966 resultados para MULTIDISCIPLINARY APPROACH
Resumo:
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.
Resumo:
Objective: To investigate the feasibility of improving screening for carriers of haemoglobin disorders in general practice by using a nurse facilitator to work with primary care teams and the relevant haematology laboratories; to identify problems in communication between all those involved in delivering the service, and to implement solutions.
Resumo:
Computer science studies possess a strong multidisciplinary aptitude since most graduates do their professional work outside of a computing environment, in close collaboration with professionals from many different areas. However, the training offered in computer science studies lacks that multidisciplinary factor, focusing more on purely technical aspects. In this paper we present a novel experience where computer studies and educational psychology find a common ground and realistic working through laboratory practices. Specifically, the work enables students of computer science education the development of diagnosis support systems, with artificial intelligence techniques, which could then be used for future educational psychologists. The applications developed by computer science students are the creation of a model for the diagnosis of pervasive developmental disorders (PDD), sometimes also commonly called the autism spectrum disorders (ASD). The complexity of this diagnosis, not only by the exclusive characteristics of every person who suffers from it, but also by the large numbers of variables involved in it, requires very strong and close interdisciplinary participation. This work demonstrates that it is possible to intervene in a curricular perspective, in the university, to promote the development of interpersonal skills. What can be shown, in this way, is a methodology for interdisciplinary practices design and a guide for monitoring and evaluation. The results are very encouraging since we obtained significant differences in academic achievement between students who attended a course using the new methodology and those who did not use it.
Resumo:
We have piloted a monthly series of multidisciplinary case discussions via videoconference in the area of child development. The project provided a forum for clinical discussion of complex cases, peer review, professional development and networking for allied health professionals and paediatricians. Six sites in Queensland participated in the project; each site presented at least one case for discussion. The videoconferences ran for 90 min each and were attended by an average of 26 health professionals. The response rate for a questionnaire survey was 71%. The respondents rated the effectiveness of case summaries and the follow-up newsletter very positively. Despite some early difficulties with the technical aspects of videoconferencing, the evaluation demonstrated the participants' satisfaction with the project and its relevance to their everyday practice.
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Sound art has a fragmented scholarship struggling to find appropriate terminology to understand and explain itself. In this context the practitioner’s perspective is often marginalised. This thesis seeks to develop new perspectives on contemporary sound practice, informed by a multi-disciplinary approach to auditory scholarship and interviews with Australian sound practitioners. The model that emerges describes an ecology of contemporary sound art where practitioners continually negotiate disciplinary and institutional boundaries while articulating distinctive models of listening and conceptions of sound. This thesis proposes a theoretical approach to sound art that recognises its interdisciplinarity as well as a distinctive engagement with the embodied experience of sound and listening.
Resumo:
An integrative multidisciplinary approach was used to delimit boundaries among cryptic species within the Anastrepha fraterculus complex in Brazil. Sexual compatibility, courtship and sexual acoustic behaviour, female morphometric variability, variation for the mitochondrial gene COI, and the presence of Wolbachia were compared among A. fraterculus populations from the Southern (Vacaria, Pelotas, Bento Gonçalves, S~ao Joaquim) and Southeastern (Piracicaba) regions of Brazil. Our results suggest full mating compatibility among A. fraterculus populations from the Southern region and partial pre-zygotic reproductive isolation of these populations when compared with the population from the Southeastern region. A. fraterculus populations from both regions differed in the frequency of courtship displays and aspects of the calling phase and mounting acoustic signal. Morphometric analysis showed differences between Southern region and Southeastern region samples. All populations analyzed were infected with Wolbachia. The trees generated from the COI sequencing data are broadly congruent with the behavioural and morphometric data with the exception of one Southern population. The likely mechanisms by which A. fraterculus populations might have diverged are discussed in detail based on behavioural, morphometric, molecular genetics, and biogeographical studies
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Introduction: Surgical outcomes after biological therapy have not been investigated yet and no information about timing, postoperative complications and survival have been recorded. Methods: This is a prospective study which compares a group of stage IIIA and IIIB NSCLC patients treated with biological therapy with patients undergoing standard induction chemotherapy. Data reported are preliminary results on the safety and effectiveness of surgery after target therapy. Results: We compared 22 patients treated with standard chemotherapy (Group 1) and 6 patients who received target therapy (Group 2). No differences were observed with an important bias due to the limited number of cases. The median time of resection was 159.8 ± 62.8 for group 1 and 201 ± 57.8 for group 2 (p=0.194). Complete resection was obtained in all Group 1-cases. Post-operative complication rate was 22% vs 16% (p=1). Pathologists reported necrosis >50% in 13% in group 1, Fibrosis >50% was presents respectively in 27% and 33% of patients (p=1). Residual vital tumor was >50% in 77% of patients undergone CT and in 66% of patients undergone TT (p=0.622). A total of 6 (31%) patients in the CT-group developed recurrence, 3 in the TT- group (64.2%), p was 0.634. No difference was observed both in terms of OS (P=0.29, Figure 3) and in term of DFS (P=0.106, Figure 4). Discussion: There is no consensus in the use of target therapy for advanced tumor in association with surgery. EGFR-tyrosine kinase inhibitors showed higher and more rapid response and our study wants to demonstrate that surgery after target therapy gives full access to the advantage of definitive local treatment. In our series, despite fibrosis, radical surgery has been achieved in all patients operated. The intraoperative blood loss, operation time, postoperative hospital stay and postoperative complication rate seems to be similar.
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To responsively manage the striped venus clam (Chamelea gallina) fisheries, a multidisciplinary approach has been adopted through the investigation of new and updated biological aspects (e.g. age, growth, reproduction, size at first maturity, fecundity) and the interaction gear- target or non-target species (e.g. reburial ability, survival potential and exerted damage). The striped venus clam is an important socio-economic species in the Italian fishery context, highly regulated by national and international laws aiming at guaranteeing both social and ecological sustainability. Studies on growth and reproduction revealed that the size at first maturity is reached within the first year of life, whereas the present Minimum Conservation Reference Size of 22 mm is reached at two year of age. The annual reproductive cycle, which is driven by rises in seawater temperature and chlorophyll-a concentration, spans during the warmer months (late spring-summer) with multiple spawning events of different intensity occurring over the spawning period, and the number of potentially emitted gametes is positively related to shell size. Reburial tests conducted on undamaged specimens highlighted the ability of clams to rebury in the sediment once discarded, independently from the size. On the other hand, survival experiments in the laboratory and at sea, on both damaged and undamaged individuals, served to demonstrate that the species has a high survival rate, thus supporting the claim that discarded individuals can contribute to restock the natural populations. Moreover, the evaluation and quantification of damage induced by dredging on the discarded macro-benthic fauna living associated with C. gallina highlighted that soft-shelled or soft-bodied species are the most affected by the fishing process and subjected to a higher mortality. All these findings are of pivotal importance to rationally support the management measures to be adopted in the striped venus clam fishery.
Resumo:
From its domestication until nowadays, the horse has assumed multiple roles in human society. Over time, this condition and the lack of specific regulation have led to the development of different kinds of management systems for this species. This Ph.D. research project aims to investigate horses' welfare in different management practices and housing systems, considering a multidisciplinary approach, taking into account biological function, naturalness, and affective dimension. The results are presented in five articles that evidence risk factors that can mine horse welfare, and examine tools and parameters that can be employed for its assessment. Our research shows the importance of considering the evolutionary history and the species-specific and behavioural needs of horses in their management and housing. Sociality, free movement, diet composition and foraging routine, and the workload that these animals undergo are important factors that should be taken into account. Furthermore, this research has evidenced the importance of employing different parameters (e.g., behaviour, endocrinological parameters, and immune activity) in welfare assessment and proposes the use of horsehair DHEA (dehydroepiandrosterone) as a possible useful additional non-invasive measure for the investigation of long-term stress conditions. Finally, our results underline the importance of considering the affective dimension in welfare research. Recently, Judgement Bias Tests (JBT), which are based on the influence of affective states on the decision-making process, have been widely employed in animal welfare research. However, our studies show that the use of spatial JBT in horses can have some limitations. Still today several management systems do not fulfill species-specific needs of horses, thus the implementation of specific regulations could ameliorate horse welfare. A multidisciplinary approach to welfare assessment is fundamental, but it should be always remembered the individual and its own characteristics, which can influence not only physiological, immunological, and behavioural responses but also emotional and cognitive dimensions.
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Allostery is a phenomenon of fundamental importance in biology, allowing regulation of function and dynamic adaptability of enzymes and proteins. Despite the allosteric effect was first observed more than a century ago allostery remains a biophysical enigma, defined as the “second secret of life”. The challenge is mainly associated to the rather complex nature of the allosteric mechanisms, which manifests itself as the alteration of the biological function of a protein/enzyme (e.g. ligand/substrate binding at the active site) by binding of “other object” (“allos stereos” in Greek) at a site distant (> 1 nanometer) from the active site, namely the effector site. Thus, at the heart of allostery there is signal propagation from the effector to the active site through a dense protein matrix, with a fundamental challenge being represented by the elucidation of the physico-chemical interactions between amino acid residues allowing communicatio n between the two binding sites, i.e. the “allosteric pathways”. Here, we propose a multidisciplinary approach based on a combination of computational chemistry, involving molecular dynamics simulations of protein motions, (bio)physical analysis of allosteric systems, including multiple sequence alignments of known allosteric systems, and mathematical tools based on graph theory and machine learning that can greatly help understanding the complexity of dynamical interactions involved in the different allosteric systems. The project aims at developing robust and fast tools to identify unknown allosteric pathways. The characterization and predictions of such allosteric spots could elucidate and fully exploit the power of allosteric modulation in enzymes and DNA-protein complexes, with great potential applications in enzyme engineering and drug discovery.
Resumo:
The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture.