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Sample records for multidisciplinary public approach

  1. Halitosis: the multidisciplinary approach

    PubMed Central

    Bollen, Curd ML; Beikler, Thomas

    2012-01-01

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

  2. Breakfast: a multidisciplinary approach

    PubMed Central

    2013-01-01

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

  3. Multidisciplinary approaches to solar hydrogen

    PubMed Central

    Bren, Kara L.

    2015-01-01

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

  4. Multidisciplinary Approach to Linear Aerospike Nozzle Optimization

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  5. Multidisciplinary Approach to Aerospike Nozzle Design

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  6. A multidisciplinary approach to improving revenue integrity.

    PubMed

    Craghead, Todd; Liston, Eric

    2014-03-01

    Intermountain Healthcare's journey toward a modern revenue integrity process began with five key steps: building a multidisciplinary team, developing department-specific charge-capture teams, providing ongoing education and training on best practices for revenue integrity, leveraging new technology and business support services, establishing a proactive approach to managing audits and compliance.

  7. Placenta accreta and anesthesia: A multidisciplinary approach

    PubMed Central

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

    2016-01-01

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

  8. Multidisciplinary Approaches in Evolutionary Linguistics

    ERIC Educational Resources Information Center

    Gong, Tao; Shuai, Lan; Wu, Yicheng

    2013-01-01

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

  9. [Tooth erosion - a multidisciplinary approach].

    PubMed

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

    2016-02-01

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

  10. [Tooth erosion - a multidisciplinary approach].

    PubMed

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

    2016-02-01

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

  11. Multidisciplinary approaches to climate change questions

    USGS Publications Warehouse

    Middleton, Beth A.; LePage, Ben A.

    2011-01-01

    Multidisciplinary approaches are required to address the complex environmental problems of our time. Solutions to climate change problems are good examples of situations requiring complex syntheses of ideas from a vast set of disciplines including science, engineering, social science, and the humanities. Unfortunately, most ecologists have narrow training, and are not equipped to bring their environmental skills to the table with interdisciplinary teams to help solve multidisciplinary problems. To address this problem, new graduate training programs and workshops sponsored by various organizations are providing opportunities for scientists and others to learn to work together in multidisciplinary teams. Two examples of training in multidisciplinary thinking include those organized by the Santa Fe Institute and Dahlem Workshops. In addition, many interdisciplinary programs have had successes in providing insight into climate change problems including the International Panel on Climate Change, the Joint North American Carbon Program, the National Academy of Science Research Grand Challenges Initiatives, and the National Academy of Science. These programs and initiatives have had some notable success in outlining some of the problems and solutions to climate change. Scientists who can offer their specialized expertise to interdisciplinary teams will be more successful in helping to solve the complex problems related to climate change.

  12. A Multidisciplinary Approach to Sustainable Management of Watershed Resources

    EPA Science Inventory

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

  13. Multidisciplinary approach to implants: a review.

    PubMed

    Ng, Doreen Y; Wong, Andrew Y C; Liston, Peter N

    2012-12-01

    As implant dentistry grows in popularity, greater numbers of general dental practitioners (GDPs) are offering this service to their patients. In order to improve treatment success for both patient and practitioner, a multidisciplinary approach to implant planning and placement should be taken. However, the literature currently holds few articles which offer advice to the GDP on how to take a multidisciplinary approach to implant treatment. The aim of this review is to provide practitioners with evidence-based guidance for taking a multidisciplinary approach to implant treatment. A MEDLINE/PubMed search for articles published between 1980 and mid-2012 was undertaken. The search strategy used different combinations of the following terms: dental implants, osseointegration, medical contraindications, patient habits, radiography, prosthodontics, endodontics, orthodontics, periodontics and surgical factors. The review demonstrated the importance of thorough medical and dental history-taking, and how different facets of each speciality contribute to the outcome of implant treatment. Successful implant treatment is the result of careful planning and integration of various areas of dentistry, not just those of prosthodontics and surgery. PMID:23477010

  14. A Unified Approach to Modeling Multidisciplinary Interactions

    NASA Technical Reports Server (NTRS)

    Samareh, Jamshid A.; Bhatia, Kumar G.

    2000-01-01

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

  15. Dynamically Reconfigurable Approach to Multidisciplinary Problems

    NASA Technical Reports Server (NTRS)

    Alexandrov, Natalie M.; Lewis, Robert Michael

    2003-01-01

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

  16. Multidisciplinary treatment approach in Treacher Collins syndrome.

    PubMed

    Hylton, Joseph B; Leon-Salazar, Vladimir; Anderson, Gary C; De Felippe, Nanci L O

    2012-01-01

    Treacher Collins syndrome (TCS) is a common genetic disorder with high penetrance and phenotypic variability. First and second branchial arches are affected in TCS, resulting in craniofacial and intraoral anomalies such as: severe convex facial profile; mid-face hypoplasia; microtia; eyelid colobomas; mandibular retrognathism; cleft palate; dental hypoplasia; heterotopic teeth; maxillary transverse hypoplasia; anterior open bite; and Angle Class II molar relationship. A high incidence of caries is also a typical finding in TCS patients. Nonetheless, even simple dental restorative procedures can be challenging in this patient population due to other associated medical conditions, such as: congenital heart defects; decreased oropharyngeal airways; hearing loss; and anxiety toward treatment. These patients often require a multidisciplinary treatment approach, including: audiology; speech and language pathology; otorhinolaryngology; general dentistry; orthodontics; oral and maxillofacial surgery; and plastic and reconstructive surgeries to improve facial appearance. This paper's purpose was to present a current understanding of Treacher Collins syndrome etiology, phenotype, and current treatment approaches.

  17. Multidisciplinary approaches to the pressure ulcer problem.

    PubMed

    Bogie, Kath M; Ho, Chester H

    2007-10-01

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

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

    PubMed

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

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

  19. Multidisciplinary approach to giant paratesticular liposarcoma

    PubMed Central

    Sopeña-Sutil, Raquel; Silan, Francesco; Butron-Vila, Maria Teresa; Guerrero-Ramos, Felix; Lagaron-Comba, Emilio; Passas-Martinez, Juan

    2016-01-01

    Primary paratesticular tumours are very rare and the spermatic cord (SCT) is the most frequent site of origin, with 20% of malignancy. Although liposarcoma is the most frequent histotype (46.6 %), less than 200 cases have been reported in the literature. We report the case of a 56-year-old man who presented a giant scrotal mass of 25 years of evolution and measuring 40 × 40 cm. It could be considered the greatest paratesticular liposarcoma described to date. Computed tomogaphy (CT) revealed mass features consistent with liposarcoma and the simultaneous presence of bilateral inguinal hernia with bladder involvement. A multidisciplinary approach was taken to remove the mass, solve the hernia, and provide functional results.

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

    PubMed

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

    2016-09-01

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

  1. Multidisciplinary approach to giant paratesticular liposarcoma

    PubMed Central

    Sopeña-Sutil, Raquel; Silan, Francesco; Butron-Vila, Maria Teresa; Guerrero-Ramos, Felix; Lagaron-Comba, Emilio; Passas-Martinez, Juan

    2016-01-01

    Primary paratesticular tumours are very rare and the spermatic cord (SCT) is the most frequent site of origin, with 20% of malignancy. Although liposarcoma is the most frequent histotype (46.6 %), less than 200 cases have been reported in the literature. We report the case of a 56-year-old man who presented a giant scrotal mass of 25 years of evolution and measuring 40 × 40 cm. It could be considered the greatest paratesticular liposarcoma described to date. Computed tomogaphy (CT) revealed mass features consistent with liposarcoma and the simultaneous presence of bilateral inguinal hernia with bladder involvement. A multidisciplinary approach was taken to remove the mass, solve the hernia, and provide functional results. PMID:27695588

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

    PubMed

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

    2016-09-01

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

  3. A Multidisciplinary Training Team in the Public Schools

    ERIC Educational Resources Information Center

    Buktenica, Norman A.

    1970-01-01

    A multidisciplinary team approach to assessing needs and working toward prevention of school maladaptation are fostered, instead of responding to crises via a case study approach. Children are viewed in the social context of the classroom, the position of the teacheris bolstered, participation of parents is encouraged, and more cooperative use of…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  5. New Approaches to HSCT Multidisciplinary Design and Optimization

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1998-01-01

    Using the formalism provided by the Systems Thinking approach, the dynamics present when operating multidisciplinary teams are examined in the context of the NASA Langley Research and Technology Group, an R&D organization organized along functional lines. The paper focuses on external dynamics and examines how an organization creates and nurtures the teams and how it disseminates and retains the lessons and expertise created by the multidisciplinary activities. Key variables are selected and the causal relationships between the variables are identified. Five "stories" are told, each of which touches on a different aspect of the dynamics. The Systems Thinking Approach provides recommendations as to interventions that will facilitate the introduction of multidisciplinary teams and that therefore will increase the likelihood of performing successful multidisciplinary developments. These interventions can be carried out either by individual researchers, line management or program management.

  7. A Multidisciplinary Approach to Improving SCIP Compliance.

    PubMed

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

    2015-07-01

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

  8. A Multidisciplinary Approach to Improving SCIP Compliance.

    PubMed

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

    2015-07-01

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

  9. A multidisciplinary approach for the management of hypodontia: case report.

    PubMed

    Valle, Accácio Lins do; Lorenzoni, Fabio C; Martins, Leandro Moura; Valle, Caio Vinícius Martins do; Henriques, José Fernando Castanha; Almeida, Ana Lúcia Pompéia Fraga de; Pegoraro, Luiz Fernando

    2011-10-01

    Hypodontia is the congenital absence of one or more teeth and may affect permanent teeth. Several options are indicated to treat hypodontia, including the maintenance of primary teeth or space redistribution for restorative treatment with partial adhesive bridges, tooth transplantation, and implants. However, a multidisciplinary approach is the most important requirement for the ideal treatment of hypodontia. This paper describes a multidisciplinary treatment plan for congenitally missing permanent mandibular second premolars involving orthodontics, implantology and prosthodontic specialties.

  10. Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.

    PubMed

    Tesher, Melissa S

    2015-06-01

    A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the biologic, psychologic, and social factors contributing to the perpetuation of chronic pain. The author reviews the diagnostic criteria, pathophysiology, and treatment of juvenile fibromyalgia. Medications, particularly antidepressants and anticonvulsants, can be useful adjuncts to therapy. However, multimodal pain management including intensive physical therapy, exercise, counseling, and sleep hygiene is most effective in treating fibromyalgia. PMID:26114368

  11. Multidisciplinary approach to the challenge of hemostasis.

    PubMed

    Levy, Jerrold H; Dutton, Richard P; Hemphill, J Claude; Shander, Aryeh; Cooper, David; Paidas, Michael J; Kessler, Craig M; Holcomb, John B; Lawson, Jeffrey H

    2010-02-01

    A multidisciplinary panel consisting of experts chosen by the 2 chairs of the group representing experts in anesthesiology, blood banking, hematology, critical care medicine, and various surgical disciplines (trauma, cardiac, pediatric, neurologic, obstetrics, and vascular) convened in January 2008 to discuss hemostasis and management of the bleeding patient across different clinical settings, with a focus on perioperative considerations. Although there are many ways to define hemostasis, one clinical definition would be control of bleeding without the occurrence of pathologic thrombotic events (i.e., when balance among procoagulant, anticoagulant, fibrinolytic, and antifibrinolytic activities is achieved). There are common hemostatic challenges that include lack of scientific evidence and standardized guidelines for the use of therapeutic drugs, need for reliable and rapid laboratory tools for measuring hemostasis, and individual variability. Clinically meaningful and accurate real-time laboratory data reflecting a patient's hemostatic status are needed to guide treatment decisions. Current available routine laboratory tests of hemostasis (e.g., platelet count, prothrombin time/international normalized ratio, and activated partial thromboplastin time) do not reflect the complexity of in vivo hemostasis and can mislead the clinician. Although point-of-care coagulation monitoring tests including measures of thromboelastography/elastometry provide insight into overall hemostatic status, they are time-consuming to perform, complex to interpret, and require trained personnel. There is a particular need to develop laboratory tests that can measure the effects of anticoagulant and antiplatelet agents for individual patients, predict bleeding complications, and guide therapy when and if treatment with blood products or pharmacologic drugs is required. Formation of an organization comprised of specialists who treat bleeding patients will foster multidisciplinary

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

    ERIC Educational Resources Information Center

    Burke, Anne; Peterson, Shelley Stagg

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Knight, Andrew; Warland, Rex

    2005-01-01

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

  14. Multidisciplinary Approach to the Management of Myopathies

    PubMed Central

    M. King, Wendy; Kissel, John T.

    2013-01-01

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

  15. Intrauterine baclofen exposure: a multidisciplinary approach.

    PubMed

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

    2004-08-01

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

  16. Fibromyalgia: a complex syndrome requiring a multidisciplinary approach.

    PubMed

    Spaeth, Michael; Briley, Mike

    2009-06-01

    Fibromyalgia is a pain syndrome which is not due to tissue damage or inflammation and is thus fundamentally different from rheumatic disorders and many other pain conditions. In addition to widespread pain it is associated with a range of other symptoms such as sleep disturbance, fatigue, cognitive disturbance, stiffness and depressive symptoms. A number of multidisciplinary therapeutic programmes involving education, exercise and cognitive therapy have been shown to be effective in bringing relief. The various medications that are currently being developed for the treatment of fibromyalgia are based on different mechanistic approaches. In particular, serotonin noradrenaline reuptake inhibitors (SNRI) such as duloxetine and milnacipran and alpha2-delta receptor ligands such as pregabalin have been shown, in a variety of placebo-controlled studies, to bring significant relief from pain and other symptoms. The complex symptomatology of fibromyalgia will, however, continue to require a multidisciplinary approach including education and exercise in addition to drug therapy to achieve the most efficient management of fibromyalgia.

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

    PubMed

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

    2010-12-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  19. Managing the pediatric patient with celiac disease: a multidisciplinary approach

    PubMed Central

    Isaac, Daniela Migliarese; Wu, Jessica; Mager, Diana R; Turner, Justine M

    2016-01-01

    Celiac disease (CD) is an autoimmune reaction to gluten, leading to intestinal inflammation, villous atrophy, and malabsorption. It is the most common autoimmune gastrointestinal disorder, with an increasing prevalence. A life-long gluten-free diet (GFD) is an effective treatment to alleviate symptoms, normalize autoantibodies, and heal the intestinal mucosa in patients with CD. Poorly controlled CD poses a significant concern for ongoing malabsorption, growth restriction, and the long-term concern of intestinal lymphoma. Achieving GFD compliance and long-term disease control poses a challenge, with adolescents at particular risk for high rates of noncompliance. Attention has turned toward innovative management strategies to improve adherence and achieve better disease control. One such strategy is the development of multidisciplinary clinic approach, and CD is a complex life-long disease state that would benefit from a multifaceted team approach as recognized by multiple national and international bodies, including the National Institutes of Health. Utilizing the combined efforts of the pediatric gastroenterologist, registered dietitian, registered nurse, and primary care provider (general practitioner or general pediatrician) in a CD multidisciplinary clinic model will be of benefit for patients and families in optimizing diagnosis, provision of GFD teaching, and long-term adherence to a GFD. This paper discusses the benefits and proposed structure for multidisciplinary care in improving management of CD. PMID:27785047

  20. Assessing and evaluating multidisciplinary translational teams: a mixed methods approach.

    PubMed

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

    2014-03-01

    A case report illustrates how multidisciplinary translational teams can be assessed using outcome, process, and developmental types of evaluation using a mixed-methods approach. Types of evaluation appropriate for teams are considered in relation to relevant research questions and assessment methods. Logic models are applied to scientific projects and team development to inform choices between methods within a mixed-methods design. Use of an expert panel is reviewed, culminating in consensus ratings of 11 multidisciplinary teams and a final evaluation within a team-type taxonomy. Based on team maturation and scientific progress, teams were designated as (a) early in development, (b) traditional, (c) process focused, or (d) exemplary. Lessons learned from data reduction, use of mixed methods, and use of expert panels are explored.

  1. The Brokering Approach for Multidisciplinary Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Nativi, S.

    2012-12-01

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

  2. The Brokering Approach for Multidisciplinary Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Nativi, Stefano

    2013-04-01

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

  3. Benign triton tumor: multidisciplinary approach to diagnosis and treatment.

    PubMed

    Thakrar, Raj; Robson, Caroline D; Vargas, Sara O; Meara, John G; Rahbar, Reza; Smith, Edward R

    2014-01-01

    Benign Triton tumor (neuromuscular choristoma) is a rare mass that most commonly occurs as a multinodular expansion of tissue in or around large nerves. Intracranial occurrence is uncommon. We report on a 4-year-old girl presenting with a right-sided facial mass and trismus. Imaging revealed a large, complex mass extending from the ventral aspect of the pons, along the trigeminal nerve, through the foramen ovale, and into the right infratemporal fossa. The lesion was partially enhancing, invaded adjacent infratemporal musculature, was associated with marked overgrowth of the right coronoid process, and induced bony erosion of the middle cranial fossa. After needle biopsy, a multidisciplinary team, including plastic surgery, otolaryngology, and neurosurgery, performed a combined, multistep, single-day surgical approach for resection. Unique to this case was the resection of the coronoid process, a modified middle fossa intradural and extradural approach, coupled with a transfacial infratemporal approach. Microscopically, the resected tissue showed skeletal muscle, fibrous tissue, and nerve in a disorganized arrangement characteristic of a benign Triton tumor. We present this case to illustrate diagnostic clues and pitfalls in the preoperative evaluation of a benign Triton tumor. We also highlight the pathologist's role as a partner in a multidisciplinary approach to diagnosis and treatment of this rare pediatric mass, potentially the largest Triton tumor in the head reported to date.

  4. An aggressive multidisciplinary approach reduces mortality in rhinocerebral mucormycosis

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Ojha, Rahul; Prasad, Asuri N

    2016-01-01

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

  6. Menkes disease: what a multidisciplinary approach can do

    PubMed Central

    Ojha, Rahul; Prasad, Asuri N

    2016-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

  8. Multidisciplinary Approach for Patients Hospitalized With Heart Failure.

    PubMed

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

    2015-10-01

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

  9. Multidisciplinary Approach for Patients Hospitalized With Heart Failure.

    PubMed

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

    2015-10-01

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

  10. Interview: Management of chronic pain requires a multidisciplinary approach.

    PubMed

    Vasudevan, Sridhar V

    2012-07-01

    Sridhar V Vasudevan(*) speaks to Roshaine Gunawardana, Commissioning Editor: Sridhar V Vasudevan, MD is clinical professor of Physical Medicine and Rehabilitation (PM&R) at the Medical College of Wisconsin in Milwaukee, WI, USA. He is Board certified in PM&R and Pain Medicine (American Board of PM&R/American Board of Anesthesiology exam). He also has Board certification in Electro-diagnostic Medicine and Independent Medical Examination. He has been involved in the evaluation and rehabilitation of individuals with sub-acute and chronic pain using a whole-person multidisciplinary approach since 1977. He is Past President of the Midwest Pain Society, the American Academy of Pain Medicine, the Wisconsin Society of Physical Medicine and Rehabilitation and the Waukesha County Medical Society, as well as Founding President of the American College of Pain Medicine (now the American Board of Pain Medicine). He has presented on the topics of Pain Rehabilitation at several national meetings and international meetings in Scotland, Denmark, Peoples Republic of China, USSR, Germany, France, Turkey, South Africa, Canada, Aruba, Mexico and India. He has authored several chapters in text books on topics of a multidisciplinary approach to pain rehabilitation and evaluation of disability in individuals with pain. He is currently associated with the Center for Pain and Work Rehabilitation in Sheboygan, WI, USA, and is the Medical Director for the Center for Pain Rehabilitation at Community Memorial Hospital in Menomonee Falls, WI, USA. He also works at the Medical College of Wisconsin clinic in Menomonee Falls, WI, USA. He currently serves as a member of the Medical Examining Board of the State of Wisconsin, WI, USA.

  11. Clinical features and multidisciplinary approaches to dementia care

    PubMed Central

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

    2011-01-01

    Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer’s disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by

  12. Right ventricular cardiomyopathies: a multidisciplinary approach to diagnosis.

    PubMed

    Limongelli, Giuseppe; Rea, Alessandra; Masarone, Daniele; Francalanci, M Paola; Anastasakis, Aris; Calabro', Raffaele; Giovanna, Russo Maria; Bossone, Eduardo; Elliott, Perry Mark; Pacileo, Giuseppe

    2015-01-01

    The physiological importance of the right ventricle (RV) has been underestimated over the past years. Finally in the early 1950s through the 1970s, cardiac surgeons recognized the importance of RV function. Since then, the importance of RV function has been recognized in many acquired cardiac heart disease. RV can be mainly or together with left ventricle (LV) affected by inherited or acquired cardiomyopathy. In fact, RV morphological and functional remodeling occurs more common during cardiomyopathies than in ischemic cardiomyopathies and more closely parallels LV dysfunction. Moreover, there are some cardiomyopathy subtypes showing a predominant or exclusive involvement of the RV, and they are probably less known by cardiologists. The clinical approach to right ventricular cardiomyopathies is often challenging. Imaging is the first step to raise the suspicion and to guide the diagnostic process. In the differential diagnosis, cardiologists should consider athlete's heart, congenital heart diseases, multisystemic disorders, and inherited arrhythmias. However, a multiparametric and multidisciplinary approach, involving cardiologists, experts in imaging, geneticists, and pathologists with a specific expertise in these heart muscle disorders is required.

  13. Oral allergy syndrome--the need of a multidisciplinary approach.

    PubMed

    Kelava, Nikolina; Lugović-Mihić, Liborija; Duvancić, Tomislav; Romić, Renata; Situm, Mirna

    2014-06-01

    Oral allergy syndrome (OAS) is one of the most common types of food allergy. The syndrome includes itching and swelling of the lips, palate and tongue, usually after consuming fresh fruits and vegetables. The underlying pathogenic mechanism is cross-reactivity between IgE antibodies specific to pollen, and antigens in food, such as fresh fruits, vegetables and nuts that are structurally similar to pollen. Both pollen and food antigens can bind to IgE and trigger type I immune reaction. Diagnosis is primarily based on the patient's history, and confirmed by skin tests, in vitro tests, and oral provocation tests. Differential diagnoses include many diseases (such as burning mouth syndrome, angioedema, hay fever, various other oral diseases, etc.), and for this reason a multidisciplinary approach is necessary, as different specialists need to be involved in the diagnostic procedure. Therapy includes avoiding, or thermal processing of, fruit and vegetables known to trigger a reaction, and antihistamine medications. If a more severe anaphylactic reaction develops, more aggressive therapy is required. The goal of this article is to present OAS, its etiopathogenesis, clinical picture, and symptoms, diagnostic approach and therapy for OAS.

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

    PubMed

    Bordoni, Bruno; Marelli, Fabiola; Bordoni, Giovannni

    2016-01-01

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

  15. Treatment timing and multidisciplinary approach in Apert syndrome

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Bordoni, Bruno; Marelli, Fabiola; Bordoni, Giovannni

    2016-01-01

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

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

    PubMed

    Bordoni, Bruno; Marelli, Fabiola; Bordoni, Giovannni

    2016-01-01

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

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

    PubMed

    2016-07-01

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  1. Modeling Mantle Heterogeneity Development in Earth's Mantle Using Multidisciplinary Approaches

    NASA Astrophysics Data System (ADS)

    de Silva, S. M. S.; Finlayson, V.; Gu, T.; Li, M.; Lithgow-Bertelloni, C. R.; Cormier, V. F.

    2014-12-01

    The process of subduction provides continuous chemical and thermal heterogeneity to Earth's mantle. How heterogeneity is stirred, stretched and distributed depends on the detail of mantle convection as well as chemical and physical properties of mantle materials. Seismic observations have revealed heterogeneities in Earth's mantle at varying scales. Seismic velocities are controlled by physical parameters such as density, bulk modulus and shear modulus, which are a function of temperature, pressure and composition. Thus, understanding the origin of seismic heterogeneities play an important role in understanding the thermal and chemical state of the present Earth's mantle. Originating from the CIDER 2014 workshop, our goal is to take a multidisciplinary approach to tackle a variety of questions, foremost what length scales of heterogeneity might we expect from the convecting process and how do they manifest themselves in seismic imaging. This touches upon fundamental issues such as the composition of the mantle, the nature of stirring and mixing, and the nature of large-scale mantle upwellings (LLSVPs). We will investigate the development of heterogeneity in response to various compositions and redox states using existing and new thermochemical mantle convection simulations, and test the sensitivity of seismic measurements to different length scales of chemical heterogeneity. We try to reconcile large differences in length scales of heterogeneity as well as fractional perturbations of seismic velocity and density predicted by tomography and scattering seismic experiments. Preliminary results from the CIDER workshop initiate with conversion of geodynamic models to profiles of seismic velocity and density which are then taken as input models to predict multiply scattered, high frequency, P wave coda envelopes synthesized by a radiative transport technique. The predicted sensitivity of P coda envelopes to varying chemical compositions and heterogeneity length scales

  2. Philosophizing about Teacher Dissatisfaction: A Multidisciplinary Hermeneutic Approach

    ERIC Educational Resources Information Center

    Santoro, Doris A.

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2014-03-01

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

  5. Electrostatic and Nanotechnology Multidisciplinary Approach - for Space Radiation Shielding

    NASA Astrophysics Data System (ADS)

    Tripathi, Ram; Wilson, John; Youngquist, Robert

    2008-03-01

    For the success of NASA's new vision for space exploration to Moon, Mars and beyond, exposures from the hazards of severe space radiation in deep space long duration missions is ``a must solve'' problem. The exploration beyond low Earth orbit to enable routine access of space will require protection from the hazards of the accumulated exposures of space radiation. There is a need to look to new horizons for newer technologies. The present multidisciplinary investigation explores the feasibility of using the active electrostatic shielding in concert with the state-of-the-art materials shielding and protection technologies. The full space radiation environment has been used, for the first time, to explore the feasibility of multidisciplinary shielding. The goal is to repel enough positive charge ions so that they miss the spacecraft without attracting thermal electrons and further attenuate the exposure using nano-materials. Conclusions are drawn for the future directions of space radiation protection.

  6. Importance of multidisciplinary approach in diagnosis of histoplasmosis*

    PubMed Central

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

    2016-01-01

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

  7. New Approaches to HSCT Multidisciplinary Design and Optimization

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  10. Effectiveness of a multidisciplinary team approach to hip fracture management.

    PubMed

    Khasraghi, Fardin A; Christmas, Colleen; Lee, Eu Jin; Mears, Simon C; Wenz, James F

    2005-01-01

    The purpose of the current study was to evaluate the effectiveness of a multidisciplinary Hip Fracture Service in the treatment of hip fractures in elderly patients. Baseline information and hospital outcomes were compared for 510 patients over the age of 65 with hip fracture treated before and after the institution of the Hip Fracture Service. Data included basic demographic data, admission laboratory results, surgical information, number of comorbidities, mortality, medical complications, discharge information, time to surgery, and length of stay in hospital. The demographics of the two groups of patients were similar. Patients treated as part of the Hip Fracture Service had fewer medical complications (36% vs. 51%), more often had surgery within 24 hours (63% vs. 35%), and had shorter hospital stays (mean, 5.7 days vs. 8.1 days) than patients treated before the Hip Fracture Service. These findings provide the rationale for a prospective, randomized trial of the service.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  13. A multidisciplinary approach to information and critical appraisal instruction.

    PubMed Central

    Dorsch, J L; Frasca, M A; Wilson, M L; Tomsic, M L

    1990-01-01

    The formulation of clinical decisions based on evidence requires the ability to locate information and evaluate it critically. A ten-week critical appraisal course for third-year medical students, taught cooperatively by library and Department of Medicine faculty, integrates education in the selection, evaluation, and application of information to patient care. The course is distinctive in that information management skills are taught by a multidisciplinary team in a problem-based format as part of the compulsory medical curriculum. Medical faculty provided instruction in reading and evaluating research methodology, as well as statistical analyses in published reports, using clinical scenarios and related journal articles at weekly sessions. Library faculty provided instruction in locating pertinent research on a sample clinical problem using standard printed and computerized indexes and local library resources, and presented criteria for selecting the most useful and significant works from those retrieved. Library faculty also met individually with students to provide instruction in online literature searching. Based on formal evaluation and informal feedback, the course was well received; it effectively presents the literature search as an integral part of critical appraisal of the medical literature and of the clinical decision-making process. PMID:2295011

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-09-01

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

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

    EPA Science Inventory

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

  19. Multidisciplinary approach of a crown-root fracture using intentional replantation: a case report.

    PubMed

    Bindo, Tatiana Zaina; de Morais, Eduardo Christiano Caregnatto; de Campos, Edson Alves; Gonzaga, Carla Castiglia; Correr, Gisele Maria; Baratto-Filho, Flares

    2010-01-01

    Crown-root fractures are complex traumatic injuries that require multidisciplinary management and afford uncertain prognosis. The purpose of this clinical article was to report the case of crown-root fracture where a multidisciplinary approach was successfully executed. A 10-year-old male patient who suffered a complicated crown-root fracture on a permanent maxillary central incisor was treated using an intentional 180°-rotation replantation technique, followed by endodontic therapy and restoration with resin composite. Two years after the initial treatment, the case was stable and the tooth was restored with a resin core and a ceramic crown. This article describes how adequate multidisciplinary treatment planning, coordination, and execution are necessary for similar cases to be properly managed. It can be concluded that the intentional replantation with 180°-rotation allowed a more conservative approach, showing, in this case, a clinical success without resorption.

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

    PubMed

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

    2016-01-01

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

  1. 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…

  2. Perspectives in the Education of Disadvantaged Children; A Multidisciplinary Approach.

    ERIC Educational Resources Information Center

    Cowles, Milly, Ed.

    A collection of original papers presents an interdisciplinary approach to the education of disadvantaged children. The volume, prepared especially for preservice and inservice teachers, is divided into three sections--poverty and its effects, the children of poverty, and educational implications. The first two parts deal with such areas as…

  3. Starting an ePortfolio: A Multi-Disciplinary Approach

    ERIC Educational Resources Information Center

    Zinger, Lana; Sinclair, Alicia

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Kerr, Dianne L.; And Others

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

  5. Full-mouth rehabilitation using a multidisciplinary approach: material and periodontal considerations.

    PubMed

    Polack, Mariano A; Mahn, Douglas H

    2008-10-01

    The complete aesthetic rehabilitation of dentition can be a complicated task. A multidisciplinary approach is often necessary to achieve ideal results. Clinical crown lengthening surgery can develop an aesthetic soft tissue profile and sufficient tooth structure for preparation and restoration. In addition, the development of novel all-ceramic zirconia materials has resulted in the delivery of improved aesthetics, function, and longevity. This article discusses the use of zirconia crowns in multidisciplinary full-mouth rehabilitation and provides recommendations to enhance the performance of these restorations.

  6. New Approaches for Virus Detection through Multidisciplinary Partnerships.

    PubMed

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

    2016-06-10

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

  7. Teaching science and ethics to undergraduates: a multidisciplinary approach.

    PubMed

    McGowan, Alan H

    2013-06-01

    The teaching of the ethical implications of scientific advances in science courses for undergraduates has significant advantages for both science and non-science majors. The article describes three courses taught by the author as examples of the concept, and examines the disadvantages as well as the advantages. A significant advantage of this approach is that many students take the courses primarily because of the ethical component who would not otherwise take science. A disadvantage is less time in the course for the science; arguably, this is outweighed by the greater retention of the science when it is put into context.

  8. Bullet embolization: multidisciplinary approach by interventional radiology and surgery.

    PubMed

    Nolan, Timothy; Phan, Ho; Hardy, Andrew Hal; Khanna, Pavan; Dong, Paul

    2012-09-01

    Bullet embolization after penetrating trauma is an infrequent but important phenomenon. It presents an unexpected sequelae to the otherwise predictable injury pattern of penetrating missile injury mechanism and poses a challenging diagnostic and therapeutic dilemma. Bullets from penetrating wounds can gain access to the vasculature and migrate to nearly every large vascular bed. Patients can be asymptomatic, but the potential complications can be devastating including limb-threatening ischemia, sepsis, endocarditis, cardiac valvular incompetence, pulmonary embolism, stroke, and even death. The exact incidence of bullet embolization is unknown, but it was estimated to be 0.3% during the Vietnam War and 1.1% in the recent conflict in Afghanistan and Iraq. The scarcity of the condition and the lack of concentrated experience at any single institution contribute to the controversies pertaining to the management approach. Traditionally, surgical extraction of embolized bullets may involve difficult and invasive surgical exposures. Recent advancement in endovascular techniques provides an additional option in this treatment algorithm. In this article, we describe a case of venous bullet embolization from the left iliac vein treated by a combined endovascular and surgical approach. PMID:23997411

  9. Overcoming obstacles to establish a multidisciplinary team approach to hepatobiliary diseases: a working model in a Caribbean setting

    PubMed Central

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

    2014-01-01

    Introduction By providing a structured forum to exchange information and ideas, multidisciplinary team meetings improve working relationships, expedite investigations, promote evidence-based treatment, and ultimately improve clinical outcomes. Methods This discursive paper reports the introduction of a multidisciplinary team approach to manage hepatobiliary diseases in Jamaica, focusing on the challenges encountered and the methods used to overcome these obstacles. Conclusion Despite multiple challenges in resource-limited environments, a multidisciplinary team approach can be incorporated into clinical practice in developing nations. Policy makers should make it a priority to support clinical, operational, and governance aspects of the multidisciplinary teams. PMID:24920917

  10. A multidisciplinary approach to scars: a narrative review

    PubMed Central

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

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

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

    PubMed

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-06-09

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

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

    PubMed

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

    2015-01-01

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

  15. Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma

    PubMed Central

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

    2014-01-01

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

  16. A multidisciplinary approach to providing care to adolescents with spinal cord trauma resulting from all-terrain vehicle accidents.

    PubMed

    Rhodes, Leslie N; Weatherford, Blakely; Locke, Lindsey N; Chung, Hoi Sing; Tidwell, Chrisla; Paton, Elizabeth; Lee, Shirleatha

    2015-01-01

    All-terrain vehicle accidents that affect the spine can lead to complex injuries in adolescents. This requires that many subspecialties work together on a multidisciplinary team to improve patient outcomes. Our case presentation will examine the multidisciplinary approach to care required for an 11-year-old adolescent involved in an all-terrain vehicle accident that resulted in traumatic spinal cord injury.

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

    PubMed Central

    Seneschall, Charlotte; Luna-Farro, Maria

    2013-01-01

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

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

    PubMed

    Seneschall, Charlotte; Luna-Farro, Maria

    2013-10-01

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

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

    PubMed

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

    2009-01-01

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

  20. Multidisciplinary approach of lumbo-sacral chordoma: From oncological treatment to reconstructive surgery.

    PubMed

    Garofalo, Fabio; di Summa, Pietro G; Christoforidis, Dimitrios; Pracht, Marc; Laudato, Pietro; Cherix, Stéphane; Bouchaab, Hanan; Raffoul, Wassim; Demartines, Nicolas; Matter, Maurice

    2015-10-01

    Lumbo-sacral chordoma is a rare, slow-growing tumor, arising from embryonic nothocordal remnants. Wide en bloc excision with clear margins remains mandatory to achieve satisfactory recurrence rates and disease-free survival. No chemotherapy has been demonstrated to be effective and radiotherapy is only marginally effective. Tyrosine kinase receptor inhibitors have showed encouraging results in locally advanced and metastatic chordoma. Reconstructive surgery may become very complex. Multidisciplinary approach in tertiary hospitals is always necessary.

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

    PubMed Central

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

    2015-01-01

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

  2. [Overview on method and strategy of therapeutic material basis in traditional Chinese medicine by multidisciplinary approach].

    PubMed

    Li, Ya-mei; Du, Zhi-min

    2015-05-01

    Traditional Chinese medicine (TCM) has a good reputation for preventing or healing diseases in clinic due to its higher efficacy, minor toxicity and abundant resources. Screening bioactive components in TCMs is not only crucial for clarifying their action mechanisms, but also the basis of their safety and quality control. TCM is characterized by multiple components, multiple targets and multiple mechanisms, however the complex composition of TCM makes it difficult to study the therapeutic material basis which has become the bottleneck in the process of its modernization and internationalization. Recently, with the rapid development of modern technologies and the unceasing progress of various disciplines, multidisciplinary approach, such as analytical chemistry, chemistry of TCM, pharmacology, cell biology, systems biology and bioinformatics has been successfully applied to the study of TCM. Multidisciplinary approach realizes the communication and interaction of multi-discipline, and accelerates the research and development of TCM. This review summarizes the application of multidisciplinary approach which may have certain potential of bringing new thoughts to TCM research and provide references for screening and identification of therapeutic material basis of TCMs. PMID:26323122

  3. The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment

    PubMed Central

    Ahlbeck, Karsten; Aldington, Dominic; Alon, Eli; Coluzzi, Flaminia; Dahan, Albert; Huygen, Frank; Kocot-Kępska, Magdalena; Mangas, Ana Cristina; Mavrocordatos, Philippe; Morlion, Bart; Müller-Schwefe, Gerhard; Nicolaou, Andrew; Pérez Hernández, Concepción; Sichère, Patrick; Schäfer, Michael; Varrassi, Giustino

    2013-01-01

    Chronic pain is currently under-diagnosed and under-treated, partly because doctors’ training in pain management is often inadequate. This situation looks certain to become worse with the rapidly increasing elderly population unless there is a wider adoption of best pain management practice. This paper reviews current knowledge of the development of chronic pain and the multidisciplinary team approach to pain therapy. The individual topics covered include nociceptive and neuropathic pain, peripheral sensitization, central sensitization, the definition and diagnosis of chronic pain, the biopsychosocial model of pain and the multidisciplinary approach to pain management. This last section includes an example of the implementation of a multidisciplinary approach in Belgium and describes the various benefits it offers; for example, the early multidimensional diagnosis of chronic pain and rapid initiation of evidence-based therapy based on an individual treatment plan. The patient also receives continuity of care, while pain relief is accompanied by improvements in physical functioning, quality of life and emotional stress. Other benefits include decreases in catastrophizing, self-reported patient disability, and depression. Improved training in pain management is clearly needed, starting with the undergraduate medical curriculum, and this review is intended to encourage further study by those who manage patients with chronic pain. PMID:23786498

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

    USGS Publications Warehouse

    Nickles, James

    2008-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  6. Sudden cardiac death in forensic medicine – Swiss recommendations for a multidisciplinary approach.

    PubMed

    Wilhelm, Matthias; Bolliger, Stephan A; Bartsch, Christine; Fokstuen, Siv; Gräni, Christoph; Martos, Viktor; Medeiros Domingo, Argelia; Osculati, Antonio; Rieubland, Claudine; Sabatasso, Sara; Saguner, Ardan M; Schyma, Christian; Tschui, Joelle; Wyler, Daniel; Bhuiyan, Zahurul A; Fellmann, Florence; Michaud, Katarzyna

    2015-01-01

    Sudden cardiac death (SCD) is by definition unexpected and cardiac in nature. The investigation is almost invariably performed by a forensic pathologist. Under these circumstances the role of the forensic pathologist is twofold: (1.) to determine rapidly and efficiently the cause and manner of death and (2.) to initiate a multidisciplinary process in order to prevent further deaths in existing family members. If the death is determined to be due to "natural" causes the district attorney in charge often refuses further examinations. However, additional examinations, i.e. extensive histopathological investigations and/or molecular genetic analyses, are necessary in many cases to clarify the cause of death. The Swiss Society of Legal Medicine created a multidisciplinary working group together with clinical and molecular geneticists and cardiologists in the hope of harmonising the approach to investigate SCD. The aim of this paper is to close the gap between the Swiss recommendations for routine forensic post-mortem cardiac examination and clinical recommendations for genetic testing of inherited cardiac diseases; this is in order to optimise the diagnostic procedures and preventive measures for living family members. The key points of the recommendations are (1.) the forensic autopsy procedure for all SCD victims under 40 years of age, (2.) the collection and storage of adequate samples for genetic testing, (3.) communication with the families, and (4.) a multidisciplinary approach including cardiogenetic counselling.

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  8. OUTCOME OF IMPLEMENTATION OF A MULTIDISCIPLINARY TEAM APPROACH TO THE CARE OF PATIENTS AFTER TRANSSPHENOIDAL SURGERY

    PubMed Central

    Carminucci, Arthur S.; Ausiello, John C.; Page-Wilson, Gabrielle; Lee, Michelle; Good, Laura; Bruce, Jeffrey N.; Freda, Pamela U.

    2016-01-01

    Objective Transsphenoidal surgery (TS) for sellar lesions is an established and safe procedure, but complications can occur, particularly involving the neuroendocrine system. We hypothesized that postoperative care of TS patients would be optimized when performed by a coordinated team including a pituitary neurosurgeon, endocrinologists, and a specialty nurse. Methods We implemented a formalized, multidisciplinary team approach and standardized postoperative protocols for the care of adult patients undergoing TS by a single surgeon (J.N.B.) at our institution beginning in July 2009. We retrospectively compared the outcomes of 214 consecutive TS-treated cases: 113 cases prior to and 101 following the initiation of the team approach and protocol implementation. Outcomes assessed included the incidence of neurosurgical and endocrine complications, length of stay (LOS), and rates of hospital readmission and unscheduled clinical visits. Results The median LOS decreased from 3 days preteam to 2 days postteam (P<.01). Discharge occurred on postoperative day 2 in 46% of the preteam group patients compared to 69% of the postteam group (P<.01). Rates of early postoperative diabetes insipidus (DI) and readmissions within 30 days for syndrome of inappropriate antidiuretic hormone (SIADH) or other complications did not differ between groups. Conclusion Implementation of a multidisciplinary team approach was associated with a reduction of LOS. Despite earlier discharge, postoperative outcomes were not compromised. The endocrinologist is central to the success of this team approach, which could be successfully applied to care of patients undergoing TS, as well as other types of endocrine surgery at other centers. PMID:26437216

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Ettema, Henriëtte

    2016-06-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Temme, Kate E; Hoch, Anne Z

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Thomas, Stephanie Margarete; Beierkuhnlein, Carl

    2013-05-01

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

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

    PubMed

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

    2014-05-01

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

  16. Intrapericardial teratoma in a low birth weight preterm infant: a successful multidisciplinary approach.

    PubMed

    Iacona, Gabriele M; Barber, Miguel A; Medina, Margarita; Abella, Raul

    2011-02-01

    We report the case of an intrapericardial teratoma, a rare tumour in infants, prenatally diagnosed and successfully treated thanks to a multidisciplinary approach. An intrapericardial cystic mass (2.5 cm) with pericardial effusion was identified in a foetus at 32 weeks gestational age (GA). Intrauterine pericardiocentesis was performed immediately (40 ml) and repeated at 33 weeks (25 ml) and then at 34 weeks GA, just before birth (36 ml). Considering the rapid growth of the mass and the risk of hydrops, vaginal delivery was induced. A baby girl weighing 1.98 kg was born without cardiorespiratory compromise. Echocardiography and thoracic CT-scan located the 4.0×3.0 cm cystic mass between the left atrial appendage and the left superior pulmonary vein. At three days of life, the mass was completely removed without cardiobypass. It arose from the ascending aorta. Postoperative course was uneventful. Pathology diagnosed an immature intrapericardial teratoma. As long-term follow-up is required, alpha-fetoprotein can be a valid tool to monitor a possible recurrence. A multidisciplinary approach allows successful prenatal management and postnatal tumour surgery.

  17. Neonatal abstinence syndrome: evaluating the effectiveness of an evidence-based multidisciplinary care approach.

    PubMed

    Saunders, Carla; King, Terry; Smith, Sheri; Buchheit, John; Cook, Kyle; Edds, Jill; Mefford, Linda

    2014-01-01

    An evidence-based, multidisciplinary neonatal abstinence syndrome protocol was developed using a stepwise continuous quality improvement (CQI) approach with the goal of standardizing care procedures for these infants. A retrospective secondary data analysis was performed to evaluate the differential effects of each step of the CQI project on 4 key clinical outcome measures: length of stay (total and post-opioid wean), weaning time from opioids, and use of adjunct medications. Data were analyzed from 386 newborn infants with a diagnosis of neonatal abstinence syndrome undergoing treatment in a level III neonatal intensive care unit. After implementation of a pharmacologic weaning protocol as a foundational first step of the CQI project, the weaning time from opioids remained stable throughout each of the subsequent CQI steps (P = .905). The overall total neonatal intensive care unit length of stay was reduced by 10.35 days (P = .002), and the length of neonatal intensive care unit stay after completing wean from opioids was reduced by 2.79 days (P < .001). Use of adjunct medications also decreased from 30.1% of infants at the initiation of the CQI project to 24.5% at the completion of the project (P = .020). These findings indicate that this multidisciplinary treatment approach led to an overall improved efficiency of both opioid weaning and symptom management for these infants.

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

    PubMed Central

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

    2015-01-01

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

  19. Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol.

    PubMed

    Chirillo, Fabio; Scotton, Piergiorgio; Rocco, Francesco; Rigoli, Roberto; Polesel, Elvio; Olivari, Zoran

    2013-09-01

    Even in the modern era of advanced diagnostic imaging, improved antibiotic therapy and potentially curative surgery, infective endocarditis remains a serious disease with high rates of morbidity and mortality. Reasons for such a persistently poor outcome may be represented by the changing epidemiology and microbiology, with new groups of patients at risk and new and more aggressive microorganisms. However, the inadequate use of both diagnostic (blood cultures and echocardiography) and therapeutic (antibiotics and surgery) means can influence the generally delayed diagnosis and poor prognosis seen in patients with infective endocarditis. We tried to identify the critical points in the management of patients with infective endocarditis and to elaborate a formal multidisciplinary approach based on the strict collaboration of specialists in infectious diseases, microbiology, cardiology and cardiac surgery. We hypothesized that this approach could increase the adherence to the published guidelines, and could represent a means to improve the outcome of patients with infective endocarditis.

  20. Minimally invasive esthetic therapy: a case report describing the advantages of a multidisciplinary approach.

    PubMed

    Pinto, Rodrigo Carlos; Chambrone, Leandro; Colombini, Bella Luna; Ishikiriama, Sérgio Kiyoshi; Britto, Isabella Maria; Romito, Giuseppe Alexandre

    2013-05-01

    The decision-making process for the treatment of esthetic areas is based on the achievement of a healthy, harmonious, and pleasant smile. These conditions are directly associated with a solid knowledge of tooth anatomy and proportions, as well as the smile line, soft tissue morphology, and osseous architecture. To achieve these objectives, a multidisciplinary approach may be necessary to create long-term harmony between the final restoration and the adjacent teeth, and the health of the surrounding soft and hard tissues. This case report describes the application of a minimally invasive therapy on a 33-year-old woman seeking esthetic treatment. Minimally invasive periodontal plastic surgery associated with porcelain laminate veneers yielded satisfactory esthetics and minimal trauma to dental and periodontal tissues. Such a combined approach may be considered a viable option for the improvement of "white" and "red" esthetics.

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

    PubMed Central

    Grant, Cynthia L; Lusk, Jaimie L

    2015-01-01

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

  2. What radiologists need to know about diagnosis and treatment of inflammatory breast cancer: a multidisciplinary approach.

    PubMed

    Yeh, Eren D; Jacene, Heather A; Bellon, Jennifer R; Nakhlis, Faina; Birdwell, Robyn L; Georgian-Smith, Dianne; Giess, Catherine S; Hirshfield-Bartek, Judi; Overmoyer, Beth; Van den Abbeele, Annick D

    2013-01-01

    Inflammatory breast cancer (IBC) is a rare breast cancer with a highly virulent course and low 5-year survival rate. Trimodality treatment that includes preoperative chemotherapy, mastectomy, and radiation therapy is the therapeutic mainstay and has been shown to improve prognosis. Proper diagnosis and staging of IBC is critical to treatment planning and requires a multidisciplinary approach that includes imaging. Patients with IBC typically present with rapid onset of breast erythema, edema, and peau d'orange. Both tissue diagnosis of malignancy and clinical findings of inflammatory disease are required to confirm diagnosis of IBC. Imaging is used to identify a biopsy target; direct biopsy; stage IBC; differentiate curable from incurable (stage IV) disease; and help plan chemotherapy, surgical management, and radiation therapy. Comparison of baseline and posttreatment images helps confirm and quantitate disease response. When imaging is used early in the course of therapy to noninvasively predict treatment response, optimal tailored strategies for management of IBC can be implemented. Imaging is vital to diagnosis and treatment planning for patients with IBC, and radiologists are an integral part of the multidisciplinary patient care team.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  5. Education for health: case studies of two multidisciplinary MPH/MSc public health programmes in the UK.

    PubMed

    El Ansari, W; Russell, J; Wills, J

    2003-09-01

    Amidst the winds of change that are blowing across the UK public health (PH) landscape in relation to the essential abilities and national standards that are required for the 'art and science' of PH, the preparation for a new cadre of 'PH professionals' is already underway. Several postgraduate masters programmes in public health (MPH) have taken on board the challenge of addressing the requisite sets of skills and expertise as a guide to their content and delivery. Although there are recommendations regarding teaching PH to undergraduate medical students, little consensus seems to exist on teaching postgraduate PH to non-medically qualified professionals, health managers and administrators. Employing a case study approach, this article analyses the methods used, philosophies and processes, structure and organization, outcomes to date, and lessons learnt from MPH programmes implemented at two institutions in the UK. The programmes have been initiated recently, and have had the opportunity to take on board the recent national guidelines about training standards. The findings indicate that preparatory work of the programmes, and the challenges and strengths in meeting the recent policy developments in PH training are pertinent points. The MPH programmes highlight key issues in interprofessional education and its purpose, its process and its outcomes in relation to multidisciplinary specialist practice. These programmes provide a variety of models for others wishing to develop or restructure their postgraduate PH teaching programmes. The finalization of the national standards for specialist practice in PH in the UK is encouraged, along with clearer working definitions of the domains of expertise required. Collectively, attention to these measures can ensure that the processes which teaching programmes embrace to refine their content and delivery will equip tomorrow's professionals with PH knowledge and skills.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    Wentzel, Jobke; Van Gemert-Pijnen, Julia EWC

    2013-01-01

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

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

    PubMed

    Jurkowski, C L

    1998-04-27

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

  9. The multidisciplinary approach to mental health crisis management: an Australian example.

    PubMed

    Webster, S; Harrison, L

    2004-02-01

    Changes within the Australian health care system have led many people with mental health disorders to use emergency departments as the point of access to mental health services. Staff in emergency departments are not necessarily equipped to assess the needs of such clients. This paper briefly describes the development of a multidisciplinary mental health liaison team, within the emergency department of one hospital in Sydney, which was designed to assist both staff and clients. Available evidence suggests the implementation of the team has been a success, however, more research is required to confirm the effectiveness of this approach. Questions are raised about appropriate referral and follow-up for some clients. The study also found deficiencies in the method of routine data collection (Emergency Department Identification System), which makes formal auditing of the team and the services it provides a difficult task.

  10. Improving perioperative care for adolescent idiopathic scoliosis patients: the impact of a multidisciplinary care approach

    PubMed Central

    Borden, Timothy C; Bellaire, Laura L; Fletcher, Nicholas D

    2016-01-01

    The complex nature of the surgical treatment of adolescent idiopathic scoliosis (AIS) requires a wide variety of health care providers. A well-coordinated, multidisciplinary team approach to the care of these patients is essential for providing high-quality care. This review offers an up-to-date overview of the numerous interventions and safety measures for improving outcomes after AIS surgery throughout the perioperative phases of care. Reducing the risk of potentially devastating and costly complications after AIS surgery is the responsibility of every single member of the health care team. Specifically, this review will focus on the perioperative measures for preventing surgical site infections, reducing the risk of neurologic injury, minimizing surgical blood loss, and preventing postoperative complications. Also, the review will highlight the postoperative protocols that emphasize early mobilization and accelerated discharge.

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

    PubMed

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

    2016-07-01

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

  12. Multidisciplinary approach for the treatment of extensive external cervical resorption after dental trauma.

    PubMed

    Alves, T P; Soares, T R C; Barreto, S C; Fried, H; Pereira, G D S; Maia, L C; Santos, A E C

    2013-01-01

    External cervical resorption (ECR) is a sequela of dentoalveolar trauma that may cause functional, esthetic, and psychologic alterations. The aim of this study was to report a successful multidisciplinary treatment approach performed in a 12-year-old patient who presented with posttraumatic ECR associated with extensive opened cavity, pulp necrosis, and periapical lesion of tooth number 9, with an initial unfavorable prognosis. Crown lengthening was done to enable restoration of vestibular surface with resin composite, forming a barrier that allowed endodontic treatment. Afterwards, a prefabricated fiberglass post was cemented and esthetic restoration was performed using the adhesive technique and direct composite veneer. Reconstructive periodontal surgery was performed to correct irregular gingival contour. After treatment and successive follow-up sessions, it was concluded that although the tooth had been indicated for extraction, low invasive direct techniques were effective to recover function and esthetics and to maintain the tooth in the oral cavity. PMID:23210917

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

    PubMed Central

    Raj, Vineet; Aeran, Himanshu

    2012-01-01

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

  14. Improving perioperative care for adolescent idiopathic scoliosis patients: the impact of a multidisciplinary care approach

    PubMed Central

    Borden, Timothy C; Bellaire, Laura L; Fletcher, Nicholas D

    2016-01-01

    The complex nature of the surgical treatment of adolescent idiopathic scoliosis (AIS) requires a wide variety of health care providers. A well-coordinated, multidisciplinary team approach to the care of these patients is essential for providing high-quality care. This review offers an up-to-date overview of the numerous interventions and safety measures for improving outcomes after AIS surgery throughout the perioperative phases of care. Reducing the risk of potentially devastating and costly complications after AIS surgery is the responsibility of every single member of the health care team. Specifically, this review will focus on the perioperative measures for preventing surgical site infections, reducing the risk of neurologic injury, minimizing surgical blood loss, and preventing postoperative complications. Also, the review will highlight the postoperative protocols that emphasize early mobilization and accelerated discharge. PMID:27695340

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

    PubMed Central

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

    2013-01-01

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

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

    SciTech Connect

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

    2008-10-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Rabah, Derbal Cobis; Hamza, Zeghlache

    2002-05-01

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

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

    PubMed

    January, Kathleen; Conway, Laura J; Deardorff, Matthew; Harrington, Ann; Krantz, Ian D; Loomes, Kathleen; Pipan, Mary; Noon, Sarah E

    2016-06-01

    Given the clinical complexities of Cornelia de Lange Syndrome (CdLS), the Center for CdLS and Related Diagnoses at The Children's Hospital of Philadelphia (CHOP) and The Multidisciplinary Clinic for Adolescents and Adults at Greater Baltimore Medical Center (GBMC) were established to develop a comprehensive approach to clinical management and research issues relevant to CdLS. Little work has been done to evaluate the general utility of a multispecialty approach to patient care. Previous research demonstrates several advantages and disadvantages of multispecialty care. This research aims to better understand the benefits and limitations of a multidisciplinary clinic setting for individuals with CdLS and related diagnoses. Parents of children with CdLS and related diagnoses who have visited a multidisciplinary clinic (N = 52) and who have not visited a multidisciplinary clinic (N = 69) were surveyed to investigate their attitudes. About 90.0% of multispecialty clinic attendees indicated a preference for multidisciplinary care. However, some respondents cited a need for additional clinic services including more opportunity to meet with other specialists (N = 20), such as behavioral health, and increased information about research studies (N = 15). Travel distance and expenses often prevented families' multidisciplinary clinic attendance (N = 41 and N = 35, respectively). Despite identified limitations, these findings contribute to the evidence demonstrating the utility of a multispecialty approach to patient care. This approach ultimately has the potential to not just improve healthcare for individuals with CdLS but for those with medically complex diagnoses in general. © 2016 Wiley Periodicals, Inc. PMID:27145433

  20. Robot-assisted laparoscopic prostatectomy and previous surgical history: a multidisciplinary approach.

    PubMed

    Bernstein, Adrien N; Lavery, Hugh J; Hobbs, Adele R; Chin, Edward; Samadi, David B

    2013-06-01

    Previous abdominal or prostate surgery can be a significant barrier to subsequent minimally invasive procedures, including radical prostatectomy (RP). This is relevant to a quarter of prostatectomy patients who have had previous surgery. The technological advances of robot-assisted laparoscopic RP (RALP) can mitigate some of these challenges. To that end, our objective was to elucidate the effect of previous surgery on RALP, and to describe a multidisciplinary approach to the previously entered abdomen. One-thousand four-hundred and fourteen RALP patients were identified from a single-surgeon database. Potentially difficult cases were discussed preoperatively and treated in a multidisciplinary fashion with a general surgeon. Operative, pathological, and functional outcomes were analyzed after stratification by previous surgical history. Four-hundred and twenty (30 %) patients underwent previous surgery at least once. Perioperative outcomes were similar among most groups. Previous major abdominal surgery was associated with increased operative time (147 vs. 119 min, p < 0.001), as was the presence of adhesions (120 vs. 154 min, p < 0.001). Incidence of complications was comparable, irrespective of surgical history. Major complications included two enterotomies diagnosed intraoperatively and one patient requiring reoperation. All cases were performed robotically, without conversion to open-RP. There was no difference in biochemical disease-free survival among surgical groups and continence and potency were equivalent between groups. In conclusion, previous abdominal surgery did not affect the safety or feasibility of RALP, with all patients experiencing comparable perioperative, functional, and oncologic outcomes. PMID:27000905

  1. 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

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

    PubMed

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

    2016-01-01

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

  3. 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.

  4. 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.

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

    NASA Astrophysics Data System (ADS)

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

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    Lakes, Richard D., Ed.

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

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

    ERIC Educational Resources Information Center

    Hope, Robert; And Others

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

  9. A multidisciplinary team case management approach reduces the burden of frequent asthma admissions

    PubMed Central

    Burke, Hannah; Davis, Jenny; Evans, Sian; Flower, Laura; Tan, Andrew

    2016-01-01

    Up to 10% of asthmatics have “difficult asthma”; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT). We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist) case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK) to support patients with frequent asthma admissions during admission and then in clinic. To assess efficacy, we systematically searched the hospital database for patients acutely admitted for asthma on two or more occasions in 2010, 2011 and 2012. Data were collected retrospectively covering patient demographics, admission details, asthma severity and comorbidity. From 2010 to 2012, 84 patients were admitted on two or more occasions per year (80% female, mean body mass index 31 kg·m−2 and 55% psychological comorbidity). After introducing an MDT approach repeat asthma admissions fell by 33% from 127 in 2010 to 84 in 2012 (p=0.0004). In addition, bed days fell by 52% from 895 in 2010 to 430 in 2010 (p=0.015). An MDT case management approach significantly reduces hospitalisation in difficult asthma patients with prior frequent admission. PMID:27730207

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

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

    PubMed

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

    2013-07-01

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

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

    ERIC Educational Resources Information Center

    Ringeling, Arthur

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    Background In contemporary dental care, an increasing number of adult patients are now seeking orthodontic treatment with the primary motive of improvement in appearance and achievement of esthetic smile. Proper recognition of the dental and facial defects at the outset of treatment is the most important key to esthetic success and is essential in satisfying the patient’s needs. By following the rules of Golden proportion smiles can be made attractive, harmonious, symmetrical, and proportionate. Methodology Consisted of 22-year-old girl who came for treatment of crowding in maxillary and mandibular arches, abnormal overjet and overbite and had unesthetic peg lateral. Results Non-extraction therapy was carried out since the patient had good soft tissue drape, alignment was achieved by expanding the arches and moving teeth in ideal axial inclination. Esthetic smile was attained using composite buildup of upper right peg lateral and minor adjunctive surgery (full thickness periodontal graft) on lower right central incisor. Conclusion The present case report orchestrates interrelationship between various branches of dentistry and orthodontics. It exhibits how multidisciplinary approach can be used to achieve ideal dental esthetics in a 22-year-old girl who was successfully treated for peg shaped lateral incisor, gingival recession, and unesthetic smile. PMID:26316821

  14. Multidisciplinary Treatment Approach for Prosthetic Vascular Graft Infection in the Thoracic Aortic Area

    PubMed Central

    Watanabe, Yoshinori

    2015-01-01

    Prosthetic vascular graft infection in the thoracic aortic area is a rare but serious complication. Adequate management of the complication is essential to increase the chance of success of open surgery. While surgical site infection is suggested as the root cause of the complication, it is also related to decreased host tolerance, especially as found in elderly patients. The handling of prosthetic vascular graft infection has been widely discussed to date. This paper mainly provides a summary of literature reports published within the past 5 years to discuss issues related to multidisciplinary treatment approaches, including surgical site infection, timing of onset, diagnostic methods, causative pathogens, auxiliary diagnostic methods, antibiotic treatment, anti-infective structures of vascular prostheses, surgical treatment, treatment strategy against infectious aortic aneurysms, future surgical treatment, postoperative systemic therapy, and antimicrobial stewardship. A thorough understanding of these issues will enable us to prevent prosthetic vascular graft infection in the thoracic aortic area as far as possible. In the event of its occurrence, the early introduction of appropriate treatment is expected to cure the disease without worsening of the underlying pathological condition. PMID:26356686

  15. Metastatic bone disease: the requirement for improvement in a multidisciplinary approach.

    PubMed

    Cumming, D; Cumming, J; Vince, A; Benson, R

    2009-04-01

    The purpose of this study was to assess the referral system, clinical notes and radiographs of patients presenting with metastatic disease of long bones. The study demonstrated that 93% of oncologists did not use a reliable scoring system to assess risk of pathological fracture, and 60% felt an improvement in communication was required. Notes and radiographs were reviewed for 37 patients presenting with femoral metastatic lesions. Sixteen patients had a Mirels' score of greater than 8. Four patients were referred for an orthopaedic opinion. Twelve patients with a score of greater than 8 were not referred; seven of these patients suffered a pathological fracture. Sixteen patients had a Mirels' score of less than 8; none of these patients were referred for an orthopaedic opinion. No pathological fractures occurred. In conclusion, the majority of patients who score above 8 in the Mirels' scoring system are at risk of fracture and do require prophylactic surgery. In keeping with the British Orthopaedic Association (BOA) guidelines, "Metastatic Bone Disease: A Guide to Good Practice", we would recommend a multidisciplinary approach and the use of a recognised scoring system.

  16. Evaluation of Neurologic Deficit Without Apparent Cause: The Importance of a Multidisciplinary Approach

    PubMed Central

    Smith, Harvey E; Rynning, Ralph E; Okafor, Chukwuka; Zaslavsky, James; Tracy, Joseph I; Ratliff, John; Harrop, James; Albert, Todd; Hilibrand, Alan; Anderson, Gregory; Sharan, Ashwini; Brown, Zoe; Vaccaro, Alexander R

    2007-01-01

    Background/Objective: A patient presenting with an acute neurologic deficit with no apparent etiology presents a diagnostic dilemma. A broad differential diagnosis must be entertained, considering both organic and psychiatric causes. Methods: A case report and thorough literature review of acute paraplegia after a low-energy trauma without a discernible organic etiology. Results: Diagnostic imaging excluded any bony malalignment or fracture and any abnormality on magnetic resonance imaging. When no organic etiology was identified, a multidisciplinary approach using neurology, psychiatry, and physical medicine and rehabilitation services was applied. Neurophysiologic testing confirmed the absence of an organic disorder, and at this juncture, diagnostic efforts focused on identifying any psychiatric disorder to facilitate appropriate treatment for this individual. The final diagnosis was malingering. Conclusions: The full psychiatric differential diagnosis should be considered in the evaluation of any patient with an atypical presentation of paralysis. A thorough clinical examination in combination with the appropriate diagnostic studies can confidently exclude an organic disorder. When considering a psychiatric disorder, the differential diagnosis should include conversion disorder and malingering, although each must remain a diagnosis of exclusion. Maintaining a broad differential diagnosis and involving multiple disciplines (neurology, psychiatry, social work, medical specialists) early in the evaluation of atypical paralysis may facilitate earlier diagnosis and initiation of treatment for the underlying etiology. PMID:18092568

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

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

    SciTech Connect

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

    2008-09-15

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Driscoll, David; Sorensen, Asta; Deerhake, Marion

    2012-03-01

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

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

    PubMed Central

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

    2016-01-01

    Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation. PMID:27239357

  3. Translating clinical research of Molecular Biology into a personalized, multidisciplinary approach of colorectal cancer patients.

    PubMed

    Strambu, V; Garofil, D; Pop, F; Radu, P; Bratucu, M; Popa, F

    2014-03-15

    Although multimodal treatment has brought important benefit, there is still great heterogeneity regarding the indication and response to chemotherapy in Stage II and III, and individual variations related to both overall survival and toxicity of new therapies in metastatic disease or tumor relapse. Recent research in molecular biology led to the development of a large scale of genetic biomarkers, but their clinical use is not concordant with the high expectations. The Aim of this review is to identify and discuss the molecular markers with proven clinical applicability as prognostic and/or predictive factors in CRC and also to establish a feasible algorithm of molecular testing, as routine practice, in the personalized, multidisciplinary approach of colorectal cancer patients in our country. Despite the revolution that occurred in the field of molecular marker research, only Serum CEA, Immunohistochemical analysis of mismatch repair proteins and PCR testing for KRAS and BRAF mutations have confirmed their clinical utility in the management of colorectal cancer. Their implementation in the current practice should partially resolve some of the controversies related to this heterogenic pathology, in matters of prognosis in different TNM stages, stage II patient risk stratification, diagnosis of hereditary CRC and likelihood of benefit from anti EGFR therapy in metastatic disease. The proposed algorithms of molecular testing are very useful but still imperfect and require further validation and constant optimization.

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

    PubMed

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

    2016-04-15

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

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

    NASA Astrophysics Data System (ADS)

    Kenney, M. A.

    2015-12-01

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

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2015-12-01

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

  8. Neotectonic and seismotectonic investigation of seismically active regions in Tunisia: a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Bahrouni, N.; Bouaziz, S.; Soumaya, A.; Ben Ayed, N.; Attafi, K.; Houla, Y.; El Ghali, A.; Rebai, N.

    2014-04-01

    Due to its key position within the Africa-Europe convergence zone, Tunisia is marked by thrusting, folding, and faulting and has a major rupture zones associated with active faults. Consequently, most of Tunisian land is seismically active with significant active deformations, showing recent seismic events and their relative surface effects. This paper reports on several aspects of the seismotectonics, historical, and present-day seismicity and places them in the general tectonic and geodynamic framework of Tunisia. Field investigations, based on an integrated multidisciplinary approach, included (1) the identification of active faults, their motion and displacement, geomorphic aspects, and scarps and their relation with the general structural map of Tunisia and (2) an extensive analysis of brittle tectonic deformation affecting Quaternary deposits in several sites throughout Tunisia. The integration of field data within the existing data related to the seismic events that took place during the last decades allowed the establishment of an earthquake distribution map, as well as major seismic zones for better understanding of the seismicity database of Tunisia. To establish microzonation maps in seismic regions such as Gafsa and its surroundings, we have analyzed surface effects and secondary structures associated with active faults and correlated them with deformation rates, reconstructed for significant seismic events. Most faults exhibited typical left-stepping en-echelon with strike-slip component pattern suggesting that Tunisia is presently subjected to NNW-SSE compression. The focal mechanism of most Tunisia earthquakes combined with the existing tectonic and structural information and reconstruction of the Quaternary stress tensor allowed (a) better understanding of seismic zoning, (b) provided better assessment of the seismic hazard, and (c) facilitated the interpretation of the relationship between seismic zones and the geodynamic African-Eurasian plate

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

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

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

  10. A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: a clinical report.

    PubMed

    Moshaverinia, Alireza; Kar, Kian; Aalam, Alexandre Amir; Takanashi, Kazunari; Kim, James W; Chee, Winston W

    2014-04-01

    This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient with a severely worn dentition. The treatment included osteotomy and immediate implant placement and loading in the mandible. The definitive restorations were implant- and tooth-supported metal ceramic restorations. These restorations were fabricated with metal occlusal surfaces at an increased occlusal vertical dimension, which provided acceptable esthetics and function. PMID:24529653

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. Multidisciplinary approach for a patient with dentinogenesis imperfecta and anterior trauma.

    PubMed

    Roh, Won-Jong; Kang, Seung-Goo; Kim, Su-Jung

    2010-09-01

    Dentinogenesis imperfecta is an inherited dentinal dysplasia involving several risks for orthodontic treatment. This case report describes the multidisciplinary treatment of a 17-year-old girl whose Class II Division 1 malocclusion was complicated by dentinogenesis imperfecta type II and maxillary anterior trauma.

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

    ERIC Educational Resources Information Center

    Franken, Ken; And Others

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Blatt, Steven D.; And Others

    1997-01-01

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

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

    ERIC Educational Resources Information Center

    Ramey, Craig T.; And Others

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  2. Complex Regional Pain Syndrome in Children: a Multidisciplinary Approach and Invasive Techniques for the Management of Nonresponders.

    PubMed

    Rodriguez-Lopez, Manuel J; Fernandez-Baena, Mariano; Barroso, Alex; Yáñez-Santos, Jose A

    2015-11-01

    Complex regional pain syndrome (CRPS) is multifactorial condition with complex pathogenesis characterized by spontaneous or stimulus-induced pain that is disproportionate to the inciting event. It is also commonly accompanied by a myriad of autonomic and motor disturbances in highly variable combinations. This condition has been underreported in children until recently. Consequently, the management of CRPS in the pediatric population presents an even greater challenge than in adults, partly because there is a lack of clinical data concerning the efficacy of the diverse treatment methods available, and partly because successful treatment of CRPS involves a multidisciplinary approach. In this retrospective case series, a multidisciplinary management plan is presented in 10 children for whom the standard noninvasive treatment was unsuccessful. Within this management plan, novel drugs were included such as the capsaicin 8% patch, in addition to invasive techniques in patients who did not respond to noninvasive therapies.

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

    SciTech Connect

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

    2000-02-07

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

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

    NASA Astrophysics Data System (ADS)

    Sciarra, Marco; Urbano, Tullio; Coco, Laura

    2016-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

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

    PubMed

    Barnes, David K A

    2002-10-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    SciTech Connect

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

    2011-09-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  10. Learning Geomicrobiology as a Team Using Microbial Mats, a Multidisciplinary Approach

    PubMed Central

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

    2007-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

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

    NASA Astrophysics Data System (ADS)

    Luino, Fabio

    2015-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

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

    PubMed Central

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

    2014-01-01

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

  15. CERN's approach to public outreach

    NASA Astrophysics Data System (ADS)

    Landua, Rolf

    2016-03-01

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

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

    SciTech Connect

    Noonan, Christine F.; Stratton, Kelly G.

    2015-07-13

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

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

    PubMed

    Rosomoff, H L; Rosomoff, R S

    1991-10-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-19

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

  20. Transformative Learning Approaches for Public Relations Pedagogy

    ERIC Educational Resources Information Center

    Motion, Judy; Burgess, Lois

    2014-01-01

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

  1. Radium 223 dichloride: a multidisciplinary approach to metastatic castration-resistant prostate cancer.

    PubMed

    Borsò, Elisa; Boni, Giuseppe; Galli, Luca; Ricci, Sergio; Farnesi, Azzurra; Mazzarri, Sara; Cianci, Claudia; Mariani, Giuliano; Falcone, Alfredo

    2015-01-01

    The role of nuclear medicine physicians in the multidisciplinary team for the management of patients with prostate cancer has been restricted because of a lack of available tools. The only drugs approved to relieve pain related to bone metastases were β-emitting radiopharmaceuticals. These drugs did not prove to prolong survival when used as single agent and resulted associated with important adverse events. This situation has changed with the introduction of radium 223 because of evidence of improved survival in patients, the good safety profile and the opportunity to avoid clonal selection of tumor cells. Cooperation among physicians involved in cancer management will lead to improvements in the treatment of bone metastases due to prostate cancer and is thought to extend to other tumor types.

  2. ED diversion: multidisciplinary approach engages high utilizers, helps them better navigate the health care system.

    PubMed

    2011-11-01

    Working with partners, the St. Charles Health System in Bend, OR, has implemented an ED diversion project that is helping patients who frequent the ED connect with more appropriate settings for their primary care needs. The hospital identifies high ED utilizers using claims data, then a multidisciplinary engagement team establishes care plans for these patients. The most at-risk patients are paired with community health workers to help them better navigate the health care system. The ED diversion project has reduced unnecessary ED utilization by 45% to 70% in cohorts of patients that the hospital has analyzed thus far. The hospital contracts with a non-profit organization to supply and train community health workers. Community health workers follow a structured model that includes more than 80 different pathways to follow, based on patient conditions. PMID:22043590

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Bye, B. L.; Godøy, Ø.

    2014-12-01

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

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

    PubMed Central

    Reynolds, Stacey

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Fall, Andrew

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    Esteban, David J.; Holloway, Kevin S.

    2015-01-01

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

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

    PubMed

    Esteban, David J; Holloway, Kevin S

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  16. A multidisciplinary combinatorial approach for tuning promising hydrogen storage materials towards automotive applications.

    PubMed

    Amieiro-Fonseca, A; Ellis, S R; Nuttall, C J; Hayden, B E; Guerin, S; Purdy, G; Soulié, J P; Callear, S K; Culligan, S D; David, W I F; Edwards, P P; Jones, M O; Johnson, S R; Pohl, A H

    2011-01-01

    HyStorM is a multidisciplinary hydrogen-storage project aiming to synthesise and tune materials hydrogen storage properties for automotive applications. Firstly, unique high-throughput combinatorial thin-film technologies are used to screen materials' hydrogen storage properties. Then promising thin-film candidate compositions are synthesised and examined in the bulk. In this paper, we report on our results within the ternary compositions Mg-Ti-B and Ca-Ti-B. Primary screening of the Mg-Ti-B ternary identified a high capacity hotspot corresponding to Mg0.36Ti0.06B0.58, with 10.6 wt% H2 capacity. Partial reversibility has been observed for this material in the thin-film. Bulk Ti-doped Mg(BH4)2 composites show rehydrogenation to MgH2 under the conditions used. The synthesised thin-film Ca-Ti-B ternary showed only low hydrogen storage capacities. In the bulk, Ti-doping experiments on Ca(BH4)2 demonstrated reversible storage capacities up to 5.9 wt% H2. Further characterisation experiments are required to decipher the role of the Ti-dopant in these systems in both films and in the bulk.

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

    PubMed

    Esteban, David J; Holloway, Kevin S

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  19. Multidisciplinary Approach for the Treatment of Horizontal Root-Fractured Maxillary Anterior Teeth

    PubMed Central

    Uzuntas, Ceren Feriha; Safaralizadeh, Reza; Demirel, Gulbike; Sevimay, Semra

    2014-01-01

    Dental trauma can lead to a wide range of injuries of which crown and root fractures are examples. Crown-root fractures often need complex treatment planning. This case report describes the use of MTA in the multidisciplinary management of a patient with a horizontally fractured central incisor and luxation in a different central incisor. A 42-year-old female patient presented within 1 h of receiving direct trauma to her maxillary area. Clinical examination revealed that the right and left maxillary central incisors presented mobility and sensitivity to percussion and palpation but no sensitivity to thermal stimulations. Occlusal displacement with extrusion in the left maxillary central incisor and luxation in the right maxillary central incisor was observed. Radiographic examination revealed horizontal root fracture at the apical third of the left maxillary central incisor. Root fracture in the right maxillary incisor was not observed. Endodontic and aesthetic restorative treatments were completed. MTA showed a good long-term outcome when used in root-fractured and luxated teeth. In addition, composite resin restoration provided satisfactory aesthetic results even after 15 months. PMID:25485158

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

    PubMed Central

    2014-01-01

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

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2011-10-01

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

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

    PubMed

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

    2011-10-01

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

  5. Multidisciplinary Care.

    PubMed

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-09-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

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

  9. Multidisciplinary approach to improve spontaneous ADR reporting in the pediatric outpatient setting: a single-institute experience in Korea.

    PubMed

    Baek, Hyun Jeong; Cho, Yoon Sook; Kim, Kwi Suk; Lee, Jin; Kang, Hye Ryun; Suh, Dong In

    2016-01-01

    In order to improve the reporting of adverse drug reactions (ADRs) as part of the routine practice at the pediatric outpatient department (OPD), we modified our ADR reporting strategy into one that facilitates the reporting process by means of a multi-disciplinary approach. In this study, we retrospectively reviewed ADR records during the period from March to September 2014 when we changed our reporting process as a part of institutional quality assurance (QA) activity. Yearly differences in the number and composition of ADRs were compared, and the descriptive analyses were done for cases reported from OPD during the QA activity in terms of the suspected drugs, type, causality, and severity of ADRs. There were 1211 pediatric ADR reports including 520 cases with underlying hemato-oncologic diseases during the period of 2014. Among the 691 non-oncologic cases, 76 were reported from the OPD, which was a significant increase (347 %) from the 17 cases reported during the previous year. Further analyses of these 76 cases revealed that the caregivers (47.4 %) initiated about half of the reports, the most frequently affected organ was the skin (32.9 %), and the most frequent suspected drugs were anticonvulsants (14.5 %). In contrast to the in-ward system, moderate cases were more frequent (51.3 %) than mild ones. In conclusion, this study provides a profile of pediatric ADRs in the OPD, which were largely under-reported during the usual clinical practice. A multi-disciplinary approach would improve spontaneous ADR reporting at the pediatric OPD. PMID:27652011

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2010-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

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

    PubMed

    Racedo Africano, Carlos J; Gallo de Moraes, Alice; Smischney, Nathan J

    2015-09-19

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    Elkort, Richard; Mozden, Peter J.

    1975-01-01

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

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

    PubMed

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

    2015-06-01

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

  19. A multidisciplinary approach directed towards the commercial release of transgenic herbicide-tolerant rice in Costa Rica.

    PubMed

    Espinoza-Esquivel, Ana M; Arrieta-Espinoza, Griselda

    2007-10-01

    This review discusses a multidisciplinary and multicomponent approach leading to the development and commercial release of transgenic Costa Rican rice varieties tolerant to the herbicide gluphosinate ammonium. We describe the field evaluations of the transgenic lines and their potential environmental impact, focusing on gene flow, particularly in relation to native wild Oryza species and weedy rice, based on trials performed in compliance with the national regulatory requirements of the country. We also present a socio-economic analysis of rice production in Costa Rica and the economic benefits of genetically modified (GM) rice as well as an environmental risk-benefit analysis for the deployment of GM rice. Additionally, food safety evaluation, intellectual property management, requirements for deregulation, and options for the commercialization of the new varieties are discussed. We also present results from a national survey aimed at assessing the level of support for GM crops in Costa Rica as this forms an integral component of our approach. Taken together, our results demonstrate that the adoption of these genetically improved rice varieties will provide clear benefits to Costa Rican rice growers and consumers.

  20. A multi-disciplinary approach to understanding hippocampal function in food-hoarding birds.

    PubMed

    Smulders, Tom Victor

    2006-01-01

    Spatial memory and the hippocampal formation (HF) of food-hoarding birds have been put forward as a prime example of how natural selection has shaped a cognitive system and its neural underpinnings. Here, I review what we know about the HF of hoarding birds and lay out the work that is currently underway to use this system to obtain a better understanding of hippocampal function in general. This interdisciplinary programme includes evolutionary, ecological, psychological, ethological, and neuroscientific approaches to the study of behaviour and cognition. Firstly, we need to understand the behaviour of the birds in their natural environment, and identify the aspects of cognition and behaviour that may be especially valuable for the species under study. Secondly, these cognitive and behavioural traits are compared to closely-related non-hoarding species. Thirdly, we also compare HF anatomy between closely-related hoarding and non-hoarding species, identifying possible neural mechanisms underlying behavioural differences. Finally, behavioural and neuroscientific approaches are combined in experiments directly investigating the involvement of the HF or any of its anatomical and physiological aspects in the behaviours under study. This process loops back upon itself in many different ways, with all the different approaches informing each other. In this way we are making progress in understanding the functioning of the HF, not only in food-hoarding birds, but in all vertebrates.

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

    PubMed

    Carlin, Alan

    2011-04-01

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

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

    PubMed

    Carlin, Alan

    2011-04-01

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

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

    PubMed Central

    Carlin, Alan

    2011-01-01

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

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

    PubMed

    Clough, S; Shehabi, Z; Morgan, C

    2016-05-27

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

  5. [Approaches for suicide prevention in Osaka Psychiatric Medical Center: the importance of multi-disciplinary cooperation and partnerships with other organizations].

    PubMed

    Iwata, Kazuhiko

    2012-01-01

    Suicide is a very common problem in psychiatric practice today. Therefore, almost all staff of psychiatric hospitals have encountered the suicide of one or more of their patients. Our hospital, Osaka Psychiatric Medical Center, is a public psychiatric hospital in Japan. We provide treatment and support for patients from the acute to chronic phases of psychiatric disorders, and patients range from children to the elderly. Because we accept many patients with severe mental illness from other hospitals, many of our staff are routinely confronted with patients' violence or suicidal attempts. If a patient commits suicide, the relevant staff immediately have a conference to implement measures for preventing a recurrence. At the same time, information about the incident is conveyed to the medical safety management office and made known to all staff in our hospital. This office was established in 2007. Currently, all information about incidents and accidents in our hospital (e.g., suicide, problems between patients, problems with hospital facilities) is aggregated in the office and distributed to all staff members through the hospital intranet. This system makes it possible for staff to consider countermeasures against similar incidents and accidents, even if not involved in the incident. Additionally, we make an effort to develop cooperative relationships with organizations including the police, public health centers, and the fire department. The social welfare council in Hirakata City, where our hospital is located, provides some services to prevent suicide (e.g., telephone counseling, meetings with bereaved family members). Our hospital cooperates with these services by providing lecturers. The partnerships with these organizations help regarding the mental crises of patients in our hospital and fulfill a role to prevent suicide. Multi-disciplinary cooperation and partnerships with community organizations are not special approaches to suicide prevention, but ordinary

  6. [Approaches for suicide prevention in Osaka Psychiatric Medical Center: the importance of multi-disciplinary cooperation and partnerships with other organizations].

    PubMed

    Iwata, Kazuhiko

    2012-01-01

    Suicide is a very common problem in psychiatric practice today. Therefore, almost all staff of psychiatric hospitals have encountered the suicide of one or more of their patients. Our hospital, Osaka Psychiatric Medical Center, is a public psychiatric hospital in Japan. We provide treatment and support for patients from the acute to chronic phases of psychiatric disorders, and patients range from children to the elderly. Because we accept many patients with severe mental illness from other hospitals, many of our staff are routinely confronted with patients' violence or suicidal attempts. If a patient commits suicide, the relevant staff immediately have a conference to implement measures for preventing a recurrence. At the same time, information about the incident is conveyed to the medical safety management office and made known to all staff in our hospital. This office was established in 2007. Currently, all information about incidents and accidents in our hospital (e.g., suicide, problems between patients, problems with hospital facilities) is aggregated in the office and distributed to all staff members through the hospital intranet. This system makes it possible for staff to consider countermeasures against similar incidents and accidents, even if not involved in the incident. Additionally, we make an effort to develop cooperative relationships with organizations including the police, public health centers, and the fire department. The social welfare council in Hirakata City, where our hospital is located, provides some services to prevent suicide (e.g., telephone counseling, meetings with bereaved family members). Our hospital cooperates with these services by providing lecturers. The partnerships with these organizations help regarding the mental crises of patients in our hospital and fulfill a role to prevent suicide. Multi-disciplinary cooperation and partnerships with community organizations are not special approaches to suicide prevention, but ordinary

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

    NASA Astrophysics Data System (ADS)

    Salmun, H.

    2015-12-01

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

  8. Multidisciplinary and esthetic approach to clinical crown lengthening: report of a case.

    PubMed

    Ngan, P; Knobloch, L

    1993-12-01

    This paper describes the combined efforts of an orthodontist, periodontist, and a restorative dentist to save an unrestorable tooth by clinical crown lengthening. A maxillary lateral incisor, originally treatment planned for extraction, was treated with orthodontic extrusion, circumferential fiberotomy, and metal-ceramic crown restoration. To maximize the esthetic appearance of the tooth during orthodontic treatment, an acrylic resin facing was designed together with the orthodontic appliance used to facilitate vertical extrusion. Clinical crown lengthening may be used as an alternative approach to the treatment of severely broken down anterior teeth.

  9. Craniofacial/Neurosurgery: a multidisciplinary approach to the repair of meningoencephaloceles in a third world country.

    PubMed

    Hack, Judith; Pieper, Daniel

    2011-08-01

    The repair of meningoencephaloceles in a third world country does not have to be an unrealized goal. Utilizing a team of specialized experienced physicians to provide the treatment, patient selection, comprehensive planning for all surgical variability, and cooperative management of the patients postoperatively with the hosting physicians is essential to the success of these surgeries. In 2007, a team of physicians, including a neurosurgeon, a craniofacial surgeon, a neurosurgical resident, and nursing personnel, traveled for the first time to Davao, in the Philippines, to repair and reconstruct four patients with meningoencephalocele. The planning, surgical approach, and outcome of the repair of this defect are discussed in this article.

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2015-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  13. Modeling the surface and interior structure of comet nuclei using a multidisciplinary approach

    NASA Technical Reports Server (NTRS)

    Odell, C. R.; Dakoulas, Panos C.; Pharr, George M.

    1991-01-01

    The goal was to investigate the structural properties of the surface of comet nucleus and how the surface should change with time under effect of solar radiation. The basic model that was adopted was that the nucleus is an aggregate of frosty particles loosely bound together, so that it is essentially a soil. The nucleus must mostly be composed of dust particles. The observed mass ratios of dust to gas in the coma is never much greater than unity, but this ratio is probably a much lower limit than that of the nucleus because it is vastly easier to remove the gaseous component by sublimation than by carrying off the dust. Therefore the described models assumed that the particles in the soil were frost covered grains of submicron basic size, closely resembling the interstellar grains. The surface properties of such a nucleus under the effects of heating and cooling as the nucleus approaches and recedes from the Sun generally characterized.

  14. Traceability of 'Limone di Siracusa PGI' by a multidisciplinary analytical and chemometric approach.

    PubMed

    Amenta, M; Fabroni, S; Costa, C; Rapisarda, P

    2016-11-15

    Food traceability is increasingly relevant with respect to safety, quality and typicality issues. Lemon fruits grown in a typical lemon-growing area of southern Italy (Siracusa), have been awarded the PGI (Protected Geographical Indication) recognition as 'Limone di Siracusa'. Due to its peculiarity, consumers have an increasing interest about this product. The detection of potential fraud could be improved by using the tools linking the composition of this production to its typical features. This study used a wide range of analytical techniques, including conventional techniques and analytical approaches, such as spectral (NIR spectra), multi-elemental (Fe, Zn, Mn, Cu, Li, Sr) and isotopic ((13)C/(12)C, (18)O/(16)O) marker investigations, joined with multivariate statistical analysis, such as PLS-DA (Partial Least Squares Discriminant Analysis) and LDA (Linear Discriminant Analysis), to implement a traceability system to verify the authenticity of 'Limone di Siracusa' production. The results demonstrated a very good geographical discrimination rate. PMID:27283690

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

    PubMed

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

    2015-01-01

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

  16. The initial phases of the 2008-2009 Mount Etna eruption: A multidisciplinary approach for hazard assessment

    NASA Astrophysics Data System (ADS)

    Bonaccorso, A.; Bonforte, A.; Calvari, S.; Del Negro, C.; di Grazia, G.; Ganci, G.; Neri, M.; Vicari, A.; Boschi, E.

    2011-03-01

    Between 2007 and early 2008, the Istituto Nazionale di Geofisica e Vulcanologia (INGV) monitoring networks on Etna volcano recorded a recharging phase that climaxed with a new effusive eruption on 13 May 2008 and lasted about 14 months. A dike-forming intrusion was accompanied by a violent seismic swarm, with more than 230 events recorded in the first 6 h, the largest being ML = 3.9. In the meanwhile, marked ground deformation was recorded by the permanent tilt and GPS networks, and sudden changes in the summit area were detected by five continuously recording magnetic stations. Poor weather conditions did not allow direct observation of the eruptive events, but important information was provided by infrared satellite images that detected the start of lava fountains from the eruptive fissure, feeding a lava flow. This flow spread within the Valle del Bove depression, covering 6.4 km on the southeastern flank of the volcano in a few hours. The seismicity and deformation pattern indicated that the dike-forming intrusion was propagating northward. It produced a dry fracture field, which generated concern for the possibility that the eruptive fissures could expand downslope toward populated areas. Monitoring and modeling of the multidisciplinary data, together with the simulations of ash dispersal and lava flows, allowed us both to infer the eruptive mechanisms and to provide correct interpretation of the ongoing phenomena, furnishing useful information for civil defense purposes. We describe how this approach of feedback between monitoring and research provides critical support to risk evaluation.

  17. A multidisciplinary approach to reservoir subdivision of the Maastrichtian chalk in the Dan field, Danish North Sea

    SciTech Connect

    Kristensen, L.; Dons, T.; Schioler, P.

    1995-11-01

    Correlation of wireline log data from the North Sea chalk reservoirs is frequently hampered by rather subtle log patterns in the chalk section due to the apparent monotonous nature of the chalk sediments, which may lead to ambiguous correlations. This study deals with a correlation technique based on an integration of biostratigraphic data, seismic interpretation, and wireline log correlation; this technique aims at producing a consistent reservoir subdivision that honors both the well data and the seismic data. This multidisciplinary approach has been used to subdivide and correlate the Maastrichtian chalk in the Dan field. The biostratigraphic subdivision is based on a new detailed dinoflagellate study of core samples from eight wells. Integrating the biostratigraphic results with three-dimensional seismic data allows recognition of four stratigraphic units within the Maastrichtian, bounded by assumed chronostratigraphic horizons. This subdivision is further refined by adding a seismic horizon and four horizons from wireline log correlations, establishing a total of nine reservoir units. The approximate chronostratigraphic nature of these units provides an improved interpretation of the depositional and structural patterns in this area. The three upper reservoir units pinch out and disappear in a northeasterly direction across the field. We interpret this stratal pattern as reflecting a relative sea level fall or regional basinal subsidence during the latest Maastrichtian, possibly combined with local synsedimentary uplift due to salt tectonics. Isochore maps indicate that the underlying six non-wedging units are unaffected by salt tectonics.

  18. Multidisciplinary approach in the management of absolute trismus with bilateral temporomandibular joint replacements for a patient with juvenile idiopathic arthritis.

    PubMed

    Fanaras, Nikolaos; Parry, Nicholas S; Matthews, N Shaun

    2014-11-01

    Juvenile idiopathic arthritis (JIA) is an exclusion diagnosis that gathers together all forms of arthritis that begin before the age of 16 years, persist for more than 6 weeks and are of unknown origin. We present the case of a 42 year old woman with a 20 year history of absolute trismus, secondary to bilateral temporomandibular joint (TMJ) ankylosis caused by JIA. The trismus resulted in grossly compromised oral hygiene and limited the patient to a semi-solid diet. JIA also affected her neck leading to a severe cervico-thoracic kyphosis. The patient who had been wheelchair bound developed severe lymphoedema of both lower limbs, complicating the pre-operative work up further. This particularly challenging case required input from specialists in anaesthetics, neurosurgery, special care dentistry, intensive care and maxillofacial surgery. Treatment consisted of ankylosis release, dental clearance and bilateral alloplastic replacement of her TMJs with custom implants. A full range of hinge movement and good functional outcome was achieved. This case presents the multidisciplinary approach to a severely compromised patient and illustrates the pre-, intra- and postoperative management of bilateral TMJ ankylosis with bespoke implants. PMID:25085804

  19. Late Quaternary cave bears and brown bears in Europe: implications for distribution, chronology, and extinction based on a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Pacher, Martina

    2010-05-01

    Cave bear remains are one of the most numerous fossils found in European caves. Despite their frequency of occurrence, many aspects of cave bear palaeontology still remain poorly understood. New methodological approaches and ongoing studies led to controversial results and discussion about its taxonomy, palaeoecology, and final extinction. Are we dealing with one single or several species of cave bears? Was cave bear exclusively vegetarian or after all more omnivorous? Did he go extinct before or after the Late Glacial Maximum? Was cave bear restricted to Europe or did he also occur in Asia? Late Pleistocene brown bears, on the other hand, are often rare and little is known about the possible co-occurrence of cave and brown bears during the Late Pleistocene. Based on direct radiocarbon dates the distribution pattern of both, cave and brown bears is reconstructed during the Late Pleistocene in Europe. In addition, the reasons for the achieved pattern will be tested leading to the main question - why did cave bear become extinct while brown bears survived until today? To answer this question palaeobiological data of Late Pleistocene cave and brown bears will be tested against results from isotope analyses, while aDNA data may contribute to the question of distinct local population or even species of bears. The current state of evidence will be presented and on the basis of resulting pattern implications for further multi-disciplinary studies will be discussed.

  20. Introducing Astrophysics and Cosmology as Part of Multidisciplinary Approaches to Liberal Arts Courses Addressing "The Big Questions" of Human Experience

    NASA Astrophysics Data System (ADS)

    Wesney, J. C.

    2012-08-01

    There is an opportunity to bring college students to the exploration of the grandeur and wonder of the universe through the design and crafting of courses for the university and liberal arts curricula that would develop multidisciplinary perspectives within the frames of reference of astrophysics and cosmology. There is broad interest within colleges and universities to provide courses that examine "The Big Questions" of human experience from a variety of perspectives. The study of the history of discoveries and insights that we have gained through the development of astrophysics and cosmology provides course options for students to use to explore these questions. Such hybrid courses enable students to approach the questions of origins, human existence, appreciation of the natural world, appreciation of the universe at large, and the significance of our evolving comprehension of the universe from a variety of disciplinary perspectives, including those that border on the astrophysical and cosmological domains. There are within such courses opportunities to examine historical, philosophical, theological, and cultural perspectives as they intersect with our scientific understanding of where and who we are. The first of these courses at Sacred Heart University has been developed and presented for the past two years as part of the new Core Curriculum. The development of that course, entitled The Journey in the Physical Universe, will be discussed, and insights will be shared.

  1. Migration and diversity in Roman Britain: a multidisciplinary approach to the identification of immigrants in Roman York, England.

    PubMed

    Leach, Stephany; Lewis, Mary; Chenery, Carolyn; Müldner, Gundula; Eckardt, Hella

    2009-11-01

    Previous anthropological investigations at Trentholme Drive, in Roman York identified an unusual amount of cranial variation amongst the inhabitants, with some individuals suggested as having originated from the Middle East or North Africa. The current study investigates the validity of this assessment using modern anthropological methods to assess cranial variation in two groups: The Railway and Trentholme Drive. Strontium and oxygen isotope evidence derived from the dentition of 43 of these individuals was combined with the craniometric data to provide information on possible levels of migration and the range of homelands that may be represented. The results of the craniometric analysis indicated that the majority of the York population had European origins, but that 11% of the Trentholme Drive and 12% of The Railway study samples were likely of African decent. Oxygen analysis identified four incomers, three from areas warmer than the UK and one from a cooler or more continental climate. Although based on a relatively small sample of the overall population at York, this multidisciplinary approach made it possible to identify incomers, both men and women, from across the Empire. Evidence for possible second generation migrants was also suggested. The results confirm the presence of a heterogeneous population resident in York and highlight the diversity, rather than the uniformity, of the population in Roman Britain.

  2. Incorporating the Performing Arts and Museum Exhibit Development in a Multidisciplinary Approach to Science Learning for Teenage Youth

    NASA Astrophysics Data System (ADS)

    Porro, I.; Dussault, M.; Barros-Smith, R.; Wise, D.; LeBlanc, D.

    2012-08-01

    It is not unusual for science educators to experience frustration in implementing learning initiatives for teenage youth who are not already hooked with science. Such frustration may lead them to focus their attention on different audiences, missing an opportunity to break the chain of science apathy among these youth. Youth's apparent lack of interest in science is associated with behavior typical of adolescence and the inadequacy of many science programs to adapt to meet the need of this audience. Teenage youth identify effective programs as those that engage them in challenging but fun activities and that contribute to their social development. Youth are looking for opportunities for skills and knowledge development that are otherwise unavailable to them in or out of school, and for positive relationships with adults with unique expertise in science and other fields. The Youth Astronomy Apprenticeship (YAA) has been successful in reaching out to teenage youth through the implementation of a model that incorporates principles of positive youth development in a multidisciplinary approach to science education. The project-based outcome of YAA participation is the creation and implementation of artistic performances, planetarium shows, museum exhibits, and even entertaining PowerPoint presentations.

  3. A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update.

    PubMed

    Vera-Garcia, Elisa; Mayoral-Cleries, Fermín; Vancampfort, Davy; Stubbs, Brendon; Cuesta-Vargas, Antonio I

    2015-10-30

    This systematic review summarizes the most recent evidence from randomized controlled trials (RCTs) considering the effectiveness of physical therapy interventions (aerobic exercises, strength exercises, relaxation training, basic body awareness exercises, or a combination of these) within the multidisciplinary management of schizophrenia. Two authors searched PubMed, PsycINFO, EMBASE, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cochrane Library considering RCTs published from July 1, 2011-October 1, 2014. Thirteen RCTs representing 549 participants met the inclusion criteria. Overall, the results demonstrate that aerobic exercise significantly reduces psychiatric symptoms, potentially improves mental and physical quality of life and reduces metabolic risk and weight. Specifically, yoga reduces psychiatric symptoms, whilst Tai-chi and progressive muscle relaxation may also have benefits to patients. Two RCTs reported on adverse events. No adverse event was observed supporting the notion that physical therapy is safe in people with schizophrenia. There was considerable heterogeneity in the design, implementation and outcomes in the included studies precluding a meaningful meta-analysis. In general, the quality of physical therapy RCTS is improving and current research demonstrates that physical therapy approaches are valuable interventions and can help improve the psychiatric, physical and quality of life of people with schizophrenia. PMID:26254795

  4. A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance.

    PubMed

    Sturke, Rachel; Harmston, Christine; Simonds, R J; Mofenson, Lynne M; Siberry, George K; Watts, D Heather; McIntyre, James; Anand, Nalini; Guay, Laura; Castor, Delivette; Brouwers, Pim; Nagel, Joan D

    2014-11-01

    In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination. PMID:25310124

  5. A Multidisciplinary Approach for Estimation of Seismic Losses: A Case Study in Turkey

    NASA Astrophysics Data System (ADS)

    Askan, A.; Erberik, M.; Un, E.

    2012-12-01

    Estimation of seismic losses including the physical, economic and social losses as well as casualties concern a wide range of authorities varying from geophysical and earthquake engineers, physical and economic planners to insurance companies. Due to the inherent uncertainties involved at each component, a probabilistic framework is required to estimate seismic losses. This study aims to propose an integrated method for predicting the potential seismic loss for a selected urban region. The main components of the proposed loss model are the seismic hazard estimation tool, building vulnerability functions, human losses and economic losses as functions of damage states of buildings. The input data for risk calculations involves regional seismicity and building fragility information. The casualty model for a given damage level considers the occupancy type, population of the building, occupancy at the time of earthquake occurrence, number of trapped occupants in the collapse, injury distribution at collapse and mortality post collapse. The economic loss module involves direct economic loss to buildings in terms of replacement, structural repair, non-structural repair costs and contents losses. Finally, the proposed loss model combines the input components within a conditional probability approach. The results are expressed in terms of expected loss. We calibrate the method with loss data from the 12 November 1999 Düzce earthquake and then predict losses for another city in Turkey (Bursa) with high seismic hazard.

  6. A multidisciplinary approach in muscle-invasive disease: novel chemotherapy combinations and targets in chemoradiation.

    PubMed

    James, Nicholas D; Hussain, Syed A

    2013-01-01

    The basic management of bladder cancer has changed depressingly little in the last 20 years, with a largely unquestioning acceptance of the role of surgery as the standard of care despite a rising mean age at diagnosis, now well into the mid-70s, meaning many patients will be high risk for a major surgical procedure. Overall survival rates for those diagnosed with bladder cancer have not improved for many years. There is a growing body of studies demonstrating the safety and efficacy of bladder preservation with combined chemo-radiation with good long-term function after such treatment. Two recent studies from the United Kingdom compared radiation alone with sensitized radiotherapy using distinct strategies, one (BCON) focusing on trying to improve tumor oxygenation, one (BC2001) using the combination of 5FU and mitomycin C. Importantly, both studies collected data on late toxicity and showed both good function and low rates of serious side effects with no increase with radio-sensitization. Furthermore, there is good evidence that survival after salvage cystectomy is similar to that seen after primary surgery, suggesting a strategy of primary chemo-radiation with salvage surgery (as used, for example, in anal cancer) may be both rational and safe. This article reviews the evidence on outcomes with chemo-radiation and calls for a rethink in our approaches to this major cancer killer. PMID:23714501

  7. Tannin impacts on microbial diversity and the functioning of alpine soils: a multidisciplinary approach.

    PubMed

    Baptist, F; Zinger, L; Clement, J C; Gallet, C; Guillemin, R; Martins, J M F; Sage, L; Shahnavaz, B; Choler, Ph; Geremia, R

    2008-03-01

    In alpine ecosystems, tannin-rich-litter decomposition occurs mainly under snow. With global change, variations in snowfall might affect soil temperature and microbial diversity with biogeochemical consequences on ecosystem processes. However, the relationships linking soil temperature and tannin degradation with soil microorganisms and nutrients fluxes remain poorly understood. Here, we combined biogeochemical and molecular profiling approaches to monitor tannin degradation, nutrient cycling and microbial communities (Bacteria, Crenarcheotes, Fungi) in undisturbed winter time soil cores exposed to low temperature (0 degrees C/-6 degrees C), amended or not with tannins, extracted from Dryas octopetala. No toxic effect of tannins on microbial populations was found, indicating that they withstand phenolics from alpine vegetation litter. Additionally at -6 degrees C, higher carbon mineralization, higher protocatechuic acid concentration (intermediary metabolite of tannin catabolism), and changes in fungal phylogenetic composition showed that freezing temperatures may select fungi able to degrade D. octopetala's tannins. In contrast, negative net nitrogen mineralization rates were observed at -6 degrees C possibly due to a more efficient N immobilization by tannins than N production by microbial activities, and suggesting a decoupling between C and N mineralization. Our results confirmed tannins and soil temperatures as relevant controls of microbial catabolism which are crucial for alpine ecosystems functioning and carbon storage.

  8. Investigating the Pathogenesis of Severe Malaria: A Multidisciplinary and Cross-Geographical Approach.

    PubMed

    Wassmer, Samuel C; Taylor, Terrie E; Rathod, Pradipsinh K; Mishra, Saroj K; Mohanty, Sanjib; Arevalo-Herrera, Myriam; Duraisingh, Manoj T; Smith, Joseph D

    2015-09-01

    More than a century after the discovery of Plasmodium spp. parasites, the pathogenesis of severe malaria is still not well understood. The majority of malaria cases are caused by Plasmodium falciparum and Plasmodium vivax, which differ in virulence, red blood cell tropism, cytoadhesion of infected erythrocytes, and dormant liver hypnozoite stages. Cerebral malaria coma is one of the most severe manifestations of P. falciparum infection. Insights into its complex pathophysiology are emerging through a combination of autopsy, neuroimaging, parasite binding, and endothelial characterizations. Nevertheless, important questions remain regarding why some patients develop life-threatening conditions while the majority of P. falciparum-infected individuals do not, and why clinical presentations differ between children and adults. For P. vivax, there is renewed recognition of severe malaria, but an understanding of the factors influencing disease severity is limited and remains an important research topic. Shedding light on the underlying disease mechanisms will be necessary to implement effective diagnostic tools for identifying and classifying severe malaria syndromes and developing new therapeutic approaches for severe disease. This review highlights progress and outstanding questions in severe malaria pathophysiology and summarizes key areas of pathogenesis research within the International Centers of Excellence for Malaria Research program.

  9. Major thoracic surgery in Jehovah's witness: A multidisciplinary approach case report

    PubMed Central

    Rispoli, Marco; Bergaminelli, Carlo; Nespoli, Moana Rossella; Esposito, Mariana; Mattiacci, Dario Maria; Corcione, Antonio; Buono, Salvatore

    2016-01-01

    Introduction A bloodless surgery can be desirable also for non Jehovah’s witnesses patients, but requires a team approach from the very first assessment to ensure adequate planning. Presentation of the case Our patient, a Jehovah’s witnesses, was scheduled for right lower lobectomy due to pulmonary adenocarcinoma. Her firm denies to receive any kind of transfusions, forced clinicians to a bloodless management of the case. Discussion Before surgery a meticulous coagulopathy research and hemodynamic optimization are useful to prepare patient to operation. During surgery, controlled hypotension can help to obtain effective hemostasis. After surgery, clinicians monitored any possible active bleeding, using continuous noninvasive hemoglobin monitoring, limiting the blood loss due to serial in vitro testing. The optimization of cardiac index and delivery of oxygen were continued to grant a fast recovery. Conclusion Bloodless surgery is likely to gain popularity, and become standard practice for all patients. The need for transfusion should be targeted on individual case, avoiding strictly fixed limit often leading to unnecessary transfusion. PMID:27107502

  10. King Charles` Star: A Multidisciplinary Approach To Dating The Supernova Known As Cassiopeia A

    NASA Astrophysics Data System (ADS)

    Lunn, Martin; Rakoczy, L.

    2011-01-01

    Few astronomical phenomena have been as studied as the supernova known as Cassiopeia A. Widely believed to have occurred in the latter half of the seventeenth century, it is also thought to have gone unrecorded. This paper will argue that Cas A did not go unobserved, but in fact was seen in Britain on May 29, 1630, and coincided with the birth of the future King Charles II of Great Britain. This `noon-day star’ is an important feature of Stuart/Restoration propaganda, the significance of which has been widely acknowledged by historians and literary experts. The argument here, however, is that in addition the historical accounts provide credible evidence for a genuine astronomical event, the nature of which must be explained. Combining documentary analysis with an overview of the current scientific thinking on dating supernova, the authors put forward their case for why Charles’ star should be recognized as a sighting of Cas A. Finally, it will be argued that a collaborative approach between the humanities and the sciences can be a valuable tool, not just in furthering our understanding of Cas A, but in the dating of supernovae in general.

  11. King Charles' Star: A Multidisciplinary Approach to Dating the Supernova Known as Cassiopeia A

    NASA Astrophysics Data System (ADS)

    Lunn, M.

    2012-06-01

    (Abstract only) Few astronomical phenomena have been as studied as the supernova known as Cassiopeia A. Widely believed to have occurred in the latter half of the seventeenth century, it is also thought to have gone unrecorded. This paper will argue that Cas A did not go unobserved, but in fact was seen in Britain on May 29, 1630, and coincided with the birth of the future King Charles II of Great Britain. This "noon-day star" is an important feature of Stuart/Restoration propaganda, the significance of which has been widely acknowledged by historians and literary experts. The argument here, however, is that in addition the historical accounts provide credible evidence for a genuine astronomical event, the nature of which must be explained. Combining documentary analysis with an overview of the current scientific thinking on dating supernovae, the authors put forward their case for why Charles' star should be recognized as a sighting of Cas A. Finally, it will be argued that a collaborative approach between the humanities and the sciences can be a valuable tool, not just in furthering our understanding of Cas A, but in the dating of supernovae in general.

  12. King Charles` Star: A Multidisciplinary Approach to Dating the Supernova Known as Cassiopeia A

    NASA Astrophysics Data System (ADS)

    Lunn, Martin

    2011-05-01

    Few astronomical phenomena have been as studied as the supernova known as Cassiopeia A. Widely believed to have occurred in the latter half of the seventeenth century, it is also thought to have gone unrecorded. This paper will argue that Cas A did not go unobserved, but in fact was seen in Britain on May 29, 1630, and coincided with the birth of the future King Charles II of Great Britain. This 'noon-day star' is an important feature of Stuart/Restoration propaganda, the significance of which has been widely acknowledged by historians and literary experts. The argument here, however, is that in addition the historical accounts provide credible evidence for a genuine astronomical event, the nature of which must be explained. Combining documentary analysis with an overview of the current scientific thinking on dating supernova, the authors put forward their case for why Charles' star should be recognized as a sighting of Cas A. Finally, it will be argued that a collaborative approach between the humanities and the sciences can be a valuable tool, not just in furthering our understanding of Cas A, but in the dating of supernovae in general.

  13. A multidisciplinary approach to the identification and evaluation of novel concepts for deeply buried hardened target defeat

    NASA Astrophysics Data System (ADS)

    Branscome, Ewell Caleb

    During the Cold War, Deeply Buried Hardened Targets (DBHTs) and the assets they protected were of great strategic and tactical concern to the Department of Defense. Megaton-class nuclear warheads were the only viable means of attacking many of these facilities, and even so, a small subset of DBHTs was anticipated to be robust even in the face of such an attack. Post Cold War, the threat posed by DBHTs has not disappeared. Rather, the conventional warfare advantages of the United States have led to an increasing emphasis by potential adversaries on the construction and use of hardened facilities such as DBHTs for protection of both conventional and unconventional assets. Further, the shift in perceived relative risk to the United States' national security from large scale all-out nuclear attack towards very limited attack by Weapons of Mass Destruction (WMD) has led some to hypothesize that "self-deterrence" may diminish the strategic value of current inventory nuclear weapons. The objective of the work described was to identify and explore a paradigm shifting solution that could offer leap-ahead capabilities to counter current and future DBHT threats while mitigating or eliminating the "self-deterrence" issue. Systematic evaluation of DHBT defeat alternatives lead to the selection of a thermal subterrene as a hypothetical means of providing such a capability. A number of possible implementation alternatives for a thermal subterrene were investigated, resulting in the identification of the RadioIsotope Powered Thermal Penetrator (RIPTP) concept for providing an effectively unlimited hard rock penetration capability using near-term technologies. However, the proposed approach was novel and thus required formulation and application of a physics based multidisciplinary analysis code to enable evaluation of lv design alternatives and analysis of performance. Technical considerations identified as important to the feasibility of a RIPTP for DBHT defeat included: packing

  14. Changing knowledge perspective in a changing world: The Adriatic multidisciplinary TDS approach

    NASA Astrophysics Data System (ADS)

    Bergamasco, Andrea; Carniel, Sandro; Nativi, Stefano; Signell, Richard P.; Benetazzo, Alvise; Falcieri, Francesco M.; Bonaldo, Davide; Minuzzo, Tiziano; Sclavo, Mauro

    2013-04-01

    The use and exploitation of the marine environment in recent years has been increasingly high, therefore calling for the need of a better description, monitoring and understanding of its behavior. However, marine scientists and managers often spend too much time in accessing and reformatting data instead of focusing on discovering new knowledge from the processes observed and data acquired. There is therefore the need to make more efficient our approach to data mining, especially in a world where rapid climate change imposes rapid and quick choices. In this context, it is mandatory to explore ways and possibilities to make large amounts of distributed data usable in an efficient and easy way, an effort that requires standardized data protocols, web services and standards-based tools. Following the US-IOOS approach, which has been adopted in many oceanographic and meteorological sectors, we present a CNR experience in the direction of setting up a national Italian IOOS framework (at the moment confined at the Adriatic Sea environment), using the THREDDS (THematic Real-time Environmental Distributed Data Services) Data Server (TDS). A TDS is a middleware designed to fill the gap between data providers and data users, and provides services allowing data users to find the data sets pertaining to their scientific needs, to access, visualize and use them in an easy way, without the need of downloading files to the local workspace. In order to achieve this results, it is necessary that the data providers make their data available in a standard form that the TDS understands, and with sufficient metadata so that the data can be read and searched for in a standard way. The TDS core is a NetCDF- Java Library implementing a Common Data Model (CDM), as developed by Unidata (http://www.unidata.ucar.edu), allowing the access to "array-based" scientific data. Climate and Forecast (CF) compliant NetCDF files can be read directly with no modification, while non-compliant files can

  15. [Deficiencies and resources of working population in relation to age: a multidisciplinary approach].

    PubMed

    Volkoff, S

    2000-01-01

    The aging of the population as a whole and the later age at which young people start work are increasing the percentage of older employees. In situations where the working conditions are highly demanding, as in shiftwork, time-pressure jobs, and adaptation to modern technology or skill diversification, this demographic trend may cause serious problems. The way in which job constraints and demands are withstood at various ages should be considered in relation to health, which is often, whether implicitly or explicitly, a selection criterion in the work place. The connection between work and health can rarely be described by a single causal relationship and requires specific epidemiological methods. Moreover, a health problem linked to age can have a feedback effect on the manner in which a job is performed. While these problems do indeed arise in the areas of work and health, they are nonetheless usually symptoms of modifications that have taken place in the work activity itself. The ergonomic approach nevertheless allows us to improve our understanding of changes in work behavior as age increases, as experience is gained, and as skills are acquired. Men and women on the job are not passive spectators of the good or poor fit between the characteristics of their jobs and their own functional state. Consciously or unconsciously, they modify their operating modes (movements, work pace, posture, etc.), reduce their effort level in some subtasks, make more plans to avoid emergency situations, check the outcome of their actions so as to reduce errors that would be costly to correct, and adjust the distribution of tasks in cooperative and collective work situations. But these strategies can only be implemented if the work conditions and organization foster and promote them.

  16. MATER - Pianeta Terra-Mare: an interactive and multidisciplinary approach to Geosphere sciences

    NASA Astrophysics Data System (ADS)

    Piangiamore, Giovanna Lucia; Fanelli, Emanuela; Furia, Stefania; Garau, Daniela; Merlino, Silvia; Musacchio, Gemma; Carla Centineo, Maria

    2016-04-01

    hydro-geological risk and climate change targeted to students from 8 to 14 years; Planet Sea was articulated in a series of laboratories on the physical-chemical properties ("a sustaining sea") and of the bio-ecological aspects ("a sea of resources") of the sea, engaging students from 4 to 14 years. Scientific conferences, targeted from teenagers and up and open to public, have been organized during the opening and closing weeks of the project, inside the "Week of Planet Earth" 2014 and 2015. The project was also a "peer-education experiment", where students of the High School "Pacinotti" (La Spezia) and of "ISA 10" (Lerici) and "ISA 2" (La Spezia) have played the role of guides in the interactive paths. MATER has reached ca. 1000 students and had excellent feedbacks from teachers and students, supported by questionnaires and press releases. Through the dedicated website, MATER is expected to reach a broader scholastic community, outside its local context. The project was a good example of cooperation of different territorial institutions/associations, working together to promote the culture of prevention and sustainability, involving future citizens to reflect on the values of appropriate behaviors and best practices towards an ethical and sustainable interaction between human activities with the geosphere.

  17. What Is the Optimal Treatment of Large Brain Metastases? An Argument for a Multidisciplinary Approach

    SciTech Connect

    Choi, Clara Y.H.; Chang, Steven D.; Gibbs, Iris C.; Adler, John R.; Harsh, Griffith R.; Atalar, Banu; Lieberson, Robert E.; Soltys, Scott G.

    2012-11-01

    Purpose: Single-modality treatment of large brain metastases (>2 cm) with whole-brain irradiation, stereotactic radiosurgery (SRS) alone, or surgery alone is not effective, with local failure (LF) rates of 50% to 90%. Our goal was to improve local control (LC) by using multimodality therapy of surgery and adjuvant SRS targeting the resection cavity. Patients and Methods: We retrospectively evaluated 97 patients with brain metastases >2 cm in diameter treated with surgery and cavity SRS. Local and distant brain failure (DF) rates were analyzed with competing risk analysis, with death as a competing risk. The overall survival rate was calculated by the Kaplain-Meier product-limit method. Results: The median imaging follow-up duration for all patients was 10 months (range, 1-80 months). The 12-month cumulative incidence rates of LF, with death as a competing risk, were 9.3% (95% confidence interval [CI], 4.5%-16.1%), and the median time to LF was 6 months (range, 3-17 months). The 12-month cumulative incidence rate of DF, with death as a competing risk, was 53% (95% CI, 43%-63%). The median survival time for all patients was 15.6 months. The median survival times for recursive partitioning analysis classes 1, 2, and 3 were 33.8, 13.7, and 9.0 months, respectively (p = 0.022). On multivariate analysis, Karnofsky Performance Status ({>=}80 vs. <80; hazard ratio 0.54; 95% CI 0.31-0.94; p = 0.029) and maximum preoperative tumor diameter (hazard ratio 1.41; 95% CI 1.08-1.85; p = 0.013) were associated with survival. Five patients (5%) required intervention for Common Terminology Criteria for Adverse Events v4.02 grade 2 and 3 toxicity. Conclusion: Surgery and adjuvant resection cavity SRS yields excellent LC of large brain metastases. Compared with other multimodality treatment options, this approach allows patients to avoid or delay whole-brain irradiation without compromising LC.

  18. A perspective multidisciplinary geological approach for mitigation of effects due to the asbestos hazard

    NASA Astrophysics Data System (ADS)

    Vignaroli, Gianluca; Rossetti, Federico; Belardi, Girolamo; Billi, Andrea

    2010-05-01

    during rock fragmentation). Accordingly, we are confident that definition of an analytical protocol based on the geological attributes of the asbestos-bearing rocks may constitute a propaedeutical tool to evaluate the asbestos hazard in natural environments. This approach may have important implications for mitigation effects of the asbestos hazard from the medical field to the engineering operations.

  19. Resource Exploration Approaches on Mars Using Multidisciplinary Earth-based Techniques

    NASA Astrophysics Data System (ADS)

    Wyrick, D. Y.; Ferrill, D. A.; Morris, A. P.; Smart, K. J.

    2005-12-01

    accumulations can be summarized by three factors: trap, reservoir and charge. This presentation focuses on a detailed characterization of the fundamental elements believed to control trap, reservoir, and charge with respect to the identification of locations for extractable resources on Mars, primarily water and ice, but also gas hydrates. This new approach to resource exploration will also provide guidance for future research and exploration activities, including movement of methane from the subsurface to the surface and potential habitat sites for past or current life on Mars.

  20. PREFACE: Water Interfaces in Physics Chemistry and Biology: a multi-disciplinary approach

    NASA Astrophysics Data System (ADS)

    Bellissent-Funel, Marie-Claire; Dore, John

    2009-07-01

    This 5-day meeting, sponsored by the European Science Foundation (ESF) in partnership with the Fonds zur Förderung der wissenschaftlichen Forschung in Österreich (FWF) was organised by Marie-Claire Bellissent-Funel (Lab. Léon Brillouin (CEA-CNRS), CEA Saclay) and John Dore (School of Physical Sciences, University of Kent). It took place in the Universitatszcentrum (University of Innsbruck), in the ski resort of Obergurgl, Austria, from 8-13 December 2007. The main aim of the meeting was to bring together various groups working on the characteristics of water in a wide range of different conditions, particularly in relation to the difference in behaviour of bulk water and water in close proximity to an interface. Another focus was on the properties of 'solid water' and the free time during the afternoon provided a good opportunity for studying ice interfaces in a different context as the snow conditions were good for ski-ing! An outline of the programme is contained in the PDF file associated with this preface. There was a wide representation encompassing 30 countries and 130 scientists drawn from different science disciplines. Furthermore there was a good range of young scientists, who made an excellent contribution to the poster session. There were, of course, many animated discussions away from the conference room and the feedback forms showed that almost everyone (96%!) felt that they had enjoyed the sessions and had learned something new. There was support for a further conference on this theme in the future. Inevitably, many of the speakers presented information that was in preparation for publication elsewhere and therefore our compilation of some papers in this brief report is not fully representative of the range of topics discussed at the meeting. Further information on specific work reported at the meeting can be obtained by following the author list through the Web of Science or by contacting the authors directly. We report eight short papers from the

  1. Public Libraries and Internet Public Access Models: Describing Possible Approaches.

    ERIC Educational Resources Information Center

    Tomasello, Tami K.; McClure, Charles R.

    2002-01-01

    Discusses ways of providing Internet access to the general public and analyzes eight models currently in use: public schools, public libraries, cybermobiles, public housing, community technology centers, community networks, kiosks, and cyber cafes. Concludes that public libraries may wish to develop collaborative strategies with other…

  2. Temporal changes of spatial soil moisture patterns: controlling factors explained with a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Martini, Edoardo; Wollschläger, Ute; Kögler, Simon; Behrens, Thorsten; Dietrich, Peter; Reinstorf, Frido; Schmidt, Karsten; Weiler, Markus; Werban, Ulrike; Zacharias, Steffen

    2016-04-01

    different hydrologic conditions and the factors controlling the temporal variability of the ECa-soil moisture relationship. The approach provided valuable insight into the time-varying contribution of local and nonlocal factors to the characteristic spatial patterns of soil moisture and the transition mechanisms. The spatial organization of soil moisture was controlled by different processes in different soil horizons, and the topsoil's moisture did not mirror processes that take place within the soil profile. Results show that, for the Schäfertal hillslope site which is presumed to be representative for non-intensively managed soils with moderate clay content, local soil properties (e.g., soil texture and porosity) are the major control on the spatial pattern of ECa. In contrast, the ECa-soil moisture relationship is small and varies over time indicating that ECa is not a good proxy for soil moisture estimation at the investigated site.Occasionally observed stronger correlations between ECa and soil moisture may be explained by background dependencies of ECa to other state variables such as pore water electrical conductivity. The results will help to improve conceptual understanding for hydrological model studies at similar or smaller scales, and to transfer observation concepts and process understanding to larger or less instrumented sites, as well as to constrain the use of EMI-based ECa data for hydrological applications.

  3. BOOK REVIEW: The Gravitational Million-Body Problem: A Multidisciplinary Approach to Star Cluster Dynamics

    NASA Astrophysics Data System (ADS)

    Heggie, D.; Hut, P.

    2003-10-01

    focus on N = 106 for two main reasons: first, direct numerical integrations of N-body systems are beginning to approach this threshold, and second, globular star clusters provide remarkably accurate physical instantiations of the idealized N-body problem with N = 105 - 106. The authors are distinguished contributors to the study of star-cluster dynamics and the gravitational N-body problem. The book contains lucid and concise descriptions of most of the important tools in the subject, with only a modest bias towards the authors' own interests. These tools include the two-body relaxation approximation, the Vlasov and Fokker-Planck equations, regularization of close encounters, conducting fluid models, Hill's approximation, Heggie's law for binary star evolution, symplectic integration algorithms, Liapunov exponents, and so on. The book also provides an up-to-date description of the principal processes that drive the evolution of idealized N-body systems - two-body relaxation, mass segregation, escape, core collapse and core bounce, binary star hardening, gravothermal oscillations - as well as additional processes such as stellar collisions and tidal shocks that affect real star clusters but not idealized N-body systems. In a relatively short (300 pages plus appendices) book such as this, many topics have to be omitted. The reader who is hoping to learn about the phenomenology of star clusters will be disappointed, as the description of their properties is limited to only a page of text; there is also almost no discussion of other, equally interesting N-body systems such as galaxies(N approx 106 - 1012), open clusters (N simeq 102 - 104), planetary systems, or the star clusters surrounding black holes that are found in the centres of most galaxies. All of these omissions are defensible decisions. Less defensible is the uneven set of references in the text; for example, nowhere is the reader informed that the classic predecessor to this work was Spitzer's 1987 monograph

  4. A multidisciplinary geomatics approach to morphometric and morphotectonic analysis of the Cannobino Basin (Piemonte Region, NW-Italy).

    NASA Astrophysics Data System (ADS)

    Bacenetti, Marco; Ghiraldi, Luca; Giardino, Marco

    2014-05-01

    The paper presents an integrated multidisciplinary approach to the morphometric and morphotectonic characterization of the Cannobino Basin (Piemonte Region, NW-Italy). The basin is drained by the Cannobino river; in its first 8 km, it flows SE to NW along a wide valley characterized by glacial landforms; thereafter it suddenly turns South assuming a W to E direction, by flowing in a deeply entrenched valley to the intermontane basin of the Maggiore Lake. This area belongs to the Lepontine Alps, which from the geological point of view belong to the Southern Alps. His Hercynian basement is divided in two units: Ivrea-Verbano Zone (IVZ) and Serie dei Laghi (SDL). The IVZ outcrops in the northern sector of the basin, while the SDL outcrops in the southern and central sector. They separated by the Cossato-Mergozzo-Brissago (CMB) and Pogallo lines (PL). These major discontinuities and the neoctonic activity of their shear zones possibly control Quaternary evolution of the alpine relief. Detailed studies of the area are needed for understanding possible interactions of neotectonic activity, fluvial/glacial erosional/depositional processes and slope dynamics. Our focus is on drainage basin characteristics and its evolutionary stages in response to local and regional base level changes and to differential rock uplift. GIS methodologies combined with DEMs analyses are among the most common geomatics approaches to geomorphology. Based on this framework, an evaluation of the geomorphometric characteristic of the Cannobino Basin has been carried out by using an aerial LIDAR DEM (5x5 meters, Regione Piemonte, 2009). The workflow followed for calculating the geomorphic indexes can be summarized in different steps: i) drainage network extraction and hierarchization; ii) lineament features digitalization and interpretation; iii) azimuthal distribution of drainage pattern; iv) DEM analysis and evaluation of linear, areal indexes and SWAT profile. The multidisciplinary and innovative

  5. The journey from opposition to recovery from eating disorders: multidisciplinary model integrating narrative counseling and motivational interviewing in traditional approaches

    PubMed Central

    2013-01-01

    Background In the world of today’s of ever-briefer therapies and interventions, people often seem more interested in outcome than process. This paper focuses on the processes used by a multidisciplinary team in the journey from opposition to change to recovery from eating disorders. The approach outlined is most relevant to those with severe and enduring illness. Methods This paper describes a five-phase journey from eating-disorder disability and back to health as it occurs for patients in a community-based facility. This integrative model uses narrative and motivational interviewing counseling weaved into traditional approaches. It approaches illness from a transdiagnostic orientation, addressing the dynamics and needs demanded by the comorbidities and at the same time responding effectively in a way that reduces the influence of the eating disorder. The treatment described involves a five-phase journey: Preliminary phase (choosing a shelter of understanding); Phase 1: from partial recognition to full acknowledgment; Phase 2: from acknowledgment to clear cognitive stance against the eating disorder; Phase 3: towards clear stance against the “patient” status; Phase 4: towards re-authoring life and regaining self-agency; Phase 5: towards recovery and maintenance. Results In a longitudinal study of patients with a severe and debilitating eating disorder treated with this approach. The drop-out rate was less than 10%. This was during the first two months of treatment for those diagnosed with bulimia nervosa, and this was higher than in those diagnosed with anorexia nervosa. At the end of treatment (15 months to 4 years later) 65% of those treated with anorexia nervosa and 81% of those treated with bulimia nervosa were either in a fully recovered state or in much improved. At the four-year follow-up, 68% of those diagnosed with anorexia nervosa and 83% of those diagnosed with bulimia nervosa were categorized as either fully recovered or much improved. All

  6. A multi-disciplinary approach to understanding the impacts of mines on traditional uses of water in Northern Mongolia.

    PubMed

    McIntyre, Neil; Bulovic, Nevenka; Cane, Isabel; McKenna, Phill

    2016-07-01

    Mongolia is an example of a nation where the rapidity of mining development is outpacing capacity to manage the potential land and water resources impacts. Further, Mongolia has a particular social and economic reliance on traditional uses of land and water, principally livestock herding. While some mining operations are setting high standards in protecting the natural resources surrounding the mine site, others have less incentive and capacity to do so and therefore are having adverse effects on surrounding communities. The paper describes a case study of the Sharyn Gol Soum in northern Mongolia where a range of mining types, from artisanal, small-scale mining to a large coal mine, operate alongside traditional herding lifestyles. A multi-disciplinary approach is taken to observe and attribute causes to the water resources impacts in the area. Surveys of the herding household community, land use mapping, and monitoring the spatial variations in water quality indicate deterioration of water resources. Collectively, the different sources of evidence suggest that the deterioration is mainly due to small-scale gold mining. The evidence included the perception of 78% of the interviewed herders that water quality had changed due to mining; a change in the footprint of small-scale gold mining from 2.8 to 15.2km(2) during the period 1999 to 2015; and pH and sulphate values in 2015 consistently outside the ranges observed at a baseline site in the same region. It is concluded that the lack of baseline data and effective governance mechanisms are fundamental challenges that need to be addressed if Mongolia's transition to a mining economy is to be managed alongside sustainability of herder lifestyles. PMID:27016688

  7. Multidisciplinary approach to the rehabilitation of a tooth with two trauma episodes: systematic review and report of a case.

    PubMed

    Sharma, Deepak; Garg, Shalini; Sheoran, Neha; Swami, Shveta; Singh, Gundeep

    2011-08-01

    Studies have shown that some children and adolescents are affected only once with dental trauma, while others seem to be accident-prone and suffer from multiple dental trauma episodes. Less is known about treatment consequences related to repeated traumatic dental injuries to the same tooth and treatment guidelines are not well established. Complicated crown fractures and crown-root fractures pose difficulties for dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis. The objective of this paper was to present and discuss a case of a child who sustained a second trauma to the same tooth following treatment of an earlier sustained crown fracture. The research-based background for establishment of the treatment plan is discussed. Reattachment of tooth fragment is a minimal invasive and esthetic method. Essential advantage of the reattached teeth is the fact that all the alternative methods as direct adhesive resin reconstruction, veneers and crowns can be performed in case of failure or a refracture. As a consequence of initial trauma, the tooth suffered a complicated crown fracture which was resolved by endodontic therapy and fragment reattachment. During follow-up, the child suffered a second trauma resulting in dislodgement and fracture of the reattached fragment and a crown-root fracture extending subgingivally with involvement of the biologic width. A conservative restorative option is described. After 1 year of follow-up, the clinical and radiographic findings demonstrated that the adopted clinical protocol was successful and yielded healthy periodontal tissues with no signs of periradicular pathosis. The occurrence of repeated traumatic dental injuries to teeth involving conservative management of both crown-root fracture and complicated crown fracture on the same tooth is extremely rare and a challenge for dental professionals to treat. PMID:21535402

  8. Implementing Universal Design Strategies in Municipalities - A Multidisciplinary Approach to Universal Design and Public Health.

    PubMed

    Jensen, Roger

    2016-01-01

    Based on a national program, the regional authorities stimulated each of the 18 municipalities in Telemark 2012-15 to plan and build promenades with universal design. The cooperation between different disciplines was an important factor for good results. The project continues from 2016. PMID:27534320

  9. Implementing Universal Design Strategies in Municipalities - A Multidisciplinary Approach to Universal Design and Public Health.

    PubMed

    Jensen, Roger

    2016-01-01

    Based on a national program, the regional authorities stimulated each of the 18 municipalities in Telemark 2012-15 to plan and build promenades with universal design. The cooperation between different disciplines was an important factor for good results. The project continues from 2016.

  10. A multidisciplinary approach to the identification and evaluation of novel concepts for deeply buried hardened target defeat

    NASA Astrophysics Data System (ADS)

    Branscome, Ewell Caleb

    During the Cold War, Deeply Buried Hardened Targets (DBHTs) and the assets they protected were of great strategic and tactical concern to the Department of Defense. Megaton-class nuclear warheads were the only viable means of attacking many of these facilities, and even so, a small subset of DBHTs was anticipated to be robust even in the face of such an attack. Post Cold War, the threat posed by DBHTs has not disappeared. Rather, the conventional warfare advantages of the United States have led to an increasing emphasis by potential adversaries on the construction and use of hardened facilities such as DBHTs for protection of both conventional and unconventional assets. Further, the shift in perceived relative risk to the United States' national security from large scale all-out nuclear attack towards very limited attack by Weapons of Mass Destruction (WMD) has led some to hypothesize that "self-deterrence" may diminish the strategic value of current inventory nuclear weapons. The objective of the work described was to identify and explore a paradigm shifting solution that could offer leap-ahead capabilities to counter current and future DBHT threats while mitigating or eliminating the "self-deterrence" issue. Systematic evaluation of DHBT defeat alternatives lead to the selection of a thermal subterrene as a hypothetical means of providing such a capability. A number of possible implementation alternatives for a thermal subterrene were investigated, resulting in the identification of the RadioIsotope Powered Thermal Penetrator (RIPTP) concept for providing an effectively unlimited hard rock penetration capability using near-term technologies. However, the proposed approach was novel and thus required formulation and application of a physics based multidisciplinary analysis code to enable evaluation of lv design alternatives and analysis of performance. Technical considerations identified as important to the feasibility of a RIPTP for DBHT defeat included: packing

  11. Helix Nebula - the Science Cloud: a public-private partnership to build a multidisciplinary cloud platform for data intensive science

    NASA Astrophysics Data System (ADS)

    Jones, Bob; Casu, Francesco

    2013-04-01

    The feasibility of using commercial cloud services for scientific research is of great interest to research organisations such as CERN, ESA and EMBL, to the suppliers of cloud-based services and to the national and European funding agencies. Through the Helix Nebula - the Science Cloud [1] initiative and with the support of the European Commission, these stakeholders are driving a two year pilot-phase during which procurement processes and governance issues for a framework of public/private partnership will be appraised. Three initial flagship use cases from high energy physics, molecular biology and earth-observation are being used to validate the approach, enable a cost-benefit analysis to be undertaken and prepare the next stage of the Science Cloud Strategic Plan [2] to be developed and approved. The power of Helix Nebula lies in a shared set of services for initially 3 very different sciences each supporting a global community and thus building a common e-Science platform. Of particular relevance is the ESA sponsored flagship application SuperSites Exploitation Platform (SSEP [3]) that offers the global geo-hazard community a common platform for the correlation and processing of observation data for supersites monitoring. The US-NSF Earth Cube [4] and Ocean Observatory Initiative [5] (OOI) are taking a similar approach for data intensive science. The work of Helix Nebula and its recent architecture model [6] has shown that is it technically feasible to allow publicly funded infrastructures, such as EGI [7] and GEANT [8], to interoperate with commercial cloud services. Such hybrid systems are in the interest of the existing users of publicly funded infrastructures and funding agencies because they will provide "freedom of choice" over the type of computing resources to be consumed and the manner in which they can be obtained. But to offer such freedom-of choice across a spectrum of suppliers, various issues such as intellectual property, legal responsibility

  12. A multi-disciplinary approach to study coastal complex landslides: the case of Torino di Sangro (Central Italy)

    NASA Astrophysics Data System (ADS)

    Sciarra, Marco; Carabba, Luigi; Urbano, Tullio; Calista, Monia

    2016-04-01

    This work illustrates the studies carried out on a complex landslide phenomenon between the Sangro and Osento River's mouths, near Torino di Sangro village in Southern Abruzzo Region (Italy). Historical activity of this landslide is well-documented since 1916; the activation/reactivation of the movements caused several interruptions of a national railway and the damage of few houses. The Torino di Sangro case study can be regarded as representative of many large landslides distributed along the central Adriatic coast (e.g., Ancona, Ortona, Vasto and Petacciato Landslides) that affect densely populated urban areas with a large amount of man-made infrastructure. The main controlling factors of these large and deep-seated landslides are still debated. From the geological and geomorphological viewpoint, the central Adriatic coast is characterized by a low-relief landscape (mesa) carved on clay-sandstone-conglomerate bedrock belonging to the Upper Pliocene - Lower Pleistocene marine deposits and locally to the Middle Pleistocene marine to continental transitional deposits. This high coast is widely affected by slope instability (rock falls, rotational, complex and shallow landslides) on both active and inactive sea cliffs, the first being mainly affected by wave-cut erosion and the latter influenced by heavy rainfall and changes of pore pressure. The main landslide has the typical characteristics of a deep-seated gravitation deformation. The landslide study was based on a multidisciplinary approach including: 1) definition and GIS mapping of geology and geomorphology factors (slope, aspect, topographic curvature, bedrock lithology, near-surface deposits, deposit thickness and land use), by means of DTM processing, multi-temporal analysis, and large-scale geomorphological field survey; 2) monitoring system in the landslide; 3) application of empiric models for the analysis of unstable sandstone-conglomerate escarpments; 4) slope stability analysis performed using a

  13. Multi-Disciplinary Approaches to Pupil Behaviour in School--The Role of Evaluation in Service Delivery

    ERIC Educational Resources Information Center

    Hartnell, Naomi

    2010-01-01

    This study evaluates the work of a multi-disciplinary Behaviour Support Team developed to support schools in managing problematic behaviour. An evidence base to inform future service delivery is developed, using a model of evaluation which incorporates both quantitative, outcome data and more explanatory qualitative data, incorporating the views…

  14. 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 "across…

  15. Multivariate and Descriptive Discriminant Analysis of Multidisciplinary Approaches to Integrating Mathematics, Science, and Technology Education in the High School.

    ERIC Educational Resources Information Center

    Wicklein, Robert C.; Schell, John W.

    A study examined the perceptions of participants in a multidisciplinary project regarding the degree to which the integration of technology, mathematics, and science had enabled advanced mental skills in technical thinking and problem solving. A literature review focused on advanced learning and thinking, ill-structured workplace problems,…

  16. Multidisciplinary Approach to the Treatment of Obese Adolescents: Effects on Cardiovascular Risk Factors, Inflammatory Profile, and Neuroendocrine Regulation of Energy Balance

    PubMed Central

    Dâmaso, Ana Raimunda; de Piano, Aline; Campos, Raquel Munhoz da Silveira; Corgosinho, Flávia Campos; Siegfried, Wolfgang; Caranti, Danielle Arisa; Masquio, Deborah Cristina Landi; Carnier, June; Sanches, Priscila de Lima; Leão da Silva, Patrícia; Nascimento, Cláudia Maria Oller; Oyama, Lila Missae; Dantas, Alexandre Dâmaso Aguilera; de Mello, Marco Túlio; Tufik, Sergio; Tock, Lian

    2013-01-01

    The prevention of obesity and health concerns related to body fat is a major challenge worldwide. The aim of this study was to investigate the role of a medically supervised, multidisciplinary approach, on reduction in the prevalence of obesity related comorbidities, inflammatory profile, and neuroendocrine regulation of energy balance in a sample of obese adolescents. A total of 97 postpuberty obese adolescents were enrolled in this study. Body composition, neuropeptides, and adipokines were analysed. The metabolic syndrome was defined by the International Diabetes Federation (IDF). The abdominal ultrasonography was performed to measure visceral, subcutaneous fat and hepatic steatosis. All measures were performed at baseline and after one year of therapy. The multidisciplinary management promoted the control of obesity reducing body fat mass. The prevalence of metabolic syndrome, asthma, nonalcoholic fatty liver disease (NAFLD), binge eating, and hyperleptinemia was reduced. An improvement in the inflammatory profile was demonstrated by an increase in anti-inflammatory adiponectin and reduction in proinflammatory adipokines, plasminogen activator inhibitor-1, interleukin-6 concentrations, and in the Lep/Adipo ratio. Moreover, a reduction in the AgRP and an increase in the alfa-MSH were noted. The multidisciplinary approach not only reduced obesity but also is efficacious in cardiovascular risk factors, inflammatory profile, and neuroendocrine regulation of energy balance. PMID:24285955

  17. Establishing a framework for building multidisciplinary programs.

    PubMed

    Meguid, Cheryl; Ryan, Carrie E; Edil, Barish H; Schulick, Richard D; Gajdos, Csaba; Boniface, Megan; Schefter, Tracey E; Purcell, W Thomas; McCarter, Martin

    2015-01-01

    While most providers support the concept of a multidisciplinary approach to patient care, challenges exist to the implementation of successful multidisciplinary clinical programs. As patients become more knowledgeable about their disease through research on the Internet, they seek hospital programs that offer multidisciplinary care. At the University of Colorado Hospital, we utilize a formal multidisciplinary approach across a variety of clinical settings, which has been beneficial to patients, providers, and the hospital. We present a reproducible framework to be used as a guide to develop a successful multidisciplinary program.

  18. Establishing a framework for building multidisciplinary programs

    PubMed Central

    Meguid, Cheryl; Ryan, Carrie E; Edil, Barish H; Schulick, Richard D; Gajdos, Csaba; Boniface, Megan; Schefter, Tracey E; Purcell, W Thomas; McCarter, Martin

    2015-01-01

    While most providers support the concept of a multidisciplinary approach to patient care, challenges exist to the implementation of successful multidisciplinary clinical programs. As patients become more knowledgeable about their disease through research on the Internet, they seek hospital programs that offer multidisciplinary care. At the University of Colorado Hospital, we utilize a formal multidisciplinary approach across a variety of clinical settings, which has been beneficial to patients, providers, and the hospital. We present a reproducible framework to be used as a guide to develop a successful multidisciplinary program. PMID:26664132

  19. Approaches to Translation of Chinese Publicity Materials

    ERIC Educational Resources Information Center

    Yin, Lu

    2009-01-01

    Chinese publicity materials are the windows for foreigners to know about China. There has been some problems in the translation for publicity materials both made by the enterprises and government departments. Especially for the growing international communication, the dispute between Chinese and its foreign counterpart is increasingly coming into…

  20. Radium-223 dichloride: illustrating the benefits of a multidisciplinary approach for patients with metastatic castration-resistant prostate cancer.

    PubMed

    Renzulli, Joseph F; Collins, Jennifer; Mega, Anthony

    2015-01-01

    Improving options for patients with metastatic castration-resistant prostate cancer (mCRPC) provide latitude in designing treatment plans that meet patients' medical needs and personal goals. The field's rapid evolution opens avenues for contributions by multiple medical specialties and requires considering more options to ensure that each patient receives the most appropriate care. A multidisciplinary clinic (MDC) focusing on patients with cancers of the genitourinary tract demonstrates an efficient and cost-effective means of integrating the diverse professional knowledge and skills needed to develop an optimal patient treatment plan. As a guide to establishing an MDC for patients with mCRPC, this article describes the operation of the Genitourinary MDC at The Miriam Hospital in Providence, RI - specifically, the successful incorporation of radium-223 dichloride (radium-223) into the treatment algorithm for men with mCRPC and symptomatic bone metastases. Radium-223 is a new treatment that, unlike earlier radionuclide therapies, has shown a survival advantage in a large randomized phase 3 trial (ALSYMPCA). The overall survival benefit was comparable to that of newer immuno-and hormonal therapies in similar populations. Radium-223 treatment also delayed onset of symptomatic skeletal events. Both benefits were independent of prior docetaxel therapy or concurrent bisphosphonate use. In our clinic, radium-223 is used primarily to extend patient survival. Patient selection, patient management, and treatment sequencing are discussed here in the context of a multidisciplinary environment.

  1. Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series

    PubMed Central

    Creighton, Sarah M; Dear, Joanna; de Campos, Claudia; Williams, Louise; Hodes, Deborah

    2016-01-01

    Objective To describe the first dedicated clinic in the UK for children with suspected or confirmed female genital mutilation (FGM) including referral patterns, clinical findings and subsequent management. Design and setting A prospective study of all children seen in a dedicated multidisciplinary FGM clinic for children over a 1-year period. Population Patients aged under 18 years referred for clinical assessment or for a second opinion on Digital Versatile Disc (DVD) images. Methods and main outcome measures Data were collected on reasons for referral, demography, genital examination findings including FGM type, and clinical recommendations. Results 38 children were referred of whom 18 (47%) had confirmed FGM; most frequently type 4 (61%). Social care and police referred 78% of cases. According to UK law FGM had been performed illegally in three cases. Anonymous information given to the police led to the referral of six children, none of whom had had FGM. Conclusions Mandatory reporting and increased media attention may increase the numbers of referrals of children with suspected FGM. This patient group have complex needs and management in a dedicated multidisciplinary service is essential. Paediatricians and gynaecologists should have the skills to carry out the consultation and detect all types of FGM including type 4 which was the most common type seen in this series. This is the first dedicated FGM service for children in the UK and similar clinics in high-prevalence areas should be established. PMID:26928027

  2. Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach

    PubMed Central

    Jonely, Holly; Brismée, Jean-Michel; Desai, Mehul J; Reoli, Rachel

    2015-01-01

    Background and purpose: Sacroiliac joint pain and dysfunction affect 15–25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction. Case description: A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises. Outcomes: The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient’s Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient’s rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up. Discussion: A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up. PMID:26309378

  3. The role of the Arrhythmia Team, an integrated, multidisciplinary approach to treatment of patients with cardiac arrhythmias: results of the European Heart Rhythm Association survey.

    PubMed

    Fumagalli, Stefano; Chen, Jian; Dobreanu, Dan; Madrid, Antonio Hernandez; Tilz, Roland; Dagres, Nikolaos

    2016-04-01

    Management of patients with cardiac arrhythmias is increasingly complex because of continuous technological advance and multifaceted clinical conditions associated with ageing of the population, the presence of co-morbidities and the need for polypharmacy. The aim of this European Heart Rhythm Association Scientific Initiatives Committee survey was to provide an insight into the role of the Arrhythmia Team, an integrated, multidisciplinary approach to management of patients with cardiac arrhythmias. Forty-eight centres from 18 European countries replied to the Web-based questionnaire. The presence of an Arrhythmia Team was reported by 44% of the respondents, whereas 17% were not familiar with this term. Apart from the electrophysiologist, health professionals who should belong to such teams, according to the majority of the respondents, include a clinical cardiologist, a nurse, a cardiac surgeon, a heart failure specialist, a geneticist, and a geriatrician. Its main activity should be dedicated to the management of patients with complex clinical conditions or refractory or inherited forms of arrhythmias. When present, the Arrhythmia Team was considered helpful by 95% of respondents; the majority of centres (79%) agreed that it should be implemented. The Arrhythmia Team seems to be connected to important expectations in the management of cardiac arrhythmias. The efficacy of such an integrated and multidisciplinary approach should be encouraged and tested in clinical practice.

  4. Structure and hydrogeochemical functioning of a sparkling natural mineral water system determined using a multidisciplinary approach: a case study from southern France

    NASA Astrophysics Data System (ADS)

    Maréchal, J. C.; Lachassagne, P.; Ladouche, B.; Dewandel, B.; Lanini, S.; Le Strat, P.; Petelet-Giraud, E.

    2013-12-01

    Natural mineral waters (NMW), often used to produce bottled water, are of high socio-economic interest and need appropriate management to ensure the sustainability of the resource. A complex sparkling NMW system at La Salvetat, southern France, was investigated using a multidisciplinary approach. Geological and geophysical investigations, pumping test analyses, time-series signal processing, hydrogeochemical and isotopic data (both stable and radiogenic), and numerical modelling provided complementary information on the geometry, hydrodynamic characteristics and functioning of this mineral system. The conceptual model consists of a compartmentalized reservoir characterized by two subvertical, parallel deeply rooted hydraulically independent permeable structures that are fed by deep CO2-rich crustal fluids. The non-mineralized shallow aquifer system corresponds to a fissured layer within the weathered zone that is recharged by leakage from the overlying saprolite. This surficial aquifer responds rapidly to recharge (40-80 days), whereas the deep system's response to recharge is much longer (up to 120 days). This research demonstrates the need for multidisciplinary approaches and modelling (quantity, hydrochemistry) for understanding complex NMW systems. This knowledge is already being applied by the bottling company that manages the resource at La Salvetat, and would be useful for conceptualising other NMW sites.

  5. The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks.

    PubMed

    Witt, Clara J; Richards, Allen L; Masuoka, Penny M; Foley, Desmond H; Buczak, Anna L; Musila, Lillian A; Richardson, Jason H; Colacicco-Mayhugh, Michelle G; Rueda, Leopoldo M; Klein, Terry A; Anyamba, Assaf; Small, Jennifer; Pavlin, Julie A; Fukuda, Mark M; Gaydos, Joel; Russell, Kevin L; Wilkerson, Richard C; Gibbons, Robert V; Jarman, Richard G; Myint, Khin S; Pendergast, Brian; Lewis, Sheri; Pinzon, Jorge E; Collins, Kathrine; Smith, Matthew; Pak, Edwin; Tucker, Compton; Linthicum, Kenneth; Myers, Todd; Mansour, Moustafa; Earhart, Ken; Kim, Heung Chul; Jiang, Ju; Schnabel, Dave; Clark, Jeffrey W; Sang, Rosemary C; Kioko, Elizabeth; Abuom, David C; Grieco, John P; Richards, Erin E; Tobias, Steven; Kasper, Matthew R; Montgomery, Joel M; Florin, Dave; Chretien, Jean-Paul; Philip, Trudy L

    2011-03-04

    The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program's ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia.

  6. A multidisciplinary environmental integrated approach to better understand the Tegnue Reefs formation, offshore Chioggia, Northern Adriatic Sea.

    NASA Astrophysics Data System (ADS)

    Bergamasco, Andrea; Donnici, Sandra; Tosi, Luigi; Tagliapietra, Davide; Zaggia, Luca; Bonaldo, Davide; Braga, Federica; Da Lio, Cristina; Keppel, Erica; Lorenzetti, Giuliano; Manfè, Giorgia; Franceschini, Gianluca; Giovanardi, Otello; Carol, Eleonora; Fornaro, Elena; Grant, Carley

    2014-05-01

    Several hard substrata cover the northwestern Adriatic shelf around 20 m depth as patchy reefs called 'Tegnue'. These submerged reefs form many discrete sets from offshore Grado south to the Po river delta with a large field located off Chioggia. Even if the outer part of the reef is constituted by a thick biogenic formation the underlying structure, mainly buried, is made by cemented sand and this seems to be correlated with its origin not yet fully understood. Different genetic interpretations have been proposed thus far, contemplating among other cementation due to beach-rock like processes (e.g., Stefanon, 1969, Bonardi and Tosi, 2002, Bonardi et al., 2006) or the action of ascending fluids enriched in hydrocarbons (e.g., Gabbianelli et al., 1997, Casellato and Stefanon, 2008). An on-going project, mainly a multidisciplinary integrated approach, combining physical, biological, geological, geomorphological, hydrogeological and geochemical data, supported by a detailed bathymetric mapping, an overall general circulation modeling at high resolution, a robust geophysical evidence, and detailed underwater surveys performed by a team of scuba-diver scientists, aims to better understand the genetic processes backing the distribution, early genesis and evolution of such relevant habitats. Actually, using all the new available data, our plan is to verify which previous interpretations on the origin of the Tegnue core better match with the diagenetic processes that led to the cementation of the sand layers lying at the base of the organic reefs. Preliminary results suggest that the Tegnue reefs formed along paleochannels features related to the former alluvial plain and submerged by the Holocene transgression. Whatever their genesis, once exposed such rocky substrata are then quickly colonized by living organisms, which contribute to the growth and expansion of the reef. Calcareous algae and in general the organic concretion could have a role during the reef accretion

  7. An approach toward public hospital performance assessment

    PubMed Central

    Nwagbara, Vitalis Chukwudi; Rasiah, Rajah; Aslam, Md. Mia

    2016-01-01

    Abstract Background: Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR). Methods: Public hospital inpatient utilization records during the period 2006 to 2013 were gathered from the Ministry of Health, Malaysia. A 2-step generalized method of moments (GMM) statistical method was used to analyze the data. BOR was adopted as the dependent variable, whereas BTR and ALOS were used as the explanatory variables. The logarithm of total bed count (BED), admission (ADM), and patient days (PD) was deployed as control variables. Three regression models were developed to explore the correlates of BOR as a hospital performance measure. Ethics committee approval was waived because no patients were identified in the study. Results: The statistical analyses show that ALOS and BTR are inversely correlated with BOR, with both coefficients significant at 1%. The control variables of BED, ADM, and PD had the right positive signs and they were significant in both sets of equations. Hence, reducing ALOS and BTR can help raise performance of public hospitals in Malaysia. Conclusion: In light of the robust results obtained, this study offers implications for improving public hospital performance. It shows a need to reduce ALOS and BTR in public hospitals to improve BOR. PMID:27603363

  8. Reclaiming Public Education: Common Sense Approaches

    ERIC Educational Resources Information Center

    Cornett, Bob

    2015-01-01

    Bob Cornett, a former state budget director for Kentucky, describes himself as a "retired bureaucrat." But as a parent, grandparent, and a person who has been involved in education reform for more than 20 years, he's come to understand that, if public education policies are to be corrected, the impetus has to come from the citizenry. In…

  9. A Multidisciplinary Paradigm and Approach to Protecting Human Health and the Environment, Society, and Stakeholders at Nuclear Facilities - 12244

    SciTech Connect

    Burger, Joanna; Gochfeld, Michael; Clarke, James; Powers, Charles W.; Kosson, David

    2012-07-01

    As the Department of Energy (DOE) continues to remediate its lands, and to consider moving toward long-term stewardship and the development of energy parks on its industrial, remediated land, it is essential to adequately characterize the environment around such facilities to protect society, human health, and the environment. While DOE sites re considering several different land-use scenarios, all of them require adequate protection of the environment. Even if DOE lands are developed for energy parks that are mainly for industrializes sections of DOE lands that will not be remediated to residential standards, there is still the need to consider the protection of human health and the environment. We present an approach to characterization and establishment of teams that will gather the information, and integrate that information for a full range of stakeholders from technical personnel, to public policy makers, and that public. Such information is needed to establish baselines, site new energy facilities in energy parks, protect existing nuclear facilities and nuclear wastes, improve the basis for emergency planning, devise suitable monitoring schemes to ensure continued protection, provide data to track local and regional response changes, and for mitigation, remediation and decommissioning planning. We suggest that there are five categories of information or data needs, including 1) geophysical, sources, fate and transport, 2) biological systems, 3) human health, 4) stakeholder and environmental justice, and 5) societal, economic, and political. These informational needs are more expansive than the traditional site characterization, but encompass a suite of physical, biological, and societal needs to protect all aspects of human health and the environment, not just physical health. We suggest a Site Committee be established that oversees technical teams for each of the major informational categories, with appropriate representation among teams and with a broad

  10. A multidisciplinary approach for the management of the water resources hosted in the multi-layer coastal aquifers of Central-Southern Tuscany

    NASA Astrophysics Data System (ADS)

    Lelli, M.; Doveri, M.; Cerrina Feroni, A.; Da Prato, S.; Ellero, A.; Marini, L.; Masetti, G.; Nisi, B.; Raco, B.

    2012-12-01

    The correct management of subterranean water resources should be based on the studies aimed to acquire informations about geological, hydrogeological and geochemical characteristics of water and aquifer. Taking in mind this idea, the subterranean water resources hosted in the multi-layer aquifers below the coastal plains of the Cecina River, Cornia River, Follonica, Grosseto, and Albegna River were recently investigated through a multidisciplinary approach in the framework of the Significant Groundwater Bodies (SGB) Project, funded by the Tuscany Region (Italy). In the first step, the distinction of main aquifer, aquitard, and aquiclude levels has been done by means of the geometrical reconstruction of the geological sequences, using available stratigraphical data. For each hydrogeological complex, the total volumes and the percentages of the different grain sizes were also calculated. The second step was addressed to elaborate the piezometric surfaces during low-flow and high-flow conditions, aimed to individuate the main flow pattern and the most exploited zones of the multi-layer aquifers. Moreover, considering the saturated zone and applying an effective porosity (weighed in function of grain sizes percentages), the amounts of the total water volumes stored in the aquifer system were estimate. The third step comprised the hydrogeochemical characterization of the areas of interest, by means of both: a deterministic approach, including the elaboration and interpretation of classification diagrams, Eh-pH plots, calculation of water speciation and saturation state, activity diagrams, etc. a geo-statistical approach, aimed to the study of the spatial distribution of the most significant geochemical parameters, such as the concentrations of chloride, sulfate, nitrate and boron. If suitable database is available, this multidisciplinary approach can allow to identify the main recharge areas and flow path and the physical-chemical processes (naturals or antropics

  11. Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report

    PubMed Central

    St-Onge, Eric; MacIntyre, Ian G.; Galea, Anthony M.

    2015-01-01

    Objective: To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management. Clinical Features: A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey. Intervention: The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks. Discussion: This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain. Summary: Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy. PMID:26816415

  12. Onwards and upwards in the Caucasus - A multidisciplinary approach to understanding the lifeways of the earliest modern humans in Armenia

    NASA Astrophysics Data System (ADS)

    Kandel, Andrew; Gasparyan, Boris; Bruch, Angela; Deckers, Katleen; Nahapetyan, Samvel; Weissbrod, Lior

    2013-04-01

    The Armenian Highlands have functioned as a gateway with regards to the peopling of the Southern Caucasus. Most importantly, changes in climate have long controlled access to this remote and often inhospitable mountainous region. Here we present the results of the multidisciplinary study of Aghitu-3 Cave which brings together researchers from the fields of archaeology, geology and geomorphology, zooarchaeology, paleobotany and paleoclimate. By integrating these areas of study, we have reconstructed the lifeways of the earliest behaviorally (and presumably anatomically) modern humans who settled Southern Armenia about 35,000 (cal BP) years ago and placed this occupational sequence within a framework of environmental change. These first Upper Paleolithic inhabitants of Armenia made temporary use of this basalt cave located along the Vorotan River corridor at an altitude of 1601 m during seasonal forays into the highlands. The infrequent use of this site as a hunting camp comes to an end at about 31,000 cal BP. The next package of sediment shows little evidence of human occupation, although fauna seem to flourish during the time between 31-29,000 cal BP. Following this phase of depopulation, the intensity of occupation increases substantially after 29,000 cal BP. Human presence is amply documented in the numerous stone artifacts, faunal remains and fireplaces that cover the site. These changes in population movement are echoed in the sequence of sediments preserved in the cave and can be correlated with the fluctuating climatic conditions associated with the late Pleistocene.

  13. Noninvasive and Multidisciplinary Approach to the Functional and Esthetic Rehabilitation of Amelogenesis Imperfecta: A Pediatric Case Report

    PubMed Central

    de Souza, Juliana Feltrin; Fragelli, Camila Maria Bullio; Paschoal, Marco Aurélio Benini; Campos, Edson Alves; Cunha, Leonardo Fernandes; Losso, Estela Maris; Cordeiro, Rita de Cássia Loiola

    2014-01-01

    Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed. PMID:25061528

  14. The genome clinic: a multidisciplinary approach to assessing the opportunities and challenges of integrating genomic analysis into clinical care.

    PubMed

    Bowdin, Sarah; Ray, Peter N; Cohn, Ronald D; Meyn, M Stephen

    2014-05-01

    Our increasing knowledge of how genomic variants affect human health and the falling costs of whole-genome sequencing are driving the development of individualized genetic medicine. This new clinical paradigm uses knowledge of an individual's genomic variants to guide health care decisions throughout life, to anticipate, diagnose, and manage disease. While individualized genetic medicine offers the promise of transformative change in health care, it forces us to reconsider existing ethical, scientific, and clinical paradigms. The potential benefits of presymptomatic identification of at risk individuals, improved diagnostics, individualized therapy, accurate prognosis, and avoidance of adverse drug reactions coexist with the potential risks of uninterpretable results, psychological harm, outmoded counseling models, and increased health care costs. Here, we review the challenges of integrating genomic analysis into clinical practice and describe a prototype for implementing genetic medicine. Our multidisciplinary team of bioinformaticians, health economists, ethicists, geneticists, genetic counselors, and clinicians has designed a "Genome Clinic" research project that addresses multiple challenges in genomic medicine-ranging from the development of bioinformatics tools for the clinical assessment of genomic variants and the discovery of disease genes to health policy inquiries, assessment of clinical care models, patient preference, and the ethics of consent.

  15. New approach for aerosol profiling with a lidar onboard an ultralight aircraft: application to the African Monsoon Multidisciplinary Analysis.

    PubMed

    Chazette, Patrick; Sanak, Joseph; Dulac, François

    2007-12-15

    A new airborne instrumental payload has been designed for an ultralight aircraft to determine the vertical profile of aerosol optical properties. It is based on Lidar Aérosols UltraViolet Aéroporté (LAUVA), a compact backscattering lidar system emitting at the wavelength of 355 nm. We operated this airborne configuration in the Sahel from the city of Niamey (Niger) during the first campaign of the African Monsoon Multidisciplinary Analysis (AMMA) in January-February 2006, when aerosols from both soil dust and savannah fires cause large visibility reductions. We take advantage of the lidar capability of pointing in different directions for retrieving the vertical profile of the aerosol backscatter to extinction ratio (BER). A synergy with a scatterometer (880 nm) and a ground-based sunphotometer allows us to further determine the vertical profile of Angström exponent (a). We identify three types of aerosol layers up to about 5 km below the free troposphere, dominated by biomass burning (BB) particles, mineral dust (D) particles, and a mixing between BB and D particles, respectively, associated with BER (a) values close to 0.008 sr(-1) (1.5), 0.025 sr(-1) (0), and 0.015 sr(-1) (0.4-1).

  16. 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.

  17. 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. PMID:26614653

  18. The Cardio-oncology Program: A Multidisciplinary Approach to the Care of Cancer Patients With Cardiovascular Disease.

    PubMed

    Parent, Sarah; Pituskin, Edith; Paterson, D Ian

    2016-07-01

    Improved cancer survivorship has resulted in a growing number of Canadians affected by cancer and cardiovascular disease. As a consequence, cardio-oncology programs are rapidly emerging to treat cancer patients with de novo and preexisting cardiovascular disease. The primary goal of a cardio-oncology program is to preserve cardiovascular health to allow the timely delivery of cancer therapy and achieve disease-free remission. Multidisciplinary programs in oncology and cardiology have been associated with enhanced patient well-being and improved clinical outcomes. Because of the complex needs of these multisystem patients, a similar model of care is gaining acceptance. The optimal composition of the cardio-oncology team will typically involve support from cardiology, oncology, and nursing. Depending on the clinical scenario, additional consultation from dietetics, pharmacy, and social services might be required. Timely access to consultation and testing is another prerequisite for cardio-oncology programs because delays in treating cardiac complications and nonadherence to prescribed cancer therapy are each associated with poor outcomes. Recommended reasons for referral to cardio-oncology programs include primary prevention for those at high risk for cardiotoxicity and the secondary treatment of new or worsening cardiovascular disease in cancer patients and survivors. Management is multifaceted and can involve lifestyle education, pharmacotherapy, enhanced cardiovascular surveillance, and support services, such as exercise training. The lack of evidence to guide clinical decisions and recommendations in cardio-oncology is a major challenge and opportunity for health care professionals. Large multicentre prospective registries are needed to adequately power risk model calculations and generate hypotheses for novel interventions.

  19. A rational approach to formulating public policy on substance abuse.

    PubMed

    Trunkey, Donald D; Bonnono, Carol

    2005-09-01

    Unlike alcohol, which is legal and regulated, current public policy makes drugs such as heroin, cocaine, methamphetamines, and marijuana illegal. This article summarizes the history of drug and alcohol use in the United States, compares our public policies on alcohol to those on drugs, and shows the direct link between alcohol or drug use and crime, corruption, violence, and health problems in other countries and in our own. A rational approach to formulating a workable public policy is presented.

  20. Young Public Manager in Romania--A New Approach

    ERIC Educational Resources Information Center

    Lucking, Richard; Profiroiu, Marius; Andrei, Tudorel

    2006-01-01

    This paper addresses issues of civil service development, in the context of public administration reform. There are, in the countries of the old and new Europes, a wide variety of approaches to training and development in the public service, and the issues raised here are based on the experience and lessons of the Young Professionals Scheme in…

  1. Public Health Approach to the Study of Mental Retardation

    ERIC Educational Resources Information Center

    Chapman, Derek A.; Scott, Keith G.; Stanton-Chapman, Tina L.

    2008-01-01

    We applied a public health approach to the study of mental retardation by providing a basic descriptive epidemiological analysis using a large statewide linked birth and public school record database (N = 327,831). Sociodemographic factors played a key role across all levels of mental retardation. Birthweight less than 1000 g was associated with…

  2. A personalist approach to public-health ethics.

    PubMed

    Petrini, Carlo; Gainotti, Sabina

    2008-08-01

    First we give an overview of the historical development of public health. Then we present some public-health deontology codes and some ethical principles. We highlight difficulties in defining ethics for public health, with specific reference to three of them that concern: (i) the adaptability to public health of the classical principles of bioethics; (ii) the duty to respect and safeguard the individual while acting within the community perspective that is typical of public health; and (iii) the application-oriented nature of public health and the general lack of attention towards the ethical implications of collective interventions (compared with research). We then mention some proposals drafted from North American bioethics "principles" and utilitarian, liberal and communitarian views. Drawing from other approaches, personalism is outlined as being the theory that offers a consistent set of values and alternative principles that are relevant for public health. PMID:18797621

  3. A personalist approach to public-health ethics.

    PubMed

    Petrini, Carlo; Gainotti, Sabina

    2008-08-01

    First we give an overview of the historical development of public health. Then we present some public-health deontology codes and some ethical principles. We highlight difficulties in defining ethics for public health, with specific reference to three of them that concern: (i) the adaptability to public health of the classical principles of bioethics; (ii) the duty to respect and safeguard the individual while acting within the community perspective that is typical of public health; and (iii) the application-oriented nature of public health and the general lack of attention towards the ethical implications of collective interventions (compared with research). We then mention some proposals drafted from North American bioethics "principles" and utilitarian, liberal and communitarian views. Drawing from other approaches, personalism is outlined as being the theory that offers a consistent set of values and alternative principles that are relevant for public health.

  4. Public health approach to address maternal mortality.

    PubMed

    Rai, Sanjay K; Anand, K; Misra, Puneet; Kant, Shashi; Upadhyay, Ravi Prakash

    2012-01-01

    Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC) would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY) that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women's health. PMID:23229211

  5. A Global Public Goods Approach to the Health of Migrants

    PubMed Central

    Widdows, Heather; Marway, Herjeet

    2015-01-01

    This paper explores a global public goods approach to the health of migrants. It suggests that this approach establishes that there are a number of health goods which must be provided to migrants not because these are theirs by right (although this may independently be the case), but because these goods are primary goods which fit the threefold criteria of global public goods. There are two key advantages to this approach: first, it is non-confrontational and non-oppositional, and second, it provides self-interested arguments to provide at least some health goods to migrants and thus appeals to those little moved by rights-based arguments. PMID:26180550

  6. Non-fatal gunshot wounds in the context of intimate partner violence. The importance of a multidisciplinary approach: a case report.

    PubMed

    Puentes, Katerina; Ribeiro, Cristina; Jardim, Patrícia; Santos, Agostinho; Magalhães, Teresa

    2011-07-01

    According to Portuguese law, if a case of intimate partner violence is noticed or suspected by a professional working in public services, reporting it to the police, medico-legal services or directly to the public prosecutor is mandatory. However, in most cases, reporting does not take place, despite its vital importance in triggering the multidisciplinary intervention that will ensure the correct and timely diagnosis and protection of the victim. In the present case, the victim, a 37 year-old woman, was sexually and physically abused by her husband in their home, and was physically abused again at the victim's mother's house. The victim mentioned that her husband struck her in the head with a hammer and shot a handgun while in her mother's house. However, she denied having a gunshot wound. The couple's daughter was also slapped in the face by her father. The police took the victim to the emergency room of a central hospital to receive medical attention, while the medical examiner on duty was called to the same emergency room to perform a medico-legal evaluation in the context of the intimate partner violence reported to the police. Medico-legal assessment revealed scalp injuries that had not been detected during the first inspection by the emergency room attending physicians who had performed a neurological examination, which revealed no neurological dysfunction. A cranial computed tomography with three-dimensional reconstitution and virtual dissection, requested by the medical examiner, revealed two projectiles trapped in between the inner and the outer table of the cranium, with linear fractures only in the inner table and no brain injuries. Gynecological examination with the collection of biological evidence, also performed by the medical examiner, made it possible to identify a male DNA profile matching her husband's. The victim was subjected to neurosurgery and a follow-up, and was released one month after the traumatic event. A forensic psychological

  7. Non-fatal gunshot wounds in the context of intimate partner violence. The importance of a multidisciplinary approach: a case report.

    PubMed

    Puentes, Katerina; Ribeiro, Cristina; Jardim, Patrícia; Santos, Agostinho; Magalhães, Teresa

    2011-07-01

    According to Portuguese law, if a case of intimate partner violence is noticed or suspected by a professional working in public services, reporting it to the police, medico-legal services or directly to the public prosecutor is mandatory. However, in most cases, reporting does not take place, despite its vital importance in triggering the multidisciplinary intervention that will ensure the correct and timely diagnosis and protection of the victim. In the present case, the victim, a 37 year-old woman, was sexually and physically abused by her husband in their home, and was physically abused again at the victim's mother's house. The victim mentioned that her husband struck her in the head with a hammer and shot a handgun while in her mother's house. However, she denied having a gunshot wound. The couple's daughter was also slapped in the face by her father. The police took the victim to the emergency room of a central hospital to receive medical attention, while the medical examiner on duty was called to the same emergency room to perform a medico-legal evaluation in the context of the intimate partner violence reported to the police. Medico-legal assessment revealed scalp injuries that had not been detected during the first inspection by the emergency room attending physicians who had performed a neurological examination, which revealed no neurological dysfunction. A cranial computed tomography with three-dimensional reconstitution and virtual dissection, requested by the medical examiner, revealed two projectiles trapped in between the inner and the outer table of the cranium, with linear fractures only in the inner table and no brain injuries. Gynecological examination with the collection of biological evidence, also performed by the medical examiner, made it possible to identify a male DNA profile matching her husband's. The victim was subjected to neurosurgery and a follow-up, and was released one month after the traumatic event. A forensic psychological

  8. Implementation of a multidisciplinary approach to solve complex nano EHS problems by the UC Center for the Environmental Implications of Nanotechnology.

    PubMed

    Xia, Tian; Malasarn, Davin; Lin, Sijie; Ji, Zhaoxia; Zhang, Haiyuan; Miller, Robert J; Keller, Arturo A; Nisbet, Roger M; Harthorn, Barbara H; Godwin, Hilary A; Lenihan, Hunter S; Liu, Rong; Gardea-Torresdey, Jorge; Cohen, Yoram; Mädler, Lutz; Holden, Patricia A; Zink, Jeffrey I; Nel, Andre E

    2013-05-27

    UC CEIN was established with funding from the US National Science Foundation and the US Environmental Protection Agency in 2008 with the mission to study the impact of nanotechnology on the environment, including the identification of hazard and exposure scenarios that take into consideration the unique physicochemical properties of engineered nanomaterials (ENMs). Since its inception, the Center has made great progress in assembling a multidisciplinary team to develop the scientific underpinnings, research, knowledge acquisition, education and outreach that is required for assessing the safe implementation of nanotechnology in the environment. In this essay, the development of the infrastructure, protocols, and decision-making tools that are required to effectively integrate complementary scientific disciplines allowing knowledge gathering in a complex study area that goes beyond the traditional safety and risk assessment protocols of the 20th century is outlined. UC CEIN's streamlined approach, premised on predictive hazard and exposure assessment methods, high-throughput discovery platforms and environmental decision-making tools that consider a wide range of nano/bio interfaces in terrestrial and aquatic ecosystems, demonstrates the implementation of a 21st-century approach to the safe implementation of nanotechnology in the environment.

  9. Exploring Flexible and Multidisciplinary Approaches to Applied Science Research Project Assessments: Case Studies from the NASA DEVELOP National Program

    NASA Astrophysics Data System (ADS)

    Crepps, G.; Childs-Gleason, L. M.; Favors, J. E.; Ross, K. W.; Rogers, L.; Allsbrook, K. N.; Ruiz, M. L.

    2015-12-01

    Within the NASA DEVELOP National Program, teams conduct rapid prototype and feasibility projects, applying NASA Earth Observations to a broad range of problems in diverse focus areas, including water resources, agriculture, disaster management, and ecological forecasting, with the goal of assisting partner organizations in their decision making processes. Projects vary in scope, design, and satellite data utilized. As a result, there is no "fixed" set of indicators that encompasses all relevant impacts of all projects. Rather, a flexible toolkit of both shared indicators and individualized approaches is needed to capture the diverse outcomes of these projects, while still allowing for comparability of the projects. This has been done through the creation of pre- and post-project partner assessments that capture partner needs, capabilities, and expectations. This provides both baseline data and an overview of project impacts on partners. Selected projects are then individually assessed in greater detail through partner follow-ups and research into the quantification of project impacts utilizing interdisciplinary approaches to fit each project. This process is discussed through three examples of project impact assessments that draw from varied discipline approaches including cost benefit analysis and ecosystem services.

  10. The importance of the multidisciplinary approach to deal with the new epidemiological scenario of Chagas disease (global health).

    PubMed

    Pinazo, Maria-Jesus; Gascon, Joaquim

    2015-11-01

    There are currently two major factors that have modified the epidemiology of Chagas disease in the last decades: climate change and migration flows. In this new scenario, there are new challenges to control and prevent Trypanosoma cruzi infection in endemic countries, such as the control of a wider distribution of triatomine vectors or the reinforcement of vertical transmission programs. In non-endemic areas, few countries are aware of the emergence of this new disease and have established changes in their health systems. To address this new public health challenge, the priorities should be control programs to avoid new cases of T. cruzi infection acquired through vertical transmission, blood transfusion or organ transplant. In both, endemic and non-endemic areas, the international community and all the actors involved in Chagas disease must join efforts mainly in two directions: better management of the infection in affected individuals and more research to cover the knowledge gap mainly in physiopathology, diagnosis and treatment.

  11. The importance of the multidisciplinary approach to deal with the new epidemiological scenario of Chagas disease (global health).

    PubMed

    Pinazo, Maria-Jesus; Gascon, Joaquim

    2015-11-01

    There are currently two major factors that have modified the epidemiology of Chagas disease in the last decades: climate change and migration flows. In this new scenario, there are new challenges to control and prevent Trypanosoma cruzi infection in endemic countries, such as the control of a wider distribution of triatomine vectors or the reinforcement of vertical transmission programs. In non-endemic areas, few countries are aware of the emergence of this new disease and have established changes in their health systems. To address this new public health challenge, the priorities should be control programs to avoid new cases of T. cruzi infection acquired through vertical transmission, blood transfusion or organ transplant. In both, endemic and non-endemic areas, the international community and all the actors involved in Chagas disease must join efforts mainly in two directions: better management of the infection in affected individuals and more research to cover the knowledge gap mainly in physiopathology, diagnosis and treatment. PMID:26187358

  12. Conference on "Multidisciplinary approaches to nutritional problems". Rank Prize Lecture. Global nutrition challenges for optimal health and well-being.

    PubMed

    Uauy, Ricardo; Corvalan, Camila; Dangour, Alan D

    2009-02-01

    Optimal health and well-being are now considered the true measures of human development. Integrated strategies for infant, child and adult nutrition are required that take a life-course perspective to achieve life-long health. The major nutrition challenges faced today include: (a) addressing the pending burden of undernutrition (low birth weight, severe wasting, stunting and Zn, retinol, Fe, iodine and folic acid deficits) affecting those individuals living in conditions of poverty and deprivation; (b) preventing nutrition-related chronic diseases (obesity, diabetes, CVD, some forms of cancer and osteoporosis) that, except in sub-Saharan Africa, are the main causes of death and disability globally. This challenge requires a life-course perspective as effective prevention starts before conception and continues at each stage of life. While death is unavoidable, premature death and disability can be postponed by providing the right amount and quality of food and by maintaining an active life; (c) delaying or avoiding, via appropriate nutrition and physical activity interventions, the functional declines associated with advancing age. To help tackle these challenges, it is proposed that the term 'malnutrition in all its forms', which encompasses the full spectrum of nutritional disorders, should be used to engender a broader understanding of global nutrition problems. This term may prove particularly helpful when interacting with policy makers and the public. Finally, a greater effort by the UN agencies and private and public development partners is called for to strengthen local, regional and international capacity to support the much needed change in policy and programme activities focusing on all forms of malnutrition with a unified agenda.

  13. Conference on "Multidisciplinary approaches to nutritional problems". Rank Prize Lecture. Global nutrition challenges for optimal health and well-being.

    PubMed

    Uauy, Ricardo; Corvalan, Camila; Dangour, Alan D

    2009-02-01

    Optimal health and well-being are now considered the true measures of human development. Integrated strategies for infant, child and adult nutrition are required that take a life-course perspective to achieve life-long health. The major nutrition challenges faced today include: (a) addressing the pending burden of undernutrition (low birth weight, severe wasting, stunting and Zn, retinol, Fe, iodine and folic acid deficits) affecting those individuals living in conditions of poverty and deprivation; (b) preventing nutrition-related chronic diseases (obesity, diabetes, CVD, some forms of cancer and osteoporosis) that, except in sub-Saharan Africa, are the main causes of death and disability globally. This challenge requires a life-course perspective as effective prevention starts before conception and continues at each stage of life. While death is unavoidable, premature death and disability can be postponed by providing the right amount and quality of food and by maintaining an active life; (c) delaying or avoiding, via appropriate nutrition and physical activity interventions, the functional declines associated with advancing age. To help tackle these challenges, it is proposed that the term 'malnutrition in all its forms', which encompasses the full spectrum of nutritional disorders, should be used to engender a broader understanding of global nutrition problems. This term may prove particularly helpful when interacting with policy makers and the public. Finally, a greater effort by the UN agencies and private and public development partners is called for to strengthen local, regional and international capacity to support the much needed change in policy and programme activities focusing on all forms of malnutrition with a unified agenda. PMID:19012808

  14. Teaching Public Health Networks in England: an innovative approach to building public health capacity and capability.

    PubMed

    Orme, J; Pilkington, P; Gray, S; Rao, M

    2009-12-01

    This paper examines the development and achievements of the Teaching Public Health Networks (TPHNs) in England; an initiative that aimed to catalyse collaborative working between the public health workforce and further and higher education, to enhance public health knowledge in the wider workforce with a view to enhancing capacity to tackle inequalities and meeting public health targets. This paper highlights activities under three outcomes: mobilizing resources, people, money and materials; building capacity through training and infrastructure development; and raising public and political awareness. The TPHN approach is shown to have led to innovative developments in public health education and training, including engagement with professionals that have not previously had exposure to public health. This paper aims to disseminate the learning from this complex public health initiative, now in its third year of development, and to share examples of good practice. It is hoped that other countries can use the TPHN approach as a model to address the various common and country-specific challenges in public health workforce development.

  15. Public health situation awareness: toward a semantic approach

    NASA Astrophysics Data System (ADS)

    Mirhaji, Parsa; Richesson, Rachel L.; Turley, James P.; Zhang, Jiajie; Smith, Jack W.

    2004-04-01

    We propose a knowledge-based public health situation awareness system. The basis for this system is an explicit representation of public health situation awareness concepts and their interrelationships. This representation is based upon the users" (public health decision makers) cognitive model of the world, and optimized towards the efficacy of performance and relevance to the public health situation awareness processes and tasks. In our approach, explicit domain knowledge is the foundation for interpretation of public health data, as apposed to conventional systems where the statistical methods are the essence of the processes. Objectives: To develop a prototype knowledge-based system for public health situation awareness and to demonstrate the utility of knowledge intensive approaches in integration of heterogeneous information, eliminating the effects of incomplete and poor quality surveillance data, uncertainty in syndrome and aberration detection and visualization of complex information structures in public health surveillance settings, particularly in the context of bioterrorism (BT) preparedness. The system employs the Resource Definition Framework (RDF) and additional layers of more expressive languages to explicate the knowledge of domain experts into machine interpretable and computable problem-solving modules that can then guide users and computer systems in sifting through the most "relevant" data for syndrome and outbreak detection and investigation of root cause of the event. The Center for Biosecurity and Public Health Informatics Research is developing a prototype knowledge-based system around influenza, which has complex natural disease patterns, many public health implications, and is a potential agent for bioterrorism. The preliminary data from this effort may demonstrate superior performance in information integration, syndrome and aberration detection, information access through information visualization, and cross-domain investigation of the

  16. Communicating Risk and Cultivating Resilience in Rural Alaskan Communities: A Multi-Disciplinary Approach to Flood Mitigation

    NASA Astrophysics Data System (ADS)

    Kontar, Y. Y.

    2014-12-01

    The increasing extent and vulnerability of technologically advanced society together with aspects of global climate change intensifies the frequency and severity of natural disasters. Every year, communities around the world face the devastating consequences of hazardous events, including loss of life, property and infrastructure damage, and environmental decline. Environmentally sound strategies have to be developed to minimize these consequences. However, hazard-prone areas differ geographically, climatically, and culturally. There is no a one-size-fits-all solution. Thus, it is crucial that future decision-makers not only know the conditions that make some natural Earth processes hazardous to people, but also understand how people perceive and adjust to potential natural hazards in their regions. In May 2013, an ice jam caused major flooding in Galena, a remote village in interior Alaska. Within two days, flooding destroyed nearly the entire region's infrastructure, and displaced over 400 residents. Almost a year later, a significant part of Galena's population was still evacuated in Fairbanks and other neighboring towns. The rebuilding holdup reflected the federal government's reluctance to spend millions of dollars an the area that may be destroyed again by the next flood. Massive floods inundated towns along the Yukon River before (e.g., Eagle in 2009 and Holycross in 1975), but people return to refurbish and again inhabit the same territories. Rivers have a significant importance to Alaskan rural communities. Not only do rivers provide food, drink, transportation, and in some cases arable land and irrigation, but they also carry cultural significance for the Native Alaskan people. The Galena case study provides a revealing example of challenges of communicating with and educating the public and policy makers about natural hazards.

  17. Management of pain and fatigue in the joint hypermobility syndrome (a.k.a. Ehlers-Danlos syndrome, hypermobility type): principles and proposal for a multidisciplinary approach.

    PubMed

    Castori, Marco; Morlino, Silvia; Celletti, Claudia; Celli, Mauro; Morrone, Aldo; Colombi, Marina; Camerota, Filippo; Grammatico, Paola

    2012-08-01

    Joint hypermobility syndrome (JHS), or Ehlers-Danlos syndrome (EDS) hypermobility type (EDS-HT), is a underdiagnosed heritable connective tissue disorder characterized by generalized joint hypermobility and a wide range of visceral, pelvic, neurologic, and cognitive dysfunctions. Deterioration of quality of life is mainly associated with pain and fatigue. Except for the recognized effectiveness of physiotherapy for some musculoskeletal features, there are no standardized guidelines for the assessment and treatment of pain and fatigue. In this work, a practical classification of pain presentations and factors contributing in generating painful sensations in JHS/EDS-HT is proposed. Pain can be topographically classified in articular limb (acute/subacute and chronic), muscular limb (myofascial and fibromyalgia), neuropathic limb, back/neck, abdominal and pelvic pain, and headache. For selected forms of pain, specific predisposing characteristics are outlined. Fatigue appears as the result of multiple factors, including muscle weakness, respiratory insufficiency, unrefreshing sleep, dysautonomia, intestinal malabsorption, reactive depression/anxiety, and excessive use of analgesics. A set of lifestyle recommendations to instruct patients as well as specific investigations aimed at characterizing pain and fatigue are identified. Available treatment options are discussed in the set of a structured multidisciplinary approach based on reliable outcome tools. PMID:22786715

  18. Urinary Metabolomics Identifies a Molecular Correlate of Interstitial Cystitis/Bladder Pain Syndrome in a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Cohort.

    PubMed

    Parker, Kaveri S; Crowley, Jan R; Stephens-Shields, Alisa J; van Bokhoven, Adrie; Lucia, M Scott; Lai, H Henry; Andriole, Gerald L; Hooton, Thomas M; Mullins, Chris; Henderson, Jeffrey P

    2016-05-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a poorly understood syndrome affecting up to 6.5% of adult women in the U.S. The lack of broadly accepted objective laboratory markers for this condition hampers efforts to diagnose and treat this condition. To identify biochemical markers for IC/BPS, we applied mass spectrometry-based global metabolite profiling to urine specimens from a cohort of female IC/BPS subjects from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. These analyses identified multiple metabolites capable of discriminating IC/BPS and control subjects. Of these candidate markers, etiocholan-3α-ol-17-one sulfate (Etio-S), a sulfoconjugated 5-β reduced isomer of testosterone, distinguished female IC/BPS and control subjects with a sensitivity and specificity >90%. Among IC/BPS subjects, urinary Etio-S levels are correlated with elevated symptom scores (symptoms, pelvic pain, and number of painful body sites) and could resolve high- from low-symptom IC/BPS subgroups. Etio-S-associated biochemical changes persisted through 3-6months of longitudinal follow up. These results raise the possibility that an underlying biochemical abnormality contributes to symptoms in patients with severe IC/BPS. PMID:27322470

  19. Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach

    PubMed Central

    2012-01-01

    Background Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. Importantly, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3–5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the outcomes and impact measured in a randomized intervention trial. Methods/Design In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9–12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by

  20. Design of the Nephrotic Syndrome Study Network (NEPTUNE) to evaluate primary glomerular nephropathy by a multidisciplinary approach.

    PubMed

    Gadegbeku, Crystal A; Gipson, Debbie S; Holzman, Lawrence B; Ojo, Akinlolu O; Song, Peter X K; Barisoni, Laura; Sampson, Matthew G; Kopp, Jeffrey B; Lemley, Kevin V; Nelson, Peter J; Lienczewski, Chrysta C; Adler, Sharon G; Appel, Gerald B; Cattran, Daniel C; Choi, Michael J; Contreras, Gabriel; Dell, Katherine M; Fervenza, Fernando C; Gibson, Keisha L; Greenbaum, Larry A; Hernandez, Joel D; Hewitt, Stephen M; Hingorani, Sangeeta R; Hladunewich, Michelle; Hogan, Marie C; Hogan, Susan L; Kaskel, Frederick J; Lieske, John C; Meyers, Kevin E C; Nachman, Patrick H; Nast, Cynthia C; Neu, Alicia M; Reich, Heather N; Sedor, John R; Sethna, Christine B; Trachtman, Howard; Tuttle, Katherine R; Zhdanova, Olga; Zilleruelo, Gastòn E; Kretzler, Matthias

    2013-04-01

    The Nephrotic Syndrome Study Network (NEPTUNE) is a North American multicenter collaborative consortium established to develop a translational research infrastructure for nephrotic syndrome. This includes a longitudinal observational cohort study, a pilot and ancillary study program, a training program, and a patient contact registry. NEPTUNE will enroll 450 adults and children with minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy for detailed clinical, histopathological, and molecular phenotyping at the time of clinically indicated renal biopsy. Initial visits will include an extensive clinical history, physical examination, collection of urine, blood and renal tissue samples, and assessments of quality of life and patient-reported outcomes. Follow-up history, physical measures, urine and blood samples, and questionnaires will be obtained every 4 months in the first year and biannually, thereafter. Molecular profiles and gene expression data will be linked to phenotypic, genetic, and digitalized histological data for comprehensive analyses using systems biology approaches. Analytical strategies were designed to transform descriptive information to mechanistic disease classification for nephrotic syndrome and to identify clinical, histological, and genomic disease predictors. Thus, understanding the complexity of the disease pathogenesis will guide further investigation for targeted therapeutic strategies.

  1. Rational design on controlled release ion-exchange polymeric microspheres and polymer-lipid hybrid nanoparticles for the delivery of water-soluble drugs through a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Li, Yongqiang

    Sulfopropyl dextran sulfate (SP-DS) microspheres and polymer-lipid hybrid nanoparticles (PLN) for the delivery of water-soluble anticancer drugs and P-glycoprotein inhibitors were developed by our group recently and demonstrated effectiveness in local chemotherapy. To optimize the delivery performance of these particulate systems, particularly PLN, an integrated multidisciplinary approach was developed, based on an in-depth understanding of drug-excipient interactions, internal structure, drug loading and release mechanisms, and application of advanced modeling/optimization techniques. An artificial neural networks (ANN) simulator capable of formulation optimization and drug release prediction was developed. In vitro drug release kinetics of SP-DS microspheres, with various drug loading and in different release media, were predicted by ANN. The effects of independent variables on drug release were evaluated. Good modeling performance suggested that ANN is a useful tool to predict drug release from ion-exchange microspheres. To further improve the performance of PLN, drug-polymer-lipid interactions were characterized theoretically and experimentally using verapamil hydrochloride (VRP) as a model drug and dextran sulfate sodium (DS) as a counter-ion polymer. VRP-DS complexation followed a stoichiometric rule and solid-state transformation of VRP were observed. Dodecanoic acid (DA) was identified as the lead lipid carrier material. Based upon the optimized drug-polymer-lipid interactions, PLN with high drug loading capacity (36%, w/w) and sustained release without initial burst release were achieved. VRP remained amorphous and was molecularly dispersed within PLN. H-bonding contributed to the miscibility between the VRP-DS complex and DA. Drug release from PLN was mainly controlled by diffusion and ion-exchange processes. Drug loading capacity and particle size of PLN depend on the formulation factors of the weight ratio of drug to lipid and concentrations of

  2. Public Opinion and the Death Penalty: A Qualitative Approach

    ERIC Educational Resources Information Center

    Falco, Diana L.; Freiburger, Tina L.

    2011-01-01

    Strong public support for capital punishment is arguably the number one reason why the death penalty continues to be used as a form of correctional policy in the U.S. criminal justice system. Therefore, it is fundamental that the measure of death penalty opinion be heavily scrutinized. Utilizing a methodological approach not typically employed in…

  3. Reconciling Statistical and Systems Science Approaches to Public Health

    ERIC Educational Resources Information Center

    Ip, Edward H.; Rahmandad, Hazhir; Shoham, David A.; Hammond, Ross; Huang, Terry T. -K.; Wang, Youfa; Mabry, Patricia L.

    2013-01-01

    Although systems science has emerged as a set of innovative approaches to study complex phenomena, many topically focused researchers including clinicians and scientists working in public health are somewhat befuddled by this methodology that at times appears to be radically different from analytic methods, such as statistical modeling, to which…

  4. A multidisciplinary approach of workload assessment in real-job situations: investigation in the field of aerospace activities.

    PubMed

    Mélan, Claudine; Cascino, Nadine

    2014-01-01

    The present contribution presents two field studies combining tools and methods from cognitive psychology and from occupational psychology in order to perform a thorough investigation of workload in employees. Cognitive load theory proposes to distinguish different load categories of working memory, in a context of instruction. Intrinsic load is inherent to the task, extraneous load refers to components of a learning environment that may be modified to reduce total load, and germane load enables schemas construction and thus efficient learning. We showed previously that this theoretical framework may be successfully extended to working memory tasks in non-instructional designs. Other theoretical models, issued from the field of occupational psychology, account for an individual's perception of work demands or requirements in the context of different psychosocial features of the (work) environment. Combining these approaches is difficult as workload assessment by job-perception questionnaires explore an individual's overall job-perception over a large time-period, whereas cognitive load investigations in working memory tasks are typically performed within short time-periods. We proposed an original methodology enabling investigation of workload and load factors in a comparable time-frame. We report two field studies investigating workload on different shift-phases and between work-shifts, with two custom-made tools. The first one enabled workload assessment by manipulating intrinsic load (task difficulty) and extraneous load (time pressure) in a working-memory task. The second tool was a questionnaire based on the theoretical concepts of work-demands, control, and psychosocial support. Two additional dimensions suspected to contribute to job-perception, i.e., work-family conflicts and availability of human and technical resources were also explored. Results of workload assessments were discussed in light of operators' alertness and job-performance.

  5. A multidisciplinary approach of workload assessment in real-job situations: investigation in the field of aerospace activities.

    PubMed

    Mélan, Claudine; Cascino, Nadine

    2014-01-01

    The present contribution presents two field studies combining tools and methods from cognitive psychology and from occupational psychology in order to perform a thorough investigation of workload in employees. Cognitive load theory proposes to distinguish different load categories of working memory, in a context of instruction. Intrinsic load is inherent to the task, extraneous load refers to components of a learning environment that may be modified to reduce total load, and germane load enables schemas construction and thus efficient learning. We showed previously that this theoretical framework may be successfully extended to working memory tasks in non-instructional designs. Other theoretical models, issued from the field of occupational psychology, account for an individual's perception of work demands or requirements in the context of different psychosocial features of the (work) environment. Combining these approaches is difficult as workload assessment by job-perception questionnaires explore an individual's overall job-perception over a large time-period, whereas cognitive load investigations in working memory tasks are typically performed within short time-periods. We proposed an original methodology enabling investigation of workload and load factors in a comparable time-frame. We report two field studies investigating workload on different shift-phases and between work-shifts, with two custom-made tools. The first one enabled workload assessment by manipulating intrinsic load (task difficulty) and extraneous load (time pressure) in a working-memory task. The second tool was a questionnaire based on the theoretical concepts of work-demands, control, and psychosocial support. Two additional dimensions suspected to contribute to job-perception, i.e., work-family conflicts and availability of human and technical resources were also explored. Results of workload assessments were discussed in light of operators' alertness and job-performance. PMID:25232346

  6. A multidisciplinary approach of workload assessment in real-job situations: investigation in the field of aerospace activities

    PubMed Central

    Mélan, Claudine; Cascino, Nadine

    2014-01-01

    The present contribution presents two field studies combining tools and methods from cognitive psychology and from occupational psychology in order to perform a thorough investigation of workload in employees. Cognitive load theory proposes to distinguish different load categories of working memory, in a context of instruction. Intrinsic load is inherent to the task, extraneous load refers to components of a learning environment that may be modified to reduce total load, and germane load enables schemas construction and thus efficient learning. We showed previously that this theoretical framework may be successfully extended to working memory tasks in non-instructional designs. Other theoretical models, issued from the field of occupational psychology, account for an individual’s perception of work demands or requirements in the context of different psychosocial features of the (work) environment. Combining these approaches is difficult as workload assessment by job-perception questionnaires explore an individual’s overall job-perception over a large time-period, whereas cognitive load investigations in working memory tasks are typically performed within short time-periods. We proposed an original methodology enabling investigation of workload and load factors in a comparable time-frame. We report two field studies investigating workload on different shift-phases and between work-shifts, with two custom-made tools. The first one enabled workload assessment by manipulating intrinsic load (task difficulty) and extraneous load (time pressure) in a working-memory task. The second tool was a questionnaire based on the theoretical concepts of work-demands, control, and psychosocial support. Two additional dimensions suspected to contribute to job-perception, i.e., work–family conflicts and availability of human and technical resources were also explored. Results of workload assessments were discussed in light of operators’ alertness and job-performance. PMID

  7. A public health approach to understanding and preventing violent radicalization

    PubMed Central

    2012-01-01

    Background Very recent acts of terrorism in the UK were perpetrated by 'homegrown', well educated young people, rather than by foreign Islamist groups; consequently, a process of violent radicalization was proposed to explain how ordinary people were recruited and persuaded to sacrifice their lives. Discussion Counterterrorism approaches grounded in the criminal justice system have not prevented violent radicalization. Indeed there is some evidence that these approaches may have encouraged membership of radical groups by not recognizing Muslim communities as allies, citizens, victims of terrorism, and victims of discrimination, but only as suspect communities who were then further alienated. Informed by public health research and practice, a new approach is proposed to target populations vulnerable to recruitment, rather than rely only on research of well known terrorist groups and individual perpetrators of terrorist acts. Conclusions This paper proposes public health research and practice to guard against violent radicalization. PMID:22332998

  8. Breaking Down the Siloes: Developing Effective Multidisciplinary HIV Research Teams.

    PubMed

    Magnus, Manya; Castel, Amanda

    2016-09-01

    As the HIV epidemic passes its 35 years mark, the role of multidisciplinary approaches to HIV research has become increasingly important. Development of diverse, cross-cutting research teams has been found to be key to engaging and retaining participants in population-based studies; it is also a crucial component of designing studies capable of examining the sensitive and nuanced issues that surround HIV related risk and adherence behavior. Expanding our understanding of these issues is central to being able to overcome them and ultimately to the development of best practices for translation of research discovery into improvements in prevention and care. The objectives of this paper are to characterize the importance of multidisciplinary teams in HIV research where they are critical to gaining information that can have a positive impact on the epidemic and to propose specific methods for creating teams to conduct research with optimal public health impact. PMID:27435076

  9. How to integrate geology, biology, and modern wireless technologies to assess biotic-abiotic interactions on coastal dune systems: a new multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Sarti, Giovanni; Bertoni, Duccio; Bini, Monica; Ciccarelli, Daniela; Ribolini, Adriano; Ruocco, Matteo; Pozzebon, Alessandro; Alquini, Fernanda; Giaccari, Riccardo; Tordella, Stefano

    2014-05-01

    Coastal dune systems are arguably one of the most dynamic environments because their evolution is controlled by many factors, both natural and human-related. Hence, they are often exposed to processes leading to erosion, which in turn determine serious naturalistic and economic losses. Most recent studies carried out on different dune fields worldwide emphasized the notion that a better definition of this environment needs an approach that systematically involves several disciplines, striving to merge every data collected from any individual analyses. Therefore, a new multidisciplinary method to study coastal dune systems has been conceived in order to integrate geology, biology, and modern wireless technologies. The aim of the work is threefold: i) to check the reliability of this new approach; ii) to provide a dataset as complete as ever about the factors affecting the evolution of coastal dunes; and iii) to evaluate the influence of any biotic and abiotic factors on plant communities. The experimentation site is located along the Pisa coast within the Migliarino - S. Rossore - Massaciuccoli Regional Park, a protected area where human influence is low (Tuscany, Italy). A rectangle of 100 x 200 m containing 50 grids of 20 x 20 m was established along the coastal dune systems from the coastline to the pinewood at the landward end of the backdune area. Sampling from each grid determined grain-size analysis carried out on surface sediment samples such as geologic aspects; topographic surveys performed by means of DGPS-RTK instruments; geophysical surveys conducted with a GPR equipment, which will be matched with core drilling activities; digital image analysis of high definition pictures taken by means of a remote controlled aircraft drone flying over the study area; biological data obtained by percent cover of each vascular plant species recorded in the sampling unit. Along with geologic and biologic methodologies, this research implemented the use of informatics

  10. Chicano Studies: A Multidisciplinary Approach.

    ERIC Educational Resources Information Center

    Garcia, Eugene E., Ed.; And Others

    One in a series on bilingual education, this book contains 15 chapters organized under the following subject headings: Chicano studies; Chicano history, social structure, and politics; literature and folklore; and education. Carlos Munoz, Jr., traces the history of Chicano studies and its impact on access to higher education. Albert Camarillo…

  11. Fibromyalgia Syndrome - a multidisciplinary approach.

    PubMed

    Binkiewicz-Glińska, Anna; Bakuła, Stanisław; Tomczak, Hanna; Landowski, Jerzy; Ruckemann-Dziurdzińska, Katarzyna; Zaborowska-Sapeta, Katarzyna; Kowalski, Ireneusz; Kiebzak, Wojciech

    2015-01-01

    According to American College of Rheumatology fibromyalgia syndrome (FMS) is a common health problem characterized by widespread pain and tenderness. The pain and tenderness, although chronic, present a tendency to fluctuate both in intensity and location around the body. Patients with FMS experience fatigue and often have sleep disorders. It is estimated that FMS affects two to four percent of the general population. It is most common in women, though it can also occur in men. FMS most often first occur in the middle adulthood, but it can start as early as in the teen years or in the old age. The causes of FMS are unclear. Various infectious agents have recently been linked with the development of FMS. Some genes are potentially linked with an increased risk of developing FMS and some other health problems, which are common comorbidities to FMS. It is the genes that determine individual sensitivity and reaction to pain, quality of the antinociceptive system and complex biochemistry of pain sensation. Diagnosis and therapy may be complex and require cooperation of many specialists. Rheumatologists often make the diagnosis and differentiate FMS with other disorders from the rheumatoid group. FMS patients may also require help from the Psychiatric Clinic (Out-Patients Clinic) due to accompanying mental problems. As the pharmacological treatment options are limited and only complex therapy gives relatively good results, the treatment plan should include elements of physical therapy. PMID:26488355

  12. Multidisciplinary approach to constrain kinematics of fault zones at shallow depths: a case study from the Cameros-Demanda thrust (North Spain)

    NASA Astrophysics Data System (ADS)

    Casas-Sainz, A. M.; Román-Berdiel, T.; Oliva-Urcia, B.; García-Lasanta, C.; Villalaín, J. J.; Aldega, L.; Corrado, S.; Caricchi, C.; Invernizzi, C.; Osácar, M. C.

    2016-06-01

    results indicate that the proposed multidisciplinary approach is useful when dealing with thrusts at shallow crustal levels.

  13. Double, double, (but mostly) toil, and trouble: A multidisciplinary approach to quantify the permeability of an active volcanic hydrothermal system (Whakaari volcano, New Zealand)

    NASA Astrophysics Data System (ADS)

    Heap, Michael; Kennedy, Ben; Farquharson, Jamie; Ashworth, James; Mayer, Klaus; Letham-Brake, Mark; Reuschlé, Thierry; Gilg, Albert; Scheu, Betty; Lavallée, Yan; Siratovich, Paul; Cole, Jim; Jolly, Art; Dingwell, Donald

    2016-04-01

    Our multidisciplinary approach, which combines field techniques and traditional laboratory methods, aims to better understand the permeability of an active volcanic hydrothermal system, a vital prerequisite for understanding and modelling the behaviour of hydrothermal systems worldwide. Whakaari volcano (an active stratovolcano located 48 km off New Zealand's North Island) hosts an open, highly reactive hydrothermal system (hot springs and mud pools, fumaroles, acid streams and lakes) and represents an ideal natural laboratory to undertake such a study. We first gained an appreciation of the different lithologies at Whakaari and (where possible) their lateral and vertical extent through reconnaissance by land, sea, and air. Due to the variable nature of these altered lithologies (mainly lavas and tuffs), we measured porosity-permeability for in excess of a hundred rock hand samples using field techniques. We also measured the permeability of recent, unconsolidated deposits using a field soil permeameter. Our field measurements were then groundtruthed on a subset of these samples (~40-50) using traditional laboratory techniques: helium pycnometry and measurements of permeability using a benchtop permeameter, including measurements under increasing confining pressure (i.e., depth). In all, our measurements highlight that the porosity of the materials at Whakaari can vary from ~0.01 to ~0.6, and permeability can vary by eight orders of magnitude. However, our data show no discernable trend between porosity and permeability. A combination of macroscopic and microscopic observations, chemistry (XRF), mineralogy (XRD), and mercury porosimetry highlight that the absence of a robust porosity-permeability relationship is the product of an insane variability in alteration and microstructure (pore size, particle size, pore connectivity, presence/absence of microcracks, layering, amongst others). While our systematic study offers the most complete porosity-permeability dataset

  14. Toll-like Receptor 4 and Comorbid Pain in Interstitial Cystitis/Bladder Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study

    PubMed Central

    Schrepf, Andrew; Bradley, Catherine S.; O'Donnell, Michael; Luo, Yi; Harte, Steven E.; Kreder, Karl; Lutgendorf, Susan

    2015-01-01

    Background Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a condition characterized by pelvic pain and urinary symptoms. Some IC/BPS patients have pain confined to the pelvic region, while others suffer widespread pain. Inflammatory processes have previously been linked to pelvic pain in IC/BPS, but their association with widespread pain in IC/BPS has not been characterized. Methods Sixty-six women meeting criteria for IC/BPS completed self-report measures of pain as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP), collected 3 days of saliva for cortisol assays, and provided blood samples. Peripheral blood mononuclear cells (PBMCs) were stimulated with Toll-Like Receptor (TLR) 2 and 4 agonists and cytokines were measured in supernatant; IL-6 was also measured in plasma. Associations between inflammatory variables and the likelihood of endorsing extra-pelvic pain, or the presence of a comorbid syndrome, were tested by logistic regression and General Linear Models, respectively. A subset of patients (n=32) completed Quantitative Sensory Testing. Results A one standard deviation increase in TLR-4 inflammatory response was associated with a 1.59 greater likelihood of endorsing extra-pelvic pain (p = .019). Participants with comorbid syndromes also had higher inflammatory responses to TLR-4 stimulation in PBMCs (p = .016). Lower pressure pain thresholds were marginally associated with higher TLR-4 inflammatory responses (p = .062), and significantly associated with higher IL-6 in plasma (p = .031). Conclusions TLR-4 inflammatory responses in PBMCs are a marker of widespread pain in IC/BPS, and should be explored in other conditions characterized by medically unexplained pain. PMID:25771510

  15. Graduate Education in Political Science, in Traditional Public Administration and in the Emerging Public Management Approach: A Comparison of the Relevance of Each to Public Service Career Preparation.

    ERIC Educational Resources Information Center

    Boynton, Robert Paul; Lehnen, Robert G.

    Three approaches to public administration are analyzed in light of their contributions to preparation for careers in public service. The approaches are graduate education in political science, traditional public administration training, and public management. The three types of programs stress different subject matter and have different…

  16. Multidisciplinary teamwork and communication training.

    PubMed

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

    2011-04-01

    Every delivery is a multidisciplinary event, involving nursing, obstetricians, anesthesiologists, and pediatricians. Patients are often in labor across multiple provider shifts, necessitating numerous handoffs between teams. Each handoff provides an opportunity for errors. Although a traditional approach to improving patient outcomes has been to address individual knowledge and skills, it is now recognized that a significant number of complications result from team, rather than individual, failures. In 2004, a Sentinel Alert issued by the Joint Commission revealed that most cases of perinatal death and injury are caused by problems with an organization's culture and communication failures. It was recommended that hospitals implement teamwork training programs in an effort to improve outcomes. Instituting a multidisciplinary teamwork training program that uses simulation offers a risk-free environment to practice skills, including communication, role clarification, and mutual support. This experience should improve patient safety and outcomes, as well as enhance employee morale. PMID:21440817

  17. Engaging a wider public health workforce for the future: a public health practitioner in residence approach.

    PubMed

    Pilkington, P; Marco, E; Grant, M; Orme, J

    2013-05-01

    This paper outlines and assesses a project that sought to use a studio residency (a public health practitioner in residence) as a vehicle to introduce public health issues and concepts into the curricula of a studio cohort of fifth and sixth year architecture students. The practitioner delivered workshops, group tutorials and one-to-one guidance on individual design projects whose aim was to improve the health and well-being of the local population. Students reported being enthused by the practitioner and developed a broader understanding of their role as future architects in the promotion and protection of the health of the public. The public health practitioner in residence model may offer an exciting way of educating and inspiring the future wider public health workforce in the built environment design focused professions. Such an approach could transform the way in which such professionals construct their societal role in terms of their future impact on population health and their contribution as members of the wider public health workforce.

  18. Assessing Students' Understanding of Human Behavior: A Multidisciplinary Outcomes Based Approach for the Design and Assessment of an Academic Program Goal.

    ERIC Educational Resources Information Center

    Keith, Bruce; Meese, Michael J.; Efflandt, Scott; Malinowski, Jon C.; LeBoeuf, Joseph; Gallagher, Martha; Hurley, John; Green, Charles

    2002-01-01

    Presents a strategy for the curricular design and assessment of one multidisciplinary program goal: understanding human behavior. Discusses how to assess a desired outcome based on four specific areas: (1) organizational context; (2) articulation of a learning model; (3) program design and implementation; and (4) outcomes assessment. (Author/KDR)

  19. [Intensify the development of public policy has the health: approaches strategic for the authorities of health public].

    PubMed

    Guyon, Ak'ingabe

    2012-11-06

    Health promotion is one of the essential functions of public health authorities. The first pillar of health promotion is the elaboration of healthy public policy. Using the theoretical foundations of the healthy public policy concept, it can be demonstrated that public health authorities are able to develop, at their own scale, healthy public policies. Three strategic approaches are proposed in order to support public health authorities in strengthening their healthy public policy actions. First, better understand the tools or policy instruments (economic, regulation, information and persuasion) at their disposal. Second, take stock of the many types of legitimacy (theoretical, legislative, administrative and scientific) available to public health authorities as they develop healthy public policy. Third, consider the potential scientific roles that can be adopted while using the various policy instruments. These approaches can represent a pragmatic and structuring support for public health authorities wanting to strengthen their healthy public policy actions.

  20. The personnel economics approach to public workforce research.

    PubMed

    Gibbs, Michael

    2009-11-01

    This article argues that the relatively new field of personnel economics (PE) holds strong potential as a tool for studying public sector workforces. This subfield of labor economics is based on a strong foundation of microeconomics, which provides a robust theoretical foundation for studying workforce and organizational design issues. PE has evolved on this foundation to a strong practical emphasis, with theoretical insights designed for practical use and with strong focus on empirical research. The field is also characterized by creative data entrepreneurship. The types of datasets that personnel economists use are described. If similar datasets can be obtained for public sector workforces, PE should be a very useful approach for studying them. PMID:19829236

  1. Hydroclimatic shifts recorded in peat archive from Rąbień mire (Central Poland) - better understanding of past climate changes using multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Słowiński, Michał; Marcisz, Katarzyna; Płóciennik, Mateusz; Obremska, Milena; Pawłowski, Dominik; Okupny, Daniel; Słowińska, Sandra; Borówka, Ryszard; Kittel, Piotr; Forysiak, Jacek; Michczyńska, Danuta J.; Lamentowicz, Mariusz

    2016-04-01

    Hydrological changes are main drivers of the processes occurring in the peatland ecosystem, e.g. organic matter accumulation and decomposition. Hydroclimatic changes in mires are caused by various non-climatic factors, such as hydroseral succession or land use changes. Central Europe, namely Poland, is characterized by a transitional climate with influence o both continental and Atlantic air masses, which makes a this region a very sensitive to climate change. Here we explore a potential of multidisciplinary approach in reconstruction of past climate change and particularly hydroclimatic conditions which control in Sphagnum peatland ecosystem. We reconstructed 3300 years (between 3,500 BC and 200 BC) history of development of Rąbień mire using several biotic proxies (pollen, plant macrofossils, testate amoebae, Cladocera, Chironomidae) and geochemistry. Study site - Rąbień mire (area 42 ha) is located in central Poland and it is protected nature reserve. The origin of the mire depression is connected with the development of the thermokarst basin isolated by dunes. Rąbień mire is limnogenic, i.e. formed by the process of terrestrialisation of a water body and thickness of biogenic deposits is 6.2 m (440 cm of lacustrine sediment and 180 cm of peat). Our results demonstrate the high potential of Rąbień peat record for reconstructing the palaeohydrological dynamics. The studied time interval is characterized by two pronounced dry periods: ~2,500 to ~1,700 cal. BC and ~800 to ~600 cal. BC, and two periods of significant increases in water table: ~1,100 to ~800 cal. BC and ~600 to ~250 cal. BC. The timing of the wet shift at 600 cal. BC corresponds to wet periods in different sites from Central and Eastern Europe. Our investigation reveals a complex pattern of proxies, what might be linked to the past atmospheric circulation patterns. Extreme hydroclimatic conditions most possibly had a direct impact on the functioning of peatland ecosystems. What has been

  2. Halting the obesity epidemic: a public health policy approach.

    PubMed Central

    Nestle, M; Jacobson, M F

    2000-01-01

    Traditional ways of preventing and treating overweight and obesity have almost invariably focused on changing the behavior of individuals, an approach that has proven woefully inadequate, as indicated by the rising rates of both conditions. Considering the many aspects of American culture that promote obesity, from the proliferation of fast-food outlets to almost universal reliance on automobiles, reversing current trends will require a multifaceted public health policy approach as well as considerable funding. National leadership is needed to ensure the participation of health officials and researchers, educators and legislators, transportation experts and urban planners, and businesses and nonprofit groups in formulating a public health campaign with a better chance of success. The authors outline a broad range of policy recommendations and suggest that an obesity prevention campaign might be funded, in part, with revenues from small taxes on selected products that provide "empty" calories-such as soft drinks-or that reduce physical activity-such as automobiles. Images p13-a p15-a p17-a p18-a p22-a PMID:10968581

  3. A systematic indoor air quality audit approach for public buildings.

    PubMed

    Asadi, Ehsan; da Silva, Manuel C Gameiro; Costa, J J

    2013-01-01

    Good indoor air quality (IAQ) in buildings provides a comfortable and healthy environment for the occupants to work, learn, study, etc. Therefore, it is important to ascertain the IAQ status in the buildings. This study is aimed to establish and demonstrate the comprehensive IAQ audit approach for public buildings, based on Portugal national laws. Four public buildings in Portugal are used to demonstrate the IAQ audit application. The systematic approach involves the measurement of physical parameters (temperature, relative humidity, and concentration of the suspended particulate matter), monitoring of the concentrations of selected chemical indicators [carbon dioxide (CO(2)), carbon monoxide, formaldehyde, ozone, and total volatile organic compounds], and the measurements of biological indicators (bacteria and fungi). In addition, air exchange rates are measured by the concentration decay method using metabolic CO(2) as the tracer gas. The comprehensive audits indicated some situations of common IAQ problems in buildings, namely: (1) insufficient ventilation rate, (2) too high particle concentration; and (3) poor filtration effectiveness and hygienic conditions in most of the air handling units. Accordingly, a set of recommendations for the improvement of IAQ conditions were advised to the building owner/managers.

  4. Multidisciplinary Care of Laryngeal Cancer.

    PubMed

    Salvador-Coloma, Carmen; Cohen, Ezra

    2016-08-01

    Treatment of larynx cancer has changed dramatically over the past several years. Novel modalities of treatment have been introduced as organ preservation has been developed. In addition, new targeted therapies have appeared, and improvements in radiotherapeutic and surgical techniques have been introduced. Thus, a large variety of treatment options is increasing local control rates and overall survival; however, selecting the most appropriate treatment remains a challenging decision. This article focuses on the multidisciplinary care of early-stage and locally advanced larynx cancer and attempts to sum up different approaches. Moreover, it reviews state-of-the-art treatment in larynx preservation, which has been consolidated in recent years. PMID:27511718

  5. Tackling the "so what" problem in scientific research: a systems-based approach to resource and publication tracking.

    PubMed

    Harris, Paul A; Kirby, Jacqueline; Swafford, Jonathan A; Edwards, Terri L; Zhang, Minhua; Yarbrough, Tonya R; Lane, Lynda D; Helmer, Tara; Bernard, Gordon R; Pulley, Jill M

    2015-08-01

    Peer-reviewed publications are one measure of scientific productivity. From a project, program, or institutional perspective, publication tracking provides the quantitative data necessary to guide the prudent stewardship of federal, foundation, and institutional investments by identifying the scientific return for the types of support provided. In this article, the authors describe the Vanderbilt Institute for Clinical and Translational Research's (VICTR's) development and implementation of a semiautomated process through which publications are automatically detected in PubMed and adjudicated using a "just-in-time" workflow by a known pool of researchers (from Vanderbilt University School of Medicine and Meharry Medical College) who receive support from Vanderbilt's Clinical and Translational Science Award. Since implementation, the authors have (1) seen a marked increase in the number of publications citing VICTR support, (2) captured at a more granular level the relationship between specific resources/services and scientific output, (3) increased awareness of VICTR's scientific portfolio, and (4) increased efficiency in complying with annual National Institutes of Health progress reports. They present the methodological framework and workflow, measures of impact for the first 30 months, and a set of practical lessons learned to inform others considering a systems-based approach for resource and publication tracking. They learned that contacting multiple authors from a single publication can increase the accuracy of the resource attribution process in the case of multidisciplinary scientific projects. They also found that combining positive (e.g., congratulatory e-mails) and negative (e.g., not allowing future resource requests until adjudication is complete) triggers can increase compliance with publication attribution requests.

  6. Tackling the "so what" problem in scientific research: a systems-based approach to resource and publication tracking.

    PubMed

    Harris, Paul A; Kirby, Jacqueline; Swafford, Jonathan A; Edwards, Terri L; Zhang, Minhua; Yarbrough, Tonya R; Lane, Lynda D; Helmer, Tara; Bernard, Gordon R; Pulley, Jill M

    2015-08-01

    Peer-reviewed publications are one measure of scientific productivity. From a project, program, or institutional perspective, publication tracking provides the quantitative data necessary to guide the prudent stewardship of federal, foundation, and institutional investments by identifying the scientific return for the types of support provided. In this article, the authors describe the Vanderbilt Institute for Clinical and Translational Research's (VICTR's) development and implementation of a semiautomated process through which publications are automatically detected in PubMed and adjudicated using a "just-in-time" workflow by a known pool of researchers (from Vanderbilt University School of Medicine and Meharry Medical College) who receive support from Vanderbilt's Clinical and Translational Science Award. Since implementation, the authors have (1) seen a marked increase in the number of publications citing VICTR support, (2) captured at a more granular level the relationship between specific resources/services and scientific output, (3) increased awareness of VICTR's scientific portfolio, and (4) increased efficiency in complying with annual National Institutes of Health progress reports. They present the methodological framework and workflow, measures of impact for the first 30 months, and a set of practical lessons learned to inform others considering a systems-based approach for resource and publication tracking. They learned that contacting multiple authors from a single publication can increase the accuracy of the resource attribution process in the case of multidisciplinary scientific projects. They also found that combining positive (e.g., congratulatory e-mails) and negative (e.g., not allowing future resource requests until adjudication is complete) triggers can increase compliance with publication attribution requests. PMID:25901872

  7. Tackling the “So What” Problem in Scientific Research: A Systems-Based Approach to Resource and Publication Tracking

    PubMed Central

    Harris, Paul A.; Kirby, Jacqueline; Swafford, Jonathan A.; Edwards, Terri L.; Zhang, Minhua; Yarbrough, Tonya R.; Lane, Lynda D.; Helmer, Tara; Bernard, Gordon R.; Pulley, Jill M.

    2015-01-01

    Peer-reviewed publications are one measure of scientific productivity. From a project, program, or institutional perspective, publication tracking provides the quantitative data necessary to guide the prudent stewardship of federal, foundation, and institutional investments by identifying the scientific return for the types of support provided. In this article, the authors describe the Vanderbilt Institute for Clinical and Translational Research’s (VICTR’s) development and implementation of a semi-automated process through which publications are automatically detected in PubMed and adjudicated using a “just-in-time” workflow by a known pool of researchers (from Vanderbilt University School of Medicine and Meharry Medical College) who receive support from Vanderbilt’s Clinical and Translational Science Award. Since implementation, the authors have: (1) seen a marked increase in the number of publications citing VICTR support; (2) captured at a more granular level the relationship between specific resources/services and scientific output; (3) increased awareness of VICTR’s scientific portfolio; and (4) increased efficiency in complying with annual National Institutes of Health progress reports. They present the methodological framework and workflow, measures of impact for the first 30 months, and a set of practical lessons learned to inform others considering a systems-based approach for resource and publication tracking. They learned that contacting multiple authors from a single publication can increase the accuracy of the resource attribution process in the case of multidisciplinary scientific projects. They also found that combining positive (e.g., congratulatory e-mails) and negative (e.g., not allowing future resource requests until adjudication is complete) triggers can increase compliance with publication attribution requests. PMID:25901872

  8. How Multidisciplinary Are the Multidisciplinary Journals Science and Nature?

    PubMed

    Solomon, Gregg E A; Carley, Stephen; Porter, Alan L

    2016-01-01

    Interest in cross-disciplinary research knowledge interchange runs high. Review processes at funding agencies, such as the U.S. National Science Foundation, consider plans to disseminate research across disciplinary bounds. Publication in the leading multidisciplinary journals, Nature and Science, may signify the epitome of successful interdisciplinary integration of research knowledge and cross-disciplinary dissemination of findings. But how interdisciplinary are they? The journals are multidisciplinary, but do the individual articles themselves draw upon multiple fields of knowledge and does their influence span disciplines? This research compares articles in three fields (Cell Biology, Physical Chemistry, and Cognitive Science) published in a leading disciplinary journal in each field to those published in Nature and Science. We find comparable degrees of interdisciplinary integration and only modest differences in cross-disciplinary diffusion. That said, though the rate of out-of-field diffusion might be comparable, the sheer reach of Nature and Science, indicated by their potent Journal Impact Factors, means that the diffusion of knowledge therein can far exceed that of leading disciplinary journals in some fields (such as Physical Chemistry and Cognitive Science in our samples).

  9. How Multidisciplinary Are the Multidisciplinary Journals Science and Nature?

    PubMed Central

    Solomon, Gregg E. A.; Carley, Stephen; Porter, Alan L.

    2016-01-01

    Interest in cross-disciplinary research knowledge interchange runs high. Review processes at funding agencies, such as the U.S. National Science Foundation, consider plans to disseminate research across disciplinary bounds. Publication in the leading multidisciplinary journals, Nature and Science, may signify the epitome of successful interdisciplinary integration of research knowledge and cross-disciplinary dissemination of findings. But how interdisciplinary are they? The journals are multidisciplinary, but do the individual articles themselves draw upon multiple fields of knowledge and does their influence span disciplines? This research compares articles in three fields (Cell Biology, Physical Chemistry, and Cognitive Science) published in a leading disciplinary journal in each field to those published in Nature and Science. We find comparable degrees of interdisciplinary integration and only modest differences in cross-disciplinary diffusion. That said, though the rate of out-of-field diffusion might be comparable, the sheer reach of Nature and Science, indicated by their potent Journal Impact Factors, means that the diffusion of knowledge therein can far exceed that of leading disciplinary journals in some fields (such as Physical Chemistry and Cognitive Science in our samples). PMID:27043924

  10. NASA's Systems Engineering Approaches for Addressing Public Health Surveillance Requirements

    NASA Technical Reports Server (NTRS)

    Vann, Timi

    2003-01-01

    NASA's systems engineering has its heritage in space mission analysis and design, including the end-to-end approach to managing every facet of the extreme engineering required for successful space missions. NASA sensor technology, understanding of remote sensing, and knowledge of Earth system science, can be powerful new tools for improved disease surveillance and environmental public health tracking. NASA's systems engineering framework facilitates the match between facilitates the match between partner needs and decision support requirements in the areas of 1) Science/Data; 2) Technology; 3) Integration. Partnerships between NASA and other Federal agencies are diagrammed in this viewgraph presentation. NASA's role in these partnerships is to provide systemic and sustainable solutions that contribute to the measurable enhancement of a partner agency's disease surveillance efforts.

  11. [Multidisciplinary therapy of Tourette syndrome].

    PubMed

    Bábel, B Tamás; Németh, Attila; Gádoros, Júlia; Bihari, Katalin

    2003-02-01

    The marked fluctuation in symptoms with a spectrum of behavioral problems contribute to misdiagnosis of Tourette syndrome. The authors review the recent progress in diagnosis and management with an emphasis on multidisciplinary approach. Possible associations with various genes have been found in etiology of Tourette syndrome. Development of the disease comes of dopaminerg neurotransmission disorder resulting in cortico-striato-thalamic system dysfunction. Tics are brief movements or sounds that occur intermittently and unpredictably mimicking fragments of normal behavior. Diagnostic criteria are based on the motor and vocal phenomena and their dynamics. The key concept in management are the tic severity scaling correlating with quality of life measurements. Therapeutic interventions indicated at severe alteration in patient's quality of life. Treatment plan combines various drug protocols, psychotherapy and behavioral therapy which should be optimalized for most disabling symptom. Social isolation and self injurious behavior complicates the treatment resistant, severe cases. In these subgroup of patient, an adequate selection of stereotactic intervention could provide an effective control of tic severity or behavioral disorder. Tourette syndrome, as a typical neuropsychiatric disorder, is a striking example for improved efficacy of multidisciplinary approach.

  12. Preemie abandonment? Multidisciplinary experts consider how to best meet preemies needs at "preterm infants: a collaborative approach to specialized care" roundtable.

    PubMed

    Als, Heidelise; Behrman, Richard; Checchia, Paul; Denne, Scott; Dennery, Phyllis; Hall, Caroline B; Martin, Richard; Panitch, Howard; Schmidt, Barbara; Stevenson, David K; Vila, Linda

    2007-06-01

    In June 2006, the Institute of Medicine (LoM), released a comprehensive study, Preterm Birth: Causes, Consequences, and Prevention. The report was a result of the IoM's efforts, in particular the Committee on Understanding Premature Birth and Assuring Healthy Outcomes, to better understand and prevent preterm birth and improve care for babies born prematurely. After its publication, a group of health care professionals came together in a roundtable session, "Preterm Infants: A Collaborative Approach to Specialized Care," to discuss the implications of the report. The following article captures the group's April 2007 discussion about the clinical and societal problems of preterm birth. It should be of interest to hospital administrators, pediatricians, third-party payers, policy makers, public health officials, academic researchers, funding agencies, allied health professionals, and others with a vested interest in curbing healthcare costs as well as what needs to be understood and done to safeguard the short- and long-term health of a most vulnerable population.

  13. Analysis Approach and Data Package for Mayak Public Doses

    SciTech Connect

    Eslinger, Paul W.; Napier, Bruce A.

    2013-09-18

    Historical activities at facilities producing nuclear materials for weapons released radioactivity into the air and water. Past studies in the United States have evaluated the release, atmospheric transport and environmental accumulation of 131I from the nuclear facilities at Hanford in Washington State and the resulting dose to members of the public (Farris et al. 1994). A multi-year dose reconstruction effort (Mokrov et al. 2004) is also being conducted to produce representative dose estimates for members of the public living near Mayak, Russia, from atmospheric releases of 131I at the facilities of the Mayak Production Association. The approach to calculating individual doses to members of the public from historical releases of airborne 131I has the following general steps: • Construct estimates of releases 131I to the air from production facilities. • Model the transport of 131I in the air and subsequent deposition on the ground and vegetation. • Model the accumulation of 131I in soil, water and food products (environmental media). • Calculate the dose for an individual by matching the appropriate lifestyle and consumption data for the individual to the concentrations of 131I in environmental media at their residence location. A number of computer codes were developed to facilitate the study of airborne 131I emissions at Hanford. Of particular interest is DESCARTES code that modeled accumulation of 131I in environmental media (Miley et al. 1994). In addition, the CIDER computer code estimated annual doses to individuals (Eslinger et al. 1994) using the equations and parameters specific to Hanford (Snyder et al. 1994). Several of the computer codes developed to model 131I releases from Hanford are general enough to be used for other facilities. Additional codes have been developed, including the new individual dose code CiderF (Eslinger and Napier 2013), and applied to historical releases of 131I from Mayak. This document provides a data package that

  14. Novel approaches for inspiring students and electrifying the public

    NASA Astrophysics Data System (ADS)

    Lidström, Suzy; Read, Alex; Parke, Stephen; Allen, Roland; Goldfarb, Steven; Mehlhase, Sascha; Ekelöf, Tord; Walker, Alan

    2014-03-01

    We will briefly summarize a wide variety of innovative approaches for inspiring students and stimulating broad public interest in fundamental physics research, as exemplified by recent activities related to the Higgs boson discovery and Higgs-Englert Nobel Prize on behalf of the Swedish Academy, CERN, Fermilab, and the Niels Bohr Institute. Personal interactions with the scientists themselves can be particularly electrifying, and these were encouraged by the wearing of ``Higgs Boson? Ask Me!'' badges, which will be made available to those attending this talk. At CERN, activities include Virtual Visits, (Google) Hangout with CERN, initiatives to grab attention (LEGO models, music videos, art programs, pins, etc.), substantive communication (lab visits and events, museum exhibits, traveling exhibits, local visits, Masterclasses, etc.), and educational activities (summer student programs, semester abroad programs, internships, graduate programs, etc.). For serious students and their teachers, or scientists in other areas, tutorial articles are appropriate. These are most effective if they also incorporate innovative approaches - for example, attractive figures that immediately illustrate the concepts, analogies that will resonate with the reader, and a broadening of perspective. Physica Scripta, Royal Swedish Academy of Sciences.

  15. Multidisciplinary management of complex care.

    PubMed

    Schofield, Deborah; Fuller, Jeffrey; Wagner, Scott; Friis, Leanne; Tyrell, Bill

    2009-02-01

    Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.

  16. Multidisciplinary Teamwork in Autism: Can One Size Fit All?

    ERIC Educational Resources Information Center

    Dillenburger, Karola; Röttgers, Hanns-Rüdiger; Dounavi, Katerina; Sparkman, Coleen; Keenan, Mickey; Thyer, Bruce; Nikopoulos, Christos

    2014-01-01

    Multidisciplinary practice has become an accepted approach in many education and social and health care fields. In fact, the right to a multidisciplinary assessment is enshrined in the United Nations Convention of the Rights for Persons with Disabilities (United Nations, 2007). In order to avert a "one size fits all" response to…

  17. Multidisciplinary computational aerosciences

    NASA Technical Reports Server (NTRS)

    Kutler, Paul

    1992-01-01

    As the challenges of single disciplinary computational physics are met, such as computational fluid dynamics, computational structural mechanics, computational propulsion, computational aeroacoustics, computational electromagnetics, etc., scientists have begun investigating the combination of these single disciplines into what is being called multidisciplinary computational aerosciences (MCAS). The combination of several disciplines not only offers simulation realism but also formidable computational challenges. The solution of such problems will require computers orders of magnitude larger than those currently available. Such computer power can only be supplied by massively parallel machines because of the current speed-of-light limitation of conventional serial systems. Even with such machines, MCAS problems will require hundreds of hours for their solution. To efficiently utilize such a machine, research is required in three areas that include parallel architectures, systems software, and applications software. The main emphasis of this paper is the applications software element. Examples that demonstrate application software for multidisciplinary problems currently being solved at NASA Ames Research Center are presented. Pacing items for MCAS are discussed such as solution methodology, physical modeling, computer power, and multidisciplinary validation experiments.

  18. Multidisciplinary management for esophageal and gastric cancer.

    PubMed

    Boniface, Megan M; Wani, Sachin B; Schefter, Tracey E; Koo, Phillip J; Meguid, Cheryl; Leong, Stephen; Kaplan, Jeffrey B; Wingrove, Lisa J; McCarter, Martin D

    2016-01-01

    The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical), and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients.

  19. Multidisciplinary management for esophageal and gastric cancer

    PubMed Central

    Boniface, Megan M; Wani, Sachin B; Schefter, Tracey E; Koo, Phillip J; Meguid, Cheryl; Leong, Stephen; Kaplan, Jeffrey B; Wingrove, Lisa J; McCarter, Martin D

    2016-01-01

    The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical), and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. PMID:27217796

  20. Public Relations Writing Needs Multi-Media Approach.

    ERIC Educational Resources Information Center

    Harrison, S. L.

    1989-01-01

    Argues that the public relations and advertising disciplines are inextricably linked and should be related in a cohesive writing sequence. Emphasizes that beginning advertising and public relations students should develop their news writing skills. (MM)

  1. Collaboration, Competencies and the Classroom: A Public Health Approach

    ERIC Educational Resources Information Center

    Waller, Lauren E.; Papadopoulos, Andrew

    2015-01-01

    The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development.…

  2. Large retroperitoneal abscess extended to the inferior right limb secondary to a perforated ileal Crohn’s disease: the importance of the multidisciplinary approach

    PubMed Central

    MASCOLINO, A.; SCERRINO, G.; GULLO, R.; GENOVA, C.; MELFA, G.I.; RASPANTI, C.; FONTANA, T.; FALCO, N.; PORRELLO, C.; GULOTTA, G.

    2016-01-01

    The typical complications of Crohn’s disease concerns small and large bowel. The full thickness inflammation of the intestinal wall develops in strictures, fistulas and abdominal abscesses. Nowadays the most accepted therapeutic for intra-abdominal abscess option is antibiotic therapy and, in case of need, percutaneous drainage of the abscess. If the abscess passes through the pelvic foramen the abscess can involve the inferior limbs. We report a case a perforation of terminal ileum in Crohn’s disease complicated by a large abscess of the right iliac fossa reaching the spaces between the anterior lateral muscles of the right thigh as far as the anterior lateral pre-tibial region. We discuss the diagnostic and therapeutic options in a multidisciplinary context. PMID:27142824

  3. Multidisciplinary approach to the treatment of a patient with chondrodystrophic myotonia (Schwartz-Jampel vel Aberfeld syndrome): case report and literature review.

    PubMed

    Nessler, Michal; Puchala, Jacek; Kwiatkowski, Stanislaw; Kobylarz, Krzysztof; Mojsa, Izabela; Chrapusta-Klimeczek, Anna

    2011-09-01

    Chondrodystrophic myotonia, Schwartz-Jampel syndrome, is a rare congenital disorder, which results from disturbance in a perlecan protein synthesis. Most affected are the muscles, acting in generalized myotonia, leading to joint contractures, weird-looking mask-like face appearance, and causing vision disturbances. Also, impaired bones and cartilages result in skeletal anomalies and dental disorders. Allergic reactions to numerous drugs occur in affected individuals. Surgical treatment is risky, due to a low tolerance of anesthetics and high risk of malignant hyperthermia. In this article, a case of 17-year-old girl with Schwartz-Jampel syndrome is presented. The patient with typical syndrome debilitations underwent long diagnostic scheme and multiple treatments in order to restore acceptable appearance and function. All procedures were performed with cautious anesthesiologists' supervision. Modern diagnostic tools can improve the diagnosis rate while multidisciplinary evaluation and advanced treatment techniques can reveal symptoms, minimizing the hazard of anesthesia and improving the quality of life.

  4. Active upper crust deformation pattern along the southern edge of the Tyrrhenian subduction zone (NE Sicily): Insights from a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Palano, Mimmo; Schiavone, Domenico; Loddo, Mariano; Neri, Marco; Presti, Debora; Quarto, Ruggiero; Totaro, Cristina; Neri, Giancarlo

    2015-08-01

    Using a multidisciplinary dataset based on gravimetric, seismic, geodetic and geological observations, we provide an improved picture of the shallow structure and dynamics of the southern edge of the Tyrrhenian subduction zone. With a local earthquake tomography we clearly identify two main crustal domains in the upper 15 km characterized by different P-wave velocity values: a high-velocity domain comprising southeasternmost Tyrrhenian Sea, NE Sicily and Messina Straits, and a low-velocity domain comprising Mt. Etna and eastern Sicily. The transition between the two domains shows a good spatial correspondence with a wider set of faults including the Taormina Fault System (TFS) and the Aeolian-Tindari-Letojanni Fault System (ATLFS), two nearly SE-striking fault systems crossing northeastern Sicily and ending on the Ionian shoreline of Sicily according to many investigators. Within this set of faults, most of the deformation/seismicity occurs along the northern and central segments of ATLFS, compared to low activity along TFS. A lack of seismicity (both recent and historical) is observed in the southern sector of ATLFS where, however, geodetic data reveal significant deformation. Our multidisciplinary dataset including offshore observations suggests the southeastward continuation of the ATLFS into the Ionian Sea until joining with the faults cutting the Ionian accretionary wedge described in the recent literature. Our findings imply the existence of a highly segmented crustal shear zone extending from the Aeolian Islands to the Ionian Abyssal plain, that we believe plays the role of accommodating differential motion between the Southern Tyrrhenian unit and the western compressional domain of Sicily. The ATLFS, which is a main part of the inferred shear zone, behaves similarly to what often observed at the edges of retreating subduction slabs, where the overriding plate drifts with a highly non-uniform transform motion along the lateral borders.

  5. A Cultural Approach to Public Relations Research: An Extension of Hofstede's Variables to Grunig's Models of Public Relations.

    ERIC Educational Resources Information Center

    Vasquez, Gabriel M.; Taylor, Maureen

    A pilot study internationalized an existing set of four models of public relations and field tested an instrument that represents a cultural approach to public relations practice. The instrument is based on a combination and extension of G. Hofstede's views of culture as mental programs comprised of values about power, distance, uncertainty…

  6. Approaches to organizing public relations functions in healthcare.

    PubMed

    Guy, Bonnie; Williams, David R; Aldridge, Alicia; Roggenkamp, Susan D

    2007-01-01

    This article provides health care audiences with a framework for understanding different perspectives of the role and functions of public relations in healthcare organizations and the resultant alternatives for organizing and enacting public relations functions. Using an example of a current issue receiving much attention in US healthcare (improving rates of organ donation), the article provides examples of how these different perspectives influence public relations goals and objectives, definitions of 'public', activities undertaken, who undertakes them and where they fit into the organizational hierarchy.

  7. A consensus-based approach to national public health accreditation.

    PubMed

    Ingram, Richard C; Bender, Kaye; Wilcox, Robin; Kronstadt, Jessica

    2014-01-01

    The Public Health Accreditation Board (PHAB) solicited (and continues to solicit) the input of more than 400 subject matter experts in various areas of public health during the development and ongoing revision of the accreditation standards and measures. This process is designed to ensure that the standards and measures remain relevant and accommodate the various contexts under which public health departments practice in the United States. One way PHAB gathers feedback is convening a series of discussion meetings, or think tanks, with thought leaders in specific areas of public health, that focus on specific programmatic areas of public health, on the broader context of public health practice, or on emerging issues, such as public health informatics. The think tanks complement other mechanisms to assure that standards and measures are relevant, including gathering input from the practice community, receiving recommendations from public health departments that have undergone the accreditation process, and reviewing relevant literature. While this process allows PHAB to demonstrate its commitment to continuous quality improvement by modifying and improving the standards and measures, it also serves as a communication vehicle for PHAB to educate thought leaders and public health practitioners about the national accreditation program.

  8. Approaches to organizing public relations functions in healthcare.

    PubMed

    Guy, Bonnie; Williams, David R; Aldridge, Alicia; Roggenkamp, Susan D

    2007-01-01

    This article provides health care audiences with a framework for understanding different perspectives of the role and functions of public relations in healthcare organizations and the resultant alternatives for organizing and enacting public relations functions. Using an example of a current issue receiving much attention in US healthcare (improving rates of organ donation), the article provides examples of how these different perspectives influence public relations goals and objectives, definitions of 'public', activities undertaken, who undertakes them and where they fit into the organizational hierarchy. PMID:19042525

  9. A Unique Pedagogical Approach to Voting and Public Goods

    ERIC Educational Resources Information Center

    Schuler, Douglas A.; Chappell, Matthew; Baggett, L. Scott

    2010-01-01

    Fourth grade students at a public elementary school in Houston, Texas, participated in a one-week exercise intended to mimic the process of creating a public good through a democratic process. The exercise involved students in four separate classes designing a class party with different characteristics (theme, music, and food) through a voluntary…

  10. High Touch: PR. Practical Approaches to Public Relations.

    ERIC Educational Resources Information Center

    Keefe, Betty; And Others

    1986-01-01

    This article relates tried, tested, and successful public relations programs in use at school library media centers. A four-step process for developing a suitable public relations program (research, planning, action, and evaluation) and programs that focus on communicating with school staff, administrators, parents, and the community are…

  11. Enhancing the Public Image of School Counseling: A Marketing Approach.

    ERIC Educational Resources Information Center

    Ritchie, Martin H.

    1989-01-01

    Suggests some basic marketing principles that might be applied to assist school counselors in selling their guidance programs to the public. Discusses assessing the needs and demands for guidance services, product development and defining the guidance program, pricing, distribution, and advertising and public relations. (NB)

  12. An Informatics Approach to Establishing a Sustainable Public Health Community

    ERIC Educational Resources Information Center

    Kriseman, Jeffrey Michael

    2012-01-01

    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  13. Experiences of Ethnobotanists with Publication: A First Approach

    ERIC Educational Resources Information Center

    Albuquerque, Ulysses P.; Ramos, Marcelo A.; Medeiros, Maria F. T.

    2011-01-01

    Writing and publishing scientific works are crucial parts of any scientist's career. Therefore, it is important, especially for those new to the process, to understand how to navigate the publication process. This study was designed to investigate the publication process in ethnobotany and to stimulate discussion among authors, reviewers, and…

  14. GRC RBCC Concept Multidisciplinary Analysis

    NASA Technical Reports Server (NTRS)

    Suresh, Ambady

    2001-01-01

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

  15. Multidisciplinary rehabilitation for chronic low back pain: systematic review

    PubMed Central

    Guzmán, Jaime; Esmail, Rosmin; Karjalainen, Kaija; Malmivaara, Antti; Irvin, Emma; Bombardier, Claire

    2001-01-01

    multidisciplinary rehabilitation for chronic pain were open to bias and did not include any of the randomised controlled trials now availableWhat this study addsIntensive, daily biopsychosocial rehabilitation with a functional restoration approach improves pain and function in chronic low back painLess intensive interventions did not show improvements in clinically relevant outcomesIt is unclear whether the improvements are worth the cost of these intensive treatments PMID:11420271

  16. A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

    PubMed Central

    Procter, Susan; Brooks, Fiona; Wilson, Patricia; Crouchman, Carolyn; Kendall, Sally

    2015-01-01

    Aim To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice. Background The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This paper identifies the potential of school nursing to provide the vision and multiagency leadership required to coordinate multidisciplinary collaboration. Method A mixed-method single-case study design using Yin’s approach, including focus groups, interviews, and analysis of policy documents and public health reports. Results A model that explains the integrated population approach to managing school-age asthma is described; the role of the lead school nurse coordinator was seen as critical to the development and sustainability of the model. Conclusion School nurses can provide strategic multidisciplinary leadership to address pressing public health issues. Health service managers and commissioners need to understand how to support clinicians working across multiagency boundaries and to identify how to develop leadership skills for collaborative interprofessional practice so that the capacity for nursing and other health care professionals to address public health issues does not rely on individual motivation. In England, this will be of particular importance to the commissioning of public health services by local authorities from 2015. PMID:25914542

  17. Multidisciplinary survey of erectile impotence.

    PubMed Central

    Collins, W. E.; McKendry, J. B.; Silverman, M.; Krul, L. E.; Collins, J. P.; Irvine, A. H.

    1983-01-01

    A study was done of 220 men referred principally by family physicians to a multidisciplinary erectile dysfunction study group to determine the factors causing or contributing to impotence that had persisted for more than 2 months and for which no cause was apparent. The men were aged 21 to 79 (mean 50.3) years, and the duration of impotence was a few months to 15 years (mean 2.65 years). The men were to be assessed from general medical, endocrinologic/metabolic, psychiatric and urogenital viewpoints. The significance of the causal or contributory factors detected was scored by application of defined criteria and a four-point scale. The degree of loss of potency and of libido as well as level of concern were also scored by each specialist. Impotence was complete in 60%, and an associated decline in libido was reported by 38%. The level of concern was high--that is, normal--in 81% and slightly reduced in 9%. Full investigation by all the specialists was precluded by the severity of other conditions in 16 patients, by the return of potency following relief of anxiety/depression or genitourinary tract infection in 16 and for logistic or other reasons in 34. Although the cause of the impotence could be attributed in 186 of the patients, only 154 were fully assessed. Among these patients general medical factors were contributory in 46%, endocrinologic/metabolic factors in 44%, psychogenic factors (primary or secondary) in 60% and urogenital factors in 49%. Multiple contributing factors were identified in 65%, which underscores the importance of a multidisciplinary approach to assessing many cases of impotence. PMID:6850465

  18. How the "Public Relations Journal" Responds to Criticism of Public Relations Ethics: A Qualitative Approach.

    ERIC Educational Resources Information Center

    Olasky, Marvin N.

    A quantitative analysis of 40 years of articles appearing in the "Public Relations Journal" was made to determine how the journal has responded to ethical criticism of public relations over the years. While 17% of the articles during one eight-year period discussed questions touching on ethics in some way, quantitative analytical tools did not…

  19. Selection of an Online Public Access Catalog: A Checklist Approach.

    ERIC Educational Resources Information Center

    O'Rourke, Victoria

    1987-01-01

    The development, field testing, and evaluation of a checklist approach to selecting an integrated library automation system are described, and recommendations for using this approach are outlined. The checklist, which is divided into five main sections of catalog features and functions, is appended. (Author/CLB)

  20. [Multidisciplinary treatment of locally advanced rectal cancer].

    PubMed

    Faes, Seraina; Gié, Olivier; Demartines, Nicolas; Hahnloser, Dieter

    2016-06-15

    Treatment of patients with locally advanced rectal cancer remains challenging. Preoperative imaging with pelvic MRI allows to identify patients for multimodal treatment including induction chemothe- rapy or neoadjuvant radio-chemotherapy and an extended surgical resection. With multidisciplinary approach and an experienced team, excellent oncologic results may be achieved, as well as a good function and quality of life, even with preservation of the anus in the majority of patients. PMID:27487624

  1. A public goods approach to major evolutionary innovations.

    PubMed

    Erwin, D H

    2015-07-01

    The history of life is marked by a small number of major transitions, whether viewed from a genetic, ecological, or geological perspective. Specialists from various disciplines have focused on the packaging of information to generate new evolutionary individuals, on the expansion of ecological opportunity, or the abiotic drivers of environmental change to which organisms respond as the major drivers of these episodes. But the critical issue for understanding these major evolutionary transitions (METs) lies in the interactions between environmental, ecologic, and genetic change. Here, I propose that public goods may serve as one currency of such interactions: biological products that are non-excludable and non-rivalrous. Such biological public goods may be involved in either the generation of new evolutionary variation, as with genetic sequences that are easily transferred between different microbial lineages, or in the construction of new ecological niches, as with the progressive oxygenation of the oceans and atmosphere. Attention to public goods emphasizes the processes by which organisms actively construct their own evolutionary opportunities. Such public goods may have facilitated some METs.

  2. Submarine Landslides: A Multidisciplinary Crossroad

    NASA Astrophysics Data System (ADS)

    Moscardelli, L. G.

    2014-12-01

    The study of submarine landslides has advanced considerably in the last decade. A multitude of geoscience disciplines, including marine, petroleum and planetary geology, as well as geohazard assessments, are concerned with the study of these units. Oftentimes, researchers working in these fields disseminate their findings within their own communities and a multidisciplinary approach seems to lack. This presentation showcases several case studies in which a broader approach has increased our understanding of submarine landslides in a variety of geologic settings. Three-dimensional seismic data from several continental margins (Trinidad, Brazil, Morocco, Canada, GOM), as well as data from outcrop localities are shown to explore geomorphological complexities associated with submarine landslides. Discussion associated with the characterization and classification of submarine landslides is also part of this work. Topics that will be cover include: 1) how data from conventional oil and gas exploration activities can be used to increase our understanding of the dynamic behavior of submarine landslides, 2) analogies between terrestrial submarine landslides and potential Martian counterparts, 3) impact of submarine landslides in margin construction, as well as their economic significance and 4) the importance of quantifying the morphology of submarine landslides in a systematic fashion.

  3. Evaluating the effectiveness of public meetings and workshops: A new approach for improving DOE public involvement

    SciTech Connect

    Young, C.; Williams, G.; Goldberg, M.

    1993-07-01

    Although public participation in the environmental cleanup process has been ongoing in the US Department of Energy (DOE) for some time, little if any evaluation of these efforts to include the public has taken place. This report contains the results of an evaluation of six regional workshops and meetings. These meetings and workshops focused on the implementation plan for the programmatic environmental impact statement on DOE`s environmental cleanup efforts. The formats of the workshops and meetings differed from typical public meetings by offering more opportunity for interaction between agency personnel and the public, using impartial facilitators, and including more elaborate promotional strategies than notification in the Federal Register. Questionnaires and focus groups were used to solicit participants` perspectives on the meetings.

  4. A New Approach to Data Publication in Ocean Sciences

    NASA Astrophysics Data System (ADS)

    Lowry, Roy; Urban, Ed; Pissierssens, Peter

    2009-12-01

    Data are collected from ocean sciences activities that range from a single investigator working in a laboratory to large teams of scientists cooperating on big, multinational, global ocean research projects. What these activities have in common is that all result in data, some of which are used as the basis for publications in peer-reviewed journals. However, two major problems regarding data remain. First, many data valuable for understanding ocean physics, chemistry, geology, biology, and how the oceans operate in the Earth system are never archived or made accessible to other scientists. Data underlying traditional journal articles are often difficult to obtain. Second, when scientists do contribute data to databases, their data become freely available, with little acknowledgment and no contribution to their career advancement. To address these problems, stronger ties must be made between data repositories and academic journals, and a “digital backbone” needs to be created for data related to journal publications.

  5. Social scientists in public health: a fuzzy approach.

    PubMed

    do Nascimento, Juliana Luporini; Stephan, Celso; Nunes, Everardo Duarte

    2015-05-01

    This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

  6. Public and political issues in HLW management: The Spanish approach

    SciTech Connect

    Gonzalez, V.; Molina, M.

    1993-12-31

    ENRESA (Empresa Nacional de Residuos Radiactivos, S.A.), is a State-owned company, founded in 1985 and is responsible for radioactive waste management in Spain. ENRESA`s activities are carried out in accordance with a General Radioactive Waste Plant approved by the Spanish Government. In Spain, as in most countries, the public is concerned about many of the activities involving radioactive or rad-waste management; this concern arises for different reasons, but mainly due to lack of information on the matter. This situation leads to the information available being misused by certain politicians, green groups and media, which serves to increase the distrust with which the public sometimes views responsible companies and institutions. At the root of both these problems is a lack of political consensus regarding development of the activity. To gain public acceptance, it would be necessary to develop a long-term information policy, since in the field of communications results are only ever achieved in the long term. ENRESA is carrying out an on-going Communication Plan (CP), implemented successfully in the areas surrounding a low- and intermediate-level waste disposal site and a disused uranium mill in which remedial actions are currently being performed. Implementation of this plan at national level is being accomplished stepwise. This document deals with the most relevant issues relating to the radioactive waste situation in Spain and with the efforts made in communications.

  7. An integrated public health and criminal justice approach to gangs: What can research tell us?

    PubMed

    Gebo, Erika

    2016-12-01

    There has been a call to better link public health and criminal justice approaches to best address crime problems generally, and youth and gang violence in particular. Importantly, there has yet to be a systematic examination of how criminal justice approaches can be integrated within a public health framework. This paper examines the strengths and challenges with mapping gang research and evidence-informed practices onto a public health approach. Conceptual examination reveals benefits to utilizing an integrated framework, but it also exposes core problems with identification and prediction of gang joining and gang membership. The gang label as a master status is called into question. It is argued that a public health framework can inform public policy approaches as to when the focus should be youth violence versus gangs and gang violence. PMID:27547719

  8. Adopting public health approaches to communication disability: challenges for the education of speech-language pathologists.

    PubMed

    Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Law, James

    2014-01-01

    Public health approaches to communication disability challenge the profession of speech-language pathology (SLP) to reconsider both frames of reference for practice and models of education. This paper reviews the impetus for public health approaches to communication disability and considers how public health is, and could be, incorporated into SLP education, both now and in the future. The paper describes tensions between clinical services, which have become increasingly specialized, and public health approaches that offer a broader view of communication disability and communication disability prevention. It presents a discussion of these tensions and asserts that public health approaches to communication are themselves a specialist field, requiring specific knowledge and skills. The authors suggest the use of the term 'communication disability public health' to refer to this type of work and offer a preliminary definition in order to advance discussion. Examples from three countries are provided of how some SLP degree programmes are integrating public health into the SLP curriculum. Alternative models of training for communication disability public health that may be relevant in the future in different contexts and countries are presented, prompting the SLP profession to consider whether communication disability public health is a field of practice for speech-language pathologists or whether it has broader workforce implications. The paper concludes with some suggestions for the future which may advance thinking, research and practice in communication disability public health.

  9. Multidisciplinary System Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Mahadevan, Sankaran; Han, Song; Chamis, Christos C. (Technical Monitor)

    2001-01-01

    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 Glenn 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 multidisciplinary 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.

  10. Multidisciplinary Assessment and Treatment of Self-Injurious Behavior in Autism Spectrum Disorder and Intellectual Disability: Integration of Psychological and Biological Theory and Approach

    ERIC Educational Resources Information Center

    Minshawi, Noha F.; Hurwitz, Sarah; Morriss, Danielle; McDougle, Christopher J.

    2015-01-01

    The objective of this review is to consider the psychological (largely behavioral) and biological [neurochemical, medical (including genetic), and pharmacological] theories and approaches that contribute to current thinking about the etiology and treatment of self-injurious behavior (SIB) in individuals with autism spectrum disorder and/or…

  11. Multidisciplinary Optimization Methods for Aircraft Preliminary Design

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  12. A Public Health Approach to Prevention: What Will It Take?

    PubMed

    Daro, Deborah

    2016-10-01

    Much of the fabric in today's society is at odds with planning a robust and generative public health response to child maltreatment prevention. A critical component of this problem is the absence of a public policy framework and related infrastructure that can create common ownership of the problem while recognizing the vast differences in individual willingness and capacity to alter their parenting behaviors. To address this challenge, it seems prudent to begin building a universal system of assessment and support that will touch all children and all families at multiple points in the developmental process. Such a system would not simply identify those at highest risk. Rather this system would be built on the premise that all parents have issues and concerns and differ only in the extent to which they have the capacity to address these issues. This commentary outlines the key elements of such a system and its benefits in strengthening both the impacts of interventions and the collective will to support all children. PMID:27580667

  13. Public Housing: A Tailored Approach to Energy Retrofits

    SciTech Connect

    Dentz, J.; Conlin, F.; Podorson, D.; Alaigh, K.

    2014-06-01

    Over one million HUD-supported public housing units provide rental housing for eligible low-income families across the country. A survey of over 100 PHAs across the country indicated that there is a high level of interest in developing low cost solutions that improve energy efficiency and can be seamlessly included in the refurbishment process. Further, PHAs, have incentives (both internal and external) to reduce utility bills. ARIES worked with two public housing authorities (PHAs) to develop packages of energy efficiency retrofit measures the PHAs can cost effectively implement with their own staffs in the normal course of housing operations at the time when units are refurbished between occupancies. The energy efficiency turnover protocols emphasized air infiltration reduction, duct sealing and measures that improve equipment efficiency. ARIES documented implementation in ten housing units. Reductions in average air leakage were 16-20% and duct leakage reductions averaged 38%. Total source energy consumption savings was estimated at 6-10% based on BEopt modeling with a simple payback of 1.7 to 2.2 years. Implementation challenges were encountered mainly related to required operational changes and budgetary constraints. Nevertheless, simple measures can feasibly be accomplished by PHA staff at low or no cost. At typical housing unit turnover rates, these measures could impact hundreds of thousands of unit per year nationally.

  14. Public Housing: A Tailored Approach to Energy Retrofits

    SciTech Connect

    Dentz, Jordan; Conlin, Francis; Podorson, David; Alaigh, Kunal

    2014-06-01

    More than 1 million HUD-supported public housing units provide rental housing for eligible low-income families across the country. A survey of over 100 public housing authorities (PHAs) across the country indicated that there is a high level of interest in developing low-cost solutions that improve energy efficiency and can be seamlessly included in the refurbishment process. Further, PHAs, have incentives (both internal and external) to reduce utility bills. ARIES worked with two PHAs to develop packages of energy efficiency retrofit measures the PHAs can cost effectively implement with their own staffs in the normal course of housing operations when units are refurbished between occupancies. The energy efficiency turnover protocols emphasized air infiltration reduction, duct sealing and measures that improve equipment efficiency. ARIES documented implementation 10 ten housing units. Total source energy consumption savings was estimated at 6%-10% based on BEopt modeling with a simple payback of 1.7 to 2.2 years. At typical housing unit turnover rates, these measures could impact hundreds of thousands of units per year nationally.

  15. A Public Health Approach to Prevention: What Will It Take?

    PubMed

    Daro, Deborah

    2016-10-01

    Much of the fabric in today's society is at odds with planning a robust and generative public health response to child maltreatment prevention. A critical component of this problem is the absence of a public policy framework and related infrastructure that can create common ownership of the problem while recognizing the vast differences in individual willingness and capacity to alter their parenting behaviors. To address this challenge, it seems prudent to begin building a universal system of assessment and support that will touch all children and all families at multiple points in the developmental process. Such a system would not simply identify those at highest risk. Rather this system would be built on the premise that all parents have issues and concerns and differ only in the extent to which they have the capacity to address these issues. This commentary outlines the key elements of such a system and its benefits in strengthening both the impacts of interventions and the collective will to support all children.

  16. [Tokophobia--a multidisciplinary problem].

    PubMed

    Billert, Hanna

    2007-10-01

    Pathological fear of childbirth known as "tokophobia" affects about 6-10% pregnancies and is of concern mainly because of remarkable sequele regarding women's morbidity, the neurobehavioral development of their children, and cesarean section on maternal request (CSMR). Fear of labor is a multidimensional problem involving a number of biological, psychological and social background factors and may be divided into primary and secondary tokophobia and tokophobia as a symptom of depression. Fear of childbirth is closely related to the fear of labor pain. It appears that women who experience fear, suffer from more pain due to alterations in the mechanisms of pregnancy induced analgesia. Despite no relevant connection between tokophobia and request for effective analgesia for labor pain relief, neuraxial techniques should always be available, especially to women with increased levels of negative emotions. However, epidural analgesia itself may increase fear level at the end and after labor and delivery. The mainstay of tokphobia treatment constitutes psychotherapeutic methods, which decrease negative labor experience; their impact on CSMR is controversial. There is a strong need for multidisciplinary approach to tokophobia due to its complexity and obstetric, anesthesiological, psychological and psychiatric implications.

  17. Multidisciplinary Management of Laryngeal Carcinoma

    SciTech Connect

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

    2007-10-01

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

  18. Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?

    PubMed Central

    Lorgelly, Paula K.; Lawson, Kenny D.; Fenwick, Elisabeth A.L.; Briggs, Andrew H.

    2010-01-01

    Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure. PMID:20623024

  19. Teaching the extracellular matrix and introducing online databases within a multidisciplinary course with i-cell-MATRIX: A student-centered approach.

    PubMed

    Sousa, João Carlos; Costa, Manuel João; Palha, Joana Almeida

    2010-03-01

    The biochemistry and molecular biology of the extracellular matrix (ECM) is difficult to convey to students in a classroom setting in ways that capture their interest. The understanding of the matrix's roles in physiological and pathological conditions study will presumably be hampered by insufficient knowledge of its molecular structure. Internet-available resources can bridge the division between the molecular details and ECM's biological properties and associated processes. This article presents an approach to teach the ECM developed for first year medical undergraduates who, working in teams: (i) Explore a specific molecular component of the matrix, (ii) identify a disease in which the component is implicated, (iii) investigate how the component's structure/function contributes to ECM' supramolecular organization in physiological and in pathological conditions, and (iv) share their findings with colleagues. The approach-designated i-cell-MATRIX-is focused on the contribution of individual components to the overall organization and biological functions of the ECM. i-cell-MATRIX is student centered and uses 5 hours of class time. Summary of results and take home message: A "1-minute paper" has been used to gather student feedback on the impact of i-cell-MATRIX. Qualitative analysis of student feedback gathered in three consecutive years revealed that students appreciate the approach's reliance on self-directed learning, the interactivity embedded and the demand for deeper insights on the ECM. Learning how to use internet biomedical resources is another positive outcome. Ninety percent of students recommend the activity for subsequent years. i-cell-MATRIX is adaptable by other medical schools which may be looking for an approach that achieves higher student engagement with the ECM.

  20. 76 FR 60505 - Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research, Approach to... notice of public workshop published in the Federal Register of July 28, 2011 (76 FR 45268). In that... Research to addressing drug shortages. FDA is opening a comment period in light of public interest in...

  1. A Process Approach to Public Speaking: The Use of Exercises and Games.

    ERIC Educational Resources Information Center

    Berryman, Cynthia L.

    The use of exercises and games in teaching the process of public speaking provides a novel and effective approach for teacher and student. This paper justifies a process orientation to public-speaking instruction and offers practical exercises, games, and activities for teaching the major rhetorical aspects involved in the process of public…

  2. Educating Masters of Public Health Students on Tobacco Control and Prevention: An Integrated Curriculum Approach

    ERIC Educational Resources Information Center

    Lowe, John; Aquilino, Mary; Abramsohn, Erin

    2007-01-01

    Objectives: Comprehensive training in the area of tobacco control and prevention has not been available to public health students receiving professional degrees. This study describes findings of a project designed to develop and evaluate an integrated approach to the education of Masters of Public Health (MPH) students at the University of Iowa…

  3. Dealing with an Angry Public: The Mutual Gains Approach to Resolving Disputes.

    ERIC Educational Resources Information Center

    Susskind, Lawrence; Field, Patrick

    Public anger is a typical reaction to governments' or companies' attempts to cover up mistakes, conceal evidence of risks, make misleading statements, or lie. Many times, this anger leads to an entrenched resistance to public or private initiatives. Ways in which this resistance can be overcome by a mutual gains approach, which involves…

  4. Open Systems Approach--Can It Work for Public School Organizations?

    ERIC Educational Resources Information Center

    Wolfe, A. E.

    The problem of public school education in today's environment is presented, and a case is made for restructuring public school organizations and/or management processes along the pattern of an open systems approach. The closed system of operating allows externalities to impact on it, and there is a continuing emphasis on reacting. With the benefit…

  5. Vocational Rehabilitation Operations Within a Prison System: One Approach to Serving the Mentally Retarded Public Offender.

    ERIC Educational Resources Information Center

    Phelps, William R.

    The purpose of this paper is to present one approach to providing vocational rehabilitation for the mentally retarded public offender. The rehabilitation process for prison inmates is described, one southeastern state program is reviewed from an operational point of view, and some traits and characteristics of the mentally retarded public offender…

  6. "Carbon in Underland": A multidisciplinary approach to producing an informative animated video for the Center for Nanoscale Control of Geological CO2

    NASA Astrophysics Data System (ADS)

    Molins, S.; Cappuccio, J. A.; Berry, I.; Miller, J.; Bourg, I. C.; Kelly, L. M.

    2011-12-01

    As part of the 'Science for Our Nation's Energy Future, Summit and Forum', each of the 46 Energy Frontier Research Centers (EFRCs) created in 2009 by the US Department of Energy was invited to design a short, engaging film with the central goal to educate, inspire, and entertain an intelligent but not expert audience about the extraordinary science, innovation and people in their center. The Center for Nanoscale Control of Geological CO2 (NCGC) is an EFRC that is building a next generation understanding of molecular-to-pore-scale processes critical to controlling the flow,transport, and ultimate mineralization in porous rock media, in particular as applied to geologic sequestration of CO2. In response to the invitation, the NCGC assembled a team that included several young scientists, the Center project manager, and members from the Public Affairs and Creative Services Office of the Lawrence Berkeley National Laboratory with the objective of preparing a submission. A videographer from the Creative Services Office was responsible for overall management including production, art direction, and editing, while scientists from the Center were responsible for scientific content and original storyline concept. The Center project manager facilitated the communication between team members. A group of scientists together with the project manager developed the original idea, which was refined and given shape as a script in dialogue form by a science writer from Public Affairs. The objective was to communicate scientific content in an entertaining manner with a simple storyline. In a second phase, the script was revised further by scientists for content. Clips from experiments and modeling simulations were requested from the Center's scientists to illustrate the scientific content. Video production and animation were done by the videographer and an animator in an iterative process that involve feedback from the Center team. The final cut was edited to meet the maximum length

  7. Including the public in pandemic planning: a deliberative approach

    PubMed Central

    2010-01-01

    Background Against a background of pandemic threat posed by SARS and avian H5N1 influenza, this study used deliberative forums to elucidate informed community perspectives on aspects of pandemic planning. Methods Two deliberative forums were carried out with members of the South Australian community. The forums were supported by a qualitative study with adults and youths, systematic reviews of the literature and the involvement of an extended group of academic experts and policy makers. The forum discussions were recorded with simultaneous transcription and analysed thematically. Results Participants allocated scarce resources of antiviral drugs and pandemic vaccine based on a desire to preserve society function in a time of crisis. Participants were divided on the acceptability of social distancing and quarantine measures. However, should such measures be adopted, they thought that reasonable financial, household and psychological support was essential. In addition, provided such support was present, the participants, in general, were willing to impose strict sanctions on those who violated quarantine and social distancing measures. Conclusions The recommendations from the forums suggest that the implementation of pandemic plans in a severe pandemic will be challenging, but not impossible. Implementation may be more successful if the public is engaged in pandemic planning before a pandemic, effective communication of key points is practiced before and during a pandemic and if judicious use is made of supportive measures to assist those in quarantine or affected by social isolation measures. PMID:20718996

  8. Benchmarking Gas Path Diagnostic Methods: A Public Approach

    NASA Technical Reports Server (NTRS)

    Simon, Donald L.; Bird, Jeff; Davison, Craig; Volponi, Al; Iverson, R. Eugene

    2008-01-01

    Recent technology reviews have identified the need for objective assessments of engine health management (EHM) technology. The need is two-fold: technology developers require relevant data and problems to design and validate new algorithms and techniques while engine system integrators and operators need practical tools to direct development and then evaluate the effectiveness of proposed solutions. This paper presents a publicly available gas path diagnostic benchmark problem that has been developed by the Propulsion and Power Systems Panel of The Technical Cooperation Program (TTCP) to help address these needs. The problem is coded in MATLAB (The MathWorks, Inc.) and coupled with a non-linear turbofan engine simulation to produce "snap-shot" measurements, with relevant noise levels, as if collected from a fleet of engines over their lifetime of use. Each engine within the fleet will experience unique operating and deterioration profiles, and may encounter randomly occurring relevant gas path faults including sensor, actuator and component faults. The challenge to the EHM community is to develop gas path diagnostic algorithms to reliably perform fault detection and isolation. An example solution to the benchmark problem is provided along with associated evaluation metrics. A plan is presented to disseminate this benchmark problem to the engine health management technical community and invite technology solutions.

  9. Multidisciplinary approach for the study of an Egyptian coffin (late 22nd/early 25th dynasty): combining imaging and spectroscopic techniques.

    PubMed

    Bracci, S; Caruso, O; Galeotti, M; Iannaccone, R; Magrini, D; Picchi, D; Pinna, D; Porcinai, S

    2015-06-15

    This paper demonstrates that an educated methodology based on both non-invasive and micro invasive techniques in a two-step approach is a powerful tool to characterize the materials and stratigraphies of an Egyptian coffin, which was restored several times. This coffin, belonging to a certain Mesiset, is now located at the Museo Civico Archeologico of Bologna (inventory number MCABo EG 1963). Scholars attributed it to the late 22nd/early 25th dynasty by stylistic comparison. The first step of the diagnostic approach applied imaging techniques on the whole surface in order to select measurements spots and to unveil both original and restored areas. Images and close microscopic examination of the polychrome surface allowed selecting representative areas to be investigated in situ by portable spectroscopic techniques: X-ray Fluorescence (XRF), Fiber Optic Reflectance Spectroscopy (FORS) and Fourier Transform Infrared spectroscopy (FTIR). After the analysis of the results coming from the first step, very few selected samples were taken to clarify the stratigraphy of the polychrome layers. The first step, based on the combination of imaging and spectroscopic techniques in a totally non-invasive modality, is quite unique in the literature on Egyptian coffins and enabled us to reveal many differences in the ground layer's composition and to identify a remarkable number of pigments in the original and restored areas. This work offered also a chance to check the limitations of the non-invasive approach applied on a complex case, namely the right localization of different materials in the stratigraphy and the identification of binding media. Indeed, to dissolve any remaining doubts on superimposed layers belonging to different interventions, it was necessary to sample few micro-fragments in some selected areas and analyze them prepared as cross-sections. The original ground layer is made of calcite, while the restored areas show the presence of either a mixture of calcite

  10. Multidisciplinary approach for the study of an Egyptian coffin (late 22nd/early 25th dynasty): combining imaging and spectroscopic techniques.

    PubMed

    Bracci, S; Caruso, O; Galeotti, M; Iannaccone, R; Magrini, D; Picchi, D; Pinna, D; Porcinai, S

    2015-06-15

    This paper demonstrates that an educated methodology based on both non-invasive and micro invasive techniques in a two-step approach is a powerful tool to characterize the materials and stratigraphies of an Egyptian coffin, which was restored several times. This coffin, belonging to a certain Mesiset, is now located at the Museo Civico Archeologico of Bologna (inventory number MCABo EG 1963). Scholars attributed it to the late 22nd/early 25th dynasty by stylistic comparison. The first step of the diagnostic approach applied imaging techniques on the whole surface in order to select measurements spots and to unveil both original and restored areas. Images and close microscopic examination of the polychrome surface allowed selecting representative areas to be investigated in situ by portable spectroscopic techniques: X-ray Fluorescence (XRF), Fiber Optic Reflectance Spectroscopy (FORS) and Fourier Transform Infrared spectroscopy (FTIR). After the analysis of the results coming from the first step, very few selected samples were taken to clarify the stratigraphy of the polychrome layers. The first step, based on the combination of imaging and spectroscopic techniques in a totally non-invasive modality, is quite unique in the literature on Egyptian coffins and enabled us to reveal many differences in the ground layer's composition and to identify a remarkable number of pigments in the original and restored areas. This work offered also a chance to check the limitations of the non-invasive approach applied on a complex case, namely the right localization of different materials in the stratigraphy and the identification of binding media. Indeed, to dissolve any remaining doubts on superimposed layers belonging to different interventions, it was necessary to sample few micro-fragments in some selected areas and analyze them prepared as cross-sections. The original ground layer is made of calcite, while the restored areas show the presence of either a mixture of calcite

  11. Multidisciplinary approach for the study of an Egyptian coffin (late 22nd/early 25th dynasty): Combining imaging and spectroscopic techniques

    NASA Astrophysics Data System (ADS)

    Bracci, S.; Caruso, O.; Galeotti, M.; Iannaccone, R.; Magrini, D.; Picchi, D.; Pinna, D.; Porcinai, S.

    2015-06-01

    This paper demonstrates that an educated methodology based on both non-invasive and micro invasive techniques in a two-step approach is a powerful tool to characterize the materials and stratigraphies of an Egyptian coffin, which was restored several times. This coffin, belonging to a certain Mesiset, is now located at the Museo Civico Archeologico of Bologna (inventory number MCABo EG 1963). Scholars attributed it to the late 22nd/early 25th dynasty by stylistic comparison. The first step of the diagnostic approach applied imaging techniques on the whole surface in order to select measurements spots and to unveil both original and restored areas. Images and close microscopic examination of the polychrome surface allowed selecting representative areas to be investigated in situ by portable spectroscopic techniques: X-ray Fluorescence (XRF), Fiber Optic Reflectance Spectroscopy (FORS) and Fourier Transform Infrared spectroscopy (FTIR). After the analysis of the results coming from the first step, very few selected samples were taken to clarify the stratigraphy of the polychrome layers. The first step, based on the combination of imaging and spectroscopic techniques in a totally non-invasive modality, is quite unique in the literature on Egyptian coffins and enabled us to reveal many differences in the ground layer's composition and to identify a remarkable number of pigments in the original and restored areas. This work offered also a chance to check the limitations of the non-invasive approach applied on a complex case, namely the right localization of different materials in the stratigraphy and the identification of binding media. Indeed, to dissolve any remaining doubts on superimposed layers belonging to different interventions, it was necessary to sample few micro-fragments in some selected areas and analyze them prepared as cross-sections. The original ground layer is made of calcite, while the restored areas show the presence of either a mixture of calcite

  12. The Importance of a Biopsychosocial Approach in Melanoma ResearchExperiences from a Single-center Multidisciplinary Melanoma Working Group in Middle-Europe.

    PubMed

    Richtig, Erika; Trapp, Michael; Kapfhammer, Hans-Peter; Jenull, Brigitte; Richtig, Georg; Trapp, Eva-Maria

    2016-08-23

    The biopsychosocial model represents a very important theoretical framework developed in the 21th century. According to a body mind unity theory, it postulates that research must focus not only on biomedical but also on other aspects in order to understand complex interactions occurring on different system levels. With regard to the occurrence of melanoma, both immunologic surveillance and a lack of cancerogenic factors are crucial in the suppression of tumor development. In addition, a reduction in mental stress (employing effective strategies for coping with stress) in cases of malignant disease seems to prolong life. Focusing on these theories, examples of studies that followed an interdisciplinary, biopsychosocial approach to melanoma research conducted at one center are given to emphasize the multi-dimensional and interdisciplinary aspects of the biopsychosocial model. PMID:27283105

  13. A multidisciplinary approach to reconstructing the chronology and environment of southwestern European Neanderthals: the contribution of Teixoneres cave (Moià, Barcelona, Spain)

    NASA Astrophysics Data System (ADS)

    López-García, Juan Manuel; Blain, Hugues-Alexandre; Burjachs, Francesc; Ballesteros, Anna; Allué, Ethel; Cuevas-Ruiz, Gloria Ericka; Rivals, Florent; Blasco, Ruth; Morales, Juan Ignacio; Hidalgo, Antonio Rodríguez; Carbonell, Eudald; Serrat, David; Rosell, Jordi

    2012-06-01

    According to pollen analysis and the 18O-isotope curve, the first part of the Late Pleistocene (ca 128-30 ka) is mainly characterized by a dynamic that alternates cold phases (Heinrich Events) and temperate phases (interstadials). These rapid fluctuations provide the context for the Neanderthal occupations in the northeastern part of the Iberian Peninsula. In this paper we present the chronological, environmental and climatic data obtained by analyzing the pollen, the charcoal, the small vertebrates (amphibians, squamates and small mammals) and the large-mammal dental wear at the Neanderthal site of Teixoneres cave, Northeastern Iberia. Levels II and III from this cavity have provided Mousterian industries and other evidence of Neanderthal occupations, such as cut-marks in large-mammal bones. A multiproxy study such as this constitutes a new approach to the chronological, environmental and climatic context in which Neanderthal populations lived in southwestern Europe (Iberian Peninsula). The results allow us to establish a relative chronology for these two levels of between ca 30-90 ka and show that they are associated with different environmental and climatic conditions: temperate and humid for Level III and cold and dry for Level II. This demonstrates that the Neanderthals were well adapted to the territory that they occupied, irrespective of the climatic conditions.

  14. Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups.

    PubMed

    Iliffe, S; De Lepeleire, J; Van Hout, H; Kenny, G; Lewis, A; Vernooij-Dassen, M

    2005-01-01

    Experts from eight European countries (Belgium, France, The Netherlands, Ireland, Italy, Portugal, Spain and the United Kingdom) and the disciplines of clinical psychology, general practice, geriatric medicine, old age psychiatry, medical sociology, nursing and voluntary body organisation met in 2003 to explore obstacles to recognition of and response to dementia in general practice within Europe. A modified focus group methodology was used in this exploratory process. Groups were conducted over a two-day period, with five sessions lasting 1-1.5 hours each. An adapted nominal group method was used to record themes arising from the group discussion, and these themes were used in a grounded theory approach to generate explanations for delayed recognition of and response to dementia. The overarching theme that arose from the focus groups was movement, which had three different expressions. These were: population movement and its consequences for localities, services and professional experience; the journey of the person with dementia along the disease process; and the referral pathway to access services and support. Change is the core issue in dementia care, with multiple pathways of change that need to be understood at clinical and organisational levels. Practitioners and people with dementia are engaged in managing emotional, social and physical risks, making explicit risk management a potentially important component of dementia care. The boundary between generalist and specialist services is a particular problem, with great potential for dysfunctionality. Stigma and ageism are variably distributed phenomena both within and between countries.

  15. Multidisciplinary approach to the treatment of invasive fungal infections in adult patients. Prophylaxis, empirical, preemptive or targeted therapy, which is the best in the different hosts?

    PubMed Central

    Zaragoza, Rafael; Pemán, Javier; Salavert, Miguel; Viudes, Ángel; Solé, Amparo; Jarque, Isidro; Monte, Emilio; Romá, Eva; Cantón, Emilia

    2008-01-01

    The high morbidity, mortality, and health care costs associated with invasive fungal infections, especially in the critical care setting and immunocompromised host, have made it an excellent target for prophylactic, empiric, and preemptive therapy interventions principally based on early identification of risk factors. Early diagnosis and treatment are associated with a better prognosis. In the last years there have been important developments in antifungal pharmacotherapy. An approach to the new diagnosis tools in the clinical mycology laboratory and an analysis of the use new antifungal agents and its application in different clinical situations has been made. Furthermore, an attempt of developing a state of the art in each clinical scenario (critically ill, hematological, and solid organ transplant patients) has been performed, trying to choose the best strategy for each clinical situation (prophylaxis, pre-emptive, empirical, or targeted therapy). The high mortality rates in these settings make mandatory the application of early de-escalation therapy in critically ill patients with fungal infection. In addition, the possibility of antifungal combination therapy might be considered in solid organ transplant and hematological patients. PMID:19337433

  16. Toward an Integrated Public Health Approach for Epilepsy in the 21st Century

    PubMed Central

    Kobau, Rosemarie; Whittemore, Vicky H.; Mann, Marie Y.; Johnson, Jennifer G.; Hutter, Joseph D.; Jones, Wanda K.

    2014-01-01

    Epilepsy, a complex spectrum of disorders, merits enhanced public health action. In 2012, the Institute of Medicine (IOM) released a seminal report on the public health dimensions of the epilepsies, recommending actions in 7 domains. The report urged a more integrated and coordinated national approach for care centering on the whole patient, including heightened attention to comorbidities and quality of life; more timely referral and access to treatments; and improved community resources, education, stakeholder collaboration, and public communication. The US Department of Health and Human Services responded to this report by accelerating and integrating ongoing initiatives and beginning new ones. This article summarizes recent federally supported activities promoting an integrated public health approach for epilepsy, highlighting progress in response to the landmark 2012 IOM report and identifying opportunities for continued public health action. PMID:25167091

  17. A multi-disciplinary approach to evaluate pluvial floods risk under changing climate: The case study of the municipality of Venice (Italy).

    PubMed

    Sperotto, A; Torresan, S; Gallina, V; Coppola, E; Critto, A; Marcomini, A

    2016-08-15

    Global climate change is likely to pose increasing threats in nearly all sectors and across all sub-regions worldwide (IPCC, 2014). Particularly, extreme weather events (e.g. heavy precipitations), together with changing exposure and vulnerability patterns, are expected to increase the damaging effect of storms, pluvial floods and coastal flooding. Developing climate and adaptation services for local planners and decision makers is becoming essential to transfer and communicate sound scientific knowledge about climate related risks and foster the development of national, regional and local adaptation strategies. In order to analyze the effect of climate change on pluvial flood risk and advice adaptation planning, a Regional Risk Assessment (RRA) methodology was developed and applied to the urban territory of the municipality of Venice. Based on the integrated analysis of hazard, exposure, vulnerability and risk, RRA allows identifying and prioritizing targets and sub-areas that are more likely to be affected by pluvial flood risk due to heavy precipitation events in the future scenario 2041-2050. From the early stages of its development and application, the RRA followed a bottom-up approach taking into account the requests, knowledge and perspectives of local stakeholders of the North Adriatic region by means of interactive workshops, surveys and discussions. Results of the analysis showed that all targets (i.e. residential, commercial-industrial areas and infrastructures) are vulnerable to pluvial floods due to the high impermeability and low slope of the topography. The spatial pattern of risk mostly reflects the distribution of the hazard and the districts with the higher percentage of receptors' surface in the higher risk classes (i.e. very high, high and medium) are Lido-Pellestrina and Marghera. The paper discusses how risk-based maps and statistics integrate scientific and local knowledge with the final aim to mainstream climate adaptation in the development

  18. A multidisciplinary study using in vivo tumor models and microfluidic cell-on-chip approach to explore the cross-talk between cancer and immune cells.

    PubMed

    Mattei, Fabrizio; Schiavoni, Giovanna; De Ninno, Adele; Lucarini, Valeria; Sestili, Paola; Sistigu, Antonella; Fragale, Alessandra; Sanchez, Massimo; Spada, Massimo; Gerardino, Annamaria; Belardelli, Filippo; Businaro, Luca; Gabriele, Lucia

    2014-10-01

    A full elucidation of events occurring inside the cancer microenvironment is fundamental for the optimization of more effective therapies. In the present study, the cross-talk between cancer and immune cells was examined by employing mice deficient (KO) in interferon regulatory factor (IRF)-8, a transcription factor essential for induction of competent immune responses. The in vivo results showed that IRF-8 KO mice were highly permissive to B16.F10 melanoma growth and metastasis due to failure of their immune cells to exert proper immunosurveillance. These events were found to be dependent on soluble factors released by cells of the immune system capable of shaping the malignant phenotype of melanoma cells. An on-chip model was then generated to further explore the reciprocal interactions between the B16.F10 and immune cells. B16.F10 and immune cells were co-cultured in a microfluidic device composed of three culturing chambers suitably inter-connected by an array of microchannels; mutual interactions were then followed using time-lapse microscopy. It was observed that WT immune cells migrated through the microchannels towards the B16.F10 cells, establishing tight interactions that in turn limited tumor spread. In contrast, IRF-8 KO immune cells poorly interacted with the melanoma cells, resulting in a more invasive behavior of the B16.F10 cells. These results suggest that IRF-8 expression plays a key role in the cross-talk between melanoma and immune cells, and under-score the value of cell-on-chip approaches as useful in vitro tools to reconstruct complex in vivo microenvironments on a microscale level to explore cell interactions such as those occurring within a cancer immunoenvironment. PMID:24597645

  19. 76 FR 45268 - Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-28

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research, Approach to... approach of the Center for Drug Evaluation and Research (CDER) to addressing drug shortages. This public... interested persons about the causes and impact of drug shortages, and possible strategies for preventing...

  20. Australian Public Universities: Are They Practising a Corporate Approach to Governance?

    ERIC Educational Resources Information Center

    Christopher, Joseph

    2014-01-01

    This article draws on the multi-theoretical approach to governance and a qualitative research method to examine the extent to which the corporate approach is practised in Australian public universities. The findings reveal that in meeting the needs of multiple stakeholders, universities are faced with a number of structural, legalistic, and…

  1. Public health policy research: making the case for a political science approach.

    PubMed

    Bernier, Nicole F; Clavier, Carole

    2011-03-01

    The past few years have seen the emergence of claims that the political determinants of health do not get due consideration and a growing demand for better insights into public policy analysis in the health research field. Several public health and health promotion researchers are calling for better training and a stronger research culture in health policy. The development of these studies tends to be more advanced in health promotion than in other areas of public health research, but researchers are still commonly caught in a naïve, idealistic and narrow view of public policy. This article argues that the political science discipline has developed a specific approach to public policy analysis that can help to open up unexplored levers of influence for public health research and practice and that can contribute to a better understanding of public policy as a determinant of health. It describes and critiques the public health model of policy analysis, analyzes political science's specific approach to public policy analysis, and discusses how the politics of research provides opportunities and barriers to the integration of political science's distinctive contributions to policy analysis in health promotion.

  2. The Structural Evolution of the Calabrian Forearc: A Multidisciplinary Approach to Investigating Time-Transgressive Deformation in a Subduction-Rollback System

    NASA Astrophysics Data System (ADS)

    Reitz, Margaret A.

    further investigate surficial deformation, I carry out geomorphic analyses of 87 river drainages. I interpret my findings in terms of structural framework and find that surficial deformation varies tremendously from east to west. The rivers draining eastward are characterized by low concavities and higher erosion rates, consistent with shortening. While just 50 km away, the westward-draining rivers are characterized by high concavities and lower erosion rates, consistent with extension. Overall, the drainages are shifting from east-draining to west-draining, likely due to the topographic growth that decreases concavities on the eastern side. Although a new interpretation, this finding is consistent with previous structural, paleomagnetic, and seismological datasets. In each of the chapters, I interpret the structural and geomorphic data in a regional framework. This extra step is critical in interpreting deformation along active plate boundaries because it is highly variable and can be seemingly contradictory. In my final chapter, I present a cross section of the plate boundary that incorporates my data and interpretations from the geomorphic results and the most recent structural event as well as data from multiple other sources (GPS, seismological, paleomagnetics, structural, tomographic, geomorphic, etc.). This approach confirms the importance of boundary conditions on deformation in a subduction-rollback system. More intriguingly, the cross-section highlights the spatial variations along the surface and with depth suggesting that there is significant interplay between active structures.

  3. Multidisciplinary Design Of Hot Composite Structures

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.; Singhal, Surendra N.

    1996-01-01

    Unified computer code developed to implement multidisciplinary approach to design and analysis of composite-material structures that must withstand high temperatures. Code modular: includes executive module communicating with and coordinating other modules performing calculations pertaining to traditionally separate disciplines like those of acoustics, structural vibrations, structural loads, and thermal effects. Essential feature, finite-element numerical simulation of relevant physical phenomena according to applicable disciplines. Same finite-element mesh used in thermal, vibrational, and structural analyses; minimizing data-preparation time and eliminating errors incurred in transforming temperatures from one finite-element mesh to another.

  4. Imaging the pneumoconioses: a multidisciplinary approach

    SciTech Connect

    Begin, R.; Masse, S.; Cantin, A.; Bisson, G.; Bergeron, D.

    1988-10-01

    The initial early reaction of pulmonary tissue to inorganic dust inhalation is a fibrosing macrophagic alveolitis. This initial pulmonary lesion can be detected by an enhanced gallium 67 pulmonary uptake and analyses of bronchoalveolar lavage. These two techniques can document not only the increased proliferation of macrophages, but also the activation of macrophages to produce excessive amounts of fibronectin and other factors of fibroblastic growth implicated in the pathogenesis of the pneumoconioses. Of equal clinical interest is the development of computed tomography, which has permitted better characterization of the early stages of fibrosis in the pneumoconioses. These refinements in disease recognition will contribute to the earlier detection of pneumoconioses before they become incapacitating. Newer therapeutic methods are also under investigation that could permit inactivation of either the dust itself or the pulmonary macrophage. The coupling of these new diagnostic and therapeutic developments will bring in a new era in occupational pulmonary medicine. 58 references.

  5. Promoting Active Lifestyles--A Multidisciplinary Approach.

    ERIC Educational Resources Information Center

    Jordan, Deb; And Others

    1993-01-01

    Presents a series of articles that address the theme of promoting active lifestyles through education. Some topics are facilities and equipment, how fear plays a part in limiting participation in physical activity, working with disabled as well as aging persons, the use of water activities, and instructor accountability. (GLR)

  6. Non-Elimination Tag: A Multidisciplinary Approach

    ERIC Educational Resources Information Center

    Townsend, J. Scott; Mohr, Derek J.; Waronsky, Clint; Grana, Mario M.

    2006-01-01

    The activity of tag may be one of the most widely played games in elementary physical education programs. It comes in many shapes and sizes and can be morphed to meet many needs. For example, tag is used as a general body warm-up for young children (Rosengard, Mckenzie, & Short, 2000), to teach chasing, dodging, and fleeing skills (Graham,…

  7. Change and Higher Education: A Multidisciplinary Approach

    ERIC Educational Resources Information Center

    Storberg-Walker, Julia; Torraco, Richard

    2004-01-01

    Higher education now finds itself in a new era and environment in which it is confronted with an array of challenges and forces for change. This paper identifies the key forces for change in higher education, assesses these forces using an established change model (the action research model), and illustrates how change literature from management,…

  8. A community development approach to deal with public drug use in Box Hill.

    PubMed

    Rogers, Neil; Anderson, Warren

    2007-01-01

    The use of alcohol and other drugs in public space is one that generates much heat in the public discourse and in the media. Too often the responses called for to reduce the problems of public amenity involve punitive policing and other responses that aim to engineer (mostly) young people out of these public spaces. Often local retailers are a key stakeholder group calling loudest for punitive action. In this Harm Reduction Digest Rogers and Anderson describe a community development approach taken to address these problems in Box Hill in the City of Whitehorse, near Melbourne. This approach which aimed to develop 'bridging social capital' between community retailers and other stakeholders in the area appears to have been effective in reducing harm associated with public drug use. Moreover these changes have become institutionalised and the approach has been expanded to address other public amenity problems in the area. It is a very nice example of how drug related harm can be reduced by grass roots networks of local councils, business people, law enforcement and health and welfare service providers to address these issues. PMID:17364841

  9. Multidisciplinary disease management in rheumatology.

    PubMed

    Oliver, Susan

    2003-11-01

    With an increasingly ageing population, the number of patients with osteoarthritis and rheumatoid arthritis is expected to rise. High-quality patient education and self-management are essential in these chronic debilitating conditions. A multidisciplinary team has produced a template to guide the assessment, treatment and holistic care of patients in primary care.

  10. Giant Serpentine Aneurysms: Multidisciplinary Management

    PubMed Central

    Anshun, W.; Feng, L.; Daming, W.

    2000-01-01

    Summary Sixty-five cases of intracranial giant serpentine aneurysms (GSΛs), including 61 cases reported in the literature and four additional cases presented in this study were reviewed. The clinical presentation, possible causes, natural history, and especially management of GSAs are discussed with emphasis on the need for aggressive intervention and multidisciplinary management. PMID:20667180

  11. Balancing Public Trust Resources of Mono Lake and Los Angeles' Water Right: An Economic Approach

    NASA Astrophysics Data System (ADS)

    Loomis, John B.

    1987-08-01

    The contingent valuation method (CVM) is used to quantify the Public Trust values of Mono Lake at alternative lake levels. The dichotomous choice approach to contingent valuation is employed using a logit model. The economic benefit to California residents of preserving Mono Lake is estimated to be 1.5 billion. Purchase of replacement water and power would cost 26.2 million annually. On efficiency grounds, reallocation of water for maintenance of Public Trust values at Mono Lake is warranted. The CVM appears to be a useful methodology to evaluate the balancing and feasibility tests of the expanded Public Trust doctrine suggested by the California Supreme Court.

  12. Public health approaches to community-based needs. Boston's infant mortality crisis as a case study.

    PubMed

    Rorie, J A; Richardson, K A; Gardner, R

    1997-01-01

    In light of a 10-year infant mortality crisis in Boston, a comprehensive public health approach was undertaken in which an extensive community-based needs assessment was used to develop a citywide maternal and child health improvement agenda. On the basis of the needs assessment, recommendations were made calling for community-based perinatal initiatives and midwifery services as critical elements in care for underserved communities and enhancement of perinatal services. A case description of one perinatal initiative illustrates the challenges of public health practice and describes a practice setting in which midwives provided leadership and guidance by using an interdisciplinary team approach in the implementation of a community empowerment project.

  13. Managing Complexity in Multidisciplinary Visualization

    NASA Technical Reports Server (NTRS)

    Miceli, Kristina D.; Lasinski, T. A. (Technical Monitor)

    1995-01-01

    As high performance computing technology progresses, computational simulations are becoming more advanced in their capabilities. In the computational aerosciences domain, single discipline steady-state simulations computed on a single grid are far from the state-of-the-art. In their place are complex, time-dependent multidisciplinary simulations that attempt to model a given geometry more realistically. The product of these multidisciplinary simulations is a massive amount of data stored in different formats, grid topologies, units of measure, etc., as a result of the differences in the simulated physical domains. In addition to the challenges posed by setting up and performing the simulation, additional challenges exist in analyzing computational results. Visualization plays an important role in the advancement of multidisciplinary simulations. To date, visualization has been used to aid in the interpretation of large amounts of simulation data. Because the human visual system is effective in digesting a large amount of information presented graphically, visualization has helped simulation scientists to understand complex simulation results. As these simulations become even more complex, integrating several different physical domains, visualization will be critical to digest the massive amount of information. Another important role for visualization is to provide a common communication medium from which the domain scientists can use to develop, debug, and analyze their work. Multidisciplinary analyses are the next step in simulation technology, not only in computational aerosciences, but in many other areas such as global climate modeling. Visualization researchers must understand and work towards the challenges posed by multidisciplinary simulation scenarios. This paper addresses some of these challenges, describing technologies that must be investigated to create a useful visualization analysis tool for domain scientists.

  14. Publications

    Cancer.gov

    Information about NCI publications including PDQ cancer information for patients and health professionals, patient-education publications, fact sheets, dictionaries, NCI blogs and newsletters and major reports.

  15. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    PubMed

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector.

  16. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development

    PubMed Central

    Gray, Kathleen

    2016-01-01

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public health The landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  17. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    PubMed

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  18. Efficiency at Faculties of Economics in the Czech Public Higher Education Institutions: Two Different Approaches

    ERIC Educational Resources Information Center

    Flégl, Martin; Vltavská, Kristýna

    2013-01-01

    The paper evaluates research and teaching efficiency at faculties of economics in the public higher education institutions in the Czech Republic. Evaluation is provided in two periods between the years 2006-2010 and 2007-2011. For this evaluation the Data Envelopment Analysis and Index approach are used. Data Envelopment Analysis measures research…

  19. Public Speaking Instruction with the Experiential, Self-Empowerment Approach (ESA): An Ethnomethodological Look.

    ERIC Educational Resources Information Center

    Bedore, Joan M.

    This paper takes a ethnomethodological look at a typical Experiential Self-Empowerment Approach (ESA)-using speech class to see how the ESA uses 12 assumptions as background expectancies (Heritage, 1984) to accomplish personal growth in college public speaking classes. The following assumptions are addressed: (1) students deserve "something more"…

  20. Cooperative Programs Between Public and Private Elementary Schools. Individual Approaches to Elementary School Programs.

    ERIC Educational Resources Information Center

    Short, Kathleen, Ed.

    This report, the result of questionnaires sent to superintendents of Catholic schools across the country, describes alternative approaches to the provision of Catholic education in the wake of Supreme Court decisions limiting the public aid available to private schools. Shared-time, dual enrollment, and ecumenical schools were some of the…

  1. Creating a Community Approach to Serving Four-Year-Old Children in Wisconsin. Public Awareness Packet.

    ERIC Educational Resources Information Center

    Landsverk, Ruth Anne

    The Wisconsin Forces for Four-Year-Olds Project promotes the community approach to offering universal access to quality care and learning services for Wisconsin 4-year-olds. Based on the view that quality early education opportunities have life-long benefits for children and the communities in which they live, this public awareness packet…

  2. An Assessment of the Client-Centered Planning Approach in Continuing Education for Public Health Professionals.

    ERIC Educational Resources Information Center

    Nichols, Ward H.; Stewart, Cynthia J.

    1983-01-01

    Presents essential elements and reviews the concept of client-centered planning as an approach to program development for continuing education in public health. Client-centered planning is aimed at the identification of individual practitioner needs and the development of educational interventions tailored to improve competency in selected areas.…

  3. Recommending Research Profiles for Multidisciplinary Academic Collaboration

    ERIC Educational Resources Information Center

    Gunawardena, Sidath Deepal

    2013-01-01

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

  4. The Contribution of Applied Social Sciences to Obesity Stigma-Related Public Health Approaches

    PubMed Central

    Bombak, Andrea E.

    2014-01-01

    Obesity is viewed as a major public health concern, and obesity stigma is pervasive. Such marginalization renders obese persons a “special population.” Weight bias arises in part due to popular sources' attribution of obesity causation to individual lifestyle factors. This may not accurately reflect the experiences of obese individuals or their perspectives on health and quality of life. A powerful role may exist for applied social scientists, such as anthropologists or sociologists, in exploring the lived and embodied experiences of this largely discredited population. This novel research may aid in public health intervention planning. Through these studies, applied social scientists could help develop a nonstigmatizing, salutogenic approach to public health that accurately reflects the health priorities of all individuals. Such an approach would call upon applied social science's strengths in investigating the mundane, problematizing the “taken for granted” and developing emic (insiders') understandings of marginalized populations. PMID:24782921

  5. Review of various approaches for assessing public health risks in regulatory decision making: choosing the right approach for the problem.

    PubMed

    Dearfield, Kerry L; Hoelzer, Karin; Kause, Janell R

    2014-08-01

    Stakeholders in the public health risk analysis community can possess differing opinions about what is meant by "conduct a risk assessment." In reality, there is no one-size-fits-all risk assessment that can address all public health issues, problems, and regulatory needs. Although several international and national organizations (e.g., Codex Alimentarius Commission, Office International des Epizooties, Food and Agricultural Organization, World Health Organization, National Research Council, and European Food Safety Authority) have addressed this issue, confusion remains. The type and complexity of a risk assessment must reflect the risk management needs to appropriately inform a regulatory or nonregulatory decision, i.e., a risk assessment is ideally "fit for purpose" and directly applicable to risk management issues of concern. Frequently however, there is a lack of understanding by those not completely familiar with risk assessment regarding the specific utility of different approaches for assessing public health risks. This unfamiliarity can unduly hamper the acceptance of risk assessment results by risk managers and may reduce the usefulness of such results for guiding public health policies, practices, and operations. Differences in interpretation of risk assessment terminology further complicate effective communication among risk assessors, risk managers, and stakeholders. This article provides an overview of the types of risk assessments commonly conducted, with examples primarily from the food and agricultural sectors, and a discussion of the utility and limitations of these specific approaches for assessing public health risks. Clarification of the risk management issues and corresponding risk assessment design needs during the formative stages of the risk analysis process is a key step for ensuring that the most appropriate assessment of risk is developed and used to guide risk management decisions. PMID:25198609

  6. Teamwork: a multidisciplinary pediatric-liaison service.

    PubMed

    Froese, A P; Kamin, L E; Levine, C A

    Psychiatrists, psychologists and social workers are often consulted about the same hospitalized patient. Since each may differ in their training, orientation and experience, the opinions expressed by them to the consultee may differ. The authors have described a multidisciplinary liaison team operating within a pediatric teaching hospital. The consultants work as a team in close collaboration with each other and with the psychiatric nurse clinician and an occupational therapist. The team approach has specific advantages. It allows for a concise and unified approach to the emotional and social needs of the patients. It presents a forum for informal consultations and interdisciplinary meetings. In addition, teaching opportunities are many as each discipline learns from the other.

  7. The Coalition for Sustainable Egg Supply: A unique public-private partnership for conducting research on the sustainability of animal housing systems using a multistakeholder approach.

    PubMed

    Mench, J A; Swanson, J C; Arnot, C

    2016-03-01

    The growing emphasis on ensuring the sustainability of animal agriculture is providing an impetus for the adoption of new approaches to structuring and conducting research. Sustainability is a complex topic involving many considerations related to the economic, social, and environmental impacts of production systems. Successfully addressing this topic requires multidisciplinary research as well as a high degree of communication with food system stakeholders to ensure that the research results contribute to informed decision making. In this paper, we provide an overview of a public-private partnership, the Coalition for Sustainable Egg Supply (CSES), which was formed to support research evaluating the sustainability of laying hen housing systems. Because of increasing public concerns about the behavioral restriction imposed on laying hens housed in conventional cages, the U.S. egg industry is faced with a need to transition to alternative systems. However, before the CSES project, there was limited information available about how this transition might affect trade-offs related to the sustainability of egg production. The goal of the CSES project was to provide this information by conducting holistic research on a commercial farm that had 3 different hen housing systems. The CSES members represented a variety of stakeholders, including food retailers and distributors, egg producers, universities, and governmental (USDA ARS) and nongovernmental organizations. The CSES was facilitated by a not-for-profit intermediary, the Center for Food Integrity, which was also responsible for communicating the research results to food system stakeholders, including via quantitative and qualitative consumer research. In this paper, we describe the structural aspects of the CSES that were responsible for the successful completion and dissemination of the research as well as the insights that were gained regarding multidisciplinary and multi-institutional collaboration, conducting

  8. The Coalition for Sustainable Egg Supply: A unique public-private partnership for conducting research on the sustainability of animal housing systems using a multistakeholder approach.

    PubMed

    Mench, J A; Swanson, J C; Arnot, C

    2016-03-01

    The growing emphasis on ensuring the sustainability of animal agriculture is providing an impetus for the adoption of new approaches to structuring and conducting research. Sustainability is a complex topic involving many considerations related to the economic, social, and environmental impacts of production systems. Successfully addressing this topic requires multidisciplinary research as well as a high degree of communication with food system stakeholders to ensure that the research results contribute to informed decision making. In this paper, we provide an overview of a public-private partnership, the Coalition for Sustainable Egg Supply (CSES), which was formed to support research evaluating the sustainability of laying hen housing systems. Because of increasing public concerns about the behavioral restriction imposed on laying hens housed in conventional cages, the U.S. egg industry is faced with a need to transition to alternative systems. However, before the CSES project, there was limited information available about how this transition might affect trade-offs related to the sustainability of egg production. The goal of the CSES project was to provide this information by conducting holistic research on a commercial farm that had 3 different hen housing systems. The CSES members represented a variety of stakeholders, including food retailers and distributors, egg producers, universities, and governmental (USDA ARS) and nongovernmental organizations. The CSES was facilitated by a not-for-profit intermediary, the Center for Food Integrity, which was also responsible for communicating the research results to food system stakeholders, including via quantitative and qualitative consumer research. In this paper, we describe the structural aspects of the CSES that were responsible for the successful completion and dissemination of the research as well as the insights that were gained regarding multidisciplinary and multi-institutional collaboration, conducting

  9. Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach

    PubMed Central

    Chan, Ruth S.M; Woo, Jean

    2010-01-01

    Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance. However, public health intervention programs have had limited success in tackling the rising prevalence of obesity. This paper reviews the definition of overweight and obesity and the variations with age and ethnicity; health consequences and factors contributing to the development of obesity; and critically reviews the effectiveness of current public health strategies for risk factor reduction and obesity prevention. PMID:20617002

  10. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

    PubMed Central

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

    2015-01-01

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

  11. Reflections on Knowledge Brokering within a Multidisciplinary Research Team

    ERIC Educational Resources Information Center

    Urquhart, Robin; Porter, Geoffrey A.; Grunfeld, Eva

    2011-01-01

    Knowledge brokering (KB) may be one approach of helping researchers and decision makers effectively communicate their needs and abilities, and move toward increased use of evidence in health care. A multidisciplinary research team in Nova Scotia, Canada, has created a dedicated KB position with the goal of improving access to quality colorectal…

  12. Mapping the progress and impacts of public health approaches to palliative care: a scoping review protocol

    PubMed Central

    Archibald, Daryll; Patterson, Rebecca; Haraldsdottir, Erna; Hazelwood, Mark; Fife, Shirley; Murray, Scott A

    2016-01-01

    Introduction Public health palliative care is a term that can be used to encompass a variety of approaches that involve working with communities to improve people's experience of death, dying and bereavement. Recently, public health palliative care approaches have gained recognition and momentum within UK health policy and palliative care services. There is general consensus that public health palliative care approaches can complement and go beyond the scope of formal service models of palliative care. However, there is no clarity about how these approaches can be undertaken in practice or how evidence can be gathered relating to their effectiveness. Here we outline a scoping review protocol that will systematically map and categorise the variety of activities and programmes that could be classified under the umbrella term ‘public health palliative care’ and highlight the impact of these activities where measured. Methods and analysis This review will be guided by Arksey and O'Malley's scoping review methodology and incorporate insights from more recent innovations in scoping review methodology. Sensitive searches of 9 electronic databases from 1999 to 2016 will be supplemented by grey literature searches. Eligible studies will be screened independently by two reviewers using a data charting tool developed for this scoping review. Ethics and dissemination This scoping review will undertake a secondary analysis of data already collected and does not require ethical approval. The results will facilitate better understanding of the practical application of public health approaches to palliative care, the impacts these activities can have and how to build the evidence base for this work in future. The results will be disseminated through traditional academic routes such as conferences and journals and also policy and third sector seminars. PMID:27417201

  13. The Multidisciplinary Translational Team (MTT) Model for Training and Development of Translational Research Investigators.

    PubMed

    Ameredes, Bill T; Hellmich, Mark R; Cestone, Christina M; Wooten, Kevin C; Ottenbacher, Kenneth J; Chonmaitree, Tasnee; Anderson, Karl E; Brasier, Allan R

    2015-10-01

    Multiinstitutional research collaborations now form the most rapid and productive project execution structures in the health sciences. Effective adoption of a multidisciplinary team research approach is widely accepted as one mechanism enabling rapid translation of new discoveries into interventions in human health. Although the impact of successful team-based approaches facilitating innovation has been well-documented, its utility for training a new generation of scientists has not been thoroughly investigated. We describe the characteristics of how multidisciplinary translational teams (MTTs) promote career development of translational research scholars through competency building, interprofessional integration, and team-based mentoring approaches. Exploratory longitudinal and outcome assessments from our experience show that MTT membership had a positive effect on the development of translational research competencies, as determined by a self-report survey of 32 scholars. We also observed that all trainees produced a large number of collaborative publications that appeared to be associated with their CTSA association and participation with MTTs. We conclude that the MTT model provides a unique training environment for translational and team-based learning activities, for investigators at early stages of career development.

  14. Multidisciplinary Graduate Education in Bioprocess Engineering

    SciTech Connect

    Mark A. Eiteman

    2006-04-18

    This report describes the accomplishments of the University of Georgia in establishing an academic program geared toward the emerging biobased products industry. By virtue of its strengths and structure, the University of Georgia is particularly well-suited for developing a program focused on plant- and microbial-based bioproducts, and it was in this general area that this program was developed. The program had several unique characteristics. First, we implemented a distinguished lecture series that brought outstanding scientists and engineers to our University to interact with students and share their vision of the biobased economy. Second, we offered industrially-oriented and multidisciplinary courses that provided students with a broad background on various facets of biobased business and technology. Third, we provided the students with opportunities to expand beyond the classroom by engaging in research lab rotations and industrial internships. Fourth, each student was engaged in a creative research project as led by a multidisciplinary faculty team. Throughout the implementation of these activities, we maintained a student-centered, mentoring approach to education. The most tangible outcome of this project was the graduation of two students who participated in a variety of scholarly activities, culminating in research toward the completion of a thesis and dissertation. Both research projects involved the use of microorganisms to produce industrial products from agricultural substrates via fermentation processes. The research advanced our understanding of microorganisms as used for industrial processes and products, as described in several articles published in scholarly journals and presentations made at scientific conferences (see information on pp. 14-15). Another outcome is one graduate course, Fermentation Engineering Laboratory, which is a unique experiential and multidisciplinary course. This course will be offered in the future as an elective to

  15. Multidisciplinary Optimization of Airborne Radome Using Genetic Algorithm

    NASA Astrophysics Data System (ADS)

    Tang, Xinggang; Zhang, Weihong; Zhu, Jihong

    A multidisciplinary optimization scheme of airborne radome is proposed. The optimization procedure takes into account the structural and the electromagnetic responses simultaneously. The structural analysis is performed with the finite element method using Patran/Nastran, while the electromagnetic analysis is carried out using the Plane Wave Spectrum and Surface Integration technique. The genetic algorithm is employed for the multidisciplinary optimization process. The thicknesses of multilayer radome wall are optimized to maximize the overall transmission coefficient of the antenna-radome system under the constraint of the structural failure criteria. The proposed scheme and the optimization approach are successfully assessed with an illustrative numerical example.

  16. NASA Multidisciplinary Design and Analysis Fellowship Program

    NASA Technical Reports Server (NTRS)

    Schrage, D. P.; Craig, J. I.; Mavris, D. N.; Hale, M. A.; DeLaurentis, D.

    1999-01-01

    This report summarizes the results of a multi-year training grant for the development and implementation of a Multidisciplinary Design and Analysis (MDA) Fellowship Program at Georgia Tech. The Program funded the creation of graduate MS and PhD degree programs in aerospace systems design, analysis and integration. It also provided prestigious Fellowships with associated Industry Internships for outstanding engineering students. The graduate program has become the foundation for a vigorous and productive research effort and has produced: 20 MS degrees, 7 Ph.D. degrees, and has contributed to 9 ongoing Ph.D. students. The results of the research are documented in 32 publications (23 of which are included on a companion CDROM) and 4 annual student design reports (included on a companion CDROM). The legacy of this critical funding is the Center for Aerospace Systems Analysis at Georgia Tech which is continuing the graduate program, the research, and the industry internships established by this grant.

  17. Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity

    PubMed Central

    Hendriks, Anna-Marie; Gubbels, Jessica S.; De Vries, Nanne K.; Seidell, Jaap C.; Kremers, Stef P. J.; Jansen, Maria W. J.

    2012-01-01

    Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated public health policies is intersectoral collaboration. Since the development of integrated policies is still in its early stages, this study aimed to answer the following research question: “What interventions can promote intersectoral collaboration and the development of integrated health policies for the prevention of childhood obesity?” Data were collected through a literature search and observations of and interviews with stakeholders. Based on a theoretical framework, we categorized potential interventions that could optimize an integrated approach regarding children's physical activity and diet. The intervention categories included education, persuasion, incentivization, coercion, training, restriction, environmental restructuring, modeling, and enablement. PMID:22792120

  18. Designing a model for trauma system management using public health approach: the case of Iran.

    PubMed

    Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

    2012-01-01

    Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level. PMID:22267372

  19. The antimicrobial resistance containment and surveillance approach--a public health tool.

    PubMed Central

    Simonsen, Gunnar S.; Tapsall, John W.; Allegranzi, Benedetta; Talbot, Elizabeth A.; Lazzari, Stefano

    2004-01-01

    Antimicrobial drug resistance (AMR) is widely recognized as a global public health threat because it endangers the effectiveness of treatment of infectious diseases. In 2001 WHO issued the Global Strategy for Containment of Antimicrobial Resistance, but it has proved difficult to translate the recommendations of the Global Strategy into effective public health actions. The purpose of the Antimicrobial Resistance Containment and Surveillance (ARCS) approach is to facilitate the formulation of public health programmes and the mobilization of human and financial resources for the containment of AMR. The ARCS approach highlights the fundamental link between rational drug use and containment of AMR. Clinical management of human and animal infections should be improved through better disease control and prevention, high quality diagnostic testing, appropriate treatment regimens and consumer health education. At the same time, systems for supplying antimicrobial drugs should include appropriate regulations, lists of essential drugs, and functional mechanisms for the approval and delivery of drugs. Containment of AMR is defined in the ARCS approach as the continuous application of this package of core interventions. Surveillance of the extent and trends of antimicrobial resistance as well as the supply, selection and use of antimicrobial drugs should be established to monitor the process and outcome of containment of AMR. The ARCS approach is represented in the ARCS diagram (Fig. 2) which provides a simplified, but comprehensive illustration of the complex problem of containment and monitoring of AMR. PMID:15654407

  20. Designing a model for trauma system management using public health approach: the case of Iran.

    PubMed

    Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

    2012-01-01

    Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

  1. Multidisciplinary interventions in the management of atopic dermatitis.

    PubMed

    LeBovidge, Jennifer S; Elverson, Wendy; Timmons, Karol G; Hawryluk, Elena B; Rea, Corinna; Lee, Margaret; Schneider, Lynda C

    2016-08-01

    Atopic dermatitis (AD) is the most common pediatric skin disease. AD has a significant effect on patient and family quality of life caused by intense pruritus, sleep disruption, dietary and nutritional concerns, and psychological stress associated with the disease and its management. Multidisciplinary approaches to AD care have been developed in appreciation of the complex interplay among biological, psychological, behavioral, and dietary factors that affect disease control and the wide range of knowledge, skills, and support that patients and families require to effectively manage and cope with this condition. Common components of multidisciplinary treatment approaches include medical evaluation and management by an AD specialist, education and nursing care, psychological and behavioral support, and nutritional assessment and guidance. Models of care include both clinical programs and structured educational groups provided as adjuncts to standard clinical care. Available evidence suggests beneficial effects of multidisciplinary interventions in improving disease severity and quality of life, particularly for patients with moderate-to-severe disease. Additional research is needed to identify the best candidates for the various multidisciplinary approaches and evaluate the cost-effectiveness of these programs. PMID:27497275

  2. Multidisciplinary strategies in the management of early chronic kidney disease.

    PubMed

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

    2013-11-01

    Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. PMID:24215785

  3. An Evidence-Based Public Health Approach to Climate Change Adaptation

    PubMed Central

    Eidson, Millicent; Tlumak, Jennifer E.; Raab, Kristin K.; Luber, George

    2014-01-01

    Background: Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Objectives: Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. Methods: We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. Discussion: A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. Conclusions: The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders. Citation: Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G. 2014. An evidence-based public

  4. Publications.

    ERIC Educational Resources Information Center

    Aviation/Space, 1980

    1980-01-01

    Presents a variety of publications available from government and nongovernment sources. The government publications are from the Federal Aviation Administration (FAA) and the National Aeronautics and Space Administration (NASA) and are designed for educators, students, and the public. (Author/SA)

  5. Biobanking and public health: is a human rights approach the tie that binds?

    PubMed

    Meslin, Eric M; Garba, Ibrahim

    2011-09-01

    Ethical principles guiding public health and genomic medicine are often at odds: whereas public health practice adopts collectivist principles that emphasize population-based benefits, recent advances in genomic and personalized medicine are grounded in an individualist ethic that privileges informed consent, and the balancing of individual risk and benefit. Indeed, the attraction of personalized medicine is the promise it holds out to help individuals get the "right medicine for the right problem at the right time." Research biobanks are an effective tool in the genomic medicine toolbox. Biobanking in public health presents a unique case study to unpack some of these issues in more detail. For example, there is a long history of using banked tissue obtained under clinical diagnostic conditions for later public health uses. But despite the collectivist approach of public health, the principles applied to the ethical challenges of biobanking (e.g. informed consent, autonomy, privacy) remain individualist. We demonstrate the value of using human rights as a public health ethics framework to address this tension in biobanking by applying it to two illustrative cases.

  6. Understanding decision neuroscience: a multidisciplinary perspective and neural substrates.

    PubMed

    Miyapuram, Krishna P; Pammi, V S Chandrasekhar

    2013-01-01

    The neuroscience of decision making is a rapidly evolving multidisciplinary research area that employs neuroscientific techniques to explain various parameters associated with decision making behavior. In this chapter, we emphasize the role of multiple disciplines such as psychology, economics, neuroscience, and computational approaches in understanding the phenomenon of decision making. Further, we present a theoretical approach that suggests understanding the building blocks of decision making as bottom-up processes and integrate these with top-down modulatory factors. Relevant neurophysiological and neuroimaging findings that have used the building-block approach are reviewed. A unifying framework emphasizing multidisciplinary views would bring further insights into the active research area of decision making. Pointing to future directions for research, we focus on the role of computational approaches in such a unifying framework.

  7. Assessing students approaches to learning using a matrix framework in a Malaysian public university.

    PubMed

    Teoh, Hee Chong; Abdullah, Maria Chong; Roslan, Samsilah; Mohd Daud, Shaffe

    2014-01-01

    This study aims to evaluate the learning characteristics of students using a matrix framework of learning approaches (MFLA) in a Malaysian public university. A survey form based on Biggs's study process questionnaire (SPQ) was distributed to a total of 350 students. This study employed a descriptive correlation research design to address the research objectives. The findings revealed that Malaysian students are prone to applying the achieving approach in their studies. The achieving approach is the most preferable learning characteristic. The results also indicated that four of the nine hypothetical learning approaches exist, two of which are positive in nature. As a result, a proposed teaching method based on the MFLA was introduced to suit the needs of these major learning characteristics among students.

  8. Supporting Gang Violence Prevention Efforts: A Public Health Approach for Nurses.

    PubMed

    McDaniel, Dawn D; Logan, J E; Schneiderman, Janet U

    2014-01-31

    The impact of gang violence on a youth's risk for death or injury is tremendous. Prevention of complex societal problems, such as gang violence, requires a substantial effort and commitment from many sectors and disciplines. Nurses are uniquely positioned to help lead such efforts. Understanding the public health perspective to gang violence may be an important tool for nurses attempting to prevent this problem. The public health approach has four key components: defining and monitoring the problem; identifying risk, protective, and promoting factors; developing and evaluating interventions; and dissemination. This article outlines these components, current research on gang violence, and concludes by summarizing critical challenges for nurses to consider as they contribute to public health initiatives to prevent gang violence.

  9. The next generation of public health approaches to asthma in Asia and the Middle East.

    PubMed

    Van Sickle, David

    2010-07-01

    Chronic respiratory diseases now affect more than half a billion people worldwide and their importance as a global health problem has risen dramatically in recent years, prompting intense epidemiological investigation and the launch of numerous initiatives. Across Asia and the Middle East, a variety of environmental exposures increase the risk for the onset or exacerbation of chronic respiratory disease, resulting in a considerable burden of morbidity and mortality. This article outlines new possibilities for public health surveillance of environmental exposures and chronic respiratory disease built around an emerging model of participatory public health: a decentralized approach that involves citizens in the collection and analysis of data, harnesses pervasive technology such as mobile phones and distributed sensors, and provides an open platform for public-private collaboration.

  10. Supporting Gang Violence Prevention Efforts: A Public Health Approach for Nurses

    PubMed Central

    McDaniel, Dawn D.; Logan, J.E.; Schneiderman, Janet U.

    2015-01-01

    The impact of gang violence on a youth’s risk for death or injury is tremendous. Prevention of complex societal problems, such as gang violence, requires a substantial effort and commitment from many sectors and disciplines. Nurses are uniquely positioned to help lead such efforts. Understanding the public health perspective to gang violence may be an important tool for nurses attempting to prevent this problem. The public health approach has four key components: defining and monitoring the problem; identifying risk, protective, and promoting factors; developing and evaluating interventions; and dissemination. This article outlines these components, current research on gang violence, and concludes by summarizing critical challenges for nurses to consider as they contribute to public health initiatives to prevent gang violence. PMID:26752944

  11. A public health approach to the needs of children affected by terrorism.

    PubMed

    Baker, Duiona R

    2002-01-01

    The devastating terrorist incidents of Pan Am Flight 103, the Oklahoma City bombing, the bombings of the embassies in Kenya and Tanzania, and the World Trade Center attack of September 11, 2001, have forever changed America. These terrorist acts have deeply shaken the sense of safety, security, and well-being of our surviving children and families. These terrorist acts may also have increased the public health risks of substance abuse and mental illness for our children. The Substance Abuse and Mental Health Services Administration is responsible for strengthening prevention and treatment of substance abuse and mental illness in children and families. America's children may exhibit a wide range of emotional, physical, and psychological reactions following natural and man-made disasters. Large-scale disasters witnessed by children all underscore the need for a broad mental health and substance abuse public health approach. This approach is critical for our children's well-being.

  12. Space Culture: Innovative Cultural Approaches To Public Engagement With Astronomy, Space Science And Astronautics

    NASA Astrophysics Data System (ADS)

    Malina, Roger F.

    2012-01-01

    In recent years a number of cultural organizations have established ongoing programs of public engagement with astronomy, space science and astronautics. Many involve elements of citizen science initiatives, artists’ residencies in scientific laboratories and agencies, art and science festivals, and social network projects as well as more traditional exhibition venues. Recognizing these programs several agencies and organizations have established mechanisms for facilitating public engagement with astronomy and space science through cultural activities. The International Astronautics Federation has established an Technical Activities Committee for the Cultural Utilization of Space. Over the past year the NSF and NEA have organized disciplinary workshops to develop recommendations relating to art-science interaction and community building efforts. Rationales for encouraging public engagement via cultural projects range from theory of creativity, innovation and invention to cultural appropriation in the context of `socially robust science’ as advocated by Helga Nowotny of the European Research Council. Public engagement with science, as opposed to science education and outreach initiatives, require different approaches. Just as organizations have employed education professionals to lead education activities, so they must employ cultural professionals if they wish to develop public engagement projects via arts and culture. One outcome of the NSF and NEA workshops has been development of a rationale for converting STEM to STEAM by including the arts in STEM methodologies, particularly for K-12 where students can access science via arts and cultural contexts. Often these require new kinds of informal education approaches that exploit locative media, gaming platforms, artists projects and citizen science. Incorporating astronomy and space science content in art and cultural projects requires new skills in `cultural translation’ and `trans-mediation’ and new kinds

  13. Reusable design: A proposed approach to Public Health Informatics system design

    PubMed Central

    2011-01-01

    Background Since it was first defined in 1995, Public Health Informatics (PHI) has become a recognized discipline, with a research agenda, defined domain-specific competencies and a specialized corpus of technical knowledge. Information systems form a cornerstone of PHI research and implementation, representing significant progress for the nascent field. However, PHI does not advocate or incorporate standard, domain-appropriate design methods for implementing public health information systems. Reusable design is generalized design advice that can be reused in a range of similar contexts. We propose that PHI create and reuse information design knowledge by taking a systems approach that incorporates design methods from the disciplines of Human-Computer Interaction, Interaction Design and other related disciplines. Discussion Although PHI operates in a domain with unique characteristics, many design problems in public health correspond to classic design problems, suggesting that existing design methods and solution approaches are applicable to the design of public health information systems. Among the numerous methodological frameworks used in other disciplines, we identify scenario-based design and participatory design as two widely-employed methodologies that are appropriate for adoption as PHI standards. We make the case that these methods show promise to create reusable design knowledge in PHI. Summary We propose the formalization of a set of standard design methods within PHI that can be used to pursue a strategy of design knowledge creation and reuse for cost-effective, interoperable public health information systems. We suggest that all public health informaticians should be able to use these design methods and the methods should be incorporated into PHI training. PMID:21333000

  14. Multidisciplinary clinical management of paroxysmal nocturnal hemoglobinuria

    PubMed Central

    Sahin, Fahri; Ozkan, Melda Comert; Mete, Nihal Gokmen; Yilmaz, Mumtaz; Oruc, Nevin; Gurgun, Alev; Kayikcioglu, Meral; Guler, Ayse; Gokcay, Figen; Bilgir, Ferda; Ceylan, Cengiz; Bilgir, Oktay; Sari, Ismail Hakan; Saydam, Guray

    2015-01-01

    Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired disease caused by clonal expansion of one or more hematopoietic stem cell (HSC) lines due to a somatic mutation of the phosphatidylinositol glycan anchor (PIG-A) gene located on Xp22.1. PNH incidence is 1.5-2 cases per million of the population per year. PNH can affect multiple systems in the body and requires multidisciplinary clinical management. Patients can manifest with severe pancytopenia, life-threatening thrombosis affecting the hepatic, abdominal, cerebral, and subdermal veins, and high requirements for blood transfusion due to haemolytic anemia. PNH can also be associated with bone marrow failure. Advances in diagnostic techniques and a targeted therapeutic approach for PNH have emerged in the last two decades. Eculizumab, a promising humanized monoclonal antibody against C5, is the first approved therapy for PNH. PMID:26171279

  15. Multidisciplinary Interventions in Motor Neuron Disease

    PubMed Central

    Williams, U. E.; Philip-Ephraim, E. E.; Oparah, S. K.

    2014-01-01

    Motor neuron disease is a neurodegenerative disease characterized by loss of upper motor neuron in the motor cortex and lower motor neurons in the brain stem and spinal cord. Death occurs 2–4 years after the onset of the disease. A complex interplay of cellular processes such as mitochondrial dysfunction, oxidative stress, excitotoxicity, and impaired axonal transport are proposed pathogenetic processes underlying neuronal cell loss. Currently evidence exists for the use of riluzole as a disease modifying drug; multidisciplinary team care approach to patient management; noninvasive ventilation for respiratory management; botulinum toxin B for sialorrhoea treatment; palliative care throughout the course of the disease; and Modafinil use for fatigue treatment. Further research is needed in management of dysphagia, bronchial secretion, pseudobulbar affect, spasticity, cramps, insomnia, cognitive impairment, and communication in motor neuron disease. PMID:26317009

  16. Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health.

    PubMed

    Webb, Jena C; Mergler, Donna; Parkes, Margot W; Saint-Charles, Johanne; Spiegel, Jerry; Waltner-Toews, David; Yassi, Annalee; Woollard, Robert F

    2010-01-01

    The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.

  17. Training multidisciplinary leaders for health promotion in developing countries: lessons learned.

    PubMed

    Chamberlain, Jean; Watt, Susan

    2012-05-01

    The global picture of maternal mortality and morbidity has changed very little over the past 20 years despite isolated (and often medically based) efforts to improve the situation. A multidisciplinary approach to this very complicated social and cultural problem has been recommended. This article describes the approach taken by the Save the Mothers program in Uganda (Master of Public Health Leadership) and its focus on training national, primarily nonmedical, advocates to bring about the political and cultural change needed to improve maternal health. Emphasis is placed on attracting the right students (through targeted advertising and interviews of candidates), delivering the appropriate package of information to these multidisciplinary students (through problem-based learning and experiential opportunities in the community), and fostering networks among students and graduates to keep the issue of maternal mortality high on their personal and political agendas. Students benefit from a flexible program that allows them to continue to work and study simultaneously while ensuring a high-quality program with faculty who are experts in their area of teaching. Students require practical assistance in their research endeavors and are encouraged to focus their topic on a field related to their place of employment. PMID:22274706

  18. Public health nutrition in the civil service (England): approaches to tackling obesity.

    PubMed

    Blackshaw, J R

    2016-08-01

    The seriousness and scale of the physical, psychological, economic and societal consequences relating to poor diets, inactivity and obesity is unprecedented. Consequently, the contextual factors underpinning the work of a nutritionist in the civil service are complex and significant; however, there are real opportunities to make a difference and help improve the health of the nation. The present paper describes the delivery of public health nutrition through two work programmes, namely action to support young people develop healthier lifestyle choices and more recently the investigation and deployment of local insights to develop action to tackle obesity. Combining the application of nutrition expertise along with broader skills and approaches has enabled the translation of research and evidence into programmes of work to better the public's health. It is evident that the appropriate evaluation of such approaches has helped to deliver engaging and practical learning opportunities for young people. Furthermore, efforts to build on local intelligence and seek collaborative development can help inform the evidence base and seek to deliver public health approaches, which resonate with how people live their lives. PMID:26947185

  19. WARF's stem cell patents and tensions between public and private sector approaches to research.

    PubMed

    Golden, John M

    2010-01-01

    While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks. PMID:20579254

  20. WARF's stem cell patents and tensions between public and private sector approaches to research.

    PubMed

    Golden, John M

    2010-01-01

    While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks.