Science.gov

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. Acute mesenteric ischemia: current multidisciplinary approach.

    PubMed

    Savlania, Ajay; Tripathi, Ramesh K

    2017-04-01

    The aim of this review was to describe and discuss the mechanisms of acute mesenteric ischemia (AMI) and the rationale and conduct of currently available endovascular and open surgical techniques in its management. We also propose an algorithm to support the current multidisciplinary approach in decision-making for mesenteric revascularization to manage this high-risk entity.

  7. 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.

  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. 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.

  11. 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...

  12. A multidisciplinary approach for improving outcomes.

    PubMed

    Sierchio, Grace P

    2003-01-01

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

  13. A multidisciplinary approach to short bowel syndrome.

    PubMed

    Denegri, Andrea; Paparo, Francesco; Denegri, Roberto; Revelli, Matteo; Frascio, Marco; Rollandi, Gian Andrea; Fornaro, Rosario

    2014-01-01

    Short bowel syndrome is a complex clinical picture, characterized by signs and symptoms of malabsorption and subsequent malnutrition, which often occurs after extensive bowel resections. Short bowel syndrome's treatment must begin together with the planning of the first surgery, especially for disease that may need multiple interventions. Patients with short bowel should be individually managed because they all are different in diagnosis, length of the remaining bowel and in psychosocial characteristics. For all these reasons, a multidisciplinary approach between the various specialists is therefore needed.

  14. 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.

  15. The Future of Public Relations: A Multi-Disciplinary Analysis.

    ERIC Educational Resources Information Center

    Neff, Bonita Dostal

    Literature reviews have indicated there is a lack of data on public relations curriculum development for communication and business departments. Observations have been reported of "spectacular" growth in public relations courses in communication (Grunig, 1989). The first multi-disciplinary survey (3,201 college and university catalogs)…

  16. 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

  17. [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.

  18. An Overview of Three Approaches to Multidisciplinary Aeropropulsion Simulations

    NASA Technical Reports Server (NTRS)

    Lawrence, Charles

    1997-01-01

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

  19. 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.…

  20. 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.

  1. 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.

  2. [Ectopia cordis: multidisciplinary approach with successful result].

    PubMed

    Serrano Gómez, Servando Germán; Bermlúez Sosa, Marco Tulio; Palma Hernández, Emigdio; del Castillo Salceda, Luis Fernando; Pinzón Muslera, Otto; Hernández Cortés, Bernardino; Méndez Machado, Gustavo

    2006-08-01

    Ectopia cordis is a pathology in which the heart is complete or partially outside of the thoracic cavity. It represents a challenge for the diagnosis and handling because of its high perinatal mortality. We present the first case of thoracic ectopia cordis with prenatal diagnostic (27th week), its multidisciplinary handling at Hospital de Ginecopediatria núm. 71 of the Centro Medico Nacional Adolfo Ruiz Cortines, IMSS, in Veracruz, Mexico. We communicate the case of a 24 year-old woman referred by her correspondent medical unit with the diagnosis of 23.6 weeks pregnancy with suspicion of heart malformation by ultrasound. The pregnancy was followed-up until the 38th week, when it was programmed a caesarean section. The newborn had ectopia cordis, which was treated at the moment of birth. In this article, we present pictures of the heart defect as well as its evolution. The up-to-date bibliography is revised about the medical profile and treatment. The handling of the ectopia cordis includes an appropriate prenatal diagnosis through echocardiograph, a multidisciplinary perinatal team, to program the caesarean operation, aseptic handling of the newborn, immediate correction of the wall defect with skin torn piece without trying to correct the costal grill, specific hemodynamic cares, to reprogramme a correction of associated defects.

  3. 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.

  4. [Multidisciplinary approach for deep endometriosis: interests and organization].

    PubMed

    Dell'oro, M; Collinet, P; Robin, G; Rubod, C

    2013-01-01

    Deep endometriosis is a frequent disease that affects reproductive age women. This disease is characterized by the presence of functional endometrium-like tissue outside the uterus. The common sites of extragenital endometriosis are the bowel and the urinary tract. This disease is also associated with infertility. Furthermore, this disease can cause physical and psychological damage. Therefore, it is really important to develop a multidisciplinary approach in the aim to offer the appropriate treatment. The multidisciplinary team approach for endometriosis is developing to improve the understanding of endometriosis and a multidisciplinary committee for endometriosis was developed in our center. During this meeting, gynecologic, digestive surgeons, urologist, radiologist, procreative medical assistance physicians analyse the case. The role of surgery, before, after or as an alternative to in vitro fertilization (IVF) must be defined. The role of the medical treatment before or after the surgery, before the IVF shall be discussed in order to propose the optimal treatment. In fact, radical surgery is no more recommended and minimally invasive conservative surgery is encouraged in order to preserve the fertility. The multidisciplinary approach permits an appropriate optimal and personalised management of this multifocal disease. The multidisciplinary team approach helps in the development of evidence-based guidelines for the diagnosis and management of endometriosis.

  5. 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…

  6. 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

  7. [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.

  8. 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.

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

    PubMed

    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.

  10. 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

  11. 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.

  12. The importance of a multidisciplinary approach to hepatocellular carcinoma

    PubMed Central

    Siddique, Osama; Yoo, Eric R; Perumpail, Ryan B; Perumpail, Brandon J; Liu, Andy; Cholankeril, George; Ahmed, Aijaz

    2017-01-01

    Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners. In most cases, HCC is diagnosed by abdominal imaging studies, preferably with a triphasic computed tomography scan of the abdomen or magnetic resonance imaging of the abdomen. Histopathological diagnosis using a guided liver biopsy may be needed in noncirrhotic patients or when radiological diagnostic criteria are not fulfilled in the setting of cirrhosis. The Barcelona Clinic Liver Cancer staging system facilitates a standardized therapeutic strategy based on the tumor burden, extent of metastasis, severity of hepatic decompensation, comorbid medical illnesses, functional status of patient, HCC-related symptoms, and preference of the patient. Treatment options include curative surgery (hepatic resection and liver transplantation) and palliative measures (radiofrequency ablation, transarterial chemoembolization, and chemotherapy with sorafenib). The role of the multidisciplinary team is crucial in promptly reconfirming the diagnosis, staging the HCC, and formulating an individualized treatment plan. In potential liver transplant candidates, timely liver transplant evaluation and coordinating bridging/downsizing treatment modalities, such as radiofrequency ablation and transarterial chemoembolization, can be time-consuming. In summary, a multidisciplinary team approach provides a timely, individualized treatment plan, which can vary from curative surgery in patients with early-stage HCC to palliative

  13. Multidisciplinary approach to traumatized teeth: a case report.

    PubMed

    Yüzügüllü, Bulem; Polat, Omür; Ungör, Mete

    2008-10-01

    Treatment of crown fractures often requires a multidisciplinary approach. In the anterior teeth, reestablishment of proper esthetics and function is quite important for the patient. However, crown-root fractures with fracture line below the gingival attachment or alveolar bone crest presents restorative difficulties. This case report presents a cervical tooth fracture that had been treated with minimal invasive approach with different disciplines. The tooth had endodontic treatment and a glass-fiber post, and a composite core was accomplished. Then, the tooth was extruded to the desired level with orthodontic forced eruption before definitive restoration.

  14. 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.

  15. Theoretical Description of Teaching-Learning Processes: A Multidisciplinary Approach

    NASA Astrophysics Data System (ADS)

    Bordogna, Clelia M.; Albano, Ezequiel V.

    2001-09-01

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

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

    PubMed

    Bordogna, C M; Albano, E V

    2001-09-10

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

  17. 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

  18. 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

  19. Recreating an esthetically and functionally acceptable dentition: a multidisciplinary approach.

    PubMed

    Goyal, Mukesh Kumar; Goyal, Shelly; Hegde, Veena; Balkrishana, Dhanasekar; Narayana, Aparna I

    2013-01-01

    Patients today demand a youthful, attractive smile with comfortable functional acceptance. The complete oral rehabilitation of patients with a functionally compromised dentition frequently involves a multidisciplinary approach and presents a considerable clinical challenge. To a great extent, proper patient selection and careful interdisciplinary treatment planning, including acknowledgment of the patient's perceived needs, reasons for seeking services, financial ability, and socioeconomic profile, can govern the predictability of successful restorations. This clinical report describes a successful interdisciplinary approach for the management of a severely worn dentition with reduced vertical dimension of occlusion. Treatment modalities included periodontal crown lengthening procedures, endodontic treatment followed by post and core restorations, and prosthetic rehabilitation for severe tooth surface loss and reduced vertical dimension of occlusion comprising metal-ceramic restorations in esthetic zones and full-metal restorations in posterior regions.

  20. 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.

  1. Cardiac amyloidosis: the importance of a multidisciplinary approach.

    PubMed

    Gómez-Bueno, Manuel; Segovia, Javier; García-Pavía, Pablo; Barceló, Juan M; Krsnik, Isabel; Sánchez-Turrión, Víctor; Salas, Clara; Alonso-Pulpón, Luis

    2009-06-01

    Cardiac amyloidosis is associated with the interstitial deposition of abnormal protein in the myocardium, which can lead to a form of restrictive cardiomyopathy with a poor prognosis. This protein can have a number of different origins, which give rise to various subtypes of amyloidosis that have different prognoses and that require different therapeutic approaches. Drugs commonly used in heart failure have little effect in amyloidosis and the use of heart transplantation is controversial because amyloidosis is a multi-organ disease and because there is a possibility of disease recurrence in the graft. The use of new techniques to identify the specific amyloidosis subtype, the emergence of novel ways of preventing or decreasing amyloid production, the ability to monitor responses to therapy and, above all, the introduction of multidisciplinary teams that can implement a combination of therapies, including multiple organ transplantation, have contributed to a substantial improvement in the prognosis of this disease.

  2. Diagnosis and treatment of pulmonary embolism: a multidisciplinary approach

    PubMed Central

    2013-01-01

    The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature. PMID:24354912

  3. Diagnosis and treatment of pulmonary embolism: a multidisciplinary approach.

    PubMed

    Lavorini, Federico; Di Bello, Vitantonio; De Rimini, Maria Luisa; Lucignani, Giovanni; Marconi, Letizia; Palareti, Gualtiero; Pesavento, Raffaele; Prisco, Domenico; Santini, Massimo; Sverzellati, Nicola; Palla, Antonio; Pistolesi, Massimo

    2013-12-19

    The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature.

  4. 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

  5. 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.

  6. Wanted: interdisciplinary, multidisciplinary, and knowledge translation and exchange training for students of public health.

    PubMed

    Mishra, Lipi; Banerjee, Ananya T; MacLennan, Mary E; Gorczynski, Paul F; Zinszer, Kate A

    2011-01-01

    Students vocalized their concern with public health training programs in Canada at the 2010 CPHA Centennial Conference. Given these concerns, we reviewed the objectives and curricula of public health graduate (master's) programs in Canada. Our objective was to understand to what extent public and population health graduate programs in Canada support interdisciplinary, multidisciplinary and knowledge translation and exchange (KTE) training. This was achieved through a review of all public and population health master's programs in Canada identified from the public health graduate programs listed on the Public Health Agency of Canada website (n = 33) plus an additional four programs that were not originally captured on the list. Of the 37 programs reviewed, 28 (76%) stated that interdisciplinary, multidisciplinary or cross-disciplinary training opportunities are of value to their program, with 12 programs (32%) providing multidisciplinary or interdisciplinary training opportunities in their curriculum. Only 14 (38%) of the 37 programs provided value statements of KTE activities in their program goals or course objectives, with 10 (27%) programs offering KTE training in their curriculum. This review provides a glimpse into how public health programs in Canada value and support interdisciplinary and multidisciplinary collaboration as well as KTE activities.

  7. Multidisciplinary Approach to Management of Temporal Bone Giant Cell Tumor

    PubMed Central

    Nicoli, Taija K.; Saat, Riste; Kontio, Risto; Piippo, Anna; Tarkkanen, Maija; Tarkkanen, Jussi; Jero, Jussi

    2016-01-01

    Background Giant cell tumors (GCTs) are rare osseous tumors that rarely appear in the skull. Methods We review the clinical course of a 28-year-old previously healthy woman with a complicated GCT. Results The reviewed patient presented with a middle cranial fossa tumor acutely complicated by reactive mastoiditis. Left tympanomastoidectomy was performed for drainage of the mastoiditis and for biopsies of the tumor. Due to the challenging tumor location, the patient was treated with denosumab, a fully humanized monoclonal antibody against receptor activator of nuclear factor kappa-B ligand, for 7 months, which resulted in significant preoperative tumor shrinkage. Extensive temporal craniotomy and resection of the tumor followed utilizing a temporomandibular joint total endoprosthesis for reconstruction. A recurrence of the tumor was detected on computed tomography at 19 months after surgery and treated with transtemporal tumor resection, parotidectomy, and mandible re-reconstruction. Conclusion A multidisciplinary approach resulted in a good functional result and, finally, an eradication of the challengingly located middle cranial fossa tumor. PMID:28078198

  8. 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.

  9. 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

  10. Early treatment of unilateral temporomandibular joint ankylosis: a multidisciplinary approach.

    PubMed

    Ataç, Mustafa Sancar; Çakir, Merve; Yücel, Ergun; Gazioğlu, Çagri; Akkaya, Sevil

    2014-05-01

    Ankylosis of temporomandibular joint is a condition in which partial or complete immobilization of mandible occurs because of fusion between mandibular condyle and skull base. This condition can be treated orthodontically, surgically, or therapeutically or by prosthodontic rehabilitation. A 10-year-old female patient presented to the Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, with limited mouth opening. She got injury in the face when she was 5 years old. Extraoral and intraoral examination findings were facial asymmetry on the left side, micrognathic mandible, and 19-mm mouth opening. After radiographic examination, ankylosis (Shawney type I) on the left side was revealed, and the patient was referred to Department of Orthodontics. After orthodontic clinical examination, we create following multidisciplinary treatment approach: (1) acrylic posterior bite block with spring application, (2) interpositional arthroplasty operation, and (3) physiotherapy (passive mouth-opening exercises). After the follow-up of 9 months, significant improvement (5 mm) was noticed in the opening of the mouth, and we decided to remove appliance and operate on the patient. Surgical procedure was performed under general anesthesia via blinded nasotracheal intubation. To prevent postoperative relapse, temporal fascia was interpositioned and sutured. Passive mouth-opening exercises were started 10 days after the surgery. Thirty-one-millimeter mouth opening was reached after the surgery and passive mouth-opening exercises. Patient's routine controls have been continued for 2 years.

  11. 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, ...

  12. 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, ...

  13. 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…

  14. Public Law 99-457: Facilitating Family Participation on the Multidisciplinary Team.

    ERIC Educational Resources Information Center

    Nash, James K.

    1990-01-01

    This paper presents the requirements for family participation on multidisciplinary teams under Public Law 99-457, reviews literature on family participation on teams working with handicapped children, identifies factors that influence team functioning, and suggests how team members can facilitate family involvement. (Author/JDD)

  15. 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.…

  16. Impact of a multidisciplinary approach in enteropathic spondyloarthritis patients.

    PubMed

    Conigliaro, Paola; Chimenti, Maria Sole; Ascolani, Marta; Triggianese, Paola; Novelli, Lucia; Onali, Sara; Lolli, Elisabetta; Calabrese, Emma; Petruzziello, Carmelina; Pallone, Francesco; Perricone, Roberto; Biancone, Livia

    2016-02-01

    onset in the last two years in conjunction with the establishment of the GI-Rhe clinic. Multidisciplinary approach improved management of rheumatic disorders in IBD patients allowing a more comprehensive care.

  17. 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.

  18. Management of low back pain in computer users: A multidisciplinary approach

    PubMed Central

    Shete, Kiran M.; Suryawanshi, Prachi; Gandhi, Neha

    2012-01-01

    Background: Low back pain is a very common phenomenon in computer users. More than 80% people using computers for more than 4 h complain of back pain. Objective: To compare the effectiveness of multidisciplinary treatment approach and conventional treatment approach amongst computer users. Materials and Methods: A prospective interventional study was carried out at a private spine clinic amongst the computer users with the complaint of low back pain. The study participants were randomly distributed in two groups. The first group comprised the study participants treated by conventional approach and the second group was treated by multidisciplinary approach. Primary outcomes analyzed were pain intensity, sick leave availed, and quality of life. Statistical analysis was done using proportions, unpaired “t” test, and Wilcoxon signed-rank test. Results: Totally 44 study participants were randomly assigned to groups I and II, and each group had 22 study participants. Intensity of pain was reduced significantly in the group treated by multidisciplinary approach (t = 5.718; P = 0.0001). Similarly only 4 (19.19%) of the study participants of the group treated by multidisciplinary approach availed sick leave due to low back pain, while 14 (63.63%) study participants availed sick leave in the other group (P = 0.02). The quality of life amongst the study participants treated by multidisciplinary approach was significantly improved compared to the group treated by conventional approach (t = 7.037; P = 0.0001). Conclusion and Recommendation: The multidisciplinary treatment approach was better than the conventional treatment approach in low back pain cases when some factors like pain and quality of life were assessed. The multidisciplinary approach for treatment of low back pain should be promoted over conventional approach. Larger studies are required to confirm the findings in different settings. PMID:23741122

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

    PubMed

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

    2015-02-01

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

  20. 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

  1. 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.

  2. A multidisciplinary team care approach improves outcomes in high-risk pediatric neuroblastoma patients.

    PubMed

    Chang, Hsiu-Hao; Liu, Yen-Lin; Lu, Meng-Yao; Jou, Shiann-Tarng; Yang, Yung-Li; Lin, Dong-Tsamn; Lin, Kai-Hsin; Tzen, Kai-Yuan; Yen, Ruoh-Fang; Lu, Ching-Chu; Liu, Chia-Ju; Peng, Steven Shinn-Forng; Jeng, Yung-Ming; Huang, Shiu-Feng; Lee, Hsinyu; Juan, Hsueh-Fen; Huang, Min-Chuan; Liao, Yung-Feng; Lee, Ya-Ling; Hsu, Wen-Ming

    2017-01-17

    We assessed the impact of a multidisciplinary team care program on treatment outcomes in neuroblastoma patients. Newly diagnosed neuroblastoma patients received treatment under the Taiwan Pediatric Oncology Group (TPOG) N2002 protocol at the National Taiwan University Hospital beginning in 2002. A multidisciplinary team care approach that included nurse-led case management for patients treated under this protocol began in January 2010. Fifty-eight neuroblastoma patients, including 29 treated between 2002 and 2009 (Group 1) and 29 treated between 2010 and 2014 (Group 2), were enrolled in the study. The 5-year overall survival (OS) and event-free survival (EFS) rates for all 58 patients were 59% and 54.7%, respectively. Group 2 patients, who were treated after implementation of the multidisciplinary team care program, had better 3-year EFS (P = 0.046), but not OS (P = 0.16), rates than Group 1 patients. In a multivariate analysis, implementation of the multidisciplinary team approach was the only significant independent prognostic factor for neuroblastoma patients. In further subgroup analyses, the multidisciplinary team approach improved EFS, but not OS, in patients with stage 4 disease, those in the high-risk group, and those with non-MYCN amplified tumors. These data indicate a multidisciplinary team care approach improved survival outcomes in high-risk neuroblastoma patients. However, further investigation will be required to evaluate the long-term effects of this approach over longer follow-up periods.

  3. [Secondary lymphedema--the importance of a multidisciplinary team approach].

    PubMed

    Heldenberg, Eitan; Bass, Arie

    2013-03-01

    Secondary lymphedema is the most common type of lymphedema. Malignancy, mainly breast carcinoma, is the main cause of upper extremity lymphedema, while groin dissection, irradiation and trauma are the cause of lower extremity lymphedema. Early recognition of the pathology followed by early referral to a vascular surgeon, leading a multidisciplinary team, who takes care of those patients, can prevent a miserable Life from these patients. Lifelong commitment of the patients, prolonged financial support of the health insurance supplier, as well as team work of the group taking care of the patient, is the only way to help these patients.

  4. Robin sequence: what the multidisciplinary approach can do

    PubMed Central

    Cohen, Stephanie M; Greathouse, S Travis; Rabbani, Cyrus C; O’Neil, Joseph; Kardatzke, Matthew A; Hall, Tasha E; Bennett, William E; Daftary, Ameet S; Matt, Bruce H; Tholpady, Sunil S

    2017-01-01

    Robin sequence (RS) is a commonly encountered triad of micrognathia, glossoptosis, and airway obstruction, with or without a cleft palate. The management of airway obstruction is of paramount importance, and multiple reviews and retrospective series outline the diagnosis and treatment of RS. This article focuses on the multidisciplinary nature of RS and the specialists’ contributions and thought processes regarding the management of the RS child from birth to skeletal maturity. This review demonstrates that the care of these children extends far beyond the acute airway obstruction and that thorough monitoring and appropriate intervention are required to help them achieve optimal outcomes. PMID:28392703

  5. 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.

  6. 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

  7. 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.

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

    PubMed

    Brose, Steven W; Wali, Eisha

    2014-01-01

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

  9. 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

  10. 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

  11. Locally advanced rectal cancer: the importance of a multidisciplinary approach.

    PubMed

    Berardi, Rossana; Maccaroni, Elena; Onofri, Azzurra; Morgese, Francesca; Torniai, Mariangela; Tiberi, Michela; Ferrini, Consuelo; Cascinu, Stefano

    2014-12-14

    Rectal cancer accounts for a relevant part of colorectal cancer cases, with a mortality of 4-10/100000 per year. The development of locoregional recurrences and the occurrence of distant metastases both influences the prognosis of these patients. In the last two decades, new multimodality strategies have improved the prognosis of locally advanced rectal cancer with a significant reduction of local relapse and an increase in terms of overall survival. Radical surgery still remains the principal curative treatment and the introduction of total mesorectal excision has significantly achieved a reduction in terms of local recurrence rates. The employment of neoadjuvant treatment, delivered before surgery, also achieved an improved local control and an increased sphincter preservation rate in low-lying tumors, with an acceptable acute and late toxicity. This review describes the multidisciplinary management of rectal cancer, focusing on the effectiveness of neoadjuvant chemoradiotherapy and of post-operative adjuvant chemotherapy both in the standard combined modality treatment programs and in the ongoing research to improve these regimens.

  12. 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...

  13. The Multi-Disciplinary Approach in History and Ethnic Studies.

    ERIC Educational Resources Information Center

    Balogh, Sandor

    1980-01-01

    Considers the fractionalization of the social science disciplines indicating that this clear delineation of intellectual territory is important to research, but that in information assimilation and dissemination an interdisciplinary approach is more appropriate. Recommends two approaches to interdisciplinary studies based around history and ethnic…

  14. 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…

  15. Child Sexual Abuse and the Multidisciplinary Team Approach: Contradictions in Practice.

    ERIC Educational Resources Information Center

    Jacobson, Maxine

    2001-01-01

    Explores the ways in which shifting meanings of childhood and constructions of sexually abused children and the structuring of team practice pose problems for multidisciplinary team members. Argues that understanding child sexual abuse and developing community-based practice approaches must be informed by broader perspectives. Suggests a model of…

  16. Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management.

    PubMed

    Ellis, Michael J; Cordingley, Dean; Girardin, Richard; Ritchie, Lesley; Johnston, Janine

    The evaluation and management of athletes presenting with clinical features of migraine headache with aura in the setting of sports-related head trauma is challenging. We present a case report of a 15-yr-old boy with a history of migraine with visual aura that developed acute visual disturbance and headache after a head injury during an ice hockey game. The patient underwent comprehensive assessment at a multidisciplinary concussion program, including neuro-ophthalmological examination, neurocognitive testing, and graded aerobic treadmill testing. Clinical history and multidisciplinary assessment was consistent with the diagnosis of coexisting sports-related concussion and migraine with brainstem aura. The authors discuss the pearls and pitfalls of managing patients who develop migraine headache with visual aura after sports-related head injury and the value of a comprehensive multidisciplinary approach to this unique patient population.

  17. 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…

  18. 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…

  19. Consumer trust in food safety--a multidisciplinary approach and empirical evidence from Taiwan.

    PubMed

    Chen, Mei-Fang

    2008-12-01

    Food scandals that happened in recent years have increased consumers' risk perceptions of foods and decreased their trust in food safety. A better understanding of the consumer trust in food safety can improve the effectiveness of public policy and allow the development of the best practice in risk communication. This study proposes a research framework from a psychometric approach to investigate the relationships between the consumer's trust in food safety and the antecedents of risk perceptions of foods based on a reflexive modernization perspective and a cultural theory perspective in the hope of benefiting the future empirical study. The empirical results from a structural equation modeling analysis of Taiwan as a case in point reveal that this research framework based on a multidisciplinary perspective can be a valuable tool for a growing understanding of consumer trust in food safety. The antecedents in the psychometric research framework comprised reflexive modernization factors and cultural theory factors have all been supported in this study except the consumer's perception of pessimism toward food. Moreover, the empirical results of repeated measures analysis of variance give more detailed information to grasp empirical implications and to provide some suggestions to the actors and institutions involved in the food supply chain in Taiwan.

  20. A multidisciplinary approach to optimization of controlled space structures

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

    A fundamental problem facing controls-structures analysts is a means of determining the trade-offs between structural design parameters and control design parameters in meeting some particular performance criteria. Developing a general optimization-based design methodology integrating the disciplines of structural dynamics and controls is a logical approach. The objective of this study is to develop such a method. Classical design methodology involves three phases. The first is structural optimization, wherein structural member sizes are varied to minimize structural mass, subject to open-loop frequency constraints. The next phase integrates control and structure design with control gains as additional design variables. The final phase is analysis of the 'optimal' integrated design phase considering 'real' actuators and 'standard' member sizes. The control gains could be further optimized for fixed structure, and actuator saturation constraints could be imposed. However, such an approach does not take full advantage of opportunities to tailor the structure and control system design as one system.

  1. Preventing chronic obstructive pulmonary disease: a multidisciplinary approach.

    PubMed

    Aronovitch, M; Groszman, M

    1980-10-01

    Chemoprophylaxis, combined with prolonged treatment of bronchospasm, in patients with incipient or minimal obstructive chest disease has shown promising results in 30 patients. Physicians should include in their regular examination some means of early detection for chronic obstructive pulmonary diseases and in suitable cases institute chemoprophylaxis during the winter, as well as preventive vaccinations. In addition, longterm treatment of bronchial problems should be continued. This combined approach will help prevent recurrent infections which accelerate the progress of chronic obstructive chest disease.

  2. A multi-disciplinary approach to congenitally missing anterior teeth.

    PubMed

    Galler, David; Quiong, Caroline; Galler, Jeffrey

    2009-01-01

    Congenitally missing teeth are not an unusual occurrence. What makes this case study unique is the combination of restorative challenges offered. The patient presented with the permanent upper right cuspid and lower anterior right and left central incisors congenitally missing, and with an underdeveloped upper right lateral incisor. Distinctive existing occlusion and tooth alignment difficulties precluded a simple approach of merely extracting the residual primary teeth and replacing the missing teeth prosthetically. Using orthodontics to create ideal interocclusal and interarch space was critical in preparing this case for prosthetic restoration.

  3. Multidisciplinary Design Optimization Under Uncertainty: An Information Model Approach (PREPRINT)

    DTIC Science & Technology

    2011-03-01

    and c ∈ R, which is easily solved using the MatLab function fmincon. The reader is cautioned not to optimize over (t, p, c). Our approach requires a...would have to be expanded. The fifteen formulas can serve as the basis for numerical simulations, an easy task using MatLab . 5.3 Simulation of the higher...Design 130, 2008, 081402-1 – 081402-12. [32] M. Loève, ” Fonctions aléatoires du second ordre,” Suplement to P. Lévy, Pro- cessus Stochastiques et

  4. 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.

  5. 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

  6. 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.

  7. 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

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

    PubMed

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

    2013-02-01

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

  9. 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.

  10. The role of the Faculty of Public Health (Medicine) in developing a multidisciplinary public health profession in the UK.

    PubMed

    Griffiths, Sian; Crown, June; McEwen, Jim

    2007-06-01

    The Faculty of Public Health (FPH) started out its life as the Faculty of Community Medicine. Its initial membership was drawn from the ranks of Medical Officers of Health (MOsH), medical administrators and consultants working in communicable disease. Born under the aegis of the three Royal Colleges of Physicians, it was de facto for members of the medical profession. This was despite the intention of some of the prime movers in its creation that its membership should reflect the multidisciplinary nature of specialist public health. As such, whilst the Faculty's establishment was indeed a triumph, the triumph was only partial, since many senior public health professionals were precluded from full membership. Over the years this situation has changed, but the road to the Faculty's current open policy, based on achieving public health excellence rather than holding a professional badge, has not been a smooth one. The fears of many medical members that the specialty would be down graded through opening up its membership posed successive presidents with many, often justifiable, challenges. In this article we, former presidents, reflect on the key events during our successive tenures.

  11. 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

  12. [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.

  13. Shades of Grey: The Need for a Multi-disciplinary Approach to Research Investigating Alcohol and Ageing

    PubMed Central

    Wilkinson, Celia; Dare, Julie

    2014-01-01

    This paper calls for an increase in multi-disciplinary research on the issue of alcohol and ageing, to ensure public health interventions reflect the complex and diverse needs of older drinkers. Older people (65+ years) represent a unique segment of the population; compared to adolescents and younger people, they are more likely to have a range of co-morbid conditions and be taking prescribed medication, and are more physiologically vulnerable to the effects of alcohol. This suggests that from a public health perspective, alcohol use by older people is problematic. However, as with younger people, alcohol use is closely associated with socialisation and social engagement. While social engagement is important at all stages of life, it is particularly critical as people age, when many of the formal social roles which provide a catalyst for social integration shift or are lost. Currently, however, there is little evidence of an integrated public health response to the complex issue of alcohol and ageing. That is, what is needed is a concurrent acknowledgement of the health problems that may be associated with contraindicated alcohol use, versus the potential health benefits that can accrue from social drinking. This will require a holistic rather than reductionist approach that integrates biomedical and social science insights to develop a more comprehensive and nuanced understanding of the implications of alcohol use amongst diverse populations of older people. Significance for public health With the rapid ageing of the global population and concerns about recent increases in the consumption of alcohol amongst older people, the issue of alcohol and ageing is becoming an important public health issue. However, there remains little research that adopts a holistic multi-disciplinary perspective. Such research is important and may offer the best way forward in terms of unravelling the complexity of competing risks and benefits associated with low to moderate drinking

  14. 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.

  15. 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

  16. 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.

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

    PubMed Central

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

    2015-01-01

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

  18. Aorta Balloon Occlusion in Trauma: Three Cases Demonstrating Multidisciplinary Approach Already on Patient’s Arrival to the Emergency Room

    SciTech Connect

    Hörer, Tal M.; Hebron, Dan; Swaid, Forat; Korin, Alexander; Galili, Offer; Alfici, Ricardo; Kessel, Boris

    2016-02-15

    PurposeTo describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care.MethodsWe briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management.ResultsThree severely injured multi-trauma patients were treated by ABO as a bridge to surgery and embolization. The procedures were performed by an interventional radiologist in the early stages of trauma management.ConclusionsThe interventional radiologist and the multidisciplinary team approach can be activated already on severe trauma patient arrival. ABO usage and other endovascular methods are becoming more widely spread, and can be used early in trauma management, without delay, thus justifying the early activation of this multidisciplinary approach.

  19. Management of veno-occlusive disease: the multidisciplinary approach to care.

    PubMed

    Wallhult, Elisabeth; Kenyon, Michelle; Liptrott, Sarah; Mank, Arno; Ní Chonghaile, Mairéad; Babic, Aleksandra; Bijkerk, Jacobine; Bompoint, Caroline; Corbacioglu, Selim; de Weijer, Roel; Fink, Claudia; Marktel, Sarah; Soni, Vivek; Sprenger, Sarah; Arjona, Eugenia Trigoso; Mohty, Mohamad

    2017-04-01

    Although it is considered a relatively rare disorder, veno-occlusive disease (VOD) is one of the main causes of overall, non-relapse mortality associated with haematopoietic stem cell transplantation (HSCT). This article, based on the consensus opinion of haemato-oncology nurses, haemato-oncologists and pharmacists from both adult and paediatric services at the VOD International Multi-Disciplinary Advisory Board at the European Society for Blood and Marrow Transplantation (EBMT) meeting, Istanbul, 2015, aims to explore the multidisciplinary approach to care for the management of VOD, with an emphasis on current challenges in this area. The careful monitoring of HSCT patients allows early detection of the symptoms associated with VOD and timely treatment, ultimately improving patient outcomes. As part of a multidisciplinary team, nurses have an essential role to play, from pretransplant assessment to medical management and overall care of the patient. Physicians and pharmacists have a responsibility to facilitate education and training so that nurses can work effectively within that team.

  20. 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.

  1. 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.

  2. 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

  3. Minnesota plan for nonsmoking and health: multidisciplinary approach to risk factor control.

    PubMed

    Dean, A G; Shultz, J M; Gust, S W; Harty, K C; Moen, M E

    1986-01-01

    In 1981, the Minnesota Department of Health began a long-term program to control risk factors for the major health problems of the State as determined by an expert committee. The methods chosen to initiate programs were social, economic, and epidemiologic background research and a multidisciplinary statewide planning process. Smoking was considered the most important problem. During 1983-84, department staff members analyzed the epidemiology and economics of smoking in Minnesota and reviewed the literature on methods of smoking control. They and a multidisciplinary technical committee prepared a coordinated plan to increase the prevalence of nonsmoking in Minnesota. The 39 recommendations address mass communication and marketing, educational programs in schools, public and private regulation, economic disincentives through taxation, and funding of programs and evaluation of results. The Minnesota Plan for Nonsmoking and Health was released in September 1984. During the first half year, the plan provided material for formation of a coalition of health organizations to promote nonsmoking. In June 1985, the Minnesota Legislature passed the Omnibus Nonsmoking and Disease Prevention Act, which provides $4 million over 2 years for promotion of nonsmoking through education, regulation, and public communications. These intervention activities will be funded by a portion of a 5-cent increase in cigarette excise tax. The foundations have been laid for what may be the most comprehensive statewide nonsmoking program in the United States.

  4. 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

  5. Partnership for Diversity: A Multidisciplinary Approach to Nurturing Cultural Competence at an Emerging Medical School.

    PubMed

    Swanberg, Stephanie M; Abuelroos, Dena; Dabaja, Emman; Jurva, Stephanie; Martin, Kimberly; McCarron, Joshua; Reed-Hendon, Caryn; Yeow, Raymond Y; Harriott, Melphine M

    2015-01-01

    Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.

  6. Interim prosthetic phase of multidisciplinary management of cleidocranial dysplasia: "the Bronx Approach".

    PubMed

    Berg, Robert W; Kurtz, Kenneth S; Watanabe, Ikuya; Lambrakos, Anthony

    2011-10-01

    This case report presents treatment of two patients with the usual characteristics of Cleidocranial Dysostosis. A multidisciplinary approach using the disciplines of prosthodontics, orthodontics, and oral surgery was effected. Exfoliation of the patient's deciduous teeth and failure of permanent anterior tooth eruption led to emotional, social, and self-esteem issues in both patients. Due to the psychosocial issues confronting these two patients, esthetics was addressed prior to active intervention with orthodontics and after some surgical intervention. The use of two interim overdenture prostheses with magnetic retention is described.

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

    SciTech Connect

    McCalla, J.L.

    1985-03-01

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

  8. 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.

  9. Towards a multidisciplinary approach to understand and manage obesity and related diseases.

    PubMed

    Bischoff, Stephan C; Boirie, Yves; Cederholm, Tommy; Chourdakis, Michael; Cuerda, Cristina; Delzenne, Nathalie M; Deutz, Nicolaas E; Fouque, Denis; Genton, Laurence; Gil, Carmen; Koletzko, Berthold; Leon-Sanz, Miguel; Shamir, Raanan; Singer, Joelle; Singer, Pierre; Stroebele-Benschop, Nanette; Thorell, Anders; Weimann, Arved; Barazzoni, Rocco

    2016-11-16

    Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens. Obesity is usually accompanied by an increased muscle mass. This might explain why obesity, under particular circumstances such as cancer or high age, might have protective effects, a phenomenon named the 'obesity paradox'. However, loss of muscle mass or function can also occur, which is associated with poor prognosis and termed 'sarcopenic obesity'. Therefore, treatment recommendations may need to be individualized and adapted to co-morbidities. Since obesity is a chronic systemic disease it requires a multidisciplinary approach, both at the level of prevention and therapy including weight loss and maintenance. In the present personal review and position paper, authors from different disciplines including endocrinology, gastroenterology, nephrology, pediatrics, surgery, geriatrics, intensive care medicine, psychology and psychiatry, sports medicine and rheumatology, both at the basic science and clinical level, present their view on the topic and underline the necessity to provide a multidisciplinary approach, to address this epidemic.

  10. Predicting ectotherm disease vector spread--benefits from multidisciplinary approaches and directions forward.

    PubMed

    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 R0) 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.

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

    PubMed

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

    2005-09-01

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

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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

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

    PubMed

    Aoki, Shiro; Hosomi, Naohisa; 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.

  19. 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

  20. A multidisciplinary approach for ocular rehabilitation following surgical treatment of retinoblastoma: One year follow-up

    PubMed Central

    Aggarwal, Himanshi; Kumar, Pradeep; Singh, Raghuwar D.; Baslas, Varun; Alvi, Habib A.; Jurel, Sunit

    2013-01-01

    Retinoblastoma is a highly malignant neoplasm. Most of the cases are usually advanced at the time of detection, requiring enucleation to salvage the child's life. Just treating the patient for cancer is not enough; the cosmetic rehabilitation of these patients is equally important and it should always be an integral part of their treatment, to help them re-integrate in the aesthetic conscious society. Rehabilitating such patients require a multidisciplinary approach involving the combined and timely efforts of an ophthalmologist, paediatric oncologist and a skilled maxillofacial prosthodontist. This paper presents a case of 3½-year-old girl who had enucleation of her right eye due to retinoblastoma along with chemotherapy and radiotherapy at the age of 3 years. The patient was recalled regularly for follow-up at 3 month intervals for ophthalmic examinations and she was rehabilitated cosmetically with customised ocular prosthesis during the various stages of her developmental growth. PMID:24249955

  1. 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

  2. Multidisciplinary studies, systems approaches and parasite eco-epidemiology: something old, something new.

    PubMed

    Giraudoux, P; Raoul, F; Pleydell, D; Craig, P S

    2008-09-01

    Parasite requires an understanding of complex transmission systems where individual, population and environmental factors and their interactions can hardly been considered separately. Moreover, the importance of space and time in host population and parasite transmission processes is increasingly recognised. The present review illustrates how epidemiology and transmission ecology have evolved in a multidisciplinary framework to a systems approach that includes both spatial and temporal dimensions. Focusing on population processes, three significant challenges are discussed: (i) integration of landscape ecology concepts and modelling across time-space scales, (ii) development of molecular methods that permits easy parasite/host identification and process tracking (e.g. host and parasite movements), and (iii) integration of sociology methods to estimate zoonotic risk and exposure.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. Patient-centered Diabetes Care in Children: An Integrated, Individualized, Systems-oriented, and Multidisciplinary Approach

    PubMed Central

    Meusers, Michael; Quecke, Birgit; Hilgard, Dörte

    2013-01-01

    Background: Type 1 diabetes mellitus in children is associated with various medical, psychological, emotional, social, and organizational hurdles. Patient-centered disease management should address all patient-relevant issues in an individualized, systems-oriented, and multidisciplinary approach. Case: A 10-year-old girl with type 1 diabetes mellitus, a developmental disorder with motor and sensory dysfunction and dyscalculia was cared for full-time by her mother and an assistant nurse. Receiving standard intensified insulin therapy, she still had poor glucose control with frequent mild and severe hypoglycemic episodes. She was socially isolated and not able to attend peer activities and was frustrated with her situation. The mother was substantially stressed, and the child-mother relationship was endangered. The girl and her family were referred to an integrated, patient-centered, and highly individualized, multidisciplinary diabetic care program that offered self-management education courses and psychosomatic care. A core element was to switch the main focus from technical management and laboratory data to the girl and her specific problems, wishes, goals, needs, and conditions. The child became an active partner in management and decisions. The program offered age-appropriate activities. Consequently, the girl was able to successively self-manage her disease, resulting in a substantial improvement in glucose control, quality of life, satisfaction, and the relationship between mother and daughter. Conclusion: Increasing technical sophistication in diabetes management tends to lay the focus on biomedical outcomes. Improved medical and psychosocial results may be achieved when the patient and his or her needs, hurdles, goals, and psychological and social issues are made central to the care he or she receives. PMID:24278841

  8. 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

  9. 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.

  10. 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)…

  11. 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...

  12. A multidisciplinary approach for the management of pathologic tooth migration in a patient with moderately advanced periodontal disease.

    PubMed

    Kim, Young-Il; Kim, Myung-Jin; Choi, Jeom-Il; Park, Soo-Byung

    2012-04-01

    The physiologic tooth position is determined by interactions between the periodontal tissue and occlusal, tongue, and lip forces. Bone destruction resulting from chronic periodontal disease disturbs the equilibrium of these interactive balances, leading to pathologic tooth migration, often requiring multidisciplinary treatment approaches. The present case demonstrates a systematic periodontal-orthodontic-prosthetic treatment for achieving the optimal structural, functional, and esthetic outcomes.

  13. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach

    PubMed Central

    Mao, Feng; Dong, Yi; Ji, Zhengbiao; Cao, Jiaying

    2017-01-01

    Aim. To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group (n = 75). All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%). Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management. PMID:28133613

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

    PubMed

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

    2016-07-01

    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.

  15. 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

  16. Multidisciplinary approaches to understanding auditory hallucinations in schizophrenia and nonschizophrenia populations: the International Consortium on Hallucination Research.

    PubMed

    Waters, Flavie

    2012-06-01

    This special theme issue of Schizophrenia Bulletin presents a series of related articles focusing on auditory hallucinations, prepared by members of the International Consortium on Hallucination Research [InCoHR] working groups. The InCoHR is a large collaborative framework that serves as a platform for researchers to meet and collaborate on multidisciplinary projects relating to auditory hallucinations [AH] and discuss methodological issues facing transdiagnostic research. Laroi et al. observe the similarities in characteristic features of AHs in different clinical and nonclinical groups, but they also note that differences exist, reflecting the contribution of disease-related process. Waters et al. use findings of shared cognitive impairments across different diagnostic groups with AHs to propose a novel theoretical cognitive framework. Allen et al. describe that the neurobiological substrates of AHs include neural systems involved in language processing, as well as sensory and nonsensory brain regions and that studies are increasingly using fine-grain analysis of patients' characteristics in analyzing neuroimaging data. Ford et al. discuss different neurophysiological approaches and describes hallucination-related alterations in activity in temporal and frontal regions of the brain and particularly in auditory cortical areas. Finally, Sommer et al. review different treatment options for AHs in schizophrenia and other disorders, including pharmacological treatment, cognitive-behavioral therapy [CBT] and acceptance and commitment therapy [ACT], transcranial magnetic stimulation [TMS], and electroconvulsive therapy [ECT]. These related publications describe the current substance and direction of research on AHs across different diagnostic groups.

  17. 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

  18. Transthoracic approach for lesions involving the anterior dorsal spine: A multidisciplinary approach with good outcomes

    PubMed Central

    Balasubramaniam, Srikant; Tyagi, Devendra K; Zafar, Sheikh H; Savant, Hemant V

    2016-01-01

    Introduction: Anterior approach provides excellent visualization and access to the anterior thoracic spine. It may be used alone, in combination with a posterior midline approach or in a staged or sequential fashion. Aims: To analyse our institutional experience in transthoracic approaches and to determine the safety and benefit of this approach in our patient series. Materials and Methods: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach. The study was for a period of 5 years from January 2011 to December 2015. Patients age ranged from 25 to 61 years with an average of 36.4 yrs. There were 7 males and 9 females. In our series 9 patients had Kochs spine, 4 patients were traumatic fracture spine and 3 had neoplastic lesion. Majority of patients had multiple symptoms with backache being present in all patients. Results: There was one post operative mortality which was unrelated to surgery. One patient had post operative delayed kyphosis. Remaining patients improved in their symptoms following surgery. Conclusion: With careful coordination by thoracic surgeons, neurospinal surgeons and anaesthetists, the anterior spine approach for dorsal spine is safe and effective. Adequate preoperative evaluation should stratify the risk and institute measures to reduce it. Accurate surgical planning and careful surgical technique are the key to yield a good outcome and to reduce the risk of complications. PMID:27891033

  19. 'Taking public health out of the ghetto': the policy and practice of multi-disciplinary public health in the United Kingdom.

    PubMed

    Evans, David

    2003-09-01

    Until recently, a medical qualification was required for senior public health posts in the UK National Health Service. Since 1997, the new Labour government has expressed its intention to take public health 'out of the ghetto' and to develop multi-disciplinary public health. In particular, it has announced the creation of a new senior professional role of specialist in public health equivalent to the consultant in public health medicine, and open to a range of disciplines. This paper asks 'what is really going on with the policy and practice of multi-disciplinary public health in the UK?' The answer draws on recent debates in the sociology of the professions, in particular the theoretical perspectives of Freidson (Profession of Medicine: a Study of the Sociology of Applied Knowledge, Dodd, Mead & Co, New York, 1970; Professional Powers: a Study of the Institutionalization of Formal Knowledge, University of Chicago Press, Chicago, 1986) and Larson (The Rise of Professionalism: a Sociological Analysis, University of California Press, Berkeley, 1977) concerning the 'professional project', Foucault's (Ideol. Consciousness 6 (1979) 5) notion of 'governmentality' and Harrison and Wood's (Public Admin. 77 (1999) 751) concept of 'manipulated emergence'. Key characteristics of the professional project are 'autonomy', the profession's ability to control its technical knowledge and application, and 'dominance', control over the work of others in the health care division of labour. Although useful as an explanatory framework for the period 1972-1997, the concept of the professional project does not easily explain the process of change since 1997. Here Foucault's concept of governmentality is helpful. Governmentality entails all those procedures, techniques, mechanisms, institutions and knowledges that empower political programmes. Professions are part of the process of governmentality, and their autonomy is always contingent upon the wider political context. Thus public health

  20. The right team at the right time - Multidisciplinary approach to multi-trauma patient with orthopedic injuries.

    PubMed

    Bach, John A; Leskovan, John J; Scharschmidt, Thomas; Boulger, Creagh; Papadimos, Thomas J; Russell, Sarah; Bahner, David P; Stawicki, Stanislaw P A

    2017-01-01

    Integrated, multidisciplinary team approach to the multiply injured patient can help optimize care, minimize morbidity, and reduce mortality. It also provides a framework for accelerated postinjury rehabilitation course. The characteristics and potential benefits of this approach, including team dynamics and interactions, are discussed in this brief review. Emphasis is placed on synergies provided by specialty teams working together in the framework of care coordination, timing of surgical and nonsurgical interventions, and injury/physiologic considerations.

  1. Multidisciplinary optimization

    SciTech Connect

    Dennis, J.; Lewis, R.M.; Cramer, E.J.; Frank, P.M.; Shubin, G.R.

    1994-12-31

    This talk will use aeroelastic design and reservoir characterization as examples to introduce some approaches to MDO, or Multidisciplinary Optimization. This problem arises especially in engineering design, where it is considered of paramount importance in today`s competitive global business climate. It is interesting to an optimizer because the constraints involve coupled dissimilar systems of parameterized partial differential equations each arising from a different discipline, like structural analysis, computational fluid dynamics, etc. Usually, these constraints are accessible only through pde solvers rather than through algebraic residual calculations as we are used to having. Thus, just finding a multidisciplinary feasible point is a daunting task. Many such problems have discrete variable disciplines, multiple objectives, and other challenging features. After discussing some interesting practical features of the design problem, we will give some standard ways to formulate the problem as well as some novel ways that lend themselves to divide-and-conquer parallelism.

  2. 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.

  3. 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

  4. Reproductive outcome of male carriers of chromosomal abnormalities: multidisciplinary approach for genetic counseling and its implications.

    PubMed

    Guo, K M; Wu, B; Wang, H B; Tian, R H

    2016-12-02

    Chromosomal abnormality is the most common genetic cause of infertility. Infertility, as a psychological problem, has received an increasing amount of attention. Psychological interventions have been shown to have beneficial effects on infertile patients with chromosomal abnormalities. The present study explored reproductive outcome of male carriers of chromosomal abnormalities, who accepted genetic counseling and psychological support. Cytogenetic analysis was performed using cultured peripheral blood lymphocytes and G-banding. The detection rate of chromosomal abnormalities was 10.3% in pre-pregnancy counseled males, with polymorphisms being most common, followed by 47,XXY and balanced translocation. Follow-up of 170 carriers with normozoospermia, after 3 years, showed that 94.7% of the cases resulted in live births. In the carriers of polymorphisms, balanced translocation, inv(9), Robertsonian translocation, inversion, and 47,XYY, live birth rates were 96.8, 85.7, 100, 83.3, 75, and 100%, respectively. Follow-up of 54 carriers with oligozoospermia or azoospermia, after 3 years, showed that 14.8% of the cases resulted in live births. In the carriers of 47,XXY with severe oligozoospermia or azoospermia, 80 or 5.9% of the cases resulted in live births, respectively. Therefore, timely psychological support would be beneficial and multidisciplinary approach should be preferentially considered for the management of individuals with chromosomal abnormalities.

  5. 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

  6. Collaborative multidisciplinary team approach to fertility issues among adolescent and young adult cancer patients.

    PubMed

    Nagel, Kim; Cassano, Jane; Wizowski, Lindsay; Neal, Michael S

    2009-08-01

    Cancer treatment and the field of reproductive technology have each made impressive advancements in the last decade. Improved cancer treatment and survival rates have increased the number of cancer survivors, who might benefit from an array of fertility preservation strategies provided by emerging and advanced assisted conception technology. The challenge becomes bridging the gap between these two separate disciplines to ultimately improve the quality of life for cancer survivors. This paper discusses the issues and process involved with bringing these two teams of health-care professionals together. This model provides a framework for coordinating efforts in providing fertility preservation options to patients undergoing treatment for cancer. Effective multidisciplinary teams that include: oncologists, nurses in the specialties of oncology and infertility, social workers, reproductive endocrinology and infertility specialists, andrologists, and embryologists are required to work together in order to achieve success. The result of this unique team approach is not only a cancer survivor, but one whose quality of life might be enhanced by being able to have a child of his or her own in the future.

  7. Multidisciplinary approach of organic catatonia in children and adolescents may improve treatment decision making.

    PubMed

    Lahutte, Bertrand; Cornic, Françoise; Bonnot, Olivier; Consoli, Angèle; An-Gourfinkel, Isabelle; Amoura, Zahir; Sedel, Frédéric; Cohen, David

    2008-08-01

    Catatonia is an infrequent but severe condition in young people. Organic diseases may be associated and need to be investigated though no specific recommendations and guidelines are available. We extensively reviewed the literature of all the cases of organic catatonia in children and adolescents from January 1969 to June 2007. We screened socio-demographic characteristics, organic diagnosis, clinical characteristics and treatment. We found 38 cases of children and adolescents with catatonia due to an organic condition. The catatonic syndrome occurred in 21 (57%) females and 16 (43%) males. The mean age of patients was 14.5 years (+/-3.39) [range=7-18 years], and three died from their condition. The organic conditions included infectious diseases (N=10), neurological conditions (N=10), toxic induced states (N=12) and genetic conditions including inborn errors of metabolism (N=6). The onset was dominantly acute, and the clinical presentation most frequently stuporous. Although benzodiazepines were recommended as primary symptomatic treatment, they were rarely prescribed. In several cases, therapeutic approach was related to organic cause (e.g., plasma exchange in lupus erythematosus; copper chelators in Wilson's disease). Based on this review and on our own experience of catatonia in youth, we proposed a consensual and multidisciplinary diagnostic strategy to help practitioners to identify underlying organic diseases.

  8. Invasive Squamous Cell Carcinoma of the Scalp and Calvarium: A Multidisciplinary Approach

    PubMed Central

    Podda, Silvio; Szymanski, Karen

    2016-01-01

    Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage. Methods: This type of reconstruction was performed utilizing a multidisciplinary approach. Our patient required calvarial reconstruction with titanium mesh, dural reconstruction, latissimus dorsi free flap, and an overlying skin graft. Results: The patient had appropriate resection of his tumor while maintaining flap viability. Postoperatively, he presented with excellent soft-tissue thickness and aesthetic result. Conclusion: We believe that this type of reconstruction was best, considering our patient had a significant scalp and calvarial defect at presentation. Using a latissimus dorsi free flap bestows a robust blood supply to help decrease infections and improve healing and circulation, especially in light of the need of further radiation therapy. PMID:27909467

  9. 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.

  10. Multidisciplinary approach to childhood epilepsy: exploring the scientific rationale and practical aspects of implementation.

    PubMed

    Goldstein, Joshua; Plioplys, Sigita; Zelko, Frank; Mass, Sarah; Corns, Christine; Blaufuss, Robert; Nordli, Douglas

    2004-05-01

    The management of childhood epilepsy requires attention to more than seizure control because children with epilepsy often suffer from comorbidities that lead to an increased frequency of psychiatric disease, learning difficulties, and other problems of psychosocial development. These comorbidities can stem in part from the same genetic traits that determine seizure susceptibility. Thus, mutations affecting potassium, calcium, and sodium channels have been linked with epilepsy syndromes and affective and behavioral abnormalities. It is important to consider the effect of antiepilepsy drugs on comorbid conditions and the effect on seizures of drugs used to treat comorbidities. A number of antiepilepsy drugs are available that have minimal adverse cognitive effects, and some can have positive effects on mood and behavior. Epilepsy in a child is a condition that affects and is affected by the entire family situation. In addition to appropriate neuropsychologic evaluation, optimal management of childhood epilepsy also can require the involvement of the social worker, advanced practice nurse, and educational specialist. Many elements of the multidisciplinary team approach can be instituted by the child neurologist in community practice and at large, specialized epilepsy centers.

  11. Diagnosis and underdiagnosis of comorbidities in psoriasis patients - need for a multidisciplinary approach*

    PubMed Central

    Duarte, Gleison Vieira; de Oliveira, Maria de Fátima S. P.; Follador, Ivonise; Silva, Thadeu Santo; de Carvalho Filho, Edgar Marcelino

    2016-01-01

    BACKGROUND Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations. OBJECTIVE To identify the prevalence of these comorbidities in 296 patients followed up at a university dermatology clinic. METHODS Systematically investigated comorbidity frequencies were compared with general practitioners' registry frequencies. Clinical features correlated with comorbidities were also investigated. RESULTS High prevalences of systematically investigated comorbidities such as hypertension (30%) and dyslipidemia (26.5%) were documented. Conversely, data from general practitioners' records showed that 33% of dyslipidemia cases were undiagnosed and indicated possible underdiagnosis of some comorbidities. Furthermore, an association was found between: the number of comorbidities and psoriasis duration, age and high body mass index an association was found between the number of comorbidities and psoriasis duration, age, high body mass index, waist circumference or waist-to-hip ratio. (p<0.05). CONCLUSION Disease duration, age and high body mass index, waist circumference or waist-to-hip ratio are possible criteria for choosing which patients should be screened for comorbidities. Underdiagnosis of comorbidities by general practitioners highlights the need for a multidisciplinary approach in psoriasis management. PMID:28099594

  12. Multidisciplinary Approach to an Extended Pressure Sore at the Lumbosacral Area

    PubMed Central

    Yoon, Sehoon; Lázaro, Hudson Alex

    2016-01-01

    A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible. The large soft tissue defect with significant depth was reconstructed with a free latissimus dorsi musculocutaneous flap, which was expected to act as a local barrier from vertical infection and provide tensionless skin coverage upon hip flexion. The extensive sacral sore was treated effectively without complication, and the deep tissue infection completely resolved. There was no evidence of donor site morbidity, and wheelchair ambulation was possible by a month after surgery. PMID:27896193

  13. The Manawatu aquifers, North Island, New Zealand: Clarification of hydrogeology using a multidisciplinary environmental tracer approach

    NASA Astrophysics Data System (ADS)

    Taylor, C. B.; Trompetter, V. J.; Brown, L. J.; Bekesi, G.

    2001-12-01

    A recently developed approach to carbon isotope methodology (process recognition via isotope diagrams) is applied in a multidisciplinary study of precipitation-recharged aquifers of the lowlands-plains area of the Manawatu (south-west North Island). Urban and rural areas rely on groundwater from the upper levels of a deep basin sequence comprising marine and terrestrial sediments of Pleistocene age. Hydrochemical and isotopic (18O, 3H, 13C and 14C) data are merged with known details of geology and hydrogeology to reveal two separate confined aquifers within the depth range to 200 m. The shallower of these, below unconfined, locally recharged groundwater, is recharged on the foothills of the Ruahine Range to the north-east of the study area; flow direction is NE-SW. The deeper confined aquifer is recharged on the Tararua Range to the immediate east; flow direction essentially is transverse (SE-NW) to that in the shallower aquifer. Two processes are identified as dominant contributors to concentration and isotopic composition of dissolved inorganic carbon (DIC), namely addition of CO2 from decay of organic materials and carbonate dissolution. Limitations of carbon isotope methods in determining residence times are illustrated by the data. Although the confined groundwater is essentially tritium-free, only a few samples showed conclusive evidence of significant ageing on the time-scale of 14C.

  14. A multidisciplinary approach to assess the welfare of weaned pigs during transport at three space allowances.

    PubMed

    Sutherland, Mhairi A; Bryer, Pamela J; Davis, Brittany L; McGlone, John J

    2010-01-01

    Transport can be a stressful experience for pigs, especially in pigs simultaneously experiencing weaning stress. The objective of this study was to use a multidisciplinary approach to assess the welfare of weaned pigs during transport at 3 space allowances. A commercial semitrailer, fitted with compartments, provided 0.05, 0.06, and 0.07 m(2)/pig. The study recorded frequency of standing, lying, sitting, and standing-rearing on another pig during the entire duration of transport. Blood samples, body weights, and lesion scores were collected from a subset of pigs (n = 48 per space allowance) in each experimental compartment. Transport time for the pigs was 148.0 +/- 10.0 min to the wean-to-finishing site. Total white blood cell counts, cortisol, and several blood chemistry values increased (p < .05) after transport regardless of space allowance. Glucose and body weight decreased (p < .05) after transport regardless of space allowance. Space allowance influenced stand-rearing, sitting, standing, and lying behaviors in pigs. Combining behavioral and physiological measures of stress provides a robust picture of piglet welfare during transport at different space allowances.

  15. [DiGeorge syndrome and vascular ring. An unusual association with multidisciplinary approach].

    PubMed

    Garcia, Pedro; Anjos, Rui; Abecassis, Miguel; Santos, José A Oliveira; Martins, F Maymone

    2009-01-01

    Velo-cardio-facial syndrome/DiGeorge/CATCH 22 is a spectrum of association, characterized by unusual face, cleft or incompetent palate, congenital heart disease with defects of the outflow tracts, absence of the thymus and parathyroid glands, often associated with developmental and behavioral disorders. This association is caused by a microdeletion in chromosome band 22q11.2. In a 4-month-old infant, with obstructive lower respiratory distress and poor weight gain since 2 months of age, truncus arteriosus was diagnosed and surgically corrected. On the postoperative period maintained dependency on mechanical ventilation, with persistent hypoventilation of the left lung. Fiberoptic bronchoscopy revealed complete obstruction of the left main bronchus by an extrinsic compression due to a vascular ring diagnosed by cardiac catheterization that showed a common anomalous origin of both right and left subclavian arteries and the ligamentum arteriosum. A second surgery by left lateral thoracotomy corrected the vascular ring. The maintenance of the collapse of the left main bronchus led to selective endobronchial stenting. The migration of the stent to the trachea, with acute respiratory distress, required emergent endoscopic removal of the stent. Thereafter, the evolution was uneventful. The association of DiGeorge syndrome with vascular ring is unusual. Unexpected evolution in these patients require a multidisciplinary technical approach for diagnosis and eventual emergent intervention.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

    PubMed Central

    Bach, John A.; Leskovan, John J.; Scharschmidt, Thomas; Boulger, Creagh; Papadimos, Thomas J.; Russell, Sarah; Bahner, David P.; Stawicki, Stanislaw P. A.

    2017-01-01

    Integrated, multidisciplinary team approach to the multiply injured patient can help optimize care, minimize morbidity, and reduce mortality. It also provides a framework for accelerated postinjury rehabilitation course. The characteristics and potential benefits of this approach, including team dynamics and interactions, are discussed in this brief review. Emphasis is placed on synergies provided by specialty teams working together in the framework of care coordination, timing of surgical and nonsurgical interventions, and injury/physiologic considerations. Republished with permission from: Bach JA, Leskovan JJ, Scharschmidt T, Boulger C, Papadimos TJ, Russell S, Bahner DP, Stawicki SPA. Multidisciplinary approach to multi-trauma patient with orthopedic injuries: the right team at the right time. OPUS 12 Scientist 2012;6(1):6-10. PMID:28382257

  1. 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.

  2. 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

  3. Evaluation of patients with a recent clinical fracture and osteoporosis, a multidisciplinary approach

    PubMed Central

    Dumitrescu, Bianca; van Helden, Svenjhalmar; ten Broeke, Rene; Nieuwenhuijzen-Kruseman, Arie; Wyers, Caroline; Udrea, Gabriela; Linden, Sjef van der; Geusens, Piet

    2008-01-01

    The aetiology of osteoporotic fractures is multifactorial, but little is known about the way to evaluate patients with a recent clinical fracture for the presence of secondary osteoporosis. The purpose of this study was to determine the prevalence of contributors to secondary osteoporosis in patients presenting with a clinical vertebral or non-vertebral fracture. Identifying and correcting these contributors will enhance treatment effect aimed at reducing the risk of subsequent fractures. In a multidisciplinary approach, including evaluation of bone and fall-related risk factors, 100 consecutive women (n = 73) and men (n = 27) older than 50 years presenting with a clinical vertebral or non-vertebral fracture and having osteoporosis (T-score ≤-2.5) were further evaluated clinically and by laboratory testing for the presence of contributors to secondary osteoporosis. In 27 patients, 34 contributors were previously known, in 50 patients 52 new contributors were diagnosed (mainly vitamin D deficiency in 42) and 14 needed further exploration because of laboratory abnormalities (mainly abnormal thyroid stimulating hormone in 9). The 57 patients with contributors were older (71 vs. 64 yrs, p < 0.01), had more vertebral deformities (67% vs. 44%, p < 0.05) and a higher calculated absolute 10-year risk for major (16.5 vs. 9.9%, p < 0.01) and for hip fracture (6.9 vs. 2.4%, p < 0.01) than patients without contributors. The presence of contributors was similar between women and men and between patients with fractures associated with a low or high-energy trauma. We conclude that more than one in two patients presenting with a clinical vertebral or non-vertebral fracture and BMD-osteoporosis have secondary contributors to osteoporosis, most of which were correctable. Identifying and correcting these associated disorders will enhance treatment effect aimed at reducing the risk of subsequent fractures in patients older than 50 years. PMID:18680609

  4. Biotic and inorganic control on travertine deposition at Bullicame 3 spring (Viterbo, Italy): A multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Di Benedetto, F.; Montegrossi, G.; Minissale, A.; Pardi, L. A.; Romanelli, M.; Tassi, F.; Delgado Huertas, A.; Pampin, E. M.; Vaselli, O.; Borrini, D.

    2011-08-01

    A multidisciplinary characterization of an active thermal spring in central Italy has been undertaken with the aim of (i) ascertaining whether microbiological activity plays a relevant role in hot-depositing travertines and (ii) establishing an experimental protocol able to identify similar effects in fossil travertines. Water, gas, and travertine samples were investigated by chemical (ICP/MS, SEM/EDS), physical (DTA-DTG), isotopic (δ 18O, δD, and δ 13C), mineralogical (XRPD), and spectroscopic (EPR) techniques. Twenty-four samples (three for each phase) were collected every 5 °C temperature drop, along a ˜100 m long artificial channel near Viterbo ( Bullicame 3, Latium, central Italy). A microbiological characterization was carried out in parallel, sampling the channel every 10 °C temperature drop. The Bullicame 3 system is revealed to be composed of two markedly different subsystems: a water/gas interface, where a kinetically fast exchange allows equilibrium of components both in water and in gases; a solid/water interface, where travertine precipitation occurs, influenced by microbiological activity. A peculiar lattice shrinking of calcite was identified, as well as an anomalous value of the zero-field splitting parameter from the EPR measurements. The interpretation of these anomalies is confirmed by the identification of calcifying cyanobacteria throughout the channel path. Our results point out that microbiological activity can play a significant role in travertine deposition from hot springs. Furthermore, the proposed approach, representing a tool to identify crystal chemical remnants of past microbiological activity, could be applicable to fossil travertines.

  5. 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

  6. Gastrointestinal stromal tumors: evolving role of the multidisciplinary team approach in management.

    PubMed

    Reichardt, Peter; Morosi, Carlo; Wardelmann, Eva; Gronchi, Alessandro

    2012-08-01

    Gastrointestinal stromal tumors (GISTs) are rare tumors of the GI tract arising from mesenchymal cells. Treatment options include surgical resection and medical therapy with imatinib. A summary of National Comprehensive Cancer Network and European Society of Medical Oncology clinical practice guidelines relating to GIST management are presented here. A multidisciplinary team of physicians is essential to the successful treatment of GIST. Evidence supports multidisciplinary team management with a gastroenterologist, surgeon, medical oncologist, pathologist and radiologist. Consultations between them are recommended to ensure optimal care of patients with GIST. The role for individual core team workers is highlighted. The benefits of multidisciplinary disease management of patients include reducing recurrent disease, optimizing timing of surgery and organ preservation, prolonging survival for the patient and enhancing response to targeted therapies.

  7. Multidisciplinary approach to "accidental" falls in the elderly: a case report.

    PubMed

    Galizia, Gianluigi; Testa, Gianluca; Mazzella, Francesca; Cacciatore, Francesco; Ungar, Andrea; Masotti, Giulio; Rengo, Franco; Abete, Pasquale

    2008-06-01

    Falls in the elderly are commonly and often wrongly identified as "accidental". We report a case of an elderly woman admitted to first aid for a trauma due to an accidental fall. Geriatric multidisciplinary evaluation revealed mild cognitive impairment associated with depressive symptoms; both findings made the anamnesis uncertain. Syncope algorithm was applied and "tachy-brady form of sick sinus syndrome" was diagnosed. Differential diagnosis between "accidental" and "apparently accidental" falls in elderly patients is very difficult but a multidisciplinary geriatric evaluation can clarify the correct diagnosis.

  8. 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.

  9. 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

  10. Biodiversity conservation: an example of a multidisciplinary approach to marine dispersal.

    PubMed

    Aliani, Stefano; Berta, Maristella; Borghini, Mireno; Carlson, Daniel; Conversi, Alessandra; Corgnati, Lorenzo; Griffa, Annalisa; Magaldi, Marcello Gatimu; Mantovani, Carlo; Marini, Simone; Mazzei, Luca; Suaria, Giuseppe; Vetrano, Anna

    The general aim of this paper is to present a possible multidisciplinary approach to the problem of connectivity among marine protected areas (MPAs) describing some of the mechanisms and vectors that control the dispersal of propagules among spatially distributed marine communities of MPAs in the Southern Adriatic Sea. A joint approach is described that focuses on (a) measurements of surface water current and model data integrated with a dedicated software (LAVA, LAgrangian Variational Analysis), (b) measurements of rafting objects and their evaluation as an alternative way to species dispersal, and (c) a tool to automatically monitor propagules and plankton species in the water column. Studies on the dynamics of water currents demonstrated that the Gargano area has the potential to supply dispersal propagules to the Southern Adriatic both along the Italian coastline and offshore across the basin, thus providing important services to the dispersal processes and the connectivity routes among MPAs. The natural dispersion is however enhanced by floating objects, on which entire marine communities are living and travelling. The number of these objects has greatly increased with the introduction of human litter: in the Adriatic, man-made litter composes nowadays the majority (79 %) of all floating objects, with this corresponding to an almost fourfold increase in the abundance of floating objects since pre-industrial times. Such enhanced dispersion may benefit transmission of propagules from MPAs along biodiversity corridors, but may also enhance the arrival of invasive species. The direct observation of organisms can provide information on the species distribution and mobility. New technology (GUARD-1 system) has been developed to automatically identify spatial or temporal distributions of selected species in the water column by image analysis. The system has so far successfully detected blooms of ctenophores in the water column and is now being tested for

  11. 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

  12. 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.

  13. A Multidisciplinary, Hospital-Based Team for Child Abuse Cases: A "Hands-on" Approach.

    ERIC Educational Resources Information Center

    Whitworth, Jay M.; And Others

    1981-01-01

    Describes a hospital-based program for providing consultation to persons who provide direct services in child abuse/neglect cases. Conceptual issues in multidisciplinary team formation and involvement are discussed. Some topics mentioned are types of service, follow-up, educational components, and long-term involvement with families. (DB)

  14. 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…

  15. Bio-events in the continental realm during the Cretaceous/Tertiary transition: a multidisciplinary approach

    NASA Astrophysics Data System (ADS)

    Feist, Monique

    This study is a short progress report of a multidisciplinary cooperation. It deals with animal and plant biotas found in five nonmarine Maastrichtian-Paleocene sequences in southern Europe (southern France, north-east Spain). In addition, contributions on North America charophyte floras are taken into account.

  16. 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…

  17. 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…

  18. 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.

  19. 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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  1. 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

  2. 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

  3. Current multidisciplinary oncology series

    PubMed Central

    Sebio, Ana

    2014-01-01

    “Cancers of the Colon and Rectum: A Multidisciplinary Approach to Diagnosis and Management” represents a truly multidisciplinary compendium of the management of these tumors that will be of value both for any physician involved in providing care for colorectal cancer (CRC) patients as well as for trainees of many medical disciplines.

  4. 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 within the…

  5. Proper function, phonetics, and aesthetics achieved with implant-supported restorations: a multidisciplinary approach.

    PubMed

    Smiler, D G; Finley, J M; Melton, B

    1995-01-01

    In a multidisciplinary restoration of the edentulous patient, close cooperation of involved personnel is essential during the treatment planning and the restorative procedures. This presentation is an overview of the rehabilitation of the edentulous maxilla, posterior maxilla, and the challenges of the single tooth implant-supported restorations. The prerequisite of teamwork is emphasized, past achievements and benefits of this treatment modality are reviewed, and three prosthetic challenges addressed. Clinical cases are used to illustrate the presentation.

  6. Integral multidisciplinary approach in a patient with chronic complete spinal cord injury and hip disarticulation

    PubMed Central

    Quinzaños-Fresnedo, J; Rodríguez-Reyes, G; Mendoza-Cosío, C; Pérez-Zavala, R; Márquez-Guitérrez, E A; Hernández-Sandoval, S

    2015-01-01

    Study design: Case report. Objectives: To highlight the importance of the integral multidisciplinary management of a patient with complete chronic spinal cord injury and hip disarticulation secondary to pressure ulcers (PU). Setting: Mexico City. Methods: The case of a 40-year-old male violinist with a spinal cord injury, American Spinal Injury Association Impairment Scale A and neurological level T4, is reported. The patient initiated with bilateral ischiatic, left trochanteric and sacral PU. The ulcers were complicated with infection with sluggish evolution. Thus, it was decided a multidisciplinary management by means of left hip disarticulation and elaboration of a cosmetic prosthesis and the manufacture of a viscous elastic foam cushion for the prevention of new PU. The patient was quickly included in his professional and social activities. Conclusion: This study proves that multidisciplinary management of patients with spinal cord injury with complications such as the presence of PU that are resistant to noninvasive treatment can be the solution for the patient’s reintegration into their normal life with adequate quality of life. PMID:28053719

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

    PubMed

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

    2016-05-30

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

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

    NASA Astrophysics Data System (ADS)

    Luino, Fabio

    2015-04-01

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

  10. 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

  11. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  13. The Johns Hopkins Venous Thromboembolism Collaborative: Multidisciplinary team approach to achieve perfect prophylaxis.

    PubMed

    Streiff, Michael B; Lau, Brandyn D; Hobson, Deborah B; Kraus, Peggy S; Shermock, Kenneth M; Shaffer, Dauryne L; Popoola, Victor O; Aboagye, Jonathan K; Farrow, Norma A; Horn, Paula J; Shihab, Hasan M; Pronovost, Peter J; Haut, Elliott R

    2016-12-01

    Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative. To achieve the goal of perfect prophylaxis for every patient, we developed evidence-based, specialty-specific computerized clinical decision support VTE prophylaxis order sets that assist providers in ordering risk-appropriate VTE prevention. We developed novel strategies to improve provider VTE prevention ordering practices including face-to-face performance reviews, pay for performance, and provider VTE scorecards. When we discovered that prescription of risk-appropriate VTE prophylaxis does not ensure its administration, our multidisciplinary research team conducted in-depth surveys of patients, nurses, and physicians to design a multidisciplinary patient-centered educational intervention to eliminate missed doses of pharmacologic VTE prophylaxis that has been funded by the Patient Centered Outcomes Research Institute. We expect that the studies currently underway will bring us closer to the goal of perfect VTE prevention care for every patient. Our learning journey to eliminate harm from VTE can be applied to other types of harm. Journal of Hospital Medicine 2016;11:S8-S14. © 2016 Society of Hospital Medicine.

  14. Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol

    PubMed Central

    Dreijer, Albert R; Kruip, Marieke J H A; Diepstraten, Jeroen; Polinder, Suzanne; Brouwer, Rolf; Leebeek, Frank W G; Vulto, Arnold G; van den Bemt, Patricia M L A

    2016-01-01

    Introduction Antithrombotic therapy carries high risks for patient safety. Antithrombotics belong to the top 5 medications involved in potentially preventable hospital admissions related to medication. To provide a standard for antithrombotic therapy and stress the importance of providing optimal care to patients on antithrombotic therapy, the Landelijke Standaard Ketenzorg Antistolling (LSKA; Dutch guideline on integrated antithrombotic care) was drafted. However, the mere publication of this guideline does not guarantee its implementation. This may require a multidisciplinary team effort. Therefore, we designed a study aiming to determine the influence of hospital-based antithrombotic stewardship on the effect and safety of antithrombotic therapy outcomes during and after hospitalisation. Methods and analysis In this study, the effect of the implementation of a multidisciplinary antithrombotic team is compared with usual care using a pre-post study design. The study is performed at the Erasmus University Medical Center Rotterdam and the Reinier de Graaf Hospital Delft. Patients who are or will be treated with antithrombotics are included in the study. We aim to include 1900 patients, 950 in each hospital. Primary outcome is the proportion of patients with a composite end point consisting of ≥1 bleeding or ≥1 thrombotic event from the beginning of antithrombotic therapy (or hospitalisation) until 3 months after hospitalisation. Bleeding is defined according to the International Society of Thrombosis and Haemostasis (ISTH) classification. A thrombotic event is defined as any objectively confirmed arterial or venous thrombosis, including acute myocardial infarction or stroke for arterial thrombosis and deep venous thrombosis or pulmonary embolism or venous thrombosis. An economic evaluation is performed to determine whether the implementation of the multidisciplinary antithrombotic team will be cost-effective. Ethics and dissemination This protocol was

  15. Implementing critical pathways and a multidisciplinary team approach to cardiovascular disease management.

    PubMed

    Peterson, Eric D; Albert, Nancy M; Amin, Alpesh; Patterson, J Herbert; Fonarow, Gregg C

    2008-09-08

    According to several medical registries, there is a need to improve the care of post-myocardial infarction (MI) patients, especially those with left ventricular dysfunction (LVD) and heart failure. This can potentially be achieved by implementing disease management programs, which include critical pathways, patient education, and multidisciplinary hospital teams. Currently, algorithms for critical pathways, including discharge processes, are lacking for post-MI LVD patients. Such schemes can increase the use of evidence-based medicines proved to reduce mortality. Educational programs are aimed at increasing patients' awareness of their condition, promoting medication compliance, and encouraging the adoption of healthy behaviors; such programs have been shown to be effective in improving outcomes of post-MI LVD patients. Reductions in all-cause hospitalizations and medical costs as well as improved survival rates have been observed when a multidisciplinary team (a nurse, a pharmacist, and a hospitalist) is engaged in patient care. In addition, the use of the "pay for performance" method, which can be advantageous for patients, physicians, and hospitals, may potentially improve the care of post-MI patients with LVD.

  16. 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.

  17. A multidisciplinary approach to full mouth rehabilitation and solving the dilemma of wriggling dentures- a case report.

    PubMed

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

    2014-04-01

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

  18. Fine needle biopsy with cytology in paediatrics: the importance of a multidisciplinary approach and the role of ancillary techniques.

    PubMed

    Barroca, H; Bom-Sucesso, M

    2014-02-01

    Fine needle biopsy (FNB) with cytology has long been regarded as an excellent technique as the first choice for diagnosing adult tumours. Being an inexpensive minimally invasive technique with high accuracy and diagnostic immediacy through rapid on-site evaluation, it is also ideal for implementation in the paediatric setting, particularly in developing countries. Furthermore, it allows complementary and advanced procedures such as flow cytometry, polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH), among others, which enhances the diagnostic capacity of this technique and gives it a key role in risk stratification and therapeutic decision-making for several tumours. The advantages of FNB are optimized in the setting of a multidisciplinary team where cytologist, clinician and radiologist play leading roles. Paediatric tumours are rare and most ancillary techniques are cost-effective but complex to be implemented in small centres with limited experience in paediatric pathology. Therefore reference centres are essential, in order to establish teams with extensive experience and expertise. Hence, any child with a suspected malignancy should be directly referred to a paediatric oncology unit. Focusing on a practical approach to the assessment of paediatric lymphadenopathies and non-central nervous system solid tumours we review the effectiveness of FNB as applied concurrently with ancillary techniques in a multidisciplinary approach to the diagnosis, prognosis and therapeutic decisions of paediatric tumours and tumour-like lesions.

  19. 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

  20. 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

  1. ID migraine questionnaire in temporomandibular disorders with craniofacial pain: a study by using a multidisciplinary approach.

    PubMed

    Di Paolo, Carlo; Di Nunno, Anna; Vanacore, Nicola; Bruti, Gianluca

    2009-08-01

    To evaluate the prevalence of migraine and related disability and the role of ID migraine questionnaire as a screening tool in patients with temporomandibular disorders (TMDs) and craniofacial pain (CFP). TMDs patients with CFP underwent stomatognathic (RDC/TMD criteria) and neurological visits (IHS criteria, 2004). ID migraine questionnaire and MIgraine Disability Assessment Scale (MIDAS) were also administered. Out of 45 patients, 69% met diagnosis of migraine plus chronic tension-type headache (CTTH); 9% presented CTTH and 20% were migraineurs. Out of 39 migraineurs who completed MIDAS, 56% presented the highest disability grade. Out of 37 patients who completed ID migraine questionnaire, 32 resulted affected by probable migraine with a diagnostic sensibility and specificity of 94% and 100%, respectively. Our findings showed a clinical association between TMDs and migraine. We support a clinical role of ID migraine and MIDAS in TMDs patients with CFP and we underline the importance of a multidisciplinary evaluation in this group of migraineurs.

  2. The importance of a multidisciplinary approach in the treatment of mutilating electrical injury: a case study.

    PubMed

    Lipový, B; Rihová, H; Kaloudová, Y; Suchánek, I; Gregorová, N; Hokynková, A; Jelínková, Z; Agalarev, V

    2010-01-01

    Electrical burns are not ranked among the most frequent type of injuries, but they have the most devastating potential of all thermal injuries and often cause lifelong stigmatization. Those primarily affected are young males: work injuries predominate. An electrical burn is a specific nosological unit that has multiple acute and chronic abnormal manifestations. In this study we describe the case of a young man who suffered an electrical injury after contact with a high-voltage line (22,000 volts) while paragliding. This contact was followed by a 10 m fall. In our work we present the need for multidisciplinary cooperation along with the opportunities, problems and risks that accompany the treatment of this type of injury.

  3. Coronary artery imaging with multidetector computed tomography: a call for an evidence-based, multidisciplinary approach.

    PubMed

    Schoenhagen, Paul; Stillman, Arthur E; Garcia, Mario J; Halliburton, Sandra S; Tuzcu, E Murat; Nissen, Steven E; Modic, Michael T; Lytle, Bruce W; Topol, Eric J; White, Richard D

    2006-05-01

    Modern multidetector computed tomography systems are capable of a comprehensive assessment of the cardiovascular system, including noninvasive assessment of coronary anatomy. Multidetector computed tomography is expected to advance the role of noninvasive imaging for coronary artery disease, but clinical experience is still limited. Clinical guidelines are necessary to standardize scanner technology and appropriate clinical applications for coronary computed tomographic angiography. Further evaluation of this evolving technology will benefit from cooperation between different medical specialties, imaging scientists, and manufacturers of multidetector computed tomography systems, supporting multidisciplinary teams focused on the diagnosis and treatment of early and advanced stages of coronary artery disease. This cooperation will provide the necessary education, training, and guidelines for physicians and technologists assuring standard of care for their patients.

  4. 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.

  5. Minding the Genes: a Multidisciplinary Approach towards Genetic Assessment of Cardiovascular Disease.

    PubMed

    Rhodes, Ashley; Rosman, Lindsey; Cahill, John; Ingles, Jodie; Murray, Brittney; Tichnell, Crystal; James, Cynthia A; Sears, Samuel F

    2016-09-30

    Genetic assessment for inherited cardiovascular disease (CVD) is increasingly available, due in part to rapid innovations in genetic sequencing technologies. While genetic testing is aimed at reducing uncertainty, it also produces awareness of potential medical conditions and can leave patients feeling uncertain about their risk, especially if there are ambiguous results. This uncertainty can produce psychological distress for patients and their families undergoing the assessment process. Additionally, patients may experience psychological distress related to living with inherited CVD. In order to more effectively manage the psychosocial challenges related to genetic assessment for CVD, a multidisciplinary model expanded to include psychologists and other allied health professionals is outlined. A case study is provided to illustrate how psychological distress can manifest in a patient living with inherited CVD, as well as proposed psychological management of this patient. Finally, a guide for genetic counselors is provided to aid in identifying and managing common psychological reactions to genetic assessment for CVD.

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

    PubMed Central

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

    2011-01-01

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

  7. 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

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

    PubMed Central

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

    2015-01-01

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

  9. 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

  10. 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

  11. 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

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

    NASA Astrophysics Data System (ADS)

    Lee, Dae Young

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

  13. Cycles of Change and Challenges for Health Professions Involved in Multidisciplinary Approaches to Prevention. (1993 AAHE Scholar Address. AAHPERD Convention, Washington, D.C.).

    ERIC Educational Resources Information Center

    Stone, Elaine J.

    1993-01-01

    Provides an overview of professions working in multidisciplinary health promotion and disease prevention efforts, focusing on medical specialties, public health, behavioral medicine, health psychology, health education, and health behavior. Major challenges general to all the fields include reimbursement, priorities, professional preparation,…

  14. 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

  15. 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

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

    PubMed

    Esteban, David J; Holloway, Kevin S

    2015-01-01

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

  17. Evaluation and management of disorders of sex development: multidisciplinary approach to a complex diagnosis.

    PubMed

    Moshiri, Mariam; Chapman, Teresa; Fechner, Patricia Y; Dubinsky, Theodore J; Shnorhavorian, Margarett; Osman, Sherif; Bhargava, Puneet; Katz, Douglas S

    2012-10-01

    Various disorders of sex development (DSD) result in abnormal development of genitalia, which may be recognized at prenatal ultrasonography, immediately after birth, or later in life. Current methods for diagnosing DSD include a thorough physical examination, laboratory tests to determine hormone levels and identify chromosomal abnormalities, and radiologic imaging of the genitourinary tract and adjacent organs. Because of the complex nature of DSD, the participation of a multidisciplinary team is required to address the patient's medical needs as well as any psychosocial issues that the patient or the family may encounter after the diagnosis. The first step in the management of DSD is sex assignment, which is based on factors such as the genotype; the presence, location, and appearance of reproductive organs; the potential for fertility; and the cultural background and beliefs of the patient's family. The primary goal of sex assignment is to achieve the greatest possible consistency between the patient's assigned sex and his or her gender identity. Once the sex is assigned, the next step in management might be surgery, hormone therapy, or no intervention at all. Patients with ovotesticular DSD and gonadal dysgenesis may require a gonadectomy, followed by reconstructive surgery. Some patients may need hormone replacement therapy during puberty. An understanding of the immediacy of families' need for sex assignment and clinicians' need for reliable diagnostic imaging results will help radiologists participate effectively in the prenatal and postnatal assessment of patients with DSD.

  18. Gorlin-Goltz syndrome--a medical condition requiring a multidisciplinary approach.

    PubMed

    Kiwilsza, Małgorzata; Sporniak-Tutak, Katarzyna

    2012-09-01

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

  19. 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

  20. [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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  6. 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…

  7. [Public Health as an Applied, Multidisciplinary Subject: Is Research-Based Learning the Answer to Challenges in Learning and Teaching?

    PubMed

    Gerhardus, A; Schilling, I; Voss, M

    2016-06-06

    Public health education aims at enabling students to deal with complex health-related challenges using appropriate methods based on sound theoretical understanding. Virtually all health-related problems in science and practice require the involvement of different disciplines. However, the necessary interdisciplinarity is only partly reflected in the curricula of public health courses. Also theories, methods, health topics, and their application are often taught side-by-side and not together. For students, it can become an insurmountable challenge to integrate the different disciplines ("horizontal integration") and theories, methods, health topics, and their application ("vertical integration"). This situation is specific for education in public health but is representative for other interdisciplinary fields as well. Several approaches are available to achieve the horizontal integration of different disciplines and vertical integration of theories, methods, health topics, and their application. A curriculum that is structured by topics, rather than disciplines might be more successful in integrating different disciplines. Vertical integration can be achieved by research-based learning. Research-based learning places a student-led research project at the centre of teaching. Students choose a topic and a research question, raise their own questions for theories and methods and will hopefully cross the seeming chasm between science and practice. Challenges of research-based learning are enhanced demands on students, teachers and curriculum design.

  8. 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

  9. 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

  10. 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...

  11. 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

  12. 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

  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. 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.…

  15. Multidisciplinary Approach to Flood Forecasting on the Base of Earth Observation Data and Hydrological Modelling

    NASA Astrophysics Data System (ADS)

    Zelentsov, Viacheslav; Potryasaev, Semen; Sokolov, Boris

    2016-08-01

    In this paper a new approach to the creation of short- term forecasting systems of river flooding is being further developed. It provides highly accurate forecasting results due to operative obtaining and integrated processing of the remote sensing and ground- based water flow data in real time. Forecasting of flood areas and depths is performed on a time interval of 12 to 48 hours to be able to perform the necessary steps to alert and evacuate the population. Forecast results are available as web services. The proposed system extends traditional separate methods based on satellite monitoring or modeling of a river's physical processes, by using an interdisciplinary approach, integration of different models and technologies, and through intelligent choice of the most suitable models for a flood forecasting.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction

    PubMed Central

    Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique

    2015-01-01

    Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case. PMID:28018799

  2. Massive Hemorrhage from Ectopic Duodenal Varices: Importance of a Multidisciplinary Approach

    PubMed Central

    House, Tyler; Webb, Patrick; Baarson, Chad

    2017-01-01

    Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices. We present a case of massive duodenal variceal hemorrhage that highlights the complexity of initial diagnosis and ultimately required a transesophageal intrahepatic portosystemic shunt with coil embolization for control of bleeding. PMID:28203136

  3. Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis: thinking about implants?

    PubMed

    de Avila, Érica Dorigatti; de Molon, Rafael Scaf; de Assis Mollo, Francisco; de Barros, Luiz Antonio Borelli; Capelozza Filho, Leopoldino; de Almeida Cardoso, Mauricio; Cirelli, Joni Augusto

    2012-11-01

    Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic patients. However, an interdisciplinary approach should be observed during the diagnosis, prognosis, and treatment plan to provide a result with good predictability and meet the esthetic and functional expectations of the patient. The present study describes a case of a young patient with tooth agenesis of maxillary lateral incisors, which was conducted with an integrated planning. After 5-year follow-up of 2 fixed implant-supported prostheses, clinical and radiographic examination showed the treatment to be successful.

  4. Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction.

    PubMed

    Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique

    2016-12-01

    Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case.

  5. Scleroderma and pulmonary hypertension complicating two pregnancies: use of neuraxial anesthesia, general anesthesia, epoprostenol and a multidisciplinary approach for cesarean delivery.

    PubMed

    Moaveni, D; Cohn, J; Brodt, J; Hoctor, K; Ranasinghe, J

    2015-11-01

    Literature regarding the anesthetic care of patients with scleroderma during labor and delivery is limited to remote case reports. No recent publications provide information on the anesthetic management of patients with coexisting pulmonary hypertension. This report describes the anesthetic and multidisciplinary management of two pregnant patients with concomitant scleroderma and pulmonary hypertension undergoing cesarean delivery; one with neuraxial anesthesia and one with general anesthesia. Considerations for neuraxial and general anesthesia in patients with concurrent scleroderma and pulmonary hypertension are discussed.

  6. 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

  7. The coexistence of paroxysmal hemicrania and temporomandibular disorder: importance of multidisciplinary approach.

    PubMed

    Porporatti, André Luis; Costa, Yuri Martins; Bonjardim, Leonardo Rigoldi; Stuginski-Barbosa, Juliana; Conti, Paulo César Rodrigues; Martori, Alexandre Henrique

    2014-01-01

    Paroxysmal hemicrania (PH) is a trigeminal autonomic cephalalgia, a rare primary headache characterized by unilateral periorbital and/or temporal attacks of severe intensity and short duration. In this situation, the determination of a correct diagnosis is crucial for the establishment of a proper management strategy. In the case of head and facial pain, this step is usually a big challenge since many conditions share the same features, as some primary headaches and temporomandibular disorders (TMD). The relationship between PH and TMD has not been determined. This paper describes a case of a female patient diagnosed with TMD and presenting concomitant headache attacks fulfilling the International Headache Society's criteria for PH. It is also emphasized the importance of dentist in this scenario, for many times responsible for the initial diagnosis of facial/head pain. Moreover, it is presented an integrated and simultaneously approach of both conditions, PH and TMD.

  8. 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.

  9. People for sale: the need for a multidisciplinary approach towards human trafficking.

    PubMed

    Van Impe, K

    2000-01-01

    The article addresses the question of how to develop appropriate measures to tackle trafficking in women, based on the findings of a study of trafficking between the Philippines and Belgium. It argues that there is no easy or unidimensional solution to human trafficking, since it is influenced by a complex set of factors, often working in combination with one another. It concludes that control measures alone cannot stop the flow of trafficking in women and that a legal approach which relies solely on one type of legislation would be too narrow. An effective strategy must combine and balance punitive measures with protection of human rights, stricter border control and the removal of the root causes of irregular movements. Measures must be agreed and coordinated between origin, transit and receiving countries.

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

    PubMed

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

    2007-04-01

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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Unknown primary cancer of the head and neck: a multidisciplinary approach.

    PubMed

    Cerezo, Laura; Raboso, Eduardo; Ballesteros, Ana Isabel

    2011-02-01

    The management of patients with cervical lymph node metastases from an unknown primary cancer (CUP) remains a matter of controversy. Although new advanced diagnostic tools, such as positron emission tomography, have recently been introduced in oncology, the frequency of this tumour entity in clinical practice means it is still relevant. Recently introduced molecular profiling platforms may provide biological classification for the primary tissue of origin as well as insights into the pathophysiology of this clinical entity, including the characterisation of the Epstein-Barr virus and human papilloma virus genomas in the metastatic cervical nodes. Due to the lack of randomised trials, a standard therapy has not been identified yet. Although neck dissection followed by post-operative radiotherapy is the most generally accepted approach, there are other curative options that can be used in some patients: neck dissection alone, nodal excision followed by post-operative radiotherapy or radiotherapy alone. A major controversy remains in the target radiation volumes that range from ipsilateral neck irradiation to prophylactic irradiation of all potential mucosal sites and both sides of the neck. Finally, the administration of concurrent chemotherapy is currently being advised for patients with adverse prognostic factors.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. [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.

  6. Landscape and history: a multidisciplinary approach. Project Group Environmental History (P.G.E.H.).

    PubMed

    1999-12-01

    Human societies have inhabited parts of the Central European country of Austria for thousands of years. The development process shopping the landscape by this long period of human impact remains poorly understood. The present study is an attempt to research landscape history on a local scale and compares an alpine, pre-alpine and midland-village area in Austria. We have developed an appropriate concept to describe the landscape ecology features of the study areas in several stages of the past from 1733 on. The landscape analysis is based on the interpretation of different kinds of historical data (e.g., documents, maps) going back to the pre-industrial epoch, which has--at least in terms of landscape ecology--hardly been accessible until now. An important aim of the study is to localize the historical information in the landscape. Individual plots can be traced back even to the early 14th century. Based on the quality of the available historical data, the historical landscape is analysed with regard to categories such as form and intensity of land use, distribution of nutrients and water as well as the pattern of landscape elements and their ecological functions. The comparison of present stages with former ones yields detailed knowledge on the dynamics and stability of landscape structure. This approach allows present-day land units to be identified as a result of long-term development going back to Medieval times. The primary aim of the study is to analyze factors that bring about change or resist it by creating stability. We therefore examine factors coupling landscape structure, agricultural production and population development. For this reason, we have studied the people and the evidence for their labor over a period of 400 years (1400-1800). Besides demographic data of the 18th and 19th century, historical registrar material has been collected; it enabled the land tenures to be reconstructed from the 15th to the 19th century. This type of data is a valuable

  7. A Multidisciplinary Approach to Medical Weight Loss Prior to Complex Abdominal Wall Reconstruction: Is it Feasible?

    PubMed

    Rosen, Michael J; Aydogdu, Kasim; Grafmiller, Kevin; Petro, Clayton C; Faiman, Gregg H; Prabhu, Ajita

    2015-08-01

    Obesity is a major risk factor for perioperative morbidity, especially for patients undergoing complex incisional hernia repair. The feasibility and effectiveness of medical weight loss programs prior to complex abdominal wall reconstruction have not been well characterized. Here, we report our experience collaborating with a medical weight loss specialist utilizing a protein sparing modified fast in order to optimize weight loss prior to complex abdominal wall reconstruction. Morbidly obese patients (body mass index (BMI) > 35 kg/m(2)) evaluated by our medical weight loss specialist prior to complex ventral hernia repair were identified within our prospective database. Our primary outcome measure was the amount of weight lost prior to surgical intervention. Our secondary outcome measure was to determine the maintenance of weight loss during long-term follow-up after the surgical intervention. A total of 25 patients with a BMI > 35 kg/m(2) were evaluated by our medical weight loss specialist prior to undergoing a planned incisional hernia repair. The mean weight of the patients preoperatively was 128 kg ± 25 (range 96-205 kg) (mean ± standard deviation), and the mean BMI was 49 kg/m(2) ± 10 (range 36-85). After completion of the preoperative modified protein sparing fast, the mean preoperative weight loss of the group was 24 kg ± 21 (range 2-80 kg). The overall change in BMI for the group prior to surgery was 9 kg/m(2) ± 8 (0.6 to 33). The percentage of excess BMI loss and total BMI loss preoperatively was 37 % ± 23 (2 to 83) and 18 % ± 12 (1 to 43), respectively. Of the 24 patients that initially lost weight in the program preoperatively, 22 (88 %) successfully maintained their weight loss for the entire study period for an average of 18 months. Collaboration with a medical weight loss specialist and a surgeon with a structured approach using a modified protein sparing fast can successfully result in meaningful weight

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. Multidisciplinary assessment and treatment of self-injurious behavior in autism spectrum disorder and intellectual disability: integration of psychological and biological theory and approach.

    PubMed

    Minshawi, Noha F; Hurwitz, Sarah; Morriss, Danielle; McDougle, Christopher J

    2015-06-01

    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 intellectual disability. Algorithms for the assessment and treatment of SIB in this context, respectively, from a multidisciplinary, integrative perspective are proposed and challenges and opportunities that exist in clinical and research settings are discussed.

  17. Barriers and Challenges in Seeking Psychiatric Intervention in a General Hospital, by the Collaborative Child Response Unit, (A Multidisciplinary Team Approach to Handling Child Abuse) A Qualitative Analysis.

    PubMed

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Mital, Anukant; Rao, Chandrika; Chandra, Girish

    2017-01-01

    Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services.

  18. 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

  19. 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

  20. 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…

  1. A Multidisciplinary Approach to Educating Preschool Children with Optic Nerve Hypoplasia and Septo-Optic Nerve Dysplasia.

    ERIC Educational Resources Information Center

    Bahar, Cheryl; Brody, Jill; McCann, Mary Ellen; Mendiola, Rosalinda; Slott, Gayle

    2003-01-01

    This article discusses the observations and experiences of a multidisciplinary team at the Blind Childrens Center in Los Angeles, which works specifically with children from birth to 5 years of age who have been diagnosed with optic nerve hypoplasia and may have septo-optic displasia. Strategies for educational interventions are explained.…

  2. 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…

  3. 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

  4. 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

  5. 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…

  6. 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

  7. 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…

  8. Optimal Design of Integrated Systems Health Management (ISHM) Systems for improving safety in NASA's Exploration Vehicles: A Two-Level Multidisciplinary Design Approach

    NASA Technical Reports Server (NTRS)

    Tumer, Irem; Mehr, Ali Farhang

    2005-01-01

    In this paper, a two-level multidisciplinary design approach is described to optimize the effectiveness of ISHM s. At the top level, the overall safety of the mission consists of system-level variables, parameters, objectives, and constraints that are shared throughout the system and by all subsystems. Each subsystem level will then comprise of these shared values in addition to subsystem-specific variables, parameters, objectives and constraints. A hierarchical structure will be established to pass up or down shared values between the two levels with system-level and subsystem-level optimization routines.

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

    PubMed Central

    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. PMID:26089679

  10. 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

  11. Multidisciplinary approach on rehabilitation of primary teeth traumatism repercussion on the permanent successor: 6-year follow-up case report.

    PubMed

    Mello-Moura, A C V; Bonini, G A V C; Suga, S S; Navarro, R S; Wanderley, M T

    2009-01-01

    Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.

  12. 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.

  13. 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.

  14. 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

  15. A multidisciplinary team approach to two-stage revision for the infected hip replacement: a minimum five-year follow-up study.

    PubMed

    Ibrahim, M S; Raja, S; Khan, M A; Haddad, F S

    2014-10-01

    We report the five year outcomes of a two-stage approach for infected total hip replacement. This is a single-surgeon experience at a tertiary centre where the more straightforward cases are treated using single-stage exchange. This study highlights the vital role of the multidisciplinary team in managing these cases. A total of 125 patients (51 male, 74 female) with a mean age of 68 years (42 to 78) were reviewed prospectively. Functional status was assessed using the Harris hip score (HHS). The mean HHS improved from 38 (6 to 78.5) pre-operatively to 81.2 (33 to 98) post-operatively. Staphylococcus species were isolated in 85 patients (68%). The rate of control of infection was 96% at five years. In all, 19 patients died during the period of the study. This represented a one year mortality of 0.8% and an overall mortality of 15.2% at five years. No patients were lost to follow-up. We report excellent control of infection in a series of complex patients and infections using a two-stage revision protocol supported by a multidisciplinary approach. The reason for the high rate of mortality in these patients is not known.

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

    PubMed Central

    2011-01-01

    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. PMID:21388561

  17. Multi-Disciplinary Consumer Education Curriculum.

    ERIC Educational Resources Information Center

    Sie, Maureen A.; And Others

    Two activities are described in this report, both of which focus on the multi-disciplinary approach in the development of a consumer education curriculum for high school students. The first activity, which demonstrated the feasibility of a multi-disciplinary approach using local school personnel and resources and university faculty in curriculum…

  18. Alternate Sources of Revenues for Public Schools: A Marketing Approach.

    ERIC Educational Resources Information Center

    Dembowski, Frederick; Biros, Janice

    1984-01-01

    After analyzing the causes of public education's current fiscal crisis, this article offers a marketing approach to educational management as a possible long range solution. A model marketing plan is outlined and some applications for raising revenues are identified. (MJL)

  19. 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…

  20. 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…

  1. 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

  2. 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

  3. Multidisciplinary audit of digoxin.

    PubMed

    Keys, P W; DeSantis, D; Duffy, M G

    1978-08-01

    Use review of digoxin as part of a medical care evaluation study in a hospital is described. This drug audit within the hospital's quality assurance program used a multidisciplinary approach. The study was designed to measure the incidence of digoxin toxicity, evaluate monitoring practices for digoxin use and evaluate the adequacy of digoxin dosing patterns. Forty-eight patients were involved. Results indicated that some patients were not adequately assessed in regard to renal function and digoxin serum level. Further, there was a 17% incidence of digoxin toxicity. Studies such as this give pharmacists an opportunity to use their knowledge of proper drug use through a structured hospital program.

  4. 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

  5. Barriers and Challenges in Seeking Psychiatric Intervention in a General Hospital, by the Collaborative Child Response Unit, (A Multidisciplinary Team Approach to Handling Child Abuse) A Qualitative Analysis

    PubMed Central

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Mital, Anukant; Rao, Chandrika; Chandra, Girish

    2017-01-01

    Child abuse is a serious criminal act against children in our country and punishable according to protection of children from sexual offenses act 2012. No one agency has the ability to respond completely to the abuse. Hence a multidisciplinary team approach was developed in India. Aim is to narrate the collaborative effort among the multiple disciplines in a general hospital to deliver child protection services and explore the barriers to integrate psychiatric services. Methodology: Members of the team were recruited from different disciplines and trained by experts. A mission statement, protocol to assess the victims and provide treatment was formulated as an algorithm. The barriers to psychiatric treatment among the stakeholders were analyzed using framework method of qualitative analysis. Results (After 20 months) the unit received 27 referrals in 20 months, 24 females, and 3 males. Age of the victims was between 8 months and 17 years. Two cases found to be physically abused. Penetrative sexual abuse was found in 23 cases, pregnant victims were 4. Most referrals were by police, trafficking found in 6 cases. Discussion: It was possible to provide multidisciplinary care to the victims and families. Recurrent themes of barriers to psychiatric treatment were stigma, victim blaming; focus on termination of pregnancy, minimization of abuse in males by stakeholders. Conclusion is collaboration needs more effort to integrate psychiatric services but can minimize the reduplication of services. PMID:28250553

  6. Ethical Issues for Public Health Approaches to Obesity.

    PubMed

    Azevedo, Suzanna M; Vartanian, Lenny R

    2015-09-01

    Obesity is a major public health concern worldwide. Because individual-level interventions have been unsuccessful at curbing obesity rates, there is an emphasis on public health approaches. In addition to testing the effectiveness of any public health interventions, it is important to consider the ethical implications of these interventions in order to protect the public's rights and promote overall well-being. In this paper, we review public health approaches to obesity in three broad domains (changes to the socio-communicative environment, changes to the economic environment, and changes to the physical environment/access) and consider the potential ethical issues that arise in each of those domains. We suggest that interventions that target the physical environment/access (making it easier for people to engage in healthy behaviors), that target the entire population (rather than just individuals with obesity), and that focus on health behaviors (rather than on weight) have the least potential for ethical concerns.

  7. 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

  8. Multidisciplinary Management of Pituitary Apoplexy

    PubMed Central

    Albani, Adriana; Angileri, Filippo Flavio; Esposito, Felice; Granata, Francesca; Ferreri, Felicia; Cannavò, Salvatore

    2016-01-01

    Pituitary apoplexy is a rare clinical syndrome due to ischemic or haemorrhagic necrosis of the pituitary gland which complicates 2–12% of pituitary tumours, especially nonfunctioning adenomas. In many cases, it results in severe neurological, ophthalmological, and endocrinological consequences and may require prompt surgical decompression. Pituitary apoplexy represents a rare medical emergency that necessitates a multidisciplinary approach. Modalities of treatment and times of intervention are still largely debated. Therefore, the management of patients with pituitary apoplexy is often empirically individualized and clinical outcome is inevitably related to the multidisciplinary team's skills and experience. This review aims to highlight the importance of a multidisciplinary approach in the management of pituitary apoplexy and to discuss modalities of presentation, treatment, and times of intervention. PMID:28074095

  9. 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

  10. 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.

  11. [Biopsychosocial approach in a multidisciplinary intervention: a report of a case of a newborn with mentally disabled parents].

    PubMed

    Berlanga-Fernández, Sofía; González-López, Noelia; Cujó-López, Eva; López-Parada, Ana María

    2012-01-01

    A case report is presented of a newborn who was seen by the paediatric nurse a Primary Care clinic, and whose parents had mental disabilities. They had been followed up for years by the social services in their area, due to difficulties and limitations in their personal, social and employment development. They were also living in unhealthy conditions, so in order to address the problem, a multidisciplinary team of professionals from different areas was formed. We prepared a standardised care plan based on the model of the basic needs of Virginia Henderson. Using taxonomies of the North American Nursing Diagnosis Association (NANDA), Nursing Outcomes Classification's (NOC) and Nursing Interventions Classification (NIC) "knowledge poor" and "parental impairment" diagnoses were made. The nursing and social work goals were to make an assessment, support and use comprehensive biopsychosocial family monitoring to enable the child to grow and develop in the best possible conditions, to monitor child protection and try to improve the living conditions of the home. The child and parents were initially monitored weekly and then monthly. The assessment showed an improvement in care: "background: infant care," "risk control: drug abuse" "child care: psychological security" and "execution of the role of parents." The joint and coordinated work of the various services involved was focused towards achieving the goals set, in order to give biopsychosocial care to the baby and family.

  12. 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.

  13. 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

  14. [Multidisciplinary approach as a model for detection and monitoring of psychiatric morbidity in patients treated with interferon and ribavirin].

    PubMed

    Cabré Serres, M; Rudi Sola, N; Pontes García, C; Vergara Gómez, M; Parra Uribe, I; Gorgas Torner, M Q

    2014-05-01

    Objetivo: Describir la experiencia recogida durante el programa multidisciplinar,y en particular describir la incidencia de los trastornos psiquiátricosen pacientes con hepatitis C crónica (HCC) durante el tratamiento coninterferón y ribavirina, y determinar la adherencia al tratamiento antiviraly la respuesta viral sobtenida (RVS).Material y métodos: Estudio observacional, descriptivo y retrospectivo realizadoa partir de los datos recogidos durante el programa de dispensaciónambulatoria de tratamiento antiviral.Se incluyó a todos los pacientes monoinfectados por el virus hepatitis C(VHC) que iniciaron tratamiento durante el 2010. El cribaje de lostrastornos psiquiátricos se realizó mediante el Hospital Anxiety-DepressionScale (HADS) y el General Health Questionnaire (Goldberg) las semanas 0,4, 12, 24, 48 y 72. La adherencia se evaluó mediante el recuento de dispensacionesy de la medicación sobrante del paciente y la exposición al fármacosegún la regla 80/80/80. La respuesta virológica se determinó por elmédico responsable de acuerdo a las definiciones estándar.Resultados: Se incluyeron 76 pacientes, 19 (25%) de los cuales teníanantecedentes psiquiátricos. La incidencia de trastornos psiquiátricos fue del33% (n = 25). El pico de resultados anormales en los test fue en la semana12. El 43% alcanzó RVS, sin diferencias entre ambos grupos (p > 0,05). Laadherencia (96,0% y 96,8%, p > 0,05) y RVS (39% y 52%, p > 0,05)fueron similares en ambos subgrupos con y sin trastornos.Conclusiones: Los trastornos psiquiátricos no tuvieron impacto en la adherenciay la RVS. El seguimiento multidisciplinar durante el tratamiento de la hepatitisC crónica (HCC) puede contribuir a la detección precoz y manejo de lostrastornos psiquiátricos y a mejorar la atención integral del paciente.

  15. 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

  16. Improving the Performance of Social Workers during Multi-Disciplinary Team Case Reviews of Delinquent Adolescents through Public Posting and Verbal Feedback.

    ERIC Educational Resources Information Center

    Carbone, Vincent J.

    This practicum was implemented to improve the rehabilitation planning skills of social workers in a juvenile correctional facility. The goal was to increase social workers' discussion of all relevant rehabilitation planning data during multi-disciplinary team meetings (Case Review Committee). A related objective was the overall improvement of…

  17. 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…

  18. A Balanced Scorecard Approach to Public Relations Management Assessment.

    ERIC Educational Resources Information Center

    Fleisher, Craig S.; Mahaffy, Darren

    1997-01-01

    Describes a new managerial approach to assessing public relations/communications (PR/C) performance using a "balanced scorecard." Reviews the current state of PR/C management assessment; illustrates the balanced scorecard framework; highlights its strengths and weaknesses; describes the process of applying the scorecard to PR/C units;…

  19. 76 FR 63305 - Approaches To Reducing Sodium Consumption; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ...-2011-0014] Approaches To Reducing Sodium Consumption; Public Meeting AGENCY: Food and Drug... Reducing Sodium Consumption.'' FDA and FSIS recently published a Federal Register notice that announced the establishment of dockets to obtain comments, data, and evidence relevant to the dietary intake of sodium as...

  20. 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…

  1. 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

  2. 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.

  3. A Novel Approach to Proactive Primary Care-Based Case Finding and Multidisciplinary Management of Falls, Syncope, and Dizziness in a One-Stop Service: Preliminary Results.

    PubMed

    Parry, Steve W; Hill, Harry; Lawson, Joanna; Lawson, Nick; Green, David; Trundle, Heidi; McNaught, Judith; Strassheim, Victoria; Caldwell, Alma; Mayland, Richard; Earley, Phillip; McMeekin, Peter

    2016-11-01

    National and international evidence and guidelines on falls prevention and management in community-dwelling elderly adults recommend that falls services should be multifactorial and their interventions multicomponent. The way that individuals are identified as having had or being at risk of falls in order to take advantage of such services is far less clear. A novel multidisciplinary, multifactorial falls, syncope, and dizziness service model was designed with enhanced case ascertainment through proactive, primary care-based screening (of individual case notes of individuals aged ≥60) for individual fall risk factors. The service model identified 4,039 individuals, of whom 2,232 had significant gait and balance abnormalities according to senior physiotherapist assessment. Significant numbers of individuals with new diagnoses ranging from cognitive impairment to Parkinson's disease to urgent indications for a pacemaker were discovered. More than 600 individuals were found who were at high risk of osteoporosis according to World Health Association Fracture Risk Assessment Tool score, 179 with benign positional paroxysmal vertigo and 50 with atrial fibrillation. Through such screening and this approach, Comprehensive Geriatric Assessment Plus (Plus falls, syncope and dizziness expertise), unmet need was targeted on a scale far outside the numbers seen in clinical trials. Further work is needed to determine whether this approach translates into fewer falls and decreases in syncope and dizziness.

  4. Multidisciplinary team approach to improved chronic care management for diabetic patients in an urban safety net ambulatory care clinic.

    PubMed

    Tapp, Hazel; Phillips, Shay E; Waxman, Dael; Alexander, Matthew; Brown, Rhett; Hall, Mary

    2012-01-01

    Since the care of patients with multiple chronic diseases such as diabetes and depression accounts for the majority of health care costs, effective team approaches to managing such complex care in primary care are needed, particularly since psychosocial and physical disorders coexist. Uncontrolled diabetes is a leading health risk for morbidity, disability and premature mortality with between 18-31% of patients also having undiagnosed or undertreated depression. Here we describe a team driven approach that initially focused on patients with poorly controlled diabetes (A1c > 9) that took place at a family medicare office. The team included: resident and faculty physicians, a pharmacist, social worker, nurses, behavioral medicine interns, office scheduler, and an information technologist. The team developed immediate integrative care for diabetic patients during routine office visits.

  5. Encapsulating Peritoneal Sclerosis in the Era of a Multi-Disciplinary Approach Based on Biocompatible Solutions: the NEXT-PD Study

    PubMed Central

    Nakayama, Masaaki; Miyazaki, Masanobu; Honda, Kazuho; Kasai, Kenji; Tomo, Tadashi; Nakamoto, Hidetomo; Kawanishi, Hideki

    2014-01-01

    ♦ Introduction: Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis (PD). Over the past decade in Japan, a multidisciplinary approach has been adopted to minimize the incidence and improve outcomes of EPS. This strategy includes planned PD discontinuation for high-risk patients and the introduction of biocompatible solutions. This study examined the current clinical status of EPS in representative PD centers in Japan. ♦ Design, setting, participants and measurements: Patients (n = 1,338) from 55 PD centers in Japan who were using neutral-pH solutions from the initiation of therapy (mean age, 62 years; median PD duration, 32 months; concomitant use of icodextrin, 35.2%; PD and hemodialysis combination therapy, 12.2%) were assessed every 6 months to ascertain the reasons for PD discontinuation and the development of EPS development. Outcomes were also recorded. The study period was from November 2008 to March 2012. ♦ Results: There were 727 patients who discontinued PD, including 163 deaths. Among all causes of PD withdrawal except for death, planned PD discontinuation to avoid EPS was utilized in 58 cases (7.1% in total). The strategy was increasingly utilized in proportion to the duration of PD: 0.5% for patients undergoing PD for < 3 years, 0.6% for patients undergoing PD for 5 years, 14.7% for patients undergoing PD for 8 years, and 35.5% for patients undergoing PD for > 8 years. Fourteen patients developed EPS (three cases after PD), which corresponded with an overall incidence of 1.0%. The incidence according to the duration of PD was 0.3% for PD < 3 years, 0.6% for PD = 5 years, 2.3% for PD = 8 years, and 1.2% for PD > 8 years. In terms of therapy, 11 patients were treated with prednisolone (PSL), and surgical enterolysis was utilized in two cases. Complete remission of abdominal symptoms was achieved in twelve patients (85.7%), and three died due to EPS (mortality rate of 21.4%). ♦ Conclusions: Use of the

  6. 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.

  7. Clinical management of gastroesophageal junction tumors: past and recent evidences for the role of radiotherapy in the multidisciplinary approach.

    PubMed

    Cellini, Francesco; Morganti, Alessio G; Di Matteo, Francesco M; Mattiucci, Gian Carlo; Valentini, Vincenzo

    2014-02-05

    Gastroesophageal cancers (such as esophageal, gastric and gastroesophageal-junction -GEJ- lesions) are worldwide a leading cause of death being relatively rare but highly aggressive. In the past years, a clear shift in the location of upper gastrointestinal tract tumors has been recorded, both affecting the scientific research and the modern clinical practice. The integration of pre- or peri-operative multimodal approaches, as radiotherapy and chemotherapy (often combined), seems promising to further improve clinical outcome for such presentations. In the past, the definition of GEJ led to controversies and confusion: GEJ tumors have been managed either grouped to gastric or esophageal lesions, following slightly different surgical, radiotherapeutic and systemic approaches. Recently, the American Joint Committee on Cancer (AJCC) changed the staging and classification system of GEJ to harmonize some staging issues for esophageal and gastric cancer. This review discusses the most relevant historical and recent evidences of neoadjuvant treatment involving Radiotherapy for GEJ tumors, and describes the efficacy of such treatment in the frame of multimodal integrated therapies, from the new point of view of the recent classification of such tumors.

  8. Factors associated with escalation and problematic approaches toward public figures.

    PubMed

    Meloy, J Reid; James, David V; Mullen, Paul E; Pathé, Michele T; Farnham, Frank R; Preston, Lulu F; Darnley, Brian J

    2011-01-01

    Detailed comparison of factors associated with abnormal approach to the prominent and with escalation from communication to approach has not hitherto been undertaken. This partially reflects the failure of individual studies to adopt compatible terminologies. This study involves a careful dissection of six public figure studies, three involving U.S. politicians, two Hollywood celebrities, and one the British Royal Family. Common findings were unearthed across six headings. Approachers were significantly more likely to exhibit serious mental illness, engage in multiple means of communication, involve multiple contacts/targets, and to incorporate into their communication requests for help. They were significantly less likely to use threatening or antagonistic language in their communications, except in those cases involving security breaches. These results emphasize the importance of integrating mental health findings and preventive measures into risk management. Approach should not be regarded as a single behavioral category and has multiple motivations. Future studies should adopt standard terminology, preferably taken from the general stalking research.

  9. 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.

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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.

  15. Research station to aid multidisciplinary study of Upper Mississippi River

    NASA Astrophysics Data System (ADS)

    Nakato, Tatsuaki

    IIHR-Hydroscience and Engineering (formerly Iowa Institute of Hydraulic Research) of the University of Iowa's College of Engineering is establishing a Mississippi Riverside Environmental Research Station (MRERS) to provide opportunities for researchers and educators around the world to study river ecosystems in a multidisciplinary setting. MRERS will provide state-of-the-art facilities to study diverse facets of the upper Mississippi River to better understand river ecosystems and their response to natural events and human activities. It will also provide students at all levels with hands-on experience as well as opportunities for public education. In light of recent flooding in the region last spring, establishment of MRERS is timely MRERS will bring a truly multidisciplinary approach to understanding and planning for one of the country's most important natural resources: the mighty Mississippi.

  16. Flank instability assessment at Kick-'em-Jenny submarine volcano (Grenada, Lesser Antilles): a multidisciplinary approach using experiments and modeling

    NASA Astrophysics Data System (ADS)

    Dondin, F. J.-Y.; Heap, M. J.; Robertson, R. E. A.; Dorville, J.-F. M.; Carey, S.

    2017-01-01

    Kick-'em-Jenny (KeJ)—located ca. 8 km north of the island of Grenada—is the only active submarine volcano of the Lesser Antilles Volcanic Arc. Previous investigations of KeJ revealed that it lies within a collapse scar inherited from a past flank instability episode. To assess the likelihood of future collapse, we employ here a combined laboratory and modeling approach. Lavas collected using a remotely operated vehicle (ROV) provided samples to perform the first rock physical property measurements for the materials comprising the KeJ edifice. Uniaxial and triaxial deformation experiments showed that the dominant failure mode within the edifice host rock is brittle. Edifice fractures (such as those at Champagne Vent) will therefore assist the outgassing of the nearby magma-filled conduit, favoring effusive behavior. These laboratory data were then used as input parameters in models of slope stability. First, relative slope stability analysis revealed that the SW to N sector of the volcano displays a deficit of mass/volume with respect to a volcanoid (ideal 3D surface). Slope stability analysis using a limit equilibrium method (LEM) showed that KeJ is currently stable, since all values of stability factor or factor of safety (Fs) are greater than unity. The lowest values of Fs were found for the SW-NW sector of the volcano (the sector displaying a mass/volume deficit). Although currently stable, KeJ may become unstable in the future. Instability (severe reductions in Fs) could result, for example, from overpressurization due to the growth of a cryptodome. Our modeling has shown that instability-induced flank collapse will most likely initiate from the SW-NW sector of KeJ, therefore mobilizing a volume of at least ca. 0.7 km3. The mobilization of ca. 0.7 km3 of material is certainly capable of generating a tsunami that poses a significant hazard to the southern islands of the West Indies.

  17. A multi-disciplinary approach to evaluate vulnerability and risks of pluvial floods under changing climate: the case study of the municipality of Venice (Italy).

    NASA Astrophysics Data System (ADS)

    Sperotto, Anna; Torresan, Silvia; Gallina, Valentina; Coppola, Erika; Critto, Andrea; Marcomini, Antonio

    2015-04-01

    Global climate change is expected to affect the intensity and frequency of extreme events (e.g. heat waves, drought, heavy precipitations events) leading to increasing natural disasters and damaging events (e.g. storms, pluvial floods and coastal flooding) worldwide. Especially in urban areas, disasters risks can be exacerbated by changes in exposure and vulnerability patterns (i.e. urbanization, population growth) and should be addressed by adopting a multi-disciplinary approach. A Regional Risk Assessment (RRA) methodology integrating climate and environmental sciences with bottom-up participative processes was developed and applied to the urban territory of the municipality of Venice in order to evaluate the potential consequences of climate change on pluvial flood risk in urban areas. Based on the consecutive analysis of hazard, exposure, vulnerability and risks, the RRA methodology is a screening risk tool to identify and prioritize major elements at risk (e.g. residential, commercial areas and infrastructures) and to localize sub-areas that are more likely to be affected by 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 to select and score site-specific vulnerability factors (e.g. slope, permeability of the soil, past flooded areas) and to consider the requests and perspectives of local stakeholders of the North Adriatic region, by means of interactive workshops, surveys and discussions. The main outputs of the assessment are risk and vulnerability maps and statistics aimed at increasing awareness about the potential effect of climate change on pluvial flood risks and at identifying hot-spot areas where future adaptation actions should be required to decrease physical-environmental vulnerabilities or building resilience and coping capacity of human society to climate change. The overall risk assessment methodology and the results

  18. Reconciling statistical and systems science approaches to public health.

    PubMed

    Ip, Edward H; Rahmandad, Hazhir; Shoham, David A; Hammond, Ross; Huang, Terry T-K; Wang, Youfa; Mabry, Patricia L

    2013-10-01

    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 the researchers are accustomed. There also appears to be conflicts between complex systems approaches and traditional statistical methodologies, both in terms of their underlying strategies and the languages they use. We argue that the conflicts are resolvable, and the sooner the better for the field. In this article, we show how statistical and systems science approaches can be reconciled, and how together they can advance solutions to complex problems. We do this by comparing the methods within a theoretical framework based on the work of population biologist Richard Levins. We present different types of models as representing different tradeoffs among the four desiderata of generality, realism, fit, and precision.

  19. Broadening the approach to youth violence prevention through public health.

    PubMed

    Hammond, W Rodney; Arias, Ileana

    2011-01-01

    Violence is a critical cause of death and nonfatal injuries among youth, and even those who witness violence can suffer serious health and mental health consequences. This highlights the need for prevention programs and policies aimed at reducing risks, promoting prosocial behavior, strengthening families, and creating communities in which youth are safe from violence. The Centers for Disease Control and Prevention's Injury Center is developing a National Public Health Strategy to Prevent Youth Violence. The strategy will establish a full application of the public health approach, ranging from research to practice. It also spotlights what is working, as a way to mobilize community leaders in supporting evidence-based initiatives. With the empirical guidance of articles such as those in this special issue, a shared strategy to prevent youth violence will help focus efforts and resources on solutions that show the most promise, and ensure that American communities undertake more comprehensive and coordinated prevention efforts to protect our nation's youth.

  20. 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

  1. Multidisciplinary teamwork--myth or reality?

    PubMed

    Rowe, H

    1996-03-01

    The provision and delivery of health care has become increasingly complex in recent years due to technological innovation in medicine and increasing client expectations. The challenge for health care workers is to meet the purchasers' demands, one option may be to shift working practices from a functionalist approach to one of multidisciplinary teamwork. This paper explores one example of multidisciplinary teamwork and examines the processes which enhance and those that limit collaboration.

  2. Prevention of Youth Violence: A Public Health Approach.

    PubMed

    Sood, Aradhana Bela; Berkowitz, Steven J

    2016-04-01

    The causes of youth violence are multifactorial and include biological, individual, familial, social, and economic factors. The influence of parents, family members, and important adults can shape the beliefs of the child toward violence in a significant manner. However, the influence of school and the neighborhood also have an important role in attitudes and behaviors of children toward violence. The complexity of factors related to violence requires a comprehensive public health approach. This article focuses on evidence-based models of intervention to reduce violence while emphasizing collective impact as a guiding principle.

  3. 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…

  4. Multidisciplinary approach of the hyperarid desert of Pampas de La Joya in southern Peru as a new Mars-like soil analog

    NASA Astrophysics Data System (ADS)

    Valdivia-Silva, Julio E.; Navarro-González, Rafael; Ortega-Gutierrez, Fernando; Fletcher, Lauren E.; Perez-Montaño, Saúl; Condori-Apaza, Reneé; McKay, Christopher P.

    2011-04-01

    The distribution of living organisms, organic matter, and chemical properties in Mars-like environments on Earth can be used as a model to guide the investigation of possible habitable environments on Mars. This work aims to demonstrate that the place known informally as the "Mar de Cuarzo" (Sea of Quartz) in the Pampas de La Joya desert southern Peru (between 16°S and 17°S latitude), contains soils with characteristics similar to those found on the Martian surface. Using a multidisciplinary approach, we studied the environmental data, geology, organic matter content, oxidant activity, and microbiology of this area. Our data show that (1) Mar de Cuarzo is a hyper arid area with a lower concentration of organic matter than those found in the Mars-like soils from Yungay area (Atacama Desert in Chile), while at the same time having, comparable extreme environmental conditions, and very low levels of microorganisms. (2) The detrital components of the soils come essentially from the Andean volcanic chain and local outcrops of Precambrian gneisses and Cretaceous granitic batholiths. (3) The presence of microclimates, geomorphological features, and the high influence of the "El Niño Southern Oscillation (ENSO)" allowed the formation of exotic and heterogeneous chemical deposits in these soils, including iron oxides, sulfates, and other evaporites. (4) Thermal volatilization in these soils (using methods similar to the Viking and Phoenix instruments) shows high oxidant activity. (5) Labeled release experiment (similar to the Viking instrument) shows high degradation of nutrients added in these soils. Altogether, the Mar de Cuarzo area in the Pampas de La Joya is an interesting place for astrobiological studies as a new analog to Mars, and for comparative analyses with other hyperarid analogs as Yungay.

  5. 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

  6. Multidisciplinary approach for fault detection: Integration of PS-InSAR, geomorphological, stratigraphic and structural data in the Venafro intermontane basin (Central-Southern Apennines, Italy)

    NASA Astrophysics Data System (ADS)

    Amato, Vincenzo; Aucelli, Pietro P. C.; Bellucci Sessa, Eliana; Cesarano, Massimo; Incontri, Pietro; Pappone, Gerardo; Valente, Ettore; Vilardo, Giuseppe

    2017-04-01

    A multidisciplinary methodology, integrating stratigraphic, geomorphological and structural data, combined with GIS-aided analysis and PS-InSAR interferometric data, was applied to characterize the relationships between ground deformations and the stratigraphic and the morphostructural setting of the Venafro intermontane basin. This basin is a morphostructural depression related to NW-SE and NE-SW oriented high angle normal faults bordering and crossing it. In particular, a well-known active fault crossing the plain is the Aquae Juliae Fault, whose recent activity is evidenced by archeoseismological data. The approach applied here reveals new evidence of possible faulting, acting during the Lower to Upper Pleistocene, which has driven the morphotectonic and the environmental evolution of the basin. In particular, the tectonic setting emerging from this study highlights the influence of the NW-SE oriented extensional phase during the late Lower Pleistocene - early Middle Pleistocene, in the generation of NE-SW trending, SE dipping, high-angle faults and NW-SE trending, high-angle transtensive faults. This phase has been followed by a NE-SW extensional one, responsible for the formation of NW-SE trending, both NW and SE dipping, high-angle normal faults, and the reactivation of the oldest NE-SW oriented structures. These NW-SE trending normal faults include the Aquae Juliae Fault and a new one, unknown until now, crossing the plain between the Venafro village and the Colle Cupone Mt. (hereinafter named the Venafro-Colle Cupone Fault, VCCF). This fault has controlled deposition of the youngest sedimentary units (late Middle Pleistocene to late Upper Pleistocene) suggesting its recent activity and it is well constrained by PS-InSAR data, as testified by the increase of the subsidence rate in the hanging wall block.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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)

  12. 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.

  13. Disparities in Abortion Rates: A Public Health Approach

    PubMed Central

    Harris, Lisa H.; Weitz, Tracy A.

    2013-01-01

    Women of lower socioeconomic status and women of color in the United States have higher rates of abortion than women of higher socioeconomic status and White women. Opponents of abortion use these statistics to argue that abortion providers are exploiting women of color and low socioeconomic status, and thus, regulations are needed to protect women. This argument ignores the underlying causes of the disparities. As efforts to restrict abortion will have no effect on these underlying factors, and instead will only result in more women experiencing later abortions or having an unintended childbirth, they are likely to result in worsening health disparities. We provide a review of the causes of abortion disparities and argue for a multifaceted public health approach to address them. PMID:23948010

  14. Primary care in Cuba: a public health approach.

    PubMed

    Swanson, K A; Swanson, J M; Gill, A E; Walter, C

    1995-01-01

    Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood/home clinics. Achievements in health outcomes as a result of Cuba's model and the consequences for women's health care are discussed. Examples are presented of the effects on health care delivery of the economic hardship that Cuba has experienced since 1991 as a result of the loss of 85% of its trade with the former Soviet Union and the intensified U.S. embargo. A critique of Cuba's model concludes the article.

  15. 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

  16. 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

  17. The MESH approach: strengthening public health systems for the MDGs.

    PubMed

    Thomas, Stephen; Mooney, Gavin; Mbatsha, Sandi

    2007-10-01

    This article addresses some of the complexities in the interactions both within the public health system and between that and civil society. It examines what needs to be done to improve the capacity of health systems, primarily through building relevant infrastructure (what is called MESH--management, economic, social and human - infrastructure) where this is lacking. This lack is most likely to occur in poorer communities and health districts. The problem of absorption and appropriate use of funds in disadvantaged areas has been highlighted as a critical bottleneck to the achievement of the millennium development goals (MDGs). MESH is defined as infrastructure which is built to improve the capacity of communities and other entities to implement health service programs efficiently. We employ this concept to determine how best to invest in health in poor areas so that they can better use any additional resources they receive. The article reviews some initial explorations of the relevance of MESH building strategies in South Africa. The research shows the usefulness of the MESH approach which requires inter alia a more developmental approach that goes beyond the vertical silos of much influential prioritization literature over the last two decades. In practice it is clear that MESH will vary from location to location which reflects the fact that investing in successful health strategies must take into account the voices of the local people with respect to what they want from their health services.

  18. 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.

  19. Multidisciplinary team and team oncology medicine research and development in China.

    PubMed

    Song, Peipei; Wu, Qiang; Huang, Yong

    2010-08-01

    In the context of transition from "Biomedical Model" to "Biology-Psychology-Society Medical Model", the treatment model of malignant tumors has changed from single-subject treatment to multidisciplinary collaboration treatment led by a Multidisciplinary Team (MDT). On this basis, the concept of "Team Oncology Medicine" strengthens the focus of malignant tumor treatment. This is not only improving cure rate and extending life span, but also paying close attention to patients' actual demands to improve their quality of life. There are many good studies and practices of Multidisciplinary Team and Team Oncology Medicine in the world. China is currently in the exploratory phase of the malignant tumor Multidisciplinary Team treatment model. Many hospitals have investigated and practiced a Multidisciplinary Team treatment model. China is faced with many problems to scientifically construct a malignant tumor treatment model which conforms to national conditions. These conditions include a medical model, a medical care insurance system, public hospitals reform, hospital management approaches, personnel framework, concern with patients' psychosis and psychology, and whether to tell patients their actual condition and how they should express their will, and so on.

  20. The Making of a Skull Base Team and the Value of Multidisciplinary Approach in the Management of Sinonasal and Ventral Skull Base Malignancies.

    PubMed

    Snyderman, Carl H; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A

    2017-02-01

    The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team.

  1. 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

  2. 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).

  3. 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.…

  4. Governance and mental health: contributions for public policy approach

    PubMed Central

    Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc

    2017-01-01

    ABSTRACT OBJECTIVE To analyze the conceptualization of the term governance on public mental health programs. METHODS In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. RESULTS We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. CONCLUSIONS The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. PMID:28146159

  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. Integrating Multidisciplinary Engineering Knowledge

    ERIC Educational Resources Information Center

    Wolff, Karin; Luckett, Kathy

    2013-01-01

    In order to design two distinct engineering qualification levels for an existing University of Technology programme, empirical evidence based on the current diploma is necessary to illuminate the nature of and the relationship between the "contextual" and "conceptual" elements underpinning a multidisciplinary engineering…

  7. 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…

  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.

  9. Structuring Decision-Making in Multidisciplinary Teams.

    ERIC Educational Resources Information Center

    Kabler, Michael L.; Genshaft, Judy L.

    1983-01-01

    Three areas related to decision making are discussed: (1) a research survey summary of multidisciplinary team decision making (MTD); (2) four approaches for structuring MTD decision making; and (3) styles of leadership as a factor that impacts on the decision-making teams. (Author/PN)

  10. 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…

  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. 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…

  14. 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

  15. 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

  16. Optimal Design of Integrated Systems Health Management (ISHM) Systems for improving safety in NASA's Exploration Vehicles: A Two-Level Multidisciplinary Design Approach

    NASA Technical Reports Server (NTRS)

    Mehr, Ali Farhang; Tumer, Irem; Barszcz, Eric

    2005-01-01

    Integrated Vehicle Health Management (ISHM) systems are used to detect, assess, and isolate functional failures in order to improve safety of space systems such as Orbital Space Planes (OSPs). An ISHM system, as a whole, consists of several subsystems that monitor different components of an OSP including: Spacecraft, Launch Vehicle, Ground Control, and the International Space Station. In this research, therefore, we propose a new methodology to design and optimize ISHM as a distributed system with multiple disciplines (that correspond to different subsystems of OSP safety). A paramount amount of interest has been given in the literature to the multidisciplinary design optimization of problems with such architecture (as will be reviewed in the full paper).

  17. NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity.

    PubMed

    Welbourn, Richard; Dixon, John; Barth, Julian H; Finer, Nicholas; Hughes, Carly A; le Roux, Carel W; Wass, John

    2016-03-01

    Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.

  18. 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.

  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... address drug shortage issues. Date and Time: The public workshop will be held on September 26, 2011,...

  20. A multidisciplinary approach to digital mapping of dinosaurian tracksites in the Lower Cretaceous (Valanginian–Barremian) Broome Sandstone of the Dampier Peninsula, Western Australia

    PubMed Central

    Hacker, Jorg M.; Zlot, Robert; Poropat, George; Bosse, Michael; Salisbury, Steven W.

    2017-01-01

    The abundant dinosaurian tracksites of the Lower Cretaceous (Valanginian–Barremian) Broome Sandstone of the Dampier Peninsula, Western Australia, form an important part of the West Kimberley National Heritage Place. Previous attempts to document these tracksites using traditional mapping techniques (e.g., surface overlays, transects and gridlines combined with conventional photography) have been hindered by the non-trivial challenges associated with working in this area, including, but not limited to: (1) the remoteness of many of the tracksites; (2) the occurrence of the majority of the tracksites in the intertidal zone; (3) the size and complexity of many of the tracksites, with some extending over several square kilometres. Using the historically significant and well-known dinosaurian tracksites at Minyirr (Gantheaume Point), we show how these issues can be overcome through the use of an integrated array of remote sensing tools. A combination of high-resolution aerial photography with both manned and unmanned aircraft, airborne and handheld high-resolution lidar imaging and handheld photography enabled the collection of large amounts of digital data from which 3D models of the tracksites at varying resolutions were constructed. The acquired data encompasses a very broad scale, from the sub-millimetre level that details individual tracks, to the multiple-kilometre level, which encompasses discontinuous tracksite exposures and large swathes of coastline. The former are useful for detailed ichnological work, while the latter are being employed to better understand the stratigraphic and temporal relationship between tracksites in a broader geological and palaeoecological context. These approaches and the data they can generate now provide a means through which digital conservation and temporal monitoring of the Dampier Peninsula’s dinosaurian tracksites can occur. As plans for the on-going management of the tracks in this area progress, analysis of the 3D data

  1. A multidisciplinary approach to digital mapping of dinosaurian tracksites in the Lower Cretaceous (Valanginian-Barremian) Broome Sandstone of the Dampier Peninsula, Western Australia.

    PubMed

    Romilio, Anthony; Hacker, Jorg M; Zlot, Robert; Poropat, George; Bosse, Michael; Salisbury, Steven W

    2017-01-01

    The abundant dinosaurian tracksites of the Lower Cretaceous (Valanginian-Barremian) Broome Sandstone of the Dampier Peninsula, Western Australia, form an important part of the West Kimberley National Heritage Place. Previous attempts to document these tracksites using traditional mapping techniques (e.g., surface overlays, transects and gridlines combined with conventional photography) have been hindered by the non-trivial challenges associated with working in this area, including, but not limited to: (1) the remoteness of many of the tracksites; (2) the occurrence of the majority of the tracksites in the intertidal zone; (3) the size and complexity of many of the tracksites, with some extending over several square kilometres. Using the historically significant and well-known dinosaurian tracksites at Minyirr (Gantheaume Point), we show how these issues can be overcome through the use of an integrated array of remote sensing tools. A combination of high-resolution aerial photography with both manned and unmanned aircraft, airborne and handheld high-resolution lidar imaging and handheld photography enabled the collection of large amounts of digital data from which 3D models of the tracksites at varying resolutions were constructed. The acquired data encompasses a very broad scale, from the sub-millimetre level that details individual tracks, to the multiple-kilometre level, which encompasses discontinuous tracksite exposures and large swathes of coastline. The former are useful for detailed ichnological work, while the latter are being employed to better understand the stratigraphic and temporal relationship between tracksites in a broader geological and palaeoecological context. These approaches and the data they can generate now provide a means through which digital conservation and temporal monitoring of the Dampier Peninsula's dinosaurian tracksites can occur. As plans for the on-going management of the tracks in this area progress, analysis of the 3D data and 3

  2. 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.

  3. Public Housing: A Tailored Approach to Energy Retrofits

    SciTech Connect

    J. Dentz; Conlin, F.; Podorson, D.; Alaigh, K.; Davis, T.

    2016-02-23

    The Building America research team Advanced Residential Integrated Energy Solutions Collaborative (ARIES) worked with four public housing authorities (PHAs) to develop packages of energy-efficiency retrofit measures that the PHAs can cost-effectively implement with their own staffs during the normal course of housing operations when units are refurbished between occupancies.

  4. A New Approach to Public Speaking Course in ESL Classroom

    ERIC Educational Resources Information Center

    Hou, Minghua

    2008-01-01

    This paper is a project report on the experiment of an English public speaking and debating course with advanced level English majors in College of Arts and Science, Yangtze University. The paper analyzes the validity of the course, introduces the design rationale, the design and experiment process, and students' responses. The paper suggests that…

  5. B-DEOS: British Dynamics of Earth and Ocean systems- new approaches for a multidisciplinary ocean observing system in the Atlantic and S Ocean

    NASA Astrophysics Data System (ADS)

    Schultz, A.; Lampitt, R. S.

    2001-12-01

    Advances in theoretical understanding of the natural systems in the sea and in the Earth below have been closely associated with new data sets made possible by technological advances. The plate tectonic revolution, the discovery of hydrothermal circulation, and many other examples can be attributed to the application of innovative new technology to the study of the sea. A consortium of research groups and institutions within the United Kingdom is planning a system of multidisciplinary ocean observatories to study the components of, and linkages between the physical, chemical and biological processes regulating the earth-ocean-atmosphere-biosphere system. An engineering feasibility design study has been completed which has resulted in a robust and flexible design for a telecommunications/power buoy system, and a UK NERC Thematic Programme is in the advanced planning stage. Representatives of the US, Japan, France, Portugal, Spain, Germany and other countries have been involved in consultations, and a coordinated international effort is expected to develop throughout the Atlantic and S Oceans, with collaborations extended to observatories operated by cooperating partners in other regions. The B-DEOS observatory system is designed to allow studies on scales of order cm to 1000 km, as well as to supplement on larger spatial scales the emerging global ocean and seafloor solid earth observatory network. The facility will make it possible to obtain requisite long-term synoptic baseline data, and to monitor natural and man-made changes to this system by: 1) Establishing a long-term, permanent and relocatable network of instrumented seafloor platforms, moorings and profiler vehicles, provided with power from the ocean surface and internal power supplies, and maintaining a real- or near-real time bidirectional Internet link to shore. 2) Examining the time varying properties of these different environments (solid earth, ocean, atmosphere, biosphere), exploring the links

  6. 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.

  7. Pineal lesions: a multidisciplinary challenge.

    PubMed

    Westphal, Manfred; Emami, Pedram

    2015-01-01

    The pineal region is a complex anatomical compartment, harbouring the pineal gland surrounded by the quadrigeminal plate and the confluents of the internal cerebral veins to form the vein of Galen. The complexity of lesions in that region, however, goes far beyond the pineal parenchyma proper. Originating in the pineal gland, there are not only benign cysts but also numerous different tumour types. In addition, lesions such as tectal gliomas, tentorial meningiomas and choroid plexus papillomas arise from the surrounding structures, occupying that regions. Furthermore, the area has an affinity for metastatic lesions. Vascular lesions complete the spectrum mainly as small tectal arteriovenous malformations or cavernous haemangiomas.Taken together, there is a wide spectrum of lesions, many unique to that region, which call for a multidisciplinary approach. The limited access and anatomical complexity have generated a spectrum of anatomical approaches and raised the interest for neuroendoscopic approaches. Equally complex is the spectrum of treatment modalities such as microsurgery as the main option but stereotactic radiosurgery as an alternative or adjuvant to surgery for selected cases, radiation as for germinoma (see below) and or combinatorial chemotherapy, which may need to precede any other ablative technique as constituents.In this context, we review the current literature and our own series to obtain a snapshot sentiment of how to approach pineal lesions, how to interrelate alternative/competing concepts and review the recent technological advances.

  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. 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.

  10. 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.

  11. Necrotizing pancreatitis: a review of multidisciplinary management.

    PubMed

    Sabo, Anthony; Goussous, Naeem; Sardana, Neeraj; Patel, Shirali; Cunningham, Steven C

    2015-03-20

    The objective of this review is to summarize the current state of the art of the management of necrotizing pancreatitis, and to clarify some confusing points regarding the terminology and diagnosis of necrotizing pancreatitis, as these points are essential for management decisions and communication between providers and within the literature. Acute pancreatitis varies widely in its clinical presentation. Despite the publication of the Atlanta guidelines, misuse of pancreatitis terminology continues in the literature and in clinical practice, especially regarding the local complications associated with severe acute pancreatitis. Necrotizing pancreatitis is a manifestation of severe acute pancreatitis associated with significant morbidity and mortality. Diagnosis is aided by pancreas-protocol computed tomography or magnetic resonance imaging, ideally 72 h after onset of symptoms to achieve the most accurate characterization of pancreatic necrosis. The extent of necrosis correlates well with the incidence of infected necrosis, organ failure, need for debridement, and morbidity and mortality. Having established the diagnosis of pancreatic necrosis, goals of appropriately aggressive resuscitation should be established and adhered to in a multidisciplinary approach, ideally at a high-volume pancreatic center. The role of antibiotics is determined by the presence of infected necrosis. Early enteral feeds improve outcomes compared with parenteral nutrition. Pancreatic necrosis is associated with a multitude of complications which can lead to long-term morbidity or mortality. Interventional therapy should be guided by available resources and the principle of a minimally invasive approach. When open debridement is necessary, it should be delayed at least 3-6 weeks to allow demarcation of necrotic from viable tissue.

  12. 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

  13. Commentary: Approaching and stalking public figures--a prerequisite to attack.

    PubMed

    Dietz, Park; Martell, Daniel A

    2010-01-01

    The concept of studying approaches to public figures (i.e., physical pursuit or stalking) arose as a proxy measure to aid in the development of tools to prevent assassination, a low base rate event. In this commentary, we review the origins of this concept and the historical record of public figure attacks in the United States that formed the empirical basis of the concept, we describe case examples of approaches toward public figures in the United States that did not result in injurious attacks, and we provide a synopsis of our findings on the ways in which communications predict approach.

  14. Translating science into action: periodontal health through public health approaches.

    PubMed

    Jürgensen, Nanna; Petersen, Poul E; Ogawa, Hiroshi; Matsumoto, Sayaka

    2012-10-01

    Clinical and public health research data have shown that a number of individual, professional and community health measures may be valuable in preventing the major oral diseases. The fundamental gap in knowledge, however, is not confined to 'what to do' but rather 'how' to translate the scientific findings into effective and sustainable programs for groups and populations. The advances in oral health science have not yet benefitted the poor and disadvantaged population groups around the world to the fullest extent possible and this has led to inequalities in periodontal health as well as in other chronic diseases. Research on the causative role of tobacco use in periodontal disease is strong because of the fact that tobacco-induced disease ultimately may lead to the loss of teeth. Studies also indicate that wound healing may be negatively affected by the use of tobacco. Likewise, research has shown that extreme use of alcohol, poor diet and nutrition, and psychological stress all have negative effects on periodontal health. Research on sociobehavioral risk factors has great implication to prevent periodontal disease. The case for tobacco is illustrated in this report. The global exposure to tobacco use in adults and adolescents is outlined. Because of the global Framework Convention for Tobacco Control (2003), the solid research on the harmful effect of tobacco is now being widely used for public health. The importance of tobacco prevention within the context of health-promoting schools is emphasized. Research on other population-directed strategies and their implications on public health would be instrumental to integrated prevention of chronic disease and periodontal disease. Community interventions and delivery of preventive oral care by oral health services may have positive outcomes for periodontal health but periodontal research needs to be further strengthened by the provision of sound evidence. It is somewhat remarkable that research on true population

  15. 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.

  16. Public Housing: A Tailored Approach to Energy Retrofits

    SciTech Connect

    Dentz, J.; Conlin, F.; Podorson, D.; Alaigh, K.; Davis, T.

    2016-02-18

    Over one 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 four 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 18 housing units. Reductions in average air leakage were 16% and duct leakage reductions averaged 23%. Total source energy consumption savings due to implemented measures was estimated at 3-10% based on BEopt modeling with a simple payback of 1.6 to 2.5 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 units per year nationally.

  17. 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.

  18. A Review of Multidisciplinary Interventions in Atopic Dermatitis

    PubMed Central

    Spielman, Sara C.; LeBovidge, Jennifer S.; Timmons, Karol G.; Schneider, Lynda C.

    2015-01-01

    Multidisciplinary interventions have been developed for patients with atopic dermatitis (AD) and their families, with the aim of improving outcomes such as disease control, adherence, and quality of life. We reviewed the content of different multidisciplinary approaches to intervention for AD and evidence for their impact on key outcome measures. We also provided data from our multidisciplinary outpatient program for pediatric AD. Studies included in the review suggest benefits of multidisciplinary interventions as models of treatment or adjuncts to standard medical care, with a positive impact on outcomes including disease severity and itching/scratching. There were limitations to existing studies, including heterogeneous methods used to assess quality of life outcomes across studies and lack of controlled studies assessing the outcome of clinical care programs. Further research will be useful in assessing the impact of multidisciplinary interventions on important outcomes such as treatment adherence and sleep, identifying the elements of multidisciplinary interventions that are most critical for improved outcomes, and identifying the best candidates for multidisciplinary intervention approaches. PMID:26239470

  19. 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…

  20. 78 FR 18932 - Public Meeting: Unmanned Aircraft Systems Test Site Program; Privacy Approach

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ...The FAA will be holding a public engagement session on Wednesday, April 3, 2013, on the proposed privacy policy approach for the unmanned aircraft systems (UAS) test site program. The FAA is seeking the views from the public with respect to proposed privacy language to be included in agreements with each test site...

  1. 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…

  2. Activating Public Administration Students in a Statistics Course: A Team-Teaching Approach.

    ERIC Educational Resources Information Center

    Hy, Ronald John; Hughes, Linda

    1988-01-01

    Describes a team teaching approach to statistics in public administration programs. Discusses a format requiring that students combine skills of critical inquiry and understanding of numerical data with the literacy skills public administrators need in order to communicate with government officials, managers, and staff. Suggests applications for…

  3. 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…

  4. 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…

  5. The Amritsar Massacre: The Origins of the British Approach of Minimal Force on Public Order Operations

    DTIC Science & Technology

    2009-10-04

    No5, 1932), 86. 116 Sir John Dill, Notes on the Tactical Lessons of the Palestine Rebellion. (London, 1936), 21 . 44 experience of internal ...nothing new; it has been a requirement of the military to support the national government in the quelling of internal public disorder since the...military approach, the application of minimal force, will constantly be under pressure. The British approach to public order and internal security

  6. Uplift Sequence of the Main Morphoestructural Units of the South Central Andes at 30°S: Insights from a Multidisciplinary Approach

    NASA Astrophysics Data System (ADS)

    Lossada, A. C.; Mardónez, D.; Suriano, J.; Hoke, G. D.; Fitzgerald, P. G.; Mahoney, J. B.; Giambiagi, L.; Aragon, E.

    2015-12-01

    The South Central Andes at 30°S represent a key area to understand the Andes geodynamics as it corresponds to the flat slab segment, characterized by a subhorizontal subduction angle, absence of Neogene magmatism and a highly compressive tectonic regime. Under these settings, crustal shortening is believed to be the principal mechanism responsible for the rise of the Andes. However, the sequence of uplift of the different morphoestructural units composing the orogen is not fully understood; neither do the location and time of activity of intracrustal detachments and their connection with shallower structures. We attempt to develop a multidisciplinary analysis that allow us to characterize the timing, magnitude and activity of the principal structures involved in the construction of the Andes at 30°S trough the Coastal Range, the Frontal Cordillera and the Precordillera. The main phase of deformation in the Coastal Range occurred between 60 and 40Ma, based on published thermochronological and structural data. Our structural analyses constrain the Frontal Cordillera uplift between 18 and 13Ma. In the Precordillera area, in turn, we carried out structural, sedimentological and U-Pb provenience studies. Provenience studies and the 12 and 9Ma ages obtained for the youngest zircons indicated that the main thrusts uplifting the western sector of the Precordillera thrust system were activated since 13Ma at this latitude, and not before that time as it was previously suggested. In order to better constrain the exhumation and thermal history of Frontal Cordillera, a thermochronological study is being conducted. Twenty samples for apatite fission tracks (AFT) and apatite (U-Th)/He (AHe) were collected from two vertical profiles located at western sector (Guanta granitoid) and eastern sector (Colanguil granitoid) of the Frontal Cordillera system. Samples are currently being processed, and they are partially reseted, which will allow us to obtain a cooling age. The aim is to

  7. A multidisciplinary approach to quantify the permeability of the Whakaari/White Island volcanic hydrothermal system (Taupo Volcanic Zone, New Zealand)

    NASA Astrophysics Data System (ADS)

    Heap, Michael J.; Kennedy, Ben M.; Farquharson, Jamie I.; Ashworth, James; Mayer, Klaus; Letham-Brake, Mark; Reuschlé, Thierry; Gilg, H. Albert; Scheu, Bettina; Lavallée, Yan; Siratovich, Paul; Cole, Jim; Jolly, Arthur D.; Baud, Patrick; Dingwell, Donald B.

    2017-02-01

    Our multidisciplinary study aims to better understand the permeability of active volcanic hydrothermal systems, a vital prerequisite for modelling and understanding their behaviour and evolution. Whakaari/White Island volcano (an active stratovolcano at the north-eastern end of the Taupo Volcanic Zone of New Zealand) hosts a highly reactive hydrothermal system 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. The main crater, filled with tephra deposits, is shielded by a volcanic amphitheatre comprising interbedded lavas, lava breccias, and tuffs. We deployed field techniques to measure the permeability and density/porosity of (1) > 100 hand-sized sample blocks and (2) layered unlithified deposits in eight purpose-dug trenches. Our field measurements were then groundtruthed using traditional laboratory techniques on almost 150 samples. Our measurements highlight that the porosity of the materials at Whakaari varies from ∼ 0.01 to ∼ 0.7 and permeability varies by eight orders of magnitude (from ∼ 10-19 to ∼ 10-11 m2). The wide range in physical and hydraulic properties is the result of the numerous lithologies and their varied microstructures and alteration intensities, as exposed by a combination of macroscopic and microscopic (scanning electron microscopy) observations, quantitative mineralogical studies (X-ray powder diffraction), and mercury porosimetry. An understanding of the spatial distribution of lithology and alteration style/intensity is therefore important to decipher fluid flow within the Whakaari volcanic hydrothermal system. We align our field observations and porosity/permeability measurements to construct a schematic cross section of Whakaari that highlights the salient findings of our study. Taken together, the alteration typical of a volcanic

  8. A multidisciplinary approach to detect active pathways for magma migration and eruption at Mt. Etna (Sicily, Italy) before the 2001 and 2002-2003 eruptions

    NASA Astrophysics Data System (ADS)

    Alparone, S.; Andronico, D.; Giammanco, S.; Lodato, L.

    2004-08-01

    Two strong flank eruptions occurred in July-August 2001 and from late October 2002 to late January 2003 at Mt. Etna volcano. The two eruptions mainly involved the upper southern flank of the volcano, a particularly active area during the last 30 years, damaging several tourist facilities and threatening some villages. The composite eruptive activity on the upper southern flank of Mt. Etna during 2001-2003 has confirmed "a posteriori" the results of a multidisciplinary study, started well before its occurrence by combining geological, seismic and geochemical data gathered in this part of the volcano. We were able, in fact, to highlight fractured zones likely to be re-activated in the near future in this area, where the largest majority of eruptive fissures in the recent past opened along N120° to N180° ranging directions. The spatial distribution of earthquake epicentres during the period June 30th 2000-June 30th 2001 showed the greatest frequency in a sector compatible with both the direction of the main fissures of the pre-2001 period and that of the 2001 and 2002 lateral eruptions. Soil CO 2 and soil temperature surveys carried out in the studied area during the last 3 years have revealed anomalous release of magmatic fluids (mainly CO 2 and water vapour) along some NNW-SSE-trending volcano-tectonic structures of the area even during inter-eruptive periods, indicating persistent convective hydrothermal systems at shallow depth connected with the main feeder conduits of Etna. The temporal changes in both seismic and geochemical data from June 30th, 2000 to June 30th, 2001 were compared with the evolution of volcanic activity. The comparison allowed to recognize at least two sequences of anomalous signals (August to December 2000 and April to June 2001), likely related to episodes of step-like magma ascent towards the surface, as indicated by the following eruptive episodes. The N120° to N180° structural directions are in accord with one of the main structural

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. Critical Issues and Trends: A Public Health Approach to Reducing Harm from Drug Use.

    ERIC Educational Resources Information Center

    Jonas, Steven

    1994-01-01

    The public health approach to the drug problem is an alternative for dealing with illegal, mood altering, recreational drug use. The proposed approach involves creating a single national drug policy based in epidemiological, pharmacological, and medical science. The proposed goals emphasize harm reduction and safe use. Program components are…

  14. 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…

  15. 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.

  16. Multidisciplinary pulmonary embolism response teams and systems

    PubMed Central

    Monteleone, Peter P.; Rosenfield, Kenneth

    2016-01-01

    Pulmonary embolism (PE) is a complex diagnosis that encompasses a wide range of clinical presentations. Often patients who present with PE have complicated medical histories which can make their management challenging. Many novel therapeutic strategies and tools are emerging to improve the care and outcomes of patients with PE. Pulmonary embolism response teams (PERTs) are developing at multiple centers to improve the decision making, efficiency and orchestration of these clinical strategies. Concordantly with development of PERT programs is the design and implementation of systems to allow for numerous specialists to convene and discuss complex PE patients in real time. The mechanisms to engage a multidisciplinary approach are proving to be an invaluable resource in the decision making processes and treatment of high risk PE patients. Ultimately, other multi-disciplinary teams may adopt these methods to better address their clinical needs. PMID:28123986

  17. 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.

  18. 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…

  19. 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.

  20. Incorporating ethnographic methods in multidisciplinary approaches to risk assessment and communication: cultural and religious uses of mercury in Latino and Caribbean communities.

    PubMed

    Riley, Donna M; Newby, C Alison; Leal-Almeraz, Tomás O

    2006-10-01

    The potential risk from cultural and religious practices involving mercury in Latino and Caribbean communities raises central methodological and ethical questions for risk assessment and risk communication. Here, specific cultural practices unfamiliar to most risk professionals carry significant inherent risks in the eyes of those professionals but not necessarily in the eyes of practitioners. Practitioners' past experience and history as targets of religious suppression and anti-immigrant sentiment create a reluctance to engage with researchers or public health officials in risk assessment or preventive risk communication efforts. The potential for the risk--in this case mercury contamination in dwellings--to extend beyond the practicing community to future occupants adds to public health concern. Understanding the risks of these practices requires both an understanding of the cultural and political context, beliefs, and behaviors of mercury users and an understanding of the fate and transport of mercury in typical use scenarios. In this study, we employed ethnographic methods (interviews and participant observation) to understand beliefs and behavior about mercury use as well as quantitative modeling and measurement to estimate and assess potential exposures. This represents a new methodology tailored to situations in which traditional activities or observances that are integral components of cultural identity pose risks in and of themselves. Our findings indicate that there are different types of mercury use stemming from different cultural and religious traditions that result in different levels of exposure. Many of the mercury uses that can result in the highest exposures to mercury vapors have previously been attributed to the religious tradition of Santeria, but appear instead to have their roots outside of the religion.

  1. "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

  2. 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.

  3. [The challenge to public health of the Millenium Development Goals: an approach from political epidemiology].

    PubMed

    Gil González, Diana; Palma Solís, Marco; Ruiz Cantero, M Teresa; Ortiz Moncada, M Rocío; Franco Giraldo, Alvaro; Stein, Airton; Alvarez-Dardet Díaz, Carlos

    2006-12-01

    The Millennium Development Goals, and within these the Millennium Targets, constitute a working plan that strives to achieve basic goals within the field of health, eradicate poverty, and ensure compliance with basic human rights. Its scope of action represents a historic breakthrough as a step toward a possible global social policy, in which cooperation between the different sectors is essential for its efficiency. Due to its multidisciplinary nature, public health, as well as political epidemiology, can be used to help increase scientific knowledge in the field of health with respect to the Millennium Development Goals. Despite the opportunity that this international agreement provides, insufficient in-depth study has been carried out on the potential -mainly political- difficulties that could arise during its implementation. Therefore, a conceptual and methodological change is required so that concern does not simply center on social determinants of health but instead takes into consideration the political reasons behind them. To reduce inequality, not only must injustice be classified but effective ways must also be found to encourage institutions with political power to take part in this initiative.

  4. 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

  5. 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

  6. Heuristic Optimization Approach to Selecting a Transport Connection in City Public Transport

    NASA Astrophysics Data System (ADS)

    Kul'ka, Jozef; Mantič, Martin; Kopas, Melichar; Faltinová, Eva; Kachman, Daniel

    2017-02-01

    The article presents a heuristic optimization approach to select a suitable transport connection in the framework of a city public transport. This methodology was applied on a part of the public transport in Košice, because it is the second largest city in the Slovak Republic and its network of the public transport creates a complex transport system, which consists of three different transport modes, namely from the bus transport, tram transport and trolley-bus transport. This solution focused on examining the individual transport services and their interconnection in relevant interchange points.

  7. 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.

  8. A multidisciplinary approach to study the functional properties of neuron-like cell models constituting a living bio-hybrid system: SH-SY5Y cells adhering to PANI substrate

    NASA Astrophysics Data System (ADS)

    Caponi, S.; Mattana, S.; Ricci, M.; Sagini, K.; Juarez-Hernandez, L. J.; Jimenez-Garduño, A. M.; Cornella, N.; Pasquardini, L.; Urbanelli, L.; Sassi, P.; Morresi, A.; Emiliani, C.; Fioretto, D.; Dalla Serra, M.; Pederzolli, C.; Iannotta, S.; Macchi, P.; Musio, C.

    2016-11-01

    A living bio-hybrid system has been successfully implemented. It is constituted by neuroblastic cells, the SH-SY5Y human neuroblastoma cells, adhering to a poly-anyline (PANI) a semiconductor polymer with memristive properties. By a multidisciplinary approach, the biocompatibility of the substrate has been analyzed and the functionality of the adhering cells has been investigated. We found that the PANI films can support the cell adhesion. Moreover, the SH-SY5Y cells were successfully differentiated into neuron-like cells for in vitro applications demonstrating that PANI can also promote cell differentiation. In order to deeply characterize the modifications of the bio-functionality induced by the cell-substrate interaction, the functional properties of the cells have been characterized by electrophysiology and Raman spectroscopy. Our results confirm that the PANI films do not strongly affect the general properties of the cells, ensuring their viability without toxic effects on their physiology. Ascribed to the adhesion process, however, a slight increase of the markers of the cell suffering has been evidenced by Raman spectroscopy and accordingly the electrophysiology shows a reduction at positive stimulations in the cells excitability.

  9. A multidisciplinary approach to study a couple of monozygotic twins discordant for the chronic fatigue syndrome: a focus on potential salivary biomarkers

    PubMed Central

    2013-01-01

    Background Chronic Fatigue Syndrome (CFS) is a severe, systemic illness characterized by persistent, debilitating and medically unexplained fatigue. The etiology and pathophysiology of CFS remains obscure, and diagnosis is formulated through the patient’s history and exclusion of other medical causes. Thereby, the availability of biomarkers for CFS could be useful for clinical research. In the present study, we used a proteomic approach to evaluate the global changes in the salivary profile in a couple of monozygotic twins who were discordant for CFS. The aim was to evaluate differences of salivary protein expression in the CFS patient in respect to his healthy twin. Methods Saliva samples were submitted to two-dimensional electrophoresis (2DE). The gels were stained with Sypro, and a comparison between CFS subject and the healthy one was performed by the software Progenesis Same Spot including the Analysis of variance (ANOVA test). The proteins spot found with a ≥2-fold spot quantity change and p<0.05 were identified by Nano-liquid chromatography electrospray ionization tandem mass spectrometry. To validate the expression changes found with 2DE of 5 proteins (14-3-3 protein zeta/delta, cyclophilin A, Cystatin-C, Protein S100-A7, and zinc-alpha-2-glycoprotein), we used the western blot analysis. Moreover, proteins differentially expressed were functionally analyzed using the Ingenuity Pathways Analysis software with the aim to determine the predominant canonical pathways and the interaction network involved. Results The analysis of the protein profiles allowed us to find 13 proteins with a different expression in CFS in respect to control. Nine spots were up-regulated in CFS and 4 down-regulated. These proteins belong to different functional classes, such as inflammatory response, immune system and metabolism. In particular, as shown by the pathway analysis, the network built with our proteins highlights the involvement of inflammatory response in CFS

  10. Brief communication "A multi-disciplinary approach to a side-flash lightning incident to human beings in the Basque Country"

    NASA Astrophysics Data System (ADS)

    López, J.; Urgoiti, V.; González, M.; Aranda, J. A.; Gaztelumendi, S.; Anitua, P.

    2013-03-01

    On 31 August 2011 a lightning incident affecting two human beings was registered in the Basque Country (northern Spain). The two individuals were sightseeing in the Painted Forest of Oma (province of Biscay, Basque Country) when an approaching thunderstorm forced them to look for shelter under the lowest branches of one of the trees. A lightning discharge in that exact place caused serious injuries to the couple, consisting of the loss of consciousness, superficial burns, a tympanic membrane perforation and a broken clavicle. The investigation presented in this paper was carried out in order to find out the causes by which the couple was hit by the lightning discharge and why the injuries were superficial and did not kill them. Using the data available by the lightning detection networks in the Basque Country and the information available by the weather radar, the exact place where the lightning discharge occurred could be found, the mechanism of lightning injury was classified and the episode was reconstructed.

  11. 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.

  12. 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

  13. A Multidisciplinary Approach to the Characterisation and Accelerated Remediation of Nuclear Contaminated Sites: Less Intrusive Techniques and Better Use of Geographical Information System (GIS) Model Development

    SciTech Connect

    Brydie, J.R.; Hiller, P.; Mathers, D.; Gordon, R.

    2006-07-01

    Rapid, cost effective decommissioning and associated remediation of many nuclear licensed sites requires the physical and chemical characterisation of a range of bulk materials including natural soils, sediments, cementitious materials, miscellaneous historically buried waste and natural waters (surface and groundwaters). Conventional techniques (such as cable percussion drilling, rotary coring of building materials, extensive soil sampling campaigns and [ground]water sampling and analysis) tend to be expensive, time consuming, in many cases provide insufficient data and typically take several months to implement. The high level aim of the work is to reduce the overall time and cost of site characterisation, whilst maintaining quality of information and increasing the safety of field and laboratory personnel. We describe here the integrated technical approach being adopted and developed within Nexia Solutions Ltd. to provide a full in situ site characterisation and modelling capability, resulting in significantly reduced costs and acceleration of the Life Cycle Baseline (LCBL) of many United Kingdom (U. K.) nuclear licensed sites. The evolving technical toolbox includes many off-the-shelf technologies, as well as innovative technologies which have either been originally conceived or have been effectively adapted from a range of technical disciplines. All of the techniques here are either in use or are being actively developed and commissioned. All information gained via in situ techniques is used to iteratively update the Geographical Information System (GIS) conceptual model, allowing further targeted site investigation, informed decision making and optioneering. (authors)

  14. A global multidisciplinary approach to ETI research: a cyclic nonperiodic natural code guides the dynamical evolution of all real perceived structures.

    NASA Astrophysics Data System (ADS)

    Pinter, L.

    The conceptual and basic questions of experimental and theoretical ETI research are tackled starting from our present knowledge of star evolution in the Galaxy and envisageable kinds of very advanced civilizations focusing on two complementary ways to do research that advanced civilizations must possess. It is argued that all evolutionary processes can be dynamically and thermally based on a common concept of natural numbers, while temperature is shown to be an undefined concept; the underlying non-separability of dynamics from thermal physics leads to a global perception of a geometrical self- evolving structure of mass and space that doesn't need the concept of time. The intrinsic numerical classification of our perception of the world is discussed, and the 6 quantities on which the entire mathematics is based, i.e. e , , i , 0 , +1 , -1 , are put into evidence. Inconsistencies in definitions of periodic functions raise doubts as to the mathematical description of nature and suggest a new entirely dynamically evolving geometry for the real fields. Past and present ways to contain and transfer information unambiguously were analyzed in trying to answer the question why there are scientifically approachable and scientifically unapproachable fields. The analysis of primitive and non-primitive concepts necessary for a real , i.e. universal perception, shows the concepts of rigid body, motion and local space to be unreal , and the groundlessness of the concept of speed for the electromagnetic spectrum. As to the so called Man/Alien incommensurability problem, the possibility of a simple universal framework of understanding, i.e. of overcoming that problem, is contemplated; which possibility, as Carl Sagan has stated, would consist of a simple interstellar Rosetta stele , based on Mendeleev's elements table and on the assumption that natural laws are the same everywhere.

  15. 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

  16. Geochemical evidence of multistage retrogressive failure during the 160,000ka Icod landslide from turbidite facies analysis: multidisciplinary investigative approaches using destructive and non-destructive methodologies

    NASA Astrophysics Data System (ADS)

    Hunt, James; Wynn, Russell; Masson, Doug; Croudace, Ian

    2010-05-01

    have been five regular subunit packages identified and correlated. This failure mechanism would have significant consequences of decreasing ensuing tsunamigenic potential. Variations in subunit mineralogy, bulk geochemistry, and volcanic glass geochemistry could yield results to support this hypothesis, and rule out other generation mechanisms such as flow reflection. ITRAX micro-XRFmeasurements taken every 100µm show variations in bulk geochemistry. Major element (K, Ca, Ti, Fe) and trace element (Zr, Y an Sr) demonstrate this when plotted in Harker variation diagrams against silica. However these variations, along with those from ICP-AES, ICP-MS and XRF, could be accounted for by density fractionation of basaltic mafic clasts and volcanic glass constituents within the turbidity current. In regards to the mineral composition, the basal subunit contains altered volcanic glass with authigenic Ti-Fe oxide growths, seen using the TM-1000 SEM, compared to unaltered glasses found in the later four intervals. Furthermore, focussed studies of the volcanic glasses using the TM-1000 SEM EDS showed that the basal subunit had volcanic glasses of different major element compositions compared to the later four subunit intervals. This study, demonstrates the application of non-destructive geochemical analytical tools in not only discriminating provenance, but being able to aid deciphering of flow mechanical problems. Also, using non-destructive geochemical instruments will help discern provenance of further deposits around the Canary Islands. De Lange, G.J., Jarvis, I., & Kuijpers, A. 1987. Geochemical characteristics and provenance of late Quaternary sediments from the Madeira Abyssal Plain, N Atlantic. In: Weaver, P.P., & Thomson, J. (eds). Geology and Geochemistry of Abyssal Plains. Geological Special Publications, no.31, pp.147-165. Pearce, T.J., & Jarvis I. 1992. Composition and provenance of turbidite sands: Late Quaternary, Madeira Abyssal Plain. Marine Geology, 109, p.21

  17. 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

  18. 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.

  19. Bringing evidence to practice: a team approach to teaching skills required for an informationist role in evidence-based clinical and public health practice*†

    PubMed Central

    Oliver, Kathleen Burr; Dalrymple, Prudence; Lehmann, Harold P.; McClellan, Deborah Ann; Robinson, Karen A.; Twose, Claire

    2008-01-01

    Objective: The objectives were (1) to develop an academic, graduate-level course designed for information professionals seeking to bring evidence to clinical medicine and public health practice and to address, in the course approach, the “real-world” time constraints of these domains and (2) to further specify and realize identified elements of the “informationist” concept. Setting: The course took place at the Division of Health Sciences Informatics, School of Medicine, Johns Hopkins University. Participants: A multidisciplinary faculty, selected for their expertise in the course core competencies, and three students, two post-graduate National Library of Medicine (NLM) informationist fellows and one NLM second-year associate, participated in the research. Intervention: A 1.5-credit, graduate-level course, “Informationist Seminar: Bringing the Evidence to Practice,” was offered in October to December 2006. In this team-taught course, a series of lectures by course faculty and panel discussions involving outside experts were combined with in-class discussion, homework exercises, and a major project that involved choosing and answering, in both oral and written form, a real-world question based on a case scenario in clinical or public health practice. Conclusion: This course represents an approach that could be replicated in other academic health centers with similar pools of expertise. Ongoing journal clubs that reiterate the question-and-answer process with new questions derived from clinical and public health practice and incorporate peer review and faculty mentoring would reinforce the skills acquired in the seminar. PMID:18219381

  20. Making Marketing Work: How a Coordinated Approach Improved a College's Enrollment, Retention, and Public Image.

    ERIC Educational Resources Information Center

    Fowler, Charles R.

    1983-01-01

    Through a coordinated approach, Evergreen State achieved three goals--enrollment growth, increased student retention, and greater public awareness. Six steps to develop a marketing plan are identified: review the institution's position; establish administrative leadership, adapt educational services; and prepare, coordinate, carry out, and…

  1. 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 Addressing Drug Shortage; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is opening a comment period for...

  2. Educating English Language Learners: Instructional Approaches and Teacher Collaboration in Philadelphia Public Schools. PERC Research Brief

    ERIC Educational Resources Information Center

    Reumann-Moore, Rebecca; Rowland, Jeannette; Hughes, Rosemary; Lin, Joshua

    2016-01-01

    Districts, charter management organizations, and individual schools can learn a great deal from each other about strategies for creating robust and supportive learning environments for English Language Learners (ELLS). This brief highlights key findings about how Philadelphia public schools were crafting instructional approaches to serve their…

  3. The Toastmasters Approach: An Innovative Way to Teach Public Speaking to EFL Learners in Taiwan

    ERIC Educational Resources Information Center

    Yu-Chih, Sun

    2008-01-01

    Toastmasters is a widely recognized international club that aims to develop and enhance the art of public speaking by offering participants educational programmes and chances to speak before groups. This article reports on the integration of the Toastmasters approach to an EFL oral-communication class in Taiwan. As both the author of this study…

  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. Multidisciplinary optimization in aircraft design using analytic technology models

    NASA Technical Reports Server (NTRS)

    Malone, Brett; Mason, W. H.

    1991-01-01

    An approach to multidisciplinary optimization is presented which combines the Global Sensitivity Equation method, parametric optimization, and analytic technology models. The result is a powerful yet simple procedure for identifying key design issues. It can be used both to investigate technology integration issues very early in the design cycle, and to establish the information flow framework between disciplines for use in multidisciplinary optimization projects using much more computational intense representations of each technology. To illustrate the approach, an examination of the optimization of a short takeoff heavy transport aircraft is presented for numerous combinations of performance and technology constraints.

  6. A new member of the multidisciplinary ALS team: the otolaryngologist.

    PubMed

    Rubin, Adam D; Griffin, Garrett R; Hogikyan, Norman D; Feldman, Eva L

    2012-02-01

    The multidisciplinary approach to treatment of amyotrophic lateral sclerosis (ALS) has improved the overall care of patients suffering from this disease ( 1 , 2 ). This approach typically has included neurologists, physiatrists, occupational therapists, respiratory therapists and speech therapists. Dysphonia, dysarthria, and dysphagia are three of the most common bulbar manifestations of ALS, and are often the presenting symptoms in bulbar-onset patients. Despite this, otolaryngologists are often not included in ALS management until a tracheostomy is considered. The otolaryngologist can play an important role in early diagnosis and subsequent management of bulbar manifestations of ALS, and would be a valuable member of the multidisciplinary team.

  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. 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

  9. 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

  10. Addressing the community/public health nursing shortage through a multifaceted regional approach.

    PubMed

    Young, Staci; Acord, Lea; Schuler, Sue; Hansen, Judith M

    2014-01-01

    Despite increasing needs resulting from emerging societal and health care issues, the number of trained community/public health (C/PH) nurses in the United States is facing a precipitous decline. Numerous factors contribute to this shortage including an aging workforce, a poorly funded public health system, inconsistencies in C/PH nursing educational approaches and opportunities, and a shortage of sites for clinical training. Determined to address the C/PH nursing shortage in their region, a consortium of public health professionals, university deans and faculty, and state nursing leaders in southeastern Wisconsin came together to address these issues from three perspectives: (a) curricular analysis and redesign, (b) expansion of clinical placement opportunities, and (c) paid community/public health nursing internships for seniors in baccalaureate nursing programs. This article outlines briefly the activities undertaken related to curricular review and clinical placements, and then describes in detail the approach, challenges and results of the senior internship program. Together, these programs produced long-lasting results including an unprecedented level of collaboration between academic institutions and public health nursing professionals, the expansion of both traditional and nontraditional clinical sites in the region, and a transformative learning experience for seventeen senior nursing students from five participating universities.

  11. 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,…

  12. 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,…

  13. New Approaches to Multidisciplinary Design and Optimization

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

    Research under the subject grant is being carried out in a jointly coordinated effort within three laboratories in the School of Aerospace Engineering and the George Woodruff School of Mechanical Engineering. The objectives and results for Year 2 of the research program are summarized. The "Objectives" and "Expected Significance" are taken directly from the Year 2 Proposal presented in October 1994, and "Results" summarize the what has been accomplished this year. A discussion of these results is provided in the following sections. A listing of papers, presentations and reports that acknowledge grant support, either in part or in whole, and that were prepared during this period is provided in an attachment.

  14. 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

  15. 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.

  16. Designing Multidisciplinary Integrated Curriculum Units

    ERIC Educational Resources Information Center

    Clayton, Marla; Hagan, Jill; Ho, Pier Sun; Hudis, Paula M.

    2010-01-01

    The term "integrated curriculum" has many different, sometimes conflicting, meanings to educators. In this manual, integrated curriculum refers to the materials and pedagogical strategies used by "multidisciplinary" teams of teachers to organize their instruction so that students are encouraged to make meaningful connections…

  17. 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

  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.

  19. 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

  20. The Multidisciplinary Translational Team (MTT) Model for Training and Development of Translational Research Investigators

    PubMed Central

    Ameredes, Bill T.; Hellmich, Mark R.; Cestone, Christina M.; Wooten, Kevin C.; Ottenbacher, Kenneth J.; Chonmaitree, Tasnee; Anderson, Karl E.; Brasier, Allan R.

    2015-01-01

    Multi-institutional 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, inter-professional 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. PMID:26010046

  1. 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.

  2. The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction.

    PubMed

    Kolodny, Andrew; Courtwright, David T; Hwang, Catherine S; Kreiner, Peter; Eadie, John L; Clark, Thomas W; Alexander, G Caleb

    2015-03-18

    Public health authorities have described, with growing alarm, an unprecedented increase in morbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increase in the prevalence of opioid addiction, which in turn has been associated with a rise in overdose deaths and heroin use. A multifaceted public health approach that utilizes primary, secondary, and tertiary opioid addiction prevention strategies is required to effectively reduce opioid-related morbidity and mortality. We describe the scope of this public health crisis, its historical context, contributing factors, and lines of evidence indicating the role of addiction in exacerbating morbidity and mortality, and we provide a framework for interventions to address the epidemic of opioid addiction.

  3. Linking Public Health and Individual Medicine: The Health Policy Approach of Surgeon General Thomas Parran.

    PubMed

    Sledge, Daniel

    2017-04-01

    Surgeon General Thomas Parran Jr was once viewed as a path-breaking leader, but his legacy is now highly contested. Scholars of national health insurance have viewed Parran as an impediment to government-backed insurance, and revelations about his role in the Tuskegee Study and in the Public Health Service's experiments in Guatemala have cast a shadow over his career. Surgeon General from 1936 to 1948, Parran led the Public Health Service during the development of key features of the modern American health system and was involved in critical debates over the role of the national government in health. I argue that Parran is best understood not as an opponent of insurance but as the proponent of an approach to health policy that sought to link public health and individual medicine. A pragmatic bureaucrat, Parran believed that effective policymaking required compromise with the American Medical Association.

  4. 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

  5. Poultry education team: a novel approach to public education and student recruitment.

    PubMed

    Chamblee, T N

    2007-12-01

    Changing public perception of the production of poultry meat and eggs is a challenge faced by all poultry scientists. The lack of public knowledge can be an obstacle to poultry integrator plans for expansion and for university recruitment of undergraduate Poultry Science majors. While many programs have been utilized for disseminating information to a wide range of people, an innovative approach for providing public education has been developed by the undergraduate students in the Department of Poultry Science at Mississippi State University. The students formed the Poultry Education Team to provide educational programs for K-12 schools, community colleges, university events, and supermarkets. Poultry Education Team members receive formal training from faculty and industry personnel prior to providing educational programs.

  6. 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.

  7. Supporting Gang Violence Prevention Efforts: A Public Health Approach for Nurses.

    PubMed

    McDaniel, Dawn D; Logan, J E; Schneiderman, Janet U

    2014-01-01

    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.

  8. Sensitivity Analysis of Multidisciplinary Rotorcraft Simulations

    NASA Technical Reports Server (NTRS)

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

    2017-01-01

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

  9. Hybrid Approach for the Public Transportation Time Dependent Orienteering Problem with Time Windows

    NASA Astrophysics Data System (ADS)

    Garcia, Ander; Arbelaitz, Olatz; Vansteenwegen, Pieter; Souffriau, Wouter; Linaza, Maria Teresa

    The Time Dependent Orienteering Problem with Time Windows (TDOPTW) consists of a set of locations with associated time windows and scores. Visiting a location allows to collect its score as a reward. Traveling time between locations varies depending on the leave time. The objective is to obtain a route that maximizes the obtained score within a limited amount of time. In this paper we target the use of public transportation in a city, where users may move on foot or by public transportation. The approach can also be applied to the logistic sector, for example to the multimodal freight transportation. We apply an hybrid approach to tackle the problem. Experimental results for the city of San Sebastian show we are able to obtain valid routes in real-time.

  10. 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

  11. 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

  12. 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.

  13. Technology Transfer: A Think Tank Approach to Managing Innovation in the Public Sector

    DTIC Science & Technology

    1985-01-01

    to managing change imposed by Naval procedural require- and managing innovative people . ments and directives. Topics discussed My thought evolution was...Technology Transfer: A Think Tank Approach to Managing Innovation in the Public Sector within the Forest Service with food for the concept " people in an...acquisition contracts with- Bechtel Corporation for his skill in out exceeding budget, for his efficient managing innovative people and managing

  14. A Multidisciplinary Process Curriculum in Environmental Education, Grade 2.

    ERIC Educational Resources Information Center

    Edmonds School District 15, Lynnwood, WA.

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

  15. 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…

  16. Publicity and public relations

    NASA Technical Reports Server (NTRS)

    Fosha, Charles E.

    1990-01-01

    This paper addresses approaches to using publicity and public relations to meet the goals of the NASA Space Grant College. Methods universities and colleges can use to publicize space activities are presented.

  17. Brookings supports breastfeeding: using public deliberation as a community-engaged approach to dissemination of research.

    PubMed

    Anderson, Jenn; Kuehl, Rebecca A; Mehltretter Drury, Sara A; Tschetter, Lois; Schwaegerl, Mary; Yoder, Julia; Gullickson, Heidi; Lamp, Jamison; Bachman, Charlotte; Hildreth, Marilyn

    2017-03-13

    Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public deliberation model for dissemination. We held focus groups, hosted a public conversation, spoke to local organizations, and promoted these efforts through local media. The hospital achieved Baby-Friendly status and opened a Baby Café. Breastfeeding support in the community improved through policies, designated pumping spaces, and signage that supports public breastfeeding at local businesses. Community awareness of the benefits of breastfeeding and breastfeeding support increased; the breastfeeding support coalition remains active. The public deliberation process for dissemination engaged the community with evidence-based promotion of breastfeeding support, increased agency, and produced sustainable results tailored to the community's unique needs.

  18. 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.

  19. A new approach to teaching veterinary public health at the Ohio State University.

    PubMed

    Hoet, Armando E; Caswell, Robert J; DeGraves, Fred J; Rajala-Schultz, Paivi J; Gebreyes, Wondwossen A; Saville, William J A; Wittum, Thomas E

    2008-01-01

    Public-health practitioners with expertise in the area of veterinary public health are expected to understand the prevention and control of zoonotic infectious diseases in both human and animal populations. This focus on multiple species is what makes the veterinary public health (VPH) official unique. The development of a new VPH specialization within the existing Master of Public Health (MPH) degree program at the Ohio State University represents a significant new collaboration between the College of Veterinary Medicine and the College of Public Health. The main objective of the VPH specialization is to educate and train professionals to provide them with the skills, knowledge, and resources necessary to protect and improve human health using a One Medicine approach. The program targets a population of students who will likely enter the professional veterinary medicine curriculum but have one year available to enhance their preparatory training in health sciences before beginning the program. A core series of VPH courses was initiated to complement the existing MPH course requirements. The program has been successful in attracting students from the primary target population, but it has also attracted students wanting the MPH as a terminal degree and veterinarians returning to school to expand their career options.

  20. 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.

  1. 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.

  2. 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

  3. A public health approach to eating disorders prevention: It’s time for public health professionals to take a seat at the table

    PubMed Central

    2012-01-01

    Background The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. Summary There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies

  4. Economic motives to use a participatory design approach in the development of public-health information systems.

    PubMed

    Vimarlund, V; Eriksson, H; Timpka, T

    2001-01-01

    Within public health, there is a tradition of co-operation between researchers and communities in planning and implementation of health promotion programs. As a consequence, public-health organizations are characterized by having complex multidisciplinary structure and dynamic organizational goals. In this paper, we discuss the economic impacts from the use of Participatory Design for development of public-health information systems. Creation of systems that have both utility and usability is suggested to be highlighted as the central goal. The identified pre-requisites for a positive impact are that the new system should be of high quality, appropriate to the nature of the health promotion tasks, and to how activities are coordinated and integrated both between and within the stakeholder groups involved. We argue further that a method that minimizes the information asymmetry in the development process is necessary for avoiding market failures 1. The conclusion is that participatory design will diminish transaction costs, will help to avoid sunk costs, and will contribute to rich efficient use of human and economic resources in public-health organizations.

  5. Insight into the development of a carbonate platform through a multi-disciplinary approach: a case study from the Upper Devonian slope deposits of Mount Freikofel (Carnic Alps, Austria/Italy)

    NASA Astrophysics Data System (ADS)

    Pas, Damien; Da Silva, Anne-Christine; Suttner, Thomas; Kido, Erika; Bultynck, Pierre; Pondrelli, Monica; Corradini, Carlo; De Vleeschouwer, David; Dojen, Claudia; Boulvain, Frédéric

    2014-03-01

    The development and behavior of million year-scaled depositional sequences recorded within Palaeozoic carbonate platform has remained poorly examined. Therefore, the understanding of palaeoenvironmental changes that occur in geological past is still limited. We herein undertake a multi-disciplinary approach (sedimentology, conodont biostratigraphy, magnetic susceptibility (MS), and geochemistry) of a long-term succession in the Carnic Alps, which offers new insights into the peculiar evolution of one of the best example of Palaeozoic carbonate platform in Europe. The Freikofel section, located in the central part of the Carnic Alps, represents an outstanding succession in a fore-reef setting, extending from the Latest Givetian (indet. falsiovalis conodont zones) to the Early Famennian (Lower crepida conodont zone). Sedimentological analysis allowed to propose a sedimentary model dominated by distal slope and fore-reef-slope deposits. The most distal setting is characterized by an autochthonous pelagic sedimentation showing local occurrence of thin-bedded turbiditic deposits. In the fore-reef slope, in a more proximal setting, there is an accumulation of various autochthonous and allochthonous fine- to coarse-grained sediments originated from the interplay of gravity-flow currents derived from the shallow-water and deepwater area. The temporal evolution of microfacies in the Freikofel section evolves in two main steps corresponding to the Freikofel (Unit 1) and the Pal (Unit 2) limestones. Distal slope to fore-reef lithologies and associate changes are from base to top of the section: (U1) thick bedded litho- and bioclastic breccia beds with local fining upward sequence and fine-grained mudstone intercalations corresponding, in the fore-reef setting, to the dismantlement of the Eifelian-Frasnian carbonate platform during the Early to Late Frasnian time ( falsiovalis to rhenana superzones) with one of the causes being the Late Givetian major rift pulse; (U2

  6. Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

    PubMed

    Fajans, Peter; Simmons, Ruth; Ghiron, Laura

    2006-03-01

    Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

  7. 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.

  8. Multidisciplinary design optimization using response surface analysis

    NASA Technical Reports Server (NTRS)

    Unal, Resit

    1992-01-01

    Aerospace conceptual vehicle design is a complex process which involves multidisciplinary studies of configuration and technology options considering many parameters at many values. NASA Langley's Vehicle Analysis Branch (VAB) has detailed computerized analysis capabilities in most of the key disciplines required by advanced vehicle design. Given a configuration, the capability exists to quickly determine its performance and lifecycle cost. The next step in vehicle design is to determine the best settings of design parameters that optimize the performance characteristics. Typical approach to design optimization is experience based, trial and error variation of many parameters one at a time where possible combinations usually number in the thousands. However, this approach can either lead to a very long and expensive design process or to a premature termination of the design process due to budget and/or schedule pressures. Furthermore, one variable at a time approach can not account for the interactions that occur among parts of systems and among disciplines. As a result, vehicle design may be far from optimal. Advanced multidisciplinary design optimization (MDO) methods are needed to direct the search in an efficient and intelligent manner in order to drastically reduce the number of candidate designs to be evaluated. The payoffs in terms of enhanced performance and reduced cost are significant. A literature review yields two such advanced MDO methods used in aerospace design optimization; Taguchi methods and response surface methods. Taguchi methods provide a systematic and efficient method for design optimization for performance and cost. However, response surface method (RSM) leads to a better, more accurate exploration of the parameter space and to estimated optimum conditions with a small expenditure on experimental data. These two methods are described.

  9. 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.

  10. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    PubMed Central

    Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

    2014-01-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

  11. The public health exposome: a population-based, exposure science approach to health disparities research.

    PubMed

    Juarez, Paul D; Matthews-Juarez, Patricia; Hood, Darryl B; Im, Wansoo; Levine, Robert S; Kilbourne, Barbara J; Langston, Michael A; Al-Hamdan, Mohammad Z; Crosson, William L; Estes, Maurice G; Estes, Sue M; Agboto, Vincent K; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y

    2014-12-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures "get under the skin". The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

  12. Measuring Inflation in Public Libraries: A Comparison of Two Approaches, the Input Cost Index and the Cost of Services Index.

    ERIC Educational Resources Information Center

    Chambers, Jay C.; Vergun, Robert

    1999-01-01

    Presents two approaches to measuring the inflation faced by public libraries: (1) an approach based on a fixed market basket of the prices of library inputs; and (2) an approach based on an econometric model of library services and costs that yields a costs of services index. Discusses uses of both models. (SLD)

  13. A Public Health Approach to Pediatric Residency Education: Responding to Social Determinants of Health

    PubMed Central

    Kuo, Alice A.; Shetgiri, Rashmi; Guerrero, Alma D.; Barreto, Patricia M.; Perez, Victor H.; Fond, Karen; Slusser, Wendelin

    2011-01-01

    Objective To evaluate the impact of a public health approach to pediatric residency education on learner knowledge, skills, attitudes, beliefs, and career choice. Background Incorporating public health principles into traditional residency education can give pediatricians the population-oriented perspective to address social determinants of health. Methods The Community Health and Advocacy Training (CHAT) program is an educational intervention with a public health framework. From 2001–2007, 215 categorical pediatric residents and 37 residents in the CHAT program were evaluated by using an annual survey of community pediatrics exposure, knowledge, attitudes, and beliefs. American Board of Pediatrics (ABP) examination passage rates for both groups were also examined, as was career choice after graduation. Results While interns in both the categorical and CHAT programs scored similarly on attitudes, beliefs, skills, and knowledge of community pediatrics, the postgraduate level-3 (PL-3) year CHAT residents scored higher in attitudes (P < .001) and skills (P < .05). Exposure to both didactic (P < .05) and practical (P < .001) community pediatrics curricular experiences were higher for CHAT residents than for categorical residents. No significant differences between ABP examination scores were found for the 2 groups, although 100% of CHAT graduates passed on the first try compared to 91% of categorical graduates during this time period. A greater percentage of CHAT graduates (82%) than categorical graduates (53%) reported pursuing careers in primary care. Conclusion With a public health approach to residency education, residents gain the knowledge, attitudes, and skills to address child health problems from a population perspective. Participation in such a curriculum still resulted in high passage rates on the ABP examination. PMID:22655145

  14. Illiberal or Simply Unorthodox? Public Administration Education in Hungary: A Comparative Perspective

    ERIC Educational Resources Information Center

    Hajnal, Gyorgy

    2016-01-01

    Over the past decades, Public Administration (PA) education programmes in Europe shifted their focus from a predominantly law-oriented approach to a more multidisciplinary, social science and managerial one. This paper deals with the tenacity of traditional, law-oriented PA education programmes that can be found in a limited, but not…

  15. [Gestational diabetes management: a multidisciplinary treatment algorithm].

    PubMed

    Weinert, Letícia Schwerz; Silveiro, Sandra Pinho; Oppermann, Maria Lúcia; Salazar, Cristiano Caetano; Simionato, Bárbara Marina; Siebeneichler, Aline; Reichelt, Angela Jacob

    2011-10-01

    Effective treatment of gestational diabetes is important as an attempt to avoid unfavorable maternal and fetal outcomes. The objective of this paper is to describe the available therapies to optimize gestational diabetes treatment and to suggest a multidisciplinary approach algorithm. Nutrition therapy is the first option for the majority of these pregnancies; light to moderate physical activity is recommended in the absence of obstetrical contraindications. Medical treatment is recommended if glycemic control is not achieved or if excessive fetal growth is detected by ultrasound. Insulin is the standard treatment although oral antidiabetic drugs have recently been considered an effective and safe option. The monitoring of gestational diabetes treatment includes capillary glucose measurements and evaluation of fetal abdominal circumference by ultrasound performed around the 28th gestational week.

  16. 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

  17. Whey protein stories - An experiment in writing a multidisciplinary biography.

    PubMed

    Jensen, Tenna; Bechshoeft, Rasmus L; Giacalone, Davide; Otto, Marie Haulund; Castro-Mejía, Josue; Bin Ahmad, Hajar Fauzan; Reitelseder, Søren; Jespersen, Astrid Pernille

    2016-12-01

    This is an experimental, dual-purpose article about whey protein and how to conduct interdisciplinary analyses and writings. On the one hand, this article is a multidisciplinary commodity biography, which consists of five descriptions of whey protein written by the five different research groups involved in the interdisciplinary research project CALM(Counteracting Age-related loss of Skeletal Muscle Mass). On the other hand, it is a meta-analysis, which aims to uncover and highlight examples of how the five descriptions contribute to each other with insights into the contextualisation of knowledge, contrasts between the descriptions and the new dimensions they bring to established fields of interest. The meta-analysis also contains a discussion of interdisciplinary study objects and the usefulness of the multidisciplinary commodity biography as a format for interdisciplinary publications. The article contributes to the field of food studies with a multidisciplinary biography of whey protein - including its sensory qualities and challenges, insights into its cultural history, its nutritional value and effects on the human body and an analysis of how it is perceived by people who consume it. The biography thereby expands upon existing understandings of whey protein while discussing the usefulness of employing the commodity biography format in interdisciplinary writing. Moreover, the article contributes to the field of interdisciplinary research by providing a practical example of a joint publication and reflections upon the existence, interaction and possibilities of monodisciplinary knowledge structures within interdisciplinary studies and publications.

  18. A multidisciplinary conceptualization of conservation opportunity.

    PubMed

    Moon, Katie; Adams, Vanessa M; Januchowski-Hartley, Stephanie R; Polyakov, Maksym; Mills, Morena; Biggs, Duan; Knight, Andrew T; Game, Edward T; Raymond, Christopher M

    2014-12-01

    An opportunity represents an advantageous combination of circumstances that allows goals to be achieved. We reviewed the nature of opportunity and how it manifests in different subsystems (e.g., biophysical, social, political, economic) as conceptualized in other bodies of literature, including behavior, adoption, entrepreneur, public policy, and resilience literature. We then developed a multidisciplinary conceptualization of conservation opportunity. We identified 3 types of conservation opportunity: potential, actors remove barriers to problem solving by identifying the capabilities within the system that can be manipulated to create support for conservation action; traction, actors identify windows of opportunity that arise from exogenous shocks, events, or changes that remove barriers to solving problems; and existing, everything is in place for conservation action (i.e., no barriers exist) and an actor takes advantage of the existing circumstances to solve problems. Different leverage points characterize each type of opportunity. Thus, unique stages of opportunity identification or creation and exploitation exist: characterizing the system and defining problems; identifying potential solutions; assessing the feasibility of solutions; identifying or creating opportunities; and taking advantage of opportunities. These stages can be undertaken independently or as part of a situational analysis and typically comprise the first stage, but they can also be conducted iteratively throughout a conservation planning process. Four types of entrepreneur can be identified (business, policy, social, and conservation), each possessing attributes that enable them to identify or create opportunities and take advantage of them. We examined how different types of conservation opportunity manifest in a social-ecological system (the Great Barrier Reef) and how they can be taken advantage of. Our multidisciplinary conceptualization of conservation opportunity strengthens and

  19. [Multidisciplinary therapy of colorectal cancer].

    PubMed

    Balogh, A; Kahán, Z; Maráz, A; Mikó, T; Nagy, F; Palkó, A; Thurzó, L; Tiszlavicz, L

    2001-03-18

    A multidisciplinary program for the treatment of colorectal cancer is described. The main objective of the authors has been to define uniform up to date guidelines based on recent progress in the treatment of colorectal cancer. Preoperative diagnostic procedures are summarized which advance determination of clinical stage and prognosis. These information essentially determine care. Sequences of surgical methods, preoperative and postoperative radiotherapy and medical treatments are discussed according to tumor stages. Guidelines for surveillance following active treatment and recommendation for the screening of population at high risk for colorectal cancer are presented.

  20. Lowering Entry Barriers for Multidisciplinary Cyber(e)-Infrastructures

    NASA Astrophysics Data System (ADS)

    Nativi, S.

    2012-04-01

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

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