Search results for: multidisciplinary study

Authors: Naza Djafarova, Tony Bates, Margaret Verkuyl, Leonora Zefi, Ozgur Turetken, Alex Ferworn, Mastrilli Paula, Daria Romaniuk, Kosha Bramesfeld, Anastasia Dimitriadou, Cheryl To

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Designing serious games for education is a challenging and resource-intensive effort. If a well-designed process that balances pedagogical principles with game mechanics is in place, it can help to simplify the design process of serious games and increase efficiency. Multidisciplinary teams involved in designing serious games can benefit tremendously from such a process in their endeavours to develop and implement these games at undergraduate and graduate levels. This paper presentation will outline research results on identified gaps within existing processes and frameworks and present an adapted process that emerged from the research. The research methodology was based on a survey, semi-structured interviews and workshops for testing the adapted process for game design. Based on the findings, the authors propose a simple process for the pre-production stage of serious game design that may help guide multidisciplinary teams in their work. This process was used to facilitate team brainstorming, and is currently being tested to assess if multidisciplinary teams find value in using it in their process of designing serious games.

Keywords: serious game-design, multidisciplinary team, game design framework, learning games, multidisciplinary game design process

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Authors: Robert Krause

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Primary progressive aphasia (PPA) is a neurodegenerative disease similar to frontotemporal and semantic dementia, while having a different clinical image and anatomic pathology topography. Nonetheless, they are often included under an umbrella term: frontotemporal lobar degeneration (FTLD). In the study, examples of diagnosing PPA are presented through the multidisciplinary lens of specialists from different fields (neurologists, psychiatrists, clinical speech therapists, clinical neuropsychologists and others) using a variety of diagnostic tools such as MR, PET/CT, genetic screening and neuropsychological and logopedic methods. Thanks to that, specialists can get a better and clearer understanding of PPA diagnosis. The study summarizes the concrete procedures and results of different specialists while diagnosing PPA in a patient of younger middle age and illustrates the importance of multidisciplinary approach to differential diagnosis of PPA.

Keywords: primary progressive aphasia, etiology, diagnosis, younger middle age

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: Reet Bishnoi

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Climate change poses a pressing global challenge, with far-reaching consequences for the planet's ecosystems and biodiversity. This abstract introduces the research topic, "Assessing the Impact of Climate Change on Biodiversity Hotspots: A Multidisciplinary Study," which delves into the intricate relationship between climate change and biodiversity in the world's most ecologically diverse regions. Biodiversity hotspots, characterized by their exceptionally high species richness and endemism, are under increasing threat due to rising global temperatures, altered precipitation patterns, and other climate-related factors. This research employs a multidisciplinary approach, incorporating ecological, climatological, and conservationist methodologies to comprehensively analyze the effects of climate change on these vital regions. Through a combination of field research, climate modelling, and ecological assessments, this study aims to elucidate the vulnerabilities of biodiversity hotspots and understand how changes in temperature and precipitation are affecting the diverse species and ecosystems that inhabit these areas. The research seeks to identify potential tipping points, assess the resilience of native species, and propose conservation strategies that can mitigate the adverse impacts of climate change on these critical regions. By illuminating the complex interplay between climate change and biodiversity hotspots, this research not only contributes to our scientific understanding of these issues but also informs policymakers, conservationists, and the public about the urgent need for coordinated efforts to safeguard our planet's ecological treasures. The outcomes of this multidisciplinary study are expected to play a pivotal role in shaping future climate policies and conservation practices, emphasizing the importance of protecting biodiversity hotspots for the well-being of the planet and future generations.

Keywords: climate change, biodiversity hotspots, ecological diversity, conservation, multidisciplinary study

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Authors: Satu Lautamäki

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This paper presents findings from a multidisciplinary course (bachelor level) implemented at Seinäjoki University of Applied Sciences, Finland. The course aims to develop innovative thinking of students, by having projects given by companies, using design thinking methods as a tool for creativity and by integrating students into multidisciplinary teams working on the given projects. The course is obligatory for all first year bachelor students across four faculties (business and culture, food and agriculture, health care and social work, and technology). The course involves around 800 students and 30 pedagogical coaches, and it is implemented as an intensive one-week course each year. The paper discusses the pedagogy, structure and coordination of the course. Also, reflections on methods for the development of creative skills are given. Experts in contemporary, global context often work in teams, which consist of people who have different areas of expertise and represent various professional backgrounds. That is why there is a strong need for new training methods where multidisciplinary approach is at the heart of learning. Creative learning takes place when different parties bring information to the discussion and learn from each other. When students in different fields are looking for professional growth for themselves and take responsibility for the professional growth of other learners, they form a mutual learning relationship with each other. Multidisciplinary team members make decisions both individually and collectively, which helps them to understand and appreciate other disciplines. Our results show that creative and multidisciplinary project learning can develop diversity of knowledge and competences, for instance, students’ cultural knowledge, teamwork and innovation competences, time management and presentation skills as well as support a student’s personal development as an expert. It is highly recommended that higher education curricula should include various studies for students from different study fields to work in multidisciplinary teams.

Keywords: multidisciplinary learning, creative skills, innovative thinking, project-based learning

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Authors: Pedro F. Albuquerque, Pedro V. Gamboa, Miguel A. Silvestre

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The present work describes the implementation of the Enhanced Collaborative Optimization (ECO) multilevel architecture with a gradient-based optimization algorithm with the aim of performing a multidisciplinary design optimization of a generic unmanned aerial vehicle with morphing technologies. The concepts of weighting coefficient and a dynamic compatibility parameter are presented for the ECO architecture. A routine that calculates the aircraft performance for the user defined mission profile and vehicle’s performance requirements has been implemented using low fidelity models for the aerodynamics, stability, propulsion, weight, balance and flight performance. A benchmarking case study for evaluating the advantage of using a variable span wing within the optimization methodology developed is presented.

Keywords: multidisciplinary, multilevel, morphing, enhanced collaborative optimization

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Authors: Madhurima S. Waghmare, Shaleen Singhal

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The concept of smartness, inclusion, sustainability is multidisciplinary and fuzzy, rooted in economic and social development theories and policies which get reflected in the spatial development of the cities. It is a challenge to convert these concepts from aspirations to transforming actions. There is a dearth of assessment and planning tools to support the city planners and administrators in developing smart, inclusive, and sustainable cities. To address this gap, this study develops an inclusive cities decision matrix based on an exploratory approach and using mixed methods. The matrix is soundly based on a review of multidisciplinary urban sector literature and refined and finalized based on inputs from experts and insights from case studies. The application of the decision matric on the case study cities in India suggests that the contemporary planning tools for cities need to be multidisciplinary and flexible to respond to the unique needs of the diverse contexts. The paper suggests that a multidimensional and inclusive approach to city planning can play an important role in building sustainable smart cities.

Keywords: inclusive-cities decision matrix, smart cities in India, city planning tools, sustainable cities

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Yen Yi Huang

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This paper aims to explore the application of strategies in applied drama to the social work education arena in order to enhance students' creativity, curiosity, and aesthetic sensitivity. Also, applied drama is used as a means to facilitate students' reflection-in-action and improve their understanding of issues on creative aging, gender equality, human rights, bullying, and prejudice. This paper mainly uses the perspective of Homi K. Bhabha's third space to explore the impact of applied drama and social work training on students. First, it focuses on how students create new understandings and insights in the third space of multidisciplinary training studies. Second, it analyzes how the hybridity and negotiation of ideas between applied drama and social work were created. Finally, it discusses the follow-up effects of the training and the factors that promote or hinder the hybridity and generation of the third space. This paper uses students' reflection papers for analysis. It is not focused on a discussion of the effectiveness of the teaching but attempts to bring new insights into the applications of applied drama to the social work education arena. The hybridity and generation of the third space require handling power strategically and looking after the emotional space of the students. Taking part in the training allows students in the third space of multidisciplinary training to reexamine the traditional framework of social work knowledge to create new ideas and possibilities.

Keywords: multidisciplinary, applied drama, social work education, third space

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Authors: Hui Wang

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Traditional collection building approaches are limited in breadth and scope and are not necessarily suitable for multidisciplinary fields development in the institutes of the Chinese Academy of Sciences. The increasing of multidisciplinary fields researches require a viable approach to collection development in these libraries. This study uses qualitative and quantitative analysis to assess collection. The quantitative analysis consists of three levels of evaluation, which including realistic demand, potential demand and trend demand analysis. For one institute, three samples were separately selected from the object institute, more than one international top institutes in highly relative research fields and future research hotspots. Each sample contains an appropriate number of papers published in recent five years. Several keywords and the organization names were reasonably combined to search in commercial databases and the institutional repositories. The publishing information and citations in the bibliographies of these papers were selected to build the dataset. One weighted evaluation model and citation analysis were used to calculate the demand intensity index of every journal and book. Principal Investigator selector and database traffic provide a qualitative evidence to describe the demand frequency. The demand intensity, demand frequency and academic committee recommendations were comprehensively considered to recommend collection development. The collection gaps or weaknesses were ascertained by comparing the current collection and the recommend collection. This approach was applied in more than 80 institutes’ libraries in Chinese Academy of Sciences in the past three years. The evaluation results provided an important evidence for collections building in the second year. The latest user survey results showed that the updated collection’s capacity to support research in a multidisciplinary subject area have increased significantly.

Keywords: citation analysis, collection assessment, collection development, quantitative analysis

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Authors: Chi-Cheng Cheng, Che-Hsin Lin, Yu-Jen Wang, Chua-Chin Wang

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The project-oriented capstone course has become a required element for most engineering educational units. It is not only because the capstone course is an important criterion for international accreditation of engineering degree programs under Washington Accord, but also the capstone course provides an opportunity for students to apply what they have learned in their school years to actual engineering problems. Nevertheless, most project-oriented capstone courses are conducted with one single project for all students or teams. In other words, students work to reach the same or similar goals by coming up with different layouts and approaches. It appears not suitable for a multidisciplinary engineering department. Therefore, a one-year multidisciplinary project-oriented capstone course was designed for the junior year of the undergraduate program. About one-half of faculty members in the department needs to be involved in generating as many projects as possible to meet different students' interests and specialties. Project achievement has to be displayed and demonstrated in the annual exposition and competition at the end of this course. Significant success in attracting attention and hardworking of students on projects was witnessed for the past two pilot years. Analysis of course evaluation demonstrates positive impact on all perspectives despite of slightly negative influence due to poor communication and collaboration between students and their project supervisors.

Keywords: Capstone course, CDIO, engineering education, project-oriented learning

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Abdul Mufid

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This study aims to integrate hadith, astronomy, and sociology studies in studying the accelerated implementation of the unification of the Hijri calendar through a multidisciplinary approach. The Hijri calendar is compiled based on the astronomical phenomena of regular movements of the earth, moon, and sun. Meanwhile, for the implementation of worship, the Hijri calendar must refer to the provisions of Islamic law or fiqh. To set the Hijri calendar, agreement on the criteria for the visibility of the new moon (first crescent), date limits, and absolute authority is required. Agreement on visibility criteria requires a valid basis for astronomical studies. Agreement on territorial boundaries is necessary because our earth is round, and the new moon cannot be observed simultaneously. And the agreement of the authorities is also needed to resolve unavoidable differences, especially differences in the appearance of the new moon and differences in schools of thought. The research is based on astronomical data, the experiences of Indonesia and Islamic countries regarding the Hijri calendar, in-depth and focused interviews with various sources, as well as a review of hadith literature. The results of the study show that the implementation of the unification of the Hijri calendar through the three approaches above can be carried out and can be accelerated.

Keywords: calendar unification, new moon (hilal) visibility, multidisciplinary approach, the unity of the Muslims

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Authors: Nickolay Jelev, Andy Keane, Carren Holden, András Sóbester

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In aircraft design, the jump from the conceptual to preliminary design stage introduces a level of complexity which cannot be realistically handled by a single optimiser, be that a human (chief engineer) or an algorithm. The design process is often partitioned along disciplinary lines, with each discipline given a level of autonomy. This introduces a number of challenges including, but not limited to: coupling of design variables; coordinating disciplinary teams; handling of large amounts of analysis data; reaching an acceptable design within time constraints. A number of classical Multidisciplinary Design Optimisation (MDO) architectures exist in academia specifically designed to address these challenges. Their limited use in the industrial aircraft design process has inspired the authors of this paper to develop an alternative strategy based on well established ideas from Decision Support Systems. The proposed rule based architecture sacrifices possibly elusive guarantees of convergence for an attractive return in simplicity. The method is demonstrated on analytical and aircraft design test cases and its performance is compared to a number of classical distributed MDO architectures.

Keywords: Multidisciplinary Design Optimisation, Rule Based Architecture, Aircraft Design, Decision Support System

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Authors: Hadjer Didouh, Mohammed Hadj Meliani, Izzaddine Sameut Bouhaik

Abstract:

This study employs a multidisciplinary approach to investigate the intricate processes governing biofilm-surface interactions. Results indicate that surface properties significantly influence initial microbial attachment, with materials characterized by increased roughness and hydrophobicity promoting enhanced biofilm adhesion. Moreover, the chemical composition of materials plays a crucial role in impacting the development of biofilms. Environmental factors, such as temperature fluctuations and nutrient availability, were identified as key determinants affecting biofilm formation dynamics. Advanced imaging techniques revealed complex three-dimensional biofilm structures, emphasizing microbial communication and cooperation within these networks. These findings offer practical implications for industries operating in crude oil environments, guiding the selection and design of materials to mitigate biofilm-related challenges and enhance operational efficiency in such settings.

Keywords: biofilm adhesion, surface properties, crude oil environments, microbial interactions, multidisciplinary investigation

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Maria Kjellgren, Sara Lilliehorn, Urban Markström

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Critical components that influence the role and performance of school social workers in Swedish elementary schools will be described and analysed, such as formal regulations, professional self-understanding, and the SSWs’ role in the interplay between professional domains involved in elementary school. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. The result reveals three main challenges for the School Social Worker (SSW): (1) To navigate in a pedagogic and medical arena within a multidisciplinary team, (2) To manage ambiguity without any formal regulations and unclear settings and leadership and finally, (3) To negotiate tasks at different levels, with a health promotional and preventive focus, where the SSW ends up, mainly in remedial work with individual children. The results also disclosed that SSWs hold a vague professional self-understanding position with a little formal mandate to perform their work.

Keywords: school social worker, multidisciplinary team, counselling, professional self-understanding, formal regulations

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Authors: Moon-Soo Kim

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In order to cope with the increasing demand for multidisciplinary learning between academy and industry, a collaborative teaching and learning model and related operational tools enabling applications to engineering education are essential. This study proposes a web-based collaborative framework for interactive teaching and learning between academy and industry as an initial step for the development of a web- and mobile-based integrated system for both engineering students and industrial practitioners. The proposed web-based collaborative teaching and learning framework defines several entities such as learner, solver and supporter or sponsor for industrial problems, and also has a systematic architecture to build information system including diverse functions enabling effective interaction among the defined entities regardless of time and places. Furthermore, the framework, which includes knowledge and information self-reinforcing mechanism, focuses on the previous problem-solving records as well as subsequent learners’ creative reusing in solving process of new problems.

Keywords: collaborative teaching and learning model, academy and industry, web-based collaborative framework, self-reinforcing mechanism

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Authors: Griaznova Svetlana, Umedov Mekhroz

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The current healthcare facilities trend is the creation of multidisciplinary large-scale centers to provide the maximum possible services in one place, minimizing the number of possible instances in the path of patient treatment. The multifunctional medical centers are mainly designed in urban infrastructure for good accessibility. However, many functions and connections define the building shape, often make it inharmonious, that greatly destroys the city's appearance. The purpose of the research is to scientifically substantiate the factors influencing the shaping, the formation of architectural solutions principles, the formation of recommendations and principles for the multifunctional medical centers' design. The result of the research is the elaboration of architectural and planning solutions principles and the determination of factors affecting the multifunctional healthcare facilities shaping. Research method: Study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research. An integrated approach to the study of existing international experience of multidisciplinary medical centers. Elaboration of graphical analysis and diagrams based on the system analysis of the processed information. Identification of methods and principles of functional zoning of nuclear medicine centers.

Keywords: health care, multifunctionality, form, medical center, hospital, PET, CT scan

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Authors: Yuri Melis, Mattia Resteghini, Emanuela Apicella, Eugenia Dozio, Leonardo Mendolicchio

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Aim: This retrospective study was created to analyze the psychometric, anthropometric and body composition values in patients at the beginning and the discharge of their of hospitalization in the residential care clinic for eating and feeding disorders (EFD’s). Method: The sample was composed by (N=59) patients with mean age N= 33,50, divided in subgroups: Anorexia Nervosa (AN) (N=28), Bulimia Nervosa (BN) (N=13) and Binge Eating Disorders (BED) (N=14) recruited from a residential care clinic for eating and feeding disorders. The psychometrics level was measured with self-report questionnaires: Eating Disorders Inventory-3 (EDI-3) The Body Uneasiness Test (BUT), Minnesota Multiphasic Personality Inventory (MMPI – 2). The anthropometric and nutritional values was collected by Body Impedance Assessment (B.I.A), Body mass index (B.M.I.). Measurements were made at the beginning and at the end of hospitalization, with an average time of recovery of about 8,6 months. Results: The all data analysis showed a statistical significance (p-value >0,05 | power size N=0,950) in variation from T0 (start of recovery) to T1 (end of recovery) in the clinical scales of MMPI-2, AN group (Hypocondria T0 64,14 – T1 56,39) (Depression T0 72,93 – T1 59,50) (Hysteria T0 61,29 – T1 56,17) (Psychopathic deviation T0 64,00 – T1 60,82) (Paranoia T0 63,82 – T1 56,14) (Psychasthenia T0 63,82 – T1 57,86) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 60,36 – T1 55,68); BN group (Hypocondria T0 64,08 – T1 47,54) (Depression T0 67,46 – T1 52,46) (Hysteria T0 60,62 – T1 47,84) (Psychopathic deviation T0 65,69 – T1 58,92) (Paranoia T0 67,46 – T1 55,23) (Psychasthenia T0 60,77 – T1 53,77) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 62,92 – T1 54,08); B.E.D groups (Hypocondria T0 59,43 – T1 53,14) (Depression T0 66,71 – T1 54,57) (Hysteria T0 59,86 – T1 53,82) (Psychopathic deviation T0 67,39 – T1 59,03) (Paranoia T0 58,57 – T1 53,21) (Psychasthenia T0 61,43 – T1 53,00) (Schizophrenia T0 62,29 – T1 56,36) (Obsessive T0 58,57 – T1 48,64). EDI-3 report mean value is higher than clinical cut-off at T0, in T1, there is a significant reduction of the general mean of value. The same result is present in the B.U.T. test in the difference between T0 to T1. B.M.I mean value in AN group is (T0 14,83 – T1 18,41) BN group (T0 20 – T1 21,33) BED group (T0 42,32 – T1 34,97) Phase Angle results: AN group (T0 4,78 – T1 5,64) BN (T0 6 – T1 6,53) BED group (T0 6 – T1 6,72). Discussion and conclusion: The evident presence that on the whole sample, we have an altered serious psychiatric and clinic conditions at the beginning of recovery. The interesting conclusions that we can draw from this analysis are that a multidisciplinary approach that includes the entire care of the subject: from the pharmacological treatment, analytical psychotherapy, Psychomotricity, nutritional rehabilitation, and rehabilitative, educational activities. Thus, this Multidisciplinary treatment allows subjects in our sample to be able to restore psychopathological and metabolic values to below the clinical cut-off.

Keywords: feeding and eating disorders, anorexia nervosa, care clinic treatment, multidisciplinary treatment

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Authors: Fabrizio Logiurato

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Light Polarization has many technological applications, and its discovery was crucial to reveal the transverse nature of the electromagnetic waves. However, despite its fundamental and practical importance, in high school, this property of light is often neglected. This is a pity not only for its conceptual relevance, but also because polarization gives the possibility to perform many brilliant experiments with low cost materials. Moreover, the treatment of this matter lends very well to an interdisciplinary approach between art, biology and technology, which usually makes things more interesting to students. For these reasons, we have developed, and in this work, we introduce a laboratory on light polarization for high school and undergraduate students. They can see beautiful pictures when birefringent materials are set between two crossed polarizing filters. Pupils are very fascinated and drawn into by what they observe. The colourful images remind them of those ones of abstract painting or alien landscapes. With this multidisciplinary teaching method, students are more engaged and participative, and also, the learning process of the respective physics concepts is more effective.

Keywords: light polarization, optical activity, multidisciplinary education, science and art

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Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

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Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: Recep Yücel, Cihat Kartal, Mustafa Kara

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On the basis of strategic management, it is believed in the necessity of a number of innovations in the postmodern management approach in the management of universities in our country. In this sense, some of these requirements are the integration of public and private universities, international integration, R & D status and increasing young population will create a dynamic structure. According to the postmodern management approach, universities, in our country despite being governed by the classical approach autonomous universities; academically are thought solid, to be non-hierarchical and creative. In fact, studies that require a multidisciplinary academic environment, universities and there is a close cooperation between formal and non-formal sub-units. Moreover, terms of postmodern management approaches, the requirements specified in the direction of solving the problem of an increasing number of universities in our country is considered to be more difficult. Therefore, considering the psychological impact on the academic personnel the university organizational structure, the study are trying to aim to propose an appropriate model of university organization. In this context, the study sought to answer the question how to have an impact innovation and international integration on the academic achievement of the classical organizational structure. Finally, in the study, due to the adoption of the classical organizational structure of the university, integration is considered to be difficult, academic cooperation between universities at the international level and maintaining it. In addition, it was understood that block the efforts of this organization structure, academic motivation, development and innovation. In this study under these purposes; on the basis of the existing organization and management structure of the universities in the Marmara Region in Turkey, a study was conducted with qualitative research methods. The data have been analyzed using content analysis and assessment was based on the results obtained.

Keywords: university, strategic management, postmodern management approaches, multidisciplinary studies

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, L. Di Thommazo, D. Braatz

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Prototypes can be understood as representations of a product concept. Furthermore, prototyping consists in an important stage in product development and results in better team communication, decision making, testing and problem solving through feedback. Although there are several methods of prototyping suggested by recent studies for designers to choose from, some methods present different advantages, such as cost and time reduction, performance and fidelity, which should be taken in account during a product development project. In this multidisciplinary study, involving areas of physiotherapy, engineering and computer science (hardware and software), we compared four developed prototypes of an ergometric step: a virtual prototype, a 3D printed prototype, a bricolage prototype and a prototype manufactured by a third-party company. These prototypes were evaluated in a comparative-qualitative approach for their contribution to the concept’s maturation of the product, the different prototyping methods used and the advantages and disadvantages of each one based on the product’s design specifications (performance, safety, materials, cost, maintenance, usability, ergonomics and portability). Our results indicated that despite prototypes show overall advantages, all of them have limitations, thus being crucial to have different methods of testing and interacting with the product. Additionally, virtual and 3D printed prototypes were essential at early stages of the project due to their low-cost and high-fidelity representation of the product, while the prototype manufactured by a third-party company and bricolage prototype introduced functional tests in real scenarios, allowing more detailed evaluations. This study also resulted in a patent for an ergometric step.

Keywords: Product Design, Product Development, Prototypes, Step

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Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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Authors: Evonne Kaplan-Liss, Val Lantz-Gefroh

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Arts and humanities are often incorporated into medical education to help deepen understanding of the human condition and the ability to communicate from a place of compassion. However, a gap remains in our knowledge of compassionate communication training for postgraduate medical professionals (as opposed to students and residents); how training opportunities include and impact the artists themselves, and how train-the-trainer models can support learners to become teachers. In this report, the authors present results from a pilot evaluation of the UC San Diego Health: Sanford Compassionate Communication Fellowship, a 60-hour experiential program that uses theater, narrative reflection, poetry, literature, and journalism techniques to train a multidisciplinary cohort of medical professionals and artists in compassionate communication. In the culminating project, fellows design and implement their own projects as teachers of compassionate communication in their respective workplaces. Qualitative methods, including field notes and 30-minute Zoom interviews with each fellow, were used to evaluate the impact of the fellowship. The cohort included both artists (n=2) and physicians representing a range of specialties (n=7), such as occupational medicine, palliative care, and pediatrics. The authors coded the data using thematic analysis for evidence of how the multidisciplinary nature of the fellowship impacted the fellows’ experiences. The findings show that the multidisciplinary cohort contributed to a greater appreciation of compassionate communication in general. Fellows expressed that the ability to witness how those in different fields approached compassionate communication enhanced their learning and helped them see how compassion can be expressed in various contexts, which was both “exhilarating” and “humbling.” One physician expressed that the fellowship has been “really helpful to broaden my perspective on the value of good communication.” Fellows shared how what they learned in the fellowship translated to increased compassionate communication, not only in their professional roles but in their personal lives as well. A second finding was the development of a supportive community. Because each fellow brought their own experiences and expertise, there was a sense of genuine ability to contribute as well as a desire to learn from others. A “brave space” was created by the fellowship facilitators and the inclusion of arts-based activities: a space that invited vulnerability and welcomed fellows to make their own meaning without prescribing any one answer or right way to approach compassionate communication. This brave space contributed to a strong connection among the fellows and reports of increased well-being, as well as multiple collaborations post-fellowship to carry forward compassionate communication training at their places of work. Results show initial evidence of the value of a multidisciplinary fellowship for promoting compassionate communication for both artists and physicians. The next steps include maintaining the supportive fellowship community and collaborations with a post-fellowship affiliate faculty program; scaling up the fellowship with non-physicians (e.g., nurses and physician assistants); and collecting data from family members, colleagues, and patients to understand how the fellowship may be creating a ripple effect outside of the fellowship through fellows’ compassionate communication.

Keywords: compassionate communication, communication in healthcare, multidisciplinary learning, arts in medicine

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Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

Abstract:

Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

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Authors: Theng Theng Ong

Abstract:

This study adopts a multidisciplinary method by combining the corpus-based discourse analysis study and language attitude study to explore the construction of Malaysia airline tragedies: MH370, MH17 and QZ8501 in the selected Malaysian and United Kingdom (UK) online news. The study aims to determine the ways in which Malaysian Airline tragedies MH370, MH17 and QZ8501 are linguistically defined and constructed in terms of keyword and collocation. The study also seeks to identify the types of discourse that are presented in the new articles. The differences or similarities in terms of keywords, topics or issues covered by the selected Malaysian and UK news media will also be examined. Finally, the language attitude study will be carried out to examine the Malaysia and UK university students’ attitudes toward the keywords, topics or issues covered by the selected Malaysian and UK news media pertaining to Malaysian Airline tragedies MH370, MH17 and QZ8501. The analysis is divided into two parts with the first part focusing on corpus-based discourse analysis on the media text. The second part of the study is to investigate Malaysians and UK news readers’ attitudes towards the online news being reported by the Malaysian and UK news media pertaining to the Airline tragedies. The main findings of corpus-based discourse analysis are essential in designing the questions in the questionnaires and interview and therefore led to the identification of the attitudes among Malaysian and UK news. This study adopts a multidisciplinary method by combining the corpus-based discourse analysis study and language attitude study to explore the construction of Malaysia airline tragedies: MH370, MH17 and QZ8501 in the selected Malaysian and United Kingdom (UK) online news. The study aims to determine the ways in which Malaysian Airline tragedies MH370, MH17 and QZ8501 are linguistically defined and constructed in terms of keyword and collocation. The study also seeks to identify the types of discourse that are presented in the new articles. The differences or similarities in terms of keywords, topics or issues covered by the selected Malaysian and UK news media will also be examined. Finally, the language attitude study will be carried out to examine the Malaysia and UK university students’ attitudes toward the keywords, topics or issues covered by the selected Malaysian and UK news media pertaining to Malaysian Airline tragedies MH370, MH17 and QZ8501. The analysis is divided into two parts with the first part focusing on corpus-based discourse analysis on the media text. The second part of the study is to investigate Malaysians and UK news readers’ attitudes towards the online news being reported by the Malaysian and UK news media pertaining to the Airline tragedies. The main findings of corpus-based discourse analysis are essential in designing the questions in the questionnaires and interview and therefore led to the identification of the attitudes among Malaysian and UK news.

Keywords: corpus linguistics, critical discourse analysis, news media, tragedies study

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