[We need interdisciplinary vessel-centered medicine].
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Cardiovascular Diseases↗
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Results for “Interdisciplinary Communication”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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[Requirements for an interdisciplinary lecture on pain. Results from a survey of medical students].
BACKGROUND: Pain therapy is not an obligatory subject of undergraduate medical education in Germany. METHODS: In order to evaluate the expectations of undergraduate medical students regarding pain therapy as a lecture, a questionnaire was distributed to students visiting a faculty lecture on pain therapy. RESULTS: The main topics voted by the students as very interesting to them were pain syndromes such as low back pain, headache, and cancer pain. Furthermore, pharmacotherapy and the structure of pain therapy units were voted as interesting. Female students were significantly more interested in pain problems of specific patient groups (women, children, older patients, HIV-infected patients). Case reports on paper or with patient presentations were regarded as the most important didactic elements of such lectures. CONCLUSIONS: An analysis of the published undergraduate curricula in pain therapy revealed that the curriculum of the IASP and of the EFIC are too long and too theoretical, respectively. The curriculum of the DGSS meets many expectations of the students in this survey. Concepts of pain therapy education in undergraduate medical schools should consider the wishes of students regarding knowledge of pain syndromes and didactic methods.
Back Pain↗
[Pain therapy in addicted patients].
Each individual is entitled to an adequate and sufficient pain therapy. However, only a few studies have examined the peculiarities of pain management in drug-dependent or formerly addicted patients. Any addiction is disadvantageous for a successful pain therapy, since some of the prescribed drugs may themselves cause addiction. Drug-dependent patients are often tolerant to opioids. Additionally, there is a risk of iatrogenic pain becoming chronic due to disregard for already known risk factors and comorbidities. However, a history of addiction should not prevent sufficient pain therapy, especially since there is no risk of addiction when the pain therapy employed is adequate for the pathophysiology involved. There are adequate pain therapies for addicted patients. The best results are achieved by taking into account the physiological and psychological peculiarities of drug-dependent patients. Importantly, this should be combined with a variety of different, optimized, multimodal therapeutic regimes, as well as with an interdisciplinary approach.
Acupuncture Therapy↗
Neurosurgeons' management of lumbosacral radicular syndrome evaluated against a clinical guideline.
To establish to what extent neurosurgeons subscribe to the lumbosacral radicular syndrome (LRS) guideline, and to evaluate their current management of patients with LRS against the guideline. All active neurosurgeons in the Netherlands (n=92) were mailed a questionnaire about the guideline and data from 66 responders were analysed. Patients were recruited via seven of the participating neurosurgeons and were interviewed once by telephone. The medical records of the participating patients (n=163) were also examined. Of the 26 propositions in the LRS guideline, seven were not fully endorsed by the neurosurgeons. Three of these seven propositions may need updating based on "new evidence". The time between the onset of the LRS episode and the actual moment of surgery was considerably longer than that recommended in the guideline. Based on their current management of LRS patients, the neurosurgeons largely adhere with the LRS guideline.
Adult↗
Mono-disciplinary or multidisciplinary back pain guidelines? How can we achieve a common message in primary care?
Description of a workshop entitled "Sharing Guidelines for Low Back Pain Between Primary Health Care Providers: Toward a Common Message in Primary Care" that was held at the Fifth International Forum on Low Back Pain in Primary Care in Canada in May 2002. Despite a considerable degree of acceptance of current evidence-based guidelines, in practice, primary health care providers still do not share a common message. The objective of the workshop was to describe the outcomes of a workshop on the sharing of guidelines in primary care. The Fifth International Forum on Low Back Pain Research in Primary Care focused on relations between stakeholders in the primary care management of back pain. Participants in this workshop contributed to an open discussion on "how and why" evidence-based guidelines about back pain do or do not work in practice. Ways to minimise the factors that inhibit implementation were discussed in the light of whether guidelines are mono-disciplinary or multidisciplinary. Examples of potential issues for debate were contained in introductory presentations. The prospects for improving implementation and reducing barriers, and the priorities for future research, were then considered by an international group of researchers. This paper summarises the conclusions of three researcher subgroups that focused on the sharing of guidelines under the headings of: (1) the content, (2) the development process, and (3) implementation. How to share the evidence and make it meaningful to practice stakeholders is the main challenge of guideline implementation. There is a need to consider the balance between the strength of evidence in multidisciplinary guidelines and the utility/feasibility of mono-disciplinary guidelines. The usefulness of both mono-disciplinary and multidisciplinary guidelines was agreed on. However, in order to achieve consistent messages, mono-disciplinary guidelines should have a multidisciplinary parent. In other words, guidelines should be developed and monitored by a multidisciplinary team, but may be transferred to practice by mono-disciplinary messengers. Despite general agreement that multi-faceted interventions are most effective for implementing guidelines, the feasibility of doing this in busy clinical settings is questioned. Research is needed from local implementation pilots and quality monitoring studies to understand how to develop and deliver the contextual understanding required. This relates to processes of care as well as outcomes, and to social factors and policymaking as well as health care interventions. We commend these considerations to all who are interested in the challenges of achieving better-integrated, evidence-based care for people with back pain.
Back Pain↗
The lumbar vertebral disc.
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Diagnostic Imaging↗
A survey of the "surgical and research" articles in the European Spine Journal, 2006.
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Data Collection↗
A survey of the "medical" articles in the European Spine Journal, 2006.
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Data Collection↗
Italian SPREAD Guidelines: from past to future.
The development of the Italian Guidelines on Stroke involved a multidisciplinary working group, named the "SPREAD Collaboration" (Stroke PREvention and Awareness Diffusion), composed at present of different professional organisations and two patients' associations. The group was organised into operative subcommittees. Each subcommittee dealt with a different area covered by the guidelines and was composed of 5-10 experts in the specific field. A "scientific task force" and an editorial board were responsible for coordinating and reviewing the texts progressively processed and produced.
Forecasting↗
Improved diagnostic accuracy of inflammatory bowel disease: a clinicopathological collaborative approach.
Although colonic biopsies have become a major source of information to the clinician investigating cases of inflammatory bowel diseases (IBD), there are still some difficulties in making definitive diagnoses. This article looks into these challenges and possible ways of dealing with them. We strongly recommend supplying the pathologist with full clinical, radiological and endoscopic information with the request form. The pathologist may then issue a preliminary working report, while the final report should be reached at the much needed regular clinicopathological conference.
Endoscopy, Digestive System↗
Guidelines for the management of headache in primary care: are they being used?
The uptake of guidelines for the management of headache in primary care was assessed using surrogate measures in patients with headache referred to secondary care (number of prior general practitioner attendances and medications prescribed). The results suggest that headache guidelines are seldom, if ever, applied in this geographical location.
Ambulatory Care Facilities↗
Transforming medical imaging: the first SCAR TRIP conference a position paper from the SCAR TRIP subcommittee of the SCAR research and development committee.
The First Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Conference and Workshop, "Transforming Medical Imaging" was held on January 31-February 1, 2005 in Bethesda, MD. Representatives from all areas of medical and scientific imaging-academia, research, industry, and government agencies-joined together to discuss the future of medical imaging and potential new ways to manage the explosion in numbers, size, and complexity of images generated by today's continually advancing imaging technologies. The two-day conference included plenary, scientific poster, and breakout sessions covering six major research areas related to TRIP. These topic areas included human perception, image processing and computer-aided detection, data visualization, image set navigation and usability, databases and systems integration, and methodology evaluation and performance validation. The plenary presentations provided a general status review of each broad research field to use as a starting point for discussion in the breakout sessions, with emphasis on specific topics requiring further study. The goals for the breakout sessions were to define specific research questions in each topic area, to list the impediments to carrying out research in these fields, to suggest possible solutions and near- and distant-future directions for each general topic, and to report back to the general session. The scientific poster session provided another mechanism for presenting and discussing TRIP-related research. This report summarizes each plenary and breakout session, and describes the group recommendations as to the issues facing the field, major impediments to progress, and the outlook for radiology in the short and long term. The conference helped refine the definition of the SCAR TRIP Initiative and the problems facing radiology with respect to the dramatic growth in medical imaging data, and it underscored a present and future need for the support of interdisciplinary translational research in radiology bridging bench-to-bedside. SCAR will continue to fund research grants exploring TRIP solutions. In addition, the organization proposes providing an infrastructure to foster collaborative research partnerships between SCAR corporate and academic members in the form of a TRIP Imaging Informatics Network (TRIPI(2)N).
Databases as Topic↗
Health care students' differing conceptions of expertise: a challenge for inter-professional care.
The aim of the study was to examine do health care students, who study at different programs, value similar expert qualities. To investigate this issue, a questionnaire was administered among health care students in a Finnish polytechnic (two cohorts, total n = 466), consisting of a scale for rating the importance of different expert qualities. The questionnaire resulted in the following dimensions of the conceptions of expertise: (1) social skills, (2) scientific skills, (3) innovativeness, (4) continuing self-development, and (5) problem-solving skills. Also the Inventory of General Study Orientations (IGSO) was applied to analyse possible motivational explanations for different conceptions of expertise. In addition to the scales, an open-ended writing task was used to explore in depth students' conceptions of expertise. It appeared that study orientations were a minor factor in the study, while study environment (study programs) clearly differentiated students' conceptions of expertise. Thus, the study argues that health care students' conceptions of expertise are constituted mainly on domain-specific bases and that students who graduate from different programs may possess very diverse ideas about their profession. Consequently, different conceptions captured during the education form a major challenge for inter-professional care later in work-life. This phenomenon should be taken into account when organising health care education.
Analysis of Variance↗
Getting the big picture in community science: methods that capture context.
Community science has a rich tradition of using theories and research designs that are consistent with its core value of contextualism. However, a survey of empirical articles published in the American Journal of Community Psychology shows that community scientists utilize a narrow range of statistical tools that are not well suited to assess contextual data. Multilevel modeling, geographic information systems (GIS), social network analysis, and cluster analysis are recommended as useful tools to address contextual questions in community science. An argument for increased methodological consilience is presented, where community scientists are encouraged to adopt statistical methodology that is capable of modeling a greater proportion of the data than is typical with traditional methods.
Cluster Analysis↗
Scientists in the swamp: narrowing the language-practice gap in community psychology.
As a confluence of unique values and activities, the collective practice of community psychology is difficult to characterize in a simple way. Increasingly, however, professional contexts are laden with pressure to define any practice--from library work to medical interventions--in the orderly, compact language of traditional science. This trend has historically been resisted in the field by those sensing a fundamental lack of fit between the fluid, emergent aspects of community psychological practice and the fixed, precise language of classic science. In response to this "language-practice gap," some have attempted to adapt the traditional language of science to better fit the field's practice, while others have explored alternative languages of practice seemingly more indigenous to the messy "swamp" of actual communities. While the former effort leaves some theoretical contradictions intact, the latter tends to discount scientific identity entirely. This paper proposes a potential step forward by resituating questions of disciplinary language and identity within a current philosophical discourse where the nature of social science itself remains sharply contested. This suggests shifting attention away from "should we be a science?" to "what kind of science might we be after all?"; in turn, alternative languages may be re-cast as legitimate contributors to a kind of science more authentic to human communities--even a viable "science in the swamp." One such language-philosophical hermeneutics--is presented as a particularly valuable supplement to traditional science. Illustrations highlight ways that hermeneutics may advance the formal language of the field towards a closer fit of what actually happens in practice, while preserving and even bolstering the empirical rigor and scientific identity of the field.
Community Mental Health Services↗
External, not internal challenges to interdisciplinary research.
This commentary draws on personal experience with interdisciplinary collaborations to suggest that Maton, Perkins, and Saegert (this issue) may overstate the challenges internal to interdisciplinary work groups. It supports their discussion of external challenges, and comments on the efforts they suggest to further interdisciplinary work.
Cooperative Behavior↗
At a crossroad: standing still and moving forward.
Reading the article, "Community psychology at the crossroads: Prospects for interdisciplinary research" (Maton, Perkins & Saegert, this issue), there is a sense that community psychology is at a crossroad with regard to being an interdisciplinary field. This paper aims to offer insight and guidance to proponents of interdisciplinary research in the community psychology field by drawing on experiences in urban studies, which shares similar origins and interdisciplinary claims.
Health Services Research↗
Building interdisciplinary/intersectoral research partnerships for community-based mental health research with older minority adults.
Community-based research often brings investigators from different disciplinary backgrounds together with community representatives to conduct research on topics of mutual concern. This paper describes a case example that illustrates an interdisciplinary/intersectoral study of depression and barriers to mental health care among older adults and illustrate the factors central to implementing a successful research partnership. It will address the following conditions that facilitate and challenge interdisciplinary/intersectoral research: (1) achieving commonality of purpose in study design and research and referral approaches; (2) ensuring the ability to develop, field-test and implement psychometrically rigorous and culturally and qualitatively appropriate instruments; (3) building effective management structures for interdisciplinary/intersectoral research partnerships; and (4) identifying, training and supporting qualified researchers to carry out a mental health study with older ethnically diverse adults. The paper concludes with strengths and limitations of the approach.
Anthropology, Cultural↗