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Research on resilience and posttraumatic growth (PTG) has significantly advanced our understanding of human adaptability to adversity, reflecting a widespread belief in the United States that such adaptability is commonplace. However, recent studies have highlighted conceptual and methodological limitations in these fields. These limitations call into question the credibility of existing research and underscore the need for multidisciplinary perspectives in understanding adaptive responses to adversity. This special issue aims to provide a foundation for a new generation of resilience and PTG research. It brings together innovative theoretical and empirical work that focuses on several key areas: the multifaceted nature and impacts of adversity, the importance of clarifying resilience and PTG in marginalized communities, methodological advancements in the field, and challenges to core theoretical and methodological assumptions underlying our scientific practice. Public Significance Statement: This introduction provides an overview of key themes that emerged across the included articles in the special issue. We envision this special issue to be a foundation for the next generation of research on resilience and posttraumatic growth, one that is simultaneously more inclusive and more rigorous. [ABSTRACT FROM AUTHOR]

In the United States (US), early intervention (EI) programs under Part C of the Individuals with Disabilities Education Act have demonstrated a commitment to teaming and collaboration through multidisciplinary assessment and coordinated service delivery. However, there continues to be broad variability as to the EI service delivery model described on public-facing EI program websites and in state-level documents. In this study, we performed a review of the websites of EI programs in all 50 states, the District of Columbia, five US territories, and two federal departments responsible for providing EI services to specific constituencies. Using a qualitative content analysis approach to analyze the data from all 58 entities led to three primary findings: (1) the challenge of finding information on public-facing websites and related documents about teaming practices within each state, (2) the inconsistency in the types of documents, dates, and ages of posted information, and (3) the variability across states, including the language used to describe and discuss teaming models and practices. These results lead to a call for action to improve the consistency of information on teaming models and the implementation of practices that better support all children and families served under Part C. [ABSTRACT FROM AUTHOR]

Introduction: Psychological evaluation is required by insurance companies in the United States prior to proceeding with a spinal cord stimulation or a dorsal root ganglion stimulation trial. Since January 2017, we implemented a Multidisciplinary Team Conference for Neuromodulation in our center to facilitate the collaboration between pain physicians and psychologists and to optimize screening of neuromodulation candidates. This study aims to report the impact of this team conference on improvement of neuromodulation outcome in our center. Methods: Appropriateness of neuromodulation were discussed in the team conference after initial visit with the pain specialist and psychological evaluation. For this study, we prospectively and retrospectively collected data on neuromodulation candidates who went through the team conference and those who did not as controls. Results: We discussed 461 patients in the team conference sessions from January 2017 to July 2023. Out of these, a spinal cord stimulator or a dorsal root ganglion stimulator trial was performed in 164 patients with 80.5% (132 cases) trial success rate leading to 140 implants. Out of these implants, 26 (18.6%) explanted and 21 (15%) required revision in 41 (29.3%) patients. We performed neuraxial neuromodulation trial for 70 patients without going through the team conference from January 2016 to July 2023 with a trial success rate of 45.7% (32 cases). In this group, 7 (21.9%) and 6 (18.8%) patients underwent explant and revision. The differences between the groups were statistically significant for trial success rate (odds ratio of 4.9 with p-value of <0.01) but not for explant (odds ratio of 0.8 with p-value of 0.627) or revision (odds ratio of 0.8 with p-value of 0.595). Conclusion: Implementing Multidisciplinary Team Conference increased trial success rate in our center. Team conference provides therapeutic benefit for patients, and also provides the opportunity for an educational discussion for trainees. [ABSTRACT FROM AUTHOR]

Background: Paediatric feeding disorder (PFD) is a common childhood condition, estimated to impact one in 37 American children under the age of five. Such high prevalence occurs against a backdrop of limited understanding of the community treatment landscape in the United States. Method: To better understand the community treatment landscape for PFD in the United States and identify provider and treatment delivery characteristics, we collected primary data through a web‐based survey targeting providers from all four PFD domains (i.e., medical, nutritional, feeding skill, and/or psychosocial) between January 2022 and March 2022. The 71‐item cross sectional survey focussed on patient, provider and treatment characteristics. We distributed the survey using an electronic survey tool through Feeding Matters listserv followed by solicitation to discipline specific listservs and professional networks. The analytic approach involved descriptive statistics compared across settings and provider types, focussing on respondents within the United States. Results: Eighty‐three percent of respondents reported practicing in the United States. Most of the US sample (74.3%) involved providers from the feeding skill domain (speech‐language pathologist – SLP, occupational therapist – OT) who reported delivering care through early intervention or outpatient settings using responsive and sensory based approaches. These approaches lack rigorous empirical evaluation. Conclusions: Survey results suggest a need to support community providers in engagement with research activity to promote a better understanding of treatment approaches and outcomes associated with a large cohort of providers delivering care (i.e. SLPs, OTs) to patients with PFD. [ABSTRACT FROM AUTHOR]

In higher education institutions, critical race theory (CRT) is known to be associated with fields that study racial disparities or systemic oppression such as law, education, and ethnic studies. The impression that CRT is unrelated to fields like business or computer science may have led scholars and practitioners from these disciplines to put their focus on elsewhere than on racial inequality and its implication in their research and practice, despite apparent need. To counter such fallacy, this review article—focusing primarily on the US context—discusses CRT literature in fields where its presence is less known which are nevertheless among the major domains of higher education institutions: health sciences, computer science and information technology, sports, business, and religion. By discussing example research of how scholars have utilized CRT in different fields to challenge the race-neutral thinking that often obscures structural racism, this paper exposes racism's ability to alter manifestations and to appear through various shapes and forms within the higher education context. Initial recommendations on how educators may engage in further discussions or actions will also be considered. This paper concludes that racist ideologies are often hidden behind discipline-specific vocabulary or technical language, and it is by tackling the ideologies at work underneath the technicalities can we address the chameleon-like nature of racism more effectively. [ABSTRACT FROM AUTHOR]

This study analysed the trends and patterns of articles published in Digital Culture and Education Journal (DCEJ) from 2009 to 2018 covering a period of 10 years. Five bibliometric measures were used for the analysis: Year-wise productivity of articles; authorship pattern of articles; core authorship; degree of author collaboration; Institution and country affiliation of authors in DCEJ. The results revealed that a total of 108 articles were published and the year 2014 (Vol. 6) had the highest number of articles with 26 (24.07%). The most prolific authors was Fabian Schäfer with three (3) articles. Single authorships were the most productive with a total of 60 (55.56%) publications. The degree of collaboration was highest at 0.8 in Volume 10 (2018). Authorship emerged from 26 countries and authors from United States of America were the highest number with 68 (30.09%). Authorship affiliated to Universities had the highest number of 161 (71.24%) articles. The findings suggests that although collaborative research is common in DCEJ, there is need to encourage multidisciplinary collaborations. This is because of the high number of single authorship patterns identified in the study. The complex nature of DCEJ will require a mix of ideas with multidisciplinary collaborations. This may be achieved by creating awareness and proper indexing in reputable databases, which will encourage visibility and build interest in the journal. Also, some important authorship information were not given such as sex and affiliations. It is recommended that the editorial team should include and ensure that future researches comply with authors' guidelines for submission. [ABSTRACT FROM AUTHOR]

Objectives: Endotracheal intubation (ETI) is a lifesaving procedure in critically ill children. Direct laryngoscopy (DL) is the most utilized method for ETI, however advanced techniques beyond DL are indicated in some patients. The purpose of this study is to describe trends of advanced ETI techniques in the critical care setting., Materials and Methods: Using the National Emergency Airway Registry for Children (NEAR4KIDS), advanced technique ETI quality improvement data were prospectively collected for ETIs in PICUs from April 2018 to September 2021. Those who underwent ETI with only DL or who underwent exchange of an existing endotracheal tube were excluded., Results: A total of 79 patients underwent advanced technique ETI with a median age of 8 (IQR 1-17) years. Advanced technique ETI was successful on the first attempt in 46.8 % of cases, with an overall success rate of 91.1 %. 1.3 % of patients received emergent surgical airway management. The most utilized advanced ETI technique was video laryngoscopy, followed by flexible bronchoscopy, and intubation through a laryngeal mask airway (LMA). The provider discipline ultimately successful in performing advanced technique ETI was most often pediatric critical care medicine (n = 26, 32.9 %), followed by anesthesia (n = 20, 25.3 %), and otolaryngology (n = 16, 20.3 %)., Conclusion: While often indicated in challenging clinical scenarios, advanced ETI techniques are ultimately successful in the vast majority of cases. Advanced technique ETI is a highly multidisciplinary process., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

PURPOSE: Children and adolescents (<18 years old) who sustain a spinal cord injury (SCI) should ideally be managed in specialized rehabilitation services. This project aims to describe the organization of pediatric SCI in ten rehabilitation units in seven countries and to qualitatively explore psychosocial aspects of adolescents living with SCI. METHODS: A multicenter cross-sectional project is planned, using quantitative (web survey) and qualitative (interview) methods in ten rehabilitation units from Norway, Sweden, United States, Israel, PR China, Russia and Palestine. Individual interviews will be conducted with ≥20 adolescents aged 13–17 years at least 6 months' post rehabilitation. RESULTS: Units involved will be described and compared, according to funding, attachment to an acute SCI unit, catchment area, number of beds, admittance and discharge procedures, availability of services, staff/patient ratio, content and intensity of rehabilitation programs, length of stay, measurement methods, follow-up services, health promotion services, and pediatric SCI prevention acts. The semi-structured interview guide will include experiences from acute care and primary rehabilitation, daily life, school, contact with friends, leisure time activities, peers, physical and psychological health, and the adolescents' plans for the future. CONCLUSION: Based on the present protocol, this project is likely to provide new insight and knowledge on pediatric SCI rehabilitation and increase the understanding of pediatric SCI in adolescents and their families internationally. [ABSTRACT FROM AUTHOR]

BACKGROUND: Higher levels of care in the form of intensive rehabilitation may be appropriate for select patients with a diagnosis of functional motor disorder (FMD). Intensive rehabilitation, as delivered through an outpatient day program or through admission to an inpatient rehabilitation facility, can offer a greater frequency and variety of integrated clinical services than most lower levels of care. OBJECTIVE: Higher levels of rehabilitation for FMD have not yet been well characterized in the literature. In this article, we will focus on the population of FMD patients who begin receiving care in the outpatient setting. METHOD: In this review, we describe a range of options for higher levels of FMD care, evaluate the supporting literature, and weigh the pros and cons of each approach. Several specific examples of intensive rehabilitation programs in the United States will be described. Finally, we will consider existing health systems barriers to each of these outpatient and inpatient higher levels of care. RESULTS: Within a stepped model of care, intensive outpatient day-programs and inpatient rehabilitation may be considered for individuals who present with complex, refractory motor deficits from FMD. For appropriately selected patients, a growing body of literature suggests that time-limited, goal-oriented intensive rehabilitation may provide an effective treatment avenue. CONCLUSION: It remains to be determined whether treatment in intensive care settings, while more costly in the short term, could lead to greater cost savings in the long term. The prospect of telemedicine rehabilitation for FND in terms of efficacy and cost also remains to be determined. [ABSTRACT FROM AUTHOR]

Objective: Our medical center implemented a multidisciplinary team to improve surgical decision making for high-risk older adults. To make this a patient-centric process, a pilot program included the patient and their family/caregiver(s) in these conversations. Our hypothesis is that multidisciplinary team discussions can improve difficult surgical decision making. Methods: From January to June 2022, we offered patients and their family participation in multidisciplinary discussions at a Veterans Affairs medical center. Semistructured interviews were conducted 1-6 days after the meeting. Interview transcripts were analyzed with qualitative mixed-methods approach. Results: Six patients and caregivers participated in the interviews. They found the discussion helpful for improving their understanding of the surgical decision. Out of these, 50% (3 of 6) of the patients changed their decision regarding the planned operation based on the discussion. Conclusion: Including patients and caregiver(s) in multidisciplinary surgical decision-making discussions resulted in half of the patients changing their surgical plans. This pilot study demonstrated both acceptance and feasibility for all participants.

Objectives: Sleep disorders are wide-ranging in their causes and impacts on other physical and mental health conditions. Thus, sleep disorders could benefit from a multidisciplinary approach to assessment and treatment. An integrated care model is often recommended but is costly to implement. We sought to understand how, in the absence of an established organizational structure for integrated sleep care, providers from different clinics work together to provide care for sleep disorders., Methods: A qualitative case study at one U.S. Department of Veterans Affairs (VA) medical center. We used a purposeful nested sampling strategy, combining maximum variation sampling and snowball sampling to recruit key staff involved in sleep care., Results: We interviewed providers (N = 10) from sleep medicine, primary care, and mental health services. Providers identified the ubiquity of sleep disorders and a concomitant need for multidisciplinary care. However, they described limited opportunities for multidisciplinary interactions and consequently a negative impact on clinical care. Providers described fragmentation in two areas: among sleep specialists and between sleep specialists and other referring and managing providers., Conclusions: A range of interventions, based on setting and resources, could improve care coordination both among sleep specialists and between sleep and nonsleep providers. While integrated sleep specialist clinics could reduce care fragmentation, they may not directly impact coordination with referring providers, like primary care and general mental health, who are essential in managing chronic conditions. Future work should continue to explore improving care coordination for sleep problems to ensure patients receive high-quality, timely, patient-centered care., Competing Interests: Declaration of conflict of interest None., (Published by Elsevier Inc.)

Rare, chronic diseases such as hemophilia and other congenital coagulation disorders require coordinated delivery of services for optimal outcomes. Hemophilia Treatment Centers (HTCs) are specialized, multidisciplinary health-care centers providing team-based care to meet the physical, psychosocial, and emotional needs of people with hemophilia (PWH) and may serve as a model for other rare coagulation disorders. Health-care purchasers, as well as the general medical community, may not appreciate the breadth and quality of services provided by HTCs. They exemplify the acculturalization and actualization of integrated care by providing comprehensive diagnostic and treatment services that reduce morbidity, mortality, avoidable emergency room visits, hospitalizations, and overall costs, while promoting a longer lifespan and improved patient functioning and outcomes. This is accomplished by a team-based approach relying upon a shared decision-making model to effectively prevent complications and manage symptoms in PWH, who are dependent on high-cost treatments. This article provides a concise yet comprehensive description of the core components of an HTC and the regional and national networks in the United States, which together achieve their incomparable value for all stakeholders. [ABSTRACT FROM AUTHOR]

The article discusses the activities and strategies adopted by ambulatory care pharmacists in the transition of ambulatory care services to telemedicine while maintaining multidisciplinary cooperation. Also cited are the pharmacists' use of conceptual framework tools like the Integrated Team Effectiveness Model (ITEM), and pharmacists' training on areas like chronic disease, medication assistance, and pharmacotherapy plan management.

Competing Interests: Declaration of competing interest No financial disclosures to report.

Competing Interests: Declaration of competing interest The authors declare no conflict of interests.

Persons with Parkinson's disease (PD) and society at large can profit from a strategic investment into a forward leaning, practical, preventative, and proactive multidisciplinary care policy. The American healthcare system is not easily bent to accommodate this type of care, and thus a tax benefit is an attractive option. An individual federal income tax benefit of $6200 each year for every person residing in the US with a diagnosis of PD, could among other offerings provide monthly access to a licensed clinical social worker and access to mental health services. The implementation of more coordinated care has the potential reduce the burden of depression, anxiety, and demoralization. Personal training would also be covered and directed by physical and occupational therapists. The combination of home-based and telemedicine services would have the added benefit of improving access. The tax benefit would also provide access to a dietician. This type of care strategy could be designed to proactively identify early signs of aspiration and urinary tract infections to 'head off' significant morbidity. A $6200/year individual tax benefit for those diagnosed with PD will thus translate into more fall prevention, more care in the home setting, less hospitalizations, less depression, less anxiety, less demoralization, better diets, and less persons placed in nursing facilities. Additionally, this tax benefit will provide the potential for billions of dollars in savings to the healthcare system. A tax benefit for PD is a practical preventative and proactive strategy which can serve to advantage both this generation and the next.

Although the United States is often ahead in both research and health care fields, it lags behind peer countries in many population health indicators. To address these complex health problems that often reflect the intersection of many socioeconomic and health issues, it is essential that scientists work collaboratively across distinct disciplines. Women's health is but one area which can benefit from such an approach given the multifaceted and complex issues underlying the different aspects of women's health research. The National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) and the Office of Women's Health of the U.S. Food and Drug Administration (FDA) cosponsored a preconference symposium at the Women's Health 2018 Conference, held in May in Arlington, VA, to highlight interdisciplinary approaches to research, how researchers can work collaboratively, and how to apply multifaceted approaches to complex real-world problems. Three speakers presented information on a range of subjects related to the health of women across the life course, including the distinction between multidisciplinary, interdisciplinary, and transdisciplinary approaches; the science behind Team Science and how its findings apply to working collaboratively; and gender inequalities in the opioid epidemic. This article summarizes the major points of the presentations and the subsequent discussions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this review is to identify how an interdisciplinary collaborative effort between occupational therapists, speech language pathologists, and physical therapists can promote mindfulness to alleviate boredom in school-age children. Methods: A review of literature was utilized to meet four objectives: establish sources of boredom, distinguish between occupational deprivation and excessive opportunities, delve specifically into the societal aspects of boredom occurring in the United States, and make recommendations for a multidisciplinary approach to boredom. Four articles met the inclusion criteria. Results: Boredom is thought to be the result of personal factors including personality, difficulty with attending, and negative attitudes. It can be the result of both excessive opportunities and deprivation. Boredom can have lifelong negative impacts. A multidisciplinary team is ideal for implementing mindfulness into practice. Conclusion: Rehabilitation professionals are in a unique position to facilitate mindfulness to eliminate boredom and create life balance, by cultivating the core building blocks of intention, attention, and a mindful way attitude. [ABSTRACT FROM AUTHOR]

This scoping review analyzed statements from 22 medical organizations in the United States to identify commonalities in the definition and governance of point-of-care ultrasound (POCUS). A total of 41 statements were included. The review found that the most commonly used elements in defining POCUS were "focused," "bedside," and "patient care." In terms of governance, consistent requirements included specific training programs, documentation in medical records, continuous quality assurance, and standards for credentialing and privileging. These findings suggest the existence of essential commonalities that could facilitate communication and the development of standardized POCUS programs in the future., (© 2023 Wiley Periodicals LLC.)

Aim: The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.", Methods: A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline., Structure: This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.

The year 2022 marked the 30th anniversary of the first Accreditation Council for Graduate Medical Education (ACGME) accreditation of pain medicine training programs. Before this, the education of pain medicine practitioners was through primarily an apprenticeship model. Since accreditation, pain medicine education has grown under the national leadership of pain medicine physicians and educational experts from the ACGME, exemplified by the release of Pain Milestones 2.0 in 2022. The rapid growth of knowledge in pain medicine, along with its multidisciplinary nature, poses challenges of fragmentation, standardization of curriculum, and adaptation to societal needs. However, these same challenges present opportunities for pain medicine educators to shape the future of the specialty., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Application of a Heart Team approach is now a central concept in the care of patients with severe aortic stenosis. It has Class I recommendations from American and European professional societies and is required for reimbursement for transcatheter aortic valve replacement in the United States. The rationale for changing traditional practice models is to improve patient selection, procedural planning, and management of patients at high or prohibitive surgical risk, thus improving outcomes. Although the concept is intuitive, a clear definition of the Heart Team, and data supporting its effectiveness, are lacking. Other specialties, including oncology, provide a precedent for investigation of the use of a multidisciplinary team and its impact on patient care. We highlight the need for clear definitions and shared metrics to advance our understanding of an optimal Heart Team approach, focusing on patient, clinician, and health system outcomes. [ABSTRACT FROM AUTHOR]

For the past 25 years, the Medical Research Council/ Uganda Virus Research Institute Uganda Research Unit on AIDS has conducted research on HIV-1, coinfections and, more recently, on non-communicable diseases. Working with various partners, the research findings of the Unit have contributed to the understanding and control of the HIV epidemic both in Uganda and globally, and informed the future development of biomedical HIV interventions, health policy and practice. In this report, as we celebrate our silver jubilee, we describe some of these achievements and the Unit's multidisciplinary approach to research. We also discuss the future direction of the Unit; an exemplar of a partnership that has been largely funded from the north but led in the south. [ABSTRACT FROM AUTHOR]

Objective: Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services. We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations via telehealth as an adaptive response to the pandemic., Methods: Patients referred to an urban academic fetal care center during the first 6 weeks of the COVID-19 pandemic underwent advanced imaging including fetal MRI, focused ultrasound, and fetal echocardiography. Subsequently, multidisciplinary telehealth consultations occurred with all providers attending virtually. Patients were given the option of attending the multidisciplinary telehealth consultation in a conference room in the hospital or from home. During these meetings, relevant images were reviewed with all participants via screen sharing through a secure video platform. Provider satisfaction with the telehealth paradigm was assessed using an electronic survey., Results: Twenty-two surveys were administered with a response rate of 82%. 89% of providers were highly satisfied with the telehealth format. 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted. 22% of providers would leave the choice to the patient's family. One provider preferred in-person visits. Some providers noted that virtual conferences limited the ability to draw pictures, show educational materials, and provide emotional support., Conclusion: Providers were overwhelmingly supportive of continuing multidisciplinary telehealth conferences for complex prenatal consultations, even after restrictions are lifted, which has led to the continuation of this model for the duration of the pandemic. Providers highlighted the convenience and improved care coordination across specialties. Further studies to examine the patient experience with virtual consultations are warranted.

To expand the clinical practice of nutrition, the influence of the American Society for Parenteral and Enteral Nutrition (ASPEN) must reach an audience outside the nutrition community, must be relevant and meaningful to clinicians, and must meet the needs of specific patient populations throughout medical and surgical specialties. Individual members of our society need to share their enthusiasm and expertise with youth through conscious, intentional mentorship. Efforts should be made to promote advanced practice, increasing the skill set of the individual nutritionist. Nutrition research should be of the highest quality, matching that of any current medical or surgical discipline. Members of a nutrition consult service should speak the same language as the physicians they work with, through discussions on rounds and in communication through their charting and consult notes. Our societal guidelines should define clinical practice. Relationships with other societies should be cultivated through these guidelines, position papers, and public health initiatives to increase the relevance and impact of our society. To position itself for future generations, the role of ASPEN should be expanded to be more comprehensive and involve all nutrition aspects of patient care., (© 2022 American Society for Parenteral and Enteral Nutrition.)

Background: As the care of hospitalized patients becomes more complex, intraprofessional coordination among nurses and among physicians, and interprofessional coordination between these groups are likely to play an increasingly important role in the provision of hospital care. Purpose: The purpose of this study was to identify the independent effects of organizational factors on provider ratings of overall coordination in inpatient medicine (OCIM). Methodology/Approach: This was an exploratory cross-sectional, descriptive study. Primary data were collected between June 2010 and September 2011 through surveys of inpatient medicine nurse managers, physicians, and chiefs of medicine at 36 Veterans Health Administration medical centers. Secondary data from the 2011 Veterans Health Administration national survey of nurses were also used. Individual-level data were aggregated and analyzed at the facility level. Multivariate linear regression models were used to assess the relationship between 55 organizational factors and provider ratings of OCIM. Findings: Organizational factors that were common across models and associated with better provider ratings of OCIM included provider perceptions that the goals of senior leadership are aligned with those of the inpatient service and that the facility is committed to the highest quality of patient care, having resources and staff that enable clinicians to do their jobs, and use of strategies that enhance interactions and communication among and between nurses and physicians. Practice Implications: To improve intraprofessional and interprofessional coordination and, consequently, patient care, facilities should consider making patient care quality a more important strategic organizational priority; ensuring that providers have the staffing, training, supplies, and other resources they need to do their jobs; and implementing strategies that improve interprofessional communication and working relationships, such as multidisciplinary rounding. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a major public health problem in the US. Worldwide, the public is largely unaware of the condition and health care providers do not seem to fully understand it. Research on PCOS has primarily focused on its etiology and clinical characteristics and less on the psychosocial aspects of human development associated with PCOS. This paper posits that a life course perspective provides a framework for further understanding the psychosocial experiences of women with PCOS and the contexts in which they live. The paper discusses how life course principles of human development, constraints on agency, interdependence of lives, time and place, and timing of events and experiences are relevant to the management of PCOS and prevention of its complications. [ABSTRACT FROM AUTHOR]

Approximately 2000 official and potential Superfund sites are located within 25 miles of the East or Gulf coasts, many of which will be at risk of flooding as sea levels rise. More than 60 million people across the United States live within 3 miles of a Superfund site. Disentangling multifaceted environmental health problems compounded by climate change requires a multidisciplinary systems approach to inform better strategies to prevent or reduce exposures and protect human health. The purpose of this minireview is to present the National Institute of Environmental Health Sciences Superfund Research Program (SRP) as a useful model of how this systems approach can help overcome the challenges of climate change while providing flexibility to pivot to additional needs as they arise. It also highlights broad-ranging SRP-funded research and tools that can be used to promote health and resilience to climate change in diverse contexts.

Competing Interests: Conflicts of interest None disclosed.

A mixed-method research study investigated the I Can Do It, You Can Do It (ICDI) program, an eight week physical activity and nutrition mentoring program for individuals with disabilities (n=660) in nine sites across the United States. After eight weeks, the study examined the degree to which: 1) organizational leaders perceived a change in the organization; 2) the group of mentors significantly changed in terms of knowledge and behaviors; 3) individuals with disabilities demonstrated significant differences in physical activity levels, nutritional intake, sedentary behavior and BMI. On the organizational level, the ICDI site coordinators developed community collaborative partnerships to allow individuals with disabilities an opportunity to participate in physical activity within a supportive environment in their own community. Based upon the content analysis of the open-ended questions about the sites' collaborations, several themes emerged on the organizational level with regard to the value of volunteers with expertise, improved accessibility, and sustainability with the collaborative effort. On the group level, 1,006 students at various sites from different disciplines (Therapeutic Recreation, Exercise Science, Physical Education, and Special Education) served as mentors for youth with disabilities. Mentors showed improvement of knowledge and behaviors concerning individuals with disabilities. Mentors valued group process with other mentors from varying disciplines. On the individual level, mentees exhibited greater enjoyment of physical activity, increased physical activity levels and improved healthy eating. Moreover, individuals with an above normal Body Mass Index (BMI) significantly decreased BMI (p <.O5) by the end of the program. The evaluation of the collaborative mentoring process, I Can Do It, showed evidence of significant changes in the organizations, groups of mentors, and the individuals with disabilities. [ABSTRACT FROM AUTHOR]

Some of the most important problems facing the United States and China, indeed facing our entire planet, require approaches that are fundamentally multidisciplinary in nature. Many of those require skills in computer science (CS), basic understanding of another discipline, and the ability to apply the skills in one discipline to the problems of another. Modern training in computer science needs to prepare students to work in other disciplines or to work on multidisciplinary problems. What do we do to prepare them for a multidisciplinary world when there are already too many things we want to teach them about computer science? This paper describes successful examples of multidisciplinary education at the interface between CS and the biological sciences, as well as other examples involving CS and security, CS and sustainability, and CS and the social and economic sciences. It then discusses general principles for multidisciplinary education of computer scientists. [ABSTRACT FROM AUTHOR]

The article focuses on the role of multidisciplinary high-fidelity simulation training in the development and maintenance of resuscitation expertise in neonatal care. It discusses the development of simulation which began in the aviation industry until it was utilized in the health care field. The author provides information on the Enhancing SIMULATION Act of 2009 HR 855 which was implemented to help in the creation of simulation centers in the U.S. and on the three teaching methods in multidisciplinary health care simulation.

This review article deals with the evolution of academic small-scale forestry research in Sweden and the USA from its early focus on timber supply to present-day interest in stewardship objectives, characteristics and attitudes. Aiming at identifying fresh opportunities for research on small-scale forestry, it reflects on the questions that have dominated the literature over the past quarter of a century, the socioeconomic conditions under which those questions arose, and their influence on the evolution of the field. The goal was to explore key drivers for research over the past 25 years and identify emerging research themes, and by that provide insight into what developments may make the research enterprise more fruitful. With some exceptions, it is based on articles in refereed journals and to academic theses covering the time span 1985-2010. It reflects a reappraisal of the subject of the research and corresponding policies. Similar research tendencies are evident in both countries. Research historically focused on the practical problem of efficient production using a weak theoretical foundation. More recently, researchers have focused on understanding diverse motivations and roles that can be played. It is argued that the field of small-scale forestry research is ripe for new multidisciplinary approaches. [ABSTRACT FROM AUTHOR]

Many healthcare organizations have implemented patient safety initiatives aimed at creating a safer healthcare environment. At North Carolina Children's Hospital at University of North Carolina Hospitals, patient safety rounds were established in the fall of 2005. Rounds are held weekly and involve all members of the healthcare team. Senior leadership actively participates and helps staff seek out solutions for the identified issues. Within the first year of operation, 191 issues were identified, of which 58% were resolved. Rounds continue to occur and have expanded over to the Women's services. Other initiatives such as Just Culture and Six Sigma have been established and help further cultivate a climate that strives toward optimizing patient safety. [ABSTRACT FROM AUTHOR]

According to the Institute of Medicine, nursing has failed to effectively shape the health care system and to advocate successfully for patients. Empowerment may be a potent tool to fulfill these responsibilities, yet nurses have not benefited from considering application of the concept to the continuum of health care advocacy in their communities, in their relationships with clients, and in their professional roles within health care organizations. This paper uses concept analysis to examine the attributes, characteristics, and uses of empowerment within diverse disciplines to clarify its meaning and explore its potential application to nursing's challenges that cross settings, disciplines, and time. [ABSTRACT FROM AUTHOR]

Purpose: Despite growth of palliative care programs and evidence on the effectiveness of radiotherapy in palliating cancer symptoms, radiotherapy is probably underused in this setting. Radiation and medical oncologists and palliative medicine specialists were surveyed regarding the perceived role of palliative radiotherapy and barriers to its use. Methods: The survey was sent electronically to all physician members of the American Society for Therapeutic Radiology and Oncology (ASTRO) and the American Academy of Hospice and Palliative Medicine (AAHPM) and a random sample of American Society of Clinical Oncology (ASCO) members, with known e-mail addresses. Results: Response rates were 27%, 14% and 26% for ASTRO, ASCO, and AAHPM respondents, respectively. Although most felt radiotherapy is an effective and important option for palliation of some common cancer symptoms, referrals for such therapy may be declining. Most agreed that radiation oncologists should be more involved in palliative care; however, multiple barriers were identified, such as poor reimbursement, emotional burden of care, insufficient training/knowledge, and the sense of unwillingness of others to share delivery of such services. Conclusions: Although multiple barriers limit optimal integration, most agree that there should be greater national and professional society efforts to promote the advancement of radiation oncology in the area of palliative care. [ABSTRACT FROM AUTHOR]

Purpose: The first Elder Abuse Forensic Center (EAFC) in the United States was instituted in 2003. People from a variety of disciplines, including Adult Protective Services social workers, law enforcement, the district attorney's office, a medical response team, public guardian deputies, ombudsmen, mental health services, a victim advocate, and a domestic violence expert work cooperatively on cases of elder and dependent-adult mistreatment. Researchers conducted an assessment of the EAFC's impact on the efficiency and effectiveness of the collaboration. Design and Methods: Mixed quantitative and qualitative methods included statistical analysis of data from outcome surveys of EAFC collaborators and illustrative case studies developed from case files and structured interviews. Results: Mean survey scores evaluating the efficiency and effectiveness of the collaboration were significantly better than neutral responses. Case studies show efficient and effective case management through cooperation of the collaborating agencies. Survey results clearly support perceptions exemplified in case studies. Implications: An EAFC enhances the efficiency and effectiveness of those who address elder abuse in one community, which in turn leads to improved outcomes. Continued analysis to identify strengths, weaknesses, and cost effectiveness of the EAFC model is ongoing. [ABSTRACT FROM AUTHOR]

Objectives. 1) To investigate health status of older (≥60 years) and younger adults (<60 years) with chronic pain and to separately compare that with existing normative data; and 2) to examine more fully differences in health status between younger and older adults with chronic pain and explore their geographic variation across three multidisciplinary pain programs in the Pacific, Mountain, and New England regions of the United States. Design. We performed a cross-sectional analysis. Patients. Initial assessments of 6,147 patients dating from January 1998 to January 2003 were used. Outcomes Measures. We used the Treatment Outcomes of Pain Survey (TOPS), a disease-specific instrument that includes the Short Form-36. Results. The health status of the older pain patients in terms of their actual scores was comparable with that of younger pain patients across the three sites. Health status is impaired to a lesser degree in older than in younger adults with chronic pain as compared with normative adults. Statistically significant differences were found in a number of domains of the TOPS. Older adults with chronic pain present with pain intensity similar to that of younger patients with chronic pain, but report better mental health ( P < 0.002), less fear-avoidance ( P < 0.05), less passive coping ( P < 0.0001), more life control ( P < 0.05), and more lower body physical limitations ( P < 0.005) than younger patients with chronic pain. Conclusions. Older adults with chronic pain differ in a number of important domains from younger adults with chronic pain: overall the former present with greater physical, and less psychosocial impairment. [ABSTRACT FROM AUTHOR]

Scientific and engineering research increasingly involves multidisciplinary collaboration, sometimes across multiple organizations. Technological advances have made such cross-boundary projects possible, yet they can carry high coordination costs. This study investigated scientific collaboration across disciplinary and university boundaries to understand the need for coordination in these collaborations and how different levels of coordination predicted success. We conducted a study of 62 scientific collaborations supported by a program of the US National Science Foundation in 1998 and 1999. Projects with principal investigators (PIs) in more disciplines reported as many positive outcomes as did projects involving fewer disciplines. By contrast, multi-university, rather than multidisciplinary, projects were problematic. Projects with PIs from more universities were significantly less well coordinated and reported fewer positive outcomes than projects with PIs from fewer universities. Coordination mechanisms that brought distant researchers together physically slightly reduced the negative impact of collaborations involving multiple universities. We discuss implications for theory, practice, and policy. [ABSTRACT FROM AUTHOR]

The United States legal system, both civil and criminal, has been underutilised in dealing with elder abuse and neglect. Social service and health practitioners have been unfamiliar with the language and procedures in legal settings. Legal remedies have been obscure or inadequate to address the problems. When elder abuse and neglect were first "discovered" in the late 1970s, efforts focused on safeguarding the victim through civil justice remedies, i.e., guardianships, mandatory reporting laws, adult protective services. The criminal justice system also became involved in order to hold the alleged wrongdoer accountable. Specialised units have developed in police departments and prosecutor offices to deal with the criminal behavior. New laws are providing more flexibility for the legal system, both civil and criminal. A multidisciplinary approach to elder abuse and neglect is needed because abused or neglected elders are frequently involved with many agencies. Attention to the legal aspects of the issue are apparent in the Summit Conference held by the National Center on Elder Abuse in 2001 and the development of the Elder Justice Act which was introduced into the U.S. Senate in 2003. [ABSTRACT FROM AUTHOR]

Background: The coronavirus pandemic has put extreme pressure on health care services in South Africa., Aim: To describe the design, patients and outcomes of a field hospital during the first wave of the coronavirus disease 2019 (COVID-19) pandemic., Setting: The Cape Town International Convention Centre was the first location in Cape Town to be commissioned as a field hospital that would serve as an intermediate care bed facility., Methods: This was a retrospective descriptive study of patients admitted to this facility between 8th June 2020 and 14th August 2020 using deidentified data extracted from patient records., Results: There were 1502 patients admitted, 56.4% female, with a mean age of 58.6 years (standard deviation [s.d.]: 14.2). The majority of patients (82.9%) had at least one comorbidity, whilst 15.4% had three or more. Nearly 80.0% (79.8%) of patients required oxygen and 63.5% received steroids, and only 5.7% of patients were required to be transferred for escalation of care. The mean length of stay was 6 days (s.d.: 4.8) with an overall mortality of 5.7%., Conclusion: This study highlights the role of a field hospital in providing surge capacity. Its use halved the predicted duration of stay at acute care hospitals, allowing them the capacity to manage more unstable and critical patients. Adaptability and responsivity as well as adequate referral platforms proved to be crucial. Daily communication with the whole health care service platform was a critical success factor. This study provides information to assist future health planning and strategy development in the current pandemic and future disease outbreaks.

(1) Background: A bibliometric review of psycho-oncology research is overdue. (2) Methods: The 100 most-cited journal articles were compiled and ranked according to Scopus. (3) Results: The total citation count for the results ranged from 488–8509 (Mean = 940.27; SD = 1015.69). A significant correlation was found between years since publication and number of citations (p = 0.039). The majority of research originated from the United States (66%). The vast majority of research publications were original articles (80%). Observational research study designs represented the majority of studies (37%). Mixed cancer population research studies represented the largest cancer research population (36%). Positive psychology topics represented the most prolific proportion of studies (30%). Findings were reported in line with PRISMA-ScR guidelines. (4) Conclusions: This analysis offers a comprehensive account of seminal journal articles in psycho-oncology, identifying landmark contributions and areas for future research developments within the field, namely highlighting a need for more RCT studies. This analysis serves as an educational tool for interdisciplinary researchers and clinicians to support compassionate cancer care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to describe the role of a certified geriatric physical therapist (PT) in a geriatric outpatient clinic. Methods: This pilot study used a model in which a geriatric certified doctor of physical therapy (DPT) provided consultations one afternoon a week for patients in the Outpatient Geriatric Clinic at the Louis Stokes Cleveland Veterans Affairs Medical Center (VAMC). Data collection included reason for referral, DPT's interventions, and clinicians' and patients' perceptions. Results: Over 7 months, the DPT consulted on 25 male patients ranging from 65 to 91 years, with a mean age of 80. The majority of patients were classified into the neuromuscular category (64%) and received a home exercise program (60%). The addition of the PT consult service in the Geriatric Outpatient Clinic was well received by the multidisciplinary team. Conclusion: In addition to their traditional roles, physical therapists now have an opportunity to engage directly in primary care. The model described serves as an example of autonomous practice and the net result is increased quality of care, improved patient satisfaction, and increased knowledge about the profession of physical therapy on behalf of the referring clinician. The findings from this study provide support for the use of this model in settings other than the VAMC's managed care setting. [ABSTRACT FROM AUTHOR]

Background: To evaluate the economic burden of locally advanced rectal cancer (LARC) treatment from a society perspective through analysis of health insurance-derived data of commercially insured and Medicare Advantage (MA) patients., Methods: Retrospective cost analysis of patients undergoing rectal resection within a multimodal (neoadjuvant chemoradiation + adjuvant chemotherapy) treatment strategy between January 1, 2010 and October 31, 2018, using the claims OptumLabs Data Warehouse database., Results: In total, 1738 (935 commercial and 803 MA) patients were included. Overall treatment costs totaled $230,881,746 (on average $183 653 ± 82 384 per commercially insured and $73 681 ± 32 917 per MA patient). Cost distribution according to category (commercially insured patients) was: 29.92% related to outpatient care (follow-up visits/diagnostics), radiotherapy: 21.83%, index resection: 20.62%, chemotherapy: 17.44%, surgical inpatient: 6.32%, medical inpatient: 3.28%, emergency room: 0.58%. Relative cost distribution of the index resection itself differed marginally between the three approaches and was 21.49% for open, 19.30% for laparoscopic, and 20.93% for robotic surgery. Relative cost distributions of neoadjuvant, adjuvant, and outpatient treatments remained unchanged, independently of the surgical approach. This representation was similar in MA patients., Conclusion: Index-surgery related costs were outweighed by costs related to oncological and outpatient workup/follow-up treatments independently of both surgical approach and insurance type., (© 2021 Wiley Periodicals LLC.)

Objective: Despite empirical support for interdisciplinary pain rehabilitation programs improving functioning and quality of life, access to this treatment approach has decreased dramatically over the last 20 years within the United States but has grown significantly in the Department of Veterans Affairs (VA). Between 2009 and 2019, VA pain rehabilitation programs accredited by the Commission on Accreditation of Rehabilitation Facilities increased 10-fold in the VA, expanding from two to 20. The aim of this collaborative observational evaluation was to examine patient outcomes across a subset of six programs at five sites., Methods: Outcomes were assessed using agreed-upon measures of patient-reported pain intensity, pain interference across various domains, pain catastrophizing, and sleep., Results: A total of 931 patients enrolled in the selected VA interdisciplinary pain programs, with 84.1% of participants completing the full course of treatment. Overall, all programs showed significant improvements from pretreatment to posttreatment in nearly all patient-reported outcomes. The effect sizes ranged from medium to large. Notably, the results demonstrate that positive outcomes were typical despite differences in structure and resources across programs., Conclusions: The adverse impacts of opioid use have highlighted the importance of chronic pain treatment approaches that emphasize team-based care focused on functional improvements. This study represents the first and largest analysis of outcomes across chronic pain rehabilitation programs and demonstrates the need for increased access to similar comprehensive approaches to pain management across the health care system. Further, it suggests that a variety of structures may be effective, encouraging flexibility in adopting this interdisciplinary approach., (Published by Oxford University Press on behalf of the American Academy of Pain Medicine.)

Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impacts health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering team-based care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in delivering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes., Objective: The study reviews the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understands the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health-related outcomes., Methods: The systematic review was performed according to the Cochrane method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systematically searched for articles. The Oxford Centre for Evidence-based Medicine Levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies., Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care management resulted in more screenings and better preventive care. Pharmacy-led interventions and technology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions., Conclusion: The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as universal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The COVID-19 pandemic caused by the SARS-CoV-2 has increased the demand for inpatient healthcare resources; however, approximately 80% of patients with COVID-19 have a mild clinical presentation and can be managed at home., Objective: This study aimed to describe the feasibility and clinical and process outcomes associated with a multidisciplinary telemedicine surveillance model to triage and manage obstetrical patients with known exposures and symptoms of COVID-19., Study Design: We implemented a multidisciplinary telemedicine surveillance model with obstetrical physicians and nurses to standardize ambulatory care for obstetrical patients with confirmed or suspected COVID-19 based on the symptoms or exposures at an urban academic tertiary care center with multiple hospital-affiliated and community-based practices. All pregnant or postpartum patients with COVID-19 symptoms, exposures, or hospitalization were eligible for inclusion in the program. Patients were assessed by means of regular nursing phone calls and were managed according to illness severity. Patient characteristics and clinical and process outcomes were abstracted from the electronic medical record., Results: A total of 135 patients were enrolled in the multidisciplinary telemedicine model from March 17 to April 19, 2020, of whom 130 were pregnant and 5 were recently postpartum. In this study, 116 of 135 patients (86%) were managed solely in the outpatient setting and did not require an in-person evaluation; 9 patients were ultimately admitted after ambulatory or urgent evaluations, and 10 patients were observed after hospital discharge. Although only 50% of the patients were tested secondary to limitations in ambulatory testing, 1 in 3 of those patients received positive results for SARS-CoV-2 (N=22, 16% of entire cohort). Patients were enrolled in the telemedicine model for a median of 7 days (interquartile range, 4-8) and averaged 1 phone call daily, resulting in 891 nursing calls and 20 physician calls over 1 month., Conclusion: A multidisciplinary telemedicine surveillance model for outpatient management of obstetrical patients with COVID-19 symptoms and exposures is feasible and resulted in rates of ambulatory management similar to those seen in nonpregnant patients. A centralized model for telemedicine surveillance of obstetrical patients with COVID-19 symptoms may preserve inpatient resources and prevent avoidable staff and patient exposures, particularly in centers with multiple ambulatory practice settings.