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Gregory D. Jay

Bio: Gregory D. Jay is an academic researcher from Brown University. The author has contributed to research in topics: Proteoglycan 4 & Synovial fluid. The author has an hindex of 53, co-authored 223 publications receiving 12132 citations. Previous affiliations of Gregory D. Jay include Washington State University & University of Massachusetts Medical School.


Papers
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Journal ArticleDOI
TL;DR: The findings point to the effectiveness of formal teamwork training for improving team behaviors, reducing errors, and improving staff attitudes among the ETCC-trained hospitals.
Abstract: The MedTeams project is a translational research effort to apply crew resource management (CRM) behavioral principles developed in aviation to emergency medical care. Hospital emergency departments share many of the same characteristics with workplaces where CRM is effective, such as time-stress, dispersed and complex information, multiple players, and high-stakes outcomes. Preliminary observations in emergency departments (ED) established that the same CRM behaviors employed by highly effective aviation teams could be useful in the ED (Weiner, Kanki, and Helmreich 1993; Simon, Morey, and Locke 1997). A retrospective review of ED closed claims revealed that failure to engage in one or more of these teamwork behaviors was associated with an adverse event and indemnity payments. In 43 percent of the cases reviewed, teamwork behaviors would have prevented or mitigated the adverse event had they been applied (Risser, Rice et al. 1999). Similar analyses attribute about 80 percent of anesthesia mishaps to human error and 70 percent of commercial aviation accidents to crew errors (Gardner-Bonneau 1993; Taggart 1994). Crew training has led to reductions in aviation mishaps beyond those produced by improvements in equipment and technology. The aviation community began introducing CRM training two decades ago and it is now required for all military and commercial U.S. aviation crews and air carriers operating internationally (Helmreich and Foushee 1993; Helmreich 1997). The basic principle of CRM is that crew communication and coordination behaviors are identifiable, teachable, and applicable to high-stakes environments. An additional principle is that those behaviors, although seen spontaneously, are not practiced reliably, regularly, or well unless specific training and reinforcement has established them. Specific CRM behaviors have been identified through experimentation and observation of high-reliability teams in demanding, time-stressed environments such as combat aviation and naval command and control centers (Leedom and Simon 1995; McIntyre and Salas 1995). Crew resource management training has been shown to be effective in these environments and is being extended into other domains (Helmreich and Foushee 1993; Salas et al. 1999). Finally, an essential principle of CRM is that a team needs to be formally established for teamwork behaviors to be effective. In contrast to the notion of a team as any loosely coordinated group of caregivers and support staff, the formal teamwork structure of this study stipulates that a team be made up of between 3 to 10 members. A team is composed of physicians, nurses, and technicians who are organized for a shift. The number of designated teams for a shift depends on factors such as staffing levels and patient volume. From these larger teams, ad hoc teams are formed to respond to emergent events such as resuscitations. In this model, teamwork is sustained by a shared set of teamwork skills rather than permanent assignments that carry over from day to day. Teamwork theory development has focused on input variables affecting team functioning such as task, work environment, and team member characteristics (Salas et al. 1992), what and how to train (Salas and Cannon-Bowers 2001), and outcome constructs of teamwork effectiveness (McIntyre, Salas 1995). Explanatory mechanisms of team processes exist in the form of constructs such as situational awareness and shared mental models, but relating team processes to work productivity outcomes has been limited by measurement difficulties with these constructs. Because this study examined the applicability of CRM to health care, a goal of this study was to generate a set of testable teamwork process–outcome propositions for future healthcare research. With respect to the training intervention, we sought to gain insight into the effectiveness of the training materials and methods, and features of the curriculum that needed revision. In addition, we sought to determine if the training intervention changed staff attitudes and behaviors and had an impact on patient care. These complementary perspectives are referred to as formative and summative evaluation in the education research literature (Bloom, Hastings, and Madaus 1971). The first objective of this study was to adapt an aviation-oriented teamwork curriculum to the particular circumstances of EDs by developing and then implementing a training curriculum (Emergency Team Coordination Course [ETCC]) organized around five team dimensions (maintain team structure and climate, apply problem-solving strategies, communicate with the team, execute plans and manage workload, and improve team skills) (Risser, Rice et al. 1999; Risser, Simon et al. 1999). The second objective was to evaluate the effectiveness of the intervention with measures developed to address three outcome constructs: Team Behaviors, Attitudes and Opinions, and ED Performance.

978 citations

Journal ArticleDOI
TL;DR: New areas of application in the realms of biology and medicine are stimulating innovation in basic and applied research into liquid-crystal materials, leading to new techniques for optically probing biological systems.
Abstract: With the maturation of the information display field, liquid-crystal materials research is undergoing a modern-day renaissance. Devices and configurations based on liquid-crystal materials are being developed for spectroscopy, imaging and microscopy, leading to new techniques for optically probing biological systems. Biosensors fabricated with liquid-crystal materials can allow label-free observations of biological phenomena. Liquid-crystal polymers are starting to be used in biomimicking colour-producing structures, lenses and muscle-like actuators. New areas of application in the realms of biology and medicine are stimulating innovation in basic and applied research into these materials.

636 citations

Journal ArticleDOI
TL;DR: It is concluded that lubricin has multiple functions in articulating joints and tendons that include the protection of surfaces and the control of synovial cell growth.
Abstract: The long-term integrity of an articulating joint is dependent upon the nourishment of its cartilage component and the protection of the cartilage surface from friction-induced wear. Loss-of-function mutations in lubricin (a secreted glycoprotein encoded by the gene PRG4) cause the human autosomal recessive disorder camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP). A major feature of CACP is precocious joint failure. In order to delineate the mechanism by which lubricin protects joints, we studied the expression of Prg4 mRNA during mouse joint development, and we created lubricin-mutant mice. Prg4 began to be expressed in surface chondrocytes and synoviocytes after joint cavitation had occurred and remained strongly expressed by these cells postnatally. Mice lacking lubricin were viable and fertile. In the newborn period, their joints appeared normal. As the mice aged, we observed abnormal protein deposits on the cartilage surface and disappearance of underlying superficial zone chondrocytes. In addition to cartilage surface changes and subsequent cartilage deterioration, intimal cells in the synovium surrounding the joint space became hyperplastic, which further contributed to joint failure. Purified or recombinant lubricin inhibited the growth of these synoviocytes in vitro. Tendon and tendon sheath involvement was present in the ankle joints, where morphologic changes and abnormal calcification of these structures were observed. We conclude that lubricin has multiple functions in articulating joints and tendons that include the protection of surfaces and the control of synovial cell growth.

550 citations

Journal ArticleDOI
TL;DR: This article describes emergency department care work teams designed to improve team communication and coordination and reduce error, which are key teamwork concepts largely drawn from successful aviation programs.

534 citations

Journal ArticleDOI
TL;DR: High fidelity medical simulation appears to be a promising method for enhancing didactic teamwork training, using a number of patients, is more representative of clinical care and is therefore the proper paradigm in which to perform teamwork training.
Abstract: Objective: To determine if high fidelity simulation based team training can improve clinical team performance when added to an existing didactic teamwork curriculum. Setting: Level 1 trauma center and academic emergency medicine training program. Participants: Emergency department (ED) staff including nurses, technicians, emergency medicine residents, and attending physicians. Intervention: : ED staff who had recently received didactic training in the Emergency Team Coordination Course (ETCC®) also received an 8 hour intensive experience in an ED simulator in which three scenarios of graduated difficulty were encountered. A comparison group, also ETCC trained, was assigned to work together in the ED for one 8 hour shift. Experimental and comparison teams were observed in the ED before and after the intervention. Design: Single, crossover, prospective, blinded and controlled observational study. Teamwork ratings using previously validated behaviorally anchored rating scales (BARS) were completed by outside trained observers in the ED. Observers were blinded to the identification of the teams. Results: There were no significant differences between experimental and comparison groups at baseline. The experimental team showed a trend towards improvement in the quality of team behavior (p = 0.07); the comparison group showed no change in team behavior during the two observation periods (p = 0.55). Members of the experimental team rated simulation based training as a useful educational method. Conclusion: High fidelity medical simulation appears to be a promising method for enhancing didactic teamwork training. This approach, using a number of patients, is more representative of clinical care and is therefore the proper paradigm in which to perform teamwork training. It is, however, unclear how much simulator based training must augment didactic teamwork training for clinically meaningful differences to become apparent.

467 citations


Cited by
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Journal ArticleDOI
TL;DR: The increased understanding of the immune mechanisms of rheumatoid arthritis has led to the development of a considerable number of new therapeutic agents that alter the natural history of the disease and reduce mortality.
Abstract: The increased understanding of the immune mechanisms of rheumatoid arthritis has led to the development of a considerable number of new therapeutic agents that alter the natural history of the disease and reduce mortality.

3,975 citations

Book
10 Feb 2011
TL;DR: The perfect complement to Nursing Research: Generating and Assessing Evidence for Nursing Practice, Ninth Edition, this knowledge builder helps you develop and reinforce basic skills essential to nursing research.
Abstract: The perfect complement to Nursing Research: Generating and Assessing Evidence for Nursing Practice, Ninth Edition, this knowledge builder helps you develop and reinforce basic skills essential to nursing research.

3,409 citations

Journal ArticleDOI
TL;DR: The specific advantages brought up by a design based on the use of the halogen bond will be demonstrated in quite different fields spanning from material sciences to biomolecular recognition and drug design.
Abstract: The halogen bond occurs when there is evidence of a net attractive interaction between an electrophilic region associated with a halogen atom in a molecular entity and a nucleophilic region in another, or the same, molecular entity. In this fairly extensive review, after a brief history of the interaction, we will provide the reader with a snapshot of where the research on the halogen bond is now, and, perhaps, where it is going. The specific advantages brought up by a design based on the use of the halogen bond will be demonstrated in quite different fields spanning from material sciences to biomolecular recognition and drug design.

2,582 citations