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Team Effort (team + effort)
Selected AbstractsNew and experimental approaches to treatment of diabetic foot ulcers: a comprehensive review of emerging treatment strategiesDIABETIC MEDICINE, Issue 11 2004R. Eldor Abstract Diabetic foot ulcers occur in up to 15% of all diabetic patients and are a leading cause of nontraumatic amputation worldwide. Neuropathy, abnormal foot biomechanics, peripheral vascular disease and external trauma are the major contributors to the development of a foot ulcer in the diabetic patient. Therapy today includes repeated debridement, offloading, and dressings, for lower grade ulcers, and broad spectrum antibiotics and occasionally limited or complete amputation for higher grades, requiring a team effort of health care workers from various specialties. The large population affected by diabetic foot ulcers and the high rates of failure ending with amputation even with the best therapeutic regimens, have resulted in the development of new therapies and are the focus of this review. These include new off loading techniques, dressings from various materials, methods to promote wound closure using artificial skin grafts, different growth factors or wound bed modulators and methods of debridement. These new techniques are promising but still mostly unproven and traditional approaches cannot be replaced. New and generally more expensive therapies should be seen as adding to traditional approaches. [source] Kootenai River velocities, depth, and white sturgeon spawning site selection , a mystery unraveled?JOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2009V. L. Paragamian Summary The Kootenai River white sturgeon Acipenser transmontanus population in Idaho, US and British Columbia (BC), Canada became recruitment limited shortly after Libby Dam became fully operational on the Kootenai River, Montana, USA in 1974. In the USA the species was listed under the Endangered Species Act in September of 1994. Kootenai River white sturgeon spawn within an 18-km reach in Idaho, river kilometer (rkm) 228.0,246.0. Each autumn and spring Kootenai River white sturgeon follow a ,short two-step' migration from the lower river and Kootenay Lake, BC, to staging reaches downstream of Bonners Ferry, Idaho. Initially, augmented spring flows for white sturgeon spawning were thought to be sufficient to recover the population. Spring discharge mitigation enhanced white sturgeon spawning but a series of research investigations determined that the white sturgeon were spawning over unsuitable incubation and rearing habitat (sand) and that survival of eggs and larvae was negligible. It was not known whether post-Libby Dam management had changed the habitat or if the white sturgeon were not returning to more suitable spawning substrates farther upstream. Fisheries and hydrology researchers made a team effort to determine if the spawning habitat had been changed by Libby Dam operations. Researchers modeled and compared velocities, sediment transport, and bathymetry with post-Libby Dam white sturgeon egg collection locations. Substrate coring studies confirmed cobbles and gravel substrates in most of the spawning locations but that they were buried under a meter or more of post-Libby Dam sediment. Analysis suggested that Kootenai River white sturgeon spawn in areas of highest available velocity and depths over a range of flows. Regardless of the discharge, the locations of accelerating velocities and maximum depth do not change and spawning locations remain consistent. Kootenai River white sturgeon are likely spawning in the same locations as pre-dam, but post-Libby Dam water management has reduced velocities and shear stress, thus sediment is now covering the cobbles and gravels. Although higher discharges will likely provide more suitable spawning and rearing conditions, this would be socially and politically unacceptable because it would bring the river elevation to or in excess of 537.66 m, which is flood stage. Thus, support should be given to habitat modifications incorporated into a management plan to restore suitable habitat and ensure better survival of eggs and larvae. [source] The application of product measures in directing software maintenance activityJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 2 2007M. P. Ware Abstract This paper is concerned with enhancing aspects of project-management techniques in relation to maintenance in commercial object-oriented software. Maintenance forms a significant proportion of the lifecycle of a product and consequently its costs. Techniques such as lean production attempt to reduce cost by focusing team effort and to pre-empt issues by the use of early detection and resolution strategies. This study involves a commercial application written in C++ and its evolution over a one-year period. Software product measures are used in conjunction with Pareto analysis to determine effective predictive class targeting in a release cycle. We assess the capability of the measures and consider how the results can be used by the project team. The study extends the work of others in this field in three ways. First, other studies have analysed procedural code, whereas we use an object-oriented code base. Second, most studies assess the predictive capability of measures against the number of software issues; we examine these factors, but uniquely test for change density using density modified measures and we also test for revision volume. Finally, we examine the implications of these results and offer a cohesive framework of recommendations placed within the lean management philosophy. Copyright © 2007 John Wiley & Sons, Ltd. [source] Therapists' experiences and perceptions of teamwork in neurological rehabilitation: reasoning behind the team approach, structure and composition of the team and teamworking processesPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2006Kitty Maria Suddick Abstract Background and Purpose.,Teamwork and the interdisciplinary team approach have been strongly advocated for use in the provision of neurological rehabilitation services. However, whether teamwork has been adopted, and in what form, has yet to be established. The present study investigated therapists' experiences and perceptions of the reasoning behind the team approach in neurological rehabilitation, the structure and composition of the team within which they worked and the teamworking process,Method.,This article reports part of an exploratory qualitative study. Five occupational therapists and five physiotherapists from three teams: a rehabilitation centre; a community team; and a stroke unit based within the UK. Semi-structured interviews were undertaken with each participant and then transcribed. Content and thematic analysis of the qualitative interview data was carried out, with respondents validating both the transcription and analysis stages.,Results.,Perceived composition and structure of the neurological rehabilitation team was variable across teams and between individual team members. There was disparity as to whether patients were included within the neurological team; the interdisciplinary team approach had not been consistently adopted and there were sub-teams and other team memberships in existence. Reasoning behind the team approach supported the perceived benefits of teamwork from a number of perspectives, and the activities reported as part of the team process were diverse.,Conclusions.,Different teams may choose to use different strategies depending on the aims and context of the team effort. In some instances interdisciplinary teamwork and patient-centred approaches were not adopted consistently and the process of teamwork itself is both complex and diverse. Copyright © 2006 John Wiley & Sons, Ltd. [source] Improvement of Chronic Pain by Treatment of Erectile DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008Jalil Arabkheradmand MD ABSTRACT Introduction., Pain specialists, who do not routinely examine patients regarding their sexual medicine problems, need to be aware that sexual problems can and do aggravate the patient's pain. Patients may refuse to admit suffering from erectile dysfunction (ED) but complain about continuous or progressive severe pain. These patients may be best managed by the combined team effort of a sexual medicine specialist and pain specialist. Aim., This report documents the management of three cases with long-term intractable pain after severe trauma. Treatment of occult ED led to significant improvement of their pain. Main Outcome Measures., The association of the treatment of uncovered ED and improvement of chronic severe pain. Methods., Three case reports of patients with severe pain who attended a pain clinic in an academic medical center. Results., Three men suffering from chronic pain due to severe trauma were observed for several years by different physicians as well as pain specialists. In spite of different treatments, including administration of several analgesics, psychotherapy, and physical therapy, pain was not alleviated. After finding ED problems, patients were referred to the family health clinic. Using different therapies such as psychosexual therapy, correction of sexual misconceptions, relaxation training, treatment of interpersonal difficulties, and pharmacological intervention ED was cured. Treatment of ED was accompanied by a significant reduction of chronic pain in all three patients. Conclusion., The present report indicates that uncovered ED in patients suffering from chronic pain may trigger their somatic pain or reduce its threshold. Significant improvement in sexual functioning may improve the pain and reduce its complications. Arabkheradmand J, Foroutan SK, Ranjbar S, Abbasi T, Hessami S, and Gorji A. Improvement of chronic pain by treatment of erectile dysfunction. J Sex Med **;**:**,**. [source] | ||||||||||