Sample records for aamm subcommittee consultation
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Preferences for active and aggressive intervention among patients with advanced cancer
Directory of Open Access Journals (Sweden)
Ennis Marguerite
2010-10-01
Full Text Available Abstract Background Intrinsic to "Patient-Centered Care" is being respectful and responsive to individual patient preferences, expressed needs, and personal values. Establishing a patient's preferences for active and aggressive intervention is imperative and foundational to the development of advance care planning. With the increasing awareness and acceptance of palliative philosophies of care, patients with advanced cancer are increasingly transitioning from active and aggressive medical management (AAMM to conservative palliative management (CPM. Methods A cross-sectional study based on a prospective and sequential case series of patients referred to a regional palliative medicine consultative program was assembled between May 1, 2005 and June 30, 2006. Patients and/or their substitute decision makers (SDM completed a questionnaire, at baseline, that assessed their preferences for AAMM en route to their eventual deaths. Seven common interventions constituting AAMM were surveyed: cardiopulmonary resuscitation (CPR & mechanical ventilation (MV, chemotherapy, antibiotics, anticoagulants, blood transfusions, feeding tubes, and artificial hydration. Multivariable analyses were conducted on the seven interventions individually as well as on the composite score that summed preferences for the seven interventions. Results 380 patients with advanced cancer agreed to participate in the study. A trend to desire a mostly conservative palliative approach was noted as 42% of patients desired one or fewer interventions. At baseline, most patients and their SDM's were relatively secure about decisions pertaining to the seven interventions as the rates of being "undecided" ranged from a high of 23.4% for chemotherapy to a low of 3.9% for feeding tubes. Multivariable modeling showed that more AAMM was preferred by younger patients (P Conclusions Although the majority of patients with advanced cancer in this study expressed preferences for CPM, younger age
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Kim, Min J; Winkler, Sabune J; Bierer, Barbara E; Wolf, Delia
2014-04-01
The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator-initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor-investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator-initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter-institutional capacity. © 2014 Wiley Periodicals, Inc.
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Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia
2014-01-01
Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986
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Relation between small airways disease and parenchymal destruction in surgical lung specimens.
Willems, L N; Kramps, J A; Stijnen, T; Sterk, P J; Weening, J J; Dijkman, J H
1990-01-01
The relation between small airways disease and parenchymal destruction was investigated in lungs and lobes removed at surgery from 27 patients aged 15-70 years. Eight of the 27 patients were life-long non-smokers. The degree of small airways disease was assessed by semi-quantitative grading (SAD score) and by measuring diameter and wall thickness of membranous bronchioles. Parenchymal destruction was measured in three ways. Firstly, the number of alveolar attachments on membranous bronchioles per millimetre of circumference (AA/mm) was counted; the number of broken attachments was subtracted from the total AA/mm to give the numbers of intact attachments (normal AA/mm). Secondly, a point counting technique was used to give a destructive index (DI). Thirdly, the mean linear intercept (Lm) was determined. Total and normal AA/mm correlated negatively with the SAD score of membranous bronchioles (rs = -0.48 and -0.51) and with wall thickness (rs = -0.37 and -0.45) and DI correlated with wall thickness (rs = 0.5) and with the SAD score of respiratory bronchioles (rs = 0.53). Lm did not correlate with indices of small airway disease and total and normal AA/mm did not correlate with diameter. Multiple regression analyses showed that the correlation of total AA/mm with the SAD score of membranous and respiratory bronchioles and with wall thickness were not confounded by age or smoking. It is concluded that small airways disease is related to destruction of peribronchiolar alveoli, and it is postulated that small airways disease has a direct role in the causation of centrilobular emphysema. PMID:2315880
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75 FR 2893 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2010-01-19
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... of the Astrophysics Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the... following topics: --Astrophysics Division Update --Updates on Select Astrophysics Missions --Discussion of...
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75 FR 13597 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2010-03-22
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... of the Astrophysics Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the...: The agenda for the meeting includes the following topics: --Astrophysics Division Update. --Kepler...
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Report of the 1983 NSAC Instrumentation Subcommittee
International Nuclear Information System (INIS)
1984-05-01
This report deals with the present state and future opportunities in instrumentation available to nuclear scientists in the United States to further probe the nature of nuclear matter. The report was written by a group convened by DOE/NSF as a subcommittee of the Nuclear Science Advisory Committee (NSAC). Findings and recommendations of the subcommittee are detailed
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National Research Council Canada - National Science Library
Fry, Ronald
2000-01-01
.... Topics covered include: a Keynote Address on Future Combat Systems, a review of the new JANNAF Modeling and Simulation Subcommittee, and technical papers on Hyper-X propulsion development and verification...
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77 FR 4026 - Army Education Advisory Subcommittee Meeting Notice
2012-01-26
... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Date of Meeting: February 23, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...
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76 FR 21382 - Pediatric Ethics Subcommittee; Notice of Meeting
2011-04-15
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0184] Pediatric Ethics Subcommittee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice... Administration (FDA). The meeting will be open to the public. Name of Committee: Pediatric Ethics Subcommittee of...
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77 FR 27209 - Army Education Advisory Subcommittee Meeting Notice
2012-05-09
... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice...: Board of Visitors, U.S. Army War College Subcommittee. Date of Meeting: May 31, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...
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78 FR 23759 - Army Education Advisory Subcommittee Meeting Notice
2013-04-22
... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Dates of Meeting: May 16, 2013. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks...
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2012-09-11
... Committee; Earth Science Subcommittee; Applied Sciences Advisory Group Meeting AGENCY: National Aeronautics... the Applied Science Advisory Group. This Subcommittee reports to the Earth Science Subcommittee... following topics: --Applied Sciences Program Update --Earth Science Data Latency Study Preliminary Update...
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77 FR 62536 - Meeting of Astrophysics Subcommittee of the NASA Advisory Council Science Committee
2012-10-15
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 12-081] Meeting of Astrophysics Subcommittee... Astrophysics Subcommittee of the NASA Advisory Council (NAC) Science Committee. This Subcommittee reports to...: The agenda for the meeting includes the following topics: --Astrophysics Division Update --Proposed...
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Status report on the NSAC Subcommittee on Electromagnetic Interactions
International Nuclear Information System (INIS)
Barnes, P.D.
1983-01-01
The Subcommittee has formulated its view of the physics program to be pursued in the coming years together with an analysis of the facility parameters that will be required in order to execute the highest priority components of this program. The Subcommittee foresees the opening of a new frontier for the investigation of nuclear phenomena in the momentum transfer range q = 5 to 15 fm -1 and electron energy range up to 4 GeV. Because of the opportunities they offer for fundamental advances using electromagnetic probes, the Subcommittee assigned the highest scientific priority to investigation of hadron structure and two body interactions, three and four body systems, and fundamental symmetries. This is both because of their intrinsic scientific interest and because of the opportunity they offer to study the largely unexplored transition between nucleon-meson and the quark-gluon descriptions of nuclear systems. The Subcommittee strongly recommends the construction of a variable energy electron beam facility capable of operation at both high intensity and high duty factor, and able to achieve an electron energy of about 4 GeV, for the purpose of making coincidence measurements on nuclear targets at large excitation energy and momentum transfer
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78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting
2013-08-08
...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...
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75 FR 74089 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2010-11-30
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-149)] NASA Advisory Council; Science... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the Science Committee of the NAC...
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76 FR 35481 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2011-06-17
... Update. --Research and Analysis Update. --Wide-Field Infrared Survey Telescope Science Definition Team... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 11-054] NASA Advisory Council; Science... Subcommittee of the NASA Advisory Council (NAC). This subcommittee reports to the Science Committee of the NAC...
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76 FR 59172 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2011-09-23
... Space Telescope, Science Definition Team. --Physics of the Cosmos/Cosmic Origins/Exoplanet Program... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-083)] NASA Advisory Council; Science... Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the Science Committee of the NAC...
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78 FR 5184 - Subcommittee Meetings
2013-01-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Subcommittee Meetings AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Five AHRQ... February 21 and closed for remainder of the meeting) 4. Healthcare Information Technology Research (HITR...
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JANNAF 17th Propulsion Systems Hazards Subcommittee Meeting. Volume 1
Cocchiaro, James E. (Editor); Gannaway, Mary T. (Editor); Rognan, Melanie (Editor)
1998-01-01
Volume 1, the first of two volumes is a compilation of 16 unclassified/unlimited technical papers presented at the 17th meeting of the Joint Army-Navy-NASA-Air Force (JANNAF) Propulsion Systems Hazards Subcommittee (PSHS) held jointly with the 35th Combustion Subcommittee (CS) and Airbreathing Propulsion Subcommittee (APS). The meeting was held on 7 - 11 December 1998 at Raytheon Systems Company and the Marriott Hotel, Tucson, AZ. Topics covered include projectile and shaped charge jet impact vulnerability of munitions; thermal decomposition and cookoff behavior of energetic materials; damage and hot spot initiation mechanisms with energetic materials; detonation phenomena of solid energetic materials; and hazard classification, insensitive munitions, and propulsion systems safety.
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2010-10-29
...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... or, are in late stage development for an adult oncology indication. The subcommittee will consider...
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2012-09-17
...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... that are in development for an adult oncology indication. The subcommittee will consider and discuss...
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2013-10-23
...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... oncology indications. The subcommittee will consider and discuss issues relating to the development of each...
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JANNAF 18th Propulsion Systems Hazards Subcommittee Meeting. Volume 1
Cocchiaro, James E. (Editor); Gannaway, Mary T. (Editor)
1999-01-01
This volume, the first of two volumes is a compilation of 18 unclassified/unlimited-distribution technical papers presented at the Joint Army-Navy-NASA-Air Force (JANNAF) 18th Propulsion Systems Hazards Subcommittee (PSHS) meeting held jointly with the 36th Combustion Subcommittee (CS) and 24th Airbreathing Propulsion Subcommittee (APS) meetings. The meeting was held 18-21 October 1999 at NASA Kennedy Space Center and The DoubleTree Oceanfront Hotel, Cocoa Beach, Florida. Topics covered at the PSHS meeting include: shaped charge jet and kinetic energy penetrator impact vulnerability of gun propellants; thermal decomposition and cookoff behavior of energetic materials; violent reaction; detonation phenomena of solid energetic materials subjected to shock and impact stimuli; and hazard classification, insensitive munitions, and propulsion systems safety.
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2010-03-09
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Subcommittee on Forensic Science; Committee on Science... participants. SUMMARY: The Subcommittee on Forensic Science of the National Science and Technology Council's... . Kenneth E. Melson, Co-Chair, Subcommittee on Forensic Science. [FR Doc. 2010-4899 Filed 3-8-10; 8:45 am...
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75 FR 52737 - Meeting of the Mobile Sources Technical Review Subcommittee
2010-08-27
.... Jackson, preferably at least 10 days prior to the meeting, to give EPA as much time as possible to process... the Subcommittee's Web Site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee web site. To subscribe...
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77 FR 13318 - Meeting of the Mobile Sources Technical Review Subcommittee
2012-03-06
... Ms. Krueger or Ms. Jackson, preferably at least 10 days prior to the meeting, to give EPA as much... the Subcommittee's Web site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee Web site. To subscribe...
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76 FR 58275 - Meeting of the Mobile Sources Technical Review Subcommittee
2011-09-20
..., preferably at least 10 days prior to the meeting, to give EPA as much time as possible to process your... the Subcommittee's Web site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee Web site. To subscribe...
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78 FR 59017 - Meeting of the Mobile Sources Technical Review Subcommittee
2013-09-25
... the meeting, to give EPA as much time as possible to process your request. Dated: September 18, 2013... be posted on the Subcommittee's Web site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee Web site...
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75 FR 19661 - NASA Advisory Council; Science Committee; Planetary Protection Subcommittee; Meeting
2010-04-15
... includes the following topics: --Review European Space Agency-NASA Coordination on Planetary Protection... Committee; Planetary Protection Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration... (NASA) announces a meeting of the Planetary Protection Subcommittee of the NASA Advisory Council (NAC...
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75 FR 8997 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2010-02-26
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-021)] NASA Advisory Council; Science...: Notice of meeting. SUMMARY: The National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to...
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78 FR 21421 - NASA Advisory Council; Science Committee; Planetary Protection Subcommittee; Meeting
2013-04-10
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: 13-048] NASA Advisory Council; Science...-463, as amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Planetary Protection Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the...
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76 FR 19095 - Meeting of the Mobile Sources Technical Review Subcommittee
2011-04-06
..., preferably at least 10 days prior to the meeting, to give EPA as much time as possible to process your... Subcommittee's Web site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee Web site. To subscribe to the MSTRS...
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76 FR 58303 - NASA Advisory Council; Science Committee; Planetary Science Subcommittee; Meeting.
2011-09-20
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (11-081)] NASA Advisory Council; Science...-463, as amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Planetary Science Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the Science...
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76 FR 31641 - NASA Advisory Council; Science Committee; Planetary Science Subcommittee; Meeting
2011-06-01
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 11-050] NASA Advisory Council; Science...-463, as amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Planetary Science Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the Science...
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78 FR 77719 - NASA Advisory Council; Science Committee; Planetary Science Subcommittee; Meeting
2013-12-24
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 13-156] NASA Advisory Council; Science...-463, as amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Planetary Science Subcommittee of the NASA Advisory Council (NAC). This Subcommittee reports to the Science...
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Consulting Basics for the Teacher-Turned-Technology Consultant.
Stager, Sue; Green, Kathy
1988-01-01
Discusses the role of educational technology consultants who may be classroom teachers with no formal training in consulting. Consulting models are described, including content-oriented and process-oriented approaches; Schein's process facilitator model is examined; and Kurpius' consulting model is explained and expanded. (LRW)
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2010-09-17
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Aviation Safety Subcommittee; Notice of... Future of Aviation Advisory Committee (FAAC): Aviation Safety Subcommittee; Notice of Meeting. SUMMARY... of the FAAC Aviation Safety Subcommittee, which will be held September 28, 2010, via teleconference...
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2010-09-29
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Aviation Safety Subcommittee; Notice of... Future of Aviation Advisory Committee (FAAC): Aviation Safety Subcommittee; Notice of Meeting. SUMMARY... of the FAAC Aviation Safety Subcommittee, which will be held October 19, 2010, in Everett, Washington...
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2010-06-17
... Committee (FAAC) Aviation Safety Subcommittee; Notice of Meeting AGENCY: Office of the Secretary of... Secretary of Transportation, announces a meeting of the FAAC Aviation Safety Subcommittee, which will be... of the global economy. The Aviation Safety Subcommittee will develop a list of priority safety issues...
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2012-02-23
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Reliability and PRA; Notice of Meeting The ACRS Subcommittee on Reliability and PRA will hold a... Modeling Application Guide.'' The Subcommittee will hear presentations by and hold discussions with the NRC...
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2012-10-09
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Nanoscale Science, Engineering and Technology Subcommittee...: The National Nanotechnology Coordination Office (NNCO), on behalf of the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the Committee on Technology, National Science and...
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Biggert named chairman of energy subcommittee
2003-01-01
U.S. Representative Judy Biggert has been named Chairman of the Energy Subcommittee of the House Science Committee, a key panel with jurisdiction over the federal government's civilian energy and science research activities, including the work done at Argonne and Fermilab (1 page).
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2010-02-22
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a....S. EPR Design Certification Document Review. The Subcommittee will gather information, analyze...
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2010-11-03
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Subcommittee on Aviation Safety; Notice of..., announces a meeting of the FAAC Subcommittee on Aviation Safety, which will be held at the offices [[Page... needs, challenges, and opportunities of the global economy. The Subcommittee on Aviation Safety will...
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75 FR 4882 - Meeting of the ACRS Subcommittee on EPR; Notice of Meeting
2010-01-29
... NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a... with Open Items concerning the U.S. EPR Design Certification (DCD) Application and the Calvert Cliffs...
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2012-01-30
... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... Turkey Point, Units 3 and 4, extended power uprate application. The Subcommittee will hear presentations... possible, so that appropriate arrangements can be made. Thirty-five hard copies of each presentation or...
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2012-05-15
... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on...) associated with the Grand Gulf Nuclear Station Unit 1 extended power uprate application. The Subcommittee... made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...
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2011-06-03
... Subcommittee on Power Uprates Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... Expanded Operating Domains-Power Distribution Validation and Pin-by-Pin Gamma Scan). The Subcommittee will... hard copies of each presentation or handout should be provided to the DFO thirty minutes before the...
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78 FR 31924 - Appraisal Subcommittee; Policy Statements
2013-05-28
... financial institutions regulatory agency engages in, contracts for, or regulates; and b) requires the... officer, director, employee or agent of a federally regulated financial institution would not be permitted... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-13] Appraisal Subcommittee...
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DEFF Research Database (Denmark)
Olson, Thomas; Poulfelt, Flemming; Greiner, Larry
This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent to cur...... current management issues facing consulting firms. These cases, together with the handbook, will prepare consultants and other business managers for a successful future in a highly competitive consulting environment.......This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent...... to current management consulting. Each of the four parts of the text presents a cogent introduction by the editors, delineating topics that are critical for today's consultants to understand. The cases represent major practice areas of consulting and afford new insights into change processes and other...
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2010-06-15
...] Tobacco Product Constituents Subcommittee of the Tobacco Products Scientific Advisory Committee; Notice of... to the public. Name of Committee: Tobacco Product Constituents Subcommittee of the Tobacco Products...-8900. Contact Person: Karen Templeton-Somers, Office of Science, Center for Tobacco Products, Food and...
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2013-04-05
... topics: --Overview of Research in Space Life and Physical Sciences --Space Station and Future Exploration... Exploration and Operations Committee; Research Subcommittee; Meeting AGENCY: National Aeronautics and Space... of the Research Subcommittee of the Human Exploration and Operations Committee (HEOC) of the NASA...
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2010-09-09
... DEPARTMENT OF COMMERCE Bureau of Industry and Security President's Export Council, Subcommittee on Export Administration; Notice of Recruitment of Private-Sector Members; Date Extension Summary: The... Subcommittee will not be compensated for their services. The PECSEA is seeking private-sector members with...
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Evolution of IEC/TC 45 works and its sub-committees from 1960 to 1983
International Nuclear Information System (INIS)
Weill, J.
1983-10-01
The IEC, founded in 1906, is an independent international standards organization. Its standardization work deals with almost all branches of electrotechnology in the electrotechnical, electronical and data-processing field, covering all applications, as for example telecommunications and nuclear energy. The IEC Central Office is situated in Geneva (Switzerland). The Technical Committee No. 45 was set up in 1960 at the IEC general meeting in New Delhi, with the scope as given in the IEC Directory. Its revised scope is under consideration in the Committee of Action of the IEC and reads: ''To prepare international standards relating to electrical and electronic equipment and systems specific to nuclear applications''. The chart shows the organigram of the Technical Committee which comprises about 75 experts in the nuclear field from about 20 industrial countries. We can see here the standard diagram of a Technical Committee with its Sub-committees and Working Groups. The meetings are held in a member country at the request of its National Committee. One shows the places of the plenary meetings of TC 45 as well as the meetings of its Sub-committees and their Working Groups held till now. The Technical Committee 45 has in addition to its seven Working Groups also two Sub-committees having several further Working Groups of their own. The Sub-committee 45 A ''Reactor Instrumentation''. The Sub-committee 45 B ''Radiation protection instrumentation''. Till now TC 45 has published about 85 standards. Regarding work in preparation, one shows the present and future work within the Technical Committee and its Sub-committees. Impact of works and liaisons is briefly discussed [fr
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2011-09-30
... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on...) associated with the Nine Mile Point extended power uprate application. The [[Page 60939
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2011-10-05
...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... adult oncology indication, or in late stage development in pediatric patients with cancer. The...
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2010-06-16
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Subcommittee on Competitiveness and... Secretary of Transportation, announces a meeting of the FAAC Subcommittee on Competitiveness and Viability... advice and recommendations to the Secretary of Transportation to ensure the competitiveness of the U.S...
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2010-07-21
... of Aviation Advisory Committee (FAAC) Subcommittee on Competitiveness and Viability; Notice of... Transportation, announces the second meeting of the FAAC Subcommittee on Competitiveness and Viability, which... recommendations to the Secretary of Transportation to ensure the competitiveness of the U.S. aviation industry and...
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2010-11-01
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Subcommittee on Competitiveness and... Secretary of Transportation, announces a meeting of the FAAC Subcommittee on Competitiveness and Viability... provide advice and recommendations to the Secretary of Transportation to ensure the competitiveness of the...
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2011-09-21
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General...
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2013-10-23
...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... the public. Name of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory... measures in the pediatric development plans of oncology products. The half-day session will provide an...
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2010-08-11
...-2010-0074] The Future of Aviation Advisory Committee (FAAC) Subcommittee on Competitiveness and... Secretary of Transportation, announces the third meeting of the FAAC Subcommittee on Competitiveness and... recommendations to the Secretary of Transportation to ensure the competitiveness of the U.S. aviation industry and...
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Small Business & Consultancy: Exploration of an Experiment with Student Consultants
I. Hollaender
2007-01-01
In this paper Ill discuss the first outcomes of an explorative research concerning the consultancy projects of a consultancy-based learning programme (Minor Consultancy 2006 - 2007, half-year bachelor programme University of Applied Sciences, Hogeschool Utrecht, The Netherlands). In order to
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2013-02-05
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy and Reactor Fuels; Notice of Meeting The Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy and...
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75 FR 54064 - Consultation Agreements: Proposed Changes to Consultation Procedures
2010-09-03
... State consultants performing worksite visits. Following the successful completion of an on-site... all types of complaints in a similar fashion. As a result, OSHA does not need to distinguish between...) * * * (2) The Consultant shall terminate an onsite consultative visit already in progress where one of the...
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Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo
2007-01-01
The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.
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International Nuclear Information System (INIS)
Fawaz, S.; Khan, Zulfiquar A.; Mossa, Samir Y.
2006-01-01
A new definition is proposed for analyzing the consultation in the primary health care, integrating other models of consultation and provides a framework by which general practitioners can apply the principles of consultation using communication skills to reconcile the respective agenda and autonomy of both doctor and patient into a negotiated agreed plan, which includes both management of health problems and health promotion. Achieving success of consultations depends on time and mutual cooperation between patient and doctor showed by doctor-patient relationship. (author)
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On becoming a consultant: A study exploring the journey to consultant practice
International Nuclear Information System (INIS)
Henwood, S.; Booth, L.
2016-01-01
Background: This paper reports a qualitative study exploring the establishment of non-medical consultant roles in Radiography. Given the difficulties reported in recruiting and retaining staff in these posts, we hope this paper offers a historical documentation of those consultants who were some of the first in post, sharing their stories of how they obtained and transitioned into their roles. Methods: This paper is part of a two year case study exploring the leadership domain of consultant practice. The focus of this paper is a reflection, by the consultants, of their journey to becoming a consultant; a documentation of some of the practical issues in establishing the roles; and the transition to higher levels of practice. Eight consultant radiographers participated in the initial interviews (two consultants withdrew from the study subsequent to this). In-depth iterative interviewing was used to explore and record individual stories and experiences. Findings: The consultants shared their perceptions of being in post, including their own motivation to progress to a new role, how prepared they felt initially, the lack of role models, the lack of clarity surrounding the role and a perception of ‘being on display’. Conclusions: The paper offers insight into the journey of these consultants and some of the common characteristics they share. These characteristics give some indication of what motivated them to step into higher level roles, in particular the need to drive change and improvement. The paper also offers suggestions for how the transition into the role could be more effectively supported. - Highlights: • Identifies characteristics thought to contribute to effective consultant practice. • A desire to change practice is a major motivator in applying for a consultant post. • The consultant role was a natural evolution for some, not a desired career pathway. • There is recognition that the initial consultants were pioneers for the profession.
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2010-02-22
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... arrangements can be made. Thirty-five hard copies of each presentation or handout should be provided to the DFO...
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The Effect of the Strictness of Consultation Requirements on Fraud Consultation
Gold, A.H.; Knechel, W.R.; Wallage, P.
2012-01-01
We investigate how the strictness of a requirement to consult on potential client fraud affects auditors' propensity to consult with firm experts. We consider two specific forms of guidance about fraud consultations: (1) strict, i.e., mandatory and binding; and (2) lenient, i.e., advisory and
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2010-05-18
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR The ACRS Subcommittee on EPR will hold a meeting on May 21, 2010, Room T-2B1, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public attendance. The agenda for...
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2010-09-30
..., announces a meeting of the FAAC Subcommittee on Financing, which will be held in the New Press Room, Denver... needs, challenges, and opportunities of the global economy. The Subcommittee on Financing will address... will be held in the New Press Room, Denver International Airport, 8500 Pe[ntilde]a Boulevard, Main...
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Inpatient Consultative Dermatology.
Biesbroeck, Lauren K; Shinohara, Michi M
2015-11-01
Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.
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Cocchiaro, James E. (Editor); Mulder, Edwin J. (Editor); Gomez-Knight, Sylvia J. (Editor)
1999-01-01
This volume contains 37 unclassified/unlimited-distribution technical papers that were presented at the JANNAF 28th Propellant Development & Characterization Subcommittee (PDCS) and 17th Safety & Environmental Protection Subcommittee (S&EPS) Joint Meeting, held 26-30 April 1999 at the Town & Country Hotel and the Naval Submarine Base, San Diego, California. Volume II contains 29 unclassified/limited-distribution papers that were presented at the 28th PDCS and 17th S&EPS Joint Meeting. Volume III contains a classified paper that was presented at the 28th PDCS Meeting on 27 April 1999. Topics covered in PDCS sessions include: solid propellant rheology; solid propellant surveillance and aging; propellant process engineering; new solid propellant ingredients and formulation development; reduced toxicity liquid propellants; characterization of hypergolic propellants; and solid propellant chemical analysis methods. Topics covered in S&EPS sessions include: space launch range safety; liquid propellant hazards; vapor detection methods for toxic propellant vapors and other hazardous gases; toxicity of propellants, ingredients, and propellant combustion products; personal protective equipment for toxic liquid propellants; and demilitarization/treatment of energetic material wastes.
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2011-02-11
... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... will review the staff's evaluation of the Point Beach Units 1 and 2 Extended Power Uprate application... can be made. Thirty five hard copies of each presentation or handout should be provided to the...
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2011-05-09
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on EPR; Cancellation to May 11, 2011, ACRS Meeting-- Federal Register Notice The Federal Register Notice for the ACRS Subcommittee Meeting on the design certification application review of the U.S...
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2010-07-21
... needs, challenges, and opportunities of the global economy. The Subcommittee is charged with ensuring... economies. Among other matters, the subcommittee will examine certain issues affecting the future employment requirements of the aviation industry: (1) The need for science, technology, engineering and math (STEM) skills...
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2010-11-03
... evolving transportation needs, challenges, and opportunities of the global economy. The subcommittee is... advanced economies. Among other matters, the subcommittee will examine certain issues affecting the future... the FAAC on December 15, 2010: (1) The need for science, technology, engineering, and math skills in...
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Exploring the research domain of consultant practice: Experiences of consultant radiographers
International Nuclear Information System (INIS)
Harris, R.; Paterson, A.
2016-01-01
Aim: This paper reports on one part of a larger study. The aim of the overall study was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This second part of the study involved telephone interviews with twenty five consultant radiographers. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers. The principal barriers revealed were: lack of time; excessive clinical workload; lack of skills and confidence to undertake research; poor research culture; and lack of support. The main facilitators noted were: dedicated time, research training and up-skilling; mutually beneficial collaborations; managerial understanding of the research domain of the role; and research focussed on clinical demand. Conclusion: Fulfilling the clinical role is imperative and integral to the profession at consultant level; however, if it is undertaken to the detriment of the other domains then these practitioners may not be operating at ‘consultant’ level. Overall improvements must be made to ensure that the consultant radiographer role is delivering on current expectations and is safeguarded for the future of the next generation of radiographers. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work regularly. • Consultant radiographers allocate little protected time for research due to clinical demands.
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International Nuclear Information System (INIS)
Harris, R.; Paterson, A.
2016-01-01
Aim: This paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice. Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question. Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload. Conclusion: Research is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain. This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work routinely. • Consultant radiographers allocate little protected time for research due to clinical demands. • Almost half of the consultant radiographers feel research should not be a core part of their roles.
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Accompanied consultations in occupational health.
Hobson, J; Hobson, H; Sharp, R
2016-04-01
Accompanied consultations are often reported as difficult by occupational physicians but have not been studied in the occupational health setting. To collect information about accompanied consultations and the impact of the companion on the consultation. We collected data on all accompanied consultations by two occupational physicians working in a private sector occupational health service over the course of 16 months. Accompanied consultations were matched to non-accompanied consultations for comparison. We collected data on 108 accompanied consultations. Accompanied consultations were more likely to be connected with ill health retirement (P Occupational health practitioners may benefit from better understanding of accompanied consultations and guidance on their management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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78 FR 69077 - Army Education Advisory Subcommittee Meeting Notice
2013-11-18
... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... leading to provisional findings will be referred to the Army Education Advisory Committee for deliberation...: ATFL-APO, Monterey, CA 93944, [email protected]us.army.mil , (831) 242-5828. SUPPLEMENTARY INFORMATION...
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Consultant management estimating tool.
2012-04-01
The New York State Department of Transportation (NYSDOT) Consultant Management Bureaus primary responsibilities are to negotiate staffing hours/resources with : engineering design consultants, and to monitor the consultant's costs. Currently the C...
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Directory of Open Access Journals (Sweden)
Jörg Jasper DÖTSCH
2016-12-01
Full Text Available Digitalization, globalization, new technologies and shorter product life cycles are only a few keywords underlining the fact that companies are under increasing pressure for faster adaptation, innovation and hence applying a higher knowledge intensity. We assume that these conditions require an increasingly important role of consulting companies, because they seem to be the intermediaries needed to bridge the faster growing gaps between existing business models, organizational structures and accelerating market change. Market pressure is growing on the market for consultant companies as well. New technologies and digitalization should influence both the structure of the consultancy market and the business models of consultancies. Christensen suggested a trend from Dzsolution shop” to Dzboutique consulting.” To track current developments, we concentrate on the German consulting market as one of the most important consultant markets worldwide and explore changes of the last two years based on various studies. Processes of change seem to be both substantially driven by digitalization and to reflect change on the non-consultancy markets. A high willingness to switch among providers documents a high pressure on performance. The impact of digitalisation seem to be observable in structural and qualitative change. With regard to the German consulting market and the latest available data we cannot validate a tendency from a dominance of “solution shop” consultancies to “boutique” consultancy services.
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2013-11-26
... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... hold discussions with the licensee, (Northern States Power Company of Minnesota), the NRC staff, and... made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...
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2010-03-17
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a... Chapters 11 and 16 of the Safety Evaluation Report with Open Items associated with the U.S. EPR Design...
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Activities of the Shielding Subcommittee of the ENDF/B Cross Section Evaluation Working Group
International Nuclear Information System (INIS)
Roussin, R.W.
1977-01-01
The Shielding Subcommittee of the Cross Section Evaluation Working Group (CSEWG) was established in 1967 to help ensure that the content of the ENDF/B cross section library was adequate for treating shielding problems. Early work of the subcommittee concentrated on devising formats for gamma-ray interaction and production data, as well as providing programs for testing the clerical and physics consistency of the files. The Radiation Shielding Information Center (RSIC) collaborated directly with evaluators on behalf of the National Neutron Cross Section Center (NNCSC) to begin testing and adding data sets to be fed into the official ENDF/B libraries. These efforts, which were sponsored by AEC-DRDT (now ERDA-DRDD), were augmented greatly through the Defense Nuclear Agency program of establishing a working cross section library in ENDF format. The effort concentrated on evaluation and testing of materials of interest to DNA programs and providing these for inclusion in the ENDF/B library. Shielding data testing efforts, as a part of the CSEWG Data Testing Program, are now also an integral part of the Shielding Subcommittee effort. Procedures for writing and approving the shielding benchmarks were devised by Shielding Subcommittee members. Data testing benchmark experiments have been documented and analyzed, and the most recent results for ENDF/B-IV are as reported as part of ENDF-230, ''Benchmark Testing of ENDF/B-IV.''
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Child consultation patterns in general practice comparing "high" and "low" consulting families.
Campion, P D; Gabriel, J
1984-01-01
All children's consultations with their general practitioner over a 12 month period in a small urban practice were analysed. Overall consultation rates ranged from 2.2 per child a year for 8 to 11 year olds, to 6.8 for those under 2. Families were grouped according to their average rate of new consultation for children, standardised for age. Families with higher consulting rates scored higher on an index of economic disadvantage, with mothers who scored higher on a test of "tendency to consul...
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2012-12-17
... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP-1000; Notice of Meeting The ACRS Subcommittee on AP-1000 will hold a meeting on January 18, 2013, Room T-2B1, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public...
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2011-07-25
..., 2011-1 p.m. until 5 p.m. The Subcommittee will review technical updates in Revision 19 to the AP1000 Design Control Document (DCD). The Subcommittee will hear presentations by and hold discussions with the... statements can be obtained from the website cited above or by contacting the identified DFO. Moreover, in...
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Energy Technology Data Exchange (ETDEWEB)
Lucas, Robert [University of Southern California, Information Sciences Institute; Ang, James [Sandia National Laboratories; Bergman, Keren [Columbia University; Borkar, Shekhar [Intel; Carlson, William [Institute for Defense Analyses; Carrington, Laura [University of California, San Diego; Chiu, George [IBM; Colwell, Robert [DARPA; Dally, William [NVIDIA; Dongarra, Jack [University of Tennessee; Geist, Al [Oak Ridge National Laboratory; Haring, Rud [IBM; Hittinger, Jeffrey [Lawrence Livermore National Laboratory; Hoisie, Adolfy [Pacific Northwest National Laboratory; Klein, Dean Micron; Kogge, Peter [University of Notre Dame; Lethin, Richard [Reservoir Labs; Sarkar, Vivek [Rice University; Schreiber, Robert [Hewlett Packard; Shalf, John [Lawrence Berkeley National Laboratory; Sterling, Thomas [Indiana University; Stevens, Rick [Argonne National Laboratory; Bashor, Jon [Lawrence Berkeley National Laboratory; Brightwell, Ron [Sandia National Laboratories; Coteus, Paul [IBM; Debenedictus, Erik [Sandia National Laboratories; Hiller, Jon [Science and Technology Associates; Kim, K. H. [IBM; Langston, Harper [Reservoir Labs; Murphy, Richard Micron; Webster, Clayton [Oak Ridge National Laboratory; Wild, Stefan [Argonne National Laboratory; Grider, Gary [Los Alamos National Laboratory; Ross, Rob [Argonne National Laboratory; Leyffer, Sven [Argonne National Laboratory; Laros III, James [Sandia National Laboratories
2014-02-10
Exascale computing systems are essential for the scientific fields that will transform the 21st century global economy, including energy, biotechnology, nanotechnology, and materials science. Progress in these fields is predicated on the ability to perform advanced scientific and engineering simulations, and analyze the deluge of data. On July 29, 2013, ASCAC was charged by Patricia Dehmer, the Acting Director of the Office of Science, to assemble a subcommittee to provide advice on exascale computing. This subcommittee was directed to return a list of no more than ten technical approaches (hardware and software) that will enable the development of a system that achieves the Department's goals for exascale computing. Numerous reports over the past few years have documented the technical challenges and the non¬-viability of simply scaling existing computer designs to reach exascale. The technical challenges revolve around energy consumption, memory performance, resilience, extreme concurrency, and big data. Drawing from these reports and more recent experience, this ASCAC subcommittee has identified the top ten computing technology advancements that are critical to making a capable, economically viable, exascale system.
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Skills for Effective Consultation.
Dustin, Dick; Ehly, Stewart
1984-01-01
Discusses counselor skills that promote effective consultation. Reviews research on effective school consultation and presents a five-stage model which involves phasing in, problem identification, implementation, evaluation, and termination. Provides recommendations for the process and products of consultation. (JAC)
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International Nuclear Information System (INIS)
Edwards, D.W.; Allen, S.R.
1988-01-01
The NUPLEX Licensing Subcommittee was organized to seek a formal license renewal mechanism that institutionalizes the current licensing basis and consequent level of safety of a plant as the legitimate standard for acceptance and approval of an application for extended operation. Along with defining the most workable approach to and scope of review for license renewal, this paper explains the reasons why a regulatory framework is needed by the early 1990s. The initial results of development work on two key issues, licensing criteria and hearing process, are also presented. at this point six potential license renewal criteria have emerged: evaluation of existing monitoring/maintenance programs, revalidation of current licensing basis, conformance to special regulations, evaluation to a safety goal, plant performance history, and environmental assessment. The work on a hearing process has led to the development of two models for future consideration: hybrid legislative and hybrid adjudicatory
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Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu
2010-01-01
The Wipro Consulting Services (WCS) case charts the evolution of the consulting initiative within Wipro Technologies; the strategic choices the management made during this evolution and the challenges facing the firm once it consolidated the various consulting initiatives to set up Wipro Consulting Services in 2008. The case deals with several questions facing the leadership team, such as the competencies to develop to move up the value chain in delivering consulting services and the extent t...
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Kreutzer, Markus; Menz, Markus
2012-01-01
This study report provides European management consulting firms' assessment of trends and currently prevailing business models in the industry. It depicts the different threats and opportunities that consulting firms with different business models, consulting foci, sizes, leverage ratios, international orientations, and geographical footprints face; it also reveals these firms' adaptation strategies. Based on an analysis of a survey of 311 consulting firms from 26 European countries, the repo...
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2011-07-27
... Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR) will hold a meeting on August 18, 2011, Room T-2B3, 11545 Rockville Pike... the meeting, if possible, so that appropriate arrangements can be made. Thirty-five hard copies of...
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Bioethics Consultations and Resources
Thomas, Jennie
2011-01-01
Making difficult healthcare decisions is often helped by consultation with a bioethics committee. This article reviews the main bioethics principles, when it is appropriate and how to call a bioethics consult, ethical concerns, and members of the consult team. Bioethics resources are included.
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Final report of advisory subcommittee on development of JENDL. Guideline for developing next JENDL
International Nuclear Information System (INIS)
Chiba, Go; Iwamoto, Osamu
2015-01-01
Advisory Subcommittee on Development of JENDL was established under JENDL Committee on fiscal year 2013 to discuss the subject concerning on development of next JENDL. Members of the subcommittee were selected from developers and users of JENDL and researchers on nuclear data measurements. They discussed guidelines on next JENDL with exchanging ideas on problems of JENDL and its solution from each view point. This report describes the results of the discussions on the problems and guideline with the present status on the JENDL development. (author)
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[Psychiatric consultations for nursing-home residents: aspects and course of such consultations].
Steenbeek, M; van Baarsen, C; Koekkoek, B
2012-01-01
Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. The psychiatric consultations requested were tabulated and were analysed. Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.
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2012-12-17
..., Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR) will hold a meeting on January 17, 2013, Room T-2B1, 11545 Rockville Pike... be made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...
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78 FR 48342 - Consultation Agreements: Proposed Changes to Consultation Procedures
2013-08-08
... clarify the high priority enforcement cases when OSHA may initiate a non-programmed inspection at those.... OSHA-2010-0010] RIN 1218-AC32 Consultation Agreements: Proposed Changes to Consultation Procedures AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Withdrawal of proposed rule...
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2010-01-01
.... Recommendations for improving the plans and making the tribal consultation process more effective, if any, should... 3 The President 1 2010-01-01 2010-01-01 false Tribal Consultation Presidential Documents Other Presidential Documents Memorandum of November 5, 2009 Tribal Consultation Memorandum for the Heads of Executive...
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Longer-term impact of cardiology e-consults.
Wasfy, Jason H; Rao, Sandhya K; Kalwani, Neil; Chittle, Melissa D; Richardson, Calvin A; Gallen, Kathleen M; Isselbacher, Eric M; Kimball, Alexandra B; Ferris, Timothy G
2016-03-01
Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown. We established a cardiac e-consult program on January 13, 2014. We then conducted detailed medical record reviews of all patients with e-consults to detect any adverse clinical events and detect subsequent traditional visits to cardiologists. We also performed 2 comparisons. First, we compared age, gender, and referral reason for e-consults vs traditional consults. Second, we compared changes in volume of referrals to cardiology vs other medical specialties that did not have e-consults. From January 13 to December 31, 2014, 1,642 traditional referrals and 165 e-consults were requested. The proportion of e-consults of all evaluations requested over that period was 9.1%. Gender balance was similar among traditional consults and e-consults (44.8% male for e-consults vs 45.0% for traditional consults, P = .981). E-consult patients were younger than traditional consult patients (55.3 vs 60.4 years, P cardiology visit during the follow-up period. E-consults are an effective and safe mechanism to enhance value in outpatient cardiology care, with low rates of bounceback to traditional consults. E-consults can account for nearly one-tenth of total outpatient consultation volume at 1 year within an accountable care organization and are associated with a reduction in traditional referrals to cardiologists. Copyright © 2015 Elsevier Inc. All rights reserved.
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78 FR 2293 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2013-01-10
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics... meeting includes the following topics: --Astrophysics Division Update --NASA Astrophysics Roadmapping It...
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78 FR 66384 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2013-11-05
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics...: --Astrophysics Division Update --Presentation of Astrophysics Roadmap --Reports from Program Analysis Groups...
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75 FR 61778 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2010-10-06
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (10-118)] NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics...
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75 FR 51116 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2010-08-18
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics... topics: --Astrophysics Division Update --2010 Astronomy and Astrophysics Decadal Survey --Update on...
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Management Consultancy As Practice: A Study Of The Duality Of The Management Consultants' Role
Hartley, Jeanette
2017-01-01
The central question addressed in this research is: “How do practicing management consultants cope with the duality of their role?” Management consultants are often responsible for internal business leadership roles as well as developing business, people and knowledge alongside client delivery (Richter et al., 2008). The research sought to understand the nature of the potentially conflicting demands of their client-facing and consultancy-facing roles on management consultants, how conflicts a...
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Reflections on the role of consultant radiographers in the UK: What is a consultant radiographer?
International Nuclear Information System (INIS)
Booth, L.; Henwood, S.; Miller, P.
2016-01-01
Context: This paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK. Methods: A longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis. Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period. Findings: The data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures. The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery. Conclusions: The paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further. - Highlights: • This paper shows the variation in roles between consultant radiographers. • The commonality with medical roles is highlighted. • Problem solving is identified as a core skill in consultant radiography. • Consultants offered evidence of the roles developing service provision. • While all four domains of practice are covered, research is the least well supported.
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DEFF Research Database (Denmark)
Muhr, Sara Louise; Kirkegaard, Line
2013-01-01
Consultants are known to work extreme hours. We show empirically how consultants fantasize about off-work activities, which are impossible to realize with their work schedule. These fantasies are, however, not obstructing their work, but important to justify the extreme hours and sustain desire f...
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International Nuclear Information System (INIS)
Clark, R.E.H.; Peacock, N.J.
2007-02-01
The 15th Meeting of the Subcommittee on Atomic and Molecular Data for Fusion of the International Fusion Research Council was held on 20-21 April 2006, at the IAEA Headquarters in Vienna, Austria. Work of the Atomic and Molecular Data Unit for the period 2004-2006 was reviewed, and recommendations were made for the 2008-2009 budget cycle. The proceedings, conclusions and recommendations of the Subcommittee meeting are briefly described in this report. Specific recommendations of the Subcommittee from this meeting, as well as the report on the activities of the IAEA Atomic and Molecular Data Unit for the period June 2004 - March 2006, are also included. (author)
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76 FR 5405 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2011-01-31
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics... contacting Marian Norris. The agenda for the meeting includes the following topics: --Astrophysics Division...
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77 FR 4370 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2012-01-27
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics... topics: --Astrophysics Division Update --Update on Balloons Return to Flight Changes --James Webb Space...
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77 FR 38090 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2012-06-26
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics...: --Astrophysics Division Update --James Webb Space Telescope Update --Wide-Field Infrared Survey Telescope Report...
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77 FR 67027 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2012-11-08
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 12- 091] NASA Advisory Council; Science... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science Subcommittee of the [[Page 67028
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Directory of Open Access Journals (Sweden)
Eduard-Gabriel Ceptureanu
2017-02-01
Full Text Available The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the most important aspects of the consulting activity on which depend the achievement of the project aims, there is scope for further investigating this subject. Here, the case of a project management consulting organization involved in large infrastructure projects in Romania, Bulgaria, Moldova, Ukraine and Serbia is analyzed. Data collected through a questionnaire-based survey among international consultants and support personnel suggest that factors related to leadership style and communication skills are more closely tied to the success of the project than more technical aspects. The results constitute an empirical evidence of main success factors for specialized consulting services in project management and can be useful in improving business and project performance and achieving business excellence.
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78 FR 20356 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2013-04-04
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics... password [email protected] The agenda for the meeting includes the following topics: --Astrophysics Division...
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Shared consultant physician posts.
LENUS (Irish Health Repository)
Cooke, J
2012-01-31
Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.
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Advanced training of tax consultants
Directory of Open Access Journals (Sweden)
Adigamova Farida F.
2016-01-01
Full Text Available The purpose of the research is to review and analyze the data on the necessity to provide an educational environment for training and advanced training of tax consultants in Russia. The article considers the types of tax consulting, the historical background of training financiers in Russia, as well as identifies conditions determining the significance of tax consulting. The research establishes the connection between the negative attitude to tax payment and tax evasion. The advanced training of tax consultants should be a continuous process as they need to take into account both external and internal taxpayers risks associated with the development of law and law-enforcement practice. Obviously, the training of tax consultants should take into account the experience of developed foreign countries, such as Germany, Austria, Czech Republic, Slovakia and other European countries as well. In Russia, it is necessary to open educational institutions, which will not only be involved in the certification of tax consultants, but also provide training courses. These courses should contribute to constant increase of tax consultants knowledge, consider the tax treatment of economic activities, as well changes in the legislation, economics, finance, accounting, manufacturing processes, which will improve the quality of services provided by tax consultants.
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Starting a nursing consultation practice.
Schulmeister, L
1999-03-01
Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.
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Nastasi, Bonnie K.; Varjas, Kristen; Bernstein, Rachel; Iavasena, Asoka
2000-01-01
Describes a participatory approach to consultation that builds upon contemporary models of research and practice and is designed to address the culture-specific needs of individuals and systems. The Participatory Culture-Specific Consultation (PCSC) model embodies a participatory interpersonal process and relies on ethnographic and action research…
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Efficiency principles of consulting entrepreneurship
Moroz Yustina S.; Drozdov Igor N.
2015-01-01
The article reviews the primary goals and problems of consulting entrepreneurship. The principles defining efficiency of entrepreneurship in the field of consulting are generalized. The special attention is given to the importance of ethical principles of conducting consulting entrepreneurship activity.
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76 FR 14106 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting
2011-03-15
... Committee; Astrophysics Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Astrophysics...: --Astrophysics Division Update. It is imperative that the meeting be held on these dates to accommodate the...
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Bhangoo, Kulwant S
2014-05-01
Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon's practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.
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2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What happens if there is no objection by an appropriate committee or subcommittee of Congress concerning the proposed... happens if there is no objection by an appropriate committee or subcommittee of Congress concerning the...
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International Nuclear Information System (INIS)
Clark, R.E.H.; Peacock, N.J.
2002-11-01
This report briefly describes the proceedings, conclusions and recommendations of the 13th Meeting of the Subcommittee on Atomic and Molecular Data for Fusion of the International Fusion Research Council held on 24-25 June, 2002 at the IAEA Headquarters in Vienna Austria. The report includes an Executive Summary of the Subcommittee from this Meeting. (author)
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Tribal Consultation Tracking System
U.S. Environmental Protection Agency — The consultation-related information the AIEO Consultation Team working with our Tribal Portal contractors has developed a Lotus Notes Database that is capable of...
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Hoek, Patrick; Grandjean, Ilse; Verhagen, Constans A H H V M; Jansen-Landheer, Marlies L E A; Schers, Henk J; Galesloot, Cilia; Vissers, Kris C P; Engels, Yvonne; Hasselaar, Jeroen G J
2015-01-01
Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation. We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations). We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations. Of the 44,443 initial consultations, most were requested by general practitioners (73%) and most concerned patients with cancer (86%). Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12) or COPD (OR 1.39; 95% CI: 1.15-1.69) than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40), agitation/delirium (OR 1.57; 95% CI: 1.47-1.68), exhaustion (OR 2.89; 95% CI: 2.61-3.20), euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96) or existential issues (OR 1.55; 95% CI: 1.31-1.83). In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.
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Directory of Open Access Journals (Sweden)
Patrick Hoek
Full Text Available Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation.We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations. We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations.Of the 44,443 initial consultations, most were requested by general practitioners (73% and most concerned patients with cancer (86%. Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12 or COPD (OR 1.39; 95% CI: 1.15-1.69 than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40, agitation/delirium (OR 1.57; 95% CI: 1.47-1.68, exhaustion (OR 2.89; 95% CI: 2.61-3.20, euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96 or existential issues (OR 1.55; 95% CI: 1.31-1.83.In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.
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78 FR 39341 - NASA Advisory Council; Science Committee; Planetary Science Subcommittee; Meeting.
2013-07-01
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: 13-070] NASA Advisory Council; Science..., the National Aeronautics and Space Administration (NASA) announces a meeting of the Planetary Science Subcommittee of the NASA Advisory Council (NAC). This [[Page 39342
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78 FR 942 - National Committee on Vital and Health Statistics: Meeting Standards Subcommittee
2013-01-07
.... The Sub-Committee is interested in evaluating the innovations underway in industry as the convergence... will be posted when available. Should you require reasonable accommodation, please contact the CDC...
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76 FR 67158 - Secretary of Energy Advisory Board Natural Gas Subcommittee
2011-10-31
... DEPARTMENT OF ENERGY Secretary of Energy Advisory Board Natural Gas Subcommittee AGENCY: Department of Energy. ACTION: Notice of Cancellation of Open Meeting. SUMMARY: This notice announces the cancellation of the November 1, 2011, meeting of the Secretary of Energy Advisory Board (SEAB) Natural Gas...
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Directory of Open Access Journals (Sweden)
Kulwant S Bhangoo
2014-01-01
Full Text Available Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon′s practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.
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Ethics in Management Consulting
Carlo Vallini
2007-01-01
Ethics is a relevant value in business and management consulting. The presence of recognized ethics tends to reduce the need for informative or legal-contractual precautions in the formalization of relationships, for both of the parts involved in a negotiation. Management Consulting on ethics will develop more and more. Law will consider more and more ethics in business and management consulting. The ethics of corporations influences their workers and behaviour with the customers. It is an e...
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Why do people consult the doctor?
Campbell, S M; Roland, M O
1996-02-01
Symptoms are an everyday part of most peoples' lives and many people with illness do not consult their doctor. The decision to consult is not based simply on the presence or absence of medical problems. Rather it is based on a complex mix of social and psychological factors. This literature review seeks to explore some of the pathways to care and those factors associated with low and high rates of consultation. The paper examines the impact of socioeconomic and demographic factors on consultation rates and, using a revised version of the Health Belief Model, it highlights the psychological factors which influence decisions to seek medical care. Barriers which can inhibit consultation are discussed, as the decision to seek care will only result in a consultation if there is adequate access to care. Whilst poor health status and social disadvantage increase both "objective" medical need and in turn, consultation rates, a range of other social and psychological factors have been shown to influence consulting behaviour.
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77 FR 60507 - Motor Carrier Safety Advisory Committee (MCSAC): Public Subcommittee Meeting
2012-10-03
... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration [Docket No. FMCSA-2006-26367] Motor Carrier Safety Advisory Committee (MCSAC): Public Subcommittee Meeting AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of Meeting of Compliance, Safety...
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MO-DE-304-02: Diagnostic Workforce Subcommittee Status and Direction
International Nuclear Information System (INIS)
Gress, D.
2015-01-01
The Abt study of medical physicist work values for radiation oncology physics services, Round IV is completed. It supersedes the Abt III study of 2008. The 2015 Abt study measured qualified medical physicist (QMP) work associated with routine radiation oncology procedures as well as some special procedures. As before, a work model was created to allow the medical physicist to defend QMP work based on both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The Abt study Round IV was designed to empower the medical physicist to negotiate a service or employment contract with providers based on measured national QMP workforce and staffing data. For a variety of reasons, the diagnostic imaging contingent of AAPM has had a more difficult time trying estimate workforce requirements than their therapy counterparts. Over the past several years, the Diagnostic Work and Workforce Study Subcommittee (DWWSS) has collected survey data from AAPM members, but the data have been very difficult to interpret. The DWWSS has reached out to include more AAPM volunteers to create a more full and accurate representation of actual clinical practice models on the subcommittee. Though much work remains, through hours of discussion and brainstorming, the DWWSS has somewhat of a clear path forward. This talk will provide attendees with an update on the efforts of the subcommittee. Learning Objectives: Understand the new information documented in the Abt studies. Understand how to use the Abt studies to justify medical physicist staffing. Learn relevant historical information on imaging physicist workforce. Understand the process of the DWWSS in 2014. Understand the intended path forward for the DWWSS
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MO-DE-304-02: Diagnostic Workforce Subcommittee Status and Direction
Energy Technology Data Exchange (ETDEWEB)
Gress, D. [MD Anderson Cancer Center (United States)
2015-06-15
The Abt study of medical physicist work values for radiation oncology physics services, Round IV is completed. It supersedes the Abt III study of 2008. The 2015 Abt study measured qualified medical physicist (QMP) work associated with routine radiation oncology procedures as well as some special procedures. As before, a work model was created to allow the medical physicist to defend QMP work based on both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The Abt study Round IV was designed to empower the medical physicist to negotiate a service or employment contract with providers based on measured national QMP workforce and staffing data. For a variety of reasons, the diagnostic imaging contingent of AAPM has had a more difficult time trying estimate workforce requirements than their therapy counterparts. Over the past several years, the Diagnostic Work and Workforce Study Subcommittee (DWWSS) has collected survey data from AAPM members, but the data have been very difficult to interpret. The DWWSS has reached out to include more AAPM volunteers to create a more full and accurate representation of actual clinical practice models on the subcommittee. Though much work remains, through hours of discussion and brainstorming, the DWWSS has somewhat of a clear path forward. This talk will provide attendees with an update on the efforts of the subcommittee. Learning Objectives: Understand the new information documented in the Abt studies. Understand how to use the Abt studies to justify medical physicist staffing. Learn relevant historical information on imaging physicist workforce. Understand the process of the DWWSS in 2014. Understand the intended path forward for the DWWSS.
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O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Clement, Jennifer; Ong, Edward
2018-01-01
The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The…
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Hicks, Dave; McCarthy, Bryan; Fanikos, John; Emamifar, Amir; Nedved, Andrea; Thompson, Bruce; Bender, Fred; McMahon, Patrick
2013-10-01
Our team surveyed a group of pharmacy directors to learn about their experiences with pharmacy consultants so that the directors might be able to use their consulting resources in a more effective manner. In May 2012, the University HealthSystem Consortium (UHC) Pharmacy Council Financial Performance Committee developed an electronic survey that collectively measured the characteristics, goals, and methodology of historical pharmacy consultant engagements and level of satisfaction. After e-mailing the initial electronic survey, we conducted follow-up telephone interviews with respondents from July through November 2012. These interviews were designed to include questions about expected outcomes, recommendations for evaluation processes, timelines for implementing the recommendations, consultants' expenses, and insights gained. A total of 23 pharmacy directors responded to the initial electronic survey; their organizations had engaged at least one consultant within the previous 5 years. Data were collected for 28 consultant engagements. Subsequent telephone interviews were conducted with 20 of the 23 pharmacy directors (87%) who completed the initial electronic survey, accounting for 25 of the 28 consultant engagements (89%). Cost reduction along with revenue enhancement was most often the focus of these engagements. These engagements were also mainly within the scope of an organization-wide effort initiated by the executive board or executive team. Consultant experiences varied greatly in terms of (1) the degree to which assistance was provided to the organization, (2) benchmarking methodologies and resources, and (3) timelines for implementing the consultants' recommendations. In general, most respondents rated their consultant experience as positive and were able to provide "pearls of wisdom" or lessons learned.
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American Psychologist, 2007
2007-01-01
The purpose of these "Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology" is to provide a common framework for use in the development, evaluation, and review of education and training in consulting psychology/organizational consulting psychology (CP/OCP). The…
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77 FR 58412 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2012-09-20
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 12-075] NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science...
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76 FR 49508 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2011-08-10
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 11-073] NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science...
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Ceptureanu, Eduard-Gabriel; Ceptureanu, Sebastian-Ion; Luchian, Cristian-Eugen; Luchian, Iuliana
2017-01-01
The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the ...
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75 FR 41899 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2010-07-19
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... . SUPPLEMENTARY INFORMATION: The agenda for the meeting includes the following topic: Earth Science Program's...
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77 FR 12086 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2012-02-28
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... following topics: --Earth Science Division Update --Committee on Earth Observations Satellites and Other...
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75 FR 65673 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2010-10-26
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... following topics: --Earth Science Division Update. --Deformation, Ecosystem Structure and Dynamics of Ice...
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76 FR 69292 - NASA Advisory Council Science Committee Planetary Science Subcommittee; Meeting
2011-11-08
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 11-113] NASA Advisory Council Science..., Public Law 92-463, as amended, the National Aeronautics and Space Administration (NASA) announces that the meeting of the Planetary Science Subcommittee of the NASA Advisory Council originally scheduled...
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Lowenstein, Margaret; Bamgbose, Olusinmi; Gleason, Nathaniel; Feldman, Mitchell D
2017-08-04
Mental health problems are commonly encountered in primary care, with primary care providers (PCPs) experiencing challenges referring patients to specialty mental health care. Electronic consultation (eConsult) is one model that has been shown to improve timely access to subspecialty care in a number of medical subspecialties. eConsults generally involve a PCP-initiated referral for specialty consultation for a clinical question that is outside their expertise but may not require an in-person evaluation. Our aim was to describe the implementation of eConsults for psychiatry in a large academic health system. We performed a content analysis of the first 50 eConsults to psychiatry after program implementation. For each question and response, we coded consults as pertaining to diagnosis and/or management as well as categories of medication choice, drug side effects or interactions, and queries about referrals and navigating the health care system. We also performed a chart review to evaluate the timeliness of psychiatrist responses and PCP implementation of recommendations. Depression was the most common consult template selected by PCPs (20/50, 40%), followed by the generic template (12/50, 24%) and anxiety (8/50, 16%). Most questions (49/50, 98%) pertained primarily to management, particularly for medications. Psychiatrists commented on both diagnosis (28/50, 56%) and management (50/50, 100%), responded in an average of 1.4 days, and recommended in-person consultation for 26% (13/50) of patients. PCPs implemented psychiatrist recommendations 76% (38/50) of the time. For the majority of patients, psychiatrists provided strategies for ongoing management in primary care without an in-person evaluation, and PCPs implemented most psychiatrist recommendations. eConsults show promise as one means of supporting PCPs to deliver mental health care to patients with common psychiatric disorders. ©Margaret Lowenstein, Olusinmi Bamgbose, Nathaniel Gleason, Mitchell D Feldman
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International Nuclear Information System (INIS)
Braams, B.J.
2012-06-01
The 17th meeting of the Subcommittee on Atomic and Molecular Data of the International Fusion Research Council (IFRC) was held on 27-28 April 2010 at IAEA Headquarters in Vienna, Austria. Activities of the Atomic and Molecular Data Unit for the period 2006-2008 were reviewed, and recommendations were made for the 2010-2011 budget cycle. The proceedings, conclusions and recommendations of the Subcommittee meeting are briefly described in this report. Specific recommendations of the Subcommittee from this meeting, as well as the report on the activities of the IAEA Atomic and Molecular Data Unit for the period May 2006 - March 2008, are also included. (author)
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Energy Technology Data Exchange (ETDEWEB)
NONE
1988-03-01
The separation and refining technology sub-committee has held two meetings in this fiscal year. The first sub-committee meeting (October 9, 1987) was held for the major agenda of the research and development of the basic studies; as the summary of the achievements in fiscal 1986, the up-grading by fractions and of the total fraction collectively, up-grading of kerosene and light oil fractions, up-grading of medium to heavy fractions; and as the study plans for fiscal 1987, the up-grading of coal liquefied oil, a technology to separate hetero compounds, development of their applications, and the reports and deliberations thereon. The major agenda of the second sub-committee meeting (February 10, 1988) were the interim report on the achievements in research of up-grading the coal liquefied oil in fiscal 1987, the interim reports on research achievements in the technology to separate hetero compounds and development of its applications, and the reports and deliberations thereon. The conventional up-grading sub-committee was dissolved in fiscal 1987 to form a new organization, whereas the 'separation and refining sub-committee' was founded newly. With respect to the up-grading matters, reports were given on the achievements thereon as a result of using a micro reaction device and a bench reaction device as in the past, and on the achievements in the application development. In addition, on the hetero related matters, directionality of the survey and the result therefrom were reported. (NEDO)
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78 FR 52216 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2013-08-22
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... . SUPPLEMENTARY INFORMATION: The primary topic on the agenda for the meeting is:- Earth Science program annual...
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78 FR 18373 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2013-03-26
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... . SUPPLEMENTARY INFORMATION: The agenda for the meeting includes the following topics: --Review of Earth Science...
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76 FR 21073 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2011-04-14
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... the room. The agenda for the meeting includes the following topics: --Earth Science Division Update...
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Consultant breast radiographers: Where are we now?
International Nuclear Information System (INIS)
Rees, Zebby
2014-01-01
Introduction: The aim of this study is to: • Evaluate the current role of the consultant breast radiographer. • Compare current practice with the four key components for consultant practice. • Gauge the support of radiologist colleagues. • Determine the other professional commitments involved with the role. This study could be the precursor for a macro study of all consultant radiographer practice in other specialities. Methodology: Methodology used was a comparative ethnographic study. Questionnaires to the 24 consultant breast radiographers currently in post, and consultant breast radiologists, who work with them, were conducted. Data collection was a qualitative thematic approach. Conclusion: Consultant breast radiographers provide high quality care to patients through excellent clinical practice, leadership and good communication. However, this study shows hospital Trusts emphasis for non medical consultants is for clinical practice first. Some radiologists are still a barrier to progression for consultant breast radiographers, and radiologists have a big influence in recruitment decisions. Consultant breast radiographer posts are well established, their numbers are increasing through recognition of the role and of their abilities and performance. Consultant breast radiographers state that becoming a consultant is the major achievement of their career, proving the Society of Radiographers' vision of the four-tier career structure has been well received by the radiography profession
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77 FR 60430 - Meeting of the Mobile Sources Technical Review Subcommittee
2012-10-03
... Ms. Krueger or Ms. Jackson, preferably at least 10 days prior to the meeting, to give EPA as much... Web site: http://www.epa.gov/air/caaac/mobile_sources.html . MSTRS listserver subscribers will receive notification when the agenda is available on the Subcommittee Web site. To subscribe to the MSTRS listserver...
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77 FR 27253 - NASA Advisory Council; Science Committee; Earth Science Subcommittee; Meeting
2012-05-09
... Committee; Earth Science Subcommittee; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration (NASA) announces a meeting of the Earth Science... Earth Science Decadal Survey Midterm Review It is imperative that the meeting be held on this date to...
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2013-04-24
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Nanoscale Science, Engineering, and Technology.... SUMMARY: The National Nanotechnology Coordination Office (NNCO), on behalf of the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the Committee on Technology, National Science and...
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International Nuclear Information System (INIS)
Braams, B.J.
2013-12-01
The 18th meeting of the Subcommittee on Atomic and Molecular Data of the International Fusion Research Council (IFRC) was held on 26-27 April 2012 at IAEA Headquarters in Vienna, Austria. Activities of the Atomic and Molecular Data Unit for the period 2010-2012 were reviewed and recommendations were made for continuig activitiees in 2012-2013 and for new projects in the 2014-2015 budget cycle. The proceedings, conclusions and recommendations of the Subcommittee meeting are briefly described in this report. Specific recommendations of the Subcommittee from this meeting, as well as the report on the activities of the IAEA Atomic and Molecular Data Unit for the period May 2010 - April 2012, are also included. (author)
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Lay Consultations in Heart Failure Symptom Evaluation.
Reeder, Katherine M; Sims, Jessica L; Ercole, Patrick M; Shetty, Shivan S; Wallendorf, Michael
2017-01-01
Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.
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2012-09-13
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Nanoscale Science, Engineering, and Technology...: Notice of webinar. SUMMARY: The National Nanotechnology Coordination Office (NNCO), on behalf of the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the Committee on Technology, National...
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Review of ASME nuclear codes and standards- subcommittee on repairs, replacements, and modifications
International Nuclear Information System (INIS)
Mawson, T.J.
1990-01-01
As requested by the ASME board on Nuclear Codes and Standards, the Pressure Vessel Research Committee initiated a project to review Sections III and XI of the ASME Boiler and Pressure Vessel Code for the purposes of improving, clarifying, providing transition, consistency, compatibility, and simplifying code requirements. The project was organized with six subcommittees to address various Code activities: design; tests and examinations; documentation; quality assurance; repair, replacement and modification; and general requirements. This paper discusses how the subcommittee on repair, replacement and modification was organized to review the repair, replacement and modification requirements of the ASME boiler and pressure vessel code, Section III and Section XI for Class 1, 2, and 3 and MC components and their supports, and other documents of the nuclear industry related to the repair, replacement and modification requirements of the ASME code
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78 FR 5243 - Motor Carrier Safety Advisory Committee (MCSAC): Public Meeting of Subcommittees
2013-01-24
... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration [Docket No. FMCSA-2006-26367] Motor Carrier Safety Advisory Committee (MCSAC): Public Meeting of Subcommittees AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of meeting of Motor Carrier Safety...
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34 CFR 75.191 - Consultation costs.
2010-07-01
... 34 Education 1 2010-07-01 2010-07-01 false Consultation costs. 75.191 Section 75.191 Education... Development of Curricula Or Instructional Materials § 75.191 Consultation costs. An applicant may budget reasonable consultation fees or planning costs in connection with the development of curricula or...
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Academic Development for Careers in Management Consulting
Adams, Susan M.; Zanzi, Alberto
2004-01-01
Explores the extent to which academic offerings are serving the consulting industry and identifies ways that academia can help. The numbers of management consulting courses, field experiences in consulting and consulting concentrations by graduate business schools were tracked over a three-year period to assess the current state of offerings. A…
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2010-07-28
... economy. The Environment Subcommittee is charged with examining steps and strategies that can be taken by... to promote effective international actions through the International Civil Aviation Organization...
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International Development Research Centre (IDRC) Digital Library (Canada)
IDRC CRDI
Qu'arrive-t-il si j'engage des dépenses avant d'avoir signé mon contrat? Combien de ... Facture-type de consultant. Cette fiche ... Le représentant du CRDI dont le nom figure dans votre contrat est votre source d'information la plus fiable.
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15 CFR 923.57 - Continuing consultation.
2010-01-01
... § 923.57 Continuing consultation. (a) As required by subsection 306(d)(3)(B) of the Act, a State must establish an effective mechanism for continuing consultation and coordination between the management agency... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Continuing consultation. 923.57...
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Learning to consult with computers.
Liaw, S T; Marty, J J
2001-07-01
To develop and evaluate a strategy to teach skills and issues associated with computers in the consultation. An overview lecture plus a workshop before and a workshop after practice placements, during the 10-week general practice (GP) term in the 5th year of the University of Melbourne medical course. Pre- and post-intervention study using a mix of qualitative and quantitative methods within a strategic evaluation framework. Self-reported attitudes and skills with clinical applications before, during and after the intervention. Most students had significant general computer experience but little in the medical area. They found the workshops relevant, interesting and easy to follow. The role-play approach facilitated students' learning of relevant communication and consulting skills and an appreciation of issues associated with using the information technology tools in simulated clinical situations to augment and complement their consulting skills. The workshops and exposure to GP systems were associated with an increase in the use of clinical software, more realistic expectations of existing clinical and medical record software and an understanding of the barriers to the use of computers in the consultation. The educational intervention assisted students to develop and express an understanding of the importance of consulting and communication skills in teaching and learning about medical informatics tools, hardware and software design, workplace issues and the impact of clinical computer systems on the consultation and patient care.
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Making consultations run smoothly
DEFF Research Database (Denmark)
Jespersen, Astrid Pernille; Elgaard Jensen, Torben
2012-01-01
This article investigates the skilful use of time in general practice consultations. It argues that consultation work involves social and material interactions, which are only partially conceptualized in existing medical practice literatures. As an alternative, this article employs ideas from the......-inspired analysis opens up a wider discussion of time as a complex resource and problem in general practice....
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Patient assessment: effective consultation and history taking.
Kaufman, Gerri
This article explores patient consultation with specific reference to the Calgary-Cambridge consultation guide. It provides an overview of history taking and explores the patient's perspective during the consultation. The article also discusses the skills required to provide information effectively. In addition, the article addresses 'safety netting' and emphasises the interdependence of communication and consultation skills.
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Energy Technology Data Exchange (ETDEWEB)
DiPiro, Pamela J.; Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H. [Dept. of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)
2017-01-15
The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.
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DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H
2017-01-01
The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.
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Consultation document Energy Market Concentrations
International Nuclear Information System (INIS)
De Maa, J.; Van Gemert, M.; Karel, A.; La Bastide, G.; Giesbertz, P.; Buijs, F.; Vermeulen, M.; Beusmans, P.
2006-06-01
This the second consultation document of the Netherlands Competition Authority (NMa) on the title subject (the first was in 2002). The purpose of the consultation is to involve all the relevant and interested parties in the development of the energy market in the Netherlands and to consult those parties on studies that have been carried out by the NMa so far: (1) defining (possible) relevant markets in the electricity sector, and (2) the vision and opinion of the NMa with respect to mergers and take-overs. Also, the consultation document is a contribution to the response of the letter from the Dutch Minister of Economic Affairs of May 2005 in which the NMa was requested to give an overview of the preconditions with regard to competition and it's legal aspects [nl
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Postpartum consultation: Occurrence, requirements and expectations
Directory of Open Access Journals (Sweden)
Carlgren Ingrid
2008-07-01
Full Text Available Abstract Background As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour. Methods All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis. Results Of the 150 interviewed women, 56% (n = 84 had a postpartum consultation of which 61.9% (n = 52 had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear. Conclusion The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care.
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Knowledge Sharing in IT Consultant and SME Interactions
Directory of Open Access Journals (Sweden)
Adrian Bradshaw
2015-10-01
Full Text Available Many small and medium enterprises (SMEs depend on consultants to overcome knowledge barriers, especially for IT projects. This paper aims to determine how IT consultants affect the IT knowledge of SMEs when IT consultants and SMEs interact. Data were collected using face-to-face interviews with both IT consultants and SME managers. The study is the first to identify what and how SMEs learn from consultants during an IT implementation project. Consultants help SMEs gain different types of knowledge, employing a broad range of knowledge sharing mechanisms. As consultants are an important part of the knowledge creation processes of SMEs, SMEs should strive to form long-term relationships with consultants and use these interactions to develop IT knowledge within the SME.
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Political consultation and large-scale research
International Nuclear Information System (INIS)
Bechmann, G.; Folkers, H.
1977-01-01
Large-scale research and policy consulting have an intermediary position between sociological sub-systems. While large-scale research coordinates science, policy, and production, policy consulting coordinates science, policy and political spheres. In this very position, large-scale research and policy consulting lack of institutional guarantees and rational back-ground guarantee which are characteristic for their sociological environment. This large-scale research can neither deal with the production of innovative goods under consideration of rentability, nor can it hope for full recognition by the basis-oriented scientific community. Policy consulting knows neither the competence assignment of the political system to make decisions nor can it judge succesfully by the critical standards of the established social science, at least as far as the present situation is concerned. This intermediary position of large-scale research and policy consulting has, in three points, a consequence supporting the thesis which states that this is a new form of institutionalization of science: These are: 1) external control, 2) the organization form, 3) the theoretical conception of large-scale research and policy consulting. (orig.) [de
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Understanding the consultation processes
International Nuclear Information System (INIS)
Laing, A.C.
1998-01-01
This presentation focuses on the consultation processes between industry, government and First Nations communities regarding resource development. The expectations of the Crown are to facilitate capacity building within First Nations, to promote traditional use studies and to participate with industry proponents on certain consultation issues. The role of industry is to encourage partnerships between established contractors and First Nations contracting firms to allow First Nations firms to grow and experience success under the guidance of a mentor company. It is important to realize that solid First Nations relations are the key to shorter time lines and lower costs in developing projects. However, consultation and involvement must be 'real' with benefits and participation that fall within the First Nations Communities' definition of success
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2012-03-05
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Nanoscale Science, Engineering, and Technology... public meeting. SUMMARY: The National Nanotechnology Coordination Office (NNCO), on behalf of the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the Committee on Technology, National...
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76 FR 15995 - Notice of Public Meeting: Northeast California Resource Advisory Council Subcommittee
2011-03-22
... District manager, (530) 224-2160; or Joseph J. Fontana, BLM public affairs officer, (530) 252-5332... as provided above. Dated: June 14, 2010. Joseph J. Fontana, Public Affairs Officer. [FR Doc. 2011... Public Meeting: Northeast California Resource Advisory Council Subcommittee AGENCY: Bureau of Land...
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Nuclear consultant - a new profession
International Nuclear Information System (INIS)
Hardung von Hardung, H.
1976-01-01
The nuclear field is an area fraugh with particular difficulties for industries, banks, public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge. (orig.) [de
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Nuclear consultant: a new profession
Energy Technology Data Exchange (ETDEWEB)
Hardung von Hardung, H
1976-02-01
The nuclear field is an area fraught with particular difficulties for industries, banks, and public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge.
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2010-09-21
... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-112)] NASA Advisory Council; Planetary Science Subcommittee; Supporting Research and Technology Working Group; Meeting AGENCY: National... announces a meeting of the Supporting Research and Technology Working Group of the Planetary Science...
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US House of Representatives, 2015
2015-01-01
This paper presents the first joint hearing of the Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies of the Committee on Homeland Security and the Subcommittee on Early Childhood, Elementary, and Secondary Education of the Committee on Education and the Workforce. The subcommittees met to examine data collection…
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Galimberti, Fabrizio; Guren, Lauren; Fernandez, Anthony P; Sood, Apra
2016-10-01
Cutaneous abnormalities are common in hospitalized patients but are frequently missed or misdiagnosed by admitting teams. Inpatient dermatology consultations provide important information to help diagnose and manage these patients. However, few studies have analyzed dermatology inpatient consultations and their effect. We prospectively collected information for 691 consecutive dermatology consultations from November 2013 to November 2014. Patients ranged in age from newborns to 97 years old. The internal medicine service requested the most consultations (45%). Only 6.5% of consultations were requested within 24 hours of appearance of cutaneous findings. Before consultation, 70.3% of patients did not receive treatment for or based on their cutaneous findings. Dermatology consultation resulted in treatment change in 81.9% of patients. The most common diagnoses were drug rash and contact dermatitis. Biopsies confirmed 71.7% of the initial bedside diagnoses by the dermatology consultation team. Common skin diseases were responsible for the majority of dermatology consultations. Most patients were not treated for their cutaneous conditions before the dermatology consultation. Dermatology consultations resulted in treatment changes in the majority of cases. © 2016 The International Society of Dermatology.
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SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA
Directory of Open Access Journals (Sweden)
Vesna PARAUSIC
2012-01-01
Full Text Available Transition process and Serbia's entering into the European Union is possible to hasten by adequate and timely consultative services, before all during the programs and methodologies creation for conducting the enterprises' restructuring processes. In such conditions, the consultative organizations help the enterprises in accomplishing their goals, solving problems in business and management, identifying and using new possibilities, increasing their knowledge and applying suggested changes in the practice. Consulting is a result of manager need for integrated and complex business information. To obtain the transfer of consultant knowledge and manager skills development, a certain conditions must be fulfilled. First of all, business integrity and consultant competence are the most important. Business integrity, i.e. consultant ethics contributes image and reputation and is important competitiveness factor on consultant services market. Regarding actual consulting trends in countries within our region, as well as developmental level of consulting in EU countries, the market of consultative services in Serbia has not significantly changed in previous period (as we saw, the acknowledgement of it was got also by empirical research. The owners and managers of enterprises still do not feel a need for external services, in order to solve business problems. Having in mind a level and quality of demand, neither a supply of consultative services had not reached satisfactory level.
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Strangers at the Benchside: Research Ethics Consultation
Cho, Mildred K.; Tobin, Sara L.; Greely, Henry T.; McCormick, Jennifer; Boyce, Angie; Magnus, David
2008-01-01
Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program. PMID:18570086
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2010-08-06
... DEPARTMENT OF COMMERCE Bureau of Industry and Security President's Export Council Subcommittee on Export Administration; Notice of Recruitment of Private-Sector Members SUMMARY: The President's Export... their services. The PECSEA is seeking private-sector members with senior export control expertise and...
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Rieger, Kendra L; Hack, Thomas F; Beaver, Kinta; Schofield, Penelope
2018-04-01
To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors. Copyright © 2017 John Wiley & Sons, Ltd.
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The guideline "consultation psychiatry" of the Netherlands Psychiatric Association.
Leentjens, Albert F G; Boenink, Annette D; Sno, Herman N; Strack van Schijndel, Rob J M; van Croonenborg, Joyce J; van Everdingen, Jannes J E; van der Feltz-Cornelis, Christina M; van der Laan, Niels C; van Marwijk, Harm; van Os, Titus W D P
2009-06-01
In 2008, the Netherlands Psychiatric Association authorized a guideline "consultation psychiatry." To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and, if so, which forms are most effective? How should a psychiatric consultations be performed? What increases adherence to recommendations given by the consulting psychiatrist? Systematic literature review. Both in general practice and in hospital settings psychiatric consultation is effective. In primary care, the effectiveness of psychiatric consultation is almost exclusively studied in the setting of "collaborative care." Procedural guidance is given on how to perform a psychiatric consultation. In this guidance, psychiatric consultation is explicitly looked upon as a complex activity that requires a broad frame of reference and adequate medical and pharmacological expertise and experience and one that should be performed by doctors. Investing in a good relation with the general practitioner, and the use of a "consultation letter" increased efficacy in general practice. In the hospital setting, investing in liaison activities and an active psychiatric follow-up of consultations increased adherence to advice. Psychiatric consultations are effective and constitute a useful contribution to the patients' treatment. With setting a standard consultations will become more transparent and checkable. It is hoped that this will increase the quality of consultation psychiatry.
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Services of strategic consulting: special features and types
Directory of Open Access Journals (Sweden)
Klenin Oleh Volodymyrovych
2016-09-01
Full Text Available In the article essence of terms “consulting” and “strategic consulting” was studied. It was proved that strategic consulting must be analyzed as professional activity in the system of enterprise strategic management. Specific features of consultative services and its composition was added from the point of view of strategic management and innovative development were studied. In the process of providing consulting services it was suggested to take into account the strategic orientation of human capital of consulting company that was accepted to determine as professional actions of consultants. It was found out main problems that could prevent stable activity of industrial enterprises. It was proved necessity of researches concerning authentication factors of industrial enterprises innovative development and the role of consulting company in its decision making. It was made review of the most widespread classifications of consulting services. Was shown author`s view concerning forming more demanded services of strategic consulting by subject basis.
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ARL/OMS Consultant Training Program.
Euster, Joanne R.
1982-01-01
Describes Academic Library Consultant Training Program begun in 1979, sponsored by Office of Management Studies (OMS) and designed to provide 80 consultants to aid academic libraries in improving performance. Viewpoints are included from OMS Director and participants concerning program objectives, trainee selection, workshops, internships, and the…
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Improving Indonesian Construction Consulting Services
Directory of Open Access Journals (Sweden)
Rizal Z. Tamin
2015-05-01
Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.
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La Via, Jennifer; Schiedermayer, David
2012-01-01
Ethics committees and palliative care consultants can function in a complementary fashion, seamlessly and effectively. Ethics committees can "air" and help resolves issues, and palliative care consultants can use a low-key, longitudinal approach.
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2010-09-30
... Update. --Performance Measures Discussion. --Report from Earth Science Subcommittee Meeting. It is... to providing the following information no less than 10 working days prior to the meeting: full name; gender; date/ place of birth; citizenship; visa/green card information (number, type, expiration date...
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Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.
Adams, Traci N; Bonsall, Joanna; Hunt, Daniel; Puig, Alberto; Richards, Jeremy B; Yu, Liyang; McSparron, Jakob I; Shah, Nainesh; Weissler, Jonathan; Miloslavsky, Eli M
2018-05-01
Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States. The survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist-fellow and hospitalist-subspecialty attending interactions. One hundred twenty-two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in-person communication occurred during less than half of consultations, and 64.4% perceived pushback at least "sometimes " in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist-consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation. The hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.
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Compensation Consultants and CEO Pay
Kabir, Mohammed Rezaul; Minhat, Marizah
2014-01-01
The study examines the practice of employing multiple compensation consultants. Examining data of a sample of UK companies over the period 2003–2006 we find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant. An increase in the number of compensation
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The Lawyer-Therapist Consultation Team.
Korelitz, Ann; Schulder, Diane
1982-01-01
Discusses a pilot study in which joint consultations with a family therapist and a matrimonial attorney were offered to 10 couples and one woman contemplating divorce. Videotaped sessions. Suggests joint consultations can be useful in helping couples understand the psychological and legal implications of conflicts expressed during separation.…
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Directory of Open Access Journals (Sweden)
van Dulmen Sandra
2010-11-01
Full Text Available Abstract Background The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background. Method We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression. Results This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach. GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition. GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity. Conclusion In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle
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Core Competencies for Training Effective School Consultants
Burkhouse, Katie Lynn Sutton
2012-01-01
The purpose of this research was to develop and validate a set of core competencies of effective school-based consultants for preservice school psychology consultation training. With recent changes in service delivery models, psychologists are challenged to engage in more indirect, preventative practices (Reschly, 2008). Consultation emerges as…
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Edgar Schein's Process versus Content Consultation Models.
Rockwood, Gary F.
1993-01-01
Describes Schein's three models of consultation based on assumptions inherent in different helping styles: purchase of expertise and doctor-patient models, which focus on content of organization problems; and process consultation model, which focuses on how organizational problems are solved. Notes that Schein has suggested that consultants begin…
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Inconsistency of residents' communication performance in challenging consultations.
Wouda, Jan C; van de Wiel, Harry B M
2013-12-01
Communication performance inconsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some consultations. Fifty residents performed two challenging consultations. Residents' communication competency was assessed with the CELI instrument. Residents' background in communication skills training (CST) was also established. We used multilevel analysis to explore communication performance inconsistency between the two consultations. We also established the relationships between inconsistency and average performance quality, the type of consultation, and CST background. Inconsistency accounted for 45.5% of variance in residents' communication performance. Inconsistency was dependent on the type of consultation. The effect of CST background training on performance quality was case specific. Inconsistency and average performance quality were related for those consultation combinations dissimilar in goals, structure, and required skills. CST background had no effect on inconsistency. Physician communication performance should be of high quality, but also consistent regardless of the type and complexity of the consultation. In order to improve performance quality and reduce performance inconsistency, communication education should offer ample opportunities to practice a wide variety of challenging consultations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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2013-05-21
... DEPARTMENT OF COMMERCE Bureau of Industry and Security President's Export Council; Subcommittee on... and Security, Space and Intelligence Systems, Building S24, Conference Center, 2020 East Imperial... security and foreign policy reasons. Agenda (Subject to Change) Tuesday, June 4 Open Session 1. Welcome and...
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Energy Technology Data Exchange (ETDEWEB)
Clark, R E.H. [International Atomic Energy Agency, Vienna (Austria)
2000-12-01
This report briefly describes the proceedings, conclusions and recommendations of the 12th Meeting of the Subcommittee on Atomic and Molecular Data for Fusion of the International Fusion Research Council held on May 8-9, 2000 at the IAEA Headquarters in Vienna Austria. The report includes the Executive Summary of the Subcommittee from this Meeting which was communicated to the IAEA Director General as well as the report on the activities of the IAEA Atomic and Molecular Data Unit for the period June 1999 - May 2000. (author)
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Does professional-centred training improve consultation outcomes?
DEFF Research Database (Denmark)
Parkin, Tracey; Barnard, K.; Cradock, S.
2006-01-01
discussed and decisions made. Patients also completed the Health Care Climate Questionnaire (HCCQ). Pre-training results were fed back to the professionals to provide an objective measure of current practice. Training day one comprised 10 minutes' observation of videoed consultations of each professional......This study aimed to examine whether professional-centred training improves consultation outcomes. Using a pre- and post-data collection design. Immediately after consultations, professionals and patients completed a consultation review sheet which was coded for the level of agreement on issues...... in order to identify strengths and training needs. Each professional identified key areas of their consultation that they felt needed further development. Training day two centred on goal setting and negotiating agendas as these were identified as priority areas requiring more skills. Data from 110...
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Akobeng, Anthony K; O'Leary, Neil; Vail, Andy; Brown, Nailah; Widiatmoko, Dono; Fagbemi, Andrew; Thomas, Adrian G
2015-09-01
Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD. We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8-16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798. Eighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI - 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8-19.6; P consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the
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IT Consultants in Acquisition IT Integration
DEFF Research Database (Denmark)
Henningsson, Stefan; Øhrgaard, Christian
2016-01-01
strategic IT initiatives and how companies can draw effectively on their services. The paper investigates the use of consultants in relation to one type of major strategic IT initiative: acquisition IT integration. Acquisition IT integration, which is the integration of the acquirer’s and target......’s IT following a corporate acquisition, presents a difficult but crucial IT challenge for the many acquiring organizations. Through a comparative case study of four acquirers, theoretically grounded in the resource-based view of the firm, it is analyzed how acquirers draw on external consultants to realize...... acquisition IT integration. Two complementary and two supplementary roles consultants assume in these projects are identified. Additionally, three characteristics of the acquisition IT integration strategy are identified that influence how the acquirers assign different roles to IT consultants. The resulting...
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Final report of advisory subcommittee on development of JENDL. Guideline for developing next JENDL
International Nuclear Information System (INIS)
Chiba, Go
2016-01-01
An advisory subcommittee on development of JENDL was established in 2013 to discuss future development of JENDL among experts on nuclear data experiments, evaluations and applications. This paper is a summary of a final report which was submitted to the JENDL committee on March in 2014. (author)
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"Systematizing" ethics consultation services.
Bruce, Courtenay R; Eves, Margot M; Allen, Nathan G; Smith, Martin L; Peña, Adam M; Cheney, John R; Majumder, Mary A
2015-03-01
While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: (1) train-the-trainer, (2) local capacity-building, (3) circuit-riding, and (4) consolidated accountability. We note each model's benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations.
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Energy Technology Data Exchange (ETDEWEB)
Janev, R K
1999-01-01
This report describes briefly the proceedings and the conclusions and recommendations of the 10th Meeting of the Subcommittee on Atomic and Molecular Data for Fusion of the International Fusion Research Council held on May 27-28, 1998 at the IAEA Headquarters in Vienna, Austria. The report includes also the Executive Summary of the Subcommittee from this Meeting which was communicated to the IAEA Director General, and is appended with the Report on Activities of IAEA A+M Data Unit for the period July 1996 - May 1998. (author)
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2010-01-29
... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Subcommittee on Forensic Science; Committee on Science; National Science and Technology Council ACTION: Notice of Panel Session. Public input is requested concerning appropriate Federal Executive Branch responses to the National Academy of Sciences 2009 report...
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2013-09-04
... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-21] Appraisal Subcommittee of the Federal Financial Institutions Examination Council; Notice of Meeting Description: In accordance with Section 1104 (b) of Title XI of the Financial Institutions Reform, Recovery, and Enforcement Act...
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2010-06-16
..., which will be open to the public. The purpose of the FAAC is to provide advice and recommendations to... global economy. The Financing Subcommittee will address the need for a stable, secure, and sufficient...
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Consultant radiographers: Profile of the first generation
International Nuclear Information System (INIS)
Forsyth, Lesley J.; Maehle, Valerie
2010-01-01
Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.
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Consultant radiographers: Profile of the first generation
Energy Technology Data Exchange (ETDEWEB)
Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)
2010-11-15
Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.
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A retrospective analysis of medical record use in e-consultations.
Pecina, Jennifer L; North, Frederick
2017-06-01
Introduction Under certain circumstances, e-consultations can substitute for a face-to-face consultation. A basic requirement for a successful e-consultation is that the e-consultant has access to important medical history and exam findings along with laboratory and imaging results. Knowing just what information the specialist needs to complete an e-consultation is a major challenge. This paper examines differences between specialties in their need for past information from laboratory, imaging and clinical notes. Methods This is a retrospective study of patients who had an internal e-consultation performed at an academic medical centre. We reviewed a random sample of e-consultations that occurred in the first half of 2013 for the indication for the e-consultation and whether the e-consultant reviewed data in the medical record that was older than one year to perform the e-consultation. Results Out of 3008 total e-consultations we reviewed 360 (12%) randomly selected e-consultations from 12 specialties. Questions on management (35.8%), image results (27.2%) and laboratory results (25%) were the three most common indications for e-consultation. E-consultants reviewed medical records in existence more than one year prior to the e-consultation 146 (40.6%) of the time with e-consultants in the specialties of endocrinology, haematology and rheumatology, reviewing records older than one year more than half the time. Labs (20.3%), office notes (20%) and imaging (17.8%) were the types of medical data older than one year that were reviewed the most frequently overall. Discussion Management questions appear to be the most common reason for e-consultation. E-consultants frequently reviewed historical medical data that is older than one year at the time of the e-consultation, especially in endocrinology, haematology and rheumatology specialties. Practices engaging in e-consultations that require transfer of data may want to include longer time frames of historical information
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2012-02-15
... diplomatic or trading relations and of controlling trade for national security and foreign policy reasons.... Welcome and remarks by Chairman and Vice Chair. 2. Presentation of Papers or Comments by the Public. 3. Review of Field Hearing. 4. Discussion/Status of 2012 Workplan. 5. Subcommittee Breakout Sessions. 6...
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2011-10-27
... public. 4. Review of Deliverables for the PEC. 5. Discussion of 2012 Workplan. 6. Subcommittee Breakout... which the United States has diplomatic or trading relations and of controlling trade for national....gov , no later than, November 7, 2011. A limited number of seats will be available for the public...
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2011-02-23
... DEPARTMENT OF COMMERCE Bureau of Industry and Security President's Export Council; Subcommittee on... security and foreign policy reasons. Agenda 1. Welcome by Under Secretary of Commerce for Industry and... Administration (PECSEA) will meet on March 10, 2011, 1 p.m., at the U.S. Department of Commerce, Herbert C...
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The transition to hospital consultant
DEFF Research Database (Denmark)
Westerman, Michiel; Teunissen, Pim W.; Jorgensen, Rasmus Lundhus
2013-01-01
Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic comp...... competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored....
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Experience of a year of adult hospital dermatology consultations.
Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P
2015-10-01
Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.
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2011-02-03
... Branch responses to the AFIS interoperability issues identified in the National Academy of Sciences 2009... OFFICE OF SCIENCE AND TECHNOLOGY POLICY Subcommittee on Forensic Science; Committee on Science; National Science and Technology Council ACTION: Notice of meeting. Public input is requested concerning...
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2013-09-04
... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-20] Appraisal Subcommittee of the Federal Financial Institutions Examination Council; Notice of Meeting Description: In accordance with Section 1104(b) of Title XI of the Financial Institutions Reform, Recovery, and Enforcement Act of...
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Consultants Group Meeting on Genetic Sexing and Population Genetics of Screwworms. Working Material
International Nuclear Information System (INIS)
2000-01-01
questions can to a large extent be answered using modern molecular techniques of DNA analysis and answers to these questions would provide support for decision makers in the planning and implementation of new SIT programmes. The consultant's reviewed work on both of these subjects during their presentations and discussed if a CRP was the appropriate vehicle to address the problems. Any progress in these areas will be dependent on the creation of a network of scientists and a CRP would be an ideal mechanism for this. The consultants also identified other partners who could interact in a positive way with any new CRP. The number of scientists currently active in the identified areas is not large and it will be important to recruit new people to the field. USDA has already made efforts in this direction both in ARS and APHIS. The consultants concluded that a viable and competent group of scientists could be identified to form the nucleus of a new CRP. A prioritized list of research activities for the CRP was formulated together with relevant institutions and partners. Having decided that a CRP would be an appropriate mechanism to address the R and D problem areas, the consultants developed a draft logical framework and this will be submitted through the appropriate channels to the Research Contracts sub-committee.
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42 CFR 493.1419 - Standard; Clinical consultant responsibilities.
2010-10-01
... Testing Laboratories Performing Moderate Complexity Testing § 493.1419 Standard; Clinical consultant... clinical consultation to the laboratory's clients; (b) Be available to assist the laboratory's clients in... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493...
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40 CFR 725.17 - Consultation with EPA.
2010-07-01
... ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS General Provisions and..., ATTN: Biotechnology Notice Consultation. Persons wishing to consult with EPA by telephone should call...
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Managing outpatient consultations: from referral to discharge.
Mitchell, Rachael; Jacob, Hannah; Morrissey, Benita; Macaulay, Chloe; Gomez, Kumudini; Fertleman, Caroline
2017-08-01
Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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The International Consultant: Substance and Culture.
Fest, Thorrel B.
To function effectively in crosscultural settings, international consultants, development specialists, and trainers should be prepared to examine objectively a number of personal qualities. Problems arise in crosscultural relationships when either the client or the consultant fails to identify objectives, fails to accommodate different views of…
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2013-06-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act...
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2011-06-29
... Pass Code 9933701. Background: The Advisory Board was established under the Energy Employees... whether there is a class of employees at any Department of Energy facility who were exposed to radiation... Subcommittee meeting includes: Selection of individual radiation dose reconstruction cases to be considered for...
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BNFL Sellafield further public consultation
International Nuclear Information System (INIS)
1994-01-01
The main issues raised during the further public consultation on the draft Sellafield authorisations for the discharge of radioactive wastes from the British Nuclear Fuel (BNFL) Sellafield site are outlined. An analysis of the categories and numbers of the 42,500 responses is made. The public consultation was based on five documents; a letter to consultees from the Department of the Environment and the Ministry of Agriculture, Fisheries and Food (MAFF); the report by Her Majesty's Inspectorate of Pollution and the Inspectorate of MAFF on their earlier consultation exercise; a paper by BNFL on the economic and commercial justification of the Thermal Oxide Reprocessing Plant (THORP); a statement of the Government's policy on reprocessing and THORP and a document prepared by BNFL on the environmental implication of THORP. (UK)
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Consulting by Business College Academics: Lessons for Business Communication Courses
Dave, Anish
2009-01-01
Business communication (BC) is a crucial aspect of management consulting. BC scholars have widely studied the relationship between BC and management consulting, including consulting by BC academics. A limited review of the studies of management consulting, including consulting done by business college academics, hereafter referred to simply as…
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Erbas, Dilek
2010-01-01
The purpose of this study is to compare the effectiveness of consultation alone and consultation plus feedback on the proper use of positive behavior support strategies (PBS) on behaviors of three mothers with children with developmental disabilities. Results indicated that consultation plus feedback was more effective than consultation alone…
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Energy Technology Data Exchange (ETDEWEB)
NONE
1993-03-01
This paper reports the activities of the brown coal liquefaction sub-committee in fiscal 1992. The first sub-committee meeting presented an interim report on the status of progress in complementary researches in fiscal 1992. The report covers the following items: discussions on effects of reaction factors on scale deposition in a preheater and a reactor and the liquefaction oil yield, supplementary experiments to enhance recovery rate of naphtha from under-flow in the de-ashing system and enhance accuracy of expression to estimate the interface precipitation velocity, and discussions on product oil types and catalyst types. The second sub-committee meeting reported fundamental discussions on the primary hydrogenation and hot water treatment of brown coal as an interim report on the achievements, and discussions on de-ashing and catalyst properties, liquefying reaction activity and scaling performance of catalysts. The third meeting reported the support on compiling the achievements by means of collecting complementary data of the pilot plant using PDU. A 7,800-hour life verification test was completed on the fixed bed secondary hydrogenation catalyst. A method was established to recover naphtha from the under-flow in a de-ashing settler. An expression to estimate the interface precipitation velocity was also established. Affirmation was made on the pylite catalyst performance, and reactivity of the category A coal assumed in the demonstration device. (NEDO)
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[Differences between patients in consultation psychiatry and psychiatric inpatients].
Unterecker, Stefan; Maloney, Julia; Pfuhlmann, Bruno; Deckert, Jürgen; Warrings, Bodo
2014-05-01
To optimize psychiatric consultation service epidemiological information is needed. We compared data on gender, age and diagnoses of patients in the consultation service to psychiatric inpatients. In psychiatric consultation service patients are older (56.6 vs. 44.9 years, p psychiatric consultation service is contacted more often in cases of organic disorders, for females in adjustment disorders (p psychiatric consultation service is different for males and females with relevance for diagnostic and therapeutic procedures. © Georg Thieme Verlag KG Stuttgart · New York.
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Franks, Helen; Howarth, Michelle
2012-10-01
This study established key attributes and perceived strengths, weaknesses, opportunities and threats (SWOT) of nurse consultants specializing in safeguarding children. The nurse consultant role in England spans four domains--clinical, leadership, education and research--and was intended to enable senior nurses to remain in clinical practice. ata identifying the time spent by the nurse consultants in the four domains was collated and a thematic content analysis of the SWOT of the role was ascertained from semi-structured interviews with nurse consultants (n = 4) and stakeholders (n = 6). Strengths and opportunities in clinical (consultancy), leadership and educational functions were identified but some weaknesses and threats in terms of nurse consultant's contributions to research were also identified. The role was neither wholly strategic nor clinical. Role ambiguity meant that they were not always valued by managers, making the role potentially expendable. Nurse consultants are pivotal within health-care organizations because they span clinical practice and leadership enabling them to support managers in strategic planning, commissioning and implementation of policy. Nurse consultants can support strategic practice development and influence quality and effectiveness service-wide. To succeed they must be understood, supported and nurtured by managers. © 2012 Blackwell Publishing Ltd.
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20 CFR 404.1616 - Medical or psychological consultants.
2010-04-01
..., psychological experts employed by or under contract with the State agencies must meet the qualification... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical or psychological consultants. 404... Determination Function § 404.1616 Medical or psychological consultants. (a) What is a medical consultant? A...
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Options for change in the NHS consultant contract.
Clarke, R W; Gray, C
The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.
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Multiple Compensation Consultants and CEO Pay
Kabir, Mohammed Rezaul; Minhat, Marizah
The study examines the practice of employing multiple compensation consultants. Data for a sample of UK companies over the period 2003-2006 are analyzed using a variety of econometric methods. We find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant.
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Consultants' Corner: System Performance. A Forum.
Drabenstott, John, Ed.
1986-01-01
Five library consultants address issues that affect online system performance: options in system design that relate to diverse library requirements; criteria that most affect performance; benchmark tests and sizing criteria; minimalizing the risks of miscalculation; and the roles and responsibilities of vendors, libraries, and consultants.…
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Therapists perspectives on the effective elements of consultation following training.
Beidas, Rinad S; Edmunds, Julie M; Cannuscio, Carolyn C; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C
2013-11-01
Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered.
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Therapists’ Perspectives on the Effective Elements of Consultation Following Training
Beidas, Rinad S.; Edmunds, Julie M.; Cannuscio, Carolyn C.; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C.
2013-01-01
Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists’ perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered. PMID:23435832
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2012-05-25
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2790-055] Boott Hydropower, Inc.; Notice of Consulting Parties and Agenda for Section 106 Consultation Meeting On May 4, 2012, the... Hydropower, Inc. and the Eldred L. Field Hydroelectric Facility Trust (co-licensees for the Lowell...
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Psychiatric Consultation and Substance Use Disorders
Directory of Open Access Journals (Sweden)
Sheila Specker
2009-01-01
Full Text Available Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data
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Psychiatric Consultation and Substance Use Disorders
Directory of Open Access Journals (Sweden)
Sheila Specker
2009-11-01
Full Text Available Background: A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives: 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method: Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results: Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions: These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in
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Incongruous consultation behaviour: results from a UK-wide population survey
Directory of Open Access Journals (Sweden)
Elliott Alison M
2012-03-01
Full Text Available Abstract Background Symptom characteristics are strong drivers of care seeking. Despite this, incongruous consultation behaviour occurs and has implications for both individuals and health-care services. The aim of this study was to determine how frequently incongruous consultation behaviour occurs, to examine whether it is more common for certain types of symptoms and to identify the factors associated with being an incongruous consulter. Methods An age and sex stratified random sample of 8,000 adults was drawn from twenty UK general practices. A postal questionnaire was used to collect detailed information on the presence and characteristics of 25 physical and psychological symptoms, actions taken to manage the symptoms, general health, attitudes to symptom management and demographic/socio-economic details. Two types of incongruous consultation behaviour were examined: i consultation with a GP for symptoms self-rated as low impact and ii no consultation with a GP for symptoms self-rated as high impact. Results A fifth of all symptoms experienced resulted in consultation behaviour which was incongruous based on respondents' own rating of the symptoms' impact. Low impact consultations were not common, although symptoms indicative of a potentially serious condition resulted in a higher proportion of low impact consultations. High impact non-consultations were more common, although there was no clear pattern in the type of associated symptoms. Just under half of those experiencing symptoms in the previous two weeks were categorised as an incongruous consulter (low impact consulter: 8.3%, high impact non-consulter: 37.1%. Employment status, having a chronic condition, poor health, and feeling that reassurance or advice from a health professional is important were associated with being a low impact consulter. Younger age, employment status, being an ex-smoker, poor health and feeling that not wasting the GPs time is important were associated with
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Telephone consultations on exposure to nuclear disaster radiation
International Nuclear Information System (INIS)
Yashima, Sachiko; Chida, Koichi
2014-01-01
The Fukushima nuclear disaster occurred on March 11, 2011. For about six weeks, I worked as a counselor for phone consultations regarding radiation risk. I analyzed the number of consultations, consultations by telephone, and their changing patterns with elapse of time, to assist with consultations about risk in the future. There were a large number of questions regarding the effects of radiation, particularly with regard to children. We believe that counseling and risk communication are the key to effectively informing the public about radiation risks. (author)
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Information giving and receiving in hematological malignancy consultations.
Alexander, Stewart C; Sullivan, Amy M; Back, Anthony L; Tulsky, James A; Goldman, Roberta E; Block, Susan D; Stewart, Susan K; Wilson-Genderson, Maureen; Lee, Stephanie J
2012-03-01
Little is known about communication with patients suffering from hematologic malignancies, many of whom are seen by subspecialists in consultation at tertiary-care centers. These subspecialized consultations might provide the best examples of optimal physician-patient communication behaviors, given that these consultations tend to be lengthy, to occur between individuals who have not met before and may have no intention of an ongoing relationship, and which have a goal of providing treatment recommendations. The aim of this paper is to describe and quantify the content of the subspecialty consultation in regards to exchanging information and identify patient and provider characteristics associated with discussion elements. Audio-recorded consultations between 236 patients and 40 hematologists were coded for recommended communication practices. Multilevel models for dichotomous outcomes were created to test associations between patient, physician and consultation characteristics and key discussion elements. Discussions about the purpose of the visit and patient's knowledge about their disease were common. Other elements such as patient's preference for his/her role in decision-making, preferences for information, or understanding of presented information were less common. Treatment recommendations were provided in 97% of the consultations and unambiguous presentations of prognosis occurred in 81% of the consultations. Unambiguous presentations of prognosis were associated with non-White patient race, lower educational status, greater number of questions asked, and specific physician provider. Although some communication behaviors occur in most consultations, others are much less common and could help tailor the amount and type of information discussed. Approximately half of the patients are told unambiguous prognostic estimates for mortality or cure. Copyright © 2011 John Wiley & Sons, Ltd.
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2011-04-18
... Disparities Subcommittee (HDS), Advisory Committee to the Director, Centers for Disease Control and Prevention... through the ACD on strategic and other health disparities and health equity issues and provide guidance on... update including the CDC Health Disparities and Inequalities Report, U.S. 2011; the National Prevention...
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2011-06-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2011-03-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2013-03-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2010-12-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2013-12-27
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2012-07-11
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2012-03-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2013-01-04
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2013-12-27
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2013-10-22
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2010-07-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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2011-12-12
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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The primary charge of the AQM Subcommittee was to develop recommendations to improve the air quality management system and address the air quality challenges in this country expected over the next 10 to 20 years. This report addresses those challenges.
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Sustainability of a Primary Care-Driven eConsult Service.
Liddy, Clare; Moroz, Isabella; Afkham, Amir; Keely, Erin
2018-03-01
Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability. We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult. Impact indicators included time interval to obtain specialist advice, effect of specialist advice on the primary care clinician's course of action, and rate of avoidance of face-to-face visits. A total of 14,105 eConsult cases were directed to 56 different medical specialty groups, completed with a median response time of 21 hours, and 65% of all eConsults were resolved without a specialist visit. We observed rapid growth in the use of eConsult during the study period: 5 years after implementation the system was in use by 1,020 primary care clinicians, with more than 700 consultations taking place per month. This study presents the first in-depth look at the growth and sustainability of the multispecialty eConsult service. The results show the positive impact of an eConsult service and can inform other regions interested in implementing similar systems. © 2018 Annals of Family Medicine, Inc.
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Thornberg, Robert
2014-01-01
The aim of this study, conducted in Sweden, was to investigate the cultural barriers between school personnel (teachers and principals) and nonschool personnel (a resource team), who were external to the school system, regarding consultation about challenging or difficult-to-teach students. Focus groups with teachers, principals, and the resource…
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19th JANNAF Safety and Environmental Protection Subcommittee Meeting. Volume 1
Cocchiaro, J. E. (Editor); Becker, D. L. (Editor)
2002-01-01
This volume, the first of two volumes, is a compilation of 22 unclassified/unlimited technical papers presented at the 19th Joint Army-Navy-NASA-Air Force (JANNAF) Safety & Environmental Protection Subcommittee Meeting. The meeting was held 18-21 March 2002 at the Sheraton Colorado Springs Hotel, Colorado Springs, Colorado. Topics covered include green energetic materials and life cycle pollution prevention; space launch range safety; propellant/munitions demilitarization, recycling, and reuse: and environmental and occupational health aspects of propellants and energetic materials.
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Bladder Pain Syndrome International Consultation on Incontinence
DEFF Research Database (Denmark)
Hanno, P.; Lin, A.; Nordling, J.
2010-01-01
Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature......, taxonomy, epidemiology, etiology, pathology, diagnosis, symptom scales, outcome assessment, principles of management, specific therapies, and future directions in research. Study Design, Materials, Methods: The emphasis was on new information developed since the last consultation 4 years previously. Where...... possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results: The consultation decided to refer to the condition as "bladder pain syndrome" (BPS) because the designation is more descriptive of the clinical condition...
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Qualification of contractor/consultant instructors
International Nuclear Information System (INIS)
Hanson, H.D.
1985-01-01
Following a brief discussion of the role of consultant instructors in Public Service Electric and Gas Company's training organization, the qualification process is presented. Consultant instructors are provided with information regarding supervision of the trainees and the instructional process and procedures required. Each individual must have his or her instructional capability, supervisory skills and technical competence verified and documented prior to conducting training independently. Concluding comments describe the overall satisfactory experience with this program
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Why Hire a Consultant if You Already Know What's Best?
Kaufman, Roger
1996-01-01
Discusses the client-consultant relationship from both sides. Argues that a consulting breakdown can be a chance for both the client and the consultant to grow through negotiation. Lists some basic guidelines for successful consulting relationships. (PEN)
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Group Work in Schools: A Process Consultation Approach
Farouk, Shaalan
2004-01-01
This paper provides a description of how an educational psychologist can consult with groups of teachers mostly in relation to their work with pupils who display emotional behavioural difficulties. The paper includes a review of the work on group consultation in schools, followed by a description of process consultation (Schein, 1988 ) and how the…
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THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT
Directory of Open Access Journals (Sweden)
Svetlana Vukotić
2017-07-01
Full Text Available Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combinations of business circumstances and experiences of different companies have allowed for the accumulation of valuable knowledge and business experience. From this coupling, or interaction of knowledge and experience of consulting companies, on the one hand and the needs of management companies to recognize their role and hire consultants, on the other hand, developed the importance of financial consulting and auditing. Rational management processes cannot be imagined without reliable information provided by the audit, especially as the strategic management includes the control phase. The importance and relationship between consulting and management in companies that do business according to modern principles is a central topic of consideration in this paper.
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76 FR 55678 - Tribal Consultation Policy
2011-09-08
... types of agency actions that will require tribal consultation in the future. ACF's response was that due... disparities of American Indians and Alaska Natives (AI/AN) and ensuring that access to critical health and... within ACF, many of which already consult with AI/ANs. 3. Background Since the formation of the Union...
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Improving access to urologists through an electronic consultation service
Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John
2017-01-01
Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830
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Simulated consultations: a sociolinguistic perspective.
Atkins, Sarah; Roberts, Celia; Hawthorne, Kamila; Greenhalgh, Trisha
2016-01-15
Assessment of consulting skills using simulated patients is widespread in medical education. Most research into such assessment is sited in a statistical paradigm that focuses on psychometric properties or replicability of such tests. Equally important, but less researched, is the question of how far consultations with simulated patients reflect real clinical encounters--for which sociolinguistics, defined as the study of language in its socio-cultural context, provides a helpful analytic lens. In this debate article, we draw on a detailed empirical study of assessed role-plays, involving sociolinguistic analysis of talk in OSCE interactions. We consider critically the evidence for the simulated consultation (a) as a proxy for the real; (b) as performance; (c) as a context for assessing talk; and (d) as potentially disadvantaging candidates trained overseas. Talk is always a performance in context, especially in professional situations (such as the consultation) and institutional ones (the assessment of professional skills and competence). Candidates who can handle the social and linguistic complexities of the artificial context of assessed role-plays score highly--yet what is being assessed is not real professional communication, but the ability to voice a credible appearance of such communication. Fidelity may not be the primary objective of simulation for medical training, where it enables the practising of skills. However the linguistic problems and differences that arise from interacting in artificial settings are of considerable importance in assessment, where we must be sure that the exam construct adequately embodies the skills expected for real-life practice. The reproducibility of assessed simulations should not be confused with their validity. Sociolinguistic analysis of simulations in various professional contexts has identified evidence for the gap between real interactions and assessed role-plays. The contextual conditions of the simulated
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International Nuclear Information System (INIS)
Clark, R.E.H.
2008-11-01
The 16th meeting of the Subcommittee on Atomic and Molecular (A and M) Data for Fusion of the International Fusion Research Council was held on 17-18 April 2008, at the IAEA Headquarters in Vienna, Austria. Activities of the Atomic and Molecular Data Unit for the period 2006-2008 were reviewed, and recommendations were made for the 2010-2011 programme and budget cycle. The discussions, conclusions and recommendations of the Subcommittee meeting are briefly described in this report. Specific recommendations of the Subcommittee from this meeting, as well as the report on the activities of the IAEA Atomic and Molecular Data Unit for the period May 2006 - March 2008, are also included. Of specific concern is the loss of three key personnel early in the upcoming budget cycle, including the A and M Data Unit Head (Dr. R.E.H. Clark), the Section Head for the Nuclear Data Section (Dr. A.L. Nichols), and the Data Unit coordinator for the computational facilities and databases (Dr. D. Humbert). Timely replacements of these key individuals are critical for the continued effective operation of the Atomic and Molecular Data Unit. (author)
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Wind power projects and Aboriginal consultation
Energy Technology Data Exchange (ETDEWEB)
Isaac, T. [McCarthy Tetrault LLP, Vancouver, BC (Canada)
2006-07-01
This presentation outlined some of the legal aspects related to Aboriginal involvement in wind power development consultation processes and disputes. Aboriginal rights are rights held by Aboriginal people that are an element of a practice, custom, or tradition integral to the culture of groups claiming such rights. Wind power developers should understand that Aboriginal rights claims may include fishing; whaling; transportation; and cultural and spiritual activities. Aboriginal title is a subcategory of Aboriginal rights, and is a right to land itself, and an encumbrance on the Crown's underlying title to land. Weak Aboriginal claims where potential infringement by energy developers is minor may only require notice and information. Strong prima facie cases for Aboriginal rights and title where the potential for infringement is of high significance may result in more extensive consultation involving interim solutions; formal Aboriginal participation in decision-making processes; and written responses demonstrating how Aboriginal concerns have been considered. There are a number of circumstances requiring a case-by-case approach, and the Crown may make decisions in the face of Aboriginal disagreement. However, energy developers should ensure that consultation processes are fair and reasonable. Conflicting interests can often be successfully resolved through consultation, and accommodation to Aboriginal rights may include mitigation, avoiding interference, and agreeing to as little infringement as possible. Aboriginal title may attach to private land but only to the Crown's underlying title. The Crown has no duty to consult respecting Aboriginal title on private land because title has already been infringed. In these cases, duty to consult and accommodate may be discharged through other regulatory processes such as environmental impact assessments. It was concluded that wind power project proponents should build a relationship with the Crown, as avoiding
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International Nuclear Information System (INIS)
Clark, R.E.H.; Peacock, N.J.
2006-01-01
The 14th Meeting of the Subcommittee on Atomic and Molecular Data for Fusion of the International Fusion Research Council was held on 24-25 June 2004, at the IAEA Headquarters in Vienna, Austria. Subcommittee members reviewed the work of the Atomic and Molecular Data Unit over the two-year period from June 2002 to June 2004, and made recommendations that covered the 2005-2006 budget cycle. The proceedings, conclusions and recommendations of the meeting are briefly described in this report, along with a short summary of the activities of the IAEA Atomic and Molecular Data Unit of the Nuclear Data Section from June 2002 to June 2004. (author)
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Energy Technology Data Exchange (ETDEWEB)
NONE
1993-03-01
This paper reports the activities of the bituminous coal liquefaction sub-committee in the Sunshine Project in fiscal 1992. With an intention of developing a technology on the process (NEDOL) suitable for liquefaction of wide range of coal types placing sub-bituminous coal at the center, researches were carried out by using a pilot plant, and engineering data purposed for practical application of the technology were acquired. The construction of the pilot plant was launched in fiscal 1991. It is necessary to execute the pilot plant plan steadily in the future, and at the same time, reliably acquire different data by means of supportive researches. Economic performance of the process is also important. The first sub-committee meeting presented the following agenda: the status of constructing the 150-t/d pilot plant, tests and investigations thereon, research works by using a 1-t/d PSU, development of the most suitable coal refining technology, development of a coal pretreatment technology, improvement of the distilled oil distribution, studies on coal liquefaction conditions, and studies on solvent hydrogenating catalysts. The second sub-committee meeting presented the following agenda: the status of constructing the pilot plant, tests and investigations on improving the performance of natural pylite catalyst and circulating solvent, technological investigations on structuring a liquefying reaction data analyzing system, studies using a 1-t/d PSU, development of the most suitable coal refining technology, studies on coal liquefaction conditions, and studies on solvent hydrogenating catalysts. (NEDO)
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Consultant-based otolaryngology emergency service: a five-year experience.
Barnes, M L; Hussain, S S M
2011-12-01
To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.
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2010-10-04
... the evaluation of advantages and disadvantages of adopting new fuel cycle technologies and the... Technology Subcommittee AGENCY: Department of Energy, Office of Nuclear Energy. ACTION: Notice of Open Meeting. SUMMARY: This notice announces an open meeting of the Reactor and Fuel Cycle Technology (RFCT...
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The guideline "consultation psychiatry" of the Netherlands Psychiatric Association
Leentjens, A.F.G.; Boenink, A.D.; Sno, H.N.; Strack van Schijndel, R.J.M.; Croonenborg, van J.J.; Everdingen, van J.J.E.; Feltz - Cornelis, van der C.M.; Laan, van der S.; Marwijk, van H.W.J.; Os, T.W.D.P. Van
2009-01-01
Background: In 2008, the Netherlands Psychiatric Association authorized a guideline "consultation psychiatry." Aim: To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and,
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Consultation for Parents of Young Gifted Children.
Wolf, Joan S.
1989-01-01
The article describes private evaluation and consultation services provided to parents of young gifted children, and discusses the benefits of private consultation and the potential role of school personnel in meeting the needs of this population. (Author/JDD)
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Public Consultation toward Ethiopia's Family Law Reform ...
African Journals Online (AJOL)
Mandefrot Belay
A comprehensive and open public consultation was conducted during the revision ... in Ethiopia which are expected to guide any legal reform process so that the ... law, the way in which public consultation forums were organized, and the ...
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International Nuclear Information System (INIS)
2002-01-01
The consultants were requested to advise the Agency on the realization of a harmonized approach to internationally compatible quality assurance systems. The consultants presented their viewpoint and position papers in relation to initial questions posed, reflecting the international efforts and their own experiences in analytical quality assurance. The consultants made specific recommendations concerning various aspects of the Agency's Analytical Quality Assurance Services Programme
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2013-05-30
..., June 4, 2013--1:00 p.m. Until 5:00 p.m. The Subcommittee will review and discuss all cyber security... Flint North building, 11555 Rockville Pike, Rockville, MD. After registering with security, please...
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Feedback as a means to improve clinical competencies: Consultants ...
African Journals Online (AJOL)
Background. Effective supervision by consultants in postgraduate medical education involves the process of feedback. Giving feedback may be challenging for consultants who have no formal training in this process, which may be further compounded in heterogeneous diverse settings. Objective. To explore consultants' ...
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Energy consultancy in the year 2000
International Nuclear Information System (INIS)
Loeve, M.J.
1998-01-01
Liberalisation of the energy markets, shifting emphasis from energy carriers to energy products, improving insights in the areas of saving energy and energy efficiency, changes in the company itself. These are the developments which will continue to influence the profession of energy consultant, according to the author. A brief impression is given of what the energy consultant can do in the year 2000
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2010-07-30
... evolving transportation needs, challenges, and opportunities of the global economy. The Aviation Safety... activities associated with the list of priority safety issues developed during the first meeting. The subcommittee will also develop a work plan for future meetings. DATES: The meeting will be held on August 24...
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Energy saving consulting in Hamburg
Energy Technology Data Exchange (ETDEWEB)
1982-10-01
For anyone who wants to realise the dream of his own house, the terms of thermal insulation and saving heating plant should be central in planning this. One needs advice from experts for this. A survey of the many consultants offices available in Hamburg is provided. The list was compiled with the assistance of the Hamburg Chamber of Commerce and the Hamburg Trades Council and of professional associations. The information on the special fields of activity of the named consultants is based on their statements.
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Implementation of an Arranged Preventive Consultation in Danish General Practice
DEFF Research Database (Denmark)
Junge, Anne Gram; Kirkegaard, Pia; Thomsen, Janus Laust
Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences...... with the arranged preventive consultation with focus on facilitators and barriers in the implementation of the consultation. Material & Method: Semi-structured interviews with 10 GPs and nurses in general practice. Results & Conclusions: Economically lucrative services are not an isolated motivation for the GPs....../nurses, but must be accompanied with a basic belief in the effect of preventive consultations in general practice. The better payment of the 0106-service is used to spend more time per consultation and it makes the GPs/nurses feel rewarded for the preventive work they perform. The consultation frames a social...
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Mental Health Consultation Among Ontario's Immigrant Populations.
Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala
2017-11-16
To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on
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14 CFR 413.5 - Pre-application consultation.
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Pre-application consultation. 413.5 Section 413.5 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING LICENSE APPLICATION PROCEDURES § 413.5 Pre-application consultation. A...
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Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.
Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P
2015-08-01
Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.
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Impact of a national specialty e-consultation implementation project on access.
Kirsh, Susan; Carey, Evan; Aron, Dacid C; Cardenas, Omar; Graham, Glenn; Jain, Rajiv; Au, David H; Tseng, Chin-Lin; Franklin, Heather; Ho, P Michael
2015-12-01
To assess the early impact of implementation of the electronic consults (e-consults) initiative by the Veterans Health Administration (VHA), designed to improve specialty care access. Observational cohort study exploiting a natural experiment begun in May 2011 at 12 VHA medical centers and expanded to 122 medical centers by December 2013. The following were assessed: 1) growth of e-consults by VHA regional networks, medical centers, and specialty; 2) location of patient's primary care provider (medical center vs community-based outpatient clinic [CBOC]); 3) potential patient miles needed to travel for a specialty care face-to-face consult in place of the observed e-consults using estimated geodesic distance; 4) use of specialty care subsequent to the e-consult. Of 11,270,638 consults completed in 13 clinics of interest, 217,014 were e-consults (adjusted rate, 1.93 e-consults per 100 consults). The e-consult rate was highest in endocrinology (5.0 per 100), hematology (3.0 per 100), and gastroenterology (3.0 per 100). The percentage of e-consult patients with CBOC-based primary care grew from 28.5% to 44.4% in the first year of implementation and to 45.6% at year 3. Of those e-consult patients from community clinics, the average potential miles needed to travel was 72.1 miles per patient (SD = 72.6; median = 54.6; interquartile range = 17.1-108), translating to a potential savings of 6,875,631 total miles and travel reimbursement costs of $2,853,387. E-consult volume increased significantly since inception within many medical and surgical specialties. For patients receiving primary care at one of more than 800 CBOCs, e-consults may decrease travel burden and direct travel costs for patients.
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Capturing the competence of management consulting work
Visscher, Klaasjan
2006-01-01
Purpose: The purpose of this article is to assess whether the effort of consulting firms and branch organizations to establish a shared and standardized methodology as a means to professionalize consulting and as a standard for training is possible and sensible. - Design/methodology/approach: A
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The preoperative cardiology consultation: indications and risk modification.
Groot, M W; Spronk, A; Hoeks, S E; Stolker, R J; van Lier, F
2017-11-01
The cardiologist is regularly consulted preoperatively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for elective non-cardiac surgery, which resulted in 273 (1%) referrals to the cardiologist for further preoperative evaluation. Medical charts were reviewed for patient characteristics, main reason for referring, requested diagnostic tests, interventions, adjustment in medical therapy, 30-day mortality and major adverse cardiac events. The most common reason for consultation was the evaluation of a cardiac murmur (95 patients, 35%). In 167 (61%) patients, no change in therapy was initiated by the cardiologist. Six consultations (2%) led to invasive interventions (electrical cardioversion, percutaneous coronary intervention or coronary artery bypass surgery). On average, consultation delayed clearance for surgery by two weeks. In most patients referred to the cardiologist after being screened at an outpatient anaesthesiology clinic, echocardiography is performed for ruling out specific conditions and to be sure that no further improvement can be made in the patient's health. In the majority, no change in therapy was initiated by the cardiologist. A more careful consideration about the potential benefits of consulting must be made for every patient.
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Public consultation: regulatory requirement or business principle?
International Nuclear Information System (INIS)
Seeley, R.
1999-01-01
A summary is included of knowledge and experiences related to planning and implementing a public consultation program over a number of years in Shell Canada's Athabasca Oil Sands development. This project consists of three major sub- projects with a total estimated capital investment of $4 billion. The three sub- projects are: the Muskeg River Mine, the Scotford Upgrader, and the Corridor Pipeline. The facilities will produce 150,000 bbl/day of synthetic crude for over 25 years and are targeted to begin production in late 2002. From the title of the paper, although public consultation is required under environmental legislation, many companies are adopting a more pro-active approach to public consultation and participation as a business principle. This commitment to engage in and dialogue with stakeholders must be open, transparent and long term, not just during the regulatory process. Successful consultation begins with the prerequisites: senior management commitment, buy-in from the project or operating team that the process adds value, and the ability to listen and make changes. A consultation program is not a short term activity, but is rather an ongoing process linked to a business or operating principle. It requires long term resources and follow through on agreements and commitments made to stakeholders and communities
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Public consultation: regulatory requirement or business principle?
Energy Technology Data Exchange (ETDEWEB)
Seeley, R. [Shell Canada Oil Sands, Calgary, AB (Canada)
1999-07-01
A summary is included of knowledge and experiences related to planning and implementing a public consultation program over a number of years in Shell Canada's Athabasca Oil Sands development. This project consists of three major sub- projects with a total estimated capital investment of $4 billion. The three sub- projects are: the Muskeg River Mine, the Scotford Upgrader, and the Corridor Pipeline. The facilities will produce 150,000 bbl/day of synthetic crude for over 25 years and are targeted to begin production in late 2002. From the title of the paper, although public consultation is required under environmental legislation, many companies are adopting a more pro-active approach to public consultation and participation as a business principle. This commitment to engage in and dialogue with stakeholders must be open, transparent and long term, not just during the regulatory process. Successful consultation begins with the prerequisites: senior management commitment, buy-in from the project or operating team that the process adds value, and the ability to listen and make changes. A consultation program is not a short term activity, but is rather an ongoing process linked to a business or operating principle. It requires long term resources and follow through on agreements and commitments made to stakeholders and communities.
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Working with boundaries in systems psychodynamic consulting
Directory of Open Access Journals (Sweden)
Henk Struwig
2012-03-01
Research purpose: The purpose of the research was to produce a set of theoretical assumptions about organisational boundaries and boundary management in organisations and, from these, to develop a set of hypotheses as a thinking framework for practising consulting psychologists when they work with boundaries from a systems psychodynamic stance. Motivation for the study: The researcher used the belief that organisational boundaries reflect the essence of organisations. Consulting to boundary managers could facilitate a deep understanding of organisational dynamics. Research design, approach and method: The researcher followed a case study design. He used systems psychodynamic discourse analysis. It led to six working hypotheses. Main findings: The primary task of boundary management is to hold the polarities of integration and differentiation and not allow the system to become fragmented or overly integrated. Boundary management is a primary task and an ongoing activity of entire organisations. Practical/managerial implications: Organisations should work actively at effective boundary management and at balancing integration and differentiation. Leaders should become aware of how effective boundary management leads to good holding environments that, in turn, lead to containing difficult emotions in organisations. Contribution/value-add: The researcher provided a boundary-consulting framework in order to assist consultants to balance the conceptual with the practical when they consult.
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Identifying challenges in project consultants engagement practices
Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul
2017-10-01
Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.
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Third Meeting of the IFRC Subcommittee on Atomic and Molecular (A+M) Data for Fusion. Summary Report
Energy Technology Data Exchange (ETDEWEB)
Lorenz, A.; Hughes, J. [International Atomic Energy Agency, Nuclear Data Section, Vienna (Austria)
1984-11-15
The Subcommittee reaffirmed its earlier position that the primary function of the IAEA A+M Data Unit is to assemble a file of evaluated atomic collision data which had been recommended by atomic physicists and disseminate these data to the fusion research community.
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2010-09-09
... manage effectively the evolving transportation needs, challenges, and opportunities of the global economy... of the world's technologically advanced economies. Among other matters, the subcommittee will examine... science, technology, engineering, and math (STEM) skills in the industry; (2) the creation of a culture of...
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Impact of Diabetes E-Consults on Outpatient Clinic Workflow.
Zoll, Brian; Parikh, Pratik J; Gallimore, Jennie; Harrell, Stephen; Burke, Brian
2015-08-01
An e-consult is an electronic communication system between clinicians, usually a primary care physician (PCP) and a medical or surgical specialist, regarding general or patient-specific, low complexity questions that would not need an in-person consultation. The objectives of this study were to understand and quantify the impact of the e-consult initiative on outpatient clinic workflow and outcomes. We collected data from 5 different Veterans Affairs (VA) outpatient clinics and interviewed several physicians and staff members. We then developed a simulation model for a primary care team at an outpatient clinic. A detailed experimental study was conducted to determine the effects of factors, such as e-consult demand, view-alert notification arrivals, walk-in patient arrivals, and PCP unavailability, on e-consult cycle time. Statistical tests indicated that 4 factors related to outpatient clinic workflow were significant, and levels within each of the 4 significant factors resulted in statistically different e-consult cycle times. The arrival rate of electronic notifications, along with patient walk-ins, had a considerable effect on cycle time. Splitting the workload of an unavailable PCP among the other PCPs, instead of the current practice of allocating it to a single PCP, increases the system's ability to handle a much larger e-consult demand. The full potential of e-consults can only be realized if the workflow at the outpatient clinics is designed or modified to support this initiative. This study furthers our understanding of how e-consult systems can be analyzed and alternative workflows tested using statistical and simulation modeling to improve care delivery and outcomes. © The Author(s) 2014.
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SOME REFLECTIONS UPON MANAGEMENT CONSULTING AS PROFESSIONAL SERVICES
Tomescu Ada; Botezat Elena
2008-01-01
Management consulting helping organizations improve their performance, primarily through the thorough analysis of existing business problems and development of plans for improvement. There is probably no activity about which the opinions are so divided as management consulting. The purpose of this paper is to make some reflections upon what role play the consulting management services as professional service to the firms and how offering these services affects the offering and delivery of oth...
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Services of strategic consulting: special features and types
Klenin Oleh Volodymyrovych
2016-01-01
In the article essence of terms “consulting” and “strategic consulting” was studied. It was proved that strategic consulting must be analyzed as professional activity in the system of enterprise strategic management. Specific features of consultative services and its composition was added from the point of view of strategic management and innovative development were studied. In the process of providing consulting services it was suggested to take into account the strategic orientation of huma...
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Crisis Communication Consultation of the Federal Reserve Bank System
Chandler, Robert C.; Wallace, J. D.
2008-01-01
This article, designed for both consulting practitioners and academics, reveals what it is like to do a high-level and high-profile client consultancy. This consultancy was highly informed by and assumes a working knowledge of instructional communication theory, research, and methods as well as drawing upon contemporary communication scholarship…
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Afifi, Ladan; Shinkai, Kanade
2017-03-01
Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.
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2010-09-30
... of the global economy. The Subcommittee on Competitiveness and Viability is charged with examining..., from 10 a.m. to 2:30 p.m. Mountain Daylight Time. ADDRESSES: The meeting will be held in the New Press... taking place on October 15, 2010, at 10 a.m. to 2:30 p.m. Mountain Daylight Time, in the New Press Room...
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Alexander, C. J.; Hiza, M.; Jenkins, G.; Karsten, J.; Molina, L.; Pyrtle, A.; Runyon, C.
2004-12-01
The American Geophysical Union (AGU) founded the Diversity Subcommittee in 2000 to address what the AGU felt were important issues for the future of the geoscience community. A recent AGU statement of commitment and concern about issues of diversity reads, in part: It is essential that new strategies for educating, recruiting, and retaining geoscientists from currently under-represented populations be developed (a) for individual investigators seeking students to fill classes or work in their research programs; (b) for institutions looking to replace faculty and researchers; (c) for the larger community looking to the public for continued research funding, and (d) for the future US membership of AGU. In an effort to fulfill its charge, the majority of the 2004-2006 sub-committee's activities will be directed towards: (1) Education of the AGU Membership, including the sub-committee itself, on the salient issues of Diversity; (2) Mentoring and supporting minority students in the pipeline of Earth and Space Science education as well as minority faculty seeking to establish successful collaborations; (3) Establishing a mechanism for quantitative assessment of (a) the AGU demographics, (b) member knowledge, and (c) success of programs in the area of Diversity; (4) Conducting the first ever Chapman Conference on the needs of investigators with disabilities (July, 2005); (5) Partnering with other agencies and societies to build bridges; (6) Creating mechanisms for marketing the Earth and Space sciences to minority audiences; (7) Nurturing of minority members already in the AGU; promoting these members for honors and awards within AGU. Details, goals, and milestones of this program will be presented.
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Energy Technology Data Exchange (ETDEWEB)
NONE
1988-03-01
The environmental safety evaluation sub-committee has held two meeting in the current fiscal year as described below. The first sub-committee meeting (August 25, 1987) was held for the agenda of the summary of future test plans, the result of overseas surveys in fiscal 1986, the results of tests in fiscal 1986, and the summary of the test plan for fiscal 1987. The major agendum of the second sub-committee meeting (February 23) was the interim reports on the overseas survey results and the safety tests in fiscal 1987. NEDO intends to ensure the labor hygiene for workers in coal liquefying plants, the effect of liquefied oil on users' health, and social acceptability of liquefied oil. Therefore, a safety test for liquefied oil in the primary hydrogenation process was performed provisionally on brown coal PP in the initial stage of operation, in addition to bituminous coal liquefied oil at the existing 1-t/d PDU. The main contents of the test performed by NEDO are based on the labor safety and hygiene law and the law related to regulation on the deliberation and manufacture of chemical materials. Different tests using guinea pigs were carried out on the total fraction mixed at the 1-t/d PDU, and each fraction of light and heavy oils, where the liquefied oil was verified to have minor degree of toxicity. (NEDO)
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Conceptual model of integrated apiarian consultancy
Bodescu, Dan; Stefan, Gavril; Paveliuc Olariu, Codrin; Magdici, Maria
2010-01-01
The socio-economic field researches have indicated the necessity of realizing an integrated consultancy service for beekeepers that will supply technical-economic solutions with a practical character for ensuring the lucrativeness and viability of the apiaries. Consequently, an integrated apiarian consultancy model has been built holding the following features: it realizes the diagnosis of the meliferous resources and supplies solutions for its optimal administration; it realizes the technica...
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Lessons Learned from a Consultation Process Overseas
Merino-Soto, César
2014-01-01
In this commentary I discuss three international school consultation experiences, highlighting aspects that serve as lessons for professional development and the implementation of effective and helpful strategies that meet the needs of children and youth in school systems. Relationships developed and maintained between the consulting teams and the…
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2010-09-13
..., time, and location of the meeting, which will be open to the public. The purpose of the FAAC is to..., challenges, and opportunities of the global economy. The Subcommittee on Financing will address the need for... 60601. Public Access: The meeting is open to the public. (See below for registration instructions...
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2010-05-07
...: Wednesday, May 19, 2010--1 p.m. until 5 p.m. The Subcommittee will review Draft Final Regulatory Guide 1.216 (previously DG-1203) ``Containment Structural Integrity Evaluation for Internal Pressure Loadings Above Design... the time allotted to present oral statements can be obtained from the website cited above or by...
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Therapists’ Perspectives on the Effective Elements of Consultation Following Training
Beidas, Rinad S.; Edmunds, Julie M.; Cannuscio, Carolyn C.; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C.
2013-01-01
Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists’ perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists ...
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2010-10-01
... of the global economy. The subcommittee is charged with ensuring the availability and quality of a... socio-economic dynamics of the world's technologically advanced economies. Among other matters, the...: (1) The need for science, technology, engineering, and math skills in the industry; (2) the creation...
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Development of a Remote Consultation System Using Avatar Technology
Ohnishi, Tatsuya; Yajima, Hiroshi; Sawamoto, Jun
The chance to use the Internet as a communications tool has been increasing, and the consultation businesses for customers at remote places are diversifying in their communication media and forms. In the remote consultation, the lack of non-verbal information is reported as one of the reasons for inefficiency and customer's dissatisfaction compared with the face-to-face consultation. The technique for supplementing non-verbal information with a TV telephone is proposed, and helps to confirm understanding degree or the utterance timing by watching the movement of the face. But the displayed face of the partner causes strong feeling of strain between strangers and the participants also care about background scene displayed on the monitor producing risks in the consultation tasks. In this paper, we propose a remote consultation method that uses avatar technology in the virtual space in order to provide non-verbal information and also avoiding the problem of TV telephone at the same time. The effectiveness of the proposed remote consultation method is confirmed by experiments.
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International telemedicine consultations for neurodevelopmental disabilities.
Pearl, Phillip L; Sable, Craig; Evans, Sarah; Knight, Joseph; Cunningham, Parker; Lotrecchiano, Gaetano R; Gropman, Andrea; Stuart, Sheela; Glass, Penny; Conway, Anne; Ramadan, Issam; Paiva, Tania; Batshaw, Mark L; Packer, Roger J
2014-06-01
A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE. Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session. Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions. Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental
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Consultation: Creating School-Based Interventions. Second Edition.
Dinkmeyer, Don, Jr.; Carlson, Jon
Decades after consultation has become a mandated function of school counselors, consultants still seek effective ways to deliver this essential role. This book, geared towards mental health professionals, provides a set of skills for working with the school-based population. The ideas, based on Adlerian psychology, present a theory of consultation…
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29 CFR 1903.10 - Consultation with employees.
2010-07-01
... 29 Labor 5 2010-07-01 2010-07-01 false Consultation with employees. 1903.10 Section 1903.10 Labor... INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.10 Consultation with employees. Compliance Safety and... extent they deem necessary for the conduct of an effective and thorough inspection. During the course of...
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Expectation Levels in Dictionary Consultation and Compilation ...
African Journals Online (AJOL)
Dictionary consultation and compilation is a two-way engagement between two parties, namely a dictionary user and a lexicographer. How well users cope with looking up words in a Bantu language dictionary and to what extent their expectations are met, depends on their consultation skills, their knowledge of the structure ...
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Consultancy and innovation the business service revolution in Europe
Wood, Peter
2003-01-01
Consultancy and Innovation links two important aspects of European economic development in the past thirty years: the pace of technical and management innovation, and the growing significance of technical and business consultancy. This book includes detailed studies of consultancy activities or 'knowledge intensive services' (KIS) in eight EU countries, written by national experts in the field.
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MED5/355: Using Web-technology for Asynchronous Telemedicine Consulting
Reviakin, Y; Sukhanov, A
1999-01-01
Introduction Common telemedicine consultations can be divided in two classes: real-time telemedicine consultations and asynchronous telemedicine consultations. The advantage of real-time consultations is obvious - this is a natural discussion between physicians, which may be realised on the basis of desktop videoconferences. But the problems are also obvious: the necessity of additional hardware and the elevated demands for channel bandwidth. Because of the latter, the use of asynchronous tel...
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Virtual online consultations: advantages and limitations (VOCAL) study.
Greenhalgh, Trisha; Vijayaraghavan, Shanti; Wherton, Joe; Shaw, Sara; Byrne, Emma; Campbell-Richards, Desirée; Bhattacharya, Satya; Hanson, Philippa; Ramoutar, Seendy; Gutteridge, Charles; Hodkinson, Isabel; Collard, Anna; Morris, Joanne
2016-01-29
Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations. To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel--audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel--interviews, ethnographic observations and analysis of documents within the trust; macrolevel--key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory. City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883. We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: 'what to expect in your virtual consultation'. The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We
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Recommendations of the Subcommittee on the taxonomy of Campylobacter and related bacteria
DEFF Research Database (Denmark)
Vandamme, P.; On, S.L.W.
2001-01-01
therefore discourages the use of the name C. hyoilei. (ii) The revised infrasubspecific nomenclature of Campylobacter sputorum is endorsed. C. sputorum is subdivided into C. sputorum biovar sputorum (characterized by the absence of catalase and urease activity); C. sputorum biovar faecalis (characterized...... by catalase but not urease activity); and C. sputorum biovar paraureolyticus (characterized by urease, but not catalase activity). (iii) The subcommittee points out that 'Flexispira rappini' is a taxon that is circumscribed by means of morphological criteria. It encompasses multiple Helicobacter species...
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Medical Student Experiences on Consultation-Liaison Psychiatry Rotations: A Nationwide Survey.
Meyer, Fremonta; Abbasi, Omair; Kasick, David; Lee, Kewchang; Pelic, Christine; Zinser, Jennifer; Harris, Thomas; Funk, Margo
Consultation-liaison (C-L) psychiatry clerkship rotations may improve medical students' understanding of psychiatric principles relevant to the settings in which they will ultimately practice. This study aimed to characterize students' experiences on C-L rotations. This cross-sectional survey study, sponsored by the Academy of Psychosomatic Medicine Subcommittee on Medical Student Education, was conducted at 5 US medical schools between 2012 and 2016. After the C-L rotation, students completed a voluntary 17-item survey. A total of 235 surveys were collected (mean response rate = 92%). The most frequently endorsed benefit of C-L was learning to manage psychiatric disorders in the context of medical illness (89%). The most frequently endorsed drawback was inconsistent/excessively variable workload (40%). Overall, 82% of respondents recommended C-L to other students; 80% reported that the ideal clerkship would include exposure to both C-L and inpatient psychiatry. Overall, 38% reported that their C-L experience increased their interest in psychiatry as a career. Effect of C-L on interest in psychiatry did not differ by study site, age, sex, clerkship length, or time spent on C-L. Respondents who noted more positive role-modeling on C-L compared to other clerkship rotations were more likely to report increased interest in a psychiatry career (odds ratio = 2.70). Most medical students perceive C-L rotations favorably. Positive role modeling may increase their consideration of psychiatry specialization. The findings that C-L rotation length did not correlate with attitudes and that most students preferred exposure to both inpatient and C-L psychiatry suggest that C-L exposure can beneficially be integrated into core clerkships containing other elements. Copyright © 2018 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
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[A successful attempt with a consulting service for boys].
Gottlieb, C; Christiansen, I; Von Segebaden, C; Wiksten-Almströmer, M
1998-08-05
As adolescence is a critical period of development, and as boys are less inclined than girls to approach the school facility for adolescent counselling, segregated consulting hours were introduced for boys to attract those with problems. The frequency of consultations by boys increased by 25 per cent, and 70 per cent of the boys reported a preference for the segregated consulting hours; 75 per cent appreciated the absence of girls from the waiting room; and of the 42 per cent with special preferences regarding the gender of the staff encountered, half reported preferring a man. Most of the boys presented with defined problems, though many revealed other problems, often relating to sexuality, in the course of consultation. The availability of segregated consulting hours for boys with adolescent problems is important, and often the only way to reach young boys who need help.
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An empirical study of multidimensional fidelity of COMPASS consultation.
Wong, Venus; Ruble, Lisa A; McGrew, John H; Yu, Yue
2018-06-01
Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a consultative intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for students with autism. The study provided 3 main findings. First, multidimensional, multilevel fidelity is a stable construct and increases over time with consultation support. Second, mediation analyses revealed that implementation-level fidelity components had distant, indirect effects on student Individualized Education Program (IEP) outcomes. Third, 3 fidelity components correlated with IEP outcomes: teacher coaching responsiveness at the implementation level, and teacher quality of delivery and student responsiveness at the intervention levels. Implications and future directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Congress of the U.S., Washington, DC. House Committee on Science.
This document presents witness testimony and supplemental materials from a Congressional hearing called to address concerns about the Internet becoming a forum through which minors can be exposed to pornographic or otherwise offensive material. It features opening statements by Congressman Steven H. Schiff, chairman of the House Subcommittee on…
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2010-08-05
... of the meeting, which will be open to the public. The purpose of the FAAC is to provide advice and... of the global economy. The Subcommittee on Financing will address the need for a stable, secure, and... Access: The meeting is open to the public. (See below for registration instructions.) Public Comments...
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An integrated occupational hygiene consultation model for the catering industry.
Lin, Yi-Kuei; Lee, Lien-Hsiung
2010-07-01
Vegetable oil used in food processing, during high-temperature exposure, will generate particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic chemical compounds, with the potential to cause lung disease for restaurant kitchen staff. This study's design includes a three-stage consultation process with eight major consultation items, in order to build an integrated consultation model for occupational hygiene. This model combines inspection and consultation, targeting Chinese restaurants in the catering industry. Characteristics of the integrated consultation model include cooperation between different government departments and collaboration with nongovernmental, professional consulting organizations. An additional benefit of the model is the building of a good partnership relationship with the Catering Trade Association. The consultation model helps Chinese restaurants attain improvements in their work environments with minimal investment. Postconsultation, results show a 63.35% and 61.98% (P < 0.001) decrease in the mean time-weighted concentration of exposure to PM and PAHs, respectively. The overall regulation compliance rate of Chinese restaurants significantly increased from 34.3% to 89.6%. These results show that the integrated consultation model for occupational hygiene not only helps small and medium enterprises reduce exposure concentrations in the workplace but also has specific potential for successful implementation in Taiwan.
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2010-09-21
... effectively manage the evolving transportation needs, challenges, and opportunities of the global economy. The... technologically advanced economies. Among other matters, the subcommittee will examine three issues affecting the..., engineering, and math skills in the industry; (2) the creation of a culture of dignity and respect in...
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[Motivations for a consultation before adoption: A multicenter study].
Thieblemont, M; Francois, P; Poirier, V; Bosdure, E; Munck, M-R; Borsa-Dorion, A; Hazart, I; Moukagni-Pelzer, M; Brunel, D; Peyron, F; de Monleon, J-V
2016-01-01
While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. Prospective multicenter study conducted from 1 January to 31 December 2013. Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations. Copyright © 2015. Published by Elsevier SAS.
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Neglected ends: clinical ethics consultation and the prospects for closure.
Fiester, Autumn
2015-01-01
Clinical ethics consultations (CECs) are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering sequelae: moral distress or negative moral emotions. The problem, succinctly named, is that such consults have insufficient "closure" for patients, families, and providers. To promote closure, and avoid the ills of moral distress and the moral emotions, I argue that CECs need to prioritize assisted conversation between the different stakeholders in these conflicts, what is often referred to as "bioethics mediation."
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The Next Frontier in Family Business: Career Consulting.
Haid, Richard L.
1995-01-01
Offers guidelines for being a consultant to family businesses' chief executive officers (CEOs). The consultant can make it easier for these CEOs to step down and complete an often painful but unavoidable transition. (Author/JOW)
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Building Interpersonal Relationships as a Key to Effective Speaking Center Consultations
Ward, Kiya; Schwartzman, Roy
2009-01-01
Although much interest has been generated regarding the functions speaking centers serve and the effects consultations can have, minimal research has addressed the dynamics of consultations themselves. This study documents what speaking center clients and consultants identify as barriers in consultations and how they address them. Analysis of…
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A Review of Gerald Caplan's "Theory and Practice of Mental Health Consultation."
Mendoza, Danielle W.
1993-01-01
Reviews Caplan's "Theory and Practice of Mental Health Consultation" (1970), considered classic seminal work in field of consultation. Presents Caplan's general definition of consultation and general principles or procedures of consultation. Describes each of Caplan's four models of consultation and compares models in terms of professional role of…
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Ubiquitous consultation tool for decentral knowledge workers
Nazari Shirehjini, A.A.; Rühl, C.; Noll, S.
2003-01-01
The special issue of this initial study is to examine the current work situation of consulting companies, and to elaborate a concept for supporting decentralized working consultants. The concept addresses significant challenges of decentralized work processes by deploying the Peer-to-Peer methodology to decentralized expert and Knowledge Management, cooperation, and enterprise resource planning.
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Interventions before consultations for helping patients address their information needs.
Kinnersley, P; Edwards, A; Hood, K; Cadbury, N; Ryan, R; Prout, H; Owen, D; Macbeth, F; Butow, P; Butler, C
2007-07-18
Patients often do not get the information they require from doctors and nurses. To address this problem, interventions directed at patients to help them gather information in their healthcare consultations have been proposed and tested. To assess the effects on patients, clinicians and the healthcare system of interventions which are delivered before consultations, and which have been designed to help patients (and/or their representatives) address their information needs within consultations. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library (issue 3 2006); MEDLINE (1966 to September 2006); EMBASE (1980 to September 2006); PsycINFO (1985 to September 2006); and other databases, with no language restriction. We also searched reference lists of articles and related reviews, and handsearched Patient Education and Counseling (1986 to September 2006). Randomised controlled trials of interventions before consultations designed to encourage question asking and information gathering by the patient. Two researchers assessed the search output independently to identify potentially-relevant studies, selected studies for inclusion, and extracted data. We conducted a narrative synthesis of the included trials, and meta-analyses of five outcomes. We identified 33 randomised controlled trials, from 6 countries and in a range of settings. A total of 8244 patients was randomised and entered into studies. The most common interventions were question checklists and patient coaching. Most interventions were delivered immediately before the consultations.Commonly-occurring outcomes were: question asking, patient participation, patient anxiety, knowledge, satisfaction and consultation length. A minority of studies showed positive effects for these outcomes. Meta-analyses, however, showed small and statistically significant increases for question asking (standardised mean difference (SMD) 0.27 (95% confidence interval (CI) 0.19 to 0.36)) and
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The representations of adolescents about gynecological consultation
Directory of Open Access Journals (Sweden)
Vera Lúcia de Oliveira Gomes
2014-06-01
Full Text Available Objective: To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. Method: Qualitative descriptive study based on the Social Representations Theory, conducted with 50 adolescents in their last year of middle school. The data was collected between April and May of 2010 by Evocations and a Focal Group. The software EVOC and contextual analysis were used in the data treatment. Results: The elements fear and constraint, constant in the central nucleus, can justify the low frequency of adolescents in consultations. The term embarrassment in the peripheral system reinforce current sociocultural norms, while prevention, associated with learning about sex and clarifying doubts, allows to envision an educative function. Obtained testimonies in the focal groups exemplify and reinforce those findings. Conclusion: For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.
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2010-10-15
... provides advice, information and recommendations on the scientific and technical aspects of air quality... charge questions, AAMMS is drafting a report to be reviewed by the chartered CASAC on November 9, 2010.../SABPRODUCT.NSF/81e39f4c09954fcb85256ead006be86e/0fc13c821ee6181a85257473005ae1ec!OpenDocument . Technical...
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On Scientific Data and Image Compression Based on Adaptive Higher-Order FEM
Czech Academy of Sciences Publication Activity Database
Šolín, Pavel; Andrš, David
2009-01-01
Roč. 1, č. 1 (2009), s. 56-68 ISSN 2070-0733 R&D Projects: GA ČR(CZ) GA102/07/0496; GA AV ČR IAA100760702 Institutional research plan: CEZ:AV0Z20570509 Keywords : data compress ion * image compress ion * adaptive hp-FEM Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering http://www.global-sci.org/aamm
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User Consultation Behaviour in Internet Dictionaries
DEFF Research Database (Denmark)
Simonsen, Henrik Køhler
2011-01-01
the participants looked, but also how they accessed lexicographic data. The paper presents a suitable method for using eye-tracking studies in Internet lexicography and advocates an increased use of this method to produce empirical data upon which additional theoretical considerations on the information and data......The purpose of this paper is to explore and discuss user consultation behaviour on the basis of eye-tracking data and interview data. To date the focus has been almost exclusively on the use of log files in Internet lexicography - an approach which is questioned in this article. The paper is based...... on empirical data from an exploratory eyetracking study of the user consultation behaviour of six participants and on interview data from a follow-up post-study interview of the participants. The paper elucidates and discusses the consultation behaviour in Internet lexicography and shows not only at what...
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Mutual construction and reconstruction in client-consultant interaction
DEFF Research Database (Denmark)
Smith, Irene Skovgaard
Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...... presented in the paper illustrates how consultancy projects evolve through processes of negotiation over whose interpretation should count and who should be in control. In the process, client actors with different posi-tions and interests play an active role in creating what become valid and what ideas...
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[Differences in the nursing consultation utilization in primary care, Spain].
Martín-Fernández, Jesús; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Vergel Gutierrez, M Ángeles; Hidalgo Escudero, Ana Victoria; Conde-López, Juan Francisco
2013-01-01
Different conditions in health services utilization may create situations of inequity. The objective was analyze the differences of nurse consultation utilization in primary care. Cross-sectional study, in 23 health centres in Madrid. Environmental variables, consultation characteristics, socio-demographic and health need characteristics were collected. The quality of life and satisfaction were also studied. The variables were classified according to the "behavioral model" in predisposing, enabling or need variables. Explanatory multivariate models were constructed (Generalized-Estimating-Equations). The higher income areas and aging, predisposing factors, were associated with increases of 17% (95% CI: 0.4 to 36.9%) and 11.0% per decade (95% CI: 6.2 - 16.2) in nursing consultations per year. Among enabling factors, each additional minute of consultation length was associated with an increase of 2.0% (95% CI :1.2-2, 9%) in number of nurse consultations, each new medical consultation was associated with a increase of 2.7% (95% CI: 2.1-3.2%) and the delay in getting appointment over a day, represented a decrease of 32.8% (95% CI: 19.3 to 44.1%) in the total nursing consultations. Each chronic condition, which expresses the need health, was associated with an increase in the number of visits of 4.8% (95% CI: 1.7 to 8.0%). The improved perception of quality of life was associated with a reduction of 5.4% (95% CI 1.0 to 8.7%) of the consultations. The difference of the use of primary care nurse consultations is based on health need criteria, but is also influenced by accessibility conditions.
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42 CFR 493.1457 - Standard; Clinical consultant responsibilities.
2010-10-01
... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing High Complexity Testing § 493.1457 Standard; Clinical consultant... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Clinical consultant responsibilities. 493...
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Business Communication Consulting and Research in Multinational Companies.
Hildebrandt, Herbert W.
1978-01-01
Describes three issues involved in communication research and consulting for multinational companies, particularly those in Germany: qualifications for doing international consulting and research, problems of American scholar-researchers in those firms, and suggestions for dealing with those issues. (JMF)
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Akobeng, Anthony K.; O'Leary, Neil; Vail, Andy; Brown, Nailah; Widiatmoko, Dono; Fagbemi, Andrew; Thomas, Adrian G.
2015-01-01
Background: Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD. Methods: We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8–16 years) with IBD were randomized to receive telephone consultation o...
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Trends in Otolaryngology Consultation Patterns at an Academic Quaternary Care Center.
Choi, Kevin J; Kahmke, Russel R; Crowson, Matthew G; Puscas, Liana; Scher, Richard L; Cohen, Seth M
2017-05-01
The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014. Clinical evaluation and bedside and operative procedures performed by the otolaryngology-head and neck surgery service. Demographics, reason for consultation, diagnosis, bedside procedures, operative interventions, and admission variables. A total of 1491 consultations were completed for adult (1091 [73.2%]; 854 men and 637 women; mean [SD] age 50.3 [19.3] years) and pediatric (400 [26.8%]; 232 boys and 168 girls; mean [SD] age, 4.0 [5.2] years) patients. Of the 1491 consultations, 766 (51.4%) originated from inpatient teams vs 725 (48.6%) from the ED. A total of 995 of all consultations (66.7%) resulted in a bedside procedure, and 243 (16.3%) required operative intervention. Consultations regarding airway evaluation (362 [47.3%] vs 143 [19.7%]), management of epistaxis (78 [10.2%] vs 33 [4.6%]), and rhinologic evaluation (79 [10.3%] vs 18 [2.5%]) were more frequent from inpatient teams than from the ED. Consultations regarding management of head and neck infections (162 [22.3%] vs 32 [4.2%]), facial trauma (235 [32.4%] vs 16 [2.1%]), and postoperative complications (73 [10.1%] vs 2 [0.3%]) were more frequent in the ED. Of the 725 consultations performed in the ED, 212 patients (29.2%) required hospitalization. The consultation volume of an otolaryngology-head and neck surgery service requires significant time and resources. Consultations are most often for rhinologic or laryngologic issues and are reflective of the clinical setting in which
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Applying research to practice: generalist and specialist (visual ergonomics) consultancy.
Long, Jennifer; Long, Airdrie
2012-01-01
Ergonomics is a holistic discipline encompassing a wide range of special interest groups. The role of an ergonomics consultant is to provide integrated solutions to improve comfort, safety and productivity. In Australia, there are two types of consultants--generalists and specialists. Both have training in ergonomics but specialist knowledge may be the result of previous education or work experience. This paper presents three projects illustrating generalist and specialist (visual ergonomics) consultancy: development of a vision screening protocol, solving visual discomfort in an office environment and solving postural discomfort in heavy industry. These case studies demonstrate how multiple ergonomics consultants may work together to solve ergonomics problems. It also describes some of the challenges for consultants, for those engaging their services and for the ergonomics profession, e.g. recognizing the boundaries of expertise, sharing information with business competitors, the costs-benefits of engaging multiple consultants and the risk of fragmentation of ergonomics knowledge and solutions. Since ergonomics problems are often multifaceted, ergonomics consultants should have a solid grounding in all domains of ergonomics, even if they ultimately only practice in one specialty or domain. This will benefit the profession and ensure that ergonomics remains a holistic discipline.
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The preoperative cardiology consultation: Indications and risk modification
M.W. de Groot (Mark); A. Spronk (Angela); S.E. Hoeks (Sanne); R.J. Stolker (Robert); F. van Lier (Felix)
2017-01-01
textabstractBackground The cardiologist is regularly consulted preop-eratively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. Methods This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for
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Introducing Farouk's Process Consultation Group Approach in Irish Primary Schools
Hayes, Marie; Stringer, Phil
2016-01-01
Research has shown that teacher consultation groups increase teachers' behaviour management skills through discussion and collaborative problem-solving. Unlike the United Kingdom, at the time of this research consultation groups were not widely used in Irish schools. This research introduced Farouk's process consultation approach in three Irish…
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Chia Nan Wang; Tran Thanh Tuyen; Nguyen Nhu Ty
2014-01-01
The topic of job satisfaction has been investigated over the years. However, the environmental impact of the work of job consulting centre’s employee satisfaction is beginning to attract the attention of the researcher. Job consulting centre has become an integral part of most organizations today, play an important role in supplying-jobs services. This study aims to examine the key factors that are closely associated with job satisfaction of employees working at job consulting centre as well ...
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Consulting Whom? Lessons from the Toronto Urban Aboriginal Strategy
Directory of Open Access Journals (Sweden)
Mai T. Nguyen
2014-04-01
Full Text Available The research conducted here looks at the current Urban Aboriginal Strategy (UAS in Toronto. The purpose of this Strategy is to provide long-term investments to support Aboriginal communities in urban settings by focusing on three priority areas: improving life skills; promoting job training, skills, and entrepreneurship; and supporting Aboriginal women, children, and families. This article seeks to answer the following question: Does the UAS provide Aboriginal participants with the ability to effectively participant in the consultation process? It argues that the UAS process of consulting with the urban Aboriginal community does not allow for the effective participation of Aboriginal peoples because of problematics related to consulting in an urban setting and despite the language of partnership, the federal government still reserves the right to make final decisions. These problems diminish the ability to build renewed Aboriginal-State relations based on mutual respect and trust, which has been absent within the Aboriginal-State apparatus and resulted in the political exclusion of Aboriginals in Canada. Though consultation can be a vehicle for empowering participants with decision-making authority, this is not the case in Toronto. The lack of a common vision, political buy-in, and the aura of secrecy leads to a political relationship built on mistrust. Mistrust between members and government renders the consultation process ineffective. This article combines the literature on public consultations with official government documents to identify critical components that must be evident for consultations to be fruitful and participation effective. These criteria are the benchmarks upon which to measure effectiveness. Based on interviews with the Steering Committee, this article finds that the UAS process of consulting with the Toronto Aboriginal community does not enable Aboriginal participants to effectively participate in the democratic process.
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Report of the Subcommittee on Domestic Uranium Enrichment
International Nuclear Information System (INIS)
1981-01-01
A report by the Subcommittee on Domestic Uranium Enrichment to the Atomic Energy Commission is described; which covers the procedure of the domestic uranium enrichment by centrifugal process up to the commercial production, reviewing the current situation in this field. Domestic uranium enrichment is important in the aspects of securing stable enrichment service, establishing sound fuel cycle, and others. As the future target, the production around the year 2000 is set at 3,000 tons SWU per year at least. The business of uranium enrichment, which is now developed in the Power Reactor and Nuclear Fuel Development Corporation, is to be carried out by private enterprise. The contents are as follows: demand and supply balance of uranium enrichment service, significance of domestic uranium enrichment, evaluation of centrifugal uranium enrichment technology, the target of domestic uranium enrichment, the policy of domestic uranium enrichment promotion. (J.P.N.)
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The Clinical Impact of Cardiology Consultation Prior to Major Vascular Surgery.
Davis, Frank M; Park, Yeo June; Grey, Scott F; Boniakowski, Anna E; Mansour, M Ashraf; Jain, Krishna M; Nypaver, Timothy; Grossman, Michael; Gurm, Hitinder; Henke, Peter K
2018-01-01
To understand statewide variation in preoperative cardiology consultation prior to major vascular surgery and to determine whether consultation was associated with differences in perioperative myocardial infarction (poMI). Medical consultation prior to major vascular surgery is obtained to reduce perioperative risk. Despite perceived benefit of preoperative consultation, evidence is lacking specifically for major vascular surgery on the effect of preoperative cardiac consultation. Patient and clinical data were obtained from a statewide vascular surgery registry between January 2012 and December 2014. Patients were risk stratified by revised cardiac risk index category and compared poMI between patients who did or did not receive a preoperative cardiology consultation. We then used logistic regression analysis to compare the rate of poMI across hospitals grouped into quartiles by rate of preoperative cardiology consultation. Our study population comprised 5191 patients undergoing open peripheral arterial bypass (n = 3037), open abdominal aortic aneurysm repair (n = 332), or endovascular aneurysm repair (n = 1822) at 29 hospitals. At the patient level, after risk-stratification by revised cardiac risk index category, there was no association between cardiac consultation and poMI. At the hospital level, preoperative cardiac consultation varied substantially between hospitals (6.9%-87.5%, P 66%) had a reduction in poMI (OR, 0.52; confidence interval: 0.28-0.98; P cardiology consultation for vascular surgery varies greatly between institutions, and does not appear to impact poMI at the patient level. However, reduction of poMI was noted at the hospitals with the highest rate of preoperative cardiology consultation as well as a variety of medical services, suggesting that other hospital culture effects play a role.
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Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration
McKenney, Elizabeth L. W.; Mann, Kacee A.; Brown, Danice L.; Jewell, Jeremy D.
2017-01-01
This study explored whether and to what extent consultation practices specifically focused on culturally responsive instruction provided additive benefit, after establishing strong classroom management. Three teachers leading culturally diverse classrooms participated in two phases of consultation. The first was a traditional, classroom-management…
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RUBLE, LISA; BIRDWHISTELL, JESSIE; TOLAND, MICHAEL D.; MCGREW, JOHN H.
2011-01-01
The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate that an autism-specific consultation planning framework known as the collaborative model for promoting competence and success (COMPASS) is effectiv...
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Participation in Written Government Consultations in Denmark and the UK
DEFF Research Database (Denmark)
Rasmussen, Anne
2015-01-01
Despite the proliferation of instruments of public consultation in liberal democracies, little is known of how the design and use of these instruments affect stakeholder participation in practice. The article examines participation in written government consultations in an analysis of approximately...... 5,000 responses to consultations in Denmark and the UK in the first half of 2008. It shows that participation is highly conditional upon system-and actor-level characteristics in practice. Our findings indicate that, even if liberal democracies have adopted similar procedures for actor consultation...
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Exploring dialectical behaviour therapy clinicians' experiences of team consultation meetings.
Walsh, Cian; Ryan, Patrick; Flynn, Daniel
2018-01-01
This article presents a detailed idiographic analysis of Dialectical Behaviour Therapy (DBT) clinicians' experiences of team consultation meetings. DBT is an evidence-based psychological intervention with a demonstrated efficacy in the treatment of borderline personality disorder (BPD). Team consultation meetings encompass one of the primary components involved in this treatment model; where DBT clinicians regularly meet to discuss client work and enhance further learning. The present study's aim was to assess what are DBT clinicians' experiences of the consultation meeting component and whether it is useful or not. Semi-structured interviews were completed with 11 DBT clinicians (nine females, two males) from three different consultation teams. The research project utilised an interpretative phenomenological analysis (IPA) framework. Audio-recorded interview data was analysed using this framework. Four superordinate themes emerged from the interview data, which included ten subordinate themes. The superordinate themes focused on: (1) the acquisition of DBT technical knowledge and other MDT related expertise (2) participants' emotional experiences of DBT and consultation meetings, and how this can evolve over time (3) the underlying processes that occur in the consultation team including the development of a team bond and the impact of membership changes and (4) the largely consistent and reliable nature of consultation meetings and how they help maintain clinician motivation. Team consultation meetings were found to be supportive; playing an important role in maintaining clinician motivation through the availability of team support, opportunities to reflect and learn, and assistance in regulating emotions. Challenges arose in relation to team membership changes and acclimatisation to the type of feedback utilised in team consultation. The study's implications for practise are considered.
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The Role of the Consultant: Content Expert or Process Facilitator?
Schein, Edgar H.
1978-01-01
This triad of consulting models identifies the assumption upon which each rests. The consultant with adequate knowledge and self-insight will understand which model is appropriate to a given situation. The three models include: (1) purchase of expertise; (2) doctor-patient role; and (3) consultation process for problem solving. (Author/MFD)
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Curbside consultation re-imagined: Borrowing from the conflict management toolkit.
Edelstein, Lauren M; Lynch, John J; Mokwunye, Nneka O; DeRenzo, Evan G
2010-03-01
Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that any guidance offered by the ethics consultant will privilege and empower one party's viewpoint over-and to the exclusion of-other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new "spaces" for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for "clinical ethics conflict coaching" can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes.
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Service Learning In Physics: The Consultant Model
Guerra, David
2005-04-01
Each year thousands of students across the country and across the academic disciplines participate in service learning. Unfortunately, with no clear model for integrating community service into the physics curriculum, there are very few physics students engaged in service learning. To overcome this shortfall, a consultant based service-learning program has been developed and successfully implemented at Saint Anselm College (SAC). As consultants, students in upper level physics courses apply their problem solving skills in the service of others. Most recently, SAC students provided technical and managerial support to a group from Girl's Inc., a national empowerment program for girls in high-risk, underserved areas, who were participating in the national FIRST Lego League Robotics competition. In their role as consultants the SAC students provided technical information through brainstorming sessions and helped the girls stay on task with project management techniques, like milestone charting. This consultant model of service-learning, provides technical support to groups that may not have a great deal of resources and gives physics students a way to improve their interpersonal skills, test their technical expertise, and better define the marketable skill set they are developing through the physics curriculum.
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42 CFR 431.105 - Consultation to medical facilities.
2010-10-01
... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... 42 Public Health 4 2010-10-01 2010-10-01 false Consultation to medical facilities. 431.105 Section 431.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...
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Malpractice and the Communication Consultant: A Proactive Approach.
Montgomery, Daniel J.; And Others
1995-01-01
Provides communication practitioners with an overview of legal and ethical issues facing individuals who market themselves as professional communication consultants. Discusses the tort of negligence. Outlines court-supported practices that professional consultants might use to help protect clients and themselves. Argues that an understanding of…
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Brief Report: Healing Touch Consults at a Tertiary Care Children's Hospital.
Schlefman, Amanda; Rappaport, David I; Adams-Gerdts, Walle; Stubblefield, Samuel C
2016-02-01
Components of complementary and alternative medicine are increasingly being implemented at academic medical centers. These approaches include therapeutic touch or healing touch (HT), an energy-based therapy using light touch on or near the body. Limited data exist regarding complementary and alternative medicine use at children's hospitals. The aim of this study was to evaluate patterns and clinical characteristics of HT consultations among children hospitalized at Nemours/A.I. duPont Hospital for Children. We conducted a retrospective chart review of all patients hospitalized from January 2012 through December 2013, comparing patients who received HT consultations with those who did not. There were 25,396 admissions during the study period; 882 (4%) of these, representing 593 individual patients, received an HT consultation. As compared with those without an HT consultation, patients receiving HT were older (median 12 years vs 5 years, P<.001), female (58% vs 46%, P<.001), and more likely to be admitted to the hematology/oncology or blood/bone marrow transplant units (P<.001). Patients with HT consultations had longer hospitalizations (median 121 hours vs 38 hours, P<.001) and more medical problems (median 12 vs 4, P<.001). Six attending physicians were responsible for placing the majority of HT consultations. Of the 593 patients receiving an HT consultation, 21% received ≥2 consultations during the study period. Certain patients, such as those with longer hospitalizations and more medical problems, were more likely to receive HT consultations. Many patients received multiple consultations, suggesting that HT may be an important aspect of ongoing care for hospitalized children.
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2010-08-11
..., the academic community and the private sector in providing IOOS environmental information, products...-Private Use Policy is available for review at Web site URL: http://www.iooc.us . For the public unable to... Subcommittee on Ocean Science and Technology--Interagency Ocean Observation Committee Public-Private Use Policy...
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20 CFR 416.1016 - Medical or psychological consultants.
2010-04-01
..., psychological experts employed by or under contract with the State agencies must meet the qualification... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical or psychological consultants. 416... Disability Determination Function § 416.1016 Medical or psychological consultants. (a) What is a medical...
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Optimizing education on the inpatient dermatology consultative service.
Afifi, Ladan; Shinkai, Kanade
2017-03-01
A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models. In addition, consultative dermatology curricula should utilize a blended curriculum model comprised of patient care and active learning and self-study modalities. Specific educational methods will discuss 2 strategies: (1) direct patient-care activities (ie, bedside teaching rounds) and (2) nonpatient care activities (ie, case presentations, didactic sessions, online modules, and reading lists). ©2017 Frontline Medical Communications.
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How lead consultants approach educational change in postgraduate medical education.
Fokkema, Joanne P I; Westerman, Michiel; Teunissen, Pim W; van der Lee, Nadine; Scherpbier, Albert J J A; van der Vleuten, Cees P M; Dörr, P Joep; Scheele, Fedde
2012-04-01
Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead consultants approach educational change. This study was conducted to explore lead consultants' approaches to educational change in specialty training and factors influencing these approaches. From an interpretative constructivist perspective, we conducted a qualitative exploratory study using semi-structured interviews with a purposive sample of 16 lead consultants in the Netherlands between August 2010 and February 2011. The study design was based on the research questions and notions from corporate business and social psychology about the roles of change managers. Interview transcripts were analysed thematically using template analysis. The lead consultants described change processes with different stages, including cause, development of content, and the execution and evaluation of change, and used individual change strategies consisting of elements such as ideas, intentions and behaviour. Communication is necessary to the forming of a strategy and the implementation of change, but the nature of communication is influenced by the strategy in use. Lead consultants differed in their degree of awareness of the strategies they used. Factors influencing approaches to change were: knowledge, ideas and beliefs about change; level of reflection; task interpretation; personal style, and department culture. Most lead consultants showed limited awareness of their own approaches to change. This can lead them to adopt a rigid approach, whereas the ability to adapt strategies to circumstances is considered important to effective change management. Interventions and research should be aimed at enhancing the awareness of lead consultants of approaches to change in PGME.
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Gupte, Gouri; Vimalananda, Varsha; Simon, Steven R; DeVito, Katerina; Clark, Justice; Orlander, Jay D
2016-02-12
Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to specialists. While most e-consults
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Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan
2014-03-06
To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor-patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. Multiple ratings of simulated general practitioner (GP)-patient consultations by trained GP evaluators. UK primary care. 21 GPs and six trained GP evaluators. GCRS score. 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0-10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15-20 ratings) receiving, on average, scores more than one point higher on a 0-10 scale. GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations.
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Lee, Jinhee; Danes, Sharon M
2012-06-01
The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team. © 2012 American Association for Marriage and Family Therapy.
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What if we shifted the basis of consulting from knowledge to knowing?
Hicks, Jeff; Nair, P.; Wilderom, Celeste P.M.
2009-01-01
In this article, we argue that a focus on the debunking of consulting knowledge has led to a disconnect between the research and the practice of management consulting. A renewed focus on consulting practice, that is, the doing of consultancy itself, affords an opportunity for bringing clients,
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Coevolution in management fashion: an agent-based model of consultant-driven innovation.
Strang, David; David, Robert J; Akhlaghpour, Saeed
2014-07-01
The rise of management consultancy has been accompanied by increasingly marked faddish cycles in management techniques, but the mechanisms that underlie this relationship are not well understood. The authors develop a simple agent-based framework that models innovation adoption and abandonment on both the supply and demand sides. In opposition to conceptions of consultants as rhetorical wizards who engineer waves of management fashion, firms and consultants are treated as boundedly rational actors who chase the secrets of success by mimicking their highest-performing peers. Computational experiments demonstrate that consultant-driven versions of this dynamic in which the outcomes of firms are strongly conditioned by their choice of consultant are robustly faddish. The invasion of boom markets by low-quality consultants undercuts popular innovations while simultaneously restarting the fashion cycle by prompting the flight of high-quality consultants into less densely occupied niches. Computational experiments also indicate conditions involving consultant mobility, aspiration levels, mimic probabilities, and client-provider matching that attenuate faddishness.
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Assessment on nursing serviceat hospital external consulting rooms
Directory of Open Access Journals (Sweden)
Mª Dolores Poyatos Ruiz
2013-05-01
Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.
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The pattern and impact of infectious diseases consultation on antimicrobial prescription
Directory of Open Access Journals (Sweden)
Jaffar A Al-Tawfiq
2013-01-01
Full Text Available Objectives: Inclusion of infectious disease (ID physicians in the care of patients with possible infection can favorably affect antibiotic usage. The aim of this study was to evaluate the role of the ID consultations in reducing inappropriate antibiotic usage. Materials and Methods: This is a prospective study evaluating all adult ID consultations from January 2006 to December 2009. A total of 1444 consultation requests were recorded during the 4-year period. Results: The most frequent consultations were from cardiology (23.1%, orthopedics (8.2%, general medicine (7.8%, hematology-oncology (7.8%, gastroenterology (7.3%, and pulmonary/critical care (7.1%. The main reason for consultation was for the choice of antibiotics (75%. The commonest diagnoses prior to consultation were fever (14.7%, bacteremia (9.1%, and urinary tract infection (8.4%. Bacteremia was documented in 21.4% of cases and 12.9% were found to have no identifiable focus of infection. Antimicrobial therapy was changed in 58.7% and antimicrobials were discontinued in 14.7% of cases. The number of antimicrobial therapy was one (49.7% and 49.9% and two (24% and 17.6%, P = 0.0001 before and after the consultation, respectively. In addition, 17.3% and 26.9% ( P = 0.0001 received no antimicrobial agents before and after ID consultation. Conclusion: ID consultation is important to reduce inappropriate antimicrobial therapy and to limit the number of dual therapy.
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Valuation of American Call Option Considering Uncertain Volatility
Czech Academy of Sciences Publication Activity Database
Hlaváček, Ivan
2010-01-01
Roč. 2, č. 2 (2010), s. 211-221 ISSN 2070-0733 R&D Projects: GA AV ČR(CZ) IAA100190803 Institutional research plan: CEZ:AV0Z10190503 Keywords : American options * parabolic variational inequality * uncertain parameter Subject RIV: BA - General Mathematics Impact factor: 0.510, year: 2010 http://www.global-sci.org/aamm/readabs.php?vol=2&no=2&doc=211&year=2010&ppage=221
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2011-03-02
...: Wednesday, March 23, 2011--8:30 a.m. until 5 p.m. The Subcommittee will continue its review of Chapter 15 of the U.S. EPR Document Control Design (DCD) Safety Evaluation Report (SER) with Open Items. The... from the website cited above or by contacting the identified DFO. Moreover, in view of the possibility...
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10 CFR 51.40 - Consultation with NRC staff.
2010-01-01
... 10 Energy 2 2010-01-01 2010-01-01 false Consultation with NRC staff. 51.40 Section 51.40 Energy....40 Consultation with NRC staff. (a) A prospective applicant or petitioner for rulemaking is encouraged to confer with NRC staff as early as possible in its planning process before submitting...
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Institutional policy learning and public consultation: the Canadian xenotransplantation experience.
Jones, Mavis; Einsiedel, Edna
2011-09-01
Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Consultancy in the development of coal deposits all over the world
Energy Technology Data Exchange (ETDEWEB)
Gold, R.; Schiebel, W.
1977-04-01
Dr. Otto Gold, Consulting Engineers, Cologne, are working as consultants in the area of prospecting, exploration and development of lignite deposits. Some projects successfully carried out are reported on, being an example for other consulting projects on the coal sector.
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A Home-Based Palliative Care Consult Service for Veterans.
Golden, Adam G; Antoni, Charles; Gammonley, Denise
2016-11-01
We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.
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A Qualitative Study of Televideo Consultations for COPD Patients
DEFF Research Database (Denmark)
Mathar, Helle; Fastholm, Pernille; Sandholm Larsen, Niels
2015-01-01
. The patients’ assessments of the service must be understood in relation to the routines and strategies developed to handle the array of problems related to a life affected by chronic illness. Keywords: COPD patients, televideo consultations, telemedicine, coping strategies, security, control.......This article presents results from a small qualitative study investigating COPD patients' experiences with televideo consultations at home as a supplement to conventional control and treatment. The research question is: what are the experiences and preferences of COPD patients related to discharge...... from hospital with televideo consultations? The study shows that the patients' assessments of the effectiveness and value of the televideo consultations in their everyday lives are based on tough cost-benefit calculation of the extent to which the intervention makes their lives easier or more difficult...
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The role of a consultant breast radiographer: A description and a reflection
International Nuclear Information System (INIS)
Kelly, Judith; Hogg, Peter; Henwood, Suzanne
2008-01-01
Consultant radiographers are a relatively new concept within the British healthcare system, with them being first established in 2003. Consultant radiographer job roles are broad and include advanced clinical activities (often being similar in nature to those delivered by medical practitioners, e.g. radiologists), professional leadership, teaching and education and service improvement. Given their relative novelty almost no literature exists to describe in detail specific roles of consultant breast radiographers. Consequently, in this article we use a case study approach to describe and reflect critically upon the role of one consultant breast radiographer. The article commences with a general introduction about consultant radiographers; it then progresses to outline the context in which the case study of the breast consultant radiographer sits. Through description and reflective commentary we take the reader through the role of the consultant breast radiographer to highlight where the role has had perceived value and also to highlight where the role has been particularly challenging for the post holder. As a consequence of the case study approach taken, the article is written partly in the first person (taken from interview comments made by the consultant breast radiographer) and partly in the third person. The final element of the article is a reflective commentary given by the consultant radiographer regarding her feelings about her first few years as a consultant breast radiographer
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International Nuclear Information System (INIS)
2010-09-01
This consultation report is an appendix to the Environmental Impact Assessment (EIA) which in turn is an appendix to SKB's application under the Environmental Code for the continued operation of CLAB (Central interim storage for spent Nuclear Fuel, located on the Simpevarp Peninsula in Oskarshamn municipality), to build the encapsulation plant and operate it integrated with CLAB and to construct and operate the disposal facility in Soederviken at Forsmark in Oesthammar municipality, and SKB's application for a license under the Nuclear Activities Act to construct and operate the disposal facility at Forsmark. The aim of the consultation report is to give an overall picture of the consultations
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Consultation and IBA negotiations in wind projects
Energy Technology Data Exchange (ETDEWEB)
Merle, Alexander [Bull Housser and Tupper LLP (Canada)
2011-07-01
This presentation aimed at providing more information on consultation and IBA negotiations in wind energy projects, it was given by a law firm Bull, Housser and Tupper LLP. The subjects tackled by this paper are: the duty to consult, what First Nations are expecting from IBAs, if IBAs will differ from one wind project to another, if templates assist in achieving equity, who should be responsible for financing IBAs, and whether benefits or payments of money can achieve equity. The presentation emphasised that it is important to cooperate and share information in determining what the role of the Crown should be. In addition, the authors believe that an innovative resolution table should be established and that legal certainty should be obtained. This presentation provided First Nations with useful information on consultation and IBA negotiations in wind energy projects.
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Management consulting : does the 'advice business' qualify as an ethical profession?
2012-01-01
M.Comm. The objective of this research could broadly be stated as an initial investigation into the field of management consulting — with regard to the ethical standards and the requirements for professions, as well as the consultant's required skill set. More detailed objectives are the following: To define the requirements necessary to view management consulting as an ethical profession based on the guidelines set for management and management consulting as a profession. To investigate t...
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Use of Electronic Consultation System to Improve Access to Care in Pediatric Hematology/Oncology.
Johnston, Donna L; Murto, Kimmo; Kurzawa, Julia; Liddy, Clare; Keely, Erin; Lai, Lillian
2017-10-01
Electronic consultations (eConsult) allow for communication between primary care providers and specialists in an asynchronous manner. This study examined provider satisfaction, topics of interest, and efficiency of eConsult in pediatric hematology/oncology in Ottawa, Canada. We conducted a cross-sectional assessment of all eConsult cases directed to pediatric hematology/oncology specialists using the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service from June 1, 2014 to May 31, 2016. There were 1064 eConsults to pediatrics during the study timeperiod and pediatric hematology/oncology consults accounted for 8% (85). During the same study timeperiod, 524 consults were seen in the pediatric hematology/oncology clinic. The majority of the eConsults were for hematology (90.5%) in contrast to oncology topics (9.5%). The most common topics were anemia, hemoglobinopathy, bleeding disorder, and thrombotic state. Primary care providers rated the eConsult service very highly, and their comments were very positive. The eConsult service resulted in deferral of 40% of consults originally contemplated to require a face-to-face specialist visit. This study showed successful implementation and use of the eConsult service for pediatric hematology/oncology and resulted in avoidance of a large number of face-to-face consultation. The common topics identified areas for continuing medical education.
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Optimal Pricing Strategy in Marketing Research Consulting.
Chang, Chun-Hao; Lee, Chi-Wen Jevons
1994-01-01
This paper studies the optimal pricing scheme for a monopolistic marketing research consultant who sells high-cost proprietary marketing information to her oligopolistic clients in the manufacturing industry. In designing an optimal pricing strategy, the consultant needs to fully consider the behavior of her clients, the behavior of the existing and potential competitors to her clients, and the behavior of her clients' customers. The authors show how the environment uncertainty, the capabilit...
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Digital audio recordings improve the outcomes of patient consultations
DEFF Research Database (Denmark)
Wolderslund, Maiken; Kofoed, Poul-Erik; Holst, René
2017-01-01
OBJECTIVES: To investigate the effects on patients' outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). METHODS: This is a three-armed randomised controlled cluster trial. One group of patients received standard care......, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires...
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Industrial Buying Behavior Related to Human Resource Consulting Services
DEFF Research Database (Denmark)
Grünbaum, Niels Nolsøe; Hollensen, Svend; Kahle, Lynn
2013-01-01
The purpose of this article is to extend the understanding of the industrial buying process in connection with purchasing professional business (B2B) services, specifically human resource (HR) consulting services. Early B2B buying-behavior literature strongly emphasizes the rational aspects...... of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies choose a consulting services supplier. Five hypotheses are developed based...
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Can audio recording of outpatient consultations improve patient outcome?
DEFF Research Database (Denmark)
Wolderslund, Maiken; Kofoed, Poul-Erik; Axboe, Mette
different departments: Orthopedics, Urology, Internal Medicine and Pediatrics. A total of 5,460 patients will be included from the outpatient clinics. All patients randomized to an intervention group are offered audio recording of their consultation. An Interactive Voice Response platform enables an audio....... The intervention will be evaluated using a questionnaire measuring different aspect of patients recall and understanding of the information given, patients need for additional information subsequent to the consultation and their overall satisfaction with the consultation. Results The study will be conducted from...
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The role of marketing in the modern local consulting
Directory of Open Access Journals (Sweden)
Bezpalova Anna
2016-02-01
Full Text Available Modern market conditions are so complex and unstable that the marketing activity of the local consulting companies becomes virtually unpredictable, difficult to plan and control. Most consulting firms previously hold claims against their marketing and the current state of the market actually triggered the rejection and the transition to spontaneous economic activity. In the framework of the article the role of the of marketing in the current activity of local consulting companies is identified and its potential perspectives for the target audience are proved
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Consulting communities: a renewable energy toolkit
Energy Technology Data Exchange (ETDEWEB)
Hinshelwood, E.; McCallum, D.
2001-07-01
Renewable Energy (RE) projects in the UK have always involved a degree of consultation. In many cases, however, it is limited to statutory consultees and key individuals in the locality of a proposed site. But as sustainable development moves up the agenda, and as the UK generation of RE is falling behind its European counterparts, the views of communities are becoming more of an issues. If priority is to be placed on sensitive and successful RE development, then it is vital to recognise local people as key stakeholders. They need to be acknowledged as potential catalysts for change, rather than as obstacles or sources of resistance to new technologies. A greater emphasis on community involvement (at all levels in RE development) represents a strategic move. It is both ethically important, and cost-effective in the long run. While there are a variety of aspects of community involvement, this guide deals specifically with community consultation, and acts as a support to organisations and companies planning the development of a Renewable Energy project. The guide is not intended as a 'tactic to get around' communities or to somehow 'win them over'. The premise behind consultation is to ensure that local people have access to relevant information and that the channels of communication exist whereby local people can contribute to project development. In a successful consultation, residents are seen as partners in the overall process of sustainable development. Local people are vital if we are to move forward. (Author)
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Cost and consultation patterns of abdominal pain in Uruguayan children.
Saps, Miguel; Bolioli, Pablo; Espana, Magali; Marshall, Beth M; Di Lorenzo, Carlo
2008-02-01
Children with abdominal pain (AP) have worse quality of life and poorer social functioning and school attendance than their healthy peers. This is the first investigation of consultation patterns and costs of AP in South American children. All data were collected from Unidad Coronaria Movil in Montevideo, Uruguay. Diagnoses of all house calls during a 4-year period (January 2002 through December 2005) were analyzed. Variances in consultation patterns based on sex and age were investigated. Supply and personnel costs were analyzed and prorated to obtain an accurate estimate of the cost per house call and outpatient visit. A total of 125,945 in-home visits and 1588 outpatient consultations were analyzed. Consultation rates for AP peaked among patients 7 to 9 years of age. Female subjects 9 to 14 years of age consulted significantly more frequently for AP than male subjects in the same age group. The average AP consultation accounted for approximately 3.8% of the per capita health care spending in Uruguay in 2005. AP is a global health problem that is present across ethnicities, nationalities, and geographic locations and is associated with significant health care expenditure.
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2010-03-31
... hold a meeting on April 20-21, 2010, at 11545 Rockville Pike, T2- B1, Rockville, Maryland. The entire... review Chapters 4, 5 and 17 of the Safety Evaluation Report with Open Items associated with the staff's... a.m.-5 p.m. The Subcommittee will review Chapter 12 of the Safety Evaluation Report with Open Items...
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2013-05-10
... Electronics Used in Safety Systems of Nuclear Power Plants;'' 5. Proposed Revision 1 to Regulatory Guide 1.173... Power Plants.'' The Subcommittee will hear presentations by and hold discussions with the NRC staff and... appropriate arrangements can be made. Thirty-five hard copies of each presentation or handout should be...
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Beyond the 'dyad': a qualitative re-evaluation of the changing clinical consultation.
Swinglehurst, Deborah; Roberts, Celia; Li, Shuangyu; Weber, Orest; Singy, Pascal
2014-09-29
To identify characteristics of consultations that do not conform to the traditionally understood communication 'dyad', in order to highlight implications for medical education and develop a reflective 'toolkit' for use by medical practitioners and educators in the analysis of consultations. A series of interdisciplinary research workshops spanning 12 months explored the social impact of globalisation and computerisation on the clinical consultation, focusing specifically on contemporary challenges to the clinician-patient dyad. Researchers presented detailed case studies of consultations, taken from their recent research projects. Drawing on concepts from applied sociolinguistics, further analysis of selected case studies prompted the identification of key emergent themes. University departments in the UK and Switzerland. Six researchers with backgrounds in medicine, applied linguistics, sociolinguistics and medical education. One workshop was also attended by PhD students conducting research on healthcare interactions. The contemporary consultation is characterised by a multiplicity of voices. Incorporation of additional voices in the consultation creates new forms of order (and disorder) in the interaction. The roles 'clinician' and 'patient' are blurred as they become increasingly distributed between different participants. These new consultation arrangements make new demands on clinicians, which lie beyond the scope of most educational programmes for clinical communication. The consultation is changing. Traditional consultation models that assume a 'dyadic' consultation do not adequately incorporate the realities of many contemporary consultations. A paradox emerges between the need to manage consultations in a 'super-diverse' multilingual society, while also attending to increasing requirements for standardised protocol-driven approaches to care prompted by computer use. The tension between standardisation and flexibility requires addressing in educational
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Clinical Ethics Consultation After God: Implications for Advocacy and Neutrality.
Parker, J Clint
2018-06-01
In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God's-eye perspective. In this paper, I focus on the implications of Engelhardt's views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants (CECs) should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt's views for this question. Finally, I discuss some of Engelhardt's foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation.
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International Nuclear Information System (INIS)
Braams, Bastiaan J.
2014-07-01
The International Fusion Research Council (IFRC) Subcommittee on Atomic and Molecular Data met at IAEA Headquarters in Vienna on 28-29 April 2014 to review the work of the Atomic and Molecular Data Unit (AMDU) within the Nuclear Data Section. The subcommittee heard presentations on the Unit’s activities in the years 2012 and 2013 and discussed priorities for database development and evaluation, coordinated research projects and other meetings, and presentation on the web and elsewhere of the work of the Unit. The IFRC Subcommittee offers the following specific recommendations. • For Coordinated Research Projects in the area of plasma-material interaction highest priority goes to a CRP on erosion and tritium retention for steel surfaces, with emphasis on the kinds of low- or reduced-activation steels that may be used in a reactor. • In the area of atomic and molecular data it is recommended to initiate a new CRP on data for charge exchange processes related to neutral beams. The main topic of interest will be beam interaction with core plasma, but processes relevant to generation of the beam may also be included. • Data for plasma interaction with liquid metals gallium and tin, certain salts and possibly also aluminium, are needed in order to assess uses of these materials in a reactor environment. For a CRP this topic has lower priority than one on steel surfaces, but it is recommended as a good topic for a Technical Meeting. • The Unit should organize again, in 2014 or early 2015, a large “decennial” meeting on atomic, molecular and plasma-material interaction data for fusion science and technology to bring together fusion scientists users of A+M+PMI data and atomic, molecular and materials scientists data producers. • The Unit has the mission to provide internationally recommended and evaluated data for atomic, molecular and plasma-material interaction process and related materials structure properties for fusion science and technology; this is
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An exploration of pharmacist-patient communication in clinic-style consultations
Greenhill, Nicola H.
2010-01-01
The importance of communication skills for pharmacists has been widely acknowledged. Research has shown that the use of good communication skills can improve patient health outcomes but little research has focussed on communication within new consultation based roles of pharmacists. This study aimed to explore the communication between pharmacists and patients in clinic style consultations and to investigate participant perceptions of communication and consultations. Eleven pharmacists ...
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Ruble, Lisa; Birdwhistell, Jessie; Toland, Michael D; McGrew, John H
2011-01-01
The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate that an autism-specific consultation planning framework known as the collaborative model for promoting competence and success (COMPASS) is effective in increasing child Individual Education Programs (IEP) outcomes (Ruble, Dal-rymple, & McGrew, 2010; Ruble, McGrew, & Toland, 2011). In this study, we describe the verbal interactions, defined as speech acts and speech act exchanges that take place during COMPASS consultation, and examine the associations between speech exchanges and child outcomes. We applied the Psychosocial Processes Coding Scheme (Leaper, 1991) to code speech acts. Speech act exchanges were overwhelmingly affiliative, failed to show statistically significant relationships with child IEP outcomes and teacher adherence, but did correlate positively with IEP quality.
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Inside the fitness for work consultation: a qualitative study.
Cohen, D A; Aylward, M; Rollnick, S
2009-08-01
Evidence now suggests that work is generally good for physical and mental health and well-being. Worklessness for whatever reason can lead to poorer physical and mental health. The role of the general practitioner (GP) in the management of fitness for work is pivotal. To understand the interaction between GP and patient in the fitness for work consultation. This study forms part of a larger research project to develop a learning programme for GPs around the fitness for work consultation based on behaviour change methodology. A qualitative study set in South Wales. Structured discussion groups with seven GPs. Two sessions each lasting 3 h were conducted to explore the GP and patient interaction around the fitness for work consultation. Multiple methods were used to enhance engagement. Thematic analysis was used to analyse the data. Four major themes emerged from the meetings: role legitimacy, negotiation, managing the patient and managing the systems. Within these, subthemes emerged around role legitimacy. 'It's not my job', 'It's not what I trained for' and the 'shifting agenda' Negotiation was likened to 'A polite tug of war' and subthemes around decision making, managing the agenda and dealing with uncertainty emerged. This study starts to unravel the complexity of the fitness for work consultation. It illustrates how GPs struggle with the 'importance' of their role and 'confidence' in managing the fitness for work consultation. It addresses the skillful negotiation that is required to manage the consultation effectively.
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EQClinic: a platform for learning communication skills in clinical consultations.
Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A
2016-01-01
Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of
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EQClinic: a platform for learning communication skills in clinical consultations
Directory of Open Access Journals (Sweden)
Chunfeng Liu
2016-07-01
Full Text Available Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs, with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7, and reported that the structure (5.4/7 and information (5.8/7 were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non
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Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan
2014-01-01
Objectives To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor–patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. Design Multiple ratings of simulated general practitioner (GP)–patient consultations by trained GP evaluators. Setting UK primary care. Participants 21 GPs and six trained GP evaluators. Outcome measures GCRS score. Methods 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. Results Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0–10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15–20 ratings) receiving, on average, scores more than one point higher on a 0–10 scale. Conclusions GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations. PMID:24604483
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The role of assessment packages for diagnostic consultations
DEFF Research Database (Denmark)
Rossen, Camilla B; Buus, Niels; Stenager, Egon
2015-01-01
and content. Assessment packages are widely used in an increasing number of medical specialities; however, there is a lack of knowledge about how packaged assessment influences the interaction between doctor and patient. In this study, we investigate the final consultation in assessment packages, which...... whose goal was to leave the consultation with clarification in the form of a definite diagnosis, but who were not offered such clarification. These patients negotiated the outcome of the consultation by applying implicit and explicit pressure, which induced the doctors to disregard the boundaries...... of the package and offer the patient more tests. The study highlights some of the problems related to introducing narrow, specialized package assessment....
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A resident's rotation in consultation psychiatry. A maturational experience.
Granet, R B; Perry, S W; Talbott, J A
1980-12-01
The authors emphasize the importance of a consultation psychiatry experience in the maturation of the young psychiatrist by examining some of the processes operational in both community and hospital consultation work, performed by the senior author during his fourth year of residency. Such experiences can provide opportunities for developing psychiatric skills not emphasized elsewhere, including the adoption of an active therapeutic stance, the application of the psychodynamic theory to the consultation system itself, and teaching without the use of jargon. In addition the experience as consultant facilitates the transition from residency to the outside world, not only through attitudinal changes achieved by exposure to less structured settings, a change in the supervisory model, and a solidification of identity as a physician and psychiatrist, but also by providing the resident the opportunity to begin de-cathecting from the training program.
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Mother-infant consultation during drug treatment: Research and innovative clinical practice
Directory of Open Access Journals (Sweden)
Lester Barry M
2008-02-01
Full Text Available Abstract Background This paper details a model for consulting with mothers and infants, and drug treatment staff used in a residential drug treatment program and relevant to other treatment settings. The role of parent-infant consultation based on the Neonatal Network Neurobehavioral Scale (NNNS was evaluated. Methods A sequential cohort model was used to assign participants to 1. NNNS consultation versus 2. standard care. The effects of NNNS consultation were evaluated using the Parenting Stress Index and NNNS summary scores. Results Participants in the NNNS consultation condition had significantly less stress overall, and less stress related to infant behavior than participants in standard care. There were no differences in infant behavior on the NNNS Summary scores. Conclusion The implications for NNNS consultation in drug treatment programs is outlined. The importance of prevention/intervention to establish satisfactory mother-infant interaction in recovery programs which include a central parenting component is indicated.
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Initiation of a medical toxicology consult service at a tertiary care children's hospital.
Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J
2015-05-01
Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.
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[The presence of a companion in the primary care consultation].
Turabián, J L; Pérez Franco, B
2015-01-01
The presence of an adult accompanying the patient in the consulting room is a significant fact that deserves the attention of the physician. Some types of companions and their presence in the consultation have been described and may improve communication, patient management, and participatory decision making, achieving greater patient satisfaction. Consultations with companion are generally longer, and patients accompanied are often elderly, women, less educated, and with poorer physical and mental health. But it is not known exactly what is the significance of a consultation with a companion. It may be a semiological fact to keep in mind for the family diagnosis, or it may be the risks of their presence, the influence of medication, or the importance of the doctors themselves that are the cause of the presence of a companion. Different communication skills must be achieved during the interview with the companion in the consultation, rather than with the patient alone. Copyright © 2014. Publicado por Elsevier España, S.L.U.
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Determinants of Management Innovation in the Ghanaian Construction Consulting Sector
Directory of Open Access Journals (Sweden)
De-Graft Owusu-Manu
2015-03-01
Full Text Available Determinants of management innovation (MI within the Ghanaian construction consulting sector are examined. A sample of 70 consulting firms is surveyed using self-administered questionnaires. Data are analysed using descriptive statistics and factor analysis. Findings indicate that determinants of MI were interwoven among seven principal factors viz: community and market demands; financial and business management practices; human resource policies; creativity and organizational strategies; corporate social responsibility; prevailing conditions; and competitive leverage. The study adds to the discourse on evolution of innovation within the global consulting sector generally, while providing reference for practitioners and academics in the field with respect to MI determinants more specifically. It is envisaged that practitioners who adopt these findings in the construction consultancy sector would enhance their ability to provide innovative services to clients. Study recommendations include that future research should explore how innovation is diffused within consulting enterprises’ value chains. Paper Type: Research article
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Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.
Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K
2016-02-01
The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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Evaluation of the Effect of Consultant Characteristics on Telemedicine Diagnosis and Treatment
Directory of Open Access Journals (Sweden)
Ann B. Bynum
2011-01-01
Full Text Available This study examined teleconsultants' specialty, practice setting, type of employment, years and training in telemedicine to evaluate the effect of these characteristics on diagnoses and treatment. A postuse survey was conducted during 1998–2003 (n=454 consultations in the University of Arkansas for Medical Sciences' Rural Hospital, Telehealth Project. There were 61 consultants who conducted the teleconsultations. The teleconsultants established a diagnosis in 121 consultations and reported a change in diagnoses in 29 consultations. The consultants established a treatment plan in 219 consultations and reported a change in the treatment plan in 100 consultations. Dermatologists were significantly more likely to establish (P<.01 and change (P=.005 the diagnosis and to establish a treatment plan (P=.03, when compared to all other specialties. Teleconsultants who were self-employed were significantly more likely to change the treatment plan (P=.012. The findings suggest that teleconsultants' characteristics can affect diagnoses and treatment in telemedicine.
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An Analysis of WhatsApp Usage for Communication Between Consulting and Emergency Physicians.
Gulacti, Umut; Lok, Ugur; Hatipoglu, Sinan; Polat, Haci
2016-06-01
The aim of this study was to evaluate WhatsApp messenger usage for communication between consulting and emergency physicians. A retrospective, observational study was conducted in the emergency department (ED) of a tertiary care university hospital between January 2014 and June 2014. A total of 614 consultations requested by using the WhatsApp application were evaluated, and 519 eligible consultations were included in the study. The WhatsApp messages that were transferred to consultant physicians consisted of 510 (98.3%) photographic images, 517 (99.6%) text messages, 59 (11.3%) videos, and 10 (1.9%) voice messages. Consultation was most frequently requested from the orthopedics clinic (n = 160, 30.8%). The majority of requested consultations were terminated only by evaluation via WhatsApp messages. (n = 311, 59.9%). Most of the consulting physicians were outside of the hospital or were mobile at the time of the consultation (n = 292, 56.3%). The outside consultation request rate was significantly higher for night shifts than for day shifts (p = .004), and the majority of outside consultation request were concluded by only WhatsApp application (p WhatsApp is useful a communication tool between physicians, especially for ED consultants who are outside the hospital, because of the ability to transfer large amounts of clinical and radiological data during a short period of time.
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76 FR 28446 - Policy on Consultation With Indian Tribes
2011-05-17
.... Consultation promotes an enhanced form of communication that emphasizes trust, respect, and shared... consultation process, ensure continuity, and demonstrate commitment to the process. Communication will be open... access to traditional areas of cultural or religious importance on Federally managed lands; 2. The...
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Koper, Ian; van der Heide, Agnes; Janssens, Rien; Swart, Siebe; Perez, Roberto; Rietjens, Judith
2014-01-01
Palliative sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for palliative sedation, however, is more stringent: it considers the use of palliative sedation without consulting an expert as injudicious and insists on input from a multi-professional palliative care team. This study investigates the considerations of Dutch physicians concerning consultation about palliative sedation with specialist palliative care services. Fifty-four physicians were interviewed on their most recent case of palliative sedation. Reasons to consult were a lack of expertise and the view that consultation was generally supportive. Reasons not to consult were sufficient expertise, the view that palliative sedation is a normal medical procedure, time pressure, fear of disagreement with the service and regarding consultation as having little added value. Arguments in favour of mandatory consultation were that many physicians lack expertise and that palliative sedation is an exceptional intervention. Arguments against mandatory consultation were practical obstacles that may preclude fulfilling such an obligation (i.e. lack of time), palliative sedation being a standard medical procedure, corroding a physician's responsibility and deterring physicians from applying palliative sedation. Consultation about palliative sedation with specialist palliative care services is regarded as supportive and helpful when physicians lack expertise. However, Dutch physicians have both practical and theoretical objections against mandatory consultation. Based on the findings in this study, there seems to be little support among Dutch physicians for the EAPC recommendations on obligatory consultation.
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Patients' reflections on communication in the second-opinion hematology-oncology consultation.
Goldman, Roberta E; Sullivan, Amy; Back, Anthony L; Alexander, Stewart C; Matsuyama, Robin K; Lee, Stephanie J
2009-07-01
The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology-oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making. In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations. Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis. Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation. Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits.
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[Effectiveness of support for asbestos health consultation in health centers].
Nagamatsu, Yasuko
2011-09-01
In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.
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The 'hidden work' of a hospital neurologist: 1000 consults later.
LENUS (Irish Health Repository)
Ali, E
2012-02-01
BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included \\'drop-down\\' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke\\/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.
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Overview of standards subcommittee 8, fissionable materials outside reactors
International Nuclear Information System (INIS)
McLaughlin, T.P.
1996-01-01
The American Nuclear Society's Standards Subcommittee 8, titled open-quotes Fissionable Materials Outside Reactors,close quotes has worked for the past 35 yr to prepare and promote standards on nuclear criticality safety for the handling, processing, storing, and transportation of fissionable materials outside reactors. The reader is referred to the Transactions of the American Nuclear Society, Vols. 39 (1981) and 64 (1991), for previous papers associated with ANS-8 poster sessions. In addition to discussions on the then-current standards, the reader will find articles on working group efforts that never materialized into standards, such as proposed 8.13, open-quotes Use of the Solid-Angle Method in Nuclear Criticality Safety,close quotes and on applications and critiques of current standards. The paper by McLendon in Vol. 39 is particularly interesting as an overview of the early history of ANS-8 and its standards
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Improving teaching on the basis of student evaluation: integrative teaching consultation.
Wibbecke, Gerald; Kahmann, Janine; Pignotti, Tanja; Altenberger, Leander; Kadmon, Martina
2015-01-01
Due to the development of medical education in the past decade the role of teachers has changed and requires higher didactic competence. Student evaluation of teaching alone does not lead to considerable improvement of teaching quality. We present the concept of "Integrative Teaching Consultation", which comprises both the teacher's reflection and own objectives to improve their teaching as well as data from students ratings. Teachers in collaboration with a teaching consultant reflect on their teaching ability and set themselves improvement goals. Then the consultant himself observes a teaching session and subsequently analyses the respective student evaluation in order to give meaningful feedback to the teacher. The combination of student feedback with professional consultation elements can initiate and maintain improvements in teaching. Teaching consultation complements existing faculty development programs and increases the benefit of student evaluations.
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Standardization Versus Innovation In Management Consultancy
Directory of Open Access Journals (Sweden)
Ciumara Tudor
2011-12-01
Full Text Available This paper is supported by the Sectoral Operational Programme Human Resources Development (SOP HRD, financed from the European Social Fund and by the Romanian Government under the contract number SOP HRD/89/1.5/S/62988. In this paper we propose some perspectives on the relationship between standardization and innovation in the management consulting business. Most of the consulting services are situated somewhere between absolute standardization and absolute innovation. Approaching any of these poles brings some advantages and disadvantages, both to the service providers and to their customers. It is important to find a balance between innovation and standardization to maximize the results of all agents involved.
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[Remote Slit Lamp Microscope Consultation System Based on Web].
Chen, Junfa; Zhuo, Yong; Liu, Zuguo; Chen, Yanping
2015-11-01
To realize the remote operation of the slit lamp microscope for department of ophthalmology consultation, and visual display the real-time status of remote slit lamp microscope, a remote slit lamp microscope consultation system based on B/S structure is designed and implemented. Through framing the slit lamp microscope on the website system, the realtime acquisition and transmission of remote control and image data is realized. The three dimensional model of the slit lamp microscope is established and rendered on the web by using WebGL technology. The practical application results can well show the real-time interactive of the remote consultation system.
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Sport psychology group consultation using social networking web sites.
Dietrich, Frederick; Shipherd, Amber M; Gershgoren, Lael; Filho, Edson Medeiros; Basevitch, Itay
2012-08-01
A social networking Web site, Facebook, was used to deliver long-term sport psychology consultation services to student-athletes (i.e., soccer players) in 30- to 60-min weekly sessions. Additional short-term team building, group cohesion, communication, anger management, injury rehabilitation, mental toughness, commitment, and leadership workshops were provided. Cohesion and overall relationships between both the student-athletes and the sport psychology consultants benefited from this process. Social networking Web sites offer a practical way of providing sport psychology consulting services that does not require use of major resources. (c) 2012 APA, all rights reserved.
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Geppert, Cynthia M.A.; Shelton, Wayne N.
2012-01-01
Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important to help the medical community appreciate ethics consultation as a vital service in today's health care setting. Therefore, this Special Article presents a comparison of medical and clinical ethics consultations in terms of fundamental goals of consultation, roles of consultants, and methodologic approaches to consultation, concluding with reflections on important lessons about the physician-patient relationship and medical education that may benefit practicing internists. Our aim is to examine ethics consultation as a clinical service integral to the medical care of patients. Studies for this analysis were obtained through the PubMed database using the keywords ethics consultation, medical consultation, ethics consults, medical consults, ethics consultants, and medical consultants. All English-language articles published from 1970 through August 2011 that pertained to the structure and process of medical and ethics consultation were reviewed. PMID:22469350
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Ohl, Ricky
In this case study, computer supported argument visualisation has been applied to the analysis and representation of the draft South East Queensland Regional Plan Consultation discourse, demonstrating how argument mapping can help deliver the transparency and accountability required in participatory democracy. Consultative democracy for regional planning falls into a category of problems known as “wicked problems”. Inherent in this environment is heterogeneous viewpoints, agendas and voices, built on disparate and often contradictory logic. An argument ontology and notation that was designed specifically to deal with consultative urban planning around wicked problems is the Issue Based Information System (IBIS) and IBIS notation (Rittel & Webber, 1984). The software used for argument visualisation in this case was Compendium, a derivative of IBIS. The high volume of stakeholders and discourse heterogeneity in this environment calls for a unique approach to argument mapping. The map design model developed from this research has been titled a “Consultation Map”. The design incorporates the IBIS ontology within a hybrid of mapping approaches, amalgamating elements from concept, dialogue, argument, debate, thematic and tree-mapping. The consultation maps developed from the draft South East Queensland Regional Plan Consultation provide a transparent visual record to give evidence of the themes of citizen issues within the consultation discourse. The consultation maps also link the elicited discourse themes to related policies from the SEQ Regional Plan providing explicit evidence of SEQ Regional Plan policy-decisions matching citizen concerns. The final consultation map in the series provides explicit links between SEQ Regional Plan policy items and monitoring activities reporting on the ongoing implementation of the SEQ Regional Plan. This map provides updatable evidence of and accountability for SEQ Regional Plan policy implementation and developments.
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High-Value Consults: A Curriculum to Promote Point-of-Care, Evidence-Based Recommendations.
Nandiwada, Deepa Rani; Kohli, Amar; McNamara, Megan; Smith, Kenneth J; Zimmer, Shanta; McNeil, Melissa; Spagnoletti, Carla; Rubio, Doris; Berlacher, Kathryn
2017-10-01
In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes. A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P = .015). The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.
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77 FR 22295 - Renewal of Department of Defense Federal Advisory Committees
2012-04-13
... membership. Board members and consultants, with the exception of travel and per diem for official travel... particular point of view and in a manner that is free from conflict of interest. The Department, when... exception of travel and per diem for official Board related travel, subcommittee members shall serve without...
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Energy Technology Data Exchange (ETDEWEB)
Hey, Tony [eScience Institute, University of Washington; Agarwal, Deborah [Lawrence Berkeley National Laboratory; Borgman, Christine [University of California, Los Angeles; Cartaro, Concetta [SLAC National Accelerator Laboratory; Crivelli, Silvia [Lawrence Berkeley National Laboratory; Van Dam, Kerstin Kleese [Pacific Northwest National Laboratory; Luce, Richard [University of Oklahoma; Arjun, Shankar [CADES, Oak Ridge National Laboratory; Trefethen, Anne [University of Oxford; Wade, Alex [Microsoft Research, Microsoft Corporation; Williams, Dean [Lawrence Livermore National Laboratory
2015-09-04
The Advanced Scientific Computing Advisory Committee (ASCAC) was charged to form a standing subcommittee to review the Department of Energy’s Office of Scientific and Technical Information (OSTI) and to begin by assessing the quality and effectiveness of OSTI’s recent and current products and services and to comment on its mission and future directions in the rapidly changing environment for scientific publication and data. The Committee met with OSTI staff and reviewed available products, services and other materials. This report summaries their initial findings and recommendations.
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The Study of Teachers' and Parents' Needs for Psychological Consultation from School Psychologist
Directory of Open Access Journals (Sweden)
Savina E.A.,
2018-04-01
Full Text Available The present study was aimed at the investigation of teachers’ and parents’ needs in consultation with a school psychologist. Participants were 159 teachers and 292 parents from three cities in Russia. Two surveys were designed to measure teachers’ and parents’ desire to receive psychological consultation regarding behavioral, emotional, learning and interpersonal problems of students; teaching methods and relationships with colleagues (for teachers; and child-parent relationships. In addition, the participants were asked to indicate whether they received a consultation from a school psychologist in the past and their satisfaction from the consultation. The results indicated that, in general, both teachers and parents are satisfied with the consultation; however, fewer parents received such a consultation compared to teachers. Both teachers and parents are more willing to receive consultation regarding children’s behavioral and emotional problems and relationships with peers. Teachers are less motivated to receive consultation about teaching methods, students’ learning problems, and teachers’ relationships with colleagues. Parents were less interested to receive consultation about child-parent relationships. The results of this study are interpreted in terms of their alignment with standards, which regulate the school psychology profession and training.
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An Exploratory Study of Informal Learning and Team Performance in the Pre-Consulting Phase
Sibarani, Roza Marsaulina
2014-01-01
This paper reports the process of informal learning in the pre-consulting phase in management-consulting firms in Indonesia. As the consulting industry significantly grows in Indonesia, more organisations use consultant services to improve their business. Pre-consulting is an important phase to define the right solutions, which involves a lot of…
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Consulting-Research Froblems with German and American Multinational Firms.
Hildebrandt, Herbert W.
International researchers need to be aware of international problems and multinational managerial codes when they work with worldwide organizations. This paper develops the premise that consulting with German multinational companies is more complex than consulting with or researching for American firms. Discussion focuses on the following three…
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Intellectual Humility and Morality as Consultee-Centered Consultation Epistemologies
Truscott, Stephen D.; Kearney, Moriah A.; Davis, Don E.; Roach, Andrew T.
2017-01-01
Little research examines how epistemological constructs affect the consultation process in schools. We consider how the epistemological constructs of (a) intellectual humility and (b) moral foundations may moderate the effectiveness of consultee-centered consultation. We define the constructs and provide examples of their potential influences on…
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WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.
Ogasawara, Katsuhiko; Abe, Tamotsu
2013-01-01
We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".
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[Evaluative study of nursing consultation in the basic networks of Curitiba, Brazil].
da Silva, Sandra Honorato; Cubas, Marcia Regina; Fedalto, Maira Aparecida; da Silva, Sandra Regina; Limas, Thaís Cristina da Costa
2010-03-01
The implementation of the electronic health record in the basic networks of Curitiba enabled an advance in the implementation of the nursing consultation and the ICNPCH, whose modeling uses the ICNP axes structure and the ICNPCH list of action. The objective of this study was to evaluate the nursing consultation from the productivity and assistance coverage perspective. The studied population was obtained from a secondary database of nursing consultations from April to June of 2005. The analysis was performed using the Datawarehouse and OLAP tool. The productivity per professional was found to be 2.5 consultations per day. Professionals use 16% of their daily work time with this activity and up to 27% of their potential per month. The ICNPCH was used in 21% of the consultations. There is a 0.08 consultation coverage per inhabitant for 6% of the population. The nursing consultation makes it possible to characterize the nurses' role in health care and a new professional position capable of affecting the construction of public politics.
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Impact of prenatal ultrasound consultation on maternal anxiety
International Nuclear Information System (INIS)
Masroor, I.; Ajmal, F.; Ahmed, H.
2008-01-01
To determine whether ultrasound consultation reduces maternal anxiety and increases feto-maternal attachment ( the desire to care for the fetus and care for self). Patients coming for routine obstetric ultrasound at the Department of Radiology, Aga Khan University Hospital Karachi were recruited in the study. The study was carried out over the period of two months from January-February 2007 in which sixty patients were included in the study. Patients were randomly assigned to a standard care group or an ultrasound consultation group (30 patients in each arm). Both groups were required to fill a questionnaire before and after their ultrasound examination. The ultrasound consultation group in addition received counseling before they went in for the ultrasound regarding fetal development and maternal-fetal interaction. The two groups were then compared for difference of change in feto maternal attachment scores and change in anxiety levels regarding their pregnancies before and after the ultrasound. SPSS software (version 14) was used for compilation of the data and the statistical computations. Categorical data was compared using Chi-square test and continuous variables were analyzed with paired t-test. P value <0.05 was considered significant. A positive difference in feto-maternal attachment and reduction in anxiety levels was seen in both the groups but this difference was statistically significant in the ultrasound consultation group only. This study suggests that ultrasound examinations with prior consultation has a positive impact on patients as it strengthens bonding toward the fetus, reduces maternal anxiety and increases maternal investment in health during the pregnancy. (author)
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The OHS consultant as a 'political reflective navigator' in technological change processes
DEFF Research Database (Denmark)
Broberg, Ole
2004-01-01
between different roles and mobilize different types of knowledge depending on the context; the consultant is a navigator in the sense of knowing how to navigate in the complex organization surrounding the technological change process. The competencies of a political reflective navigator are outlined...... of OHS consultants is placed on the line between an expert and a process consultant. Based on evidence from the cases and on the concepts of actor-network theory on technological development, we suggest a supplementary third role, that of the 'political reflective navigator', where the OHS consultant...... is an 'actor' who pursues a work environment agenda in a complex network in which other actors pursue other agendas such as productivity, economics, quality, etc. The consultant is political in the sense of pursuing a work environment agenda; the consultant is reflective in the sense of being able to switch...
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Wilk, Adam S; Chen, Lena M
2017-12-01
Hospital administrators are seeking to improve efficiency in medical consultation services, yet whether consultants make decisions to provide more or less care is unknown. We examined how medical consultants account for prior consultants' care when determining whether to provide intensive consulting care or sign off in the treatment of complex surgical inpatients. We applied three distinct theoretical frameworks in the interpretation of our results. We performed a retrospective cohort study of consultants' care intensity, measured alternately using a dummy variable for providing two or more days consulting (versus one) and a continuous measure of total days consulting, with 100% Medicare claims data from 2007-2010. Our analytic samples included consults for beneficiaries undergoing coronary artery bypass grafting (n = 61,785) or colectomy (n = 33,460) in general acute care hospitals. We compared the care intensity of consultants who observed different patterns of consulting care before their initial consults using ordinary least squares regression models at the patient-physician dyad level, controlling for patient comorbidity and many other patient- and physician-level factors as well as hospital region and year fixed effects. Consultants were less likely to provide intensive consulting care with each additional prior consultant on the case (1.2-1.7 percent) or if a prior consultant rendered intensive consulting care (20.6-21.5 percent) but more likely when prior consults were more concentrated across consultants (2.9-3.1 percent). Effects on consultants' total days consulting were similar. On average, consultants appeared to calibrate their care intensity for individual patients to maximize their value to all patients. Interventions for improving consulting care efficiency should seek to facilitate (not constrain) consultants' decision-making processes.
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Keeping experience at the bedside: the emergency consultant nurse role.
Currie, Jane
The consultant nurse concept has not yet been transferred to the military setting. The motivation for developing the role in the NHS was to improve the quality of patient care by strengthening professional leadership and extending the clinical career ladder. The consultant nurse may be defined as an expert in their clinical field, possessing expert leadership and visionary skills. The role is based on four domains: expert practice, professional leadership, education and research. Typically, the emergency consultant nurse spends 50% of their time working clinically, thereby providing senior clinical expertise and adding value to the clinical role. In a military context the consultant nurse role could be perceived as the coming together of the senior command and administrative role and the clinical role. The military has the opportunity to develop a senior clinical emergency nurse role encompassing elements of the civilian consultant nurse model, which may strengthen leadership, provide a central resource of expertise and raise the profile of military nursing. This has the added potential to provide inspiration for junior nurses and retain experienced emergency nurses in the clinical arena.
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Observations of sexually transmitted disease consultations in India.
Mertens, T E; Smith, G D; Kantharaj, K; Mugrditchian, D; Radhakrishnan, K M
1998-03-01
To assess the quality of sexually transmitted disease (STD) case management provided in public and private health facilities in selected areas of Madras, Tamil Nadu, India, in order to make recommendations for improving the quality of care and promote the syndromic approach to STD treatment. Structured observations of consultations for STDs in health care facilities. Scoring of the observations according to standards for history taking, examination, treatment and provision of basic health promotion advice allows evaluation of STD case management. With STD treatment adequacy scored against Indian national guidelines (which recommend aetiologic treatment), history taking, examination and treatment were satisfactory in 76 out of 108 (70%) of observed consultations. However, if STD treatment adequacy is scored with respect to the syndrome approach towards selected STD (male urethritis and non herpetic genital ulcer for both sexes), only 8 out of 81 (10%) of the patients were satisfactory managed. During 32 out of 108 (30%) of the consultations, advice on the use of condoms in order to prevent STD or HIV/AIDS was given. Instructions regarding how to use condoms were offered to seven (6%) patients and condoms were only provided to one patient (1%). Patients were urged to refer their partner(s) for treatment during 29 (27%) of consultations. A criterion of adequate use of the STD consultation for health promotion, requiring both promotion of condoms and encouragement to refer partner(s) for treatment, was met during 13 (12%) of consultations. Monitoring and improving the standards of care at facilities at which STDs are treated have become key roles of STD/HIV/AIDS programmes. The present report suggests that in Madras the activities of medical practitioners who treat STD patients are far from ideal at present. Improvements would involve simplifying existing treatment guidelines by promoting the syndromic approach to STD management, continuing education programmes for
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Improving teaching on the basis of student evaluation: Integrative teaching consultation
Directory of Open Access Journals (Sweden)
Wibbecke, Gerald
2015-02-01
Full Text Available Objective: Due to the development of medical education in the past decade the role of teachers has changed and requires higher didactic competence. Student evaluation of teaching alone does not lead to considerable improvement of teaching quality. We present the concept of "Integrative Teaching Consultation", which comprises both the teacher’s reflection and own objectives to improve their teaching as well as data from students ratings.Methods: Teachers in collaboration with a teaching consultant reflect on their teaching ability and set themselves improvement goals. Then the consultant himself observes a teaching session and subsequently analyses the respective student evaluation in order to give meaningful feedback to the teacher.Results: The combination of student feedback with professional consultation elements can initiate and maintain improvements in teaching. Conclusion: Teaching consultation complements existing faculty development programs and increases the benefit of student evaluations.
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The role of culture in the general practice consultation process.
Ali, Nasreen; Atkin, Karl; Neal, Richard
2006-11-01
In this paper, we will examine the importance of culture and ethnicity in the general practice consultation process. Good communication is associated with positive health outcomes. We will, by presenting qualitative material from an empirical study, examine the way in which communication within the context of a general practitioner (GP) consultation may be affected by ethnicity and cultural factors. The aim of the study was to provide a detailed understanding of the ways in which white and South Asian patients communicate with white GPs and to explore any similarities and differences in communication. This paper reports on South Asian and white patients' explanations of recent videotaped consultations with their GP. We specifically focus on the ways in which issues of ethnic identity impacted upon the GP consultation process, by exploring how our sample of predominantly white GPs interacted with their South Asian patients and the extent to which the GP listened to the patients' needs, gave patients information, engaged in social conversation and showed friendliness. We then go on to examine patients' suggestions on improvements (if any) to the consultation. We conclude, by showing how a non-essentialist understanding of culture helps to comprehend the consultation process when the patients are from Great Britain's ethnicised communities. Our findings, however, raise generic issues of relevance to all multi-racial and multi-ethnic societies.
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10 CFR 19.15 - Consultation with workers during inspections.
2010-01-01
... 10 Energy 1 2010-01-01 2010-01-01 false Consultation with workers during inspections. 19.15...: INSPECTION AND INVESTIGATIONS § 19.15 Consultation with workers during inspections. (a) Commission inspectors... inspectors deem necessary for the conduct of an effective and thorough inspection. (b) During the course of...
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Consultation and the TADS Experience. Occasional Paper Number 1.
Trohanis, Pascal L.; And Others
During the past 10 years, the Technical Assistance Development System's (TADS) staff and advisory board members along with 500 other people have provided consultation services to model demonstration programs and state education agencies that help young handicapped children and their families. Consultants are usually located through a sponsor or…
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Kampik, Timotheus; Larsen, Frank; Bellika, Johan Gustav
2015-01-01
The objective of the study was to identify experiences and attitudes of German and Norwegian general practitioners (GPs) towards Internet-based remote consultation solutions supporting communication between GPs and patients in the context of the German and Norwegian healthcare systems. Interviews with four German and five Norwegian GPs were conducted. The results were qualitatively analyzed. All interviewed GPs stated they would like to make use of Internet-based remote consultations in the future. Current experiences with remote consultations are existent to a limited degree. No GP reported to use a comprehensive remote consultation solution. The main features GPs would like to see in a remote consultation solution include asynchronous exchange of text messages, video conferencing with text chat, scheduling of remote consultation appointments, secure login and data transfer and the integration of the remote consultation solution into the GP's EHR system.
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The association between question type and the outcomes of a Dermatology eConsult service.
O'Toole, Ashley; Joo, Jiyeh; DesGroseilliers, Jean-Pierre; Liddy, Clare; Glassman, Steven; Afkham, Amir; Keely, Erin
2017-08-01
eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults. The time it took the PCP to receive a reply and the amount of time reported by the specialist to answer eConsult were proactively recorded and analyzed. A subset of 154 most recent eConsults was categorized for dermatology content and question type (e.g. diagnosis or management) using a validated taxonomy. A total of 965 eConsults were directed to dermatology from 217 unique PCPs. The majority of eConsults (64%) took the specialist between 10 and 15 minutes to answer. The overall value of this service to the provider was rated as very good or excellent in 95% of cases. In 49%, traditional in-person assessments were avoided. In the subset of the most recent cases, diagnosis was the most common question type asked (65.2%) followed by management (29%) and drug treatment (10.6%). The top five subject areas (40%) were: Dermatitis, Infections, Neoplasm, Nevi, and Pruritus. eConsults was feasible and well received by PCPs, which improves access to dermatology care with a potential to reduce wait times for traditional consultation. © 2017 The International Society of Dermatology.
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International Nuclear Information System (INIS)
Lorenz, A.; Seamon, R.E.
1977-08-01
In this paper the minutes of the second meeting of the Joint IFRC/INDC Subcommittee (International Fusion Research Committee - International Nuclear Data Committee) on Atomic and Molecular Data for Fusion are given
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Patient and professional accuracy of recalled treatment decisions in out-patient consultations
DEFF Research Database (Denmark)
Skinner, T. C.; Barnard, K.; Cradock, S.
2007-01-01
Aims: To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions. Methods: One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patien...
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Teachers' Perceptions and Experiences Consulting with School Counselors: A Qualitative Study
Cholewa, Blair; Goodman-Scott, Emily; Thomas, Antoinette; Cook, Jennifer
2016-01-01
School counselor-teacher consultation is an efficient strategy for school counselors to indirectly serve students on their caseload. Teachers' perceptions are crucial in examining this consultation process. This qualitative study examined elementary school teachers' perceptions and experiences of school counselor-teacher consultation. The…
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Rhodes, Penny; Small, Neil; Rowley, Emma; Langdon, Mark; Ariss, Steven; Wright, John
2008-09-01
Two routine consultations in primary care diabetes clinics are compared using extracts from video recordings of interactions between nurses and patients. The consultations were chosen to present different styles of interaction, in which the nurse's gaze was either primarily toward the computer screen or directed more toward the patient. Using conversation analysis, the ways in which nurses shift both gaze and body orientation between the computer screen and patient to influence the style, pace, content, and structure of the consultation were investigated. By examining the effects of different levels of engagement between the electronic medical record and the embodied patient in the consultation room, we argue for the need to consider the contingent nature of the interface of technology and the person in the consultation. Policy initiatives designed to deliver what is considered best-evidenced practice are modified in the micro context of the interactions of the consultation.
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Beyond the ‘dyad’: a qualitative re-evaluation of the changing clinical consultation
Swinglehurst, Deborah; Roberts, Celia; Li, Shuangyu; Weber, Orest; Singy, Pascal
2014-01-01
Objective To identify characteristics of consultations that do not conform to the traditionally understood communication ‘dyad’, in order to highlight implications for medical education and develop a reflective ‘toolkit’ for use by medical practitioners and educators in the analysis of consultations. Design A series of interdisciplinary research workshops spanning 12 months explored the social impact of globalisation and computerisation on the clinical consultation, focusing specifically on contemporary challenges to the clinician–patient dyad. Researchers presented detailed case studies of consultations, taken from their recent research projects. Drawing on concepts from applied sociolinguistics, further analysis of selected case studies prompted the identification of key emergent themes. Setting University departments in the UK and Switzerland. Participants Six researchers with backgrounds in medicine, applied linguistics, sociolinguistics and medical education. One workshop was also attended by PhD students conducting research on healthcare interactions. Results The contemporary consultation is characterised by a multiplicity of voices. Incorporation of additional voices in the consultation creates new forms of order (and disorder) in the interaction. The roles ‘clinician’ and ‘patient’ are blurred as they become increasingly distributed between different participants. These new consultation arrangements make new demands on clinicians, which lie beyond the scope of most educational programmes for clinical communication. Conclusions The consultation is changing. Traditional consultation models that assume a ‘dyadic’ consultation do not adequately incorporate the realities of many contemporary consultations. A paradox emerges between the need to manage consultations in a ‘super-diverse’ multilingual society, while also attending to increasing requirements for standardised protocol-driven approaches to care prompted by computer use. The
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36 CFR 1270.50 - Consultation with law enforcement agencies.
2010-07-01
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Consultation with law enforcement agencies. 1270.50 Section 1270.50 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION PRESIDENTIAL RECORDS PRESIDENTIAL RECORDS Presidential Records Compiled for Law Enforcement Purposes § 1270.50 Consultation with...
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Minimizing the legal risk with 'curbside' consultation.
Kreichelt, Ray; Hilbert, Mary Lou; Shinn, Deidre
2008-01-01
"Curbside consultations"--in which a physician obtains insights on a medical case from another physician who has not seen the patient or reviewed the record--can yield advantages to the requesting physician. However, shortcomings are inherent in this common type of exchange and pose legal risk to the curbside consultant. This article provides background and practical tips that might help avoid being caught up in a lawsuit by surprise, or if named as a party, avoid being held culpable when the only involvement was a brief conversation with a colleague.
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THE IMPORTANCE OF CONSULTING IN CONTEMPORARY BUSINESS MANAGEMENT
Svetlana Vukotić; Jugoslav Aničić; Radovan Vukotić
2017-01-01
Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combin...
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Performance of consultants on government projects in ghana: Client and contractor pespective
Directory of Open Access Journals (Sweden)
J. Dadzie
2013-07-01
Full Text Available Construction project consultants share the characteristics of helping their clients address problems and improve upon project performance; they have a passion for the wisdom and expertise they bring to the project, and they have the ability to galvanize clients into action. However, it is an open secret that many projects often delay. Also, it is a known fact that most project contract figures swell more than double the original tender figure. Meanwhile, there are supervising consultants who are engaged and paid to manage such important projects. Their role however, is to complement the effort of contractors to ensure a successful completion of a project. The aim of this research is to identify factors affecting the performance of consultants on government projects, and to rank these factors according to their relative importance from the perspective of consultants. Analysis of the factors considered in a survey indicate that the main factors negatively affecting the performance of consultants are: urgency of the project at hand, project duration, variations, political influence from higher authority, timely decision making on the part of the consulting team and the experience of the design team on the project. The others are the ability of the consultants to work as a team, creativity on the part of the consultants in controlling cost and developing own efficiencies so that contract sums are kept within budget .
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Pinto, Priya; Brown, Tartania; Khilkin, Michael; Chuang, Elizabeth
2018-04-01
To compare the clinical outcomes of patients who did and did not receive palliative care consultation among those who experienced out-of-hospital cardiac arrest and underwent therapeutic hypothermia. We identified patients at a single academic medical center who had undergone therapeutic hypothermia after out-of-hospital cardiac arrest between 2009 and 2013. We performed a retrospective chart review for demographic data, hospital and critical care length of stay, and clinical outcomes of care. We reviewed the charts of 62 patients, of which 35 (56%) received a palliative care consultation and 27 (44%) did not. Palliative care consultation occurred an average of 8.3 days after admission. Patients receiving palliative care consultation were more likely to have a do-not-resuscitate (DNR) order placed (odds ratio: 2.3, P care or not (16.7 vs 17.1 days, P = .90). Intensive care length of stay was also similar (11.3 vs 12.6 days, P = .55). Palliative care consultation was underutilized and utilized late in this cohort. Palliative consultation was associated with DNR orders but did not affect measures of utilization such as hospital and intensive care length of stay.
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The Role of Consulting a Dictionary in Reading and Vocabulary Learning
Directory of Open Access Journals (Sweden)
Carol A. Fraser
1999-12-01
Full Text Available Abstract This article reviews recent research on consulting a dictionary in L2 reading and vocabulary learning. From the perspective of cognitive learning theory, the author re-evaluates the limited role that has often been accorded to dictionary consulting. It is noted that, among the three available lexical processing strategies (inferencing, consulting and ignoring, learners tend to use consulting infrequently and selectively and also to differ among each other in their strategy use. Consulting in combination with inferencing is shown to have the greatest positive effect on performance in L2 reading and vocabulary learning, although consulting is found to slow down task completion. Excerpts from think-aloud protocols illustrate the potential contribution of strategic dictionary use to the cognitive processes required for vocabulary acquisition: attention to form-meaning connections, rehearsal of words for storage in long-term memory and elaboration of associations with other knowledge. Among the pedagogical implications of these findings is the need for training in lexical processing strategies in order to help learners use the dictionary effectively and accurately in L2 reading comprehension and vocabulary learning.
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Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.
Southerland, Lauren T; Gure, Tanya R; Ruter, Daniel I; Li, Michael M; Evans, David C
2017-08-01
The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n = 94) to those who did not (n = 103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, P quality indicators is needed. Copyright © 2017 Elsevier Inc. All rights reserved.
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Nurse consultants 10 years on: an insight to the role for nurse managers.
Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette
2011-09-01
To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.
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[Clinical ethics consultation - an integrative model for practice and reflection].
Reiter-Theil, Stella
2008-07-01
Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.
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Got Guilt? Consultant Guilt in the Writing Center Community
Nicklay, Jennifer
2012-01-01
During class discussions, the author's fellow consultants would often lament consultations that could have gone better if they had only known the "rules" of how to handle the situation. They perceived that there were acceptable and unacceptable ways to approach certain situations, rather than a range of flexible choices. The author began to…
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Consultation with First Nations stakeholders : an Alberta perspective
Energy Technology Data Exchange (ETDEWEB)
Rutwind, S. [Alberta Justice, Edmonton, AB (Canada). Aboriginal Law
2005-07-01
Aboriginal issues present risks and challenges to resource development in Alberta. This paper provided an overview of significant precedents and acts which may impact on oil and gas activities. The Constitution Act of 1982 acknowledged that existing Aboriginal and treaty rights of the Aboriginal peoples of Canada were recognized and confirmed. In the case of R v. Sparrow, justification was established where there was a valid legislative objective, such as conservation and resource management, and a precedent was set regarding the interpretation of disputes of section 35 subsection 1 concerning legal restriction of the exercise of treaty rights, such as hunting and fishing. In R v. Badger, the Supreme Court of Canada (SCC) advised that the framework applied to treaty rights as well as Aboriginal rights. The Natural Resources Transfer Agreement transferred powers over natural resources from Canada to Alberta in relation to hunting rights. Proof of rights issues were discussed in Taku River Tlingit First Nation v. Tulesequa Chief Mine Project, as well as in Haida Nation v. British Columbia, where it was concluded that an Aboriginal right need not be proven before a duty to consult arises. A review of Alberta's consultation practices was presented, as well as the Aboriginal issues and resource development initiative, which recognizes the importance of consultation with affected Aboriginal people and communities when regulatory and development activities infringe their existing treaty and other constitutional rights, such as the rights to hunt, fish and trap for food. Details of the Consultation Coordination Group were presented. A draft of the Government of Alberta's First Nations Consultation Policy on Land Management and Resource Development was also presented. tabs, figs.
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2010-07-01
... Implementation Plans of Transportation Plans, Programs, and Projects Developed, Funded or Approved Under Title 23... EPA with MPOs, State departments of transportation, and DOT in developing applicable implementation...) through (e) of this section. Public consultation procedures will be developed in accordance with the...
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Electronic consultation system demonstrates educational benefit for primary care providers.
Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S
2017-01-01
Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse
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A report on the green plan consultations
International Nuclear Information System (INIS)
1990-08-01
This document is a summary of what Canadians who participated in the consultations had to say about environmental issues and concerns; the solutions, roles and responsibilities, and priorities for action. It is based on detailed reports from 41 information sessions and 17 consultation workshops held across Canada. It is based on some 3,000 pages of comments and suggestions, an analysis of 4,500 question response forms, and written submissions from more than 1,000 individuals and organizations. The report is organized into two sections: improving decision making; and, action on environmental issues. The first section deals with science, education, enforcement, decision-making processes and partnerships. The second section deals with specific environmental issues identified in the consultation document, such as global warming and toxic substances, and other publicly identified issues, including energy and land use. Suggestions for further consideration represent possible policy, program and legislative elements of 'The Green Plan'. They are intended as a basis for a more focused debate which will help in the establishment of priorities
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The experience of organization of consulting and diagnostical work in central polyclinic
International Nuclear Information System (INIS)
Bredikhin, V.V.; Knysh, V.I.; Novikov, V.S.; Taranukha, V.K.; Rogovchenko, G.A.
1995-01-01
Advisability of creating regional large-scale consulting-diagnostical centers is indicated. The consulting-diagnostical assistance is provides for relative to 24 medical professions. Above 64000 patients were consulted and more than 30.5 thousand X-ray and ultrasonic examinations were performed during the period of 1989-1993. 2 tabs
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OHS consultants as facilitators of learning processes in client enterprises
DEFF Research Database (Denmark)
Broberg, Ole
2004-01-01
emphasis on initiating learning processes in the client enter-prise in a way that will develop the OHS management capabilities of that enterprise. This presentation is based on a research program focussing on how OHS consultants go about when they are involved in consultancy on technological change...... processes in client enter-prises. Specifically the learning perspective will be touched upon. The research programme included four cases in different client enterprises: 1) New tech-nology in a logistic department of a brewery, 2) new pharmaceutical process facility, 3) design of a new catering centre...... in another institution than pre-sent the users to blueprints and then ask them to put forward technical suggestions to im-prove the workplace design. In conclusion, the study pointed out that the OHS consultants had different work practices on learning aspects of their consultancy. Several constraining...
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Preparation + consultation = better regulation
International Nuclear Information System (INIS)
Bines, W.
2001-01-01
This paper describes the recent experience of the Health and Safety Commission and its executive arm, the Health and Safety Executive (H.S.E.), in consulting over implementation of the bulk of the revised Basic Safety Standards Directive 96/29/EURATOM (the B.B.S.directive) and provides a personal assessment of the successful and challenges of this approach. (N.C.)
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'HAs fail to consult Irish people in UK'.
1992-11-10
Health authorities are failing to consult local people on their health needs, a conference on the mental health of Irish people living in the UK heard last week. Consulting Irish people was often only 'symbolic', despite the requirements of the NHS and Community Care Act, conference Chair Padraic Kenna, Director of Innisfree Housing Association, told delegates. 'The Irish caught the boat in the 1950s only to miss the boat ever since,' he said.
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The Concept of Body Language in the Medical Consultation.
Lindsley, Isabella; Woodhead, Sophie; Micallef, Claranne; Agius, Mark
2015-09-01
In this paper we wish to argue that the human body is an instrument of communication that can be used by the individual. This can be shown by the use of phenomenology, as described by Husserl, and that indeed empathy, as described by phenomenology, can be seen as a link enabling two human bodies/persons to communicate. We then wish to show from neuroscience that empathy can itself be seen as a bodily function. We then will describe how the doctor-patient relationship in the consultation is an extremely important type of communication between two persons, and how teaching of consultation skills has developed. We will show that, once consultation skills teaching was established, then study of body language became an essential part of this teaching, as soon as the technology was developed, and finally we will demonstrate that it is now possible to confirm by observational and controlled trials that appropriate use of body language does indeed enhance the effectiveness of the consultation, including, we would suggest, by appropriate communication of empathy and understanding.
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International Nuclear Information System (INIS)
Driftmann, Christian; Josipovic, Neven
2015-01-01
The booklet on consultancy and knowledge management for radioactive waste disposal - use of external knowledge of the Asse archive covers the following topics: (i) Basic principles for consulting the government by external consultants: terminology, external consultancy in the legislative process, external consultancy in the administration. (ii) External consultancy in the frame of the final repository search: external consultancy profiles, legal appraisal.
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Teaching and assessing consultation skills: an evaluation of a South ...
African Journals Online (AJOL)
Teaching and assessing consultation skills: an evaluation of a South African workshop ... of this work is unsupervised consultations with patients suffering from new or ... Their attitudes to the LAP and the forms of teaching that its use promotes ...
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Gender and Race in the Timing of Requests for Ethics Consultations: A Single-Center Study.
Spielman, Bethany; Gorka, Christine; Miller, Keith; Pointer, Carolyn A; Hinze, Barbara
2016-01-01
Clinical ethics consultants are expected to "reduce disparities, discrimination, and inequities when providing consultations," but few studies about inequities in ethics consultation exist.1 The objectives of this study were (1) to determine if there were racial or gender differences in the timing of requests for ethics consultations related to limiting treatment, and (2) if such differences were found, to identify factors associated with that difference and the role, if any, of ethics consultants in mitigating them. The study was a mixed methods retrospective study of consultation summaries and hospital and ethics center data on 56 age-and gender-matched Caucasian and African American Medicare patients who received ethics consultations related to issues around limiting medical treatment in the period 2011 to 2014. The average age of patients was 70.9. Consultation requests for females were made significantly earlier in their stays in the hospital (6.57 days) than were consultation requests made for males (16.07 days). For African American patients, the differences in admission-to-request intervals for female patients (5.93 days) and male patients (18.64 days) were greater than for Caucasian male and female patients. Differences in the timing of a consultation were not significantly correlated with the presence of an advance directive, the specialty of the attending physician, or the reasons for the consult request. Ethics consultants may have mitigated problems that developed during the lag in request times for African American males by spending more time, on average, on those consultations (316 minutes), especially more time, on average, than on consultations with Caucasian females (195 minutes). Most consultations (40 of 56) did result in movement toward limiting treatment, but no statistically significant differences were found among the groups studied in the movement toward limiting treatment. The average number of days from consult to discharge or death were
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Hungin, A P S; Hill, C; Raghunath, A
2009-08-15
Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Systematic literature searches. Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.
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The Organizational Communication Consulting Spectrum.
Tubbs, Stewart L.
Surveys of businesses and business managers indicate that developing communication skills within organizations is a priority. Communication consulting exists over a wide spectrum of activities that include guest speaking, conducting workshops, and conducting management training programs. These three processes can include a "canned program" that…
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Development of a Knowledge Base for Enduser Consultation of AAL-Systems.
Röll, Natalie; Stork, Wilhelm; Rosales, Bruno; Stephan, René; Knaup, Petra
2016-01-01
Manufacturer information, user experiences and product availability of assistive living technologies are usually not known to citizens or consultation centers. The different knowledge levels concerning the availability of technology shows the need for building up a knowledge base. The aim of this contribution is the definition of requirements in the development of knowledge bases for AAL consultations. The major requirements, such as a maintainable and easy to use structure were implemented into a web based knowledge base, which went productive in ~3700 consulting interviews of municipal technology information centers. Within this field phase the implementation of the requirements for a knowledge base in the field of AAL consulting was evaluated and further developed.
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DEFF Research Database (Denmark)
Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary
Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...
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Directory of Open Access Journals (Sweden)
József Poór
2015-03-01
Full Text Available This paper aims to analyze the evolution of Human Resources (HR consulting in transitional economies of Eastern Europe (EE from the political changes till the economic crisis (2008. This article provides insights into the specific socio-economic environment and HR practice of the region. Following Markham's model (1999 we analyze specific characteristics of four typical ways of external consultant involvement: informative-becnhmarking, design, change and organizational learning consulting. in this region. In general, before the political changes at the end of the 1980's, in most EE countries , consulting service was redendered by sector research institutes, controlled by the state or by the different minsitries. Consulting approach in EE countries were predominant similar to the school of scientific management. HR consulting hardly existed that time. Since changes in the regime's consulting linked to privatization, firm restructuring, and development has been developing significantly in all countries of the region. HR consulting underwent a significant development in the region.
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Otolaryngology Consult Carts: Maximizing Patient Care, Surgeon Efficiency, and Cost Containment.
Royer, Mark C; Royer, Allison K
2015-11-01
The objective of this study was to develop an otolaryngology consult cart system to ensure prompt delivery to the bedside of all the unique equipment and medications required for emergent and urgent otolaryngology consults. An otolaryngology practice responsible for emergency room and hospital consult coverage sought to create a cart containing all equipment, medications, and supplies for otolaryngology consults. Meetings with hospital administration and emergency room, nursing, pharmacy, central processing, and operating room staff were held to develop a system for the emergent delivery of the cart to the needed location, sterilization and restocking of equipment between uses, and appropriate billing of supplies. Two months were required from conception to implementation. All equipment was purchased new, including flexible scopes and headlights. The cart is sterilized, restocked, and maintained by central processing after each use. The equipment is available to handle all airway emergencies as well as all common otolaryngology consults and is delivered bedside in less than 5 minutes. The development of a self-contained otolaryngology consult cart requires coordination with a wide variety of hospital departments. This system, while requiring initial monetary and time investment, has resulted in improved patient care, cost containment, and surgeon convenience. © The Author(s) 2015.
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Talking with the alien: interaction with computers in the GP consultation.
Dowell, Anthony; Stubbe, Maria; Scott-Dowell, Kathy; Macdonald, Lindsay; Dew, Kevin
2013-01-01
This study examines New Zealand GPs' interaction with computers in routine consultations. Twenty-eight video-recorded consultations from 10 GPs were analysed in micro-detail to explore: (i) how doctors divide their time and attention between computer and patient; (ii) the different roles ascribed to the computer; and (iii) how computer use influences the interactional flow of the consultation. All GPs engaged with the computer in some way for at least 20% of each consultation, and on average spent 12% of time totally focussed on the computer. Patterns of use varied; most GPs inputted all or most notes during the consultation, but a few set aside dedicated time afterwards. The computer acted as an additional participant enacting roles like information repository and legitimiser of decisions. Computer use also altered some of the normal 'rules of engagement' between doctor and patient. Long silences and turning away interrupted the smooth flow of conversation, but various 'multitasking' strategies allowed GPs to remain engaged with patients during episodes of computer use (e.g. signposting, online commentary, verbalising while typing, social chat). Conclusions were that use of computers has many benefits but also significantly influences the fine detail of the GP consultation. Doctors must consciously develop strategies to manage this impact.
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Perceived Educational Needs of the Integrated Care Psychiatric Consultant.
Ratzliff, Anna; Norfleet, Kathryn; Chan, Ya-Fen; Raney, Lori; Unützer, Jurgen
2015-08-01
With the increased implementation of models that integrate behavioral health with other medical care, there is a need for a workforce of integrated care providers, including psychiatrists, who are trained to deliver mental health care in new ways and meet the needs of a primary care population. However, little is known about the educational needs of psychiatrists in practice delivering integrated care to inform the development of integrated care training experiences. The educational needs of the integrated care team were assessed by surveying psychiatric consultants who work in integrated care. A convenience sample of 52 psychiatrists working in integrated care responded to the survey. The majority of the topics included in the survey were considered educational priorities (>50% of the psychiatrists rated them as essential) for the psychiatric consultant role. Psychiatrists' perspectives on educational priorities for behavioral health providers (BHPs) and primary care providers (PCPs) were also identified. Almost all psychiatrists reported that they provide educational support for PCPs and BHPs (for PCP 92%; for BHP 96%). The information provided in this report suggests likely educational needs of the integrated care psychiatric consultant and provides insight into the learning needs of other integrated care team members. Defining clear priorities related to the three roles of the integrated care psychiatric consultant (clinical consultant, clinical educator, and clinical team leader) will be helpful to inform residency training programs to prepare psychiatrists for work in this emerging field of psychiatry.
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Co-constructive consulting : a pragmatic, relational constructionist approach
Hicks, Jeff
2010-01-01
Management consulting is a $300 billion industry, about 70% of which is accounted for by organizational change work. These numbers aren’t especially remarkable, unless you consider that a similar percentage of change initiatives—about 70%, according to numerous studies—fail to meet their stated objectives. It’s not too difficult, in other words, to make a case for fundamental change in management and business consulting. In this dissertation, we develop an alternative approach we refer to as ...
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Teaching medical students consultation skills using e-learning
DEFF Research Database (Denmark)
Jørgensen, Merete; Witt, Klaus; Fridorff-Jens, Peter Kindt
2015-01-01
of a student includes a test-video of a consultation with the student in the doctor role, seeing a real patient, and the student´s skills in the subsequent analysis of the communication process according to its patientcentredness. The aim of the study is to measure the effect of adding access to 16 video cases......Teaching consultation skills to medical students using e-learning. Introduction: We have been teaching Family Medicine at the University of Copenhagen for more than twenty years. We wish to develop a method to evaluate the current teaching of consultation skills and the effect of new interventions...... of the ten items. The students were able to identify more elements in the test-video, related to patient function, to inform the patient properly, the use of summarizing and safety-netting Conclusion On-line video cases used interactively in the classroom sessions increase the students’ skills in analysing...
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Directory of Open Access Journals (Sweden)
Geeta S. Pardeshi
2008-11-01
Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.
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Experiences of using email for general practice consultations: a qualitative study.
Atherton, Helen; Pappas, Yannis; Heneghan, Carl; Murray, Elizabeth
2013-11-01
Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice. To understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts. A qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs. A maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance. Consultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.
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The Role of Ethics Committees and Ethics Consultation in Allocation Decisions
Strech, Daniel; Hurst, Samia; Danis, Marion
2013-01-01
Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163
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Congress of the U.S., Washington, DC. House Committee on Education and Labor.
The hearings consider a bill, H.R. 8618, to amend the Occupational Safety and Health Act of 1970 (OSHA) which would provide on-site consultative services to employers desiring to comply with OSHA standards. H.R. 8616 was introduced to strengthen OSHA by providing an additional program that would encourage employers to voluntarily comply with…
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Directory of Open Access Journals (Sweden)
Mansour Ezati Jivan
2012-04-01
Full Text Available Consulting helps managers or other people find appropriate solutions for challenges they face in their businesses. Most of the losses incurred by the people and the society could be prevented using appropriate consultation. Consultation, also, refers to people's participation in decision making. Despite dramatic development in management consulting industry in the world during the last three decades, consulting industry in Iran has faced numerous challenges. This study aims to examine the factors affecting the efficiency of management consulting services in small and medium-sized businesses and it focuses on food industries in Tehran as a real-world case study. The necessary suggestions regarding the hiring of a consultant and increasing the efficiency of management consulting services in business have been offered in this study. Some recommendations deal with the way that management consultants should respond to the managers' needs, act as a reliable and efficient adviser in public or private businesses and find their position in the Iranian market. The conceptual model of this study shows the influence of key factors affecting the purpose of consulting on the efficiency of management consulting services. To do the research, 90 people are selected as the sample size in a descriptive study with random sampling of the managers of aforementioned companies using a questionnaire. Cronbach’s alpha method was used to assess the reliability of the questionnaire. For assessing the validity of the questionnaire, we use standard questionnaire, which has already been used.
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Consultation in the Gifted-Education Arena: Old Wine in a New Skin
Worrell, Frank C.
2007-01-01
In this commentary, I provide a brief overview of definitions and types of consultation, as well as a discussion of the distinction between consultation and collaboration. I then apply the information from this review to the four articles on consulting about gifted and talented students. Using Caplan's framework, I argue that these papers contain…
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Van Campen, Luann E; Allen, Albert J; Watson, Susan B; Therasse, Donald G
2015-04-03
Background : Bioethics consultations are conducted in varied settings, including hospitals, universities, and other research institutions, but there is sparse information about bioethics consultations conducted in corporate settings such as pharmaceutical companies. The purpose of this article is to describe a bioethics consultation service at a pharmaceutical company, to report characteristics of consultations completed by the service over a 6-year period, and to share results of a consultation feedback survey. Methods : Data on the descriptive characteristics of bioethics consultations were collected from 2008 to 2013 and analyzed in Excel 2007. Categorical data were analyzed via the pivot table function, and time-based variables were analyzed via formulas. The feedback survey was administered to consultation requesters from 2009 to 2012 and also analyzed in Excel 2007. Results : Over the 6-year period, 189 bioethics consultations were conducted. The number of consultations increased from five per year in 2008 to approximately one per week in 2013. During this time, the format of the consultation service was changed from a committee-only approach to a tiered approach (tailored to the needs of the case). The five most frequent topics were informed consent, early termination of a clinical trial, benefits and risks, human biological samples, and patient rights. The feedback survey results suggest the consultation service is well regarded overall and viewed as approachable, helpful, and responsive. Conclusions : Pharmaceutical bioethics consultation is a unique category of bioethics consultation that primarily focuses on pharmaceutical research and development but also touches on aspects of clinical ethics, business ethics, and organizational ethics. Results indicate there is a demand for a tiered bioethics consultation service within this pharmaceutical company and that advice was valued. This company's experience indicates that a bioethics consultation service
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Evaluation of the AECB's process of consultation with employees of its licensees
International Nuclear Information System (INIS)
Hart, D.; Eedy, W.; Hostovsky, C.; Burt, A.J.; Maghy, R.
1986-03-01
The study involved a review of public consultation methods used by various Federal Government agencies. These were then compared to the existing AECB programs to evaluate potential improvements. These were also referred to in later surveys of employees at licensed facilities to determine their perceived appropriateness. The majority of employees were both aware of AECB and correctly understood its function. Both of these aspects increased as a function of union membership, age, income, male sex and ARW status. However, the use of AECB consultative documents declined with union membership and increased with membership in professional associations. Satisfaction with the AECB consultative process was fairly low. Workers tended to be more satisfied with other agencies or safety associations. Feelings of job safety were greatest among those who received consultative documents or read AECB press releases. Feelings of safety also increased with age, education, income and professional association membership, but declined with union membership. Unionized employees expressed a desire for more consultation with AECB. Recommendations to improve the process of consultation are included
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Energy Technology Data Exchange (ETDEWEB)
NONE
1993-03-01
This paper reports the activities of the environmental safety evaluation sub-committee for the coal liquefaction plant in fiscal 1992. The sub-committee, upon having received reports on the result of environmental safety evaluation tests performed in fiscals 1991 and 1992 by NEDO, deliberated and discussed carefully the contents thereof. In order to ensure labor hygiene for coal liquefaction plant workers, health influence on liquefied oil users, and social acceptability of the liquefied oil, NEDO has performed the comprehensive brown coal pilot plant operation and oil safety tests. The tests are in accordance with the labor safety and hygiene law, the chemicals examination law, and the MPD issued by OECD, and performed on each fraction produced in the pilot plant and the whole fraction mixing the former fractions, using rats, rabbits, and guinea pigs. The test items included: acute inhalation toxicity and oral repeated administration (using rats); eye stimulation, repeated coating and skin stimulation (using rabbits); photo-toxicity (using guinea pigs); mutagenicity tests (microorganisms, bacteria and chromosome anomaly); resolution tests; fish toxicity; concentration degrees; algae growth obstruction; and water flea breeding obstruction. As the result, the toxicity was found light. (NEDO)
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Tutoring Mentoring Peer Consulting
Szczyrba, Birgit; Wildt, Johannes
2006-01-01
Consulting, Coaching und Supervision, Tutoring, Mentoring und kollegiale Beratung: Beratungsangebote verschiedenster Art werden wie selbstverständlich in den Berufen nachgefragt, die mit Beziehung und Interaktion, mit komplexen sozialen Organisationen und Systemen, mit hoher Verantwortlichkeit, aber unsicheren Handlungsbedingungen zu tun haben. Mittlerweile beginnt diese Nachfrage auch in den Hochschulen zu steigen. Eine solche Steigerung wird ausgelöst durch den Wandel in den Lehr-Lernkultur...
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A Critical Review of Videoconferencing Software to Support School Consultation
Fischer, Aaron J.; Schultz, Brandon K.; Collier-Meek, Melissa A.; Zoder-Martell, Kimberly A.; Erchul, William P.
2018-01-01
With recent advances in technology, several viable options now exist for school consultants to communicate with teachers via synchronous online videoconferencing (VC) without the need for specialized equipment. Unfortunately, few studies have evaluated the effectiveness of school consultation through VC, so practitioners are provided little…
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Federal Consulting: Strategies and Tools for the Career Development Professional.
Kahnweiler, Jennifer B.; Pressman, Sue
The Federal Government is America's largest employer and is expanding consulting opportunities for career development professionals. Increased Federal mandates for outsourcing have opened wide doors for the entrepreneurial-spirited career counselors and created new challenges for traditional methods of offering career services. As consultants who…
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Vascular neurology nurse practitioner provision of telemedicine consultations.
Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr
2010-01-01
Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 +/- 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 +/- 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.
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Interpreting SCAMPI for a People CMM Appraisal at Tata Consultancy Services
National Research Council Canada - National Science Library
Radice, Ron; Hefley, William E; Curtis, Bill; Ferguson, Jack; Hayes, Will
2005-01-01
Tata Consultancy Services (TCS) is a large information technology consulting, services, and business process outsourcing organization interested in reducing the costs of conducting process improvement appraisals at its multiple locations...