As health care delivery moves toward more complex, team-based systems, the topic of medical teamwork has gained considerable attention and study across disciplines. This systematic review integrates empirical research on teamwork and health care to identify broad trends. We identified and coded 1,818 relevant, English, and peer-reviewed journal articles using a teamwork processes rubric. Several themes emerged. The health care teamwork literature has grown substantially over the past 20 years. Approximately half of the studies were descriptive (rather than interventional or psychometric); the majority relied on quantitative methods. Health care teamwork was also studied in thematically distinct manners. Interpersonal processes were most commonly studied across fields. Of all disciplines, medicine focused most on transition processes, whereas those from team science centered more highly on action processes. There were also finer grained disciplinary differences in content areas of communication and collaboration. Interprofessional journals represent a potential area for interdisciplinary efforts. Implications and future directions are discussed.
Background: The neural crest is a group of multipotent cells that give rise to a wide variety of cells, especially portion of the peripheral nervous system. Neural crest cells show evolutionary conserved fate restrictions based on their axial level of origin: cranial, vagal, trunk and sacral. While much is known about these cells in mammals, birds, amphibians, and fish, relatively little is known in other types of amniotes such as snakes, lizards and turtles. We attempt here to provide a more detailed description of the early phase of trunk NCC development in turtle embryos. Results: In this study, we show, for the first time, migrating trunk NCC in the pharyngula embryo of Trachemys scripta by vital-labeling the NCC with DiI and through immunofluorescence. We found that A) tNCC form a line along the sides of the trunk NT. B) The presence of late migrating tNCC on the medial portion of the somite. C) The presence of lateral mesodermal migrating tNCC in pharyngula embryos. D) That turtle embryos have large/thick peripheral nerves. Conclusions: The similarities and differences in trunk NCC migration and early PNS development that we observe across sauropsids (birds, snake, gecko and turtle) suggests that these species evolved some distinct NCC pathways.
Growth Differentiation Factor 15 (GDF15) is a divergent member of transforming growth factor-beta (TGF-β) superfamily and is ubiquitously expressed, under normal physiological conditions. GDF15 expression increases during many pathological states and serves a marker of cellular stress. GDF15 has multiple and even paradoxical roles within a pathological condition, as its effects can be dose- and time-dependent and vary based on the targeted tissues and downstream pathways. GDF15 has emerged as one of the most recognized proteins as part of the senescence associated secretory phenotype. Cellular senescence plays a major role in many lung diseases across the life-span from bronchopulmonary dysplasia in the premature neonate to COPD and idiopathic pulmonary fibrosis in aged adults. GDF15 levels have been reported to be as a useful biomarker in chronic obstructive pulmonary disease, lung fibrosis and pulmonary arterial hypertension and predict disease severity, decline in lung function and mortality. Glial-cell-line-derived neurotrophic factor family receptor alpha-like (GFRAL) in the brain stem has been identified as the only validated GDF15 receptor and mediates GDF15-mediated anorexia and wasting. The mechanisms and pathways by which GDF15 exerts its pulmonary effects are being elucidated. GDF15 may also have an impact on the lung based on the changes in circulating levels or through the central action of GDF15 activating peripheral metabolic changes. This review focuses on the role of GDF15 in different lung diseases across the lifespan and its role in cellular senescence.
The enteric nervous system (ENS) is a vast intrinsic network of neurons and glia within the gastrointestinal tract and is largely derived from enteric neural crest cells (ENCCs) that emigrate into the gut during vertebrate embryonic development. Study of ENCC migration dynamics and their genetic regulators provides great insights into fundamentals of collective cell migration and nervous system formation, and are a pertinent subject for study due to their relevance to the human congenital disease, Hirschsprung disease (HSCR). For the first time, we performed in toto gut imaging and single-cell generation tracing of ENCC migration in WT and a novel ret heterozygous background zebrafish (retwmr1/+) to gain insight into ENCC dynamics in vivo. We observed that retwmr1/+ zebrafish produced fewer ENCCs while localized along the gut, which failed to reach the hindgut, resulting in HSCR-like phenotypes. Specifically, we observed a proliferation dependent migration mechanism, where cell divisions were associated with inter-cell distances and migration speed. Lastly, we detected a premature neuronal differentiation gene expression signature in retwmr1/+ ENCCs, collectively suggesting that Ret signaling may function to regulate maintenance of a stem-state in ENCCs.
Teamwork in healthcare is particularly salient in the dynamic domains of critical care: emergency medicine, surgery, and trauma and resuscitation. Within and across these services, teams must be coordinated to provide optimal care in order to provide optimal delivery of health care. Although many disciplines study teamwork, it is unclear how scholars and clinicians conceptualize, study, and apply these processes. The current systematic review investigates how these fields 1) study teams through the application of a teamwork processes rubric and 2) distinguish themselves from other medical disciplines through the empirical research. We drew upon a taxonomy of teamwork processes (Marks et al., Acad. Manag. Rev. 26, 356 ‐376; LePine et al., Person. Psychol. 61, 273 ‐307), operationalizing transition, action, and interpersonal processes, to guide this work. Overall, the dynamic domains of literature studied teamwork processes at high rates, relative to other medical fields. Specifically, they were strongly associated with transition and action processes and the content areas of leadership and performance. Given these emphases, research and practical interventions may want to focus on more interpersonal and collaborative approaches in teamwork
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