Human intervention studies are gaining traction and recognition in the Developmental Origins of Health and Disease (DOHaD) field. Since DOHaD intervention studies will most frequently use complex public health interventions, collaborations across science and social science disciplines are critical for obtaining and interpreting DOHaD evidence in ways that matter for policy recommendation. This chapter explores the application of biosocial collaboration in a DOHaD intervention trial, namely Bukhali, the Healthy Life Trajectories Initiative (HeLTI) South Africa randomised controlled trial. Bukhali evaluates a complex intervention initiated prior to conception, through pregnancy, and into early childhood, with the primary aim of addressing childhood obesity. As part of the first trials assessing the potential of preconception interventions to shape intergenerational health, the trial is significant to DOHaD science. Bukhali has adopted a pragmatic approach, allowing for ongoing adaptation to new knowledge as it arises and testing not only the primary hypothesis but also undertaking process evaluation analyses. This requires a multidisciplinary process that serves as a case study of how biosocial collaboration can enhance DOHaD-inspired intervention research.

Comprehensive geriatric assessment (CGA) has been one of the cornerstones of geriatric medicine since its introduction by Marjory Warren in 1936. This kind of assessment is defined as a multidimensional and multidisciplinary process related to identifying medical, social, and functional needs and developing an integrated care plan designed to meet the patien’st needs.The practice and applications of CGA have been used to various degrees in mainstream care for older people in the UK and internationally.

Some limitations still exist around the wider implementation of CGA, as its practice relies on members of the multidisciplinary team (MDT) and on an effective communication between them, the patients, and their families. This kind of assessment has been criticised for not adequately acknowledging frailty and for not using patient-reported outcome measures to test its efficacy.

Randomised controlled studies, systematic reviews, and meta-analyses provided considerable evidence for the clinical and financial effectiveness of CGA in various hospital specialties. However, there are still concerns about the generalisability of CGA in community settings. Further research to identify target populations for CGA-led interventions and a consensus on outcome measures are required to realise CGA benefits.

In this chapter we describe required skills and practical tips to deliver CGA across a variety of settings.

The book’s closing Chapter 9 on change in economics begins with an examination of the methodological problem of explaining what counts as change, and argues change in economics needs to be explained in terms of economics’ relationships to other disciplines. It argues that economics’ core–periphery structure works to insulate its core from other disciplines’ influences upon it, minimizing their influences. This raises the question: Can other disciplines influence economics’ core and potentially produce change in economics? To investigate this question, the chapter develops an open–closed systems model of disciplinary boundary crossings and argues that economics’ core is only incompletely closed and consequently its adopting other disciplines’ contents can change its interpretation. Using the different forms of relationships between disciplines distinguished in Chapter 7, mainstream economics’ relations to other disciplines are argued to currently be interdisciplinarity, but may also be unstable and can break down. When and under what circumstances? Moving from what happens within social science, two sets of external forces influencing change in economics – change in how research is done and historical changes in social values and social expectations regarding what economics is and should be about – are argued likely to increase boundary crossings between economics and other disciplines, undermine the insularity of its core, and move economics toward being a multidisciplinary, more pluralistic discipline. What would then be especially different about economics would be that individuals are seen as socially embedded and an objective economics is seen as a normative, value-entangled science.

Chapter 2 explains the multidisciplinary nature of prehistoric archeology, providing an overview of many of the disciplines and explaining their basic applications in the field. It describes how archeological data is amassed and interpreted in ever-more efficient ways thanks to constantly evolving modern technologies.

Effective services are patient and family centred, value and encourage staff and use resources effectively.

Effective services are patient and family centred, value and encourage staff and use resources effectively.

How does the Anthropocene change human stories? In a word, drastically. Many people don't want our altered planet to alter their stories. This group, in the spirit of "anything goes," ignores or attacks the science and sometimes the scientists as well. But more and more, writers, social scientists, and humanistic scholars are beginning to engage seriously with Anthropocene science and its radical vision. This engagement results in two new types of narrative. The first kind is the singular collective story of humans from our ancestral species moving out of Africa through all our evolutionary permutations until we became a global force, an Earth System agent, in the mid-twentieth century. The other way of telling human stories in response to Anthropocene science is to acknowledge our species as an Earth System agent, but to point to the many textured, contingent, and small-scale human stories. Some of these are congruent with the overall global narrative; others point to alternatives. This essay takes the reader on a tour of how humanists and social scientists are responding to the Anthropocene through three kinds of stories: those that deny scientific evidence; those highlighting humanity as a collective planetary force, and those focusing on diverse alternative histories within planetary limits.

This chapter considers the meaning and role of interdisciplinary approaches to research and teaching in medical law and ethics, itself an inherently interdisciplinary field. It notes that formidable challenges persist, however, especially when navigating methodological and conceptual differences across disciplines, and operating outwith a disciplinary ‘home’. The chapter looks at how complementary strands of diverse specialisms can come together to create the constellation of critical tools needed to address contemporary legal, regulatory and ethical challenges in medicine, health care and the biosciences. In the three case studies, the authors examine the contribution of multi- and interdisciplinary approaches to pedagogy, critical scholarship and the production of practical research outputs, and how these have informed and influenced their own work, with and alongside that of Graeme Laurie. Throughout, the discussions highlight the myriad ways that his research and teaching exemplify the openness of spirit and the intellectual curiosity required to engage meaningfully in interdisciplinarity.

Thinking and practice have evolved about the role that academics play in civic discourse, particularly about the influence of their scholarly, peer-reviewed research in the policy world. This chapter reviews different types of impact that academics have and can have inside the academy through publishing in academic journals, and outside the academy by translating knowledge to policy including through participating on and leading committees and other policy organisations. Both environments also include an under-appreciated type of impact, namely the legacy of one’s work through interactions with others. The chapter describes the changing landscape in which knowledge production and dissemination occur, highlighting the growth of international, collaborative work, to place the changing faces of impact into a broader environmental context. Finally, these two strands of impact and legacy are brought together for some concluding reflections about their future importance.

The prescribing of medicines by a range of health professions is pivotal to the success of the future NHS. Prescribing is a key enabler of specialist and advanced practice, and health professionals that can prescribe medicines are crucial members of healthcare delivery teams. Widening the prescribing of medicines to some professions in addition to the medical profession has changed the role boundaries of those prescribing professions, necessitating changes to relationships between those involved in the patient’s care. The teams in which prescribers work are across the full range of professions, extending beyond traditional boundaries, and include consideration of housing, education, employment as well as physical, mental and social health. This diversity has introduced a need for further integrated working and collaboration across the system. Excellent teamwork, clinical governance, communication and information sharing are crucial, as is the need for team members to have a clear understanding of one another’s roles and the ability to communicate with one another.

Chronic pelvic pain, is defined as any pelvic pain lasting over six months. It can result from a variety of urological, gynaecological or gastrointestinal aetiologies. It tends to affect women of reproductive age and can have a signi?cant impact on women’s health, relationships and quality of life. In a majority of cases no aetiological factors are identifiable and there is no consensus in treating and managing such patients. Treatment can be frustrating and can lead to breakdown of the patient–doctor relationship.

Key Learning Points

1. 1. A high degree of clinical suspicion is required to effectively diagnose and treat myocarditis.

2. 2. Endomyocardial biopsy (EMB) is required to attain a certain diagnosis and direct effective management.

3. 3. Supportive care is the mainstay of medical management if the diagnosis is unclear, and may necessitate the use of inotropic drugs and mechanical assist devices.

4. 4. Complex diagnostic and management issues require a multidisciplinary approach – intensivist, cardiologist, pathologist (trained in myocardial pathology), clinical immunologist and infectious disease specialist.

5. 5. Suspect myocarditis in young patients (<35 years old) with unexplained heart failure or arrhythmia.

Key Learning Points

1. 1. Clear and effective communication is crucial between healthcare teams.

2. 2. A clear and informative handover is essential for ensuring the continuity of excellent patient care.

3. 3. The role of an intensivist not only involves the delivery of care on an intensive care unit, but rather extends across the whole hospital at all hours.

4. 4. Patient-centred care and safety are your primary concerns.

5. 5. The intensivist is also a key player in creating a positive working environment that both respects and encourages the input and contribution of other team members in making the best decisions for patient care.

Key Learning Points

1. 1. Insight into habitual barriers leads to an effective ward round.

2. 2. The importance of location, which should be at the bedside, with the patient at the focus.

3. 3. The importance of a structured approach, physical examination, checklists and goal setting.

4. 4. The ward round should be multidisciplinary, promoting a culture of collaborative input, with all individual roles acknowledged and respected.

5. 5. The ward round should be concluded by clarification of agreed goals for the day, defining individual responsibilities within the attending team and contemporaneous documentation.