphics, biomechanics, and physics. It is rapidly gaining importance in the field of forensics. This approach has been recently used by forensic odontologists, but yet to make its own mark in the field. This article mainly deals with “virtopsy” where in various articles were web searched, relevant data was selected, extracted, and summarized here. PMID:28584475
Providing an integrated clinical data view in a hospital information system that manages multimedia data.

PubMed

Dayhoff, R E; Maloney, D L; Kenney, T J; Fletcher, R D

1991-01-01

The VA's hospital information system, the Decentralized Hospital Computer Program (DHCP), is an integrated system based on a powerful set of software tools with shared data accessible from any of its application modules. It includes many functionally specific application subsystems such as laboratory, pharmacy, radiology, and dietetics. Physicians need applications that cross these application boundaries to provide useful and convenient patient data. One of these multi-specialty applications, the DHCP Imaging System, integrates multimedia data to provide clinicians with comprehensive patient-oriented information. User requirements for cross-disciplinary image access can be studied to define needs for similar text data access. Integration approaches must be evaluated both for their ability to deliver patient-oriented text data rapidly and their ability to integrate multimedia data objects. Several potential integration approaches are described as they relate to the DHCP Imaging System.
Providing an integrated clinical data view in a hospital information system that manages multimedia data.

PubMed Central

Dayhoff, R. E.; Maloney, D. L.; Kenney, T. J.; Fletcher, R. D.

1991-01-01

The VA's hospital information system, the Decentralized Hospital Computer Program (DHCP), is an integrated system based on a powerful set of software tools with shared data accessible from any of its application modules. It includes many functionally specific application subsystems such as laboratory, pharmacy, radiology, and dietetics. Physicians need applications that cross these application boundaries to provide useful and convenient patient data. One of these multi-specialty applications, the DHCP Imaging System, integrates multimedia data to provide clinicians with comprehensive patient-oriented information. User requirements for cross-disciplinary image access can be studied to define needs for similar text data access. Integration approaches must be evaluated both for their ability to deliver patient-oriented text data rapidly and their ability to integrate multimedia data objects. Several potential integration approaches are described as they relate to the DHCP Imaging System. PMID:1807651
Expanding Access to HCV Treatment - Extension for Community Healthcare Outcomes (ECHO) Project: Disruptive Innovation in Specialty Care

PubMed Central

Arora, Sanjeev; Kalishman, Summers; Thornton, Karla; Dion, Denise; Murata, Glen; Deming, Paulina; Parish, Brooke; Brown, John; Komaromy, Miriam; Colleran, Kathleen; Bankhurst, Arthur; Katzman, Joanna; Harkins, Michelle; Curet, Luis; Cosgrove, Ellen; Pak, Wesley

2013-01-01

The Extension for Community Healthcare Outcomes (ECHO) Model was developed by the University of New Mexico Health Sciences Center (UNMHSC) as a platform to deliver complex specialty medical care to underserved populations through an innovative educational model of team-based inter-disciplinary development. Using state-of-the-art telehealth technology, best practice protocols, and case based learning, ECHO trains and supports primary care providers to develop knowledge and self-efficacy on a variety of diseases. As a result, they can deliver best practice care for complex health conditions in communities where specialty care is unavailable. ECHO was first developed for the management of hepatitis C virus (HCV), optimal management of which requires consultation with multi-disciplinary experts in medical specialties, mental health and substance abuse. Few practitioners, particularly in rural and underserved areas, have the knowledge to manage its emerging treatment options, side effects, drug toxicities and treatment-induced depression. In addition data was obtained from observation of ECHO weekly clinics and database of ECHO clinic participation and patient presentations by clinical provider, evaluation of the ECHO program incorporates annual survey integrated into the ECHO annual meeting and routine surveys of community providers about workplace learning, personal and professional experiences, systems and environmental factors associated with professional practice, self-efficacy, facilitators and barriers to ECHO. The initial survey data show a significant improvement in provider knowledge, self-efficacy and professional satisfaction through participation in ECHO HCV clinics. Clinicians reported a moderate to major benefit from participation. We conclude that ECHO expands access to best practice care for underserved populations, builds communities of practice to enhance professional development and satisfaction of primary care clinicians, and expands sustainable capacity for care by building local centers of excellence. PMID:20607688
The emergent discipline of health web science.

PubMed

Luciano, Joanne S; Cumming, Grant P; Wilkinson, Mark D; Kahana, Eva

2013-08-22

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large. Discussions about the clinical and health research implications of the widespread adoption of information technologies, including the Internet, have been subsumed under the disciplinary label of Medicine 2.0. More recently, however, multi-disciplinary research has emerged that is focused on the achievement and promise of the Web itself, as it relates to healthcare issues. In this paper, we explore and interrogate the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. From this, we introduce Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0. This paper builds on the presentations and subsequent interdisciplinary dialogue that developed among Web-oriented investigators present at the 2012 Medicine 2.0 Conference in Boston, Massachusetts.
The Emergent Discipline of Health Web Science

PubMed Central

2013-01-01

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large. Discussions about the clinical and health research implications of the widespread adoption of information technologies, including the Internet, have been subsumed under the disciplinary label of Medicine 2.0. More recently, however, multi-disciplinary research has emerged that is focused on the achievement and promise of the Web itself, as it relates to healthcare issues. In this paper, we explore and interrogate the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. From this, we introduce Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0. This paper builds on the presentations and subsequent interdisciplinary dialogue that developed among Web-oriented investigators present at the 2012 Medicine 2.0 Conference in Boston, Massachusetts. PMID:23968998
Pharmacists subjected to disciplinary action: characteristics and risk factors.

PubMed

Phipps, Denham L; Noyce, Peter R; Walshe, Kieran; Parker, Dianne; Ashcroft, Darren M

2011-10-01

OBJECTIVE To establish whether there are any characteristics of pharmacists that predict their likelihood of being subjected to disciplinary action. METHODS The setting was the Royal Pharmaceutical Society of Great Britain's Disciplinary Committee. One hundred and seventeen pharmacists, all of whom had been referred to the Disciplinary Committee, were matched with a quota sample of 580 pharmacists who had not been subjected to disciplinary action but that matched the disciplined pharmacists on a set of demographic factors (gender, country of residence, year of registration). Frequency analysis and regression analysis were used to compare the two groups of pharmacists in terms of sector of work, ethnicity, age and country of training. Descriptive statistics were also obtained from the disciplined pharmacists to further explore characteristics of disciplinary cases and those pharmacists who undergo them. KEY FINDINGS While a number of characteristics appeared to increase the likelihood of a pharmacist being referred to the disciplinary committee, only one of these - working in a community pharmacy - was statistically significant. Professional misconduct accounted for a greater proportion of referrals than did clinical malpractice, and approximately one-fifth of pharmacists who went before the Disciplinary Committee had previously been disciplined by the Society. CONCLUSIONS This study provides initial evidence of pharmacist characteristics that are associated with an increased risk of being disciplined, based upon the data currently available. It is recommended that follow-up work is carried out using a more extensive dataset in order to confirm the statistical trends identified here. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.
The Use of Silviculture and Prescribed Fire to Manage Stand Structure and Fuel Profiles in a Multi-aged Lodgepole Pine Forest

Treesearch

Colin C. Hardy; Helen Y. Smith; Ward McCaughey

2006-01-01

This paper presents several components of a multi-disciplinary project designed to evaluate the ecological and biological effects of two innovative silvicultural treatments coupled with prescribed fire in an attempt to both manage fuel profiles and create two-aged stand structures in lodgepole pine. Two shelterwood silvicultural treatments were designed to replicate as...
An audit of the nature and impact of clinical coding subjectivity variability and error in otolaryngology.

PubMed

Nouraei, S A R; Hudovsky, A; Virk, J S; Chatrath, P; Sandhu, G S

2013-12-01

To audit the accuracy of clinical coding in otolaryngology, assess the effectiveness of previously implemented interventions, and determine ways in which it can be further improved. Prospective clinician-auditor multidisciplinary audit of clinical coding accuracy. Elective and emergency ENT admissions and day-case activity. Concordance between initial coding and the clinician-auditor multi-disciplinary teams (MDT) coding in respect of primary and secondary diagnoses and procedures, health resource groupings health resource groupings (HRGs) and tariffs. The audit of 3131 randomly selected otolaryngology patients between 2010 and 2012 resulted in 420 instances of change to the primary diagnosis (13%) and 417 changes to the primary procedure (13%). In 1420 cases (44%), there was at least one change to the initial coding and 514 (16%) health resource groupings changed. There was an income variance of £343,169 or £109.46 per patient. The highest rates of health resource groupings change were observed in head and neck surgery and in particular skull-based surgery, laryngology and within that tracheostomy, and emergency admissions, and specially, epistaxis management. A randomly selected sample of 235 patients from the audit were subjected to a second audit by a second clinician-auditor multi-disciplinary team. There were 12 further health resource groupings changes (5%) and at least one further coding change occurred in 57 patients (24%). These changes were significantly lower than those observed in the pre-audit sample, but were also significantly greater than zero. Asking surgeons to 'code in theatre' and applying these codes without further quality assurance to activity resulted in an health resource groupings error rate of 45%. The full audit sample was regrouped under health resource groupings 3.5 and was compared with a previous audit of 1250 patients performed between 2007 and 2008. This comparison showed a reduction in the baseline rate of health resource groupings change from 16% during the first audit cycle to 9% in the current audit cycle (P < 0.001). Otolaryngology coding is complex and susceptible to subjectivity, variability and error. Coding variability can be improved, but not eliminated through regular education supported by an audit programme. © 2013 John Wiley & Sons Ltd.
Developing translational research infrastructure and capabilities associated with cancer clinical trials.

PubMed

Hall, Jacqueline A; Brown, Robert

2013-09-27

The integration of molecular information in clinical decision making is becoming a reality. These changes are shaping the way clinical research is conducted, and as reality sets in, the challenges in conducting, managing and organising multi-disciplinary research become apparent. Clinical trials provide a platform to conduct translational research (TR) within the context of high quality clinical data accrual. Integrating TR objectives in trials allows the execution of pivotal studies that provide clinical evidence for biomarker-driven treatment strategies, targeting early drug development trials to a homogeneous and well defined patient population, supports the development of companion diagnostics and provides an opportunity for deepening our understanding of cancer biology and mechanisms of drug action. To achieve these goals within a clinical trial, developing translational research infrastructure and capabilities (TRIC) plays a critical catalytic role for translating preclinical data into successful clinical research and development. TRIC represents a technical platform, dedicated resources and access to expertise promoting high quality standards, logistical and operational support and unified streamlined procedures under an appropriate governance framework. TRIC promotes integration of multiple disciplines including biobanking, laboratory analysis, molecular data, informatics, statistical analysis and dissemination of results which are all required for successful TR projects and scientific progress. Such a supporting infrastructure is absolutely essential in order to promote high quality robust research, avoid duplication and coordinate resources. Lack of such infrastructure, we would argue, is one reason for the limited effect of TR in clinical practice beyond clinical trials.
A national appraisal of haemodialysis vascular access provision in Scotland.

PubMed

Oliver, Scott W; Campbell, Jacqueline; Kingsmore, David B; Kasthuri, Ram; Metcalfe, Wendy; Traynor, Jamie P; Fischbacher-Smith, Denis; Jardine, Alan G; Thomson, Peter C

2017-03-21

Published registry data demonstrate longstanding variation in the utilisation of different vascular access (VA) modalities between Scottish renal units; this may reflect different clinical processes between centres. A comprehensive appraisal was undertaken to understand the processes underpinning VA creation and maintenance across Scotland. A mixed methods approach was utilised. Fifty-two semi-structured interviews were conducted with patients and clinicians in all ten, adult and paediatric, Scottish renal units. Interview transcripts were subjected to thematic analysis. Clinical activity data were prospectively collected for six weeks, and correlated with registry data. VA accounts for a large clinical workload. There was significant inter-centre variation in the utilisation of different VA modalities, and patients described frustrating, dissatisfying experiences. VA creation and maintenance pathways functioned best when nephrologists, surgeons and radiologists were co-located on the same campus with close multi-disciplinary working, protected clinical time, and proactive VA maintenance. No unit routinely measured or discussed procedure outcomes or strategic aspects of their service. Varied clinical outcomes reflected varied clinical processes. Optimised clinical pathways, staff education and measurement of clinical outcomes may improve VA service quality and facilitate safer, more effective, patient-centred care.
Brain Tumor Epidemiology Consortium (BTEC)

Cancer.gov

The Brain Tumor Epidemiology Consortium is an open scientific forum organized to foster the development of multi-center, international and inter-disciplinary collaborations that will lead to a better understanding of the etiology, outcomes, and prevention of brain tumors.
Applying Theory across Settings, Behaviors and Populations: Translational Challenges and Opportunities

PubMed Central

Mermelstein, Robin J.; Revenson, Tracey A.

2013-01-01

Basic social psychological theories have much to contribute to our understanding of health problems and health-related behaviors and may provide potential avenues for intervention development. However, for these theories to have broader reach and applicability to the field of health psychology, more work needs to be done in integrating contexts into these theories and addressing more specifically their application across settings, behaviors, and populations. We argue that integration of these theories into a broader multi-disciplinary and multi-level ecological framework is needed to enhance their translation into real-world applications. To enhance this translation, we make several recommendations, including breaking down silos between disciplinary perspectives and enhancing bidirectional communication and translation; analyzing boundary conditions of theories; expanding research approaches to move outside the laboratory and maintain a focus on external validity; and conducting efficacy testing of theories with meaningful, relevant endpoints. PMID:23646843
Reduction of Thoroughbred racing fatalities at New York Racing Association racetracks using a multi-disciplinary mortality review process.

PubMed

Palmer, Scott E; McDonough, Sean P; Mohammed, Hussni O

2017-07-01

Between January 1, 2013 and December 31, 2015, findings of a New York State Gaming Commission-Cornell University postmortem examination program were utilized in a multi-disciplinary mortality review process to review 129 racing fatalities at Thoroughbred racetracks operated by the New York Racing Association (NYRA). Musculoskeletal fractures comprised 79% of the fatalities; cardiopulmonary conditions accounted for 12% of the fatalities. Other causes of death included gastrointestinal (3%), respiratory (5%), and central nervous system (2%) conditions. Fetlock failure represented 50% of the musculoskeletal fatalities. The general distribution of these findings was very similar to that reported by the California Animal Health and Food Safety Laboratory System during the same period. These findings, used in conjunction with a comprehensive mortality review process and regulatory reform, have contributed to a significant reduction of the incidence of Thoroughbred racing fatalities at NYRA racetracks during the period of this review.
Disciplinary power and the process of training informal carers on stroke units.

PubMed

Sadler, Euan; Hawkins, Rebecca; Clarke, David J; Godfrey, Mary; Dickerson, Josie; McKevitt, Christopher

2018-01-01

This article examines the process of training informal carers on stroke units using the lens of power. Care is usually assumed as a kinship obligation but the state has long had an interest in framing the carer and caring work. Training carers in healthcare settings raises questions about the power of the state and healthcare professionals as its agents to shape expectations and practices related to the caring role. Drawing on Foucault's notion of disciplinary power, we show how disciplinary forms of power exercised in interactions between healthcare professionals and carers shape the engagement and resistance of carers in the process of training. Interview and observational field note extracts are drawn from a multi-sited study of a training programme on stroke units targeting family carers of people with stroke to consider the consequences of subjecting caring to this intervention. We found that the process of training informal carers on stroke units was not simply a matter of transferring skills from professional to lay person, but entailed disciplinary forms of power intended to shape the conduct of the carer. We interrogate the extent to which a specific kind of carer is produced through such an approach, and the wider implications for the participation of carers in training in healthcare settings and the empowerment of carers. © 2017 Foundation for the Sociology of Health & Illness.
Improving Interoperability between Registries and EHRs

PubMed Central

Blumenthal, Seth

2018-01-01

National performance measurement needs clinical data that track the performance of multi disciplinary teams across episodes of care. Clinical registries are ideal platforms for this work due to their capture of structured, specific data across specialties. Because registries collect data at a national level, and registry data are captured in a consistent structure and format within each registry, registry data are useful for measurement and analysis “out of the box”. Registry business models are hampered by the cost of collecting data from EHRs and other source systems and abstracting or mapping them to fit registry data models. The National Quality Registry Network (NQRN) has launched Registries on FHIR, an initiative to lower barriers to achieving semantic interoperability between registries and source data systems. In 2017 Registries on FHIR conducted an information gathering campaign to learn where registries want better interoperability, and how to go about improving it. PMID:29888033
Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) Trial: Design and Rationale

PubMed Central

Reeves, Gordon R.; Whellan, David J.; Duncan, Pamela; O’Connor, Christopher M.; Pastva, Amy M.; Eggebeen, Joel D; Hewston, Leigh Ann; Morgan, Timothy M.; Reed, Shelby D.; Rejeski, W. Jack; Mentz, Robert J.; Rosenberg, Paul B.; Kitzman, Dalane W.

2017-01-01

Background Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. Hypothesis Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. Study Design Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) is a multi-center clinical trial in which 360 patients ≥ 60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. Conclusions REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities. PMID:28267466
Clinical trial designs for rare diseases: Studies developed and discussed by the International Rare Cancers Initiative

PubMed Central

Bogaerts, Jan; Sydes, Matthew R.; Keat, Nicola; McConnell, Andrea; Benson, Al; Ho, Alan; Roth, Arnaud; Fortpied, Catherine; Eng, Cathy; Peckitt, Clare; Coens, Corneel; Pettaway, Curtis; Arnold, Dirk; Hall, Emma; Marshall, Ernie; Sclafani, Francesco; Hatcher, Helen; Earl, Helena; Ray-Coquard, Isabelle; Paul, James; Blay, Jean-Yves; Whelan, Jeremy; Panageas, Kathy; Wheatley, Keith; Harrington, Kevin; Licitra, Lisa; Billingham, Lucinda; Hensley, Martee; McCabe, Martin; Patel, Poulam M.; Carvajal, Richard; Wilson, Richard; Glynne-Jones, Rob; McWilliams, Rob; Leyvraz, Serge; Rao, Sheela; Nicholson, Steve; Filiaci, Virginia; Negrouk, Anastassia; Lacombe, Denis; Dupont, Elisabeth; Pauporté, Iris; Welch, John J.; Law, Kate; Trimble, Ted; Seymour, Matthew

2015-01-01

Background The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research. Settings The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional – usually randomised – clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed. Results The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design. Interpretation Trials can be designed using a wide array of possibilities. There is no ‘one size fits all’ solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases. PMID:25542058

Linking urban families to community resources in the context of pediatric primary care.

PubMed

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

2010-05-01

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

PubMed

Bogaerts, Jan; Sydes, Matthew R; Keat, Nicola; McConnell, Andrea; Benson, Al; Ho, Alan; Roth, Arnaud; Fortpied, Catherine; Eng, Cathy; Peckitt, Clare; Coens, Corneel; Pettaway, Curtis; Arnold, Dirk; Hall, Emma; Marshall, Ernie; Sclafani, Francesco; Hatcher, Helen; Earl, Helena; Ray-Coquard, Isabelle; Paul, James; Blay, Jean-Yves; Whelan, Jeremy; Panageas, Kathy; Wheatley, Keith; Harrington, Kevin; Licitra, Lisa; Billingham, Lucinda; Hensley, Martee; McCabe, Martin; Patel, Poulam M; Carvajal, Richard; Wilson, Richard; Glynne-Jones, Rob; McWilliams, Rob; Leyvraz, Serge; Rao, Sheela; Nicholson, Steve; Filiaci, Virginia; Negrouk, Anastassia; Lacombe, Denis; Dupont, Elisabeth; Pauporté, Iris; Welch, John J; Law, Kate; Trimble, Ted; Seymour, Matthew

2015-02-01

The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research. The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed. The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design. Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Development of Integrative STEM Curriculum: A Multiple Case Study of Multi-Disciplinary Teams in Two Pennsylvania High Schools

NASA Astrophysics Data System (ADS)

Rider-Bertrand, Joey H.

At the start of the 21st century, STEM education was a new priority in many schools as the focus shifted from separate disciplines to integrative STEM education. Unfortunately, there was limited research to offer guidance to practitioners (Brown, 2012; Honey, Pearson & Schweingruber, 2014). This qualitative, multiple case study explored the experiences of two multi-disciplinary teams of secondary teachers from Pennsylvania who developed and implemented integrative STEM curriculum. Four teachers from a rural high school and four teachers from a suburban high school participated in the study. A document review of integrative STEM curriculum and semi-structured interviews were conducted to learn about the curriculum development process and teachers' perceptions regarding conditions that support or hinder success. Individual and cross-case analyses were performed to establish findings and themes. Although the individual case themes varied slightly, the cross-case themes and assertions that emerged provided highly sought after guidance to practitioners and added to the limited body of research on integrative STEM education. This study found that current curriculum models do not fit integrative STEM curriculum, the development process is fluid, and substantial administrative support and resources are necessary to develop, implement, and sustain integrative STEM education programs. The results offered implications for all educators, as well as two examples of how teachers navigated the terrain of integrative STEM curriculum.
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
Risk-based analysis and decision making in multi-disciplinary environments

NASA Technical Reports Server (NTRS)

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

2003-01-01

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

PubMed

Barley, Elizabeth A; Murray, Joanna; Churchill, Rachel

2009-12-01

Clinicians report difficulties using research in their practices. The aim of the study was to describe needs and preferences for a mental health clinical question-answering service designed to assist this process. Multi-disciplinary clinicians participated in a focus group; users of the service supplied feedback. Fifty-four clinicians received answers to 84 questions about mental health treatments. User ratings showed that the answers had multiple uses: informing health care (43), education (22), staff development (28) and research (12), and were considered useful, clear, relevant and helpful. Focus group participants appreciated critically appraised summaries of evidence and stressed the time-saving benefit of the service. Clinicians without a medical training were least confident in applying evidence. Attitudes to research were positive, but concern was expressed about its potential misuse for political purposes. This appeared to arise from an ambiguity around the term 'insufficient evidence', which participants felt is widely misinterpreted as 'evidence of no effect'. A highly valued, responsive service has been developed. A range of clinicians find critically appraised summaries of research useful. Education about the use of research may help clinicians to be more evidence based.
Progress in the Visualization and Mining of Chemical and Target Spaces.

PubMed

Medina-Franco, José L; Aguayo-Ortiz, Rodrigo

2013-12-01

Chemogenomics is a growing field that aims to integrate the chemical and target spaces. As part of a multi-disciplinary effort to achieve this goal, computational methods initially developed to visualize the chemical space of compound collections and mine single-target structure-activity relationships, are being adapted to visualize and mine complex relationships in chemogenomics data sets. Similarly, the growing evidence that clinical effects are many times due to the interaction of single or multiple drugs with multiple targets, is encouraging the development of novel methodologies that are integrated in multi-target drug discovery endeavors. Herein we review advances in the development and application of approaches to generate visual representations of chemical space with particular emphasis on methods that aim to explore and uncover relationships between chemical and target spaces. Also, progress in the data mining of the structure-activity relationships of sets of compounds screened across multiple targets are discussed in light of the concept of activity landscape modeling. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Academic Cross-Pollination: The Role of Disciplinary Affiliation in Research Collaboration

PubMed Central

Dhand, Amar; Luke, Douglas A.; Carothers, Bobbi J.; Evanoff, Bradley A.

2016-01-01

Academic collaboration is critical to knowledge production, especially as teams dominate scientific endeavors. Typical predictors of collaboration include individual characteristics such as academic rank or institution, and network characteristics such as a central position in a publication network. The role of disciplinary affiliation in the initiation of an academic collaboration between two investigators deserves more attention. Here, we examine the influence of disciplinary patterns on collaboration formation with control of known predictors using an inferential network model. The study group included all researchers in the Institute of Clinical and Translational Sciences (ICTS) at Washington University in St. Louis. Longitudinal data were collected on co-authorships in grants and publications before and after ICTS establishment. Exponential-family random graph models were used to build the network models. The results show that disciplinary affiliation independently predicted collaboration in grant and publication networks, particularly in the later years. Overall collaboration increased in the post-ICTS networks, with cross-discipline ties occurring more often than within-discipline ties in grants, but not publications. This research may inform better evaluation models of university-based collaboration, and offer a roadmap to improve cross-disciplinary collaboration with discipline-informed network interventions. PMID:26760302
Summary and Recommendations from the National Cancer Institute’s Clinical Trials Planning Meeting on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer

PubMed Central

Lerner, Seth P.; Bajorin, Dean F.; Dinney, Colin P.; Efstathiou, Jason A.; Groshen, Susan; Hahn, Noah M.; Hansel, Donna; Kwiatkowski, David; O’Donnell, Michael; Rosenberg, Jonathan; Svatek, Robert; Abrams, Jeffrey S.; Al-Ahmadie, Hikmat; Apolo, Andrea B.; Bellmunt, Joaquim; Callahan, Margaret; Cha, Eugene K.; Drake, Charles; Jarow, Jonathan; Kamat, Ashish; Kim, William; Knowles, Margaret; Mann, Bhupinder; Marchionni, Luigi; McConkey, David; McShane, Lisa; Ramirez, Nilsa; Sharabi, Andrew; Sharpe, Arlene H.; Solit, David; Tangen, Catherine M.; Amiri, Abdul Tawab; Van Allen, Eliezer; West, Pamela J.; Witjes, J. A.; Quale, Diane Zipursky

2016-01-01

The NCI Bladder Cancer Task Force convened a Clinical Trials Planning Meeting (CTPM) Workshop focused on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer (NMIBC). Meeting attendees included a broad and multi-disciplinary group of clinical and research stakeholders and included leaders from NCI, FDA, National Clinical Trials Network (NCTN), advocacy and the pharmaceutical and biotech industry. The meeting goals and objectives were to: 1) create a collaborative environment in which the greater bladder research community can pursue future optimally designed novel clinical trials focused on the theme of molecular targeted and immune-based therapies in NMIBC; 2) frame the clinical and translational questions that are of highest priority; and 3) develop two clinical trial designs focusing on immunotherapy and molecular targeted therapy. Despite successful development and implementation of large Phase II and Phase III trials in bladder and upper urinary tract cancers, there are no active and accruing trials in the NMIBC space within the NCTN. Disappointingly, there has been only one new FDA approved drug (Valrubicin) in any bladder cancer disease state since 1998. Although genomic-based data for bladder cancer are increasingly available, translating these discoveries into practice changing treatment is still to come. Recently, major efforts in defining the genomic characteristics of NMIBC have been achieved. Aligned with these data is the growing number of targeted therapy agents approved and/or in development in other organ site cancers and the multiple similarities of bladder cancer with molecular subtypes in these other cancers. Additionally, although bladder cancer is one of the more immunogenic tumors, some tumors have the ability to attenuate or eliminate host immune responses. Two trial concepts emerged from the meeting including a window of opportunity trial (Phase 0) testing an FGFR3 inhibitor and a second multi-arm multi-stage trial testing combinations of BCG or radiotherapy and immunomodulatory agents in patients who recur after induction BCG (BCG failure). PMID:27376138
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.
The integration of chiropractors into healthcare teams: a case study from sport medicine.

PubMed

Theberge, Nancy

2008-01-01

This article examines the integration of chiropractors into multi-disciplinary healthcare teams in the specialisation of sport medicine. Sport medicine is practised in a number of contexts in professional and amateur sport. The current analysis focuses on the highest levels of amateur sport, as exemplified by the Olympics. Data are taken from interviews with 35 health professionals, including physicians, physiotherapists, athletic therapists and chiropractors. A defining feature of sport medicine is an emphasis on performance, which is the basis for a client-centred model of practice. These two elements have provided the main grounds for the inclusion of chiropractic in sport medicine. While the common understanding that 'athletes wanted them' has helped to secure a position for chiropractic within the system of sport medicine professions, this position is marked by ongoing tensions with other professions over the scope and content of practice, and the nature of the patient-practitioner relationship. In the context of these tensions, chiropractors' success in achieving acceptance on sport medicine teams is contingent on two factors: (a) reduced scope of practice in which they work primarily as manual therapists; and (b) the exemplary performance of individual practitioners who 'fit' into multi-disciplinary sport medicine teams.
Understanding hydrothermal circulation patterns at a low-enthalpy thermal spring using audio-magnetotelluric data: A case study from Ireland

NASA Astrophysics Data System (ADS)

Blake, Sarah; Henry, Tiernan; Muller, Mark R.; Jones, Alan G.; Moore, John Paul; Murray, John; Campanyà, Joan; Vozar, Jan; Walsh, John; Rath, Volker

2016-09-01

Kilbrook spring is a thermal spring in east-central Ireland. The temperatures in the spring are the highest recorded for any thermal spring in Ireland (maximum of 25 °C). The temperature is elevated with respect to average Irish groundwater temperatures (9.5-10.5 °C), and represents a geothermal energy potential, which is currently under evaluation. A multi-disciplinary investigation based upon an audio-magnetotelluric (AMT) survey, and hydrochemical analysis including time-lapse temperature and chemistry measurements, has been undertaken with the aims of investigating the provenance of the thermal groundwater and characterising the geological structures facilitating groundwater circulation in the bedrock. The three-dimensional (3-D) electrical resistivity model of the subsurface at Kilbrook spring was obtained by the inversion of AMT impedances and vertical magnetic transfer functions. The model is interpreted alongside high resolution temperature and electrical conductivity measurements, and a previous hydrochemical analysis. The hydrochemical analysis and time-lapse measurements suggest that the thermal waters have a relatively stable temperature and major ion hydrochemistry, and flow within the limestones of the Carboniferous Dublin Basin at all times. The 3-D resistivity model of the subsurface reveals a prominent NNW aligned structure within a highly resistive limestone lithology that is interpreted as a dissolutionally enhanced strike-slip fault, of Cenozoic age. The karstification of this structure, which extends to depths of at least 500 m directly beneath the spring, has provided conduits that facilitate the operation of a relatively deep hydrothermal circulation pattern (likely estimated depths between 560 and 1000 m) within the limestone succession of the Dublin Basin. The results of this study support the hypothesis that the winter thermal maximum and simultaneous increased discharge at Kilbrook spring is the result of rapid infiltration, heating and re-circulation of meteoric waters within this structurally controlled hydrothermal circulation system. This paper illustrates how AMT may be useful in a multi-disciplinary investigation of an intermediate-depth (100-1000 m), low-enthalpy, geothermal target, and shows how the different strands of inquiry from a multi-disciplinary investigation may be woven together to gain a deeper understanding of a complex hydrothermal system.
Assessing the net impact of long-term drainage disturbance on a permafrost ecosystem through multi-disciplinary observations

NASA Astrophysics Data System (ADS)

Goeckede, Mathias; Kwon, Min Jung; Kittler, Fanny; Burjack, Ina; Heimann, Martin; Zimov, Nikita; Zimov, Sergey

2016-04-01

This study presents findings from a multi-disciplinary disturbance experiment established on the floodplain of the Kolyma River near Chersky, Northeast Siberia. Parts of our site have been artificially drained by ditches since 2004 to study shifts in biogeochemical and biogeophysical ecosystem properties following a sustained lowering of the water table. In particular, we are interested in changes in carbon and energy flux patterns, and resulting effects on the sustainability of the permafrost carbon pool. We conduct a paired experiment with two uniformly instrumented sites representing drained and reference tundra, respectively. Year-round fluxes of carbon (CO2 and CH4) and energy are available from two eddy-covariance towers, supplemented by a comprehensive monitoring of surface layer meteorology. These tower datasets are supplemented by observations targeting microsite flux rates with flux chamber transects, microbial and vegetation community structures, radiocarbon signals, nutrient availability and seasonal dynamics in phenology. Through our multi-disciplinary observations we can document that the drainage triggered a suite of secondary changes in ecosystem properties, including e.g. vegetation structure (more tussocks and shrubs), snow cover regime (earlier buildup, earlier snow melt), soil temperature (warmer soils throughout the year) and thaw depth (reduced). Concerning the energy budget, this results in an intensification of energy transfer to the lower atmosphere, particularly in form of sensible heat. The CO2 exchange between ecosystem and atmosphere is intensified as well, with drainage leading to both higher assimilation (taller vegetation) and respiration (warmer topsoils) rates. Increases in respiration dominate here, thus the net sink strength of the ecosystem for CO2 is reduced as a consequence of lowering the water table. CH4 emissions are reduced by more then 50% following the drainage, since in the disturbed area conditions for both production (dryer soils) and transport (less plant-mediated transport due to shifts in vegetation) have negative impacts on flux rates. Summarizing, drainage results in complex effects with both positive and negative contributions to the net global warming potential of this ecosystem, with the long-term effect most likely leading to a positive feedback with global warming.
Diversity in action: exchange of perspectives and reflections on taxonomies of individual differences.

PubMed

Uher, Jana; Trofimova, Irina; Sulis, William; Netter, Petra; Pessoa, Luiz; Posner, Michael I; Rothbart, Mary K; Rusalov, Vladimir; Peterson, Isaac T; Schmidt, Louis A

2018-04-19

Throughout the last 2500 years, the classification of individual differences in healthy people and their extreme expressions in mental disorders has remained one of the most difficult challenges in science that affects our ability to explore individuals' functioning, underlying psychobiological processes and pathways of development. To facilitate analyses of the principles required for studying individual differences, this theme issue brought together prominent scholars from diverse backgrounds of which many bring unique combinations of cross-disciplinary experiences and perspectives that help establish connections and promote exchange across disciplines. This final paper presents brief commentaries of some of our authors and further scholars exchanging perspectives and reflecting on the contributions of this theme issue.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'. © 2018 The Author(s).
Travel behavior, residential preference, and urban design : a multi-disciplinary national analysis

DOT National Transportation Integrated Search

2011-01-01

This report summarizes the findings of a national project to examine the travel behavior, social capital, health, and lifestyle preferences of residents of neotraditional developments (NTD) compared to more standard suburban developments. We compare ...
Small Bodies, Big Concepts: Bringing Visual Analysis into the Middle School Classroom

NASA Astrophysics Data System (ADS)

Cobb, W. H.; Lebofsky, L. A.; Ristvey, J. D.; Buxner, S.; Weeks, S.; Zolensky, M. E.

2012-03-01

Multi-disciplinary PD model digs into high-end planetary science backed by a pedagogical framework, Designing Effective Science Instruction. NASA activities are sequenced to promote visual analysis of emerging data from Discovery Program missions.
Multi-Disciplinary Diagnosis.

ERIC Educational Resources Information Center

Schiffman, Gilbert B.

The diagnosis of severely retarded pupils as an interdisciplinary concern is discussed. Descriptions of the severe reading disability syndrome given by various disciplines are presented under the following headings: Neurological Factors--minimal brain damage, lateral dominance; Physical Factors--endocrine and metabolic disorders, optical and…
Green modes of transportation for Connecticut's mixed used developments.

DOT National Transportation Integrated Search

2011-02-01

Our multi-disciplinary team will not be single-minded. We will create a dynamic business and transportation model for the delivery of goods for : the existing and proposed commercial establishments located in Downtown Storrs. These models will demons...
The Children's Inn at NIH - Three Stories | NIH MedlinePlus the Magazine

MedlinePlus

... in the school environment." Dr. Brian Brooks—The Team Co-Leader Dr. Brian Brooks uses a puppet ... much experience with." He coordinates a multi-disciplinary team of researchers, geneticists, nurses, counselors, and patients' families— ...
Trace Elements: The Little Things that Count

ERIC Educational Resources Information Center

Evans, Gary W.

1977-01-01

Examines recent findings regarding the importance of trace elements to good health. Copper, chromium, and zinc are discussed. Described also are multi-disciplinary experiments in progress at the Human Nutrition Laboratory, a federal facility in Grand Forks, North Dakota. (CS)

Logistic-based patient grouping for multi-disciplinary treatment.

PubMed

Maruşter, Laura; Weijters, Ton; de Vries, Geerhard; van den Bosch, Antal; Daelemans, Walter

2002-01-01

Present-day healthcare witnesses a growing demand for coordination of patient care. Coordination is needed especially in those cases in which hospitals have structured healthcare into specialty-oriented units, while a substantial portion of patient care is not limited to single units. From a logistic point of view, this multi-disciplinary patient care creates a tension between controlling the hospital's units, and the need for a control of the patient flow between units. A possible solution is the creation of new units in which different specialties work together for specific groups of patients. A first step in this solution is to identify the salient patient groups in need of multi-disciplinary care. Grouping techniques seem to offer a solution. However, most grouping approaches in medicine are driven by a search for pathophysiological homogeneity. In this paper, we present an alternative logistic-driven grouping approach. The starting point of our approach is a database with medical cases for 3,603 patients with peripheral arterial vascular (PAV) diseases. For these medical cases, six basic logistic variables (such as the number of visits to different specialist) are selected. Using these logistic variables, clustering techniques are used to group the medical cases in logistically homogeneous groups. In our approach, the quality of the resulting grouping is not measured by statistical significance, but by (i) the usefulness of the grouping for the creation of new multi-disciplinary units; (ii) how well patients can be selected for treatment in the new units. Given a priori knowledge of a patient (e.g. age, diagnosis), machine learning techniques are employed to induce rules that can be used for the selection of the patients eligible for treatment in the new units. In the paper, we describe the results of the above-proposed methodology for patients with PAV diseases. Two groupings and the accompanied classification rule sets are presented. One grouping is based on all the logistic variables, and another grouping is based on two latent factors found by applying factor analysis. On the basis of the experimental results, we can conclude that it is possible to search for medical logistic homogenous groups (i) that can be characterized by rules based on the aggregated logistic variables; (ii) for which we can formulate rules to predict to which cluster new patients belong.
An Exploration of the Interaction between Global Education Policy Orthodoxies and National Education Practices in Cambodia, Illuminated through the Voices of Local Teacher Educators

ERIC Educational Resources Information Center

Courtney, Jane

2017-01-01

This research is based on a multi-disciplinary and multi-levelled analysis of evidence to present the case that education reform needs to be contextualised far more widely than is currently practised. It focuses on the voices of Cambodian local teacher trainers through interviews over a five-year period. Interview data is triangulated against…
The development and implementation of cardiac arrest centers.

PubMed

Donnino, Michael W; Rittenberger, Jon C; Gaieski, David; Cocchi, Michael N; Giberson, Brandon; Peberdy, Mary Ann; Abella, Benjamin S; Bobrow, Bentley J; Callaway, Clifton

2011-08-01

In the last decade, many regionalized centers for the care of post-cardiac arrest patients (cardiac arrest centers) have all independently developed with a common goal of providing multi-disciplinary and organized care plans for this patient population. The American Heart Association recently issued support for regionalized and organized comprehensive care for post-arrest patients through a position paper as well as the 2010 American Heart Association BLS/ACLS guidelines. This paper outlines the formation, structure, and implementation of four cardiac arrest centers, and also discusses a statewide model of post-arrest center care. This paper may assist other potential clinical sites that are considering or actively developing cardiac arrest centers of their own. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Wing Configuration Impact on Design Optimums for a Subsonic Passenger Transport

NASA Technical Reports Server (NTRS)

Wells, Douglas P.

2014-01-01

This study sought to compare four aircraft wing configurations at a conceptual level using a multi-disciplinary optimization (MDO) process. The MDO framework used was created by Georgia Institute of Technology and Virginia Polytechnic Institute and State University. They created a multi-disciplinary design and optimization environment that could capture the unique features of the truss-braced wing (TBW) configuration. The four wing configurations selected for the study were a low wing cantilever installation, a high wing cantilever, a strut-braced wing, and a single jury TBW. The mission that was used for this study was a 160 passenger transport aircraft with a design range of 2,875 nautical miles at the design payload, flown at a cruise Mach number of 0.78. This paper includes discussion and optimization results for multiple design objectives. Five design objectives were chosen to illustrate the impact of selected objective on the optimization result: minimum takeoff gross weight (TOGW), minimum operating empty weight, minimum block fuel weight, maximum start of cruise lift-to-drag ratio, and minimum start of cruise drag coefficient. The results show that the design objective selected will impact the characteristics of the optimized aircraft. Although minimum life cycle cost was not one of the objectives, TOGW is often used as a proxy for life cycle cost. The low wing cantilever had the lowest TOGW followed by the strut-braced wing.
Telangiectatic osteosarcoma: Outcome analyses and a diagnostic model for differentiation from aneurysmal bone cyst.

PubMed

Yin, Jun-Qiang; Fu, Yi-Wei; Xie, Xian-Biao; Cheng, Xiao-Yu; Yang, Xiao-Yu; Liu, Wei-Hai; Tu, Jian; Gao, Zhen-Hua; Shen, Jing-Nan

2018-06-01

Telangiectatic osteosarcoma (TOS), a rare variant of osteosarcoma, may be easily misdiagnosed as aneurysmal bone cyst (ABC). The aims of this study were to investigate the diagnostic and prognostic factors of TOS by reviewing our experience with TOS and to develop a diagnostic model that may distinguish TOS from ABC. We identified 51 cases of TOS treated at the First Affiliated Hospital of Sun Yat-Sen University from March 2001 to January 2016 and reviewed their records, imaging information and pathological studies. A diagnostic model was developed to differentiate TOS and ABC by Bayes discriminant analysis and was evaluated. The log-rank test was used to analyze the prognostic factors of TOS and to compare the outcome differences between TOS and other high-grade osteosarcoma subtypes. The multi-disciplinary diagnostic method employed that combined clinical, imaging, and pathological studies enhanced the diagnostic accuracy. Age 18 years or younger and pathologic fracture were more common among the TOS patients than among the ABC patients (P = .004 and .005, respectively). The average white blood cell (WBC), platelet, lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) values of the TOS patients were higher than those of the ABC patients ( P = .002, .003, .007, and .007, respectively). Our diagnostic model, including the aforementioned factors, accurately predicted 62% and 78% of the TOS patients in the training and validation sets, respectively. The 5-year estimates of event-free survival and overall survival of the TOS patients were 52.5 ± 9.4% and 54.9 ± 8.8%, respectively, which were similar to those of patients with other osteosarcoma subtypes ( P = .950 and .615, respectively). Tumor volume and the LDH level were predictive prognostic factors ( P = .040 and .044) but not the presence of pathologic fracture or misdiagnosis ( P = .424 and .632, all respectively). The multi-disciplinary diagnostic method and diagnostic model based on predictive factors, i.e. , age, the presence of pathologic fracture, and platelet, LDH, ALP and WBC levels, aided the differentiation of TOS and ABC. Smaller tumors and normal LDH levels were associated with better outcomes.
Workshop: Preventing Air Pollution-related Cardiopulmonary Illnesses: Innovative, Cross-disciplinary Solutions

EPA Pesticide Factsheets

On Sept. 28-29, 2016 in Washington, DC, EPA’s held its first workshop to share multi-stakeholder perspectives on how to improve cardiopulmonary health outcomes through the integration of environmental health, public health, health care services, data.
RELATING AIR QUALITY AND ENVIRONMENTAL PUBLIC HEALTH TRACKING DATA

EPA Science Inventory

Initiated in February 2004, the Public Health Air Surveillance Evaluation (PHASE) Project is a multi-disciplinary collaboration between the Centers for Disease Control and Prevention (CDC), the U.S Environmental Protection Agency (EPA), and three Environmental Public Health Track...
Our Vision | Center for Cancer Research

Cancer.gov

Our Vision The mission of the NCI-CCR-LCP is to develop a multi-disciplinary program focused on the prevention, early detection, improved diagnosis and treatment of liver cancer. Liver cancer is the 2nd most common cause of cancer-related death worldwide.
National Security Challenges: Insights from Social, Neurobiological, and Complexity Sciences. Topical Strategic Multi-Layer Assessment (SMA) and U.S. Army ERDC Multi-Agency/Multi-Disciplinary White Papers in Support of National Security Challenges

DTIC Science & Technology

2012-07-01

population. The amount of information on Facebook doubles every 6 months. This under- scores the nation’s need to understand what is happening on a ...QL—Russia: Emerging Insight Into Muslim Populations (October 2011) • QL— A Trend Toward Increased Information Communication Technol- ogy (ICT...Hendrix ( College of William & Mary), Mr. Eric A . Knudson (PACOM), Mr. Joseph T. Lee (PACOM), Mr. Kalev Leetaru (University of Illinois at Urbana), Lt
Strategies for Conducting Adolescent Health Research in the Clinical Setting: The Mount Sinai Adolescent Health Center HPV Experience

PubMed Central

Braun-Courville, Debra K.; Schlecht, Nicolas F.; Burk, Robert D.; Strickler, Howard D.; Rojas, Mary; Lorde-Rollins, Elizabeth; Nucci-Sack, Anne; Hollman, Dominic; Linares, L. Oriana; Diaz, Angela

2013-01-01

Background Clinical research with adolescents can be challenging due to issues of informed consent, parental involvement, institutional review board requirements, and adolescent psychosocial development. This presents a dilemma, particularly in the area of sexual health research, as adolescents are disproportionately affected by sexually transmitted infections such as human papillomavirus (HPV). To successfully conduct adolescent research in the clinical setting, one requires an awareness of state statutes regarding adolescent confidentiality and consent for medical care, and a close partnership with the IRB. Case Study In 2007, the Mount Sinai Adolescent Health Center (MSAHC) in collaboration with the Albert Einstein College of Medicine developed a longitudinal research study to examine the natural history of oral, cervical, and anal HPV in an adolescent female population engaged in high-risk sexual behaviors. We use this research project as a case study to explore the ethical, methodological, and clinical issues related to conducting adolescent health research. Summary and Conclusions Several strategies were identified to promote adolescent study participation, including: (1) building a research team that is motivated to work with adolescents; (2) combining research and patient care visits to avoid duplication of services; and (3) establishing a personalized communication network with participants. Using these methods, adolescent sexual health research can successfully be integrated into the clinical setting. While retaining a prospective cohort of adolescents has its challenges, a persistent and multi-disciplinary approach can help improve recruitment, sustain participation, and acquire critical data that will lead to improved healthcare knowledge applicable to understudied populations of adolescents. PMID:24332677
An environmental scan of weight assessment and management practices in paediatric spina bifida clinics across Canada.

PubMed

McPherson, Amy C; Leo, Jennifer; Church, Paige; Lyons, Julia; Chen, Lorry; Swift, Judy

2014-01-01

Childhood obesity is a global health concern, but children with spina bifida in particular have unique interacting risk factors for increased weight. To identify and explore current clinical practices around weight assessment and management in pediatric spina bifida clinics. An online, self-report survey of healthcare professionals (HCPs) was conducted in all pediatric spina bifida clinics across Canada (15 clinics). Summary and descriptive statistics were calculated and descriptive thematic analysis was performed on free text responses. 52 responses across all 15 clinics indicated that weight and height were assessed and recorded most of the time using a wide variety of methods, although some HCPs questioned their suitability for children with spina bifida. Weight and height information was not routinely communicated to patients and their families and HCPS identified considerable barriers to discussing weight-related information in consultations. Despite weight and height reportedly being measured regularly, HCPs expressed concern over the lack of appropriate assessment and classification tools. Communication across multi-disciplinary team members is required to ensure that children with weight-related issues do not inadvertently get overlooked. Specific skill training around weight-related issues and optimizing consultation time should be explored further for HCPs working with this population.
[The hardest battles begin after the war].

PubMed

Sodemann, Morten; Svabo, Arndis; Jacobsen, Arne

2010-01-11

While psychic effects of war trauma are well-described, the somatic long-term consequences of war trauma have not previously been described. In three clinical cases from the Migrant Health Clinic at Odense University Hospital, we describe the complicated somatic problems which can be associated with a refugee status. The cross disciplinary team chose three cases that describe the long-term effects of war trauma. Post-traumatic stress disorder (PTSD) can appear 10-20 years after a primary war-related trauma and secondary trauma after the arrival in Denmark trigger and prolong post-traumatic stress symptoms with a range of somatic symptoms. Warning signs of an underlying PTSD disorder have often been present for many years, but overlooked or ignored. Many patients with PTSD and somatic symptoms loose previously acquired language skills, disintegrate and drop out of the labour market after 3-4 years in Denmark. Somatic symptoms along with PTSD can develop into a seriously complicated condition that requires skilled cross-disciplinary management. Experience from the Cross Disciplinary Migrant Health Clinic shows that by investing time in obtaining a full clinical and social history it is possible to increase the quality of life of these patients. Early screening and early specialized cross disciplinary and cross sectorial management are crucial to secure and maintain integration, but unfortunately the long waiting list to institutions that treat PTSD contributes to the high level of disintegration.
Multi-Disciplinary Techniques for Understanding Time-Varying Space-Based Imagery.

DTIC Science & Technology

1985-05-10

problem, and I V WY" 3 discuss the impgrtage of this work to Air Force technology and to related Air Force programs. Section 1.5 provides a summary of...development of new algorithms and their realization in a hybrid optical/digital architecture. However, devices and architectures being developed in related ...and relate these representntions to object and surface contour properties of the scene. The techniques studied included Probabilistic Graph Matching
Problem-oriented patient record model as a conceptual foundation for a multi-professional electronic patient record.

PubMed

De Clercq, Etienne

2008-09-01

It is widely accepted that the development of electronic patient records, or even of a common electronic patient record, is one possible way to improve cooperation and data communication between nurses and physicians. Yet, little has been done so far to develop a common conceptual model for both medical and nursing patient records, which is a first challenge that should be met to set up a common electronic patient record. In this paper, we describe a problem-oriented conceptual model and we show how it may suit both nursing and medical perspectives in a hospital setting. We started from existing nursing theory and from an initial model previously set up for primary care. In a hospital pilot site, a multi-disciplinary team refined this model using one large and complex clinical case (retrospective study) and nine ongoing cases (prospective study). An internal validation was performed through hospital-wide multi-professional interviews and through discussions around a graphical user interface prototype. To assess the consistency of the model, a computer engineer specified it. Finally, a Belgian expert working group performed an external assessment of the model. As a basis for a common patient record we propose a simple problem-oriented conceptual model with two levels of meta-information. The model is mapped with current nursing theories and it includes the following concepts: "health care element", "health approach", "health agent", "contact", "subcontact" and "service". These concepts, their interrelationships and some practical rules for using the model are illustrated in this paper. Our results are compatible with ongoing standardization work at the Belgian and European levels. Our conceptual model is potentially a foundation for a multi-professional electronic patient record that is problem-oriented and therefore patient-centred.
Cognitive and behavioral assessment in dogs and pet food market applications.

PubMed

Zicker, Steven C

2005-03-01

A multi-disciplinary program was developed to assess the efficacy of antioxidant inclusion in a canine pet food on cognitive decline in aged beagles. A systematic approach to development of the food was used prior to beginning the cognitive studies. Comprehensive evaluation of antioxidant ingredients included assessments of commodities with naturally occurring antioxidants and synthetic antioxidants not commonly utilized, or at different concentrations than what was commonly utilized, in commercial pet foods. Studies were conducted to insure stability through processing, absorption from the gastrointestinal tract, safety, and tests for potential antioxidant biological benefit by ex vivo tests. Testing of the antioxidant-fortified food in aged beagles slowed the rate of cognitive decline in aged dogs. In addition, environmental enrichment also slowed the rate of cognitive decline. Importantly, the combination of dietary antioxidants and environmental enrichment was synergistic and resulted in the least amount of cognitive decline over the 30-month study period. Finally, a clinical study showed that antioxidant fortified food improved age-related behavioral changes in older pet dogs at in-home situations.
A Matrix Based Integrated Framework for Multi Disciplinary Exploration of Cyber-International Relations

DTIC Science & Technology

2010-06-01

infrastructures, the information can now be dynamically "personalized" and made available on demand, thus blurring the boundaries between storage and...It is also the first truly global media carrier. It has enabled multi-directional communication between different individuals (or group of individuals...terms. Such common terms refer to the objects, and relations that may exist between those objects/terms, as applied to the phenomenon of cyberspace, which
Future volcanic lake research: revealing secrets from poorly studied lakes

NASA Astrophysics Data System (ADS)

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

2012-04-01

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

EPA Science Inventory

Cross-media, integrated, multi-disciplinary approach to sustainably manage reactive nitrogen and co-pollutant loadings to air and water to reduce adverse impacts on the environment and human health. The goal of the Roadmap is to develop a common understanding of the Agency's rese...
National Park Service's Alternative Transportation Program : Pilot Data Collection Summary and Future Recommendations.

DOT National Transportation Integrated Search

2006-03-31

In the summer of 2002 an interagency, multi-disciplinary team was formed to develop a plan for defining and collecting performance data needed for better managing the National Park Services (NPS) Alternative Transportation Program (ATP). Members o...
Daniel Inman | NREL

Science.gov Websites

of Agriculture Natural Resources Conservation Service, 2000-2001 Graduate Research Assistant, Dept . "A Synthesis of Multi-Disciplinary Research in Precision Agriculture: Site-Specific Management Zones in the Semi-Arid Western Great Plains of the USA." Journal of Precision Agriculture 9 (2008

SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS - ELECTRONIC (SMARTE) - 09-05-2007

EPA Science Inventory

Revitalization of sites potentially contaminated with environmentally toxic or hazardous materials (e.g., brownfields) is a global concern requiring a multi-disciplinary approach to mitigate the risks to human health and the environment. Many countries have committed extensive re...
Introduction: Sustainability: Multi-Disciplinary Perspectives

EPA Science Inventory

WHAT DOES SUSTAINABILITY MEAN? The word sustainability has over the past two or three decades become widely used in both professional and public speech. But what does it actually mean? As again mentioned in Chapter 9, according to one standard reference of the English languag...
Systems Engineering News | Wind | NREL

Science.gov Websites

News Systems Engineering News The Wind Plant Optimization and Systems Engineering newsletter covers range from multi-disciplinary design analysis and optimization of wind turbine sub-components to wind plant optimization and uncertainty analysis to concurrent engineering and financial engineering
The science of animal behavior and welfare: challenges, opportunities and global perspective

USDA-ARS?s Scientific Manuscript database

Animal welfare science is a relatively new scientific discipline. Originally heavily focused on animal behavior, it has emerged into a truly multi- and inter-disciplinary science, encompassing such sciences as behavior, physiology, pathology, immunology, endocrinology and neuroscience, and influence...
PHOTOCHEMICAL AIR POLLUTANT EFFECTS ON MIXED CONIFER ECOSYSTEMS

EPA Science Inventory

In 1972, a multi-disciplinary team of ecologists assembled to monitor and analyze some of the ecological consequences of photochemical oxidant air pollutants in California Mixed Conifer Forest ecosystems of the San Bernardino Mountains east of Los Angeles. The purposes included g...
MU-SPIN Project Update

NASA Technical Reports Server (NTRS)

Harrington, James L., Jr.

2000-01-01

The Minority University Space Interdisciplinary (MUSPIN) Network project is a comprehensive outreach and education initiative that focuses on the transfer of advanced computer networking technologies and relevant science to Historically Black Colleges and Universities (HBCU's) and Other Minority Universities (OMU's) for supporting multi-disciplinary education research.
From Multi-Sensors Observations Towards Cross-Disciplinary Study of Pre-Earthquake Signals. What have We Learned from the Tohoku Earthquake?

NASA Technical Reports Server (NTRS)

Ouzounov, D.; Pulinets, S.; Papadopoulos, G.; Kunitsyn, V.; Nesterov, I.; Hayakawa, M.; Mogi, K.; Hattori, K.; Kafatos, M.; Taylor, P.

2012-01-01

The lessons we have learned from the Great Tohoku EQ (Japan, 2011) how this knowledge will affect our future observation and analysis is the main focus of this presentation.We present multi-sensors observations and multidisciplinary research in our investigation of phenomena preceding major earthquakes. These observations revealed the existence of atmospheric and ionospheric phenomena occurring prior to theM9.0 Tohoku earthquake of March 11, 2011, which indicates s new evidence of a distinct coupling between the lithosphere and atmosphere/ionosphere, as related to underlying tectonic activity. Similar results have been reported before the catastrophic events in Chile (M8.8, 2010), Italy (M6.3, 2009) and Sumatra (M9.3, 2004). For the Tohoku earthquake, our analysis shows a synergy between several independent observations characterizing the state of the lithosphere /atmosphere coupling several days before the onset of the earthquakes, namely: (i) Foreshock sequence change (rate, space and time); (ii) Outgoing Long wave Radiation (OLR) measured at the top of the atmosphere; and (iii) Anomalous variations of ionospheric parameters revealed by multi-sensors observations. We are presenting a cross-disciplinary analysis of the observed pre-earthquake anomalies and will discuss current research in the detection of these signals in Japan. We expect that our analysis will shed light on the underlying physics of pre-earthquake signals associated with some of the largest earthquake events
Psychosocial screening at paediatric BEEC clinics: a pilot evaluation study.

PubMed

Hurrell, Ruth A; Fullwood, Catherine; Keys, Joni; Dickson, Alan P; Fishwick, Janet; Whitnall, Beverley; Cervellione, Raimondo M

2015-04-01

Bladder Exstrophy and Epispadias Complex (BEEC) is associated with an increased risk of impaired mental health, quality of life, and psychosocial functioning. Therefore, screening patients to help identify and evaluate potential psychosocial difficulty is arguably an important consideration for BEEC Services. To screen paediatric BEEC patients for a range of general psychosocial difficulties in a multi-disciplinary out-patient clinic setting. This cross-sectional evaluation was conducted between April 2012 and July 2013. Families attending BEEC multi-disciplinary out-patient clinics were asked to complete a range of standardised psychosocial questionnaires, including the Paediatric Quality of Life Inventory (PedsQL 4.0 Generic Core and Family Impact Module), the Strengths and Difficulties Questionnaire (SDQ), the Paediatric Index of Emotional Distress (PI-ED), and the Hospital Anxiety and Depression Scale (HADS). 108 children attended clinic of which 80 (74.1%) patients and their parents/carers completed some or all of the questionnaires. The mean patient age was 8.41 years (SD = 4.46, range = 1-18 years). There were more boys (N = 50, 62.5%) and the majority had a diagnosis of classic bladder exstrophy (N = 51, 63.8%), followed by primary epispadias (N = 22, 27.5%) and cloacal exstrophy (N = 7, 8.7%). Mean total scores fell within the average/normal range on all questionnaires used (See table below). However, variation around these means was high. Age, gender and diagnosis were found to significantly influence certain questionnaire responses with older-age groups, males, and those with classic bladder exstrophy particularly at risk across some domains. The children/adolescents self-reported better health related quality of life (HRQoL) scores than published results for a range of paediatric chronic health conditions. Differences between parent and child responses on both the PedsQL and SDQ favoured a more positive response on the child self-report questionnaire but were not statistically significant. Mean scores on the measures used suggest a relatively optimistic picture of general psychosocial well-being, especially for HRQoL, in the BEEC population studied. Positive HRQoL outcomes have recently been reported for BEEC paediatric populations. Our results reflect this trend with better mean HRQoL scores than paediatric patients with a range of other chronic health conditions. However, this optimism is cautious given the limitations of this evaluation study and the high variation around the means. Limitations included the small sample size (especially for patients with cloacal exstrophy), the lack of a control group, the limited sensitivity of generic questionnaires in respect of BEEC-specific issues, and the low mean age of patients in the study. Future screening programmes may wish to consider measuring BEEC-specific variables (e.g. satisfaction with genital appearance/function); collecting information on medical aspects, such as continence, pubertal stage and frequency/timing of medical intervention; and asking both parents/carers (where possible) to complete the questionnaires. Screening questionnaire responses were used in conjunction with clinical psychology consultations to evaluate a range of psychosocial aspects in BEEC paediatric patients. Whilst mean scores on the measures used suggest a relatively optimistic picture, certain individual scores did fall within the clinical ranges, highlighting the potential need for further assessment. Developmentally tailored consultations with a clinical psychologist can provide detailed information around questionnaire responses and further assess BEEC specific aspects. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Experiences of nurses as postgraduate students of pharmacology and therapeutics: a multiple case narrative study.

PubMed

Lim, Anecita Gigi; North, Nicola; Shaw, John

2014-06-01

Pharmacology and therapeutics are essential components of educational programmes in prescribing, yet little is known about students' experiences in studying these subjects for a prescribing role. To investigate the views and experiences of nurses as postgraduate students who were studying pharmacology and therapeutics in preparation for a prescribing role. Qualitative study using a multiple case narrative approach. The participants were undertaking or had recently completed a Master's degree programme; they worked in a range of clinical areas and services in the Auckland region. Twenty nurses, with advanced clinical backgrounds and experience engaged in postgraduate studies in pharmacology and therapeutics. A semi-structured interview of approximately 1h was undertaken with each participant. Transcripts were analysed within and across cases using Narralizer software to support thematic analysis. There were four broad thematic areas. In the first, 'prescribing in the context of advanced nursing practice', participants reflected on why prescribing authority was important to them. In the second theme, 'adequacy of prior pharmacology knowledge' they discussed the relative lack of pharmacology in their undergraduate programmes and in nursing practice. In the third, 'drawing on clinical experience in acquiring pharmacology knowledge', participants discussed how, as they grappled with new pharmacological science, they drew on clinical experience which facilitated their learning. In the fourth theme, 'benefits of increased pharmacology knowledge' they discussed how their studies improved their interactions with patients, medical colleagues and as members of multi-disciplinary teams. All nurses viewed their studies in pharmacology as fundamental to their roles as prescribers, through knowledge development and an increase in confidence. Although pharmacology theory was new to many participants, their learning was facilitated because they were able to reflect on previous clinical experience and apply this to theory. Copyright © 2014 Elsevier Ltd. All rights reserved.
A Simple Tool for the Design and Analysis of Multiple-Reflector Antennas in a Multi-Disciplinary Environment

NASA Technical Reports Server (NTRS)

Katz, Daniel S.; Cwik, Tom; Fu, Chuigang; Imbriale, William A.; Jamnejad, Vahraz; Springer, Paul L.; Borgioli, Andrea

2000-01-01

The process of designing and analyzing a multiple-reflector system has traditionally been time-intensive, requiring large amounts of both computational and human time. At many frequencies, a discrete approximation of the radiation integral may be used to model the system. The code which implements this physical optics (PO) algorithm was developed at the Jet Propulsion Laboratory. It analyzes systems of antennas in pairs, and for each pair, the analysis can be computationally time-consuming. Additionally, the antennas must be described using a local coordinate system for each antenna, which makes it difficult to integrate the design into a multi-disciplinary framework in which there is traditionally one global coordinate system, even before considering deforming the antenna as prescribed by external structural and/or thermal factors. Finally, setting up the code to correctly analyze all the antenna pairs in the system can take a fair amount of time, and introduces possible human error. The use of parallel computing to reduce the computational time required for the analysis of a given pair of antennas has been previously discussed. This paper focuses on the other problems mentioned above. It will present a methodology and examples of use of an automated tool that performs the analysis of a complete multiple-reflector system in an integrated multi-disciplinary environment (including CAD modeling, and structural and thermal analysis) at the click of a button. This tool, named MOD Tool (Millimeter-wave Optics Design Tool), has been designed and implemented as a distributed tool, with a client that runs almost identically on Unix, Mac, and Windows platforms, and a server that runs primarily on a Unix workstation and can interact with parallel supercomputers with simple instruction from the user interacting with the client.
Reengineering health care: management systems for survivors.

PubMed

Griffith, J R

1994-01-01

To survive in the coming era, health care organizations must support the powerful concepts of continuous quality improvement with better internal management systems that include: (1) new processes for making decisions from mission to clinical guidelines; (2) hoshin planning, which emphasizes strong financial management and innovation to meet customer needs; (3) new organizations that make cross-disciplinary teams as important as traditional clinical support services; and (4) expanded information covering several new dimensions, including enhanced analytic capability, and supporting both traditional organization and cross-disciplinary teams.
The clinical presentation and management of zygomatic complex fractures in a Nigeria Teaching Hospital.

PubMed

Anyanechi, C E; Charles, E A; Saheeb, B D; Birch, D S

2012-01-01

Fractures of the zygomatic complex occur worldwide and are a component part of injuries that can be sustained in the maxillofacial region. The objective was to analyze the clinical presentation and management ofzygomatic complex fractures. This was a prospective study carried out over a period of five years at the University of Calabar Teaching Hospital, Nigeria. Data documented were patients' age, gender, time of presentation, cause and type of fracture, associated head and maxillofacial injuries, clinical features, types of plain radiographs, treatment methods, duration of follow-up and complications. Majority of the patients (n = 81, 63.3%) were in their third and fourth decades of life while the male to female ratio was 20.3:1. Road traffic accident (n = 111, 86.7%) was the most common cause of fracture. Fractures of the zygomatic complex alone (n = 105, 82.0%) were more common than isolated fractures of the arch (n = 13, 10.2%) and combined fractures of the zygomatic complex and arch (n = 10, 7.8%). While multi-disciplinary approach to treatment is important, majority of the fractures were treated by simple elevation and transosseous wire osteosynthesis. Delay in presentation, associated injuries and non-availability of mini-plating technique contributed to the development of complications.
Mechanical System Analysis/Design Tool (MSAT) Quick Guide

NASA Technical Reports Server (NTRS)

Lee, HauHua; Kolb, Mark; Madelone, Jack

1998-01-01

MSAT is a unique multi-component multi-disciplinary tool that organizes design analysis tasks around object-oriented representations of configuration components, analysis programs and modules, and data transfer links between them. This creative modular architecture enables rapid generation of input stream for trade-off studies of various engine configurations. The data transfer links automatically transport output from one application as relevant input to the next application once the sequence is set up by the user. The computations are managed via constraint propagation - the constraints supplied by the user as part of any optimization module. The software can be used in the preliminary design stage as well as during the detail design of product development process.
Multimedia platform for authoring and presentation of clinical rounds in cardiology

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Allada, Vivekanand; Dahlbom, Magdalena; Lapstra, Lorelle

2003-05-01

We developed a multimedia presentation platform that allows retrieving data from any digital and analog modalities and to prepare a script of a clinical presentation in an XML format. This system was designed for cardiac multi-disciplinary conferences involving different cardiology specialists as well as cardiovascular surgeons. A typical presentation requires preparation of summary reports of data obtained from the different investigations and imaging techniques. An XML-based scripting methodology was developed to allow for preparation of clinical presentations. The image display program uses the generated script for the sequential presentation of different images that are displayed on pre-determined presentation settings. The ability to prepare and present clinical conferences electronically is more efficient and less time consuming than conventional settings using analog and digital documents, films and videotapes. The script of a given presentation can further be saved as part of the patient record for subsequent review of the documents and images that supported a given medical or therapeutic decision. This also constitutes a perfect documentation method for surgeons and physicians responsible of therapeutic procedures that were decided upon during the clinical conference. It allows them to review the relevant data that supported a given therapeutic decision.
A Survey of Current Trends in Master's Programs in Microelectronics

ERIC Educational Resources Information Center

Bozanic, Mladen; Sinha, Saurabh

2018-01-01

Contribution: This paper brings forward a paradigm shift in microelectronic and nanoelectronic engineering education. Background: An increasing number of universities are offering graduate-level electrical engineering degree programs with multi-disciplinary Master's-level specialization in microelectronics or nanoelectronics. The paradigm shift…
78 FR 24694 - Family Advocacy Command Assistance Team (FACAT)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... be composed of personnel from appropriate disciplines, including, medicine, psychology, and child... in all allegations of child abuse and neglect. DATES: Comments must be received by June 25, 2013... multi-disciplinary Family Advocacy Command Assistant Team to respond to allegations of child sexual...
Task force on deterrence of air piracy : final report.

DOT National Transportation Integrated Search

1978-11-01

In February 1969, as the frequency of hijacking of U.S. air carrier aircraft was rising to an all-time high, the Federal Aviation Administration established a multi-disciplinary Task Force on Deterrence of Air Piracy. The work of the Task Force in de...
Using an Integrated, Multi-disciplinary Framework to Support Quantitative Microbial Risk Assessments

EPA Science Inventory

The Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) provides the infrastructure to link disparate models and databases seamlessly, giving an assessor the ability to construct an appropriate conceptual site model from a host of modeling choices, so a numbe...
IEP Common Talk. PAGE Bulletin.

ERIC Educational Resources Information Center

Pennsylvania Association for Gifted Education, Norristown.

This bulletin presents basic information for parents about identification and services for gifted students in Pennsylvania. Written in a question and answer format, the bulletin addresses the following concerns: the Individualized Education Program (IEP) required for all exceptional students in the state; the multi-disciplinary evaluation process;…
Assessing demand for improved sustainable sanitation in low-income informal settlements of urban areas: a critical review.

PubMed

Okurut, Kenan; Kulabako, Robinah Nakawunde; Chenoweth, Jonathan; Charles, Katrina

2015-01-01

Sanitation improvement is crucial in saving lives that are lost due to water contamination. Progress towards achieving full sanitation coverage is still slow in low-income informal settlements in most developing countries. Furthermore, resources are being wasted on installing facilities that are later misused or never used because they do not meet the local demand. Understanding demand for improved sanitation in the local context is critical if facilities are to be continually used. Various approaches that attempt to change peoples' behaviours or create demand have been reviewed to identify what they are designed to address. A multi-disciplinary research team using mixed methods is re-emphasised as a comprehensive approach for assessing demand for improved sanitation in low-income informal settlements, where the sanitation situation is more challenging than in other areas. Further research involving a multi-disciplinary research team and use of mixed methods to assess sanitation demand in informal settlements is needed.

Virtual physiological human: training challenges.

PubMed

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

2010-06-28

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

PubMed

Chiasson, Mike; Reddy, Madhu; Kaplan, Bonnie; Davidson, Elizabeth

2007-06-01

The effective use of information technology (IT) is a crucial component for the delivery of effective services in health care. Current approaches to medical informatics (MI) research have significantly contributed to the success of IT use in health care but important challenges remain to be addressed. We believe that expanding the multi-disciplinary basis for MI research is important to meeting these research challenges. In this paper, we outline theories and methods used in information systems (IS) research that we believe can inform our understanding of health care IT applications and outcomes. To do so, we discuss some general differences in the focus and methods of MI and IS research to identify broad opportunities. We then review conceptual and methodological approaches in IS that have been applied in health care IT research. These include: technology-use mediation, collaborative work, genre theory, interpretive research, action research, and modeling. Examples of these theories and methods in healthcare IS research are illustrated.
Launch vehicle design and GNC sizing with ASTOS

NASA Astrophysics Data System (ADS)

Cremaschi, Francesco; Winter, Sebastian; Rossi, Valerio; Wiegand, Andreas

2018-03-01

The European Space Agency (ESA) is currently involved in several activities related to launch vehicle designs (Future Launcher Preparatory Program, Ariane 6, VEGA evolutions, etc.). Within these activities, ESA has identified the importance of developing a simulation infrastructure capable of supporting the multi-disciplinary design and preliminary guidance navigation and control (GNC) design of different launch vehicle configurations. Astos Solutions has developed the multi-disciplinary optimization and launcher GNC simulation and sizing tool (LGSST) under ESA contract. The functionality is integrated in the Analysis, Simulation and Trajectory Optimization Software for space applications (ASTOS) and is intended to be used from the early design phases up to phase B1 activities. ASTOS shall enable the user to perform detailed vehicle design tasks and assessment of GNC systems, covering all aspects of rapid configuration and scenario management, sizing of stages, trajectory-dependent estimation of structural masses, rigid and flexible body dynamics, navigation, guidance and control, worst case analysis, launch safety analysis, performance analysis, and reporting.
Control/structure interaction conceptual design tool

NASA Technical Reports Server (NTRS)

Briggs, Hugh C.

1990-01-01

The JPL Control/Structure Interaction Program is developing new analytical methods for designing micro-precision spacecraft with controlled structures. One of these, the Conceptual Design Tool, will illustrate innovative new approaches to the integration of multi-disciplinary analysis and design methods. The tool will be used to demonstrate homogeneity of presentation, uniform data representation across analytical methods, and integrated systems modeling. The tool differs from current 'integrated systems' that support design teams most notably in its support for the new CSI multi-disciplinary engineer. The design tool will utilize a three dimensional solid model of the spacecraft under design as the central data organization metaphor. Various analytical methods, such as finite element structural analysis, control system analysis, and mechanical configuration layout, will store and retrieve data from a hierarchical, object oriented data structure that supports assemblies of components with associated data and algorithms. In addition to managing numerical model data, the tool will assist the designer in organizing, stating, and tracking system requirements.
Surviving catastrophic disintegration of a large left atrial myxoma: the importance of multi-disciplinary team.

PubMed

Habbab, Louay; Alfaraidi, Haifa; Lamy, Andre

2014-09-12

Atrial myxomas are the most common primary cardiac tumors, representing ∼50% of all benign cardiac tumors. Patients with a left atrial myxoma (LAM) generally present with symptoms of mechanical obstruction of blood flow, systemic emboli or constitutional symptoms. Embolic complications may occur any time with progression of the tumor; therefore, myxoma is usually considered an indication for urgent surgery. This report describes a patient with mobile large LAM who survived multiple emboli to the brain, spleen, kidneys, abdominal aorta and lower limbs during hospitalization for surgery, illustrating the critical nature of this finding and its possible catastrophic complications and demonstrating the importance of multi-disciplinary team in the decision-making process and the management of such complications and supporting the hypothesis that intravenous thrombolysis may be safely used in the treatment of embolic stroke due to cardiac myxoma. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2014.
New perspectives in offshore wind energy

PubMed Central

Failla, Giuseppe; Arena, Felice

2015-01-01

The design of offshore wind turbines is one of the most fascinating challenges in renewable energy. Meeting the objective of increasing power production with reduced installation and maintenance costs requires a multi-disciplinary approach, bringing together expertise in different fields of engineering. The purpose of this theme issue is to offer a broad perspective on some crucial aspects of offshore wind turbines design, discussing the state of the art and presenting recent theoretical and experimental studies. PMID:25583869
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.
Concepts for a global resources information system

NASA Technical Reports Server (NTRS)

Billingsley, F. C.; Urena, J. L.

1984-01-01

The objective of the Global Resources Information System (GRIS) is to establish an effective and efficient information management system to meet the data access requirements of NASA and NASA-related scientists conducting large-scale, multi-disciplinary, multi-mission scientific investigations. Using standard interfaces and operating guidelines, diverse data systems can be integrated to provide the capabilities to access and process multiple geographically dispersed data sets and to develop the necessary procedures and algorithms to derive global resource information.
Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program).

PubMed

Fenner, Ashley A; Howie, Erin K; Davis, Melissa C; Straker, Leon M

2016-07-07

Limited studies have investigated relationships in psychosocial outcomes between adolescents who are obese and their parents and how psychosocial outcomes change during participation in a physical activity and healthy eating intervention. This study examined both adolescent and parent psychosocial outcomes while participating in a one - year multi-disciplinary family-based intervention: Curtin University's Activity, Food, and Attitudes Program (CAFAP). Following a waitlist control period, the intervention was delivered to adolescent (n = 56, ages 11-16) and parent participants over 8 weeks, with one-year maintenance follow-up. Adolescent depression and quality of life, family functioning, and parent depression, anxiety, and stress were assessed at six time points: baseline and prior to intervention (e.g., waitlist control period), immediately following intervention, and at 3, 6, and 12 months post-intervention. Relationships between adolescent and parent psychosocial outcomes were assessed using Spearman correlations and changes in both adolescent and parent outcomes were assessed using linear mixed models. Changes in adolescent psychosocial outcomes were compared to changes in behavioural (physical activity and healthy eating) and physical (weight) outcomes using independent samples t-tests. The majority of psychosocial outcomes were significantly correlated between adolescents and parents across the one-year follow-up. Adolescent depression, psychosocial and physical quality of life outcomes significantly improved before or following intervention and were maintained at 6-months or one-year follow-up. Parent symptoms of depression, anxiety, and stress were reduced during waitlist and primarily remained improved. Changes in adolescent psychosocial outcomes were shown to be partially associated with behavioural changes and independent of physical changes. Adolescents in CAFAP improved psychosocial and physical quality of life and reversed the typical trajectory of depressive symptoms in adolescents who are obese during a one-year maintenance period. CAFAP was also effective at maintaining reductions in parent symptoms of depression, anxiety, and stress demonstrated during the waitlist period. The trial was registered with the Australian and New Zealand Clinical Trials Registry (No. 12611001187932 ).
Psychiatrists, mental health provision and 'senile dementia' in England, 1940s-1979.

PubMed

Hilton, Claire

2015-06-01

Until around 1979, 'confused' or mentally unwell people over 65 years of age tended to be labelled as having 'senile dementia'. Senile dementia was usually regarded as a single, inevitably hopeless condition, despite gradually accumulating clinical and pathological evidence to the contrary. Specific psychiatric services for mental illness in older people began to emerge in the 1950s, but by 1969 there were fewer than 10 dedicated services nationally. During the 1970s, 'old age psychiatrists' established local services and campaigned nationally for them. By 1979, about 100 old age psychiatrists were leading multi-disciplinary teams in half the health districts in England. This paper explores the tortuous development of these new services, focusing on provision for people with dementia. © The Author(s) 2015.
Teleform scannable data entry: an efficient method to update a community-based medical record? Community care coordination network Database Group.

PubMed Central

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

1995-01-01

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

PubMed

Janssen, Bienke M; Snoeren, Miranda W C; Van Regenmortel, Tine; Abma, Tineke A

2015-01-01

Although multi-disciplinary cooperation between professionals is a prerequisite to provide integrated care in the community, this seems hard to realise in practice. Yet, little is known about the experiences of professionals who implement it nor about the organisational features professionals identify as empowering during this cooperation process. Therefore, a case study of a multi-disciplinary geriatric team was performed. The data-collection included observations of meetings, in-depth interviews and focus groups with professionals (N = 12). Data were analysed inductively and related to the three organisational levels within the model of organisational empowerment of Peterson and Zimmerman. Signs of empowering organisational features on the intraorganisational level were mutual trust and clear working routines. On the interorganisational level important features included improved linkages between participating organisations and increased insight into each other's tasks. Tensions occurred relating to the inter- and the extraorganisational level. Professionals felt that the commitment of the management of involved organisations should be improved just as the capacity of the team to influence (local) policy. It is recommended that policymakers should not determine the nature of professional cooperation in advance, but to leave that to the local context as well as to the judgement of involved professionals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Health care professionals' experience, understanding and perception of need of advanced cancer patients with cachexia and their families: The benefits of a dedicated clinic.

PubMed

Scott, David; Reid, Joanne; Hudson, Peter; Martin, Peter; Porter, Sam

2016-12-30

Cachexia is defined as the on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It is found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. Previous studies demonstrate that many healthcare professionals receive little formal education in cachexia management leading them to feel that they have limited understanding of the syndrome and cannot intervene effectively. This study aims to examine the value of a dedicated cachexia clinic and its influence on staff understanding and practice. An exploratory qualitative study was conducted. The study employed semi-structured interviews with a range of healthcare professionals responsible for designing and delivering cancer care in a large teaching hospital in Australia. This hospital had a dedicated cachexia clinic. In-depth interviews were conducted with 8 healthcare professionals and senior managers. Four themes were identified: formal and informal education; knowledge and understanding; truth telling in cachexia and palliative care; and, a multi-disciplinary approach. Findings show that improved knowledge and understanding across a staff body can lead to enhanced staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families. Comparisons with similar previous research demonstrate the advantages of providing a structure for staff to gain knowledge about cachexia and how this can contribute to feelings of improved understanding and confidence necessary to respond to the challenge of cachexia.
Events and decision-making in the long-term care of Dutch nursing home patients in a vegetative state.

PubMed

Lavrijsen, Jan; van den Bosch, Hans; Koopmans, Raymond; van Weel, Chris; Froeling, Paul

2005-01-01

To clarify characteristics of long-term care and treatment of patients in a vegetative state. Qualitative, descriptive study in a Dutch nursing home. Review of clinical records of patients in a vegetative state after acute brain damage between 1978-2002. Five patients received intensive care of a multi-disciplinary team and showed considerable co-morbidity. There was no standard scenario for end-of-life decisions. Physicians play a more proactive role by evaluating the total medical treatment instead of withholding therapy in case of incidental complications. The families' attitude is a crucial factor in their ultimate decision. There is no standard solution to alleviate the fate of patients in a vegetative state and their families. Withdrawing all medical treatment, including artificial nutrition and hydration, can be an acceptable scenario for letting the patient die. More research is needed to identify the factors that contribute to acceptance of the physician's decision by the family.
Life expectancy calculation in urology: Are we equitably treating older patients?

PubMed

Bhatt, Nikita R; Davis, Niall F; Breen, Kieran; Flood, Hugh D; Giri, Subhasis K

2017-01-01

The aim of our study was to determine the contemporary practice in the utilization of life expectancy (LE) calculations among urological clinicians. Members of the Irish Society of Urology (ISU) and the British Association of Urological Surgeons (BAUS) completed a questionnaire on LE utilization in urological practice. The survey was delivered to 1251 clinicians and the response rate was 17% (n = 208/1251). The majority (61%, n = 127) of urologists were aware of methods available for estimated LE calculation.Seventy-one percent (n = 148) had never utilized LE analysis in clinical practice and 81% (n = 170) routinely used 'eyeballing' (empiric prediction) for estimating LE. Life expectancy tables were utilized infrequently (12%, n = 25) in making the decision for treatment in the setting of multi-disciplinary meetings. LE is poorly integrated into treatment decision-making; not only for the management of urological patients but also in the multidisciplinary setting. Further education and awareness regarding the importance of LE is vital.
[Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

PubMed

Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

2010-03-01

Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. EDP Sciences, SFODF, 2010.
Cellular therapies for heart disease: unveiling the ethical and public policy challenges.

PubMed

Raval, Amish N; Kamp, Timothy J; Hogle, Linda F

2008-10-01

Cellular therapies have emerged as a potential revolutionary treatment for cardiovascular disease. Promising preclinical results have resulted in a flurry of basic research activity and spawned multiple clinical trials worldwide. However, the optimal cell type and delivery mode have not been determined for target patient populations. Nor have the mechanisms of benefit for the range of cellular interventions been clearly defined. Experiences to date have unveiled a myriad of ethical and public policy challenges which will affect the way researchers and clinicians make decisions for both basic and clinical research. Stem cells derived from embryos are at the forefront of the ethical and political debate, raising issues of which derivation methods are morally and socially permissible to pursue, as much as which are technically feasible. Adult stem cells are less controversial; however, important challenges exist in determining study design, cell processing, delivery mode, and target patient population. Pathways to successful commercialization and hence broad accessibility of cellular therapies for heart disease are only beginning to be explored. Comprehensive, multi-disciplinary and collaborative networks involving basic researchers, clinicians, regulatory officials and policymakers are required to share information, develop research, regulatory and policy standards and enable rational and ethical cell-based treatment approaches.
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…
75 FR 18503 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... promotion and disease prevention research on a broad range of topics using a multi- disciplinary and... Project Prevention Research Centers Program National Evaluation Reporting System (OMB No. 0920-0650 exp. 8... Brief Description The Prevention Research Centers (PRC) Program was established by Congress through the...
Genomic Diversity and the Microenvironment as Drivers of Progression in DCIS

DTIC Science & Technology

2015-10-01

integration of team members over the past year via frequent conferencing , face to face meetings, and constant communication. This multi-disciplinary...several searches into our electronic medical records to identify qualifying DCIS cases from our institution. From over 1300 initial candidates, we have

Identification and Prediction of Fish Assemblages in Streams of the Albemarle-Pamlico Basin, USA

EPA Science Inventory

Set within the Ecological Services Research Program (ESRP) of USEPA’s Office of Research and Development, a multi-disciplinary research collaborative (MEERT –Multimedia Ecological Exposure Research Team) has taken on a challenge to develop a regional assessment of several ecosyst...
GLOBAL CHANGE RESEARCH NEWS #2: MID-ATLANTIC REGIONAL ASSESSMENT (MARA)

EPA Science Inventory

As part of this National Assessment effort mandated by the Global Change Research Act of 1990, EPA's Global Change Research Program is sponsoring the Mid-Atlantic Regional Assessment (MARA). With EPA sponsorship, a multi-disciplinary team of faculty members is leading the first a...
Kansas Early Childhood Research Institute on Transitions. Final Report.

ERIC Educational Resources Information Center

Rice, Mabel L.; O'Brien, Marion

This final report describes research projects and other activities of the Kansas Early Childhood Research Institute (KECRI), a multi-investigator, cross-disciplinary Institute focusing on successful transitions for young (birth to age 8) children with disabilities or developmental delays. Interventions were developed, evaluated, and disseminated…
The Chinese House Game.

ERIC Educational Resources Information Center

Lee, James R.

1989-01-01

Discussion of the use of simulations to teach international relations (IR) highlights the Chinese House Game, a computer-based decision-making game based on Inter Nation Simulation (INS). Topics discussed include the increasing role of artificial intelligence in IR simulations, multi-disciplinary approaches, and the direction of IR as a…
Use of multi-disciplinary mooring data to extend intermittent OA observations from ship surveys

NASA Astrophysics Data System (ADS)

Send, U.; Ohman, M. D.; Martz, T. R.; Dickson, A. G.; Feely, R. A.; Demer, D.; Washburn, L.

2012-12-01

Ship surveys along the US West Coast have provided valuable insight into the conditions and changes in the water column that affect the ocean acidification state. Examples are the decades of CalCOFI sampling off southern California, and the West Coast ship survey published in Feely et al 2008. What is lacking in these observations is a description of the temporal variability of the conditions observed, and of the processes at work that lead to observed conditions or changes. Multi-disciplinary moorings are ideally suited for adding this dimension to the available observations which is critical for an understanding of the OA mechanisms. One example is the occurrence of corrosive water near the seafloor on the continental shelf, which was found in the Feely et al survey. Time series data from a mooring off Del Mar, California, with oxygen and pH sensors near the bottom in 100m depth show the frequency and intensity of corrosive and hypoxic conditions there, and how they relate to physical processes (cross-shelf and along-shelf flow), biological conditions, and climate processes (here La Nina). In the upwelling and open-ocean regimes off Pt. Conception two moorings (CCE1, CCE2) have been collecting data since early 2009 and 2010, respectively, co-located with CalCOFI stations and CCE LTER cardinal sites for ship observations. A glider also routinely passes by these moorings (along CalCOFI line 80). The moorings carry physical, oxygen, pH, pCO2, nutrient, and ecosystem sensors (chlorophyll fluorescence, water column irradiance absorption, acoustic backscatter) and telemeter most data in real-time. The mooring time series show the variability of OA parameters on daily, weekly, seasonal, and interannual time scales, and in the context of the spatial and historical sampling from ships. The multi-disciplinary sensor suite allows to study the forcing of the OA variability on those various time scales, and the impact on the ecosystem. Combined with the spatial information from ships, and with the physical and biological variables observed at the mooring, we can also start to estimate individual terms in a carbon budget. Examples for these applications will be given in the presentation.
Clinical research informatics and electronic health record data.

PubMed

Richesson, R L; Horvath, M M; Rusincovitch, S A

2014-08-15

The goal of this survey is to discuss the impact of the growing availability of electronic health record (EHR) data on the evolving field of Clinical Research Informatics (CRI), which is the union of biomedical research and informatics. Major challenges for the use of EHR-derived data for research include the lack of standard methods for ensuring that data quality, completeness, and provenance are sufficient to assess the appropriateness of its use for research. Areas that need continued emphasis include methods for integrating data from heterogeneous sources, guidelines (including explicit phenotype definitions) for using these data in both pragmatic clinical trials and observational investigations, strong data governance to better understand and control quality of enterprise data, and promotion of national standards for representing and using clinical data. The use of EHR data has become a priority in CRI. Awareness of underlying clinical data collection processes will be essential in order to leverage these data for clinical research and patient care, and will require multi-disciplinary teams representing clinical research, informatics, and healthcare operations. Considerations for the use of EHR data provide a starting point for practical applications and a CRI research agenda, which will be facilitated by CRI's key role in the infrastructure of a learning healthcare system.
Clinical Research Informatics and Electronic Health Record Data

PubMed Central

Horvath, M. M.; Rusincovitch, S. A.

2014-01-01

Summary Objectives The goal of this survey is to discuss the impact of the growing availability of electronic health record (EHR) data on the evolving field of Clinical Research Informatics (CRI), which is the union of biomedical research and informatics. Results Major challenges for the use of EHR-derived data for research include the lack of standard methods for ensuring that data quality, completeness, and provenance are sufficient to assess the appropriateness of its use for research. Areas that need continued emphasis include methods for integrating data from heterogeneous sources, guidelines (including explicit phenotype definitions) for using these data in both pragmatic clinical trials and observational investigations, strong data governance to better understand and control quality of enterprise data, and promotion of national standards for representing and using clinical data. Conclusions The use of EHR data has become a priority in CRI. Awareness of underlying clinical data collection processes will be essential in order to leverage these data for clinical research and patient care, and will require multi-disciplinary teams representing clinical research, informatics, and healthcare operations. Considerations for the use of EHR data provide a starting point for practical applications and a CRI research agenda, which will be facilitated by CRI’s key role in the infrastructure of a learning healthcare system. PMID:25123746
Imaging findings in Idiopathic lobular granulomattous mastitis, case report and review of literature.

PubMed

Boarki, K; Labib, M

2010-01-01

Idiopathic lobular granulomatous mastititis is a rare inflammatory disease of the breast. Since the clinical manifestations simulate those of mammary malignancy, it is often misdiagnosed. We report a case in a 25 yrs old Egyptian woman who had presented with complaint of a painful mass in her right breast of 3 months duration. Clinical and radiological examinations were indeterminate of its nature and the diagnosis was established by histopathogical, microbiological and serological tests. Review of relevant literature mention the features of Idiopathic lobular granulomatous mastititis, which impose significant challenge on clinical, radiological and even histopathological diagnosis. These correlate well with our case scenario also. Complete resection of the lesions and/or administration of steroids are usually the recommended treatment, however about 38% patients may experience recurrence. Hence proper post treatment follow up is mandatory. Awareness among the clinicians, radiologists and pathologists about this disease entity is required and multi disciplinary approach is imperative to establish the diagnosis. We hope to convey these facts through this article with the review of relevant literature.
Experiences sharing of implementing Template-based Electronic Medical Record System (TEMRS) in a Hong Kong medical organization.

PubMed

Ting, S L; Kwok, S K; Tsang, Albert H C; Lee, W B; Yee, K F

2011-12-01

This paper aims to investigate the efficacy and feasibility of Template-based Electronic Medical Record System (TEMRS) and factors for its successful implementation. A TEMRS was designed and implemented in one core clinic of a Hong Kong professional multi-disciplinary medical services provider with four core clinics located in different parts of Hong Kong. Eight doctors participated in the study. Surveys and interviews were conducted to acquire the users' feedback and satisfaction level. The design, development, and the factors related to the success of the implementation of TEMRS were analyzed. In the study period, 3,032 cases were collected. The most encountered diagnosis were upper respiratory tract infection (50.59%), gastroenteritis (10.19%), dermatitis (5.87%), dyspepsia (5.28%) and rhinitis (4.82%). The system gained an overall satisfaction by the users and the most satisfied areas were rapid retrieving the necessary information of patient (75%) and fasten the diagnostic selection (75%). TEMRS is an enabling system which can reduce the user resistance in new technology with its flexibility. The consideration of cost, security, human, technical, data migration and standardization issues are essential in the implementation of the TEMRS and further research should be conducted to expand the TEMRS's implementation in health care system.
Brain Metastasis: Unique Challenges and Open Opportunities

PubMed Central

Lowery, Frank J.; Yu, Dihua

2016-01-01

The metastasis of cancer to the central nervous system (CNS) remains a devastating clinical reality, carrying an estimated survival time of less than one year in spite of recent therapeutic breakthroughs for other disease contexts. Advances in brain metastasis research are hindered by a number of reasons, including its complicated nature and the difficulty of modeling metastatic cancer growth in the unique brain microenvironment. In this review, we will discuss the clinical challenge, and compare the values and limitations of the available models for brain metastasis research. Additionally, we will specifically address current knowledge on how brain metastases take advantage of the unique brain environment to benefit their own growth. Finally, we will explore the distinctive metabolic and nutrient characteristics of the brain; how these paradoxically represent barriers to establishment of brain metastasis, but also provide ample supplies for metastatic cells’ growth in the brain. We envision that multi-disciplinary innovative approaches will open opportunities for the field to make breakthroughs in tackling unique challenges of brain metastasis. PMID:27939792
A multi-disciplinary approach to the management of fungal osteomyelitis: current concepts in post-traumatic lower extremity reconstruction: a case report.

PubMed

Cetrulo, Curtis L; Leto Barone, Angelo A; Jordan, Kathleen; Chang, David S; Louie, Kevin; Buntic, Rudolf F; Brooks, Darrell

2012-02-01

Limb salvage in fungal osteomyelitis of the post-traumatic lower extremity represents a difficult clinical problem requiring aggressive management. We report lower extremity salvage by radical bony debridement, free tissue transfer, distraction osteogenesis with bone-docking, and a novel antifungal regimen in a clinical setting of infection with Scedosporium inflatum, historically requiring amputation in 100% of cases. We treated Scedosporium inflatum osteomyelitis of the tibia and calcaneus with radical debridement of infected bone, free partial medial rectus abdominis muscle flap coverage, transport distraction osteogenesis, and combination voriconazole/terbinafine chemotherapy, a novel antifungal regimen. We achieved successful control of the infection, limb salvage, and an excellent functional outcome through aggressive debridement of infected bone and soft tissue, elimination of dead space within the bony defect, the robust perfusion provided by the free flap, the hypervascular state induced by distraction osteogenesis, and the synergism of the novel antifungal regimen.
Development of Lightweight CubeSat with Multi-Functional Structural Battery Systems

NASA Technical Reports Server (NTRS)

Karkkainen, Ryan L.; Hunter, Roger C.; Baker, Christopher

2017-01-01

This collaborative multi-disciplinary effort aims to develop a lightweight, 1-unit (1U) CubeSat (10x10x10 cm) which utilizes improved and fully integrated structural battery materials for mission life extension, larger payload capability, and significantly reduced mass.The electrolytic carbon fiber material serves the multifunctional capacitive energy system as both a lightweight, load bearing structure and an electrochemical battery system. This implementation will improve traditional multifunctional energy storage concepts with a highly effective energy storage capability.
Establishing a clinical cardiac MRI service.

PubMed

O'Regan, D P; Schmitz, S A

2006-03-01

After several years of research development cardiovascular MRI has evolved into a widely accepted clinical tool. It offers important diagnostic and prognostic information for a variety of clinical indications, which include ischaemic heart disease, cardiomyopathies, valvular dysfunction and congenital heart disorders. It is a safe non-invasive technique that employs a variety of imaging sequences optimized for temporal or spatial resolution, tissue-specific contrast, flow quantification or angiography. Cardiac MRI offers specific advantages over conventional imaging techniques for a significant number of patients. The demand for cardiac MRI studies from cardiothoracic surgeons, cardiologists and other referrers is likely to continue to rise with pressure for more widespread local service provision. Setting up a cardiac MRI service requires careful consideration regarding funding issues and how it will be integrated with existing service provision. The purchase of cardiac phased array coils, monitoring equipment and software upgrades must also be considered, as well as the training needs of those involved. The choice of appropriate imaging protocols will be guided by operator experience, clinical indication and equipment capability, and is likely to evolve as the service develops. Post-processing and offline analysis form a significant part of the time taken to report studies and an efficient method of providing quantitative reports is an important requirement. Collaboration between radiologists and cardiologists is needed to develop a successful service and multi-disciplinary meetings are key component of this. This review will explore these issues from our perspective of a new clinical cardiac MRI service operating over its first year in a teaching hospital imaging department.
Underground laboratories in Asia

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

Lin, Shin Ted, E-mail: linst@mails.phys.sinica.edu.tw; Yue, Qian, E-mail: yueq@mail.tsinghua.edu.cn

2015-08-17

Deep underground laboratories in Asia have been making huge progress recently because underground sites provide unique opportunities to explore the rare-event phenomena for the study of dark matter searches, neutrino physics and nuclear astrophysics as well as the multi-disciplinary researches based on the low radioactive environments. The status and perspectives of Kamioda underground observatories in Japan, the existing Y2L and the planned CUP in Korea, India-based Neutrino Observatory (INO) in India and China JinPing Underground Laboratory (CJPL) in China will be surveyed.
New perspectives in offshore wind energy.

PubMed

Failla, Giuseppe; Arena, Felice

2015-02-28

The design of offshore wind turbines is one of the most fascinating challenges in renewable energy. Meeting the objective of increasing power production with reduced installation and maintenance costs requires a multi-disciplinary approach, bringing together expertise in different fields of engineering. The purpose of this theme issue is to offer a broad perspective on some crucial aspects of offshore wind turbines design, discussing the state of the art and presenting recent theoretical and experimental studies. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
Underground laboratories in Asia

NASA Astrophysics Data System (ADS)

Lin, Shin Ted; Yue, Qian

2015-08-01

Deep underground laboratories in Asia have been making huge progress recently because underground sites provide unique opportunities to explore the rare-event phenomena for the study of dark matter searches, neutrino physics and nuclear astrophysics as well as the multi-disciplinary researches based on the low radioactive environments. The status and perspectives of Kamioda underground observatories in Japan, the existing Y2L and the planned CUP in Korea, India-based Neutrino Observatory (INO) in India and China JinPing Underground Laboratory (CJPL) in China will be surveyed.
Gauge invariant lattice quantum field theory: Implications for statistical properties of high frequency financial markets

NASA Astrophysics Data System (ADS)

Dupoyet, B.; Fiebig, H. R.; Musgrove, D. P.

2010-01-01

We report on initial studies of a quantum field theory defined on a lattice with multi-ladder geometry and the dilation group as a local gauge symmetry. The model is relevant in the cross-disciplinary area of econophysics. A corresponding proposal by Ilinski aimed at gauge modeling in non-equilibrium pricing is implemented in a numerical simulation. We arrive at a probability distribution of relative gains which matches the high frequency historical data of the NASDAQ stock exchange index.
[Reform and practice of teaching methods for culture of medicinal plant].

PubMed

Si, Jinping; Zhu, Yuqiu; Liu, Jingjing; Bai, Yan; Zhang, Xinfeng

2012-02-01

Culture of pharmaceutical plant is a comprehensive multi-disciplinary theory, which has a long history of application. In order to improve the quality of this course, some reformation schemes have been carried out, including stimulating enthusiasm for learning, refining the basic concepts and theories, promoting the case study, emphasis on latest achievements, enhancing exercise in laboratory and planting base, and guiding students to do scientific and technological innovation. Meanwhile, the authors point out some teaching problems of this course.
Examining school-based bullying interventions using multilevel discrete time hazard modeling.

PubMed

Ayers, Stephanie L; Wagaman, M Alex; Geiger, Jennifer Mullins; Bermudez-Parsai, Monica; Hedberg, E C

2012-10-01

Although schools have been trying to address bullying by utilizing different approaches that stop or reduce the incidence of bullying, little remains known about what specific intervention strategies are most successful in reducing bullying in the school setting. Using the social-ecological framework, this paper examines school-based disciplinary interventions often used to deliver consequences to deter the reoccurrence of bullying and aggressive behaviors among school-aged children. Data for this study are drawn from the School-Wide Information System (SWIS) with the final analytic sample consisting of 1,221 students in grades K - 12 who received an office disciplinary referral for bullying during the first semester. Using Kaplan-Meier Failure Functions and Multi-level discrete time hazard models, determinants of the probability of a student receiving a second referral over time were examined. Of the seven interventions tested, only Parent-Teacher Conference (AOR = 0.65, p < .01) and Loss of Privileges (AOR = 0.71, p < .10) were significant in reducing the rate of the reoccurrence of bullying and aggressive behaviors. By using a social-ecological framework, schools can develop strategies that deter the reoccurrence of bullying by identifying key factors that enhance a sense of connection between the students' mesosystems as well as utilizing disciplinary strategies that take into consideration student's microsystem roles.
Examining School-Based Bullying Interventions Using Multilevel Discrete Time Hazard Modeling

PubMed Central

Wagaman, M. Alex; Geiger, Jennifer Mullins; Bermudez-Parsai, Monica; Hedberg, E. C.

2014-01-01

Although schools have been trying to address bulling by utilizing different approaches that stop or reduce the incidence of bullying, little remains known about what specific intervention strategies are most successful in reducing bullying in the school setting. Using the social-ecological framework, this paper examines school-based disciplinary interventions often used to deliver consequences to deter the reoccurrence of bullying and aggressive behaviors among school-aged children. Data for this study are drawn from the School-Wide Information System (SWIS) with the final analytic sample consisting of 1,221 students in grades K – 12 who received an office disciplinary referral for bullying during the first semester. Using Kaplan-Meier Failure Functions and Multi-level discrete time hazard models, determinants of the probability of a student receiving a second referral over time were examined. Of the seven interventions tested, only Parent-Teacher Conference (AOR=0.65, p<.01) and Loss of Privileges (AOR=0.71, p<.10) were significant in reducing the rate of the reoccurrence of bullying and aggressive behaviors. By using a social-ecological framework, schools can develop strategies that deter the reoccurrence of bullying by identifying key factors that enhance a sense of connection between the students’ mesosystems as well as utilizing disciplinary strategies that take into consideration student’s microsystem roles. PMID:22878779

Forward Bay Cover Separation Modeling and Testing for the Orion Multi-Purpose Crew Vehicle

NASA Technical Reports Server (NTRS)

Ali, Yasmin; Chuhta, Jesse D.; Hughes, Michael P.; Radke, Tara S.

2015-01-01

Spacecraft multi-body separation events during atmospheric descent require complex testing and analysis to validate the flight separation dynamics models used to verify no re-contact. The NASA Orion Multi-Purpose Crew Vehicle (MPCV) architecture includes a highly-integrated Forward Bay Cover (FBC) jettison assembly design that combines parachutes and piston thrusters to separate the FBC from the Crew Module (CM) and avoid re-contact. A multi-disciplinary team across numerous organizations examined key model parameters and risk areas to develop a robust but affordable test campaign in order to validate and verify the FBC separation event for Exploration Flight Test-1 (EFT-1). The FBC jettison simulation model is highly complex, consisting of dozens of parameters varied simultaneously, with numerous multi-parameter interactions (coupling and feedback) among the various model elements, and encompassing distinct near-field, mid-field, and far-field regimes. The test campaign was composed of component-level testing (for example gas-piston thrusters and parachute mortars), ground FBC jettison tests, and FBC jettison air-drop tests that were accomplished by a highly multi-disciplinary team. Three ground jettison tests isolated the testing of mechanisms and structures to anchor the simulation models excluding aerodynamic effects. Subsequently, two air-drop tests added aerodynamic and parachute elements, and served as integrated system demonstrations, which had been preliminarily explored during the Orion Pad Abort-1 (PA-1) flight test in May 2010. Both ground and drop tests provided extensive data to validate analytical models and to verify the FBC jettison event for EFT-1. Additional testing will be required to support human certification of this separation event, for which NASA and Lockheed Martin are applying knowledge from Apollo and EFT-1 testing and modeling to develop a robust human-rated FBC separation event.
The hardwood ecosystem experiment: goals, design, and implementation

Treesearch

Rebecca A. Kalb; Cortney J. Mycroft

2013-01-01

The Hardwood Ecosystem Experiment (HEE) is a long-term, landscape-level field experiment initiated in 2006 by the Indiana Department of Natural Resources-Division of Forestry. The HEE is a multi-disciplinary, collaborative research project involving researchers from Purdue University, Indiana State University, Ball State University, Indiana University of Pennsylvania,...
Systematic Approach to Food Safety Education on the Farm

ERIC Educational Resources Information Center

Shaw, Angela; Strohbehn, Catherine; Naeve, Linda; Domoto, Paul; Wilson, Lester

2015-01-01

Food safety education from farm to end user is essential in the mitigation of food safety concerns associated with fresh produce. Iowa State University developed a multi-disciplinary three-level sequential program ("Know," "Show," "Go") to provide a holistic approach to food safety education. This program provides…
Michigan's agricultural heritage: using historical data to develop authentic heritage attractions

Treesearch

Craig Wiles; Terry Shaffer; Gail Vander Stoep

2003-01-01

The Michigan Agricultural Heritage Project, a multi-disciplinary research effort at Michigan State University sponsored by the Michigan Department of Transportation, is currently completing a rural agricultural context document. While the main purpose of this project is to provide information, tools and resources for historic preservation consultants...
Intercultural Teaching Competence: A Multi-Disciplinary Model for Instructor Reflection

ERIC Educational Resources Information Center

Dimitrov, Nanda; Haque, Aisha

2016-01-01

This article presents a model for Intercultural Teaching Competence (ITC) that instructors may use as a tool for reflection as they prepare to facilitate learning across cultures. Building on previous research on intercultural competence, culturally relevant teaching, intercultural trainer competencies, and student-centred approaches to teaching,…
Consumer Education Resource Guide, K-12. A Multi-Disciplinary Approach.

ERIC Educational Resources Information Center

Calhoun, Calfrey C.; And Others

The guide suggests methods and resources for planning learning experiences in teaching consumer education to students at the K-12 levels. The major topics and related areas are: (1) financial planning (estimating income, estimating expenses, establishing goals, making decisions, and making the financial plan); (2) buying (importance of planned…
Ecological Risk Assessment in the 21st Century: The Role of Ecotoxicogenomics and the Need for Multi-disciplinary Research

EPA Science Inventory

Ecological risk assessments have traditionally relied on analytical chemistry for exposure assessment and whole animal toxicity testing for hazard/effects assessment. However, these approaches are costly and limited in their applicability to a broad diversity of chemical and non...
A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

EPA Science Inventory

Science has a critical role to play in guiding more sustainable development trajectories. Here we present the Sustainable Amazon Network (Rede Amazônia Sustentável, RAS): a multi-disciplinary research initiative involving more than 30 partner organisations working to assess both ...
A Project-Based Model for Professional Environmental Experience

ERIC Educational Resources Information Center

Meehan, Barry; Thomas, Ian

2006-01-01

The projects described in this article were designed to provide a real world situation akin to the work of environmental professionals. The projects were conducted with Australian students working on environmental issues in Vietnam. The projects demonstrated that multi-disciplinary teamwork fits well into environmental projects, and importantly…
Teamwork: Education for Entrants to the Environment Professions

ERIC Educational Resources Information Center

Meehan, Barry; Thomas, Ian

2006-01-01

Numerous reports over recent years emphasise the importance of teamwork training in undergraduate programs in environment education at tertiary level. This paper describes a project undertaken by a team of final year undergraduate environment students from four faculties at RMIT University in Australia working on a multi-disciplinary environment…
[From rehabilitation to re-adaptation, preparing the return home].

PubMed

Froger, Jérôme; Jourdan, Claire; Dabek, Marie-Christine; Petitqueux, Sophie; Gardes, Raphaël; Dupeyron, Arnaud

2017-03-01

After a serious head trauma, the return home constitutes a key moment in the patient's reintegration. It is prepared by a multi-disciplinary team throughout the rehabilitation and re-adaptation process, taking into account the patient's prognosis for recovery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Preparing for Multi-Disciplinary Undergraduate Research Conferences

ERIC Educational Resources Information Center

Hill, Jennifer; West, Harry; Kneale, Pauline

2018-01-01

National undergraduate research conferences have been commonplace in the US for many years e.g. the National Conference on Undergraduate Research (NCUR), and are becoming more frequent elsewhere. Alongside national conferences many universities hold their own events, which are often institution-wide, so as to appeal to a large proportion of their…
Abstract for 1999 Rational Software User Conference

NASA Technical Reports Server (NTRS)

Dunphy, Julia; Rouquette, Nicolas; Feather, Martin; Tung, Yu-Wen

1999-01-01

We develop spacecraft fault-protection software at NASA/JPL. Challenges exemplified by our task: 1) high-quality systems - need for extensive validation & verification; 2) multi-disciplinary context - involves experts from diverse areas; 3) embedded systems - must adapt to external practices, notations, etc.; and 4) development pressures - NASA's mandate of "better, faster, cheaper".
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…
The SENNAPE Project: An University-Industry Joint Program in Information Technology.

ERIC Educational Resources Information Center

Seixas, J. M.; Maidantchik, C.; Caloba, L. P.

The SENNAPE (Software Engineering and Neural Networks Applied to Physics and Electricity) project has been putting together the European and the Brazilian industries towards neural processing developments in the fields of high-energy physics and electricity. It is a multi-disciplinary international collaboration with the participation of different…
Engineering Communication Interface: An Engineering Multi-Disciplinary Project

ERIC Educational Resources Information Center

Prescott, David; El-Sakran, Tharwat; Albasha, Lutfi; Aloul, Fadi; Al-Assaf, Yousef

2011-01-01

Well-developed professional communication skills, collaborative work practices, effective self-management and a clear understanding of social responsibility and ethical practices are essential for the new engineer who hopes to contribute to the profession and build a career. These attributes are in addition to the traditional sound knowledge of…
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)
Lesbian Presentations and Representations of Leadership, and the Implications for HRD

ERIC Educational Resources Information Center

Gedro, Julie

2010-01-01

Purpose: This paper seeks to identify, examine, and discuss the unique challenges for lesbians who serve in leadership positions in corporate America. Design/methodology/approach: Drawing upon a multi-disciplinary framework of management, diversity, feminist, and leadership literature, the paper critically examines the myriad of pressures exerted…
A multi-disciplinary approach to sugarcane research at the USDA, ARS, Sugarcane Research Unit in Houma

USDA-ARS?s Scientific Manuscript database

The mission of the Sugarcane Research Unit (SRU) is to provide research-based solutions that enhance the viability of domestic sugarcane industry. To accomplish this mission, SRU uses a multidisciplinary approach to develop improved varieties and environmentally friendly production strategies. Cons...
The role of vegetation in mitigating air quality impacts from traffic emissions--journal

EPA Science Inventory

On Apri1 27-28, 2019, a multi-disciplinary group of researchers and po1icymakers met to discuss the state-of-the-science regarding the potential of roadside vegetation to mitigate near-road air quality impacts. Concerns over population exposures to traffic-generated pollutants ne...

'Commitment' secures rooftop SSD contract.

PubMed

Davies, John

2010-01-01

John Davies, operations manager of multi-disciplinary mechanical and electrical and construction contractor cfes, describes a "turnkey" project that the company is undertaking for the Yeovil District Hospital (YDH) NHS Foundation Trust, involving both the design and construction of a new sterile services department, and substantial input into the facility's subsequent operation and management.
Is This the Paradigm Shift We Need?

ERIC Educational Resources Information Center

Mirvis, Jonathan

2012-01-01

Dr. Woocher's essay, states Mirvis, is seminal in the field of Jewish education. It proposes a new paradigm for Jewish education in North America. This proposed paradigm is supported by a comprehensive multi-disciplinary research drawing on literature from education, philosophy, history, sociology, psychology, and economics. The essay reflects a…
STEAM-y Partnerships: A Case of Interdisciplinary Professional Development and Collaboration

ERIC Educational Resources Information Center

Kelton, Molly L.; Saraniero, Patti

2018-01-01

Museum partnerships can involve significant tensions, especially when these collaborations reach across institutions to blend disciplines such as art and mathematics. Rather than simply being obstacles to overcome, we suggest that tensions arising in multi-institutional, cross-disciplinary collaborations can be highly generative for collaborators,…
Building Bridges for Dance through Arts-Based Research

ERIC Educational Resources Information Center

Wilson, Lisa; Moffett, Ann-Thomas

2017-01-01

This paper considers arts-based research (ABR) as a useful resource for creating fluid and dialogic spaces between multiple domains of dance knowledge and practices. Through the lens of a multi-disciplinary, arts-based research project "Same Story, Different Countries" explored the socio-political phenomena of racism in the United States…
Exploding the Hierarchical Fallacy: The Significance of Foundation-Level Courses

ERIC Educational Resources Information Center

Maimon, Elaine P.

2017-01-01

Reform in American higher education depends on recognizing freshman courses as the foundation of higher-order thinking and learning. These courses must be recognized for their intellectual significance and their inherent possibilities for multi-disciplinary scholarship. The Maimon Hierarchical Fallacy is a phrase coined by Elaine Maimon to refer…
Family-Centered Early Intervention with Infants & Toddlers: Innovative Cross-Disciplinary Approaches.

ERIC Educational Resources Information Center

Brown, Wesley, Ed.; And Others

This multi-contributor volume addresses the challenges of providing early intervention services to infants and toddlers with disabilities, within a family-centered framework. The book provides a legislative review of the key elements of eligibility, assessment, and evaluation and then examines service coordination, curricula, special intervention…
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…
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…
Validation of Testing for a Multi-Disciplinary Technical Position.

ERIC Educational Resources Information Center

Sheppard, Valarie

This paper describes a testing program that established job-related standards of performance and testing procedures for the technician position within a gas transportation company. New standards were being established in response to safety concerns stemming from investigations that identified training inadequacy as a cause of accidents. The job…
Students-Designers' Professional Competencies Formation by Means of Folk Arts and Crafts

ERIC Educational Resources Information Center

Budkeev, Sergey Mikhailovich; Kiryushina, Julia Vladimirovna; Shokorova, Larisa Vladimirovna

2016-01-01

This article reviewed the structure of design activities, special aspects of the specialists' training in multi-disciplinary design environment, the formation process of their cultural and professional competences, necessary for artistic, creative and research activities in the field of design. It identified the components of the national…
An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases

PubMed Central

Doğan, Mehmet-Sinan; Callea, Michele; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayşe; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

2015-01-01

Background This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. Material and Methods In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. Results The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved. Key words: Ectodermal dysplasia, three-dimensional dental tomography. PMID:25662550
A study of information management in the patient surgical pathway in NHSScotland.

PubMed

Bouamrane, Matt-Mouley; Mair, Frances S

2013-01-01

We conducted a study of information management processes across the patient surgical pathway in NHSScotland. While the majority of general practitioners (GPs) consider electronic medical records systems as an essential and integral part of their work during the patient consultation, many were not fully satisfied with the functionalities of these systems. A majority of GPs considered that the national eReferral system streamlined referral processes. Almost all GPs reported marked variability in the quality of discharge information. Preoperative processes vary significantly across Scotland, with most services using paper-based systems. Insufficient use is made of information provided through the patient electronic referral leading to a considerable duplication of tasks already performed in primary care. Three health-boards have implemented electronic preoperative information systems. These have transformed clinical practices and facilitated communication and information-sharing among the multi-disciplinary team and within the health-boards. Substantial progress has been made towards improving information transfer and sharing within the surgical pathway in recent years. However, there remains scope for further improvements at the interface between services.
Ultrasound enhanced thrombolysis: Clinical evidence

NASA Astrophysics Data System (ADS)

Alexandrov, Andrei V.

2005-04-01

Phase II CLOTBUST randomized clinical trial (Houston, Barcelona, Edmonton, Calgary) evaluated patients with acute ischemic stroke due to intracranial occlusion and treated with intravenous tissue plasminogen activator (TPA) within 3 h of symptom onset. Randomization: monitoring with pulsed wave 2 MHz transcranial Doppler (TCD) (Target) or placebo monitoring (Control). Safety: symptomatic bleeding to the brain (sICH). Primary end-point: complete recanalization on TCD or dramatic clinical recovery by the total NIHSS score <3, or improvement by >10 NIHSS points within 2 hours after TPA bolus. All projected 126 patients were randomized 1:1 to target (median NIHSS 16) or control (NIHSS 17). sICH: 4.8% Target, 4.8% Controls. Primary end-point was achieved by 31 (49%, Target) versus 19 (30%, Control), p<0.03. At 3 months, 22 (42% Target) and 14 (29% Control) patients achieved favorable outcomes. Continuous TCD monitoring of intracranial occlusion safely augments TPA-induced arterial recanalization, and 2 MHz diagnostic ultrasound has a positive biological activity that aids systemic thrombolytic therapy. For the first time in clinical medicine, the CLOTBUST trial provides the evidence that ultrasound enhances thrombolytic activity of a drug in humans thereby confirming intense multi-disciplinary experimental research conducted worldwide for the past 30 years.
Geomorphic analysis of large alluvial rivers

NASA Astrophysics Data System (ADS)

Thorne, Colin R.

2002-05-01

Geomorphic analysis of a large river presents particular challenges and requires a systematic and organised approach because of the spatial scale and system complexity involved. This paper presents a framework and blueprint for geomorphic studies of large rivers developed in the course of basic, strategic and project-related investigations of a number of large rivers. The framework demonstrates the need to begin geomorphic studies early in the pre-feasibility stage of a river project and carry them through to implementation and post-project appraisal. The blueprint breaks down the multi-layered and multi-scaled complexity of a comprehensive geomorphic study into a number of well-defined and semi-independent topics, each of which can be performed separately to produce a clearly defined, deliverable product. Geomorphology increasingly plays a central role in multi-disciplinary river research and the importance of effective quality assurance makes it essential that audit trails and quality checks are hard-wired into study design. The structured approach presented here provides output products and production trails that can be rigorously audited, ensuring that the results of a geomorphic study can stand up to the closest scrutiny.
Strategies for conducting adolescent health research in the clinical setting: the Mount Sinai Adolescent Health Center HPV experience.

PubMed

Braun-Courville, Debra K; Schlecht, Nicolas F; Burk, Robert D; Strickler, Howard D; Rojas, Mary; Lorde-Rollins, Elizabeth; Nucci-Sack, Anne; Hollman, Dominic; Linares, L Oriana; Diaz, Angela

2014-10-01

Clinical research with adolescents can be challenging due to issues of informed consent, parental involvement, institutional review board requirements, and adolescent psychosocial development. These requirements present a dilemma, particularly in the area of sexual health research, as adolescents are disproportionately affected by sexually transmitted infections such as human papillomavirus (HPV). To successfully conduct adolescent research in the clinical setting, one requires an awareness of state statutes regarding adolescent confidentiality and consent for medical care, and a close partnership with the IRB. In 2007, the Mount Sinai Adolescent Health Center in collaboration with the Albert Einstein College of Medicine developed a longitudinal research study to examine the natural history of oral, cervical, and anal HPV in an adolescent female population engaged in high-risk sexual behaviors. We use this research project as a case study to explore the ethical, methodological, and clinical issues related to conducting adolescent health research. Several strategies were identified to promote adolescent study participation, including: (1) building a research team that is motivated to work with adolescents; (2) combining research and patient care visits to avoid duplication of services; and (3) establishing a personalized communication network with participants. Using these methods, adolescent sexual health research can successfully be integrated into the clinical setting. While retaining a prospective cohort of adolescents has its challenges, a persistent and multi-disciplinary approach can help improve recruitment, sustain participation, and acquire critical data that will lead to improved healthcare knowledge applicable to understudied populations of adolescents. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
The Agricultural Model Intercomparison and Improvement Project (AgMIP) Town Hall

NASA Technical Reports Server (NTRS)

Ruane, Alex; Rosenzweig, Cynthia; Kyle, Page; Basso, Bruno; Winter, Jonathan; Asseng, Senthold

2015-01-01

AgMIP (www.agmip.org) is an international community of climate, crop, livestock, economics, and IT experts working to further the development and application of multi-model, multi-scale, multi-disciplinary agricultural models that can inform policy and decision makers around the world. This meeting will engage the AGU community by providing a brief overview of AgMIP, in particular its new plans for a Coordinated Global and Regional Assessment of climate change impacts on agriculture and food security for AR6. This Town Hall will help identify opportunities for participants to become involved in AgMIP and its 30+ activities.
Probabilistic Multi-Scale, Multi-Level, Multi-Disciplinary Analysis and Optimization of Engine Structures

NASA Technical Reports Server (NTRS)

Chamis, Christos C.; Abumeri, Galib H.

2000-01-01

Aircraft engines are assemblies of dynamically interacting components. Engine updates to keep present aircraft flying safely and engines for new aircraft are progressively required to operate in more demanding technological and environmental requirements. Designs to effectively meet those requirements are necessarily collections of multi-scale, multi-level, multi-disciplinary analysis and optimization methods and probabilistic methods are necessary to quantify respective uncertainties. These types of methods are the only ones that can formally evaluate advanced composite designs which satisfy those progressively demanding requirements while assuring minimum cost, maximum reliability and maximum durability. Recent research activities at NASA Glenn Research Center have focused on developing multi-scale, multi-level, multidisciplinary analysis and optimization methods. Multi-scale refers to formal methods which describe complex material behavior metal or composite; multi-level refers to integration of participating disciplines to describe a structural response at the scale of interest; multidisciplinary refers to open-ended for various existing and yet to be developed discipline constructs required to formally predict/describe a structural response in engine operating environments. For example, these include but are not limited to: multi-factor models for material behavior, multi-scale composite mechanics, general purpose structural analysis, progressive structural fracture for evaluating durability and integrity, noise and acoustic fatigue, emission requirements, hot fluid mechanics, heat-transfer and probabilistic simulations. Many of these, as well as others, are encompassed in an integrated computer code identified as Engine Structures Technology Benefits Estimator (EST/BEST) or Multi-faceted/Engine Structures Optimization (MP/ESTOP). The discipline modules integrated in MP/ESTOP include: engine cycle (thermodynamics), engine weights, internal fluid mechanics, cost, mission and coupled structural/thermal, various composite property simulators and probabilistic methods to evaluate uncertainty effects (scatter ranges) in all the design parameters. The objective of the proposed paper is to briefly describe a multi-faceted design analysis and optimization capability for coupled multi-discipline engine structures optimization. Results are presented for engine and aircraft type metrics to illustrate the versatility of that capability. Results are also presented for reliability, noise and fatigue to illustrate its inclusiveness. For example, replacing metal rotors with composites reduces the engine weight by 20 percent, 15 percent noise reduction, and an order of magnitude improvement in reliability. Composite designs exist to increase fatigue life by at least two orders of magnitude compared to state-of-the-art metals.
Prematurity and respiratory outcomes program (PROP): study protocol of a prospective multicenter study of respiratory outcomes of preterm infants in the United States.

PubMed

Pryhuber, Gloria S; Maitre, Nathalie L; Ballard, Roberta A; Cifelli, Denise; Davis, Stephanie D; Ellenberg, Jonas H; Greenberg, James M; Kemp, James; Mariani, Thomas J; Panitch, Howard; Ren, Clement; Shaw, Pamela; Taussig, Lynn M; Hamvas, Aaron

2015-04-10

With improved survival rates, short- and long-term respiratory complications of premature birth are increasing, adding significantly to financial and health burdens in the United States. In response, in May 2010, the National Institutes of Health (NIH) and the National Heart, Lung, and Blood Institute (NHLBI) funded a 5-year $18.5 million research initiative to ultimately improve strategies for managing the respiratory complications of preterm and low birth weight infants. Using a collaborative, multi-disciplinary structure, the resulting Prematurity and Respiratory Outcomes Program (PROP) seeks to understand factors that correlate with future risk for respiratory morbidity. The PROP is an observational prospective cohort study performed by a consortium of six clinical centers (incorporating tertiary neonatal intensive care units [NICU] at 13 sites) and a data-coordinating center working in collaboration with the NHLBI. Each clinical center contributes subjects to the study, enrolling infants with gestational ages 23 0/7 to 28 6/7 weeks with an anticipated target of 750 survivors at 36 weeks post-menstrual age. In addition, each center brings specific areas of scientific focus to the Program. The primary study hypothesis is that in survivors of extreme prematurity specific biologic, physiologic and clinical data predicts respiratory morbidity between discharge and 1 year corrected age. Analytic statistical methodology includes model-based and non-model-based analyses, descriptive analyses and generalized linear mixed models. PROP incorporates aspects of NICU care to develop objective biomarkers and outcome measures of respiratory morbidity in the <29 week gestation population beyond just the NICU hospitalization, thereby leading to novel understanding of the nature and natural history of neonatal lung disease and of potential mechanistic and therapeutic targets in at-risk subjects. Clinical Trials.gov NCT01435187.
Evaluation of a multidisciplinary rehabilitation programme for elderly patients with hip fracture: A prospective cohort study.

PubMed

Cheung, Wing-Hoi; Shen, Wan-Yiu; Dai, David Lok-Kwan; Lee, Kin Bong; Zhu, Tracy Y; Wong, Ronald Man-Yeung; Leung, Kwok-Sui

2018-02-28

To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP) for fragility hip fracture patients. Prospective cohort study. Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care. CFFMP provided geri-orthopaedic co-management, physician consultations, group-exercise and vibration-therapy. Timed-up-and-go test (TUG), Elderly Mobility Scale (EMS), Berg Balance Scale (BBS) and fall risk screening (FS) were used to assess functional performance. Incidences of falls and secondary fractures, the cost of the programme and related healthcare resources were recorded. A total of 76 patients were included in the intervention group (mean age 77.9 years ((standard deviation; SD) 6.1) ) and 77 in the control group (79.9 (SD 7.2)), respectively. The re-fracture rate in the control group (10.39%) was significantly higher than in the intervention group (1.32%) (p = 0.034). The intervention group improved significantly in TUG, EMS and FS after a 1-year programme. The overall healthcare costs per patient in the intervention and control groups were US$22,450 and US$25,313, respectively. Multi-disciplinary CFFMP is effective, with reduced overall cost, reduced length of hospital stay and reduced secondary fracture rate. The rehabilitation community service favours rehabilitation and improved quality of life of hip fracture patients.
Measuring soil sustainability via soil resilience.

PubMed

Ludwig, Marie; Wilmes, Paul; Schrader, Stefan

2018-06-01

Soils are the nexus of water, energy and food, which illustrates the need for a holistic approach in sustainable soil management. The present study therefore aimed at identifying a bioindicator for the evaluation of soil management sustainability in a cross-disciplinary approach between soil science and multi-omics research. For this purpose we first discuss the remaining problems and challenges of evaluating sustainability and consequently suggest one measurable bioindicator for soil management sustainability. In this concept, we define soil sustainability as the maintenance of soil functional integrity. The potential to recover functional and structural integrity after a disturbance is generally defined as resilience. This potential is a product of the past and the present soil management, and at the same time prospect of possible soil responses to future disturbances. Additionally, it is correlated with the multiple soil functions and hence reflecting the multifunctionality of the soil system. Consequently, resilience can serve as a bioindicator for soil sustainability. The measurable part of soil resilience is the response diversity, calculated from the systematic contrasting of multi-omic markers for genetic potential and functional activity, and referred to as potential Maximum Ecological Performance (MEPpot) in this study. Calculating MEPpot will allow to determine the thresholds of resistance and resilience and potential tipping points for a regime shift towards irreversible or permanent unfavorable soil states for each individual soil considered. The calculation of such ecosystem thresholds is to our opinion the current global cross-disciplinary challenge. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Next generation of network medicine: interdisciplinary signaling approaches.

PubMed

Korcsmaros, Tamas; Schneider, Maria Victoria; Superti-Furga, Giulio

2017-02-20

In the last decade, network approaches have transformed our understanding of biological systems. Network analyses and visualizations have allowed us to identify essential molecules and modules in biological systems, and improved our understanding of how changes in cellular processes can lead to complex diseases, such as cancer, infectious and neurodegenerative diseases. "Network medicine" involves unbiased large-scale network-based analyses of diverse data describing interactions between genes, diseases, phenotypes, drug targets, drug transport, drug side-effects, disease trajectories and more. In terms of drug discovery, network medicine exploits our understanding of the network connectivity and signaling system dynamics to help identify optimal, often novel, drug targets. Contrary to initial expectations, however, network approaches have not yet delivered a revolution in molecular medicine. In this review, we propose that a key reason for the limited impact, so far, of network medicine is a lack of quantitative multi-disciplinary studies involving scientists from different backgrounds. To support this argument, we present existing approaches from structural biology, 'omics' technologies (e.g., genomics, proteomics, lipidomics) and computational modeling that point towards how multi-disciplinary efforts allow for important new insights. We also highlight some breakthrough studies as examples of the potential of these approaches, and suggest ways to make greater use of the power of interdisciplinarity. This review reflects discussions held at an interdisciplinary signaling workshop which facilitated knowledge exchange from experts from several different fields, including in silico modelers, computational biologists, biochemists, geneticists, molecular and cell biologists as well as cancer biologists and pharmacologists.
Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management.

PubMed

Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-04-01

Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.
Multi-disciplinary assessments of climate change impacts on agriculture to support adaptation decision making in developing countries

NASA Astrophysics Data System (ADS)

Fujisawa, Mariko; Kanamaru, Hideki

2016-04-01

Many existing climate change impact studies, carried out by academic researchers, are disconnected from decision making processes of stakeholders. On the other hand many climate change adaptation projects in developing countries lack a solid evidence base of current and future climate impacts as well as vulnerabilities assessment at different scales. In order to fill this information gap, FAO has developed and implemented a tool "MOSAICC (Modelling System for Agricultural Impacts of Climate Change)" in several developing countries such as Morocco, the Philippines and Peru, and recently in Malawi and Zambia. MOSAICC employs a multi-disciplinary assessment approach to addressing climate change impacts and adaptation planning in the agriculture and food security sectors, and integrates five components from different academic disciplines: 1. Statistical downscaling of climate change projections, 2. Yield simulation of major crops at regional scale under climate change, 3. Surface hydrology simulation model, 4. Macroeconomic model, and 5. Forestry model. Furthermore MOSAICC has been developed as a capacity development tool for the national scientists so that they can conduct the country assessment themselves, using their own data, and reflect the outcome into the national adaptation policies. The outputs are nation-wide coverage, disaggregated at sub-national level to support strategic planning, investments and decisions by national policy makers. MOSAICC is designed in such a way to promote stakeholders' participation and strengthen technical capacities in developing countries. The paper presents MOSAICC and projects that used MOSAICC as a tool with case studies from countries.
Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

PubMed

Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

2014-01-01

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.
Management of a rare case of idiopathic multiple unerupted impacted permanent teeth in an adult female patient

PubMed Central

Shetty, Karunakar; Kumar, Mahesh; Amanna, Susan; Sridharan, Srirangarajan; Reddy, Satyanarayan

2016-01-01

This clinical case report describes the multi-disciplinary approach in the management of an unusual presentation of idiopathic multiple unerupted impacted permanent teeth in a 20-year-old female patient. The case was unique in that, not only were there multiple missing permanent teeth, but also over retained deciduous teeth and attrited existing permanent teeth with loss of vertical dimension of occlusion. Since the patient was young, it was decided to retain all the erupted permanent teeth and extract the infected deciduous teeth with the objective of fabricating overlay complete dentures. This is a simple, reversible and an economical treatment modality, which satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated and, in addition, provides a stable occlusion. PMID:27621553
Nonribosomal Peptides from Marine Microbes and Their Antimicrobial and Anticancer Potential

PubMed Central

Agrawal, Shivankar; Acharya, Debabrata; Adholeya, Alok; Barrow, Colin J.; Deshmukh, Sunil K.

2017-01-01

Marine environments are largely unexplored and can be a source of new molecules for the treatment of many diseases such as malaria, cancer, tuberculosis, HIV etc. The Marine environment is one of the untapped bioresource of getting pharmacologically active nonribosomal peptides (NRPs). Bioprospecting of marine microbes have achieved many remarkable milestones in pharmaceutics. Till date, more than 50% of drugs which are in clinical use belong to the nonribosomal peptide or mixed polyketide-nonribosomal peptide families of natural products isolated from marine bacteria, cyanobacteria and fungi. In recent years large numbers of nonribosomal have been discovered from marine microbes using multi-disciplinary approaches. The present review covers the NRPs discovered from marine microbes and their pharmacological potential along with role of genomics, proteomics and bioinformatics in discovery and development of nonribosomal peptides drugs. PMID:29209209
Overview of sports vision

NASA Astrophysics Data System (ADS)

Moore, Linda A.; Ferreira, Jannie T.

2003-03-01

Sports vision encompasses the visual assessment and provision of sports-specific visual performance enhancement and ocular protection for athletes of all ages, genders and levels of participation. In recent years, sports vision has been identified as one of the key performance indicators in sport. It is built on four main cornerstones: corrective eyewear, protective eyewear, visual skills enhancement and performance enhancement. Although clinically well established in the US, it is still a relatively new area of optometric specialisation elsewhere in the world and is gaining increasing popularity with eyecare practitioners and researchers. This research is often multi-disciplinary and involves input from a variety of subject disciplines, mainly those of optometry, medicine, physiology, psychology, physics, chemistry, computer science and engineering. Collaborative research projects are currently underway between staff of the Schools of Physics and Computing (DIT) and the Academy of Sports Vision (RAU).
Physical activity and exercise on diabetic foot related outcomes: A systematic review.

PubMed

Matos, Monica; Mendes, Romeu; Silva, André B; Sousa, Nelson

2018-05-01

Diabetic foot is one of the most common complications of diabetes. It has the potential risk of pathologic consequences including infection, ulceration and amputation, but a growing body of evidence suggests that physical activity and exercise may improve diabetic foot outcomes. To analyze de effects of exercise and physical activity interventions on diabetic foot outcomes. A comprehensive and systematic search was conducted according to PRISMA recommendations. Only controlled clinical trials with patients with diabetes were included. Six studies, involving 418 patients with diabetes, were included. Two studies used only aerobic exercise; two studies combined aerobic, resistance and balance exercise; and two studies combined aerobic and balance exercise by Thai Chin Chuan methods. Physical activity and exercise significantly improved nerve velocity conduction, peripheral sensory function and foot peak pressure distribution. Moreover, the ulcers incidence rate per year was lower in the intervention groups, compared with the controls [0.02 vs. 0.12]. This review suggests evidence that physical activity and exercise is an effective non-pharmacological intervention to improve diabetic foot related outcomes. Combined multi-disciplinary treatments are more effective in the prevention of foot complications in patients with diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.
Learning by Doing--Teaching Systematic Review Methods in 8 Weeks

ERIC Educational Resources Information Center

Li, Tianjing; Saldanha, Ian J.; Vedula, S. Swaroop; Yu, Tsung; Rosman, Lori; Twose, Claire; Goodman, Steven N.; Dickersin, Kay

2014-01-01

Objective: The objective of this paper is to describe the course "Systematic Reviews and Meta-analysis" at the Johns Hopkins Bloomberg School of Public Health. Methods: A distinct feature of our course is a group project in which students, assigned to multi-disciplinary groups, conduct a systematic review. In-class sessions comprise…
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…
The Changing Nature of Educational Technology Programs

ERIC Educational Resources Information Center

Spector, J. Michael

2015-01-01

The many changes in educational technologies have been well documented in both the professional and popular literature. What is less well documented is the changing nature of programs that prepare individuals for careers in the broad multi-disciplinary field of educational technology. This article is a first attempt to look at how educational…
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 Perceived Life Impact of a University Outdoor Education Course

ERIC Educational Resources Information Center

Wigglesworth, Jennifer

2012-01-01

Learning in the outdoors provides lasting educational experiences. Most students retain information best when doing an activity, and the outdoors allows for these opportunities. Outdoor education (OE) is a large, multi-disciplinary field cultivated from many roots. Since OE offers such vivid learning opportunities, it is an important area for…
Work, Productivity, and Job Satisfaction. An Evaluation of Policy-Related Research.

ERIC Educational Resources Information Center

Katzell, Raymond A.; And Others

This report is a multi-disciplinary evaluation of policy-related research (which met relatively high standards of scientific validity) dealing with features of work affecting both the productivity and job satisfaction of employees. Its purpose is to determine whether and how worker job satisfaction and productivity together may be enhanced by…
Go Figure. HEADJAM. Teaching Guide [and Videotape].

ERIC Educational Resources Information Center

MATHCOUNTS Foundation, Alexandria, VA.

The HeadJam series is comprised of six programs exploring mathematics, science, and critical thinking skills. It is an award-winning, educational videotape series for middle school students that explores multi-disciplinary skills in a highly entertaining way. The teacher's guide and 22-minute video, "Go Figure," demonstrate how math is used in the…
Multilevel Multi-Informant Structure of the Authoritative School Climate Survey

ERIC Educational Resources Information Center

Konold, Timothy; Cornell, Dewey; Huang, Francis; Meyer, Patrick; Lacey, Anna; Nekvasil, Erin; Heilbrun, Anna; Shukla, Kathan

2014-01-01

The Authoritative School Climate Survey was designed to provide schools with a brief assessment of 2 key characteristics of school climate--disciplinary structure and student support--that are hypothesized to influence 2 important school climate outcomes--student engagement and prevalence of teasing and bullying in school. The factor structure of…
Scientist, Single Cell Analysis Facility | Center for Cancer Research

Cancer.gov

The Cancer Research Technology Program (CRTP) develops and implements emerging technology, cancer biology expertise and research capabilities to accomplish NCI research objectives. The CRTP is an outward-facing, multi-disciplinary hub purposed to enable the external cancer research community and provides dedicated support to NCI’s intramural Center for Cancer Research (CCR).
Multi-Disciplinary Peer-Mark Moderation of Group Work

ERIC Educational Resources Information Center

Willmot, Peter; Pond, Keith

2012-01-01

Self and peer assessment offers benefits for enhancing student learning. Peer moderation provides a convenient solution for awarding individual marks in group assignments. This paper provides a significant review of peer-mark moderation, and describes an award winning, web-based tool that was developed in the UK and is now spreading across the…
Common Elements of Capstone Projects in the World's Top-Ranked Engineering Universities

ERIC Educational Resources Information Center

Ward, Thomas A.

2013-01-01

"Capstone" is a metaphor used to describe a final achievement that builds upon previous works and encapsulates them. Capstone projects are included in engineering curricula to integrate multi-disciplinary subjects and teach professional skills that are difficult to impart in a traditional lectured course. Since these projects serve to…
Assessment Practices of Multi-Disciplinary School Team Members in Determining Special Education Services for English Language Learners

ERIC Educational Resources Information Center

Sadowski, Garrett; O'Neill, Rob; Bermingham, Doug

2014-01-01

Multidisciplinary team members were surveyed to identify the frequency with which they use recommended assessment practices, how they interpret assessment information, and their confidence working with English Language Learners (ELLs) for the purpose of determining possible eligibility to receive special education services. Results of this study…

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